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Sample records for activity knee motion

  1. Ambulatory measurement of knee motion and physical activity: preliminary evaluation of a smart activity monitor

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    Malchau Henrik

    2006-09-01

    Full Text Available Abstract Background There is currently a paucity of devices available for continuous, long-term monitoring of human joint motion. Non-invasive, inexpensive devices capable of recording human activity and joint motion have many applications for medical research. Such a device could be used to quantify range of motion outside the gait laboratory. The purpose of this study was to test the accuracy of the modified Intelligent Device for Energy Expenditure and Activity (IDEEA in measuring knee flexion angles, to detect different physical activities, and to quantify how often healthy subjects use deep knee flexion in the ambulatory setting. Methods We compared Biomotion Laboratory (BML "gold standard" data to simultaneous IDEEA measures of knee motion and gait, step up/down, and stair descent in 5 healthy subjects. In addition, we used a series of choreographed physical activities outside the BML to confirm the IDEEA's ability to accurately measure 7 commonly-performed physical activities. Subjects then continued data collection during ordinary activities outside the gait laboratory. Results Pooled correlations between the BML and IDEEA knee flexion angles were .97 +/- .03 for step up/down, .98 +/- .02 for stair descent, and .98 +/- .01 for gait. In the BML protocol, the IDEEA accurately identified gait, but was less accurate in identifying step up/down and stair descent. During sampling outside the BML, the IDEEA accurately detected walking, running, stair ascent, stair descent, standing, lying, and sitting. On average, subjects flexed their knees >120° for 0.17% of their data collection periods outside the BML. Conclusion The modified IDEEA system is a useful clinical tool for evaluating knee motion and multiple physical activities in the ambulatory setting. These five healthy subjects rarely flexed their knees >120°.

  2. Complementary limb motion estimation for the control of active knee prostheses.

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    Vallery, Heike; Burgkart, Rainer; Hartmann, Cornelia; Mitternacht, Jürgen; Riener, Robert; Buss, Martin

    2011-02-01

    To restore walking after transfemoral amputation, various actuated exoprostheses have been developed, which control the knee torque actively or via variable damping. In both cases, an important issue is to find the appropriate control that enables user-dominated gait. Recently, we suggested a generic method to deduce intended motion of impaired or amputated limbs from residual human body motion. Based on interjoint coordination in physiological gait, statistical regression is used to estimate missing motion. In a pilot study, this complementary limb motion estimation (CLME) strategy is applied to control an active knee exoprosthesis. A motor-driven prosthetic knee with one degree of freedom has been realized, and one above-knee amputee has used it with CLME. Performed tasks are walking on a treadmill and alternating stair ascent and descent. The subject was able to walk on the treadmill at varying speeds, but needed assistance with the stairs, especially to descend. The promising results with CLME are compared with the subject's performance with her own prosthesis, the C-Leg from Otto Bock.

  3. Older Adults without Radiographic Knee Osteoarthritis: Knee Alignment and Knee Range of Motion

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    Lissa Fahlman; Emmeline Sangeorzan; Nimisha Chheda; Daphne Lambright

    2014-01-01

    This study describes knee alignment and active knee range of motion (ROM) in a community-based group of 78-year old adults (n = 143) who did not have radiographic evidence of knee osteoarthritis in either knee (KL 0.001) than women with varus or...

  4. EFFECTS OF FATIGUE ON FRONTAL PLANE KNEE MOTION, MUSCLE ACTIVITY, AND GROUND REACTION FORCES IN MEN AND WOMEN DURING LANDING

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    Michael P. Smith

    2009-09-01

    Full Text Available Women tear their Anterior Cruciate Ligament (ACL 2-8 times more frequently than men. Frontal plane knee motion can produce a pathological load in the ACL. During a state of fatigue the muscles surrounding the knee joint may lose the ability to protect the joint during sudden deceleration while landing. The purpose of this study was to investigate the effects of fatigue and gender on frontal plane knee motion, EMG amplitudes, and GRF magnitudes during drop- jump landing. Pretest-posttest comparison group design was used. Twenty-six volunteers (14 women; 12 Men; Mean ± standard deviation age = 24.5 ± 2.7 yrs; height = 1.73 ± 0.09 m; mass = 74.3 ± 11.8 kg participated in the study. Knee frontal plane ranges of motion and positions, ground reaction force peak magnitudes, and surface EMG RMS amplitudes from five lower extremity muscles (vastus medialis, vastus lateralis, medial hamstring, lateral hamstring, and lateral gastrocnemius were obtained during the landing phase of a drop-jump. MANOVA and ANOVA indicated that peak GRF significantly (p < 0.05; 2.50 ± 0.75 BW vs. 2.06 ± 0.93 BW decreased during fatigued landings. No other variables exhibited a fatigue main effect, although there was a significant (p < 0.05 fatigue by gender interaction for the frontal plane range of motion from initial contact to max knee flexion variable. Follow-up analyses failed to reveal significant gender differences at the different levels of fatigue for this variable. Additionally, no variables exhibited a significant gender main effect. Single subject analysis indicated that fatigue significantly altered frontal plane knee motion, peak GRF, and EMG in some subjects and the direction of differences varied by individual. Fatigue altered some aspects of landing performance in both men and women, but there were no gender differences. Additionally, both group and single subject analyses provided valuable but different information about factors representing

  5. Anterior cruciate ligament-deficient patients with passive knee joint laxity have a decreased range of anterior-posterior motion during active movements.

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    Boeth, Heide; Duda, Georg N; Heller, Markus O; Ehrig, Rainald M; Doyscher, Ralf; Jung, Tobias; Moewis, Philippe; Scheffler, Sven; Taylor, William R

    2013-05-01

    Although instability of the knee joint is known to modify gait patterns, the amount that patients compensate for joint laxity during active movements remains unknown. By developing a novel technique to allow the assessment of tibiofemoral kinematics, this study aimed to elucidate the role of passive joint laxity on active tibiofemoral kinematics during walking. Controlled laboratory study. Using motion capture, together with combinations of advanced techniques for assessing skeletal kinematics (including the symmetrical axis of rotation approach [SARA], symmetrical center of rotation estimation [SCoRE], and optimal common shape technique [OCST]), a novel noninvasive approach to evaluate dynamic tibiofemoral motion was demonstrated as both reproducible and repeatable. Passive and active anterior-posterior translations of the tibiofemoral joint were then examined in 13 patients with anterior cruciate ligament (ACL) ruptures that were confirmed by magnetic resonance imaging and compared with those in their healthy contralateral limbs. Passive tibial anterior translation was significantly greater in the ACL-ruptured knees than in the contralateral healthy controls. However, the femora of the ACL-ruptured knees generally remained more posterior (~3 mm) relative to the tibia within a gait cycle of walking compared with the healthy limbs. Surprisingly, the mean range of tibiofemoral anterior-posterior translation over an entire gait cycle was significantly lower in ACL-ruptured knees than in the healthy joints (P = .026). A positive correlation was detected between passive laxity and active joint mobility, but with a consistent reduction in the range of tibiofemoral anterior-posterior translation of approximately 3 mm in the ACL-deficient knees. It seems that either active stabilization of tibiofemoral kinematics or anterior subluxation of the tibia reduces joint translation in lax knees. This implies that either a muscular overcompensation mechanism or a physical

  6. Knee motion variability in patients with knee osteoarthritis: the effect of self-reported instability

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    Gustafson, Jonathan A.; Robinson, Megan E.; Fitzgerald, G. Kelley; Tashman, Scott; Farrokhi, Shawn

    2015-01-01

    Background Knee osteoarthritis has been previously associated with a stereotypical knee-stiffening gait pattern and reduced knee joint motion variability due to increased antagonist muscle co-contractions and smaller utilized arc of motion during gait. However, episodic self-reported instability may be a sign of excessive motion variability for a large subgroup of patients with knee osteoarthritis. The objective of this work was to evaluate the differences in knee joint motion variability during gait in patients with knee osteoarthritis with and without self-reported instability compared to a control group of older adults with asymptomatic knees. Methods Forty-three subjects, 8 with knee osteoarthritis but no reports of instability (stable), 11 with knee osteoarthritis and self-reported instability (unstable), and 24 without knee osteoarthritis or instability (control) underwent Dynamic Stereo X-ray analysis during a decline gait task on a treadmill. Knee motion variability was assessed using parametric phase plots during the loading response phase of decline gait. Findings The stable group demonstrated decreased sagittal-plane motion variability compared to the control group (p=0.04), while the unstable group demonstrated increased sagittal-plane motion variability compared to the control (p=0.003) and stable groups (pknee motion variability in patients with knee osteoarthritis without self-reported instability supports previous research. However, presence of self-reported instability is associated with increased knee motion variability in patients with knee osteoarthritis and warrants further investigation. PMID:25796536

  7. Development of a knee joint motion simulator to evaluate deep knee flexion of artificial knee joints.

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    Takano, Y; Ueno, M; Kiguchi, K; Ito, J; Mawatari, M; Hotokebuchi, T

    2008-01-01

    A purpose of this study is to examine the effect that quadriceps femoris force gives to rotation angle and joint reaction force of total knee prosthesis during deep knee flexion such as a unique sitting style called 'seiza' in Japanese. For the evaluation, we developed the knee motion simulator which could bend to 180 degrees continually simulating the passive flexion performed by clinicians. A total knee prosthesis, which is a specially-devised posterior stabilized type and capable of flexion up to 180 degrees, was inserted into bone model. And this prosthesis pulled by three kinds of quadriceps femoris forces to perform parameter study. The results obtained in this study were showed the same tendency with those in the past cadaveric experiment. It is suggested that the rotation angle and joint reaction force of total knee prosthesis are affected by shape of prosthesis, a vector of quadriceps femoris force, and bony aliments during deep knee flexion.

  8. Does knee motion contribute to feet-in-place balance recovery?

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    Cheng, Kuangyou B

    2016-06-14

    Although knee motions have been observed at loss of balance, the ankle and hip strategies have remained the focus of past research. The present study aimed to investigate whether knee motions contribute to feet-in-place balance recovery. This was achieved by experimentally monitoring knee motions during recovery from forward falling, and by simulating balance recovery movements with and without knee joint as the main focus of the study. Twelve participants initially held a straight body configuration and were released from different forward leaning positions. Considerable knee motions were observed especially at greater leaning angles. Simulations were performed using 3-segment (feet, shanks+thighs, and head+arms+trunk) and 4-segment (with separate shanks and thighs segments) planar models. Movements were driven by joint torque generators depending on joint angle, angular velocity, and activation level. Optimal joint motions moved the mass center projection to be within the base of support without excessive joint motion. The 3-segment model (without knee motions) generated greater backward linear momentum and had better balance performance, which confirmed the advantage of having only ankle/hip strategies. Knee motions were accompanied with less body angular momentum and a lower body posture, which could be beneficial for posture control and reducing falling impact, respectively.

  9. Varus thrust and knee frontal plane dynamic motion in persons with knee osteoarthritis.

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    Chang, A H; Chmiel, J S; Moisio, K C; Almagor, O; Zhang, Y; Cahue, S; Sharma, L

    2013-11-01

    Varus thrust visualized during walking is associated with a greater medial knee load and an increased risk of medial knee osteoarthritis (OA) progression. Little is known about how varus thrust presence determined by visual observation relates to quantitative gait kinematic data. We hypothesized that varus thrust presence is associated with greater knee frontal plane dynamic movement during the stance phase of gait. Participants had knee OA in at least one knee. Trained examiners assessed participants for varus thrust presence during ambulation. Frontal plane knee motion during ambulation was captured using external passive reflective markers and an 8-camera motion analysis system. To examine the cross-sectional relationship between varus thrust and frontal plane knee motion, we used multivariable regression models with the quantitative motion measures as dependent variables and varus thrust (present/absent) as predictor; models were adjusted for age, gender, body mass index (BMI), gait speed, and knee static alignment. 236 persons [mean BMI: 28.5 kg/m(2) (standard deviation (SD) 5.5), mean age: 64.9 years (SD 10.4), 75.8% women] contributing 440 knees comprised the study sample. 82 knees (18.6%) had definite varus thrust. Knees with varus thrust had greater peak varus angle and greater peak varus angular velocity during stance than knees without varus thrust (mean differences 0.90° and 6.65°/s, respectively). These patterns remained significant after adjusting for age, gender, BMI, gait speed, and knee static alignment. Visualized varus thrust during walking was associated with a greater peak knee varus angular velocity and a greater peak knee varus angle during stance phase of gait. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  10. Patella Eversion Reduces Early Knee Range of Motion and Muscle Torque Recovery after Total Knee Arthroplasty: Comparison between Minimally Invasive Total Knee Arthroplasty and Conventional Total Knee Arthroplasty

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    Tokifumi Majima

    2011-01-01

    Full Text Available We hypothesized that patella eversion during total knee arthroplasty (TKA reduces early return of active knee extension and flexion, quadriceps muscle strength, and postoperative pain. In 100 conventional TKA knees and 100 minimally invasive TKA (MIS TKA knees, we compared knee range of motion (ROM, postoperative pain, and quadriceps muscle strength at 1 day, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 12 weeks, 1 year, and 5 years after surgery. The differences of surgical approach between MIS TKA and conventional TKA of this study are length of skin incision with subcutaneal flap and patella eversion. In MIS TKA, skin incision is shorter than conventional TKA. Furthermore, patella is not everted in MIS TKA procedure. There were no significant differences in preoperative factors. Postoperative improvement of ROM, postoperative muscle strength recovery, and postoperative improvement of visual analog scale were faster in patients with MIS TKA when compared to that in patients with conventional TKA. On the other hand, no significant difference was observed in complication, 5-year clinical results of subjective knee function score, and the postoperative component angle and lower leg alignment. These results indicate that patella eversion may affect muscle strength recovery and postoperative pain.

  11. Improvements in knee biomechanics during walking are associated with increased physical activity after total knee arthroplasty.

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    Arnold, John B; Mackintosh, Shylie; Olds, Timothy S; Jones, Sara; Thewlis, Dominic

    2015-12-01

    Total knee arthroplasty (TKA) in people with knee osteoarthritis increases knee-specific and general physical function, but it has not been established if there is a relationship between changes in these elements of functional ability. This study investigated changes and relationships between knee biomechanics during walking, physical activity, and use of time after TKA. Fifteen people awaiting TKA underwent 3D gait analysis before and six months after surgery. Physical activity and use of time were determined in free-living conditions from a high resolution 24-h activity recall. After surgery, participants displayed significant improvements in sagittal plane knee biomechanics and improved their physical activity profiles, standing for 105 more minutes (p=0.001) and performing 64 min more inside chores on average per day (p=0.008). Changes in sagittal plane knee range of motion (ROM) and peak knee flexion positively correlated with changes in total daily energy expenditure, time spent undertaking moderate to vigorous physical activity, inside chores and passive transport (r=0.52-0.66, p=0.005-0.047). Restoration of knee function occurs in parallel and is associated with improvements in physical activity and use of time after TKA. Increased functional knee ROM is required to support improvements in total and context specific physical activity. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  12. Recognizing knee pathologies by classifying instantaneous screws of the six degrees-of-freedom knee motion.

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    Wolf, Alon; Degani, Amir

    2007-05-01

    We address the problem of knee pathology assessment by using screw theory to describe the knee motion and by using the screw representation of the motion as an input to a machine learning classifier. The flexions of knees with different pathologies are tracked using an optical tracking system. The instantaneous screw parameters which describe the transformation of the tibia with respect to the femur in each two successive observation is represented as the instantaneous screw axis of the motion given in its Plücker line coordinates along with its corresponding pitch. The set of instantaneous screw parameters associated with a particular knee with a given pathology is then identified and clustered in R(6) to form a "signature" of the motion for the given pathology. Sawbones model and two cadaver knees with different pathologies were tracked, and the resulting screws were used to train a classifier system. The system was then tested successfully with new, never-trained-before data. The classifier demonstrated a very high success rate in identifying the knee pathology.

  13. Muscle strength and knee range of motion after femoral lengthening

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    Bhave, Anil; Shabtai, Lior; Woelber, Erik; Apelyan, Arman; Paley, Dror; Herzenberg, John E

    2017-01-01

    Background and purpose Femoral lengthening may result in decrease in knee range of motion (ROM) and quadriceps and hamstring muscle weakness. We evaluated preoperative and postoperative knee ROM, hamstring muscle strength, and quadriceps muscle strength in a diverse group of patients undergoing femoral lengthening. We hypothesized that lengthening would not result in a significant change in knee ROM or muscle strength. Patients and methods This prospective study of 48 patients (mean age 27 (9–60) years) compared ROM and muscle strength before and after femoral lengthening. Patient age, amount of lengthening, percent lengthening, level of osteotomy, fixation time, and method of lengthening were also evaluated regarding knee ROM and strength. The average length of follow-up was 2.9 (2.0–4.7) years. Results Mean amount of lengthening was 5.2 (2.4–11.0) cm. The difference between preoperative and final knee flexion ROM was 2° for the overall group. Congenital shortening cases lost an average of 5% or 6° of terminal knee flexion, developmental cases lost an average of 3% or 4°, and posttraumatic cases regained all motion. The difference in quadriceps strength at 45° preoperatively and after lengthening was not statistically or clinically significant (2.7 Nm; p = 0.06). Age, amount of lengthening, percent lengthening, osteotomy level, fixation time, and lengthening method had no statistically significant influence on knee ROM or quadriceps strength at final follow-up. Interpretation Most variables had no effect on ROM or strength, and higher age did not appear to be a limiting factor for femoral lengthening. Patients with congenital causes were most affected in terms of knee flexion. PMID:27892743

  14. Static progressive stretch improves range of motion in arthrofibrosis following total knee arthroplasty.

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    Bonutti, Peter M; Marulanda, German A; McGrath, Mike S; Mont, Michael A; Zywiel, Michael G

    2010-02-01

    Arthrofibrosis is a relatively common complication after total knee arthroplasty that negatively affects function and quality of life. Static progressive stretching is a technique that has shown promising results in the treatment of contractures of the elbow, ankle, wrist and knee. This study evaluated a static progressive stretching device as a treatment method for patients who had refractory knee stiffness after total knee arthroplasty. Twenty-five patients who had knee stiffness and no improvement with conventional physical therapy modalities were treated with the device. After a median of 7 weeks (range, 3-16 weeks), the median increase in range of motion was 25 degrees (range, 8-82 degrees). The median gain in knee active flexion was 19 degrees (range, 5-80 degrees). Ninety-two percent of patients were satisfied with the results. The authors believe static progressive stretching devices may be an effective method for increasing the ranges of motion and satisfaction levels of patients who develop arthrofibrosis after total knee arthroplasty.

  15. [Recovery from total knee arthroplasty through continuous passive motion].

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    Sánchez Mayo, B; Rodríguez-Mansilla, J; González Sánchez, B

    2015-01-01

    The purpose of this study was to know the effects of continuous passive mobilization in patients who underwent total knee arthroplasty. A search strategy was developed to retrieve all clinical trials, written in English and/or Spanish, published in the electronic search databases PubMed, Cochrane Library Plus, Dialnet, CSIC and PEDro. The inclusion criteria were: clinical trials published from January 2000 until November 2014 in English or Spanish. Out of 537 clinical trials that were potentially relevant, a total of 12 were included in this review. The evaluation of 1,153 patients shows that there is no significant difference in improving the range of the joint, pain, balance, motion, healing and hospital stay using continuous passive mobilization against the regular physiotherapy treatment for total knee arthroplasty. The application of continuous passive mobilization in the long-term does not provide any benefit in terms of the breadth of the range of the joint, pain and improvement of standing and motion in comparison with conventional postoperative physiotherapy treatment in total knee arthroplasty. In the short term an improvement is obtained in the range of joint motion in knee flexion.

  16. EFFECTS OF KINESIOTAPING ALONG WITH QUADRICEPS STRENGTHENING EXERCISES ON PAIN, JOINT RANGE OF MOTION AND FUNCTIONAL ACTIVITIES OF KNEE IN SUBJECTS WITH PATELLOFEMORAL OSTEOARTHRITIS

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    M. Harshitha

    2014-08-01

    Full Text Available Background: Patello femoral Osteoarthritis is the most common degenerative disease in older age group, causing pain, physical disability, and decreased quality of life.As many treatment options available, kinesiotaping is an efficacious treatment for management of pain & disability in patellofemoral joint osteoarthritis. Previous studies have shown that kinesiotaping as well as quadriceps strengthening significantly yields functional benefits. But there is lack of evidence revealing combined effectiveness & effects of kinesiotaping along with quadriceps strengthening in subjects with patellofemoral joint osteoarthritis. Methods: 30 subjects with symptoms of patellofemoral osteoarthritis fulfilled the inclusion criteria were randomly assigned into 2 groups of 15 in each group. Taping along with quadriceps strengthening program is compared to the quadriceps strengthening program alone. Pain were measured by Visual Analogue Scale (VAS, knee ROM were measured by Goniometer, Functional status were measured by Western Ontario McMaster Universities index (WOMAC, score. Measurements were taken pre & post intervention. Results: The results indicated that kinesiotaping along with quadriceps strengthening exercises showed there was statistically significant improvement in pain (<0.05, knee ROM (<0.05 and functional activities (<0.05 after 6 weeks compared to quadriceps strengthening alone. Conclusion: Subjects with kinesiotaping along with quadriceps strengthening showed significant improvement in reducing pain, in improving ROM & functional activities at the end of 6th week treatment when compared to subjects with patellofemoral osteoarthritis underwent quadriceps strengthening exercises alone.

  17. Data Collection and Analysis Using Wearable Sensors for Monitoring Knee Range of Motion after Total Knee Arthroplasty

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    Chiang, Chih-Yen; Chen, Kun-Hui; Liu, Kai-Chun; Hsu, Steen Jun-Ping; Chan, Chia-Tai

    2017-01-01

    Total knee arthroplasty (TKA) is the most common treatment for degenerative osteoarthritis of that articulation. However, either in rehabilitation clinics or in hospital wards, the knee range of motion (ROM) can currently only be assessed using a goniometer. In order to provide continuous and objective measurements of knee ROM, we propose the use of wearable inertial sensors to record the knee ROM during the recovery progress. Digitalized and objective data can assist the surgeons to control the recovery status and flexibly adjust rehabilitation programs during the early acute inpatient stage. The more knee flexion ROM regained during the early inpatient period, the better the long-term knee recovery will be and the sooner early discharge can be achieved. The results of this work show that the proposed wearable sensor approach can provide an alternative for continuous monitoring and objective assessment of knee ROM recovery progress for TKA patients compared to the traditional goniometer measurements. PMID:28241434

  18. Reliability of knee joint range of motion and circumference measurements after total knee arthroplasty: does tester experience matter?

    DEFF Research Database (Denmark)

    Jakobsen, Thomas Linding; Christensen, Malene; Christensen, Stine Sommer

    2010-01-01

    BACKGROUND AND PURPOSE: Two of the most utilized outcome measures to assess knee joint range of motion (ROM) and intra-articular effusion are goniometry and circumference, respectively. Neither goniometry nor circumference of the knee joint have been examined for both intra-tester and inter-teste...

  19. Active knee joint flexibility and sports activity

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    Hahn, Thomas; Foldspang, Anders; Vestergaard, E

    1999-01-01

    was significantly higher in women than in men and significantly positively associated with weekly hours of swimming and weekly hours of competitive gymnastics. Active knee flexion was significantly positively associated with participation in basketball, and significantly negatively associated with age and weekly...

  20. Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243

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    Markus A. Wimmer

    2015-01-01

    Full Text Available Walking is only one of many daily activities performed by patients following total knee replacement (TKR. The purpose of this study was to examine the hypotheses (a that subject activity characteristics are correlated with knee flexion range of motion (ROM and (b that there is a significant difference between the subject’s flexion/extension excursion throughout the day and the ISO specified input for knee wear testing. In order to characterize activity, the number of walking and stair stepping cycles, the time spent with dynamic and stationary activities, the number of activity sequences, and the knee flexion/extension excursion of 32 TKR subjects were collected during daily activity. Flexion/extension profiles were compared with the ISO 14243 simulator input profile using a level crossing classification algorithm. Subjects took an average of 3102 (range: 343–5857 walking cycles including 65 (range: 0–319 stair stepping cycles. Active and passive ROMs were positively correlated with stair walking time, stair step counts, and stair walking sequences. Simulated knee motion according to ISO showed significantly fewer level crossings at the flexion angles 20–40° and beyond 50° than those measured with the monitor. This suggests that implant wear testing protocols should contain more cycles and a variety of activities requiring higher knee flexion angles with incorporated resting/transition periods to account for the many activity sequences.

  1. Dynamic Finite Element Analysis of Mobile Bearing Type Knee Prosthesis under Deep Flexional Motion

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    Mohd Afzan Mohd Anuar

    2014-01-01

    Full Text Available The primary objective of this study is to distinguish between mobile bearing and fixed bearing posterior stabilized knee prostheses in the mechanics performance using the finite element simulation. Quantifying the relative mechanics attributes and survivorship between the mobile bearing and the fixed bearing prosthesis remains in investigation among researchers. In the present study, 3-dimensional computational model of a clinically used mobile bearing PS type knee prosthesis was utilized to develop a finite element and dynamic simulation model. Combination of displacement and force driven knee motion was adapted to simulate a flexion motion from 0° to 135° with neutral, 10°, and 20° internal tibial rotation to represent deep knee bending. Introduction of the secondary moving articulation in the mobile bearing knee prosthesis has been found to maintain relatively low shear stress during deep knee motion with tibial rotation.

  2. Clinically assessed mediolateral knee motion: impact on gait

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    Thorlund, Jonas Bloch; Creaby, Mark W; Simic, Milena;

    2011-01-01

    Mediolateral knee movement can be assessed visually with clinical tests. A knee-medial-to-foot position is associated with an increased risk of knee injuries and pathologies. However, the implications of such findings on daily tasks are not well understood. The aim of this study was to investigate...... if a knee-medial-to-foot position assessed during a clinical test was associated with altered hip and knee joint kinematics and knee joint kinetics during gait compared with those with a knee-over-foot position....

  3. Is latero-medial patellar mobility related to the range of motion of the knee joint after total knee arthroplasty?

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    Ota, Susumu; Nakashima, Takeshi; Morisaka, Ayako; Omachi, Takaaki; Ida, Kunio; Kawamura, Morio

    2010-12-01

    Diminished range of motion (ROM) of the knee joint after total knee arthroplasty (TKA) is thought to be related to reduced patellar mobility. This has not been confirmed clinically due to a lack of quantitative methods adequate for measuring patellar mobility. We investigated the relationship between patellar mobility by a reported quantitative method and knee joint ROM after TKA. Forty-nine patients [osteoarthritis--OA: 29 knees; rheumatoid arthritis--RA: 20 knees] were examined after TKA. Respective medial and lateral patellar mobility was measured 1 and 6 months postoperatively using a patellofemoral arthrometer (PFA). Knee joint ROM was also measured in each of those 2 sessions. Although the flexion and extension of the knee joints improved significantly from 1 to 6 months after TKA, the medial and lateral patellar displacements (LPDs) failed to improve during that same period. Moreover, only the changes in knee flexion and medial patellar displacement (MPD) between the two sessions were positively correlated (r = 0.31, p knee ROM after TKA.

  4. Quantifying the Consistency of Wearable Knee Acoustical Emission Measurements During Complex Motions.

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    Toreyin, Hakan; Jeong, Hyeon Ki; Hersek, Sinan; Teague, Caitlin N; Inan, Omer T

    2016-09-01

    Knee-joint sounds could potentially be used to noninvasively probe the physical and/or physiological changes in the knee associated with rehabilitation following acute injury. In this paper, a system and methods for investigating the consistency of knee-joint sounds during complex motions in silent and loud background settings are presented. The wearable hardware component of the system consists of a microelectromechanical systems microphone and inertial rate sensors interfaced with a field programmable gate array-based real-time processor to capture knee-joint sound and angle information during three types of motion: flexion-extension (FE), sit-to-stand (SS), and walking (W) tasks. The data were post-processed to extract high-frequency and short-duration joint sounds (clicks) with particular waveform signatures. Such clicks were extracted in the presence of three different sources of interference: background, stepping, and rubbing noise. A histogram-vector Vn(→) was generated from the clicks in a motion-cycle n, where the bin range was 10°. The Euclidean distance between a vector and the arithmetic mean Vav(→) of all vectors in a recording normalized by the Vav(→) is used as a consistency metric dn. Measurements from eight healthy subjects performing FE, SS, and W show that the mean (of mean) consistency metric for all subjects during SS (μ [ μ (dn)] = 0.72 in silent, 0.85 in loud) is smaller compared with the FE (μ [ μ (dn)] = 1.02 in silent, 0.95 in loud) and W ( μ [ μ (dn)] = 0.94 in silent, 0.97 in loud) exercises, thereby implying more consistent click-generation during SS compared with the FE and W. Knee-joint sounds from one subject performing FE during five consecutive work-days (μ [ μ (dn) = 0.72) and five different times of a day (μ [ μ (dn) = 0.73) suggests high consistency of the clicks on different days and throughout a day. This work represents the first time, to the best of our knowledge, that joint sound consistency has been

  5. Patient Self-Assessed Passive Range of Motion of the Knee Cannot Replace Health Professional Measurements.

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    Borgbjerg, Jens; Madsen, Frank; Odgaard, Anders

    2017-03-01

    The purpose of this study was to investigate whether patients can accurately self-assess their knee passive range of motion (PROM). A picture-based questionnaire for patient self-assessment of knee PROM was developed and posted to patients. The self-assessed PROM from 58 patients was compared with surgeon-assessed PROM using a short-arm goniometer. Agreement between the measurement methods was calculated with the Bland-Altman method. We calculated the sensitivity and specificity of patient-assessed PROM in dichotomously detecting knee motion impairment in both flexion (≤ 100 degrees) and extension (≥ 10-degree flexion contracture). Surgeon- and patient-assessed knee PROM showed a mean difference (95% limits of agreement) of -2.1 degrees (-42.5 to 38.3 degrees) for flexion and -8.1 degrees (-28.8 to 12.7 degrees) for extension. The sensitivity of patient self-assessed PROM in identifying knee flexion and extension impairments was 86 and 100%, respectively, whereas its specificity was 84 and 43%, respectively. Although wide limits of agreement were observed between surgeon- and patient-assessed knee PROM, the picture-based questionnaire for patient assessment of knee ROM was found to be a valid tool for dichotomously detecting knee motion impairment in flexion (≤ 100 degrees). However, the specificity of the questionnaire for detection of knee extension impairments (≥ 10-degree flexion contracture) was low, which limits is practical utility for this purpose.

  6. Knee biomechanics during popular recreational and daily activities in older men.

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    Pfeiffer, Julie L; Zhang, Songning; Milner, Clare E

    2014-06-01

    Physical activity is recommended for older adults, including those with knee pathology. However, demands on the knee during popular recreational activities are unclear. The study purpose was to determine knee biomechanics in healthy older men during golf and bowling and compare them to activities of daily living. Three-dimensional motion analysis was used to determine knee biomechanics in 19 healthy males (45-73 years): 11 golfers and eight bowlers. Subjects performed walking, stair ascent, stair descent, and either golf or bowling. Comparisons were made between the recreational activity and activities of daily living. During bowling, flexion angle at peak extensor moment was as high as during stair descent, and peak extensor moment was as high as during stair ascent. For the golf lead knee, flexion angle at peak extensor moment and peak extensor moment were as high as during stair ascent, and peak abduction moment, internal and external rotation angles were larger than during all activities of daily living. Peak external rotation angle for the golf trail knee was larger than all activities of daily living. The greatest challenge for the knee of healthy older males during bowling is eccentric control of knee flexion. Golf poses challenges in all three planes of motion for the lead knee and in the transverse plane for the trail knee. Comparing mechanical demands on the knee during bowling and golf to those of stair negotiation provides a reference for clinicians when recommending recreational activities for older adults with knee pathology. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Instantaneous screws of weight-bearing knee: what can the screws tell us about the knee motion.

    Science.gov (United States)

    Wolf, Alon

    2014-07-01

    There are several ways to represent a given object's motion in a 3D space having 6DOF i.e., three translations and three rotations. Some of the methods that are used are mathematical and do not provide any geometrical insight into the nature of the motion. Screw theory is a mathematical, while at the same time, geometrical method in which the 6DOF motion of an object can be represented. We describe the 6DOF motion of a weight-bearing knee by its screw parameters, that are extracted from 3D Optical Reflective motion capture data. The screw parameters which describe the transformation of the shank with respect to the thigh in each two successive frames, is represented as the instantaneous screw axis of the motion given in its Plücker line coordinate, along with its corresponding pitch and intensity values. Moreover, the Striction curve associated with the motion provides geometrical insight into the nature of the motion and its repeatability. We describe the theoretical background and demonstrate what the screw can tell us about the motion of healthy subjects' knee.

  8. Auricular Acupressure for Managing Postoperative Pain and Knee Motion in Patients with Total Knee Replacement: A Randomized Sham Control Study

    Directory of Open Access Journals (Sweden)

    Ling-hua Chang

    2012-01-01

    Full Text Available Background. Postoperative pain management remains a significant challenge for all healthcare providers. A randomized controlled trial was conducted to examine the adjuvant effects of auricular acupressure on relieving postoperative pain and improving the passive range of motion in patients with total knee replacement (TKR. Method. Sixty-two patients who had undergone a TKR were randomly assigned to the acupressure group and the sham control group. The intervention was delivered three times a day for 3 days. A visual analog scale (VAS and the Short-Form McGill Pain Questionnaire were used to assess pain intensity. Pain medication consumption was recorded, and the knee motion was measured using a goniometer. Results. The patients experienced a moderately severe level of pain postoperatively (VAS 58.66 ± 20.35 while being on the routine PCA. No differences were found in pain scores between the groups at all points. However, analgesic drug usage in the acupressure group patients was significantly lower than in the sham control group (<0.05, controlling for BMI, age, and pain score. On the 3rd day after surgery, the passive knee motion in the acupressure group patients was significantly better than in the sham control group patients (<0.05, controlling for BMI. Conclusion. The application of auricular acupressure at specific therapeutic points significantly reduces the opioid analgesia requirement and improves the knee motion in patients with TKR.

  9. The effects of kinesiology taping therapy on degenerative knee arthritis patients' pain, function, and joint range of motion.

    Science.gov (United States)

    Lee, Kwansub; Yi, Chae-Woo; Lee, Sangyong

    2016-01-01

    [Purpose] The purpose of the present study was to examine the effects of kinesiology taping therapy on degenerative knee arthritis patients' pain, function, and joint range of motion. [Subjects] To conduct the experiment in the present study, 30 patients with degenerative knee arthritis were divided into a control group (the conservative treatment group) of 15 patients, who received conservative physical therapy, and an experimental group (the kinesiology taping group) of 15 patients, who received kinesiology taping therapy. [Methods] All patients received treatment three times per week for four weeks. The kinesiology taping group had elastic tapes applied to the hamstring muscles, anterior tibialis, quadriceps femoris, and gastrocnemius. The range of motion was measured using joint goniometers, pain was measured using visual analog scales, and functional evaluation was conducted using the Korean Western Ontario and McMaster Universities Osteoarthritis Index. [Results] In intragroup comparisons of the kinesiology taping group and the conservative treatment group, the visual analog scale and Korean Western Ontario and McMaster Universities Osteoarthritis Index scores significantly decreased, and the range of motion increased more than significantly. In intergroup comparisons, the kinesiology taping group showed significantly lower visual analog scale and Korean Western Ontario and McMaster Universities Osteoarthritis Index scores and significantly larger ranges of motion than the conservative treatment group. [Conclusion] Kinesiology taping therapy is considered to be an effective nonsurgical intervention method for pain relief, daily living activities, and range of motion of degenerative knee arthritis patients.

  10. Reflex responses to combined hip and knee motion in human chronic spinal cord injury

    Directory of Open Access Journals (Sweden)

    Ming Wu, PhD

    2010-04-01

    Full Text Available The relative contributions of hip and knee proprioceptors to the origination of extensor spasms were examined in 11 subjects with chronic spinal cord injury (SCI. Ramp and hold extension and combined hip and knee oscillation movements were imposed to the right leg while the ankle was held in a static position by a custom-designed robot. Isometric joint torques of the hip, knee, and ankle and surface electromyograms (EMGs from seven leg muscles were recorded following controlled hip and knee extension. A stereotypical torque response consisting of hip flexion, knee extension, and ankle plantar flexion was observed following hip and knee perturbations. Further, the hip or knee joint posture modulated the spastic reflexes triggered by the extension movement of the other joint, with larger responses observed with the hip and knee extended. In addition, combined hip and knee oscillation movements were imposed to one leg with four different phasing conditions. The phasing between the hip and knee modulated the reflex activity triggered by hip and knee oscillations. The EMG patterns of the spastic reflexes were generally consistent with muscle timing during locomotion in human SCI. This knowledge may help identify rehabilitation strategies that produce functional movements in human SCI.

  11. Rapid knee-extensions to increase quadriceps muscle activity in patients with total knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

    2017-01-01

    BACKGROUND: Inhibition of the quadriceps muscle and reduced knee-extension strength is common shortly following total knee arthroplasty (weeks to months), due to reduced voluntary activation of the quadriceps muscle. In healthy subjects, strength training with heavy loads is known to increase...... agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions. PURPOSE: The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which...... rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions. STUDY DESIGN: A randomized cross-over study. METHODS: Twenty-four patients (age 66.5) 4-8 weeks post total knee...

  12. Motion analysis of knee joint using dynamic volume images

    Science.gov (United States)

    Haneishi, Hideaki; Kohno, Takahiro; Suzuki, Masahiko; Moriya, Hideshige; Mori, Sin-ichiro; Endo, Masahiro

    2006-03-01

    Acquisition and analysis of three-dimensional movement of knee joint is desired in orthopedic surgery. We have developed two methods to obtain dynamic volume images of knee joint. One is a 2D/3D registration method combining a bi-plane dynamic X-ray fluoroscopy and a static three-dimensional CT, the other is a method using so-called 4D-CT that uses a cone-beam and a wide 2D detector. In this paper, we present two analyses of knee joint movement obtained by these methods: (1) transition of the nearest points between femur and tibia (2) principal component analysis (PCA) of six parameters representing the three dimensional movement of knee. As a preprocessing for the analysis, at first the femur and tibia regions are extracted from volume data at each time frame and then the registration of the tibia between different frames by an affine transformation consisting of rotation and translation are performed. The same transformation is applied femur as well. Using those image data, the movement of femur relative to tibia can be analyzed. Six movement parameters of femur consisting of three translation parameters and three rotation parameters are obtained from those images. In the analysis (1), axis of each bone is first found and then the flexion angle of the knee joint is calculated. For each flexion angle, the minimum distance between femur and tibia and the location giving the minimum distance are found in both lateral condyle and medial condyle. As a result, it was observed that the movement of lateral condyle is larger than medial condyle. In the analysis (2), it was found that the movement of the knee can be represented by the first three principal components with precision of 99.58% and those three components seem to strongly relate to three major movements of femur in the knee bend known in orthopedic surgery.

  13. Effectiveness of prolonged use of continuous passive motion (CPM as an adjunct to physiotherapy following total knee arthroplasty: Design of a randomised controlled trial [ISRCTN85759656

    Directory of Open Access Journals (Sweden)

    Geesink Ruud JT

    2006-02-01

    Full Text Available Abstract Background Adequate and intensive rehabilitation is an important requirement for successful Total Knee Arthroplasty. The primary focus of early rehabilitation is ambulation of patients and regaining range of motion in the knee. Although research suggests that Continuous Passive Motion should be implemented in the first rehabilitation phase following surgery, there is substantial debate about the duration of each session and the total period of CPM application and. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. Methods In a randomised controlled trial we intend to investigate the efficacy of prolonged use of a continuous passive motion (CPM device in the home situation as an adjunct to standardised physical therapy. The experimental treatment is compared to standardised physical therapy, in patients with osteoarthritis of the knee undergoing Total Knee Arthroplasty (TKA. Efficacy will be assessed in terms of faster improvements in range of motion and functional recovery. Seventy patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment (less than 80° of knee flexion at the time of discharge will be randomised over two treatment groups, a usual care group and an experimental group The experimental group will receive CPM + physiotherapy for 17 consecutive days after surgery, whereas the usual care group will receive the same treatment during the in-hospital phase (i.e. about four days, followed by physical therapy alone (usual care in the first two weeks after hospital discharge. From 18 days to three months after discharge, both groups will receive standardised PT. The primary focus of rehabilitation will be functional recovery (e.g. ambulation and regaining range of motion (ROM in the knee

  14. The effect of age and knee osteoarthritis on muscle activation patterns and knee joint biomechanics during dual belt treadmill gait.

    Science.gov (United States)

    Rutherford, Derek; Baker, Matthew; Wong, Ivan; Stanish, William

    2017-06-01

    To compare a group of individuals with moderate medial compartment knee osteoarthritis (OA) to both an age-matched asymptomatic group of older adults and younger adults to determine whether differences in knee joint muscle activation patterns and joint biomechanics exist during gait between these three groups. 20 young adults, 20 older adults, and 40 individuals with moderate knee OA were recruited. Using standardized procedures, surface electromyograms were recorded from the vastus lateralis and medialis, rectus femoris and the medial and lateral hamstrings. All individuals walked on a dual belt instrumented treadmill while segment motions and ground reaction forces were recorded. Sagittal plane motion and net external sagittal and frontal plane moments were calculated. Discrete measures and principal component analyses extracted amplitude and temporal waveform features. Analysis of Variance models using Bonferroni corrections determined between and within group differences in these gait features (α=0.05). Individuals with knee OA have distinct biomechanics and muscle activation patterns when compared to age-matched asymptomatic adults and younger adults whereas differences between the young and older adults were few and included only measures of muscle activation amplitude. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Motion analysis of Chinese normal knees during gait based on a novel portable system.

    Science.gov (United States)

    Zhang, Yu; Yao, Zilong; Wang, Shaobai; Huang, Wenhan; Ma, Limin; Huang, Huayang; Xia, Hong

    2015-03-01

    Normative tibiofemoral data of Chinese or Asian subjects during gait is rarely reported. This study is aimed at investigating the six-degree-of-freedom (6DOF) knee kinematics of adult Chinese during gait, based on a novel portable system. Twenty-eight healthy Chinese subjects (56 knees) were studied during their treadmill gaits. A set of optical marker clusters were attached to the thighs and shanks of each subject, who was tracked by an optical joint kinematics measurement system. Knee landmarks were initially digitized with respect to the marker cluster sets to determine the local coordinate systems for calculation of 6DOF knee joint kinematics. The range of motion (ROM) in 6DOF and 5 kinematic parameters were calculated and compared between bilateral knees and genders. We discovered that knee rotations, as well as motion in proximodistal and mediolateral translations, showed similar patterns in flexion and extension. However, the anteroposterior translations did not show a clear pattern. The results of ROM in 6DOF obtained in this study are comparable with those reported in existing literature. No statistical difference was found between left and right knees either in the ROMs or in the 5 kinematic parameters. However, the ROM in the mediolateral direction during gait was found to be higher in men than women (P=0.014). In addition, the femurs of female subjects rotated more internally than the femurs of male during the stance phase (P=0.011). We concluded that normal Chinese knees exhibited distinct gait patterns, except for anteroposterior motion. Women and men exhibit different axial rotations and mediolateral translation patterns during their treadmill gait.

  16. Knee rotationplasty: motion of the body centre of mass during walking

    Science.gov (United States)

    Rota, Viviana; Okita, Yusuke; Manfrini, Marco; Tesio, Luigi

    2016-01-01

    Knee rotationplasty (KRP) is a type of surgery in which the rotated ankle serves as a new knee after being removed for bone tumor. Although this limb salvage surgery is rarely indicated in properly selected patients, it may offer functional advantages over transfemoral amputation, and more durable results compared with a prosthesis. The walking mechanics of adult patients after KRP is believed to be close to that of below-knee amputees. In this study, we evaluated steady-state walking of KRP patients from the viewpoint of the overall muscle power needed to keep the body centre of mass in motion. Three adult patients after KRP, all athletes, were evaluated. Ground reactions during walking were recorded during six subsequent strides on a force treadmill. The positive mechanical work and power sustaining the motion of the centre of mass and the recovery of muscle energy due to the pendulum-like mechanism of walking were computed and compared with those obtained in previous studies from above-knee, below-knee amputees and healthy individuals. In KRP patients, walking was sustained by a muscle power output which was 1.4–3.6 times lower during the step performed on the rotated limb than on the subsequent step. The recovery of muscle energy was slightly lower (0.9) or higher (1.3–1.4 times) on the affected side. In two out of the three KRP patients, our findings were more similar to those from above-knee amputees than to those from below-knee amputees. After KRP, the rotated limb does not necessarily provide the same power provided by below-knee amputation. This may have a relevance for the paralympic classification of KRP athletes. PMID:27685013

  17. Range of joint motion and disability in patients with osteoarthritis of the knee or hip.

    NARCIS (Netherlands)

    Steultjens, M.P.M.; Dekker, J.; Baar, M.E. van; Oostendorp, R.A.B.; Bijlsma, J.W.J.

    2000-01-01

    OBJECTIVE: To establish the relationships between the range of joint motion (ROM) and disability in patients with osteoarthritis (OA) of the knee or hip. Two related issues were addressed: (1) the inter-relationships between ROMs of joint actions, and (2) the relationship between ROM and disability.

  18. THE ROLE OF KNEE POSITIONING AND RANGE-OF-MOTION ON THE CLOSED-STANCE FOREHAND TENNIS SWING

    Directory of Open Access Journals (Sweden)

    Steven M. Nesbit

    2008-03-01

    Full Text Available This paper discusses the role of knee positioning and range-of- motion on the closed-stance forehand tennis swing. The analyses of tennis swing mechanics were performed using a computer model comprised of a full-body model of a human and an inertial model of a racket. The model was driven by subject forehand swings (16 female college-level subjects recorded with a high-speed digital motion analysis system. The study discovered that both initial knee positioning and range-of-motion were positively related to racket velocity and characteristic of more skilled players. The direct effects of knee positioning and range-of-motion on racket movement are minimal, however there are several indirect biomechanical effects on the forehand motion such as movement of the body mass center, work of the knee, hip and back joints, and the angular range-of-motion of the hips and torso. Some of these indirect effects were related to racket velocity and characteristic of more skilled players. Factors that influenced knee positioning and range-of-motion include years of playing, amount of coaching, and body style. Efforts to both increase and restrict the knee movements of the subjects resulted in substantially lower racket velocities (and other detrimental biomechanical effects implying that there may be optimal knee positions and range-of-motion for a given subject. The most skilled subject exhibited a high degree of consistency of knee positioning and range-of-motion. This subject adjusted for varying ball height through modified initial knee positioning while maintaining fairly constant ranges-of-motion

  19. Safety of Early Application of Continuous Passive Motion in Patients after Total Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    顾晓园; 陈文红; 张中南; 励建安

    2002-01-01

    ObjectiveThis research aimed to study the effect of early application of continuous passive motion (CPM) on the drainage volume of knee joints post total knee arthroplasty (TKA).MethodsThe drainage volume was measured 1 h before,during and after CPM on the day and next day of the operation.ResultsThere was no significant difference in the drainage volume before,during and after CPM(P >0.05).ConclusionEarly application of CPM is safe for TKA patients.``

  20. Safety of Early Application of Continuous Passive Motion in Patients after Total Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    顾晓园; 陈文红; 等

    2002-01-01

    Objective This research aimed to study the effect of early application of continuous passive motion(CPM) on the drainage volume of knee joints post total knee arthroplasty (TKA).Methods The drainage volume was measured 1h before,during and after CPM on the day and next day of the operation.Results There was no significant difference in the drainage volume before,during and after CPM(P>0.05).Conclusion Early application of CPM is safe for TKA patients.

  1. RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY

    DEFF Research Database (Denmark)

    Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

    2017-01-01

    BACKGROUND: Inhibition of the quadriceps muscle and reduced knee-extension strength is common shortly following total knee arthroplasty (weeks to months), due to reduced voluntary activation of the quadriceps muscle. In healthy subjects, strength training with heavy loads is known to increase ago...

  2. Validity and inter-rater reliability of medio-lateral knee motion observed during a single-limb mini squat

    DEFF Research Database (Denmark)

    Ageberg, Eva; Bennell, Kim L; Hunt, Michael A

    2010-01-01

    Muscle function may influence the risk of knee injury and outcomes following injury. Clinical tests, such as a single-limb mini squat, resemble conditions of daily life and are easy to administer. Fewer squats per 30 seconds indicate poorer function. However, the quality of movement, such as the ......, such as the medio-lateral knee motion may also be important. The aim was to validate an observational clinical test of assessing the medio-lateral knee motion, using a three-dimensional (3-D) motion analysis system. In addition, the inter-rater reliability was evaluated....

  3. A parallel framework for the FE-based simulation of knee joint motion.

    Science.gov (United States)

    Wawro, Martin; Fathi-Torbaghan, Madjid

    2004-08-01

    We present an object-oriented framework for the finite-element (FE)-based simulation of the human knee joint motion. The FE model of the knee joint is acquired from the patients in vivo by using magnetic resonance imaging. The MRI images are converted into a three-dimensional model and finally an all-hexahedral mesh for the FE analysis is generated. The simulation environment uses nonlinear finite-element analysis (FEA) and is capable of handling contact of the model to handle the complex rolling/sliding motion of the knee joint. The software strictly follows object-oriented concepts of software engineering in order to guarantee maximum extensibility and maintainability. The final goal of this work-in-progress is the creation of a computer-based biomechanical model of the knee joint which can be used in a variety of applications, ranging from prosthesis design and treatment planning (e.g., optimal reconstruction of ruptured ligaments) over surgical simulation to impact computations in crashworthiness simulations.

  4. Unilateral eccentric exercise of the knee flexors affects muscle activation during gait.

    Science.gov (United States)

    Dover, Geoffrey C; Legge, Laura; St-Onge, Nancy

    2012-05-01

    Uni-lateral muscle soreness is common yet the effects on gait or electromyographic (EMG) activity are unknown. The purpose of our study was to induce delayed onset muscle soreness (DOMS) in the knee flexor group and measure the resultant change in EMG activity and knee motion during gait. Nine healthy subjects participated in the study. Measures of function, evoked tenderness of the biceps femoris, as well as knee angle, and EMG activity during gait were assessed prior and 48 h after an eccentric exercise protocol. DOMS was induced unilaterally in the knee flexors using an isokinetic dynamometer and subjects exercised until they could not generate 50% of their maximal voluntary isometric contraction (MVIC). There was a significant decrease in biceps femoris activity after DOMS during the last phase of gait. Moreover, there was a day × phase interaction for gastrocnemius activity with the last two phases displaying an increase in activity. There was no significant change in knee angle during gait. The decrease in biceps femoris activity as well as the increase in gastrocnemius activity could be evidence of a protective mechanism designed to decrease activity of the sore muscle while increasing the activity of a synergistic muscle. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Knee joint secondary motion accuracy improved by quaternion-based optimizer with bony landmark constraints.

    Science.gov (United States)

    Wang, Hongsheng; Zheng, Naiqaun Nigel

    2010-12-01

    Skin marker-based motion analysis has been widely used in biomechanical studies and clinical applications. Unfortunately, the accuracy of knee joint secondary motions is largely limited by the nonrigidity nature of human body segments. Numerous studies have investigated the characteristics of soft tissue movement. Utilizing these characteristics, we may improve the accuracy of knee joint motion measurement. An optimizer was developed by incorporating the soft tissue movement patterns at special bony landmarks into constraint functions. Bony landmark constraints were assigned to the skin markers at femur epicondyles, tibial plateau edges, and tibial tuberosity in a motion analysis algorithm by limiting their allowed position space relative to the underlying bone. The rotation matrix was represented by quaternion, and the constrained optimization problem was solved by Fletcher's version of the Levenberg-Marquardt optimization technique. The algorithm was validated by using motion data from both skin-based markers and bone-mounted markers attached to fresh cadavers. By comparing the results with the ground truth bone motion generated from the bone-mounted markers, the new algorithm had a significantly higher accuracy (root-mean-square (RMS) error: 0.7 ± 0.1 deg in axial rotation and 0.4 ± 0.1 deg in varus-valgus) in estimating the knee joint secondary rotations than algorithms without bony landmark constraints (RMS error: 1.7 ± 0.4 deg in axial rotation and 0.7 ± 0.1 deg in varus-valgus). Also, it predicts a more accurate medial-lateral translation (RMS error: 0.4 ± 0.1 mm) than the conventional techniques (RMS error: 1.2 ± 0.2 mm). The new algorithm, using bony landmark constrains, estimates more accurate secondary rotations and medial-lateral translation of the underlying bone.

  6. Case series utilizing drop-out casting for the treatment of knee joint extension motion loss following anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Logerstedt, David; Sennett, Brian J

    2007-07-01

    Case series. Four patients who had developed knee extension motion loss following anterior cruciate ligament reconstruction were referred to physical therapy for treatment. They were treated with drop-out casting and completed a Lower Extremity Functional Scale at baseline, at the time of application of the drop-out casting, and at discharge. Three males and 1 female with a mean age of 20.5 years (range, 18-22 years) were referred to physical therapy a mean of 31 days (range, 19-49 days) following bone-patella tendon-bone autograft anterior cruciate ligament reconstruction. The mean number of physical therapy sessions attended was 29.5 visits (range, 20-47 visits). The mean improvement in knee extension range of motion (ROM) and knee flexion ROM prior to the application of drop-out casting was 4.3 degrees (range, -1 degree to 10 degrees) and 24.3 degrees (range, 0 degree to 40 degrees), respectively. The mean improvement on the Lower Extremity Functional Scale was 10.3 points prior to drop-out casting. At time of discharge, the total mean improvement in knee extension ROM loss was 11.0 degrees (range, 4 degrees to 15 degrees), knee flexion ROM was 30.8 degrees (range, 22 degrees to 35 degrees), and Lower Extremity Functional Scale was 12 points (range, -5 to 21 points). Two of the patients were able to complete a running program without difficulty, while the other 2 patients had difficulty with higher-level activities. Despite the low incidence of knee extension ROM loss following surgery, the inability to achieve full knee extension does occur and can have debilitating consequences. When early emphasis of full passive knee extension has been inadequate, these results suggest that improving knee extension motion without inhibiting knee flexion motion is possible with the use of a drop-out cast. Future research should focus on comparison of drop-out casting to dynamic splinting, as well as the optimal frequency and duration of low-load long-duration stretching using

  7. Knee joint contact mechanics during downhill gait and its relationship with varus/valgus motion and muscle strength in patients with knee osteoarthritis.

    Science.gov (United States)

    Farrokhi, Shawn; Voycheck, Carrie A; Gustafson, Jonathan A; Fitzgerald, G Kelley; Tashman, Scott

    2016-01-01

    The objective of this exploratory study was to evaluate tibiofemoral joint contact point excursions and velocities during downhill gait and assess the relationship between tibiofemoral joint contact mechanics with frontal-plane knee joint motion and lower extremity muscle weakness in patients with knee osteoarthritis (OA). Dynamic stereo X-ray was used to quantify tibiofemoral joint contact mechanics and frontal-plane motion during the loading response phase of downhill gait in 11 patients with knee OA and 11 control volunteers. Quantitative testing of the quadriceps and the hip abductor muscles was also performed. Patients with knee OA demonstrated larger medial/lateral joint contact point excursions (p < 0.02) and greater heel-strike joint contact point velocities (p < 0.05) for the medial and lateral compartments compared to the control group. The peak medial/lateral joint contact point velocity of the medial compartment was also greater for patients with knee OA compared to their control counterparts (p = 0.02). Additionally, patients with knee OA demonstrated significantly increased frontal-plane varus motion excursions (p < 0.01) and greater quadriceps and hip abductor muscle weakness (p = 0.03). In general, increased joint contact point excursions and velocities in patients with knee OA were linearly associated with greater frontal-plane varus motion excursions (p < 0.04) but not with quadriceps or hip abductor strength. Altered contact mechanics in patients with knee OA may be related to compromised frontal-plane joint stability but not with deficits in muscle strength.

  8. Comparison of Range of Motion After Total Knee Prosthesis According to Different Type of Prosthesis

    Directory of Open Access Journals (Sweden)

    Firat Seyfettinoglu

    2016-07-01

    Full Text Available Aim: The aim of this study is to determine the effectiveness and range of motion of different type of knee prosthesis. Material and Method: This study includes 180 of 225 patients (139 F, 41 M, average age: 65, range of age: 51-82 between April 2005 and September 2007 with the diagnosis of gonarthrosis. All patients underwent to primary total knee arthroplasty. Primary osteoartrhritis is the reason of gonarthrosis. The patients with secondary osteoartrhritis were excluded from the study. All the patients were operated by the same surgical team and rehabilitated after surgery. Patella didnt change any patient. PCL was protected in some of the patients and cut some of patients. Totally seven type prosthesis in 16 subgroup were applied to the patients. All measurement were done by the same surgeon. Average follow up period was 31 months (24-49 months. Results: Patients without subgrouping were tested according to the range of motion before and after surgery to the type of the prosthesis trademark. Range of motion was decreased with the usage of Rotaglide and LCS® type of prosthesis. Range of motion didnt change with the usage of Maxim and Kinemax type. The range of motion increased in the other trademark of prosthesis. Flexion angle was increased statistically significant with nexgen® and scorpio® prosthesis (p

  9. Designing for scale: development of the ReMotion Knee for global emerging markets.

    Science.gov (United States)

    Hamner, Samuel R; Narayan, Vinesh G; Donaldson, Krista M

    2013-09-01

    Amputees living in developing countries have a profound need for affordable and reliable lower limb prosthetic devices. The World Health Organization estimates there are approximately 30 million amputees living in low-income countries, with up to 95% lacking access to prosthetic devices. Effective prosthetics can significantly affect the lives of these amputees by increasing opportunity for employment and providing improvements to long-term health and well-being. However, current solutions are inadequate: state-of-the-art solutions from the US and Europe are cost-prohibitive, while low-cost devices have been challenged by poor quality and/or unreliable performance, and have yet to achieve large scale impact. The introduction of new devices is hampered by the lack of a cohesive prosthetics industry in low-income areas; the current network of low-cost prosthetic clinics is informal and loosely organized with significant disparities in geography, patient volume and demographics, device procurement, clinical and logistical infrastructure, and funding. At D-Rev (Design Revolution) we are creating the ReMotion Knee, which is an affordable polycentric prosthetic knee joint that performs on par with devices in more industrialized regions, like the US and Europe. As of September 2012, over 4200 amputees have been fitted with the initial version of the ReMotion Knee through a partnership with the JaipurFoot Organization, with an 79% compliance rate after 2 years. We are currently scaling production of the ReMotion Knee using centralized manufacturing and distribution to serve the existing clinics in low-income countries and increase the availability of devices for amputees without access to appropriate care. At D-Rev, we develop products that target these customers through economically-sustainable models and provide a measurable impact in the lives of the world's amputees.

  10. Comparing Levels of Depression in Healthy Active and Inactive Elders versus Those with Knee Osteoarthritis Disease

    Directory of Open Access Journals (Sweden)

    Amir Shams

    2016-04-01

    Full Text Available Knee osteoarthritis can have negative effects on the physical and mental conditions, social and family relations, general health and positive feelings of elders. For example, severe limitation of motion and increased depression, which are results of this disease, can have negative impacts on elders. The purpose of this study was to compare the levels of depression in healthy active and inactive elders versus those with knee osteoarthritis disease. Two hundred and twenty (220 elders with knee osteoarthritis disease (110 active and 110 inactive patients and 220 healthy elders (110 active and 110 inactive were voluntarily selected, and they filled the questionnaire about elders’ personal characteristics, physical activity and depression levels. Four groups had differences with respect to education, age and gender. The results of chi-square test revealed that women with knee osteoarthritis disease had increased levels of depression compared to men with the same condition (p<0.05. Older patients had increased levels of depression and educated elders reported lower levels of depression. The results of the one way analysis of variance (ANOVA revealed that there exist a significant difference in depression scores of healthy active and healthy inactive elders and those with knee osteoarthritis disease. The results of Tukey’s test revealed that healthy active elder had lower depression scores compared to inactive elders with knee osteoarthritis disease. Carrying out exercises and physical activities can help improve the health state of patients with knee osteoarthritis problem and can also improve the elders’ mental condition and thus decrease their pain and depression.

  11. Effects of Group-Based Exercise on Range of Motion, Muscle Strength, Functional Ability, and Pain During the Acute Phase After Total Knee Arthroplasty: A Controlled Clinical Trial.

    Science.gov (United States)

    Hiyama, Yoshinori; Kamitani, Tsukasa; Wada, Osamu; Mizuno, Kiyonori; Yamada, Minoru

    2016-09-01

    Study Design Prospective observational study including a historical control group. Background The extent to which group-based exercise (G-EXE) improves knee range of motion (ROM), quadriceps strength, and gait ability is similar to that of individualized exercise (I-EXE) at 6 weeks and 8 months after total knee arthroplasty (TKA). However, the benefits of G-EXE for patients during the acute recovery phase after TKA remain unclear. Objective To determine the effects of G-EXE during the acute recovery phase after TKA on knee ROM, quadriceps strength, functional ability, and knee pain. Methods Two hundred thirty-one patients participated in G-EXE in addition to regular ambulation and activities-of-daily-living exercises twice daily during the hospital stay. Outcomes were compared to those of a retrospectively identified, historical control group (I-EXE group [n = 206]) that included patients who performed exercises identical to those performed by the G-EXE group. The outcomes included knee ROM, quadriceps strength, pain intensity, and timed up-and-go test score at 1 month before surgery and at discharge. Analyses were adjusted for age, body mass index, sex, length of hospital stay, and preoperative values. Results Changes in ROM of knee flexion and extension (Pexercises demonstrated greater changes in knee ROM, quadriceps strength, and knee pain than those performing I-EXE in addition to regular ambulation and activities-of-daily-living exercises. The nonrandomized, asynchronous design decreases certainty of these findings. Level of Evidence Therapy, level 2b. J Orthop Sports Phys Ther 2016;46(9):742-748. Epub 5 Aug 2016. doi:10.2519/jospt.2016.6409.

  12. Effectiveness of prolonged use of continuous passive motion (CPM, as an adjunct to physiotherapy, after total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Geesink Ruud JT

    2008-04-01

    Full Text Available Abstract Background Adequate and intensive rehabilitation is an important requirement for successful total knee arthroplasty. Although research suggests that Continuous Passive Motion (CPM should be implemented in the first rehabilitation phase after surgery, there is substantial debate about the duration of each session and the total period of CPM application. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. Methods In a randomised controlled trial we investigated the effectiveness of prolonged CPM use in the home situation as an adjunct to standardised PT. Efficacy was assessed in terms of faster improvements in range of motion (RoM and functional recovery, measured at the end of the active treatment period, 17 days after surgery. Sixty patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment were randomised over two treatment groups. The experimental group received CPM + PT for 17 consecutive days after surgery, whereas the usual care group received the same treatment during the in-hospital phase (i.e. about four days, followed by PT alone (usual care in the first two weeks after hospital discharge. From 18 days to three months after surgery, both groups received standardised PT. The primary focus of rehabilitation was functional recovery (e.g. ambulation and regaining RoM in the knee. Results Prolonged use of CPM slightly improved short-term RoM in patients with limited RoM at the time of discharge after total knee arthroplasty when added to a semi-standard PT programme. Assessment at 6 weeks and three months after surgery found no long-term effects of this intervention Neither did we detect functional benefits of the improved RoM at any of the outcome assessments. Conclusion Although results

  13. Displacement of the medial meniscus within the passive motion characteristics of the human knee joint: an RSA study in human cadaver knees.

    Science.gov (United States)

    Tienen, T G; Buma, P; Scholten, J G F; van Kampen, A; Veth, R P H; Verdonschot, N

    2005-05-01

    The objective of this study was to validate an in vitro human cadaver knee-joint model for the evaluation of the meniscal movement during knee-joint flexion. The question was whether our model showed comparable meniscal displacements to those found in earlier meniscal movement studies in vivo. Furthermore, we determined the influence of tibial torque on the meniscal displacement during knee-joint flexion. Three tantalum beads were inserted in the medial meniscus of six human-cadaver joints. The knee joints were placed and loaded in a loading apparatus, and the movements of the beads were determined by means of RSA during knee-joint flexion and extension with and without internal tibial (IT) and external tibial (ET) torque. During flexion without tibial torque, all menisci moved in posterior and lateral direction. The anterior horn showed significantly greater excursions than the posterior horn in both posterior and lateral direction. Internal tibial torque caused an anterior displacement of the pathway on the tibial plateau. External tibial torque caused a posterior displacement of the pathway. External tibial torque restricted the meniscal displacement during the first 30 degrees of knee-joint flexion. The displacements of the meniscus in this experiment were similar to the displacements described in the in vivo MRI studies. Furthermore, the application of tibial torque confirmed the relative immobility of the posterior horn of the meniscus. During external tibial torque, the posterior displacement of the pathway on the tibial plateau during the first 30 degrees of flexion might be restricted by the attached knee-joint capsule or the femoral condyle. This model revealed representative meniscal displacements during simple knee-joint flexion and also during the outer limits of passive knee-joint motion.

  14. Muscle activity during knee-extension strengthening exercise performed with elastic tubing and isotonic resistance.

    Science.gov (United States)

    Jakobsen, Markus Due; Sundstrup, Emil; Andersen, Christoffer H; Bandholm, Thomas; Thorborg, Kristian; Zebis, Mette K; Andersen, Lars L

    2012-12-01

    While elastic resistance training, targeting the upper body is effective for strength training, the effect of elastic resistance training on lower body muscle activity remains questionable. The purpose of this study was to evaluate the EMG-angle relationship of the quadriceps muscle during 10-RM knee-extensions performed with elastic tubing and an isotonic strength training machine. 7 women and 9 men aged 28-67 years (mean age 44 and 41 years, respectively) participated. Electromyographic (EMG) activity was recorded in 10 muscles during the concentric and eccentric contraction phase of a knee extension exercise performed with elastic tubing and in training machine and normalized to maximal voluntary isometric contraction (MVC) EMG (nEMG). Knee joint angle was measured during the exercises using electronic inclinometers (range of motion 0-90°). When comparing the machine and elastic resistance exercises there were no significant differences in peak EMG of the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM) during the concentric contraction phase. However, during the eccentric phase, peak EMG was significantly higher (p70% nEMG) quadriceps muscle activity during the concentric contraction phase, but slightly lower during the eccentric contraction phase, as knee extensions performed using an isotonic training machine. During the concentric contraction phase the two different conditions displayed reciprocal EMG-angle patterns during the range of motion. 5.

  15. Association of radiographic osteoarthritis, pain on passive movement and knee range of motion: a cross-sectional study.

    Science.gov (United States)

    Hilfiker, Roger; Jüni, Peter; Nüesch, Eveline; Dieppe, Paul A; Reichenbach, Stephan

    2015-04-01

    Knee pain is associated with radiographic knee osteoarthritis, but the relationships between physical examination, pain and radiographic features are unclear. To examine whether deficits in knee extension or flexion were associated with radiographic severity and pain during clinical examination in persons with knee pain or radiographic features of osteoarthritis. Cross-sectional data of the Somerset and Avon Survey of Health (SASH) cohort study. Participants with knee pain or radiographic features of osteoarthritis were included. We assessed the range of passive knee flexion and extension, pain on movement and Kellgren and Lawrence (K/L) grades. Odds ratios were calculated for the association between range of motion and pain as well as radiographic severity. Of 1117 participants with a clinical assessment, 805 participants and 1530 knees had complete data and were used for this analysis. Pain and radiographic changes were associated with limited range of motion. In knees with pain on passive movement, extension and flexion were reduced per one grade of K/L by -1.4° (95% CI -2.2 to -0.5) and -1.6° (95% CI -2.8 to -0.4), while in knees without pain the reduction was -0.3° (95% CI -0.6 to -0.1) (extension) and -1.1° (-1.8 to -0.3) (flexion). The interaction of pain with K/L was significant (p = 0.021) for extension but not for flexion (p = 0.333). Pain during passive movement, which may be an indicator of reversible soft-tissue changes, e.g., reversible through physical therapy, is independently associated with reduced flexion and extension of the knee. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Evaluation Of Patellar Tracking During Knee Range Of Motion In Patients With Patellar Lateralization And Normal Subjects

    Directory of Open Access Journals (Sweden)

    Goharpei S

    2004-08-01

    Full Text Available Background: Patellofemoral joint disorders are the most common cause of anterior knee pain in patients who referred to orthopedic clinics. Patellar lateralization cause anterior knee pain due to weakness of vastus medialis oblique muscle or tightness of lateral structures like lateral retinaculum or iliotibial band muscle. Materials and Methods: For evaluation of this abnormality, plane radiography, CT scan and MRI are useful. In plane radiography only one view in a single joint position can be obtained, because of that it is not a good method to detect abnormal tracking during knee range of motion. The purpose of this study was to evaluate patellar tracking by kinematics MRI during five serial degrees of knee range of motion (40, 30, 20, 10, 0 degrees in 30 patients with patellar lateralization and 10 normal subjects, aged 18-30 years. Results and Conclusion: tistical analysis showed that in patients group, patella had the most stability in 40 degree of knee flexion and this stability reduced when knee reached to full extension. At this point, patella moved laterally and the most instability was seen during 20 to 0 degree of knee extension.

  17. Perioperative rehabilitation using a knee extension device and arthroscopic debridement in the treatment of arthrofibrosis.

    Science.gov (United States)

    Biggs-Kinzer, Angie; Murphy, Brian; Shelbourne, K Donald; Urch, Scott

    2010-09-01

    Arthrofibrosis is a postoperative complication of intra-articular knee surgery that can be difficult to treat. Evidence suggests that maximizing knee range of motion may improve outcomes in patients with arthrofibrosis who undergo arthroscopic debridement. Patients who achieve greater knee range of motion will have better subjective scores. Retrospective case series analysis. A review of records was performed for 33 patients with arthrofibrosis who underwent knee arthroscopy and scar resection coupled with perioperative rehabilitation to maximize knee range of motion. Patient demographics and preoperative and postoperative range of motion measurements were extracted from the records. The International Knee Documentation Committee (IKDC) Subjective Knee Form was administered to assess pain, activity, and knee function. Patients performed a preoperative and postoperative rehabilitation program utilizing a knee extension device to maximize knee extension. According to the IKDC range of motion criteria, 27 of 33 patients achieved normal knee extension, and 14 of 33 achieved normal knee flexion at a mean of 8.6 months after surgery. Patients with normal knee motion had a mean IKDC Subjective Knee Form score of 72.6 ± 13.6, which was significantly higher than patients who did not achieve normal motion (P = .04). Overall, mean IKDC Subjective Knee Form scores improved from 45.3 ± 16.7 preoperatively to 67.1 ± 18.0 postoperatively (P arthrofibrosis who undergo arthroscopic scar resection. In support of our hypothesis, patients who achieved greater knee range of motion had better subjective knee scores.

  18. Correlation between hip function and knee kinematics evaluated by three-dimensional motion analysis during lateral and medial side-hopping

    Science.gov (United States)

    Itoh, Hiromitsu; Takiguchi, Kohei; Shibata, Yohei; Okubo, Satoshi; Yoshiya, Shinichi; Kuroda, Ryosuke

    2016-01-01

    [Purpose] Kinematic and kinetic characteristics of the limb during side-hopping and hip/knee interaction during this motion have not been clarified. The purposes of this study were to examine the biomechanical parameters of the knee during side hop and analyze its relationship with clinical measurements of hip function. [Subjects and Methods] Eleven male college rugby players were included. A three-dimensional motion analysis system was used to assess motion characteristics of the knee during side hop. In addition, hip range of motion and muscle strength were evaluated. Subsequently, the relationship between knee motion and the clinical parameters of the hip was analyzed. [Results] In the lateral touchdown phase, the knee was positioned in an abducted and externally rotated position, and increasing abduction moment was applied to the knee. An analysis of the interaction between knee motion and hip function showed that range of motion for hip internal rotation was significantly correlated with external rotation angle and external rotation/abduction moments of the knee during the lateral touchdown phase. [Conclusion] Range of motion for hip internal rotation should be taken into consideration for identifying the biomechanical characteristics in the side hop test results.

  19. Female recreational athletes demonstrate different knee biomechanics from male counterparts during jumping rope and turning activities.

    Science.gov (United States)

    Tanikawa, Hidenori; Matsumoto, Hideo; Harato, Kengo; Kiriyama, Yoshimori; Suda, Yasunori; Toyama, Yoshiaki; Nagura, Takeo

    2014-01-01

    A variety of athletic exercises are performed in sports training or rehabilitation after knee injuries. However, it remains unclear whether males and females exhibit similar joint loading during the various athletic motions. The purpose of this study was to identify gender differences in knee biomechanics during the athletic motions. Three-dimensional knee kinematics and kinetics were investigated in 20 recreational athletes (10 males and 10 females) while jumping rope, backward running, side running, side-to-side running, side-to-forward running, inside turning, and outside turning. The strengths of the quadriceps and hamstring muscles, the knee joint force, the knee joint angle, and the knee joint moment were compared between males and females using one-tailed t tests. Peak knee anterior force was greater in female recreational athletes than in their male counterparts during jumping rope, side-to-forward running, inside turning, and outside turning. Female subjects displayed greater peak knee abduction angles and greater peak knee flexion moments while jumping rope compared to their male counterparts. There were no significant differences between the sexes in knee kinematics and kinetics in the frontal and transverse planes during running and turning motions. Female recreational athletes exhibited significantly different knee biomechanics compared with male counterparts during jumping rope and turning motions.

  20. The efficacy of continuous passive motion after total knee arthroplasty: a comparison of three protocols.

    Science.gov (United States)

    Boese, C Kent; Weis, Marcia; Phillips, Tamra; Lawton-Peters, Sheila; Gallo, Theresa; Centeno, Leslie

    2014-06-01

    We conducted a randomized, controlled trial to determine the efficacy of CPM following total knee arthroplasty (TKA). Postoperative outcomes of interest were: swelling, drop in hemoglobin, self-reported pain scores, range of motion, and hospital length of stay. A total of 160 subjects were randomized into one of three treatment groups: CPM device on and moving from the immediate post-operative period, CPM device on and stationary at 90 degree flexion for the first night and then moving throughout the rest of their stay, and no CPM (N = 55, 51, and 54, respectfully). Subjects were followed during the first and second postoperative day until their first follow-up appointment approximately 3-4 weeks post-operatively. Cost of CPM was further evaluated. CPM provided no benefit to patients recovering from TKA. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Validity and reliability of using photography for measuring knee range of motion: a methodological study

    Directory of Open Access Journals (Sweden)

    Adie Sam

    2011-04-01

    Full Text Available Abstract Background The clinimetric properties of knee goniometry are essential to appreciate in light of its extensive use in the orthopaedic and rehabilitative communities. Intra-observer reliability is thought to be satisfactory, but the validity and inter-rater reliability of knee goniometry often demonstrate unacceptable levels of variation. This study tests the validity and reliability of measuring knee range of motion using goniometry and photographic records. Methods Design: Methodology study assessing the validity and reliability of one method ('Marker Method' which uses a skin marker over the greater trochanter and another method ('Line of Femur Method' which requires estimation of the line of femur. Setting: Radiology and orthopaedic departments of two teaching hospitals. Participants: 31 volunteers (13 arthritic and 18 healthy subjects. Knee range of motion was measured radiographically and photographically using a goniometer. Three assessors were assessed for reliability and validity. Main outcomes: Agreement between methods and within raters was assessed using concordance correlation coefficient (CCCs. Agreement between raters was assessed using intra-class correlation coefficients (ICCs. 95% limits of agreement for the mean difference for all paired comparisons were computed. Results Validity (referenced to radiographs: Each method for all 3 raters yielded very high CCCs for flexion (0.975 to 0.988, and moderate to substantial CCCs for extension angles (0.478 to 0.678. The mean differences and 95% limits of agreement were narrower for flexion than they were for extension. Intra-rater reliability: For flexion and extension, very high CCCs were attained for all 3 raters for both methods with slightly greater CCCs seen for flexion (CCCs varied from 0.981 to 0.998. Inter-rater reliability: For both methods, very high ICCs (min to max: 0.891 to 0.995 were obtained for flexion and extension. Slightly higher coefficients were obtained

  2. Prevalence of knee instability in relation to sports activity

    DEFF Research Database (Denmark)

    Hahn, Thomas; Foldspang, Anders; Hansen, Thorsten Ingemann

    2001-01-01

    to be positively associated with female gender and different features of occupational work. In conclusion, knee instability is a commonly reported phenomenon among active athletes. It was found to be independent of the type and the amount of sports activity but highly dependent on female gender, type and amount...

  3. Accuracy of a Custom Physical Activity and Knee Angle Measurement Sensor System for Patients with Neuromuscular Disorders and Gait Abnormalities

    Directory of Open Access Journals (Sweden)

    Frank Feldhege

    2015-05-01

    Full Text Available Long-term assessment of ambulatory behavior and joint motion are valuable tools for the evaluation of therapy effectiveness in patients with neuromuscular disorders and gait abnormalities. Even though there are several tools available to quantify ambulatory behavior in a home environment, reliable measurement of joint motion is still limited to laboratory tests. The aim of this study was to develop and evaluate a novel inertial sensor system for ambulatory behavior and joint motion measurement in the everyday environment. An algorithm for behavior classification, step detection, and knee angle calculation was developed. The validation protocol consisted of simulated daily activities in a laboratory environment. The tests were performed with ten healthy subjects and eleven patients with multiple sclerosis. Activity classification showed comparable performance to commercially available activPAL sensors. Step detection with our sensor system was more accurate. The calculated flexion-extension angle of the knee joint showed a root mean square error of less than 5° compared with results obtained using an electro-mechanical goniometer. This new system combines ambulatory behavior assessment and knee angle measurement for long-term measurement periods in a home environment. The wearable sensor system demonstrated high validity for behavior classification and knee joint angle measurement in a laboratory setting.

  4. Accuracy of a custom physical activity and knee angle measurement sensor system for patients with neuromuscular disorders and gait abnormalities.

    Science.gov (United States)

    Feldhege, Frank; Mau-Moeller, Anett; Lindner, Tobias; Hein, Albert; Markschies, Andreas; Zettl, Uwe Klaus; Bader, Rainer

    2015-05-06

    Long-term assessment of ambulatory behavior and joint motion are valuable tools for the evaluation of therapy effectiveness in patients with neuromuscular disorders and gait abnormalities. Even though there are several tools available to quantify ambulatory behavior in a home environment, reliable measurement of joint motion is still limited to laboratory tests. The aim of this study was to develop and evaluate a novel inertial sensor system for ambulatory behavior and joint motion measurement in the everyday environment. An algorithm for behavior classification, step detection, and knee angle calculation was developed. The validation protocol consisted of simulated daily activities in a laboratory environment. The tests were performed with ten healthy subjects and eleven patients with multiple sclerosis. Activity classification showed comparable performance to commercially available activPAL sensors. Step detection with our sensor system was more accurate. The calculated flexion-extension angle of the knee joint showed a root mean square error of less than 5° compared with results obtained using an electro-mechanical goniometer. This new system combines ambulatory behavior assessment and knee angle measurement for long-term measurement periods in a home environment. The wearable sensor system demonstrated high validity for behavior classification and knee joint angle measurement in a laboratory setting.

  5. The efficacy of brotzman physiotherapy protocol on pain and knee range of motion in post surgical total knee arthroplasty subjects with obesity

    Directory of Open Access Journals (Sweden)

    K Narasimha sridhar

    2013-04-01

    Full Text Available Background:To evaluate the efficacy of Brotzman physiotherapy protocol on pain and knee range of motion in post surgical T.K.A subjects with obesity and normal BMI . Materials and Methods:30 subjects were divided into two groups based on BMI. The group I having normal BMI (18.5 – 24.9 and group II having BMI more than 30. Both groups received Brotzman physiotherapy protocols for duration of 30 - 45 minutes, 1 se ssion per day, 6 days per week for a total of 6 weeks. Results:After 6 weeks treatment period, the subjects in thegroup I were compared with the subjects in the group II. Group I had shown a significant difference with outcome measures at 0.05 level.Conclusion:The study shows that there is a marginal significance ofBROTZMAN physiotherapy protocol in TKA subjects with obesity regarding relief of pain, improvement of knee ROM and WOMAC indx.

  6. Definition and evaluation of testing scenarios for knee wear simulation under conditions of highly demanding daily activities.

    Science.gov (United States)

    Schwiesau, Jens; Schilling, Carolin; Kaddick, Christian; Utzschneider, Sandra; Jansson, Volkmar; Fritz, Bernhard; Blömer, Wilhelm; Grupp, Thomas M

    2013-05-01

    The objective of our study was the definition of testing scenarios for knee wear simulation under various highly demanding daily activities of patients after total knee arthroplasty. This was mainly based on a review of published data on knee kinematics and kinetics followed by the evaluation of the accuracy and precision of a new experimental setup. We combined tibio-femoral load and kinematic data reported in the literature to develop deep squatting loading profiles for simulator input. A servo-hydraulic knee wear simulator was customised with a capability of a maximum flexion of 120°, a tibio-femoral load of 5000N, an anterior-posterior (AP) shear force of ±1000N and an internal-external (IE) rotational torque of ±50Nm to simulate highly demanding patient activities. During the evaluation of the newly configurated simulator the ability of the test machine to apply the required load and torque profiles and the flexion kinematics in a precise manner was examined by nominal-actual profile comparisons monitored periodically during subsequent knee wear simulation. For the flexion kinematics under displacement control a delayed actuator response of approximately 0.05s was inevitable due to the inertia of masses in movement of the coupled knee wear stations 1-3 during all applied activities. The axial load and IE torque is applied in an effective manner without substantial deviations between nominal and actual load and torque profiles. During the first third of the motion cycle a marked deviation between nominal and actual AP shear load profiles has to be noticed but without any expected measurable effect on the latter wear simulation due to the fact that the load values are well within the peak magnitude of the nominal load amplitude. In conclusion the described testing method will be an important tool to have more realistic knee wear simulations based on load conditions of the knee joint during activities of daily living.

  7. Approach to the active patient with chronic anterior knee pain.

    Science.gov (United States)

    Atanda, Alfred; Ruiz, Devin; Dodson, Christopher C; Frederick, Robert W

    2012-02-01

    The diagnosis and management of chronic anterior knee pain in the active individual can be frustrating for both the patient and physician. Pain may be a result of a single traumatic event or, more commonly, repetitive overuse. "Anterior knee pain," "patellofemoral pain syndrome," and "chondromalacia" are terms that are often used interchangeably to describe multiple conditions that occur in the same anatomic region but that can have significantly different etiologies. Potential pain sources include connective or soft tissue irritation, intra-articular cartilage damage, mechanical irritation, nerve-mediated abnormalities, systemic conditions, or psychosocial issues. Patients with anterior knee pain often report pain during weightbearing activities that involve significant knee flexion, such as squatting, running, jumping, and walking up stairs. A detailed history and thorough physical examination can improve the differential diagnosis. Plain radiographs (anteroposterior, anteroposterior flexion, lateral, and axial views) can be ordered in severe or recalcitrant cases. Treatment is typically nonoperative and includes activity modification, nonsteroidal anti-inflammatory drugs, supervised physical therapy, orthotics, and footwear adjustment. Patients should be informed that it may take several months for symptoms to resolve. It is important for patients to be aware of and avoid aggravating activities that can cause symptom recurrence. Patients who are unresponsive to conservative treatment, or those who have an underlying systemic condition, should be referred to an orthopedic surgeon or an appropriate medical specialist.

  8. Intravoxel incoherent motion magnetic resonance imaging of the knee joint in children with juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Hilbert, Fabian; Sauer, Alexander; Koestler, Herbert [University Hospital Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Holl-Wieden, Annette [University Hospital Wuerzburg, Department of Paediatrics, Wuerzburg (Germany); Neubauer, Henning [University Hospital Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); University Hospital Ulm, Department of Diagnostic and Interventional Radiology, Ulm (Germany)

    2017-05-15

    MRI of synovitis relies on use of a gadolinium-based contrast agent. Diffusion-weighted MRI (DWI) visualises thickened synovium but is of limited use in the presence of joint effusion. To investigate the feasibility and diagnostic accuracy of diffusion-weighted MRI with intravoxel incoherent motion (IVIM) for diagnosing synovitis in the knee joint of children with juvenile idiopathic arthritis. Twelve consecutive children with confirmed or suspected juvenile idiopathic arthritis (10 girls, median age 11 years) underwent MRI with contrast-enhanced T1-weighted imaging and DWI at 1.5 T. Read-out segmented multi-shot DWI was acquired at b values of 0 s/mm{sup 2}, 200 s/mm{sup 2}, 400 s/mm{sup 2} and 800 s/mm{sup 2}. We calculated the IVIM parameters perfusion fraction (f) and tissue diffusion coefficient (D). Diffusion-weighted images at b=800 s/mm{sup 2}, f parameter maps and post-contrast T1-weighted images were retrospectively assessed by two independent readers for synovitis using the Juvenile Arthritis MRI Scoring system. Seven (58%) children showed synovial hypertrophy on contrast-enhanced imaging. Diagnostic ratings for synovitis on DWI and on f maps were fully consistent with contrast-enhanced imaging, the diagnostic reference. Two children had equivocal low-confidence assessments on DWI. Median f was 6.7±2.0% for synovitis, 2.1±1.2% for effusion, 5.0±1.0% for muscle and 10.6±5.7% for popliteal lymph nodes. Diagnostic confidence was higher based on f maps in three (25%) children and lower in one child (8%), as compared to DWI. DWI with IVIM reliably visualises synovitis of the knee joint. Perfusion fraction maps differentiate thickened synovium from joint effusion and hence increase diagnostic confidence. (orig.)

  9. A pneumatically powered knee-ankle-foot orthosis (KAFO) with myoelectric activation and inhibition.

    Science.gov (United States)

    Sawicki, Gregory S; Ferris, Daniel P

    2009-06-23

    The goal of this study was to test the mechanical performance of a prototype knee-ankle-foot orthosis (KAFO) powered by artificial pneumatic muscles during human walking. We had previously built a powered ankle-foot orthosis (AFO) and used it effectively in studies on human motor adaptation, locomotion energetics, and gait rehabilitation. Extending the previous AFO to a KAFO presented additional challenges related to the force-length properties of the artificial pneumatic muscles and the presence of multiple antagonistic artificial pneumatic muscle pairs. Three healthy males were fitted with custom KAFOs equipped with artificial pneumatic muscles to power ankle plantar flexion/dorsiflexion and knee extension/flexion. Subjects walked over ground at 1.25 m/s under four conditions without extensive practice: 1) without wearing the orthosis, 2) wearing the orthosis with artificial muscles turned off, 3) wearing the orthosis activated under direct proportional myoelectric control, and 4) wearing the orthosis activated under proportional myoelectric control with flexor inhibition produced by leg extensor muscle activation. We collected joint kinematics, ground reaction forces, electromyography, and orthosis kinetics. The KAFO produced approximately 22%-33% of the peak knee flexor moment, approximately 15%-33% of the peak extensor moment, approximately 42%-46% of the peak plantar flexor moment, and approximately 83%-129% of the peak dorsiflexor moment during normal walking. With flexor inhibition produced by leg extensor muscle activation, ankle (Pearson r-value = 0.74 +/- 0.04) and knee ( r = 0.95 +/- 0.04) joint kinematic profiles were more similar to the without orthosis condition compared to when there was no flexor inhibition (r = 0.49 +/- 0.13 for ankle, p = 0.05, and r = 0.90 +/- 0.03 for knee, p = 0.17). The proportional myoelectric control with flexor inhibition allowed for a more normal gait than direct proportional myoelectric control. The current orthosis

  10. A pneumatically powered knee-ankle-foot orthosis (KAFO with myoelectric activation and inhibition

    Directory of Open Access Journals (Sweden)

    Ferris Daniel P

    2009-06-01

    Full Text Available Abstract Background The goal of this study was to test the mechanical performance of a prototype knee-ankle-foot orthosis (KAFO powered by artificial pneumatic muscles during human walking. We had previously built a powered ankle-foot orthosis (AFO and used it effectively in studies on human motor adaptation, locomotion energetics, and gait rehabilitation. Extending the previous AFO to a KAFO presented additional challenges related to the force-length properties of the artificial pneumatic muscles and the presence of multiple antagonistic artificial pneumatic muscle pairs. Methods Three healthy males were fitted with custom KAFOs equipped with artificial pneumatic muscles to power ankle plantar flexion/dorsiflexion and knee extension/flexion. Subjects walked over ground at 1.25 m/s under four conditions without extensive practice: 1 without wearing the orthosis, 2 wearing the orthosis with artificial muscles turned off, 3 wearing the orthosis activated under direct proportional myoelectric control, and 4 wearing the orthosis activated under proportional myoelectric control with flexor inhibition produced by leg extensor muscle activation. We collected joint kinematics, ground reaction forces, electromyography, and orthosis kinetics. Results The KAFO produced ~22%–33% of the peak knee flexor moment, ~15%–33% of the peak extensor moment, ~42%–46% of the peak plantar flexor moment, and ~83%–129% of the peak dorsiflexor moment during normal walking. With flexor inhibition produced by leg extensor muscle activation, ankle (Pearson r-value = 0.74 ± 0.04 and knee ( r = 0.95 ± 0.04 joint kinematic profiles were more similar to the without orthosis condition compared to when there was no flexor inhibition (r = 0.49 ± 0.13 for ankle, p = 0.05, and r = 0.90 ± 0.03 for knee, p = 0.17. Conclusion The proportional myoelectric control with flexor inhibition allowed for a more normal gait than direct proportional myoelectric control. The current

  11. Does the Q - H index show a stronger relationship than the H:Q ratio in regard to knee pain during daily activities in patients with knee osteoarthritis?

    Science.gov (United States)

    Fujita, Remi; Matsui, Yasumoto; Harada, Atsushi; Takemura, Marie; Kondo, Izumi; Nemoto, Tetsuya; Sakai, Tadahiro; Hiraiwa, Hideki; Ota, Susumu

    2016-12-01

    [Purpose] The purpose of this study was to elucidate the relationship between knee muscle strength and knee pain in activities of daily living, based on consideration of the difference between extension and flexion strength (Q - H) and the hamstring:quadriceps (H:Q) ratio in patients with knee osteoarthritis. [Subjects and Methods] The participants were 78 females with knee osteoarthritis, and a total of 133 knees that had not been treated surgically were the targets of this research. The legs were divided according to dominance. Isometric knee extension and flexion muscle strength and knee pain during activities of daily living were measured. The H:Q ratio (flexion/extension muscle strength) and the difference between extension and flexion strength, (extension muscle strength/weight) minus (flexion muscle strength/weight), that is, Q - H, were calculated. The correlation between these indices and the knee pain score during activities of daily living was investigated. [Results] Greater knee pain during activities of daily living was related to lower knee extension muscle strength and Q - H in both the dominant and nondominant legs. Knee flexion muscle strength and the H:Q ratio were not significantly correlated with knee pain during any activities of daily living. [Conclusion] Knee extension muscle strength and Q - H were found to be significantly correlated with knee pain during activities of daily living, whereas the H:Q ratio was not.

  12. Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty : improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis

    NARCIS (Netherlands)

    Everts, Peter A. M.; Devilee, Roger J. J.; Oosterbos, Cornelis J. M.; Mahoney, Christine Brown; Schattenkerk, Maarten Eeftinck; Knape, Johannes T. A.; van Zundert, Andre

    2007-01-01

    In this study we describe the potential role of autologous platelet gel and fibrin sealant in unilateral total knee arthroplasty to improve the postoperative range of motion and to reduce the incidence of arthrofibrosis. Total knee arthroplasty is often associated with a considerable amount of post-

  13. Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty : improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis

    NARCIS (Netherlands)

    Everts, Peter A. M.; Devilee, Roger J. J.; Oosterbos, Cornelis J. M.; Mahoney, Christine Brown; Schattenkerk, Maarten Eeftinck; Knape, Johannes T. A.; van Zundert, Andre

    2007-01-01

    In this study we describe the potential role of autologous platelet gel and fibrin sealant in unilateral total knee arthroplasty to improve the postoperative range of motion and to reduce the incidence of arthrofibrosis. Total knee arthroplasty is often associated with a considerable amount of post-

  14. 78 FR 38098 - Proposed Information Collection (Knee and Lower Leg Disability Benefits Questionnaire) Activity...

    Science.gov (United States)

    2013-06-25

    ... AFFAIRS Proposed Information Collection (Knee and Lower Leg Disability Benefits Questionnaire) Activity... Disability Benefits Questionnaire)'' in any correspondence. During the comment period, comments may be viewed.... SUPPLEMENTARY INFORMATION: Title: Knee and Lower Leg Conditions Disability Benefits Questionnaire, VA Form...

  15. Use of a portable motion analysis system for knee dynamic stability assessment in anterior cruciate ligament deficiency during single-legged hop landing

    Directory of Open Access Journals (Sweden)

    Man-Yi Yeung

    2016-07-01

    Conclusion: The altered knee kinematics in ACL-deficient patients can be revealed by a portable motion capture system, which may enable the clinical application of kinematic assessment in the evaluation of ACL deficiency.

  16. Can generic knee joint models improve the measurement of osteoarthritic knee kinematics during squatting activity?

    Science.gov (United States)

    Clément, Julien; Dumas, Raphaël; Hagemeister, Nicola; de Guise, Jaques A

    2017-01-01

    Knee joint kinematics derived from multi-body optimisation (MBO) still requires evaluation. The objective of this study was to corroborate model-derived kinematics of osteoarthritic knees obtained using four generic knee joint models used in musculoskeletal modelling - spherical, hinge, degree-of-freedom coupling curves and parallel mechanism - against reference knee kinematics measured by stereo-radiography. Root mean square errors ranged from 0.7° to 23.4° for knee rotations and from 0.6 to 9.0 mm for knee displacements. Model-derived knee kinematics computed from generic knee joint models was inaccurate. Future developments and experiments should improve the reliability of osteoarthritic knee models in MBO and musculoskeletal modelling.

  17. Uncertainty of knee joint muscle activity during knee joint torque exertion: the significance of controlling adjacent joint torque.

    Science.gov (United States)

    Nozaki, Daichi; Nakazawa, Kimitaka; Akai, Masami

    2005-09-01

    In the single-joint torque exertion task, which has been widely used to control muscle activity, only the relevant joint torque is specified. However, the neglect of the neighboring joint could make the procedure unreliable, considering our previous result that even monoarticular muscle activity level is indefinite without specifying the adjacent joint torque. Here we examined the amount of hip joint torque generated with knee joint torque and its influence on the activity of the knee joint muscles. Twelve healthy subjects were requested to exert various levels of isometric knee joint torque. The knee and hip joint torques were obtained by using a custom-made device. Because no information about hip joint torque was provided to the subjects, the hip joint torque measured here was a secondary one associated with the task. The amount of hip joint torque varied among subjects, indicating that they adopted various strategies to achieve the task. In some subjects, there was a considerable internal variability in the hip joint torque. Such variability was not negligible, because the knee joint muscle activity level with respect to the knee joint torque, as quantified by surface electromyography (EMG), changed significantly when the subjects were requested to change the strategy. This change occurred in a very systematic manner: in the case of the knee extension, as the hip flexion torque was larger, the activity of mono- and biarticular knee extensors decreased and increased, respectively. These results indicate that the conventional single knee joint torque exertion has the drawback that the intersubject and/or intertrial variability is inevitable in the relative contribution among mono- and biarticular muscles because of the uncertainty of the hip joint torque. We discuss that the viewpoint that both joint torques need to be considered will bring insights into various controversial problems such as the shape of the EMG-force relationship, neural factors that help

  18. Effect of repeated manipulation on range of motion in patients with stiff total knee arthroplasty.

    Science.gov (United States)

    Choi, Ho-Rim; Siliski, John M; Malchau, Henrik; Kwon, Young-Min

    2015-03-01

    Although manipulation under anesthesia (MUA) has been considered effective first-line treatment for stiff total knee arthroplasty (TKA), there is no consensus regarding the usefulness of repeated MUA. The purpose of this study was to investigate the usefulness of repeated MUA performed for patients in whom satisfactory range of motion (ROM) was not achieved by MUA. The authors retrospectively reviewed 15 patients who underwent repeated MUA after failure of initial MUA for stiff TKA. Demographic and ROM data were collected. A final ROM of less than 90° was considered a failed manipulation (failure group) and a final ROM of 90° or more was considered a successful manipulation (success group). Average pre-repeated MUA ROM (72.3°±19.5°) immediately improved to 112.3°±9.7° (Pstiff TKA. The success rate of repeated MUA was less than that of primary MUA; however, it is a useful treatment modality for stiff TKA. Decreased pre-TKA ROM appeared to be associated with poor outcomes after repeated MUA.

  19. Biofeedback relaxation for pain associated with continuous passive motion in Taiwanese patients after total knee arthroplasty.

    Science.gov (United States)

    Wang, Tsae-Jyy; Chang, Ching-Fen; Lou, Meei-Fang; Ao, Man-Kuan; Liu, Chiung-Chen; Liang, Shu-Yuan; Wu, Shu-Fang Vivienne; Tung, Heng-Hsing

    2015-02-01

    Effective pain management is crucial for patient recovery after total knee arthroplasty (TKA). Biofeedback therapy, which encourages relaxation and helps alleviate various conditions associated with stress, may help to decrease postoperative pain in patients undergoing TKA. A quasi- experimental design was used to investigate the efficacy of a biofeedback relaxation intervention in reducing pain associated with postoperative continuous passive motion (CPM) therapy. Sixty-six patients admitted to a general hospital in Taiwan for TKA were recruited and randomly assigned to the intervention or control group. The intervention group received biofeedback training twice daily for 5 days, concurrent with CPM therapy, whereas the control group did not receive the biofeedback intervention. Pain was measured using a numeric rating scale before and after each CPM therapy session on postoperative days 1 through 5. The CPM-elicited pain score was calculated by subtracting the pre-CPM pain score from the post-CPM pain score. Results of repeated-measures analysis of variance showed intervention group reported significantly less pain caused by CPM than did the control group (f = 29.70, p biofeedback relaxation, a non-invasive and non-pharmacological intervention, as a complementary treatment option for pain management in this population.

  20. Assessment of transfemoral amputees using a passive microprocessor-controlled knee versus an active powered microprocessor-controlled knee for level walking.

    Science.gov (United States)

    Creylman, Veerle; Knippels, Ingrid; Janssen, Paul; Biesbrouck, Evelyne; Lechler, Knut; Peeraer, Louis

    2016-12-19

    In transfemoral (TF) amputees, the forward propulsion of the prosthetic leg in swing has to be mainly carried out by hip muscles. With hip strength being the strongest predictor to ambulation ability, an active powered knee joint could have a positive influence, lowering hip loading and contributing to ambulation mobility. To assess this, gait of four TF amputees was measured for level walking, first while using a passive microprocessor-controlled prosthetic knee (P-MPK), subsequently while using an active powered microprocessor-controlled prosthetic knee (A-MPK). Furthermore, to assess long-term effects of the use of an A-MPK, a 4-weeks follow-up case study was performed. The kinetics and kinematics of the gait of four TF amputees were assessed while walking with subsequently the P-MPK and the A-MPK. For one amputee, a follow-up study was performed: he used the A-MPK for 4 weeks, his gait was measured weekly. The range of motion of the knee was higher on both the prosthetic and the sound leg in the A-MPK compared to the P-MPK. Maximum hip torque (HT) during early stance increased for the prosthetic leg and decreased for the sound leg with the A-MPK compared to the P-MPK. During late stance, the maximum HT decreased for the prosthetic leg. The difference between prosthetic and sound leg for HT disappeared when using the A-MPK. Also, an increase in stance phase duration was observed. The follow-up study showed an increase in confidence with the A-MPK over time. Results suggested that, partially due to an induced knee flexion during stance, HT can be diminished when walking with the A-MPK compared to the P-MPK. The single case follow-up study showed positive trends indicating that an adaptation time is beneficial for the A-MPK.

  1. ARTHROFIBROSIS FOLLOWING TOTAL KNEE ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Ravi B. Solanki

    2014-11-01

    Full Text Available Arthrofibrosis following total knee arthroplasty is an uncommon complication defined as less than 80 degrees of knee flexion 6-8 weeks post operatively. It is characterized by abnormal scarring of the joint in which the formation of dense fibrous tissue and tissue metaplasia prevent normal range of motion. Clinical features include limited knee Range of motion with extension deficit, pain with activities of daily living and unusual amount of pain and swelling post operatively in the absence of infection, bleeding or mechanical complications. We present case of 55 years old female who undergone for total knee replacement before 3 months and presented to our department with complain of knee pain and swelling with activities of daily living. She was diagnosed on the basis of clinical examination. Her detailed evaluation was carried out and Physiotherapy treatment was started.

  2. Kinematics of hip, knee, ankle of the young and elderly Chinese people during kneeling activity

    Institute of Scientific and Technical Information of China (English)

    Hai ZHOU; Dong-mei WANG; Tao-ran LIU; Xiang-sen ZENG; Cheng-tao WANG

    2012-01-01

    Objective:The purpose of this study was to measure the kinematics of the lower limbs of Chinese people during normal kneeling activity,as such data could be valuable in designing joint prosthesis and arthroplasty that meet the needs of Chinese citizens' daily activities.Methods:Thirty young and twenty elderly Chinese participants with no personal history of joint diseases were recruited,and matched by age (average age:23.8 years for the young group,60.8 years for the elderly group).Each participant performed six trials during which three-dimensional (3D) kinematics data were collected and the means of the 3D angles of the ankle,knee,and hip joints of two groups were calculated.Results:There were no obvious differences between the two groups in the knee and ankle joints.The mean range of knee flexion was 139.6° for the young group and 140.9° for the elderly group.The mean range of ankle flexion was 35.7° for the young group and 37.6° for the elderly group.The maximal eccentric flexion at the hip joint was 67.5° for the young group compared to 100.5° for the elderly group.Conclusions:The elderly uses more hip flexion angles than the young when assuming the kneeling posture.The ranges of motion obtained during kneeling activity are greater than the reported mean ranges of motion achieved following joint arthroplasty.The data could be valuable in establishing criteria for lower limb prosthetics and rehabilitation protocol for the Chinese population.

  3. Effect of Planning on Trunk Motion and Knee Moments During a Side Step Cut Task

    Science.gov (United States)

    Houck, Jeff; Gorniak, Stacey; Nicholson, Kristen

    2004-03-01

    Recent studies suggest that alterations in knee biomechanics associated with unanticipated cutting tasks place athletes at higher risk of knee injuries. Besier et al observed alterations in knee moments during unanticipated cutting tasks that were consistent with in-vitro ACL injury mechanisms. During similar tasks, Patla et al observed lateral trunk lean and decreased foot placement, suggesting that full body center of mass control is perturbed during such tasks. The purpose of this study was to compare the trunk and knee frontal plane moments and evaluate a relationship between the two during unanticipated cutting tasks. The results of this study suggest that there is a relationship between the trunk and knee frontal plane moments during the first 200-400ms of the stance phase of gait.

  4. Use of drop and dangle rehabilitation protocol to increase knee flexion following total knee arthroplasty: a comparison with continuous passive motion machine.

    Science.gov (United States)

    Pongkunakorn, Anuwat; Sawatphap, Duangrak

    2014-09-01

    There are variations in the type of rehabilitation program and duration of using the continuous passive motion (CPM) machine to increase range of motion (ROM) following total knee arthroplasty (TKA). To compare the outcomes of the 'drop and dangle' (D&D) protocol vs. a 3-hour daily CPM for the purpose of increasing flexion following TKA. A prospective non-concurrent controlled intervention study was conducted on patients who underwent primary TKA atLampang Hospital from December 2009 to August 2011 (D&D group, n = 36) andfrom September 2011 to December 2012 (CPM group, n = 33). The same surgeon using the same prosthesis design performed all surgeries. The legs in D&D group were placed into the knee immobilizer at 70 flexion and removed on postoperative day 1 (POD1). The passive ROM exercise was then started by dropping the affected leg over the bedside, and gently flexing and bending the knee with the help of the unaffected leg to achieve maximal flexion. The legs in the CPM group were immobilized with a Jones bandage in full extension for 24 hours, and then placed into CPM machine for three, 1-hour per day sessions. The clinical data were statistically compared between the two groups. Patient baseline characteristics in both groups were not different. The D&D group had more average passive flexion in POD1 (67.0° ± 14.2° vs. 59.1° ± 3.2°, p < 0.001) and POD2 (76.6° ± 14.2° vs. 69.8° ± 13.3° , p = 0.008). Higher rates of flexion were observed in PODs 3-7 but they were not significant. Flexion at discharge in the D&D group was 100.6° ± 6.8° and 96.4°+10.2° in the CPM group (p = 0.005). At 6 weeks, rates of flexion in both groups were similar (D&D 99.8° ±10.4°, CPM 103.9° ± 10.4°, p = 0.138). Rates offlexion were also similar at 1 year (D&D 112.0° ± 10.4°, CPM 111.6° ± 12.6°, p = 0.892). D&D protocol provided more passive knee flexion than the use of CPM in the first two days after TKA and at discharge. These differences were not

  5. Gait and muscle activation changes in men with knee osteoarthritis.

    Science.gov (United States)

    Liikavainio, Tuomas; Bragge, Timo; Hakkarainen, Marko; Karjalainen, Pasi A; Arokoski, Jari P

    2010-01-01

    The aim was to examine the biomechanics of level- and stair-walking in men with knee osteoarthritis (OA) at different pre-determined gait speeds and to compare the results with those obtained from healthy control subjects. Special emphasis was placed on the estimation of joint loading. Fifty-four men with knee OA (50-69 years) and 53 healthy age- and sex-matched controls were enrolled in the study. The participants walked barefoot in the laboratory (1.2 m/s+/-5%), corridor (1.2; 1.5 and 1.7 m/s+/-5%), and climbing and coming down stairs (0.5 and 0.8 m/s+/-5%) separately. Joint loading was assessed with skin mounted accelerometers (SMAs) attached just above and below the more affected knee joint. The 3-D ground reaction forces (GRFs) and muscle activation with surface-electromyography (EMG) from vastus medialis (VM) and biceps femoris (BF) were also measured simultaneously. There were no differences in SMA variables between groups during level-walking, but maximal loading rate (LR(max)) was higher bilaterally in the controls (Pstair descent at faster speed. The distinctions in muscle activation both at level- and stair ambulation in VM and BF muscles revealed that the patients used different strategies to execute the same walking tasks. It is concluded that the differences in measured SMA and GRF parameters between the knee OA patients and the controls were only minor at constant gait speeds. It is speculated that the faster speeds in the stair descent subjected the compensatory mechanisms to the maximum highlighting the differences between groups.

  6. Physical activity after total knee arthroplasty: A critical review.

    Science.gov (United States)

    Paxton, Roger J; Melanson, Edward L; Stevens-Lapsley, Jennifer E; Christiansen, Cory L

    2015-09-18

    Total knee arthroplasty (TKA) is the most commonly performed elective surgery in the United States. TKA typically improves functional performance and reduces pain associated with knee osteoarthritis. Little is known about the influence of TKA on overall physical activity levels. Physical activity, defined as "any bodily movement produced by skeletal muscles that results in energy expenditure", confers many health benefits but typically decreases with endstage osteoarthritis. The purpose of this review is to describe the potential benefits (metabolic, functional, and orthopedic) of physical activity to patients undergoing TKA, present results from recent studies aimed to determine the effect of TKA on physical activity, and discuss potential sources of variability and conflicting results for physical activity outcomes. Several studies utilizing self-reported outcomes indicate that patients perceive themselves to be more physically active after TKA than they were before surgery. Accelerometry-based outcomes indicate that physical activity for patients after TKA remains at or below pre-surgical levels. Several different factors likely contributed to these variable results, including the use of different instruments, duration of follow-up, and characteristics of the subjects studied. Comparison to norms, however, suggests that daily physical activity for patients following TKA may fall short of healthy age-matched controls. We propose that further study of the relationship between TKA and physical activity needs to be performed using accelerometry-based outcome measures at multiple post-surgical time points.

  7. Influence of advanced prosthetic knee joints on perceived performance and everyday life activity level of low-functional persons with a transfemoral amputation or knee disarticulation

    NARCIS (Netherlands)

    Theeven, P.J.; Hemmen, B.; Geers, R.P.; Smeets, R.J.P.; Brink, P.R.; Seelen, H.A.

    2012-01-01

    OBJECTIVE: To assess the effects of two types of microprocessor-controlled prosthetic knee joints (MPKs) on perceived performance and everyday life activity level. DESIGN: Randomized cross-over trial. SUBJECTS: Thirty persons with a unilateral above-knee amputation or knee disarticulation classified

  8. Influence of advanced prosthetic knee joints on perceived performance and everyday life activity level of low-functional persons with a transfemoral amputation or knee disarticulation

    NARCIS (Netherlands)

    Theeven, P.J.; Hemmen, B.; Geers, R.P.; Smeets, R.J.P.; Brink, P.R.; Seelen, H.A.

    2012-01-01

    OBJECTIVE: To assess the effects of two types of microprocessor-controlled prosthetic knee joints (MPKs) on perceived performance and everyday life activity level. DESIGN: Randomized cross-over trial. SUBJECTS: Thirty persons with a unilateral above-knee amputation or knee disarticulation classified

  9. Interaction between pre-landing activities and stiffness regulation of the knee joint musculoskeletal system in the drop jump: implications to performance.

    Science.gov (United States)

    Horita, T; Komi, P V; Nicol, C; Kyröläinen, H

    2002-11-01

    The purpose of the present study was to investigate the interaction between the pre-landing activities and the stiffness regulation of the knee joint musculoskeletal system and the takeoff speed during a drop jump (DJ). Nine healthy male subjects performed a DJ test from the height of 50 cm. The surface electromyographic (EMG) activity of the vastus lateralis (VL) muscle was recorded to evaluate both the pre-landing and post-landing muscle activation levels. Simultaneous recording of the jumping motion and ground reaction force was performed by a high-speed video camera (100 frames x s(-1)), and a force platform was employed to allow joint moment analysis. Joint stiffness was calculated by a linear regression of the knee joint moment/angle relationship. Elasticity of the knee extensor muscle during DJ was estimated by means of a four-element muscle model consisting of a parallel elastic component, a series elastic component (SEC), a viscous damper, and a contractile element. DJ performance correlated positively with the positive peak power of the knee joint (P knee joint at the end of stretch (P power of the ankle joint. The knee joint moment at the end of stretch correlated with the SEC stiffness during the transmission phase from the end of the initial impact to the onset of the concentric action (P knee extensors (P analysis showed that the SEC stiffness during the transmission phase of the knee joint can be explained by a combination of the pre-activity of the VL muscle and the knee joint angular velocity at touchdown (F = 5.76, P knee extensor muscle in conjunction with the muscle contractile property play a major role in regulating the performance in DJ.

  10. Knee pain during activities of daily living and its relationship with physical activity in patients with early and severe knee osteoarthritis.

    Science.gov (United States)

    Fukutani, Naoto; Iijima, Hirotaka; Aoyama, Tomoki; Yamamoto, Yuko; Hiraoka, Masakazu; Miyanobu, Kazuyuki; Jinnouchi, Masashi; Kaneda, Eishi; Tsuboyama, Tadao; Matsuda, Shuichi

    2016-09-01

    This study aimed to investigate whether knee pain during various activities of daily living (ADLs) is associated with physical activity in patients with early and severe knee osteoarthritis (OA). We hypothesized that the painful ADLs associated with decreased physical activity differ according to disease severity. This cross-sectional study enrolled 270 patients with medial knee OA, assigned to either the early (Kellgren Lawrence [K/L] grade 1-2) or the severe group (K/L grade 3-4). Physical activity was assessed using a pedometer. Knee pain during six ADLs (waking up in the morning, walking on a flat surface, ascending stairs, etc.) was evaluated using a questionnaire. We performed multiple regression and quantile regression analysis to investigate whether knee pain during each ADL was associated with physical activity. In the early group, the more knee pain they experienced while ascending stairs, the lower their physical activity was (75th regression coefficient = -1033.70, P = 0.018). In the severe group, the more knee pain they experienced while walking on a flat surface or bending to the floor or standing up, the lower their physical activity was (unstandardized coefficients = -1850.87, P = 0.026; unstandardized coefficients = -2640.35, P = 0.010). Knee pain while ascending stairs and while walking on a flat surface or bending to the floor or standing up was a probable limiting factor for physical activity in early and severe knee OA, respectively. These findings suggested that a reduction in task-specific knee pain according to disease severity could improve physical activity levels.

  11. Evaluation Of Range Of Motion After Arthroscopic Arthroloysis In Postoperative Arthrofibrosis Of The Knee

    Directory of Open Access Journals (Sweden)

    Moghtader Azadi G

    2003-07-01

    Full Text Available Arthrofibrosis continue to be a difficult complication of operative procedures of trauma about the knee. We present our experience in 8 cases of arthroscopic Arthrolysis between 1997 and 2001. in 3 Cases the etiology was prior Knee ligament surgery and 5 cases had sustained fractures about the knee. Technique begins with the liberation of the adhesions of suprapatellar Pouch, continues down both gutters , and ends with a cleaning of the notch where necessary. The result obtained are very satisfactory, with an average increase in the arc of mobility of 61 degrees."n 

  12. Physical Activity and Spatial Differences in Medial Knee T1rho and T2 Relaxation Times in Knee Osteoarthritis

    Science.gov (United States)

    KUMAR, DEEPAK; SOUZA, RICHARD B.; SINGH, JUSTIN; CALIXTO, NATHANIEL E.; NARDO, LORENZO; LINK, THOMAS M.; LI, XIAOJUAN; MAJUMDAR, SHARMILA

    2015-01-01

    STUDY DESIGN Cross-sectional. OBJECTIVES To investigate the association between knee loading–related osteoarthritis (OA) risk factors (obesity, malalignment, and physical activity) and medial knee laminar (superficial and deep) T1rho and T2 relaxation times. BACKGROUND The interaction of various modifiable loading-related knee risk factors and cartilage health in knee OA is currently not well known. METHODS Participants with and without knee OA (n = 151) underwent magnetic resonance imaging at 3 T for superficial and deep cartilage T1rho and T2 magnetic resonance relaxation times in the medial femur (MF) and medial tibia (MT). Other variables included radiographic Kellgren-Lawrence (KL) grade, alignment, pain and symptoms using the Knee injury and Osteoarthritis Outcome Score, and physical activity using the International Physical Activity Questionnaire (IPAQ). Individuals with a KL grade of 4 were excluded. Group differences were calculated using 1-way analysis of variance, adjusting for age and body mass index. Linear regression models were created with age, sex, body mass index, alignment, KL grade, and the IPAQ scores to predict the laminar T1rho and T2 times. RESULTS Total IPAQ scores were the only significant predictors among the loading-related variables for superficial MF T1rho (P = .005), deep MT T1rho (P = .026), and superficial MF T2 (P = .049). Additionally, the KL grade predicted the superficial MF T1rho (P = .023) and deep MT T1rho (P = .022). CONCLUSION Higher physical activity levels and worse radiographic severity of knee OA, but not obesity or alignment, were associated with worse cartilage composition. PMID:25353261

  13. Muscle Activation Profiles and Co-Activation of Quadriceps and Hamstring Muscles around Knee Joint in Indian Primary Osteoarthritis Knee Patients.

    Science.gov (United States)

    Sharma, Sanjeev Kumar; Yadav, Shiv Lal; Singh, U; Wadhwa, Sanjay

    2017-05-01

    Osteoarthritis (OA) of knee is a common joint disease. It is associated with reduced knee joint stability due to impaired quadriceps strength, pain, and an altered joint structure. There is altered muscle activation in knee OA patients, which interferes with normal load distribution around the knee and facilitates disease progression. Our primary aim was to determine activation patterns of the muscles i.e., quadriceps and hamstrings in knee OA patients during walking. We also studied co-activation of muscles around knee joint in primary OA knee patients including directed medial and lateral co-contractions. This observational study was done at Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India. Fourty-four patients with medial compartment primary knee OA were included in study after satisfying inclusion and exclusion criteria. All the patients were assessed for mean, peak and integrated Root Mean Square (RMS), EMG values, muscle activation patterns and co-activation of muscles around knee joint by surface Electromyography (EMG) analysis of Vastus Medialis Obliques (VMO), Vastus Lateralis (VL), Semitendinosus (SMT) and Biceps Femoris (BF) muscles during gait cycle. The EMG waveform for each muscle was amplitude normalized and time normalized to 100% of gait cycle and plotted on graph. Quantitative variables were assessed for normal distribution and accordingly mean±SD or median (range), as appropriate, was computed. For primary OA knee, mean age 61±5 years, mean weight 63.7±10.1 kg, mean height 153.9±7.2 cm, and mean Body Mass Index (BMI) 26.8±3.0 kg/m(2) was found. The muscle activity of hamstrings (SMT muscle and BF) was increased during midstance, late stance and early swing phase of gait cycle as compared to quadriceps (VMO and VL) muscle activity respectively, suggesting co-contraction of opposing muscles around knee joint. Patients with knee OA walk with increased hamstring muscle activity (during

  14. Provocative mechanical tests of the peripheral nervous system affect the joint torque-angle during passive knee motion.

    Science.gov (United States)

    Andrade, R J; Freitas, S R; Vaz, J R; Bruno, P M; Pezarat-Correia, P

    2015-06-01

    This study aimed to determine the influence of the head, upper trunk, and foot position on the passive knee extension (PKE) torque-angle response. PKE tests were performed in 10 healthy subjects using an isokinetic dynamometer at 2°/s. Subjects lay in the supine position with their hips flexed to 90°. The knee angle, passive torque, surface electromyography (EMG) of the semitendinosus and quadriceps vastus medialis, and stretch discomfort were recorded in six body positions during PKE. The different maximal active positions of the cervical spine (neutral; flexion; extension), thoracic spine (neutral; flexion), and ankle (neutral; dorsiflexion) were passively combined for the tests. Visual analog scale scores and EMG were unaffected by body segment positioning. An effect of the ankle joint was verified on the peak torque and knee maximum angle when the ankle was in the dorsiflexion position (P Upper trunk positioning had an effect on the knee submaximal torque (P cervical and thoracic spines were flexed (P angle response since different positions of head, upper trunk, and foot induce dissimilar knee mechanical responses during passive extension.

  15. A new protocol from real joint motion data for wear simulation in total knee arthroplasty: stair climbing.

    Science.gov (United States)

    Battaglia, Santina; Belvedere, Claudio; Jaber, Sami Abdel; Affatato, Saverio; D'Angeli, Valentina; Leardini, Alberto

    2014-12-01

    In its normal lifespan, a knee prosthesis must bear highly demanding loading conditions, going beyond the sole activity of level walking required by ISO standard 14243. We have developed a protocol for in vitro wear simulation of stair climbing on a displacement controlled knee simulator. The flexion/extension angle, intra/extra rotation angle, and antero/posterior translation were obtained in patients by three-dimensional video-fluoroscopy. Axial load data were collected by gait analysis. Kinematics and load data revealed a good consistence across patients, in spite of the different prosthesis size. The protocol was then implemented and tested on a displacement controlled knee wear simulator, showing an accurate reproduction of stair climbing waveforms with a relative error lower than 5%.

  16. [Sports activities after osteotomies around the knee].

    Science.gov (United States)

    Paul, J; Heitner, A H; Mauch, M; Imhoff, A B

    2017-07-01

    In the current literature, the rate of return to sports following high tibial osteotomy is high. Patients are largely able to carry out the type of exercise done before the onset of symptoms and are satisfied with the clinical outcome. In general, however, a differentiated view of the sporting ability should be made, and the different requirements of the sport should be considered. A classification according to functional and biomechanical movement analysis seems to advisable. In addition, the recommendations of the treating physician seem to have a high impact on the postoperative level of the sports activities of the patients. A realistic assessment (by both the patient and the treating physician) that considers the sport, its requirements and the level of performance is necessary.

  17. Effect of Continuous Passive Motion on Pain and Range of Motion after Knee Arthroplasty%持续被动运动在膝关节置换术后早期康复治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    王东; 魏更生; 宋华伟; 蒋毅; 王艺伟; 吴磊

    2011-01-01

    Objective To evaluate the effect of continuous passive motion (CPM) as an adjunct to active physiotherapy on pain and range of motion (ROM) after knee arthroplasty. Methods 20 female osteoarthritis patients (40 knees) undergoing bilateral knee arthroplasty were assigned into two groups. The experimental group received CPM and active physiotherapy twice a day while the control group received active physiotherapy only. They were assessed with visual analogue scale (VAS) and goniometer on pain and ROM of knee before and after operation. Results There were no statistical difference between these two groups for any outcome measures either 2 weeks or 3 months after operation (P>0.05), and they all improved in pain and ROM 3 months after operation compared with before (P< 0.01). Conclusion CPM as an adjunctive therapy is not found to have an additional effect on pain or ROM 3 months after operation while active physiotherapy was used.%目的 评价持续被动运动(CPM)在膝关节置换术后早期康复治疗中对疼痛和膝关节主动屈伸活动度的作用.方法 20例(40膝)女性重度骨性关节炎患者行双膝关节同时置换术.分为实验组和对照组,每组10例20膝.实验组术后每天2次行CPM和主动康复治疗,对照组每天2次主动康复治疗.术前、术后2周和3个月应用疼痛视觉模拟评分(VAS)和角度测量仪评估两组患者的疼痛和膝关节主动屈伸活动度.结果 术后2周和3个月,两组患者的疼痛评分和膝关节活动度均无显著性差异(P>0.05).与术前相比,疼痛评分和膝关节主动屈伸活动度在术后3个月均有明显改善(P<0.01).结论 进行主动康复治疗后,CPM的辅助应用对膝关节置换术后3个月内疼痛和关节活动度的改善无明显促进作用.

  18. Effects of ankle joint mobilization with movement and weight-bearing exercise on knee strength, ankle range of motion, and gait velocity in patients with stroke: a pilot study.

    Science.gov (United States)

    An, Chang-Man; Won, Jong-Im

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of ankle joint mobilization with movement on knee strength, ankle range of motion, and gait velocity, compared with weight-bearing exercise in stroke patients. [Subjects and Methods] Thirty subjects with chronic stroke were divided into three groups: MWM (n = 12), WBE (n = 8), and control (n = 10). All groups attended physical therapy sessions 3 times a week for 5 weeks. Subjects in the MWM group performed mobilization with movement exercises, whilst participants in the WBE group performed weight-bearing exercises. Knee peak torque, ankle range of motion, and spatiotemporal gait parameters were evaluated before and after the interventions. [Results] Knee extensor peak torque increased significantly in both MWM and WBE groups. However, only the MWM group showed significant improvement in passive and active ankle range of motion and gait velocity, among the three groups. [Conclusion] Ankle joint mobilization with movement intervention is more effective than simple weight-bearing intervention in improving gait speed in stroke patients with limited ankle motion.

  19. Effects of Low-Impact Dance on Blood Biochemistry, Bone Mineral Density, the Joint Range of Motion of Lower Extremities, Knee Extension Torque, and Fall in Females.

    Science.gov (United States)

    Wu, Hui Ying; Tu, Jui Hung; Hsu, Chin Hsing; Tsao, Te Hung

    2016-01-01

    The effect of low-impact dance on blood metabolites, the joint range of motion (ROM) of the lower extremities, knee extension torque, bone mass density (BMD), the number of falls, and the confidence to perform daily activities (Modified Falls Efficacy Scale [MFES]) was examined in older sedentary women (age: 59 ± 4 years) before and after a 16-week intervention. Results showed that the average score for the MFES, some parameters of blood chemistry, and joint ROM were significantly improved after low-impact intervention. In addition to improvements in blood lipids and body fat percentages, the increases shown in the parameters regarding the lower extremities may contribute to confidence in performing common daily activities in older women, although the number of falls did not significantly differ between the two groups during the 16-week period.

  20. A prosthetic knee using magnetorhelogical fluid damper for above-knee amputees

    Science.gov (United States)

    Park, Jinhyuk; Choi, Seung-Bok

    2015-04-01

    A prosthetic knee for above-knee (AK) amputees is categorized into two types; namely a passive and an active type. The passive prosthetic knee is generally made by elastic materials such as carbon fiber reinforced composite material, titanium and etc. The passive prosthetic knee easy to walk. But, it has disadvantages such that a knee joint motion is not similar to ordinary people. On the other hand, the active prosthetic knee can control the knee joint angle effectively because of mechanical actuator and microprocessor. The actuator should generate large damping force to support the weight of human body. But, generating the large torque using small actuator is difficult. To solve this problem, a semi-active type prosthetic knee has been researched. This paper proposes a semi-active prosthetic knee using a flow mode magneto-rheological (MR) damper for AK amputees. The proposed semi-active type prosthetic knee consists of the flow mode MR damper, hinge and prosthetic knee body. In order to support weight of human body, the required energy of MR damper is smaller than actuator of active prosthetic leg. And it can control the knee joint angle by inducing the magnetic field during the stance phase.

  1. Measurement of the screw-home motion of the knee is sensitive to errors in axis alignment.

    Science.gov (United States)

    Piazza, S J; Cavanagh, P R

    2000-08-01

    Measurements of joint angles during motion analysis are subject to error caused by kinematic crosstalk, that is, one joint rotation (e. g., flexion) being interpreted as another (e.g., abduction). Kinematic crosstalk results from the chosen joint coordinate system being misaligned with the axes about which rotations are assumed to occur. The aim of this paper is to demonstrate that measurement of the so-called "screw-home" motion of the human knee, in which axial rotation and extension are coupled, is especially prone to errors due to crosstalk. The motions of two different two-segment mechanical linkages were examined to study the effects of crosstalk. The segments of the first linkage (NSH) were connected by a revolute joint, but the second linkage (SH) incorporated gearing that caused 15 degrees of screw-home rotation to occur with 90 degrees knee flexion. It was found that rotating the flexion axis (inducing crosstalk) could make linkage NSH appear to exhibit a screw-home motion and that a different rotation of the flexion axis could make linkage SH apparently exhibit pure flexion. These findings suggest that the measurement of screw-home rotation may be strongly influenced by errors in the location of the flexion axis. The magnitudes of these displacements of the flexion axis were consistent with the inter-observer variability seen when five experienced observers defined the flexion axis by palpating the medial and lateral femoral epicondyles. Care should be taken when interpreting small internal-external rotations and abduction-adduction angles to ensure that they are not the products of kinematic crosstalk.

  2. Motion

    CERN Document Server

    Graybill, George

    2007-01-01

    Take the mystery out of motion. Our resource gives you everything you need to teach young scientists about motion. Students will learn about linear, accelerating, rotating and oscillating motion, and how these relate to everyday life - and even the solar system. Measuring and graphing motion is easy, and the concepts of speed, velocity and acceleration are clearly explained. Reading passages, comprehension questions, color mini posters and lots of hands-on activities all help teach and reinforce key concepts. Vocabulary and language are simplified in our resource to make them accessible to str

  3. Geometric control of active collective motion

    CERN Document Server

    Theillard, Maxime; Saintillan, David

    2016-01-01

    Recent experimental studies have shown that confinement can profoundly affect self-organization in semi-dilute active suspensions, leading to striking features such as the formation of steady and spontaneous vortices in circular domains and the emergence of unidirectional pumping motions in periodic racetrack geometries. Motivated by these findings, we analyze the two-dimensional dynamics in confined suspensions of active self-propelled swimmers using a mean-field kinetic theory where conservation equations for the particle configurations are coupled to the forced Navier-Stokes equations for the self-generated fluid flow. In circular domains, a systematic exploration of the parameter space casts light on three distinct states: equilibrium with no flow, stable vortex, and chaotic motion, and the transitions between these are explained and predicted quantitatively using a linearized theory. In periodic racetracks, similar transitions from equilibrium to net pumping to traveling waves to chaos are observed in ag...

  4. Comparing the Effects of Therapeutic Exercise and Hydrotherapy on Pain Severity and Knee Range of Motion in Patients with Hemophilia: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    V Mazloum

    2013-10-01

    . Results: Both experimental groups exhibited significant reduction of pain along with improved knee flexion and extension compared with the control group (P<0.001. Pain reduction in subjects treated in water treatment was significantly higher than exercise group in drought (P0.05. Conclusion: The use of therapeutic exercise in water with regular exercise rehabilitation for patients with hemophilia can be helpful to reduce pain and improve range of motion in hemophilia patients. The effect of exercise therapy on pain reduction is more effective compared to traditional pain therapy. Key words: Hydrotherapy, Exercise Therapy, Hemophilia, Knee Range of Motion

  5. The remains of anterior cruciate ligament graft tension after cyclic knee motion

    NARCIS (Netherlands)

    Arnold, MR; Lie, DTT; Verdonschot, N; de Graaf, R; Amis, AA; van Kampen, A

    2005-01-01

    Background: There is sometimes a return of excess knee laxity after anterior cruciate ligament reconstruction. One of the contributing factors might be a loss in graft tension. It is unknown whether the tension imposed on an anterior cruciate ligament graft degrades with time and, if so, the effect

  6. Console video games, postural activity, and motion sickness during passive restraint.

    Science.gov (United States)

    Chang, Chih-Hui; Pan, Wu-Wen; Chen, Fu-Chen; Stoffregen, Thomas A

    2013-08-01

    We examined the influence of passive restraint on postural activity and motion sickness in individuals who actively controlled a potentially nauseogenic visual motion stimulus (a driving video game). Twenty-four adults (20.09 ± 1.56 years; 167.80 ± 7.94 cm; 59.02 ± 9.18 kg) were recruited as participants. Using elastic bands, standing participants were passively restrained at the head, shoulders, hips, and knees. During restraint, participants played (i.e., controlled) a driving video game (a motorcycle race), for 50 min. During game play, we recorded the movement of the head and torso, using a magnetic tracking system. Following game play, participants answered a forced choice, yes/no question about whether they were motion sick, and were assigned to sick and well groups on this basis. In addition, before and after game play, participants completed the Simulator Sickness Questionnaire, which provided numerical ratings of the severity of individual symptoms. Five of 24 participants (20.83 %) reported motion sickness. Participants moved despite being passively restrained. Both the magnitude and the temporal dynamics of movement differed between the sick and well groups. The results show that passive restraint of the body can reduce motion sickness when the nauseogenic visual stimulus is under participants' active control and confirm that motion sickness is preceded by distinct patterns of postural activity even during passive restraint.

  7. Influence of restricted vision and knee joint range of motion on gait properties during level walking and stair ascent and descent.

    Science.gov (United States)

    Demura, Tomohiro; Demura, Shin-ich

    2011-01-01

    Because elderly individuals experience marked declines in various physical functions (e.g., vision, joint function) simultaneously, it is difficult to clarify the individual effects of these functional declines on walking. However, by imposing vision and joint function restrictions on young men, the effects of these functional declines on walking can be clarified. The authors aimed to determine the effect of restricted vision and range of motion (ROM) of the knee joint on gait properties while walking and ascending or descending stairs. Fifteen healthy young adults performed level walking and stair ascent and descent during control, vision restriction, and knee joint ROM restriction conditions. During level walking, walking speed and step width decreased, and double support time increased significantly with vision and knee joint ROM restrictions. Stance time, step width, and walking angle increased only with knee joint ROM restriction. Stance time, swing time, and double support time were significantly longer in level walking, stair descent, and stair ascent, in that order. The effects of vision and knee joint ROM restrictions were significantly larger than the control conditions. In conclusion, vision and knee joint ROM restrictions affect gait during level walking and stair ascent and descent. This effect is marked in stair ascent with knee joint ROM restriction.

  8. Neuromuscular activity and knee kinematics in adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin; Olesen, Jens L.

    2013-01-01

    This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS).......This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS)....

  9. Superior results with continuous passive motion compared to active motion after periosteal transplantation. A retrospective study of human patella cartilage defect treatment.

    Science.gov (United States)

    Alfredson, H; Lorentzon, R

    1999-01-01

    Fifty-seven consecutive patients (33 men and 24 women), with a mean age of 32 years (range 16-53 years), who suffered from an isolated full-thickness cartilage defect of the patella and disabling knee pain of long duration, were treated by autologous periosteal transplantation to the cartilage defect. The first 38 consecutive patients (group A) were postoperatively treated with continuous passive motion (CPM), and the next 19 consecutive patients (group B) were treated with active motion for the first 5 days postoperatively. In both groups, the initial regimens were followed by active motion, slowly progressive strength training, and slowly progressive weight bearing. In group A, after a mean follow-up of 51 months (range 33-92 months), 29 patients (76%) were graded as excellent or good, 7 patients (19%) were graded as fair, and 2 patients (5%) were graded as poor. In group B, after a mean follow-up of 21 months (range 14-28 months), 10 patients (53%) were graded as excellent or good, 6 patients (32%) were graded as fair, and 3 patients (15%) were graded as poor. Altogether, nine of the fair or poor cases (50%) were diagnosed with chondromalacia of the patella. Our results, after performing autologous periosteal transplantation in patients with full-thickness cartilage defects of the patella and disabling knee pain, are good if CPM is used postoperatively. The clinical results using active motion postoperatively are not acceptable, especially not in patients with chondromalacia of the patella.

  10. Contributions of biarticular myogenic components to the limitation of the range of motion after immobilization of rat knee joint

    Science.gov (United States)

    2014-01-01

    Background Muscle atrophy caused by immobilization in the shortened position is characterized by a decrease in the size or cross-sectional area (CSA) of myofibers and decreased muscle length. Few studies have addressed the relationship between limitation of the range of motion (ROM) and the changes in CSA specifically in biarticular muscles after atrophy because of immobilization. We aimed to determine the contribution of 2 distinct muscle groups, the biarticular muscles of the post thigh (PT) and those of the post leg (PL), to the limitation of ROM as well as changes in the myofiber CSAs after joint immobilization surgery. Methods Male Wistar rats (n = 40) were randomly divided into experimental and control groups. In the experimental group, the left knee was surgically immobilized by external fixation for 1, 2, 4, 8, or 16 weeks (n = 5 each) and sham surgery was performed on the right knee. The rats in the control groups (n = 3 per time point) did not undergo surgery. After the indicated immobilization periods, myotomy of the PT or PL biarticular muscles was performed and the ROM was measured. The hamstrings and gastrocnemius muscles from the animals operated for 1 or 16 weeks were subjected to morphological analysis. Results In immobilized knees, the relative contribution of the PT biarticular myogenic components to the total restriction reached 80% throughout the first 4 weeks and decreased thereafter. The relative contribution of the PL biarticular myogenic components remained contracture did not significantly change during the experimental period. However, the ratio of hamstrings CSAs to the sham side was larger than the ratio of medial gastrocnemius CSAs to the sham side after complete atrophy because of immobilization. PMID:25001065

  11. Prosthesis alignment affects axial rotation motion after total knee replacement: a prospective in vivo study combining computed tomography and fluoroscopic evaluations

    Directory of Open Access Journals (Sweden)

    Harman Melinda K

    2012-10-01

    Full Text Available Abstract Background Clinical consequences of alignment errors in total knee replacement (TKR have led to the rigorous evaluation of surgical alignment techniques. Rotational alignment in the transverse plane has proven particularly problematic, with errors due to component malalignment relative to bone anatomic landmarks and an overall mismatch between the femoral and tibial components’ relative positions. Ranges of nominal rotational alignment are not well defined, especially for the tibial component and for relative rotational mismatch, and some studies advocate the use of mobile-bearing TKR to accommodate the resulting small rotation errors. However, the relationships between prosthesis rotational alignment and mobile-bearing polyethylene insert motion are poorly understood. This prospective, in vivo study evaluates whether component malalignment and mismatch affect axial rotation motions during passive knee flexion after TKR. Methods Eighty patients were implanted with mobile-bearing TKR. Rotational alignment of the femoral and tibial components was measured from postoperative CT scans. All TKR were categorized into nominal or outlier groups based on defined norms for surgical rotational alignment relative to bone anatomic landmarks and relative rotational mismatch between the femoral and tibial components. Axial rotation motion of the femoral, tibial and polyethylene bearing components was measured from fluoroscopic images acquired during passive knee flexion. Results Axial rotation motion was generally accomplished in two phases, dominated by polyethylene bearing rotation on the tibial component in early to mid-flexion and then femoral component rotation on the polyethylene articular surface in later flexion. Opposite rotations of the femur-bearing and bearing-baseplate articulations were evident at flexion greater than 80°. Knees with outlier alignment had lower magnitudes of axial rotation and distinct transitions from external to

  12. Muscle strength, physical performance and physical activity as predictors of future knee replacement

    DEFF Research Database (Denmark)

    Skou, Søren T; Wise, Barton L; Lewis, Cora E;

    2016-01-01

    OBJECTIVE: To investigate associations between lower levels of muscle strength, physical performance and physical activity and the risk of knee replacement (KR) in older adults with frequent knee pain. METHOD: Participants from the Multicenter Osteoarthritis Study (MOST) with knee pain on most...... of the past 30 days at baseline were included (n=1,257; mean (SD) age of 62.2 (8.2)). We examined the association between 1) baseline peak isokinetic knee extensor strength, (60°/sec, maximum out of 4 trials), 2) best time to stand in timed chair stand (2 trials of 5 repetitions), and 3) baseline Physical......% CI) 0.99 (0.99 to 1.00)), but not when adjusting for Kellgren-Lawrence grade (p = 0.97). CONCLUSION: Lower levels of chair stand performance and self-reported physical activity are not associated with an increased risk of KR within 7 years, while the independent effect of knee extensor strength...

  13. A magnetorheological fluid-based controllable active knee brace

    Science.gov (United States)

    Ahmadkhanlou, Farzad; Zite, Jamaal L.; Washington, Gregory N.

    2007-04-01

    High customization costs and reduction of natural mobility put current rehabilitative knee braces at a disadvantage. A resolution to this problem is to integrate a Magnetorheological (MR) fluid-based joint into the system. A MR joint will allow patients to apply and control a resistive torque to knee flexion and extension. The resistance torque can also be continuously adjusted as a function of extension angle and patient strength (or as a function of time), which is currently impossible with state of the art rehabilitative knee braces. A novel MR fluid-based controllable knee brace is designed and prototyped in this research. The device exhibits large resistive torque in the on-state and low resistance in the offstate. The controllable variable stiffness, compactness, and portability of the system make it a proper alternative to current rehabilitative knee braces.

  14. A Study on the Differences of Quadriceps Femoris Activities by Knee Alignment during Isometric Contraction.

    Science.gov (United States)

    Park, Seol; Ko, Yu-Min; Jang, Gwon-Uk; Hwang, Yoon-Tae; Park, Ji-Won

    2014-11-01

    [Purpose] This study attempted to identify how genu varum or valgum affects the electromyographic activities of the vastus medialis, vastus lateralis, and rectus femoris during knee isometric contraction. [Subjects] Fifty-two healthy young adults were enrolled in this study. They were enrolled and classified into three groups by knee alignment conditions: the genu varum, genu valgum, and control groups. [Methods] The electromyographic activity ratio of the vastus medialis to the vastus lateralis and rectus femoris were calculated using the percentage of maximum voluntary contraction. The participants contracted their quadriceps during isometric contraction at 30 and 60° of knee flexion. [Results] The genu varum group had more activity in the vastus medialis than in the vastus lateralis and rectus femoris, whereas the genu valgum group had more activity in the vastus lateralis and rectus femoris than in the vastus medialis. There was a significant difference in the muscle activity ratio between the vastus medialis and vastus lateralis by angle of knee flexion degree only in the genu valgum. There were no significant differences in any of the three groups in terms of the muscle activity ratio of the vastus medialis to the rectus femoris by angle of knee flexion. [Conclusion] The quadriceps femoris was used for different strategies according to knee alignment during isometric contraction at 30 and 60°. This study suggests that rehabilitation training programs used to strengthen the quadriceps should consider the knee alignment conditions of the target subjects.

  15. BLADE technology to eliminate MRI of knee joint motion artifacts%BLADE技术在消除MRI膝关节运动伪影方面的应用

    Institute of Scientific and Technical Information of China (English)

    顾勇坚; 郑建刚; 许建兴; 刘良卿; 周鸿雁

    2012-01-01

    目的 探讨刀锋伪影校正(BLADE)技术在消除MRI膝关节运动伪影的应用价值.方法 32例膝关节常规MRI检查中出现运动伪影的患者,改用BLADE技术扫描(PD矢状位、T2矢状位),以是否能够清晰显示膝关节结构、半月板及交叉韧带为标准,与常规序列对比评估BLADE技术对消除膝关节运动伪影的应用价值.结果 膝关节常规序列扫描中出现运动伪影,改用BLADE技术扫描后,图像运动伪影消除,图像质量明显改善.结论 BLADE技术对膝关节常规扫描中产生的运动伪影有明显的校正作用,可广泛用于产生运动伪影的膝关节MRI检查中.%Objective To investigate the value of the blade artifact correction (BLADE) technology in eliminating the knee joint motion artifacts in the MR examination. Methods 32 patients with motion artifacts in the knee conventional MR examination were added standard BLADE technology to scan (PD sagittal, T2 sagittal), compared with conventional sequence, assessed the value of the BLADE technology to eliminate motion artifacts of the knee with a standard of clear display of the structure of the knee, meniscus and cruciate ligament. Results Switching to BLADE technology scanning, the image motion artifacts produced in the knee conventional examination was disappeared, and the image quality was improved significantly. Conclusion BLADE technology with significant role in correction the motion artifacts produced in the conventional scanning of the knee can be widely used to produce motion artifacts knee MRI examination.

  16. Displacement of the medial meniscus within the passive motion characteristics of the human knee joint: an RSA study in human cadaver knees.

    NARCIS (Netherlands)

    Tienen, T.G. van; Buma, P.; Scholten, J.G.; Kampen, A. van; Veth, R.P.H.; Verdonschot, N.J.J.

    2005-01-01

    The objective of this study was to validate an in vitro human cadaver knee-joint model for the evaluation of the meniscal movement during knee-joint flexion. The question was whether our model showed comparable meniscal displacements to those found in earlier meniscal movement studies in vivo. Furth

  17. Displacement of the medial meniscus within the passive motion characteristics of the human knee joint: an RSA study in human cadaver knees.

    NARCIS (Netherlands)

    Tienen, T.G. van; Buma, P.; Scholten, J.G.; Kampen, A. van; Veth, R.P.H.; Verdonschot, N.J.J.

    2005-01-01

    The objective of this study was to validate an in vitro human cadaver knee-joint model for the evaluation of the meniscal movement during knee-joint flexion. The question was whether our model showed comparable meniscal displacements to those found in earlier meniscal movement studies in vivo. Furth

  18. A magnetorheological fluid based orthopedic active knee brace

    Science.gov (United States)

    Zite, Jamaal L.; Ahmadkhanlou, Farzad; Neelakantan, Vijay A.; Washington, Gregory N.

    2006-03-01

    The disadvantage of current knee braces ranges from high cost for customization to a loss in physical mobility and limited rehabilitative value. One approach to solving this problem is to use a Magnetorheological (MR) device to make the knee brace have a controllable resistance. Our design solution is to replace the manufacturer's joint with an rotary MR fluid based shear damper. The device is designed based on a maximum yield stress, a corresponding magnetic field, a torque and the MR fluid viscosity. The analytical and experimental results show the advantages and the feasibility of using the proposed MR based controllable knee braces.

  19. Testosterone Reduces Knee Passive Range of Motion and Expression of Relaxin Receptor Isoforms via 5α-Dihydrotestosterone and Androgen Receptor Binding

    Directory of Open Access Journals (Sweden)

    Firouzeh Dehghan

    2014-03-01

    Full Text Available Ovarian steroids such as estrogen and progesterone have been reported to influence knee laxity. The effect of testosterone, however, remains unknown. This study investigated the effect of testosterone on the knee range of motion (ROM and the molecular mechanisms that might involve changes in the expression of relaxin receptor isoforms, Rxfp1 and Rxfp2 in the patella tendon and lateral collateral ligament of the female rat knee. Ovariectomized adult female Wistar rats received three days treatment with peanut oil (control, testosterone (125 and 250 μg/kg and testosterone (125 and 250 μg/kg plus flutamide, an androgen receptor blocker or finasteride, a 5α-reductase inhibitor. Duplicate groups received similar treatment however in the presence of relaxin (25 ng/kg. A day after the last drug injection, knee passive ROM was measured by using a digital miniature goniometer. Both tendon and ligament were harvested and then analysed for protein and mRNA expression for Rxfp1 and Rxfp2 respectively. Knee passive ROM, Rxfp1 and Rxfp2 expression were significantly reduced following treatment with testosterone. Flutamide or finasteride administration antagonized the testosterone effect. Concomitant administration of testosterone and relaxin did not result in a significant change in knee ROM as compared to testosterone only treatment; however this was significantly increased following flutamide or finasteride addition. Testosterone effect on knee passive ROM is likely mediated via dihydro-testosterone (DHT, and involves downregulation of Rxfp1 and Rxfp2 expression, which may provide the mechanism underlying testosterone-induced decrease in female knee laxity.

  20. RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY: A RANDOMIZED CROSS-OVER STUDY

    Science.gov (United States)

    Wilquin, Lousia; Jakobsen, Thomas Linding; Holsgaard-Larsen, Anders; Bandholm, Thomas

    2017-01-01

    Background Inhibition of the quadriceps muscle and reduced knee-extension strength is common shortly following total knee arthroplasty (weeks to months), due to reduced voluntary activation of the quadriceps muscle. In healthy subjects, strength training with heavy loads is known to increase agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions. Purpose The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions. Study Design A randomized cross-over study. Methods Twenty-four patients (age 66.5) 4-8 weeks post total knee arthroplasty randomly performed one set of five rapid, and one set of five slow knee-extensions with the operated leg, using a load of their 10 repetition maximum, while surface electromyography recordings were obtained from the vastus medialis and lateralis of the quadriceps muscle. Results Data from 23 of the 24 included patients were analyzed. Muscle activity was significantly higher during rapid knee-extensions (120.2% [10th-90th percentile: 98.3-149.1]) compared to slow knee-extensions (106.0% [88.8-140.8]) for the vastus lateralis (pknee-extensions were performed at a median angular velocity of 19.7 degrees/sec (13.7-24.4) and 51.4 degrees/sec (28.9-63.1), respectively Conclusion Four to eight weeks after their total knee arthroplasty, the patients in the present study were able to conduct rapid knee-extensions according to the experimental protocol with an approximately doubled angular velocity compared to slow knee-extensions. This was associated with increased muscle activity in the vastus lateralis when compared to slow knee-extensions, but not in the vastus medialis. Whether

  1. An ex vivo continuous passive motion model in a porcine knee for assessing primary stability of cell-free collagen gel plugs

    Directory of Open Access Journals (Sweden)

    El-Zayat Bilal

    2010-12-01

    Full Text Available Abstract Background Primary stability of cartilage repair constructs is of the utmost importance in the clinical setting but few continuous passive motion (CPM models are available. Our study aimed to establish a novel ex vivo CPM animal model and to evaluate the required motion cycles for testing the mechanical properties of a new cell-free collagen type I gel plug (CaReS®-1S. Methods A novel ex vivo CPM device was developed. Full-thickness cartilage defects (11 mm diameter by 6 mm deep were created on the medial femoral condyle of porcine knee specimens. CaReS®-1S was implanted in 16 animals and each knee underwent continuous passive motion. After 0, 2000, 4000, 6000, and 8000 motions, standardized digital pictures of the grafts were taken, focusing on the worn surfaces. The percentage of worn surface on the total CaReS®-1S surface was evaluated with image processing software. Results Significant differences in the worn surface were recorded between 0 and 2000 motion cycles (p ®-1S with an empty defect site was recorded. Conclusion The ex vivo CPM animal model is appropriate in investigating CaReS®-1S durability under continuous passive motion. 2000 motion cycles appear adequate to assess the primary stability of type I collagen gels used to repair focal chondral defects.

  2. Water on the Knee

    Science.gov (United States)

    ... your knee joint. Some people call this condition "water on the knee." A swollen knee may be ... Choose low-impact exercise. Certain activities, such as water aerobics and swimming, don't place continuous weight- ...

  3. Comparison of the Cervical Extension Angle and the Upper Trapezius Muscle Activity between Overhead Work and Below-knee Work.

    Science.gov (United States)

    Yoo, Won-Gyu

    2013-10-01

    [Purpose] The purpose of this study was to compare the cervical extension angle and the upper trapezius muscle activity between overhead work and below-knee work. [Subjects] Twelve males aged 20-30 years, were recruited. [Methods] We measured the cervical extension angle and upper trapezius muscle activity during overhead work and below-knee work. [Results] The results show that the cervical extension angle and upper trapezius muscle activity were significantly increased during below-knee work compared to overhead work. [Conclusion] Below-knee work is more likely to cause neck and shoulder pain than overhead work. Therefore, future studies should investigate below-knee work in detail.

  4. Position controlled Knee Rehabilitation Orthotic Device for Patients after Total Knee Replacement Arthroplasty

    Science.gov (United States)

    Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

    2016-11-01

    Knee rehabilitation after total knee replacement arthroplasty is essential for patients during their post-surgery recovery period. This study is about designing one degree of freedom knee rehabilitation equipment to assist patients for their post-surgery exercise. The equipment is designed to be used in sitting position with flexion/extension of knee in sagittal plane. The range of knee joint motion is starting from 0 to 90 degrees angle for knee rehabilitation motion. The feature includes adjustable link for different human proportions and the torque feedback control at knee joint during rehabilitation and the control of flexion/extension speed. The motion of the rehabilitation equipment was set to move at low speed (18 degrees/sec) for knee rehabilitation. The rehabilitation link without additional load took one second to move from vertical hanging up to 90° while the corresponding torque increased from 0 Nm to 2 Nm at 90°. When extra load is added, the link took 1.5 seconds to move to 90° The torque is then increased from 0 Nm to 4 Nm. After a period of time, the speed of the motion can be varied. User can adjust the motion to 40 degrees/sec during recovery activity of the knee and users can increase the level of exercise or motion up to 60 degrees/sec to strengthen the muscles during throughout their rehabilitation program depends on each patient. Torque control is included to prevent injury. Patients can use the equipment for home exercise to help reduce the number of hospital visit while the patients can receive an appropriate therapy for their knee recovery program.

  5. Effect of generalized joint hypermobility on knee function and muscle activation in children and adults

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Olesen, Annesofie T.; Pedersen, Mogens Theisen

    2013-01-01

    were evaluated in 39 children and 36 adults during isometric knee extension and flexion. Subjects performed isometric maximum contractions, submaximal contractions at 25% maximum voluntary contraction (MVC), and explosive contractions. Results: Agonist activation was reduced, and coactivation ratio...

  6. Effect of a high intensity quadriceps fatigue protocol on knee joint mechanics and muscle activation during gait in young adults.

    Science.gov (United States)

    Murdock, Gillian Hatfield; Hubley-Kozey, Cheryl L

    2012-02-01

    The purpose of this study was to determine the effect of impaired quadriceps function on knee joint biomechanics and neuromuscular function during gait. Surface electromyograms, three-dimensional motion and ground reaction forces were collected during gait before and after 20 healthy adults completed a high intensity quadriceps fatigue protocol. Pattern recognition techniques were utilized to examine changes in amplitude and temporal characteristics of all gait variables. The fatigue protocol resulted in decreased knee extensor torque generation and quadriceps median power frequencies for 18 of 20 participants (p gait data from these 18 participants was analyzed. The knee external rotation angle increased (p knee motion and loading characteristics were altered following a high intensity fatigue protocol in a manner that may place the knee joint at greater risk for joint pathology and injury.

  7. Exercise and physical activity in older adults with knee pain: a mixed methods study.

    Science.gov (United States)

    Holden, Melanie A; Nicholls, Elaine E; Young, Julie; Hay, Elaine M; Foster, Nadine E

    2015-03-01

    To describe and explore current exercise and physical activity behaviour in older adults with knee pain in the UK. A survey was mailed to 2234 adults ≥50 years of age registered with one general practice within the UK to determine the presence and severity of knee pain and levels of physical activity. Semi-structured interviews were conducted with 22 questionnaire responders with knee pain. The questionnaire response rate was 59% (n = 1276) and 611 respondents reported knee pain. Only ∼40% of individuals with knee pain were sufficiently active to meet physical activity recommendations. Interviews revealed individual differences in the type and setting of physical activity completed and some self-monitored their symptoms in response to physical activity in order to guide future behaviour. Innovative interventions that can be adapted to suit individual needs and preferences are required to help older adults with knee pain become more physically active. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology.

  8. [CPM--Continuous Passive Motion: treatment of injured or operated knee-joints using passive movement. A meta-analysis of current literature].

    Science.gov (United States)

    Kirschner, P

    2004-04-01

    There is still a controversial discussion in literature about the use of motor driven splints in knee surgery--as the principle of continuous passive motion, CPM. For this reason it seemed useful for an evaluation to look through the papers which were published since 1990. It was obvious, that negative results were published often before this year, but this papers are still quoted standard works. In medical data bases subito-doc.de, medscape.com, medica.de and zbmed.de 230 papers were found by search CPM, continuous passive motion and arthromot. Coincidentally there was a search for authors who were already quoted in other papers. 36 papers concerning CPM after knee surgery were utilized. The role of CPM regarding the range of motion, swelling, duration of hospital stay, use of analgesics, costs, postoperative manipulations, wound healing and thrombo embolic complications was evaluated. Although the results of this partial retrospective, partial prospective, sometimes randomized or double blinded studies are in contradiction, there can only be found a trend to better results. New clinical studies for evidence based guidelines in the handling of continuous passive motion after knee surgery are necessary.

  9. Does the Q − H index show a stronger relationship than the H:Q ratio in regard to knee pain during daily activities in patients with knee osteoarthritis?

    Science.gov (United States)

    Fujita, Remi; Matsui, Yasumoto; Harada, Atsushi; Takemura, Marie; Kondo, Izumi; Nemoto, Tetsuya; Sakai, Tadahiro; Hiraiwa, Hideki; Ota, Susumu

    2016-01-01

    [Purpose] The purpose of this study was to elucidate the relationship between knee muscle strength and knee pain in activities of daily living, based on consideration of the difference between extension and flexion strength (Q − H) and the hamstring:quadriceps (H:Q) ratio in patients with knee osteoarthritis. [Subjects and Methods] The participants were 78 females with knee osteoarthritis, and a total of 133 knees that had not been treated surgically were the targets of this research. The legs were divided according to dominance. Isometric knee extension and flexion muscle strength and knee pain during activities of daily living were measured. The H:Q ratio (flexion/extension muscle strength) and the difference between extension and flexion strength, (extension muscle strength/weight) minus (flexion muscle strength/weight), that is, Q − H, were calculated. The correlation between these indices and the knee pain score during activities of daily living was investigated. [Results] Greater knee pain during activities of daily living was related to lower knee extension muscle strength and Q − H in both the dominant and nondominant legs. Knee flexion muscle strength and the H:Q ratio were not significantly correlated with knee pain during any activities of daily living. [Conclusion] Knee extension muscle strength and Q − H were found to be significantly correlated with knee pain during activities of daily living, whereas the H:Q ratio was not. PMID:28174444

  10. Physiological alterations of maximal voluntary quadriceps activation by changes of knee joint angle.

    Science.gov (United States)

    Becker, R; Awiszus, F

    2001-05-01

    The purpose of this study was to investigate the influence of different angles of the knee joint on voluntary activation of the quadriceps muscle, estimating the ability of a subject to activate a muscle maximally by means of voluntary contraction. Isometric torque measurement was performed on 6 healthy subjects in 5 degrees intervals between 30 degrees and 90 degrees of knee joint flexion. Superimposed twitches at maximal voluntary contraction (MVC) and at a level of 60% and 40% of the MVC were applied and the voluntary activation estimated. At between 30 degrees and 75 degrees of knee flexion, the maximal extension torque increased at an average rate of 2.67 +/- 0.6 Nm/degree, followed by a decline with further flexion. However, throughout the joint-angle range tested, voluntary activation increased on average by 0.37%/degree with a maximum at 90 degrees of flexion. Due to the influence of joint position it is not possible to generalize results obtained at the knee joint angle of 90 degrees of flexion, which is usually used for the quadriceps twitch-interpolation technique. Consequently, it is useful to investigate voluntary activation deficits in knee joint disorders at a range of knee joint angles that includes, in particular, the more extended joint angles used frequently during daily activity.

  11. Comparison of a Vibrating Foam Roller and a Non-vibrating Foam Roller Intervention on Knee Range of Motion and Pressure Pain Threshold: A Randomized Controlled Trial.

    Science.gov (United States)

    Cheatham, Scott W; Stull, Kyle R; Kolber, Morey J

    2017-08-08

    The use of foam rollers to provide soft-tissue massage has become a common intervention among health and fitness professionals. Recently, manufacturers have merged the science of vibration therapy and foam rolling with the development of vibrating foam rollers. To date, no peer reviewed investigations have been published on this technology. The purpose of this study was to compare the effects of a vibrating roller and non-vibrating roller intervention on prone knee flexion passive range of motion (ROM) and pressure pain thresholds (PPT) of the quadriceps musculature. Forty-five recreationally active adults were randomly allocated to one of three groups: vibrating roller, non-vibrating roller, and control. Each roll intervention lasted a total of 2 minutes. The control group did not roll. Dependent variables included prone knee flexion ROM and PPT measures. Statistical analysis included parametric and non-parametric tests to measure changes among groups. The vibrating roller demonstrated the greatest increase in PPT (180kPa, pvibrating roller (112kPa, pcontrol (61kPa, pvibrating roller demonstrated the greatest increase in ROM (7 degrees, pvibrating roller (5 degrees, pcontrol (2 degrees, pvibrating and non-vibrating roller (p=.03) and vibrating roller and control (pvibrating roller and control (pvibrating and non-vibrating roller (p=.31). A significant difference was found between the vibrating roller and control group (pvibrating roller and control (pvibrating roller may increase an individual's tolerance to pain greater than a non-vibrating roller. This investigation should be considered exploratory and a starting point for future research on this technology.

  12. Video shot boundary detection using motion activity descriptor

    CERN Document Server

    Amel, Abdelati Malek; Abdellatif, Mtibaa

    2010-01-01

    This paper focus on the study of the motion activity descriptor for shot boundary detection in video sequences. We interest in the validation of this descriptor in the aim of its real time implementation with reasonable high performances in shot boundary detection. The motion activity information is extracted in uncompressed domain based on adaptive rood pattern search (ARPS) algorithm. In this context, the motion activity descriptor was applied for different video sequence.

  13. Design, construction and evaluation of an electromechanical stance-control knee-ankle-foot orthosis.

    Science.gov (United States)

    Yakimovich, Terris; Kofman, Jonathan; Lemaire, Edward

    2005-01-01

    A new electromechanical Stance-Control Knee-Ankle-Foot Orthosis (SCKAFO) was designed to provide improved gait for people with knee-extensor weakness. This SCKAFO inhibits knee flexion at any knee angle while allowing knee extension during weight bearing. During swing or other non-weight bearing activities, the SCKAFO allows free knee motion. A prototype joint was mechanically tested to determine the moment at failure, loading behaviour, and device safety. Quantitative kinematic gait analysis of three able-bodied subjects and three knee-ankle-foot-orthosis (KAFO) users showed that the new SCKAFO had a desired minimal effect on able-bodied walking gait. The SCKAFO permitted a mean increase in sagittal knee motion (488%) during swing for the three KAFO users and a reduction in pelvic obliquity and hip abduction angle abnormalities during terminal stance and swing for two KAFO users.

  14. Effects of ankle joint mobilization with movement and weight-bearing exercise on knee strength, ankle range of motion, and gait velocity in patients with stroke: a pilot study

    National Research Council Canada - National Science Library

    An, Chang-Man; Won, Jong-Im

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of ankle joint mobilization with movement on knee strength, ankle range of motion, and gait velocity, compared with weight-bearing exercise in stroke patients...

  15. Astym® Therapy for the Management of Recalcitrant Knee Joint Stiffness after Total Knee Arthroplasty.

    Science.gov (United States)

    Bhave, Anil; Corcoran, James; Cherian, Jeffery J; Mont, Michael A

    2016-01-01

    Knee stiffness is a common complication after total knee arthroplasty (TKA). Despite studies published on the surgical management of reduced range of motion (ROM) after TKA, there is limited evidence on the nonoperative management of joint and soft tissue imbalances possibly contributing to reduced knee ROM. This report assesses changes in ROM, pain, function, and patellar tendon length after Astym® joint mobilization use. A 38-year-old male professional skier had a right TKA 3 months before presentation with 2 subsequent manipulations under anesthesia secondary to persistent knee stiffness. He had patellar baja on radiograph, a reduced arc of ROM, reduced patellar mobility and muscular extensibility, and pain to palpation along the patellar tendon. He had 12 visits of physical therapy with the use of Astym®, patellar mobilization, and tibio-femoral mobilizations with movement. The patient also used a customized knee device at home for prolonged knee extension stretching. The patient was treated for 12 visits, along with home use of customized bracing for knee extension. Significant improvements were seen in pain, function, and ROM. He returned to work full-time, ambulated prolonged distances, and negotiated stairs pain-free. He also demonstrated resolution of patellar baja radiographically. Conservative management of recalcitrant knee joint stiffness after primary TKA can be effective in restoring knee mobility and reducing pain and activity limitation. A multimodal approach using Astym® treatment, customized knee bracing, and targeted joint mobilization can be effective in resolving knee joint stiffness.

  16. Functional Performance Among Active Female Soccer Players After Unilateral Primary Anterior Cruciate Ligament Reconstruction Compared With Knee-Healthy Controls.

    Science.gov (United States)

    Fältström, Anne; Hägglund, Martin; Kvist, Joanna

    2017-02-01

    Good functional performance with limb symmetry is believed to be important to minimize the risk of injury after a return to pivoting and contact sports after anterior cruciate ligament reconstruction (ACLR). This study aimed to investigate any side-to-side limb differences in functional performance and movement asymmetries in female soccer players with a primary unilateral anterior cruciate ligament (ACL)-reconstructed knee and to compare these players with knee-healthy controls from the same soccer teams. Cross-sectional study; Level of evidence, 3. This study included 77 active female soccer players at a median of 18 months after ACLR (interquartile range [IQR], 14.5 months; range, 7-39 months) and 77 knee-healthy female soccer players. The mean age was 20.1 ± 2.3 years for players with an ACL-reconstructed knee and 19.5 ± 2.2 years for controls. We used a battery of tests to assess postural control (Star Excursion Balance Test) and hop performance (1-legged hop for distance, 5-jump test, and side hop). Movement asymmetries in the lower limbs and trunk were assessed with the drop vertical jump and the tuck jump using 2-dimensional analyses. The reconstructed and uninvolved limbs did not differ in any of the tests. In the 5-jump test, players with an ACL-reconstructed knee performed worse than controls (mean 8.75 ± 1.05 m vs 9.09 ± 0.89 m; P = .034). On the drop vertical jump test, the ACL-reconstructed limb had significantly less knee valgus motion in the frontal plane (median 0.028 m [IQR, 0.049 m] vs 0.045 m [IQR, 0.043 m]; P = .004) and a lower probability of a high knee abduction moment (pKAM) (median 69.2% [IQR, 44.4%] vs 79.8% [IQR, 44.8%]; P = .043) compared with the control players' matched limb (for leg dominance). Results showed that 9% to 49% of players in both groups performed outside recommended guidelines on the different tests. Only 14 players with an ACL-reconstructed knee (18%) and 15 controls (19%) had results that met the recommended

  17. Role of flexors in knee stability.

    Science.gov (United States)

    Chen, C Y; Jiang, C C; Jan, M H; Lai, J S

    1995-05-01

    The muscle strength of knee extensors is commonly used as an indicator of a patient's functional recovery following reconstruction of the anterior cruciate ligament (ACL). The knee flexors are dynamic stabilizers that prevent tibial anterior displacement and may reinforce the function of the ACL. The purpose of this study was to examine the relationship of knee flexor performance assessed by isokinetic dynamometer and clinical evaluations including KT-1000 stability tests, shuttle run tests, thigh and calf circumference and range of motion of the knee joint. Ten patients who received ACL reconstruction over a 3- to 5-year period were included in this study, as were 15 normal controls who were tested for comparison. There was no significant difference in the time taken for the shuttle run test between normal controls and patients who underwent ACL, but there was a positive correlation between the shuttle run test and laxity of the knee joint. The knee laxity of ACL patients was significantly greater than that of the normal controls under passive anterior force. However, no significant difference was seen in the stability test under active contraction of the knee extensors. In addition, a positive correlation was seen between the KT-1000 knee ligament arthrometry test results and both torque acceleration energy and the average power of the flexors. These results suggest that physical therapy for patients following ACL reconstruction should emphasize the explosiveness of knee flexors to help strengthen the dynamic stability of the knee joint and motor performance.

  18. A pilot study of the effect of Kinesiology tape on knee proprioception after physical activity in healthy women.

    Science.gov (United States)

    Hosp, Simona; Bottoni, Giuliamarta; Heinrich, Dieter; Kofler, Philipp; Hasler, Michael; Nachbauer, Werner

    2015-11-01

    Kinesiology tape has gained significant popularity in recent years and is widely used as an adjunct for treatment and prevention of musculoskeletal injuries. However, evidence regarding its influence on knee proprioception is scarce. The purpose of this study was to evaluate the effect of Kinesiology tape on knee proprioception after physical activity in healthy women. It was hypothesized that Kinesiology tape enhances knee proprioception. Longitudinal analysis, pretest-posttest design. Twelve young women with healthy knees were tested for knee proprioception without the use of Kinesiology tape and wearing Kinesiology tape at the knee. The joint position sense was measured at the start and after a 30-min uphill walking protocol on a treadmill. Outcome was the knee angle deviation. No significant difference of proprioceptive performance between the application with Kinesiology tape and without Kinesiology tape was found after uphill walking (p > 0.05). However, when the participants' results for knee angle deviation were graded into good ( 6.1°), Kinesiology tape significantly enhanced those with poor proprioceptive ability after uphill walking, compared to the untaped knee (p = 0.002). This study has shown that the application of Kinesiology tape did not improve knee proprioception in a group of healthy young women. However, it also has demonstrated that Kinesiology tape provided significant proprioceptive enhancement at the knee joint after uphill walking in healthy women with poor proprioceptive ability. This may support its use in sports medicine for preventing knee injuries. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  19. Ten-year results of physical activity after high tibial osteotomy in patients with knee osteoarthritis.

    Science.gov (United States)

    W-Dahl, Annette; Toksvig-Larsen, Sören; Lindstrand, Anders

    2017-03-01

    The purpose was to describe physical activity with respect to leisure and working activity in patients operated on by high tibial osteotomy using the hemicallotasis technique for knee osteoarthritis (OA), preoperatively and 10 years postoperatively. Seventy-nine patients, median age 55 (range 35-66), operated on by high tibial osteotomy using the hemicallotasis technique for knee OA 2001-2003 were included. Questionnaires for evaluation of physical and working activity, satisfaction as well as the Knee injury and Osteoarthritis Outcome Score (KOOS) were filled in preoperatively and 2 and 10 years postoperatively. Conversion to knee arthroplasty was obtained through the Swedish Knee Arthroplasty Register. Changes between two postoperative measurements were assessed by Wilcoxon's rank test. Twenty-five patients were converted to a total knee arthroplasty, and nine patients were lost to follow-up during the 10 years, resulted in 45 patients available for follow-up. Preoperatively, 33/45 patients were physically active mainly in heavy yard/household work, and 43/45 patients were working active. Ten years after the HCO, 23/45 patients were still active with golf, dancing, hiking, etc., and 23/45 were retired. At 10 years postoperatively compared to 2 years postoperatively, the patients experienced more problems with pain (89 compared to 69, p = <0.0001). Of 45 patients, 36 were satisfied with the high tibial osteotomy surgery in general 10 years postoperatively, while 13/45 were satisfied with their sport and recreational function. The 10-year results indicate that high tibial osteotomy using the hemicallotasis technique for knee OA is an option for selected patients that improves the level of physical activity, with mild deterioration over time, and gives the majority of the patients the possibility to be working active until retirement. Level IV.

  20. Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty: improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis.

    Science.gov (United States)

    Everts, Peter A M; Devilee, Roger J J; Oosterbos, Cornelis J M; Mahoney, Christine Brown; Schattenkerk, Maarten Eeftinck; Knape, Johannes T A; van Zundert, André

    2007-07-01

    In this study we describe the potential role of autologous platelet gel and fibrin sealant in unilateral total knee arthroplasty to improve the postoperative range of motion and to reduce the incidence of arthrofibrosis. Total knee arthroplasty is often associated with a considerable amount of post-operative blood loss. Persistent limited motion directly after surgery may ultimately result in arthrofibrosis. To counteract these effects we investigated whether the use of autologous derived platelet gel and fibrin sealant would reduce postoperative blood loss, decrease the impaired range of motion and the incidence of arthrofibrosis. All patients were consecutively operated and assigned to the study or control groups. Study group patients (n = 85) were treated with the application of autologous platelet gel and fibrin sealant at the end of surgery. Eighty patients were operated without the use of platelet gel and fibrin sealant, and served as the control group. The postoperative hemoglobin decrease, range of motion and length of hospitalization were recorded. During a 5-month postoperative period patients were followed to observe the incidence of arthrofibrosis. In patients in the treatment group the hemoglobin concentration in blood decreased significantly less when compared to the control group. They also showed a superior postoperative range of motion when compared to those of the control group (P arthrofibrosis and subsequent forced manipulation was significantly less (P arthrofibrosis.

  1. Comparison of the Cervical Extension Angle and the Upper Trapezius Muscle Activity between Overhead Work and Below-knee Work

    OpenAIRE

    Yoo, Won-gyu

    2013-01-01

    [Purpose] The purpose of this study was to compare the cervical extension angle and the upper trapezius muscle activity between overhead work and below-knee work. [Subjects] Twelve males aged 20–30 years, were recruited. [Methods] We measured the cervical extension angle and upper trapezius muscle activity during overhead work and below-knee work. [Results] The results show that the cervical extension angle and upper trapezius muscle activity were significantly increased during below-knee wor...

  2. Instabilities, motion and deformation of active fluid droplets

    Science.gov (United States)

    Whitfield, Carl A.; Hawkins, Rhoda J.

    2016-12-01

    We consider two minimal models of active fluid droplets that exhibit complex dynamics including steady motion, deformation, rotation and oscillating motion. First we consider a droplet with a concentration of active contractile matter adsorbed to its boundary. We analytically predict activity driven instabilities in the concentration profile, and compare them to the dynamics we find from simulations. Secondly, we consider a droplet of active polar fluid of constant concentration. In this system we predict, motion and deformation of the droplets in certain activity ranges due to instabilities in the polarisation field. Both these systems show spontaneous transitions to motility and deformation which resemble dynamics of the cell cytoskeleton in animal cells.

  3. Design and control of a prosthetic leg for above-knee amputees operated in semi-active and active modes

    Science.gov (United States)

    Park, Jinhyuk; Yoon, Gun-Ha; Kang, Je-Won; Choi, Seung-Bok

    2016-08-01

    This paper proposes a new prosthesis operated in two different modes; the semi-active and active modes. The semi-active mode is achieved from a flow mode magneto-rheological (MR) damper, while the active mode is obtained from an electronically commutated (EC) motor. The knee joint part of the above knee prosthesis is equipped with the MR damper and EC motor. The MR damper generates reaction force by controlling the field-dependent yield stress of the MR fluid, while the EC motor actively controls the knee joint angle during gait cycle. In this work, the MR damper is designed as a two-end type flow mode mechanism without air chamber for compact size. On other hand, in order to predict desired knee joint angle to be controlled by EC motor, a polynomial prediction function using a statistical method is used. A nonlinear proportional-derivative controller integrated with the computed torque method is then designed and applied to both MR damper and EC motor to control the knee joint angle. It is demonstrated that the desired knee joint angle is well achieved in different walking velocities on the ground ground.

  4. The role of knee joint moments and knee impairments on self-reported knee pain during gait in patients with knee osteoarthritis.

    Science.gov (United States)

    O'Connell, Megan; Farrokhi, Shawn; Fitzgerald, G Kelley

    2016-01-01

    The association between high mechanical knee joint loading during gait with onset and progression of knee osteoarthritis has been extensively studied. However, less attention has been given to risk factors related to increased pain during gait. The purpose of this study was to evaluate knee joint moments and clinical characteristics that may be associated with gait-related knee pain in patients with knee osteoarthritis. Sixty-seven participants with knee osteoarthritis were stratified into three groups of no pain (n=18), mild pain (n=27), or moderate/severe pain (n=22) based on their self-reported symptoms during gait. All participants underwent three-dimensional gait analysis. Quadriceps strength, knee extension range of motion, radiographic knee alignment and self-reported measures of global pain and function were also quantified. The moderate/severe pain group demonstrated worse global pain (Pknee flexion moments during the midstance phase of gait compared to the no pain group (P=0.02). Additionally, the moderate/severe pain group demonstrated greater varus knee malalignment (P=0.009), which was associated with higher weight acceptance peak knee adduction moments (P=0.003) and worse global pain (P=0.003) and physical function scores (P=0.006). Greater knee flexion moment is present during the midstance phase of gait in patients with knee osteoarthritis and moderate/severe pain during gait. Additionally, greater varus malalignment may be a sign of increased global knee joint dysfunction that can influence many activities of daily living beyond gait. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Agonist muscle activity and antagonist muscle co-activity levels during standardized isotonic and isokinetic knee extensions.

    Science.gov (United States)

    Remaud, Anthony; Cornu, Christophe; Guével, Arnaud

    2009-06-01

    This study aimed to analyze the effects of the contraction mode (isotonic vs. isokinetic concentric conditions), the joint angle and the investigated muscle on agonist muscle activity and antagonist muscle co-activity during standardized knee extensions. Twelve healthy adult subjects performed three sets of isotonic knee extensions at 40% of their maximal voluntary isometric torque followed by three sets of maximal isokinetic knee extensions on an isokinetic dynamometer. For each set, the mean angular velocity and the total external amount of work performed were standardized during the two contraction modes. Surface electromyographic activity of vastus lateralis (VL), vastus medialis (VM), rectus femoris (RF), semitendinosus (ST) and biceps femoris (BF) muscles was recorded. Root mean square values were then calculated for each 10 degrees between 85 degrees and 45 degrees of knee extension (0 degrees =horizontal position). Results show that agonist muscle activity and antagonist muscle co-activity levels are significantly greater in isotonic mode compared to isokinetic mode. Quadriceps activity and hamstrings co-activity are significantly lower at knee extended position in both contraction modes. Considering agonist muscles, VL reveals a specific pattern of activity compared to VM and RF; whereas considering hamstring muscles, BF shows a significantly higher co-activity than ST in both contraction modes. Results of this study confirmed our hypothesis that higher quadriceps activity is required during isotonic movements compared to isokinetic movements leading to a higher hamstrings co-activity.

  6. Vitality and the course of limitations in activities in osteoarthritis of the hip or knee

    Directory of Open Access Journals (Sweden)

    van Dijk Gabriella M

    2011-11-01

    Full Text Available Abstract Background The objective of the study was to determine whether psychological and social factors predict the course of limitations in activities in elderly patients with osteoarthritis of the hip or knee, in addition to established somatic and cognitive risk factors. Methods A longitudinal cohort study with a follow-up period of three years was conducted. Patients (N = 237 with hip or knee osteoarthritis were recruited from rehabilitation centers and hospitals. Body functions, comorbidity, cognitive functioning, limitations in activities and psychological and social factors (mental health, vitality, pain coping and perceived social support were assessed. Statistical analyses included univariate and multivariate regression analyses. Psychological and social factors were added to a previously developed model with body functions, comorbidity and cognitive functioning. Results In knee OA, low vitality has a negative impact on the course of self-reported and performance-based limitations in activities, after controlling for somatic and cognitive factors. In hip OA, psychological and social factors had no additional contribution to the model. Conclusion Low vitality predicts deterioration of limitations in activities in elderly patients with osteoarthritis of the knee, in addition to established somatic and cognitive risk factors. However, the contribution of vitality is relatively small. Results of this study are relevant for the group of patients with knee or hip OA, attending hospitals and rehabilitation centers.

  7. Changes in voluntary quadriceps activation predict changes in muscle strength and gait biomechanics following knee joint effusion.

    Science.gov (United States)

    Pietrosimone, Brian; Lepley, Adam S; Murray, Amanda M; Thomas, Abbey C; Bahhur, Nael O; Schwartz, Todd A

    2014-09-01

    It has been hypothesized that arthrogenic muscle inhibition is responsible for altering physical function following knee injury. The association between the onset of arthrogenic muscle inhibition, measured using voluntary quadriceps activation, and changes in muscle strength and gait biomechanics are unknown. Outcomes were collected before and following a 60 ml experimental knee effusion in eighteen healthy participants. Voluntary quadriceps activation was the predictor variable, while the criterion variable included, maximal voluntary isometric strength, peak knee flexion angle, peak internal knee extension moment, and peak vertical ground reaction forces during the first half of stance phase upon stair descent. Percent change scores (Δ) were imputed into linear regression equations to determine associations between predictor and criterion variables. The variance in Δ voluntary quadriceps activation significantly predicted 87% the variance in the Δ strength (R(2)=0.87, Pknee flexion angle, Δ voluntary quadriceps activation predicted an additional 29% (Δ R(2)=0.29, P=0.007) of the variance in the Δ knee extension moment (R(2)=0.54, P=0.003, Δ knee extension moment=-10.79+0.74Δ knee flexion angle+1.64Δ voluntary quadriceps activation) following knee effusion. Immediate quadriceps activation deficits following joint effusion result in immediate alterations in muscle strength, knee extensor moment and vertical ground reaction force during gait. Published by Elsevier Ltd.

  8. Changes in the activity of trunk and hip extensor muscles during bridge exercises with variations in unilateral knee joint angle

    Science.gov (United States)

    Kim, Juseung; Park, Minchul

    2016-01-01

    [Purpose] This study compared abdominal and hip extensor muscle activity during a bridge exercise with various knee joint angles. [Subjects and Methods] Twenty-two healthy male subjects performed a bridge exercise in which the knee joint angle was altered. While subjects performed the bridge exercise, external oblique, internal oblique, gluteus maximus, and semitendinosus muscle activity was measured using electromyography. [Results] The bilateral external and internal oblique muscle activity was significantly higher at 0° knee flexion compared to 120°, 90°, and 60°. The bilateral gluteus maximus muscle activity was significantly different at 0° of knee flexion compared to 120°, 90°, and 60°. The ipsilateral semitendinosus muscle activity was significantly increased at 90° and 60° of knee flexion compared to 120°, and significantly decreased at 0° knee flexion compared with 120°, 90°, and 60°. The contralateral semitendinosus muscle activity was significantly higher at 60° of knee flexion than at 120°, and significantly higher at 0° of knee flexion than at 120°, 90°, and 60°. [Conclusion] Bridge exercises performed with knee flexion less than 90° may be used to train the ipsilateral semitendinosus. Furthermore, bridge exercise performed with one leg may be used to train abdominal and hip extensor muscles. PMID:27799688

  9. Single- vs. double-bundle anterior cruciate ligament reconstruction: a new aspect of knee assessment during activities involving dynamic knee rotation.

    Science.gov (United States)

    Czamara, Andrzej; Królikowska, Aleksandra; Szuba, Łukasz; Widuchowski, Wojciech; Kentel, Maciej

    2015-02-01

    Few studies have compared single-bundle (SB) and double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) in the knee joint during activities involving change-of-direction maneuvers and knee rotation. This study examined whether the type of ACLR contributes to postphysiotherapy outcomes, with an emphasis on knee function assessment during activities involving dynamic knee rotation. Fifteen male patients after SB ACLR and 15 male patients after DB ACLR took part in the same physiotherapy program. Twenty-four weeks after ACLR, both groups underwent anterior laxity measurement, pivot shift tests, range of movement and joint circumference measurements, subjective assessment of pain and stability levels in the knee joint, peak torque measurement of the muscles rotating the tibia toward the femur, and a run test with maximal speed and change-of-direction maneuvers. Comparative analysis did not show any differences between the results of anterior tibial translation, pivot shift test, range of movement and joint circumference, and subjective assessment of pain and knee joint stability levels. No differences were noted between the groups in peak torque values obtained from the muscles responsible for internal and external tibial rotation or results of the run test. The data obtained from this study can be used by research teams to monitor and compare the effectiveness of various study protocols involving surgical and physiotherapy treatment. The data are especially useful when combined with the clinical assessment of patients who would like to return to sport.

  10. Physical Activity Participation Among Patients After Total Hip and Knee Arthroplasty

    NARCIS (Netherlands)

    Stevens, Martin; Reininga, Inge H. F.; Bulstra, Sjoerd K.; Wagenmakers, Robert; van den Akker-Scheek, Inge

    2012-01-01

    Total hip (THA) and knee arthroplasty (TKA) are successful operative interventions, yet little is known about the physical activity behavior of patients after THA/TKA. For older adults, there are beneficial effects of regular physical activity after THA/TKA. The objective of this paper is to review

  11. 人工全膝关节置换后关节活动度影响因素的研究趋势%Research trend of factors influencing range of motion after artificial total knee replacement

    Institute of Scientific and Technical Information of China (English)

    王九辉

    2012-01-01

    背景:人工全膝关节置换后关节活动度是评价患者对治疗是否满意的关键,是患者膝关节功能恢复的主要观察指标.目的:分析人工全膝关节置换后关节活动度研究领域的发展趋势,探讨人工全膝关节置换后关节活动度的影响因素.方法:由作者用计算机检索CNKI数据库2002/2011收录的有关人工全膝关节置换后关节活动度的相关文献,检索时间为2002/2011,中文检索词为"膝关节,人工关节,人工假体,关节活动度",英文检索词为"knee,artificial joint,prosthesis,range of motion".共检索到244篇文章,按纳入标准和排除标准对文献进行筛选和分析,共纳入211篇文章.从膝关节置换前膝关节活动度、人工假体类型和置换后康复训练等方面来分析其影响因素.结果与结论:近10年来,CNKI数据库学术期刊收录膝关节置换后关节活动度研究文献数量呈上升趋势,2010年发表文献量最多为38篇,占总文献量的18.0%;从检索的关键词可见膝关节置换在骨关节炎疾病的治疗中应用最多;相关研究文献的基金资助项目较少;<中国组织工程研究与临床康复>杂志因设有硬组织植入物栏目,发表的相关文献量最多为41篇,占全部文献量的19.4%.文献计量学的分析为中国从事人工全膝关节置换的临床医务工作者提供更有价值的参考信息,影响人工全膝关节置换后关节活动度因素有很多,而且存在很多争议,临床医生应该不断提高治疗技术和康复训练方法,尽可能的恢复患者的膝关节活动功能.%BACKGROUND: Range of motion after artificial total knee replacement is the key to evaluate whether the patients are satisfied with the treatment or not, as well as the main outcome measures of functional recovery of joint knee.OBJECTIVE: To analyze the trends in the field of joint activity after artificial total knee replacement and to explore the influence factors of joint activity

  12. Knee Arthroscopy

    Science.gov (United States)

    ... experience any of the following: • Fever • Chills • Persistent warmth or redness around the knee • Persistent or increased ... you should be able to return to most physical activities a er 6 to 8 weeks, or ...

  13. Loading of the knee joint during activities of daily living measured in vivo in five subjects.

    Science.gov (United States)

    Kutzner, I; Heinlein, B; Graichen, F; Bender, A; Rohlmann, A; Halder, A; Beier, A; Bergmann, G

    2010-08-10

    Detailed knowledge about loading of the knee joint is essential for preclinical testing of implants, validation of musculoskeletal models and biomechanical understanding of the knee joint. The contact forces and moments acting on the tibial component were therefore measured in 5 subjects in vivo by an instrumented knee implant during various activities of daily living. Average peak resultant forces, in percent of body weight, were highest during stair descending (346% BW), followed by stair ascending (316% BW), level walking (261% BW), one legged stance (259% BW), knee bending (253% BW), standing up (246% BW), sitting down (225% BW) and two legged stance (107% BW). Peak shear forces were about 10-20 times smaller than the axial force. Resultant forces acted almost vertically on the tibial plateau even during high flexion. Highest moments acted in the frontal plane with a typical peak to peak range -2.91% BWm (adduction moment) to 1.61% BWm (abduction moment) throughout all activities. Peak flexion/extension moments ranged between -0.44% BWm (extension moment) and 3.16% BWm (flexion moment). Peak external/internal torques lay between -1.1% BWm (internal torque) and 0.53% BWm (external torque). The knee joint is highly loaded during daily life. In general, resultant contact forces during dynamic activities were lower than the ones predicted by many mathematical models, but lay in a similar range as measured in vivo by others. Some of the observed load components were much higher than those currently applied when testing knee implants.

  14. Sustained Rhythmic Brain Activity Underlies Visual Motion Perception in Zebrafish

    Directory of Open Access Journals (Sweden)

    Verónica Pérez-Schuster

    2016-10-01

    Full Text Available Following moving visual stimuli (conditioning stimuli, CS, many organisms perceive, in the absence of physical stimuli, illusory motion in the opposite direction. This phenomenon is known as the motion aftereffect (MAE. Here, we use MAE as a tool to study the neuronal basis of visual motion perception in zebrafish larvae. Using zebrafish eye movements as an indicator of visual motion perception, we find that larvae perceive MAE. Blocking eye movements using optogenetics during CS presentation did not affect MAE, but tectal ablation significantly weakened it. Using two-photon calcium imaging of behaving GCaMP3 larvae, we find post-stimulation sustained rhythmic activity among direction-selective tectal neurons associated with the perception of MAE. In addition, tectal neurons tuned to the CS direction habituated, but neurons in the retina did not. Finally, a model based on competition between direction-selective neurons reproduced MAE, suggesting a neuronal circuit capable of generating perception of visual motion.

  15. Women with knee osteoarthritis have more pain and poorer function than men, but similar physical activity prior to total knee replacement

    Directory of Open Access Journals (Sweden)

    Tonelli Shalome M

    2011-11-01

    Full Text Available Abstract Background Osteoarthritis of the knee is a major clinical problem affecting a greater proportion of women than men. Women generally report higher pain intensity at rest and greater perceived functional deficits than men. Women also perform worse than men on function measures such as the 6-minute walk and timed up and go tests. Differences in pain sensitivity, pain during function, psychosocial variables, and physical activity levels are unclear. Further the ability of various biopsychosocial variables to explain physical activity, function and pain is unknown. Methods This study examined differences in pain, pain sensitivity, function, psychosocial variables, and physical activity between women and men with knee osteoarthritis (N = 208 immediately prior to total knee arthroplasty. We assessed: (1 pain using self-report measures and a numerical rating scale at rest and during functional tasks, (2 pain sensitivity using quantitative sensory measures, (3 function with self-report measures and specific function tasks (timed walk, maximal active flexion and extension, (4 psychosocial measures (depression, anxiety, catastrophizing, and social support, and (5 physical activity using accelerometry. The ability of these mixed variables to explain physical activity, function and pain was assessed using regression analysis. Results Our findings showed significant differences on pain intensity, pain sensitivity, and function tasks, but not on psychosocial measures or physical activity. Women had significantly worse pain and more impaired function than men. Their levels of depression, anxiety, pain catastrophizing, social support, and physical activity, however, did not differ significantly. Factors explaining differences in (1 pain during movement (during gait speed test were pain at rest, knee extension, state anxiety, and pressure pain threshold; (2 function (gait speed test were sex, age, knee extension, knee flexion opioid medications, pain

  16. Effect of shoes containing nanosilica particles on knee valgus in active females during landing

    Directory of Open Access Journals (Sweden)

    Zahra Bassiri

    2015-01-01

    Full Text Available Objective(s: The effect of silica nanoparticles (SNPs in sport shoes outsoles on the  parameters related to anterior cruciate ligament (ACL Injury has not been investigated. The aim of this study was to investigate the effect of shoes outsole containing a composite of thermoplastic elastomer based on styrene-butadiene and silica nanoparticles (TPEN shoe on Knee Valgus Angle (KVA as a risk factor of ACL injuries during landing Materials and Methods: Fourteen active healthy women without knee injuries and disorders performed bilateral drop jump (DJ and single leg drop landing (SLL tasks in barefoot, wearing shoes fabricated with polyvinyl chloride outsole (PVC shoe and TPEN shoes conditions , randomly. The knee valgus angle values of right and left legs were calculated in the landing conditions. Two factors repeated measures ANOVA were used to investigate the effect of landing and footwear conditions on KVA of right and left legs.  Results: For both left and right limbs, the KVA was at maximum and minimum values during landing with barefoot and TPEN shoes, respectively. PVC shoe significantly reduced the knee valgus by 3.84% in left and 4.18% in right knee (P

  17. Role of gastrocnemius activation in knee joint biomechanics: gastrocnemius acts as an ACL antagonist.

    Science.gov (United States)

    Adouni, M; Shirazi-Adl, A; Marouane, H

    2016-01-01

    Gastrocnemius is a premier muscle crossing the knee, but its role in knee biomechanics and on the anterior cruciate ligament (ACL) remains less clear when compared to hamstrings and quadriceps. The effect of changes in gastrocnemius force at late stance when it peaks on the knee joint response and ACL force was initially investigated using a lower extremity musculoskeletal model driven by gait kinematics-kinetics. The tibiofemoral joint under isolated isometric contraction of gastrocnemius was subsequently analyzed at different force levels and flexion angles (0°-90°). Changes in gastrocnemius force at late stance markedly influenced hamstrings forces. Gastrocnemius acted as ACL antagonist by substantially increasing its force. Simulations under isolated contraction of gastrocnemius confirmed this role at all flexion angles, in particular, at extreme knee flexion angles (0° and 90°). Constraint on varus/valgus rotations substantially decreased this effect. Although hamstrings and gastrocnemius are both knee joint flexors, they play opposite roles in respectively protecting or loading ACL. Although the quadriceps is also recognized as antagonist of ACL, at larger joint flexion and in contrast to quadriceps, activity in gastrocnemius substantially increased ACL forces (anteromedial bundle). The fact that gastrocnemius is an antagonist of ACL should help in effective prevention and management of ACL injuries.

  18. Abdominal muscle activation changes if the purpose is to control pelvis motion or thorax motion.

    Science.gov (United States)

    Vera-Garcia, Francisco J; Moreside, Janice M; McGill, Stuart M

    2011-12-01

    The aim of this study was to compare trunk muscular recruitment and lumbar spine kinematics when motion was constrained to either the thorax or the pelvis. Nine healthy women performed four upright standing planar movements (rotations, anterior-posterior translations, medial-lateral translations, and horizontal circles) while constraining pelvis motion and moving the thorax or moving the pelvis while minimizing thorax motion, and four isometric trunk exercises (conventional curl-up, reverse curl-up, cross curl-up, and reverse cross curl-up). Surface EMG (upper and lower rectus abdominis, lateral and medial aspects of external oblique, internal oblique, and latissimus dorsi) and 3D lumbar displacements were recorded. Pelvis movements produced higher EMG amplitudes of the oblique abdominals than thorax motions in most trials, and larger lumbar displacements in the medial-lateral translations and horizontal circles. Conversely, thorax movements produced larger rotational lumbar displacement than pelvis motions during rotations and higher EMG amplitudes for latissimus dorsi during rotations and anterior-posterior translations and for lower rectus abdominis during the crossed curl-ups. Thus, different neuromuscular compartments appear when the objective changes from pelvis to thorax motion. This would suggest that both movement patterns should be considered when planning spine stabilization programs, to optimize exercises for the movement and muscle activations desired. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Which patients with osteoarthritis of hip and/or knee benefit most from behavorial graded activity?

    NARCIS (Netherlands)

    Veenhof, C.; Ende, C.H.M. van den; Dekker, J.; Köke, A.J.A.; Oostendorp, R.A.; Bijlsma, J.W.J.

    2007-01-01

    Our objective was to investigate whether behavioral graded activity (BGA) has particular benefit in specific subgroups of osteoarthritis (OA) patients. Two hundred participants with OA of hip or knee, or both (clinical American College of Rheumatology, ACR, criteria) participated in a randomized cli

  20. Increased muscle activity to stabilise mobile bearing knees in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Garling, E.H.; Eck, M; Wedding, T.; Veeger, H.E.J.; Valstar, E.R.; Nelissen, R.G.H.H.

    2005-01-01

    The aim of this study was to assess the differences in muscle activity (surface EMG) between a posterior stabilised (PS) total knee design and a mobile bearing (MB) posterior cruciate ligament retaining design in rheumatoid arthritis (RA) patients during a step-up task. Four patients with a PS total

  1. Which patients with osteoarthritis of hip and/or knee benefit most from behavioral graded activity?

    NARCIS (Netherlands)

    Veenhof, C.; Ende, C.H.M. van den; Dekker, J.; Kiike, A.J.; Oostendorp, R.A.B.; Bijlsma, J.W.J.

    2007-01-01

    Our objective was to investigate whether behavioral graded activity (BGA) has particular benefit in specific subgroups of osteoarthritis (OA) patients. Two hundred participants with OA of hip or knee, or both (clinical American College of Rheumatology, ACR, criteria) participated in a randomized cli

  2. Effect of limiting ankle-dorsiflexion range of motion on lower extremity kinematics and muscle-activation patterns during a squat.

    Science.gov (United States)

    Macrum, Elisabeth; Bell, David Robert; Boling, Michelle; Lewek, Michael; Padua, Darin

    2012-05-01

    Limitations in gastrocnemius/soleus flexibility that restrict ankle dorsiflexion during dynamic tasks have been reported in individuals with patellofemoral pain (PFP) and are theorized to play a role in its development. To determine the effect of restricted ankle-dorsiflexion range of motion (ROM) on lower extremity kinematics and muscle activity (EMG) during a squat. The authors hypothesized that restricted ankle-dorsiflexion ROM would alter knee kinematics and lower extremity EMG during a squat. Cross-sectional. 30 healthy, recreationally active individuals without a history of lower extremity injury. Each participant performed 7 trials of a double-leg squat under 2 conditions: a no-wedge condition (NW) with the foot flat on the floor and a wedge condition (W) with a 12° forefoot angle to simulate reduced plantar-flexor flexibility. 3-dimensional hip and knee kinematics, medial knee displacement (MKD), and ankle-dorsiflexion angle. EMG of vastus medialis oblique (VMO), vastus lateralis (VL), lateral gastrocnemius (LG), and soleus (SOL). One-way repeated-measures ANOVAs were performed to determine differences between the W and NW conditions. Compared with the NW condition, the wedge produced decreased peak knee flexion (P .05). Altering ankle-dorsiflexion starting position during a double-leg squat resulted in increased knee valgus and MKD, as well as decreased quadriceps activation and increased soleus activation. These changes are similar to those seen in people with PFP.

  3. Validation of the French version of two on high-activity knee questionnaires.

    Science.gov (United States)

    Diesinger, Y; Jenny, J-Y

    2014-09-01

    Self-administered quality-of-life questionnaires are valuable evaluation tools in orthopedic surgery. The conventional questionnaires are limited by a substantial ceiling effect. We wished to validate a French translation of two English questionnaires for high-activity patients: the High-Activity Arthroplasty Score (HAAS) and the Activity Scale for Arthroplasty Patients (ASAP). One hundred patients operated on for knee replacement were selected. The answers to both questionnaires were analyzed and compared to the Oxford Knee Score (OKS) and to the scoring system of the American Knee Society (AKS). There is no correlation between the results of both high-activity questionnaires and of the two conventional scoring systems. All questions were easily understood. The mean scores of the HAAS and ASAP questionnaires were 8.2±3.0 and 30.7±9.6, respectively. The distributions were not considered normal. There was no floor effect, but there was a limited ceiling effect (0% and 14%, respectively). The internal coherence of both questionnaires was satisfactory. There was a significant correlation between the high-activity scores and the conventional scores. Both high-activity questionnaires in our French translation can potentially measure the overall function of a patient after knee replacement as accurately as the index English version. It is self-administered, easy to use, can collect patients' answers by postage mailing, and involves no ceiling effect. All these points should allow its routine use for evaluation after knee replacement. The HAAS evaluation seems to be superior to the ASAP evaluation. Case-control study, level III. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. Medium-term evaluation of total knee arthroplasty without patellar replacement

    Directory of Open Access Journals (Sweden)

    José Wanderley Vasconcelos

    2013-06-01

    Full Text Available OBJECTIVE: To mid-term evaluate patients who were submitted to total knee arthroplasty without patellar resurfacing. METHODS: It was realized a retrospective cross-sectional study of patients who were submitted to total knee arthroplasty without patellar resurfacing. In all patients clinical examination was done based on the protocol of the Knee Society Scoring System, which assessed pain, range of motion, stability, contraction, knee alignment and function, and radiological evaluation. RESULTS: A total of 36 patients were evaluated. Of these, 07 were operated only on left knee, 12 only on right knee and 17 were operated bilaterally, totaling 53 knees. Ages ranged from 26 to 84 years. Of the 53 knees evaluated, 33 (62.26% had no pain. The maximum flexion range of motion averaged 104.7°. No knee had difficulty in active extension. As to the alignment for anatomical axis twelve knees (22.64% showed deviation between 0° and 4° varus. Thirty-nine (75.49% knees showed pace without restriction and the femorotibial angle ranged between 3° varus and 13° valgus with an average of 5° valgus. The patellar index ranged from 0.2 to 1.1. CONCLUSION: Total knee arthroplasty whitout patellar resurfacing provides good results in mid-term evaluation.

  5. Acute effects of instrument assisted soft tissue mobilization vs. foam rolling on knee and hip range of motion in soccer players.

    Science.gov (United States)

    Markovic, Goran

    2015-10-01

    The aim of the present investigation was to evaluate the acute effects of foam rolling (FR) and a new form of instrument-assisted soft tissue mobilization (IASTM), Fascial Abrasion Technique ™ (FAT) on hip and knee range of motion in soccer players. Twenty male soccer players randomly allocated into FR and FAT group (n = 10 each). Passive knee flexion and straight leg raise tests were measured before, immediately after and 24 h after intervention (FR or FAT). The FR group applied a 2-min quadriceps and hamstrings rolling, while FAT group received a 2-min application of FAT to the quadriceps and hamstrings muscles. Both groups significantly improved knee and hip ROM (p < 0.05), with higher gains observed in FAT group (10-19% vs. 5-9%). At 24 h post-treatment, only FAT group preserved most of the gains in ROM (7-13%; p < 0.05). These results support the use of the newly developed IASMT, Fascial Abrasion Technique ™ and FR for increasing lower extremity ROM of athletes.

  6. Two Different Protocols for Knee Joint Motion Analyses in the Stance Phase of Gait: Correlation of the Rigid Marker Set and the Point Cluster Technique

    Directory of Open Access Journals (Sweden)

    Takashi Fukaya

    2012-01-01

    Full Text Available Objective. There are no reports comparing the protocols provided by rigid marker set (RMS and point cluster technique (PCT, which are similar in terms of estimating anatomical landmarks based on markers attached to a segment. The purpose of this study was to clarify the correlation of the two different protocols, which are protocols for knee motion in gait, and identify whether measurement errors arose at particular periods during the stance phase. Methods. The study subjects were 10 healthy adults. All estimated anatomical landmarks were which their positions, calculated by each protocol of the PCT and RMS, were compared using Pearson’s product correlation coefficients. To examine the reliability of the angle changes of the knee joint measured by RMS and the PCT, the coefficient of multiple correlations (CMCs was used. Results. Although the estimates of the anatomical landmarks showed high correlations of >0.90 (<0.01 for the Y- and Z-coordinates, the correlations were low for the X-coordinates at all anatomical landmarks. The CMC was 0.94 for flexion/extension, 0.74 for abduction/adduction, and 0.71 for external/internal rotation. Conclusion. Flexion/extension and abduction/adduction of the knee by two different protocols had comparatively little error and good reliability after 30% of the stance phase.

  7. Differences between actual and expected leisure activities after total knee arthroplasty for osteoarthritis.

    Science.gov (United States)

    Jones, Dina L; Bhanegaonkar, Abhijeet J; Billings, Anthony A; Kriska, Andrea M; Irrgang, James J; Crossett, Lawrence S; Kwoh, C Kent

    2012-08-01

    This prospective cohort study determined the type, frequency, intensity, and duration of actual vs expected leisure activity among a cohort undergoing total knee arthroplasty. Data on actual and expected participation in 36 leisure activities were collected preoperatively and at 12 months in 90 patients with knee osteoarthritis. Despite high expectations, there were statistically and clinically significant differences between actual and expected activity at 12 months suggesting that expectations may not have been fulfilled. The differences were equivalent to walking 14 less miles per week than expected, which is more than the amount of activity recommended in national physical activity guidelines. Perhaps an educational intervention could be implemented to help patients establish appropriate and realistic leisure activity expectations before surgery.

  8. Image-based compensation for involuntary motion in weight-bearing C-arm cone-beam CT scanning of knees

    Science.gov (United States)

    Unberath, Mathias; Choi, Jang-Hwan; Berger, Martin; Maier, Andreas; Fahrig, Rebecca

    2015-03-01

    We previously introduced four fiducial marker-based strategies to compensate for involuntary knee-joint motion during weight-bearing C-arm CT scanning of the lower body. 2D methods showed significant reduction of motion- related artifacts, but 3D methods worked best. However, previous methods led to increased examination times and patient discomfort caused by the marker attachment process. Moreover, sub-optimal marker placement may lead to decreased marker detectability and therefore unstable motion estimates. In order to reduce overall patient discomfort, we developed a new image-based 2D projection shifting method. A C-arm cone-beam CT system was used to acquire projection images of five healthy volunteers at various flexion angles. Projection matrices for the horizontal scanning trajectory were calibrated using the Siemens standard PDS-2 phantom. The initial reconstruction was forward projected using maximum-intensity projections (MIP), yielding an estimate of a static scan. This estimate was then used to obtain the 2D projection shifts via registration. For the scan with the most motion, the proposed method reproduced the marker-based results with a mean error of 2.90 mm +/- 1.43 mm (compared to a mean error of 4.10 mm +/- 3.03 mm in the uncorrected case). Bone contour surrounding modeling clay layer was improved. The proposed method is a first step towards automatic image-based, marker-free motion-compensation.

  9. Experimental muscle pain during a forward lunge--the effects on knee joint dynamics and electromyographic activity

    DEFF Research Database (Denmark)

    Henriksen, Marius; Alkjaer, T; Simonsen, Erik Bruun

    2009-01-01

    OBJECTIVE: The purpose of this study was to investigate whether the knee joint dynamics during a forward lunge could be modulated by experimentally induced vastus medialis pain in healthy subjects. DESIGN: Randomised cross-over study. SETTING: Biomechanical movement laboratory. PARTICIPANTS: 20 h...... of muscle pain and prevention of injuries during activities involving the knee joint....

  10. Video summarization using descriptors of motion activity: a motion activity based approach to key-frame extraction from video shots

    Science.gov (United States)

    Divakaran, Ajay; Radhakrishnan, Regunathan; Peker, Kadir A.

    2001-10-01

    We describe a video summarization technique that uses motion descriptors computed in the compressed domain. It can either speed up conventional color-based video summarization techniques, or rapidly generate a key-frame based summary by itself. The basic hypothesis of the work is that the intensity of motion activity of a video segment is a direct indication of its `summarizability,' which we experimentally verify using the MPEG-7 motion activity descriptor and the fidelity measure proposed in H. S. Chang, S. Sull, and S. U. Lee, `Efficient video indexing scheme for content-based retrieval,' IEEE Trans. Circuits Syst. Video Technol. 9(8), (1999). Note that the compressed domain extraction of motion activity intensity is much simpler than the color-based calculations. We are thus able to quickly identify easy to summarize segments of a video sequence since they have a low intensity of motion activity. We are able to easily summarize these segments by simply choosing their first frames. We can then apply conventional color-based summarization techniques to the remaining segments. We thus speed up color-based summarization by reducing the number of segments processed. Our results also motivate a simple and novel key-frame extraction technique that relies on a motion activity based nonuniform sampling of the frames. Our results indicate that it can either be used by itself or to speed up color-based techniques as explained earlier.

  11. Short-term follow-up of total knee arthroplasty with LPS-Flex Mobile Bearing System knee prosthesis:range of motion of knee joint and function evaluation%高屈曲旋转平台型假体全膝关节置换的近期随访:膝关节活动度及功能评价

    Institute of Scientific and Technical Information of China (English)

    吴广鹏; 徐耀增; 朱永生; 朱锋; 邵洪国; 李荣群; 周军

    2015-01-01

    -Flex Mobile Bearing system artificial knee prosthesis (Zimmer, USA), and to assess the biocompatibility of artificial prosthesis and host using range of motion of knee and function after replacement. METHODS:We retrospectively analyzed 37 patients (42 knees) undergoing total knee arthroplasty using Zimmer LPS-Flex Mobile Bearing prostheses (high-flexion rotating platform type knee prosthesis) in The First Hospital Affiliated to Soochow University from February 2012 to March 2014, including 9 males (10 knees) and 28 females (32 knees), aged 47-78 years, averagely 63.7 years. Bone cement fixation was used, and the patel a was not treated with replacement. Postoperative complications were observed. Ranges of motion of knee joint preoperatively and postoperatively were compared. The recovery of knee joint function was evaluated using Hospital for Special Surgery Knee Score. RESULTS AND CONCLUSION:A total of 34 cases (38 knees) were fol owed up for 6-28 months. Range of motion of knee joint improved from 88.5° before operation to 124.2° after operation on average. Hospital for Special Surgery Knee Score improved from 52.5 before replacement to 91.1 after replacement, showing significant differences (P<0.01). Therapeutic effects were assessed according to Hospital for Special Surgery Knee Score:excel ent in 20 cases, good in 16 cases, average in 2 cases, with an excel ent and good rate of 95%. The incidence of various complications was low. These data suggested that short-period clinical outcomes of high-flexion rotating platform type knee prosthesis replacement are satisfactory. This prosthesis has advantages in its design, which is more close to the physical structure of knee joint, but its long-period outcomes deserve further investigations.

  12. Anterior cruciate ligament injury after more than 20 years: I. Physical activity level and knee function.

    Science.gov (United States)

    Tengman, E; Brax Olofsson, L; Nilsson, K G; Tegner, Y; Lundgren, L; Häger, C K

    2014-12-01

    Little is known about physical activity level and knee function including jump capacity and fear of movement/reinjury more than 20 years after injury of the anterior cruciate ligament (ACL). Seventy persons with unilateral ACL injury participated (23 ± 2 years post-injury): 33 treated with physiotherapy in combination with surgical reconstruction (ACLR ), and 37 treated with physiotherapy alone (ACLPT ). These were compared with 33 age- and gender-matched controls. Assessment included knee-specific and general physical activity level [Tegner activity scale, International Physical Activity Questionnaire (IPAQ)], knee function [Lysholm score, Knee injury and Osteoarthritis Outcome Score (KOOS)], jump capacity (one-leg hop, vertical jump, side hops), and fear of movement/reinjury [Tampa Scale for Kinesiophobia (TSK)]. Outcomes were related to degree of osteoarthritis (OA). ACL-injured had lower Lysholm, KOOS, and Tegner scores than controls (P < 0.001), while IPAQ score was similar. ACL-injured demonstrated inferior jump capacity in injured compared with noninjured leg (6-25%, P < 0.001-P = 0.010 in the different jumps), while noninjured leg had equal jump capacity as controls. ACL groups scored 33 ± 7 and 32 ± 7 of 68 on TSK. Lower scores on Lysholm and KOOS symptom were seen for persons with moderate-to-high OA than for no-or-low OA, while there were no differences for physical activity and jump capacity. Regardless of treatment, there are still negative knee-related effects of ACL injury more than 20 years later.

  13. Dynamic contact mechanics on the tibial plateau of the human knee during activities of daily living.

    Science.gov (United States)

    Gilbert, Susannah; Chen, Tony; Hutchinson, Ian D; Choi, Dan; Voigt, Clifford; Warren, Russell F; Maher, Suzanne A

    2014-06-27

    Despite significant advances in scaffold design, manufacture, and development, it remains unclear what forces these scaffolds must withstand when implanted into the heavily loaded environment of the knee joint. The objective of this study was to fully quantify the dynamic contact mechanics across the tibial plateau of the human knee joint during gait and stair climbing. Our model consisted of a modified Stanmore knee simulator (to apply multi-directional dynamic forces), a two-camera motion capture system (to record joint kinematics), an electronic sensor (to record contact stresses on the tibial plateau), and a suite of post-processing algorithms. During gait, peak contact stresses on the medial plateau occurred in areas of cartilage-cartilage contact; while during stair climb, peak contact stresses were located in the posterior aspect of the plateau, under the meniscus. On the lateral plateau, during gait and in early stair-climb, peak contact stresses occurred under the meniscus, while in late stair-climb, peak contact stresses were experienced in the zone of cartilage-cartilage contact. At 45% of the gait cycle, and 20% and 48% of the stair-climb cycle, peak stresses were simultaneously experienced on both the medial and lateral compartment, suggesting that these phases of loading warrant particular consideration in any simulation intended to evaluate scaffold performance. Our study suggests that in order to design a scaffold capable of restoring 'normal' contact mechanics to the injured knees, the mechanics of the intended site of implantation should be taken into account in any pre-clinical testing regime.

  14. Voluntary activation of human knee extensors measured using transcranial magnetic stimulation.

    Science.gov (United States)

    Goodall, S; Romer, L M; Ross, E Z

    2009-09-01

    The aim of this study was to determine the applicability and reliability of a transcranial magnetic stimulation twitch interpolation technique for measuring voluntary activation of a lower limb muscle group. Cortical voluntary activation of the knee extensors was determined in nine healthy men on two separate visits by measuring superimposed twitch torques evoked by transcranial magnetic stimulation during isometric knee extensions of varying intensity. Superimposed twitch amplitude decreased linearly with increasing voluntary torque between 50 and 100% of mean maximal torque, allowing estimation of resting twitch amplitude and subsequent calculation of voluntary activation. There were no systematic differences for maximal voluntary activation within day (mean +/- s.d. 90.9 +/- 6.2 versus 90.7 +/- 5.9%; P = 0.98) or between days (90.8 +/- 6.0 versus 91.2 +/- 5.7%; P = 0.92). Systematic bias and random error components of the 95% limits of agreement were 0.23 and 9.3% within day versus 0.38 and 7.5% between days. Voluntary activation was also determined immediately after a 2 min maximal voluntary isometric contraction; in four of these subjects, voluntary activation was determined 30 min after the sustained contraction. Immediately after the sustained isometric contraction, maximal voluntary activation was reduced from 91.2 +/- 5.7 to 74.2 +/- 12.0% (P knee extensors.

  15. Self-reported activity level and knee function in amateur football players

    DEFF Research Database (Denmark)

    Frobell, R B; Svensson, E; Göthrick, M

    2008-01-01

    ) amateur football players in 10 football clubs from each division below national level participated in the study. Self-reported Tegner Activity Scale, and the Knee injury and Osteoarthritis Outcome Score (KOOS) are the main outcome measures. Older age, female gender and lower level of competition (football...... is recommended. We suggest that self-reported Tegner Activity Scale scores should be adjusted for age, gender and level of competition. In amateur football players, KOOS scores do not need adjustment for age and gender....

  16. 高空运动落地后对膝盖的冲击力学分析%Analysis of Knee Motion Force Parameters After Air Sport Landfall

    Institute of Scientific and Technical Information of China (English)

    孙斌

    2015-01-01

    传统方法构建的高空运动落体后对膝盖的冲击力学分析模型只能求解局部的膝关节受力和发力参数,对膝盖及下肢的各个关节驱动作用和受力冲击运动势能等参数求解建模困难.提出一种基于七连杆驱动结构的高空运动落体后的冲击动力学分析模型.构建人体在高空落地后的下肢膝盖的运动链数学模型,分析落地冲击对膝盖的运动链位姿变换关系,采用7连杆驱动结构对人体高空落地后的下肢进行7连杆结构分解,采用Lagrange动力学方程实现对冲击力学参数的全局分析,得出优化解向量.仿真结果表明,采用该受力分析模型,对膝盖冲击力的受力分析逼近于理论值,计算精度较高,性能优越,为体育训练和运动医疗提供准确的数据基础.%The impact of knee mechanics analysis model of high altitude exercise fall, driving torque and dynamic parame-ters of human lower limb joints, provides the model and the data base for the guidance of scientific sports training and sports medicine. Impact mechanics of knee motion analysis of high altitude falling after the traditional method of the knee joint model can solve the local force and force parameters of each joint, knee and lower limb function and the driving force of impact energy parameters modeling difficulty movement. An analysis model of driving air sports fall based on the struc-ture of the seven link rear impact dynamics is proposed. Construction at high altitude after landing leg knee motion of hu-man body even mathematical model, analysis the impact of the kinematic chain knee pose transformation relations, the 7 connecting rod to drive the structure of the human body at high altitude after the fall of the lower limb was decomposed 7 connecting rod structure, the dynamic equation of Lagrange to achieve the overall impact of mechanical parameters analy-sis, obtains the optimization solution vector. Simulation results show that the stress

  17. Methods for dynamic characterization of the major muscles activating the lower limb joints in cycling motion

    Directory of Open Access Journals (Sweden)

    Navit Roth

    2014-09-01

    Full Text Available The functional activation, through electrical stimulation, of the lower limb consisting of several deficient muscles requires well-patterned and coordinated activation of these muscles. This study presents a method for characterizing the parameters of the major muscle groups controlling the ankle and knee joints in cycling motion, the latter having particular significance in the rehabilitation of locomotion. To lower mechanical indeterminacy in the joints the system is reduced by grouping the muscles acting in synergism. The joint torques were calculated by inverse dynamics methods from cycling motion data, including kinematics and foot/pedal reaction loads (forces, moments. The mechanical indeterminacy was resolved by applying optimization criteria and the individual muscle torques were parceled-out from the joint torques. System identification of the individual muscles, part of which being bi-articular, in this non-isometric condition was performed from the relationship between the evaluated force and the measured EMG of each the muscles, using both first and second order linear transfer functions. Feasibility of the presented method was demonstrated through the computation of the coefficients of the muscles involved and validating the results on the experimental data obtained from one subject.

  18. MUSCLE ACTIVITY RESPONSE TO EXTERNAL MOMENT DURING SINGLE-LEG DROP LANDING IN YOUNG BASKETBALL PLAYERS: THE IMPORTANCE OF BICEPS FEMORIS IN REDUCING INTERNAL ROTATION OF KNEE DURING LANDING

    Directory of Open Access Journals (Sweden)

    Meguru Fujii

    2012-06-01

    Full Text Available Internal tibial rotation with the knee close to full extension combined with valgus collapse during drop landing generally results in non-contact anterior cruciate ligament (ACL injury. The purpose of this study was to investigate the relationship between internal rotation of the knee and muscle activity from internal and external rotator muscles, and between the internal rotation of knee and externally applied loads on the knee during landing in collegiate basketball players. Our hypothesis was that the activity of biceps femoris muscle would be an important factor reducing internal knee rotation during landing. The subjects were 10 collegiate basketball students: 5 females and 5 males. The subjects performed a single-leg drop landing from a 25-cm height. Femoral and tibial kinematics were measured using a 3D optoelectronic tracking system during the drop landings, and then the knee angular motions were determined. Ground reaction forces and muscle activation patterns (lateral hamstring and medial hamstring were simultaneously measured and computed. Results indicated that lower peak internal tibial rotation angle at the time of landing was associated with greater lateral hamstring activity (r = -0.623, p < 0.001. When gender was considered, the statistically significant correlation remained only in females. There was no association between the peak internal tibial rotation angle and the knee internal rotation moment. Control of muscle activity in the lateral to medial hamstring would be an important factor in generating sufficient force to inhibit excessive internal rotation during landing. Strengthening the biceps femoris might mitigate the higher incidence of non-contact ACL injury in female athletes

  19. Assessment of Knee Cartilage Stress Distribution and Deformation Using Motion Capture System and Wearable Sensors for Force Ratio Detection

    Directory of Open Access Journals (Sweden)

    N. Mijailovic

    2015-01-01

    Full Text Available Knowledge about the knee cartilage deformation ratio as well as the knee cartilage stress distribution is of particular importance in clinical studies due to the fact that these represent some of the basic indicators of cartilage state and that they also provide information about joint cartilage wear so medical doctors can predict when it is necessary to perform surgery on a patient. In this research, we apply various kinds of sensors such as a system of infrared cameras and reflective markers, three-axis accelerometer, and force plate. The fluorescent marker and accelerometers are placed on the patient’s hip, knee, and ankle, respectively. During a normal walk we are recording the space position of markers, acceleration, and ground reaction force by force plate. Measured data are included in the biomechanical model of the knee joint. Geometry for this model is defined from CT images. This model includes the impact of ground reaction forces, contact force between femur and tibia, patient body weight, ligaments, and muscle forces. The boundary conditions are created for the finite element method in order to noninvasively determine the cartilage stress distribution.

  20. The effects of agonist and antagonist muscle activation on the knee extension moment-angle relationship in adults and children.

    Science.gov (United States)

    O'Brien, Thomas D; Reeves, Neil D; Baltzopoulos, Vasilios; Jones, David A; Maganaris, Constantinos N

    2009-08-01

    The present study examined the effect of agonist activation and antagonist co-activation on the shape of the knee extension moment-angle relationship in adults and children. Isometric knee extension maximum voluntary contractions (MVCs) were performed at every 5 degrees of knee flexion between 55 degrees and 90 degrees (full extension = 0 degrees) by ten men, ten women, ten boys and ten girls. For each trial, the knee extensors' voluntary activation level was quantified using magnetic stimulation and the level of antagonist co-activation was quantified from their electromyographical activity. Peak MVC moment was greater for men (264 +/- 63 N m) than women (177 +/- 60 N m), and greater for adults than children (boys 78 +/- 17 N m, girls 91 +/- 28 N m) (p architecture, and the pattern of the moment arm-angle relationship may in combination occur so that as children develop and mature into adults the shape of the moment-angle relationship is not altered.

  1. Companion classroom activities for "stop faking it!" force and motion

    CERN Document Server

    Robertson, William C

    2011-01-01

    Never has it been so easy for educators to learn to teach physical science with confidence. Award-winning author Bill Robertson launched his bestselling Stop Faking It! series in 2002 with Force and Motion--offering elementary and middle school teachers a jargon-free way to learn the background for teaching physical science with confidence. Combining easy-to-understand if irreverent explanations and quirky diagrams, Stop Faking It! Force and Motion helped thousands of teachers, parents, and homeschoolers conquer topics from Newton s laws to the physics of space travel. Now Companion Classroom Activities for Stop Faking It! Force and Motion proves an ideal supplement to the original book or a valuable resource of its own. The hands-on activities and highly readable explanations allow students to first investigate concepts, then discuss learned concepts, and finally apply the concepts to everyday situations. Robertson's wit and humor are sure to keep students and teachers entertained while they tackle topics ...

  2. Breast size impacts spine motion and postural muscle activation.

    Science.gov (United States)

    Schinkel-Ivy, Alison; Drake, Janessa D M

    2016-11-21

    While it is generally accepted that large breast sizes in females contribute to back pain and poor posture, the effects of breast size on spinal motion and muscle activation characteristics are poorly understood. This study examined the relationship between breast size, spine motion, and trunk muscle activation. Fifteen university-aged females, free of back pain symptoms, were tested. Breast sizes were calculated, and three-dimensional spine motion and activation from five trunk muscles bilaterally were measured during standing and trunk flexion movements. Correlations between breast size and motion and muscle activation measures were assessed. Head and trunk angles were strongly, negatively correlated to breast size during upright standing; thoracic angles were moderately, positively correlated to breast size during thoracic flexion movements. Trunk muscles showed positive, moderate-strength relationships with breast size during upright standing and some trunk movements. These findings provide a preliminary indication that increasing breast sizes are associated with altered postures and increased muscle activation in a non-clinical population, and constitute a baseline for the study of females with a full range of breast sizes. Further research is required to confirm the generalizability of these findings to other sizes, in order to inform strategies for the prevention or reduction of back pain, as well as diagnosis, treatment, and rehabilitation techniques associated with breast size and back pain.

  3. Fiducial marker-based correction for involuntary motion in weight-bearing C-arm CT scanning of knees. II. Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jang-Hwan [Department of Radiology, Stanford University, Stanford, California 94305 and Department of Mechanical Engineering, Stanford University, Stanford, California 94305 (United States); Maier, Andreas; Keil, Andreas; McWalter, Emily J.; Gold, Garry E.; Fahrig, Rebecca [Department of Radiology, Stanford University, Stanford, California 94305 (United States); Pal, Saikat [Biomedical Engineering Department, California Polytechnic State University, San Luis Obispo, California 93407 (United States); Beaupré, Gary S. [Musculoskeletal Research Laboratory, VA Palo Alto Health Care System, Palo Alto, California 94304 (United States)

    2014-06-15

    Purpose: A C-arm CT system has been shown to be capable of scanning a single cadaver leg under loaded conditions by virtue of its highly flexible acquisition trajectories. In Part I of this study, using the 4D XCAT-based numerical simulation, the authors predicted that the involuntary motion in the lower body of subjects in weight-bearing positions would seriously degrade image quality and the authors suggested three motion compensation methods by which the reconstructions could be corrected to provide diagnostic image quality. Here, the authors demonstrate that a flat-panel angiography system is appropriate for scanning both legs of subjectsin vivo under weight-bearing conditions and further evaluate the three motion-correction algorithms using in vivo data. Methods: The geometry of a C-arm CT system for a horizontal scan trajectory was calibrated using the PDS-2 phantom. The authors acquired images of two healthy volunteers while lying supine on a table, standing, and squatting at several knee flexion angles. In order to identify the involuntary motion of the lower body, nine 1-mm-diameter tantalum fiducial markers were attached around the knee. The static mean marker position in 3D, a reference for motion compensation, was estimated by back-projecting detected markers in multiple projections using calibrated projection matrices and identifying the intersection points in 3D of the back-projected rays. Motion was corrected using three different methods (described in detail previously): (1) 2D projection shifting, (2) 2D deformable projection warping, and (3) 3D rigid body warping. For quantitative image quality analysis, SSIM indices for the three methods were compared using the supine data as a ground truth. Results: A 2D Euclidean distance-based metric of subjects’ motion ranged from 0.85 mm (±0.49 mm) to 3.82 mm (±2.91 mm) (corresponding to 2.76 to 12.41 pixels) resulting in severe motion artifacts in 3D reconstructions. Shifting in 2D, 2D warping, and 3D

  4. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee

    Directory of Open Access Journals (Sweden)

    Arwert Henk

    2008-06-01

    Full Text Available Abstract Background This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i to describe the prevalence of comorbidity and (ii to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity. Methods A cross-sectional cohort study was conducted, in which 288 elderly patients with hip or knee osteoarthritis were included. Apart from demographic and clinical data, information about comorbidity, limitations in activities (WOMAC, SF-36 and timed walking test and pain (VAS was collected by questionnaires and tests. Statistical analyses included descriptive statistics, multivariate regression techniques, t-tests and one-way ANOVA. Results Almost all patients suffered from at least one comorbid disease, with cardiac diseases, diseases of eye, ear, nose, throat and larynx, other urogenital diseases and endocrine/metabolic diseases being most prevalent. Morbidity count and severity index were associated with more limitations in activities and with more pain. The presence of most of the moderate or severe diseases and obesity was associated with limitations in activities or with pain. Conclusion The results of this study emphasize the importance of comorbidity in the rehabilitation of elderly patients with osteoarthritis of the hip or knee. Clinical practitioners should be aware of the relationship of comorbidity with functional problems in OA patients.

  5. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee

    Science.gov (United States)

    van Dijk, Gabriella M; Veenhof, Cindy; Schellevis, Francois; Hulsmans, Harry; Bakker, Jan PJ; Arwert, Henk; Dekker, Jos HM; Lankhorst, Guus J; Dekker, Joost

    2008-01-01

    Background This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i) to describe the prevalence of comorbidity and (ii) to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases) and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity. Methods A cross-sectional cohort study was conducted, in which 288 elderly patients with hip or knee osteoarthritis were included. Apart from demographic and clinical data, information about comorbidity, limitations in activities (WOMAC, SF-36 and timed walking test) and pain (VAS) was collected by questionnaires and tests. Statistical analyses included descriptive statistics, multivariate regression techniques, t-tests and one-way ANOVA. Results Almost all patients suffered from at least one comorbid disease, with cardiac diseases, diseases of eye, ear, nose, throat and larynx, other urogenital diseases and endocrine/metabolic diseases being most prevalent. Morbidity count and severity index were associated with more limitations in activities and with more pain. The presence of most of the moderate or severe diseases and obesity was associated with limitations in activities or with pain. Conclusion The results of this study emphasize the importance of comorbidity in the rehabilitation of elderly patients with osteoarthritis of the hip or knee. Clinical practitioners should be aware of the relationship of comorbidity with functional problems in OA patients. PMID:18582362

  6. Technology Efficacy in Active Prosthetic Knees for Transfemoral Amputees: A Quantitative Evaluation

    Directory of Open Access Journals (Sweden)

    Amr M. El-Sayed

    2014-01-01

    Full Text Available Several studies have presented technological ensembles of active knee systems for transfemoral prosthesis. Other studies have examined the amputees’ gait performance while wearing a specific active prosthesis. This paper combined both insights, that is, a technical examination of the components used, with an evaluation of how these improved the gait of respective users. This study aims to offer a quantitative understanding of the potential enhancement derived from strategic integration of core elements in developing an effective device. The study systematically discussed the current technology in active transfemoral prosthesis with respect to its functional walking performance amongst above-knee amputee users, to evaluate the system’s efficacy in producing close-to-normal user performance. The performances of its actuator, sensory system, and control technique that are incorporated in each reported system were evaluated separately and numerical comparisons were conducted based on the percentage of amputees’ gait deviation from normal gait profile points. The results identified particular components that contributed closest to normal gait parameters. However, the conclusion is limitedly extendable due to the small number of studies. Thus, more clinical validation of the active prosthetic knee technology is needed to better understand the extent of contribution of each component to the most functional development.

  7. Strength Training to Contraction Failure Increases Voluntary Activation of the Quadriceps Muscle Shortly After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Mikkelsen, Elin Karin; Jakobsen, Thomas Linding; Holsgaard-Larsen, Anders;

    2016-01-01

    OBJECTIVE: The objective of this study was to investigate voluntary activation of the quadriceps muscle during one set of knee extensions performed until contraction failure in patients shortly after total knee arthroplasty. DESIGN: This was a cross-sectional study of 24 patients with total knee...... arthroplasty. One set of knee extensions was performed until contraction failure, using a predetermined 10 repetition maximum loading. In the operated leg, electromyographic (EMG) activity of the lateral and medial vastus, semitendinosus, and biceps femoris muscles was recorded during the set. Muscle activity...... (%EMGmax) and median power frequency of the EMG power spectrum were calculated for each repetition decile (10%-100% contraction failure). RESULTS: Muscle activity increased significantly over contractions from a mean of 90.0 and 93.6 %EMGmax (lateral vastus and medial vastus, respectively) at 10...

  8. Level of physical activity and the risk of radiographic and symptomatic knee osteoarthritis in the elderly: the Framingham study.

    Science.gov (United States)

    McAlindon, T E; Wilson, P W; Aliabadi, P; Weissman, B; Felson, D T

    1999-02-01

    Because osteoarthritis may be caused by "wear and tear," we examined the association between level of physical activity and risk of knee osteoarthritis in the elderly. Eligible subjects were participants in the Framingham Heart Study cohort who had radiographically normal knees at biennial exam 18 (1983-1985) and who also completed a physical activity questionnaire at exam 20 (1988-1989). Follow-up knee radiographs were obtained at biennial exam 22 (1992-1993). The study outcomes were the development of incident radiographic or symptomatic knee osteoarthritis between the baseline and follow-up exams. The number of hours per day of heavy physical activity was associated with the risk of incident radiographic knee osteoarthritis (odds ratio = 1.3 per hour, 95% confidence limits 1.1-1.6, P for trend = 0.006). Adjustment for age, sex, body mass index, weight loss, knee injury, health status, total calorie intake, and smoking strengthened this association (eg, odds ratio for > or = 4 hours heavy physical activity/day compared with no heavy physical activity = 7.0, 95% confidence limits 2.4-20, P for trend = 0.0002). Risk was greatest among individuals in the upper tertile of body mass index (odds ratio for > or = 3 hours/day of heavy physical activity = 13.0, 95% confidence limits 3.3-51). For incident symptomatic knee osteoarthritis, the results were similar, although the number of cases was small. No effects on these outcomes were observed from moderate and light physical activity, number of blocks walked, or number of flights of stairs climbed daily. Heavy physical activity is an important risk factor for the development of knee osteoarthritis in the elderly, especially among obese individuals. Light and moderate activities do not appear to increase risk.

  9. Muscle activity during knee-extension strengthening exercise performed with elastic tubing and isotonic resistance

    DEFF Research Database (Denmark)

    Jakobsen, Markus Due; Sundstrup, Emil; Andersen, Christoffer H

    2012-01-01

    tubing induces similar high (>70% nEMG) quadriceps muscle activity during the concentric contraction phase, but slightly lower during the eccentric contraction phase, as knee extensions performed using an isotonic training machine. During the concentric contraction phase the two different conditions...... muscle during 10-RM knee-extensions performed with elastic tubing and an isotonic strength training machine. METHODS: 7 women and 9 men aged 28-67 years (mean age 44 and 41 years, respectively) participated. Electromyographic (EMG) activity was recorded in 10 muscles during the concentric and eccentric...... the machine and elastic resistance exercises there were no significant differences in peak EMG of the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM) during the concentric contraction phase. However, during the eccentric phase, peak EMG was significantly higher (p

  10. H.264 MOTION ESTIMATION ALGORITHM BASED ON VIDEO SEQUENCES ACTIVITY

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Motion estimation is an important part of H.264/AVC encoding progress, with high computational complexity. Therefore, it is quite necessary to find a fast motion estimation algorithm for real-time applications. The algorithm proposed in this letter adjudges the macroblocks activity degree first; then classifies different video sequences, and applies different search strategies according to the result. Experiments show that this method obtains almost the same video quality with the Full Search (FS) algorithm but with reduced more than 95% computation cost.

  11. Statistics of Superluminal Motion in Active Galactic Nuclei

    Institute of Scientific and Technical Information of China (English)

    Yong-Wei Zhang; Jun-Hui Fan

    2008-01-01

    We have collected an up-to-date sample of 123 superluminal sources (84 quasars, 27 BL Lac objects and 12 galaxies) and calculated the apparent velocities (βapp) for 224 components in the sources with the A-CDM model. We checked the relationships between their proper motions, redshifts,βapp and 5 GHz flux densities. Our analysis shows that the radio emission is strongly boosted by the Doppler effect. The superluminal motion and the relativistic beaming boosting effect are, to some extent, the same in active galactic nuclei.

  12. Knee hemarthrosis after arthroscopic surgery in an athlete with low factor XIII activity

    OpenAIRE

    Tsujii Akira; Tanaka Yoshinari; Yonetani Yasukazu; Shiozaki Yoshiki; Tomiyama Yoshiaki; Horibe Shuji

    2012-01-01

    Abstract We report a thirteen-year-old tennis player with knee hemarthrosis caused by low factor XIII activity. She visited our hospital because of medial peripatellar pain for two years. Although there was no abnormal sign in X-ray or MRI, diagnostic arthroscopy was performed. It revealed some cartilage debris, medial plica and complete septum of suprapatellar plica. Removing the debris by washing out and resecting the medial plica, she could return to play tennis without perioperative sympt...

  13. Does the GMFCS level influence the improvement in knee range of motion after rectus femoris transfer in cerebral palsy?

    Science.gov (United States)

    Blumetti, Francesco C; Morais Filho, Mauro C; Kawamura, Cátia M; Cardoso, Michelle O; Neves, Daniella L; Fujino, Marcelo H; Lopes, José Augusto F

    2015-09-01

    The aim of this study was to evaluate the influence of the Gross Motor Function Classification System (GMFCS) on the outcomes of rectus femoris transfer (RFT) for patients with cerebral palsy and stiff knee gait. We performed a retrospective review of patients seen at our gait laboratory from 1996 to 2013. Inclusion criteria were (i) spastic diplegic cerebral palsy, (ii) GMFCS levels I-III, (iii) reduced peak knee flexion in swing (PKFSwGMFCS levels I and II. In the non-RFT group, no improvement in KROM was observed in any GMFCS level. In this study, patients at GMFCS levels I and II were more likely to benefit from the RFT procedure.

  14. Computational modelling of motion at the bone-implant interface after total knee arthroplasty: The role of implant design and surgical fit.

    Science.gov (United States)

    Conlisk, Noel; Howie, Colin R; Pankaj, Pankaj

    2017-08-01

    Aseptic loosening, osteolysis, and infection are the most commonly reported reasons for revision total knee arthroplasty (TKA). This study examined the role of implant design features (e.g. condylar box, pegs) and stems in resisting loosening, and also explored the sensitivity of the implants to a loose surgical fit due to saw blade oscillation. Finite element models of the distal femur implanted with four different implant types: cruciate retaining (CR), posterior stabilising (PS), total stabilising (TS) with short stem (12mm×50mm), and a total stabilising (TS) with long stem (19mm×150mm) were developed and analysed in this study. Two different fit conditions were considered: a normal fit, where the resections on the bone exactly match the internal profile of the implant, and a loose fit due to saw blade oscillation, characterised by removal of one millimetre of bone from the anterior and posterior surfaces of the distal femur. Frictional interfaces were employed at the bone-implant interfaces to allow relative motions to be recorded. The results showed that interface motions increased with increasing flexion angle and loose fit. Implant design features were found to greatly influence the surface area under increased motion, while only slightly influencing the values of peak motion. Short uncemented stems behaved similarly to PS implants, while long canal filling stems exhibited the least amount of motion at the interface under any fit condition. In conclusion, long stemmed prostheses appeared less susceptible to surgical cut errors than short stemmed and stemless implants. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. A conceptual framework for a sports knee injury performance profile (SKIPP) and return to activity criteria (RTAC)

    Science.gov (United States)

    Logerstedt, David; Arundale, Amelia; Lynch, Andrew; Snyder-Mackler, Lynn

    2015-01-01

    Injuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and safe to return to sport. A system centered on specific indicators that can be used to develop a comprehensive profile to monitor rehabilitation progression and to establish return to activity criteria is recommended to clear athletes to begin a progressive and systematic approach to activities and sports. Integration of a sports knee injury performance profile with return to activity criteria can guide clinicians in facilitating an athlete's safe return to sport, prevention of subsequent injury, and life-long knee joint health. PMID:26537805

  16. A conceptual framework for a sports knee injury performance profile (SKIPP and return to activity criteria (RTAC

    Directory of Open Access Journals (Sweden)

    David Logerstedt

    2015-10-01

    Full Text Available ABSTRACTInjuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and safe to return to sport. A system centered on specific indicators that can be used to develop a comprehensive profile to monitor rehabilitation progression and to establish return to activity criteria is recommended to clear athletes to begin a progressive and systematic approach to activities and sports. Integration of a sports knee injury performance profile with return to activity criteria can guide clinicians in facilitating an athlete's safe return to sport, prevention of subsequent injury, and life-long knee joint health.

  17. A long term clinical outcome of the Medial Pivot Knee Arthroplasty System.

    Science.gov (United States)

    Macheras, George A; Galanakos, Spyridon P; Lepetsos, Panagiotis; Anastasopoulos, Panagiotis P; Papadakis, Stamatios A

    2017-03-01

    The ideal total knee arthroplasty (TKA) should provide maximum range of motion and functional stability for all desired daily activities and, if possible, to replicate normal knee kinematics and function. The ADVANCE® Medial Pivot (AMP) Knee System was designed with a highly congruent medial compartment and a less conforming lateral compartment to more closely mimic the kinematics of the normal knee and to offer more stability through out of range of motion (ROM). The purpose of this study was to evaluate the long-term clinical and radiographic outcomes of this TKA system. Three hundred and twenty-five (325) patients (347 knees) with knee osteoarthritis underwent a TKA using the AMP prosthesis in our Department. For evaluation, objective and subjective clinical rating systems along with radiograph series were used. The average follow-up was 15.2years. All patients showed a statistically significant improvement (p<0.0005) in the Knee Society clinical rating system, Western Ontario and McMaster Universities Osteoarthritis Index questionnaire, SF-12® questionnaire, and Oxford knee score. The majority of patients (94%) were able to perform age-appropriate activities with a mean knee flexion of 120° (range, 105°-135°) at final follow-up. Survival analysis showed a cumulative success rate of 98.8% at 17years. The obtained results demonstrate excellent long-term clinical outcome for this knee design. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  18. Swing Phase Control of Semi-Active Prosthetic Knee Using Neural Network Predictive Control With Particle Swarm Optimization.

    Science.gov (United States)

    Ekkachai, Kittipong; Nilkhamhang, Itthisek

    2016-11-01

    In recent years, intelligent prosthetic knees have been developed that enable amputees to walk as normally as possible when compared to healthy subjects. Although semi-active prosthetic knees utilizing magnetorheological (MR) dampers offer several advantages, they lack the ability to generate active force that is required during some states of a normal gait cycle. This prevents semi-active knees from achieving the same level of performance as active devices. In this work, a new control algorithm for a semi-active prosthetic knee during the swing phase is proposed to reduce this gap. The controller uses neural network predictive control and particle swarm optimization to calculate suitable command signals. Simulation results using a double pendulum model show that the generated knee trajectory of the proposed controller is more similar to the normal gait than previous open-loop controllers at various ambulation speeds. Moreover, the investigation shows that the algorithm can be calculated in real time by an embedded system, allowing for easy implementation on real prosthetic knees.

  19. Knee Angle Estimation Algorithm for Myoelectric Control of Active Transfemoral Prostheses

    Science.gov (United States)

    Delis, Alberto López; de Carvalho, João Luiz Azevedo; Da Rocha, Adson Ferreira; de Oliveira Nascimento, Francisco Assis; Borges, Geovany Araújo

    This paper presents a bioinstrumentation system for the acquisition and pre-processing of surface electromyographic (SEMG) signals, and a knee angle estimation algorithm for control of active transfemoral leg prostheses, using methods for feature extraction and classification of myoelectric signal patterns. The presented microcontrolled bioinstrumentation system is capable of recording up to four SEMG channels, and one electrogoniometer channel. The proposed neural myoelectric controller algorithm is capable of predicting the intended knee joint angle from the measured SEMG signals. The algorithm is designed in three stages: feature extraction, using auto-regressive model and amplitude histogram; feature projection, using self organizing maps; and pattern classification, using a Levenberg-Marquardt neural network. The use of SEMG signals and additional mechanical information such as that provided by the electrogoniometer may improve precision in the control of leg prostheses. Preliminary results are presented.

  20. Active Control Does Not Eliminate Motion-Induced Illusory Displacement

    Directory of Open Access Journals (Sweden)

    Ian M. Thornton

    2011-05-01

    Full Text Available When the sine-wave grating of a Gabor patch drifts to the left or right, the perceived position of the entire object is shifted in the direction of local motion. In the current work we explored whether active control of the physical position of the patch overcomes such motion induced illusory displacement. In Experiment 1 we created a simple computer game and asked participants to continuously guide a Gabor patch along a randomly curving path using a joystick. When the grating inside the Gabor patch was stationary, participants could perform this task without error. When the grating drifted to either left or right, we observed systematic errors consistent with previous reports of motion-induced illusory displacement. In Experiment 2 we created an iPad application where the built-in accelerometer tilt control was used to steer the patch through as series of “gates”. Again, we observed systematic guidance errors that depended on the direction and speed of local motion. In conclusion, we found no evidence that participants could adapt or compensate for illusory displacement given active control of the target.

  1. The benefits and barriers to physical activity and lifestyle interventions for osteoarthritis affecting the adult knee

    Directory of Open Access Journals (Sweden)

    Stevenson Jonathan

    2012-03-01

    Full Text Available Abstract Osteoarthritis prevalence is increasing, placing greater demands on healthcare and future socioeconomic costing models. Exercise and non-pharmacological methods should be employed to manage this common and disabling disease. Expectations at all stages of disease are increasing with a desire to remain active and independent. Three key areas have been reviewed; the evidence for physical activity, lifestyle changes and motivational techniques concerning knee osteoarthritis and the barriers to instituting such changes. Promotion of activity in primary care is discussed and evidence for compliance has been reviewed. This article reviews a subject that is integral to all professionals involved with osteoarthritis care.

  2. Knee Bursitis

    Science.gov (United States)

    Knee bursitis Overview By Mayo Clinic Staff Knee bursitis is inflammation of a small fluid-filled sac (bursa) situated ... in your knee can become inflamed, but knee bursitis most commonly occurs over the kneecap or on ...

  3. Knee Replacement

    Science.gov (United States)

    Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...

  4. Intra-articular morphine versus bupivacaine for knee motion among patients with osteoarthritis: randomized double-blind clinical trial

    Directory of Open Access Journals (Sweden)

    Miriam Bellini Gazi

    Full Text Available CONTEXT AND OBJECTIVE: Osteoarthritis causes pain and disability in a high percentage of elderly people. The aim of the present study was to assess the efficacy of intra-articular morphine and bupivacaine on the joint flexion and extension angles of patients with knee osteoarthritis. DESIGN AND SETTING: A randomized double-blind study was performed at a pain clinic of Universidade Federal de São Paulo. METHODS: Thirty-nine patients with pain for more than three months, of intensity greater than three on a numerical scale (zero to 10, were included. G1 patients received 1 mg (1 ml of morphine diluted in 9 ml of saline, intra-articularly, and G2 patients received 25 mg (10 ml of 0.25% bupivacaine without epinephrine. Pain was assessed on a numerical scale and knee flexion and extension angles were measured after administration of the drugs at rest and during movement. The total amount of analgesic supplementation using 500 mg doses of paracetamol was also determined. RESULTS: No significant difference in pain intensity was observed between G1 and G2. Significant decreases in pain at rest and during movement and significant increases in mean flexion and extension angles were observed in both groups, with no significant difference between the two groups. The mean total amount of paracetamol used over a seven-day period was 3578 mg in G1 and 5333 mg in G2 (P = 0.2355; Mann-Whitney test. CONCLUSION: The analgesic effects of 1 mg of morphine and 25 mg of 0.25% bupivacaine were similar among patients with osteoarthritis of the knee.

  5. Wear testing of moderate activities of daily living using in vivo measured knee joint loading.

    Directory of Open Access Journals (Sweden)

    Jörn Reinders

    Full Text Available Resumption of daily living activities is a basic expectation for patients provided with total knee replacements. However, there is a lack of knowledge regarding the impact of different activities on the wear performance. In this study the wear performance under application of different daily activities has been analyzed. In vivo load data for walking, walking downstairs/upstairs, sitting down/standing up, and cycling (50 W & 120 W has been standardized for wear testing. Wear testing of each activity was carried out on a knee wear simulator. Additionally, ISO walking was tested for reasons of comparison. Wear was assessed gravimetrically and wear particles were analyzed. In vivo walking produced the highest overall wear rates, which were determined to be three times higher than ISO walking. Moderate wear rates were determined for walking upstairs and downstairs. Low wear rates were determined for standing up/sitting down and cycling at power levels of 50 W and 120 W. The largest wear particles were observed for cycling. Walking based on in vivo data has been shown to be the most wear-relevant activity. Highly demanding activities (stair climbing produced considerably less wear. Taking into account the expected number of loads, low-impact activities like cycling may have a greater impact on articular wear than highly demanding activities.

  6. Functional outcomes of uni-knee arthroplasty for medial compartment knee arthropathy in asian patients

    Directory of Open Access Journals (Sweden)

    To Wong

    2014-12-01

    Full Text Available Background: Uni-knee arthroplasty (UKA has shown better knee kinematics and motion that may better suit the activities of daily living in Eastern countries. The purpose of this study was to evaluate the functional outcomes of UKA for medial compartment knee arthropathy in Asian patients. Methods: The study cohort consisted of 48 patients with 51 UK A knees. Only one type of prosthesis was used and all components were cemented. Postoperative management included ambulation with weight bearing, range of motion, and muscle strengthening exercises as tolerated until full recovery. The average follow-up was 52.0 ± 24.0 (range 12-92 months. The evaluation included functional assessment, the Knee Society knee and functional scores, the International Knee Document Committee (IKDC subjective and objective scores, and radiographs of the knee. Results: The overall clinical outcomes of the knee showed the functional outcome of the knee to be normal in 51%, nearly normal in 37%, abnormal in 8%, and severely abnormal in 4%. The functional activities included stair climbing in 96%, squatting in 76%, jogging in 71% and kneeling in 47%. Three-quarters of the patients were able to kneel for daily activities. Approximately 98% of the patients were satisfied with the operation. The survivorship of the prosthesis was 98% with one revision pending. Radiographic evaluations revealed the components were centered in 82% and off-centered in 18%. Osteoarthritis was 22% preoperative and 27% postoperative for the patellofemoral compartment, and 0% before and 4% after surgery for the lateral compartment. The functional outcomes showed no difference between patients with and without patellofemoral arthritis. The complications included one component malposition and one knee pain of undetermined origin. Conclusions: UKA provides excellent pain relief and restoration of knee function including kneeling, squatting, and sit-to-stand activities that perfectly fit the oriental

  7. An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force.

    Science.gov (United States)

    MacDonald, Graham Z; Penney, Michael D H; Mullaley, Michelle E; Cuconato, Amanda L; Drake, Corey D J; Behm, David G; Button, Duane C

    2013-03-01

    Foam rolling is thought to improve muscular function, performance, overuse, and joint range of motion (ROM); however, there is no empirical evidence demonstrating this. Thus, the objective of the study was to determine the effect of self-myofascial release (SMR) via foam roller application on knee extensor force and activation and knee joint ROM. Eleven healthy male (height 178.9 ± 3.5 cm, mass 86.3 ± 7.4 kg, age 22.3 ± 3.8 years) subjects who were physically active participated. Subjects' quadriceps maximum voluntary contraction force, evoked force and activation, and knee joint ROM were measured before, 2 minutes, and 10 minutes after 2 conditions: (a) 2, 1-minute trials of SMR of the quadriceps via a foam roller and (b) no SMR (Control). A 2-way analysis of variance (condition × time) with repeated measures was performed on all dependent variables recorded in the precondition and postcondition tests. There were no significant differences between conditions for any of the neuromuscular dependent variables. However, after foam rolling, subjects' ROM significantly (p foam rolling, which no longer existed after foam rolling. In conclusion, an acute bout of SMR of the quadriceps was an effective treatment to acutely enhance knee joint ROM without a concomitant deficit in muscle performance.

  8. Total knee arthroplasty for knee varus deformity:follow-up evaluation of femorotibial angle and range of motion%全膝关节置换修复膝内翻畸形:胫股角及膝关节活动度随访评价

    Institute of Scientific and Technical Information of China (English)

    李广伟; 王红军; 孙晓智; 陈林斌; 高宇亮; 白忠旭; 程新胜

    2015-01-01

      结果与结论:所有患者均获得随访,随访时间为12-96个月,随访方式为门诊复查随访。胫股角由置换前平均内翻17.69°(5°-30°)纠正至置换后的5.66°(2°-8°),膝关节活动度由置换前的74.29°(60°-95°)提高到置换后119.46°(105°-130°);HSS评分由置换前的26.60分(14-42分)提高到置换后89.03分(82-95分),优28膝,良7膝;WOMAC评分由42.83分(28-54分)提高到置换后90.17分(85-95分)。结果经统计学分析提示,所有病例置换后胫股角、膝关节活动度、HSS及WOMAC评分均较置换前显著改善(P OBJECTIVE:To observe the femorotibial angle and range of knee joint motion of adults patients with knee varus deformity during 1-year fol ow-up after total knee arthroplasty. METHODS:A total of 31 patients (35 knees) with knee varus deformity were treated with posterior stabilized prosthesis replacement from June 2006 to June 2013. Using patel ar medial approach, the correct osteotomy and selective soft tissue release were performed to restore normal knee alignment and soft tissue balance. Posterior stabilized prosthesis in total knee arthroplasty was applied to achieve knee stability. Postoperative targeted rehabilitation training was also fol owed. The femorotibial angle was measured before and after surgery. The range of knee joint motion was determined during postoperative fol ow-up. Patients were evaluated with the Hospital for Special Surgery (HSS) score and the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. RESULTS AND CONCLUSION:Al patients were fol owed up for 12-96 months through out-patient clinic. The femorotibial angle was corrected from preoperative varus 17.69° (5°-30°) to postoperative 5.66° (2°-8°);the range of knee joint motion was improved from preoperative 74.29° (60°-95°) to 119.46° (105°-130°);the HSS score increased from preoperative 26.60 points (14-42 points) to postoperative 89.03 points (82-95 points

  9. Hybrid magnetic mechanism for active locomotion based on inchworm motion

    Science.gov (United States)

    Kim, Sung Hoon; Hashi, Shuichiro; Ishiyama, Kazushi

    2013-02-01

    Magnetic robots have been studied in the past. Insect-type micro-robots are used in various biomedical applications; researchers have developed inchworm micro-robots for endoscopic use. A biological inchworm has a looping locomotion gait. However, most inchworm micro-robots depend on a general bending, or bellows, motion. In this paper, we introduce a new robotic mechanism using magnetic force and torque control in a rotating magnetic field for a looping gait. The proposed robot is controlled by the magnetic torque, attractive force, and body mechanisms (two stoppers, flexible body, and different frictional legs). The magnetic torque generates a general bending motion. In addition, the attractive force and body mechanisms produce the robot’s looping motion within a rotating magnetic field and without the use of an algorithm for field control. We verified the device’s performance and analyzed the motion through simulations and various experiments. The robot mechanism can be applied to active locomotion for various medical robots, such as wireless endoscopes.

  10. Cooling does not affect knee proprioception.

    Science.gov (United States)

    Ozmun, J C; Thieme, H A; Ingersoll, C D; Knight, K L

    1996-01-01

    The effect of cooling on proprioception of the knee has not been studied extensively. In this study, we investigated the movement reproduction (timing and accuracy) aspect of proprioception. Subjects were tested under two conditions: a 20-minute application of ice and control. Proprioceptive accuracy and timing were measured by passively moving the knee, then comparing the subject's active reproduction of the passive movement. Subjects were blindfolded, then tested in three sectors of the knee's range of motion: 90 degrees to 60 degrees , 60 degrees to 30 degrees , and 30 degrees to full extension. Ice application had no apparent effect on the subject's ability to perform accurate movement reproductions in the sectors tested. However, accuracy of the subject's final angle reproduction varied between the sectors as did the total time of the movement. One possible explanation for the difference between sectors is that different receptors are active at different points in the knee's range of motion. We conclude that cooling the knee joint for 20 minutes does not have an adverse effect on proprioception.

  11. In vivo prompt gamma neutron activation analysis for the screening of boron-10 distribution in a rabbit knee: a simulation study

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, X; Yanch, J [Department of Nuclear Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA (United States); Clackdoyle, R [Laboratoire Hubert Curien, Mixed Research Unit (UMR) 5516, CNRS and Universite Jean Monnet, Saint Etienne (France); Shortkroff, S [Department of Orthopedic Surgery, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States)

    2008-05-21

    Boron neutron capture synovectomy (BNCS) is under development as a potential treatment modality for rheumatoid arthritis (RA). RA is characterized by the inflammation of the synovium (the membrane lining articular joints), which leads to pain and a restricted range of motion. BNCS is a two-part procedure involving the injection of a boronated compound directly into the diseased joint followed by irradiation with a low-energy neutron beam. The neutron capture reactions taking place in the synovium deliver a local, high-linear energy transfer (LET) dose aimed at destroying the inflamed synovial membrane. For successful treatment via BNCS, a boron-labeled compound exhibiting both high synovial uptake and long retention time is necessary. Currently, the in vivo uptake behavior of potentially useful boronated compounds is evaluated in the knee joints of rabbits in which arthritis has been induced. This strategy involves the sacrifice and dissection of a large number of animals. An in vivo {sup 10}B screening approach is therefore under investigation with the goal of significantly reducing the number of animals needed for compound evaluation via dissection studies. The 'in vivo prompt gamma neutron activation analysis' (IVPGNAA) approach uses a narrow neutron beam to irradiate the knee from several angular positions following the intra-articular injection of a boronated compound whose uptake characteristics are unknown. A high-purity germanium detector collects the 478 keV gamma photons produced by the {sup 10}B capture reactions. The {sup 10}B distribution in the knee is then reconstructed by solving a system of simultaneous equations using a weighted least squares algorithm. To study the practical feasibility of IVPGNAA, simulation data were generated with the Monte Carlo N-particle transport code. The boron-containing region of a rabbit knee was partitioned into 8 compartments, and the {sup 10}B prompt gamma signals were tallied from 16 angular positions

  12. In vivo prompt gamma neutron activation analysis for the screening of boron-10 distribution in a rabbit knee: a simulation study

    Science.gov (United States)

    Zhu, X.; Clackdoyle, R.; Shortkroff, S.; Yanch, J.

    2008-05-01

    Boron neutron capture synovectomy (BNCS) is under development as a potential treatment modality for rheumatoid arthritis (RA). RA is characterized by the inflammation of the synovium (the membrane lining articular joints), which leads to pain and a restricted range of motion. BNCS is a two-part procedure involving the injection of a boronated compound directly into the diseased joint followed by irradiation with a low-energy neutron beam. The neutron capture reactions taking place in the synovium deliver a local, high-linear energy transfer (LET) dose aimed at destroying the inflamed synovial membrane. For successful treatment via BNCS, a boron-labeled compound exhibiting both high synovial uptake and long retention time is necessary. Currently, the in vivo uptake behavior of potentially useful boronated compounds is evaluated in the knee joints of rabbits in which arthritis has been induced. This strategy involves the sacrifice and dissection of a large number of animals. An in vivo 10B screening approach is therefore under investigation with the goal of significantly reducing the number of animals needed for compound evaluation via dissection studies. The 'in vivo prompt gamma neutron activation analysis' (IVPGNAA) approach uses a narrow neutron beam to irradiate the knee from several angular positions following the intra-articular injection of a boronated compound whose uptake characteristics are unknown. A high-purity germanium detector collects the 478 keV gamma photons produced by the 10B capture reactions. The 10B distribution in the knee is then reconstructed by solving a system of simultaneous equations using a weighted least squares algorithm. To study the practical feasibility of IVPGNAA, simulation data were generated with the Monte Carlo N-particle transport code. The boron-containing region of a rabbit knee was partitioned into 8 compartments, and the 10B prompt gamma signals were tallied from 16 angular positions. Results demonstrate that for this

  13. Thermally activated depinning motion of contact lines in pseudopartial wetting.

    Science.gov (United States)

    Du, Lingguo; Bodiguel, Hugues; Colin, Annie

    2014-07-01

    We investigate pressure-driven motion of liquid-liquid menisci in circular tubes, for systems in pseudopartial wetting conditions. The originality of this type of wetting lies in the coexistence of a macroscopic contact angle with a wetting liquid film covering the solid surface. Focusing on small capillary numbers, we report observations of an apparent contact angle hysteresis at first sight similar to the standard partial wetting case. However, this apparent hysteresis exhibits original features. We observe very long transient regimes before steady state, up to several hundreds of seconds. Furthermore, in steady state, the velocities are nonzero, meaning that the contact line is not strongly pinned to the surface defects, but are very small. The velocity of the contact line tends to vanish near the equilibrium contact angle. These observations are consistent with the thermally activated depinning theory that has been proposed to describe partial wetting systems on disordered substrates and suggest that a single physical mechanism controls both the hysteresis (or the pinning) and the motion of the contact line. The proposed analysis leads to the conclusion that the depinning activated energy is lower with pseudopartial wetting systems than with partial wetting ones, allowing the direct observation of the thermally activated motion of the contact line.

  14. Understanding barriers and facilitators to healthy eating and physical activity from patients either before and after knee arthroplasty.

    Science.gov (United States)

    Pellegrini, Christine A; Ledford, Gwendolyn; Chang, Rowland W; Cameron, Kenzie A

    2017-05-05

    We sought to identify patient-reported barriers and facilitators to healthy eating and physical activity among patients before or after knee arthroplasty. Twenty patients with knee osteoarthritis aged 40-79 years who had knee arthroplasty surgery scheduled or completed within 3 months were interviewed. Interview topics included perceived barriers and facilitators to healthy eating and activity before or after surgery. Interviews were coded and analyzed using constant comparative analysis. Interviews were completed with 11 pre-operative (67.1 ± 7.6 years, 45.5% female, BMI 31.2 ± 6.3) and nine post-operative patients (61.7 ± 11.7 years, 44.4% female, BMI 30.2 ± 4.7 kg/m(2)). The most commonly identified personal barriers to healthy eating identified were desire for high-fat/high-calorie foods, managing overconsumption and mood. Factors related to planning, portion control and motivation to improve health were identified as healthy eating facilitators. Identified personal barriers for activity included pain, physical limitations and lack of motivation, whereas facilitators included having motivation to improve knee symptoms/outcomes, personal commitment to activity and monitoring activity levels. Identifying specific eating and activity barriers and facilitators, such as mood and motivation to improve outcomes, provides critical insight from the patient perspective, which will aid in developing weight management programs during rehabilitation for knee arthroplasty patients. Implications for rehabilitation This study provides insight into the identified barriers and facilitators to healthy eating and physical activity in knee arthroplasty patients, both before and after surgery. Intrapersonal barriers that may hinder engagement in physical activity and rehabilitation include pain, physical limitations and lack of motivation; factors that may help to improve activity and the rehabilitation process include being motivated to improve knee outcomes

  15. A study on muscle activity and ratio of the knee extensor depending on the types of squat exercise

    Science.gov (United States)

    Kang, Jeong-Il; Park, Joon-Su; Choi, Hyun; Jeong, Dae-Keun; Kwon, Hye-Min; Moon, Young-Jun

    2017-01-01

    [Purpose] For preventing the patellofemoral pain syndrome, this study aims to suggest a proper squat method, which presents selective muscle activity of Vastus Medialis Oblique and muscle activity ratios of Vastus Medialis Oblique/Vastus Lateralis by applying squat that is a representative weight bearing exercise method in various ways depending on the surface conditions and knee bending angles. [Subjects and Methods] An isometric squat that was accompanied by hip adduction, depending on the surface condition and the knee joint flexion angle, was performed by 24 healthy students. The muscle activity and the ratio of muscle activity were measured. [Results] In a comparison of muscle activity depending on the knee joint flexion angle on a weight-bearing surface, the vastus medialis oblique showed a significant difference at 15° and 60°. Meanwhile, in a comparison of the muscle activity ratio between the vastus medialis oblique and the vastus lateralis depending on the knee joint flexion angle on a weight-bearing surface, significant differences were observed at 15° and 60°. [Conclusion] An efficient squat exercise posture for preventing the patellofemoral pain syndrome is to increase the knee joint bending angle on a stable surface. But it would be efficient for patients with difficulties in bending the knee joint to keep a knee joint bending angle of 15 degrees or less on an unstable surface. It is considered that in future, diverse studies on selective Vastus Medialis Oblique strengthening exercise methods would be needed after applying them to patients with the patellofemoral pain syndrome. PMID:28210036

  16. Motion sickness and tilts of the inertial force environment: active suspension systems vs. active passengers

    NARCIS (Netherlands)

    Golding, J.F.; Bles, W.; Bos, J.E.; Haynes, T.; Gresty, M.A.

    2003-01-01

    Maneuvering in vehicles exposes occupants to low frequency forces (<1 Hz) which can provoke motion sickness. Hypothesis: Aligning with the tilting inertial resultant (gravity + imposed horizontal acceleration: gravito-inertial force (GIF)) may reduce motion sickness when tilting is either 'active'

  17. Motion sickness and tilts of the inertial force environment: active suspension systems vs. active passengers

    NARCIS (Netherlands)

    Golding, J.F.; Bles, W.; Bos, J.E.; Haynes, T.; Gresty, M.A.

    2003-01-01

    Maneuvering in vehicles exposes occupants to low frequency forces (<1 Hz) which can provoke motion sickness. Hypothesis: Aligning with the tilting inertial resultant (gravity + imposed horizontal acceleration: gravito-inertial force (GIF)) may reduce motion sickness when tilting is either 'active' (

  18. Activity, Sleep and Cognition After Fast-Track Hip or Knee Arthroplasty

    DEFF Research Database (Denmark)

    Krenk, Lene; Jennum, Poul; Kehlet, Henrik

    2013-01-01

    Optimized perioperative care after total hip and knee arthroplasty (THA/TKA) has decreased length of stay (LOS) but data on activity, sleep and cognition after discharge are limited. We included 20 patients ≥60years undergoing THA/TKA, monitoring them for 3days preoperatively and 9days postoperat......Optimized perioperative care after total hip and knee arthroplasty (THA/TKA) has decreased length of stay (LOS) but data on activity, sleep and cognition after discharge are limited. We included 20 patients ≥60years undergoing THA/TKA, monitoring them for 3days preoperatively and 9days...... postoperatively with actigraphs for sleep and activity assessment. Pain scores were recorded daily. Cognition was evaluated by 2 cognitive tests. Results showed a mean age was 70.5years and mean LOS was 2.6days. Actigraphs showed increased daytime sleep and decreased motor activity postoperatively. Early...... postoperatively cognitive decline and increased pain returned to preoperative levels by postoperative day (POD) 5-9. Despite the small sample size the study illustrated that post-discharge activity is decreased and daytime sleep is increased after fast-track THA/TKA, while cognition and pain return...

  19. 全膝关节置换治疗成人膝外翻畸形:胫股角及膝关节活动度变化%Total knee arthroplasty for knee valgus deformity in the adults: Changes of tibiofemoral angle and range of motion of knee joint

    Institute of Scientific and Technical Information of China (English)

    李广伟

    2012-01-01

    BACKGROUND: Application of total knee arthroplasty (TKA) for knee valgus deformity can be difficult technically in many aspects and exist a lot of controversy.OBJECTIVE: To investigate the clinical efficiency and surgical methods of TKA for knee valgus deformity in the adults.METHODS: Totally 15 knees from 12 patients underwent patellar lateral approach for proper osteotomy and selective lysis of the soft tissue to regain normal biomechanics and soft tissue balance of knee were selected. Posterior stabilized prosthesis was used for TKA to obtain the stability of the knee. After the surgery, rehabilitation therapy pertinently was adopted. Before and after the surgery, tibiofemoral angle was measured. Range of motion (ROM) was examined and HSS score was evaluated.RESULTS AND CONCLUSION: All patients were followed up over 6 months. Tibiofemoral angle decreased from 21.47° preoperatively to 5.47° postoperatively (P < 0.01). The ROM increased from 81.33° preoperatively to 121.07° postoperatively (P < 0.01). HSS score improved from 25.47 preoperatively to 89.87 postoperatively (P < 0.01). After replacement, 1 case affected more joint effusion, 2 cases affected knee instability. There was no dislocation or subluxation of the patella. Force line of lower limb returned to normal. TKA can effectively correct the knee valgus deformity, and can significantly improve the function of the knee.%背景:膝外翻畸形施行人工全膝关节置换难度很大,涉及面多,争议亦颇多.目的:观察全膝关节置换治疗成人膝外翻畸形的手术方法和临床效果.方法:对12例15膝采用髌骨内侧入路,正确截骨,选择性的软组织松解,恢复膝关节正常的力线和软组织平衡,采用后稳定型假体进行全膝关节置换,获得膝关节的稳定,置换后采取针对性的康复训练,置换前后测量胫股角,并置换后定期随访检查膝关节活动度并进行HSS评分.结果与结论:所有患者获得随访均>6

  20. Collective motion in an active suspension of Escherichia coli bacteria

    Science.gov (United States)

    Gachelin, J.; Rousselet, A.; Lindner, A.; Clement, E.

    2014-02-01

    We investigate experimentally the emergence of collective motion in the bulk of an active suspension of Escherichia coli bacteria. When increasing the concentration from a dilute to a semi-dilute regime, we observe a continuous crossover from a dynamical cluster regime to a regime of ‘bio-turbulence’ convection patterns. We measure a length scale characterizing the collective motion as a function of the bacteria concentration. For bacteria fully supplied with oxygen, the increase of the correlation length is almost linear with concentration and at the largest concentrations tested, the correlation length could be as large as 24 bacterial body sizes (or 7-8 when including the flagella bundle). In contrast, under conditions of oxygen shortage the correlation length saturates at a value of around 7 body lengths.

  1. Influence of knee flexion angle and age on triceps surae muscle activity during heel raises.

    Science.gov (United States)

    Hébert-Losier, Kim; Schneiders, Anthony G; García, José A; Sullivan, S John; Simoneau, Guy G

    2012-11-01

    Triceps surae and Achilles tendon injuries are frequent in sports medicine, particularly in middle-aged adults. Muscle imbalances and weakness are suggested to be involved in the etiology of these conditions, with heel-raise testing often used to assess and treat triceps surae (TS) injuries. Although heel raises are recommended with the knee straight for gastrocnemius and bent for soleus (SOL), the extent of muscle selectivity in these positions is not clear. This study aimed to determine the influence of knee angle and age on TS muscle activity during heel raises. Forty-eight healthy men and women were recruited from a younger-aged (18-25 years) and middle-aged (35-45 years) population. All the subjects performed unilateral heel raises in 0° and 45° knee flexion (KF). Soleus, gastrocnemius medialis (GM) and gastrocnemius lateralis (GL) surface electromyography signals were processed to compute root-mean-square amplitudes, and data were analyzed using mixed-effects models and stepwise regression. The mean TS activity during heel raises was 23% of maximum voluntary isometric contraction when performed in 0° KF and 21% when in 45°. Amplitudes were significantly different between TS muscles (p < 0.001) and KF angles (p < 0.001), with a significant interaction (p < 0.001). However, the age of the population did not influence the results (p = 0.193). The findings demonstrate that SOL activity was 4% greater when tested in 45° compared with 0° KF and 5% lower in the GM and GL. The results are consistent with the recommended use of heel raises in select knee positions for assessing, training, and rehabilitating the SOL and gastrocnemius muscles; however, the 4-5% documented change in activity might not be enough to significantly influence clinical outcome measures or muscle-specific benefits. Contrary to expectations, TS activity did not distinguish between middle-aged and younger-aged adults, despite the higher injury prevalence in middle age.

  2. Motion of Euglena gracilis: Active fluctuations and velocity distribution

    Science.gov (United States)

    Romanczuk, P.; Romensky, M.; Scholz, D.; Lobaskin, V.; Schimansky-Geier, L.

    2015-07-01

    We study the velocity distribution of unicellular swimming algae Euglena gracilis using optical microscopy and active Brownian particle theory. To characterize a peculiar feature of the experimentally observed distribution at small velocities we use the concept of active fluctuations, which was recently proposed for the description of stochastically self-propelled particles [Romanczuk, P. and Schimansky-Geier, L., Phys. Rev. Lett. 106, 230601 (2011)]. In this concept, the fluctuating forces arise due to internal random performance of the propulsive motor. The fluctuating forces are directed in parallel to the heading direction, in which the propulsion acts. In the theory, we introduce the active motion via the depot model [Schweitzer, et al., Phys. Rev. Lett. 80(23), 5044 (1998)]. We demonstrate that the theoretical predictions based on the depot model with active fluctuations are consistent with the experimentally observed velocity distributions. In addition to the model with additive active noise, we obtain theoretical results for a constant propulsion with multiplicative noise.

  3. Investigation on Inter-Limb Coordination and Motion Stability, Intensity and Complexity of Trunk and Limbs during Hands-Knees Crawling in Human Adults.

    Science.gov (United States)

    Ma, Shenglan; Chen, Xiang; Cao, Shuai; Yu, Yi; Zhang, Xu

    2017-03-28

    This study aimed to investigate the inter-limb coordination pattern and the stability, intensity, and complexity of the trunk and limbs motions in human crawling under different speeds. Thirty healthy human adults finished hands-knees crawling trials on a treadmill at six different speeds (from 1 km/h to 2.5 km/h). A home-made multi-channel acquisition system consisting of five 3-axis accelerometers (ACC) and four force sensors was used for the data collection. Ipsilateral phase lag was used to represent inter-limb coordination pattern during crawling and power, harmonic ratio, and sample entropy of acceleration signals were adopted to depict the motion intensity, stability, and complexity of trunk and limbs respectively. Our results revealed some relationships between inter-limb coordination patterns and the stability and complexity of trunk movement. Trot-like crawling pattern was found to be the most stable and regular one at low speed in the view of trunk movement, and no-limb-pairing pattern showed the lowest stability and the greatest complexity at high speed. These relationships could be used to explain why subjects tended to avoid no-limb-pairing pattern when speed was over 2 km/h no matter which coordination type they used at low speeds. This also provided the evidence that the central nervous system (CNS) chose a stable inter-limb coordination pattern to keep the body safe and avoid tumbling. Although considerable progress has been made in the study of four-limb locomotion, much less is known about the reasons for the variety of inter-limb coordination. The research results of the exploration on the inter-limb coordination pattern choice during crawling from the standpoint of the motion stability, intensity, and complexity of trunk and limbs sheds light on the underlying motor control strategy of the human CNS and has important significance in the fields of clinical diagnosis, rehabilitation engineering, and kinematics research.

  4. Acute effects of blood flow restriction on muscle activity and endurance during fatiguing dynamic knee extensions at low load.

    Science.gov (United States)

    Wernbom, Mathias; Järrebring, Rickard; Andreasson, Mikael A; Augustsson, Jesper

    2009-11-01

    The purpose of this study was to investigate muscle activity and endurance during fatiguing low-intensity dynamic knee extension exercise with and without blood flow restriction. Eleven healthy subjects with strength training experience performed 3 sets of unilateral knee extensions with no relaxation between repetitions to concentric torque failure at 30% of the 1 repetition maximum. One leg was randomized to exercise with cuff occlusion and the other leg to exercise without occlusion. The muscle activity in the quadriceps was recorded with electromyography (EMG). Ratings of perceived exertion (RPE) and acute pain were collected immediately, and delayed onset muscle soreness (DOMS) was rated before and at 24, 48, and 72 hours after exercise. The results demonstrated high EMG levels in both experimental conditions, but there were no significant differences regarding maximal muscle activity, except for a higher EMG in the eccentric phase in set 3 for the nonoccluded condition (p = 0.005). Significantly more repetitions were performed with the nonoccluded leg in every set (p knee extension decreases the endurance but does not increase the maximum muscle activity compared with training without restriction when both regimes are performed to failure. The high levels of muscle activity suggest that performing low-load dynamic knee extensions in a no-relaxation manner may be a useful method in knee rehabilitation settings when large forces are contraindicated. However, similarly to fatiguing blood flow restricted exercise, this method is associated with ischemic muscle pain, and thus its applications may be limited to highly motivated individuals.

  5. Human-robot interaction: kinematics and muscle activity inside a powered compliant knee exoskeleton.

    Science.gov (United States)

    Knaepen, Kristel; Beyl, Pieter; Duerinck, Saartje; Hagman, Friso; Lefeber, Dirk; Meeusen, Romain

    2014-11-01

    Until today it is not entirely clear how humans interact with automated gait rehabilitation devices and how we can, based on that interaction, maximize the effectiveness of these exoskeletons. The goal of this study was to gain knowledge on the human-robot interaction, in terms of kinematics and muscle activity, between a healthy human motor system and a powered knee exoskeleton (i.e., KNEXO). Therefore, temporal and spatial gait parameters, human joint kinematics, exoskeleton kinetics and muscle activity during four different walking trials in 10 healthy male subjects were studied. Healthy subjects can walk with KNEXO in patient-in-charge mode with some slight constraints in kinematics and muscle activity primarily due to inertia of the device. Yet, during robot-in-charge walking the muscular constraints are reversed by adding positive power to the leg swing, compensating in part this inertia. Next to that, KNEXO accurately records and replays the right knee kinematics meaning that subject-specific trajectories can be implemented as a target trajectory during assisted walking. No significant differences in the human response to the interaction with KNEXO in low and high compliant assistance could be pointed out. This is in contradiction with our hypothesis that muscle activity would decrease with increasing assistance. It seems that the differences between the parameter settings of low and high compliant control might not be sufficient to observe clear effects in healthy subjects. Moreover, we should take into account that KNEXO is a unilateral, 1 degree-of-freedom device.

  6. After total knee arthroplasty, many people are not active enough to maintain their health and fitness : an observational study

    NARCIS (Netherlands)

    Groen, Jan-Willem; Stevens, Martin; Kersten, Roel F. M. R.; Reininga, Inge H. F.; van den Akker-Scheek, Inge

    2012-01-01

    Questions: What proportion of people after total knee arthroplasty adheres to the physical activity regimen recommended for maintenance of health (moderate intensity physical activity for at least 30 min on 5 days/week)? What proportion adheres to the activity regimen recommended to improve fitness

  7. Knee problems and its associated factors among active cyclists in Eastern Province, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdullatif K Althunyan

    2017-01-01

    Conclusion: Knee injuries are common with cyclists. Factors such as the type of the bicycle, the goal of bicycling, club type, body mass index, and participation in other sports play a significant role in the rate of knee pain.

  8. Fusion of smartphone motion sensors for physical activity recognition.

    Science.gov (United States)

    Shoaib, Muhammad; Bosch, Stephan; Incel, Ozlem Durmaz; Scholten, Hans; Havinga, Paul J M

    2014-06-10

    For physical activity recognition, smartphone sensors, such as an accelerometer and a gyroscope, are being utilized in many research studies. So far, particularly, the accelerometer has been extensively studied. In a few recent studies, a combination of a gyroscope, a magnetometer (in a supporting role) and an accelerometer (in a lead role) has been used with the aim to improve the recognition performance. How and when are various motion sensors, which are available on a smartphone, best used for better recognition performance, either individually or in combination? This is yet to be explored. In order to investigate this question, in this paper, we explore how these various motion sensors behave in different situations in the activity recognition process. For this purpose, we designed a data collection experiment where ten participants performed seven different activities carrying smart phones at different positions. Based on the analysis of this data set, we show that these sensors, except the magnetometer, are each capable of taking the lead roles individually, depending on the type of activity being recognized, the body position, the used data features and the classification method employed (personalized or generalized). We also show that their combination only improves the overall recognition performance when their individual performances are not very high, so that there is room for performance improvement. We have made our data set and our data collection application publicly available, thereby making our experiments reproducible.

  9. Fusion of Smartphone Motion Sensors for Physical Activity Recognition

    Directory of Open Access Journals (Sweden)

    Muhammad Shoaib

    2014-06-01

    Full Text Available For physical activity recognition, smartphone sensors, such as an accelerometer and a gyroscope, are being utilized in many research studies. So far, particularly, the accelerometer has been extensively studied. In a few recent studies, a combination of a gyroscope, a magnetometer (in a supporting role and an accelerometer (in a lead role has been used with the aim to improve the recognition performance. How and when are various motion sensors, which are available on a smartphone, best used for better recognition performance, either individually or in combination? This is yet to be explored. In order to investigate this question, in this paper, we explore how these various motion sensors behave in different situations in the activity recognition process. For this purpose, we designed a data collection experiment where ten participants performed seven different activities carrying smart phones at different positions. Based on the analysis of this data set, we show that these sensors, except the magnetometer, are each capable of taking the lead roles individually, depending on the type of activity being recognized, the body position, the used data features and the classification method employed (personalized or generalized. We also show that their combination only improves the overall recognition performance when their individual performances are not very high, so that there is room for performance improvement. We have made our data set and our data collection application publicly available, thereby making our experiments reproducible.

  10. Photothermally activated motion and ignition using aluminum nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Abboud, Jacques E.; Chong Xinyuan; Zhang Mingjun; Zhang Zhili [Mechanical, Aerospace and Biomedical Engineering Department, University of Tennessee, Knoxville, Tennessee 37996 (United States); Jiang Naibo; Roy, Sukesh [Spectral Energies, LLC, 5100 Springfield Street, Suite 301, Dayton, Ohio 45431 (United States); Gord, James R. [Air Force Research Laboratory, Propulsion Directorate, Wright-Patterson Air Force Base, Ohio 45433 (United States)

    2013-01-14

    The aluminum nanoparticles (Al NPs) are demonstrated to serve as active photothermal media, to enhance and control local photothermal energy deposition via the photothermal effect activated by localized surface plasmon resonance (LSPR) and amplified by Al NPs oxidation. The activation source is a 2-AA-battery-powered xenon flash lamp. The extent of the photothermally activated movement of Al NPs can be {approx}6 mm. Ignition delay can be {approx}0.1 ms. Both scanning electron microscopy and energy-dispersive X-ray spectroscopy measurements of motion-only and after-ignition products confirm significant Al oxidation occurs through sintering and bursting after the flash exposure. Simulations suggest local heat generation is enhanced by LSPR. The positive-feedback effects from the local heat generation amplified by Al oxidation produce a large increase in local temperature and pressure, which enhances movement and accelerates ignition.

  11. Photothermally activated motion and ignition using aluminum nanoparticles

    Science.gov (United States)

    Abboud, Jacques E.; Chong, Xinyuan; Zhang, Mingjun; Zhang, Zhili; Jiang, Naibo; Roy, Sukesh; Gord, James R.

    2013-01-01

    The aluminum nanoparticles (Al NPs) are demonstrated to serve as active photothermal media, to enhance and control local photothermal energy deposition via the photothermal effect activated by localized surface plasmon resonance (LSPR) and amplified by Al NPs oxidation. The activation source is a 2-AA-battery-powered xenon flash lamp. The extent of the photothermally activated movement of Al NPs can be ˜6 mm. Ignition delay can be ˜0.1 ms. Both scanning electron microscopy and energy-dispersive X-ray spectroscopy measurements of motion-only and after-ignition products confirm significant Al oxidation occurs through sintering and bursting after the flash exposure. Simulations suggest local heat generation is enhanced by LSPR. The positive-feedback effects from the local heat generation amplified by Al oxidation produce a large increase in local temperature and pressure, which enhances movement and accelerates ignition.

  12. Motion of Euglena Gracilis: Active Fluctuations and Velocity Distribution

    CERN Document Server

    Romanczuk, Pawel; Scholz, Dimitri; Lobaskin, Vladimir; Schimansky-Geier, Lutz

    2015-01-01

    We study the velocity distribution of unicellular swimming algae Euglena gracilis using optical microscopy and theory. To characterize a peculiar feature of the experimentally observed distribution at small velocities we use the concept of active fluctuations, which was recently proposed for the description of stochastically self-propelled particles [Romanczuk, P. and Schimansky-Geier, L., Phys. Rev. Lett. 106, 230601 (2011)]. In this concept, the fluctuating forces arise due to internal random performance of the propulsive motor. The fluctuating forces are directed in parallel to the heading direction, in which the propulsion acts. In the theory, we introduce the active motion via the depot model [Schweitzer et al., Phys. Rev. Lett. 80, 23, 5044 (1998)]. We demonstrate that the theoretical predictions based on the depot model with active fluctuations are consistent with the experimentally observed velocity distributions. In addition to the model with additive active noise, we obtain theoretical results for a...

  13. Knee hemarthrosis after arthroscopic surgery in an athlete with low factor XIII activity

    Directory of Open Access Journals (Sweden)

    Tsujii Akira

    2012-10-01

    Full Text Available Abstract We report a thirteen-year-old tennis player with knee hemarthrosis caused by low factor XIII activity. She visited our hospital because of medial peripatellar pain for two years. Although there was no abnormal sign in X-ray or MRI, diagnostic arthroscopy was performed. It revealed some cartilage debris, medial plica and complete septum of suprapatellar plica. Removing the debris by washing out and resecting the medial plica, she could return to play tennis without perioperative symptom. Two months after the first operation, her knee got swelling without any apparent cause. Since 20 ml blood was aspirated twice and MRI revealed suprapatellar mass, we performed arthroscopy again. Suprapatellar mass was old blood clot covered with complete suprapatellar plica. Resection of suprapatellar plica and washing out blood clot were performed, and severe postoperative hemarthrosis was progressively occurred. As factor XIII level was 54% preoperatively, we diagnosed that this condition was caused by low activity level of the factor and administered factor XIII concentrates. The level got improved to 129% and then hemarthrosis gradually relieved. She had no signs of recurrence. We should keep in mind of low factor XIII activity case in case of unexplained postoperative hemarthrosis after arthroscopy because consumption of the factor might promote this condition.

  14. Knee hemarthrosis after arthroscopic surgery in an athlete with low factor XIII activity.

    Science.gov (United States)

    Tsujii, Akira; Tanaka, Yoshinari; Yonetani, Yasukazu; Shiozaki, Yoshiki; Tomiyama, Yoshiaki; Horibe, Shuji

    2012-10-02

    We report a thirteen-year-old tennis player with knee hemarthrosis caused by low factor XIII activity. She visited our hospital because of medial peripatellar pain for two years. Although there was no abnormal sign in X-ray or MRI, diagnostic arthroscopy was performed. It revealed some cartilage debris, medial plica and complete septum of suprapatellar plica. Removing the debris by washing out and resecting the medial plica, she could return to play tennis without perioperative symptom. Two months after the first operation, her knee got swelling without any apparent cause. Since 20 ml blood was aspirated twice and MRI revealed suprapatellar mass, we performed arthroscopy again. Suprapatellar mass was old blood clot covered with complete suprapatellar plica. Resection of suprapatellar plica and washing out blood clot were performed, and severe postoperative hemarthrosis was progressively occurred. As factor XIII level was 54% preoperatively, we diagnosed that this condition was caused by low activity level of the factor and administered factor XIII concentrates. The level got improved to 129% and then hemarthrosis gradually relieved. She had no signs of recurrence. We should keep in mind of low factor XIII activity case in case of unexplained postoperative hemarthrosis after arthroscopy because consumption of the factor might promote this condition.

  15. Differential brain activity states during the perception and nonperception of illusory motion as revealed by magnetoencephalography.

    Science.gov (United States)

    Crowe, David A; Leuthold, Arthur C; Georgopoulos, Apostolos P

    2010-12-28

    We studied visual perception using an annular random-dot motion stimulus called the racetrack. We recorded neural activity using magnetoencephalography while subjects viewed variants of this stimulus that contained no inherent motion or various degrees of embedded motion. Subjects reported seeing rotary motion during viewing of all stimuli. We found that, in the absence of any motion signals, patterns of brain activity differed between states of motion perception and nonperception. Furthermore, when subjects perceived motion, activity states within the brain did not differ across stimuli of different amounts of embedded motion. In contrast, we found that during periods of nonperception brain-activity states varied with the amount of motion signal embedded in the stimulus. Taken together, these results suggest that during perception the brain may lock into a stable state in which lower-level signals are suppressed.

  16. The Effects of Knee Joint and Hip Abduction Angles on the Activation of Cervical and Abdominal Muscles during Bridging Exercises.

    Science.gov (United States)

    Lee, Su-Kyoung; Park, Du-Jin

    2013-07-01

    [Purpose] The purpose of this study was to examine the effects of the flexion angle of the knee joint and the abduction angle of the hip joint on the activation of the cervical region and abdominal muscles. [Subjects] A total of 42 subjects were enrolled 9 males and 33 females. [Methods] The bridging exercise in this study was one form of exercise with a knee joint flexion angle of 90°. Based on this, a bridging exercise was conducted at the postures of abduction of the lower extremities at 0, 5, 10, and 15°. [Result] The changes in the knee joint angle and the hip abduction angle exhibited statistically significant effects on the cervical erector spinae, adductor magnus, and gluteus medius muscles. The abduction angles did not result in statistically significant effects on the upper trapezium, erector spinae, external oblique, and rectus abdominis muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. [Conclusion] When patients with both cervical and back pain do a bridging exercise, widening the knee joint angle would reduce cervical and shoulder muscle activity through minimal levels of abduction, permitting trunk muscle strengthening with reduced cervical muscle activity. This method would be helpful for strengthening trunk muscles in a selective manner.

  17. Knee Extensor Electromyographic Activity-to-Work Ratio is Greater With Isotonic Than Isokinetic Contractions.

    Science.gov (United States)

    Schmitz, Randy J.; Westwood, Kevin C.

    2001-12-01

    OBJECTIVE: To determine whether isotonic or isokinetic contractions produced greater electromyographic (EMG) activity per unit of work during isotonic and isokinetic knee-extension exercise. DESIGN AND SETTING: Subjects performed three 3-second maximal voluntary isometric contractions of the dominant knee extensors for EMG normalization. Exercise testing performed on the Biodex System 3 Dynamometer involved 10 isokinetic contractions at 180 degrees.s(-1) and 10 isotonic contractions with the resistance set at 50% of the previously recorded maximal voluntary isometric contraction. SUBJECTS: Recreationally active college students (10 men and 11 women). MEASUREMENTS: Surface EMG signals were collected from the vastus medialis and lateralis muscles and then integrated (IEMG) over the concentric phase of each repetition for both exercises. The IEMG was divided by the total work performed during the concentric phase for each exercise (IEMG/W). RESULTS: We analyzed the IEMG/W data using a 1-between (sex), 2-within (exercise and muscle) repeated-measures analysis of variance. There was a significant main effect for exercise, with the isotonic IEMG/W value being significantly greater than the isokinetic IEMG/W value. Additionally, the IEMG/W relationship did not appear to be affected by sex or individual muscle tested. CONCLUSIONS: Per unit of work performed, the isotonic contractions resulted in greater motor unit recruitment or an increased rate of firing, or both. This finding may have implications for the early phase of rehabilitation, when goals include complete motor unit recruitment of injured or atrophied muscles.

  18. Time-driven activity based costing of total knee replacement surgery at a London teaching hospital.

    Science.gov (United States)

    Chen, Alvin; Sabharwal, Sanjeeve; Akhtar, Kashif; Makaram, Navnit; Gupte, Chinmay M

    2015-12-01

    The aim of this study was to conduct a time-driven activity based costing (TDABC) analysis of the clinical pathway for total knee replacement (TKR) and to determine where the major cost drivers lay. The in-patient pathway was prospectively mapped utilising a TDABC model, following 20 TKRs. The mean age for these patients was 73.4 years. All patients were ASA grade I or II and their mean BMI was 30.4. The 14 varus knees had a mean deformity of 5.32° and the six valgus knee had a mean deformity of 10.83°. Timings were prospectively collected as each patient was followed through the TKR pathway. Pre-operative costs including pre-assessment and joint school were £ 163. Total staff costs for admission and the operating theatre were £ 658. Consumables cost for the operating theatre were £ 1862. The average length of stay was 5.25 days at a total cost of £ 910. Trust overheads contributed £ 1651. The overall institutional cost of a 'noncomplex' TKR in patients without substantial medical co-morbidities was estimated to be £ 5422, representing a profit of £ 1065 based on a best practice tariff of £ 6487. The major cost drivers in the TKR pathway were determined to be theatre consumables, corporate overheads, overall ward cost and operating theatre staffing costs. Appropriate discounting of implant costs, reduction in length of stay by adopting an enhanced recovery programme and control of corporate overheads through the use of elective orthopaedic treatment centres are proposed approaches for reducing the overall cost of treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Age-related changes in kinematics of the knee joint during deep squat.

    Science.gov (United States)

    Fukagawa, Shingo; Leardini, Alberto; Callewaert, Barbara; Wong, Pius D; Labey, Luc; Desloovere, Kaat; Matsuda, Shuichi; Bellemans, Johan

    2012-06-01

    Researchers frequently use the deep knee squat as a motor task in order to evaluate the kinematic performance after total knee arthroplasty. Many authors reported about the kinematics of a normal squatting motion, however, little is known on what the influence of aging is. Twenty-two healthy volunteers in various age groups (range 21-75 years) performed a deep knee squat activity while undergoing motion analysis using an optical tracking system. The influence of aging was evaluated with respect to kinematics of the trunk, hip, knee and ankle joints. Older subjects required significantly more time to perform a deep squat, especially during the descending phase. They also had more knee abduction and delayed peak knee flexion. Older subjects were slower in descend than ascend during the squat. Although older subjects had a trend towards less maximal flexion and less internal rotation of the knee compared to younger subjects, this difference was not significant. Older subjects also showed a trend towards more forward leaning of the trunk, resulting in increased hip flexion and anterior thoracic tilt. This study confirmed that some aspects of squat kinematics vary significantly with age, and that the basic methodology employed here can successfully detect these age-related trends. Older subjects had more abduction of the knee joint, and this may indicate the load distribution of the medial and lateral condyles could be different amongst ages. Age-matched control data are therefore required whenever the performance of an implant is evaluated during a deep knee squat.

  20. Development and preliminary testing of a computerized Animated Activity Questionnaire (AAQ) in patients with hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Peter, Wf; Loos, M; de Vet, Hcw

    2015-01-01

    Objective To develop an Animated Activity Questionnaire (AAQ), based on video animations, for assessing activity limitations in patients with hip/knee osteoarthritis (OA), which combines the advantages of self-reported questionnaires and performance-based tests, without many of their limitations......, 4) existing measurement instruments, and 5) focus groups of patients. Test-retest reliability was assessed in 30/110 patients. In 110 patients correlations were calculated between AAQ and self-reported Hip disability and Knee injury Osteoarthritis Outcome ADL subscale (H/KOOS). In 45/110 patients...

  1. Individuals with medial knee osteoarthritis show neuromuscular adaptation when perturbed during walking despite functional and structural impairments.

    Science.gov (United States)

    Kumar, Deepak; Swanik, Charles Buz; Reisman, Darcy S; Rudolph, Katherine S

    2014-01-01

    Neuromuscular control relies on sensory feedback that influences responses to changing external demands, and the normal response is for movement and muscle activation patterns to adapt to repeated perturbations. People with knee osteoarthritis (OA) are known to have pain, quadriceps weakness, and neuromotor deficits that could affect adaption to external perturbations. The aim of this study was to analyze neuromotor adaptation during walking in people with knee OA (n = 38) and controls (n = 23). Disability, quadriceps strength, joint space width, malalignment, and proprioception were assessed. Kinematic and EMG data were collected during undisturbed walking and during perturbations that caused lateral translation of the foot at initial contact. Knee excursions and EMG magnitudes were analyzed. Subjects with OA walked with less knee motion and higher muscle activation and had greater pain, limitations in function, quadriceps weakness, and malalignment, but no difference was observed in proprioception. Both groups showed increased EMG and decreased knee motion in response to the first perturbation, followed by progressively decreased EMG activity and increased knee motion during midstance over the first five perturbations, but no group differences were observed. Over 30 trials, EMG levels returned to those of normal walking. The results illustrate that people with knee OA respond similarly to healthy individuals when exposed to challenging perturbations during functional weight-bearing activities despite structural, functional, and neuromotor impairments. Mechanisms underlying the adaptive response in people with knee OA need further study.

  2. Thompson′s quadricepsplasty for stiff knee

    Directory of Open Access Journals (Sweden)

    Kundu Z

    2007-01-01

    Full Text Available Background : Stiffness of the knee after trauma and/or surgery for femoral fractures is one of the most common complications and is difficult to treat. Stiffness in extension is more common and can be reduced by vigorous physiotherapy. If it does not improve then quadricepsplasty is indicated. The present study was undertaken to evaluate the results of Thompsons quadricepsplasty. Materials and Methods : 22 male patients (age range 20-45 years with posttraumatic knee stiffness following distal femoral fractures underwent Thompson′s quadricepsplasty where knee flexion range was less than 45°. The index injury in these patients was treated with plaster cast (n=5, plates (n=3, intramedullary nailing (n=3 and external fixator for open fractures (n=9. Thompson′s quadricepsplasty was performed in all the patients using anterior approach, with incision extending from upper thigh to tibial tubercle. Release of rectus femoris from underlying vastus intermedius and release of intraarticular adhesions were performed. After surgery the patients needed parentral analgesia for three days and then oral analgesics for three weeks. Active assisted knee mobilization exercises were started on the first post-operative day. Continous passive motion machine was used from the same day. Supervised physiotherapy was continued in hospital for six weeks followed by intensive knee flexion and extension exercise including cycling at home for atleast another six months. Results : Out of 22 patients, 20 had excellent to good results and two patients had poor results using criteria devised by Judet. One poor result was due to peroperative fracture of patella which was then internally fixed and hence the flexion of knee could not be started immediately. There was peroperative avulsion of tibial tuberosity in another patient who finally gained less than 50° knee flexion and hence a poor result. Conclusion : Thompsons quadricepsplasty followed by a strict and rigourous

  3. Knee-extension-assist for knee-ankle-foot orthoses.

    Science.gov (United States)

    Spring, Alexander; Kofman, Jonathan; Lemaire, Edward

    2011-01-01

    Individuals with quadriceps muscle weakness often have difficulty generating the knee-extension moments required for common mobility tasks. A new device that provides a knee-extension moment was designed to help individuals perform sit-to-stand and stand-to-sit. The knee-extension-assist (KEA) was designed as a modular component to be incorporated into existing knee-ankle-foot-orthoses (KAFO). The KEA loads a set of springs as the knee flexes under bodyweight and returns the stored energy as an extension moment during knee extension. The springs can be locked in place at the end of flexion to prevent unwanted knee extension while seated. When the affected leg is unloaded, the device disengages, allowing free joint motion. A prototype KEA underwent mechanical testing and biomechanical evaluation on an able-bodied individual during sit-to-stand and stand-to-sit.

  4. Prevalent knee pain and sport

    DEFF Research Database (Denmark)

    Hahn, Thomas; Foldspang, Anders

    1998-01-01

    STUDY OBJECTIVE: To estimate the prevalence of knee pain in active athletes and to investigate potential associations to type, amount and duration of sports participation. MEASUREMENTS: 339 athletes gave information about occupation, sports activity and different features of knee pain, based...... on a self-filled questionnaire. MAIN RESULTS: The prevalence of knee pain within the preceding 12 months, constant or recurrent knee pain, absence from sport and absence from work due to knee pain, was 54%, 34%, 19% and 4%, respectively. Knee pain was positively associated with years of jogging...... and with weekly hours of participation in competitive gymnastics but negatively with weekly hours of tennis. Constant or recurrent knee pain was positively associated with years of swimming. Absence from sport due to knee pain was positively associated with weekly hours of soccer participation. CONCLUSIONS: Knee...

  5. Fuzzy Modelling of Knee Joint with Genetic Optimization

    Directory of Open Access Journals (Sweden)

    B. S. K. K. Ibrahim

    2011-01-01

    Full Text Available Modelling of joint properties of lower limbs in people with spinal cord injury is significantly challenging for researchers due to the complexity of the system. The objective of this study is to develop a knee joint model capable of relating electrical parameters to dynamic joint torque as well as knee angle for functional electrical stimulation application. The joint model consists of a segmental dynamic, time-invariant passive properties and uncertain time-variant active properties. The knee joint model structure comprising optimised equations of motion and fuzzy models to represent the passive viscoelasticity and active muscle properties is formulated. The model thus formulated is optimised using genetic optimization, and validated against experimental data. The developed model can be used for simulation of joint movements as well as for control development. The results show that the model developed gives an accurate dynamic characterisation of the knee joint.

  6. Coupling of Active Motion and Advection Shapes Intracellular Cargo Transport

    CERN Document Server

    Trong, P Khuc; Goldstein, R E; 10.1103/PhysRevLett.109.028104

    2012-01-01

    Intracellular cargo transport can arise from passive diffusion, active motor-driven transport along cytoskeletal filament networks, and passive advection by fluid flows entrained by such motor/cargo motion. Active and advective transport are thus intrinsically coupled as related, yet different representations of the same underlying network structure. A reaction-advection-diffusion system is used here to show that this coupling affects the transport and localization of a passive tracer in a confined geometry. For sufficiently low diffusion, cargo localization to a target zone is optimized either by low reaction kinetics and decoupling of bound and unbound states, or by a mostly disordered cytoskeletal network with only weak directional bias. These generic results may help to rationalize subtle features of cytoskeletal networks, for example as observed for microtubules in fly oocytes.

  7. Generation of physiological parameter sets for hip joint motions and loads during daily life activities for application in wear simulators of the artificial hip joint.

    Science.gov (United States)

    Fabry, Christian; Herrmann, Sven; Kaehler, Michael; Klinkenberg, Ernst-Dieter; Woernle, Christoph; Bader, Rainer

    2013-01-01

    At present, wear investigations of total hip replacements are performed in accordance with the ISO standard 14242, which is based on simplified kinematic and force data of the gait cycle. The aim of this analytical study was to generate parameter sets of daily life activities in order to replicate more realistic joint load situations in wear testing. Hence, published in vivo motion and force data of daily life activities were evaluated and adjusted using analytical techniques. The created kinematically and dynamically consistent parameter sets comprised time trajectories of three Cardan angles to describe the motion of the femur with respect to the pelvis and time trajectories of three force components, representing the hip joint contact force. The parameter sets include the activities of walking, knee bending, stair climbing and a combined load case of sitting down and standing up. Additionally, a motion sequence following the frequency of daily life activities was presented. Differences of the evaluated angular motions and joint contact forces in comparison to the ISO standard 14242-1 were pointed out. The results of this study offer the possibility to extend the kinematics and dynamics of the ISO standard test protocol and to support the loading conditions of hip wear simulators with a comprehensive set of motions and loads close to reality.

  8. Knee Problems

    Science.gov (United States)

    ... BMI Calculator myhealthfinder Immunization Schedules Nutrient Shortfall Questionnaire Knee ProblemsPain, swelling, stiffness and "water" on the knee are common symptoms. Follow this chart for more ...

  9. Intracellular water motion decreases in apoptotic macrophages after caspase activation.

    Science.gov (United States)

    Hortelano, S; García-Martín, M L; Cerdán, S; Castrillo, A; Alvarez, A M; Boscá, L

    2001-10-01

    Triggering of the macrophage cell line RAW 264.7 with lipopolysaccharide and interferon-gamma promoted apoptosis that was prevented by inhibitors of type 2 nitric oxide synthase or caspase. Using (1)H NMR analysis, we have investigated the changes of the intracellular transverse relaxation time (T(2)) and apparent diffusion coefficient (ADC) as parameters reflecting the rotational and translational motions of water in apoptotic macrophages. T(2) values decreased significantly from 287 to 182 ms in cells treated for 18 h with NO-donors. These changes of T(2) were prevented by caspase inhibitors and were not due to mitochondrial depolarization or microtubule depolymerization. The decrease of the intracellular values of T(2) and ADC in apoptotic macrophages was observed after caspase activation, but preceded phosphatidylserine exposure and nucleosomal DNA cleavage. The changes of water motion were accompanied by an enhancement of the hydrophobic properties of the intracellular milieu, as detected by fluorescent probes. These results indicate the occurrence of an alteration in the physicochemical properties of intracellular water during the course of apoptosis.

  10. Sport and physical activity following unicompartmental knee arthroplasty: a systematic review.

    Science.gov (United States)

    Waldstein, Wenzel; Kolbitsch, Paul; Koller, Ulrich; Boettner, Friedrich; Windhager, Reinhard

    2017-03-01

    Unicompartmental knee arthroplasty (UKA) can be a surgical treatment option for patients with high expectations regarding the post-operative level of physical activity. A systematic review was undertaken to answer three research questions: (1) is there an improvement of physical activity based on validated activity scores following UKA? (2) What are the sport disciplines and the sport patterns of UKA patients? (3) What are the pre- and post-operative sport participation rates and the return to activity rates of UKA patients? Following the PRISMA guidelines, EMBASE, MEDLINE, ISI Web of Science and the Cochrane Central Register of Controlled Trials were searched for studies reporting the level of sport and/or physical activity before and after UKA, and/or included at least one activity score before and after UKA. Seventeen studies were identified reporting on 2972 UKAs, of which 89 % were medial UKAs and 92 % were mobile-bearing implants, respectively. Ten studies reported a statistically significant improvement of physical activity following UKA according to the UCLA activity score, the Tegner activity score or the High Activity Arthroplasty Score, respectively. Hiking, cycling and swimming are the most common activities following UKA. Sport participation before the onset of restricting symptoms ranged from 64 to 93 % and slightly decreased by 2-9 % following UKA. The return to activity rate ranged from 87 to 98 %. Patients following UKA are physically active according to validated activity scores. A significant increase in low-impact activities and a decrease in high-impact activities after UKA was observed. Patients with a UKA regularly participate in sports; however, sport participation slightly decreased compared to pre-arthritic levels. This systematic review helps physicians to manage the expectations of patients regarding the level of physical activity following UKA. III.

  11. Muscle activation and knee biomechanics during squatting and lunging after lower extremity fatigue in healthy young women.

    Science.gov (United States)

    Longpré, Heather S; Acker, Stacey M; Maly, Monica R

    2015-02-01

    Muscle activations and knee joint loads were compared during squatting and lunging before and after lower extremity neuromuscular fatigue. Electromyographic activations of the rectus femoris, vastus lateralis and biceps femoris, and the external knee adduction and flexion moments were collected on 25 healthy women (mean age 23.5 years, BMI of 23.7 kg/m(2)) during squatting and lunging. Participants were fatigued through sets of 50 isotonic knee extensions and flexions, with resistance set at 50% of the peak torque achieved during a maximum voluntary isometric contraction. Fatigue was defined as a decrease in peak isometric knee extension or flexion torque ≥25% from baseline. Co-activation indices were calculated between rectus femoris and biceps femoris; and between vastus lateralis and biceps femoris. Fatigue decreased peak isometric extension and flexion torques (pknee adduction and flexion moments during lunging (p<0.05). Quadriceps activations were greater during lunging than squatting (p<0.05). Thus, fatigue altered the recruitment strategy of the quadriceps during squatting and lunging. Lunging challenges quadriceps activation more than squatting in healthy, young women.

  12. Diabetes that impacts on routine activities predicts slower recovery after total knee arthroplasty: an observational study

    Directory of Open Access Journals (Sweden)

    Nurudeen Amusat

    2014-12-01

    Full Text Available Question: In the 6 months after total knee arthroplasty (TKA, what is the pattern of pain resolution and functional recovery in people without diabetes, with diabetes that does not impact on routine activities, and with diabetes that does impact on routine activities? Is diabetes that impacts on routine activities an independent predictor of slower resolution of pain and functional recovery after TKA? Design: Community-based prospective observational study. Participants: A consecutive cohort of 405 people undergoing primary TKA, of whom 60 (15% had diabetes. Participants with diabetes were also asked preoperatively whether diabetes impacted on their routine activities. Participants were categorised into three groups: no diabetes (n = 345, diabetes with no impact on activities (n = 41, and diabetes that impacted activities (n = 19. Outcome measures: Pain and function were measured using the Western Ontario and McMaster Universities (WOMAC Osteoarthritis Index within the month before surgery and 1, 3 and 6 months after surgery. Demographic, medical and surgical factors were also measured, along with depression, social support and health-related quality of life. Results: No baseline differences in pain and function were seen among the three groups (p > 0.05. Adjusting for age, gender and contralateral joint involvement across the 6 postoperative months, participants with diabetes that impacted on routine activities had pain scores that were 8.3 points higher (indicating greater pain and function scores that were 5.4 points higher (indicating lower function than participants without diabetes. Participants with diabetes that doesn’t impact on routine activities had similar recovery to those without diabetes. Conclusion: People undergoing TKA who report preoperatively that diabetes impacts on their routine activities have less recovery over 6 months than those without diabetes or those with diabetes that does not impact on routine activities

  13. The Effects of Knee Joint and Hip Abduction Angles on the Activation of Cervical and Abdominal Muscles during Bridging Exercises

    OpenAIRE

    Lee, Su-Kyoung; Park, Du-Jin

    2013-01-01

    [Purpose] The purpose of this study was to examine the effects of the flexion angle of the knee joint and the abduction angle of the hip joint on the activation of the cervical region and abdominal muscles. [Subjects] A total of 42 subjects were enrolled 9 males and 33 females. [Methods] The bridging exercise in this study was one form of exercise with a knee joint flexion angle of 90°. Based on this, a bridging exercise was conducted at the postures of abduction of the lower extremities at 0...

  14. Unwinding motion of a twisted active region filament

    Energy Technology Data Exchange (ETDEWEB)

    Yan, X. L.; Xue, Z. K.; Kong, D. F. [Yunnan Observatories, Chinese Academy of Sciences, Kunming 650011 (China); Liu, J. H. [Department of Physics, Shijiazhuang University, Shijiazhuang 050035 (China); Xu, C. L. [Yunnan Normal University, Kunming 650092 (China)

    2014-12-10

    To better understand the structures of active region filaments and the eruption process, we study an active region filament eruption in active region NOAA 11082 in detail on 2010 June 22. Before the filament eruption, the opposite unidirectional material flows appeared in succession along the spine of the filament. The rising of the filament triggered two B-class flares at the upper part of the filament. As the bright material was injected into the filament from the sites of the flares, the filament exhibited a rapid uplift accompanying the counterclockwise rotation of the filament body. From the expansion of the filament, we can see that the filament consisted of twisted magnetic field lines. The total twist of the filament is at least 5π obtained by using a time slice method. According to the morphology change during the filament eruption, it is found that the active region filament was a twisted flux rope and its unwinding motion was like a solar tornado. We also find that there was a continuous magnetic helicity injection before and during the filament eruption. It is confirmed that magnetic helicity can be transferred from the photosphere to the filament. Using the extrapolated potential fields, the average decay index of the background magnetic fields over the filament is 0.91. Consequently, these findings imply that the mechanism of solar filament eruption could be due to the kink instability and magnetic helicity accumulation.

  15. Unwinding motion of a twisted active-region filament

    CERN Document Server

    Yan, X L; Liu, J H; Kong, D F; Xu, C L

    2014-01-01

    To better understand the structures of active-region filaments and the eruption process, we study an active-region filament eruption in active region NOAA 11082 in detail on June 22, 2010. Before the filament eruption, the opposite unidirectional material flows appeared in succession along the spine of the filament. The rising of the filament triggered two B-class flares at the upper part of the filament. As the bright material was injected into the filament from the sites of the flares, the filament exhibited a rapid uplift accompanying the counterclockwise rotation of the filament body. From the expansion of the filament, we can see that the filament is consisted of twisted magnetic field lines. The total twist of the filament is at least 5$\\pi$ obtained by using time slice method. According to the morphology change during the filament eruption, it is found that the active-region filament was a twisted flux rope and its unwinding motion was like a solar tornado. We also find that there was a continuous magn...

  16. Unwinding Motion of a Twisted Active Region Filament

    Science.gov (United States)

    Yan, X. L.; Xue, Z. K.; Liu, J. H.; Kong, D. F.; Xu, C. L.

    2014-12-01

    To better understand the structures of active region filaments and the eruption process, we study an active region filament eruption in active region NOAA 11082 in detail on 2010 June 22. Before the filament eruption, the opposite unidirectional material flows appeared in succession along the spine of the filament. The rising of the filament triggered two B-class flares at the upper part of the filament. As the bright material was injected into the filament from the sites of the flares, the filament exhibited a rapid uplift accompanying the counterclockwise rotation of the filament body. From the expansion of the filament, we can see that the filament consisted of twisted magnetic field lines. The total twist of the filament is at least 5π obtained by using a time slice method. According to the morphology change during the filament eruption, it is found that the active region filament was a twisted flux rope and its unwinding motion was like a solar tornado. We also find that there was a continuous magnetic helicity injection before and during the filament eruption. It is confirmed that magnetic helicity can be transferred from the photosphere to the filament. Using the extrapolated potential fields, the average decay index of the background magnetic fields over the filament is 0.91. Consequently, these findings imply that the mechanism of solar filament eruption could be due to the kink instability and magnetic helicity accumulation.

  17. Effectiveness of behavioral graded activity in patients with osteoarthritis of hip and/or knee: a randomized clinical trial.

    NARCIS (Netherlands)

    Veenhof, C.; Köke, A.J.A.; Dekker, J.; Oostendorp, R.A.; Bijlsma, J.W.J.; Tulder, M.W. van; Ende, C.H.M. van den

    2006-01-01

    Objective: To determine the effectiveness of a behavioral graded activity program (BGA) compared with usual care (UC; exercise therapy and advice) according to the Dutch guidelines for physiotherapy in patients with osteoarthritis (OA) of the hip and/or knee. The BGA intervention is intended to incr

  18. The effect of gender on force, muscle activity, and frontal plane knee alignment during maximum eccentric leg-press exercise.

    Science.gov (United States)

    Liebensteiner, Michael C; Platzer, Hans-Peter; Burtscher, Martin; Hanser, Friedrich; Raschner, Christian

    2012-03-01

    To investigate for gender differences during eccentric leg-press exercise. Tears of the anterior cruciate ligament (ACL) are considered to be related to eccentric tasks, altered neuromuscular control (e.g., reduced co-contraction of hamstrings), and increased knee abduction (valgus alignment). Based on these observations and the fact that ACL tears are more common in women, it was hypothesized that men and women differ significantly with regard to key parameters of force, knee stabilization, and muscle activity when exposed to maximum eccentric leg extension. Thirteen women and thirteen men were matched for age and physical activity. They performed maximum isokinetic eccentric leg-pressing against footplates of varied stability. The latter was done because earlier studies had shown that perturbational test conditions might be relevant in respect of ACL injuries. Key parameters of force, frontal plane knee stabilization, and muscle recruitment of significant muscles crossing the knee were recorded. The 'force stabilization deficit' (difference between maximum forces under normal and perturbed leg-pressing) did not differ significantly between genders. Likewise, parameters of muscle activity and frontal plane leg stabilization revealed no significant differences between men and women. This study is novel, in that gender differences in parameters of force, muscle activity, and leg kinematic were investigated during functional conditions of eccentric leg-pressing. No gender differences were observed in the measured parameters. However, the conclusion should be viewed with caution because the findings concurred with, but also contrasted, previous research in this field. Diagnostic study, Level III.

  19. Physical activity and exercise adherence in physical therapy exercise treatment in patients with osteoarthritis of hip or knee.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Bakker, D. de; Schellevis, F.G.; Dekker, J.

    2008-01-01

    Purpose: a lack of regular physical activity in patients with osteoarthritis (OA) of the hip and/or knee is an important risk factor for functional decline. The ultimate goal of exercise therapy is to improve the overall physical function and to help individuals meet the demands of daily living. Ear

  20. Effectiveness of behavioral graded activity in patients with osteoarthritis of the hip and/or knee: A randomized clinical trial.

    NARCIS (Netherlands)

    Veenhof, C.; Koke, A.J.; Dekker, J.; Oostendorp, R.A.B.; Bijlsma, J.W.J.; Tulder, M.W. van; Ende, C.H.M. van den

    2006-01-01

    OBJECTIVE: To determine the effectiveness of a behavioral graded activity program (BGA) compared with usual care (UC; exercise therapy and advice) according to the Dutch guidelines for physiotherapy in patients with osteoarthritis (OA) of the hip and/or knee. The BGA intervention is intended to incr

  1. Factors associated with physical activity in patients with osteoarthritis of the hip or knee: a systematic review.

    NARCIS (Netherlands)

    Veenhof, C.; Huisman, P.A.; Barten, J.A.; Takken, T.; Pisters, M.F.

    2012-01-01

    OBJECTIVE: To give an overview of factors related to the level of physical activity in patients with hip or knee osteoarthritis (OA). METHODS: An extensive systematic literature search was conducted in PubMed, CINAHL and Embase. Inclusion criteria were: studies on patients with a diagnosis of OA of

  2. Physical activity and exercise adherence in physical therapy exercise treatment in patients with osteoarthritis of hip or knee.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Bakker, D. de; Schellevis, F.G.; Dekker, J.

    2008-01-01

    Purpose: a lack of regular physical activity in patients with osteoarthritis (OA) of the hip and/or knee is an important risk factor for functional decline. The ultimate goal of exercise therapy is to improve the overall physical function and to help individuals meet the demands of daily living. Ear

  3. Factors associated with physical activity in patients with osteoarthritis of the hip or knee: a systematic review.

    NARCIS (Netherlands)

    Veenhof, C.; Huisman, P.A.; Barten, J.A.; Takken, T.; Pisters, M.F.

    2012-01-01

    OBJECTIVE: To give an overview of factors related to the level of physical activity in patients with hip or knee osteoarthritis (OA). METHODS: An extensive systematic literature search was conducted in PubMed, CINAHL and Embase. Inclusion criteria were: studies on patients with a diagnosis of OA of

  4. Peak triceps surae muscle activity is not specific to knee flexion angles during MVIC.

    Science.gov (United States)

    Hébert-Losier, Kim; Schneiders, Anthony G; García, José A; Sullivan, S John; Simoneau, Guy G

    2011-10-01

    There is limited research on peak activity of the separate triceps surae muscles in select knee flexion (KF) positions during a maximum voluntary isometric contraction (MVIC) used to normalize EMG signals. The aim of this study was to determine how frequent peak activity occurred during an MVIC for soleus (SOL), gastrocnemius medialis (GM), and gastrocnemius lateralis (GL) in select KF positions, and if these peaks were recorded in similar KF positions. Forty-eight healthy individuals performed unilateral plantar-flexion MVIC in standing with 0°KF and 45°KF, and in sitting with 90°KF. Surface EMG of SOL, GM, and GL were collected and processed in 250 ms epochs to determine peak root-mean-square amplitude. Peak activity was most frequently captured in standing and rarely in sitting, with no position selective to SOL, GM or GL activity. Peak GM and GL activity was more frequent in 0°KF than 45°KF, and more often in similar KF positions than not. Peak SOL activity was just as likely in 45°KF as 0°KF, and more in positions similar to GM, but not GL. The EMG amplitudes were at least 20% greater in positions that captured peak activity over those that did not. The overall findings support performing an MVIC in more than one KF position to normalize triceps surae EMG. It is emphasized that no KF position is selective to SOL, GM, or GL alone.

  5. Strength asymmetry of the knee extensors and physical activity in middle-aged women

    Directory of Open Access Journals (Sweden)

    Michal Lehnert

    2014-09-01

    Full Text Available Background: Differences between muscle strength and power of lower limbs is one of the factors associated with falls in the elderly population. Muscle strength asymmetry of lower limbs increases with age. Objective: The aim of the study is to assess differences in the volume and intensity of physical activity (PA in the subgroups of women being at higher and lower risk of falls (with and without strength asymmetry of the knee extensors of dominant and non-dominant lower limb. Methods: Data from 42 women (age 56.3 ± 4.4 years; weight 76.5 ± 16.1 kg; body height 164.3 ± 5.2 cm; body mass index 28.1 ± 5.3 kg . m-2 were used for the purpose of the presented analysis. Furthermore the sample was divided into subgroups with lower and higher strength asymmetry of quadriceps muscle (as a criterion the asymmetry greater than 15% was chosen. Absolute concentric peak torque of the knee extensors was evaluated by an isokinetic dynamometer IsoMed 2000 in a sitting position at angular velocity of 180° . s-1. PA was monitored using Yamax SW-700 pedometers throughout 7 consecutive days and using the Czech version of standardized International Physical Activity Questionnaire. Results: Statistically significant differences between groups with lower and higher strength asymmetry were found in the amount of self-reported vigorous PA (p = .04; d = 0.6 only. Differences between the observed groups were not significant in self-reported moderate PA and walking. There were also no significant differences in the daily numbers of steps measured objectively. Conclusions: The results of the study indicate that from the point of view of strength asymmetry of knee extensors as a factor associated with falls in middle-aged women, intensity of PA could be an important characteristic of PA. This suggestion should be taken into account in habitual PA and training programs in middle-aged population.

  6. In Vivo Healthy Knee Kinematics during Dynamic Full Flexion

    Directory of Open Access Journals (Sweden)

    Satoshi Hamai

    2013-01-01

    Full Text Available Healthy knee kinematics during dynamic full flexion were evaluated using 3D-to-2D model registration techniques. Continuous knee motions were recorded during full flexion in a lunge from 85° to 150°. Medial and lateral tibiofemoral contacts and femoral internal-external and varus-valgus rotations were analyzed as a function of knee flexion angle. The medial tibiofemoral contact translated anteroposteriorly, but remained on the center of the medial compartment. On the other hand, the lateral tibiofemoral contact translated posteriorly to the edge of the tibial surface at 150° flexion. The femur exhibited external and valgus rotation relative to the tibia over the entire activity and reached 30° external and 5° valgus rotations at 150° flexion. Kinematics’ data during dynamic full flexion may provide important insight as to the designing of high-flexion total knee prostheses.

  7. Primary visual cortex activity along the apparent-motion trace reflects illusory perception.

    Directory of Open Access Journals (Sweden)

    Lars Muckli

    2005-08-01

    Full Text Available The illusion of apparent motion can be induced when visual stimuli are successively presented at different locations. It has been shown in previous studies that motion-sensitive regions in extrastriate cortex are relevant for the processing of apparent motion, but it is unclear whether primary visual cortex (V1 is also involved in the representation of the illusory motion path. We investigated, in human subjects, apparent-motion-related activity in patches of V1 representing locations along the path of illusory stimulus motion using functional magnetic resonance imaging. Here we show that apparent motion caused a blood-oxygenation-level-dependent response along the V1 representations of the apparent-motion path, including regions that were not directly activated by the apparent-motion-inducing stimuli. This response was unaltered when participants had to perform an attention-demanding task that diverted their attention away from the stimulus. With a bistable motion quartet, we confirmed that the activity was related to the conscious perception of movement. Our data suggest that V1 is part of the network that represents the illusory path of apparent motion. The activation in V1 can be explained either by lateral interactions within V1 or by feedback mechanisms from higher visual areas, especially the motion-sensitive human MT/V5 complex.

  8. Knee Bursitis

    Science.gov (United States)

    ... make a diagnosis of knee bursitis during a physical exam. Your doctor will inspect your knee by: Comparing the condition of both knees, particularly if only one is painful Gently pressing on different areas of your knee to detect warmth, swelling and the source of pain Carefully moving ...

  9. Rough terrain motion planning for actively reconfigurable mobile robots

    Energy Technology Data Exchange (ETDEWEB)

    Brunner, Michael

    2015-02-05

    In the aftermath of the Tohoku earthquake and the nuclear meltdown at the power plant of Fukushima Daiichi in 2011, reconfigurable robots like the iRobot Packbot were deployed. Instead of humans, the robots were used to investigate contaminated areas. Other incidents are the two major earthquakes in Northern Italy in May 2012. Besides many casualties, a large number of historical buildings was severely damaged. Due to the imminent danger of collapse, it was too dangerous for rescue personnel to enter many of the buildings. Therefore, the sites were inspected by reconfigurable robots, which are able to traverse the rubble and debris of the partially destroyed buildings. This thesis develops a navigation system enabling wheeled and tracked robots to safely traverse rough terrain and challenging structures. It consists of a planning mechanism and a controller. The focus of this thesis, however, is on the contribution to motion planning. The planning scheme employs a hierarchical approach to motion planning for actively reconfigurable robots in rough environments. Using a map of the environment the algorithm estimates the traversability under the consideration of uncertainties. Based on this analysis, an initial path search determines an approximate solution with respect to the robot's operating limits.Subsequently, a detailed planning step refines the initial path where it is required. The refinement step considers the robot's actuators and stability in addition to the quantities of the first search. Determining the robot-terrain interaction is very important in rough terrain. This thesis presents two path refinement approaches: a deterministic and a randomized approach. The experimental evaluation investigates the separate components of the planning scheme, the robot-terrain interaction for instance.In simulation as well as in real world experiments the evaluation demonstrates the necessity of such a planning algorithm in rough terrain and it provides

  10. Muscle Activation Differs between Three Different Knee Joint-Angle Positions during a Maximal Isometric Back Squat Exercise

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Marchetti

    2016-01-01

    Full Text Available The purpose of this study was to compare muscle activation of the lower limb muscles when performing a maximal isometric back squat exercise over three different positions. Fifteen young, healthy, resistance-trained men performed an isometric back squat at three knee joint angles (20°, 90°, and 140° in a randomized, counterbalanced fashion. Surface electromyography was used to measure muscle activation of the vastus lateralis (VL, vastus medialis (VM, rectus femoris (RF, biceps femoris (BF, semitendinosus (ST, and gluteus maximus (GM. In general, muscle activity was the highest at 90° for the three quadriceps muscles, yet differences in muscle activation between knee angles were muscle specific. Activity of the GM was significantly greater at 20° and 90° compared to 140°. The BF and ST displayed similar activation at all joint angles. In conclusion, knee position alters muscles activation of the quadriceps and gluteus maximus muscles. An isometric back squat at 90° generates the highest overall muscle activation, yet an isometric back squat at 140° generates the lowest overall muscle activation of the VL and GM only.

  11. Viewing the motion of human body parts activates different regions of premotor, temporal, and parietal cortex.

    Science.gov (United States)

    Wheaton, Kylie J; Thompson, James C; Syngeniotis, Ari; Abbott, David F; Puce, Aina

    2004-05-01

    Activation of premotor and temporoparietal cortex occurs when we observe others movements, particularly relating to objects. Viewing the motion of different body parts without the context of an object has not been systematically evaluated. During a 3T fMRI study, 12 healthy subjects viewed human face, hand, and leg motion, which was not directed at or did not involve an object. Activation was identified relative to static images of the same human face, hand, and leg in both individual subject and group average data. Four clear activation foci emerged: (1) right MT/V5 activated to all forms of viewed motion; (2) right STS activated to face and leg motion; (3) ventral premotor cortex activated to face, hand, and leg motion in the right hemisphere and to leg motion in the left hemisphere; and (4) anterior intraparietal cortex (aIP) was active bilaterally to viewing hand motion and in the right hemisphere leg motion. In addition, in the group data, a somatotopic activation pattern for viewing face, hand, and leg motion occurred in right ventral premotor cortex. Activation patterns in STS and aIP were more complex--typically activation foci to viewing two types of human motion showed some overlap. Activation in individual subjects was similar; however, activation to hand motion also occurred in the STS with a variable location across subjects--explaining the lack of a clear activation focus in the group data. The data indicate that there are selective responses to viewing motion of different body parts in the human brain that are independent of object or tool use.

  12. Physical performance and self-report outcomes associated with use of passive, adaptive, and active prosthetic knees in persons with unilateral, transfemoral amputation: Randomized crossover trial

    Directory of Open Access Journals (Sweden)

    Brian J. Hafner, PhD

    2015-09-01

    Full Text Available Prosthetic knees are a vital component in an artificial limb. Contemporary knees include passive (mechanical, adaptive (computerized, or active (motorized control systems and have the potential to mitigate amputation-related functional impairments and activity limitations. A 14 mo randomized crossover trial was conducted. Participants (n = 12, mean age = 58 yr were tested under three conditions: passive control (existing knee, adaptive control (Ossur Rheo Knee II, and active control (Ossur Power Knee II. Training and acclimation time were provided to participants in the adaptive and active knees. Outcome measures included indoor tests (Timed Up and Go test [TUG], stairs, and ramp, outdoor tests (walking course and perceived exertion, step activity monitor, self-report surveys (mobility, balance confidence, physical function, fatigue, and general health, and fall incidence. Mixed-effects linear regression modeling was used to evaluate data. Compared with passive control, adaptive control significantly improved comfortable TUG time (difference = 0.91 s, p = 0.001 and reported physical function (difference = 1.26 [T-score], p = 0.03. Active control significantly increased comfortable TUG, fast TUG, and ramp times (difference = 3.02, 2.66, and 0.96 s, respectively, all p < 0.03 and increased balance confidence (difference = 3.77, p = 0.003 compared with passive control. Findings suggest that adaptive knee control may enhance function compared with passive control but that active control can restrict mobility in middle-age or older users with transfemoral amputation.

  13. Knee complaints seen in general practice : active sport participants versus non-sport participants

    NARCIS (Netherlands)

    van Middelkoop, Marienke; van Linschoten, Robbart; Berger, Marjolein Y.; Koes, Bart W.; Bierma-Zeinstra, Sita M. A.

    2008-01-01

    Background: Since knee complaints are common among athletes and are frequently presented in general practice, it is of interest to investigate the type of knee complaints represented in general practice of athletes in comparison with those of non-athletes. Therefore, the aim of this study is to inve

  14. Knee complaints seen in general practice : active sport participants versus non-sport participants

    NARCIS (Netherlands)

    van Middelkoop, Marienke; van Linschoten, Robbart; Berger, Marjolein Y.; Koes, Bart W.; Bierma-Zeinstra, Sita M. A.

    2008-01-01

    Background: Since knee complaints are common among athletes and are frequently presented in general practice, it is of interest to investigate the type of knee complaints represented in general practice of athletes in comparison with those of non-athletes. Therefore, the aim of this study is to

  15. Effects of image noise, respiratory motion, and motion compensation on 3D activity quantification in count-limited PET images

    Science.gov (United States)

    Siman, W.; Mawlawi, O. R.; Mikell, J. K.; Mourtada, F.; Kappadath, S. C.

    2017-01-01

    The aims of this study were to evaluate the effects of noise, motion blur, and motion compensation using quiescent-period gating (QPG) on the activity concentration (AC) distribution—quantified using the cumulative AC volume histogram (ACVH)—in count-limited studies such as 90Y-PET/CT. An International Electrotechnical Commission phantom filled with low 18F activity was used to simulate clinical 90Y-PET images. PET data were acquired using a GE-D690 when the phantom was static and subject to 1-4 cm periodic 1D motion. The static data were down-sampled into shorter durations to determine the effect of noise on ACVH. Motion-degraded PET data were sorted into multiple gates to assess the effect of motion and QPG on ACVH. Errors in ACVH at AC90 (minimum AC that covers 90% of the volume of interest (VOI)), AC80, and ACmean (average AC in the VOI) were characterized as a function of noise and amplitude before and after QPG. Scan-time reduction increased the apparent non-uniformity of sphere doses and the dispersion of ACVH. These effects were more pronounced in smaller spheres. Noise-related errors in ACVH at AC20 to AC70 were smaller (15%). The accuracy of ACmean was largely independent of the total count. Motion decreased the observed AC and skewed the ACVH toward lower values; the severity of this effect depended on motion amplitude and tumor diameter. The errors in AC20 to AC80 for the 17 mm sphere were  -25% and  -55% for motion amplitudes of 2 cm and 4 cm, respectively. With QPG, the errors in AC20 to AC80 of the 17 mm sphere were reduced to  -15% for motion amplitudes  0.5, QPG was effective at reducing errors in ACVH despite increases in image non-uniformity due to increased noise. ACVH is believed to be more relevant than mean or maximum AC to calculate tumor control and normal tissue complication probability. However, caution needs to be exercised when using ACVH in post-therapy 90Y imaging because of its susceptibility to image

  16. Evaluation of a variable resistance orthotic knee joint.

    Science.gov (United States)

    Herbert-Copley, Andrew; Lemaire, Edward D; Baddour, Natalie

    2016-08-01

    Knee-ankle-foot orthoses (KAFOs) are full leg braces for individuals with knee extensor weakness, designed to support the person during weight bearing activities by preventing knee flexion. KAFOs typically result in an unnatural gait pattern and are primarily used for level ground walking. A novel variable resistance orthotic knee joint, the Ottawalk-Variable Speed (OWVS), was designed to address these limitations. This paper presents a pilot test to evaluate the OWVS functional performance during walking and stair descent. A carbon-fiber KAFO was adjusted for an able-bodied participant by a certified orthotist, with a standard orthotic single axis knee joint on the medial side and the OWVS on the lateral side. The participant performed level ground walking (stance-control, open, closed) and stair descent tests. The operator was able to manually switch between closed mode in terminal swing to open mode in terminal stance for stance-control walking. Knee angle kinematics were similar between open and stance control modes. For stair descent, resistance settings supported the participant as they lowered their body to the next step, but with smaller range of motion compared to the open setting. The Ottawalk-Variable Speed design successfully controls knee flexion during stance and stair descent, with one lateral control joint. Mode switching was fast and appropriate. This microprocessor controlled SCKAFO has a low profile that fits beneath clothing and the variable resistance design will allow people to negotiate different terrain types.

  17. Knee problems and its associated factors among active cyclists in Eastern Province, Saudi Arabia

    Science.gov (United States)

    Althunyan, Abdullatif K.; Darwish, Magdy A.; Abdel Wahab, Moataza M.

    2017-01-01

    INTRODUCTION: Bicycling is one of the most enjoyable aerobic exercises recommended for the promotion of an individual's health. The Eastern Province of Saudi Arabia has seen a huge increase in the number of people who cycle. People have different goals for bicycling, but the injuries they sustain are common. Most of them relate to overuse, particularly of lower body joints. This study was conducted to determine the prevalence of knee problems and factors associated with knee pain in cyclists. MATERIALS AND METHODS: A cross-sectional study was conducted in October 2015, using an online self-administered questionnaire. The questionnaire was based on pertinent literature, was piloted, and validated. A web link was sent to 513 cyclists (professional and amateur) using E-mail, WhatsApp application, or SMS. Three hundred and eleven responses were received, 283 of which were included in the analysis. RESULTS: The overall prevalence of knee pain was 25.8%; 27.6% for amateur cyclists and 15.9% for professional cyclists. Only 17.2% knee pain was attributed to cycling, whereas in 32.8% it happened spontaneously and in 25% of cases it occurred while running. Majority of the cyclists reported pain as mild (61.6%) or moderate (28.7%); anterior knee pain accounted for 58.1% knee pain. Different goals of cycling and different bicycle types had statistically significant difference on the rate of knee pain. Of underweight cyclists, 62.2% reported knee pain. Cyclists who run more or participated in football had a higher rate of pain. CONCLUSION: Knee injuries are common with cyclists. Factors such as the type of the bicycle, the goal of bicycling, club type, body mass index, and participation in other sports play a significant role in the rate of knee pain. PMID:28163572

  18. Assessing the Relative Contributions of Active Ankle and Knee Assistance to the Walking Mechanics of Transfemoral Amputees Using a Powered Prosthesis.

    Science.gov (United States)

    Ingraham, Kimberly A; Fey, Nicholas P; Simon, Ann M; Hargrove, Levi J

    2016-01-01

    Powered knee-ankle prostheses are capable of providing net-positive mechanical energy to amputees. Yet, there are limitless ways to deliver this energy throughout the gait cycle. It remains largely unknown how different combinations of active knee and ankle assistance affect the walking mechanics of transfemoral amputees. This study assessed the relative contributions of stance phase knee swing initiation, increasing ankle stiffness and powered plantarflexion as three unilateral transfemoral amputees walked overground at their self-selected walking speed. Five combinations of knee and ankle conditions were evaluated regarding the kinematics and kinetics of the amputated and intact legs using repeated measures analyses of variance. We found eliminating active knee swing initiation or powered plantarflexion was linked to increased compensations of the ipsilateral hip joint during the subsequent swing phase. The elimination of knee swing initiation or powered plantarflexion also led to reduced braking ground reaction forces of the amputated and intact legs, and influenced both sagittal and frontal plane loading of the intact knee joint. Gradually increasing prosthetic ankle stiffness influenced the shape of the prosthetic ankle plantarflexion moment, more closely mirroring the intact ankle moment. Increasing ankle stiffness also corresponded to increased prosthetic ankle power generation (despite a similar maximum stiffness value across conditions) and increased braking ground reaction forces of the amputated leg. These findings further our understanding of how to deliver assistance with powered knee-ankle prostheses and the compensations that occur when specific aspects of assistance are added/removed.

  19. Assessing the Relative Contributions of Active Ankle and Knee Assistance to the Walking Mechanics of Transfemoral Amputees Using a Powered Prosthesis

    Science.gov (United States)

    Simon, Ann M.; Hargrove, Levi J.

    2016-01-01

    Powered knee-ankle prostheses are capable of providing net-positive mechanical energy to amputees. Yet, there are limitless ways to deliver this energy throughout the gait cycle. It remains largely unknown how different combinations of active knee and ankle assistance affect the walking mechanics of transfemoral amputees. This study assessed the relative contributions of stance phase knee swing initiation, increasing ankle stiffness and powered plantarflexion as three unilateral transfemoral amputees walked overground at their self-selected walking speed. Five combinations of knee and ankle conditions were evaluated regarding the kinematics and kinetics of the amputated and intact legs using repeated measures analyses of variance. We found eliminating active knee swing initiation or powered plantarflexion was linked to increased compensations of the ipsilateral hip joint during the subsequent swing phase. The elimination of knee swing initiation or powered plantarflexion also led to reduced braking ground reaction forces of the amputated and intact legs, and influenced both sagittal and frontal plane loading of the intact knee joint. Gradually increasing prosthetic ankle stiffness influenced the shape of the prosthetic ankle plantarflexion moment, more closely mirroring the intact ankle moment. Increasing ankle stiffness also corresponded to increased prosthetic ankle power generation (despite a similar maximum stiffness value across conditions) and increased braking ground reaction forces of the amputated leg. These findings further our understanding of how to deliver assistance with powered knee-ankle prostheses and the compensations that occur when specific aspects of assistance are added/removed. PMID:26807889

  20. Assessing the Relative Contributions of Active Ankle and Knee Assistance to the Walking Mechanics of Transfemoral Amputees Using a Powered Prosthesis.

    Directory of Open Access Journals (Sweden)

    Kimberly A Ingraham

    Full Text Available Powered knee-ankle prostheses are capable of providing net-positive mechanical energy to amputees. Yet, there are limitless ways to deliver this energy throughout the gait cycle. It remains largely unknown how different combinations of active knee and ankle assistance affect the walking mechanics of transfemoral amputees. This study assessed the relative contributions of stance phase knee swing initiation, increasing ankle stiffness and powered plantarflexion as three unilateral transfemoral amputees walked overground at their self-selected walking speed. Five combinations of knee and ankle conditions were evaluated regarding the kinematics and kinetics of the amputated and intact legs using repeated measures analyses of variance. We found eliminating active knee swing initiation or powered plantarflexion was linked to increased compensations of the ipsilateral hip joint during the subsequent swing phase. The elimination of knee swing initiation or powered plantarflexion also led to reduced braking ground reaction forces of the amputated and intact legs, and influenced both sagittal and frontal plane loading of the intact knee joint. Gradually increasing prosthetic ankle stiffness influenced the shape of the prosthetic ankle plantarflexion moment, more closely mirroring the intact ankle moment. Increasing ankle stiffness also corresponded to increased prosthetic ankle power generation (despite a similar maximum stiffness value across conditions and increased braking ground reaction forces of the amputated leg. These findings further our understanding of how to deliver assistance with powered knee-ankle prostheses and the compensations that occur when specific aspects of assistance are added/removed.

  1. Predicting sagittal plane biomechanics that minimize the axial knee joint contact force during walking.

    Science.gov (United States)

    Miller, Ross H; Brandon, Scott C E; Deluzio, Kevin J

    2013-01-01

    Both development and progression of knee osteoarthritis have been associated with the loading of the knee joint during walking. We are, therefore, interested in developing strategies for changing walking biomechanics to offload the knee joint without resorting to surgery. In this study, simulations of human walking were performed using a 2D bipedal forward dynamics model. A simulation generated by minimizing the metabolic cost of transport (CoT) resembled data measured from normal human walking. Three simulations targeted at minimizing the peak axial knee joint contact force instead of the CoT reduced the peak force by 12-25% and increased the CoT by 11-14%. The strategies used by the simulations were (1) reduction in gastrocnemius muscle force, (2) avoidance of knee flexion during stance, and (3) reduced stride length. Reduced gastrocnemius force resulted from a combination of changes in activation and changes in the gastrocnemius contractile component kinematics. The simulations that reduced the peak contact force avoided flexing the knee during stance when knee motion was unrestricted and adopted a shorter stride length when the simulated knee motion was penalized if it deviated from the measured human knee motion. A higher metabolic cost in an offloading gait would be detrimental for covering a long distance without fatigue but beneficial for exercise and weight loss. The predicted changes in the peak axial knee joint contact force from the simulations were consistent with estimates of the joint contact force in a human subject who emulated the predicted kinematics. The results demonstrate the potential of using muscle-actuated forward dynamics simulations to predict novel joint offloading interventions.

  2. Implied motion because of instability in Hokusai Manga activates the human motion-sensitive extrastriate visual cortex: an fMRI study of the impact of visual art.

    Science.gov (United States)

    Osaka, Naoyuki; Matsuyoshi, Daisuke; Ikeda, Takashi; Osaka, Mariko

    2010-03-10

    The recent development of cognitive neuroscience has invited inference about the neurosensory events underlying the experience of visual arts involving implied motion. We report functional magnetic resonance imaging study demonstrating activation of the human extrastriate motion-sensitive cortex by static images showing implied motion because of instability. We used static line-drawing cartoons of humans by Hokusai Katsushika (called 'Hokusai Manga'), an outstanding Japanese cartoonist as well as famous Ukiyoe artist. We found 'Hokusai Manga' with implied motion by depicting human bodies that are engaged in challenging tonic posture significantly activated the motion-sensitive visual cortex including MT+ in the human extrastriate cortex, while an illustration that does not imply motion, for either humans or objects, did not activate these areas under the same tasks. We conclude that motion-sensitive extrastriate cortex would be a critical region for perception of implied motion in instability.

  3. Differences in hip-knee joint coupling during gait after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Gribbin, Timothy C; Slater, Lindsay V; Herb, C Collin; Hart, Joseph M; Chapman, Ryan M; Hertel, Jay; Kuenze, Christopher M

    2016-02-01

    After anterior cruciate ligament injury, patients have increased risk for developing degenerative osteoarthritis, potentially due to the kinematic changes that persist after surgical reconstruction. Current research only describes single joint kinematic differences rather than the way in which two joints behave concurrently, termed joint coupling. The purpose of this study was to compare knee motion relative to hip motion in anterior cruciate ligament reconstructed and healthy limbs during walking and jogging. Thirty-seven recreationally active volunteers (22 reconstructed, 15 healthy) walked and jogged at 4.83 km/h and 9.66 km/h respectively. Vector coding methods were used to calculate stride-to-stride variability, magnitude, and vector angle of 6 joint couples during walking and jogging: hip frontal-knee frontal planes, hip frontal-knee sagittal, hip frontal-knee transverse, hip sagittal-knee frontal, hip sagittal-knee transverse, and hip transverse-knee frontal planes. The hip sagittal-knee frontal and hip sagittal-knee transverse joint couples had decreased variability during mid-stance, and all other couples had increased variability during the stance phase in the reconstructed group. The reconstructed group had decreased magnitude of joint excursion in the hip frontal-knee sagittal couple during all phases of gait during walking. Vector angles of the hip frontal-knee transverse couple increased in the reconstructed group during the loading, middle, and terminal stance phases, and swing phase of gait during walking. The increased variability and decreased magnitude of joint excursion indicate that movement patterns were less consistent during walking gait despite employing a more constrained system during movement in the reconstructed limb compared to healthy controls. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Knee complaints seen in general practice: active sport participants versus non-sport participants

    Directory of Open Access Journals (Sweden)

    Koes Bart W

    2008-03-01

    Full Text Available Abstract Background Since knee complaints are common among athletes and are frequently presented in general practice, it is of interest to investigate the type of knee complaints represented in general practice of athletes in comparison with those of non-athletes. Therefore, the aim of this study is to investigate the differences in type of knee complaints between sport participants, in this study defined as athletes, and non-sport participants, defined as non-athletes, presenting in general practice. Further, differences in the initial policy of the GP, medical consumption, and outcome at one-year follow-up were also investigated. Methods Patients consulting their GP for a new episode of knee complaints were invited to participate in this prospective cohort study. From the total HONEUR knee cohort population (n = 1068 we extracted patients who were athletes (n = 421 or non-athletes (n = 388. Results The results showed that acute distortions of the knee were significantly more diagnosed in athletes than in non-athletes (p = 0.04. Further, more athletes were advised by their GP to 'go easy on the knee' than the non-athletes (p Conclusion There are no major differences in the diagnosis and prognosis of knee complaints between athletes and non-athletes presented to the GP. This implies that there are no indications for different treatment strategies applied in both groups. However, athletes are more often advised to 'go easy on the knee' and to rest than non-athletes. Further, there is a trend towards increased medical consumption among athletes while functional disability and pain are lower than among the non-athletes.

  5. Classifying Motion.

    Science.gov (United States)

    Duzen, Carl; And Others

    1992-01-01

    Presents a series of activities that utilizes a leveling device to classify constant and accelerated motion. Applies this classification system to uniform circular motion and motion produced by gravitational force. (MDH)

  6. Effects of therapeutic exercise and hydrotherapy on pain severity and knee range of motion in patients with hemophilia: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Vahid Mazloum

    2014-01-01

    Conclusions: Using hydrotherapy in addition to usual rehabilitation training can result in beneficial effect in terms of pain and knee joint ROM. However, it appears that hydrotherapy is more effective in reducing pain.

  7. A triboelectric motion sensor in wearable body sensor network for human activity recognition.

    Science.gov (United States)

    Hui Huang; Xian Li; Ye Sun

    2016-08-01

    The goal of this study is to design a novel triboelectric motion sensor in wearable body sensor network for human activity recognition. Physical activity recognition is widely used in well-being management, medical diagnosis and rehabilitation. Other than traditional accelerometers, we design a novel wearable sensor system based on triboelectrification. The triboelectric motion sensor can be easily attached to human body and collect motion signals caused by physical activities. The experiments are conducted to collect five common activity data: sitting and standing, walking, climbing upstairs, downstairs, and running. The k-Nearest Neighbor (kNN) clustering algorithm is adopted to recognize these activities and validate the feasibility of this new approach. The results show that our system can perform physical activity recognition with a successful rate over 80% for walking, sitting and standing. The triboelectric structure can also be used as an energy harvester for motion harvesting due to its high output voltage in random low-frequency motion.

  8. The use of the greater trochanter marker in the thigh segment model:Implications for hip and knee frontal and transverse plane motion

    Institute of Scientific and Technical Information of China (English)

    Valentina Graci; Gretchen B. Salsich

    2016-01-01

    Background: The greater trochanter marker is commonly used in 3-dimensional (3D) models; however, its influence on hip and knee kinematics during gait is unclear. Understanding the influence of the greater trochanter marker is important when quantifying frontal and transverse plane hip and knee kinematics, parameters which are particularly relevant to investigate in individuals with conditions such as patellofemoral pain, knee osteoarthritis, anterior cruciate ligament (ACL) injury, and hip pain. The aim of this study was to evaluate the effect of including the greater trochanter in the construction of the thigh segment on hip and knee kinematics during gait. Methods: 3D kinematics were collected in 19 healthy subjects during walking using a surface marker system. Hip and knee angles were compared across two thigh segment definitions (with and without greater trochanter) at two time points during stance:peak knee flexion (PKF) and minimum knee flexion (MinKF). Results: Hip and knee angles differed in magnitude and direction in the transverse plane at both time points. In the thigh model with the greater trochanter the hip was more externally rotated than in the thigh model without the greater trochanter (PKF:−9.34° ± 5.21° vs. 1.40° ± 5.22°, MinKF:−5.68° ± 4.24° vs. 5.01° ± 4.86°;p<0.001). In the thigh model with the greater trochanter, the knee angle was more internally rotated compared to the knee angle calculated using the thigh definition without the greater trochanter (PKF:14.67° ± 6.78° vs. 4.33° ± 4.18°, MinKF:10.54° ± 6.71° vs.−0.01° ± 2.69°;p<0.001). Small but significant differences were detected in the sagittal and frontal plane angles at both time points (p<0.001). Conclusion: Hip and knee kinematics differed across different segment definitions including or excluding the greater trochanter marker, especially in the transverse plane. Therefore when considering whether to include the greater trochanter in the thigh segment

  9. Does increasing step width alter knee biomechanics in medial compartment knee osteoarthritis patients during stair descent?

    Science.gov (United States)

    Paquette, Max R; Zhang, Songning; Milner, Clare E; Klipple, Gary

    2014-06-01

    Research shows that one of the first complaints from knee osteoarthritis (OA) patients is difficulty in stair ambulation due to knee pain. Increased step width (SW) has been shown to reduce first and second peak internal knee abduction moments, a surrogate variable for medial compartment knee joint loading, during stair descent in healthy older adults. This study investigates the effects of increased step width (SW) on knee biomechanics and knee pain in medial compartment knee OA patients during stair descent. Thirteen medial compartment knee OA patients were recruited for the study. A motion analysis system was used to obtain three-dimensional joint kinematics. An instrumented staircase was used to collect ground reaction forces (GRF). Participants performed stair descent trials at their self-selected speed using preferred, wide, and wider SW. Participants rated their knee pain levels after each SW condition. Increased SW had no effect on peak knee abduction moments and knee pain. Patients reported low levels of knee pain during all stair descent trials. The 2nd peak knee adduction angle and frontal plane GRF at time of 2nd peak abduction moment were reduced with increasing SW. The findings suggest that increases in SW may not influence knee loads in medial compartment knee OA patients afflicted with low levels of knee pain during stair descent. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Construction of an in vivo motion evaluation system for the knee joint of athletes%运动员膝关节在体运动检测系统的建立

    Institute of Scientific and Technical Information of China (English)

    宋军; 李凭跃; 游辅宇; 孔祥雪; 肖菊姣; 李鉴轶

    2013-01-01

    目的 探讨利用2D/3D图像配准技术建立运动员膝关节在体运动检测系统的可行性.方法 采集1名健康成年志愿者(男性,37岁)左侧膝关节的CT影像,进行三维重建获得骨结构的三维模型.取志愿者保持约30°屈曲的2张X线片,在3Ds Max7软件系统中构建虚拟X线系统,采用2D/3D图像配准技术重现膝关节的位置,将CT数据中胫骨作为配准基点并利用逆向工程技术计算摄X线片时膝关节的相对运动. 结果 经2D/3D图像配准可还原膝关节的三维空间位置.逆向工程技术计算结果显示:与采集CT数据时的位置相比,摄X线片时左侧股骨下段相对位移X轴为0.01mm,Y轴为5.20 mm,Z轴为2.05 mm;相对角度X轴为26.67°,Y轴为-0.97°,Z轴为-15.14°. 结论 利用2D/3D图像配准技术可实现膝关节的在体运动评价,但其配准效率尚需进一步研究.%Objective To construct an in vivo motion evaluation system for the knee joint of athletes using 2D/3D registration.Methods CT data of the left knee from a male 37-year-old healthy adult volunteer were collected for 3D reconstruction of computer model of the knee joint.Two orthogonal images of the knee at a 30° flexion angle were captured using 2 C-arm fluoroscopic machines that were perpendicular to each other.A virtual fluoroscopy was then created in software 3Ds Max for reconstruction of the relative positions of the 2 orthogonal images.The 3D computer models of the left femur and tibia were then introduced into the virtual fluoroscopy respectively before they were projected onto the orthogonal images by 2 virtual cameras.The 3D positions of the knee joint were determined by matching the projections of the knee model to the orthogonal images of the knee.After the tibia in the CT data was taken as the base position for registration,the relatively displacements and angles of the femur were calculated with the reverse engineering technique.Results After 2D/3D registration,the 3D positions

  11. Modulation of muscle activity and force fluctuations in the plantarflexors after bedrest depends on knee position.

    Science.gov (United States)

    Yoshitake, Yasuhide; Kouzaki, Motoki; Fukuoka, Hideoki; Fukunaga, Tetsuo; Shinohara, Minoru

    2007-06-01

    Force fluctuations in leg muscles increase after bedrest, perhaps due to modulation of the neural strategy that is specific to a muscle or common to agonist muscles. The purpose of this study was to examine the modulation of muscle activity and force fluctuations during steady contractions with variable involvement of plantarflexor muscles after bedrest at knee-flexed (FLX) and extended (EXT) positions. Before and after 20-day bedrest, plantarflexion force and surface electromyogram (EMG) in the medial gastrocnemius (MG), lateral gastrocnemius, and soleus muscles were measured during steady isometric contractions in five young men. In EXT, power EMG of MG increased significantly after bedrest. This low-frequency modulation of muscle activity in MG accompanied a 29% increase in the standard deviation of force. There was no change in EMG in other muscles. In FLX, there was no adjustment in EMG or force fluctuations. These results suggest that low-frequency modulation of MG plays a role in increasing force fluctuations during steady plantarflexion in EXT after bedrest. The findings indicate task/muscle specificity in the modulation of neural strategy during steady contractions after bedrest and underscore the importance of designing a specific training regimen targeted to particular tasks/muscles with regard to force fluctuations in multiple-agonist systems.

  12. The effect of total knee arthroplasty on knee joint kinematics and kinetics during gait.

    Science.gov (United States)

    Hatfield, Gillian L; Hubley-Kozey, Cheryl L; Astephen Wilson, Janie L; Dunbar, Michael J

    2011-02-01

    This study determined how total knee arthroplasty (TKA) altered knee motion and loading during gait. Three-dimensional kinematic and kinetic gait patterns of 42 patients with severe knee osteoarthritis were collected 1 week prior and 1-year post-TKA. Principal component analysis extracted major patterns of variability in the gait waveforms. Overall and midstance knee adduction moment magnitude decreased. Overall knee flexion angle magnitude increased due to an increase during swing. Increases in the early stance knee flexion moment and late stance knee extension moment were found, indicating improved impact attenuation and function. A decrease in the early stance knee external rotation moment indicated alteration in the typical rotation mechanism. Most changes moved toward an asymptomatic pattern and would be considered improvements in motion, function, and loading.

  13. A Comparison of the Performance Improvement by Collocated and Noncollocated Active Damping in Motion Systems

    NARCIS (Netherlands)

    Babakhani, B.; de Vries, Theodorus J.A.; van Amerongen, J.

    2012-01-01

    In this paper, both collocated and noncollocated active vibration control (AVC) of a the vibrations in a motion system are considered. Pole-zero plots of both the AVC loop and the motion-control (MC) loop are used to analyze the effect of the applied active damping on the system dynamics. Using

  14. UTILIZATION OF PULSED ELECTROMAGNETIC FIELD AND TRADITIONAL PHYSIOTHERAPY IN KNEE OSTEOARTHRITIS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Kadrya H. Battecha

    2015-04-01

    Full Text Available Background and Objectives: Pulsed electromagnetic field (PEMF has been suggested as a treatment method for musculoskeletal system disorders. The present study was conducted to determine whether the addition of PEMF to traditional physiotherapy produces better clinical outcomes than traditional physiotherapy alone in the management of moderate knee osteoarthritis (OA. Design: A single-blinded, randomized controlled study Methods: Twenty subjects (5 men and 15 women with unilateral moderate knee OA (Kellgren-Lawrence criteria grade 2. They were randomly allocated in 2 groups to receive: group (A PEMF plus ultrasound plus exercises; or (B ultrasound plus exercises. Both groups received the respective treatments 3 times per week for 4 weeks and underwent the same pretreatment and post treatment evaluation that included active knee range of motion (ROM by universal goniometer, knee pain score by visual analogue scale (VAS and knee functional performance by Western Ontario and McMaster Universities osteoarthritis index (WOMAC. Result: There was an improvement in both groups in active knee flexion ROM, reduced VAS score and improved WOMAC index , however, all outcomes were significantly better in group (A (p <0.05. Moreover, the percentages of outcomes improvement were in favor of group (A. Conclusion: The addition of PEMF to traditional physiotherapy in managing Knee OA produced a greater improvement in pain relief, range of motion and resulted in better functional performance than did traditional physiotherapy alone. The improvement in current study should be limited to short term outcomes of PEMF.

  15. The effect of active recovery, cold water immersion and passive recovery on subsequent knee extension and flexion strength

    Directory of Open Access Journals (Sweden)

    Barbora Strejcová

    2012-09-01

    Full Text Available BACKGROUND: Recovery is an important aspect of every physical activity. Many athletes train hard without giving their body time to recover which can lead to overreaching, burnout or poor performance. Currently cold-water immersion recovery and active recovery have emerged as some of the most popular interventions enabling faster recovery. OBJECTIVE: To assess the effect of three kinds of recovery (active recovery, cold water immersion, passive recovery on medium-term knee strength in the extension and flexion. METHODS: Fourteen athletes at the age of 26.6 ± 4.4 years performed, in a random cross-over design, 3 sessions with 3 repeated medium-term isokinetic tests. The effect of active recovery, passive rest and cold water immersion were assessed by 3 × 3 (time × recovery repeated-measure ANOVA, respectively. The dependent variables were – peak torque, total work and average power. RESULTS: We found significantly lower absolute differences between the first and third trial in knee extension for peak torque after the active recovery (↑ 0.9 N × m than after the cold water immersion (↓ 14.6 N × m or the passive recovery (↓ 13.9 N × m. The decrease of the average power was significantly lower differences after the active recovery (↓ 5 W than after the cold water immersion (↓ 23.7 W or passive recovery (↓ 25.9 W. The changes in total work were not significant. We did not found any changes in the isokinetic strength for the knee flexors after different kinds of recovery. Maximal heart rate (HRmax was significantly higher during the active recovery than during the cold water immersion and the passive recovery (173 ± 14, 166 ± 14 and 167 ± 14 rpm. We have found significant differences in the average heart rates (HRavg during active recovery, cold water immersion and passive recovery (124 ± 8, 97 ± 9 and 107 ± 12 rpm. CONCLUSION: We found the positive effect of the active recovery on the subsequent medium-term performance for

  16. Knee Injuries

    Science.gov (United States)

    ... bursitis . Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of ... injury without the aid of a television screen. Physical Therapy Depending on the type of knee injury ...

  17. Abdominal compliance, parasternal activation, and chest wall motion.

    Science.gov (United States)

    Cala, S J; Edyvean, J; Engel, L A

    1993-03-01

    We measured abdominal compliance (Cab) and rib cage displacement (delta Vrc) relative to abdominal displacement (delta Vab) during relaxation and tidal breathing in upright (U) and supine (S) postures in five normal subjects. In S, an abdominal binder was used to decrease Cab in two to five increments. We also measured the electrical activity of the parasternal muscle (EMGps) with the use of fine-wire intramuscular electrodes during CO2 rebreathing in U and in supine unbound (SU) and supine bound (SB) postures. During maximum binding (SB2), Cab decreased to 39 +/- 7% of the SU value (P = 0.01), matching Cab in U (P = 0.16). In the SB condition, the ratio of tidal delta Vrc/delta Vab to relaxation delta Vrc/delta Vab increased as Cab decreased, matching the data in U. For the group, this ratio decreased during SU to 47 +/- 10% (P = 0.02) but increased during SB2 to 86 +/- 7% (P = 0.18) of the value in U. During CO2 rebreathing, EMGps increased linearly with tidal volume (r > 0.727, P < 0.01). However, at any given tidal volume, the SU and SB2 EMGps were not significantly different (P = 0.12), and both were less than that in U (P < 0.02). The results suggest that the differences in chest wall motion between U and S may be due to the difference in Cab and not to different patterns of respiratory muscle recruitment. The mechanism may relate to changes in mechanical coupling between the diaphragm and the rib cage.

  18. Influence factors of range of motion after total knee arthroplasty%影响全膝关节置换术后关节活动度的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    曾勉东; 杨波; 谢景开; 吕玉明; 尹彪

    2012-01-01

    目的 分析全膝关节置换术后关节活动度的相关影响因素,旨在探讨如何提高术后膝关节活动范围.方法 回顾性研究2008年10月~2010年10月37例全膝关节置换术.术后1年25例膝关节屈曲度>90°的患者作为对照组,12例膝关节屈曲度<90°的患者作为实验组.两组根据年龄、性别、体重指数(BMI)、手术时间、术中出血和随访时间等进行配对病例对照研究分析影响因素.结果 两组患者年龄、性别、手术时间、术中出血、随访时间及术前合并症比较,差异无统计学意义.手术前后两组膝关节屈曲度比较,差异有显著统计学意义(P<0.01).手术前后两组的胫骨倾斜度与关节力线对位不良的比较,差异有统计学意义(P<0.05).结论 全膝关节置换术后膝关节活动度受肥胖、下肢力线对位情况和术后主动功能锻炼等因素影响,术中术后减少以上因素影响可以提高膝关节术后活动度.%Objective To analyze the related factors of the range of motion(ROM) after total knee arthroplasty and discuss how to improve the ROM of knee. Methods A retrospective review was given to the data from 37 patients undergoing total knee arthroplasty between October 2008 and October 2010. There're 25 TKA patients with greater than 90° flexion at 1 year postoperative served as control group, 12 patients with a 1 -year postoperative flexion range of less than 90° was taken as treatment group. The age, sex, body mass index, time for surgery, intraoperative bleeding, follow-up time of the control group were matched to those of the treatment group. Results No significant differences were found with regard to the age,sex,body mass index, time for surgery, intraoperative bleeding, follow-up time. Significant differences were found between preoperative flexion and postopeartive flexion (P <0.01). Preoperative and postoperative the gradient of tibial and force line of lower extremities were significantly

  19. Steeper posterior tibial slope markedly increases ACL force in both active gait and passive knee joint under compression.

    Science.gov (United States)

    Marouane, H; Shirazi-Adl, A; Adouni, M; Hashemi, J

    2014-04-11

    The role of the posterior tibial slope (PTS) in anterior cruciate ligament (ACL) risk of injury has been supported by many imaging studies but refuted by some in vitro works. The current investigation was carried out to compute the effect of ±5(o) change in PTS on knee joint biomechanics in general and ACL force/strain in particular. Two validated finite element (FE) models of the knee joint were employed; one active lower extremity musculoskeletal model including a complex FE model of the knee joint driven by in vivo kinematics/kinetics collected in gait of asymptomatic subjects, and the other its isolated unconstrained passive tibiofemoral (TF) joint considered under 1400 N compression at four different knee flexion angles (0°-45°). In the TF model, the compression force was applied at the joint mechanical balance point causing no rotations in sagittal and frontal planes. Changes in PTS moderately affected muscle forces and joint contact forces at mid-stance period. Both active (at mid-stance) and passive (at all flexion angles) models showed a substantial increase in the anterior tibial translation and ACL force as PTS increased with reverse trends as PTS decreased. In the active model of gait at mid-stance, ACL force increased by 75% (from 181 N to 317 N) in steeper PTS but decreased by 44% (to 102 N) in flatter PTS. The posterolateral bundle of ACL carried the load at smaller flexion angles with a shift to its anteromedial bundle as flexion increased. In accordance with earlier imaging studies, greater PTS is a major risk factor for ACL rupture especially in activities involving large compression forces. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Physical performance and self-report outcomes associated with use of passive, adaptive, and active prosthetic knees in persons with unilateral, transfemoral amputation: Randomized crossover trial.

    Science.gov (United States)

    Hafner, Brian J; Askew, Robert L

    2015-01-01

    Prosthetic knees are a vital component in an artificial limb. Contemporary knees include passive, (mechanical), adaptive (computerized), or active (motorized) control systems and have the potential to mitigate amputation-related functional impairments and activity limitations. A 14 mo randomized crossover trial was conducted. Participants (n = 12, mean age = 58 yr) were tested under three conditions: passive control (existing knee), adaptive control (Ossur Rheo Knee II), and active control (Ossur Power Knee II). Training and acclimation time were provided to participants in the adaptive and active knees. Outcome measures included indoor tests (Timed Up and Go test [TUG], stairs, and ramp), outdoor tests (walking course and perceived exertion), step activity monitor, self-report surveys (mobility, balance confidence, physical function, fatigue, and general health), and fall incidence. Mixed-effects linear regression modeling was used to evaluate data. Compared with passive control, adaptive control significantly improved comfortable TUG time (difference = 0.91 s, p = 0.001) and reported physical function (difference = 1.26 [T-score], p = 0.03). Active control significantly increased comfortable TUG, fast TUG, and ramp times (difference = 3.02, 2.66, and 0.96 s, respectively, all p passive control. Findings suggest that adaptive knee control may enhance function compared with passive control but that active control can restrict mobility in middle-age or older users with transfemoral amputation. ClinicalTrials.gov; "Use of Passive, Adaptive, and Active Prosthetic Knees in Persons With Unilateral, Transfemoral Amputation": NCT02219230; https://clinicaltrials.gov/ct2/show/NCT02219230.

  1. Prosthetic knee design by simulation

    Energy Technology Data Exchange (ETDEWEB)

    Hollerbach, K; Hollister, A

    1999-07-30

    Although 150,000 total knee replacement surgeries are performed annually in North America, current designs of knee prostheses have mechanical problems that include a limited range of motion, abnormal gait patterns, patellofemoral joint dysfunction, implant loosening or subsidence, and excessive wear. These problems fall into three categories: failure to reproduce normal joint kinematics, which results in altered limb function; bone-implant interface failure; and material failure. Modern computer technology can be used to design, prototype, and test new total knee implants. The design team uses the full range of CAD-CAM to design and produce implant prototypes for mechanical and clinical testing. Closer approximation of natural knee kinematics and kinetics is essential for improved patient function and diminished implant loads. Current knee replacement designs are based on 19th Century theories that the knee moves about a variable axis of rotation. Recent research has shown, however, that knee motion occurs about two fixed, offset axes of rotation. These aces are not perpendicular to the long axes of the bones or to each other, and the axes do not intersect. Bearing surfaces of mechanisms that move about axes of rotation are surfaces of revolution of those axes which advanced CAD technology can produce. Solids with surfaces of revolution for the two axes of rotation for the knee have been made using an HP9000 workstation and Structural Ideas Master Series CAD software at ArthroMotion. The implant's CAD model should closely replicate movements of the normal knee. The knee model will have a range of flexion-extension (FE) from -5 to 120 degrees. Movements include varus, valgus, internal and external rotation, as well as flexion and extension. The patellofemoral joint is aligned perpendicular to the FE axis and replicates the natural joint more closely than those of existing prostheses. The bearing surfaces will be more congruent than current designs and should

  2. Quantifying thigh muscle co-activation during isometric knee extension contractions: within- and between-session reliability.

    Science.gov (United States)

    Katsavelis, Dimitrios; Threlkeld, A Joseph

    2014-08-01

    Muscle co-activation around the knee is important during ambulation and balance. The wide range of methodological approaches for the quantification of co-activation index (CI) makes comparisons across studies and populations difficult. The present study determined within- and between-session reliability of different methodological approaches for the quantification of the CI of the knee extensor and flexor muscles during maximum voluntary isometric contractions (MVICs). Eight healthy volunteers participated in two repeated testing sessions. A series of knee extension MVICs of the dominant leg with concomitant torque and electromyographic (EMG) recordings were captured. CI was calculated utilizing different analytical approaches. Intraclass correlation coefficient (ICC) showed that within-session measures displayed higher reliability (ICC>0.861) and lower variability (Coefficient of variation; CV24.2%). A selection of a 500ms or larger window of RMS EMG activity around the PT delivered more reliable and less variable results than other approaches. Our findings suggest that the CI can provide a reliable measure for comparisons among conditions and is best utilized for within-session experimental designs.

  3. Knee joint neuromuscular activation performance during muscle damage and superimposed fatigue.

    Science.gov (United States)

    Minshull, Claire; Eston, Roger; Rees, David; Gleeson, Nigel

    2012-01-01

    This study examined the concurrent effects of exercise-induced muscle damage and superimposed acute fatigue on the neuromuscular activation performance of the knee flexors of nine males (age: 26.7 ± 6.1 years; height 1.81 ± 0.05 m; body mass 81.2 ± 11.7 kg [mean±s]). Measures were obtained during three experimental conditions: (i) 'fatigue-muscle damage', involving acute fatiguing exercise performed on each assessment occasion plus a single episode of eccentric exercise performed on the first occasion and after the fatigue trial; (ii) 'fatigue', involving the fatiguing exercise only; and (iii) 'control' consisting of no exercise. Assessments were performed prior to (pre) and at 1 h, 24 h, 48 h, 72 h, and 168 h relative to the muscle damaging eccentric exercise. Repeated-measures analyses of variance (ANOVAs) showed that muscle damage elicited reductions of up to 38%, 24% and 65% in volitional peak force, electromechanical delay and rate of force development compared to baseline and controls, respectively (F ([10, 80]) = 2.3 to 4.6; P exercise.

  4. Within- and between-session reliability of the maximal voluntary knee extension torque and activation.

    Science.gov (United States)

    Park, Jihong; Hopkins, J Ty

    2013-01-01

    A ratio between the torque generated by maximal voluntary isometric contraction (MVIC) and exogenous electrical stimulus, central activation ratio (CAR), has been widely used to assess quadriceps function. To date, no data exist regarding between-session reliability of this measurement. Thirteen neurologically sound volunteers underwent three testing sessions (three trials per session) with 48 hours between-session. Subjects performed MVICs of the quadriceps with the knee locked at 90° flexion and the hip at 85°. Once the MVIC reached a plateau, an electrical stimulation from superimposed burst technique (SIB: 125 V with peak output current 450 mA) was manually delivered and transmitted directly to the quadriceps via stimulating electrodes. CAR was calculated by using the following equation: CAR = MVIC torque/MVIC + SIB torque. Intraclass correlation coefficients (ICC) were calculated within- (ICC((2,1))) and between-session (ICC((2,k))) for MVIC torques and CAR values. Our data show that quadriceps MVIC and CAR are very reliable both within- (ICC((2,1)) = 0.99 for MVIC; 0.94 for CAR) and between-measurement sessions (ICC((2,k)) = 0.92 for MVIC; 0.86 for CAR) in healthy young adults. For clinical research, more data of the patients with pathological conditions are required to ensure reproducibility of calculation of CAR.

  5. Active Brownian motion of an asymmetric rigid particle

    CERN Document Server

    Mammadov, Gulmammad

    2012-01-01

    Individual movements of a rod-like self-propelled particle on a flat substrate are quantified. Biological systems that fit into this description may be the Gram-negative delta-proteobacterium Myxococcus xanthus, Gram-negative bacterium Escherichia coli, and Mitochondria. There are also non-living analogues such as vibrated polar granulates and self-driven anisotropic colloidal particles. For that we study the Brownian motion of an asymmetric rod-like rigid particle self-propelled at a fixed speed along its long axis in two dimensions. The motion of such a particle in a uniform external potential field is also considered. The theoretical model presented here is anticipated to better describe individual cell motion as well as intracellular transport in 2D than previous models.

  6. Evaluation of (241)Am deposited in different parts of the leg bones and skeleton to justify in vivo measurements of the knee for estimating total skeletal activity.

    Science.gov (United States)

    Khalaf, Majid; Brey, Richard R; Derryberry, DeWayne

    2013-01-01

    The percentage of Am deposited in different parts of leg bones relative to the total leg activity was calculated from radiochemical analysis results from six whole body donors participating in the U.S. Transuranium and Uranium Registries (USTUR). In five of these six USTUR cases, the percentage of Am deposited in the knee region as well as in the entire leg was separately calculated relative to total skeletal activity. The purpose of this study is to find a region in the leg that is both suitable for in vivo measurement of Am deposited in the bones and has a good correlation with the total skeletal Am burden. In all analyzed cases, the femur was the bone with the highest percentage of Am deposited in the leg (48.8%). In the five cases that have complete whole skeletal analysis, the percentage of Am activity in the knee relative to entire skeletal activity was 4.8%, and the average value of its coefficient of variation was 10.6%. The percentage of Am in the leg relative to total skeletal activity was 20% with an average coefficient of variation of 13.63%. The Am activity in the knee as well as in the leg was strongly correlated (R = 99.5% and R = 99.1%, respectively) with the amount of Am activity in the entire skeleton using a simple linear relationship. The highest correlation was found between the amount of Am deposited in the knee and the amount of Am deposited in the entire skeleton. This correlation is important because it might enable an accurate assessment of the total skeletal Am burden to be performed from in vivo monitoring of the knee region. In all analyzed cases, an excellent correlation (R = 99.9%) was found between the amount of Am activity in the knee and the amount of Am activity in the entire leg. The results of this study suggest three simple models: two models to predict the total skeletal activity based on either leg or knee activity, and the third model to predict the total leg activity based on knee activity. The results also suggest that the

  7. Total Knee Replacement

    Science.gov (United States)

    ... walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other low-impact sports. With appropriate activity ... help prevent leg swelling and blood clots. Physical Therapy Most patients begin exercising their knee the day ...

  8. The effects of a single game of rugby on active cervical range of motion.

    Science.gov (United States)

    Lark, Sally D; McCarthy, Peter W

    2009-03-01

    The cumulative effect of playing rugby over many years decreases active cervical range of motion, especially in the forwards. This in itself should influence long-term neck care; however, it leaves the important question of how noticeable the acute effects of active cervical range of motion are following a single game. The active cervical range of motion was measured in 21 elite rugby players (mean age 24.4 +/- 4.3 years; average professional career of 7 +/- 3.4 years) before and after a single game of rugby at the start of the season. The active cervical range of motion was recorded in flexion, extension, left and right side flexion, plus left and right rotation using a cervical range of motion device. The results show generally decreased active cervical range of motion from before to after a game independent of position played. Rugby backs had significantly (P cervical range of motion in flexion, while forwards were affected in extension and left lateral flexion (P cervical range of motion), and the affected neck movement appears to be related to the role of positional play. The authors suggest that neck training and muscle damage repair should be an important part of a rugby player's post-game recovery to limit the reduction in functional capacity.

  9. Investigation the efficacy of intra-articular prolotherapy with erythropoietin and dextrose and intra-articular pulsed radiofrequency on pain level reduction and range of motion improvement in primary osteoarthritis of knee

    Directory of Open Access Journals (Sweden)

    Poupak Rahimzadeh

    2014-01-01

    Full Text Available Background: Osteoarthritis is one of the most common diseases and the knee is the most commonly affected joint. Intra-articular prolotherapy is being utilized in acute and chronic pain management setting. This study was designed to compare the efficacy of three methods of intra-articular knee joint therapies with erythropoietin, dextrose, and pulsed radiofrequency. Materials and Methods: After approval by the Ethics Committee and explaining the therapeutic method to volunteers, 70 patients who were suffering from primary knee osteoarthrosis went through one of the treatment methods (erythropoietin, dextrose, and pulsed radiofrequency. The study was double-blind randomized clinical trial performed from December 2012 to July 2013. Patients′ pain level was assessed through the visual analog pain scale (VAS, and range of motion (ROM was measured by goniometric method. Furthermore, patients′ satisfaction was assessed before and after different treatment methods in weeks 2, 4, and 12. For analysis, Chi-square, one-way ANOVA, and repeated measured ANOVA were utilized. Results: The demographic results among the three groups did not indicate any statistical difference. The mean VAS in erythropoietin group in the 2 nd , 4 th , and 12 th weeks was 3.15 ± 1.08, 3.15 ± 1.08, and 3.5 ± 1.23, respectively (P ≤ 0.005. Knee joint ROM in the erythropoietin group in the 2 nd , 4 th , and 12 th weeks was 124 ± 1.50, 124 ± 1.4, and 123 ± 1.53 respectively (P ≤ 0.005. Satisfaction score in the 12 th week in erythropoietin group was extremely satisfied 15%, satisfied 55%, and moderately satisfied 30%, (P = 0.005. No specific side-effects were observed. Conclusion: Intra-articular prolotherapy with erythropoietin was more effective in terms of pain level reduction and ROM improvement compared with dextrose and pulsed radiofrequency.

  10. Kinematic alterations of the lower limbs and pelvis during an ascending stairs task are associated with the degree of knee osteoarthritis severity.

    Science.gov (United States)

    Gonçalves, Glaucia Helena; Selistre, Luiz Fernando Approbato; Petrella, Marina; Mattiello, Stela Márcia

    2017-03-01

    Individuals with knee osteoarthritis (OA) generally demonstrate great difficulty in ascending stairs. The strategies and compensations used by these individuals in stair activities have not been fully established. The purpose of this study was to investigate the joint kinematics of the pelvis, hip, knee and ankle throughout the gait cycle, in the sagittal and frontal planes, in individuals with mild and moderate knee OA, during an ascending stairs task. Thirty-one individuals with knee OA and 19 controls were subjected to clinical and radiographic analysis, divided into three groups: control, mild knee OA, and moderate knee OA. Participants answered a self-reported questionnaire, carried out performance-based tests, and their kinematic data were recorded during an ascending stairs task using an eight-camera Qualisys 3D-Motion analysis system. The individuals with moderate degrees of knee OA demonstrated kinematic alterations in the pelvis, hip, knee, and ankle in the sagittal plane. The individuals with mild degrees of knee OA demonstrated kinematic alterations of the hip in the frontal plane, and kinematic alterations of the ankle in the sagittal plane. The ascending stairs task allowed verification of meaningful information regarding gait strategies used by individuals with mild and moderate knee OA. The strategies of these two groups of individuals are different for this task, although more pronounced in individuals with moderate knee OA. The findings should be taken into account in the development of rehabilitation programs. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Activity Increase Despite Arthritis (AÏDA: design of a Phase II randomised controlled trial evaluating an active management booklet for hip and knee osteoarthritis [ISRCTN24554946

    Directory of Open Access Journals (Sweden)

    Edwards Rhiannon T

    2009-09-01

    Full Text Available Abstract Background Hip and knee osteoarthritis is a common cause of pain and disability, which can be improved by exercise interventions. However, regular exercise is uncommon in this group because the low physical activity level in the general population is probably reduced even further by pain related fear of movement. The best method of encouraging increased activity in this patient group is not known. A booklet has been developed for patients with hip or knee osteoarthritis. It focuses on changing disadvantageous beliefs and encouraging increased physical activity. Methods/Design This paper describes the design of a Phase II randomised controlled trial (RCT to test the effectiveness of this new booklet for patients with hip and knee osteoarthritis in influencing illness and treatment beliefs, and to assess the feasibility of conducting a larger definitive RCT in terms of health status and exercise behaviour. A computerised search of four general medical practice patients' record databases will identify patients older than 50 years of age who have consulted with hip or knee pain in the previous twelve months. A random sample of 120 will be invited to participate in the RCT comparing the new booklet with a control booklet, and we expect 100 to return final questionnaires. This trial will assess the feasibility of recruitment and randomisation, the suitability of the control intervention and outcome measurement tools, and will provide an estimate of effect size. Outcomes will include beliefs about hip and knee pain, beliefs about exercise, fear avoidance, level of physical activity, health status and health service costs. They will be measured at baseline, one month and three months. Discussion We discuss the merits of testing effectiveness in a phase II trial, in terms of intermediate outcome measures, whilst testing the processes for a larger definitive trial. We also discuss the advantages and disadvantages of testing the psychometric

  12. Effect of two different kinesio taping techniques on knee kinematics and kinetics in young females.

    Science.gov (United States)

    Guner, Senem; Alsancak, Serap; Koz, Mitat

    2015-10-01

    [Purpose] The application of kinesio taping may improve strength and performance, inhibit and facilitate motor activity, and increase range of motion. The aim of this study was to compare the effects of kinesio taping facilitation and inhibition applications on spatiotemporal knee kinematics and kinetics during walking activity in healthy subjects. [Subjects and Methods] A three-dimensional quantitative gait evaluation was performed without tape and with, facilitation and inhibition kinesio taping application on the knee. Sixteen healthy female college students (age, 19.7 ± 0.4 years; height, 1.64 ± 3.4 cm; body mass, 51.5 ± 4.8 kg) participated in the study. [Results] Spatiotemporal parameters (cadence, walking speed, stride length) were significantly different among the trials. Knee joint sagittal plane range of motion was not different with either kinesio taping application. Knee external flexion moment during the early stance phase decreased significantly with facilitation kinesio taping and increased with the inhibition kinesio taping. Knee external extension moment during the mid-stance phase increased with facilitation kinesio taping. Knee power parameters, eccentric activity in the rectus femoris during the pre-swing phase was significantly increased with inhibition kinesio taping application, while eccentric activity of the hamstrings during the terminal swing of gait was decreased. [Conclusion] These findings showed that facilitation kinesio taping application affected the terminal stance phase and that inhibition kinesio taping influenced the terminal swing phase compared with the no tape condition.

  13. Effect of two different kinesio taping techniques on knee kinematics and kinetics in young females

    Science.gov (United States)

    Guner, Senem; Alsancak, Serap; Koz, Mitat

    2015-01-01

    [Purpose] The application of kinesio taping may improve strength and performance, inhibit and facilitate motor activity, and increase range of motion. The aim of this study was to compare the effects of kinesio taping facilitation and inhibition applications on spatiotemporal knee kinematics and kinetics during walking activity in healthy subjects. [Subjects and Methods] A three-dimensional quantitative gait evaluation was performed without tape and with, facilitation and inhibition kinesio taping application on the knee. Sixteen healthy female college students (age, 19.7 ± 0.4 years; height, 1.64 ± 3.4 cm; body mass, 51.5 ± 4.8 kg) participated in the study. [Results] Spatiotemporal parameters (cadence, walking speed, stride length) were significantly different among the trials. Knee joint sagittal plane range of motion was not different with either kinesio taping application. Knee external flexion moment during the early stance phase decreased significantly with facilitation kinesio taping and increased with the inhibition kinesio taping. Knee external extension moment during the mid-stance phase increased with facilitation kinesio taping. Knee power parameters, eccentric activity in the rectus femoris during the pre-swing phase was significantly increased with inhibition kinesio taping application, while eccentric activity of the hamstrings during the terminal swing of gait was decreased. [Conclusion] These findings showed that facilitation kinesio taping application affected the terminal stance phase and that inhibition kinesio taping influenced the terminal swing phase compared with the no tape condition. PMID:26644651

  14. The effect of ankle bracing on knee kinetics and kinematics during volleyball-specific tasks.

    Science.gov (United States)

    West, T; Ng, L; Campbell, A

    2014-12-01

    The purpose of this study was to examine the effects of ankle bracing on knee kinetics and kinematics during volleyball tasks. Fifteen healthy, elite, female volleyball players performed a series of straight-line and lateral volleyball tasks with no brace and when wearing an ankle brace. A 14-camera Vicon motion analysis system and AMTI force plate were used to capture the kinetic and kinematic data. Knee range of motion, peak knee anterior-posterior and medial-lateral shear forces, and peak ground reaction forces that occurred between initial contact with the force plate and toe off were compared using paired sample t-tests between the braced and non-braced conditions (P volleyball tasks. However, ankle bracing was demonstrated to reduce knee lateral shear forces during all of the lateral movement volleyball tasks. Wearing the Active Ankle T2 brace will not impact knee joint range of motion and may in fact reduce shear loading to the knee joint in volleyball players. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. The effects of Juchumseogi and Juchumseo Jireugi motions of taekwondo on muscle activation of paraspinal muscles.

    Science.gov (United States)

    Baek, Jongmyeng; Lee, Jaeseok; Kim, Jonghyun; Kim, Jeonghun; Han, Dongwook; Byun, Sunghak

    2015-09-01

    [Purpose] The purpose of this study is to examine the effects of Juchumseogi and Juchumseo Jireugi motions on muscle activation of the paraspinal muscles. [Subjects] The subjects of this study were 20 healthy male students who listened to an explanation of the study methods and the purpose of the experiment, and agreed to participate in the study. [Methods] Muscle activation measurements of the paraspinal muscles at C3, T7, and L3 were taken while standing still and while performing Juchumseogi and Juchumseo Jireugi movements. The Juchumseogi and Juchumseo Jireugi motions were performed 3 times, and its mean value was used for analysis. [Results] The right and left muscle activation of paraspinal muscles induced by Juchumseogi and Juchumseo Jireugi motions in C3 and T7 were significantly higher than those induced by just standing. Muscle activation of paraspinal muscles induced by Juchumseo Jireugi motions in C3, T7, and L3 were significantly higher than those induced by Juchumseogi alone. The right and left muscle activation of paraspinal muscles induced by Juchumseo Jireugi motion in C3, T7, and L3 were significantly higher than those induced by standing and Juchumseogi alone. [Conclusion] This study demonstrated that Juchumseogi and Juchumseo Jireugi motions of Taekwondo could increase muscle activation of paraspinal muscles, and Juchumseo Jireugi motions were more effective for enhancing muscle activation of paraspinal muscles.

  16. Longitudinal impact of joint pain comorbidity on quality of life and activity levels in knee osteoarthritis: data from the Osteoarthritis Initiative.

    Science.gov (United States)

    Hoogeboom, Thomas J; den Broeder, Alfons A; de Bie, Rob A; van den Ende, Cornelia H M

    2013-03-01

    Joint pain comorbidity (JPC) is common in individuals with knee OA. This study investigates the longitudinal association between JPC and health-related quality of life (HRQoL) and physical activity levels in individuals with knee OA. Data from the progression cohort of the Osteoarthritis Initiative (n = 1233; age 61 years and 58% females) were analysed. JPC was considered present if individuals reported pain in three or more joint groups, including the knee joints. HRQoL was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life subscale, and self-reported physical activity was determined using the Physical Activity Scale for the Elderly (PASE). Generalized estimating equation (GEE) analyses were performed, adjusted for age, sex, duration of complaints, medical comorbidity, and physical and mental functioning. Over the 4-year period, 32% of participants never reported JPC, whereas 12% always reported JPC. GEE modelling demonstrated that having JPC was negatively associated with HRQoL [regression coefficient β (95% CI) -3.57 (-4.69, -2.44)] and not associated with physical activity [-1.32 (-6.61, 3.98)]. Considering the impact of JPC on the HRQoL of individuals with knee OA, the assessment of JPC in individuals with knee OA might be a daily routine.

  17. Implied Motion Activation in Cortical Area MT Can Be Explained by Visual Low-level Features

    NARCIS (Netherlands)

    Lorteije, Jeannette A.M.; Barraclough, Nick E.; Jellema, Tjeerd; Raemaekers, Mathijs; Duijnhouwer, Jacob; Xiao, Dengke; Oram, Mike W.; Lankheet, Martin J.M.; Perrett, David I.; van Wezel, Richard Jack Anton

    To investigate form-related activity in motion-sensitive cortical areas, we recorded cell responses to animate implied motion in macaque middle temporal (MT) and medial superior temporal (MST) cortex and investigated these areas using fMRI in humans. In the single-cell studies, we compared responses

  18. Kettlebell swing, snatch, and bottoms-up carry: back and hip muscle activation, motion, and low back loads.

    Science.gov (United States)

    McGill, Stuart M; Marshall, Leigh W

    2012-01-01

    The intent of this study was to quantify spine loading during different kettlebell swings and carries. No previously published studies of tissue loads during kettlebell exercises could be found. Given the popularity of kettlebells, this study was designed to provide an insight into the resulting joint loads. Seven male subjects participated in this investigation. In addition, a single case study of the kettlebell swing was performed on an accomplished kettlebell master. Electromyography, ground reaction forces (GRFs), and 3D kinematic data were recorded during exercises using a 16-kg kettlebell. These variables were input into an anatomically detailed biomechanical model that used normalized muscle activation; GRF; and spine, hip, and knee motion to calculate spine compression and shear loads. It was found that kettlebell swings create a hip-hinge squat pattern characterized by rapid muscle activation-relaxation cycles of substantial magnitudes (∼50% of a maximal voluntary contraction [MVC] for the low back extensors and 80% MVC for the gluteal muscles with a 16-kg kettlebell) resulting in about 3,200 N of low back compression. Abdominal muscular pulses together with the muscle bracing associated with carries create kettlebell-specific training opportunities. Some unique loading patterns discovered during the kettlebell swing included the posterior shear of the L4 vertebra on L5, which is opposite in polarity to a traditional lift. Thus, quantitative analysis provides an insight into why many individuals credit kettlebell swings with restoring and enhancing back health and function, although a few find that they irritate tissues.

  19. Effect of exercise therapy on neuromuscular activity and knee strength in female adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S.; Samani, Afshin; Olesen, Jens L.

    2016-01-01

    BACKGROUND: Female adolescents with patellofemoral pain are characterized by altered neuromuscular knee control and reduced maximal quadriceps torque. The purpose of this study is to investigate whether exercise therapy and patient education are associated with larger improvements in neuromuscular...... knee control and maximal quadriceps torque compared with patient education alone. METHODS: This is an ancillary analysis of a cluster randomized controlled trial investigating the effect of patient education and exercise therapy on self-reported recovery in 121 adolescents with patellofemoral pain...... flexion/extension kinematics and maximal quadriceps torque. FINDINGS: There was an 8-15% greater decrease in the complexity of surface electromyography suggesting an improvement in neuromuscular knee control among those randomized to exercise therapy (0.08

  20. Knee kinematics and kinetics in former soccer players with a 16-year-old ACL injury – the effects of twelve weeks of knee-specific training

    Directory of Open Access Journals (Sweden)

    Holmström Eva

    2007-04-01

    Full Text Available Abstract Background Training of neuromuscular control has become increasingly important and plays a major role in rehabilitation of subjects with an injury to the anterior cruciate ligament (ACL. Little is known, however, of the influence of this training on knee stiffness during loading. Increased knee stiffness occurs as a loading strategy of ACL-injured subjects and is associated with increased joint contact forces. Increased or altered joint loads contribute to the development of osteoarthritis. The aim of the study was to determine if knee stiffness, defined by changes in knee kinetics and kinematics of gait, step activity and cross-over hop could be reduced through a knee-specific 12-week training programme. Methods A 3-dimensional motion analysis system (VICON and a force plate (AMTI were used to calculate knee kinetics and kinematics before and after 12 weeks of knee-specific training in 12 males recruited from a cohort with ACL injury 16 years earlier. Twelve uninjured males matched for age, sex, BMI and activity level served as a reference group. Self-reported patient-relevant data were obtained by the KOOS questionnaire. Results There were no significant changes in knee stiffness during gait and step activity after training. For the cross-over hop, increased peak knee flexion during landing (from 44 to 48 degrees, p = 0.031 and increased internal knee extensor moment (1.28 to 1.55 Nm/kg, p = 0.017 were seen after training, indicating reduced knee stiffness. The KOOS sport and recreation score improved from 70 to 77 (p = 0.005 and was significantly correlated with the changes in knee flexion during landing for the cross-over hop (r = 0.6, p = 0.039. Conclusion Knee-specific training improved lower extremity kinetics and kinematics, indicating reduced knee stiffness during demanding hop activity. Self-reported sport and recreational function correlated positively with the biomechanical changes supporting a clinical importance of the

  1. Total knee replacement for posttraumatic degenerative arthritis of the knee

    Institute of Scientific and Technical Information of China (English)

    WU Li-dong; XIONG Yan; YAN Shi-gui; YANG Quan-sen

    2005-01-01

    Objective: To evaluate the results of total knee arthroplasty (TKA) in patients with posttraumatic degenerative arthritis due to a previous fracture around the knee. Methods: We analyzed the results of 15 TKAs, performed from 1997 to 2003, in 15 patients with post-traumatic degenerative arthritis due to a previous fracture around knee. There were 3 women and 12 men with an average age of 58 years (range, 31-76 years). The time from fracture to arthroplasty averaged 8.2 years (range, 2-27 years). Internal fixation had previously been performed in 8 patients resulting in retained hardware. At the time of arthroplasty a femoral fracture malunion was present in two knees. Lateral retinacular release (4 knees), extensor mechanism realignment (1 knee) or medial collateral ligament reconstruction (1 knee) were needed at the time of arthroplasty. Results: Follow-up averaged 35 months (range, 12-73 months). No patient was lost for follow-up. According to the Knee Society Score scale, the mean preoperative knee score was 37 (range, 10-70) and functional score was 41 (range, 0-60). They were improved significantly to a mean of 84 (range, 10-100) and 76 (range, 20-100) points, respectively at the latest follow-up. The mean knee arc of motion were improved from 84° preoperation to 94° at the latest follow-up. Postoperative manipulation under anesthesia for poor motion was carried out in 4 knees. No knee had aseptic loosening that required subsequent revision. Two knees developed superficial infection and were treated with debridement. It subsequently recovered with the retention of components. Conclusions: Significant improvement in function and relief of pain has been achieved in patients with previous fractures undergoing subsequent TKA. However, this procedure is technically demanding and patients are at increased risk for restricted motion and need more care following TKA. This study suggests that the outcome of TKA may be improved further by making special efforts to

  2. Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis: A Randomized Clinical Trial.

    Science.gov (United States)

    Bennell, Kim L; Campbell, Penny K; Egerton, Thorlene; Metcalf, Ben; Kasza, Jessica; Forbes, Andrew; Bills, Caroline; Gale, Janette; Harris, Anthony; Kolt, Gregory S; Bunker, Stephen J; Hunter, David J; Brand, Caroline A; Hinman, Rana S

    2017-01-01

    To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). A total of 168 inactive adults ages ≥50 years with knee pain on a numeric rating scale ≥4 (NRS; range 0-10) and knee OA were recruited from the community and randomly assigned to a physiotherapy (PT) and coaching group (n = 84) or PT-only (n = 84) group. All participants received five 30-minute consultations with a physiotherapist over 6 months for education, home exercise, and physical activity advice. PT+coaching participants also received 6-12 telephone coaching sessions by clinicians trained in behavioral-change support for exercise and physical activity. Primary outcomes were pain (NRS) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC; score range 0-68]) at 6 months. Secondary outcomes were these same measures at 12 and 18 months, as well as physical activity, exercise adherence, other pain and function measures, and quality of life. Analyses were intent-to-treat with multiple imputation for missing data. A total of 142 (85%), 136 (81%), and 128 (76%) participants completed 6-, 12-, and 18-month measurements, respectively. The change in NRS pain (mean difference 0.4 unit [95% confidence interval (95% CI) -0.4, 1.3]) and in WOMAC function (1.8 [95% CI -1.9, 5.5]) did not differ between groups at 6 months, with both groups showing clinically relevant improvements. Some secondary outcomes related to physical activity and exercise behavior favored PT+coaching at 6 months but generally not at 12 or 18 months. There were no between-group differences in most other outcomes. The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program. © 2016, American College of Rheumatology.

  3. Quadriceps Strength Asymmetry After Anterior Cruciate Ligament Reconstruction Alters Knee Joint Biomechanics and Functional Performance at Time of Return to Activity.

    Science.gov (United States)

    Palmieri-Smith, Riann M; Lepley, Lindsey K

    2015-07-01

    Quadriceps strength deficits are observed clinically after anterior cruciate ligament (ACL) injury and reconstruction and are often not overcome despite rehabilitation. Given that quadriceps strength may be important for achieving symmetrical joint biomechanics and promoting long-term joint health, determining the magnitude of strength deficits that lead to altered mechanics is critical. To determine if the magnitude of quadriceps strength asymmetry alters knee and hip biomechanical symmetry as well as functional performance and self-reported function. Cross-sectional study; Level of evidence, 3. A total of 73 patients were tested at the time they were cleared for return to activity after ACL reconstruction. Quadriceps strength and activation, scores on the International Knee Documentation Committee form, the hop for distance test, and sagittal plane lower extremity biomechanics were recorded while patients completed a single-legged hop. Patients with high and moderate quadriceps strength symmetry had larger central activation ratios as well as greater limb symmetry indices on the hop for distance compared with patients with low quadriceps strength symmetry (P knee flexion angle and external moment symmetry were higher in the patients with high and moderate quadriceps symmetry compared with those with low symmetry (P knee angle and moment symmetry (P knee in the sagittal plane. Quadriceps strength was related to movement asymmetries and functional performance. Rehabilitation after ACL reconstruction needs to focus on maximizing quadriceps strength, which likely will lead to more symmetrical knee biomechanics. © 2015 The Author(s).

  4. Targeted lipidomics reveals activation of resolution pathways in knee osteoarthritis in humans.

    Science.gov (United States)

    Jónasdóttir, H S; Brouwers, H; Kwekkeboom, J C; van der Linden, H M J; Huizinga, T; Kloppenburg, M; Toes, R E M; Giera, M; Ioan-Facsinay, A

    2017-07-01

    To investigate the presence of inflammation and resolution pathways in osteoarthritis (OA). Tissues were obtained from knee OA patients and control rheumatoid arthritis (RA) patients. Cells in synovial fluid (SF) were visualized by flow cytometry. Cytokines and chemokines were measured by multiplex assay. Lipid mediators (LMs) were determined by targeted lipidomics using liquid-chromatography mass spectrometry. SF of OA patients contained less cells, especially neutrophils, less cytokines and comparable levels of chemokines compared to RA controls. Thirty-seven lipids were detected in the soluble fraction of SF, including polyunsaturated fatty acids (PUFAs) and their pro-inflammatory and pro-resolving lipoxygenase (LOX) and cyclooxygenase (COX) pathway markers in both OA and RA patients. Among these, pro-inflammatory LM such as prostaglandin E2 (PGE2) and thromboxane B2, as well as precursors and pathway markers of resolution such as 17-HDHA and 18-HEPE were detected. Interestingly, the pro-resolving lipid RvD2 could also be detected, but only in the insoluble fraction (cells and undigested matrix). Ratios of metabolites to their precursors indicated a lower activity of 5-LOX and 15-LOX in OA compared to RA, with no apparent differences in COX-derived products. Interestingly, synovial tissue and SF cells could produce 5-LOX and 15-LOX metabolites, indicating these cells as possible source of LM. By using a state-of-the-art technique, we show for the first time that resolution pathways are present in OA patients. A better understanding of these pathways could guide us to more effective therapeutic approaches to inhibit inflammation and further structural damage in OA and RA. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  5. Time-driven Activity-based Cost of Fast-Track Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Andreasen, Signe E; Holm, Henriette B; Jørgensen, Mira; Gromov, Kirill; Kjærsgaard-Andersen, Per; Husted, Henrik

    2017-06-01

    Fast-track total hip and knee arthroplasty (THA and TKA) has been shown to reduce the perioperative convalescence resulting in less postoperative morbidity, earlier fulfillment of functional milestones, and shorter hospital stay. As organizational optimization is also part of the fast-track methodology, the result could be a more cost-effective pathway altogether. As THA and TKA are potentially costly procedures and the numbers are increasing in an economical limited environment, the aim of this study is to present baseline detailed economical calculations of fast-track THA and TKA and compare this between 2 departments with different logistical set-ups. Prospective data collection was analyzed using the time-driven activity-based costing method (TDABC) on time consumed by different staff members involved in patient treatment in the perioperative period of fast-track THA and TKA in 2 Danish orthopedic departments with standardized fast-track settings, but different logistical set-ups. Length of stay was median 2 days in both departments. TDABC revealed minor differences in the perioperative settings between departments, but the total cost excluding the prosthesis was similar at USD 2511 and USD 2551, respectively. Fast-track THA and TKA results in similar cost despite differences in the organizational set-up. Compared to cost associated with longer more conventional published pathways, fast-track is cheaper, which on top of the favorable published clinical outcome adds to cost efficiency and the potential for economic savings. Detailed baseline TDABC calculations are provided for comparison and further optimization of cost-benefit effectiveness. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Gait evaluation of an automatic stance-control knee orthosis in a patient with postpoliomyelitis.

    Science.gov (United States)

    Hebert, Jackie S; Liggins, Adrian B

    2005-08-01

    To determine gait differences in a subject ambulating with a knee-ankle-foot orthosis (KAFO) with a locked knee joint versus an automatic stance-control knee joint. Single-subject crossover design. Tertiary rehabilitation facility with a motion analysis laboratory. A 61-year-old ambulatory male volunteer with postpoliomyelitis walking with a stance-control KAFO. Instrumented gait analysis and Physiological Cost Index in the locked knee and stance-control modes. Differences in gait parameters. On the braced limb, stance-control mode showed a near-normal knee flexion wave in swing, reduced pelvic retraction and rotational excursion, and improved hip power generation. On the nonbraced limb, the stance-control mode allowed elimination of vaulting, reduction in abnormal ankle and hip power generation, increased knee power absorption, and more typical quadriceps activation. There was a trend toward improved energy efficiency in the stance-control mode. Use of a stance-control knee joint in a KAFO appears to improve gait biomechanics and improve energy efficiency compared with a locked knee.

  7. Immediate effect of Masai Barefoot Technology shoes on knee joint moments in women with knee osteoarthritis.

    Science.gov (United States)

    Tateuchi, Hiroshige; Taniguchi, Masashi; Takagi, Yui; Goto, Yusuke; Otsuka, Naoki; Koyama, Yumiko; Kobayashi, Masashi; Ichihashi, Noriaki

    2014-01-01

    Footwear modification can beneficially alter knee loading in patients with knee osteoarthritis. This study evaluated the effect of Masai Barefoot Technology shoes on reductions in external knee moments in patients with knee osteoarthritis. Three-dimensional motion analysis was used to examine the effect of Masai Barefoot Technology versus control shoes on the knee adduction and flexion moments in 17 women (mean age, 63.6 years) with radiographically confirmed knee osteoarthritis. The lateral and anterior trunk lean values, knee flexion and adduction angles, and ground reaction force were also evaluated. The influence of the original walking pattern on the changes in knee moments with Masai Barefoot Technology shoes was evaluated. The knee flexion moment in early stance was significantly reduced while walking with the Masai Barefoot Technology shoes (0.25±0.14Nm/kgm) as compared with walking with control shoes (0.30±0.19 Nm/kgm); whereas the knee adduction moment showed no changes. Masai Barefoot Technology shoes did not increase compensatory lateral and anterior trunk lean. The degree of knee flexion moment in the original walking pattern with control shoes was correlated directly with its reduction when wearing Masai Barefoot Technology shoes by multiple linear regression analysis (adjusted R2=0.44, PBarefoot Technology shoes reduced the knee flexion moment during walking without increasing the compensatory trunk lean and may therefore reduce external knee loading in women with knee osteoarthritis.

  8. Knee-Extension Training with a Single-Joint Hybrid Assistive Limb during the Early Postoperative Period after Total Knee Arthroplasty in a Patient with Osteoarthritis

    Science.gov (United States)

    Sugaya, Hisashi; Kubota, Shigeki; Onishi, Mio; Kanamori, Akihiro; Sankai, Yoshiyuki; Yamazaki, Masashi

    2016-01-01

    The knee range of motion is an important outcome of total knee arthroplasty (TKA). According to previous studies, the knee range of motion temporarily decreases for approximately 1 month after TKA due to postoperative pain and quadriceps dysfunction following surgical invasion into the knee extensor mechanism. We describe our experience with a knee-extension training program based on a single-joint hybrid assistive limb (HAL-SJ, Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after TKA. HAL-SJ is a wearable robot suit that facilitates the voluntary control of knee joint motion. A 76-year-old man underwent HAL-SJ-based knee-extension training, which enabled him to perform knee function training during the acute phase after TKA without causing increased pain. Thus, he regained the ability to fully extend his knee postoperatively. HAL-SJ-based knee-extension training can be used as a novel post-TKA rehabilitation modality.

  9. Influence of Active Manipulation of an Object on Visual Motion Perception

    Directory of Open Access Journals (Sweden)

    Kazumichi Matsumiya

    2011-10-01

    Full Text Available When we manipulate an object by hand, the movements of the object are produced with the visual and haptic movements of our hands. Studies of multimodal perception show the interaction between touch and vision in visual motion perception(1,2. The influence of touch on visual motion perception is shown by the fact that adaptation to tactile motion across the observer's hand induces a visual motion aftereffect, which is a visual illusion in which exposure to a moving visual pattern makes a subsequently viewed stationary visual pattern appear to move in the opposite direction(2. This visuo-tactile interaction plays an important role in skillful manipulation(3. However, it is not clear how haptic information influences visual motion perception. We measured the strength of a visual motion aftereffect after visuo-haptic adaptation to a windmill rotated by observers. We found that the visual motion aftereffect was enhanced when observers actively rotated the windmill. The motion aftereffect was not enhanced when the observer's hand was passively moved. Our results suggest the presence of a visual motion system that is linked to the intended haptic movements.

  10. Comparison of knee gait kinematics of workers exposed to knee straining posture to those of non-knee straining workers.

    Science.gov (United States)

    Gaudreault, Nathaly; Hagemeister, Nicola; Poitras, Stéphane; de Guise, Jacques A

    2013-06-01

    Workers exposed to knee straining postures, such as kneeling and squatting, may present modifications in knee gait kinematics that can make them vulnerable to osteoarthritis. In this study, knee kinematics of workers exposed to occupational knee straining postures (KS workers) were compared to those of non-knee straining (non-KS) workers. Eighteen KS workers and 20 non-KS workers participated in the study. Three-dimensional gait kinematic data were recorded at the knee using an electromagnetic motion tracking system. The following parameters were extracted from flexion/extension, adduction/abduction and internal/external rotation angle data and used for group comparisons: knee angle at initial foot contact, peak angles, minimal angles and angle range during the entire gait cycle. Group comparisons were performed with Student t-tests. In the sagittal plane, KS workers had a greater knee flexion angle at initial foot contact, a lower peak knee flexion angle during the swing phase and a lower angle range than non-KS workers (p<0.05). In the frontal plane, all parameters indicated that KS workers had their knees more adducted than non-KS workers. External/internal rotation range was greater for KS workers. This study provides new knowledge on work related to KS postures and knee kinematics. The results support the concept that KS workers might exhibit knee kinematics that are different from those of non-KS workers.

  11. Physical Activity Recognition Based on Motion in Images Acquired by a Wearable Camera.

    Science.gov (United States)

    Zhang, Hong; Li, Lu; Jia, Wenyan; Fernstrom, John D; Sclabassi, Robert J; Mao, Zhi-Hong; Sun, Mingui

    2011-06-01

    A new technique to extract and evaluate physical activity patterns from image sequences captured by a wearable camera is presented in this paper. Unlike standard activity recognition schemes, the video data captured by our device do not include the wearer him/herself. The physical activity of the wearer, such as walking or exercising, is analyzed indirectly through the camera motion extracted from the acquired video frames. Two key tasks, pixel correspondence identification and motion feature extraction, are studied to recognize activity patterns. We utilize a multiscale approach to identify pixel correspondences. When compared with the existing methods such as the Good Features detector and the Speed-up Robust Feature (SURF) detector, our technique is more accurate and computationally efficient. Once the pixel correspondences are determined which define representative motion vectors, we build a set of activity pattern features based on motion statistics in each frame. Finally, the physical activity of the person wearing a camera is determined according to the global motion distribution in the video. Our algorithms are tested using different machine learning techniques such as the K-Nearest Neighbor (KNN), Naive Bayesian and Support Vector Machine (SVM). The results show that many types of physical activities can be recognized from field acquired real-world video. Our results also indicate that, with a design of specific motion features in the input vectors, different classifiers can be used successfully with similar performances.

  12. Active Damping of Vibrations in High-Precision Motion Systems

    OpenAIRE

    Babakhani, B.

    2012-01-01

    Technology advancements feed the need for ever faster and more accurate industrial machines. Vibration is a significant source of inaccuracy of such machines. A light-weight design in favor of the speed, and avoiding the use of energy-dissipating materials from the structure to omit any source of inaccuracy, contribute to a low structural damping. The goal of this research is to investigate the addition of damping to the rotational vibration mode of a linearly actuated motion system to •achie...

  13. Relação entre altura da patela e amplitude de movimentos após a artroplastia total do joelho Relationship between patellar height and range of motion after total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Lúcio Honório de Carvalho Júnior

    2011-01-01

    Full Text Available OBJETIVO: Avaliar se após a artroplastia total do joelho existe correlação entre a altura da patela e a amplitude de movimento (ADM alcançada pelo paciente após seis meses de pós-operatório. MÉTODOS: Foram avaliados 45 pacientes submetidos a artroplastia total do joelho, todos com, no mínimo, 12 meses de pós-operatório, totalizando 54 joelhos. Sob fluoroscopia, todos os joelhos tiveram suas amplitudes de movimentos (ADM máximas e mínimas registradas, bem como a altura da patela pelo índice de Blackburne e Peel. Foram avaliadas as duas correlações possíveis: relação entre altura da patela e ADM e altura da patela e a variação de ADM entre o pré e o pós-operatório. RESULTADOS: Foi observada correlação entre altura da patela e ADM no pós-operatório (p = 0,04. Não foi observada correlação entre altura da patela e variação de ADM (p = 0,182. CONCLUSÃO: No pós-operatório da artroplastia total do joelho, quanto mais baixa a patela, pior a ADM.OBJECTIVE: To evaluate whether, after total knee arthroplasty, there is any correlation between patellar height and range of motion (ROM achieved by patients six months after the operation. METHODS: Forty-five patients who underwent total knee arthroplasty were assessed at least 12 months after the operation (total of 54 knees. The maximum and minimum ROM of all the knees was recorded under fluoroscopy, along with patellar height according to the Blackburne and Peel ratio. Two possible correlations were evaluated: patellar height and ROM; and patellar height and ROM variation from before to after the operation. RESULTS: A correlation was found between patellar height and postoperative ROM (p = 0.04. There was no correlation between patellar height and ROM variation (p = 0.182. CONCLUSION: After total knee arthroplasty, the lower the patella is, the worse the ROM is.

  14. Expectation of sensory stimulation modulates brain activation during visual motion stimulation.

    Science.gov (United States)

    Brandt, Thomas; Deutschländer, Angela; Glasauer, Stefan; Nolte, Annina; Brückmann, Hartmut; Dieterich, Marianne; Stephan, Thomas

    2005-04-01

    The differential effects of visual hemifield motion stimulation during fixation of a stationary target were compared under two conditions: fixation straight ahead without any further instructions and fixation straight ahead with attention shifted to the "dark hemifield." Data from nine right-handed volunteers revealed that striate and extrastriate right hemispheric visual areas exhibited larger activations during left hemifield motion stimulation when attention was shifted to the right dark hemifield. Montreal Neurological Institute (MNI) coordinates (26, -98, -4) of the additional clusters activated in the latter condition corresponded best to the kinetic occipital region, which is known to process both shape and motion information, and to parts of area V3 posterior to V3A, which has been shown repeatedly to mediate motion perception. A simple computational model of transhemispheric visuovisual interaction is proposed. The basic mechanism of this model is a central predictor formed by a feedback loop that detects a mismatch between input to the two hemispheres. Predicted stimulation is then compared with the actual input. If the sensed motion of a visual hemifield is larger than the predicted net motion in the model, activation of the respective neural population is increased; conversely, a smaller actual motion causes less activation.

  15. Mobile and fixed bearing total knee prosthesis functional comparison during stair climbing.

    Science.gov (United States)

    Catani, F; Benedetti, M G; De Felice, R; Buzzi, R; Giannini, S; Aglietti, P

    2003-06-01

    seemed to be adopted particularly by the mobile bearing patients during ascending stairs. Total knee replacement patient with mobile bearing design can feel excessive femoro-tibial motion during daily living activities such as stair climbing and descending. Proprioceptive control of this tibio-femoral translation is needed as demonstrated by the lower limb compensatory mechanism. This data suggest that antero-posterior constraint structures (ligamentous or mechanical) are important to obtain reproducible knee kinematics.

  16. Effect of knee joint cooling on the electromyographic activity of lower extremity muscles during a plyometric exercise.

    Science.gov (United States)

    Schmid, Stefan; Moffat, Marilyn; Gutierrez, Gregory M

    2010-12-01

    During sporting events, injured athletes often return to competition after icing because of the reduction in pain. Although some controversy exists, several studies suggest that cryotherapy causes a decrease in muscle activity, which may lead to a higher risk of injury upon return to play. The purpose of this study was to investigate the effect of a 20-min knee joint cryotherapy application on the electromyographic activity of leg muscles during a single-leg drop jump in twenty healthy subjects, randomly assigned to an experimental and a control group. After the pre-tests, a crushed-ice bag was applied to the knee joint of the experimental group subjects for 20 min, while the control group subjects rested for 20 min. All subjects were retested immediately after this period and retested again after another 20 min of rest. Average electromyographic activity and ground contact time were calculated for the pre- and post-test sessions. Decreases in electromyographic activity of the lower extremity musculature were found in pre-activation, eccentric (braking), and concentric (push-off) phases immediately after the icing, and after 20 min of rest. The results lend support to the suggestion that cryotherapy during sporting events may place the individuals in a vulnerable position. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Four Weeks of Mobility After 8 Weeks of Immobility Fails to Restore Normal Motion

    Science.gov (United States)

    Trudel, Guy; Zhou, Jian; Uhthoff, Hans K.

    2008-01-01

    Prolonged immobilization reduces passive range of motion of joints creating joint contractures. Whether and to what extent these iatrogenic contractures can be reduced is unknown. We raised three questions using an animal model: What degree of contracture remains at the end of a defined remobilization period? Do contractures in sham-operated and immobilized joints differ? What is the contribution of the posterior knee capsule in limiting knee extension? We immobilized one knee of 11 adult male rats in flexion to induce a joint contracture; 10 control animals underwent a sham operation. After 8 weeks, the internal fixation device was removed, and the animals were allowed to resume unrestricted activity for 4 weeks at the end of which the knee range of motion was measured with standardized torques. The mean flexion contracture was higher in the immobilized group (51.9° ± 2.8°) than in the sham-operated group (18.9° ± 2.1°). Eighty-eight percent of the contractures remained in the immobilized group after dividing skin and muscle, suggesting an important contribution of the posterior knee capsule in limiting knee mobility. Based on our preliminary study the range of motion of rat knees immobilized for 8 weeks remained substantially reduced after a 4-week period of unassisted remobilization. PMID:18299947

  18. The visual perception of natural motion: abnormal task-related neural activity in DYT1 dystonia.

    Science.gov (United States)

    Sako, Wataru; Fujita, Koji; Vo, An; Rucker, Janet C; Rizzo, John-Ross; Niethammer, Martin; Carbon, Maren; Bressman, Susan B; Uluğ, Aziz M; Eidelberg, David

    2015-12-01

    Although primary dystonia is defined by its characteristic motor manifestations, non-motor signs and symptoms have increasingly been recognized in this disorder. Recent neuroimaging studies have related the motor features of primary dystonia to connectivity changes in cerebello-thalamo-cortical pathways. It is not known, however, whether the non-motor manifestations of the disorder are associated with similar circuit abnormalities. To explore this possibility, we used functional magnetic resonance imaging to study primary dystonia and healthy volunteer subjects while they performed a motion perception task in which elliptical target trajectories were visually tracked on a computer screen. Prior functional magnetic resonance imaging studies of healthy subjects performing this task have revealed selective activation of motor regions during the perception of 'natural' versus 'unnatural' motion (defined respectively as trajectories with kinematic properties that either comply with or violate the two-thirds power law of motion). Several regions with significant connectivity changes in primary dystonia were situated in proximity to normal motion perception pathways, suggesting that abnormalities of these circuits may also be present in this disorder. To determine whether activation responses to natural versus unnatural motion in primary dystonia differ from normal, we used functional magnetic resonance imaging to study 10 DYT1 dystonia and 10 healthy control subjects at rest and during the perception of 'natural' and 'unnatural' motion. Both groups exhibited significant activation changes across perceptual conditions in the cerebellum, pons, and subthalamic nucleus. The two groups differed, however, in their responses to 'natural' versus 'unnatural' motion in these regions. In healthy subjects, regional activation was greater during the perception of natural (versus unnatural) motion (P perception of unnatural (versus natural) motion (P perception is disrupted in DYT1

  19. Focusing on Increasing Velocity during Heavy Resistance Knee Flexion Exercise Boosts Hamstring Muscle Activity in Chronic Stroke Patients

    Science.gov (United States)

    Jakobsen, Markus D.

    2016-01-01

    Background. Muscle strength is markedly reduced in stroke patients, which has negative implications for functional capacity and work ability. Different types of feedback during strength training exercises may alter neuromuscular activity and functional gains. Objective. To compare levels of muscle activity during conditions of blindfolding and intended high contraction speed with a normal condition of high-intensity knee flexions. Methods. Eighteen patients performed unilateral machine knee flexions with a 10-repetition maximum load. Surface electromyography (EMG) was recorded from the quadrics and hamstring muscles and normalized to maximal EMG (nEMG) of the nonparetic limb. Results. For the paretic leg, the speed condition showed higher values of muscle activity compared with the normal and blindfolded conditions for both biceps femoris and semitendinosus. Likewise, the speed condition showed higher co-contraction values compared with the normal and blindfolded conditions for the vastus lateralis. No differences were observed between exercise conditions for the nonparetic leg. Conclusion. Chronic stroke patients are capable of performing heavy resistance training with intended high speed of contraction. Focusing on speed during the concentric phase elicited higher levels of muscle activity of the hamstrings compared to normal and blindfolded conditions, which may have implications for regaining fast muscle strength in stroke survivors. PMID:27525118

  20. Habitual Physical Activity After Total Knee Replacement : analysis in 830 patients and comparison with a sex-and age-matched normative population (vol 92, pg 1109, 2012)

    NARCIS (Netherlands)

    Kersten, Roel F. M. R.; Stevens, Martin; van Raay, Jos J. A. M.; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge

    2012-01-01

    Background. Previous studies on physical activity after total knee arthroplasty (TKA) concentrated mainly on a return to sports activities. Objective. The objectives of this study were to determine the habitual physical activity behavior of people who had undergone TKA (TKA group) 1 to 5 years after

  1. Sporting Activity Is Reduced 11 Years After First-Generation Autologous Chondrocyte Implantation in the Knee Joint

    DEFF Research Database (Denmark)

    Erdle, Benjamin; Herrmann, Simon; Porichis, Stella

    2017-01-01

    of sporting activity correlated significantly with clinical long-term outcomes. MRI analysis with a mean repair tissue T2 relaxation time of 35.2 milliseconds and mean MOCART score of 44.9 showed no conclusive significant correlation to sporting activity. Level of performance was the only sporting activity......BACKGROUND: Little is known about long-term sporting activity after periosteal autologous chondrocyte implantation (ACI-P) and its correlation to clinical, morphological, and ultrastructural cartilage characteristics on magnetic resonance imaging (MRI). PURPOSE: To evaluate long-term sporting...... activity after ACI-P and to correlate with clinical and MRI findings. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Patients who underwent ACI-P for isolated cartilage defects of the knee joint between 1997 and 2001 were analyzed for sporting ability for 3 different time points: lifetime until...

  2. Prevalent knee pain and sport

    DEFF Research Database (Denmark)

    Hahn, Thomas; Foldspang, Anders

    1998-01-01

    STUDY OBJECTIVE: To estimate the prevalence of knee pain in active athletes and to investigate potential associations to type, amount and duration of sports participation. MEASUREMENTS: 339 athletes gave information about occupation, sports activity and different features of knee pain, based...... pain is a common symptom in athletes. The prevalence is associated with the type, amount and duration of sports participation....

  3. Differences in evoked potentials during the active processing of sound location and motion.

    Science.gov (United States)

    Richter, Nicole; Schröger, Erich; Rübsamen, Rudolf

    2013-06-01

    Difference in the processing of motion and static sounds in the human cortex was studied by electroencephalography with subjects performing an active discrimination task. Sound bursts were presented in the acoustic free-field between 47° to the left and 47° to the right under three different stimulus conditions: (i) static, (ii) leftward motion, and (iii) rightward motion. In an active oddball design, subject was asked to detect target stimuli which were randomly embedded within a stream of frequently occurring non-target events (i.e. 'standards') and rare non-target stimuli (i.e. 'deviants'). The respective acoustic stimuli were presented in blocks with each stimulus type presented in either of three stimulus conditions: as target, as non-target, or as standard. The analysis focussed on the event related potentials evoked by the different stimulus types under the respective standard condition. Same as in previous studies, all three different acoustic stimuli elicited the obligatory P1/N1/P2 complex in the range of 50-200 ms. However, comparisons of ERPs elicited by static stimuli and both kinds of motion stimuli yielded differences as early as ~100 ms after stimulus-onset, i.e. at the level of the exogenous N1 and P2 components. Differences in signal amplitudes were also found in a time window 300-400 ms ('d300-400 ms' component in 'motion-minus-static' difference wave). For motion stimuli, the N1 amplitudes were larger over the hemisphere contralateral to the origin of motion, while for static stimuli N1 amplitudes over both hemispheres were in the same range. Contrary to the N1 component, the ERP in the 'd300-400 ms' time period showed stronger responses over the hemisphere contralateral to motion termination, with the static stimuli again yielding equal bilateral amplitudes. For the P2 component a motion-specific effect with larger signal amplitudes over the left hemisphere was found compared to static stimuli. The presently documented N1 components comply

  4. Does knee awareness differ between different knee arthroplasty prostheses?

    DEFF Research Database (Denmark)

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

    2016-01-01

    BACKGROUND: Low knee awareness after Total Knee Arthroplasty (TKA) has become the ultimate goal in trying to achieve a natural feeling knee that meet patient expectations. To accommodate this manufacturers of TKAs have developed new prosthetic designs that potentially could give patients a more...... natural feeling knee during activities. The purpose af this study was to compare the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) of patients treated with a previous generation standard Cruciate Retaining (CR) TKA to the scores obtained by patients treated with a newer generation CR TKA...... and pre- and postoperative knee alignment. Patients were asked to complete the FJS and OKS questionnaires. Of the 316 patients completing the survey 64 standard CR TKAs to 35 new generation CR TKAs and 121 standard CR TKAs to 68 mobile bearing TKAs were matched. The FJS and OKS scores of the three TKA...

  5. Move with Science: Energy, Force, & Motion. An Activities-Based Teacher's Guide.

    Science.gov (United States)

    Beven, Roy Q.

    The secondary school level activities contained in this book use the subject of transportation to teach the basic concepts of physics and several areas of human biology. The material is organized into sections including curriculum design, activities, background readings, and resources. Activities focus on such topics as notions of motion stability…

  6. A group-mediated physical activity intervention in older knee osteoarthritis patients: effects on social cognitive outcomes.

    Science.gov (United States)

    Focht, Brian C; Garver, Matthew J; Lucas, Alexander R; Devor, Steven T; Emery, Charles F; Hackshaw, Kevin V; Fairman, Ciaran M; Bowman, Jessica; Rejeski, W Jack

    2017-01-20

    The objective of the present study was to compare a group-mediated cognitive behavioral (GMCB) physical activity intervention with traditional exercise therapy (TRAD) upon select social cognitive outcomes in sedentary knee osteoarthritis (knee OA) patients. A total of 80 patients (mean age = 63.5 years; 84% women) were recruited using clinic and community-based strategies to a 12-month, single-blind, two-arm, randomized controlled trial. Mobility-related self-efficacy, self-regulatory self-efficacy (SRSE), and satisfaction with physical function (SPF) were assessed at baseline, 3, and 12 months. Results of intent-to-treat 2 (Treatment: GMCB and TRAD) × 2 (Time: 3 and 12 month) analyses of covariance yielded significantly greater increases in SRSE and SPF (P physical activity and mobility at 3 and 12-months. The GMCB intervention yielded more favorable effects on important social cognitive outcomes than TRAD; these effects were related to improvements in physical activity and mobility.

  7. Acute phase response of selenium status and glutathione peroxidase activity in blood plasma before and after total knee arthroplasty surgery.

    Science.gov (United States)

    Defi, Irma Ruslina; Yamazaki, Chiho; Kameo, Satomi; Kobayashi, Kenji; Nakazawa, Minato; Shinya, Yanagisawa; Sato, Naoki; Wada, Naoki; Shirakura, Kenji; Koyama, Hiroshi

    2011-12-01

    Several studies show the consistent results of the decrease in plasma or serum selenium (Se) after surgery, and the change is suggested to be a negative acute phase response of Se to the surgical inflammation. Plasma glutathione peroxidase (GPx), which is included in the acute phase response proteins, is a selenoenzyme. However, previous studies failed to show any changes in GPx activity before and after surgery. In the present study, we investigated the Se- and selenoenzyme responses that accompany the acute inflammatory reactions during and following major surgery. Patients who underwent elective total knee arthroplasty surgery due to knee osteoarthritis at the Department of Orthopaedic Surgery at Gunma University Hospital in Japan were studied. The plasma Se concentration was determined, and the activity of plasma GPx was measured. C-reactive protein (CRP), albumin, blood urea nitrogen (BUN), and white blood cell (WBC) count were also analysed. Increases in the inflammatory biomarkers of CRP and WBC showed inflammatory reactions with the surgery. A significant increase in plasma GPx activity (p production of other series of acute phase proteins, the present results suggest that there is a redistribution of plasma Se to GPx that occurs as an acute phase response, and the source of Se for GPx could be, at least partly, from albumin.

  8. Quantitative MR characterization of disease activity in the knee in children with juvenile idiopathic arthritis: a longitudinal pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Workie, Dagnachew W. [University of Cincinnati, Department of Physics, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Imaging Research Center, Cincinnati, OH (United States); Graham, T.B. [Cincinnati Children' s Hospital Medical Center, Division of Rheumatology, Cincinnati, OH (United States); Laor, Tal; Racadio, Judy M. [Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Rajagopal, Akila; O' Brien, Kendall J.; Bommer, Wendy A. [Cincinnati Children' s Hospital Medical Center, Imaging Research Center, Cincinnati, OH (United States); Shire, Norah J. [University of Cincinnati, Division of Epidemiology and Biostatistics, Cincinnati, OH (United States); University of Cincinnati, Division of Digestive Diseases, Cincinnati, OH (United States); Dardzinski, Bernard J. [Cincinnati Children' s Hospital Medical Center, Imaging Research Center, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2007-06-15

    The development of a quantifiable and noninvasive method of monitoring disease activity and response to therapy is vital for arthritis management. The purpose of this study was to investigate the utility of quantitative dynamic contrast-enhanced MRI (DCE-MRI) based on pharmacokinetic (PK) modeling to evaluate disease activity in the knee and correlate the results with the clinical assessment in children with juvenile idiopathic arthritis (JIA). A group of 17 children with JIA underwent longitudinal clinical and laboratory assessment and DCE-MRI of the knee at enrollment, 3 months, and 12 months. A PK model was employed using MRI signal enhancement data to give three parameters, K{sup trans} ' (min{sup -1}), k{sub ep} (min{sup -1}), and V{sub p} ' and to calculate synovial volume. The PK parameters, synovial volumes, and clinical and laboratory assessments in most children were significantly decreased (P < 0.05) at 12 months when compared to the enrollment values. There was excellent correlation between the PK and synovial volume and the clinical and laboratory assessments. Differences in MR and clinical parameter values in individual subjects illustrate persistent synovitis when in clinical remission. A decrease in PK parameter values obtained from DCE-MRI in children with JIA likely reflects diminution of disease activity. This technique may be used as an objective follow-up measure of therapeutic efficacy in patients with JIA. MR imaging can detect persistent synovitis in patients considered to be in clinical remission. (orig.)

  9. Measurement of perioperative flexion-extension mechanics of the knee joint.

    Science.gov (United States)

    Giori, N J; Giori, K L; Woolson, S T; Goodman, S B; Lannin, J V; Schurman, D J

    2001-10-01

    Perioperative knee mechanics currently are evaluated Perioperative knee mechanics currently are evaluated by measuring range of motion. This is an incomplete measurement, however, because the torque applied to achieve the motion is not measured. We hypothesized that a custom goniometer and force transducer could measure the torque required to passively flex a knee through its full range of motion. This measurement was done in the operating room immediately before and after surgery in 20 knees having total knee arthroplasty and 9 having surgery on another limb. Surgery changed the mechanics of 8 knees, whereas unoperated knees remained unchanged. This measurement technique is safe, easy, and repeatable. It improves on the current standard of perioperative knee measurement and can be applied to investigate the effects of surgery and rehabilitation on ultimate knee motion.

  10. Use of Knee Extension Device During Rehabilitation of a Patient with Type 3 Arthrofibrosis after ACL Reconstruction.

    Science.gov (United States)

    Biggs, Angie; Shelbourne, K Donald

    2006-08-01

    Arthrofibrosis is a frequent complication following rehabilitation of a patient with anterior cruciate ligament (ACL) reconstruction. Although prevention is the best treatment, little information exists within the literature regarding the management and rehabilitation intervention for arthrofibrosis. In this case report a rehabilitation program in the treatment of a patient with arthrofibrosis is described. To identify the importance of discrete measures of knee range of motion in the knee of a patient following ACL reconstruction in order to help prevent postoperative complications. The patient was an 18-year-old female who sustained an ACL and medial collateral ligament (MCL) injury in a basketball game and underwent an ACL reconstruction with an ipsilateral patellar tendon graft. The patient developed arthrofibrosis and, despite traditional physical therapy of therapeutic exercise and manual therapy, the patient continued to complain of pain, stiffness, limited activities of daily living, and the inability to participate in competitive sports. This patient used a knee extension device as part of her rehabilitation program. The patient was able to obtain knee extension and flexion equal to her opposite normal knee. Upon completion of the rehabilitation program, the patient returned to full activities of daily living and competitive sports. Increasing and maintaining knee extension that is equal to the opposite normal knee is an important component in the successful outcome for the patient after ACL reconstruction. The use of a knee extension device may provide an effective rehabilitation intervention in the treatment of arthrofibrosis.

  11. Application of computational lower extremity model to investigate different muscle activities and joint force patterns in knee osteoarthritis patients during walking.

    Science.gov (United States)

    Nha, Kyung Wook; Dorj, Ariunzaya; Feng, Jun; Shin, Jun Ho; Kim, Jong In; Kwon, Jae Ho; Kim, Kyungsoo; Kim, Yoon Hyuk

    2013-01-01

    Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA) patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups. The OA patients had higher extensor muscle forces and lateral component of the knee joint force than normal subjects as well as force and torque ratios of extensor and flexor muscles, while the other parameters had little differences. The results explained that OA patients increased the level of antagonistic cocontraction and the adduction moment on the knee joint. The presented findings and technologies provide insight into biomechanical changes in OA patients and can also be used to evaluate the postoperative functional outcomes of the OA treatments.

  12. Application of Computational Lower Extremity Model to Investigate Different Muscle Activities and Joint Force Patterns in Knee Osteoarthritis Patients during Walking

    Directory of Open Access Journals (Sweden)

    Kyung Wook Nha

    2013-01-01

    Full Text Available Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups. The OA patients had higher extensor muscle forces and lateral component of the knee joint force than normal subjects as well as force and torque ratios of extensor and flexor muscles, while the other parameters had little differences. The results explained that OA patients increased the level of antagonistic cocontraction and the adduction moment on the knee joint. The presented findings and technologies provide insight into biomechanical changes in OA patients and can also be used to evaluate the postoperative functional outcomes of the OA treatments.

  13. The associations between quadriceps muscle strength, power, and knee joint mechanics in knee osteoarthritis: A cross-sectional study.

    Science.gov (United States)

    Murray, Amanda M; Thomas, Abbey C; Armstrong, Charles W; Pietrosimone, Brian G; Tevald, Michael A

    2015-12-01

    Abnormal knee joint mechanics have been implicated in the pathogenesis and progression of knee osteoarthritis. Deficits in muscle function (i.e., strength and power) may contribute to abnormal knee joint loading. The associations between quadriceps strength, power and knee joint mechanics remain unclear in knee osteoarthritis. Three-dimensional motion analysis was used to collect peak knee joint angles and moments during the first 50% of stance phase of gait in 33 participants with knee osteoarthritis. Quadriceps strength and power were assessed using a knee extension machine. Strength was quantified as the one repetition maximum. Power was quantified as the peak power produced at 40-90% of the one repetition maximum. Quadriceps strength accounted for 15% of the variance in peak knee flexion angle (P=0.016). Quadriceps power accounted for 20-29% of the variance in peak knee flexion angle (Pknee adduction moment (P=0.05). These data suggest that quadriceps power explains more variance in knee flexion angle and knee adduction moment during gait in knee osteoarthritis than quadriceps strength. Additionally, quadriceps power at multiple loads is associated with knee joint mechanics and therefore should be assessed at a variety of loads. Taken together, these results indicate that quadriceps power may be a potential target for interventions aimed at changing knee joint mechanics in knee osteoarthritis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Translational Optic Flow Induces Shifts in Direction of Active Forward and Backward Self-Motion

    Directory of Open Access Journals (Sweden)

    Kenzo Sakurai

    2011-05-01

    Full Text Available Previously, we reported that when observers passively experience real linear oscillatory somatic motion while viewing orthogonal visual optic flow patterns, their perceived motion direction is intermediate to those specified by visual and vestibular information individually (Sakurai et al., 2002, ACV; 2003, ECVP; 2010, VSS; Kubodera et al., 2010, APCV. Here, we extend those studies to active somatic motion, measuring the angular shift in body direction after active body motion while viewing synchronized orthogonal optic flow. Experimental visual stimuli consisted of 1 second of translating leftward (rightward random-dots and 1 second of random noise. Control stimuli consisted of two 1-second intervals of random noise separated by a static interval. Observers viewed the stimulus for 30 seconds through a face-mounted display while actively stepping forward and backward such that their forward body movement was synchronized with the random-dot translational motion. Observers' body direction was measured before and after each trial. Translational optic flow induced shifts in body direction that were opposite to shifts in perceived direction with passive viewing in our previous reports. Observers may have compensated their body motion in response to perceived direction shifts similar to those we reported for passive viewing.

  15. Quantitative Time Profiling of Children's Activity and Motion.

    Science.gov (United States)

    Barnes, Claire M; Clark, Cain C T; Holton, Mark D; Stratton, Gareth; Summers, Huw D

    2017-01-01

    The aim of this study was to establish children's mechanical movement patterns during a standardized assessment of fitness by using an accelerometer. Further to this, our objective was to use the information from the accelerometer to profile individual time courses of exercise, across the cohort. A multistage fitness test study was performed with 103 children (mean ± SD age = 10.3 ± 0.6 yr). Children wore an ankle-mounted accelerometer, and gait data were collected on radial acceleration traces obtained at a frequency of 40 Hz. Time-resolved metrics of foot impact force, maximum leg lift angle, and stride frequency were used to profile children's performance across the test duration. A whole-history metric of stride quality, based on the changing ratio of stride length to stride frequency, was used in bivariate analyses of physical performance and body metrics. Stride angle derived by our protocol was found to have a strong positive correlation with integrated acceleration, synonymous with counts, widely used in the sport science community (r = 0.81, 0.79, and 0.80 across different stages of the multistage fitness test). Accelerometer data show that differing performance in the test is related to the children's ability to accurately control their gait, with high performers displaying a linearly increasing speed, delivered through stride extension and well matched to the demand level of the test. A negative correlation was found between stride quality and body measures of body mass index (r = -0.61) and body mass (r = -0.60). Profiles of the gait parameters provide information on the mechanics of child's motion, allowing detailed assessment of multiple parameter during increasing intensities of exercise.

  16. Effect of anterior cruciate ligament reconstruction on biomechanical features of knee in level walking: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    SHI Dong-liang; WANG Yu-bin; AI Zi-sheng

    2010-01-01

    Background The anterior cruciate ligament (ACL) is one of the most commonly injured knee ligaments. Even following ACL reconstruction, significant articular cartilage degeneration can be observed and most patients suffer from premature osteoarthritis. Articular cartilage degeneration and osteoarthritis development after ACL injury are regarded as progressive process that are affected by cyclic loading during frequently performed low-intensity daily activities. The purpose of this study was to perform a meta analysis on studies assessing the effects of ACL reconstruction on kinematics, kinetics and proprioception of knee during level walking.Methods This meta analysis was conducted according to the methodological guidelines outlined by the Cochrane Collaboration. An electronic search of the literature was performed and all trials published between January 1966 and July 2010 comparing gait and proprioception of a reconstructed-ACL group with an intact-ACL group were pooled for this review. Thirteen studies were included in the final meta analysis.Results There was no significant difference in step length, walking speed, maximum knee flexion angle during loading response, joint position sense and threshold to detect passive motion between the reconstructed-ACL group and the intact-ACL group (P >0.05). However, there was a significant difference in peak knee flexion angle, maximum angular knee flexion excursion during stance, peak knee flexion moment during walking and maximum external tibial rotation angle throughout the gait cycle between the reconstructed-ACL group and the intact-ACL group (P <0.05).Conclusions Step length, walking speed, maximum knee flexion angle during loading response, joint position sense and threshold to detect passive motion usually observed with ACL deficiency were restored after the ACL reconstruction and rehabilitation, but no significant improvements were observed for peak knee flexion angle, maximum angular knee flexion excursion

  17. Design of a continuous passive and active motion device for hand rehabilitation.

    Science.gov (United States)

    Birch, B; Haslam, E; Heerah, I; Dechev, N; Park, E J

    2008-01-01

    This paper presents the design of a novel, portable device for hand rehabilitation. The device provides for CPM (continuous passive motion) and CAM (continuous active motion) hand rehabilitation for patients recovering from damage such as flexor tendon repair and strokes. The device is capable of flexing/extending the MCP (metacarpophalangeal) and PIP (proximal interphalangeal) joints through a range of motion of 0 degrees to 90 degrees for both the joints independently. In this way, typical hand rehabilitation motions such as intrinsic plus, intrinsic minus, and a fist can be achieved without the need of any splints or attachments. The CPM mode is broken into two subgroups. The first mode is the use of preset waypoints for the device to cycle through. The second mode involves motion from a starting position to a final position, but senses the torque from the user during the cycle. Therefore the user can control the ROM by resisting when they are at the end of the desired motion. During the CPM modes the device utilizes a minimum jerk trajectory model under PD control, moving smoothly and accurately between preselected positions. CAM is the final mode where the device will actively resist the movement of the user. The user moves from a start to end position while the device produces a torque to resist the motion. This active resistance motion is a unique ability designed to mimic the benefits of a human therapist. Another unique feature of the device is its ability to independently act on both the MCP and PIP joints. The feedback sensing built into the device makes it capable of offering a wide and flexible range of rehabilitation programs for the hand.

  18. PENINGKATAN PRODUKTIVITAS DAN EFISIENSI BIAYA MELALUI INTEGRASI TIME & MOTION STUDY DAN ACTIVITY-BASED COSTING

    Directory of Open Access Journals (Sweden)

    Monika Kussetya Ciptani

    2001-01-01

    Full Text Available Organizations today have many activities that increase continuously. There are some activities that companies have to do to meet customers' need. Some companies try to increase efficiency in performing their activities and try to measure activities they do although the difficulties in measuring each activities are very high. In this case, time & motion study method is one of the solutions to help the company measuring their activity. The company's activity consume time and resources, that is why time & motion study provides many techniques to measure activity in the company, for example: work sampling method, work-unit activity, time standard method, etc. Using these techniques, company can measure the productivity of resources used for every activity. In order to get better performance in cost reduction, the company should assign their cost to the product resulted. The method used is Activity-Based Costing method (ABC method. ABC method gives better result in assigning indirect costs to the product because it assigns costs to the product according to their activity. ABC method is the most appropriate method to be integrated with time & motion study method. The integration of the two methods could increase the ability of a company to measure and to control their productivity and cost efficiency in order to satisfy customers' demand. Abstract in Bahasa Indonesia : Kemajuan perusahaan sebagai organisasi bisnis, membuat aktivitas yang dilakukan oleh perusahaan semakin meningkat. Berbagai macam aktivitas dilakukan oleh perusahaan dalam rangka memenuhi apa yang menjadi kebutuhan dan keinginan customer. Perusahaan berusaha untuk meningkatkan efisiensi aktivitas dan melakukan pengukuran tingkat aktivitas yang dilakukan, padahal tingkat kesulitan yang dihadapi perusahaan untuk melakukan pengukuran setiap aktivitas yang dilakukan cukup tinggi. Metode time & motion study memberikan solusi bagi perusahaan untuk melakukan pengukuran tingkat aktivitas yang

  19. Complex Human Activity Recognition Using Smartphone and Wrist-Worn Motion Sensors

    NARCIS (Netherlands)

    Shoaib, Muhammad; Bosch, Stephan; Durmaz Incel, Ozlem; Scholten, Hans; Havinga, Paul J.M.

    2016-01-01

    The position of on-body motion sensors plays an important role in human activity recognition. Most often, mobile phone sensors at the trouser pocket or an equivalent position are used for this purpose. However, this position is not suitable for recognizing activities that involve hand gestures, such

  20. Embodied Semiotic Activities and Their Role in the Construction of Mathematical Meaning of Motion Graphs

    Science.gov (United States)

    Botzer, Galit; Yerushalmy, Michal

    2008-01-01

    This paper examines the relation between bodily actions, artifact-mediated activities, and semiotic processes that students experience while producing and interpreting graphs of two-dimensional motion in the plane. We designed a technology-based setting that enabled students to engage in embodied semiotic activities and experience two modes of…

  1. State of the art review of knee-ankle-foot orthoses.

    Science.gov (United States)

    Tian, Feng; Hefzy, Mohamed Samir; Elahinia, Mohammad

    2015-02-01

    Knee-ankle-foot orthoses (KAFOs) are used to assist in ambulation. The purpose of this paper is to review existing KAFO designs which can be grouped into passive KAFOs, stance control (SC) KAFOs, and dynamic KAFOs. The conventional passive KAFOs do not provide any active control for knee motions. SCKAFOs lock the knee joint during the stance phase and allow free rotations during the swing phase. Some SCKAFOs switch between the stance and swing phases using body posture, while others use some kind of a control system to perform this switch. Finally, dynamic KAFOs control the knee joint during both stance and swing phases. Four dynamic systems are identified in the literature that use pneumatics, linear springs, hydraulics, and torsional rods made of superelastic alloys to control the knee joint during the gait cycle. However, only the two systems that use linear springs and torsional rods can reproduce the normal knee stiffness pattern which has two distinct characteristics: a soft stiffness during the swing phase and a hard stiffness during the stance phase. This review indicates that there is a need to conduct research regarding new KAFO designs that duplicate normal knee function during the whole gait cycle.

  2. Total Knee Arthroplasty Designed to Accommodate the Presence or Absence of the Posterior Cruciate Ligament

    Directory of Open Access Journals (Sweden)

    Melinda K. Harman

    2014-01-01

    Full Text Available Evidence for selecting the same total knee arthroplasty prosthesis whether the posterior cruciate ligament (PCL is retained or resected is rarely documented. This study reports prospective midterm clinical, radiographic, and functional outcomes of a fixed-bearing design implanted using two different surgical techniques. The PCL was completely retained in 116 knees and completely resected in 43 knees. For the entire cohort, clinical knee (96±7 and function (92±13 scores and radiographic outcomes were good to excellent for 84% of patients after 5–10 years in vivo. Range of motion averaged 124˚±9˚, with 126 knees exhibiting ≥120° flexion. Small differences in average knee flexion and function scores were noted, with the PCL-resected group exhibiting an average of 5° more flexion but an average function score that was 7 points lower compared to the PCL-retained group. Fluoroscopic analysis of 33 knees revealed stable tibiofemoral translations. This study demonstrates that a TKA articular design with progressive congruency in the lateral compartment can provide for femoral condyle rollback in maximal flexion activities and achieve good clinical and functional performance in patients with PCL-retained and PCL-resected TKA. This TKA design proved suitable for use with either surgical technique, providing surgeons with the choice of maintaining or sacrificing the PCL.

  3. Sagittal knee joint kinematics and energetics in response to different landing heights and techniques.

    Science.gov (United States)

    Yeow, C H; Lee, P V S; Goh, J C H

    2010-03-01

    Single-leg and double-leg landing techniques are common athletic maneuvers typically performed from various landing heights during intensive sports activities. However, it is still unclear how the knee joint responds in terms of kinematics and energetics to the combined effects of different landing heights and techniques. We hypothesized that the knee displays greater flexion angles and angular velocities, joint power and work in response to the larger peak ground reaction force from 0.6-m height, compared to 0.3-m height. We further hypothesized that the knee exhibits elevated flexion angles and angular velocities, joint power and work during double-leg landing, relative to single-leg landing. Ground reaction force, knee joint kinematics and energetics data were obtained from 10 subjects performing single-leg and double-leg landing from 0.3-m to 0.6-m heights, using motion-capture system and force-plates. Higher peak ground reaction force (pheight. We found greater knee flexion angles and angular velocities (pheight. Elevated knee joint power and work were noted (pheight. The knee joint is able to respond more effectively in terms of kinematics and energetics to a larger landing impact from an elevated height during double-leg landing, compared to single-leg landing. This allows better shock absorption and thus minimizes the risk of sustaining lower extremity injuries.

  4. Return to Sports and Physical Activity After Total and Unicondylar Knee Arthroplasty: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Witjes, Suzanne; Gouttebarge, Vincent; Kuijer, P Paul F M; van Geenen, Rutger C I; Poolman, Rudolf W; Kerkhoffs, Gino M M J

    2016-02-01

    People today are living longer and want to remain active. While obesity is becoming an epidemic, the number of patients suffering from osteoarthritis (OA) is expected to grow exponentially in the coming decades. Patients with OA of the knee are progressively being restricted in their activities. Since a knee arthroplasty (KA) is a well accepted, cost-effective intervention to relieve pain, restore function and improve health-related quality of life, indications are expanding to younger and more active patients. However, evidence concerning return to sports (RTS) and physical activity (PA) after KA is sparse. Our aim was to systematically summarise the available literature concerning the extent to which patients can RTS and be physically active after total (TKA) and unicondylar knee arthroplasty (UKA), as well as the time it takes. PRISMA guidelines were followed and our study protocol was published online at PROSPERO under registration number CRD42014009370. Based on the keywords (and synonyms of) 'arthroplasty', 'sports' and 'recovery of function', the databases MEDLINE, Embase and SPORTDiscus up to January 5, 2015 were searched. Articles concerning TKA or UKA patients who recovered their sporting capacity, or intended to, were included and were rated by outcomes of our interest. Methodological quality was assessed using Quality in Prognosis Studies (QUIPS) and data extraction was performed using a standardised extraction form, both conducted by two independent investigators. Out of 1115 hits, 18 original studies were included. According to QUIPS, three studies had a low risk of bias. Overall RTS varied from 36 to 89% after TKA and from 75 to >100% after UKA. The meta-analysis revealed that participation in sports seems more likely after UKA than after TKA, with mean numbers of sports per patient postoperatively of 1.1-4.6 after UKA and 0.2-1.0 after TKA. PA level was higher after UKA than after TKA, but a trend towards lower-impact sports was shown after both TKA

  5. The Clinical Effect of Platelet Rich Plasma Prepared Through Different Activation Methods on Patients with Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Nevres Aydogan

    2016-11-01

    Full Text Available Aim: Intra-articular application of platelet rich plasma (PRP can be an alternative treatment method for knee osteoarthritis. The objective of this study was to compare the activation methods of platelet rich plasma before intra-articular application. Material and Method: A total 51 patients (76 knees was randomly selected into two groups. In group 1, activation of PRP was managed by adding calcium chloride (CaCl. In group 2, activation of PRP was managed by keeping the solution at -70° degrees for 24 hours after preparation and immersed in water at 37oC for a period of 5 minutes for complete dissolution. Then PRP was applied. The patients were assessed with VAS and WOMAC pain scores both baseline and after 2nd, 6th and 12th months of the treatment. Results: VAS and WOMAC pain scores were significantly higher at baseline compared to the results obtained at the 2nd, 6th and 12th months (p=0.06. Following 2nd, 6th and 12th months a gradual downward tendency was seen in both scores, even though no significant difference was found between the groups after 2nd, 6th and 12th months. Discussion: Patients received some clinical benefits from both activation methods. There is no significant difference between activating PRP by CaCl or -70°C which compared in terms of clinical benefits. Therefore, blood storage at -70ºC may be preferred primary due to no need for additional material such as CaCl.

  6. Spontaneous Motion in Hierarchically Assembled Active Cellular Materials

    Science.gov (United States)

    Chen, Daniel

    2013-03-01

    With exquisite precision and reproducibility, cells orchestrate the cooperative action of thousands of nanometer-sized molecular motors to carry out mechanical tasks at much larger length scales, such as cell motility, division and replication. Besides their biological importance, such inherently far-from-equilibrium processes are an inspiration for the development of soft materials with highly sought after biomimetic properties such as autonomous motility and self-healing. I will describe our exploration of such a class of biologically inspired soft active materials. Starting from extensile bundles comprised of microtubules and kinesin, we hierarchically assemble active analogs of polymeric gels, liquid crystals and emulsions. At high enough concentration, microtubule bundles form an active gel network capable of generating internally driven chaotic flows that enhance transport and fluid mixing. When confined to emulsion droplets, these 3D networks buckle onto the water-oil interface forming a dense thin film of bundles exhibiting cascades of collective buckling, fracture, and self-healing driven by internally generated stresses from the kinesin clusters. When compressed against surfaces, this active nematic cortex exerts traction stresses that propel the locomotion of the droplet. Taken together, these observations exemplify how assemblies of animate microscopic objects exhibit collective biomimetic properties that are fundamentally distinct from those found in materials assembled from inanimate building blocks. These assemblies, in turn, enable the generation of a new class of materials that exhibit macroscale flow phenomena emerging from nanoscale components.

  7. Fusion of Smartphone Motion Sensors for Physical Activity Recognition

    NARCIS (Netherlands)

    Shoaib, Muhammad; Bosch, Stephan; Durmaz Incel, Ozlem; Scholten, Hans; Havinga, Paul J.M.

    2014-01-01

    For physical activity recognition, smartphone sensors, such as an accelerometer and a gyroscope, are being utilized in many research studies. So far, particularly, the accelerometer has been extensively studied. In a few recent studies, a combination of a gyroscope, a magnetometer (in a supporting r

  8. Weight Status and Differences in Mobility Performance, Pain Symptoms, and Physical Activity in Older, Knee Osteoarthritis Patients

    Directory of Open Access Journals (Sweden)

    Matthew J. Garver

    2014-01-01

    Full Text Available Knee osteoarthritis (OA is a leading cause of functional disability among American adults. Obesity is a strong independent risk factor for OA. While research emphasizes the role of obesity in the OA-physical function relationship, the extent to which weight status impacts salient physical, health, and pain measures in older, knee OA patients is not well delineated. The primary aim of this study was to assess differences in mobility performance (stair climb and 400-meter walk, mobility-related self-efficacy, pain symptoms (WOMAC, and measures of accelerometer-determined physical activity (PA as a function of weight status. Analysis of covariance was conducted to examine differences on the dependent variables. Obese class III patients were outperformed by their counterparts on nearly every measure of mobility, mobility-related self-efficacy, and the assessment of pain symptoms. These outcomes did not differ among other weight comparisons. Normal weight subjects outperformed classes I, II, and III counterparts on most measures of PA (engagement in moderate or greater PA and total weekly steps. Additionally, overweight participants outperformed obese class II participants and obese class I participants outperformed obese classes II and III participants on total weekly steps. Collectively, these findings underscore the meaningful differences observed in relevant OA outcomes as a function of increasing levels of body weight.

  9. Total Knee Arthroplasty for Severe Flexion Contracture in Rheumatoid Arthritis Knees

    Science.gov (United States)

    Hwang, Youn Soo; Moon, Kyu Pill; Kim, Kyung Taek; Kim, Jin Wan; Park, Won Seok

    2016-01-01

    Flexion contracture deformities, as well as severe varus and valgus deformities of the knee joint, accompany osteoarthritis or rheumatoid arthritis (RA). In particular, severe flexion contracture deformity of the knee joint is often found in patients with RA, which renders them nonambulatory. This report describes a 26-year-old female patient diagnosed with RA 10 years ago. She had chronic joint pain, severe flexion contracture, valgus deformity in both knees, and limited range of motion in both knees and became nonambulatory. She underwent a total knee arthroplasty (TKA) and serial casting and physical therapy to restore stable joint movement and correct knee joint deformity. Her pain was successfully relieved, and she was able to walk after surgery. Here, we report the excellent results of TKA in this RA patient with severe flexion contracture of both knees. PMID:27894181

  10. Objective clinical performance outcome of total knee prostheses. A study of mobile bearing knees using fluoroscopy, electromyography and roentgenstereophotogrammetry

    NARCIS (Netherlands)

    Garling, Eric Harald

    2008-01-01

    The aim of the thesis was to to assess with accurate and objective methods the function and fixation of total knee prostheses with special emphasis on mobile bearing total knee designs. The mobile bearing of a rotating platform design showed limited motion or no motion during a step-up task thereby

  11. High knee valgus in female subjects does not yield higher knee translations during drop landings: a biplane fluoroscopic study.

    Science.gov (United States)

    Torry, Michael R; Shelburne, Kevin B; Myers, Casey; Giphart, J Erik; Pennington, W Wesley; Krong, Jacob P; Peterson, Daniel S; Steadman, J Richard; Woo, Savio L-Y

    2013-02-01

    The goal of this study was to determine the effects of peak knee valgus angle and peak knee abductor moment on the anterior, medial, and lateral tibial translations (ATT, MTT, LTT) in the "at risk" female knee during drop landing. Fifteen female subjects performed drop landings from 40 cm. Three-dimension knee motion was simultaneously recorded using a high speed, biplane fluoroscopy system, and a video-based motion analysis system. Valgus knee angles and knee abduction moments were stratified into low, intermediate, and high groups and peak ATT, MTT, and LTT were compared between these groups with ANOVA (α = 0.05). Significant differences were observed between stratified groups in peak knee valgus angle (p < 0.0001) and peak knee abduction moment (p < 0.0001). However, no corresponding differences in peak ATT, LTT, and MTT between groups exhibiting low to high-peak knee valgus angles (ATT: p = 0.80; LTT: p = 0.25; MTT: p = 0.72); or, in peak ATT (p = 0.61), LTT (p = 0.26) and MTT (p = 0.96) translations when stratified according to low to high knee abduction moments, were found. We conclude that the healthy female knee is tightly regulated with regard to translations even when motion analysis derived knee valgus angles and abduction moments are high.

  12. High Knee Valgus in Female Subjects Does Not Yield Higher Knee Translations During Drop Landings: A Biplane Fluoroscopic Study

    Science.gov (United States)

    Torry, Michael R.; Shelburne, Kevin B.; Myers, Casey; Giphart, J. Erik; Pennington, W. Wesley; Krong, Jacob P.; Peterson, Daniel S.; Steadman, J. Richard; Woo, Savio L-Y.

    2012-01-01

    The goal of this study was to determine the effects of peak knee valgus angle and peak knee abductor moment on the anterior, medial, and lateral tibial translations (ATT, MTT, LTT) in the ‘at risk’ female knee during drop landing. Fifteen female subjects performed drop landings from 40 cm. 3D knee motion was simultaneously recorded using a high speed, biplane fluoroscopy system and a video-based motion analysis system. Valgus knee angles and knee abduction moments were stratified into low, intermediate and high groups and peak ATT, MTT and LTT were compared between these groups with ANOVA (α = .05). Significant differences were observed between stratified groups in peak knee valgus angle (p knee abduction moment (p knee valgus angles (ATT: p = .80; LTT: p = .25; MTT: p = .72); or, in peak ATT (p = .61), LTT (p = .26) and MTT (p = .96) translations when stratified according to low to high knee abduction moments, were found. We conclude that the healthy female knee is tightly regulated with regard to translations even when motion analysis derived knee valgus angles and abduction moments are high. PMID:22968826

  13. Primary osteosynthesis augmented with autologous bone graft with total knee arthroplasty in patients with stress fractures of medial femoral condyle with knee osteoarthritis: a cost effective approach

    Directory of Open Access Journals (Sweden)

    Vikram Indrajit Shah

    2016-06-01

    Results: Mean follow-up was 7.0 years. All patients showed statistically significant improvement in their WOMAC total scores (p <0.05. Stress fractures united with good knee alignment. All patients had recovered full range of motion with no pain at the time of final follow-up. No adverse events were noted in any of the patient treated. Conclusions: The present approach is a successful procedure for the elderly population with an arthritic knee with stress fracture of medial femoral condyle. Return to pre-morbid level of functional activity occurs very swiftly. [Int J Res Med Sci 2016; 4(6.000: 2408-2412

  14. Knee Replacement

    Science.gov (United States)

    ... need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some ... a total living space on one floor since climbing stairs can be difficult. Install safety bars or a ...

  15. Runner's Knee

    Science.gov (United States)

    ... Over the summer he bought a pair of running shoes and took up jogging. He started with ... bending the knee — when walking, kneeling, squatting, or running, for example. Walking or running downhill or even ...

  16. Knee Biomechanics During Jogging After Arthroscopic Partial Meniscectomy: A Longitudinal Study.

    Science.gov (United States)

    Hall, Michelle; Wrigley, Tim V; Metcalf, Ben R; Hinman, Rana S; Cicuttini, Flavia M; Dempsey, Alasdair R; Lloyd, David G; Bennell, Kim L

    2017-07-01

    Altered knee joint biomechanics is thought to play a role in the pathogenesis of knee osteoarthritis and has been reported in patients after arthroscopic partial meniscectomy (APM) while performing various activities. Longitudinally, understanding knee joint biomechanics during jogging may assist future studies to assess the implications of jogging on knee joint health in this population. To investigate knee joint biomechanics during jogging in patients 3 months after APM and a healthy control group at baseline and 2 years later at follow-up. Controlled laboratory study. Seventy-eight patients who underwent medial APM and 38 healthy controls underwent a 3-dimensional motion analysis during barefoot overground jogging at baseline. Sixty-four patients who underwent APM and 23 controls returned at follow-up. External peak moments (flexion and adduction) and the peak knee flexion angle during stance were evaluated for the APM leg, non-APM leg (nonoperated leg), and control leg. At baseline, the peak knee flexion angle was 1.4° lower in the APM leg compared with the non-APM leg ( P = .03). No differences were found between the moments in the APM leg compared with the control leg (all P > .05). However, the normalized peak knee adduction moment was 35% higher in the non-APM leg compared with the control leg ( P = .008). In the non-APM leg, the normalized peak knee adduction and flexion moments were higher compared with the APM leg by 16% and 10%, respectively, at baseline ( P ≤ .004). Despite the increase in the peak knee flexion moment in the APM leg compared with the non-APM leg ( P knee flexion moment or any other parameter assessed at 2-year follow-up between the legs ( P > .05). Comparing the APM leg and control leg, no differences in knee joint biomechanics during jogging for the variables assessed were observed. Higher knee moments in the non-APM leg may have clinical implications for the noninvolved leg. Kinematic differences were small (~1.4°) and therefore

  17. DEFINITION AND ANALYSIS OF MOTION ACTIVITY AFTER-STROKE PATIENT FROM THE VIDEO STREAM

    Directory of Open Access Journals (Sweden)

    M. Yu. Katayev

    2014-01-01

    Full Text Available This article describes an approach to the assessment of motion activity of man in after-stroke period, allowing the doctor to get new information to give a more informed recommendations on rehabilitation treatment than in traditional approaches. Consider description of the hardware-software complex for determination and analysis of motion activity after-stroke patient for the video stream. The article provides a description of the complex, its algorithmic filling and the results of the work on the example of processing of the actual data. The algorithms and technology to significantly accelerate the gait analysis and improve the quality of diagnostics post-stroke patients.

  18. Effects of Neuromuscular Fatigue on Quadriceps Strength and Activation and Knee Biomechanics in Individuals post Anterior Cruciate Ligament Reconstruction and Healthy Adults

    Science.gov (United States)

    Thomas, Abbey C.; Lepley, Lindsey K.; Wojtys, Edward M.; McLean, Scott G.; Palmieri-Smith, Riann M.

    2016-01-01

    Study design Laboratory based experiment using a pre/post-test design. Objectives To determine the effects of neuromuscular fatigue on quadriceps strength and activation and sagittal and frontal plane knee biomechanics during dynamic landing following anterior cruciate ligament reconstruction (ACLr). Background Impaired quadriceps central activation occurs post-ACLr, likely altering lower extremity biomechanics. Neuromuscular fatigue similarly reduces volitional muscle activation and impairs neuromuscular control. Upon return to full activity post-ACLr, individuals likely concurrently experience quadriceps central activation deficits and neuromuscular fatigue, though the effects of fatigue on muscle strength and activation and biomechanics post-ACLr are unknown. Methods Seventeen individuals 7–10 months post-ACLr and 16 controls participated. Quadriceps strength and central activation ratio were recorded pre-/post-fatigue, which was induced via sets of double-leg squats. Knee biomechanics were recorded during a dynamic landing activity pre-/post-fatigue. Results Both groups demonstrated smaller knee flexion (initial contact:P=.017; peak:P=.004) and abduction (initial contact:P=.005; peak:P=.009) angles post-fatigue. The ACLr group had smaller peak knee flexion angles (PKnee flexion moment was smaller in ACLr than controls pre- (Pknee flexion moments post-fatigue (P=.001). Knee abduction moment was smaller in both groups post-fatigue (P=.003). All participants demonstrated significantly lower strength (Pbiomechanics presented post-fatigue in both groups, confirming that neuromuscular fatigue may increase non-contact ACL injury risk. However, these changes were not exaggerated in ACLr participants, likely because they already demonstrated a stiff-legged landing strategy pre-fatigue. PMID:26471851

  19. Comparison of the Danish Physical Activity Questionnaire with a validated position and motion instrument

    DEFF Research Database (Denmark)

    Matthiessen, Jeppe; Biltoft-Jensen, Anja Pia; Rasmussen, Lone Banke;

    2008-01-01

    Objective To compare the Danish Physical Activity Questionnaire (DPAQ) estimating physical activity energy expenditure (PAEE) and physical activity level (PAL) and the pattern of physical activity (including health-related physical activity) with measurements from a validated position and motion...... measured by the ActiReg((R)) (rho = 0.53, P physical activity (MVPA) in healthy adults at group level......), but not for men. The correlation between methods was good for PAEE (r = 0.71, P physical activity (MVPA) (P = 0.40). Time reported in MVPA with the DPAQ was positively correlated with time spent in MVPA...

  20. Knee Injuries and Disorders

    Science.gov (United States)

    Your knee joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty ...

  1. Activation of the Human MT Complex by Motion in Depth Induced by a Moving Cast Shadow.

    Science.gov (United States)

    Katsuyama, Narumi; Usui, Nobuo; Taira, Masato

    2016-01-01

    A moving cast shadow is a powerful monocular depth cue for motion perception in depth. For example, when a cast shadow moves away from or toward an object in a two-dimensional plane, the object appears to move toward or away from the observer in depth, respectively, whereas the size and position of the object are constant. Although the cortical mechanisms underlying motion perception in depth by cast shadow are unknown, the human MT complex (hMT+) is likely involved in the process, as it is sensitive to motion in depth represented by binocular depth cues. In the present study, we examined this possibility by using a functional magnetic resonance imaging (fMRI) technique. First, we identified the cortical regions sensitive to the motion of a square in depth represented via binocular disparity. Consistent with previous studies, we observed significant activation in the bilateral hMT+, and defined functional regions of interest (ROIs) there. We then investigated the activity of the ROIs during observation of the following stimuli: 1) a central square that appeared to move back and forth via a moving cast shadow (mCS); 2) a segmented and scrambled cast shadow presented beside the square (sCS); and 3) no cast shadow (nCS). Participants perceived motion of the square in depth in the mCS condition only. The activity of the hMT+ was significantly higher in the mCS compared with the sCS and nCS conditions. Moreover, the hMT+ was activated equally in both hemispheres in the mCS condition, despite presentation of the cast shadow in the bottom-right quadrant of the stimulus. Perception of the square moving in depth across visual hemifields may be reflected in the bilateral activation of the hMT+. We concluded that the hMT+ is involved in motion perception in depth induced by moving cast shadow and by binocular disparity.

  2. MAGNETIC HELICITY TRANSPORTED BY FLUX EMERGENCE AND SHUFFLING MOTIONS IN SOLAR ACTIVE REGION NOAA 10930

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Y. [Key Laboratory of Solar Activity, National Astronomical Observatories, Chinese Academy of Sciences, Chaoyang District, Beijing 100012 (China); Kitai, R.; Takizawa, K., E-mail: zhangyin@kwasan.kyoto-u.ac.jp, E-mail: zhangyin@bao.ac.cn [Kwasan and Hida Observatories, Kyoto University, Yamashina-ku, Kyoto 607-8471 (Japan)

    2012-06-01

    We present a new methodology which can determine magnetic helicity transport by the passage of helical magnetic field lines from the sub-photosphere and the shuffling motions of footpoints of preexisting coronal field lines separately. It is well known that only the velocity component, which is perpendicular to the magnetic field ({upsilon}{sub B}), has contributed to the helicity accumulation. Here, we demonstrate that {upsilon}{sub B} can be deduced from a horizontal motion and vector magnetograms under a simple relation of {upsilon}{sub t} = {mu}{sub t} + ({upsilon}{sub n}/B{sub n} ) B{sub t}, as suggested by Demoulin and Berger. Then after dividing {upsilon}{sub B} into two components, as one is tangential and the other is normal to the solar surface, we can determine both terms of helicity transport. Active region (AR) NOAA 10930 is analyzed as an example during its solar disk center passage by using data obtained by the Spectropolarimeter and the Narrowband Filter Imager of Solar Optical Telescope on board Hinode. We find that in our calculation the helicity injection by flux emergence and shuffling motions have the same sign. During the period we studied, the main contribution of helicity accumulation comes from the flux emergence effect, while the dynamic transient evolution comes from the shuffling motions effect. Our observational results further indicate that for this AR the apparent rotational motion in the following sunspot is the real shuffling motions on the solar surface.

  3. Altered Tibiofemoral Joint Contact Mechanics and Kinematics in Patients with Knee Osteoarthritis and Episodic Complaints of Joint Instability

    Science.gov (United States)

    Farrokhi, Shawn; Voycheck, Carrie A.; Klatt, Brian A.; Gustafson, Jonathan A.; Tashman, Scott; Fitzgerald, G. Kelley

    2014-01-01

    Background To evaluate knee joint contact mechanics and kinematics during the loading response phase of downhill gait in knee osteoarthritis patients with self-reported instability. Methods Forty-three subjects, 11 with medial compartment knee osteoarthritis and self-reported instability (unstable), 7 with medial compartment knee osteoarthritis but no reports of instability (stable), and 25 without knee osteoarthritis or instability (control) underwent Dynamic Stereo X-ray analysis during a downhill gait task on a treadmill. Findings The medial compartment contact point excursions were longer in the unstable group compared to the stable (p=0.046) and the control groups (p=0.016). The peak medial compartment contact point velocity was also greater for the unstable group compared to the stable (p=0.047) and control groups (p=0.022). Additionally, the unstable group demonstrated a coupled movement pattern of knee extension and external rotation after heel contact which was different than the coupled motion of knee flexion and internal rotation demonstrated by stable and control groups. Interpretation Our findings suggest that knee joint contact mechanics and kinematics are altered during the loading response phase of downhill gait in knee osteoarthritis patients with self-reported instability. The observed longer medial compartment contact point excursions and higher velocities represent objective signs of mechanical instability that may place the arthritic knee joint at increased risk for disease progression. Further research is indicated to explore the clinical relevance of altered contact mechanics and kinematics during other common daily activities and to assess the efficacy of rehabilitation programs to improve altered joint biomechanics in knee osteoarthritis patients with self-reported instability. PMID:24856791

  4. Evaluation of an intact, an ACL-deficient, and a reconstructed human knee joint finite element model.

    Science.gov (United States)

    Vairis, Achilles; Stefanoudakis, George; Petousis, Markos; Vidakis, Nectarios; Tsainis, Andreas-Marios; Kandyla, Betina

    2016-02-01

    The human knee joint has a three-dimensional geometry with multiple body articulations that produce complex mechanical responses under loads that occur in everyday life and sports activities. Understanding the complex mechanical interactions of these load-bearing structures is of use when the treatment of relevant diseases is evaluated and assisting devices are designed. The anterior cruciate ligament (ACL) in the knee is one of four main ligaments that connects the femur to the tibia and is often torn during sudden twisting motions, resulting in knee instability. The objective of this work is to study the mechanical behavior of the human knee joint and evaluate the differences in its response for three different states, i.e., intact, ACL-deficient, and surgically treated (reconstructed) knee. The finite element models corresponding to these states were developed. For the reconstructed model, a novel repair device was developed and patented by the author in previous work. Static load cases were applied, as have already been presented in a previous work, in order to compare the calculated results produced by the two models the ACL-deficient and the surgically reconstructed knee joint, under the exact same loading conditions. Displacements were calculated in different directions for the load cases studied and were found to be very close to those from previous modeling work and were in good agreement with experimental data presented in literature. The developed finite element model for both the intact and the ACL-deficient human knee joint is a reliable tool to study the kinematics of the human knee, as results of this study show. In addition, the reconstructed human knee joint model had kinematic behavior similar to the intact knee joint, showing that such reconstruction devices can restore human knee stability to an adequate extent.

  5. Knee joint laxity and neuromuscular characteristics of male and female soccer and basketball players.

    Science.gov (United States)

    Rozzi, S L; Lephart, S M; Gear, W S; Fu, F H

    1999-01-01

    Anterior cruciate ligament injuries are occurring at a higher rate in female athletes compared with their male counterparts. Research in the area of anterior cruciate ligament injury has increasingly focused on the role of joint proprioception and muscle activity in promoting knee joint stability. We measured knee joint laxity, joint kinesthesia, lower extremity balance, the amount of time required to generate peak torque of the knee flexor and extensor musculature, and electromyographically assessed muscle activity in 34 healthy, collegiate-level athletes (average age, 19.6 +/- 1.5 years) who played soccer or basketball or both. Independent t-tests were used to determine significant sex differences. Results revealed that women inherently possess significantly greater knee joint laxity values, demonstrate a significantly longer time to detect the knee joint motion moving into extension, possess significantly superior single-legged balance ability, and produce significantly greater electromyographic peak amplitude and area of the lateral hamstring muscle subsequent to landing a jump. The excessive joint laxity of women appears to contribute to diminished joint proprioception, rendering the knee less sensitive to potentially damaging forces and possibly at risk for injury. Unable to rely on ligamentous structures, healthy female athletes appear to have adopted compensatory mechanisms of increased hamstring activity to achieve functional joint stabilization.

  6. Overuse Knee Injuries in Athletes

    Directory of Open Access Journals (Sweden)

    Miroslav Kezunović

    2013-03-01

    Full Text Available According to many statistics over 55% of all sports-related injuries are incurred in the knee joint (active sportsmen and recreationists. The statistics definitely differ, depending on type of sport and specific movements habitually performed in a particular sport. Therefore, in addition to acute knee injuries overuse syndromes are common in the knee area also due to specificities of patellofemoral joint just because specific diseases like „jumper's knee“ and „runner's knee“ are related to certain sport activities. Generally speaking, these syndromes occur due to poor orientation of the knee extensor mechanism, i.e. friction of iliotibial band and patellofemoral chondromalacia. It is believed that about 45% of all overuse syndromes in the knee area occur as a result of running.

  7. Evaluation and management of knee pain in young athletes: overuse injuries of the knee.

    Science.gov (United States)

    Patel, Dilip R; Villalobos, Ana

    2017-07-01

    Recurrent or chronic activity related knee pain is common in young athletes. Numerous intrinsic conditions affecting the knee can cause such pain. In addition, knee pain can be referred pain from low back, hip or pelvic pathology. The most common cause of knee pain in young athletes is patellofemoral pain syndrome, or more appropriately termed idiopathic anterior knee pain. Although, numerous anatomical and biomechanical factors have been postulated to contribute the knee pain in young athletes, the most common underlying reason is overuse injury. In this paper, we have reviewed selected conditions that case knee pain in athletes, including anterior knee pain syndrome, Osgood-Schlatter disease, Sinding-Larsen-Johanssen syndrome, juvenile osteochondritis dissecans (JOCD), bipartite patella, plica syndrome, and tendonitis around the knee.

  8. Arthroscopy of the knee without pathological findings.

    Science.gov (United States)

    Schlepckow, P; Weber, M; Hempel, K

    1994-01-01

    From 1983 to 1990, 82 knee arthroscopies (8.2%) carried out in our patients found nothing pathological. Sixty-four percent of these patients were active in sports, but trauma was noted in 32% of the cases only. Football and other ball games, skiing, and track and field athletics were the main causes. Twenty-six percent of the patients had undergone previous surgery in the affected knee. At a mean of 4.6 years postoperatively, clinical and radiological re-assessment was conducted so as to compare our pre- and intraoperative findings with the further course of events. We found that 48.2% of the patients were symptom-free after the diagnostic arthroscopy, 37.5% had persistent discomfort and 14.3% had a recurrence of discomfort after 6 months to 2 years. The objective measurement score (Zarins Rowe score), at 47.5 out of 50 points, was better than the subjective score, at 40 out of 50 points. Our diagnoses had to be changed retrospectively: meniscal lesions were diagnosed too frequently, while chondropathia patellae and instability were often missed. Additionally, complaints could be related to abnormal axis, limited range of motion of the hip or knee, leg length inequality and hypermobility. Being unable to verify a presumed intra-articular lesion arthroscopically is frustrating for both doctor and patient. Our data suggest that meniscal signs should be looked at more critically and emphasise the need for a complete evaluation of the whole locomotor system.

  9. Active experiments and single ion motion in the magnetotail

    Science.gov (United States)

    Rothwell, P. L.; Yates, G. K.

    1983-07-01

    Analytic solutions to the Lorentz equation which indicate that the magnetic field in the plasma sheet focuses selected ions from the plasma sheet boundaries on the neutral sheet are obtained. The kinetic energy of these ions usually exceeds the threshold energy required for the ion tearing mode instability. Two active experiments based on this effect are proposed. Heavy ions injected towards dusk on the plasma sheet boundary would become focused on the neutral sheet and perhaps trigger the ion tearing mode. A boundary perturbation, such as a thermal chemical release, that locally enhances the boundary turbulence level could be introduced, causing sufficient ksq = 1 ions to be focused on the neutral sheet to trigger the ion tearing mode.

  10. Can origin of the 2400-year cycle of solar activity be caused by solar inertial motion?

    Directory of Open Access Journals (Sweden)

    I. Charvátová

    Full Text Available A solar activity cycle of about 2400 years has until now been of uncertain origin. Recent results indicate it is caused by solar inertial motion. First we describe the 178.7-year basic cycle of solar motion. The longer cycle, over an 8000 year interval, is found to average 2402.2 years. This corresponds to the Jupiter/Heliocentre/Barycentre alignments (9.8855 × 243. Within each cycle an exceptional segment of 370 years has been found characterized by a looping pattern by a trefoil or quasitrefoil geometry. Solar activity, evidenced by 14C tree-ring proxies, shows the same pattern. Solar motion is computable in advance, so this provides a basis for future predictive assessments. The next 370-year segment will occur between AD 2240 and 2610.

    Key words: Solar physics (celestial mechanics

  11. VO2 estimation using 6-axis motion sensor with sports activity classification.

    Science.gov (United States)

    Nagata, Takashi; Nakamura, Naoteru; Miyatake, Masato; Yuuki, Akira; Yomo, Hiroyuki; Kawabata, Takashi; Hara, Shinsuke

    2016-08-01

    In this paper, we focus on oxygen consumption (VO2) estimation using 6-axis motion sensor (3-axis accelerometer and 3-axis gyroscope) for people playing sports with diverse intensities. The VO2 estimated with a small motion sensor can be used to calculate the energy expenditure, however, its accuracy depends on the intensities of various types of activities. In order to achieve high accuracy over a wide range of intensities, we employ an estimation framework that first classifies activities with a simple machine-learning based classification algorithm. We prepare different coefficients of linear regression model for different types of activities, which are determined with training data obtained by experiments. The best-suited model is used for each type of activity when VO2 is estimated. The accuracy of the employed framework depends on the trade-off between the degradation due to classification errors and improvement brought by applying separate, optimum model to VO2 estimation. Taking this trade-off into account, we evaluate the accuracy of the employed estimation framework by using a set of experimental data consisting of VO2 and motion data of people with a wide range of intensities of exercises, which were measured by a VO2 meter and motion sensor, respectively. Our numerical results show that the employed framework can improve the estimation accuracy in comparison to a reference method that uses a common regression model for all types of activities.

  12. Electroencephalogram evidence for mirror neuron activity during the observation of drawn hand motion

    Institute of Scientific and Technical Information of China (English)

    Huaping Zhu; Yaoru Sun; Wenya Duan

    2011-01-01

    The present study used electroencephalography to examine mu rhythm suppression (a putative index of human mirror neuron system activation) at frontal sites (F3, Fz and F4), central sites (C3, Cz and C4), parietal sites (P3, Pz and P4) and occipital sites (O1 and O2), while subjects observed real hand motion (real hand motion condition) and illustrative depictions of hand motion (drawn hand motion condition). Experimental data revealed that mu rhythm suppression was exhibited in the mirror neuron system when subjects observed both real and drawn hand motion. Moreover, the mu rhythm recorded at the F3, Fz, F4, and Pz poles was significantly suppressed while observing both stimulus types, but no obvious mu suppression occurred at the O1, O2 and O3 poles. These results suggest that the observation of drawings of human hand actions can activate the human mirror neuron system. This evidence supports the hypothesis that the mirror neuron system may be involved in intransitively abstract action understanding.

  13. Adaptations in muscular activation of the knee extensor muscles with strength training in young and older adults.

    Science.gov (United States)

    Knight, C A; Kamen, G

    2001-12-01

    The purpose of this study was to compare the extent of muscular activation during maximal voluntary knee extension contractions in old and young individuals and to examine the effects of resistance training on muscular activation in each group. The interpolated twitch technique was used to estimate muscular activation during two pre-training baseline tests, and after two and six weeks of resistance training. Throughout the study, the older group was 30% less strong than the young group (p=0.02). The training protocol was effective in both groups with overall isometric strength gains of 30 and 36% in the older (p=0.01) and young (pmuscular activation between groups (p=0.3) did not explain the large disparity in strength. Muscular activation increased by 2% in both groups throughout training (pmuscular strength in the older group, muscular activation was greater than 95% of maximum and appears to be equal in both young and older individuals. Both groups demonstrated similar but small increases in muscular activation throughout training.

  14. High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty

    DEFF Research Database (Denmark)

    Calatayud, Joaquin; Casaña, Jose; Ezzatvar, Yasmin;

    2017-01-01

    -four subjects (7 men, 37 women) scheduled for unilateral TKA for osteoarthritis (OA) during 2014 participated in this randomized controlled trial. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Physical Functioning Scale of the Short Form-36 questionnaire (SF-36), a 10-cm visual...... analogue scale (VAS), isometric knee flexion, isometric knee extension, isometric hip abduction, active knee range of motion and functional tasks (Timed Up and Go test and Stair ascent-descent test) were assessed at 8 weeks before surgery (T1), after 8 weeks of training (T2), 1 month after TKA (T3...

  15. The association between symptoms, pain coping strategies, and physical activity among people with symptomatic knee and hip osteoarthritis

    Directory of Open Access Journals (Sweden)

    Susan L Murphy

    2012-09-01

    Full Text Available Effective use of coping strategies by people with chronic pain conditions is associated with better functioning and adjustment to chronic disease. Although the effects of coping on pain have been well studied, less is known about how specific coping strategies relate to actual physical activity patterns in daily life. The purpose of this study was to evaluate how different coping strategies relate to symptoms and physical activity patterns in a sample of adults with knee and hip osteoarthritis (N = 44. Physical activity was assessed by wrist-worn accelerometry; coping strategy use was assessed by the Chronic Pain Coping Inventory. We hypothesized that the use of coping strategies that reflect approach behaviors (e.g., Task Persistence, would be associated with higher average levels of physical activity, whereas avoidance coping behaviors (e.g., Resting, Asking for Assistance, Guarding and Pacing would be associated with lower average levels of physical activity. We also evaluated whether coping strategies moderated the association between momentary symptoms (pain and fatigue and activity. We hypothesized that higher levels of approach coping would be associated with a weaker association between symptoms and activity compared to lower levels of this type of coping. Multilevel modeling was used to analyze the momentary association between coping and physical activity. We found that higher body mass index, fatigue, and the use of Guarding were significantly related to lower activity levels, whereas Asking for Assistance was significantly related to higher activity levels. Only Resting moderated the association between pain and activity. Guarding, Resting, Task Persistence, and Pacing moderated the association between fatigue and activity. This study provides an initial understanding of how people with osteoarthritis cope with symptoms as they engage in daily life activities using ecological momentary assessment and objective physical activity

  16. Does knee awareness differ between different knee arthroplasty prostheses?

    DEFF Research Database (Denmark)

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

    2016-01-01

    BACKGROUND: Low knee awareness after Total Knee Arthroplasty (TKA) has become the ultimate goal in trying to achieve a natural feeling knee that meet patient expectations. To accommodate this manufacturers of TKAs have developed new prosthetic designs that potentially could give patients a more...... natural feeling knee during activities. The purpose af this study was to compare the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) of patients treated with a previous generation standard Cruciate Retaining (CR) TKA to the scores obtained by patients treated with a newer generation CR TKA...... or a mobile bearing CR TKA. METHODS: We identified all patients receiving a new generation CR TKA or mobile bearing TKA at our institution between 2010 and 2012. These were matched to a population of patients receiving a standard CR TKA regarding age, gender, year of surgery, Kellgren-Lawrence (KL) grade...

  17. sEMG during Whole-Body Vibration Contains Motion Artifacts and Reflex Activity

    Directory of Open Access Journals (Sweden)

    Karin Lienhard

    2015-01-01

    Full Text Available The purpose of this study was to determine whether the excessive spikes observed in the surface electromyography (sEMG spectrum recorded during whole-body vibration (WBV exercises contain motion artifacts and/or reflex activity. The occurrence of motion artifacts was tested by electrical recordings of the patella. The involvement of reflex activity was investigated by analyzing the magnitude of the isolated spikes during changes in voluntary background muscle activity. Eighteen physically active volunteers performed static squats while the sEMG was measured of five lower limb muscles during vertical WBV using no load and an additional load of 33 kg. In order to record motion artifacts during WBV, a pair of electrodes was positioned on the patella with several layers of tape between skin and electrodes. Spectral analysis of the patella signal revealed recordings of motion artifacts as high peaks at the vibration frequency (fundamental and marginal peaks at the multiple harmonics were observed. For the sEMG recordings, the root mean square of the spikes increased with increasing additional loads (p < 0.05, and was significantly correlated to the sEMG signal without the spikes of the respective muscle (r range: 0.54 - 0.92, p < 0.05. This finding indicates that reflex activity might be contained in the isolated spikes, as identical behavior has been found for stretch reflex responses evoked during direct vibration. In conclusion, the spikes visible in the sEMG spectrum during WBV exercises contain motion artifacts and possibly reflex activity.

  18. Population activity in the human dorsal pathway predicts the accuracy of visual motion detection

    NARCIS (Netherlands)

    Donner, T.H.; Siegel, M.; Oostenveld, R.; Fries, P.; Bauer, M.; Engel, A.K.

    2007-01-01

    A person's ability to detect a weak visual target stimulus varies from one viewing to the next. We tested whether the trial-to-trial fluctuations of neural population activity in the human brain are related to the fluctuations of behavioral performance in a "yes-no" visual motion-detection task. We

  19. Complex Human Activity Recognition Using Smartphone and Wrist-Worn Motion Sensors.

    Science.gov (United States)

    Shoaib, Muhammad; Bosch, Stephan; Incel, Ozlem Durmaz; Scholten, Hans; Havinga, Paul J M

    2016-03-24

    The position of on-body motion sensors plays an important role in human activity recognition. Most often, mobile phone sensors at the trouser pocket or an equivalent position are used for this purpose. However, this position is not suitable for recognizing activities that involve hand gestures, such as smoking, eating, drinking coffee and giving a talk. To recognize such activities, wrist-worn motion sensors are used. However, these two positions are mainly used in isolation. To use richer context information, we evaluate three motion sensors (accelerometer, gyroscope and linear acceleration sensor) at both wrist and pocket positions. Using three classifiers, we show that the combination of these two positions outperforms the wrist position alone, mainly at smaller segmentation windows. Another problem is that less-repetitive activities, such as smoking, eating, giving a talk and drinking coffee, cannot be recognized easily at smaller segmentation windows unlike repetitive activities, like walking, jogging and biking. For this purpose, we evaluate the effect of seven window sizes (2-30 s) on thirteen activities and show how increasing window size affects these various activities in different ways. We also propose various optimizations to further improve the recognition of these activities. For reproducibility, we make our dataset publicly available.

  20. The Effects of Continued Rehabilitation After Primary Knee Replacement

    Science.gov (United States)

    Radulovic, Tatjana Nozica; Lazovic, Milica; Jandric, Slavica; Bucma, Tatjana; Cvjetkovic, Dragana Dragicevic; Manojlovic, Slavko

    2016-01-01

    Introduction: Tasks of rehabilitation after arthroplasty are to provide painless joint movements, to improve the range of motion, to establish a scheme of walking, to achieve independence in activities of daily living. The aim: of the study is to determine the effects of continued rehabilitation on the range of the knee motion and reducing the swelling after total knee replacement. Methods: The study was conducted from 2011 to 2013 and included 140 patients of both sexes, aged 45 to 85 with implanted endoprosthesis based on primary osteoarthritis. They were divided into two groups, experimental, which after early rehabilitation continued ongoing rehabilitation for a period of three weeks, while the control group after completion of early rehabilitation began rehabilitation two months from the surgery for a period of three weeks. The range of motion in the knee joint and the extent of the knee joint in the medium of patella were measured in both groups during the admission and discharge from rehabilitation. In the experimental group, control measurements were carried out three months after surgery. Results: In both groups, there was a significant reduction of the swelling at the discharge in relation to the admission while in the experimental group there was no change on the control of the joint swelling after three months in relation to the release from rehabilitation. In the experimental group, the range of motion of flexion and extension was improved at the discharge in relation to the admission as well as the flexion during the control while the range of motion of extension wasn’t significantly changing during the control examination. In the control group, the extension and flexion were significantly improved at the discharge compared to the admission. Comparing both groups, the results showed that there was a significant improvement in flexion movements in the experimental group during rehabilitation in comparison to the control group, while the range of

  1. Contrast-enhanced MRI of the knee in children unaffected by clinical arthritis compared to clinically active juvenile idiopathic arthritis patients

    Energy Technology Data Exchange (ETDEWEB)

    Nusman, Charlotte M.; Hemke, Robert [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Benninga, Marc A.; Kindermann, Angelika [University of Amsterdam, Department of Pediatric Gastroenterology, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Schonenberg-Meinema, Dieneke; Berg, J.M. van den; Kuijpers, Taco W. [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Rossum, Marion A.J. van [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Reade, Department of Pediatric Rheumatology, Amsterdam (Netherlands); Maas, Mario [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands)

    2016-04-15

    To evaluate enhancing synovial thickness upon contrast-enhanced magnetic resonance imaging (MRI) of the knee in children unaffected by clinical arthritis compared with clinically active juvenile idiopathic arthritis (JIA) patients. A secondary objective was optimization of the scoring method based on maximizing differences on MRI between these groups. Twenty-five children without history of joint complaints nor any clinical signs of joint inflammation were age/sex-matched with 25 clinically active JIA patients with arthritis of at least one knee. Two trained radiologists, blinded for clinical status, independently evaluated location and extent of enhancing synovial thickness with the validated Juvenile Arthritis MRI Scoring system (JAMRIS) on contrast-enhanced axial fat-saturated T1-weighted MRI of the knee. Enhancing synovium (≥2 mm) was present in 13 (52 %) unaffected children. Using the total JAMRIS score for synovial thickening, no significant difference was found between unaffected children and active JIA patients (p = 0.091). Additional weighting of synovial thickening at the JIA-specific locations enabled more sensitive discrimination (p = 0.011). Mild synovial thickening is commonly present in the knee of children unaffected by clinical arthritis. The infrapatellar and cruciate ligament synovial involvement were specific for JIA, which - in a revised JAMRIS - increases the ability to discriminate between JIA and unaffected children. (orig.)

  2. The biomechanics and energetics of human running using an elastic knee exoskeleton.

    Science.gov (United States)

    Elliott, Grant; Sawicki, Gregory S; Marecki, Andrew; Herr, Hugh

    2013-06-01

    While the effects of series compliance on running biomechanics are well documented, the effects of parallel compliance are known only for the simpler case of hopping. As many practical exoskeletal and orthotic designs act in parallel with the leg, it is desirable to understand the effects of such an intervention. Spring-like forces offer a natural choice of perturbation for running, as they are both biologically motivated and energetically inexpensive to implement. To this end, we investigate the hypothesis that the addition of an external elastic element at the knee during the stance phase of running results in a reduction in knee extensor activation so that total joint quasi-stiffness is maintained. An exoskeletal knee brace consisting of an elastic element engaged by a clutch is used to provide this stance phase extensor torque. Motion capture of five subjects is used to investigate the consequences of running with this device. No significant change in leg stiffness or total knee stiffness is observed due to the activation of the clutched parallel knee spring. However, this pilot data suggests differing responses between casual runners and competitive long-distance runners, whose total knee torque is increased by the device. Such a relationship between past training and effective utilization of an external force is suggestive of limitations on the applicability of assistive devices.

  3. Motional Stark Effect and Its Active Cancellation in Diamagnetic Spectrum of Barium

    Institute of Scientific and Technical Information of China (English)

    QUAN Wei; LIU Hong-Ping; SHEN Li; ZHAN Ming-Sheng

    2007-01-01

    With time-of-flight and electric field ionization detection technique, we investigate the motional Stark effect for highly excited Rydberg barium in high magnetic field and its active cancellation experimentally. In the experiment, the atom beam is aligned at a small angle of 15° with respect to the magnetic field. The motional Stark effect cancellation is demonstrated on two sets of circularly polarized spectra in static magnetic field B = 1.00000 Tesla and B = 1.70000 Tesla, respectively, although the effect is very small (~ 3.5 Vcm-1) in our apparatus configuration.

  4. Knee injuries in football

    African Journals Online (AJOL)

    estimated 240 million (in 2000)1 to 265 million (in 2006)2 players ... injuries during a season, but due to variations in the definition of ... a risk for a major knee injury, with 20% of illegal activity-related ... Rob Collins is a lecturer in the Section Sports Medicine at the University of .... full return to football is between 6 and 9.

  5. Impact of lumbar spine posture on thoracic spine motion and muscle activation patterns.

    Science.gov (United States)

    Nairn, Brian C; Drake, Janessa D M

    2014-10-01

    Complex motion during standing is typical in daily living and requires movement of both the thoracic and lumbar spine; however, the effects of lumbar spine posture on thoracic spine motion patterns remain unclear. Thirteen males moved to six positions involving different lumbar (neutral and flexed) and thoracic (flexed and twisted) posture combinations. The thoracic spine was partitioned into three segments and the range of motion from each posture was calculated. Electromyographical data were collected from eight muscles bilaterally. Results showed that with a flexed lumbar spine, the lower-thoracic region had 14.83 ° and 15.6 1 ° more flexion than the upper- and mid-thoracic regions, respectively. A flexed lumbar spine significantly reduced the mid-thoracic axial twist angle by 5.21 ° compared to maximum twist in the mid-thoracic region. Functional differences emerged across muscles, as low back musculature was greatest in maintaining flexed lumbar postures, while thoracic erector spinae and abdominals showed bilateral differences with greater activations to the ipsilateral side. Combined postures have been previously identified as potential injury modulators and bilateral muscle patterns can have an effect on loading pathways. Overall, changes in thoracic motion were modified by lumbar spine posture, highlighting the importance of considering a multi-segmented approach when analyzing trunk motion. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. The Effect of Continuous Passive Motion after Total Knee Replacement%人工全膝关节置换术后持续被动运动的早期临床效果研究

    Institute of Scientific and Technical Information of China (English)

    范继峰; 张卫国; 李杰; 宫福良

    2011-01-01

    探讨持续被动运动用于人工全膝关节置换术后的早期疗效.自2008年至2010年我科共完成人工全膝关节置换术36例(43膝),将全部病例随机分为2组,A组术后单纯应用物理治疗及自身锻炼,B组采用持续被动锻炼加主动锻炼.观察术后12小时、24小时引流量,术后1周、2周膝关节主动活动范围,切口拆线时间,患者平均住院时间.术后2周彩超检查下肢深静脉血栓的发生情况.2组间在术后12小时、24小时引流量,切口拆线时间,患者平均住院时间及术后2周下肢深静脉血栓的发生率方面均无显著差异(P>0.05).术后第1周及第2周关节主动活动范围方面B组明显优于A组(P<0.05).使用持续被动运动可明显增加人工全膝关节置换术后早期膝关节主动运动范围,并不增加切口并发症的发生率.%To evaluate the early clinical effects of continuous passive motion (CPM ) after total knee replacement (TKR). From 2008 to 2010,36 patients (43 knees) who underwent TKR were divided into 2 groups. Group B were treated with CPM after operation,compared to group A with single physiotherapy and initiative exercise. There was statistically significant difference between the two groups in range of motion (ROM ) in 1 and 2 week after operation. CPM is benefit to the ROM of the joint in early stage post operation.

  7. Effects of unilateral airway occlusion on rib motion and inspiratory intercostal activity in dogs.

    Science.gov (United States)

    Leduc, Dimitri; Marechal, Sarah; Taton, Olivier; Blairon, Bernard; Legrand, Alexandre

    2017-04-01

    Unilateral bronchial occlusion, a complication of many lung diseases, causes dyspnea but the mechanism of this symptom is uncertain. In this study, electromyographic (EMG) activity in the parasternal and external intercostal muscles in the third intercostal space and inspiratory motion of the third rib on both sides of the thorax were assessed during occlusion of a main bronchus for a single breath in anesthetized dogs. Occlusion produced a 65% increase in external intercostal EMG activity in both hemithoraces without altering parasternal EMG activity. Concomitantly, the inspiratory cranial rib motion showed a 50% decrease on both sides of the thorax. These changes were unaffected by bilateral vagotomy. However, when an external, caudally oriented force was applied to the third rib on the right or left side so that its inspiratory cranial displacement was abolished, activity in the adjacent external intercostals showed a twofold increase, but rib motion and external activity in the contralateral hemithorax remained unchanged. It is concluded that during occlusion of a main bronchus, the increase in external intercostal activity is induced by the decrease in inspiratory cranial rib displacement in both hemithoraces, and that this decrease is determined by the increase in pleural pressure swings on both sides of the mediastinum. This mechanism, combined with the decrease in PaO2, induces similar alterations when unilateral bronchial occlusion is maintained for a series of consecutive breaths. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  8. Effects of prophylactic knee bracing on knee joint kinetics and kinematics during netball specific movements.

    Science.gov (United States)

    Sinclair, Jonathan K; Vincent, Hayley; Richards, Jim D

    2017-01-01

    To investigate the effects of a prophylactic knee brace on knee joint kinetics and kinematics during netball specific movements. Repeated measures. Laboratory. Twenty university first team level female netball players. Participants performed three movements, run, cut and vertical jump under two conditions (brace and no-brace). 3-D knee joint kinetics and kinematics were measured using an eight-camera motion analysis system. Knee joint kinetics and kinematics were examined using 2 × 3 repeated measures ANOVA whilst the subjective ratings of comfort and stability were investigated using chi-squared tests. The results showed no differences (p > 0.05) in knee joint kinetics. However the internal/external rotation range of motion was significantly (p knee brace improved knee stability in all movements. Further study is required to determine whether reductions in transverse plane knee range of motion serve to attenuate the risk from injury in netballers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. The INDUS knee prosthesis - Prospective multicentric trial of a posteriorly stabilized high-flex design: 2 years follow-up

    Directory of Open Access Journals (Sweden)

    Sancheti Kantilal

    2009-01-01

    Full Text Available Background: The anatomical and morphological differences and high-flexion daily activities in the Asian population have since ever prompted for development of customized knee replacement systems. INDUS knee system has advantages both of high-flex designs and is developed by keeping the anatomical variations of the native population in mind. The purpose of this study is to analyze the 2-year follow-up results using the INDUS prosthesis. Materials and Methods: Two hundred and ninety-seven knees in 276 patients were prospectively analyzed. There were 65 men (72 knees and 211 (225 knees women with a mean age of 64.56 years. Two hundred and forty-five knees had primary osteoarthritis, 48 knees had rheumatoid arthritis, and four knees had post-traumatic arthritis. Clinical parameters, including the Knee Society scores (knee score and function score, range of motion, post-operative anterior knee pain, and complications were recorded. Pre- and post-operative serial radiographs were analyzed for limb alignment, component positioning, and evidence of loosening. Results: The patients were followed-up for an average of 2.59 years (range, 2-3.3 years. The mean knee score and the mean function score were significantly improved from a pre-operative value of 39.4 points and 46.7 points to a post-operative value of 87 points and 86 points, respectively (P value < 0.05. Two hundred and thirty four knees had no anterior knee pain while 63 knees had mild to moderate pain, but none of the patients requested any intervention for the same. Of the 276 patients (297 knees, 79 knees had flexion above 140°, 167 had a flexion range of 130-140°, 27 had a flexion range of 100-130°, and 24 knees had a flexion < 100°, with the mean range of movement being 132.9°. Improvements in the range of movement were retained over time and a total of 205 patients (224 knees, 75.7% could squat or sit cross-legged at the final follow-up. The mean tibiofemoral angle was 8.5°± 6.9º of

  10. Design of a Knee Exoskeleton Using Foot Pressure and Knee Torque Sensors

    Directory of Open Access Journals (Sweden)

    Jung-Hoon Kim

    2015-08-01

    Full Text Available This study presents the development of a modular knee exoskeleton system that supports the knee joints of hemiplegic patients. The device is designed to realize the polycentric motion of real human knees using a fourbar linkage and to minimize its total weight. In order to determine the user’s intention, force-sensitive resistors (FSRs in the user’s insole, a torque sensor on the robot knee joint, and an encoder in the motor are used. The control algorithm is based on a finite state machine (FSM, where the force control, position control and virtual damping control are applied in each state. The proposed hardware design and algorithm are verified by performing experiments on the standing, walking and sitting motion controls while wearing the knee exoskeleton.

  11. Anterior Knee Pain (Chondromalacia Patellae).

    Science.gov (United States)

    Garrick, James G.

    1989-01-01

    This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

  12. The Evaluation of Protein C Activity and Some Inflammatory Markers in Synovia of Patients Undergoing Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Ahmet Ata Alturfan

    2011-06-01

    Full Text Available Objective: Total knee arthroplasty (TKA is a major risk factor for thrombosis in patients over 40 years of age and this risk persists for several weeks after the surgery. Since inflammatory mechanisms affect coagulation and the natural anticoagulant system, we aimed to investigate protein C activities and inflammatory markers in patients undergoing TKA surgery.Material and Methods: We included 20 osteoarthritis patients and 20 healthy controls. Protein C activity and tumor necrosis factor-α (TNF-α levels in plasma and synovia were evaluated by ELISA technique. Results: In the patient group, protein C activities decreased and TNF-α levels increased significantly both in synovia and plasma when compared with the controls. Erythrocyte sedimentation rate of the patient group was found to be significantly elevated in comparison to the controls. On the other hand, serum C reactive protein values increased insignificantly when compared to controls.Conclusion: The decreased activity of protein C and increased levels of inflammatory markers in preoperative plasma and synovia of the patient group may enhance the risk for developing thrombosis.

  13. A Review of Accelerometry-Based Wearable Motion Detectors for Physical Activity Monitoring

    Directory of Open Access Journals (Sweden)

    Che-Chang Yang

    2010-08-01

    Full Text Available Characteristics of physical activity are indicative of one’s mobility level, latent chronic diseases and aging process. Accelerometers have been widely accepted as useful and practical sensors for wearable devices to measure and assess physical activity. This paper reviews the development of wearable accelerometry-based motion detectors. The principle of accelerometry measurement, sensor properties and sensor placements are first introduced. Various research using accelerometry-based wearable motion detectors for physical activity monitoring and assessment, including posture and movement classification, estimation of energy expenditure, fall detection and balance control evaluation, are also reviewed. Finally this paper reviews and compares existing commercial products to provide a comprehensive outlook of current development status and possible emerging technologies.

  14. Effect of two different kinesio taping techniques on knee kinematics and kinetics in young females

    OpenAIRE

    Guner, Senem; Alsancak, Serap; KOZ, Mitat

    2015-01-01

    [Purpose] The application of kinesio taping may improve strength and performance, inhibit and facilitate motor activity, and increase range of motion. The aim of this study was to compare the effects of kinesio taping facilitation and inhibition applications on spatiotemporal knee kinematics and kinetics during walking activity in healthy subjects. [Subjects and Methods] A three-dimensional quantitative gait evaluation was performed without tape and with, facilitation and inhibition kinesio t...

  15. Examining the Magnetic Field Strength and the Horizontal and Vertical Motions in an Emerging Active Region

    CERN Document Server

    Lin, Chia-Hsien

    2016-01-01

    Earlier observational studies have used the time evolution of emerging magnetic flux regions at the photosphere to infer their subsurface structures, assuming that the flux structure does not change significantly over the near-surface layer.In this study, we test the validity of this assumption by comparing the horizontal and vertical motions of an emerging active region. The two motions would be correlated if the emerging structure is rigid. The selected active region (AR) NOAA 11645 is not embedded in detectable preexisting magnetic field. The observed horizontal motion is quantified by the separation of the two AR polarities and the extension of the region. The vertical motion is derived from the magnetic buoyancy theory. Our results show that the separation of the polarities is fastest at the beginning with a velocity of $\\approx$~4~Mm hr$^{-1}$ and decreases to $\\le$~1~Mm hr$^{-1}$ after the main growing phase of flux emergence. The derived thick flux-tube buoyant velocity is between 1 and 3~Mm hr$^{-1}$...

  16. Strong Ground Motion Evaluation for an Active Fault System by the Empirical Green Function Method

    Energy Technology Data Exchange (ETDEWEB)

    Choi, In Kil; Choun, Young Sun [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of); Shiba, Yoshiaki; Ohtori, Yasuki [Central Research Institute of Electric Power Industry, Chiba (Japan)

    2005-07-01

    In an area with a high seismic activity, a design earthquake ground motion is generally determined empirically by investigating the historical records concerning damaging events. But it is difficult in Korea to obtain such seismic records that reflect the local characteristics because of the low seismic activity. A geological survey on the active faults near the sites of nuclear power plants has been carried out recently, and the segmentation, slip rate and the latest activity of the fault system are partly revealed. It will be significant for the advanced seismic design of nuclear facilities to utilize the information derived from these geological investigations and evaluate the strong ground motions. In this study, the empirical Green's function method (EFGM) was used to simulate strong ground motions from an active fault system in Korea. The source models are assumed by using the information obtained from the geological survey and the trench investigation on the fault system. Finally, the applicability of this approach to Korea was estimated.

  17. Cross-cultural validity of the animated activity questionnaire (AAQ) that assesses activity limitations in patients with hip or knee osteoarthritis

    DEFF Research Database (Denmark)

    Peter, W. F.; De Vet, R.; Boers, M.

    2015-01-01

    Background: The Animated Activity Questionnaire (AAQ) measures activity limitations in hip and knee osteoarthritis (HKOA), and demonstrated good validity and reliability [1]. The AAQ shows stylized video animations of different levels of activity performance. Patients are asked to choose which....... Objectives: To evaluate cross-cultural validity of the AAQ. Methods: In 7 European countries patients were asked to complete the AAQ. An example of an item of the AAQ is shown on: http://kmin-vumc.nl/-14-0.html. Ordinal logistic regression was used to evaluate DIF across languages (Dutch versus 6 other...... languages). As a criterion for uniform DIF we used an odds ratio outside the interval 0.53-1.89. An significant interaction term (p-value...

  18. Treatment of knee arthrofibrosis and quadriceps insufficiency after patellar tendon repair: a case report including use of the graston technique.

    Science.gov (United States)

    Black, Douglass W

    2010-06-23

    Arthrofibrosis of the knee is a surgical complication that can limit range of motion, inhibit muscle activity, and decrease patient function. Optimal conservative treatment has not been well established in the literature, leaving a clinician with limited evidence for treatment planning. Described here is part of the rehabilitative course of care for a patient with arthrofibrotic limitations after a mid-substance patellar tendon repair with augmentation. Marked limitations in knee flexion range of motion and quadriceps activity were addressed using the Graston Technique to deal with soft-tissue adhesions; traditional physical therapy care was also provided. Clear improvement in range of motion and quadriceps activity and function was noted over the course of 5 treatments during 1 month. Treatment process and clinical reasoning are offered to promote understanding and to facilitate future inquiry.

  19. Presentation and management of arthrofibrosis of the knee: A case report.

    Science.gov (United States)

    Scholtes, Sara A; Khoo-Summers, Lynnette; Damico, Katherine J

    2017-10-01

    Case report. Arthrofibrosis is a debilitating condition that results in pain, decreased range of motion, and decreased function. Although surgical management of arthrofibrosis has been well described in the literature, rehabilitation of the arthrofibrotic knee is less well described. A 28-year-old female presented with swelling, pain, and decreased strength, range of motion, patellar mobility, and function following an exploratory arthroscopy of her left knee. After failed conservative management, the patient underwent two additional surgeries to remove scar tissue. Following each surgery, the emphasis was on decreasing inflammation and maintaining patellar mobility while increasing joint range of motion and strength. Therapy progression was determined by the presence or absence of inflammatory signs. The second scar tissue removal surgery resulted in a femoral neuropathy that further complicated the rehabilitation process. At 3-year follow-up, the patient continued to present with decreased range of motion and strength compared to the uninvolved limb, but had returned to a modified running program and reported pain no longer limited her ability to participate in activities of daily living. This case report highlights the importance of recognizing that arthrofibrosis may result following a minor knee surgery and with minimal range of motion loss. Additional complications also may result during arthrofibrosis treatment. Progressing rehabilitation based on the inflammatory response may decrease the likelihood of additional scar tissue formation and potentially improve the outcome for the patient.

  20. Total knee arthroplasty for severe valgus knee deformity

    Institute of Scientific and Technical Information of China (English)

    Zhou Xinhua; Wang Min; Liu Chao; Zhang Liang; Zhou Yixin

    2014-01-01

    Background Primary total knee arthroplasty (TKA) in severe valgus knees may prove challenging,and choice of implant depends on the severity of the valgus deformity and the extent of soft-tissue release.The purpose of this study was to review 8 to 11 years (mean,10 years) follow-up results of primary TKA for varient-Ⅲ valgus knee deformity with use of different type implants.Methods Between January 2002 and January 2005,20 women and 12 men,aged 47 to 63 (mean,57.19±6.08) years old,with varient-Ⅲ valgus knees underwent primary TKA.Of the 32 patients,37 knees had varient-Ⅲ deformities.Pie crusting was carefully performed with small,multiple inside-out incisions,bone resection balanced the knee in lieu of soft tissue releases that were not used in the series.Cruciate-retaining knees (Gemini MKⅡ,Link Company,Germany) were used in 13 knees,Genesis Ⅱ (Simth & Nephew Company,USA) in 14 knees,and hinged knee (Endo-Model Company,Germany) in 10 knees.In five patients with bilateral variant-Ⅲll TKAs,three patients underwent 1-stage bilateral procedures,and two underwent 2-stage procedures.All implants were cemented and the patella was not resurfaced.The Hospital for Special Surgery (HSS) knee score was assessed.Patients were followed up from 8 to 11 years.Results The mean HSS knee score were improved from 50.33±11.60 to 90.06±3.07 (P <0.001).The mean tibiofemoral alignment were improved from valgus 32.72°±9.68° pre-operation to 4.89°±0.90° post-operation (P <0.001).The mean range of motion were improved from 93.72°±23.69° pre-operation to 116.61±16.29° post-operation (P <0.001).No patients underwent revision.One patient underwent open reduction and internal fixation using femoral condylar plates for supracondylar femoral fractures secondary to a fall at three years.Three patients developed transient peroneal nerve palsies,which resolved within nine months.Two patients developed symptomatic deep vein thrombosis that was managed with rivaroxaban

  1. Addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis: A randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Bennell Kim L

    2012-12-01

    Full Text Available Abstract Background Knee osteoarthritis (OA is one of the most common and costly chronic musculoskeletal conditions world-wide and is associated with substantial pain and disability. Many people with knee OA also experience co-morbidities that further add to the OA burden. Uptake of and adherence to physical activity recommendations is suboptimal in this patient population, leading to poorer OA outcomes and greater impact of associated co-morbidities. This pragmatic randomised controlled trial will investigate the clinical- and cost-effectiveness of adding telephone coaching to a physiotherapist-delivered physical activity intervention for people with knee OA. Methods/Design 168 people with clinically diagnosed knee OA will be recruited from the community in metropolitan and regional areas and randomly allocated to physiotherapy only, or physiotherapy plus nurse-delivered telephone coaching. Physiotherapy involves five treatment sessions over 6 months, incorporating a home exercise program of 4–6 exercises (targeting knee extensor and hip abductor strength and advice to increase daily physical activity. Telephone coaching comprises 6–12 telephone calls over 6 months by health practitioners trained in applying the Health Change Australia (HCA Model of Health Change to provide behaviour change support. The telephone coaching intervention aims to maximise adherence to the physiotherapy program, as well as facilitate increased levels of participation in general physical activity. The primary outcomes are pain measured by an 11-point numeric rating scale and self-reported physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale after 6 months. Secondary outcomes include physical activity levels, quality-of-life, and potential moderators and mediators of outcomes including self-efficacy, pain coping and depression. Relative cost-effectiveness will be determined from health service usage and outcome

  2. Evaluation of predicted knee-joint muscle forces during gait using an instrumented knee implant.

    Science.gov (United States)

    Kim, Hyung J; Fernandez, Justin W; Akbarshahi, Massoud; Walter, Jonathan P; Fregly, Benjamin J; Pandy, Marcus G

    2009-10-01

    Musculoskeletal modeling and optimization theory are often used to determine muscle forces in vivo. However, convincing quantitative evaluation of these predictions has been limited to date. The present study evaluated model predictions of knee muscle forces during walking using in vivo measurements of joint contact loading acquired from an instrumented implant. Joint motion, ground reaction force, and tibial contact force data were recorded simultaneously from a single subject walking at slow, normal, and fast speeds. The body was modeled as an 8-segment, 21-degree-of-freedom articulated linkage, actuated by 58 muscles. Joint moments obtained from inverse dynamics were decomposed into leg-muscle forces by solving an optimization problem that minimized the sum of the squares of the muscle activations. The predicted knee muscle forces were input into a 3D knee implant contact model to calculate tibial contact forces. Calculated and measured tibial contact forces were in good agreement for all three walking speeds. The average RMS errors for the medial, lateral, and total contact forces over the entire gait cycle and across all trials were 140 +/- 40 N, 115 +/- 32 N, and 183 +/- 45 N, respectively. Muscle coordination predicted by the model was also consistent with EMG measurements reported for normal walking. The combined experimental and modeling approach used in this study provides a quantitative framework for evaluating model predictions of muscle forces in human movement.

  3. Combination of Accumulated Motion and Color Segmentation for Human Activity Analysis

    Directory of Open Access Journals (Sweden)

    Ioannis Kompatsiaris

    2008-03-01

    Full Text Available The automated analysis of activity in digital multimedia, and especially video, is gaining more and more importance due to the evolution of higher-level video processing systems and the development of relevant applications such as surveillance and sports. This paper presents a novel algorithm for the recognition and classification of human activities, which employs motion and color characteristics in a complementary manner, so as to extract the most information from both sources, and overcome their individual limitations. The proposed method accumulates the flow estimates in a video, and extracts “regions of activity” by processing their higher-order statistics. The shape of these activity areas can be used for the classification of the human activities and events taking place in a video and the subsequent extraction of higher-level semantics. Color segmentation of the active and static areas of each video frame is performed to complement this information. The color layers in the activity and background areas are compared using the earth mover's distance, in order to achieve accurate object segmentation. Thus, unlike much existing work on human activity analysis, the proposed approach is based on general color and motion processing methods, and not on specific models of the human body and its kinematics. The combined use of color and motion information increases the method robustness to illumination variations and measurement noise. Consequently, the proposed approach can lead to higher-level information about human activities, but its applicability is not limited to specific human actions. We present experiments with various real video sequences, from sports and surveillance domains, to demonstrate the effectiveness of our approach.

  4. Arthroscopic knee debridement can delay total knee replacement in painful moderate haemophilic arthropathy of the knee in adult patients.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos; Gomez-Cardero, Primitivo

    2016-09-01

    The role of arthroscopic debridement of the knee in haemophilia is controversial in the literature. The purpose of this study is to describe the results of arthroscopic knee debridement (AKD), with the aim of determining whether it is possible to delay total knee replacement (TKR) for painful moderate haemophilic arthropathy of the knee in adult patients. In a 14-year period (1998-2011), AKD was performed for moderate haemophilic arthropathy of the knee in 27 patients with haemophilia A. Their average age at operation was 28.6 years (range 26-39 years). Indications for surgery were as follows: more than 90° of knee flexion, flexion deformity less than 30°, good axial alignment of the knee, good patellar alignment, and pain above >60 points in a visual analogue scale [0 (no pain) to 100 points]. Secondary haematological prophylaxis and rehabilitation (physiotherapy) was given for at least 3 months after surgery. Follow-up was for an average of 7.5 years (range 2-14 years). We assessed the clinical outcome before surgery and at the time of latest follow-up using the Knee Society pain and function scores, the range of motion, and the radiological score of the World Federation of Haemophilia. Knee Society pain scores improved from 39 preoperatively to 66 postoperatively, and function scores improved from 36 to 52. Range of motion improved on an average from -15° of extension and 90° of flexion before surgery, to -5° of extension and 110° of flexion at the last follow-up. A radiological deterioration of 2.8 points on average was found. There were two (7.4%) postoperative complications (haemarthroses resolved by joint aspiration). One patient (3.7%) required a TKR 12.5 years later. AKD should be considered in painful moderate haemophilic arthropathy of the knee in adult patients to delay TKR.

  5. Treatment of knee flexion contracture in patients with chronic juvenile arthritis: A case report

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    Matijević Radmila

    2006-01-01

    Full Text Available Introduction. Knee flexion contractures are common after-effects of juvenile arthritis. Treatment is usually conservative and may include physical therapy and kinesitherapy. Surgical treatment, particularly of the soft parts, indicated for contractures resistant to conservative treatment, helps to correct the deformity, maintain movements, and relieves pain. Intensive postoperative physiotherapy is of special importance. Case report. A 23-year-old female patient with chronic juvenile arthritis since the age of one was admitted for treatment of flexion con­tractures in both knees, muscle hypotrophy, loss of strength and gait disability. The patient underwent arthroscopic synovectomy. The operation was first performed on the right and after 3 mouths on the left knee. The pre operative range of motion in the rigth knee was 30°-70° and in the left 40°-80°. The patient underwent intensive physical therapy to reduce postoperative swelling of knees and firstly passive and then active kinesitherapy. Nine months after the first surgery and six months after the second, the range of motion in the right knee was 0°-100° and in the left 0°-105°. The strength of tested muscles was increased and gait was improved. Conclusion. Management and rehabilitation of patients with chronic juvenile arthritis include maintenance or improvement in position and function of joints that is achieved with synovectomy. The results depend on combined interdisciplinary rehabilitation, well-experienced staff, and pre- and post-operative physiotherapy as well as kinesitherapy. Arthroscopic synovectomy has many advantages and we believe that it was a better solution than open capsulosynovectomy in this patient with chronic juvenile arthritis of the knee. .

  6. Analysing the Hydraulic Actuator-based Knee Unit Kinematics and Correlating the Numerical Results and Walking Human Knee Joint Behavior

    Directory of Open Access Journals (Sweden)

    K. A. Trukhanov

    2014-01-01

    the mechanical device kinematics to replace an amputee’s knee joint.3. An analytical dependence is found for the reduced load on the actuator, which is part of the knee unit, on the time in the bending knee when walking.4. A value of required capacity and a type of analytical dependence in the case of active knee unit is determined.The analysis allows us to conclude the following:1. It is found from the obtained results that the motion and human walk parameters can be described by functional dependencies.2. Calculation has shown that the obtained relationships defining knee joint kinematics can be used to describe a walk of the amputee with artificial limb on the flat surface with accuracy of up to 6 %.3. Established relationships may be useful in other fields of engineering to assess the kinematics of mechanisms with similar structure, such as excavation equipment and robotic systems. 4. The resulting dependence for the reduced load on the stock of A is necessary to perform a shock absorber synthesis.

  7. What Are the Prognostic Factors for Radiographic Progression of Knee Osteoarthritis? A Meta-analysis

    NARCIS (Netherlands)

    A.N. Bastick (Alex); J.N. Belo (Janneke); J. Runhaar (Jos); S.M. Bierma-Zeinstra (Sita)

    2015-01-01

    textabstractBackground: A previous systematic review on prognostic factors for knee osteoarthritis (OA) progression showed associations for generalized OA and hyaluronic acid levels. Knee pain, radiographic severity, sex, quadriceps strength, knee injury, and regular sport activities were not associ

  8. Varus thrust in women with early medial knee osteoarthritis and its relation with the external knee adduction moment.

    Science.gov (United States)

    Mahmoudian, Armaghan; van Dieen, Jaap H; Bruijn, Sjoerd M; Baert, Isabel Ac; Faber, Gert S; Luyten, Frank P; Verschueren, Sabine Mp

    2016-11-01

    Varus thrust, defined as an abrupt increase of the knee varus angle during weight-bearing in gait, has been shown to be present in patients with moderate to severe knee osteoarthritis and is considered to be one of the risk factors for progression of symptomatic medial knee osteoarthritis. We evaluated the presence and magnitude of varus thrust and its relation with the Knee Adduction Moment in women with early medial knee osteoarthritis, and compared it to that in a group of controls and in a group of subjects with established medial knee osteoarthritis. Twenty-seven women with early medial knee osteoarthritis, 20 women with established medial knee osteoarthritis and 24 asymptomatic controls were evaluated. Varus thrust was estimated as an increase of the knee varus angle during the weight-bearing phase of gait at self-selected speed, assessed by 3D motion analysis. Varus thrust was significantly higher in both early and established osteoarthritis groups compared to the control group (Pthrust was significantly correlated with the second peak knee adduction moment. Higher varus thrust was found both in early and established stages of knee osteoarthritis, suggesting that problems with dynamic stabilization of the knee are present early in the development of knee osteoarthritis. This highlights the necessity of considering dynamic alignment in rehabilitation already in the early stages of the disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Motion interactive games for children with motor disorders : motivation, physical activity, and motor control

    OpenAIRE

    Sandlund, Marlene

    2011-01-01

    As motion interactive games have become more widespread the interest in using these games in rehabilitation of children with motor disorders has increased among both clinical professionals and the families of these children. The general aim of this thesis was to evaluate the feasibility of using interactive games in rehabilitation of children to promote motivation for practice, physical activity, and motor control. A systematic review of published intervention studies was conducted to obtain ...

  10. POST TRAUMATIC KNEE FRACTURE ( X-RAY

    Directory of Open Access Journals (Sweden)

    Dr. Jalaja Prakash.

    2013-06-01

    Full Text Available A 51 year old male patient met with a road traffic accident on August 2010. On examination thepatient was unable to stand and walk. His right knee was swollen and complained of pain withinstability. The X-Ray of patient showed transverse fracture of patella along with comminutedfracture of lower end of femur. He was treated with “K” wire and internal fixation. The patient wasadvised early physiotherapy which include range of motion exercises, knee strengthening and gaittraining.

  11. Activity and Kinematics of White Dwarf-M Dwarf Binaries from the SUPERBLINK Proper Motion Survey

    Science.gov (United States)

    Skinner, Julie N.; Morgan, Dylan P.; West, Andrew A.; Lépine, Sébastien; Thorstensen, John R.

    2017-09-01

    We present an activity and kinematic analysis of high proper motion white dwarf-M dwarf binaries (WD+dMs) found in the SUPERBLINK survey, 178 of which are new identifications. To identify WD+dMs, we developed a UV–optical–IR color criterion and conducted a spectroscopic survey to confirm each candidate binary. For the newly identified systems, we fit the two components using model white dwarf spectra and M dwarf template spectra to determine physical parameters. We use Hα chromospheric emission to examine the magnetic activity of the M dwarf in each system, and investigate how its activity is affected by the presence of a white dwarf companion. We find that the fraction of WD+dM binaries with active M dwarfs is significantly higher than their single M dwarf counterparts at early and mid-spectral types. We corroborate previous studies that find high activity fractions at both close and intermediate separations. At more distant separations, the binary fraction appears to approach the activity fraction for single M dwarfs. Using derived radial velocities and the proper motions, we calculate 3D space velocities for the WD+dMs in SUPERBLINK. For the entire SUPERBLINK WD+dMs, we find a large vertical velocity dispersion, indicating a dynamically hotter population compared to high proper motion samples of single M dwarfs. We compare the kinematics for systems with active M dwarfs and those with inactive M dwarfs, and find signatures of asymmetric drift in the inactive sample, indicating that they are drawn from an older population. Based on observations obtained at the MDM Observatory operated by Dartmouth College, Columbia University, The Ohio State University, and the University of Michigan.

  12. Clinical Evaluation of a Mobile Sensor-Based Gait Analysis Method for Outcome Measurement after Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tilman Calliess

    2014-08-01

    Full Text Available Clinical scores and motion-capturing gait analysis are today’s gold standard for outcome measurement after knee arthroplasty, although they are criticized for bias and their ability to reflect patients’ actual quality of life has been questioned. In this context, mobile gait analysis systems have been introduced to overcome some of these limitations. This study used a previously developed mobile gait analysis system comprising three inertial sensor units to evaluate daily activities and sports. The sensors were taped to the lumbosacral junction and the thigh and shank of the affected limb. The annotated raw data was evaluated using our validated proprietary software. Six patients undergoing knee arthroplasty were examined the day before and 12 months after surgery. All patients reported a satisfactory outcome, although four patients still had limitations in their desired activities. In this context, feasible running speed demonstrated a good correlation with reported impairments in sports-related activities. Notably, knee flexion angle while descending stairs and the ability to stop abruptly when running exhibited good correlation with the clinical stability and proprioception of the knee. Moreover, fatigue effects were displayed in some patients. The introduced system appears to be suitable for outcome measurement after knee arthroplasty and has the potential to overcome some of the limitations of stationary gait labs while gathering additional meaningful parameters regarding the force limits of the knee.

  13. Clinical evaluation of a mobile sensor-based gait analysis method for outcome measurement after knee arthroplasty.

    Science.gov (United States)

    Calliess, Tilman; Bocklage, Raphael; Karkosch, Roman; Marschollek, Michael; Windhagen, Henning; Schulze, Mareike

    2014-08-28

    Clinical scores and motion-capturing gait analysis are today's gold standard for outcome measurement after knee arthroplasty, although they are criticized for bias and their ability to reflect patients' actual quality of life has been questioned. In this context, mobile gait analysis systems have been introduced to overcome some of these limitations. This study used a previously developed mobile gait analysis system comprising three inertial sensor units to evaluate daily activities and sports. The sensors were taped to the lumbosacral junction and the thigh and shank of the affected limb. The annotated raw data was evaluated using our validated proprietary software. Six patients undergoing knee arthroplasty were examined the day before and 12 months after surgery. All patients reported a satisfactory outcome, although four patients still had limitations in their desired activities. In this context, feasible running speed demonstrated a good correlation with reported impairments in sports-related activities. Notably, knee flexion angle while descending stairs and the ability to stop abruptly when running exhibited good correlation with the clinical stability and proprioception of the knee. Moreover, fatigue effects were displayed in some patients. The introduced system appears to be suitable for outcome measurement after knee arthroplasty and has the potential to overcome some of the limitations of stationary gait labs while gathering additional meaningful parameters regarding the force limits of the knee.

  14. Physical Therapy Activities in Stroke, Knee Arthroplasty, and Traumatic Brain Injury Rehabilitation: Their Variation, Similarities, and Association With Functional Outcomes

    Science.gov (United States)

    Hsieh, Ching-Hui; Putman, Koen; Smout, Randall J.; Horn, Susan D.; Tian, Wenqiang

    2011-01-01

    Background The mix of physical therapy services is thought to be different with different impairment groups. However, it is not clear how much variation there is across impairment groups. Furthermore, the extent to which the same physical therapy activities are associated with functional outcomes across different types of patients is unknown. Objective The purposes of this study were: (1) to examine similarities and differences in the mix of physical therapy activities used in rehabilitation among patients from different impairment groups and (2) to examine whether the same physical therapy activities are associated with functional improvement across impairment groups. Design This was a prospective observational cohort study. Methods The study was conducted in inpatient rehabilitation facilities. The participants were 433 patients with stroke, 429 patients with total knee arthroplasty (TKA), and 207 patients with traumatic brain injury (TBI). Measures used in this study included: (1) the Comprehensive Severity Index to measure the severity of each patient's medical condition, (2) the Functional Independence Measure (FIM) to measure function, and (3) point-of-care instruments to measure time spent in specific physical therapy activities. Results All 3 groups had similar admission motor FIM scores but varying cognitive FIM scores. Patients with TKA spent more time on exercise than the other 2 groups (average=31.7 versus 6.2 minutes per day). Patients with TKA received the most physical therapy (average=65.3 minutes per day), whereas the TBI group received the least physical therapy (average=38.3 minutes per day). Multivariate analysis showed that only 2 physical therapy activities (gait training and community mobility) were both positively associated with discharge motor FIM outcomes across all 3 groups. Three physical therapy activities (assessment time, bed mobility, and transfers) were negatively associated with discharge motor FIM outcome. Limitations The study

  15. Knee pain (image)

    Science.gov (United States)

    ... front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage as ... knee. Overall knee pain can be due to bursitis, arthritis, tears in the ligaments, osteoarthritis of the ...

  16. Knee microfracture surgery

    Science.gov (United States)

    Cartilage regeneration - knee ... Three types of anesthesia may be used for knee arthroscopy surgery: Medicine to relax you, and shots of painkillers to numb the knee Spinal (regional) anesthesia General anesthesia (you will be ...

  17. Preventing Knee Injuries

    Science.gov (United States)

    ... Our Newsletter Donate Blog Skip breadcrumb navigation Preventing Knee Injuries Knee injuries in children and adolescent athletes ... this PDF Share this page: WHAT ARE COMMON KNEE INJURIES? Pain Syndromes One of the most common ...

  18. Cross-cultural adaptation and validation of the Portuguese version of the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS)

    OpenAIRE

    Gonçalves, Rui Soles; Cabri, Jan; Pinheiro, João Páscoa

    2008-01-01

    Abstract The objective of this study was to cross-culturally adapt and validate the Portuguese version of the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS). This version was obtained with forward/backward translations, consensus panels and pre-testing. The Portuguese KOS-ADLS and Medical Outcomes Study, 36-item Short Form (SF-36) questionnaires, visual analogue scales (VAS) of pain, disability and discomfort, and a form for patient’s characteristics were administered to 168...

  19. Suspected feigned knee extensor weakness: usefulness of 3D gait analysis. Case report.

    Science.gov (United States)

    Chaler, Joaquim; Müller, Bertram; Maiques, Anna; Pujol, Eduard

    2010-07-01

    The purpose of the present case report is to show the potential for use of 3D gait analysis as an assessment method of feigned muscle weakness. We describe a patient complaining of right leg pain and weakness. Physical examination showed severe quadriceps muscle weakness in a highly abnormal gait pattern context. Conventional diagnostic workup did not show any relevant findings. Three-dimensional (3D) gait analysis was performed with a 3D motion capture system. Joint angles, internal moments and powers were computed from the motion data. Lower leg muscle surface-electromyography was also performed. During the late stance phase, flexor moment and negative power peaks (indicating eccentric knee extensor activity) were generated in the knee, together with relevant Rectus femoris activity. All findings were highly inconsistent with true quadriceps weakness and gave objective ground to suspect insincerity of patient complaints. 3D gait analysis might be a valuable clinical assessment tool in suspected feigned lower limb muscle weakness.

  20. Preclinical computational models: predictors of tibial insert damage patterns in total knee arthroplasty: AAOS exhibit selection.

    Science.gov (United States)

    Morra, Edward A; Heim, Christine S; Greenwald, A Seth

    2012-09-19

    Computational models that predict clinical surface damage of the tibial insert during activities of daily living are emerging as powerful tools to assess the safety and efficacy of contemporary total knee arthroplasty designs. These models have the advantage of quickly determining the performance of new designs at low cost, and they allow direct comparison with the performance of classic, clinically successful designs. This study validated finite element and kinematic modeling predictions through comparison with preclinical physical testing results, damage patterns on retrieved tibial inserts, and clinically measured knee motion. There is a mounting body of evidence to support the role of computational modeling as a preclinical tool that enables the optimization of total knee arthroplasty designs and the auditing of component quality control before large-scale manufacturing is undertaken.

  1. Prediction of near-field strong ground motions for scenario earthquakes on active fault

    Institute of Scientific and Technical Information of China (English)

    Wang Haiyun; Xie Lili; Tao Xiaxin; Li Jie

    2006-01-01

    A method to predict near-field strong ground motions for scenario earthquakes on active faults is proposed. First,macro-source parameters characterizing the entire source area, i.e., global source parameters, including fault length, fault width,rupture area, average slip on the fault plane, etc., are estimated by seismogeology survey, seismicity and seismic scaling laws.Second, slip distributions characterizing heterogeneity or roughness on the fault plane, i.e., local source parameters, are reproduced/evaluated by the hybrid slip model. Finally, the finite fault source model, developed from both the global and local source parameters, is combined with the stochastically synthetic technique of ground motion using the dynamic corner frequency based on seismology. The proposed method is applied to simulate the acceleration time histories on three base-rock stations during the 1994 Northridge earthquake. Comparisons between the predicted and recorded acceleration time histories show that the method is feasible and practicable.

  2. Arm position influences the activation patterns of trunk muscles during trunk range-of-motion movements.

    Science.gov (United States)

    Siu, Aaron; Schinkel-Ivy, Alison; Drake, Janessa Dm

    2016-10-01

    To understand the activation patterns of the trunk musculature, it is also important to consider the implications of adjacent structures such as the upper limbs, and the muscles that act to move the arms. This study investigated the effects of arm positions on the activation patterns and co-activation of the trunk musculature and muscles that move the arm during trunk range-of-motion movements (maximum trunk axial twist, flexion, and lateral bend). Fifteen males and fifteen females, asymptomatic for low back pain, performed maximum trunk range-of-motion movements, with three arm positions for axial twist (loose, crossed, abducted) and two positions for flexion and lateral bend (loose, crossed). Electromyographical data were collected for eight muscles bilaterally, and activation signals were cross-correlated between trunk muscles and the muscles that move the arms (upper trapezius, latissimus dorsi). Results revealed consistently greater muscle co-activation (higher cross-correlation coefficients) between the trunk muscles and upper trapezius for the abducted arm position during maximum trunk axial twist, while results for the latissimus dorsi-trunk pairings were more dependent on the specific trunk muscles (either abdominal or back) and latissimus dorsi muscle (either right or left side), as well as the range-of-motion movement. The findings of this study contribute to the understanding of interactions between the upper limbs and trunk, and highlight the influence of arm positions on the trunk musculature. In addition, the comparison of the present results to those of individuals with back or shoulder conditions may ultimately aid in elucidating underlying mechanisms or contributing factors to those conditions.

  3. Modelling and Analysis on Biomechanical Dynamic Characteristics of Knee Flexion Movement under Squatting

    Directory of Open Access Journals (Sweden)

    Jianping Wang

    2014-01-01

    Full Text Available The model of three-dimensional (3D geometric knee was built, which included femoral-tibial, patellofemoral articulations and the bone and soft tissues. Dynamic finite element (FE model of knee was developed to simulate both the kinematics and the internal stresses during knee flexion. The biomechanical experimental system of knee was built to simulate knee squatting using cadaver knees. The flexion motion and dynamic contact characteristics of knee were analyzed, and verified by comparing with the data from in vitro experiment. The results showed that the established dynamic FE models of knee are capable of predicting kinematics and the contact stresses during flexion, and could be an efficient tool for the analysis of total knee replacement (TKR and knee prosthesis design.

  4. A bio-inspired test system for bionic above-knee prosthetic knees

    Science.gov (United States)

    Wang, Dai-Hua; Xu, Lei; Fu, Qiang; Yuan, Gang

    2013-04-01

    Recently, prosthetic knees in the developing stage are usually tested by installing them on amputees' stumps directly or on above-knee prostheses (AKPs) test platforms. Although amputees can fully provide the actual motion state of the thigh, immature prosthetic knees may hurt amputees. For AKPs test platforms, it just can partly simulate the actual motion state of the thigh with limitation of the motion curve of the thigh, the merits or demerits of newly developed bionic above-knee prosthetic knees cannot be accessed thoroughly. Aiming at the defects of two testing methods, this paper presents a bio-inspired AKPs test system for bionic above-knee prosthetic knees. The proposed bio-inspired AKPs test system is composed of a AKPs test platform, a control system, and a bio-inspired system. The AKPs test platform generates the motion of the thigh simulation mechanism (TSM) via two screw pairs with servo motors. The bio-inspired system includes the tester and the bio-inspired sensor wore by the tester. The control system, which is inspired by the bio-inspired system, generates the control command signal to move the TSM of the AKPs test platform. The bio-inspired AKPs test system is developed and experimentally tested with a commercially available prosthetic knee. The research results show that the bio-inspired AKPs test system can not only ensure the safety of the testers, but also track all kinds of the actual motion state of the thigh of the testers in real time.

  5. Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion.

    Science.gov (United States)

    Collin, Philippe; Matsumura, Noboru; Lädermann, Alexandre; Denard, Patrick J; Walch, Gilles

    2014-08-01

    Management of massive chronic rotator cuff tears remains controversial, with no clearly defined clinical presentation as yet. The purpose of the study was to evaluate the effect of tear size and location on active motion in patients with chronic and massive rotator cuff tears with severe muscle degeneration. One hundred patients with massive rotator cuff tears accompanied by muscle fatty infiltration beyond Goutallier stage 3 were prospectively included in this study. All patients were divided into 5 groups on the basis of tear pattern (supraspinatus, superior subscapularis, inferior subscapularis, infraspinatus, and teres minor). Active range of shoulder motion was assessed in each group and differences were analyzed. Active elevation was significantly decreased in patients with 3 tear patterns involved. Pseudoparalysis was found in 80% of the cases with supraspinatus and complete subscapularis tears and in 45% of the cases with tears involving the supraspinatus, infraspinatus, and superior subscapularis. Loss of active external rotation was related to tears involving the infraspinatus and teres minor; loss of active internal rotation was related to tears of the subscapularis. This study revealed that dysfunction of the entire subscapularis and supraspinatus or 3 rotator cuff muscles is a risk factor for pseudoparalysis. For function to be preserved in patients with massive chronic rotator cuff tears, it may be important to avoid fatty infiltration with anterior extension into the lower subscapularis or involvement of more than 2 rotator cuff muscles. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  6. Relationship between active cervical range of motion and flexion-relaxation ratio in asymptomatic computer workers.

    Science.gov (United States)

    Yoo, Won-Gyu; Park, Se-Yeon; Lee, Mi-Ra

    2011-01-01

    A high prevalence and incidence of neck and shoulder pain is present in the working population, especially sedentary workers. Recent findings have indicated that the flexion-relaxation (FR) ratio in the cervical erector spinae (CES) muscles might be a significant criteria of neuromuscular impairment and function. Additionally, the active cervical range of motion (ROM) is frequently used for discriminating between individuals with pain and those who are asymptomatic. The purpose of the present study was to examine the relationship between the active cervical ROM and the FR ratio in a sample of regular visual display terminal (VDT) workers. In total, 20 asymptomatic male VDT workers were recruited. Active cervical ROM was measured by a cervical ROM (CROM) instrument. Surface electromyography (EMG) was used to collect myoelectrical signals from the CES muscles, and the FR ratio was calculated for statistical analysis. Pearson correlation coefficients were used to quantify the linear relationship between the active cervical ROM and the FR ratio. The values obtained for the FR ratio in the right CES muscles correlated significantly with the active cervical ROM measured in flexion (r=0.73, pactivation patterns in CES demonstrated as cervical FR ratio are associated with reduction of the cervical range of motion including flexion and lateral flexion. In addition, muscular dysfunction of the CES could occur in regular computer workers prior to occurrence of pain; this means that the FR ratio could be used to evaluate the potential risk of neck discomfort in computer workers.

  7. Analysis of in vitro and in vivo function of total knee replacements using dynamic contact models

    Science.gov (United States)

    Zhao, Dong

    Despite the high incidence of osteoarthritis in human knee joint, its causes remain unknown. Total knee replacement (TKR) has been shown clinically to be effective in restoring the knee function. However, wear of ultra-high molecular weight polyethylene has limited the longevity of TKRs. To address these important issues, it is necessary to investigate the in vitro and in vivo function of total knee replacements using dynamic contact models. A multibody dynamic model of an AMTI knee simulator was developed. Incorporating a wear prediction model into the contact model based on elastic foundation theory enables the contact surface to take into account creep and wear during the dynamic simulation. Comparisons of the predicted damage depth, area, and volume lost with worn retrievals from a physical machine were made to validate the model. In vivo tibial force distributions during dynamic and high flexion activities were investigated using the dynamic contact model. In vivo medial and lateral contact forces experienced by a well-aligned instrumented knee implant, as well as upper and lower bounds on contact pressures for a variety of activities were studied. For all activities, the predicted medial and lateral contact forces were insensitive to the selected material model. For this patient, the load split during the mid-stance phase of gait and during stair is more equal than anticipated. The external knee adduction torque has been proposed as a surrogate measure for medial compartment load during gait. However, a direct link between these two quantities has not been demonstrated using in vivo measurement of medial compartment load. In vivo data collected from a subject with an instrumented knee implant were analyzed to evaluate this link. The subject performed five different overground gait motions (normal, fast, slow, wide, and toe out) while instrumented implant, video motion, and ground reaction data were simultaneously collected. The high correlation coefficient

  8. EFFECTS OF THE GENIUM MICROPROCESSOR KNEE SYSTEM ON KNEE MOMENT SYMMETRY DURING HILL WALKING.

    Science.gov (United States)

    Highsmith, M Jason; Klenow, Tyler D; Kahle, Jason T; Wernke, Matthew M; Carey, Stephanie L; Miro, Rebecca M; Lura, Derek J

    2016-09-01

    Use of the Genium microprocessor knee (MPK) system reportedly improves knee kinematics during walking and other functional tasks compared to other MPK systems. This improved kinematic pattern was observed when walking on different hill conditions and at different speeds. Given the improved kinematics associated with hill walking while using the Genium, a similar improvement in the symmetry of knee kinetics is also feasible. The purpose of this study was to determine if Genium MPK use would reduce the degree of asymmetry (DoA) of peak stance knee flexion moment compared to the C-Leg MPK in transfemoral amputation (TFA) patients. This study used a randomized experimental crossover of TFA patients using Genium and C-Leg MPKs (n = 20). Biomechanical gait analysis by 3D motion tracking with floor mounted force plates of TFA patients ambulating at different speeds on 5° ramps was completed. Knee moment DoA was significantly different between MPK conditions in the slow and fast uphill as well as the slow and self-selected downhill conditions. In a sample of high-functioning TFA patients, Genium knee system accommodation and use improved knee moment symmetry in slow speed walking up and down a five degree ramp compared with C-Leg. Additionally, the Genium improved knee moment symmetry when walking downhill at comfortable speed. These results likely have application in other patients who could benefit from more consistent knee function, such as older patients and others who have slower walking speeds.

  9. Biomechanical Analysis of the Effects of Bilateral Hinged Knee Bracing

    Science.gov (United States)

    Lee, Hangil; Ha, Dokyeong; Kang, Yeoun-Seung; Park, Hyung-Soon

    2016-01-01

    This research analyzed the effect of bilateral hinged knee braces on a healthy knee from a biomechanical frame in vivo. This was accomplished by fitting a knee brace with two customized wireless force/torque (F/T) sensors that could readily record force and torque during live motion, while the kinetics at the knee were computed using the inverse dynamics of the motion capture and force plate data. Four tasks to test the brace’s effects were drop vertical jumping, pivoting, stop vertical jumping, and cutting. The results showed that the hinges in the knee brace can absorb up to 18% of the force and 2.7% of the torque at the knee during various athletic motions. Thus, the hinges demonstrated minimal effect in reducing the mechanical load on the knee. There were limitations concerning the consistency of the motions performed by the subjects during the trials and the influence of the other portions of the brace to evaluate the overall effectiveness of the brace as a whole. Future works may incorporate a fatigue protocol and injured subjects to better determine the effects of the brace. There is still a need for more research on the biomechanical influence of knee braces to develop safer and more effective products. PMID:27379233

  10. Biomechanical Analysis of the Effects of Bilateral Hinged Knee Bracing.

    Science.gov (United States)

    Lee, Hangil; Ha, Dokyeong; Kang, Yeoun-Seung; Park, Hyung-Soon

    2016-01-01

    This research analyzed the effect of bilateral hinged knee braces on a healthy knee from a biomechanical frame in vivo. This was accomplished by fitting a knee brace with two customized wireless force/torque (F/T) sensors that could readily record force and torque during live motion, while the kinetics at the knee were computed using the inverse dynamics of the motion capture and force plate data. Four tasks to test the brace's effects were drop vertical jumping, pivoting, stop vertical jumping, and cutting. The results showed that the hinges in the knee brace can absorb up to 18% of the force and 2.7% of the torque at the knee during various athletic motions. Thus, the hinges demonstrated minimal effect in reducing the mechanical load on the knee. There were limitations concerning the consistency of the motions performed by the subjects during the trials and the influence of the other portions of the brace to evaluate the overall effectiveness of the brace as a whole. Future works may incorporate a fatigue protocol and injured subjects to better determine the effects of the brace. There is still a need for more research on the biomechanical influence of knee braces to develop safer and more effective products.

  11. Impact of Physical Activity in Cardiovascular and Musculoskeletal Health: Can Motion Be Medicine?

    Science.gov (United States)

    Curtis, Gannon L.; Chughtai, Morad; Khlopas, Anton; Newman, Jared M.; Khan, Rafay; Shaffiy, Shervin; Nadhim, Ali; Bhave, Anil; Mont, Michael A.

    2017-01-01

    Physical activity is a well-known therapeutic tool for various types of medical conditions, including vasculopathic diseases such as coronary artery disease, stroke, type 2 diabetes, and obesity. Additionally, increased physical activity has been proposed as a therapy to improve musculoskeletal health; however, there are conflicting reports about physical activity potentially leading to degenerative musculoskeletal disease, especially osteoarthritis (OA). Additionally, although physical activity is known to have its benefits, it is unclear as to what amount of physical activity is the most advantageous. Too much, as well as not enough exercise can have negative consequences. This could impact how physicians advise their patients about exercise intensity. Multiple studies have evaluated the effect of physical activity on various aspects of health. However, there is a paucity of systematic studies which review cardiovascular and musculoskeletal health as outcomes. Therefore, the purpose of this review was to assess how physical activity impacts these aspects of health. Specifically, we evaluated the effect of various levels of physical activity on: 1) cardiovascular and 2) musculoskeletal health. The review revealed that physical activity may decrease cardiovascular disease and improve OA symptoms, and therefore, motion can be considered a “medicine”. However, because heavy activity can potentially lead to increased OA risk, physicians should advise their patients that excessive activity can also potentially impact their health negatively, and should be done in moderation, until further study.

  12. Design, fabrication, and preliminary results of a novel below knee prosthesis for snowboarding: A case report

    NARCIS (Netherlands)

    Minnoye, A.L.M.; Plettenburg, D.H.

    2010-01-01

    Snowboarding with a below-knee prosthesis is compromised by the limited rotation capabilities of the existing below-knee prostheses, which are designed for use in normal walking. Based on snowboarding range of motion analyses, a novel below-knee prosthesis was designed with the aim to achieve simila

  13. Prospective Study of the Relation between Landing Biomechanics and Jumper's Knee

    NARCIS (Netherlands)

    van der Worp, H.; van der Does, H. T. D.; Brink, M. S.; Zwerver, J.; Hijmans, J. M.

    The literature on the relation between jump biomechanics and jumper's knee indicates that a jump with horizontal displacement poses a threat for developing jumper's knee. Subjects with jumper's knee have been shown to display a stiff landing pattern characterized by a small range of motion. However,

  14. Prospective Study of the Relation between Landing Biomechanics and Jumper's Knee

    NARCIS (Netherlands)

    van der Worp, H.; van der Does, H. T. D.; Brink, M. S.; Zwerver, J.; Hijmans, J. M.

    2016-01-01

    The literature on the relation between jump biomechanics and jumper's knee indicates that a jump with horizontal displacement poses a threat for developing jumper's knee. Subjects with jumper's knee have been shown to display a stiff landing pattern characterized by a small range of motion. However,

  15. Quantification of functional brace forces for posterior cruciate ligament injuries on the knee joint: an in vivo investigation.

    Science.gov (United States)

    LaPrade, Robert F; Smith, Sean D; Wilson, Katharine J; Wijdicks, Coen A

    2015-10-01

    Counteracting posterior translation of the tibia with an anterior force on the posterior proximal tibia has been demonstrated clinically to improve posterior knee laxity following posterior cruciate ligament (PCL) injury. This study quantified forces applied to the posterior proximal tibia by two knee braces designed for treatment of PCL injuries. The forces applied by two knee braces to the posterior proximal tibia and in vivo three-dimensional knee kinematics of six adult, male, healthy volunteer subjects (mean ± standard deviation: height, 182.5 ± 5.2 cm; body mass, 83.2 ± 9.3 kg; body mass index, 24.9 ± 1.5 kg/m(2); age, 25.8 ± 2.9 years) were measured using a custom pressure mapping technique and traditional surface marker motion capture techniques, while subjects performed three functional activities. The activities included seated unloaded knee flexion, squatting, and stair descent in a new generation dynamic force (DF) PCL brace and a static force (SF) PCL brace. During unloaded flexion at the lowest force level setting, the force applied by the DF brace increased as a function of flexion angle (slope = 0.7 N/°; p knee laxity following PCL injury. II.

  16. Retrospective comparison of functional and radiological outcome, between two contemporary high flexion knee designs

    Directory of Open Access Journals (Sweden)

    Kapoor Vikash

    2016-01-01

    Full Text Available Introduction: Patient satisfaction after total knee replacement (TKR depends on the amount of pain relief and the functional activities achieved. An important criterion of good functional outcome is the amount of flexion achieved and whether the patient can manage high flexion activities. In order to increase the amount of safe flexion, various implant designs have been developed. This study aims to compare the outcome after TKR using two contemporary high flexion knee designs: Sigma CR150 High Flex Knee prosthesis (Depuy, Warsaw, Indiana and NexGen High Flex Knee prosthesis (Zimmer, Warsaw, Indiana. Material: A retrospective study was conducted with 100 cases of each design and their functional and radiological outcome was assessed after two years of follow-up. Results: The two groups had comparable results in terms of subjective satisfaction, range of motion achieved and radiological outcome. Depuy group fared better than Zimmer in terms of functional outcome (modified Oxford knee score. Conclusion: Depuy group was found to have fared better than Zimmer in terms of functional outcome. However, it is very difficult to rate one design above the other based on our small sample size and short duration of follow-up.

  17. Retrospective comparison of functional and radiological outcome, between two contemporary high flexion knee designs

    Science.gov (United States)

    Kapoor, Vikash; Chatterjee, Daipayan; Hazra, Sutanu; Chatterjee, Anirban; Garg, Parag; Debnath, Kaustav; Mandal, Soham; Sarkar, Sudipto

    2016-01-01

    Introduction: Patient satisfaction after total knee replacement (TKR) depends on the amount of pain relief and the functional activities achieved. An important criterion of good functional outcome is the amount of flexion achieved and whether the patient can manage high flexion activities. In order to increase the amount of safe flexion, various implant designs have been developed. This study aims to compare the outcome after TKR using two contemporary high flexion knee designs: Sigma CR150 High Flex Knee prosthesis (Depuy, Warsaw, Indiana) and NexGen High Flex Knee prosthesis (Zimmer, Warsaw, Indiana). Material: A retrospective study was conducted with 100 cases of each design and their functional and radiological outcome was assessed after two years of follow-up. Results: The two groups had comparable results in terms of subjective satisfaction, range of motion achieved and radiological outcome. Depuy group fared better than Zimmer in terms of functional outcome (modified Oxford knee score). Conclusion: Depuy group was found to have fared better than Zimmer in terms of functional outcome. However, it is very difficult to rate one design above the other based on our small sample size and short duration of follow-up. PMID:27748254

  18. Modeling meiotic chromosome pairing: nuclear envelope attachment, telomere-led active random motion, and anomalous diffusion

    Science.gov (United States)

    Marshall, Wallace F.; Fung, Jennifer C.

    2016-04-01

    The recognition and pairing of homologous chromosomes during meiosis is a complex physical and molecular process involving a combination of polymer dynamics and molecular recognition events. Two highly conserved features of meiotic chromosome behavior are the attachment of telomeres to the nuclear envelope and the active random motion of telomeres driven by their interaction with cytoskeletal motor proteins. Both of these features have been proposed to facilitate the process of homolog pairing, but exactly what role these features play in meiosis remains poorly understood. Here we investigate the roles of active motion and nuclear envelope tethering using a Brownian dynamics simulation in which meiotic chromosomes are represented by a Rouse polymer model subjected to tethering and active forces at the telomeres. We find that tethering telomeres to the nuclear envelope slows down pairing relative to the rates achieved by unattached chromosomes, but that randomly directed active forces applied to the telomeres speed up pairing dramatically in a manner that depends on the statistical properties of the telomere force fluctuations. The increased rate of initial pairing cannot be explained by stretching out of the chromosome conformation but instead seems to correlate with anomalous diffusion of sub-telomeric regions.

  19. Functional assessments of the knee joint biomechanics by using pendulum test in adults with Down syndrome.

    Science.gov (United States)

    Casabona, Antonino; Valle, Maria Stella; Pisasale, Mariangela; Pantò, Maria Rosita; Cioni, Matteo

    2012-12-01

    In this study, we assessed kinematics and viscoelastic features of knee joint in adults with Down syndrome (DS) by means of the Wartenberg pendulum test. This test allows the measuring of the kinematics of the knee joint during passive pendular motion of leg under the influence of gravity. In addition, by a combination of kinematic and anthropometric data, pendulum test provides estimates of joint viscoelastic properties by computing damping and stiffness coefficients. To monitor the occurrences of muscle activation, the surface electromyogram (EMG) of muscle rectus femoris was recorded. The experimental protocol was performed in a group of 10 adults with DS compared with 10 control adults without DS. Joint motion amplitude, velocity, and acceleration of the leg during the first knee flexion significantly decreased in persons with DS with respect to those without DS. This behavior was associated with the activation of rectus femoris in subjects with DS that resulted in increasing of joint resistance shortly after the onset of the first leg flexion. The EMG bursts mostly occurred between 50 and 150 ms from the leg flexion onset. During the remaining cycles of pendular motion, persons with DS exhibited passive leg oscillations with low tonic EMG activity and reduced damping coefficient compared with control subjects. These results suggest that adults with DS might perform preprogrammed contractions to increase joint resistance and compensate for inherent joint instability occurring for quick and unpredictable perturbations. The reduction of damping coefficients observed during passive oscillations could be a predictor of muscle hypotonia.

  20. Development of Kinematic Graphs of Median Nerve during Active Finger Motion: Implications of Smartphone Use.

    Directory of Open Access Journals (Sweden)

    Hoi-Chi Woo

    Full Text Available Certain hand activities cause deformation and displacement of the median nerve at the carpal tunnel due to the gliding motion of tendons surrounding it. As smartphone usage escalates, this raises the public's concern whether hand activities while using smartphones can lead to median nerve problems.The aims of this study were to 1 develop kinematic graphs and 2 investigate the associated deformation and rotational information of median nerve in the carpal tunnel during hand activities.Dominant wrists of 30 young adults were examined with ultrasonography by placing a transducer transversely on their wrist crease. Ultrasound video clips were recorded when the subject performing 1 thumb opposition with the wrist in neutral position, 2 thumb opposition with the wrist in ulnar deviation and 3 pinch grip with the wrist in neutral position. Six still images that were separated by 0.2-second intervals were then captured from the ultrasound video for the determination of 1 cross-sectional area (CSA, 2 flattening ratio (FR, 3 rotational displacement (RD and 4 translational displacement (TD of median nerve in the carpal tunnel, and these collected information of deformation, rotational and displacement of median nerve were compared between 1 two successive time points during a single hand activity and 2 different hand motions at the same time point. Finally, kinematic graphs were constructed to demonstrate the mobility of median nerve during different hand activities.Performing different hand activities during this study led to a gradual reduction in CSA of the median nerve, with thumb opposition together with the wrist in ulnar deviation causing the greatest extent of deformation of the median nerve. Thumb opposition with the wrist in ulnar deviation also led to the largest extent of TD when compared to the other two hand activities of this study. Kinematic graphs showed that the motion pathways of median nerve during different hand activities were complex