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Sample records for single limb stance

  1. Postural control strategies during single limb stance following acute lateral ankle sprain.

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    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

    2014-06-01

    Single-limb stance is maintained via the integration of visual, vestibular and somatosensory afferents. Musculoskeletal injury challenges the somatosensory system to reweight distorted sensory afferents. This investigation supplements kinetic analysis of eyes-open and eyes-closed single-limb stance tasks with a kinematic profile of lower limb postural orientation in an acute lateral ankle sprain group to assess the adaptive capacity of the sensorimotor system to injury. Sixty-six participants with first-time acute lateral ankle sprain completed a 20-second eyes-open single-limb stance task on their injured and non-injured limbs (task 1). Twenty-three of these participants successfully completed the same 20-second single-limb stance task with their eyes closed (task 2). A non-injured control group of 19 participants completed task 1, with 16 completing task 2. 3-dimensional kinematics of the hip, knee and ankle joints, as well as associated fractal dimension of the center-of-pressure path were determined for each limb during these tasks. Between trial analyses revealed significant differences in stance limb kinematics and fractal dimension of the center-of-pressure path for task 2 only. The control group bilaterally assumed a position of greater hip flexion compared to injured participants on their side-matched "involved"(7.41 [6.1°] vs 1.44 [4.8]°; η(2)=.34) and "uninvolved" (9.59 [8.5°] vs 2.16 [5.6°]; η(2)=.31) limbs, with a greater fractal dimension of the center-of-pressure path (involved limb=1.39 [0.16°] vs 1.25 [0.14°]; uninvolved limb=1.37 [0.21°] vs 1.23 [0.14°]). Bilateral impairment in postural control strategies present following a first time acute lateral ankle sprain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Balance in single-limb stance after surgically treated ankle fractures: a 14-month follow-up

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    Ageberg Eva

    2006-04-01

    Full Text Available Abstract Background The maintenance of postural control is fundamental for different types of physical activity. This can be measured by having subjects stand on one leg on a force plate. Many studies assessing standing balance have previously been carried out in patients with ankle ligament injuries but not in patients with ankle fractures. The aim of this study was to evaluate whether patients operated on because of an ankle fracture had impaired postural control compared to an uninjured age- and gender-matched control group. Methods Fifty-four individuals (patients operated on because of an ankle fracture were examined 14 months postoperatively. Muscle strength, ankle mobility, and single-limb stance on a force-platform were measured. Average speed of centre of pressure movements and number of movements exceeding 10 mm from the mean value of centre of pressure were registered in the frontal and sagittal planes on a force-platform. Fifty-four age- and gender-matched uninjured individuals (controls were examined in the single-limb stance test only. The paired Student t-test was used for comparisons between patients' injured and uninjured legs and between side-matched legs within the controls. The independent Student t-test was used for comparisons between patients and controls. The Chi-square test, and when applicable, Fisher's exact test were used for comparisons between groups. Multiple logistic regression was performed to identify factors associated with belonging to the group unable to complete the single-limb stance test on the force-platform. Results Fourteen of the 54 patients (26% did not manage to complete the single-limb stance test on the force-platform, whereas all controls managed this (p Conclusion One in four patients operated on because of an ankle fracture had impaired postural control compared to an age- and gender-matched control group. Age over 45 years and decreased strength in the ankle plantar flexors and dorsiflexors

  3. Balance failure in single limb stance due to ankle sprain injury: an analysis of center of pressure using the fractal dimension method.

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    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

    2014-01-01

    Instrumented postural control analysis plays an important role in evaluating the effects of injury on dynamic stability during balance tasks, and is often conveyed with measures based on the displacement of the center-of-pressure (COP) assessed with a force platform. However, the desired outcome of the task is frequently characterized by a loss of dynamic stability, secondary to injury. Typically, these failed trials are discarded during research investigations, with the potential loss of informative data pertaining to task success. The novelty of the present study is that COP characteristics of failed trials in injured participants are compared to successful trial data in another injured group, and a control group of participants, using the fractal dimension (FD) method. Three groups of participants attempted a task of eyes closed single limb stance (SLS): twenty-nine participants with acute ankle sprain successfully completed the task on their non-injured limb (successful injury group); twenty eight participants with acute ankle sprain failed their attempt on their injured limb (failed injury group); sixteen participants with no current injury successfully completed the task on their non-dominant limb (successful non-injured group). Between trial analyses of these groups revealed significant differences in COP trajectory FD (successful injury group: 1.58±0.06; failed injury group: 1.54±0.07; successful non-injured group: 1.64±0.06) with a large effect size (0.27). These findings demonstrate that successful eyes-closed SLS is characterized by a larger FD of the COP path when compared to failed trials, and that injury causes a decrease in COP path FD. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Evaluation of a single leg stance balance test in children.

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    Zumbrunn, Thomas; MacWilliams, Bruce A; Johnson, Barbara A

    2011-06-01

    Balance is a major determinate of gait. In high functioning individuals without significant vestibular or vision impairments, a ceiling effect may be present when using a double limb support protocol to assess balance function. For these populations, a single leg stance protocol may be more suitable. 47 typically developing (TD) subjects and 10 patients with CEV performed a single leg stance test on a force plate. The center of pressure (COP) was determined and several COP derived variables were calculated. Included measurements were: standard deviation, maximum excursion, area, average radial displacement, path velocity and frequency of the COP. Directional components of suitable variables were used to analyze anterior/posterior and medial/lateral contributions. Correlations with age of TD subjects indicated that all balance variables except frequency were significantly correlated. Most parameters were highly inter-correlated. Age adjusted COP balance variables also correlated to the Bruininks-Oseretsky balance subtest. Highest correlations were determined by the maximum excursion and velocity of the COP in the anterior/posterior direction. Statistical comparisons between the CEV group and a 4-6 TD group indicated significant differences between groups for most COP balance parameters. These results indicated that a single limb balance assessment may be a useful assessment for determining balance impairments in higher functioning children with orthopedic impairments. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Stance limb ground reaction forces in high functioning stroke and healthy subjects during gait initiation.

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    Sharma, Sheena; McMorland, Angus J C; Stinear, James W

    2015-08-01

    Following stroke, little is known about ground reaction forces during gait initiation. To compare stroke patients' with healthy subjects' anterior, medial, and lateral ground reaction forces generated during gait initiation. Patients with left paresis, right paresis, and age-similar healthy subjects were recruited. During gait initiation the average peak anterior, medial, and lateral ground reaction forces acting on each lower limb were calculated when it was the stance limb. Anterior ground reaction forces acting on the right and left stance limbs of healthy subjects were greater than anterior forces acting on the nonparetic and paretic limbs of stroke patients. Medial ground reaction forces for the nonparetic and paretic limbs of stroke patients and for the right and left stance limbs of healthy subjects were equivalent. While lateral ground reaction forces acting on the nonparetic and paretic limbs were equivalent for left paretic patients, for right paretic patients lateral forces acting on the nonparetic limb were greater compared to the paretic limb and also greater compared to the left limb of healthy subjects. An effect of side-of-lesion was revealed in average peak lateral ground reaction force data. Larger lateral ground reaction forces acting on the left nonparetic stance limb of right paretic patients compared to the right nonparetic stance limb of left paretic patients during gait initiation may be an indication of differing adaptations that depend on the side-of-lesion. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Limb-bone scaling indicates diverse stance and gait in quadrupedal ornithischian dinosaurs.

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    Susannah C R Maidment

    Full Text Available BACKGROUND: The most primitive ornithischian dinosaurs were small bipeds, but quadrupedality evolved three times independently in the clade. The transition to quadrupedality from bipedal ancestors is rare in the history of terrestrial vertebrate evolution, and extant analogues do not exist. Constraints imposed on quadrupedal ornithischians by their ancestral bipedal bauplan remain unexplored, and consequently, debate continues about their stance and gait. For example, it has been proposed that some ornithischians could run, while others consider that none were cursorial. METHODOLOGY/PRINCIPAL FINDINGS: Drawing on biomechanical concepts of limb bone scaling and locomotor theory developed for extant taxa, we use the largest dataset of ornithischian postcranial measurements so far compiled to examine stance and gait in quadrupedal ornithischians. Differences in femoral midshaft eccentricity in hadrosaurs and ceratopsids may indicate that hadrosaurs placed their feet on the midline during locomotion, while ceratopsids placed their feet more laterally, under the hips. More robust humeri in the largest ceratopsids relative to smaller taxa may be due to positive allometry in skull size with body mass in ceratopsids, while slender humeri in the largest stegosaurs may be the result of differences in dermal armor distribution within the clade. Hadrosaurs are found to display the most cursorial morphologies of the quadrupedal ornithischian cades, indicating higher locomotor performance than in ceratopsids and thyreophorans. CONCLUSIONS/SIGNIFICANCE: Limb bone scaling indicates that a previously unrealised diversity of stances and gaits were employed by quadrupedal ornithischians despite apparent convergence in limb morphology. Grouping quadrupedal ornithischians together as a single functional group hides this disparity. Differences in limb proportions and scaling are likely due to the possession of display structures such as horns, frills and dermal armor

  7. Limb-bone scaling indicates diverse stance and gait in quadrupedal ornithischian dinosaurs.

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    Maidment, Susannah C R; Linton, Deborah H; Upchurch, Paul; Barrett, Paul M

    2012-01-01

    The most primitive ornithischian dinosaurs were small bipeds, but quadrupedality evolved three times independently in the clade. The transition to quadrupedality from bipedal ancestors is rare in the history of terrestrial vertebrate evolution, and extant analogues do not exist. Constraints imposed on quadrupedal ornithischians by their ancestral bipedal bauplan remain unexplored, and consequently, debate continues about their stance and gait. For example, it has been proposed that some ornithischians could run, while others consider that none were cursorial. Drawing on biomechanical concepts of limb bone scaling and locomotor theory developed for extant taxa, we use the largest dataset of ornithischian postcranial measurements so far compiled to examine stance and gait in quadrupedal ornithischians. Differences in femoral midshaft eccentricity in hadrosaurs and ceratopsids may indicate that hadrosaurs placed their feet on the midline during locomotion, while ceratopsids placed their feet more laterally, under the hips. More robust humeri in the largest ceratopsids relative to smaller taxa may be due to positive allometry in skull size with body mass in ceratopsids, while slender humeri in the largest stegosaurs may be the result of differences in dermal armor distribution within the clade. Hadrosaurs are found to display the most cursorial morphologies of the quadrupedal ornithischian cades, indicating higher locomotor performance than in ceratopsids and thyreophorans. Limb bone scaling indicates that a previously unrealised diversity of stances and gaits were employed by quadrupedal ornithischians despite apparent convergence in limb morphology. Grouping quadrupedal ornithischians together as a single functional group hides this disparity. Differences in limb proportions and scaling are likely due to the possession of display structures such as horns, frills and dermal armor that may have affected the center of mass of the animal, and differences in locomotor

  8. Single leg stance control in individuals with symptomatic gluteal tendinopathy.

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    Allison, Kim; Bennell, Kim L; Grimaldi, Alison; Vicenzino, Bill; Wrigley, Tim V; Hodges, Paul W

    2016-09-01

    Lateral hip pain during single leg loading, and hip abductor muscle weakness, are associated with gluteal tendinopathy, but it has not been shown how or whether kinematics in single leg stance differ in those with gluteal tendinopathy. To compare kinematics in preparation for, and during, single leg stance between individuals with and without gluteal tendinopathy, and the effect of hip abductor muscle strength on kinematics. Twenty individuals with gluteal tendinopathy and 20 age-matched pain-free controls underwent three-dimensional kinematic analysis of single leg stance and maximum isometric hip abductor strength testing. Maximum values of hip adduction, pelvic obliquity (contralateral pelvis rise/drop), lateral pelvic translation (ipsilateral/contralateral shift) and ipsilateral trunk lean during preparation for leg lift and average values in steady single leg stance, were compared between groups using an analysis of covariance, with and without anthropometric characteristics and strength as covariates. Individuals with gluteal tendinopathy demonstrated greater hip adduction (standardized mean difference (SMD)=0.70, P=0.04) and ipsilateral pelvic shift (SMD=1.1, P=0.002) in preparation for leg lift, and greater hip adduction (SMD=1.2, P=0.002) and less contralateral pelvic rise (SMD=0.86, P=0.02) in steady single leg stance than controls. When including strength as a covariate, only between-group differences in lateral pelvic shift persisted (SMD=1.7, P=0.01). Individuals with gluteal tendinopathy use different frontal plane kinematics of the hip and pelvis during single leg stance than pain-free controls. This finding is not influenced by pelvic dimension or the potentially modifiable factor of body mass index, but is by hip abductor muscle weakness. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Single Stance Stability and Proprioceptive Control in Older Adults Living at Home: Gender and Age Differences

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    Dario Riva

    2013-01-01

    Full Text Available In developed countries, falls in older people represent a rising problem. As effective prevention should start before the risk becomes evident, an early predictor is needed. Single stance instability would appear as a major risk factor. Aims of the study were to describe single stance stability, its sensory components, and their correlation with age and gender. A random sample of 597 older adults (319 men, 278 women living at home, aged 65–84, was studied. Stability tests were performed with an electronic postural station. The single stance test showed the impairment of single stance stability in older individuals (75–84 yrs. The significant decline of stability in the older subjects may be explained by the impairment of proprioceptive control together with the decrease in compensatory visual stabilization and emergency responses. Younger subjects (65–74 yrs exhibited better, but still inadequate, proprioceptive control with compensatory visual stabilization. Gender differences appeared in older subjects: women were significantly less stable than men. The measurement of the sensory components of single stance stability could aid in the early detection of a decay in antigravity movements many years before the risk of falling becomes evident. Adequate proprioceptive control could mitigate the effects of all other risks of falling.

  10. The Relationship of Anticipatory Gluteus Medius Activity to Pelvic and Knee Stability in the Transition to Single-Leg Stance.

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    Kim, Daehan; Unger, Janelle; Lanovaz, Joel L; Oates, Alison R

    2016-02-01

    The knee abduction moment in a weight-bearing limb is an important risk factor of conditions such as patellofemoral pain and knee osteoarthritis. Excessive pelvic drop in single-leg stance can increase the knee abduction moment. The gluteus medius muscle is crucial to prevent pelvic drop and must be activated in anticipation of the transition from double-leg to single-leg stance. To examine the relationship of anticipatory activity of the gluteus medius to pelvic drop and knee abduction moment. Observational, cross-sectional correlational study. Research laboratory. Twenty female adults (mean age 22.6 years, standard deviation 2.5) were recruited and fully participated. Participant selection was limited to healthy women who did not have a history of knee and ankle ligament injuries, any indication of knee, hip, and/or low back pain, and/or knowledge of the proper squat technique. Participants performed 16 single-leg mini squats on their nondominant leg. The onset and magnitude of anticipatory gluteus medius activity were measured in relation to toe-off of the dominant leg during the transition from double-leg to single-leg stance. Preplanned correlations between anticipatory gluteus medius onset and its activation magnitude, pelvic obliquity, and knee abduction moment were examined. The magnitude of anticipatory gluteus medius activity was significantly correlated with the knee abduction moment (rs (18) = -0.303, P pelvic obliquity (rs (18) = 0.361, P pelvic obliquity. The amount of gluteus medius activity is more important for controlling knee and pelvic stability in the frontal plane than the onset of activation. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  11. Asymmetrical stabilization and mobilization exploited during static single leg stance and goal directed kicking.

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    King, Adam C; Wang, Zheng

    2017-08-01

    The motor control properties of the right and left legs are dependent on the stabilization and mobilization features of the motor tasks. The current investigation examined the right and left leg control differences - interlateral asymmetries - during static single leg stance and dynamic goal directed kicking with an emphasis of the asymmetrical stabilization and mobilization components of movements. Ten young, healthy, right-leg preferred individuals with minimal kicking experience completed both tests on each limb. During static single leg stance, participants were requested to stand as still as possible with one leg in contact with a force platform. Interlateral asymmetries of the standing leg were quantified using postural variability measures of the center of pressure (COP) standard deviation in the anterior-posterior (SD-COP AP ) and medial-lateral (SD-COP ML ) directions, resultant COP length and velocity, and 95% COP elliptical area. During dynamic goal directed kicking, participants stood on two adjacent force platforms in a side-by-side foot position and kicked a soccer ball toward three different directions as soon as they received an auditory cue of kicking. Three targets were located -30°, 0° or 30° in front and 3.05 m away from the participants' midline. Participants kicked the ball toward the targets with each of their feet. The vertical ground reaction force (vGRF) of the kicking leg was used to define the preparation (from above two standard deviations of vGRF baseline to toe-off) and swing (from toe-off to toe-return) phases of dynamic kicking. To determine the presence of interlateral asymmetries during dynamic kicking, the magnitude and timing of the anticipatory postural adjustments (APA) during the preparation phase of kicking were quantified using the lateral net COP (COPnet-ML) time series derived from both force platforms. Postural variability measures of the support leg and the kinematic joint range of motion (JROM) trajectories of the

  12. Trunk's natural inclination influences stance limb kinetics, but not body kinematics, during gait initiation in able men.

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    Sébastien Leteneur

    Full Text Available The imposing mass of the trunk in relation to the whole body has an important impact on human motion. The objective of this study is to determine the influence of trunk's natural inclination--forward (FW or backward (BW with respect to the vertical--on body kinematics and stance limb kinetics during gait initiation.Twenty-five healthy males were divided based on their natural trunk inclination (FW or BW during gait initiation. Instantaneous speed was calculated at the center of mass at the first heel strike. The antero-posterior impulse was calculated by integrating the antero-posterior ground reaction force in time. Ankle, knee, hip and thoraco-lumbar (L5 moments were calculated using inverse dynamics and only peaks of the joint moments were analyzed. Among all the investigated parameters, only joint moments present significant differences between the two groups. The knee extensor moment is 1.4 times higher (P<0.001 for the BW group, before the heel contact. At the hip, although the BW group displays a flexor moment 2.4 times higher (P<0.001 before the swing limb's heel-off, the FW group displays an extensor moment 3.1 times higher (P<0.01 during the swing phase. The three L5 extensor peaks after the toe-off are respectively 1.7 (P<0.001, 1.4 (P<0.001 and 1.7 (P<0.01 times higher for the FW group. The main results support the idea that the patterns described during steady-state gait are already observable during gait initiation. This study also provides reference data to further investigate stance limb kinetics in specific or pathologic populations during gait initiation. It will be of particular interest for elderly people, knowing that this population displays atypical trunk postures and present a high risk of falling during this forward stepping.

  13. Trunk's natural inclination influences stance limb kinetics, but not body kinematics, during gait initiation in able men.

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    Leteneur, Sébastien; Simoneau, Emilie; Gillet, Christophe; Dessery, Yoann; Barbier, Franck

    2013-01-01

    The imposing mass of the trunk in relation to the whole body has an important impact on human motion. The objective of this study is to determine the influence of trunk's natural inclination--forward (FW) or backward (BW) with respect to the vertical--on body kinematics and stance limb kinetics during gait initiation.Twenty-five healthy males were divided based on their natural trunk inclination (FW or BW) during gait initiation. Instantaneous speed was calculated at the center of mass at the first heel strike. The antero-posterior impulse was calculated by integrating the antero-posterior ground reaction force in time. Ankle, knee, hip and thoraco-lumbar (L5) moments were calculated using inverse dynamics and only peaks of the joint moments were analyzed. Among all the investigated parameters, only joint moments present significant differences between the two groups. The knee extensor moment is 1.4 times higher (P<0.001) for the BW group, before the heel contact. At the hip, although the BW group displays a flexor moment 2.4 times higher (P<0.001) before the swing limb's heel-off, the FW group displays an extensor moment 3.1 times higher (P<0.01) during the swing phase. The three L5 extensor peaks after the toe-off are respectively 1.7 (P<0.001), 1.4 (P<0.001) and 1.7 (P<0.01) times higher for the FW group. The main results support the idea that the patterns described during steady-state gait are already observable during gait initiation. This study also provides reference data to further investigate stance limb kinetics in specific or pathologic populations during gait initiation. It will be of particular interest for elderly people, knowing that this population displays atypical trunk postures and present a high risk of falling during this forward stepping.

  14. A finite element model of the lower limb during stance phase of gait cycle including the muscle forces.

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    Diffo Kaze, Arnaud; Maas, Stefan; Arnoux, Pierre-Jean; Wolf, Claude; Pape, Dietrich

    2017-12-07

    Results of finite element (FE) analyses can give insight into musculoskeletal diseases if physiological boundary conditions, which include the muscle forces during specific activities of daily life, are considered in the FE modelling. So far, many simplifications of the boundary conditions are currently made. This study presents an approach for FE modelling of the lower limb for which muscle forces were included. The stance phase of normal gait was simulated. Muscle forces were calculated using a musculoskeletal rigid body (RB) model of the human body, and were subsequently applied to a FE model of the lower limb. It was shown that the inertial forces are negligible during the stance phase of normal gait. The contact surfaces between the parts within the knee were modelled as bonded. Weak springs were attached to the distal tibia for numerical reasons. Hip joint reaction forces from the RB model and those from the FE model were similar in magnitude with relative differences less than 16%. The forces of the weak spring were negligible compared to the applied muscle forces. The maximal strain was 0.23% in the proximal region of the femoral diaphysis and 1.7% in the contact zone between the tibia and the fibula. The presented approach based on FE modelling by including muscle forces from inverse dynamic analysis of musculoskeletal RB model can be used to perform analyses of the lower limb with very realistic boundary conditions. In the present form, this model can be used to better understand the loading, stresses and strains of bones in the knee area and hence to analyse osteotomy fixation devices.

  15. Postural stability during the transition from double-leg stance to single-leg stance in anterior cruciate ligament injured subjects.

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    Dingenen, Bart; Janssens, Luc; Luyckx, Thomas; Claes, Steven; Bellemans, Johan; Staes, Filip F

    2015-03-01

    An anterior cruciate ligament injury may lead to deteriorations in postural stability. The goal of this study was to evaluate postural stability during the transition from double-leg stance to single-leg stance of both legs in anterior cruciate ligament injured subjects and non-injured control subjects with a standardized methodology. Fifteen control subjects and 15 anterior cruciate ligament injured subjects (time after injury: mean (SD)=1.4 (0.7) months) participated in the study. Both groups were similar for age, gender, height, weight and body mass index. Spatiotemporal center of pressure outcomes of both legs of each subject were measured during the transition from double-leg stance to single-leg stance in eyes open and eyes closed conditions. Movement speed was standardized. The center of pressure displacement after a new stability point was reached during the single-leg stance phase was significantly increased in the anterior cruciate ligament injured group compared to the control group in the eyes closed condition (Plegs within both groups (P>.05). No significant differences were found during the transition itself (P>.05). The anterior cruciate ligament injured group showed postural stability deficits during the single-leg stance phase compared to the non-injured control group in the eyes closed condition. Using the non-injured leg as a normal reference when evaluating postural stability of the injured leg may lead to misinterpretations, as no significant differences were found between the injured and non-injured leg of the anterior cruciate ligament injured group. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Lower extremity muscle activation onset times during the transition from double-leg stance to single-leg stance in anterior cruciate ligament reconstructed subjects.

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    Dingenen, Bart; Janssens, Luc; Claes, Steven; Bellemans, Johan; Staes, Filip F

    2016-06-01

    Previous studies mainly focused on muscles at the operated knee after anterior cruciate ligament reconstruction, less on muscles around other joints of the operated and non-operated leg. The aim of this study was to investigate muscle activation onset times during the transition from double-leg stance to single-leg stance in anterior cruciate ligament reconstructed subjects. Lower extremity muscle activation onset times of both legs of 20 fully returned to sport anterior cruciate ligament reconstructed subjects and 20 non-injured control subjects were measured during the transition from double-leg stance to single-leg stance in eyes open and eyes closed conditions. Analysis of covariance (ANCOVA) was used to evaluate differences between groups and differences between legs within both groups, while controlling for peak center of pressure velocity. Significantly delayed muscle activation onset times were found in the anterior cruciate ligament reconstructed group compared to the control group for gluteus maximus, gluteus medius, vastus medialis obliquus, medial hamstrings, lateral hamstrings and gastrocnemius in both eyes open and eyes closed conditions (Panterior cruciate ligament reconstructed group, no significant different muscle activation onset times were found between the operated and non-operated leg (P>.05). Despite completion of rehabilitation and full return to sport, the anterior cruciate ligament reconstructed group showed neuromuscular control deficits that were not limited to the operated knee joint. Clinicians should focus on relearning multi-segmental anticipatory neuromuscular control strategies after anterior cruciate ligament reconstruction. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. The Effect of Single-Leg Stance on Dancer and Control Group Static Balance.

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    Kilroy, Elisabeth A; Crabtree, Olivia M; Crosby, Brittany; Parker, Amanda; Barfield, William R

    The purpose of this study was to compare kinetic differences of static balance between female dancers (D) with at least seven years of dance experience and female non-dancers (ND) who were typical college students. Participants were tested in single-leg stance. Both the dominant leg (DL) and non-dominant leg (NDL) were tested with the participants shod (S) and barefoot (BF). Kinetic variables (vertical, medio-lateral [ML], antero-posterior [AP] maximum ground reaction forces (GRF), and center of pressure (COP) ML and AP) were measured by a Bertec force platform at 1000 Hz with participants S and BF. Each subject's stance was measured over 3 × 30-second intervals. No significant differences (p≥0.05) existed between groups for height, body mass, or age. Significant differences existed between groups for balance time, AP GRF in both BF and S conditions for both DL and NDL, and ML GRF in BF NDL and S DL and NDL conditions. D and ND in BF and S conditions with DL and NDL static stance demonstrate different AP and ML GRF when balancing over a 30-second time interval. Data may suggest that ND are more prone to lose their balance. Further investigation is warranted to understand whether individuals in the rehabilitative field and athletic populations can use dance therapy for injury prevention and rehabilitation.

  18. The impact of the initial stance position on lower limb joint kinetics in the taekwondo roundhouse kick

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    Daniel Jandačka

    2013-06-01

    Full Text Available BACKGROUND: To achieve good performance, taekwondo athletes should optimize the stance position of the foot on the ground. OBJECTIVE: The aim of this study is to compare generated net joint power (hip, knee and ankle during stance phase, magnitude of peak foot velocity of the attacking lower extremity and execution stance time produced from three stance positions (forward "0°", diagonal "45°", orthogonal "90°" in the taekwondo roundhouse kick. METHODS: Ten taekwondo athletes participated in the study; their experience of practicing taekwondo ranged between 13.8 ± 5.8 years. The kinetics and kinematics of the athletes’ movement during the roundhouse kick were recorded. The execution stance time and the magnitude of peak foot velocity were determined. The net joint power of the kicking lower extremity during the stance phase was calculated using the inverse dynamics method. Then the peak net joint power was determined. RESULTS: The analysis of variance for repeated measures showed that there is a significant main effect of the stance position on the peak net hip joint power in the three planes. In addition, the stance position does not affect the magnitude of the peak foot velocity of the kicking lower extremity and execution stance time. CONCLUSIONS: The necessity to produce a higher net hip joint power in the stance phase of the roundhouse kick from the position when the feet are placed orthogonal to the target of the kick, compared with the execution of the kick from the forward or diagonal position, must be taken into account for purposes of rationalizing strength training of taekwondo athletes or for selecting the technique of the roundhouse kick.

  19. Ankle muscle activity modulation during single-leg stance differs between children, young adults and seniors.

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    Kurz, Eduard; Faude, Oliver; Roth, Ralf; Zahner, Lukas; Donath, Lars

    2018-02-01

    Incomplete maturation and aging-induced declines of the neuromuscular system affect postural control both in children and older adults and lead to high fall rates. Age-specific comparisons of the modulation of ankle muscle activation and behavioral center of pressure (COP) indices during upright stance have been rarely conducted. The objective of the present study was to quantify aging effects on a neuromuscular level. Thus, surface electromyography (SEMG) modulation and co-activity of ankle muscles during single-leg standing was compared in healthy children, young adults and seniors. Postural steadiness (velocity and mean sway frequency of COP), relative muscle activation (SEMG modulation) and co-activation of two ankle muscles (tibialis anterior, TA; soleus, SO) were examined during single-leg stance in 19 children [age, 9.7 (SD 0.5) years], 30 adults [23.3 (1.5) years] and 29 seniors [62.7 (6.1) years]. Velocity of COP in medio-lateral and anterior-posterior directions, mean sway frequency in anterior-posterior direction, relative muscle activation (TA and SO) and co-activation revealed large age effects (P  0.14). Post-hoc comparisons indicated higher COP velocities, anterior-posterior frequencies, relative SO activation and co-activation in children and seniors when compared with adults. Relative TA activation was higher in children and adults compared with seniors (P modulation. However, TA modulation is higher in children and adults, whereas seniors' TA modulation capacity is diminished. An aging-induced decline of TA motor units might account for deteriorations of TA modulation in seniors.

  20. Postural stability deficits during the transition from double-leg stance to single-leg stance in anterior cruciate ligament reconstructed subjects.

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    Dingenen, Bart; Janssens, Luc; Claes, Steven; Bellemans, Johan; Staes, Filip F

    2015-06-01

    The goal of this study was to evaluate postural stability during the transition from double-leg stance (DLS) to single-leg stance (SLS) in anterior cruciate ligament reconstructed (ACLR) (n=20) and non-injured control subjects (n=20). All ACLR subjects had fully returned to their pre-injury sport participation. Both groups were similar for age, gender, height, weight, body mass index and activity level. Spatiotemporal center of pressure outcomes of both legs of each subject were measured during the transition from DLS to SLS in eyes open and eyes closed conditions. Movement speed was standardized. The center of pressure displacement after a new stability point was reached during the SLS phase was significantly increased in the ACLR group compared to the control group in the eyes closed condition (P=.001). No significant different postural stability outcomes were found between the operated and non-operated legs. In conclusion, the ACLR group showed postural stability deficits, indicating that these persons may have a decreased ability to stabilize their body after the internal postural perturbation created by the transition from DLS to SLS. The non-operated leg may not be the best reference when evaluating postural stability of the operated leg after ACLR, as no differences were found between legs. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Influence of shoes and foot orthoses on lower extremity muscle activation onset times in healthy subjects during the transition from double-leg stance to single-leg stance.

    Science.gov (United States)

    Dingenen, B; Peeraer, L; Deschamps, K; Fieuws, S; Janssens, L; Staes, F

    2015-01-01

    The aim of this study was to evaluate the influence of shoes and foot orthoses on lower extremity muscle activation patterns in healthy subjects during the transition from double-leg stance to single-leg stance. Eight male and seven female young asymptomatic adults who wear foot orthoses were recruited. Muscle activation onset times of 9 lower extremity muscles were recorded using surface electromyography during the transition from double-leg stance to single-leg stance, performed with eyes open and with eyes closed. This was tested in 4 experimental conditions: 1) barefoot (BF); 2) shoes only (SO); 3) shoes with standardized FO (SSFO); and 4) shoes with customized FO (SCFO). Based on a four-way (condition-region-leg-vision) linear model for repeated measures, we found a significant condition effect (P=0.025). Differences between conditions did not depend on the leg and/or the vision condition, but on the region (ankle-knee-hip). Based on a two-way (condition-muscle) linear model within each region, only significant differences between conditions for peroneus longus (P=0.003) were found. The onset times of peroneus longus were significantly earlier in SO (P=0.029) and SCFO (P=0.001) compared to BF. These results indicate that SO and SCFO can accelerate peroneus longus muscle activation onset times during the transition from double-leg stance to single-leg stance. Further research is required to determine how these adaptations may develop over time.

  2. How does postural stability following a single leg drop jump landing task relate to postural stability during a single leg stance balance task?

    NARCIS (Netherlands)

    Fransz, Duncan P.; Huurnink, Arnold; Kingma, Idsart; van Dieën, Jaap H.

    2014-01-01

    We aimed to verify whether the static phase after a single leg drop jump (DJ) landing on a force plate may serve as a proxy for a single leg stance (SLS) balance task, as this would increase the application possibilities of landing tasks in the evaluation of sensorimotor function in relation to

  3. Shoe drop reduction influences the lower limb biomechanics of children tennis players during an open stance forehand: A longitudinal study.

    Science.gov (United States)

    Herbaut, Alexis; Simoneau-Buessinger, Emilie; Barbier, Franck; Gillet, Christophe; Roux, Maxime; Guéguen, Nils; Chavet, Pascale

    2017-11-01

    Compared to traditional tennis shoes, using 0-drop shoes was shown to induce an immediate switch from rear- to forefoot strike pattern to perform an open stance tennis forehand for 30% of children tennis players. The purpose of the study was to examine the long-term effects of a gradual reduction in the shoe drop on the biomechanics of children tennis players performing open stance forehands. Thirty children tennis players participated in 2 laboratory biomechanical test sessions (intermediate: +4 months and final: +8 months) after an inclusion visit where they were randomly assigned to control (CON) or experimental (EXP) group. CON received 12-mm-drop shoes twice, whereas EXP received 8 mm then 4-mm-drop shoes. Strike index indicated that all CON were rearfoot strikers in intermediate and final test sessions. All EXP were rearfoot strikers in intermediate test session, but half the group switched towards a forefoot strike pattern in final test session. This switch resulted in a decreased loading rate of the ground reaction force (-73%, p = .005) but increased peak ankle plantarflexors moment (+47%, p = .050) and peak ankle power absorption (+107%, p = .005) for these participants compared with CON. Biomechanical changes associated with the long-term use of partial minimalist shoes suggest a reduction in heel compressive forces but an increase in Achilles tendon tensile forces.

  4. Contribution of each leg to the control of unperturbed bipedal stance in lower limb amputees: new insights using entropy.

    Directory of Open Access Journals (Sweden)

    Petra Hlavackova

    Full Text Available The present study was designed to assess the relative contribution of each leg to unperturbed bipedal posture in lower limb amputees. To achieve this goal, eight unilateral traumatic trans-femoral amputees (TFA were asked to stand as still as possible on a plantar pressure data acquisition system with their eyes closed. Four dependent variables were computed to describe the subject's postural behavior: (1 body weight distribution, (2 amplitude, (3 velocity and (4 regularity of centre of foot pressure (CoP trajectories under the amputated (A leg and the non-amputated (NA leg. Results showed a larger body weight distribution applied to the NA leg than to the A leg and a more regular CoP profiles (lower sample entropy values with greater amplitude and velocity under the NA leg than under the A leg. Taken together, these findings suggest that the NA leg and the A leg do not equally contribute to the control of unperturbed bipedal posture in TFA. The observation that TFA do actively control unperturbed bipedal posture with their NA leg could be viewed as an adaptive process to the loss of the lower leg afferents and efferents because of the unilateral lower-limb amputation. From a methodological point of view, these results demonstrate the suitability of computing bilateral CoP trajectories regularity for the assessment of lateralized postural control under pathological conditions.

  5. Removing Single Limbs Using a Rotary Auger Cutter

    Science.gov (United States)

    Nels S. Christopherson

    1984-01-01

    An experiment using auger cutters to remove single limbs from six species showed that torque required depends on species and relative cutter rotation direction and that all species require 2 horsepower or less per inch width of cut using 2 1/2-inch-diameter cutters

  6. Individuals with chronic ankle instability exhibit decreased postural sway while kicking in a single-leg stance.

    Science.gov (United States)

    dos Santos, Marcio José; Gorges, Ana Luiza; Rios, Jaqueline Lourdes

    2014-01-01

    Individuals with chronic ankle instability (CAI) usually experience deficits in balance control, which increase displacement in the body's center of pressure (COP) when they balance on a single leg. Little is known, however, about whether or not these individuals use the strategies of postural adjustment properly, especially during functional tasks that may predispose them to ankle sprain. The aim of this study was to investigate anticipatory (APA) and compensatory (CPA) postural adjustments in individuals with and without CAI as they kick a ball while standing in a single-leg stance with their ankle in neutral and supinated positions. COP displacements were calculated and their magnitudes (range) analyzed during APA and CPA intervals and over the duration of the whole task, represented by the COP area of sway and mean velocity. The CAI group exhibited a significant decrease in CPA and area of sway over the whole task, relative to controls. These results suggest that the decreased balance sway could be caused by the need for further stabilization of the ankle in more unstable postures to prevent recurrent sprain. Our findings could help clinicians to better understand the strategies of postural adjustments in individuals with CAI, and may assist and motivate new investigations into balance control interventions in such individuals, as well as proactively address recurrent ankle sprain conditions. Published by Elsevier B.V.

  7. Immediate effects of a single session of robot-assisted gait training using Hybrid Assistive Limb (HAL) for cerebral palsy.

    Science.gov (United States)

    Matsuda, Mayumi; Mataki, Yuki; Mutsuzaki, Hirotaka; Yoshikawa, Kenichi; Takahashi, Kazushi; Enomoto, Keiko; Sano, Kumiko; Mizukami, Masafumi; Tomita, Kazuhide; Ohguro, Haruka; Iwasaki, Nobuaki

    2018-02-01

    [Purpose] Robot-assisted gait training (RAGT) using Hybrid Assistive Limb (HAL, CYBERDYNE) was previously reported beneficial for stroke and spinal cord injury patients. Here, we investigate the immediate effect of a single session of RAGT using HAL on gait function for cerebral palsy (CP) patients. [Subjects and Methods] Twelve patients (average age: 16.2 ± 7.3 years) with CP received a single session of RAGT using HAL. Gait speed, step length, cadence, single-leg support per gait cycle, hip and knee joint angle in stance, and swing phase per gait cycle were assessed before, during, and immediately after HAL intervention. [Results] Compared to baseline values, single-leg support per gait cycle (64.5 ± 15.8% to 69.3 ± 12.1%), hip extension angle in mid-stance (149.2 ± 19.0° to 155.5 ± 20.1°), and knee extension angle in mid-stance (137.6 ± 20.2° to 143.1 ± 19.5°) were significantly increased immediately after intervention. Further, the knee flexion angle in mid-swing was significantly decreased immediately after treatment (112.0 ± 15.5° to 105.2 ± 17.1°). Hip flexion angle in mid-swing also decreased following intervention (137.2 ± 14.6° to 129.7 ± 16.6°), but not significantly. Conversely, gait speed, step length, and cadence were unchanged after intervention. [Conclusion] A single-time RAGT with HAL improved single-leg support per gait cycle and hip and knee joint angle during gait, therapeutically improving gait function in CP patients.

  8. Testing single and double limb standing balance performance: comparison of COP path length evaluation between two devices.

    Science.gov (United States)

    Donath, Lars; Roth, Ralf; Zahner, Lukas; Faude, Oliver

    2012-07-01

    Center of pressure (COP) path length evaluation was commonly applied to measure postural sway and usually obtained from gold standard force plates. Thus, we comparatively investigated the feasible and less-expensive GKS® balance system (GKS) with the Kistler® force platform (KIS). 34 non-specifically trained but active adults (14 males, 20 females, age: 25.4±4.8 years; weight: 69.3±12.3 kg; height: 1.75±0.09 m, sports activity: 5.8±3.6 hours per week) were randomly tested on both devices during double and single limb stance with opened and closed eyes. Irrespective of the analysed time frame, repeated measures analyses of variances revealed higher path length readings for GKS compared to KIS for 30 s (F=6.8, p=0.01) and 10 s (F=21.2, p=0.001). Large effect sizes of the COP path length differences between GKS and KIS decreased from easy tasks (double limb, eyes open; d(30-s)=2.55, d(10-s)=2.04) to the most severe task (single limb, eyes closed; d(30-s)=0.02, d(10-s)=0.23). According to Bland and Altman, the limits of agreements indicated a high random variability component (between 29%, double limb, eyes open and 67%, single limb, eyes closed). The overall intraclass correlation coefficients (ICC) across all four standing balance tasks were moderate for the 30 s- (0.57) as well as the 10 s-analysis (0.65). In conclusion, the COP path length displacements obtained from the GKS balance system seem to differ with a considerable random variability from Kistler force platform data. Thus, measurements of the evaluated devices should not be used interchangeably. Further methodological investigations regarding balance measures seem warranted. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Clinical outcomes and frontal plane two-dimensional biomechanics during the 30-second single leg stance test in patients before and after hip abductor tendon reconstructive surgery.

    Science.gov (United States)

    Huxtable, Rose E; Ackland, Timothy R; Janes, Gregory C; Ebert, Jay R

    2017-07-01

    Hip abductor tendon tears are a common cause of Greater Trochanteric Pain Syndrome. Conservative treatments are often ineffective and surgical reconstruction may be recommended. This study investigated the improvement in clinical outcomes and frontal plane two-dimensional biomechanics during a 30-second single leg stance test, in patients undergoing reconstruction. We hypothesized that clinical scores and pertinent biomechanical variables would significantly improve post-surgery, and these outcomes would be significantly correlated. Twenty-one patients with symptomatic tendon tears underwent reconstruction. Patients were evaluated pre-surgery, and at 6 and 12months post-surgery, using patient-reported outcome measures, assessment of hip abductor strength and six-minute walk capacity. Frontal plane, two-dimensional, biomechanical variables including pelvis-on-femur angle, pelvic drop, trunk lean and lateral pelvic shift, were evaluated throughout a 30-second single leg stance test. ANOVA evaluated outcomes over time, while Pearson's correlations investigated associations between clinical scores, pain, functional and biomechanical outcome variables. While clinical and functional measures significantly improved (P0.05) were observed in biomechanical variables from pre- to post-surgery. While five patients displayed a positive Trendelenburg sign pre-surgery, only one was positive post-surgery. Clinical outcomes and biomechanical variables during the single leg stance test were not correlated. Despite improvements in clinical and functional measures over time, biomechanical changes during a weight bearing single leg stance test were not significantly different following tendon repair. Follow up beyond 12months may be required, whereby symptomatic relief may precede functional and biomechanical improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Staying in dynamic balance on a prosthetic limb : A leg to stand on?

    NARCIS (Netherlands)

    Curtze, Carolin; Hof, At L; Postema, Klaas; Otten, Bert

    With the loss of a lower limb, amputees lack the active muscle empowered control of the ankle that is important for balance control. We examined single-leg stance on prosthesis vs. sound limb balancing on narrow ridges in transtibial amputees. When balancing on the prosthetic limb, the lateral

  11. Determining the activation of gluteus medius and the validity of the single leg stance test in chronic, nonspecific low back pain.

    Science.gov (United States)

    Penney, Tracy; Ploughman, Michelle; Austin, Mark W; Behm, David G; Byrne, Jeannette M

    2014-10-01

    To determine the activation of the gluteus medius in persons with chronic, nonspecific low back pain compared with that in control subjects, and to determine the association of the clinical rating of the single leg stance (SLS) with chronic low back pain (CLBP) and gluteus medius weakness. Cohort-control comparison. Academic research laboratory. Convenience sample of people (n=21) with CLBP (>12wk) recruited by local physiotherapists, and age- and sex-matched controls (n=22). Subjects who received specific pain diagnoses were excluded. Not applicable. Back pain using the visual analog scale (mm); back-related disability using the Oswestry Back Disability Index (%); strength of gluteus medius measured using a hand dynamometer (N/kg); SLS test; gluteus medius onset and activation using electromyography during unipedal stance on a forceplate. Individuals in the CLBP group exhibited significant weakness in the gluteus medius compared with controls (right, P=.04; left, P=.002). They also had more pain (CLBP: mean, 20.50mm; 95% confidence interval [CI], 13.11-27.9mm; control subjects: mean, 1.77mm; 95% CI, -.21 to 3.75mm) and back-related disability (CLBP: mean, 18.52%; 95% CI, 14.46%-22.59%; control subjects: mean, .68%; 95% CI, -.41% to 1.77%), and reported being less physically active. Weakness was accompanied by increased gluteus medius activation during unipedal stance (R=.50, P=.001) but by no difference in muscle onset times. Although greater gluteus medius weakness was associated with greater pain and disability, there was no difference in muscle strength between those scoring positive and negative on the SLS test (right: F=.002, P=.96; left: F=.1.75, P=.19). Individuals with CLBP had weaker gluteus medius muscles than control subjects without back pain. Even though there was no significant difference in onset time of the gluteus medius when moving to unipedal stance between the groups, the CLBP group had greater gluteus medius activation. A key finding was that

  12. Staying in dynamic balance on a prosthetic limb: A leg to stand on?

    Science.gov (United States)

    Curtze, Carolin; Hof, At L; Postema, Klaas; Otten, Bert

    2016-06-01

    With the loss of a lower limb, amputees lack the active muscle empowered control of the ankle that is important for balance control. We examined single-leg stance on prosthesis vs. sound limb balancing on narrow ridges in transtibial amputees. When balancing on the prosthetic limb, the lateral displacement of the center of pressure was reduced and was compensated by an increase in counter-rotation. We show that single-leg stance on a prosthetic limb can be compared to balancing on a narrow ridge. Standing on a prosthetic limb involves the same balance mechanisms as balancing on narrow ridges of 40-mm to 20-mm width. Yet, the ability to balance on a narrow ridge with the sound limb was only a weak predictor for an amputee's ability to stand on the prosthetic limb. Balancing in single-leg stance on a prosthetic limb is not a common activity. The ability to compensate with the sound limb may therefore be functionally more important than the ability to stay in dynamic balance on the prosthetic limb. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  13. Comparison of a laboratory grade force platform with a Nintendo Wii Balance Board on measurement of postural control in single-leg stance balance tasks.

    Science.gov (United States)

    Huurnink, Arnold; Fransz, Duncan P; Kingma, Idsart; van Dieën, Jaap H

    2013-04-26

    Training and testing of balance have potential applications in sports and medicine. Laboratory grade force plates (FP) are considered the gold standard for the measurement of balance performance. Measurements in these systems are based on the parameterization of center of pressure (CoP) trajectories. Previous research validated the inexpensive, widely available and portable Nintendo Wii Balance Board (WBB). The novelty of the present study is that FP and WBB are compared on CoP data that was collected simultaneously, by placing the WBB on the FP. Fourteen healthy participants performed ten sequences of single-leg stance tasks with eyes open (EO), eyes closed (EC) and after a sideways hop (HOP). Within trial comparison of the two systems showed small root-mean-square differences for the CoP trajectories in the x and y direction during the three tasks (mean±SD; EO: 0.33±0.10 and 0.31±0.16 mm; EC: 0.58±0.17 and 0.63±0.19 mm; HOP: 0.74±0.34 and 0.74±0.27 mm, respectively). Additionally, during all 420 trials, comparison of FP and WBB revealed very high Pearson's correlation coefficients (r) of the CoP trajectories (x: 0.999±0.002; y: 0.998±0.003). A general overestimation was found on the WBB compared to the FP for 'CoP path velocity' (EO: 5.3±1.9%; EC: 4.0±1.4%; HOP: 4.6±1.6%) and 'mean absolute CoP sway' (EO: 3.5±0.7%; EC: 3.7±0.5%; HOP: 3.6±1.0%). This overestimation was highly consistent over the 140 trials per task (r>0.996). The present findings demonstrate that WBB is sufficiently accurate in quantifying CoP trajectory, and overall amplitude and velocity during single-leg stance balance tasks. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Single element ultrasonic imaging of limb geometry: an in-vivo study with comparison to MRI

    Science.gov (United States)

    Zhang, Xiang; Fincke, Jonathan R.; Anthony, Brian W.

    2016-04-01

    Despite advancements in medical imaging, current prosthetic fitting methods remain subjective, operator dependent, and non-repeatable. The standard plaster casting method relies on prosthetist experience and tactile feel of the limb to design the prosthetic socket. Often times, many fitting iterations are required to achieve an acceptable fit. Use of improper socket fittings can lead to painful pathologies including neuromas, inflammation, soft tissue calcification, and pressure sores, often forcing the wearer to into a wheelchair and reducing mobility and quality of life. Computer software along with MRI/CT imaging has already been explored to aid the socket design process. In this paper, we explore the use of ultrasound instead of MRI/CT to accurately obtain the underlying limb geometry to assist the prosthetic socket design process. Using a single element ultrasound system, multiple subjects' proximal limbs were imaged using 1, 2.25, and 5 MHz single element transducers. Each ultrasound transducer was calibrated to ensure acoustic exposure within the limits defined by the FDA. To validate image quality, each patient was also imaged in an MRI. Fiducial markers visible in both MRI and ultrasound were used to compare the same limb cross-sectional image for each patient. After applying a migration algorithm, B-mode ultrasound cross-sections showed sufficiently high image resolution to characterize the skin and bone boundaries along with the underlying tissue structures.

  15. The effect of different skin-ankle brace application pressures on quiet single-limb balance and electromyographic activation onset of lower limb muscles.

    Science.gov (United States)

    Papadopoulos, Emmanuel S; Nikolopoulos, Christos; Badekas, Athanasios; Vagenas, George; Papadakis, Stamatios A; Athanasopoulos, Spyros

    2007-09-12

    Several studies have been carried out in order to investigate the effect of ankle bracing on ankle joint function and performance. However, no study so far has examined the role of skin-brace interface pressure in neuromuscular control. The aim of this study was to investigate the effect of different skin-ankle brace interface pressures on quiet single limb balance and the electromyographic (EMG) activation sequence of four lower limb muscles. Thirty three male physical education students who volunteered to take part in the study were measured under three ankle brace conditions: i) without brace, ii) with brace and 30 kPa application pressure and iii) with brace and 60 kPa application pressure. Single limb balance (anteroposterior and mediolateral parameter) was assessed on the dominant lower limb, with open and closed eyes, on a force platform, simultaneously with the EMG recording of four lower lower limb muscles' (gastrocnemius, peroneus longus, rectus femoris and biceps femoris) activation onset. The results showed that overall balance (total stability parameter) was not significantly affected in any of the three ankle brace conditions. However, the anteroposterior centre of pressure excursion and centre of pressure excursion velocity were significantly increased with the application of ankle brace, both with 30 and 60 kPa application pressures. Furthermore, it was found that single limb balance was significantly worse with closed eyes compared to open eyes. EMG measurements showed that the sequence of lower limb activation onset was not affected in any of the three ankle brace application conditions. The results of this study showed that the application of an ankle brace with two different skin-brace interface pressures had no effect on overall single limb balance and the sequence of lower limb muscle activation. These findings suggest that peripheral joint receptors are either not adequately stimulated by the brace application and therefore are not able to

  16. The effect of different skin-ankle brace application pressures on quiet single-limb balance and electromyographic activation onset of lower limb muscles

    Directory of Open Access Journals (Sweden)

    Papadakis Stamatios A

    2007-09-01

    Full Text Available Abstract Background Several studies have been carried out in order to investigate the effect of ankle bracing on ankle joint function and performance. However, no study so far has examined the role of skin-brace interface pressure in neuromuscular control. The aim of this study was to investigate the effect of different skin-ankle brace interface pressures on quiet single limb balance and the electromyographic (EMG activation sequence of four lower limb muscles. Methods Thirty three male physical education students who volunteered to take part in the study were measured under three ankle brace conditions: i without brace, ii with brace and 30 kPa application pressure and iii with brace and 60 kPa application pressure. Single limb balance (anteroposterior and mediolateral parameter was assessed on the dominant lower limb, with open and closed eyes, on a force platform, simultaneously with the EMG recording of four lower lower limb muscles' (gastrocnemius, peroneus longus, rectus femoris and biceps femoris activation onset. Results The results showed that overall balance (total stability parameter was not significantly affected in any of the three ankle brace conditions. However, the anteroposterior centre of pressure excursion and centre of pressure excursion velocity were significantly increased with the application of ankle brace, both with 30 and 60 kPa application pressures. Furthermore, it was found that single limb balance was significantly worse with closed eyes compared to open eyes. EMG measurements showed that the sequence of lower limb activation onset was not affected in any of the three ankle brace application conditions. The results of this study showed that the application of an ankle brace with two different skin-brace interface pressures had no effect on overall single limb balance and the sequence of lower limb muscle activation. Conclusion These findings suggest that peripheral joint receptors are either not adequately

  17. Stratospheric isotopic water profiles from a single submillimeter limb scan by TELIS

    Directory of Open Access Journals (Sweden)

    A. de Lange

    2009-08-01

    Full Text Available Around 490 GHz relatively strong HDO and H218O emission lines can be found in the submillimeter thermal-emission spectrum of the Earth's atmosphere, along with lines of the principal isotopologue of water vapour. These can be used for remote sensing of the rare/principal isotope ratio in the stratosphere. A sensitivity study has been performed for retrieval simulations of water isotopologues from balloon-borne measurements by the limb sounder TELIS (TErahertz and submillimeter LImb Sounder. The study demonstrates the capability of TELIS to determine, from a single limb scan, the profiles for H218O and HDO between 20 km and 37 km with a retrieval error of ≈3 and a spatial resolution of 1.5 km, as determined by the width of the averaging kernel. In addition HDO can be retrieved in the range of 10–20 km, albeit with a strongly deteriorated retrieval error. Expected uncertainties in instrumental parameters have only limited impact on the retrieval results.

  18. Posterior Femoral Single Limb Osteotomy for the Removal of Well-Fixed Modular Femoral Neck Components

    Directory of Open Access Journals (Sweden)

    Keith A Fehring

    2017-07-01

    Full Text Available Modular neck femoral components were introduced to optimize femoral neck anteversion, leg length, offset, and stability in total hip arthroplasty. However, concerns have been raised in recent years regarding early failure of these implants due to corrosion, pseudotumor, as well as fracture of the modular neck. Removing modular neck femoral implants is challenging as removal of the modular femoral neck leaves a proximally coated femoral stem level with the proximal bone of the femoral neck. We describe a posterior femoral single limb osteotomy  (posterior cut of an extended trochanteric osteotomy for the removal of a modular neck femoral component.

  19. Lower Limb Interjoint Postural Coordination One Year after First-Time Lateral Ankle Sprain.

    Science.gov (United States)

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Sweeney, Kevin; Patterson, Matthew R; Delahunt, Eamonn

    2015-11-01

    Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This investigation combined measures of lower limb interjoint coordination and stabilometry to evaluate static unipedal stance with the eyes open (condition 1) and closed (condition 2) in a group of participants with chronic ankle instability (CAI) compared to lateral ankle sprain "copers" (both recruited 12 months after sustaining an acute first-time lateral ankle sprain) and a group of noninjured controls. Twenty-eight participants with CAI, 42 lateral ankle sprain "copers," and 20 noninjured controls completed three 20-s single-limb stance trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb three-dimensional kinematic data for similarity to establish patterns of interjoint coordination. The fractal dimension of the stance limb center of pressure path was also calculated. Between-group analyses revealed that participants with CAI displayed notable increases in ankle-hip linked coordination compared with both lateral ankle sprain "copers" (-0.52 (1.05) vs 0.28 (0.9), P = 0.007) and controls (-0.52 (1.05) vs 0.63 (0.64), P = 0.006) in condition 1 and compared with controls only (0.62 (1.92) vs 0.1 (1.0) P = 0.002) in condition 2. Participants with CAI also exhibited a decrease in the fractal dimension of the center-of-pressure path during condition 2 compared with both controls and lateral ankle sprain "copers." Participants with CAI present with a hip-dominant strategy of eyes-open and eyes-closed static unipedal stance. This coincided with reduced complexity of the stance limb center of pressure path in the eyes-closed condition.

  20. Safety and walking ability of KAFO users with the C-Brace? Orthotronic Mobility System, a new microprocessor stance and swing control orthosis

    OpenAIRE

    Pr?bsting, Eva; Kannenberg, Andreas; Zacharias, Britta

    2016-01-01

    Background: There are clear indications for benefits of stance control orthoses compared to locked knee ankle foot orthoses. However, stance control orthoses still have limited function compared with a sound human leg. Objectives: The aim of this study was to evaluate the potential benefits of a microprocessor stance and swing control orthosis compared to stance control orthoses and locked knee ankle foot orthoses in activities of daily living. Study design: Survey of lower limb orthosis user...

  1. Cortical control of upright stance in elderly.

    Science.gov (United States)

    Ozdemir, Recep A; Contreras-Vidal, Jose L; Paloski, William H

    2018-01-01

    This study examined differences between young and elderly volunteers in cortical involvement to human posture control during quiet stance with normal and altered sensory stimulation (Experiment-1), and biomechanical perturbations (Experiment-2). The primary focus of the first part was to monitor changes in cortical activity when unexpectedly altering the sensory conditions of upright stance, such as switching from stable (eyes open, fixed support surface) to less-stable (eyes closed, sway-referenced support surface) conditions. Our results demonstrate increased cortical activations in delta (0.2-4 Hz) and gamma (30-50 Hz) oscillations, primarily over central-frontal, central, and central parietal cortices during challenging postural conditions. While increased delta rhythms were observed in both groups during challenging sensory conditions, elderly individuals also showed increased gamma band activity over sensorimotor and parietal cortices, when compared to the younger group. To our knowledge, this study is the first to show age differences in balance related cortical activations during continuous postural tasks with challenging sensory conditions. Preliminary correlations also suggest that increased cerebral activity became more relevant to the control of Center of Mass (COM) dynamics when upright stance is threatened. The results of Experiment-2 also showed for the first time that oscillatory rhythms of the cortex are coherent with muscle firing characteristics suggesting increased corticospinal drive from leg motor cortex to lower limb motoneurons following postural perturbations. Finally, perturbation evoked potential (PEP) analyses suggest that, rather than motor system malfunctioning, impairments in perceptual processing of sensory afference forms the basis of prolonged muscle response delays during perturbed balance in the elderly. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Skill transfer from symmetric and asymmetric bimanual training using a robotic system to single limb performance.

    Science.gov (United States)

    Trlep, Matic; Mihelj, Matjaž; Munih, Marko

    2012-07-17

    . Transfer of learned skills from bimanual training to unimanual movements was also observed, as bimanual training also improved single limb performance with the dominant arm. Changes of force symmetry did not have an effect on motor learning. As motor learning is believed to be an important mechanism of rehabilitation, our findings could be tested for future post-stroke rehabilitation systems.

  3. Epistemic Stance in Courtroom Interaction

    DEFF Research Database (Denmark)

    Mortensen, Sune Sønderberg; Mortensen, Janus

    2017-01-01

    The oral examination of defendants and witnesses is a cornerstone in most criminal trials, where the weight and credibility of what is said and the certainty with which testimony is delivered will often be decisive for the ruling of the court. This chapter presents a case study of the linguistic...... construction of certainty and uncertainty – or epistemic stance taking – in Danish courtroom interaction. Based on transcribed audio recordings from a criminal trial in Denmark in 2014, we examine the ways in which the defendant, the alleged victim and an eyewitness construct epistemic stances during...

  4. Effects of fatigue on lower limb, pelvis and trunk kinematics and lower limb muscle activity during single-leg landing after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Lessi, Giovanna Camparis; Serrão, Fábio Viadanna

    2017-08-01

    Because there are no studies that have evaluated the effects of fatigue on the kinematics of the trunk and pelvis or on muscle activation in subjects with ACL reconstruction, the aim of this study was to evaluate the effects of fatigue on the lower limb, pelvis and trunk kinematics and lower limb muscle activation in subjects with ACL reconstruction during a single-leg landing compared to a healthy control group. The participants included 20 subjects with ACL reconstruction (ACL reconstruction group-ACLRG) and 20 healthy subjects (control group-CG) who were aged between 18 and 35 years. Kinematic and electromyographic analyses were performed during a single-leg landing before and after fatigue. The fatigue protocol included a series of 10 squats, two vertical jumps, and 20 steps. The effects of fatigue were increased peak trunk flexion and increased activation of the vastus lateralis, biceps femoris (BF) and gluteus maximus (GMax) during the landing phase. After the fatigue protocol, an increase in peak trunk flexion and activation of the GMax and BF were observed, most likely as a strategy to reduce the load on the ACL. ACL injury prevention programs should include strength and endurance exercises for the hip and trunk extensor muscles so that they can efficiently control trunk flexion during landing. Prospective comparative study, Level II.

  5. A comparison of ballet dancers with different level of experience in performing single-leg stance on retiré position.

    Science.gov (United States)

    Lin, Chia-Wei; Lin, Cheng-Feng; Hsue, Bih-Jen; Su, Fong-Chin

    2014-04-01

    The purpose of the current study was to evaluate the postural stability of single-leg standing on the retiré position in ballet dancers having three different levels of skill. Nine superior experienced female ballet dancers, 9 experienced, and 12 novice dancers performed single-leg standing in the retiré position. The parameters of center of pressure (COP) in the anterior-posterior and medial-lateral directions and the maximum distance between COP and the center of mass (COM) were measured. The inclination angles of body segments (head, torso, and supporting leg) in the frontal plane were also calculated. The findings showed that the novice dancers had a trend of greater torso inclination angles than the experienced dancers but that the superior experienced dancers had greater maximum COM-COP distance in the anterior-posterior direction. Furthermore, both experienced and novice dancers had better balance when standing on the nondominant leg, whereas the superior experienced dancers had similar postural stability between legs. Based on the findings, ballet training should put equal focus on both legs and frontal plane control (medial-lateral direction) should be integrated to ballet training program.

  6. Retrospective study of the investigations of children presenting with lower limbs spasticity in a single institution.

    Science.gov (United States)

    Spagnoli, Carlotta; de Sousa, Carlos

    2014-04-01

    This retrospective study was undertaken to identify how children with spasticity entirely or mainly affecting lower limbs are investigated in a single institution, to address the diagnostic yield of these investigations, and to establish an improved diagnostic algorithm. Clinical documents regarding children referred to our institution for the diagnostic investigation of spastic diplegia and receiving their first clinical appointment between the July 1, 2010, and the December 31, 2010, were identified in our electronic database. Clinical correspondence, case-notes, magnetic resonance imaging reports, and other investigation results were reviewed. For the 26 patients (16 males) identified, there was much variability in the investigations offered. In the 53.84% of them, a specific diagnosis was found, including one case of hereditary spastic paraplegia 3A and one of neuroblastoma. Diagnostic rate could be optimized by a more standardized approach to investigations and by rational genetic testing. A comprehensive diagnostic algorithm is proposed for implementation of etiological diagnosis. Georg Thieme Verlag KG Stuttgart · New York.

  7. Mild hallux valgus angle affects single-limb postural stability in asymptomatic subjects.

    Science.gov (United States)

    Çınar-Medeni, Özge; Atalay Guzel, Nevin; Basar, Selda

    2016-01-01

    Single-limb postural stability is a key component of lower extremity functional status. Factors affecting postural stability should be well defined to prevent injuries. The aim of this study was to investigate the effect of the hallux valgus angle on postural stability in asymptomatic subjects. A total of 19 subjects were included in the study. The hallux valgus angle and postural stability were assessed. Participants were assigned to two groups according to whether the hallux valgus angle was pathological or not. A hallux valgus angle greater than 15 degrees was accepted as pathological. The relationship between the hallux valgus angle and postural stability, and the differences in postural stability scores between the two groups were analyzed. Postural stability was assessed with a stabilometer. The test was performed with the eyes open. We found a significant correlation between the hallux valgus angle and mediolateral and overall stability index (r= 0.484, p= 0.036; r = 0.463, p= 0.046 respectively). Subjects with a pathological mild hallux valgus angle had greater stability index scores than normal subjects (phallux valgus angle has negative effects on postural stability as a forefoot deformity. This deformity should be taken into account for injury prevention strategies in pain-free younger adults.

  8. Increased Lower Limb Spasticity but Not Strength or Function Following a Single-Dose Serotonin Reuptake Inhibitor in Chronic Stroke.

    Science.gov (United States)

    Gourab, Krishnaj; Schmit, Brian D; Hornby, T George

    2015-12-01

    To investigate the effects of single doses of a selective serotonin reuptake inhibitor (SSRI) on lower limb voluntary and reflex function in individuals with chronic stroke. Double-blind, randomized, placebo-controlled crossover trial. Outpatient research setting. Individuals (N=10; 7 men; mean age ± SD, 57±10y) with poststroke hemiplegia of >1 year duration who completed all assessments. Patients were assessed before and 5 hours after single-dose, overencapsulated 10-mg doses of escitalopram (SSRI) or placebo, with 1 week between conditions. Primary assessments included maximal ankle and knee isometric strength, and velocity-dependent (30°/s-120°/s) plantarflexor stretch reflexes under passive conditions, and separately during and after 3 superimposed maximal volitional drive to simulate conditions of increased serotonin release. Secondary measures included clinical measures of lower limb coordination and locomotion. SSRI administration significantly increased stretch reflex torques at higher stretch velocities (eg, 90°/s; P=.03), with reflexes at lower velocities enhanced by superimposed voluntary drive (P=.02). No significant improvements were seen in volitional peak torques or in clinical measures of lower limb function (lowest P=.10). Increases in spasticity but not strength or lower limb function were observed with single-dose SSRI administration in individuals with chronic stroke. Further studies should evaluate whether repeated dosing of SSRIs, or as combined with specific interventions, is required to elicit significant benefit of these agents on lower limb function poststroke. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  9. The effect of double versus single oscillating exercise devices on trunk and limb muscle activation.

    Science.gov (United States)

    Arora, Shruti; Button, Duane C; Basset, Fabien A; Behm, David G

    2013-08-01

    Proper strengthening of the core and upper extremities is important for muscular health, performance, and rehabilitation. Exercise devices have been developed that attempt to disrupt the center of gravity in order to activate the trunk stabilizing muscles. The objective of this study was to analyze the trunk and shoulder girdle muscle activation with double and single oscillating exercise devices (DOD and SOD respectively) in various planes. TWELVE MALE SUBJECTS PERFORMED THREE INTERVENTIONS USING BOTH DEVICES UNDER RANDOMIZED CONDITIONS: single-handed vertical orientation of DOD and SOD to produce 1) medio-lateral oscillation in the frontal plane 2) dorso-ventral oscillation in the sagittal plane and 3) single-handed horizontal orientation for superior and inferior oscillation in the transverse plane. Electromyographic (EMG) activity during the interventions of the anterior deltoid, triceps brachii, biceps brachii, forearm flexors as well as lower abdominal and back stabilizer muscles was collected, and were normalized to maximal voluntary contractions. A two way repeated measures ANOVA (2x3) was conducted to assess the influence of the devices and movement planes on muscle activation. The DOD provided 35.9%, 40.8%, and 52.3% greater anterior deltoid, transverse abdominus (TA)/internal oblique (IO) and lumbo-sacral erector spinae (LSES) activation than did the SOD respectively. Effect size calculations revealed that these differences were of moderate to large magnitude (0.86, 0.48, and 0.61 respectively). There were no significant differences in muscular activation achieved between devices for the triceps brachii, biceps brachii and forearm flexor muscles. Exercise in the transverse plane resulted in 30.5%, 29.5%, and 19.5% greater activation than the sagittal and 21.8%, 17.2%, and 26.3% greater activation than the frontal plane for the anterior deltoid, TA/IO and LSES respectively. A DOD demonstrated greater muscular activity for trunk and shoulder muscle

  10. Below the knee PTA in critical limb ischemia results after 12 months: Single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Balzer, Joern O., E-mail: balzerjo@t-online.d [Dept. for Radiology and Nuclear medicine, Catholic Clinic Mainz, An der Goldgrube 11, Mainz 55131 (Germany); Khan, Verena [Dept. of Diagnostic and Interventional Radiology, Clinic Nurnberg North (Germany); Thalhammer, Axel; Vogl, Thomas J.; Lehnert, Thomas [Dept. of Diagnostic and Interventional Radiology, Univ. Clinic, Johann Wolfgang Goethe-University Frankfurt/Main (Germany)

    2010-07-15

    Purpose: Evaluation of angioplasty with bare metal stents in infrapopliteal occlusions or severe stenoses in patients with critical limb ischemia. Material and methods: Percutaneous stent angioplasty was performed in 58 limbs in 47 patients with critical limb ischemia (CLI) in Rutherford stage 4-6. Lesions with up to 5 cm in length with at least one patent vessel below the obstruction were treated. 121 bare metal stents (diameter of 2.5-4 mm; length of 18-38 mm) were implanted. Follow-up examinations were performed up to 12 months postinterventionally using clinical examination, ABI calculation, and color-coded duplex sonography. Patency rates were calculated on the basis of the Kaplan-Meier analysis. Results: Technical success was achieved in 100%. Minor complications (hematoma, distal emboli, vessel dissection) were documented in 5.17% (n = 3) limbs, respectively. The 3-month, 6-month, and 1-year primary patency rate was 93.0%, 78.9% and 66.7%, respectively. 86.9% of the lesions healed postinterventionally. The cumulative limb salvage rate was 96.6%. Conclusion: Stent angioplasty in infrapopliteal arteries is a safe and effective technique for the treatment of patients with CLI. By consequent clinical monitoring high secondary patency rates can be achieved. The use of a bare metal stent seems to result in high limb salvage, primary and secondary patency rates in the mid-term follow-up.

  11. Single cell analysis of caspase-3 in apoptotic and non-apoptotic cells during mouse limb development

    Czech Academy of Sciences Publication Activity Database

    Adamová, Eva; Klepárník, Karel; Matalová, E.

    2014-01-01

    Roč. 3, - (2014), PP58 ISSN 2052-1219. [European Calcified Tissue Society Congress /41./. 17.05.2014-20.05.2014, Praha] R&D Projects: GA ČR GAP206/11/2377; GA ČR(CZ) GA14-28254S Institutional support: RVO:68081715 Keywords : single cell analysis * caspase-3 * mouse limb development Subject RIV: CB - Analytical Chemistry, Separation

  12. Ranking-based Method for News Stance Detection

    KAUST Repository

    Zhang, Qiang

    2018-04-18

    A valuable step towards news veracity assessment is to understand stance from different information sources, and the process is known as the stance detection. Specifically, the stance detection is to detect four kinds of stances (

  13. Safety and walking ability of KAFO users with the C-Brace®Orthotronic Mobility System, a new microprocessor stance and swing control orthosis.

    Science.gov (United States)

    Pröbsting, Eva; Kannenberg, Andreas; Zacharias, Britta

    2017-02-01

    There are clear indications for benefits of stance control orthoses compared to locked knee ankle foot orthoses. However, stance control orthoses still have limited function compared with a sound human leg. The aim of this study was to evaluate the potential benefits of a microprocessor stance and swing control orthosis compared to stance control orthoses and locked knee ankle foot orthoses in activities of daily living. Survey of lower limb orthosis users before and after fitting of a microprocessor stance and swing control orthosis. Thirteen patients with various lower limb pareses completed a baseline survey for their current orthotic device (locked knee ankle foot orthosis or stance control orthosis) and a follow-up for the microprocessor stance and swing control orthosis with the Orthosis Evaluation Questionnaire, a new self-reported outcome measure devised by modifying the Prosthesis Evaluation Questionnaire for use in lower limb orthotics and the Activities of Daily Living Questionnaire. The Orthosis Evaluation Questionnaire results demonstrated significant improvements by microprocessor stance and swing control orthosis use in the total score and the domains of ambulation ( p = .001), paretic limb health ( p = .04), sounds ( p = .02), and well-being ( p = .01). Activities of Daily Living Questionnaire results showed significant improvements with the microprocessor stance and swing control orthosis with regard to perceived safety and difficulty of activities of daily living. The microprocessor stance and swing control orthosis may facilitate an easier, more physiological, and safer execution of many activities of daily living compared to traditional leg orthosis technologies. Clinical relevance This study compared patient-reported outcomes of a microprocessor stance and swing control orthosis (C-Brace) to those with traditional knee ankle foot orthosis and stance control orthosis devices. The C-Brace offers new functions including controlled

  14. The intentional stance and cultural learning

    DEFF Research Database (Denmark)

    Michael, John Andrew

    2015-01-01

    In this paper, I propose a developmental explanation of the reliability of the intentional stance as an interpretive strategy, and by doing so counter an objection to Dennett’s intentional stance theory (i.e.the ‘If it isn’t true, why does it work?’ objection). Specifically, young children’s use...... of the intentional stance enables them to learn from and thereby to become more similar to the adults in their culture. Asa result, they themselves become increasingly intelligible to other people taking the intentional stance.Thus, the intentional stance and cultural learning constitute a feedback loop...... that (partially) explainsthe reliability of the intentional stance, and does so – contra Dennett’s realist critics – without appealing to a realist interpretation of the descriptions speakers attach to intentional terms. However, I also suggest that this developmental perspective provides grist to the mill...

  15. Epidemiologic data of trauma-related lower limb amputees: A single center 10-year experience.

    Science.gov (United States)

    Yaşar, Evren; Tok, Fatih; Kesikburun, Serdar; Ada, A Mustafa; Kelle, Bayram; Göktepe, A Salim; Yazıcıoğlu, Kamil; Tan, A Kenan

    2017-02-01

    The aim of this study is three fold: 1) to introduce epidemiologic data of patients with trauma-related amputations as a 10-year experience of a rehabitation center; 2) to determine comorbidities and secondary conditions of lower limb loss; 3) to determine the rehospitalization reasons for lower limb amputee patients. This retrospective study was conducted in a tertiary rehabilitation center in Turkey. Clinical and demographic data of amputees including sex, age, employment status, time since amputation, time after amputation to first hospitalization, length of hospitalization, how many times the patient was hospitalized, reason for hospitalization, stump complications, comorbid conditions, amputation level and K classifacation were documented. Three hundred ninetynine patients with a mean age of 23,48±6,04 (4-74) years were included in this study. Mean duration after amputation was 119,71±68,86months. Patients were 3,43±2,53 times hospitalized. Landmine explosion was the most common etiology of amputation with 370 patients (92.7%). Below knee amputation was the most common amputation level with 230 (50,77%) amputations. 399 patients were hospitalized 1369 times and the most common hospitalization reason were stump complications (356 times, 26,00%). Spur formation (202 times) was the most common stump complications. Pyscologic disorders were the most common comorbidity with 68 patient (37,56%). Patients with traumatic limb amputations are likely to experience several complications and comorbidities. Prevention of secondary conditions affecting those living with the loss of a limb is an important part of amputee rehabilitation and may prevent rehospitalization. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. 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

    , 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.......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...

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

    Directory of Open Access Journals (Sweden)

    Simic Milena

    2010-11-01

    Full Text Available Abstract Background 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 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. Methods Twenty-five (17 women non-injured participants (mean age 25.6 years, range 18-37 were included. Visual analysis of the medio-lateral knee motion, scored as knee-over-foot or knee-medial-to-foot by two raters, and 3-D kinematic data were collected simultaneously during a single-limb mini squat. Frontal plane 2-D peak tibial, thigh, and knee varus-valgus angles, and 3-D peak hip internal-external rotation, and knee varus-valgus angles were calculated. Results Ten subjects were scored as having a knee-medial-to-foot position and 15 subjects a knee-over-foot position assessed by visual inspection. In 2-D, the peak tibial angle (mean 89.0 (SE 0.7 vs mean 86.3 (SE 0.4 degrees, p = 0.001 and peak thigh angle (mean 77.4 (SE 1.0 vs mean 81.2 (SE 0.5 degrees, p = 0.001 with respect to the horizontal, indicated that the knee was more medially placed than the ankle and thigh, respectively. Thus, the knee was in more valgus (mean 11.6 (SE 1.5 vs 5.0 (SE 0.8 degrees, p 0.90 and 96 between raters. Conclusions Medio-lateral motion of the knee can reliably be assessed during a single-leg mini-squat. The test is valid in 2-D, while the actual movement, in 3-D, is mainly exhibited as increased internal hip rotation. The single-limb mini squat is feasible and easy to administer in the clinical setting and in research to address lower extremity movement quality.

  18. Real-time gait event detection for lower limb amputees using a single wearable sensor.

    Science.gov (United States)

    Maqbool, H F; Husman, M A B; Awad, M I; Abouhossein, A; Mehryar, P; Iqbal, N; Dehghani-Sanij, A A

    2016-08-01

    This paper presents a rule-based real-time gait event/phase detection system (R-GEDS) using a shank mounted inertial measurement unit (IMU) for lower limb amputees during the level ground walking. Development of the algorithm is based on the shank angular velocity in the sagittal plane and linear acceleration signal in the shank longitudinal direction. System performance was evaluated with four control subjects (CS) and one transfemoral amputee (TFA) and the results were validated with four FlexiForce footswitches (FSW). The results showed a data latency for initial contact (IC) and toe off (TO) within a range of ± 40 ms for both CS and TFA. A delay of about 3.7 ± 62 ms for a foot-flat start (FFS) and an early detection of -9.4 ± 66 ms for heel-off (HO) was found for CS. Prosthetic side showed an early detection of -105 ± 95 ms for FFS whereas intact side showed a delay of 141 ±73 ms for HO. The difference in the kinematics of the TFA and CS is one of the potential reasons for high variations in the time difference. Overall, detection accuracy was 99.78% for all the events in both groups. Based on the validated results, the proposed system can be used to accurately detect the temporal gait events in real-time that leads to the detection of gait phase system and therefore, can be utilized in gait analysis applications and the control of lower limb prostheses.

  19. The effect of different skin-ankle brace application pressures with and without shoes on single-limb balance, electromyographic activation onset and peroneal reaction time of lower limb muscles.

    Science.gov (United States)

    Papadopoulos, E S; Nikolopoulos, C S; Athanasopoulos, S

    2008-12-01

    Several studies have been carried out in order to investigate the effect of ankle bracing on ankle joint function and performance. However, no study so far has examined the role of skin-brace interface pressure in neuromuscular control. The aim of this study was to investigate the effect of different skin-ankle brace interface pressures, with and without shoes, on quiet single-limb balance and the electromyographic (EMG) activation sequence of four lower limb muscles. Twelve male physical education students who volunteered to take part in the study were measured with and without shoes under three ankle brace conditions: (i) without brace, (ii) with brace and 30 kilopascals (kPa) application pressure and (iii) with brace and 60 kPa application pressure. Single-limb balance (anteroposterior and mediolateral parameter) was assessed on the dominant lower limb, with open and closed eyes, on a force platform, simultaneously with the EMG recording of four lower lower limb muscles' (gastrocnemius, peroneus longus, rectus femoris and biceps femoris) activation onset. Peroneus longus reaction time was also measured by provoking a sudden subtalar inversion stress test using a trap-door. The results showed that the application of athletic footwear resulted in a significant difference between the condition with shoes and without shoes, with a significantly increased anteroposterior sway and sway velocity, in all three ankle brace application conditions with shoes (F=50.9, d.f.=1, plower limb muscles. Lastly, ankle brace application with 30 and 60 kPa application pressures, with and without athletic footwear, led to a significant delay in the peroneus longus reaction time (F=9.71, d.f.=2, plimb balance, and peroneal reaction time. The application of athletic footwear, further adversely affects these parameters significantly. Further research is needed in this area with more dynamic and functional measurements, before the safe use of ankle bracing can be widely recommended.

  20. Impact of stance phase microprocessor-controlled knee prosthesis on ramp negotiation and community walking function in K2 level transfemoral amputees.

    Science.gov (United States)

    Burnfield, Judith M; Eberly, Valerie J; Gronely, Joanne K; Perry, Jacquelin; Yule, William Jared; Mulroy, Sara J

    2012-03-01

    Microprocessor controlled prosthetic knees (MPK) offer opportunities for improved walking stability and function, but some devices' swing phase features may exceed needs of users with invariable cadence. One MPK offers computerized control of only stance (C-Leg Compact). To assess Medicare Functional Classification Level K2 walkers' ramp negotiation performance, function and balance while using a non-MPK (NMPK) compared to the C-Leg Compact. Crossover. Gait while ascending and descending a ramp (stride characteristics, kinematics, electromyography) and function were assessed in participant's existing NMPK and again in the C-Leg Compact following accommodation. Ramp ascent and descent were markedly faster in the C-Leg Compact compared to the NMPK (p ≤ 0.006), owing to increases in stride length (p ≤ 0.020) and cadence (p ≤ 0.020). Residual limb peak knee flexion and ankle dorsiflexion were significantly greater (12.9° and 4.9° more, respectively) during single limb support while using the C-Leg Compact to descend ramps. Electromyography (mean, peak) did not differ significantly between prosthesis. Function improved in the C-Leg Compact as evidenced by a significantly faster Timed Up and Go and higher functional questionnaire scores. Transfemoral K2 walkers exhibited significantly improved function and balance while using the stance-phase only MPK compared to their traditional NMPK.

  1. Limb Prosthetics

    Science.gov (United States)

    ... Catheter Insertion Additional Content Medical News Overview of Limb Prosthetics By James Baird, CPO, Director of Education, Hanger ... DOCTORS: Click here for the Professional Version Limb Prosthetics Overview of Limb Prosthetics Prosthetic Parts Options for Limb Prostheses Preparing ...

  2. Impact of a stance phase microprocessor-controlled knee prosthesis on level walking in lower functioning individuals with a transfemoral amputation.

    Science.gov (United States)

    Eberly, Valerie J; Mulroy, Sara J; Gronley, JoAnne K; Perry, Jacquelin; Yule, William J; Burnfield, Judith M

    2014-12-01

    For individuals with transfemoral amputation, walking with a prosthesis presents challenges to stability and increases the demand on the hip of the prosthetic limb. Increasing age or comorbidities magnify these challenges. Computerized prosthetic knee joints improve stability and efficiency of gait, but are seldom prescribed for less physically capable walkers who may benefit from them. To compare level walking function while wearing a microprocessor-controlled knee (C-Leg Compact) prosthesis to a traditionally prescribed non-microprocessor-controlled knee prosthesis for Medicare Functional Classification Level K-2 walkers. Crossover. Stride characteristics, kinematics, kinetics, and electromyographic activity were recorded in 10 participants while walking with non-microprocessor-controlled knee and Compact prostheses. Walking with the Compact produced significant increase in velocity, cadence, stride length, single-limb support, and heel-rise timing compared to walking with the non-microprocessor-controlled knee prosthesis. Hip and thigh extension during late stance improved bilaterally. Ankle dorsiflexion, knee extension, and hip flexion moments of the prosthetic limb were significantly improved. Improvements in walking function and stability on the prosthetic limb were demonstrated by the K-2 level walkers when using the C-Leg Compact prosthesis. Understanding the impact of new prosthetic designs on gait mechanics is essential to improve prescription guidelines for deconditioned or older persons with transfemoral amputation. Prosthetic designs that improve stability for safety and walking function have the potential to improve community participation and quality of life. © The International Society for Prosthetics and Orthotics 2013.

  3. Toward a Situated Stance in Organizational Institutionalism

    DEFF Research Database (Denmark)

    Boxenbaum, Eva

    2014-01-01

    Organizational Institutionalism is gradually embracing a more situated, actor-centered stance that is prompting empirical inquiry into how embedded actors respond to institutional complexity. French Pragmatist Sociology can contribute to this endeavor because it provides a situated, relational......, and practice-oriented framework for studying how actors negotiate and justify actions through shared moral “worlds” that are akin to institutional logics. French Pragmatist Sociology can help illuminate three questions that are key to a situated stance in Organizational Institutionalism: (a) How free...

  4. Inter-joint coordination strategies during unilateral stance following first-time, acute lateral ankle sprain: A brief report.

    Science.gov (United States)

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Sweeney, Kevin; Delahunt, Eamonn

    2015-07-01

    This investigation combined measures of inter-joint coordination and stabilometry to evaluate eyes-open (condition 1) and eyes-closed (condition 2) static unilateral stance performance in a group of participants with an acute, first-time lateral ankle sprain injury in comparison to a control group. Sixty-six participants with an acute first-time lateral ankle sprain and 19 non-injured controls completed three 20-second unilateral stance task trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb 3-D kinematic data for similarity in the aim of establishing patterns of inter-joint coordination for these groups. Between-group analyses revealed significant differences in stance limb inter-joint coordination strategies for conditions 1 and 2. Injured participants displayed increases in ankle-hip linked coordination compared to controls in condition 1 (sagittal/frontal plane: 0.12 [0.09] vs 0.06 [0.04]; η(2)=.16) and condition 2 (sagittal/frontal plane: 0.18 [0.13] vs 0.08 [0.06]; η(2)=0.37). Participants with acute first-time lateral ankle sprain exhibit a hip-dominant coordination strategy for static unilateral stance compared to non-injured controls. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Interpersonal Stance in Conflict Conversation: Police Interviews

    NARCIS (Netherlands)

    Bruijnes, Merijn

    2013-01-01

    In this work we focus on the dynamics of the conflict that often arises in a police interview between suspects and police officers. Police interviews are a special type of social encounter, primarily because of the authority role of the police interviewer and the often uncooperative stance that the

  6. Numerical time-domain modelling of hoof-ground interaction during the stance phase.

    Science.gov (United States)

    Behnke, R

    2017-11-09

    Hoof-ground interaction impacts on the health and performance characteristics of horses. Due to complex interactions between hoof and ground during the stance phase, previous experimentally dominated studies concentrated on subproblems of the phenomena observed. A multidisciplinary methodology with mathematical modelling, material testing and in vivo experimental measurements seems promising. With the help of a mathematical approach, this contribution aims to explain from a biomechanical point of view the phenomena observed during experimental investigations (hoof acceleration, interacting forces) and aims to contribute to an overall experimental-mathematical multidisciplinary approach. In silico modelling of hoof-ground interaction (limb, hoof and horizontally unbounded ground). Hoof-ground interaction is represented by a time-domain finite element model including the limb, the hoof and the unbounded representation of the ground via the scaled boundary finite element method to capture radiation damping during the stance phase. Motoric forces (driving forces) of the horse during locomotion are included. Numerical model results for acceleration-time relations (hoof) at different trotting velocities are compared with previously published acceleration-time relations and show qualitative agreement. From the model approach, power loss due to different ground properties and ground damping is computed in combination with the maximum limb force during the stance phase. Intentionally, a simplified model approach for the material and structural representation of the limb, the hoof and the ground in terms of material features and spatial resolution has been used for this study, which might be the basis for a model refinement in terms of contact properties as well as the integration of bone and joint structures. The comparison to experimentally obtained results demonstrates the applicability of the model, which, in turn, enables an insight into the processes taking place

  7. Lower limb muscle pre-motor time measures during a choice reaction task associate with knee abduction loads during dynamic single leg landings.

    Science.gov (United States)

    McLean, Scott G; Borotikar, Bhushan; Lucey, Sarah M

    2010-07-01

    Female neuromuscular control during dynamic landings is considered central to their increased ACL injury risk relative to males. There is limited insight, however, into the neuromuscular parameters governing this risk, which may hinder prevention success. This study targeted a new screenable and potentially trainable neuromuscular risk factor. Specifically, we examined whether lower limb muscle pre-motor times, being the time between stimulus presentation and initiation of the muscle EMG burst, elicited during a simple choice reaction task correlated with knee abduction loads during separate single leg landings. Twenty female NCAA athletes had muscle (n=8) pre-motor time and knee biomechanics data recorded bilaterally during a choice reaction task. Knee biomechanics were also quantified during anticipated and unanticipated single (dominant and non-dominant) leg landings. Mean peak knee abduction loads during landings were submitted to a two-way ANOVA to test for limb and decision effects. Individual regression coefficients were initially computed between-limb-based muscle pre-motor times and peak abduction moments elicited during both the choice reaction and landing tasks. Limb-based linear stepwise regression coefficients were also computed between muscle PMT's demonstrating significant (Pmuscle pre-motor times during a specific choice reaction task are associated with peak knee abduction loads during separate single leg landings. These muscles appear critical in stabilizing the knee against the extreme dynamic load states associated with such tasks. Targeted screening and training of supraspinal processes governing these muscle pre-motor times may ultimately enable external knee loads associated with landings to be more effectively countered by the overarching neuromuscular strategy. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  8. Effect of Feedback Corrective Exercise on Knee Valgus and Electromyographic Activity of Lower Limb Muscles in Single Leg Squat

    Directory of Open Access Journals (Sweden)

    Negar Koorosh-fard

    2015-07-01

    Full Text Available Objective: The aim of this study was assessing the effect of feedback correcting exercise in front of mirror during running on frontal plane knee and pelvic kinematic and electromyography activity of some lower extremity muscles in single leg squat (SLS. Materials & Methods: This study was quasi experimental. 23 active female subjects participated in two experimental and control groups with mean age (21.86± 2.43 years .experimental group contains subjects with knee valgus and pelvic drop angle more than a mean plus one standard deviation of the population in functional SLS. Muscular activity (RMS of gluteus maximus, Gluteus medius, rectus femoris, vastus medialis, vastus lateralis, biceps femoris and semitendinosus, angle of knee valgus and pelvic drop were register in end of SLS Pre and post of 8 training sessions. Comparing Variable has done with independent t statistical test between 2 groups and pair sample t test within each groups with significant level of 0.05. Results: Statistical analysis Before training showed no significant differences in pelvic drop between two groups (P&ge0.05, but knee valgus angle was significantly more than control group (P&le0.05. In spit that most muscle activities (% MVC except biceps femoris (P&le0.05, were greater in experimental group, no significant difference (P&ge0.05 has seen in two groups. Comparing pre and post test has showed no significant difference in knee valgus of experimental group, however it decreased around 2 degrees and although %MVC decreased in all muscles, just rectuse femoris has shown significant difference (P&le0.05. No significant difference has seen in control group in all variables (P&ge0.05. Conclusion: Findings showed poor neuromuscular control in experimental group which improved to some extent after training because lower muscle activity and energy consumption in specific movement with similar kinematic indicate improvement of motor control or cause learning. It seems that

  9. Use of physical therapy in a dog with bilateral severe plantigrade stance.

    Science.gov (United States)

    Ree, Jennifer; Hayashi, Kei; Woelz, Jacqueline; Kim, Sun Young

    2015-01-01

    A 3.5 yr old spayed female Staffordshire terrier weighing 25.5 kg was presented with a 7 wk history of bilateral plantigrade stance in the pelvic limbs directly following an ovariohysterectomy procedure. Upon presentation, the dog had bilateral atrophy of the distal pelvic limb muscles, enlarged popliteal lymph nodes, and ulcerative wounds on the dorsa of her rear paws. Orthopedic examination revealed intact calcaneal tendons bilaterally and neurologic examination localized the lesion to the distal sciatic nerve. A diagnosis of compressive and stretch neuropathy was made affecting the distal sciatic nerve branches. Physical therapy modalities included neuromuscular electrical stimulation, ultrasound, and low-level laser therapy. Other therapeutic modalities included the use of orthotics and progressive wound care. The dog had increased muscle mass, return of segmental reflexes, return of nociception, and the ability to walk on pelvic limbs with higher carriage of the hock 15 mo following presentation. The use of custom orthotics greatly increased the quality of life and other physical therapy modalities may have improved the prognosis in this dog with severe bilateral plantigrade stance due to neuropathy.

  10. Assessing the effect of high-repetitive single limb exercises (HRSLE) on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD): study protocol for randomized controlled trial

    OpenAIRE

    Nyberg, Andre; Lindström, Britta; Wadell, Karin

    2012-01-01

    Abstract Background Single-limb knee extension exercises have been found to be effective at improving lower extremity exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Since the positive local physiological effects of exercise training only occur in the engaged muscle(s), should upper extremity muscles also be included to determine the effect of single limb exercises in COPD patients. Methods/design Trial design: a prospective, assessor-blind, block randomized c...

  11. Inter-joint coordination strategies during unilateral stance 6-months following first-time lateral ankle sprain.

    Science.gov (United States)

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Sweeney, Kevin; Delahunt, Eamonn

    2015-02-01

    Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This investigation combined measures of inter-joint coordination and stabilometry to evaluate eyes-open (condition 1) and eyes-closed (condition 2) static unilateral stance performance in a group of participants, 6-months after they sustained an acute, first-time lateral ankle sprain in comparison to a control group. Sixty-nine participants with a 6-month history of first-time lateral ankle sprain and 20 non-injured controls completed three 20-second unilateral stance task trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb 3-dimensional kinematic data for similarity in the aim of establishing patterns of lower-limb inter-joint coordination. The fractal dimension of the stance limb centre of pressure path was also calculated. Between-group analyses revealed significant differences in stance limb inter-joint coordination strategies for conditions 1 and 2, and in the fractal dimension of the centre-of-pressure path for condition 2 only. Injured participants displayed increases in ankle-hip linked coordination compared to controls in condition 1 (sagittal/frontal plane: 0.15 [0.14] vs 0.06 [0.04]; η(2)=.19; sagittal/transverse plane: 0.14 [0.11] vs 0.09 [0.05]; η(2)=0.14) and condition 2 (sagittal/frontal plane: 0.15 [0.12] vs 0.08 [0.06]; η(2)=0.23), with an associated decrease in the fractal dimension of the centre-of-pressure path (injured limb: 1.23 [0.13] vs 1.36 [0.13]; η(2)=0.20). Participants with a 6-month history of first-time lateral ankle sprain exhibit a hip-dominant coordination strategy for static unilateral stance compared to non-injured controls. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. The effects of acute experimental hip muscle pain on dynamic single-limb balance performance in healthy middle-aged adults.

    Science.gov (United States)

    Hatton, Anna L; Hug, François; Chen, Sarah H; Reid, Christine; Sorensen, Nicole A; Tucker, Kylie

    2016-10-01

    Middle-aged adults with painful hip conditions show balance impairments that are consistent with an increased risk of falls. Pathological changes at the hip, accompanied by pain, may accelerate pre-existing age-related balance deficits present in midlife. To consider the influence of pain alone, we investigated the effects of acute experimental hip muscle pain on dynamic single-limb balance in middle-aged adults. Thirty-four healthy adults aged 40-60 years formed two groups (Group-1: n=16; Group-2: n=18). Participants performed four tasks: Reactive Sideways Stepping (ReactSide); Star Excursion Balance Test (SEBT); Step Test; Single-Limb Squat; before and after an injection of hypertonic saline into the right gluteus medius muscle (Group-1) or ∼5min rest (Group-2). Balance measures included the range and standard deviation of centre of pressure (CoP) movement in mediolateral and anterior-posterior directions, and CoP total path velocity (ReactSide, Squat); reach distance (SEBT); and number of completed steps (Step Test). Data were assessed using three-way analysis of variance. Motor outcomes were altered during the second repetition of tasks irrespective of exposure to experimental hip muscle pain or rest, with reduced SEBT anterior reach (-1.2±4.1cm, P=0.027); greater step number during Step Test (1.5±1.7 steps, PCoP velocity during Single-Limb Squat (-4.9±9.4mms -1 , P=0.024). Factors other than the presence of pain may play a greater role in balance impairments in middle-aged adults with hip pathologies. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. The effect of limb amputation on standing weight distribution in the remaining three limbs in dogs.

    Science.gov (United States)

    Cole, Grayson Lee; Millis, Darryl

    2017-01-16

    Despite the fact that limb amputation is a commonly performed procedure in veterinary medicine, quantitative data regarding outcomes are lacking. The intention of this study was to evaluate the effect of limb amputation on weight distribution to the remaining three limbs at a stance in dogs. Ten dogs with a prior forelimb amputation and ten dogs with a prior hindlimb amputation; all of which had no history of orthopaedic or neural disease in the remaining three limbs were included in the study. Standing weight bearing was evaluated with a commercial stance analyzer in all dogs. Five valid trials were obtained and a mean percentage of weight bearing was calculated for each remaining limb. The dogs with a previous forelimb amputation, and also those with a previous hindlimb amputation, had the largest mean increase in weight bearing in the contralateral forelimb. In conclusion, proactive monitoring of orthopaedic disease in the contralateral forelimb may be advisable in dogs with a previous limb amputation. In addition, when determining candidacy for a limb amputation, disease of the contralateral forelimb should be thoroughly evaluated.

  14. Adult-acquired flatfoot deformity and age-related differences in foot and ankle kinematics during the single-limb heel-rise test.

    Science.gov (United States)

    Chimenti, Ruth L; Tome, Joshua; Hillin, Cody D; Flemister, Adolph S; Houck, Jeff

    2014-04-01

    Cross-sectional laboratory study. To compare single-limb heel-rise performance and foot-ankle kinematics between persons with stage 2 adult-acquired flat foot deformity (AAFD) and healthy controls. The inability to perform a single-limb heel rise is considered a positive functional diagnostic test for AAFD. However, which foot motions contribute to poor performance of this task are not known. Fifty individuals participated in this study, 20 with stage 2 AAFD (mean ± SD age, 57.6 ± 11.3 years), and 15 older participants (age, 56.8 ± 5.3 years) and 15 younger participants (age, 22.2 ± 2.4 years) without AAFD as control groups. Forefoot (sagittal plane) and rear foot (sagittal and frontal planes) kinematics were collected using a 3-D motion analysis system. Heel-rise performance (heel height) and kinematics (joint angles, excursions) were evaluated. One-way and 2-way analyses of variance were used to examine differences in heel-rise performance and kinematics between groups. Individuals with AAFD and older controls demonstrated lower heel-rise height than those in the younger control group (Pfoot kinematics in the sagittal plane, as opposed to the frontal plane, contributed to the lower heel height in participants with stage 2 AAFD. Older controls demonstrated lower heel-rise height than younger controls, indicating that clinical expectations of heel-rise performance may need to be adjusted for age.

  15. Limb anomalies

    DEFF Research Database (Denmark)

    Gurrieri, Fiorella; Kjær, Klaus Wilbrandt; Sangiorgi, Eugenio

    2002-01-01

    In this review we describe the developmental mechanisms involved in the making of a limb, by focusing on the nature and types of interactions of the molecules that play a part in the regulation of limb patterning and characterizing clinical conditions that are known to result from the abnormal...... of limb development has been conserved for more than 300 millions years, with all the necessary adaptive modifications occurring throughout evolution, we also take into consideration the evolutionary aspects of limb development in terms of genetic repertoire, molecular pathways, and morphogenetic events....

  16. Mobility function of a prosthetic knee joint with an automatic stance phase lock.

    Science.gov (United States)

    Andrysek, Jan; Klejman, Susan; Torres-Moreno, Ricardo; Heim, Winfried; Steinnagel, Bryan; Glasford, Shane

    2011-06-01

    There is a need for a prosthetic knee joint design that is technologically and functionally appropriate for use in developing countries. To develop and clinically evaluate a new type of stance phase controlled prosthetic knee joint that provides stance phase stability without inhibiting swing phase flexion. A crossover repeated measures study design comparing the new knee joint to the participant's conventional low- or high-end prosthetic knee joint. The new knee joint was fitted to fourteen individuals aged 15 to 67 years with unilateral lower limb amputations. Walk tests were performed to measure walking speed. Energy expenditure was estimated using the physiological cost index (PCI). Walking speeds with the new knee joint were on average 0.14 m/s faster than conventional low-end knees (p < 0.0001), but 0.07 m/s slower than conventional high-end prosthetic knees (p = 0.008). The PCI was similar across all three knee joint technologies (p = 0.276). Mobility function with the new knee joint, in terms of walking speed, was more closely matched to high-end than low-end prosthetic knee joints. Therefore, given its relatively simple design, the new stance phase control mechanism may offer a functional and cost effective solution for active transfemoral amputees. This paper describes a new type of prosthetic knee joint mechanism that is intended to be cost-effective while providing high-level stance phase function to active individuals with a transfemoral amputation. Initial clinical testing suggests that the new knee joint may have some functional advantages over existing technologies in this category.

  17. Combination of eccentric exercise and neuromuscular electrical stimulation to improve biomechanical limb symmetry after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Lepley, Lindsey K; Wojtys, Edward M; Palmieri-Smith, Riann M

    2015-08-01

    We have previously reported that an eccentrically-based rehabilitation protocol post-ACLr induced greater quadriceps activation and strength than a neuromuscular electrical stimulation (NMES) intervention and was just as effective as a combined NMES and eccentric intervention. However, the effect an eccentrically-based intervention has on restoring normal knee mechanics during a single-legged landing task remains unknown. Thirty-six individuals post-injury were placed into four treatment groups: NMES and eccentrics, eccentrics-only, NMES-only, standard of care, and healthy controls participated. NMES and eccentrics received a combined NMES and eccentric protocol post-reconstruction (each treatment 2× per week for 6 weeks), whereas groups NMES-only and eccentric-only received only the NMES or eccentric therapy, respectively. To evaluate knee mechanics limb symmetry, the area under the curve for knee flexion angle and extension moment was derived and then normalized to the contralateral limb. Quadriceps strength was evaluated using the quadriceps index. Compared to healthy, reduced sagittal plane knee limb symmetry was found for groups NMES-only, ECC-only and standard of care for knee extension moment (P0.06). No difference between groups was detected for knee flexion angle limb symmetry (P>0.05). Greater knee flexion angles and moments over stance were related to quadriceps strength. The NMES and eccentrics group was found to restore biomechanical limb symmetry that was most closely related to healthy individuals following ACL reconstruction. Greater knee flexion angles and moments over stance were related to quadriceps strength. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Imaging the Intentional Stance in a Competitive Game

    DEFF Research Database (Denmark)

    Gallagher, Helen; Jack, Anthony I.; Roepstorff, Andreas

    2002-01-01

    The "intentional stance" is the disposition to treat an entity as a rational agent, possessing particular beliefs, desires, and intentions, in order to interpret and predict it's behavior. The intentional stance is a component of a broader social cognitive function, mentalizing. Here we report a ...

  19. Effects of 4-week slackline training on lower limb joint motion and muscle activation.

    Science.gov (United States)

    Pfusterschmied, Jürgen; Stöggl, Thomas; Buchecker, Michael; Lindinger, Stefan; Wagner, Herbert; Müller, Erich

    2013-11-01

    To investigate the effects of four weeks of slacklining on lower limb kinematics and muscle activity following a slip of the upright stance. A randomized, gender matched study. Twenty-four young healthy adults participated in the study and were assigned to either a training or a control group. The training group completed a 4-week training program on slacklines, while the control group received no slackline training. Before and after training, participants performed single leg standing tasks on a moveable platform. During medio-lateral platform perturbation, platform displacement, lower limb joint motion (ankle, knee and hip) and surface electromyography (EMG) measurements from six lower limb muscles were recorded. In the training group, a decrease in platform mean and maximum velocity (all p0.05) of the platform. Regarding lower limb kinematics, a reduced corrective action was detected in the knee joint (pslacklining can improve postural control and enhance functional knee joint stability, which seems to be induced by enhanced preparatory muscle activation of the rectus femoris. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Single-stage multilevel soft-tissue surgery in the lower limbs with spastic cerebral palsy: Experience from a rehabilitation unit

    Directory of Open Access Journals (Sweden)

    Gupta Anupam

    2008-01-01

    Full Text Available Background: To assess the effect of single-stage multilevel soft-tissue surgery (Single Event Multiple Level Resections, SEMLR on deformities and locomotion in patients with cerebral palsy (CP with static contracture(s in lower limbs. Patients and Methods: Study included 34 patients (M:F, 23:11 with mean age of 9.53 ± 3.92 years (4-16 years. Among them 22 had diplegia and four each had quadriplegia and right and left hemiplegia. Fourteen patients (41.2% had their intelligence quotient (IQ in the normal range (IQ ≥ 80, while others had mental retardation (MR of varying severity: borderline MR (IQ = 70-79 in 12, mild MR (IQ = 50-69 in 5, and moderate MR (IQ = 35-49 in patients 3. All patients underwent surgery (total number of procedures 153, average 4.5 procedures/patient over a period of 30 months (April 2005 to September 2007. Improvement in functional abilities and locomotion was assessed using Gross Motor Functional Classification Scale (GMFCS scores and by physical examination. Results: Significant improvement in function was observed ( P = 0.000 after surgery when comparing the preoperative and postoperative GMFCS scores. All patients were maintaining ambulation at a mean follow-up duration of 13.12 ± 6.07 months (3-24 months, with five patients using knee-ankle-foot orthoses (KAFO, 22 using ankle-foot orthoses (AFO, and six patients using knee gaiters. Sixteen patients were using walker, and two were using crutches as assistive devices. Conclusion: This study suggests that CP patients with good trunk control and static contractures at multiple joints in the lower limbs can be made ambulant with single-stage multilevel soft-tissue surgery. It has to be a team effort of the surgeon and the rehabilitation team in the postoperative period for the attainment of satisfactory goal.

  1. A simple method of equine limb force vector analysis and its potential applications

    Directory of Open Access Journals (Sweden)

    Sarah Jane Hobbs

    2018-02-01

    Full Text Available Background Ground reaction forces (GRF measured during equine gait analysis are typically evaluated by analyzing discrete values obtained from continuous force-time data for the vertical, longitudinal and transverse GRF components. This paper describes a simple, temporo-spatial method of displaying and analyzing sagittal plane GRF vectors. In addition, the application of statistical parametric mapping (SPM is introduced to analyse differences between contra-lateral fore and hindlimb force-time curves throughout the stance phase. The overall aim of the study was to demonstrate alternative methods of evaluating functional (asymmetry within horses. Methods GRF and kinematic data were collected from 10 horses trotting over a series of four force plates (120 Hz. The kinematic data were used to determine clean hoof contacts. The stance phase of each hoof was determined using a 50 N threshold. Vertical and longitudinal GRF for each stance phase were plotted both as force-time curves and as force vector diagrams in which vectors originating at the centre of pressure on the force plate were drawn at intervals of 8.3 ms for the duration of stance. Visual evaluation was facilitated by overlay of the vector diagrams for different limbs. Summary vectors representing the magnitude (VecMag and direction (VecAng of the mean force over the entire stance phase were superimposed on the force vector diagram. Typical measurements extracted from the force-time curves (peak forces, impulses were compared with VecMag and VecAng using partial correlation (controlling for speed. Paired samples t-tests (left v. right diagonal pair comparison and high v. low vertical force diagonal pair comparison were performed on discrete and vector variables using traditional methods and Hotelling’s T2 tests on normalized stance phase data using SPM. Results Evidence from traditional statistical tests suggested that VecMag is more influenced by the vertical force and impulse, whereas

  2. Shoulder motion assistance using a single-joint Hybrid Assistive Limb®robot: Evaluation of its safety and validity in healthy adults.

    Science.gov (United States)

    Makihara, Takeshi; Kadone, Hideki; Onishi, Shinzo; Kubota, Shigeki; Hada, Yasushi; Shimizu, Yukiyo; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi

    2017-01-01

    To evaluate the feasibility of using the single-joint Hybrid Assistive Limb ® robot (HAL) to assist with shoulder flexion-extension in healthy adults, and to assess the capacity of the HAL to analyze the bioelectrical signals of muscle activity for shoulder flexion-extension. This cross-sectional feasibility study included six healthy adult men with no impairment in shoulder motion. The single-joint HAL was fixed to a custom-designed platform and upper arm attachment, and aligned 3 cm below the acromion process. Vital signs, shoulder fatigue, and shoulder pain were evaluated before and after the shoulder elevation exercise performed with and without the HAL. Activity of selected muscles of the shoulder was recorded using a wireless superficial electromyography device. Shoulder movement was captured using a three-dimensional motion analysis system. The HAL supported smooth flexion-extension of the arm at the shoulder joint, with no negative effects on vital signs, shoulder fatigue, and shoulder pain. The HAL decreased muscle activity levels, with a 55% decrease in trapezius muscle activity. The upward rotation angle of the scapula was significantly lower with the HAL at 120° of shoulder flexion. The single-joint HAL provided safe and effective assistance to scapular plane shoulder flexion-extension among healthy adults.

  3. Lower Limb Symmetry: Comparison of Muscular Power Between Dominant and Nondominant Legs in Healthy Young Adults Associated With Single-Leg-Dominant Sports.

    Science.gov (United States)

    Vaisman, Alex; Guiloff, Rodrigo; Rojas, Juan; Delgado, Iris; Figueroa, David; Calvo, Rafael

    2017-12-01

    Achieving a symmetrical power performance (difference symmetry does not act as a viable comparison. To (1) compare maximal muscular power between the dominant and nondominant legs in healthy young adults, (2) evaluate the effect of a single-leg-dominant sport activity performed at the professional level, and (3) propose a parameter of normality for maximal power difference in the lower limbs of this young adult population. Controlled laboratory study. A total of 78 healthy, male, young adults were divided into 2 groups according to sport activity level. Group 1 consisted of 51 nonathletes (mean ± SD age, 20.8 ± 1.5 years; weight, 71.9 ± 10.5 kg) who participated in less than 8 hours a week of recreational physical activity with nonspecific training; group 2 consisted of 27 single-leg-dominant professional soccer players (age, 18.4 ± 0.6 years; weight, 70.1 ± 7.5 kg) who specifically trained and competed at their particular activity 8 hours or more a week. For assessment of maximal leg power, both groups completed the single-leg squat jump test. Dominance was determined when participants completed 2 of 3 specific tests with the same extremity. Statistical analysis included the Student t test. No statistical difference was found for maximal power between dominant and nondominant legs for nonathletes ( t = -1.01, P = .316) or single-leg-dominant professional soccer players ( t = -1.10, P = .281). A majority (95%) of participants studied showed a power difference of less than 15% between their lower extremities. Among young healthy adults, symmetrical power performance is expected between lower extremities independent of the existence of dominance and difference in sport activity level. A less than 15% difference in power seems to be a proper parameter to define symmetrical power performance assessed by vertical single-leg jump tests.

  4. Intensive virtual reality-based training for upper limb motor function in chronic stroke: a feasibility study using a single case experimental design and fMRI.

    Science.gov (United States)

    Schuster-Amft, Corina; Henneke, Andrea; Hartog-Keisker, Birgit; Holper, Lisa; Siekierka, Ewa; Chevrier, Edith; Pyk, Pawel; Kollias, Spyros; Kiper, Daniel; Eng, Kynan

    2015-01-01

    To evaluate feasibility and neurophysiological changes after virtual reality (VR)-based training of upper limb (UL) movements. Single-case A-B-A-design with two male stroke patients (P1:67 y and 50 y, 3.5 and 3 y after onset) with UL motor impairments, 45-min therapy sessions 5×/week over 4 weeks. Patients facing screen, used bimanual data gloves to control virtual arms. Three applications trained bimanual reaching, grasping, hand opening. Assessments during 2-week baseline, weekly during intervention, at 3-month follow-up (FU): Goal Attainment Scale (GAS), Chedoke Arm and Hand Activity Inventory (CAHAI), Chedoke-McMaster Stroke Assessment (CMSA), Extended Barthel Index (EBI), Motor Activity Log (MAL). Functional magnetic resonance imaging scans (FMRI) before, immediately after treatment and at FU. P1 executed 5478 grasps (paretic arm). Improvements in CAHAI (+4) were maintained at FU. GAS changed to +1 post-test and +2 at FU. P2 executed 9835 grasps (paretic arm). CAHAI improvements (+13) were maintained at FU. GAS scores changed to -1 post-test and +1 at FU. MAL scores changed from 3.7 at pre-test to 5.5 post-test and 3.3 at FU. The VR-based intervention was feasible, safe, and intense. Adjustable application settings maintained training challenge and patient motivation. ADL-relevant UL functional improvements persisted at FU and were related to changed cortical activation patterns. Implications for Rehabilitation YouGrabber trains uni- and bimanual upper motor function. Its application is feasible, safe, and intense. The control of the virtual arms can be done in three main ways: (a) normal (b) virtual mirror therapy, or (c) virtual following. The mirroring feature provides an illusion of affected limb movements during the period when the affected upper limb (UL) is resting. The YouGrabber training led to ADL-relevant UL functional improvements that were still assessable 12 weeks after intervention finalization and were related to changed cortical

  5. Crouch gait can be an effective form of forced-use/no constraint exercise for the paretic lower limb in stroke.

    Science.gov (United States)

    Tesio, Luigi; Rota, Viviana; Malloggi, Chiara; Brugliera, Luigia; Catino, Luigi

    2017-09-01

    In hemiplegic gait the paretic lower limb provides less muscle power and shows a briefer stance compared with the unaffected limb. Yet, a longer stance and a higher power can be obtained from the paretic lower limb if gait speed is increased. This supports the existence of a 'learned non-use' phenomenon, similar to that underlying some asymmetric impairments of the motion of the eyes and of the upper limbs. Crouch gait (CG) (bent-hip bent-knee, about 30° minimum knee flexion) might be an effective form of 'forced-use' treatment of the paretic lower limb. It is not known whether it also stimulates a more symmetric muscle power output. Gait analysis on a force treadmill was carried out in 12 healthy adults and seven hemiplegic patients (1-127 months after stroke, median: 1.6). Speed was imposed at 0.3 m/s. Step length and single and double stance times, sagittal joint rotations, peak positive power, and work in extension of the hip, knee, and ankle (plantar flexion), and surface electromyography (sEMG) area from extensor muscles during the generation of power were measured on either side during both erect and crouch walking. Significance was set at P less than 0.05; corrections for multiplicity were applied. Patients, compared with healthy controls, adopted in both gait modalities and on both sides a shorter step length (61-84%) as well as a shorter stance (76-90%) and swing (63-83%) time. As a rule, they also provided a higher muscular work (median: 137%, range: 77-250%) paralleled by a greater sEMG area (median: 174%, range: 75-185%). In erect gait, the generation of peak extensor power across hip, knee, and ankle joints was in general lower (83-90%) from the paretic limb and higher (98-165%) from the unaffected limb compared with control values. In CG, peak power generation across the three lower limb joints was invariably higher in hemiparetic patients: 107-177% from the paretic limb and 114-231% from the unaffected limb. When gait shifted from erect to crouch

  6. Detecting Underlying Stance Adopted When Human Construe Behavior of Entities

    Science.gov (United States)

    Terada, Kazunori; Ono, Kouhei; Ito, Akira

    Whether or not humans can construe the behaviors of entities depends on their psychological stance. The philosopher Dennett proposed human cognitive strategies (three stances) in which humans construe the behavior of other animated objects, including other humans, artifacts, and physical phenomena:‘intentional’, ‘design’ and ‘physical’ stances. Detecting the psychological stance taken toward entities is difficult, because such mental state attribution is a subjective cognitive process and hard to measure. In the present study, we proposed a novel method for detecting underlying stance adopted when human construe behavior of entities. In our method the subject was asked to select the most suitable action sequence shown in three movies each of which representing Dennett’s three stances. To valid our method we have conducted an experiment in which the subjects were presented thirty short videos and asked to compare them to the three movies. The result indicated that the subjects did not focused on prior knowledge about the entity but could focused on motion characteristics per se, owing to simple and typical motion of an abstract shaped object.

  7. Sex and the single (-eared) female: leg function, limb autotomy and mating history trade-offs in field crickets (Gryllus bimaculatus)

    Science.gov (United States)

    Bateman, Philip W; Fleming, Patricia A

    2005-01-01

    Both male and female field crickets (Gryllus bimaculatus) autotomize front (tympanal) limbs more slowly than hind limbs. Arguably, this pattern could reflect possible differences in the mechanism of limb autotomy. However, we demonstrate that, for females, limb autotomy is also dependent on their mating status: virgin females autotomize front legs significantly more slowly than mated females. This response suggests a central control for leg autotomy in these animals, and less readiness to autotomize a front leg, possibly because the tympanum is crucial for mate location. PMID:17148319

  8. Estimation of quasi-stiffness of the human knee in the stance phase of walking.

    Directory of Open Access Journals (Sweden)

    Kamran Shamaei

    Full Text Available Biomechanical data characterizing the quasi-stiffness of lower-limb joints during human locomotion is limited. Understanding joint stiffness is critical for evaluating gait function and designing devices such as prostheses and orthoses intended to emulate biological properties of human legs. The knee joint moment-angle relationship is approximately linear in the flexion and extension stages of stance, exhibiting nearly constant stiffnesses, known as the quasi-stiffnesses of each stage. Using a generalized inverse dynamics analysis approach, we identify the key independent variables needed to predict knee quasi-stiffness during walking, including gait speed, knee excursion, and subject height and weight. Then, based on the identified key variables, we used experimental walking data for 136 conditions (speeds of 0.75-2.63 m/s across 14 subjects to obtain best fit linear regressions for a set of general models, which were further simplified for the optimal gait speed. We found R(2 > 86% for the most general models of knee quasi-stiffnesses for the flexion and extension stages of stance. With only subject height and weight, we could predict knee quasi-stiffness for preferred walking speed with average error of 9% with only one outlier. These results provide a useful framework and foundation for selecting subject-specific stiffness for prosthetic and exoskeletal devices designed to emulate biological knee function during walking.

  9. Single-stage osseointegrated reconstruction and rehabilitation of lower limb amputees: the Osseointegration Group of Australia Accelerated Protocol-2 (OGAAP-2) for a prospective cohort study.

    Science.gov (United States)

    Al Muderis, Munjed; Lu, William; Tetsworth, Kevin; Bosley, Belinda; Li, Jiao Jiao

    2017-03-22

    Lower limb amputations have detrimental influences on the quality of life, function and body image of the affected patients. Following amputation, prolonged rehabilitation is required for patients to be fitted with traditional socket prostheses, and many patients experience symptomatic socket-residuum interface problems which lead to reduced prosthetic use and quality of life. Osseointegration has recently emerged as a novel approach for the reconstruction of amputated limbs, which overcomes many of the socket-related problems by directly attaching the prosthesis to the skeletal residuum. To date, the vast majority of osseointegration procedures worldwide have been performed in 2 stages, which require at least 4 months and up to 18 months for the completion of reconstruction and rehabilitation from the time of the initial surgery. The current prospective cohort study evaluates the safety and efficacy of a single-stage osseointegration procedure performed under the Osseointegration Group of Australia Accelerated Protocol-2 (OGAAP-2), which dramatically reduces the time of recovery to ∼3-6 weeks. The inclusion criteria for osseointegrated reconstruction under the OGAAP-2 procedure are age over 18 years, unilateral transfemoral amputation and experiencing problems or difficulties in using socket prostheses. All patients receive osseointegrated implants which are press-fitted into the residual bone. Functional and quality-of-life outcome measures are recorded preoperatively and at defined postoperative follow-up intervals up to 2 years. Postoperative adverse events are also recorded. The preoperative and postoperative values are compared for each outcome measure, and the benefits and harms of the single-stage OGAAP-2 procedure will be compared with the results obtained using a previously employed 2-stage procedure. This study has received ethics approval from the University of Notre Dame, Sydney, Australia (014153S). The study outcomes will be disseminated

  10. Comparison of human and humanoid robot control of upright stance.

    Science.gov (United States)

    Peterka, Robert J

    2009-01-01

    There is considerable recent interest in developing humanoid robots. An important substrate for many motor actions in both humans and biped robots is the ability to maintain a statically or dynamically stable posture. Given the success of the human design, one would expect there are lessons to be learned in formulating a postural control mechanism for robots. In this study we limit ourselves to considering the problem of maintaining upright stance. Human stance control is compared to a suggested method for robot stance control called zero moment point (ZMP) compensation. Results from experimental and modeling studies suggest there are two important subsystems that account for the low- and mid-frequency (DC to approximately 1Hz) dynamic characteristics of human stance control. These subsystems are (1) a "sensory integration" mechanism whereby orientation information from multiple sensory systems encoding body kinematics (i.e. position, velocity) is flexibly combined to provide an overall estimate of body orientation while allowing adjustments (sensory re-weighting) that compensate for changing environmental conditions and (2) an "effort control" mechanism that uses kinetic-related (i.e., force-related) sensory information to reduce the mean deviation of body orientation from upright. Functionally, ZMP compensation is directly analogous to how humans appear to use kinetic feedback to modify the main sensory integration feedback loop controlling body orientation. However, a flexible sensory integration mechanism is missing from robot control leaving the robot vulnerable to instability in conditions where humans are able to maintain stance. We suggest the addition of a simple form of sensory integration to improve robot stance control. We also investigate how the biological constraint of feedback time delay influences the human stance control design. The human system may serve as a guide for improved robot control, but should not be directly copied because the

  11. Limb symmetry during double-leg squats and single-leg squats on land and in water in adults with long-standing unilateral anterior knee pain; a cross sectional study.

    Science.gov (United States)

    Severin, Anna C; Burkett, Brendan J; McKean, Mark R; Wiegand, Aaron N; Sayers, Mark G L

    2017-01-01

    The presence of pain during movement typically results in changes in technique. However, the physical properties of water, such as flotation, means that water-based exercise may not only reduce compensatory movement patterns but also allow pain sufferers to complete exercises that they are unable to perform on land. The purpose of this study was to assess bilateral kinematics during double-leg squats and single-leg squats on land and in water in individuals with unilateral anterior knee pain. A secondary aim was to quantify bilateral asymmetry in both environments in affected and unaffected individuals using a symmetry index. Twenty individuals with unilateral knee pain and twenty healthy, matched controls performed body weight double- and single-leg squats in both environments while inertial sensors (100 Hz) recorded trunk and lower body kinematics. Repeated-measures statistics tested for environmental effects on movement depths and peak angles within the anterior knee pain group. Differences in their inter-limb symmetry in each environments was compared to the control group using analysis of variance tests. Water immersion allowed for greater movement depths during both exercises (double-leg squat: +7 cm, p  = 0.032, single-leg squat: +9 cm, p  = 0.002) for the knee pain group. The double-leg squat was symmetrical on land but water immersion revealed asymmetries in the lower body frontal plane movements. The single-leg squat revealed decreased hip flexion and frontal plane shank motions on the affected limb in both environments. Water immersion also affected the degree of lower limb asymmetry in both groups, with differences also showing between groups. Individuals with anterior knee pain achieved increased squat depth during both exercises whilst in water. Kinematic differences between the affected and unaffected limbs were often increased in water. Individuals with unilateral anterior knee pain appear to utilise different kinematics in the affected

  12. Body size and lower limb posture during walking in humans.

    Directory of Open Access Journals (Sweden)

    Martin Hora

    Full Text Available We test whether locomotor posture is associated with body mass and lower limb length in humans and explore how body size and posture affect net joint moments during walking. We acquired gait data for 24 females and 25 males using a three-dimensional motion capture system and pressure-measuring insoles. We employed the general linear model and commonality analysis to assess the independent effect of body mass and lower limb length on flexion angles at the hip, knee, and ankle while controlling for sex and velocity. In addition, we used inverse dynamics to model the effect of size and posture on net joint moments. At early stance, body mass has a negative effect on knee flexion (p < 0.01, whereas lower limb length has a negative effect on hip flexion (p < 0.05. Body mass uniquely explains 15.8% of the variance in knee flexion, whereas lower limb length uniquely explains 5.4% of the variance in hip flexion. Both of the detected relationships between body size and posture are consistent with the moment moderating postural adjustments predicted by our model. At late stance, no significant relationship between body size and posture was detected. Humans of greater body size reduce the flexion of the hip and knee at early stance, which results in the moderation of net moments at these joints.

  13. Specificity of foot configuration during bipedal stance in ballet dancers.

    Science.gov (United States)

    Casabona, Antonino; Leonardi, Giuseppa; Aimola, Ettore; La Grua, Giovanni; Polizzi, Cristina Maria; Cioni, Matteo; Valle, Maria Stella

    2016-05-01

    Learning highly specialized upright postures may be of benefit for more common as well as for novel stances. In this study, we asked whether this generalization occurs with foot configurations previously trained or depends on a generic increase in balance difficulty. We also explored the possibility that the benefit may concern not only the level of postural performance but also the structural organization of the upright standing. Ten elite professional ballet dancers were compared to ten untrained subjects, measuring the motion of the center of pressure (COP) across a set of five stances with different foot configurations. The balance stability was measured computing the area, the sway path, and the root mean square of the COP motion, whereas the structure of the postural control was assessed by compute approximate entropy, fractal dimension and the mean power frequency. The foot position included common and challenging stances, with the level of difficulty changed across the configurations. Among these conditions, only one foot configuration was familiar to the dancers. Statistically significant differences between the two groups, for all the parameters, were observed only for the stance with the foot position familiar to the dancers. Stability and structural parameters exhibited comparable differences. We concluded that the benefit from classical ballet is limited to a specific foot configuration, regardless of the level of stance difficulty or the component of postural control. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Management of the multiple limb amputee.

    Science.gov (United States)

    Davidson, J H; Jones, L E; Cornet, J; Cittarelli, T

    2002-09-10

    Multiple limb amputations involving at least one upper extremity are very uncommon. The amputation of both an upper and lower limb is even more uncommon. Due to the rarity of these amputations therapists are uncertain regarding the most appropriate treatment methods. While the majority of the protocols used for single limb amputations are appropriate for these multiple limb amputees, there are differences. Loss of multiple limbs creates a problem of overheating for the individual. Loss of an arm and leg results in difficulty donning the prostheses and difficulty using crutches and parallel bars during mobilization. A review is given of 16 multiple limb amputees seen in our rehabilitation centre in the last 15 years. Return to work was seen in one third and was not related to the number of the amputations. A higher proportion of these multiple limb amputations occur through alcoholism or attempted suicide behaviour than occurs with either single upper limb amputations or lower limb amputations. This existing behaviour can create a management problem for the rehabilitation team during rehabilitation. Guidelines as to appropriate prosthetic and preprosthetic care are provided to assist the practitioner who has the acute and long term care of these patients. All multiple limb amputees should be referred to a specialized rehabilitation centre to discuss prosthetic options and long term rehabilitation requirements. This paper does not discuss bilateral lower limb amputations when not combined with an upper limb amputation.

  15. Effects of Initial Stance of Quadruped Trotting on Walking Stability

    Directory of Open Access Journals (Sweden)

    Peisun Ma

    2008-11-01

    Full Text Available It is very important for quadruped walking machine to keep its stability in high speed walking. It has been indicated that moment around the supporting diagonal line of quadruped in trotting gait largely influences walking stability. In this paper, moment around the supporting diagonal line of quadruped in trotting gait is modeled and its effects on body attitude are analyzed. The degree of influence varies with different initial stances of quadruped and we get the optimal initial stance of quadruped in trotting gait with maximal walking stability. Simulation results are presented.

  16. Non-contrast-enhanced MR angiography in critical limb ischemia: performance of quiescent-interval single-shot (QISS) and TSE-based subtraction techniques

    International Nuclear Information System (INIS)

    Altaha, Mustafa A.; Jaskolka, Jeffrey D.; Tan, Kongteng; Menezes, Ravi J.; Rick, Manuela; Schmitt, Peter; Wintersperger, Bernd J.

    2017-01-01

    The aim of this study was to evaluate diagnostic performance of non-contrast-enhanced 2D quiescent-interval single-shot (QISS) and 3D turbo spin-echo (TSE)-based subtraction magnetic resonance angiography (MRA) in the assessment of peripheral arteries in patients with critical limb ischemia (CLI). Nineteen consecutive patients (74 % male, 72.8 ± 9.9 years) with CLI underwent 2D QISS and 3D TSE-based subtraction MRA at 1.5 T. Axial-overlapping QISS MRA (3 mm/2 mm; 1 x 1 mm 2 ) covered from the toes to the aortic bifurcation while coronal 3D TSE-based subtraction MRA (1.3 x 1.2 x 1.3 mm 3 ) was restricted to the calf only. MRA data sets (two readers) were evaluated for stenosis (≥50 %) and image quality. Results were compared with digital subtraction angiography (DSA). Two hundred and sixty-seven (267) segments were available for MRA-DSA comparison, with a prevalence of stenosis ≥50 % of 41.9 %. QISS MRA was rated as good to excellent in 79.5-96.0 % of segments without any nondiagnostic segments; 89.8-96.1 % of segments in 3D TSE-based subtraction MRA were rated as nondiagnostic or poor. QISS MRA sensitivities and specificities (segmental) were 92 % and 95 %, respectively, for reader one and 81-97 % for reader two. Due to poor image quality of 3D TSE-based subtraction MRA, diagnostic performance measures were not calculated. QISS MRA demonstrates excellent diagnostic performance and higher robustness than 3D TSE-based subtraction MRA in the challenging patient population with CLI. (orig.)

  17. Non-contrast-enhanced MR angiography in critical limb ischemia: performance of quiescent-interval single-shot (QISS) and TSE-based subtraction techniques

    Energy Technology Data Exchange (ETDEWEB)

    Altaha, Mustafa A. [University Health Network, Department of Medical Imaging, Peter Munk Cardiac Centre, Toronto, Ontario (Canada); Jaskolka, Jeffrey D.; Tan, Kongteng; Menezes, Ravi J. [University Health Network, Department of Medical Imaging, Peter Munk Cardiac Centre, Toronto, Ontario (Canada); University of Toronto, Department of Medical Imaging, Toronto, Ontario (Canada); Rick, Manuela; Schmitt, Peter [Siemens Healthcare, Erlangen (Germany); Wintersperger, Bernd J. [University Health Network, Department of Medical Imaging, Peter Munk Cardiac Centre, Toronto, Ontario (Canada); University of Toronto, Department of Medical Imaging, Toronto, Ontario (Canada); Toronto General Hospital, Department of Medical Imaging, Toronto, Ontario (Canada)

    2017-03-15

    The aim of this study was to evaluate diagnostic performance of non-contrast-enhanced 2D quiescent-interval single-shot (QISS) and 3D turbo spin-echo (TSE)-based subtraction magnetic resonance angiography (MRA) in the assessment of peripheral arteries in patients with critical limb ischemia (CLI). Nineteen consecutive patients (74 % male, 72.8 ± 9.9 years) with CLI underwent 2D QISS and 3D TSE-based subtraction MRA at 1.5 T. Axial-overlapping QISS MRA (3 mm/2 mm; 1 x 1 mm{sup 2}) covered from the toes to the aortic bifurcation while coronal 3D TSE-based subtraction MRA (1.3 x 1.2 x 1.3 mm{sup 3}) was restricted to the calf only. MRA data sets (two readers) were evaluated for stenosis (≥50 %) and image quality. Results were compared with digital subtraction angiography (DSA). Two hundred and sixty-seven (267) segments were available for MRA-DSA comparison, with a prevalence of stenosis ≥50 % of 41.9 %. QISS MRA was rated as good to excellent in 79.5-96.0 % of segments without any nondiagnostic segments; 89.8-96.1 % of segments in 3D TSE-based subtraction MRA were rated as nondiagnostic or poor. QISS MRA sensitivities and specificities (segmental) were 92 % and 95 %, respectively, for reader one and 81-97 % for reader two. Due to poor image quality of 3D TSE-based subtraction MRA, diagnostic performance measures were not calculated. QISS MRA demonstrates excellent diagnostic performance and higher robustness than 3D TSE-based subtraction MRA in the challenging patient population with CLI. (orig.)

  18. Effects of jump and balance training on knee kinematics and electromyography of female basketball athletes during a single limb drop landing: pre-post intervention study

    Directory of Open Access Journals (Sweden)

    Nagano Yasuharu

    2011-07-01

    Full Text Available Abstract Background Some research studies have investigated the effects of anterior cruciate ligament (ACL injury prevention programs on knee kinematics during landing tasks; however the results were different among the studies. Even though tibial rotation is usually observed at the time of ACL injury, the effects of training programs for knee kinematics in the horizontal plane have not yet been analyzed. The purpose of this study was to determine the effects of a jump and balance training program on knee kinematics including tibial rotation as well as on electromyography of the quadriceps and hamstrings in female athletes. Methods Eight female basketball athletes participated in the experiment. All subjects performed a single limb landing at three different times: the initial test, five weeks later, and one week after completing training. The jump and balance training program lasted for five weeks. Knee kinematics and simultaneous electromyography of the rectus femoris and Hamstrings before training were compared with those measured after completing the training program. Results After training, regarding the position of the knee at foot contact, the knee flexion angle for the Post-training trial (mean (SE: 24.4 (2.1 deg was significantly larger than that for the Pre-training trial (19.3 (2.5 deg (p Conclusions The jump and balance training program successfully increased knee flexion and hamstring activity of female athletes during landing, and has the possibility of producing partial effects to avoid the characteristic knee position observed in ACL injury, thereby preventing injury. However, the expected changes in frontal and transverse kinematics of the knee were not observed.

  19. Effects of jump and balance training on knee kinematics and electromyography of female basketball athletes during a single limb drop landing: pre-post intervention study.

    Science.gov (United States)

    Nagano, Yasuharu; Ida, Hirofumi; Akai, Masami; Fukubayashi, Toru

    2011-07-14

    Some research studies have investigated the effects of anterior cruciate ligament (ACL) injury prevention programs on knee kinematics during landing tasks; however the results were different among the studies. Even though tibial rotation is usually observed at the time of ACL injury, the effects of training programs for knee kinematics in the horizontal plane have not yet been analyzed. The purpose of this study was to determine the effects of a jump and balance training program on knee kinematics including tibial rotation as well as on electromyography of the quadriceps and hamstrings in female athletes. Eight female basketball athletes participated in the experiment. All subjects performed a single limb landing at three different times: the initial test, five weeks later, and one week after completing training. The jump and balance training program lasted for five weeks. Knee kinematics and simultaneous electromyography of the rectus femoris and Hamstrings before training were compared with those measured after completing the training program. After training, regarding the position of the knee at foot contact, the knee flexion angle for the Post-training trial (mean (SE): 24.4 (2.1) deg) was significantly larger than that for the Pre-training trial (19.3 (2.5) deg) (p training trial (40.2 (1.9) deg) was significantly larger than that for the Pre-training trial (34.3 (2.5) deg) (p training. A significant increase was also found in the activity of the hamstrings 50 ms before foot contact (p jump and balance training program successfully increased knee flexion and hamstring activity of female athletes during landing, and has the possibility of producing partial effects to avoid the characteristic knee position observed in ACL injury, thereby preventing injury. However, the expected changes in frontal and transverse kinematics of the knee were not observed.

  20. Choosing an Epistemic Stance | Gabriel | African Journal of Finance ...

    African Journals Online (AJOL)

    The connection of what we claim to know (ontology) and how do we claim to know (epistemology) will be addressed in this paper. Some mapping tools will be used to make understanding easier. It should be understood that making a choice of a certain epistemic stance is not the end of the journey. The critical aspect is to ...

  1. Muscle activity during stance phase of walking: comparison of males with transfemoral amputation with osseointegrated fixations to nondisabled male volunteers.

    Science.gov (United States)

    Pantall, Annette; Ewins, David

    2013-01-01

    A recent development in prosthetics is the osseointegrated fixation (OF), with improvements in comfort, fatigue, hip movement, and ease of prosthetic attachment reported. However, little information is available regarding muscle function. This study reports on selected gait parameters of the residual limb during the stance phase of level overground walking, focusing on muscle activity. Five males with transfemoral amputation (TFA) with OFs were recruited. Ground reaction force (GRF), lower-limb kinematics, and surface electromyography (sEMG) from residual-limb muscles were recorded. sEMG data were also collected from a group of 10 nondisabled male subjects. Interstance variability of gait parameters was assessed by coefficient of multiple correlations. Repeatability of GRF and hip kinematics was high, whereas repeatability of the sEMG was low for four of the five individuals with TFA. Interstance variability of the sEMG for gluteus medius (GMED) was significantly greater in the group with TFA. The main difference in sEMG between the groups was the phase, with GMED and adductor magnus displaying greater differences than their counterparts in the nondisabled group. Results demonstrate that muscles in the residual limb retain aspects of their previous functional pattern.

  2. Asymmetric sensory reweighting in human upright stance.

    Directory of Open Access Journals (Sweden)

    David Logan

    Full Text Available To investigate sensory reweighting as a fundamental property of sensor fusion during standing, we probed postural control with simultaneous rotations of the visual scene and surface of support. Nineteen subjects were presented with pseudo-random pitch rotations of visual scene and platform at the ankle to test for amplitude dependencies in the following conditions: low amplitude vision: high amplitude platform, low amplitude vision: low amplitude platform, and high amplitude vision: low amplitude platform. Gain and phase of frequency response functions (FRFs to each stimulus were computed for two body sway angles and a single weighted EMG signal recorded from seven muscles. When platform stimulus amplitude was increased while visual stimulus amplitude remained constant, gain to vision increased, providing strong evidence for inter-modal reweighting between vision and somatosensation during standing. Intra-modal reweighting of vision was also observed as gains to vision decreased as visual stimulus amplitude increased. Such intra-modal and inter-modal amplitude dependent changes in gain were also observed in muscular activity. Gains of leg segment angle and muscular activity relative to the platform, on the other hand, showed only intra-modal reweighting. That is, changing platform motion amplitude altered the responses to both visual and support surface motion whereas changing visual scene motion amplitude did not significantly affect responses to support surface motion, indicating that the sensory integration scheme between somatosensation (at the support surface and vision is asymmetric.

  3. Hysteresis in Center of Mass Velocity Control during the Stance Phase of Treadmill Walking

    Directory of Open Access Journals (Sweden)

    Raymond K. Chong

    2017-04-01

    Full Text Available Achieving a soft landing during walking can be quantified by analyzing changes in the vertical velocity of the body center of mass (CoM just prior to the landing of the swing limb. Previous research suggests that walking speed and step length may predictably influence the extent of this CoM control. Here we ask how stable this control is. We altered treadmill walking speed by systematically increasing or decreasing it at fixed intervals. We then reversed direction. We hypothesized that the control of the CoM vertical velocity during the late stance of the walking gait may serve as an order parameter which has an attribute of hysteresis. The presence of hysteresis implies that the CoM control is not based on simply knowing the current input conditions to predict the output response. Instead, there is also the influence of previous speed conditions on the ongoing responses. We found that the magnitudes of CoM control were different depending on whether the treadmill speed (as the control parameter was ramped up or down. Changes in step length also influenced CoM control. A stronger effect was observed when the treadmill speed was speeded up compared to down. However, the effect of speed direction remained significant after controlling for step length. The hysteresis effect of CoM control as a function of speed history demonstrated in the current study suggests that the regulation of CoM vertical velocity during late stance is influenced by previous external conditions and constraints which combine to influence the desired behavioral outcome.

  4. Adaptive behaviour of the spinal cord in the transition from quiet stance to walking

    Directory of Open Access Journals (Sweden)

    Serrao Mariano

    2012-07-01

    Full Text Available Abstract Background Modulation of nociceptive withdrawal reflex (NWR excitability was evaluated during gait initiation in 10 healthy subjects to investigate how load- and movement-related joint inputs activate lower spinal centres in the transition from quiet stance to walking. A motion analysis system integrated with a surface EMG device was used to acquire kinematic, kinetic and EMG variables. Starting from a quiet stance, subjects were asked to walk forward, at their natural speed. The sural nerve was stimulated and EMG responses were recorded from major hip, knee and ankle muscles. Gait initiation was divided into four subphases based on centre of pressure and centre of mass behaviours, while joint displacements were used to categorise joint motion as flexion or extension. The reflex parameters were measured and compared between subphases and in relation to the joint kinematics. Results The NWR was found to be subphase-dependent. NWR excitability was increased in the hip and knee flexor muscles of the starting leg, just prior to the occurrence of any movement, and in the knee flexor muscles of the same leg as soon as it was unloaded. The NWR was hip joint kinematics-dependent in a crossed manner. The excitability of the reflex was enhanced in the extensor muscles of the standing leg during the hip flexion of the starting leg, and in the hip flexors of the standing leg during the hip extension of the starting leg. No notable reflex modulation was observed in the ankle muscles. Conclusions Our findings show that the NWR is modulated during the gait initiation phase. Leg unloading and hip joint motion are the main sources of the observed modulation and work in concert to prepare and assist the starting leg in the first step while supporting the contralateral leg, thereby possibly predisposing the lower limbs to the cyclical pattern of walking.

  5. Olecranon orientation as an indicator of elbow joint angle in the stance phase, and estimation of forelimb posture in extinct quadruped animals.

    Science.gov (United States)

    Fujiwara, Shin-Ichi

    2009-09-01

    Reconstruction of limb posture is a challenging task in assessing functional morphology and biomechanics of extinct tetrapods, mainly because of the wide range of motions possible at each limb joint and because of our poor knowledge of the relationship between posture and musculoskeletal structure, even in the extant taxa. This is especially true for extinct mammals such as the desmostylian taxa Desmostylus and Paleoparadoxia. This study presents a procedure that how the elbow joint angles of extinct quadruped mammals can be inferred from osteological characteristics. A survey of 67 dried skeletons and 113 step cycles of 32 extant genera, representing 25 families and 13 orders, showed that the olecranon of the ulna and the shaft of the humerus were oriented approximately perpendicular to each other during the stance phase. At this angle, the major extensor muscles maximize their torque at the elbow joint. Based on this survey, I suggest that olecranon orientation can be used for inferring the elbow joint angles of quadruped mammals with prominent olecranons, regardless of taxon, body size, and locomotor guild. By estimating the elbow joint angle, it is inferred that Desmostylus would have had more upright forelimbs than Paleoparadoxia, because their elbow joint angles during the stance phase were approximately 165 degrees and 130 degrees , respectively. Difference in elbow joint angles between these two genera suggests possible differences in stance and gait of these two mammals. Copyright 2009 Wiley-Liss, Inc.

  6. Assessment of AK (Above Knee) Prosthesis with Different Ankle Assembly Using GRF Pattern in Stance Phase

    Science.gov (United States)

    Kim, Sung-Min; Kim, Sung-Jae; Bae, Ha-Suk

    In this study, ground reaction force (GRF), absolute symmetry index (ASI) and coefficient of variation (CV) of fixed, single-axis and multi-axis prosthetic ankle assemblies were investigated by biomechanical evaluation of above knee amputees. In the experiments, 37 normal male volunteers, two male and two female Above Knee (AK) amputees GRF data were tested with fixed, single-axis and multi-axis prosthetic ankle assembly. A gait analysis was carried out to derive the ratio of GRF to weight as the percentage of total stance phase for ten points. The results showed that fixed-axis ankle assembly was superior to other two ankle assemblies for forwarding and braking forces. Multi-axis ankle was relatively superior to other two ankle assemblies for gait balancing and movement of the mass center. Single-axis ankle was relatively superior to the other two ankle assemblies for CV and ASI of GRF.

  7. Rehabilitation plus OnabotulinumtoxinA Improves Motor Function over OnabotulinumtoxinA Alone in Post-Stroke Upper Limb Spasticity: A Single-Blind, Randomized Trial

    Directory of Open Access Journals (Sweden)

    Deidre Devier

    2017-07-01

    Full Text Available Background: OnabotulinumtoxinA (BoNT-A can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. Methods: This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation. They were injected up to two times, and followed for 24 weeks. The primary outcome was change in the Fugl–Meyer upper extremity score, which measures motor function, sensation, range of motion, coordination, and speed. Results: The ‘rehab’ group significantly improved on the Fugl–Meyer upper extremity score (Visit 1 = 60, Visit 5 = 67 while the ‘no rehab’ group did not improve (Visit 1 = 59, Visit 5 = 59; p = 0.006. This improvement was largely driven by the upper extremity “movement” subscale, which showed that the ‘rehab’ group was improving (Visit 1 = 33, Visit 5 = 37 while the ‘no rehab’ group remained virtually unchanged (Visit 1 = 34, Visit 5 = 33; p = 0.034. Conclusions: Following injection of BoNT-A, adding a program of rehabilitation improved motor recovery compared to an injected group with no rehabilitation.

  8. Rehabilitation plus OnabotulinumtoxinA Improves Motor Function over OnabotulinumtoxinA Alone in Post-Stroke Upper Limb Spasticity: A Single-Blind, Randomized Trial.

    Science.gov (United States)

    Devier, Deidre; Harnar, JoAnn; Lopez, Leandro; Brashear, Allison; Graham, Glenn

    2017-07-11

    OnabotulinumtoxinA (BoNT-A) can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation. They were injected up to two times, and followed for 24 weeks. The primary outcome was change in the Fugl-Meyer upper extremity score, which measures motor function, sensation, range of motion, coordination, and speed. The 'rehab' group significantly improved on the Fugl-Meyer upper extremity score (Visit 1 = 60, Visit 5 = 67) while the 'no rehab' group did not improve (Visit 1 = 59, Visit 5 = 59; p = 0.006). This improvement was largely driven by the upper extremity "movement" subscale, which showed that the 'rehab' group was improving (Visit 1 = 33, Visit 5 = 37) while the 'no rehab' group remained virtually unchanged (Visit 1 = 34, Visit 5 = 33; p = 0.034). Following injection of BoNT-A, adding a program of rehabilitation improved motor recovery compared to an injected group with no rehabilitation.

  9. Manipulated Changes in Limb Mass and Rotational Inertia in Trotting Dogs (Canis lupus familiaris) and Their Effect on Limb Kinematics.

    Science.gov (United States)

    Kilbourne, Brandon M; Carrier, David R

    2016-12-01

    While the mass distribution of limbs is known to influence the metabolic energy consumed during locomotion, it remains unknown how the mass distribution of limbs may influence overall limb kinematics and whether the influence of limb mass distribution on limb kinematics differs between fore- and hindlimbs. To examine limb mass distribution's influence upon fore- and hindlimb kinematics, temporal stride parameters and swing phase joint kinematics were recorded from four dogs trotting on a treadmill with 0.5% and 1.0% body mass added to each limb, forelimbs alone, and hindlimbs alone, as well as with no added mass. Under all loading conditions, stride period did not differ between fore- and hindlimbs; however, forelimbs exhibited greater duty factors and stance durations, whereas hindlimbs exhibited greater swing durations, which may be related to the hindlimb's greater mass. Changes in forelimb joint and hip range of motion (RoM), flexion, and extension were subject to a high amount of kinematic plasticity among dogs. In contrast, for the knee and ankle, distally loading all four limbs or hindlimbs alone substantially increased joint RoM and flexion. Increased flexion of the knee and ankle has the potential to reduce the hindlimb's rotational inertia during swing phase. The differing response of fore- and hindlimbs with regard to joint kinematics is likely due to differences in their mass and mass distribution and differences in the physiological traits of fore- and hindlimb protractors and joint flexors. © 2017 Wiley Periodicals, Inc.

  10. Students' stance-taking in the literature classroom

    DEFF Research Database (Denmark)

    Kabel, Kristine

    In this paper, I present and discuss two key findings from a recent study on disciplinary literacy in the literature classroom in L1 Danish (Kabel, 2016). In particular, I explore students’ choices of resources for stance-taking in their written interpretations of literature and I relate these ch...... these choices to students’ reflections on the discipline and to aspects of the pedagogical context, namely which resources the students are encouraged to apply in writing.......In this paper, I present and discuss two key findings from a recent study on disciplinary literacy in the literature classroom in L1 Danish (Kabel, 2016). In particular, I explore students’ choices of resources for stance-taking in their written interpretations of literature and I relate...

  11. House Prices and the stance of Monetary Policy.

    OpenAIRE

    Jarociński, Marek; Smets, Frank

    2008-01-01

    This paper estimates a Bayesian VAR for the US economy which includes a housing sector and addresses the following questions. Can developments in the housing sector be explained on the basis of developments in real and nominal GDP and interest rates? What are the effects of housing demand shocks on the economy? How does monetary policy affect the housing market? What are the implications of house price developments for the stance of monetary policy? Regarding the latter question, we implement...

  12. Alternative Indicator of Monetary Policy Stance for Macedonia

    OpenAIRE

    Petrovska, Magdalena; Georgievska, Ljupka

    2015-01-01

    This paper applies a SVAR model which combines different monetary policy instruments to construct an alternative indicator of monetary policy stance in Macedonia. It employs the approach introduced by Bernanke and Mihov (1998) of isolating monetary policy shocks from the whole set of monetary policy instruments that otherwise react to real developments. The residuals from such VAR are cleaned from the central bank's reaction function and represent true monetary policy innovations. Furthermore...

  13. Two Mechanisms of Sensorimotor Set Adaptation to Inclined Stance

    Directory of Open Access Journals (Sweden)

    Kyoung-Hyun Lee

    2017-10-01

    Full Text Available Orientation of posture relative to the environment depends on the contributions from the somatosensory, vestibular, and visual systems mixed in varying proportions to produce a sensorimotor set. Here, we probed the sensorimotor set composition using a postural adaptation task in which healthy adults stood on an inclined surface for 3 min. Upon returning to a horizontal surface, participants displayed a range of postural orientations – from an aftereffect that consisted of a large forward postural lean to an upright stance with little or no aftereffect. It has been hypothesized that the post-incline postural change depends on each individual’s sensorimotor set: whether the set was dominated by the somatosensory or vestibular system: Somatosensory dominance would cause the lean aftereffect whereas vestibular dominance should steer stance posture toward upright orientation. We investigated the individuals who displayed somatosensory dominance by manipulating their attention to spatial orientation. We introduced a distraction condition in which subjects concurrently performed a difficult arithmetic subtraction task. This manipulation altered the time course of their post-incline aftereffect. When not distracted, participants returned to upright stance within the 3-min period. However, they continued leaning forward when distracted. These results suggest that the mechanism of sensorimotor set adaptation to inclined stance comprises at least two components. The first component reflects the dominant contribution from the somatosensory system. Since the postural lean was observed among these subjects even when they were not distracted, it suggests that the aftereffect is difficult to overcome. The second component includes a covert attentional component which manifests as the dissipation of the aftereffect and the return of posture to upright orientation.

  14. Running With an Elastic Lower Limb Exoskeleton.

    Science.gov (United States)

    Cherry, Michael S; Kota, Sridhar; Young, Aaron; Ferris, Daniel P

    2016-06-01

    Although there have been many lower limb robotic exoskeletons that have been tested for human walking, few devices have been tested for assisting running. It is possible that a pseudo-passive elastic exoskeleton could benefit human running without the addition of electrical motors due to the spring-like behavior of the human leg. We developed an elastic lower limb exoskeleton that added stiffness in parallel with the entire lower limb. Six healthy, young subjects ran on a treadmill at 2.3 m/s with and without the exoskeleton. Although the exoskeleton was designed to provide ~50% of normal leg stiffness during running, it only provided 24% of leg stiffness during testing. The difference in added leg stiffness was primarily due to soft tissue compression and harness compliance decreasing exoskeleton displacement during stance. As a result, the exoskeleton only supported about 7% of the peak vertical ground reaction force. There was a significant increase in metabolic cost when running with the exoskeleton compared with running without the exoskeleton (ANOVA, P exoskeletons for human running are human-machine interface compliance and the extra lower limb inertia from the exoskeleton.

  15. Balance (perceived and actual) and preferred stance width during pregnancy.

    Science.gov (United States)

    Jang, John; Hsiao, Katherine T; Hsiao-Wecksler, Elizabeth T

    2008-05-01

    Pregnant women often remark that their balance degrades during pregnancy; however, it appears that no studies have documented the gravida's perception of her balance nor measured direction-specific changes in balance throughout pregnancy or after delivery. Thirty women, fifteen pregnant and fifteen non-pregnant controls, were tested monthly and through 6-month postpartum. For each session, perceived degradation in sense of balance, laboratory-based balance measures, stance width, and the number of falls since the previous session were recorded. Laboratory-based balance measures, quantified by direction-specific measures of postural sway, were computed from ten 30s quiet-standing trials on a stationary force platform. Repeated-measures analysis of variance, paired t-tests, and Pearson correlations were use to examine group and time effects. For the pregnant group, perceived balance degradation and stance width were highly correlated (r = 0.94). Both increased during pregnancy (P r > 0.72) and also decreased significantly between the third trimester and postpartum (P pregnancy, but increased after delivery. Contrary to recent work suggesting fall rates of 25%, only 13% of our subjects (n = 2) fell during pregnancy. Perceived degradation in balance during pregnancy was strongly related to increasing postural sway instability in the anterior-posterior direction. Lateral stability was maintained during pregnancy and likely accomplished by increasing stance width.

  16. Stance and influence of Twitter users regarding the Brexit referendum.

    Science.gov (United States)

    Grčar, Miha; Cherepnalkoski, Darko; Mozetič, Igor; Kralj Novak, Petra

    2017-01-01

    Social media are an important source of information about the political issues, reflecting, as well as influencing, public mood. We present an analysis of Twitter data, collected over 6 weeks before the Brexit referendum, held in the UK in June 2016. We address two questions: what is the relation between the Twitter mood and the referendum outcome, and who were the most influential Twitter users in the pro- and contra-Brexit camps? First, we construct a stance classification model by machine learning methods, and are then able to predict the stance of about one million UK-based Twitter users. The demography of Twitter users is, however, very different from the demography of the voters. By applying a simple age-adjusted mapping to the overall Twitter stance, the results show the prevalence of the pro-Brexit voters, something unexpected by most of the opinion polls. Second, we apply the Hirsch index to estimate the influence, and rank the Twitter users from both camps. We find that the most productive Twitter users are not the most influential, that the pro-Brexit camp was four times more influential, and had considerably larger impact on the campaign than the opponents. Third, we find that the top pro-Brexit communities are considerably more polarized than the contra-Brexit camp. These results show that social media provide a rich resource of data to be exploited, but accumulated knowledge and lessons learned from the opinion polls have to be adapted to the new data sources.

  17. The cat vertebral column: stance configuration and range of motion

    Science.gov (United States)

    Macpherson, J. M.; Ye, Y.; Peterson, B. W. (Principal Investigator)

    1998-01-01

    This study examined the configuration of the vertebral column of the cat during independent stance and in various flexed positions. The range of motion in the sagittal plane is similar across most thoracic and lumbar joints, with the exception of a lesser range at the transition region from thoracic-type to lumbar-type vertebrae. The upper thoracic column exhibits most of its range in dorsiflexion and the lower thoracic and lumbar in ventroflexion. Lateral flexion is limited to less than 5 degrees at all segments. The range in torsion is almost 180 degrees and occurs primarily in the midthoracic region, T4-T11. Contrary to the depiction in most atlases, the standing cat exhibits several curvatures, including a mild dorsiflexion in the lower lumbar segments, a marked ventroflexion in the lower thoracic and upper lumbar segments, and a profound dorsiflexion in the upper thoracic (above T9) and cervical segments. The curvatures are not significantly changed by altering stance distance but are affected by head posture. During stance, the top of the scapula lies well above the spines of the thoracic vertebrae, and the glenohumeral joint is just below the bodies of vertebrae T3-T5. Using a simple static model of the vertebral column in the sagittal plane, it was estimated that the bending moment due to gravity is bimodal with a dorsiflexion moment in the lower thoracic and lumbar region and a ventroflexion moment in the upper thoracic and cervical region. Given the bending moments and the position of the scapula during stance, it is proposed that two groups of scapular muscles provide the major antigravity support for the head and anterior trunk. Levator scapulae and serratus ventralis form the lateral group, inserting on the lateral processes of cervical vertebrae and on the ribs. The major and minor rhomboids form the medial group, inserting on the spinous tips of vertebrae from C4 to T4. It is also proposed that the hypaxial muscles, psoas major, minor, and quadratus

  18. Assessing the effect of high-repetitive single limb exercises (HRSLE) on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD): study protocol for randomized controlled trial.

    Science.gov (United States)

    Nyberg, Andre; Lindström, Britta; Wadell, Karin

    2012-07-23

    Single-limb knee extension exercises have been found to be effective at improving lower extremity exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Since the positive local physiological effects of exercise training only occur in the engaged muscle(s), should upper extremity muscles also be included to determine the effect of single limb exercises in COPD patients. a prospective, assessor-blind, block randomized controlled, parallel-group multicenter trial. stage II-IV COPD patients, > 40 years of age, ex-smokers, with stable medical treatment will be included starting May 2011. Recruitment at three locations in Sweden. 1) high-repetitive single limb exercise (HRSLE) training with elastic bands, 60 minutes, three times/week for 8 weeks combined with four sessions of 60 minutes patient education, or 2) the same patient education alone. Primary: determine the effects of HRSLE on local muscle endurance capacity (measured as meters walked during 6-minute walk test and rings moved on 6-minute ring and pegboard test) and quality of life (measured as change on the Swedish version of the Chronic Respiratory Disease Questionnaire). Secondary: effects on maximal strength, muscular endurance, dyspnea, self-efficacy, anxiety and depression. The relationship between changes in health-related variables and changes in exercise capacity, sex-related differences in training effects, feasibility of the program, strategies to determine adequate starting resistance and provide accurate resistance for each involved movement and the relationship between muscle fatigue and dyspnea in the different exercise tests will also be analyzed. Randomization: performed by a person independent of the recruitment process and using a computer random number generator. Stratification by center and gender with a 1:1 allocation to the intervention or control using random block sizes. Blinding: all outcome assessors will be blinded to group assignment. The results of

  19. Age-related alterations in the activation of trunk and lower limb muscles during walking.

    Science.gov (United States)

    Marques, Nise Ribeiro; Hallal, Camilla Zamfolini; Spinoso, Deborah Hebling; Crozara, Luciano Fernandez; Morcelli, Mary Hellen; Karuka, Aline Harumi; Navega, Marcelo Tavella; Gonçalves, Mauro

    2016-04-27

    Walking is a complex motor task that requires an integrated coordination of the trunk, lower limb, and upper limb movements. Previously, few studies have investigated the activation pattern of trunk muscles during walking. However, the mechanisms by how aging affects the recruitment of trunk muscles during walking remain unclear. The present study aimed to compare the activation of trunk and lower limb muscles during walking in younger and older women. Fifteen younger women between 18 and 30 yr and 19 older women between 60-82 yr walked on the treadmill at a self-selected speed, while 1-min surface electromyography (EMG) signals were recorded from the multifidus, internal oblique, gluteus maximus, rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius lateralis. EMG signals were processed and a linear envelope was calculated at an initial stance (50 ms after heel contact) and final stance (50 ms before toe-off). Compared with younger women, older women had 52.32% lower activation of the internal oblique (p = 0.027) and 39.95% lower activation of the rectus femoris (p = 0.003) at initial stance. Results of this study demonstrated that older women had lower activation of trunk and knee muscles during the initial stance, which may have resulted from weakness and balance impairments caused by aging.

  20. Toward a Critical Stance: Citizenship Education in the Classroom

    Directory of Open Access Journals (Sweden)

    Diane M. Vetter

    2008-01-01

    Full Text Available In this paper the author presents the argument that through the use of rich classroom talk, students can be motivated to take a critical stance on issues of citizenship, such as social justice, equity and environmental concern. Suggesting that students who are not part of the solution are, indeed, part of the problem, the author advocates giving young children a voice through the integration of citizenship education and critical literacy across the curriculum to promote student awareness and to empower students to become pro active global citizens.

  1. Electrically Assisted Movement Therapy in Chronic Stroke Patients With Severe Upper Limb Paresis: A Pilot, Single-Blind, Randomized Crossover Study.

    Science.gov (United States)

    Carda, Stefano; Biasiucci, Andrea; Maesani, Andrea; Ionta, Silvio; Moncharmont, Julien; Clarke, Stephanie; Murray, Micah M; Millán, José Del R

    2017-08-01

    To evaluate the effects of electrically assisted movement therapy (EAMT) in which patients use functional electrical stimulation, modulated by a custom device controlled through the patient's unaffected hand, to produce or assist task-specific upper limb movements, which enables them to engage in intensive goal-oriented training. Randomized, crossover, assessor-blinded, 5-week trial with follow-up at 18 weeks. Rehabilitation university hospital. Patients with chronic, severe stroke (N=11; mean age, 47.9y) more than 6 months poststroke (mean time since event, 46.3mo). Both EAMT and the control intervention (dose-matched, goal-oriented standard care) consisted of 10 sessions of 90 minutes per day, 5 sessions per week, for 2 weeks. After the first 10 sessions, group allocation was crossed over, and patients received a 1-week therapy break before receiving the new treatment. Fugl-Meyer Motor Assessment for the Upper Extremity, Wolf Motor Function Test, spasticity, and 28-item Motor Activity Log. Forty-four individuals were recruited, of whom 11 were eligible and participated. Five patients received the experimental treatment before standard care, and 6 received standard care before the experimental treatment. EAMT produced higher improvements in the Fugl-Meyer scale than standard care (PFugl-Meyer points and 1 Fugl-Meyer point after the experimental treatment and standard care, respectively. The improvement was also significant in subjective reports of quality of movement and amount of use of the affected limb during activities of daily living (P<.05). EAMT produces a clinically important impairment reduction in stroke patients with chronic, severe upper limb paresis. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. Frontal Plane Modelling of Human Dynamics during Standing in Narrow-Stance

    Science.gov (United States)

    Sonobe, M.; Yamaguchi, H.; Hino, J.

    2016-09-01

    Standing ride type vehicles like electric skateboards have been developed in recent years. Although these vehicles have advantages as being compact and low cost due to their simple structure, it is necessary to improve the riding quality. Therefore, the system aiding riders to keep their balance on a skateboard by feedback control or feedforward control has been required. To achieve it, a human balance model should be built as simple as possible. In this study, we focus on the human balance modelling during standing when the support surface moves largely. We restricted the model on frontal plane and narrow stance because the restrictions allow us to assume single-degree-of-freedom model. The balance control system is generally assumed as a delayed feedback control system. The model was identified through impulse response test and frequency response test. As a result, we found the phase between acceleration of the skateboard and posture angle become opposite phase in low frequency range.

  3. Reliability and validity of the Lower Limb Function Questionnaire when completed by young adult orthotic and prosthetic device users.

    Science.gov (United States)

    Funk, Luke; Thiessen, Danielle; Wright, Virginia; Andrysek, Jan; Rispin, Karen

    2017-04-01

    Purpose The Lower Limb Function Questionnaire (LLFQ) was developed as a self-report assessment of lower-limb functional ability for orthotic and prosthetic (O&P) device users to be suitable for a wide range of conditions, cultures, and ages. The measure aims to address an existing gap in tools for the assessment of functional ability in this population. The purpose of this study is to evaluate LLFQ reliability and validity in a sample of young adult O&P users. Methods Adolescents from a secondary school in Kenya completed the LLFQ twice, 6 d apart, and test-retest reliability was assessed using intra-class correlation coefficients. Validity evaluations involved Timed Up-and-Go, 6-min walk, 6-min obstacle course, and/or spatiotemporal gait assessments. Oxygen consumption was measured during walk tests. Associations between the LLFQ and each measure were evaluated using Pearson correlation coefficients for construct validity. Results LLFQ reliability was acceptable (ICC = 0.79, 95% CIs 0.64-0.89). Construct validity was demonstrated via moderate correlation (r  >  0.60) with obstacle course distance, gait velocity, stride length, and stance/single support/double support percent of gait cycle. Conclusions Both LLFQ reliability and validity were acceptable in the sample of youth in Kenya. Further testing is required to determine applicability in other cultural contexts. Implications for Rehabilitation The LLFQ may be clinically useful across a variety of cultures and conditions to provide feedback on the effectiveness of rehabilitative treatment or assistive devices for youth with lower limb impairments. The LLFQ may enable specific strengths and challenges to lower limb function to be identified to enable planning of well-targeted rehabilitation.

  4. [Single event multilevel surgery to improve gait in diplegic cerebral palsy - a prospective controlled trial].

    Science.gov (United States)

    Zwick, E B; Saraph, V; Strobl, W; Steinwender, G

    2001-01-01

    To evaluate prospectively the outcome of gait-improvement surgery in children with spastic diplegia. Three-dimensional gait analysis was performed in twenty children with spastic diplegia. Ten children underwent single event multilevel surgery for gait improvement. Indications for individual procedures followed a fixed set of selection criteria. The other ten children continued with their physiotherapy programme and served as a control group. A second gait analysis was performed in all children after 1.5 years. Time-distance parameters and kinematics of the pelvis, hip, knee and ankle joints in the sagittal plane served as main outcome measures The patients walked faster with an increased stride length after surgery in comparison to the conservatively treated controls. The average pelvic tilt increased slightly and the range of motion of the knee joint increased considerably after multilevel surgery. The motion at the ankle remained unchanged over the study period in both the groups. An improved knee extension during the stance phase of gait served to improve stance limb stability and facilitated an unhindered swing phase of the opposite limb. This prospective trial showed favourable changes in gait function after multilevel surgery in spastic diplegic children.

  5. Phantom limb pain

    Science.gov (United States)

    ... limb is still there. This is called phantom sensation. You may feel: Pain in your limb even though it is physically not there Tingly Prickly Numb Hot or cold Like your missing toes or fingers are moving ...

  6. Assessing the effect of high-repetitive single limb exercises (HRSLE on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD: study protocol for randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Nyberg Andre

    2012-07-01

    Full Text Available Abstract Background Single-limb knee extension exercises have been found to be effective at improving lower extremity exercise capacity in patients with chronic obstructive pulmonary disease (COPD. Since the positive local physiological effects of exercise training only occur in the engaged muscle(s, should upper extremity muscles also be included to determine the effect of single limb exercises in COPD patients. Methods/design Trial design: a prospective, assessor-blind, block randomized controlled, parallel-group multicenter trial. Participants: stage II-IV COPD patients, > 40 years of age, ex-smokers, with stable medical treatment will be included starting May 2011. Recruitment at three locations in Sweden. Interventions: 1 high-repetitive single limb exercise (HRSLE training with elastic bands, 60 minutes, three times/week for 8 weeks combined with four sessions of 60 minutes patient education, or 2 the same patient education alone. Outcomes: Primary: determine the effects of HRSLE on local muscle endurance capacity (measured as meters walked during 6-minute walk test and rings moved on 6-minute ring and pegboard test and quality of life (measured as change on the Swedish version of the Chronic Respiratory Disease Questionnaire. Secondary: effects on maximal strength, muscular endurance, dyspnea, self-efficacy, anxiety and depression. The relationship between changes in health-related variables and changes in exercise capacity, sex-related differences in training effects, feasibility of the program, strategies to determine adequate starting resistance and provide accurate resistance for each involved movement and the relationship between muscle fatigue and dyspnea in the different exercise tests will also be analyzed. Randomization: performed by a person independent of the recruitment process and using a computer random number generator. Stratification by center and gender with a 1:1 allocation to the intervention or control using random

  7. Students’ Resources for Stance-taking in the Literature Classroom

    DEFF Research Database (Denmark)

    Kabel, Kristine

    Making aspects of privileged ways of participating visible is central to support students’ literacy development within different educational disciplines (Hasan, 1996, 2011). In my doctoral work I focus on the discipline of literature in lower secondary school in the school subject of Danish......, exploring students’ resources for stance-taking in their written literary response texts. In my presentation on Friday I will outline the theoretical grounding of the study and the preliminary findings. Drawing on the appraisal system within SFL (Hood, 2011; Martin & White, 2005) and the dimension...... of specialization within LCT (Maton, 2007, 2010), my analyses show a variation in students’ interpersonal meaning-making choices, linking their literary response texts within the same task to either primarily a knower or a knowledge code. This variation suggests a tension in the literature education at this time...

  8. Human vs. Computer performance in voice-based recognition of interpersonal stance

    NARCIS (Netherlands)

    Formolo, Daniel; Bosse, Tibor

    2017-01-01

    © 2017, Springer International Publishing AG. This paper presents an algorithm to automatically detect interpersonal stance in vocal signals. The focus is on two stances (referred to as ‘Dominant’ and ‘Empathic’) that play a crucial role in aggression de-escalation. To develop the algorithm, first a

  9. Signaling Organization and Stance: Academic Language Use in Middle Grade Persuasive Writing

    Science.gov (United States)

    Dobbs, Christina L.

    2014-01-01

    Effective academic writing is accessible to readers because writers follow shared conventions for organization and signal their stance on particular topics; however, few specifics are known about how middle graders might develop knowledge of and use these academic language forms and functions to signal their organization and stance in persuasive…

  10. Linguistic Markers of Stance in Early and Advanced Academic Writing: A Corpus-Based Comparison

    Science.gov (United States)

    Aull, Laura L.; Lancaster, Zak

    2014-01-01

    This article uses corpus methods to examine linguistic expressions of stance in over 4,000 argumentative essays written by incoming first-year university students in comparison with the writing of upper-level undergraduate students and published academics. The findings reveal linguistic stance markers shared across the first-year essays despite…

  11. Exploring Valued Patterns of Stance in Upper-Level Student Writing in the Disciplines

    Science.gov (United States)

    Lancaster, Zak

    2014-01-01

    Drawing on the appraisal framework from systemic functional linguistics (SFL), this article examines patterns of stance in a corpus of 92 high- and low-graded argumentative papers written in the context of an upper-level course in economics. It interprets differential patterns of stance in students' texts in light of interview commentaries…

  12. Explicit Learning of Authorial Stance-taking by L2 Doctoral Students

    Directory of Open Access Journals (Sweden)

    Peichin Chang

    2016-02-01

    Full Text Available Research on the texts of apprentice academic writers has found that they often exhibit weaknesses related to presenting an authoritative argumentative stance. This study rendered explicit linguistic resources for stance-taking and engaged advanced L2 writers in exploring stance expressions in published research. Both linguistic and language learning theories informed this study. Seven Mandarin-speaking learners of English from fields in social sciences engaged in three writing sessions in which they consulted a concordance tool organized and created to present genre moves (Swales 1990; 2004 and engagement strategies (Martin & White, 2005 used by academic authors in research introductions. Analysis of their drafts showed improvement in rhetorical move structure and stance deployment after using the tool. They were found to be more accurate in applying and identifying stances that present assertive claims and factual statements than moderately assertive stance expressions that present expansive meanings. Despite some success in learning, close text analysis reveals that more help is needed to support students in deploying appropriately assertive claims, substantiating strong claims, and managing their stance expression across several clauses. Overall, this study found that an explicit approach to learning about authorial stance has the potential to raise L2 writers’ consciousness and improve their writing.

  13. A Cross-Cultural Analysis of Stance in Disaster News Reports

    Science.gov (United States)

    Liu, Lian; Stevenson, Marie

    2013-01-01

    This study examines stance in cross-cultural media discourse by comparing disaster news reports on the Sichuan earthquake of May 2008 in a Chinese, an Australian Chinese, and an Australian newspaper. The stance taken in the news reports is examined using the Attitude sub-system of Martin and White's (2005) Appraisal framework. The analysis…

  14. The influence of the boxing stance on performance in professional boxers

    Directory of Open Access Journals (Sweden)

    Sorokowski Piotr

    2014-12-01

    Full Text Available In boxing, athletes choose between two strategies: the orthodox stance characteristic of right handed competitors, or the southpaw stance characteristic of left-handers. Despite a conviction popular among the practitioners of this sport that fighting against a southpaw opponent constitutes a handicap, the effectiveness of the type of stance has so far not been examined. We extracted the statistics of the top twenty active male professionals boxing in each of the seventeen weight divisions. Out of the 340 boxers who composed our group, 75% used the orthodox stance and 25% were southpaw. Generally, we found that boxing stance had no effect on the percentage of 340 top professional boxers’ victories. However, both the southpaw and the orthodox athletes had a higher percentage of victories against orthodox boxers than against southpaws.

  15. Limb dominance changes in walking evolution explored by asymmetric correlations in gait dynamics

    Science.gov (United States)

    Echeverria, Juan C.; Rodriguez, Eduardo; Velasco, Alejandra; Alvarez-Ramirez, Jose

    2010-04-01

    Fluctuations in the stride interval time series of unconstrained walking are not random but seem to exhibit long-range correlations that decay as a power law (Hausdorff et al. (1995) [35]). Here, we examine whether asymmetries are present in the long-range correlations of different gait parameters (stride, swing and stance intervals) for the left and right limbs. Gait dynamics corresponding to 16 healthy subjects were obtained from the Physionet database, which contains stride, stance and swing intervals for both left and right limbs. Detrended Fluctuation Analysis (DFA) revealed the presence of asymmetric long-range correlations in all gait cycle variables investigated. A rich variety of scaling exponent dynamics was found, with the presence of synchronicity, decreased correlations and dominant correlations. The results are discussed in terms of the hypothesis that reduced strength of long-range correlations reflect both enhanced stability and adaptability.

  16. Facilitation of motor and balance recovery by thermal intervention for the paretic lower limb of acute stroke: a single-blind randomized clinical trial.

    Science.gov (United States)

    Chen, Jia-Ching; Lin, Chun-Hsiang; Wei, Yu-Chun; Hsiao, Jung; Liang, Chung-Chao

    2011-09-01

    To evaluate the effectiveness of thermal stimulation accompanied by either active or passive movement added to standard rehabilitation in facilitating motor and balance function of the paretic leg of acute stroke. Pilot, observer-blinded, randomized clinical trial. Department of rehabilitation medicine in a general hospital. Thirty-six patients were enrolled within four weeks of the onset of a stroke causing moderate to severe leg paresis (Brunnstrom stage ≤III). Patients were randomly assigned to thermal (standard rehabilitation plus approximately 30-40 minutes of thermal stimulation therapy daily for six weeks) and control (standard rehabilitation only) groups. Fugl-Meyer lower extremity score, Medical Research Council scale for lower extremity, Modified Motor Assessment Scale, Postural Assessment Scale for Stroke Patients Trunk Control, Berg Balance Scale, Functional Ambulation Classification and Modified Ashworth Scale. Patients in the thermal group experienced significantly better median scores for Fugl-Meyer lower extremity (14.0; interquartile range, 10.5-15.5), Medical Research Council scale for lower extremity (6.0; 4.0-7.0), Modified Motor Assessment Scale (16.0; 12.5-18.5), Berg Balance Scale (28.0; 20.5-33.5), and Functional Ambulation Classification (2.0; 2.0-2.0) (all P < 0.05). The thermal group also had more independent walkers (15/17; 88.2%) than the control group (9/16; 56.3%) after six weeks (P = 0.06). No adverse effect occurred. Thermal stimulation accompanied by either manual facilitation or encouragement for active participation of the paretic lower limb may be an effective promising supplementary treatment for the early-phase rehabilitation of moderate to severe stroke that warrants additional study.

  17. A multisensory integration model of human stance control.

    Science.gov (United States)

    van der Kooij, H; Jacobs, R; Koopman, B; Grootenboer, H

    1999-05-01

    A model is presented to study and quantify the contribution of all available sensory information to human standing based on optimal estimation theory. In the model, delayed sensory information is integrated in such a way that a best estimate of body orientation is obtained. The model approach agrees with the present theory of the goal of human balance control. The model is not based on purely inverted pendulum body dynamics, but rather on a three-link segment model of a standing human on a movable support base. In addition, the model is non-linear and explicitly addresses the problem of multisensory integration and neural time delays. A predictive element is included in the controller to compensate for time delays, necessary to maintain erect body orientation. Model results of sensory perturbations on total body sway closely resemble experimental results. Despite internal and external perturbations, the controller is able to stabilise the model of an inherently unstable standing human with neural time delays of 100 ms. It is concluded, that the model is capable of studying and quantifying multisensory integration in human stance control. We aim to apply the model in (1) the design and development of prostheses and orthoses and (2) the diagnosis of neurological balance disorders.

  18. Stance disturbance in multiple sclerosis: brainstem lesions and posturographic assessment

    Directory of Open Access Journals (Sweden)

    Peter Schalek

    2012-01-01

    Full Text Available

    Background. Balance disorders are commonly evidenced during the course of multiple sclerosis (MS. The aim of this study is to report characteristics of MS patient stance control disorders, measured by means of posturography and related to the brainstem lesions.

    Methods. Thirty-eight patients affected by MS, mildly to moderately disable according to Kurtzke’s Expanded Disability Status Scale, underwent a complete clinical neurological and vestibular evaluation and brain MRI scanning. All patients were then tested on a static posturography platform (Tetrax, Israel in four conditions: eyes open and closed standing on a firm surface and on a foam pad.

    Results. Clinical and/or MRI evidence of brainstem involvement was observed in 55.3 % of patients. When brainstem lesion was detected, Fourier analysis showed a typical pattern characterized by inversion of the  0- 0.1 Hz and  0.1 - 0.25 Hz. frequency bands.

    Conclusions. MS leads to pervasive postural disturbances in the majority of subjects, including the visuo-vestibular loops and proprioception involving vestibulo-spinal pathways in at least 55.3 % of patients. Our results may also suggest the presence of Fourier inversion in patients with brainstem lesions.


  19. Does Iliopsoas Tightness Affects Synergistic Muscle Activity in Hip Extension During Stance Phase of Gait?

    Directory of Open Access Journals (Sweden)

    Shirin Aali

    2017-06-01

    Full Text Available Background and objective: Iliopsoas stiffness and restricted hip extension ROM affect muscle balance and lumbopelvic alignment. The purpose of this research is study of iliopsoas tightness’ effect on electromyographic activity of hip extensor synergists during gait. Methods: In this case-control study 15 adolescents with iliopsoas tightness as experimental group, and 15 healthy adolescents which matched based on age, height, weight, BMI, dominant leg, and sport experience participated voluntarily as control group. Surface electromyographic (sEMG activity of the gluteus maximus, adductor magnus, and biceps femoris, were measured between groups during stance phase of gait. Results: Individuals with restricted hip flexor muscle length demonstrated more gluteus maximus activation during terminal stance (p=0.001, more biceps femoris activation during mid stance (p=0.002 and late stance (p=0.001 and more adductor magnus activation during mid stance (p=0.04 and late stance (p=0.001. Discussion and conclusion: Adolescent soccer athletes with hip flexor muscle tightness exhibit more biceps femoris and adductor magnus and gluteus maximus activation during stance phase of gait. Thus, individuals with hip flexor muscle tightness appear to utilize different neuromuscular strategies to control lower extremity motion.

  20. Upper Limb Exoskeleton

    NARCIS (Netherlands)

    Rusak, Z.; Luijten, J.; Kooijman, A.

    2015-01-01

    The present invention relates a wearable exoskeleton for a user having a torso with an upper limb to support motion of the said upper limb. The wearable exoskeleton comprises a first fixed frame mountable to the torso, an upper arm brace and a first group of actuators for moving the upper arm brace

  1. Walking with wider steps increases stance phase gluteus medius activity.

    Science.gov (United States)

    Kubinski, Samantha N; McQueen, Christina A; Sittloh, Keir A; Dean, Jesse C

    2015-01-01

    Increases in step width have been reported for several clinical populations, including older adults and stroke survivors. These populations often also exhibit decreased hip abductor strength, suggesting that walking with wider steps may be an adaptive response in order to reduce the mechanical demands on the hip abductors. The purpose of this study was to quantify the relationship between step width and gluteus medius (GM) activity during walking. Fourteen young, uninjured adults walked on a treadmill at 1.25 m/s for four step width conditions (Normal, Narrow, Medium, and Wide) while step width and stance phase GM electromyographic (EMG) activity were quantified. We also measured hip abduction torque and GM activity during maximum voluntary isometric contractions (MVICs) at three hip angles (neutral, abducted 10°, and abducted 20°). During walking trials, GM activity was significantly (p < 0.0001) influenced by step width; compared to Normal walking, GM activity was 47% higher with Wide steps and 24% lower with Narrow steps. We also observed a weak positive correlation (r = 0.18 ± 0.14) between step width and GM activity during Normal walking, as GM activity was higher with wider steps. These results cannot be attributed to changes in GM conformation under the recording electrode, as GM activity was not influenced by hip angle during MVICs. The increased GM activity with wider steps does not support the proposal that increasing step width would be a beneficial adaptation to weakened hip abductors. A likely alternative explanation is that increased step width is a response to decreased gait balance. Published by Elsevier B.V.

  2. Leg movement tracking in automatic video-based one-leg stance evaluation.

    Science.gov (United States)

    Kawa, Jacek; Stępień, Paula; Kapko, Wojciech; Niedziela, Aleksandra; Derejczyk, Jarosław

    2018-04-01

    Falls are a major risk in elder population. Early diagnosis is therefore an important step towards increasing the safety of elders. One of the common diagnostic tests is the Berg Balance Scale (BBS), consisting of 14 exercises arranged from the easiest (sitting-to-standing) to the most demanding (one-leg stance). In this study a novel approach to the automatic assessment of the time in which the patient can remain in the one-leg stance position without loosing balance is introduced. The data is collected using a regular video camera. No markers, special garments, or system calibration are required. Two groups are examined. The first group consists of 16 students: healthy, young adults (12 female, 4 male, avg. 20yrs±1). The second group consists of 50 elders (39 female, 11 male, avg. 78.8yrs±5.9). Data (short, one minute recordings) are collected in a controlled environment using a digital video recorder (50fps, 1920×1080) fixed to a tripod. Data are processed off-line. First, the region of interest is determined. Next, the Kanade-Lucas-Tomasi tracking is performed. Best tracks are selected based on the registered vertical movement and two tracks are obtained corresponding to the left and right leg movements. Tracks are later subjected to the sparse signal baseline estimation, denoising and thresholding to detect the raised leg. Results are compared frame-wise to the ground truth reference obtained in the manual processing procedure. Both legs are evaluated in the elder group (in all cases several attempts featuring both legs were registered), resulting in 89.18%±11.27% DICE, 93.07%±5.43% sensitivity and 96.94%±6.11% specificity values for both legs. The signal of a single leg is evaluated in the student group (in all cases only one attempt was needed to perform the full examination) resulting in 98.96%±1.2% DICE, 98.78%±1.65% sensitivity and 98.73%±2.69% specificity values. This is the first step towards a video-based system enabling the automatic

  3. Adaptive behaviour of the spinal cord in the transition from quiet stance to walking

    OpenAIRE

    Serrao Mariano; Ranavolo Alberto; Andersen Ole; Conte Carmela; Don Romildo; Cortese Francesca; Mari Silvia; Draicchio Francesco; Padua Luca; Sandrini Giorgio; Pierelli Francesco

    2012-01-01

    Abstract Background Modulation of nociceptive withdrawal reflex (NWR) excitability was evaluated during gait initiation in 10 healthy subjects to investigate how load- and movement-related joint inputs activate lower spinal centres in the transition from quiet stance to walking. A motion analysis system integrated with a surface EMG device was used to acquire kinematic, kinetic and EMG variables. Starting from a quiet stance, subjects were asked to walk forward, at their natural speed. The su...

  4. Tibialis anterior stretch reflex in early stance is suppressed by repetitive transcranial magnetic stimulation

    DEFF Research Database (Denmark)

    Zuur, Abraham T; Christensen, Mark Schram; Sinkjær, Thomas

    2009-01-01

    Abstract A rapid plantar flexion perturbation in the early stance phase of walking elicits a large stretch reflex in tibialis anterior (TA). In this study we use repetitive Transcranial Magnetic Stimulation (rTMS) to test if this response is mediated through a transcortical pathway. TA stretch...... reflexes were elicited in the early stance phase of the step cycle during treadmill walking. 20 minutes of 1 Hz rTMS at 115% resting motor threshold (MTr) significantly decreased (p

  5. Homunculi, the mereological fallacy and crypto-dualism. Two dilemmas for the intentional stance

    OpenAIRE

    Balderas-Rosas, G.C. (Gloria del Carmen)

    2014-01-01

    Neuroscientist Maxwell Bennett and philosopher Peter Hacker defend the need to eradicate the mereological fallacy of cognitive neuroscience. This fallacy attributes to the parts of an animal psychological predicates that make sense only when applied to the whole animal. In contrast, philosopher Daniel Dennett argues that it is possible to explain behavior and cognitive abilities by applying the Intentional Stance (IS) to the brain, a stance that attributes increasingly simple psychological ca...

  6. Unilateral Stance Strategies of Athletes With ACL Deficiency

    Science.gov (United States)

    Di Stasi, Stephanie L.; Hartigan, Erin H.; Snyder-Mackler, Lynn

    2013-01-01

    Aberrant movement strategies are characteristic of ACL-deficient athletes with recurrent knee instability (non-copers), and may instigate premature or accelerate joint degradation. Biomechanical evaluation of kinematic changes over time may elucidate noncopers’ responses to neuromuscular intervention and ACL reconstruction (ACLR). Forty noncopers were randomized into a perturbation group or a strength training only group. We evaluated the effects of perturbation training, and then gender on knee angle and tibial position during a unilateral standing task before and after ACLR. No statistically significant interactions were found. Before surgery, the strength training only group demonstrated knee angle asymmetry, but 6 months after ACLR, both groups presented with similar knee flexion between limbs. Aberrant and asymmetrical tibial position was found only in females following injury and ACLR. Neither treatment group showed distinct unilateral standing strategies following intervention; however, males and female noncopers appear to respond uniquely to physical therapy and surgery. PMID:22983931

  7. Limb, tooth, beak: Three modes of development and evolutionary ...

    Indian Academy of Sciences (India)

    Here we compare the embryological processes that shape the vertebrate limb bud, the mammalian tooth and the avian beak. The implied notion of development in the standard evolutionary picture is met only in the case of the vertebrate limb, a single-primordium organ with morphostatic shaping, in which cells rearrange in ...

  8. As Go the Feet … : On the Estimation of Attentional Focus from Stance

    Science.gov (United States)

    Quek, Francis; Ehrich, Roger; Lockhart, Thurmon

    2010-01-01

    The estimation of the direction of visual attention is critical to a large number of interactive systems. This paper investigates the cross-modal relation of the position of one's feet (or standing stance) to the focus of gaze. The intuition is that while one CAN have a range of attentional foci from a particular stance, one may be MORE LIKELY to look in specific directions given an approach vector and stance. We posit that the cross-modal relationship is constrained by biomechanics and personal style. We define a stance vector that models the approach direction before stopping and the pose of a subject's feet. We present a study where the subjects' feet and approach vector are tracked. The subjects read aloud contents of note cards in 4 locations. The order of `visits' to the cards were randomized. Ten subjects read 40 lines of text each, yielding 400 stance vectors and gaze directions. We divided our data into 4 sets of 300 training and 100 test vectors and trained a neural net to estimate the gaze direction given the stance vector. Our results show that 31% our gaze orientation estimates were within 5°, 51% of our estimates were within 10°, and 60% were within 15°. Given the ability to track foot position, the procedure is minimally invasive. PMID:20830212

  9. PROJECTING GENDER IDENTITY THROUGH METADISCOURSE MARKING: INVESTIGATING WRITERS’ STANCE TAKING IN WRITTEN DISCOURSE

    Directory of Open Access Journals (Sweden)

    Zari Sadat Seyyedrezaie

    2017-01-01

    Full Text Available The present study aimed at investigating gender identity through the expression of interpersonal metadiscourse stance marking. The current study investigated male and female authors' pattern of stance markers utilization, focusing on totally 60 English and Persian articles, and English articles written by Persian speakers. Based on Xu and Longs'(2008 classification, five categories of stance markers (textual, epistemic, attitudinal, deontic and causation were identified and the frequencies of their occurrences were computed. The differences in each group were investigated separately through running chi-square tests. Regarding English articles, it was found that both male and female writers used the same pattern of stance taking except the epistemic markers. Another finding of this study was that both male and female writers followed the same pattern of stance taking in Persian articles except the deontic ones. In English articles written by Persian speakers, female writers used the same pattern as their native counterparts, while male ones were affected mostly by their native language. Attending to stance taking patterns, this article provides an informative picture which illustrates the common preferences of disciplinary community especially between male and female writers. Hence, the implications of this study can be helpful in academic writing, in assessment, and textbooks.

  10. Comparison of Open and Closed Stance Forehand Strokes among Intermediate Tennis Players

    Directory of Open Access Journals (Sweden)

    Tajul Arifin Muhamad

    2016-01-01

    Full Text Available Background: Nowadays tennis is becoming faster and players are able to hit powerful from virtually anywhere on the tennis court. Training programmers and effective planning will help in designing safe, effective, and productive programs designed to help optimize the tennis performance of players. Objective: This research examine the effectiveness of open and closed stance forehand strokes in terms of percentage of success, accuracy and also to investigate whether there is a relation between level of accuracy and the choice of forehand strokes used by tennis player. Method: Participants were divided into two groups, namely, male and female who learned forehand strokes for one month. The participants were tested by using a two skill test for percentage of success and level of accuracy. Result: Founding showed that the closed stance forehand stroke has far better percentage of success and accuracy among the intermediate tennis players, but the difference was not significant. In addition, male players showed more accuracy and success in this research. And also accuracy did not have any influence to choice of forehand stroke among the intermediate tennis players. Conclusion: This research could improve the training protocol design for teaching the closed stance and open stance strokes. Keywords: Forehand stroke, open stance, closed stance, tennis accuracy, percentage of success

  11. Social support satisfaction in adults with eating disorders: Does stance matter?

    Science.gov (United States)

    Geller, Josie; Iyar, Megumi; Srikameswaran, Suja; Zelichowska, Joanna; Dunn, Erin C

    2017-07-01

    Although the role of social support is clearly established in the recovery of youth with eating disorders, little is known about factors that contribute to support satisfaction and improved treatment outcome in adults. This study examined the contribution of patient factors and perceived support stance used by family and friends in determining social support satisfaction. Individuals meeting DSM-IV criteria for an eating disorder (n = 182) completed measures of eating disorder and psychiatric severity, interpersonal functioning, perceived support stance used by family and friends, and social support satisfaction. Correlations indicated that both patient factors (lower psychiatric distress and fewer interpersonal difficulties) and perceived support stance (higher concerned and lower directive support) were associated with patient support satisfaction. Multiple regression analyses indicated that perceived support stance accounted for greater variance in social support satisfaction than did patient factors. Patient age was associated with differences in preferred support stance: expressions of caring were most critical for younger patients, whereas not being criticized or told what to do was most significant for older patients. This research suggests that the stance used when offering support is vital to the care of individuals with eating disorders. © 2017 Wiley Periodicals, Inc.

  12. Accuracy and precision of equine gait event detection during walking with limb and trunk mounted inertial sensors

    DEFF Research Database (Denmark)

    Olsen, Emil; Andersen, Pia Haubro; Pfau, Thilo

    2012-01-01

    Measurement Units (IMUs). Four IMUs were mounted on the distal limb and five IMUs were attached to the skin over the dorsal spinous processes at the withers, fourth lumbar vertebrae and sacrum as well as left and right tuber coxae. IMU data were synchronised to a force plate array and a motion capture system....... Accuracy (bias) and precision (SD of bias) was calculated to compare force plate and IMU timings for gait events. Data were collected from seven horses. One hundred and twenty three (123) front limb steps were analysed; hoof-on was detected with a bias (SD) of -7 (23) ms, hoof-off with 0.7 (37) ms...... and front limb stance with -0.02 (37) ms. A total of 119 hind limb steps were analysed; hoof-on was found with a bias (SD) of -4 (25) ms, hoof-off with 6 (21) ms and hind limb stance with 0.2 (28) ms. IMUs mounted on the distal limbs and sacrum can detect gait events accurately and precisely....

  13. Comparison of hamstring and quadriceps femoris electromyographic activity between men and women during a single-limb squat on both a stable and labile surface.

    Science.gov (United States)

    Youdas, James W; Hollman, John H; Hitchcock, James R; Hoyme, Gregory J; Johnsen, Jeremiah J

    2007-02-01

    The purpose of this study was to determine if women are quadriceps dominant and men are hamstring dominant during the performance of a partial single-leg squat (SLS) on both a stable and labile ground surface against body weight resistance. Thirty healthy participants (15 men and 15 women) performed an SLS on both a stable surface and a 6.4-cm-thick vinyl pad. Surface electromyographic (EMG) recordings were obtained from the quadriceps femoris and hamstring muscles during the extension phase of the SLS. Statistical analysis revealed that women produced 14% more EMG activity (p = 0.04) in their quadriceps than the men during the SLS on a stable surface, whereas the men generated 18% more EMG activity (p = 0.04) in their hamstrings than the women during the SLS on a labile surface. Additionally, we found a statistically significant sex effect (p = 0.048) for the hamstring/quadriceps (H/Q) EMG ratio, which was 2.25 and 0.62, respectively, for men and women on the stable surface and 2.52 and 0.71, respectively, on the labile surface. We concluded that women are quadriceps dominant and men are hamstring dominant during the performance of SLS against body weight resistance on either a stable or labile surface condition. During an SLS, men showed an H/Q ratio approximately 3.5 times larger than their female counterparts, suggesting that men activate their hamstrings more effectively than women during an SLS. According to our data, the SLS may not be an ideal exercise for activating the hamstring muscles in women without additional neuromuscular training techniques, because women are quadriceps dominant during the SLS.

  14. Running over rough terrain reveals limb control for intrinsic stability.

    Science.gov (United States)

    Daley, Monica A; Biewener, Andrew A

    2006-10-17

    Legged animals routinely negotiate rough, unpredictable terrain with agility and stability that outmatches any human-built machine. Yet, we know surprisingly little about how animals accomplish this. Current knowledge is largely limited to studies of steady movement. These studies have revealed fundamental mechanisms used by terrestrial animals for steady locomotion. However, it is unclear whether these models provide an appropriate framework for the neuromuscular and mechanical strategies used to achieve dynamic stability over rough terrain. Perturbation experiments shed light on this issue, revealing the interplay between mechanics and neuromuscular control. We measured limb mechanics of helmeted guinea fowl (Numida meleagris) running over an unexpected drop in terrain, comparing their response to predictions of the mass-spring running model. Adjustment of limb contact angle explains 80% of the variation in stance-phase limb loading following the perturbation. Surprisingly, although limb stiffness varies dramatically, it does not influence the response. This result agrees with a mass-spring model, although it differs from previous findings on humans running over surfaces of varying compliance. However, guinea fowl sometimes deviate from mass-spring dynamics through posture-dependent work performance of the limb, leading to substantial energy absorption following the perturbation. This posture-dependent actuation allows the animal to absorb energy and maintain desired velocity on a sudden substrate drop. Thus, posture-dependent work performance of the limb provides inherent velocity control over rough terrain. These findings highlight how simple mechanical models extend to unsteady conditions, providing fundamental insights into neuromuscular control of movement and the design of dynamically stable legged robots and prosthetic devices.

  15. Unilateral hip osteoarthritis: Its effects on preoperative lower limb muscle activation and intramuscular coordination patterns.

    Science.gov (United States)

    Schmidt, André; Stief, Felix; Lenarz, Katharina; Froemel, Dara; Lutz, Frederick; Barker, John; Meurer, Andrea

    2016-03-01

    The objective of this study was to test if patients with unilateral hip osteoarthritis (OA) show greater muscle activity asymmetry between their affected and non-affected limbs than healthy controls between their left and right limbs. Seventeen patients with unilateral hip OA (7 females, 10 males) and 17 age-matched healthy controls (7 females, 10 males) participated in this study. Both groups performed instrumented gait analysis at comparable speeds. Muscle activity was recorded simultaneously for the tibialis anterior (TA), gastrocnemius medialis (GM), vastus lateralis (VL), semitendinosus (ST), tensor fasciae latae (TFL), and gluteus medius (GLM) muscles. In hip OA patients, EMG data showed greater activity of the TA muscle in the non-affected limb, and greater TFL muscle activity in the affected limb. Compared to healthy controls, greater asymmetries between paired limbs were observed for the TA and GM muscles. Finally, the TFL muscle of the affected limb contributed more to the total limb muscle activity than did the non-affected limb. The observed alterations in TA and GM muscle activity in hip OA patients may be due to the greater peak braking and peak vertical forces measured in the non-affected limb. Contrary to this, greater TLF muscle activity of the affected limb indicates the demands put on stabilizing the hip during stance phase. Further studies are necessary to test whether leg length discrepancy affects muscle activation alterations between the affected and non-affected limb in unilateral hip OA patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Frontal Plane Motion of the Pelvis and Hip during Gait Stance Discriminates Children with Diplegia Levels I and II of the GMFCS.

    Science.gov (United States)

    Kirkwood, Renata Noce; Franco, Rosa de Lourdes Lima Dias; Furtado, Sheyla Cavalcanti; Barela, Ana Maria Forti; Deluzio, Kevin John; Mancini, Marisa Cotta

    2012-01-01

    Objective. To determine if gait waveform could discriminate children with diplegic cerebral palsy of the GMFCS levels I and II. Patients. Twenty-two children with diplegia, 11 classified as level I and 11 as level II of the GMFCS, aged 7 to 12 years. Methods. Gait kinematics included angular displacement of the pelvis and lower limb joints during the stance phase. Principal components (PCs) analyses followed by discriminant analysis were conducted. Results. PC1s of the pelvis and hip in the frontal plane differ significantly between groups and captured 80.5% and 86.1% of the variance, respectively. PC1s captured the magnitude of the pelvic obliquity and hip adduction angle during the stance phase. Children GMFCS level II walked with reduced pelvic obliquity and hip adduction angles, and these variables could discriminate the groups with a cross-validation of 95.5%. Conclusion. Reduced pelvic obliquity and hip adduction were observed between children GMFCS level II compared to level I. These results could help the classification process of mild-to-moderate children with diplegia. In addition, it highlights the importance of rehabilitation programs designed to improve pelvic and hip mobility in the frontal plane of diplegic cerebral palsy children level II of the GMFCS.

  17. Climate Literacy for Kids: Finding Medium, Message, and Stance

    Science.gov (United States)

    Fisher, D. K.; Leon, N.; Jackson, R.; Greene, M. P.

    2011-12-01

    . Various recycling bins (glass, plastic, metal, and paper) are lined up on the left and right sides of the screen, with a trash bin at the bottom. As an item drops, the player must quickly decide what kind of material it is made of and whether it is recyclable, then guide it into the appropriate bin. As the rate of items entering play increases, any missed items fall into the trash and stay there for a length of time proportional to their decomposition time. If the trash bin gets full, the game is over. While enjoying the increasing challenge of the game, players learn to identify many items as recyclable that they may not have recognized as recyclable before. Another feature on Climate Kids is "Climate Tales," a slightly edgy animated cartoon series (two episodes so far) about the adventures of a blundering polar bear, a chirpy tamarin monkey, and a grumpy old fish as "accidental tourists" around the planet, observing and dealing with the environmental conditions they encounter. Fairly complex concepts (such as reasons and implications of the declining abundance of phytoplankton) are woven into the tales. Climate Kids is a fun site for kids, educational and realistic, and yet positive and hopeful-the only reasonable stance to present to this young audience.

  18. Use of Hybrid Assistive Limb (HAL®) for a postoperative patient with cerebral palsy: a case report.

    Science.gov (United States)

    Mataki, Yuki; Kamada, Hiroshi; Mutsuzaki, Hirotaka; Shimizu, Yukiyo; Takeuchi, Ryoko; Mizukami, Masafumi; Yoshikawa, Kenichi; Takahashi, Kazushi; Matsuda, Mayumi; Iwasaki, Nobuaki; Kawamoto, Hiroaki; Wadano, Yasuyoshi; Sankai, Yoshiyuki; Yamazaki, Masashi

    2018-03-27

    The Hybrid Assistive Limb (HAL ® ) is an exoskeleton wearable robot suit that assists in voluntary control of knee and hip joint motion. There have been several studies on HAL intervention effects in stroke, spinal cord injury, and cerebral palsy. However, no study has investigated HAL intervention for patients with cerebral palsy after surgery. We report a case of using HAL in a postoperative patient with cerebral palsy. A 15-year-old boy was diagnosed with spastic diplegia cerebral palsy Gross Motor Function Classification System level IV, with knee flection contracture, equinus foot, and paralysis of the right upper extremity with adduction contracture. He underwent tendon lengthening of the bilateral hamstrings and Achilles tendons. Although the flexion contractures of the bilateral knees and equinus foot improved, muscle strength decreased after the soft tissue surgery. HAL intervention was performed twice during postoperative months 10 and 11. Walking speed, stride, and cadence were increased after HAL intervention. Post HAL intervention, extension angles of the knee in stance phase and hip in the pre-swing phase were improved. In the gait cycle, the proportion of terminal stance in the stance and swing phase was increased. Hybrid Assistive Limb intervention for postoperative patients with cerebral palsy whose muscle strength decreases can enhance improvement in walking ability. Further studies are needed to examine the safety and potential application of HAL in this setting.

  19. Changes in involved and uninvolved limb function during rehabilitation after anterior cruciate ligament reconstruction: implications for Limb Symmetry Index measures.

    Science.gov (United States)

    Rohman, Eric; Steubs, J Tyler; Tompkins, Marc

    2015-06-01

    Functional testing is used to assess anterior cruciate ligament (ACL) reconstruction rehabilitation, with the goal of symmetric ability. The pattern of change in the uninvolved limb's function during rehabilitation is not established. (1) Involved and uninvolved limb ability increases during rehabilitation, but the uninvolved limb ability increases to a lesser degree. (2) Hop tests will show larger initial asymmetry and will improve the most with rehabilitation. Cohort study; Level of evidence, 3. This was a retrospective case series of 122 patients who underwent ACL reconstruction at our ambulatory surgery center and received multiple postoperative Standard Functional Tests (SFTs) between October 2009 and October 2013. Ten of the 12 individual tests within the SFT battery were analyzed. The patients' earliest and latest SFTs were compared for changes in Limb Symmetry Index (LSI) and absolute function in each limb. We also analyzed the subgroup with SFTs (n = 38) at both 4 and 6 months postoperatively. In all patients with multiple SFTs, involved limb performance increased in all tests except eyes-closed stork. Uninvolved limb performance increased in 4 SFT component tests and decreased in none. LSI significantly improved in 6 tests, all of which also showed involved limb improvement that was significant. Of these 6 tests, 5 showed initial LSI below 90%: single-leg squat, retro step-up, single-leg hop, crossover triple hop, and timed hop. Retro step-up and single-leg hop showed LSI improvements greater than 10 percentage points. In patients with 4- and 6-month data, involved limb performance increased in all tests except single-leg triple hop. Uninvolved limb performance increased in 5 SFT component tests and decreased in none. LSI significantly improved in 4 tests, all of which had initial LSI below 90%, and showed involved limb improvement that was significant. Retro step-up, single-leg hop, and crossover triple hop showed LSI improvements greater than 10

  20. Enhancing Organizational Survivability in a Crisis: Perceived Organizational Crisis Responsibility, Stance, and Strategy

    Directory of Open Access Journals (Sweden)

    JiYeon Jeong

    2015-08-01

    Full Text Available For the purpose of enhancing organizational sustainability during a crisis, an organization takes a position in decision-making, how to respond toward its public, and that is supposed to determine which stance or tactic to employ. This study aims to examine whether publics’ perceptions of organizational crisis responsibility affect their expectations that an organization should choose certain stances and strategies toward the public in a crisis. To address these concerns, an experiment was conducted. As the specific public of this research, health journalists were selected, since they affect public perceptions significantly and public opinion can ultimately put pressure on an organization. Results from an analysis of the experimental data with health journalists confirm that they expect a more accommodative stance/strategy when they perceive that the organization is highly responsible for a health-related crisis. Conversely, when the journalists perceive that an organization has a low level of responsibility for a crisis, they expect a more advocative stance/strategy. By taking into account the health journalists’ expectations along with the needs of the organization, public relations practitioners are better able to make optimal decisions regarding their client organizations’ adopted stance and strategy, and finally, enhance organizational sustainability in a crisis.

  1. Modulation of phase durations, phase variations, and temporal coordination of the four limbs during quadrupedal split-belt locomotion in intact adult cats.

    Science.gov (United States)

    D'Angelo, Giuseppe; Thibaudier, Yann; Telonio, Alessandro; Hurteau, Marie-France; Kuczynski, Victoria; Dambreville, Charline; Frigon, Alain

    2014-10-15

    Stepping along curvilinear paths produces speed differences between the inner and outer limb(s). This can be reproduced experimentally by independently controlling left and right speeds with split-belt locomotion. Here we provide additional details on the pattern of the four limbs during quadrupedal split-belt locomotion in intact cats. Six cats performed tied-belt locomotion (same speed bilaterally) and split-belt locomotion where one side (constant side) stepped at constant treadmill speed while the other side (varying side) stepped at several speeds. Cycle, stance, and swing durations changed in parallel in homolateral limbs with shorter and longer stance and swing durations on the fast side, respectively, compared with the slow side. Phase variations were quantified in all four limbs by measuring the slopes of the regressions between stance and cycle durations (rSTA) and between swing and cycle durations (rSW). For a given limb, rSTA and rSW were not significantly different from one another on the constant side whereas on the varying side rSTA increased relative to tied-belt locomotion while rSW became more negative. Phase variations were similar for homolateral limbs. Increasing left-right speed differences produced a large increase in homolateral double support on the slow side, while triple-support periods decreased. Increasing left-right speed differences altered homologous coupling, homolateral coupling on the fast side, and coupling between the fast hindlimb and slow forelimb. Results indicate that homolateral limbs share similar control strategies, only certain features of the interlimb pattern adjust, and spinal locomotor networks of the left and right sides are organized symmetrically. Copyright © 2014 the American Physiological Society.

  2. Immediate effects of the trunk stabilizing exercise on static balance parameters in double-leg and one-leg stances

    OpenAIRE

    Kim, Jwa-jun; Park, Se-yeon

    2016-01-01

    [Purpose] The purpose of this study was to evaluate the immediate effect of stabilizing exercise using the PNF technique on standing balance in one-leg and double-leg stances. [Subjects and Methods] The present study recruited 34 healthy participants from a local university. The Participants performed four balance tests (double-leg stance with and without vision, one-leg stance with and without vision), before and after exercise. The exercise consisted of exercises performed using PNF techniq...

  3. Effect of lower limb preference on variability of centre of pressure movement during gait

    Directory of Open Access Journals (Sweden)

    Zdeněk Svoboda

    2015-12-01

    Full Text Available Background: Centre of pressure (COP movement variability, as an example of 'end-point' variability (stability, may be one of the indicators that can assess the functional gait asymmetry caused by foot preference in relation to fall risk. Objective: The aim of this study was to investigate the possible differences in COP movement variability during the stance phase of gait caused by both aging and lower limb preference. Methods: Two groups of females participated in this study: Younger (n = 25, age 22.2 ± 1.8 years and Middle-aged (n = 25, age 56.6 ± 4.9 years. COP movement and ground reaction forces during gait at self-selected speed were recorded using two force platforms. The standard deviations of the medial-lateral and anterior-posterior COP displacements in four subphases: loading response (LR, midstance (MSt, terminal stance (TSt and pre-swing (PSw were assessed. Results: The observed variables indicated significantly higher mean values in almost all cases in subphases LR and PSw in comparison with MSt and TSt. When comparing preferred and non-preferred limb, the preferred limb showed greater variability in medial-lateral direction during LR and less variability in anterior-posterior direction during PSw. In the Younger group, greater variability was found on preferred limb in anterior-posterior direction during LR. When assessing age-related differences all significant cases showed higher variability in the Middle-aged group. Conclusions: The results suggest that COP movement variability is less on the non-preferred limb during weight acceptance and on the preferred limb during propulsion.

  4. The application of accelerometers to measure movements of upper limbs: Pilot study

    Directory of Open Access Journals (Sweden)

    Patrik Kutilek

    2017-03-01

    Full Text Available Background: Even though inertial measurement units (IMU are already being used experimentally for evaluating movements of segment of the axial skeleton, no studies have been found which have used IMUs to measure the behavior of the segments of upper limbs during quiet stance. Objective: The objective is to design a suitable application of IMUs to measure movements of the upper extremities in Romberg's test and analyze spontaneous arm movements. Second aim is to identify possible discrepancies between the dominant and non-dominant arm movements. Methods: The dominant and non-dominant upper limb of each participant was identified. Then, the movements of both upper limbs were measured by the Xsens system equipped with MTx motion trackers during the quiet stance on a firm surface with eyes open (EO and eyes closed (EC. The measured data was used to calculate the medians and maximums of the superior-inferior, medio-lateral and anterior-posterior acceleration. Also, tremor intensity was calculated to quantitatively evaluate the measured data. Results: The comparison of values of maximal accelerations of the dominant and non-dominant arms showed significant difference between the arms during EC conditions. The comparison of values of median accelerations of the dominant and non-dominant arms showed significant differences between the acceleration of arms in medio-lateral direction during EO and EC conditions. In all cases, values of maximal and median accelerations and values of tremor intensity of the dominant limb strongly correlated with values on the non-dominant limb. Conclusions: Findings suggest possible usefulness of the designed application of IMUs and evaluation methods for their use in Romberg's test in clinical practice for evaluation of upper limb movements.

  5. Effects of taping and proprioceptive neuromuscular facilitation for stance phase duration of stroke patients.

    Science.gov (United States)

    Sung, Youn-Bum; Lee, Jun-Cheol; Kim, Kyoung

    2017-11-01

    [Purpose] The purpose of this study was to investigate the effects of taping and proprioceptive neuromuscular facilitation in stroke patients. [Subjects and Methods] Thirty patients who were diagnosed with hemiparalysis due to stroke were selected as subjects of study. Experiment group 1 patients had Kinesio taping applied before applying the PNF, while experiment group 2 patients had McConell taping applied before applying the PNF. The control group had only the PNF applied. The dartfish program was used to evaluate the stance phase of stroke patients. [Results] Experiment group 1 and experiment group 2 showed a significantly longer stance phase duration of the affected side than the control group in week 6. [Conclusion] Application of Kinesio taping has a more positive effect on the stance phase duration than McConell taping in the patients with stroke.

  6. Adolescent social media interaction and authorial stance in Indonesian teen fiction

    Directory of Open Access Journals (Sweden)

    Dwi Noverini Djenar

    2013-04-01

    Full Text Available This article examines representations of adolescent social media interaction in two Indonesian teen novels to show how adolescent communication styles are typified. It is argued that public discourse on the potential danger of social media interaction is resounded in the novels. The article demonstrates that the authors of both novels take a similar moral stance on the issue of social media but use different rhetorical strategies for indexing that stance. Both draw on the social values of registers to communicate the stance. In Online addicted, standard Indonesian is used in narration to convey an authoritative voice and a stern moral tone, while the gaul register indexes an alignment with favourable aspects of the protagonist’s character. In Jurnal Jo online, gaul is similarly given a positive value by virtue of its juxtaposition with the Alay register. In this novel, gaul is the preferred, standard register. In both novels, there is a strong orientation toward “standardness”.

  7. Detection of knee unlock during stance using accelerometry

    NARCIS (Netherlands)

    Veltink, Petrus H.; Franken, Henry M.; Franken, H.M.

    1996-01-01

    Detection of knee unlock is a crucial part of finite state artificial reflex control of paraplegic standing supported by functional neuromuscular stimulation (FNS). This paper investigates knee unlock detection schemes using small uniaxial accelerometers mounted on the thigh and shank. Four single

  8. Lower-limb proprioceptive awareness in professional ballet dancers.

    Science.gov (United States)

    Kiefer, Adam W; Riley, Michael A; Shockley, Kevin; Sitton, Candace A; Hewett, Timothy E; Cummins-Sebree, Sarah; Haas, Jacqui G

    2013-09-01

    Enhanced proprioceptive feedback strengthens synergistic muscle groups and stabilizes the coordination of limbs, thus contributing to the movement efficiency of ballet dancers. The present study compared lower-limb proprioceptive awareness in professional ballet dancers to matched controls who had no dance training. Two assessment methods were used to test the hypothesis that ballet dancers would demonstrate increased proprioceptive awareness in the ankle, knee, and hip: 1. a joint-position matching task to assess static proprioceptive joint awareness, and 2. an eyes-closed, quiet standing task to assess both static and dynamic proprioceptive awareness through measures of center of pressure (COP) variability. Results of the matching task indicated that the dancers exhibited greater proprioceptive awareness than controls for all three joints (p 0.05), whereas controls were less aware of their ankle position compared to their knee and hip joints (p 0.05). This indicates that quiet stance may have limited value as a means for evaluating proprioception. These findings provide preliminary evidence that enhanced proprioceptive awareness of lower limb joints should be considered as an evaluative criterion for dancers' ability to learn complex ballet skills. They also indicate that quiet standing tasks may not provide sufficient challenge for dancers' enhanced proprioceptive awareness to manifest.

  9. Organization position statements and the stance of "studied neutrality" on euthanasia in palliative care.

    Science.gov (United States)

    Johnstone, Megan-Jane

    2012-12-01

    In recent years, palliative care and related organizations have increasingly adopted a stance of "studied neutrality" on the question of whether euthanasia should be legalized as a bona fide medical regimen in palliative care contexts. This stance, however, has attracted criticism from both opponents and proponents of euthanasia. Pro-euthanasia activists see the stance as an official position of indecision that is fundamentally disrespectful of a patient's right to "choose death" when life has become unbearable. Some palliative care constituents, in turn, are opposed to the stance, contending that it reflects an attitude of "going soft" on euthanasia and as weakening the political resistance that has hitherto been successful in preventing euthanasia from becoming more widely legalized. In this article, attention is given to examining critically the notion and possible unintended consequences of adopting a stance of studied neutrality on euthanasia in palliative care. It is argued that although palliative care and related organizations have an obvious stake in the outcome of the euthanasia debate, it is neither unreasonable nor inconsistent for such organizations to be unwilling to take a definitive stance on the issue. It is further contended that, given the long-standing tenets of palliative care, palliative care organizations have both a right and a responsibility to defend the integrity of the principles and practice of palliative care and to resist demands for euthanasia to be positioned either as an integral part or logical extension of palliative care. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  10. Limb and Trunk Mechanisms for Balance Control during Locomotion in Quadrupeds

    Science.gov (United States)

    Musienko, Pavel E.; Deliagina, Tatiana G.; Gerasimenko, Yury P.; Orlovsky, Grigori N.

    2014-01-01

    In quadrupeds, the most critical aspect of postural control during locomotion is lateral stability. However, neural mechanisms underlying lateral stability are poorly understood. Here, we studied lateral stability in decerebrate cats walking on a treadmill with their hindlimbs. Two destabilizing factors were used: a brief lateral push of the cat and a sustained lateral tilt of the treadmill. It was found that the push caused considerable trunk bending and twisting, as well as changes in the stepping pattern, but did not lead to falling. Due to postural reactions, locomotion with normal body configuration was restored in a few steps. It was also found that the decerebrate cat could keep balance during locomotion on the laterally tilted treadmill. This postural adaptation was based on the transformation of the symmetrical locomotor pattern into an asymmetrical one, with different functional lengths of the right and left limbs. Then, we analyzed limb and trunk neural mechanisms contributing to postural control during locomotion. It was found that one of the limb mechanisms operates in the transfer phase and secures a standard (relative to the trunk) position for limb landing. Two other limb mechanisms operate in the stance phase; they counteract distortions of the locomotor pattern by regulating the limb stiffness. The trunk configuration mechanism controls the body shape on the basis of sensory information coming from trunk afferents. We suggest that postural reactions generated by these four mechanisms are integrated, thus forming a response of the whole system to perturbation of balance during locomotion. PMID:24741060

  11. Isolated limb perfusion.

    Science.gov (United States)

    Gillespie, Rosalyn; Chantier, Nariane

    1994-12-08

    Growing concern over the rising incidence of malignant melanoma has brought about a need for information on this disorder and the treatment available. Isolated limb perfusion is a relatively new technique used in only a few hospitals. An increased knowledge base will lead to a better understanding of the nursing care required and to a more in-depth care plan.

  12. The association between intersegmental coordination in the lower limb and gait speed in elderly females.

    Science.gov (United States)

    Ogaya, Shinya; Iwata, Akira; Higuchi, Yumi; Fuchioka, Satoshi

    2016-07-01

    Human multi-segmental motion is a complex task requiring motor coordination. Uncoordinated motor control may contribute to the decline in mobility; however, it is unknown whether the age-related decline in intersegmental coordination relates to the decline in gait performance. The aim of this study was to clarify the association between intersegmental coordination and gait speed in elderly females. Gait measurements were performed in 91 community-dwelling elderly females over 60 years old. Foot, shank, and thigh sagittal motions were assessed. Intersegmental coordination was analyzed using the mean value of the continuous relative phase (mCRP) during four phases of the gait cycle to investigate phase differences in foot-shank and shank-thigh motions during a normal gait. The results showed that foot-shank mCRP at late stance had negative correlations with gait speed (r=-0.53) and cadence (r=-0.54) and a positive correlation with age (r=0.25). In contrast, shank-thigh mCRP at late stance had positive correlations with gait speed (r=0.37) and cadence (r=0.56). Moreover, partial correlation, controlling age, height, and weight, revealed that foot-shank mCRP at late stance had negative correlations with gait speed (r=-0.52) and cadence (r=-0.54). Shank-thigh mCRP at late stance had a positive correlation with gait speed (r=0.28) and cadence (r=0.51). These findings imply that the foot-shank and shank-thigh coordination patterns at late stance relate to gait speed, and uncoordinated lower limb motion is believed to be associated with the age-related decline in cadence. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Biomechanics of the upper limb

    OpenAIRE

    Łukasz Jaworski; Robert Karpiński; Angelika Dobrowolska

    2016-01-01

    The article presents basics of the human upper limb’s anatomy, including skeletal system, joints and basic division of muscles in the limb. The biomechanics of the upper limb is introduced. The range of performed motions is depicted. The possible applications of anatomy and biomechanics of the upper limb are shown.

  14. How Can a Taxonomy of Stances Help Clarify Classical Debates on Scientific Change?

    Directory of Open Access Journals (Sweden)

    Hakob Barseghyan

    2017-11-01

    Full Text Available In this paper, we demonstrate how a systematic taxonomy of stances can help elucidate two classic debates of the historical turn—the Lakatos–Feyerabend debate concerning theory rejection and the Feyerabend–Kuhn debate about pluralism during normal science. We contend that Kuhn, Feyerabend, and Lakatos were often talking at cross-purposes due to the lack of an agreed upon taxonomy of stances. Specifically, we provide three distinct stances that scientists take towards theories: acceptance of a theory as the best available description of its domain, use of a theory in practical applications, and pursuit (elaboration of a theory. We argue that in the Lakatos–Feyerabend debate, Lakatos was concerned with acceptance whereas Feyerabend was mainly concerned with pursuit. Additionally, we show how Feyerabend and Kuhn’s debate on the role of pluralism/monism in normal science involved a crucial conflation of all three stances. Finally, we outline a few general lessons concerning the process of scientific change.

  15. Effect of a Wide Stance on Block Start Performance in Sprint Running.

    Science.gov (United States)

    Otsuka, Mitsuo; Kurihara, Toshiyuki; Isaka, Tadao

    2015-01-01

    This study aimed to clarify the effect of widened stance width at the set position during the block start phase in sprint running on kinematics and kinetics at the hip joint and block-induced power. Fourteen male sprinters volunteered to participate in this study. They performed three block-start trials with a normal stance width (25 ± 1 cm, normal condition) and a widened stance width (45 ± 2 cm, widened condition) at the set position. The block start movements were recorded at 250 Hz with high-speed cameras and the ground reaction forces at 1250 Hz with force plates. During the block phase in the widened condition, the hip abduction and external rotation angles in both legs were significantly larger and smaller, respectively, than those in the normal condition. The positive peak value of the hip power in the rear leg was significantly greater in the widened condition than that in the normal condition. However, no significant difference was seen in the normalized block-induced power between the widened and normal conditions. We conclude that a widened stance width at the set position affects the hip-joint kinematics and rear hip power generation during the block start phase, but no effect on the block-induced power when considering sprinting performance during the whole block start phase.

  16. Changing and Changed Stance toward Norm Selection in Philippine Universities: Its Pedagogical Implications

    Science.gov (United States)

    Bernardo, Alejandro S.

    2014-01-01

    This paper reports the results of a survey which involved College English teachers from three leading universities in the Philippines. The results point to one conclusion--College English teachers now have a changing and changed stance toward norm selection in Philippine Universities. The results give the impression that a good number of College…

  17. Taking things at face value: how stance informs politeness of virtual agents

    NARCIS (Netherlands)

    Linssen, Johannes Maria; Theune, Mariet; Heylen, Dirk K.J.; Hindriks, K.; de Weerdt, M.; van Riemsdijk, B.; Warnier, M.

    2013-01-01

    We propose a combination of theories about interpersonal stances and politeness to inform virtual agent behaviour in a serious game, aimed at social interaction training in the domain of law enforcement. A pilot study we conducted showed promising results based on which we will refine our model.

  18. Influence of virtual reality on postural stability during movements of quiet stance.

    Science.gov (United States)

    Horlings, Corinne G C; Carpenter, Mark G; Küng, Ursula M; Honegger, Flurin; Wiederhold, Brenda; Allum, John H J

    2009-02-27

    Balance problems during virtual reality (VR) have been mentioned in the literature but seldom investigated despite the increased use of VR systems as a training or rehabilitation tool. We examined the influence of VR on body sway under different stance conditions. Seventeen young subjects performed four tasks (standing with feet close together or tandem stance on firm and foam surfaces for 60s) under three visual conditions: eyes open without VR, eyes closed, or while viewing a virtual reality scene which moved with body movements. Angular velocity transducers mounted on the shoulder provided measures of body sway in the roll and pitch plane. VR caused increased pitch and roll angles and angular velocities compared to EO. The effects of VR were, for the most part, indistinguishable from eyes closed conditions. Use of a foam surface increased sway compared to a firm surface under eyes closed and VR conditions. During the movements of quiet stance, VR causes an increase in postural sway in amplitude similar to that caused by closing the eyes. This increased sway was present irrespective of stance surface, but was greatest on foam.

  19. Stance and Engagement in Pure Mathematics Research Articles: Linking Discourse Features to Disciplinary Practices

    Science.gov (United States)

    McGrath, Lisa; Kuteeva, Maria

    2012-01-01

    Recent ESP research into academic writing has shown how writers convey their stance and interact with readers across different disciplines. However, little research has been carried out into the disciplinary writing practices of the pure mathematics academic community from an ESP genre analysis perspective. This study begins to address this gap by…

  20. The Stance Leads the Dance: The Emergence of Role in a Joint Supra-Postural Task

    Directory of Open Access Journals (Sweden)

    Tehran J. Davis

    2017-05-01

    Full Text Available Successfully meeting a shared goal usually requires co-actors to adopt complementary roles. However, in many cases, who adopts what role is not explicitly predetermined, but instead emerges as a consequence of the differences in the individual abilities and constraints imposed upon each actor. Perhaps the most basic of roles are leader and follower. Here, we investigated the emergence of “leader-follower” dynamics in inter-personal coordination using a joint supra-postural task paradigm (Ramenzoni et al., 2011; Athreya et al., 2014. Pairs of actors were tasked with holding two objects in alignment (each actor manually controlled one of the objects as they faced different demands for stance (stable vs. difficult and control (which actor controlled the larger or smaller object. Our results indicate that when actors were in identical stances, neither led the inter-personal (between actors coordination by any systematic fashion. Alternatively, when asymmetries in postural demands were introduced, the actor with the more difficult stance led the coordination (as determined using cross-recurrence quantification analysis. Moreover, changes in individual stance difficulty resulted in similar changes in the structure of both intra-personal (individual and inter-personal (dyadic coordination, suggesting a scale invariance of the task dynamics. Implications for the study of interpersonal coordination are discussed.

  1. Stances and Dances: The Negotiation of Subjectivities in a Reading/Language Arts Classroom.

    Science.gov (United States)

    Broughton, Mary A.; Fairbanks, Colleen M.

    2002-01-01

    Describes how in the examination of a sixth-grade girl's participation in the language arts classroom that is driven by high-stakes testing and by a regimented classroom culture, the authors came to view students' approaches to literacy events as "stances" and their negotiation of their subjectivities in response to literacy events as…

  2. Changes in the fiscal stance and the composition of public spending

    Czech Academy of Sciences Publication Activity Database

    Stančík, Juraj; Välilä, T.

    2012-01-01

    Roč. 43, č. 1 (2012), s. 199-217 ISSN 0377-7332 Institutional research plan: CEZ:AV0Z70850503 Keywords : fiscal policy * public expenditure * fiscal stance Subject RIV: AH - Economics Impact factor: 0.614, year: 2012

  3. The recognition of acted interpersonal stance in police interrogations and the influence of actor proficiency

    NARCIS (Netherlands)

    Bruijnes, Merijn; op den Akker, Hendrikus J.A.; Spitters, Sophie; Sanders, Merijn; Fu, Quihua

    2015-01-01

    This paper reports on judgement studies regarding the perception of interpersonal stances taken by humans playing the role of a suspect in a police interrogation setting. Our project aims at building believable embodied conversational characters to play the role of suspects in a serious game for

  4. Turkish Language Teachers' Stance Taking Movements in the Discourse on Globalization and Language

    Science.gov (United States)

    Coskun, Ibrahim

    2013-01-01

    This study investigates how Turkish teachers take and give stances in the discourse on globalization and language by using linguistic resources. According to the findings obtained through the discourse analysis of the corpus that consisted of 36 h of recording of the discussion among 4 teachers with 5 to 10 years of teaching experience, the…

  5. Communicating Epistemic Stance: How Speech and Gesture Patterns Reflect Epistemicity and Evidentiality

    Science.gov (United States)

    Roseano, Paolo; González, Montserrat; Borràs-Comes, Joan; Prieto, Pilar

    2016-01-01

    This study investigates how epistemic stance is encoded and perceived in face-to-face communication when language is regarded as comprised by speech and gesture. Two studies were conducted with this goal in mind. The first study consisted of a production task in which participants performed opinion reports. Results showed that speakers communicate…

  6. Explanations pertaining to the hip joint flexor moment during the stance phase of human walking.

    Science.gov (United States)

    Simonsen, Erik B; Cappelen, Katrine L; Skorini, Ragnhild ί; Larsen, Peter K; Alkjær, Tine; Dyhre-Poulsen, Poul

    2012-11-01

    A hip joint flexor moment in the last half of the stance phase during walking has repeatedly been reported. However, the purpose of this moment remains uncertain and it is unknown how it is generated. Nine male subjects were instructed to walk at 4.5 km/h with their upper body in three different positions: normal, inclined and reclined. Net joint moments were calculated about the hip, knee and ankle joint. The peak hip joint flexor moment during late stance was significantly lower during inclined walking than in the two other conditions. During normal walking the iliacus muscle showed no or very weak activity and first at the transition from stance to swing. When walking reclined, a clear but rather low activity level of the iliacus muscle was seen in the first half of the stance phase, which could contribute to the hip moment. In the inclined condition the iliacus showed much increased activity but only in the swing phase. It is concluded that the hip flexor moment in question is largely generated by passive structures in the form of ligaments resisting hip joint extension.

  7. EFL Doctoral Students' Conceptions of Authorial Stance in Academic Knowledge Claims and the Tie to Epistemic Beliefs

    Science.gov (United States)

    Chang, Peichin; Tsai, Chin-Chung

    2014-01-01

    Taking an effective authorial stance in research argumentation has been designated as both vitally important and challenging. The study investigated English as a foreign language (EFL) doctoral students' conceptions of authorial stance, the role of domains in affecting their conceptions, and the ties of the conceptions to the participants'…

  8. "Seeing the Everyday through New Lenses": Pedagogies and Practices of Literacy Teacher Educators with a Critical Stance

    Science.gov (United States)

    Dharamshi, Pooja

    2018-01-01

    This article explores the practices and pedagogies of six literacy teacher educators with a critical stance. In this qualitative research study, three semi-structured interviews were conducted with each participant over a three-year period. They were able to negotiate a critical stance into their teacher education courses in several ways: using an…

  9. A three-dimensional biomechanical analysis of the squat during varying stance widths.

    Science.gov (United States)

    Escamilla, R F; Fleisig, G S; Lowry, T M; Barrentine, S W; Andrews, J R

    2001-06-01

    The purpose of this study was to quantify biomechanical parameters employing two-dimensional (2-D) and three-dimensional (3-D) analyses while performing the squat with varying stance widths. Two 60-Hz cameras recorded 39 lifters during a national powerlifting championship. Stance width was normalized by shoulder width (SW), and three stance groups were defined: 1) narrow stance squat (NS), 107 +/- 10% SW; 2) medium stance squat (MS), 142 +/- 12% SW; and 3) wide stance squat (WS), 169 +/- 12% SW. Most biomechanical differences among the three stance groups and between 2-D and 3-D analyses occurred between the NS and WS. Compared with the NS at 45 degrees and 90 degrees knee flexion angle (KF), the hips flexed 6-11 degrees more and the thighs were 7-12 degrees more horizontal during the MS and WS. Compared with the NS at 90 degrees and maximum KF, the shanks were 5-9 degrees more vertical and the feet were turned out 6 degrees more during the WS. No significant differences occurred in trunk positions. Hip and thigh angles were 3-13 degrees less in 2-D compared with 3-D analyses. Ankle plantar flexor (10-51 N.m), knee extensor (359-573 N.m), and hip extensor (275-577 N.m) net muscle moments were generated for the NS, whereas ankle dorsiflexor (34-284 N.m), knee extensor (447-756 N.m), and hip extensor (382-628 N.m) net muscle moments were generated for the MS and WS. Significant differences in ankle and knee moment arms between 2-D and 3-D analyses were 7-9 cm during the NS, 12-14 cm during the MS, and 16-18 cm during the WS. Ankle plantar flexor net muscle moments were generated during the NS, ankle dorsiflexor net muscle moments were produced during the MS and WS, and knee and hip moments were greater during the WS compared with the NS. A 3-D biomechanical analysis of the squat is more accurate than a 2-D biomechanical analysis, especially during the WS.

  10. Support stance in carers of adults with eating disorders: Factors associated with collaborative versus directive approaches.

    Science.gov (United States)

    Geller, Josie; Srikameswaran, Suja; Iyar, Megumi; Zelichowska, Joanna; Thibodeau, Michel; Brown, Krista E; Dunn, Erin C

    2017-05-01

    The support provided by family and friends is integral to patient motivation and clinical outcomes across health care populations. However, little is known about factors that promote or interfere with the type of support offered. This research examined factors associated with collaborative versus directive support among carers of adults with eating disorders. Participants were mothers, fathers, partners, friends, and siblings (N = 141) of eating disorder patients in hospital or residential treatment. Two methodologies were used to assess directive and collaborative support stance: a questionnaire of support behaviors and coded responses to clinical vignettes. Measures of interpersonal functioning, psychiatric distress, caregiving experience, and closeness with their loved one were also completed. Although carers rated a collaborative stance as more helpful than a directive stance, 60% of responses to the clinical vignettes were directive. Across both methodologies, collaborative support behaviors were associated with beliefs about helpful support and with a less vindictive and cold interpersonal style. Whereas use of a directive support stance was exclusively associated with negative caregiving experiences, collaborative responses were associated with both positive and negative experiences. Although the benefits of collaborative support have been well established, this is the first study to examine factors associated with the use of support stance. Findings suggest a number of ways to help carers create and maintain collaborative relationships, including addressing beliefs and interpersonal style and capitalizing on both positive and negative experiences with their loved one. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:498-505). © 2016 Wiley Periodicals, Inc.

  11. Athletes Rated as Poor Single-Leg Squat Performers Display Measureable Differences in Single-Leg Squat Biomechanics Compared to Good Performers.

    Science.gov (United States)

    Garrick, Lachlan E; Alexander, Bryce C; Schache, Anthony G; Pandy, Marcus G; Crossley, Kay M; Collins, Natalie J

    2017-11-15

    It is important to validate single-leg squat visual rating criteria used in clinical practice and research. Foot orthoses may improve single-leg squat performance in those who demonstrate biomechanics associated with increased risk of lower-limb injury. Validate visual rating criteria proposed by Crossley et al, by determining whether athletes rated as poor single-leg squat performers display different single-leg squat biomechanics than good performers; and evaluate immediate effects of foot orthoses on single-leg squat biomechanics in poor performers. Comparative cross-sectional study. University laboratory. 79 asymptomatic athletes underwent video classification of single-leg squat performance based on established visual rating criteria (overall impression, trunk posture, pelvis 'in space', hip movement, knee movement), and were rated as good (n=23), fair (n=41) or poor (n=15) performers. A subset of good (n=16) and poor (n=12) performers underwent biomechanical assessment, completing five continuous single-leg squats on their dominant limb while three-dimensional motion analysis and ground reaction force data were recorded. Poor performers repeated the task standing on prefabricated foot orthoses. Peak external knee adduction moment (KAM) and peak angles for the trunk, hip, knee and ankle. Compared to good performers, poor performers had a significantly lower peak KAM (mean difference 0.11 Nm/kg, 95% confidence interval [CI] 0.02 to 0.2 Nm/kg), higher peak hip adduction angle (-4.3°, -7.6° to -0.9°), and higher peak trunk axial rotation towards their stance limb (3.8°, 0.4° to 7.2°). Foot orthoses significantly increased the peak KAM in poor performers (-0.06 Nm/kg, -0.1 to -0.01 Nm/kg), with values approximating those observed in good performers. Findings validate Crossley et al's visual rating criteria for single-leg squat performance in asymptomatic athletes, and suggest that 'off-the-shelf' foot orthoses may be a simple intervention for poor performers

  12. Methods of Identifying Limb Dominance in Adolescent Female Basketball Players: Implications for Clinical and Biomechanical Research.

    Science.gov (United States)

    Mulrey, Colleen R; Shultz, Sandra J; Ford, Kevin R; Nguyen, Anh-Dung; Taylor, Jeffrey B

    2018-03-29

    To identify relationships between self-reported limb preferences and performance measures for determining limb dominance in adolescent female basketball players. Cross-sectional cohort study. Forty adolescent female basketball players. Participants provided self-reported preferred kicking and jumping limbs, then completed 3 trials of a single-limb countermovement hop (HOPVER) and unilateral triple hop for distance (HOPHOR) on each limb. Each test was used to independently define limb dominance by the limb that produced the largest maximum vertical height and horizontal distance, respectively. Chi-square tests for independence identified a significant relationship between self-reported preferred kicking and jumping legs (χ = 7.41, P = 0.006). However, no significant relationships were found when comparing self-reported preference to measures of performance during the HOPHOR (χ = 0.33, P = 0.57) or HOPVER (χ = 0.06, P = 0.80). In addition, the 2 performance measures did not consistently produce the same definition of limb dominance among individuals (χ = 1.52, P = 0.22). Self-selection of the dominant limb is unrelated to performance. Furthermore, limb dominance, as defined by vertical jump height, is unrelated to limb dominance defined by horizontal jump distance. The results of this study call into question the validity of consistently defining limb dominance by self-reported measures in adolescent female basketball players.

  13. Quantitative estimation of foot-flat and stance phase of gait using foot-worn inertial sensors.

    Science.gov (United States)

    Mariani, Benoit; Rouhani, Hossein; Crevoisier, Xavier; Aminian, Kamiar

    2013-02-01

    Time periods composing stance phase of gait can be clinically meaningful parameters to reveal differences between normal and pathological gait. This study aimed, first, to describe a novel method for detecting stance and inner-stance temporal events based on foot-worn inertial sensors; second, to extract and validate relevant metrics from those events; and third, to investigate their suitability as clinical outcome for gait evaluations. 42 subjects including healthy subjects and patients before and after surgical treatments for ankle osteoarthritis performed 50-m walking trials while wearing foot-worn inertial sensors and pressure insoles as a reference system. Several hypotheses were evaluated to detect heel-strike, toe-strike, heel-off, and toe-off based on kinematic features. Detected events were compared with the reference system on 3193 gait cycles and showed good accuracy and precision. Absolute and relative stance periods, namely loading response, foot-flat, and push-off were then estimated, validated, and compared statistically between populations. Besides significant differences observed in stance duration, the analysis revealed differing tendencies with notably a shorter foot-flat in healthy subjects. The result indicated which features in inertial sensors' signals should be preferred for detecting precisely and accurately temporal events against a reference standard. The system is suitable for clinical evaluations and provides temporal analysis of gait beyond the common swing/stance decomposition, through a quantitative estimation of inner-stance phases such as foot-flat. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. Limb immobilization and corticobasal syndrome.

    Science.gov (United States)

    Graff-Radford, Jonathan; Boeve, Bradley F; Drubach, Daniel A; Knopman, David S; Ahlskog, J Eric; Golden, Erin C; Drubach, Dina I; Petersen, Ronald C; Josephs, Keith A

    2012-12-01

    Recently, we evaluated two patients with corticobasal syndrome (CBS) who reported symptom onset after limb immobilization. Our objective was to investigate the association between trauma, immobilization and CBS. The charts of forty-four consecutive CBS patients seen in the Mayo Clinic Alzheimer Disease Research Center were reviewed with attention to trauma and limb immobilization. 10 CBS patients (23%) had immobilization or trauma on the most affected limb preceding the onset or acceleration of symptoms. The median age at onset was 61. Six patients manifested their first symptoms after immobilization from surgery or fracture with one after leg trauma. Four patients had pre-existing symptoms of limb dysfunction but significantly worsened after immobilization or surgery. 23 percent of patients had immobilization or trauma of the affected limb. This might have implications for management of CBS, for avoiding injury, limiting immobilization and increasing movement in the affected limb. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Limb lengthening in achondroplasia

    Directory of Open Access Journals (Sweden)

    Sanjay K Chilbule

    2016-01-01

    Full Text Available Background: Stature lengthening in skeletal dysplasia is a contentious issue. Specific guidelines regarding the age and sequence of surgery, methods and extent of lengthening at each stage are not uniform around the world. Despite the need for multiple surgeries, with their attendant complications, parents demanding stature lengthening are not rare, due to the social bias and psychological effects experienced by these patients. This study describes the outcome and complications of extensive stature lengthening performed at our center. Materials and Methods: Eight achondroplasic and one hypochondroplasic patient underwent bilateral transverse lengthening for tibiae, humeri and femora. Tibia lengthening was carried out using a ring fixator and bifocal corticotomy, while a monolateral pediatric limb reconstruction system with unifocal corticotomy was used for the femur and humerus. Lengthening of each bone segment, height gain, healing index and complications were assessed. Subgroup analysis was carried out to assess the effect of age and bone segment on the healing index. Results: Nine patients aged five to 25 years (mean age 10.2 years underwent limb lengthening procedures for 18 tibiae, 10 femora and 8 humeri. Four patients underwent bilateral lengthening of all three segments. The mean length gain for the tibia, femur and humerus was 15.4 cm (100.7%, 9.9 cm (52.8% and 9.6 cm (77.9%, respectively. Healing index was 25.7, 25.6 and 20.6 days/cm, respectively, for the tibia, femur and humerus. An average of 33.3% height gain was attained. Lengthening of both tibia and femur added to projected height achieved as the 3 rd percentile of standard height in three out of four patients. In all, 33 complications were encountered (0.9 complications per segment. Healing index was not affected by age or bone segment. Conclusion: Extensive limb lengthening (more than 50% over initial length carries significant risk and should be undertaken only after due

  16. Severe limb ischemia syndrome.

    Science.gov (United States)

    Suchý, T

    1991-01-01

    In the course of the study of the syndrome of severe limb ischemia (SLI) in a representative clinical material of 300 patients and a number of experimental studies, we arrived to the proposal of this optimal methodical procedure for acute vascular closures of traumatic and non-traumatic origin in the limbs: a) In every injury and sudden pain with a change of the function of the limb, it is necessary to think of the SLI syndrome and to search targetedly for it. b) In injuries connected with bleeding our first-rate task is the control of this bleeding. For a temporary arrest of the bleeding it is necessary to prefer more physiological methods sparing collateral circulation to the still most used tourniquet. For this purpose a new device for temporary hemostasis called Hemostop has proved itself, designed by the author and attested both experimentally and clinically, protected as a Czechoslovak patent. From surgical measures have acquitted themselves from this viewpoint the insertion of vascular clamp, ligature of the vessel or its temporary cannulation. c) To set the diagnosis of SLI, it usually suffices a careful anamnesis and clinical examination, advantageous is the investigation by ultrasound. The angiography because of time consumption should be used only in indicated cases. d) The time factor--"race against the time"--has to be always borne on our mind. It is necessary to achieve the recovery of blood circulation in the limb up to 6 or at the latest up to 10 hours from the onset of injury or closure. e) For shortening of the period of tissue hypoxia it is of advantage to use the temporary cannulation of injured vessels. This should be used always, whenever because of any reasons, it is not possible to execute the final reconstructive operation up to 10 hours since the injury, e. g. in polytraumatism, transport difficulties and the like. f) In isolated vascular injuries without bleeding (about 45%) and in all non-traumatic SLI the patients must be efficiently

  17. Towards a Critical Health Equity Research Stance: Why Epistemology and Methodology Matter More Than Qualitative Methods.

    Science.gov (United States)

    Bowleg, Lisa

    2017-10-01

    Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with this premise, I address four themes in this commentary. First, I criticize the ubiquitous and uncritical use of the term health disparities in U.S. public health. Next, I advocate for the increased use of qualitative methodologies-namely, photovoice and critical ethnography-that, pursuant to critical approaches, prioritize dismantling social-structural inequities as a prerequisite to health equity. Thereafter, I discuss epistemological stance and its influence on all aspects of the research process. Finally, I highlight my critical discourse analysis HIV prevention research based on individual interviews and focus groups with Black men, as an example of a critical health equity research approach.

  18. The Sacrifice and the Ludic Stances Reflected Through the Theatre Practice of the 20th Century

    Czech Academy of Sciences Publication Activity Database

    Koubová, Alice

    2017-01-01

    Roč. 72, č. 6 (2017), s. 451-462 ISSN 0046-385X R&D Projects: GA ČR(CZ) GA16-23046S Institutional support: RVO:67985955 Keywords : performative turn * performance * sacrifice * ludic stance * play * postmodern condition * Brecht * Benjamin * Grotowski Subject RIV: AA - Philosophy ; Religion OBOR OECD: Philosophy , History and Philosophy of science and technology http://www.klemens.sav.sk/fiusav/doc/filozofia/2017/6/451-462.pdf

  19. Mosaic structures in living beings in the light of several modern stances

    OpenAIRE

    Chapouthier , Georges

    2012-01-01

    International audience; Biocosmology implies that the laws of the microcosm (i.e. the laws governing living beings and their minds) mimic the laws of the macrocosm. These laws are based on a mosaic structure and triune organisation, with some roots that may be in the classical dialectical movement. A number of modern stances can be seen in relation to the Biocosmological perspective. The relationship to the mosaic structure may be direct, as with the experimental work of Michod, or indirect, ...

  20. Stance and strategy: post-structural perspective and post-colonial engagement to develop nursing knowledge.

    Science.gov (United States)

    Sochan, Anne M

    2011-07-01

    How should nursing knowledge advance? This exploration contextualizes its evolution past and present. In addressing how it evolved in the past, a probable historical evolution of its development draws on the perspectives of Frank & Gills's World System Theory, Kuhn's treatise on Scientific Revolutions, and Foucault's notions of Discontinuities in scientific knowledge development. By describing plausible scenarios of how nursing knowledge evolved, I create a case for why nursing knowledge developers should adopt a post-structural stance in prioritizing their research agenda(s). Further, by adopting a post-structural stance, I create a case on how nurses can advance their disciplinary knowledge using an engaging post-colonial strategy. Given an interrupted history caused by influence(s) constraining nursing's knowledge development by power structures external, and internal, to nursing, knowledge development can evolve in the future by drawing on post-structural interpretation, and post-colonial strategy. The post-structural writings of Deleuze & Guattari's understanding of 'Nomadology' as a subtle means to resist being constrained by existing knowledge development structures, might be a useful stance to understanding the urgency of why nursing knowledge should advance addressing the structural influences on its development. Furthermore, Bhabha's post-colonial elucidation of 'Hybridity' as an equally discreet means to change the culture of those constraining structures is an appropriate strategy to enact how nursing knowledge developers can engage with existing power structures, and simultaneously influence that engagement. Taken together, 'post-structural stance' and 'post-colonial strategy' can refocus nursing scholarship to learn from its past, in order to develop relevant disciplinary knowledge in its future. © 2011 Blackwell Publishing Ltd.

  1. Distal muscle activity alterations during the stance phase of gait in restless leg syndrome (RLS) patients.

    Science.gov (United States)

    Dafkin, Chloe; Green, Andrew; Olivier, Benita; McKinon, Warrick; Kerr, Samantha

    2018-05-01

    To assess if there is a circadian variation in electromyographical (EMG) muscle activity during gait in restless legs syndrome (RLS) patients and healthy control participants. Gait assessment was done in 14 RLS patients and 13 healthy control participants in the evening (PM) and the morning (AM). Muscle activity was recorded bilaterally from the tibialis anterior (TA), lateral gastrocnemius (GL), rectus femoris (RF) and biceps femoris (BF) muscles. A circadian variation during the stance phase in only TA (PM > AM, p  Controls, p < 0.05) during early stance and decreased GL activity (RLS < Controls, p < 0.01) during terminal stance in comparison to control participants in the evening. No other significant differences were noted between RLS patients and control participants. Activation of GL during the swing phase was noted in 79% of RLS patients and in 23% of control participants in the morning compared to 71% and 38% in the evening, respectively. EMG muscle activity shows no circadian variation in RLS patients. Evening differences in gait muscle activation patterns between RLS patients and control participants are evident. These results extend our knowledge about alterations in spinal processing during gait in RLS. A possible explanation for these findings is central pattern generator sensitization caused by increased sensitivity in cutaneous afferents in RLS patients. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Estimation of Human Ankle Impedance During the Stance Phase of Walking

    Science.gov (United States)

    Rouse, Elliott J.; Hargrove, Levi J.; Perreault, Eric J.; Kuiken, Todd A.

    2018-01-01

    Human joint impedance is the dynamic relationship between the differential change in the position of a perturbed joint and the corresponding response torque; it is a fundamental property that governs how humans interact with their environments. It is critical to characterize ankle impedance during the stance phase of walking to elucidate how ankle impedance is regulated during locomotion, as well as provide the foundation for future development of natural, biomimetic powered prostheses and their control systems. In this study, ankle impedance was estimated using a model consisting of stiffness, damping and inertia. Ankle torque was well described by the model, accounting for 98 ± 1.2% of the variance. When averaged across subjects, the stiffness component of impedance was found to increase linearly from 1.5 Nm/rad/kg to 6.5 Nm/rad/kg between 20% and 70% of stance phase. The damping component was found to be statistically greater than zero only for the estimate at 70% of stance phase, with a value of 0.03 Nms/rad/kg. The slope of the ankle’s torque-angle curve—known as the quasi-stiffness—was not statistically different from the ankle stiffness values, and showed remarkable similarity. Finally, using the estimated impedance, the specifications for a biomimetic powered ankle prosthesis were introduced that would accurately emulate human ankle impedance during locomotion. PMID:24760937

  3. From relational ontology to transformative activist stance on development and learning: expanding Vygotsky's (CHAT) project

    Science.gov (United States)

    Stetsenko, Anna

    2008-07-01

    This paper offers steps towards overcoming current fragmentation within sociocultural approaches by expansively reconstructing a broad dialectical view on human development and learning (drawing on Vygotsky's project) underwritten by ideology of social justice. The common foundation for sociocultural approaches is developed by dialectically supplanting relational ontology with the notion that collaborative purposeful transformation of the world is the core of human nature and the principled grounding for learning and development. An activist transformative stance suggests that people come to know themselves and their world as well as ultimately come to be human in and through (not in addition to) the processes of collaboratively transforming the world in view of their goals. This means that all human activities (including psychological processes and the self) are instantiations of contributions to collaborative transformative practices that are contingent on both the past and the vision for the future and therefore are profoundly imbued with ideology, ethics, and values. And because acting, being, and knowing are seen from a transformative activist stance as all rooted in, derivative of, and instrumental within a collaborative historical becoming, this stance cuts across and bridges the gaps (a) between individual and social and (b) among ontological, epistemological, and moral-ethical (ideological) dimensions of activity.

  4. Explanations pertaining to the Hip Joint Flexor Moment During the Stance Phase of Human Walking

    DEFF Research Database (Denmark)

    Simonsen, Erik B; Cappelen, Katrine L; Skorini, Ragnhild

    2012-01-01

    A hip joint flexor moment in the last half of the stance phase during walking has repeatedly been reported. However, the purpose of this moment remains uncertain and it is unknown how it is generated. Nine male subjects were instructed to walk at 4.5 km/h with their upper body in three different ...... activity but only in the swing phase. It is concluded that the hip flexor moment in question is largely generated by passive structures in the form of ligaments resisting hip joint extension.......A hip joint flexor moment in the last half of the stance phase during walking has repeatedly been reported. However, the purpose of this moment remains uncertain and it is unknown how it is generated. Nine male subjects were instructed to walk at 4.5 km/h with their upper body in three different...... positions: normal, inclined and reclined. Net joint moments were calculated about the hip, knee and ankle joint. The peak hip joint flexor moment during late stance was significantly lower during inclined walking than in the two other conditions. During normal walking the iliacus muscle showed no or very...

  5. Ballistic Trauma of Limbs

    Science.gov (United States)

    Lamah, Léopold; Keita, Damany; Marie Camara, Ibrahima; Lamine Bah, Mohamed; Sory, Sidimé; Diallo, Mamadou Moustapha

    2017-01-01

    The objective of our study was to report the management and follow-up of a particular case of ballistic trauma and to do the literature review. Observation: A 35-year-old patient, a trader who was the victim of a firearm accident under not very clear circumstances. He was admitted to the emergency department after 3 hours. Clinically, the patient had significant bleeding in the arm and was in a state of clouding of consciousness. We could notice on the right arm, a posterior large transfixing wound of 1 cm and a 6 cm one on the antero-internal side. The limb was cold with a small and thready pulse. Sensitivity was decreased in the radial nerve area. The radiograph showed bone comminution from the middle 1/3 to the superior 1/3 of the humeral diaphysis. The treatment was orthopedic (after debridement) by scapula-brachio-ante-brachiopalmar plaster splint with thoracic strap. The wound healed in 46 days and the patient resumed his activities after 11 months and 2 weeks. Conclusion: The authors presented the value of using the scapulo-brachio-palmar plaster splints with thoracic strap in some severe upper limb trauma in the absence of the external fixator. PMID:28567155

  6. Lower limb movement variability in patients with peripheral arterial disease.

    Science.gov (United States)

    Crowther, Robert G; Spinks, Warwick L; Leicht, Anthony S; Quigley, Frank; Golledge, Jonathan

    2008-10-01

    Peripheral arterial disease is a chronic obstructive disease of the arteries of the lower limb caused by atherosclerosis. The resultant decrease in blood flow can result in symptoms of pain in the lower limb on exercise known as intermittent claudication. Exercise induced pain is experienced in the calves, thigh or buttocks restricting activities of daily living and thus reducing quality of life. This study investigated lower limb movement variability in individuals with peripheral arterial disease-intermittent claudication (n=28) compared to individuals without peripheral arterial disease-intermittent claudication (control, n=25). A further aim was to examine the efficacy of various techniques used to describe single joint movement variability. All participants underwent two-dimensional angular kinematics analysis of the lower limb during normal walking. Single joint movement variability was measured using linear (spanning set and coefficient of variation) techniques. Between group differences were examined by one-way ANOVA. The peripheral arterial disease-intermittent claudication participants displayed significantly higher levels of lower limb movement variability in all joints when assessed using the coefficient of variation technique. There were no significant between group differences using the spanning set technique. Individuals with peripheral arterial disease-intermittent claudication have higher levels of lower limb movement variability and reduced walking speed compared to healthy age and mass matched controls. This variability may be an adaptation to the gradual onset of ischaemic pain in this population.

  7. Percutaneous osseointegrated prostheses for amputees: Limb compensation in a 12-month ovine model.

    Science.gov (United States)

    Shelton, Trevor J; Beck, J Peter; Bloebaum, Roy D; Bachus, Kent N

    2011-10-13

    Percutaneous osseointegrated prostheses are being investigated as an alternative strategy to attach prosthetic limbs to patients. Although the use of these implants has shown to be promising in clinical trials, the ability to maintain a skin seal around an osseointegrated implant interface is a major challenge to prevent superficial and deep periprosthetic infections. The specific aim of this study was to establish a translational load-bearing ovine model to assess postoperative limb compensation and gait symmetry following a percutaneous osseointegrated implant. We tested the following hypotheses: (1) the animals would return to pre-amputation limb loads within 12-months; (2) the animals would return to a symmetrical gait pattern (stride length and time in stance) within 12-months. The results demonstrated that one month following surgery, the sheep loaded their amputated limb to a mean value of nearly 80% of their pre-amputation loading condition; by 12-months, this mean had dropped to approximately 74%. There was no statistical differences between the symmetry of the amputated forelimb and the contralateral forelimb at any time point for the animals stride length or the time spent in the stance phase of their gait cycle. Thus, the data showed that while the animals maintained symmetric gait patterns, they did not return to full weight-bearing after 12-months. The results of this study showed that a large animal load-bearing model had a symmetric gait and was weight bearing for up to 12 months. While the current investigation utilizes an ovine model, the data show that osseointegrated implant technology with postoperative follow-up can help our human patients return to symmetric gait and maintain an active lifestyle, leading to an improvement in their quality of life following amputation. Published by Elsevier Ltd.

  8. Recovery times of stance and gait balance control after an acute unilateral peripheral vestibular deficit.

    Science.gov (United States)

    Allum, John H J; Honegger, Flurin

    2016-01-01

    Acute unilateral peripheral vestibular deficit (aUPVD) patients have balance deficits that can improve after several weeks. Determining differences in vestibulo-spinal reflex (VSR) influences on balance control and vestibular ocular reflex (VOR) responses with peripheral recovery and central compensation would provide insights into CNS plasticity mechanisms. Also, clinically, knowing when balance control is approximately normal again should contribute to decisions about working ability after aUPVD. Usually VORs are employed for this purpose, despite a lack of knowledge about correlations with balance control. Given this background, we examined whether balance and VOR measures improve similarly and are correlated. Further whether balance improvements are different for stance and gait. 26 patients were examined at onset of aUPVD, and 3, 6 and 13 weeks later. To measure balance control and thereby assess the contribution of VSR influences during stance and gait, body-worn gyroscopes mounted at lumbar 1-3 recorded the angular velocity of the lower trunk in the roll (lateral) and pitch (anterior-posterior) directions. These signals were integrated to yield angle deviations. To measure VOR function, rotating chair (ROT) tests were performed with triangular velocity profiles with accelerations of 20°/s(2) and 5°/s(2), and caloric tests with bithermal (44 and 30°C) water irrigation of the external auditory meatus. Changes in average balance and VOR measures at the 4 examination time points were modelled with exponential decays. Improvements were assumed to plateau when model values were to within 10% of steady state. Balance improvement rates were task and direction dependent, ranging from 3-9 weeks post aUPVD, similar to the range of ROT VOR improvement rates. Stance balance control improved similarly in the pitch and roll directions. Both reached steady state at 7.5 weeks. However, changes in visual and proprioceptive influences on stance sway velocities continued to

  9. Intramuscular psoas lengthening during single-event multi-level surgery fails to improve hip dynamics in children with spastic diplegia. Clinical and kinematic outcomes in the short- and medium-terms.

    Science.gov (United States)

    Mallet, C; Simon, A-L; Ilharreborde, B; Presedo, A; Mazda, K; Penneçot, G-F

    2016-06-01

    In children with spastic diplegia, hip extension in terminal stance is limited by retraction of the psoas muscle, which decreases stride propulsion and step length on the contralateral side. Whether intramuscular psoas lengthening (IMPL) is effective remains controversial. The objective of this study was to assess the impact of IMPL as a component of single-event multi-level surgery (SEMLS) on spatial and temporal gait parameters, clinical hip flexion deformity, and hip flexion kinematics. IMPL as part of SEMLS does not significantly improve hip flexion kinematics. A retrospective review was conducted of the medical charts of consecutive ambulatory children with cerebral palsy who had clinical hip flexion deformity (>10°) with more than 10° of excess hip flexion in terminal stance and who underwent SEMLS. The groups with and without IMPL were compared. Preoperative values of the clinical hip flexion contracture, hip flexion kinematics in terminal stance, and spatial and temporal gait parameters were compared to the values recorded after a mean postoperative follow-up of 2.4±2.0 years (range, 1.0-8.7 years). Follow-up was longer than 3 years in 6 patients. Of 47 lower limbs (in 34 patients) included in the analysis, 15 were managed with IMPL. There were no significant between-group differences at baseline. Surgery was followed in all limbs by significant decreases in kinematic hip flexion and in the Gillette Gait Index. In the IMPL group, significant improvements occurred in clinical hip flexion deformity, walking speed, and step length. The improvement in kinematic hip extension was not significantly different between the two groups. Crouch gait recurred in 3 (8%) patients. The improvement in kinematic hip extension in terminal stance was not significantly influenced by IMPL but was, instead, chiefly dependent on improved knee extension and on the position of the ground reaction vector after SEMLS. IMPL remains indicated only when the clinical hip flexion

  10. Static balance control and lower limb strength in blind and sighted women.

    Science.gov (United States)

    Giagazoglou, Paraskevi; Amiridis, Ioannis G; Zafeiridis, Andreas; Thimara, Maria; Kouvelioti, Vassiliki; Kellis, Elefthrerios

    2009-11-01

    The aim of the present study was to examine isokinetic and isometric strength of the knee and ankle muscles and to compare center of pressure (CoP) sway between blind and sighted women. A total of 20 women volunteered to participate in this study. Ten severe blind women (age 33.5 +/- 7.9 years; height 163 +/- 5 cm; mass 64.5 +/- 12.2 kg) and 10 women with normal vision (age 33.5 +/- 8.3 years; height 164 +/- 6 cm; mass 61.9 +/- 14.5 kg) performed 3 different tasks of increasing difficulty: Normal Quiet Stance (1 min), Tandem Stance (20 s), and One-Leg Stance (10 s). Participants stood barefoot on two adjacent force platforms and the CoP variations [peak-to-peak amplitude (CoPmax) and SD of the CoP displacement (CoPsd)] were analyzed. Sighted participants performed the tests in eyes open and eyes closed conditions. Torque/angular velocity and torque/angular position relationships were also established using a Cybex dynamometer for knee extensors and flexors as well as for ankle plantar and dorsiflexors. The main finding of this study was that the ability to control balance in both anterior/posterior and medio/lateral directions was inferior in blind than in sighted women. However, when sighted participants performed the tests blindfolded, their CoP sway increased significantly in both directions. There were no differences in most isometric and concentric strength measurements of the lower limb muscles between the blind and sighted individuals. Our results demonstrate that vision is a more prominent indicator of performance during the postural tasks compared to strength of the lower limbs. Despite similar level of strength, blind individuals performed significantly worse in all balance tests compared to sighted individuals.

  11. Extracting time-frequency feature of single-channel vastus medialis EMG signals for knee exercise pattern recognition.

    Science.gov (United States)

    Zhang, Yi; Li, Peiyang; Zhu, Xuyang; Su, Steven W; Guo, Qing; Xu, Peng; Yao, Dezhong

    2017-01-01

    The EMG signal indicates the electrophysiological response to daily living of activities, particularly to lower-limb knee exercises. Literature reports have shown numerous benefits of the Wavelet analysis in EMG feature extraction for pattern recognition. However, its application to typical knee exercises when using only a single EMG channel is limited. In this study, three types of knee exercises, i.e., flexion of the leg up (standing), hip extension from a sitting position (sitting) and gait (walking) are investigated from 14 healthy untrained subjects, while EMG signals from the muscle group of vastus medialis and the goniometer on the knee joint of the detected leg are synchronously monitored and recorded. Four types of lower-limb motions including standing, sitting, stance phase of walking, and swing phase of walking, are segmented. The Wavelet Transform (WT) based Singular Value Decomposition (SVD) approach is proposed for the classification of four lower-limb motions using a single-channel EMG signal from the muscle group of vastus medialis. Based on lower-limb motions from all subjects, the combination of five-level wavelet decomposition and SVD is used to comprise the feature vector. The Support Vector Machine (SVM) is then configured to build a multiple-subject classifier for which the subject independent accuracy will be given across all subjects for the classification of four types of lower-limb motions. In order to effectively indicate the classification performance, EMG features from time-domain (e.g., Mean Absolute Value (MAV), Root-Mean-Square (RMS), integrated EMG (iEMG), Zero Crossing (ZC)) and frequency-domain (e.g., Mean Frequency (MNF) and Median Frequency (MDF)) are also used to classify lower-limb motions. The five-fold cross validation is performed and it repeats fifty times in order to acquire the robust subject independent accuracy. Results show that the proposed WT-based SVD approach has the classification accuracy of 91.85%±0.88% which

  12. Extracting time-frequency feature of single-channel vastus medialis EMG signals for knee exercise pattern recognition.

    Directory of Open Access Journals (Sweden)

    Yi Zhang

    Full Text Available The EMG signal indicates the electrophysiological response to daily living of activities, particularly to lower-limb knee exercises. Literature reports have shown numerous benefits of the Wavelet analysis in EMG feature extraction for pattern recognition. However, its application to typical knee exercises when using only a single EMG channel is limited. In this study, three types of knee exercises, i.e., flexion of the leg up (standing, hip extension from a sitting position (sitting and gait (walking are investigated from 14 healthy untrained subjects, while EMG signals from the muscle group of vastus medialis and the goniometer on the knee joint of the detected leg are synchronously monitored and recorded. Four types of lower-limb motions including standing, sitting, stance phase of walking, and swing phase of walking, are segmented. The Wavelet Transform (WT based Singular Value Decomposition (SVD approach is proposed for the classification of four lower-limb motions using a single-channel EMG signal from the muscle group of vastus medialis. Based on lower-limb motions from all subjects, the combination of five-level wavelet decomposition and SVD is used to comprise the feature vector. The Support Vector Machine (SVM is then configured to build a multiple-subject classifier for which the subject independent accuracy will be given across all subjects for the classification of four types of lower-limb motions. In order to effectively indicate the classification performance, EMG features from time-domain (e.g., Mean Absolute Value (MAV, Root-Mean-Square (RMS, integrated EMG (iEMG, Zero Crossing (ZC and frequency-domain (e.g., Mean Frequency (MNF and Median Frequency (MDF are also used to classify lower-limb motions. The five-fold cross validation is performed and it repeats fifty times in order to acquire the robust subject independent accuracy. Results show that the proposed WT-based SVD approach has the classification accuracy of 91.85%±0

  13. Peripheral muscle dysfunction in COPD: lower limbs versus upper limbs.

    Science.gov (United States)

    Miranda, Eduardo Foschini; Malaguti, Carla; Corso, Simone Dal

    2011-01-01

    In patients with COPD, the degree of functional impairment appears to differ between the upper and lower limbs. Significant dyspnea and fatigue have been reported by these patients when performing tasks with unsupported upper limbs and two mechanisms have been proposed to explain this fact: neuromechanical dysfunction of respiratory muscles; and changes in lung volume during such activities. The neuromechanical dysfunction seen in COPD patients during this type of exercise is related to changes in the breathing pattern, as well as to the simultaneity of afferent and efferent muscle stimuli, resulting in respiratory muscle asynchrony. In addition, the increased ventilation during upper limb exercise in patients with COPD leads to dynamic hyperinflation at different workloads. During lower limb exercises, the strength and endurance of the quadriceps muscle is lower in COPD patients than in healthy subjects. This could by explained by abnormal muscle metabolism (decreased aerobic capacity), dependence on glycolytic metabolism, and rapid accumulation of lactate during exercise. In comparison with lower limb exercises, upper limb exercises result in higher metabolic and ventilatory demands, as well as in a more intense sensation of dyspnea and greater fatigue. Because there are differences between the upper and lower limb muscles in terms of the morphological and functional adaptations in COPD patients, specific protocols for strength training and endurance should be developed and tested for the corresponding muscle groups.

  14. Propulsive forces of mudskipper fins and salamander limbs during terrestrial locomotion: implications for the invasion of land.

    Science.gov (United States)

    Kawano, Sandy M; Blob, Richard W

    2013-08-01

    The invasion of land was a pivotal event in vertebrate evolution that was associated with major appendicular modifications. Although fossils indicate that the evolution of fundamentally limb-like appendages likely occurred in aquatic environments, the functional consequences of using early digited limbs, rather than fins, for terrestrial propulsion have had little empirical investigation. Paleontological and experimental analyses both have led to the proposal of an early origin of "hind limb-driven" locomotion among tetrapods or their ancestors. However, the retention of a pectoral appendage that had already developed terrestrial adaptations has been proposed for some taxa, and few data are available from extant functional models that can provide a foundation for evaluating the relative contributions of pectoral and pelvic appendages to terrestrial support among early stem tetrapods. To examine these aspects of vertebrate locomotor evolution during the invasion of land, we measured three-dimensional ground reaction forces (GRFs) produced by isolated pectoral fins of mudskipper fishes (Periophthalmus barbarus) during terrestrial crutching, and compared these to isolated walking footfalls by the forelimbs and hind limbs of tiger salamanders (Ambystoma tigrinum), a species with subequally-sized limbs that facilitate comparisons to early tetrapods. Pectoral appendages of salamanders and mudskippers exhibited numerous differences in GRFs. Compared with salamander forelimbs, isolated fins of mudskippers bear lower vertical magnitudes of GRFs (as a proportion of body weight), and had GRFs that were oriented more medially. Comparing the salamanders' forelimbs and hind limbs, although the peak net GRF occurs later in stance for the forelimb, both limbs experience nearly identical mediolateral and vertical components of GRF, suggesting comparable contributions to support. Thus, forelimbs could also have played a significant locomotor role among basal tetrapods that had limbs

  15. Long-term clinical evaluation of the automatic stance-phase lock-controlled prosthetic knee joint in young adults with unilateral above-knee amputation.

    Science.gov (United States)

    Andrysek, Jan; Wright, F Virginia; Rotter, Karin; Garcia, Daniela; Valdebenito, Rebeca; Mitchell, Carlos Alvarez; Rozbaczylo, Claudio; Cubillos, Rafael

    2017-05-01

    The purpose of this study was to clinically evaluate the automatic stance-phase lock (ASPL) knee mechanism against participants' existing weight-activated braking (WAB) prosthetic knee joint. This prospective crossover study involved 10 young adults with an above-knee amputation. Primary measurements consisted of tests of walking speeds and capacity. Heart rate was measured during the six-minute walk test and the Physiological Cost Index (PCI) which was calculated from heart rate estimated energy expenditure. Activity was measured with a pedometer. User function and quality of life were assessed using the Lower Limb Function Questionnaire (LLFQ) and Prosthetic Evaluation Questionnaire (PEQ). Long-term follow-up over 12 months were completed. Walking speeds were the same for WAB and APSL knees. Energy expenditure (PCI) was lower for the ASPL knees (p = 0.007). Step counts were the same for both knees, and questionnaires indicated ASPL knee preference attributed primarily to knee stability and improved walking, while limitations included terminal impact noise. Nine of 10 participants chose to keep using the ASPL knee as part of the long-term follow-up. Potential benefits of the ASPL knee were identified in this study by functional measures, questionnaires and user feedback, but not changes in activity or the PEQ.

  16. A unified deformable (UD) segment model for quantifying total power of anatomical and prosthetic below-knee structures during stance in gait.

    Science.gov (United States)

    Takahashi, Kota Z; Kepple, Thomas M; Stanhope, Steven J

    2012-10-11

    Anatomically-relevant (AR) biomechanical models are traditionally used to quantify joint powers and segmental energies of lower extremity structures during gait. While AR models contain a series of rigid body segments linked together via mechanical joints, prosthetic below-knee structures are often deformable objects without a definable ankle joint. Consequently, the application of AR models for the study of prosthetic limbs has been problematic. The purpose of this study was to develop and validate a unified deformable (UD) segment model for quantifying the total power of below-knee structures. Estimates of total below-knee power derived via the UD segment model were compared to those derived via an AR model during stance in gait of eleven healthy subjects. The UD segment model achieved similar results to the AR model. Differences in peak power, total positive work, and total negative work were 1.91±0.31%, 3.97±0.49%, and 1.39±0.33%, relative to the AR model estimates. The main advantage of the UD segment model is that it does not require the definition of an ankle joint or foot structures. Therefore, this technique may be valuable for facilitating direct comparisons between anatomical and disparate prosthetic below-knee structures in future studies. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Agency over Phantom Limb Enhanced by Short-Term Mirror Therapy

    Directory of Open Access Journals (Sweden)

    Shu Imaizumi

    2017-10-01

    Full Text Available Most amputees experience phantom limb, whereby they feel that the amputated limb is still present. In some cases, these experiences include pain that can be alleviated by “mirror therapy.” Mirror therapy consists of superimposing a mirrored image of the moving intact limb onto the phantom limb. This therapy provides a closed loop between the motor command to the amputated limb and its predicted visual feedback. This loop is also involved in the sense of agency, a feeling of controlling one’s own body. However, it is unclear how mirror therapy is related to the sense of agency over a phantom limb. Using mirror therapy, we investigated phantom limb pain and the senses of agency and ownership (i.e., a feeling of having one’s own body of the phantom limb. Nine upper-limb amputees, five of whom reported recent phantom limb pain, underwent a single 15-min trial of mirror therapy. Before and after the trial, the participants completed a questionnaire regarding agency, ownership, and pain related to their phantom limb. They reported that the sense of agency over the phantom limb increased following the mirror therapy trial, while the ownership slightly increased but not as much as did the agency. The reported pain did not change; that is, it was comparably mild before and after the trial. These results suggest that short-term mirror therapy can, at least transiently, selectively enhance the sense of agency over a phantom limb, but may not alleviate phantom limb pain.

  18. The intentional stance as structure learning: a computational perspective on mindreading.

    Science.gov (United States)

    Dindo, Haris; Donnarumma, Francesco; Chersi, Fabian; Pezzulo, Giovanni

    2015-10-01

    Recent theories of mindreading explain the recognition of action, intention, and belief of other agents in terms of generative architectures that model the causal relations between observables (e.g., observed movements) and their hidden causes (e.g., action goals and beliefs). Two kinds of probabilistic generative schemes have been proposed in cognitive science and robotics that link to a "theory theory" and "simulation theory" of mindreading, respectively. The former compares perceived actions to optimal plans derived from rationality principles and conceptual theories of others' minds. The latter reuses one's own internal (inverse and forward) models for action execution to perform a look-ahead mental simulation of perceived actions. Both theories, however, leave one question unanswered: how are the generative models - including task structure and parameters - learned in the first place? We start from Dennett's "intentional stance" proposal and characterize it within generative theories of action and intention recognition. We propose that humans use an intentional stance as a learning bias that sidesteps the (hard) structure learning problem and bootstraps the acquisition of generative models for others' actions. The intentional stance corresponds to a candidate structure in the generative scheme, which encodes a simplified belief-desire folk psychology and a hierarchical intention-to-action organization of behavior. This simple structure can be used as a proxy for the "true" generative structure of others' actions and intentions and is continuously grown and refined - via state and parameter learning - during interactions. In turn - as our computational simulations show - this can help solve mindreading problems and bootstrap the acquisition of useful causal models of both one's own and others' goal-directed actions.

  19. Influence of enhanced visual feedback on postural control and spinal reflex modulation during stance.

    Science.gov (United States)

    Taube, Wolfgang; Leukel, Christian; Gollhofer, Albert

    2008-07-01

    The present study assessed the influence of visual feedback on stance stability and soleus H-reflex excitability. The centre of pressure (COP) displacement was measured in upright stance on a rigid surface (stable surface) and on a spinning top (unstable surface) while subjects either received "normal" visual feedback (without laser pointer = WLP) or pointed with a laser pointer on a target on the wall (LP). In order to verify that laser pointing influenced visual feedback, two additional experiments were conducted: (1) Subjects performed a finger reaction task which was thought to increase attention and cognitive demands without alteration of the visual feedback. (2) The effect of laser pointing on the wall was compared with pointing at a board, which was attached to the subjects themselves. In this case, the laser point could not serve as a reference for sway because the board moved in synchrony with the body. On stable and unstable surface, COP displacement was reduced in the LP compared to the WLP task (-17 cm +/- 6, P < 0.05; -14 cm +/- 6, P < 0.05). Conversely, H-reflexes were greater in the LP condition (stable: +20 microV +/- 30, not significant; unstable +115 microV +/- 40, P < 0.05). Stance stability and H-reflex modulation were negatively correlated (R(2) = -0.5; P < 0.001). The finger reaction task did neither influence COP displacement nor H-reflexes. Pointing at the body-fixed target did not alter COP displacement. These findings suggest that postural sway can be reduced by a handheld laser pointer targeting on an external reference point. It is argued that altered visual input was responsible for modulating the H-reflex.

  20. Balance in Astronauts Performing Jumps, Walking and Quiet Stance Following Spaceflight

    Science.gov (United States)

    Reschke, Millard F.; Bloomberg, J. J.; Wood, S. J.; Harm, D. L.

    2011-01-01

    Introduction: Both balance and locomotor ataxia is severe in astronauts returning from spaceflight with serious implications for unassisted landings. As a part of an ongoing effort to demonstrate the functional significance of the postflight ataxia problem our laboratory has evaluated jumping, walking heel-to-toe and quite stance balance immediately following spaceflight. Methods: Six astronauts from 12-16 day flights and three from 6-month flights were asked to perform three self-initiated two-footed jumps from a 30-cm-high platform, walking for 10 steps (three trials) placing the feet heel to toe in tandem, arms folded across the chest and the eyes closed, and lastly, recover from a simulated fall by standing from a prone position on the floor and with eyes open maintain a quiet stance for 3 min with arms relaxed along the side of the body and feet comfortably positioned on a force plate. Crewmembers were tested twice before flight, on landing day (short-duration), and days 1, 6, and 30 following all flight durations. Results/Conclusions: Many of astronauts tested fell on their first postflight jump but recovered by the third jump showing a rapid learning progression. Changes in take-off strategy were clearly evident in duration of time in the air between the platform and the ground (significant reduction in time to land), and also in increased asymmetry in foot latencies on take-off postflight. During the tandem heel-to-toe walking task there was a significant decrease in percentage of correct steps on landing day (short-duration crew) and on first day following landing (long-duration) with only partial recovery the following day. Astronauts for both short and long duration flight times appeared to be unaware of foot position relative to their bodies or the floor. During quite stance most of crewmembers tested exhibited increased stochastic activity (larger short-term COP diffusion coefficients postflight in all planes and increases in mean sway speed).

  1. How Joint Torques Affect Hamstring Injury Risk in Sprinting Swing–Stance Transition

    Science.gov (United States)

    SUN, YULIANG; WEI, SHUTAO; ZHONG, YUNJIAN; FU, WEIJIE; LI, LI; LIU, YU

    2015-01-01

    ABSTRACT Purpose The potential mechanisms of hamstring strain injuries in athletes are not well understood. The study, therefore, was aimed at understanding hamstring mechanics by studying loading conditions during maximum-effort overground sprinting. Methods Three-dimensional kinematics and ground reaction force data were collected from eight elite male sprinters sprinting at their maximum effort. Maximal isometric torques of the hip and knee were also collected. Data from the sprinting gait cycle were analyzed via an intersegmental dynamics approach, and the different joint torque components were calculated. Results During the initial stance phase, the ground reaction force passed anteriorly to the knee and hip, producing an extension torque at the knee and a flexion torque at the hip joint. Thus, the active muscle torque functioned to produce flexion torque at the knee and extension torque at the hip. The maximal muscle torque at the knee joint was 1.4 times the maximal isometric knee flexion torque. During the late swing phase, the muscle torque counterbalanced the motion-dependent torque and acted to flex the knee joint and extend the hip joint. The loading conditions on the hamstring muscles were similar to those of the initial stance phase. Conclusions During both the initial stance and late swing phases, the large passive torques at both the knee and hip joints acted to lengthen the hamstring muscles. The active muscle torques generated mainly by the hamstrings functioned to counteract those passive effects. As a result, during sprinting or high-speed locomotion, the hamstring muscles may be more susceptible to high risk of strain injury during these two phases. PMID:24911288

  2. Non-Gaussian center-of-pressure velocity distribution during quiet stance

    Science.gov (United States)

    Santos, E. S. D.; Picoli, S.; Deprá, P. P.; Mendes, R. S.

    2015-02-01

    In the present study, we investigate patterns in the postural sway that characterize the static balance in human beings. To measure the postural sway, sixteen healthy young subjects performed quiet stance tasks providing the center-of-pressure (COP) trajectories. From these trajectories, we obtained the COP velocities. We verified that the velocity distributions exhibit non-normal behavior and can be approximated by generalized Gaussians with fat tails. We also discuss possible implications of modeling COP velocity by using generalized Fokker-Planck equations related to Tsallis statistics and Richardson anomalous diffusion.

  3. Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation

    Science.gov (United States)

    Desmond, Deirdre M.; MacLachlan, Malcolm

    2010-01-01

    This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence…

  4. Prediction of three-dimensional contact stress and ligament tension in the ankle during stance determined from computational modeling.

    Science.gov (United States)

    Haraguchi, Naoki; Armiger, Robert S; Myerson, Mark S; Campbell, John T; Chao, Edmund Y S

    2009-02-01

    Our goal was to quantify and visualize the three-dimensional loading relationship between the ligaments and articular surfaces of the ankle to identify and determine the stabilizing roles of these anatomical structures during the stance phase of gait. We applied discrete element analysis to computationally model the three-dimensional contact characteristics and ligament loading of the ankle joint. Physiologic loads approximating those at five positions in the stance phase of a normal walk cycle were applied. We analyzed joint contact pressures and periankle ligament tension concurrently. Most ankle joint loading during the stance phase occurred across the articular surfaces of the joint, and the amount of ligament tension was small. The tibiotalar articulation showed full congruency throughout most of the stance phase, with peak pressure developing anteriorly toward the toe-off frame. Of the periankle ligaments, the deep deltoid ligament transferred the most force during the stance phase (57.2%); the superficial deltoid ligament transferred the second-most force (26.1%). The anterior talofibular ligament transferred force between the talus and fibula continuously, whereas the calcaneofibular ligament did not carry force during gait. The distal tibiofibular ligaments and the interosseous membrane were loaded throughout the stance phase. Force transmission through the ankle joint during the stance phase is predominantly through the articular surfaces, and the periankle ligaments do not play a major stabilizing role in constraining ankle motion. The medial ligaments have a more important role than do the lateral ligaments in stabilizing the ankle joint. In addition to ligament insufficiency, other factors, such as varus tilt of the tibial plafond, may be important in the development of recurrent instability. Continuous loading of syndesmosis ligaments provides a theoretical basis for evidence of syndesmosis screw breakage or loosening. The analysis method has

  5. Longitudinal kinematic and kinetic adaptations to obstacle crossing in recent lower limb amputees.

    Science.gov (United States)

    Barnett, Cleveland T; Polman, Remco C J; Vanicek, Natalie

    2014-12-01

    Obstacle crossing is an important activity of daily living, necessary to avoid tripping or falling, although it is not fully understood how transtibial amputees adapt to performing this activity of daily living following discharge from rehabilitation. The objective of this study was to investigate the longitudinal adaptations in obstacle crossing in transtibial amputees post-discharge from rehabilitation. Longitudinal repeated measures. Seven unilateral transtibial amputees crossed an obstacle 0.1m high positioned along a walkway while kinematic and kinetic data were recorded at 1, 3 and 6 months post-discharge. At 6 months post-discharge, walking velocity had increased (0.17 m.s(-1)) with most participants self-selecting an intact lead limb preference. During swing phase, peak knee flexion (p = 0.03) and peak knee power absorption (K4; p = 0.01) were greater with an intact versus affected lead limb preference. Having crossed the obstacle, intact limb peak ankle power generation in pre-swing (A2; p = 0.01) and knee power absorption (K3; p = 0.05) during stance phase were greater when compared to the affected limb. Obstacle crossing improved, although a greater reliance on intact limb function was highlighted. Results suggested that further improvements to locomotor performance may be obtained by increasing affected limb knee range of motion and concentric and eccentric strength of the knee extensors and flexors. The novel objective data from this study establish an understanding of how recent transtibial amputees adapt to performing obstacle crossing following discharge from rehabilitation. This allows for evidence-based clinical interventions to be developed, aimed at optimising biomechanical function, thus improving overall locomotor performance and perhaps subsequent quality of life. © The International Society for Prosthetics and Orthotics 2013.

  6. Limb apraxia in aphasic patients.

    Science.gov (United States)

    Ortiz, Karin Zazo; Mantovani-Nagaoka, Joana

    2017-11-01

    Limb apraxia is usually associated with left cerebral hemisphere damage, with numerous case studies involving aphasic patients. The aim of this study was to verify the occurrence of limb apraxia in aphasic patients and analyze its nature. This study involved 44 healthy volunteers and 28 aphasic patients matched for age and education. AH participants were assessed using a limb apraxia battery comprising subtests evaluating lexical-semantic aspects related to the comprehension/production of gestures as well as motor movements. Aphasics had worse performances on many tasks related to conceptual components of gestures. The difficulty found on the imitation of dynamic gesture tasks also indicated that there were specific motor difficulties in gesture planning. These results reinforce the importance of conducting limb apraxia assessment in aphasic patients and also highlight pantomime difficulties as a good predictor for semantic disturbances.

  7. Limb Salvage After Bone Cancer

    Science.gov (United States)

    ... or replace part or all of the implant. Contractures – After a limb salvage procedure, muscles, tendons, and ligaments sometimes stiffen or shrink, forming contractures (permanent tightening of the joint). This is more ...

  8. The relation between patient characteristics and their carers' use of a directive versus collaborative support stance.

    Science.gov (United States)

    Geller, Josie; Iyar, Megumi; Srikameswaran, Suja; Zelichowska, Joanna; Zhou, Yuan; Dunn, Erin C

    2018-01-01

    Collaborative support provided by carers (family and friends) of individuals with eating disorders has been shown to be integral to patient motivation and clinical outcome. Little is known about factors that contribute to carers' use of collaborative, as opposed to directive, support stance. This exploratory research investigated associations between patient characteristics and carers' support beliefs and behaviors. Eating disorder patients (n = 72) completed measures of readiness for change, eating disorder, and psychiatric symptom severity, and interpersonal functioning. Their carers (n = 72) completed measures of collaborative and directive support. Patient demographic variables, readiness for change, and psychiatric symptom severity were not associated with carer beliefs or behaviors. However, some patient interpersonal functioning scores were; higher Domineering/Controlling scores were associated with carers viewing directive support as more helpful, and with their use of more directive support behaviors. Higher Vindictive/Self-Centered and Intrusive/Needy scores in patients were also associated with carers viewing directive support as more helpful. This exploratory study suggests that carers may be more prone to utilizing a directive, rather than a collaborative, support stance with patients experiencing higher levels of threat, anger, and hostility, and lower levels of safety, closeness, and trust. © 2017 Wiley Periodicals, Inc.

  9. A simple new device to examine human stance: the totter-slab.

    Science.gov (United States)

    Roth, Robin; Wank, Veit; Müller, Otto; Hochwald, Harald; Günther, Michael

    2010-02-01

    This article describes a new measuring device to investigate balancing strategies of human stance: the totter-slab, i.e., a standing plate suspended with steel cables to hooks on a steel frame. First, we analysed the physical properties of the device by recording free oscillations under different conditions [varying amplitude, mass and centre of mass (COM) height]. This allowed us to determine the eigenfrequency f and the damping coefficient Dslab. We found that the totter-slab is a useful, well-defined, reliable and developable measuring device for different non-rigid-ground stance conditions. In a second part of the investigation, we compared the frequency spectra of six subjects balancing on the totter-slab with their spectra while standing quietly on a force plate fixed to the ground. The totter-slab spectra showed two distinct, dominant peak regions at approximately 0.3 and 1.1 Hz. This finding enforces the double inverted pendulum to be an adequate model particularly for balancing on the totter-slab. Compared with the firm ground condition, these two peak regions were more pronounced when balancing on the totter-slab. However, there is a variety of frequencies in the region 0.2...1.5 Hz specific for an individual subject in both balancing conditions.

  10. TENS to the Lateral Aspect of the Knees During Stance Attenuates Postural Sway in Young Adults

    Directory of Open Access Journals (Sweden)

    Yocheved Laufer

    2007-01-01

    Full Text Available Somatosensory input is known to be essential for postural control. The present study examined the effects on postural sway of sensory input delivered via transcutaneous electrical nerve stimulation (TENS applied to the knees during stance. Electrodes from a dual-channel portable TENS unit were adhered to the skin overlying the lateral and medial aspect of both knees of 20 young healthy volunteers (mean age 24.0 years, standard deviation 4.0. Postural sway parameters were obtained during static bipedal stance with an AMTI force platform. Four stimulation conditions were tested with eyes open and with eyes closed: no TENS; TENS applied bilaterally; and TENS applied to either the right or the left knee. Participants underwent two eight-trial blocks, with each trial lasting 30 seconds. The order of conditions was randomized for each participant. Stimulation consisted of a biphasic symmetrical stimulus delivered at the sensory detection level, with a pulse duration of 200μsec and a pulse frequency of 100Hz. The application of TENS induced significant reductions in mean sway velocity and in the medio-lateral dispersion of the center of pressure, with no corresponding effect on the anterior-posterior dispersion. These findings suggest that electrical stimulation delivered at the sensory detection level to the lateral aspects of the knees may be effective in improving balance control, and that this effect may be directionally specific.

  11. Muscle activity of leg muscles during unipedal stance on therapy devices with different stability properties.

    Science.gov (United States)

    Wolburg, Thomas; Rapp, Walter; Rieger, Jochen; Horstmann, Thomas

    2016-01-01

    To test the hypotheses that less stable therapy devices require greater muscle activity and that lower leg muscles will have greater increases in muscle activity with less stable therapy devices than upper leg muscles. Cross-sectional laboratory study. Laboratory setting. Twenty-five healthy subjects. Electromyographic activity of four lower (gastrocnemius medialis, soleus, tibialis anterior, peroneus longus) and four upper leg muscles (vastus medialis and lateralis, biceps femoris, semitendinosus) during unipedal quiet barefoot stance on the dominant leg on a flat rigid surface and on five therapy devices with varying stability properties. Muscle activity during unipedal stance differed significantly between therapy devices (P leg) and therapy device (P = 0.985). Magnitudes of additional relative muscle activity for the respective therapy devices differed substantially among lower extremity muscles. The therapy devices offer a progressive increase in training intensity, and thus may be useful for incremental training programs in physiotherapeutic practice and sports training programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Irony as a figure of speech and moral stance (with regard to Wittlin and Kierkegaard

    Directory of Open Access Journals (Sweden)

    Katarzyna Szewczyk-Haake

    2015-12-01

    Full Text Available In his work as a writer, Józef Wittlin searched for literature able to grant the   reader moral support, while at the same time being artistically successful. In his novel Salt of the Earth, the way to com-bine these two, to a certain extent contradictionary aims, is found in the use of irony. An analysis of the classical types of irony appearing in the novel (naive irony, irony of the sender, verbal irony leads to the conclusion that each of those was remarkably modified by the author. As a result, the “ironical anthropology” created by Wittlin in his novel lacks any elements of simple moralizing or giving ready-made moral solutions, but brings a striking image of a human commu-nity, unified not by a common status, but by a common fate. In the novel, irony turns out to be not only a textual figure, but first and foremost a moral stance, approximate to that of Socrates as described by Kierkegaard. Thanks to this stance, Wittlin enthuses his readers with the longing for the ideal, shaping their moral sensibility, at the same time granting them the sovereignty to which the reader of a literary work should be entitled.

  13. Generation of the Human Biped Stance by a Neural Controller Able to Compensate Neurological Time Delay

    Science.gov (United States)

    Jiang, Ping; Chiba, Ryosuke; Takakusaki, Kaoru; Ota, Jun

    2016-01-01

    The development of a physiologically plausible computational model of a neural controller that can realize a human-like biped stance is important for a large number of potential applications, such as assisting device development and designing robotic control systems. In this paper, we develop a computational model of a neural controller that can maintain a musculoskeletal model in a standing position, while incorporating a 120-ms neurological time delay. Unlike previous studies that have used an inverted pendulum model, a musculoskeletal model with seven joints and 70 muscular-tendon actuators is adopted to represent the human anatomy. Our proposed neural controller is composed of both feed-forward and feedback controls. The feed-forward control corresponds to the constant activation input necessary for the musculoskeletal model to maintain a standing posture. This compensates for gravity and regulates stiffness. The developed neural controller model can replicate two salient features of the human biped stance: (1) physiologically plausible muscle activations for quiet standing; and (2) selection of a low active stiffness for low energy consumption. PMID:27655271

  14. "It's a wild thing, waiting to get me": stance analysis of African Americans with diabetes.

    Science.gov (United States)

    Davis, Boyd H; Pope, Charlene; Mason, Peyton R; Magwood, Gayenell; Jenkins, Carolyn M

    2011-01-01

    This mixed methods study uses a unique approach from social science and linguistics methodologies, a combination of positioning theory and stance analysis, to examine how 20 African Americans with type 2 diabetes make sense of the practices that led to recurrent emergency department visits to identify needs for more effective intervention. In a purposive sample of postemergency department visit interviews with a same-race interviewer, people responded to open-ended questions reflecting on the decision to seek emergency department care. As applied to diabetes education, positioning theory explains that people use their language to position themselves toward their disease, their medications, and the changes in their lives. Transcriptions were coded using discourse analysis to categorize themes. As a form of triangulation, stance analysis measured language patterns using factor analysis to see when and how speakers revealed affect, attitude, and agentive choices for action. Final analysis revealed that one third of the sample exhibited high scores for positive agency or capacity for decision-making and self-management, while the rest expressed less control and more negative emotions and fears that may preclude self-management. This approach suggests a means to tailor diabetes education considering alternative approaches focused on communication for those facing barriers.

  15. Modelling the effect of race surface and racehorse limb parameters on in silico fetlock motion and propensity for injury.

    Science.gov (United States)

    Symons, J E; Hawkins, D A; Fyhrie, D P; Upadhyaya, S K; Stover, S M

    2017-09-01

    The metacarpophalangeal joint (fetlock) is the most commonly affected site of racehorse injury, with multiple observed pathologies consistent with extreme fetlock dorsiflexion. Race surface mechanics affect musculoskeletal structure loading and injury risk because surface forces applied to the hoof affect limb motions. Race surface mechanics are a function of controllable factors. Thus, race surface design has the potential to reduce the incidence of musculoskeletal injury through modulation of limb motions. However, the relationship between race surface mechanics and racehorse limb motions is unknown. To determine the effect of changing race surface and racehorse limb model parameters on distal limb motions. Sensitivity analysis of in silico fetlock motion to changes in race surface and racehorse limb parameters using a validated, integrated racehorse and race surface computational model. Fetlock motions were determined during gallop stance from simulations on virtual surfaces with differing average vertical stiffness, upper layer (e.g. cushion) depth and linear stiffness, horizontal friction, tendon and ligament mechanics, as well as fetlock position at heel strike. Upper layer depth produced the greatest change in fetlock motion, with lesser depths yielding greater fetlock dorsiflexion. Lesser fetlock changes were observed for changes in lower layer (e.g. base or pad) mechanics (nonlinear), as well as palmar ligament and tendon stiffness. Horizontal friction and fetlock position contributed less than 1° change in fetlock motion. Simulated fetlock motions are specific to one horse's anatomy reflected in the computational model. Anatomical differences among horses may affect the magnitude of limb flexion, but will likely have similar limb motion responses to varied surface mechanics. Race surface parameters affected by maintenance produced greater changes in fetlock motion than other parameters studied. Simulations can provide evidence to inform race surface

  16. Discourse Motivations of Mental Construal and the Expression of Stance in Speech: A Case Study of English

    Directory of Open Access Journals (Sweden)

    Екатерина Юрьевна Хрисонопуло

    2017-12-01

    Full Text Available This paper presents an account of the phenomenon of mental construal manifested in English expressions of stance through the distinction of clauses that are headed by subjects associated with two conceptual archetypes: participant (P invoked by the first-person pronoun ( I am certain that and abstract setting (S conveyed by anticipatory it ( It is certain that . With recourse to the main theoretical points on the anchoring of linguistic meaning in the acts of speech activity (Leontiev A.A., mental construal (Langacker R., processes of discourse-driven conceptualization and categorization (Kubryakova E.S. and with reference to discourse oriented studies of stance (Biber D., Finegan E., Kärkkäinen E., the conducted analysis focuses on a corpus of about 350 examples that represent narrative and dialogic discourse in English-language fiction. As evidenced by linguistic data, the choice of stance expressions with P- and S-subjects is motivated, respectively, by the distinctions that arise in discourse between actual and mentally represented types of reality, the contrast between reference-making and viewing as types of cognitive events and the distinction between event-schemas and mental experiences. These discursively relevant distinctions are further shown to be related to narrative and dialogic strategies that are used in literary texts for the expression of stance with the alternative stance-clauses.

  17. Treatment of chronic SFA in-stent occlusion with combined laser atherectomy and drug-eluting balloon angioplasty in patients with critical limb ischemia: a single-center, prospective, randomized study.

    Science.gov (United States)

    Gandini, Roberto; Del Giudice, Costantino; Merolla, Stefano; Morosetti, Daniele; Pampana, Enrico; Simonetti, Giovanni

    2013-12-01

    To compare the safety and efficacy of laser debulking (LD) and drug-eluting balloon (DEB) angioplasty to treatment with DEB angioplasty alone in patients affected by critical limb ischemia (CLI) and superficial femoral artery (SFA) chronic stent occlusion in a prospective, randomized study. Among 448 CLI patients treated from December 2009 to March 2011, 48 patients (39 men; mean age 72.7±7.8 years) with chronic SFA in-stent occlusion were randomly assigned to treatment using LD+DEB (n=24) or DEB angioplasty alone (n=24). Patency at 12 months was the primary outcome measure; secondary outcomes were target lesion revascularization (TLR) and clinical success at 12 months. In the LD+DEB group, the patency rates at 6 and 12 months (91.7% and 66.7%, respectively) were significantly higher (p=0.01) than in the DEB only patients (58.3% and 37.5%, respectively). TLR at 12 months was 16.7% in the LD+DEB group and 50% in the DEB only group (p=0.01). Two (8%) patients needed major amputations in the LD+DEB group vs. 11 (46%) in the DEB only group at 12 months (p=0.003). In this small initial experience, combined treatment with LD and DEB angioplasty is correlated with better outcomes in CLI patients with occluded SFA stents.

  18. Individuals with a vestibular-related disorder use a somatosensory-dominant strategy for postural orientation after inclined stance.

    Science.gov (United States)

    Chong, R; Berl, B; Cook, B; Turner, P; Walker, K

    2017-06-01

    The visual, somatosensory, and vestibular systems are critical for establishing a sensorimotor set for postural control and orientation. The goal of this study was to assess how individuals with a vestibular-related disorder keep their balance following prolonged stance on an inclined surface. We hypothesize that subjects will show greater reliance on the somatosensory system than age-matched controls as inferred by the presence of a forward postural lean aftereffect following the inclined stance (i.e., a positive response). The results revealed an underlying somatosensory-dominant strategy for postural control in the vestibular group: 100% of the subjects tested positive compared to 58% in the control group (P=.006). Individuals with a vestibular-related disorder use a somatosensory-dominant strategy for postural orientation following prolonged inclined stance. The implications for the management of this population are discussed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. The phantom limb in dreams.

    Science.gov (United States)

    Brugger, Peter

    2008-12-01

    Mulder and colleagues [Mulder, T., Hochstenbach, J., Dijkstra, P. U., Geertzen, J. H. B. (2008). Born to adapt, but not in your dreams. Consciousness and Cognition, 17, 1266-1271.] report that a majority of amputees continue to experience a normally-limbed body during their night dreams. They interprete this observation as a failure of the body schema to adapt to the new body shape. The present note does not question this interpretation, but points to the already existing literature on the phenomenology of the phantom limb in dreams. A summary of published investigations is complemented by a note on phantom phenomena in the dreams of paraplegic patients and persons born without a limb. Integration of the available data allows the recommendation for prospective studies to consider dream content in more detail. For instance, "adaptation" to the loss of a limb can also manifest itself by seeing oneself surrounded by amputees. Such projective types of anosognosia ("transitivism") in nocturnal dreams should also be experimentally induced in normally-limbed individuals, and some relevant techniques are mentioned.

  20. Principles of obstacle avoidance with a transfemoral prosthetic limb.

    Science.gov (United States)

    van Keeken, Helco G; Vrieling, Aline H; Hof, At L; Postema, Klaas; Otten, Bert

    2012-10-01

    In this study, conditions that enable a prosthetic knee flexion strategy in transfemoral amputee subjects during obstacle avoidance were investigated. This study explored the hip torque principle and the static ground principle as object avoidance strategies. A prosthetic limb simulator device was used to study the influence of applied hip torques and static ground friction on the prosthetic foot trajectory. Inverse dynamics were used to calculate the energy produced by the hip joint. A two-dimensional forward dynamics model was used to investigate the relation between obstacle-foot distance and the necessary hip torques utilized during obstacle avoidance. The study showed that a prosthetic knee flexion strategy was facilitated by the use of ground friction and by larger active hip torques. This strategy required more energy produced by the hip compared to a knee extension strategy. We conclude that when an amputee maintains enough distance between the distal tip of the foot and the obstacle during stance, he or she produces sufficiently high, yet feasible, hip torques and uses static ground friction, the amputee satisfies the conditions for enable stepping over an obstacle using a knee flexion strategy. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  1. Center of mass control and multi-segment coordination in children during quiet stance.

    Science.gov (United States)

    Wu, Jianhua; McKay, Sandra; Angulo-Barroso, Rosa

    2009-07-01

    This study aimed to apply an uncontrolled manifold (UCM) approach to investigate how children utilize the variability of multiple body segment movement to facilitate the center of mass (COM) control during quiet stance. Three groups of participants were included in this study: younger children (YC, mean age 6.3 years), older children (OC, mean age 10.3 years), and young adults (YA, mean age 20.5 years). Participants stood on a force platform with their hands on the iliac crests for 40 s in each trial. Two visual conditions were examined including eyes-open and eyes-closed and three trials were collected for each condition. Results showed that all three groups partitioned more variability of multi-segment movement into the UCM subspace (maintaining the mean COM position) than into the ORT subspace (a subspace orthogonal to the UCM subspace, causing the deviation of the COM from its mean position) in both eyes-open and eyes-closed conditions. Furthermore, both the YC and OC groups partitioned a significantly higher percentage of variability into the UCM subspace than the YA group regardless of visual condition. In addition, results of conventional COM variables indicated that only the YC group produced significantly faster sway velocity and greater standard deviation than the YA group. All the results together suggest that children at 6-10 years of age use a similar variability-partitioning strategy (a greater V(UCM) and a smaller V(ORT)) like young adults in quiet stance to facilitate the COM control, but it takes more than 10 years for children to refine this strategy and achieve an adult-like variability-partitioning capability (i.e., UCM ratio). It also suggests that postural development may include two phases in which children learn to regulate the position and movement of multiple body segments and the COM first and gain an adult-like variability-partitioning capability later.

  2. Functional limb weakness and paralysis.

    Science.gov (United States)

    Stone, J; Aybek, S

    2016-01-01

    Functional (psychogenic) limb weakness describes genuinely experienced limb power or paralysis in the absence of neurologic disease. The hallmark of functional limb weakness is the presence of internal inconsistency revealing a pattern of symptoms governed by abnormally focused attention. In this chapter we review the history and epidemiology of this clinical presentation as well as its subjective experience highlighting the detailed descriptions of authors at the end of the 19th and early 20th century. We discuss the relevance that physiological triggers such as injury and migraine and psychophysiological events such as panic and dissociation have to understanding of mechanism and treatment. We review many different positive diagnostic features, their basis in neurophysiological testing and present data on sensitivity and specificity. Diagnostic bedside tests with the most evidence are Hoover's sign, the hip abductor sign, drift without pronation, dragging gait, give way weakness and co-contraction. © 2016 Elsevier B.V. All rights reserved.

  3. The evolutionary continuum of limb function from early theropods to birds.

    Science.gov (United States)

    Hutchinson, John R; Allen, Vivian

    2009-04-01

    The bipedal stance and gait of theropod dinosaurs evolved gradually along the lineage leading to birds and at some point(s), flight evolved. How and when did these changes occur? We review the evidence from neontology and paleontology, including pectoral and pelvic limb functional morphology, fossil footprints/trackways and biomechanical models and simulations. We emphasise that many false dichotomies or categories have been applied to theropod form and function, and sometimes, these impede research progress. For example, dichotomisation of locomotor function into 'non-avian' and 'avian' modes is only a conceptual crutch; the evidence supports a continuous transition. Simplification of pelvic limb function into cursorial/non-cursorial morphologies or flexed/columnar poses has outlived its utility. For the pectoral limbs, even the classic predatory strike vs. flight wing-stroke distinction and separation of theropods into non-flying and flying--or terrestrial and arboreal--categories may be missing important subtleties. Distinguishing locomotor function between taxa, even with quantitative approaches, will always be fraught with ambiguity, making it difficult to find real differences if that ambiguity is properly acknowledged. There must be an 'interpretive asymptote' for reconstructing dinosaur limb function that available methods and evidence cannot overcome. We may be close to that limit, but how far can it be stretched with improved methods and evidence, if at all? The way forward is a combination of techniques that emphasises integration of neontological and paleontological evidence and quantitative assessment of limb function cautiously applied with validated techniques and sensitivity analysis of unknown variables.

  4. Lower limb control and strength in runners with and without patellofemoral pain syndrome.

    Science.gov (United States)

    Esculier, Jean-Francois; Roy, Jean-Sébastien; Bouyer, Laurent Julien

    2015-03-01

    Recreational runners with patellofemoral pain syndrome (PFPS) have been shown to present altered movement kinematics, muscle activations, and ground reaction forces (GRF) during running as well as decreased lower limb strength. However, these variables have never been concurrently evaluated in a specific cohort. Therefore, the aim of this study was to compare lower limb control variables during running in recreational runners with and without PFPS. Lower limb control during treadmill running under typical training conditions (usual shoes, foot strike pattern, and speed) was compared between runners with (n=21) and without (n=20) PFPS using lower limb kinematics, electromyographic (EMG) recordings from representative muscles (gluteus medius/maximus, quadriceps and soleus), and vertical GRF. Isometric muscle strength was also evaluated. When comparing all runners from both groups, no between-group differences were found in variables commonly associated with PFPS such as peak hip adduction, hip internal rotation, contralateral pelvic drop, EMG of gluteal and quadriceps muscles, vertical loading rate, or lower limb strength. However, runners with PFPS showed significantly higher hip adduction at toe-off, lower excursion in hip adduction during late-stance, and longer duration of soleus activation. Sub-analyses were performed for females and for rearfoot strikers (RFS), and revealed that these subgroups accounted for most of between-group differences in hip adduction kinematics. Specifically for RFS with PFPS, lower activation of gluteus medius as well as lower GRF were observed. Our results suggest that deficits reported in runners with PFPS may vary depending on gender and on foot strike pattern. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

    OpenAIRE

    Çildağ, Mehmet Burak; Köseoğlu, Ömer Faruk Kutsi

    2017-01-01

    Objective. The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. Methods. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postproc...

  6. The Transformative Power of Taking an Inquiry Stance on Practice: Practitioner Research as Narrative and Counter-Narrative

    Science.gov (United States)

    Ravitch, Sharon M.

    2014-01-01

    Within the ever-developing, intersecting, and overlapping contexts of globalization, top-down policy, mandates, and standardization of public and higher education, many conceptualize and position practitioner research as a powerful stance and a tool of social, communal, and educational transformation, a set of methodological processes that…

  7. The Correlation between Dynamic Balance Measures and Stance Sub-phase COP Displacement Time in Older Adults during Obstacle Crossing.

    Science.gov (United States)

    Park, Seol; Ko, Yu-Min; Park, Ji-Won

    2013-09-01

    [Purpose] This study examined the relationship between the center of pressure (COP) displacement time during the stance subphases and dynamic balance ability when elderly cross obstacles 0, 10, and 40 cm in height. [Subjects] Fifteen older adults were enrolled in this study (≥65 years of age). [Methods] An F-Scan System was used to measure the COP displacement time when subjects crossed obstacles 0, 10, and 40 cm in height, and the Dynamic Gait Index, Berg Balance Scale, and Four Square Step Test were used to measure dynamic balance ability. [Results] The Dynamic Gait Index, Berg Balance Scale, and Four Square Step Test were correlated with each other. Dynamic balance tests were correlated with the COP displacement time during the stance phase. At obstacle heights of 10 and 40 cm during loading response and at all heights during pre-swing, there were correlations with dynamic balance ability. However, dynamic balance ability did not affect the COP displacement time during mid-stance and terminal stance. [Conclusion] People with a lower dynamic balance ability show a larger COP displacement time during loading response and pre-swing. Therefore, dynamic balance ability can be predicted by measuring the COP displacement time.

  8. Reading Sacred Texts in the Classroom: The Alignment between Students and Their Teacher's Interpretive Stances When Reading the Hebrew Bible

    Science.gov (United States)

    Hassenfeld, Ziva R.

    2016-01-01

    This study investigated the voices of students interpreting Hebrew Bible texts in one fourth-grade classroom. Through think-alouds on the Biblical text with each student, exit interviews, teacher interviews, and classroom observations, this study found that those students whose interpretive stances were more aligned with the teacher's were given…

  9. Why an Investigative Stance Matters in Intercultural Language Teaching and Learning: An Orientation to Classroom-Based Investigation

    Science.gov (United States)

    Crichton, Jonathan

    2008-01-01

    This paper develops the idea that classroom investigation can be an integral part of teaching and learning, an ongoing "stance" that enables us to gather valuable information about teaching and learning that may otherwise go unnoticed. This information can in turn inform how teachers understand and develop intercultural language teaching and…

  10. Long-Term Adaptations to Unexpected Surface Perturbations: Postural Control During Stance and Gait in Train Conductors.

    Science.gov (United States)

    Baumgart, Christian; Hoppe, Matthias Wilhelm; Freiwald, Jürgen

    2016-01-01

    The authors aimed to evaluate the differences in postural control during stance and gait between train conductors and controls. Twenty-one train conductors and 21 office workers performed 6 unilateral and bilateral balance tests on stable and unstable surfaces as well as a gait analysis. In the balance tests, the mean velocity of the center of pressure and unstable surface was measured. In the bilateral balance tests the selected stance width was measured. During gait the length, width, frequency, and velocity of the steps were calculated from the ground reaction forces. Train conductors showed a significantly greater step width during gait (15.4 ± 4.7 vs. 13.0 ± 3.4 cm; p = .035) and stance width during the bilateral stance on the unstable surface (21.0 ± 5.1 vs. 17.8 ± 3.7 cm; p = .026) than the office workers, while no differences were revealed in balance variables. The revealed differences between train conductors and office workers may represent task-specific feedforward control strategies, which increase the base of support and may be helpful to resist unexpected perturbations in trains.

  11. The influence of visual information on multi-muscle control during quiet stance: a spectral analysis approach

    NARCIS (Netherlands)

    Danna-Dos-Santos, A.; Degani, A.M.; Boonstra, T.W.; Mochizuki, L.; Harney, A.M.; Schmeckpeper, M.M; Tabor, L.C.; Leonard, C.T.

    2015-01-01

    Standing upright requires the coordination of neural drives to a large set of muscles involved in controlling human bipedal stance (i.e., postural muscles). The coordination may deteriorate in situations where standing is performed under more challenging circumstances, such as standing on a smaller

  12. Epidemiology of post-traumatic limb amputation: a National Trauma Databank analysis.

    Science.gov (United States)

    Barmparas, Galinos; Inaba, Kenji; Teixeira, Pedro G R; Dubose, Joseph J; Criscuoli, Michele; Talving, Peep; Plurad, David; Green, Donald; Demetriades, Demetrios

    2010-11-01

    The purpose of this study was to examine the epidemiology and outcomes of posttraumatic upper (UEA) and lower extremity amputations (LEA). The National Trauma Databank version 5 was used to identify all posttraumatic amputations. From 2000 to 2004 there were 8910 amputated patients (1.0% of all trauma patients). Of these, 6855 (76.9%) had digit and 2055 (23.1%) had limb amputation. Of those with limb amputation, 92.7 per cent (1904/2055) had a single limb amputation. LEA were more frequent than UEA among patients in the single limb amputation group (58.9% vs 41.1%). The mechanism of injury was blunt in 83 per cent; most commonly after motor vehicle collisions (51.0%), followed by machinery accidents (19.4%). Motor vehicle collision occupants had more UEA (54.5% vs 45.5%, P Traumatic limb amputation is not uncommon after trauma in the civilian population and is associated with significant morbidity. Although single limb amputation did not impact mortality, the need for multiple limb amputation was an independent risk factor for death.

  13. Endograft Limb Occlusion in EVAR

    DEFF Research Database (Denmark)

    Taudorf, M; Jensen, L P; Vogt, K C

    2014-01-01

    % at 3 years. Logistic regression showed that iliac artery tortuosity (DIS) (p = .001) and body mass index (p = .007) had a significant impact on graft patency. CONCLUSION: A tortuous vessel on the preoperative CTA is associated with an increased risk of limb occlusion after EVAR. Adjunctive stenting...

  14. Learning about Vertebrate Limb Development

    Science.gov (United States)

    Liang, Jennifer O.; Noll, Matthew; Olsen, Shayna

    2014-01-01

    We have developed an upper-level undergraduate laboratory exercise that enables students to replicate a key experiment in developmental biology. In this exercise, students have the opportunity to observe live chick embryos and stain the apical ectodermal ridge, a key tissue required for development of the vertebrate limb. Impressively, every…

  15. Lower-limb venous thrombosis

    African Journals Online (AJOL)

    muscle strains, tears, or twisting injuries to the leg. • other causes of lower-limb swelling such as cardiac, hepatic and renal pathologies. • lymphoedema. • chronic venous hypertension and its complications. • popliteal (Baker's) cysts. • cellulitis. • other knee pathologies. The objective methods of making a diagnosis of DVT ...

  16. Premier's imaging IR limb sounder

    Science.gov (United States)

    Kraft, Stefan; Bézy, Jean-Loup; Meynart, Roland; Langen, Jörg; Carnicero Dominguez, Bernardo; Bensi, Paolo; Silvestrin, Pierluigi

    2017-11-01

    The Imaging IR Limb Sounder (IRLS) is one of the two instruments planned on board of the candidate Earth Explorer Core Mission PREMIER. PREMIER stands for PRocess Exploration through Measurements of Infrared and Millimetre-wave Emitted Radiation. PREMIER went recently through the process of a feasibility study (Phase A) within the Earth Observation Envelope Program. Emerging from recent advanced instrument technologies IRLS shall, next to a millimetre-wave limb sounder (called STEAMR), explore the benefits of three-dimensional limb sounding with embedded cloud imaging capability. Such 3D imaging technology is expected to open a new era of limb sounding that will allow detailed studies of the link between atmospheric composition and climate, since it will map simultaneously fields of temperature and many trace gases in the mid/upper troposphere and stratosphere across a large vertical and horizontal field of view and with high vertical and horizontal resolution. PREMIER shall fly in a tandem formation looking backwards to METOP's swath and thereby improve meteorological and environmental analyses.

  17. Adolescent Neuroblastoma of Lower Limb

    Directory of Open Access Journals (Sweden)

    Rajeshwari K

    2013-04-01

    Full Text Available Neuroblastoma is an embryonic tumour of neural crest origin, commonly seen in children with upper abdomen involvement. Rarely neuroblastomas present in adolescents and adults involving lower limb. Histopathologically neuroblastoma of lower limb can be confused with other small round cell tumour especially with Ewing's sarcoma and rhabdomyosarcoma. A 16 year old male presented with 15x11cm swelling, pain and multiple discharging sinuses of right leg since 4 months. Routine haematological and biochemical analysis were within normal limits. Radiology of right leg showed large soft tissue swelling encompassing the pathological fracture of tibia and bowing of fibula. Fine needle aspiration of the swelling revealed malignant small round cell tumour. Histopathology revealed poorly differentiated neuroblastoma of lower limb. The immunohistochemistry of Synaptophysin and Chromogranin were positive and CD 99 was negative. Neuroblastoma diagnosed at unusual site with uncommon age has poor prognosis. Hence, one must keep in mind the differential diagnosis of neuroblastoma as one of the differential diagnosis in evaluating the soft tissue tumours of lower limb.

  18. Development of a Novel Fully Passive Treadmill Training Paradigm for Lower Limb Therapeutic Intervention

    Directory of Open Access Journals (Sweden)

    M. Saiful Huq

    2013-01-01

    Full Text Available A simulation based study of a completely new form of body-weight supported treadmill training (BWSTT technique which is fully passive in nature is presented in this paper. The approach does not require any powered means at the lower limbs and is implemented using a combination of coordinated joint locking/unlocking and flexible torque transfer mechanisms. The hip extension pertaining to the stance phase of the gait cycle is achieved through the stance foot being literally dragged by the treadmill belt while the required manoeuvring of the trunk is expected to be accomplished by the voluntary arm-support from the subject. The swing phase, on the other hand, is initiated through appropriately coupling the swing knee with the contralateral extending hip and eventually achieve full knee extension through switching the treadmill speed to a lower value. Considering adequate support from the able arms, the process effectively turns the frictional force at the foot-treadmill belt interface into an agent causing the required whole body mechanical energy fluctuation during the gait cycle.

  19. Musculoskeletal modelling of an ostrich (Struthio camelus pelvic limb: influence of limb orientation on muscular capacity during locomotion

    Directory of Open Access Journals (Sweden)

    John R. Hutchinson

    2015-06-01

    Full Text Available We developed a three-dimensional, biomechanical computer model of the 36 major pelvic limb muscle groups in an ostrich (Struthio camelus to investigate muscle function in this, the largest of extant birds and model organism for many studies of locomotor mechanics, body size, anatomy and evolution. Combined with experimental data, we use this model to test two main hypotheses. We first query whether ostriches use limb orientations (joint angles that optimize the moment-generating capacities of their muscles during walking or running. Next, we test whether ostriches use limb orientations at mid-stance that keep their extensor muscles near maximal, and flexor muscles near minimal, moment arms. Our two hypotheses relate to the control priorities that a large bipedal animal might evolve under biomechanical constraints to achieve more effective static weight support. We find that ostriches do not use limb orientations to optimize the moment-generating capacities or moment arms of their muscles. We infer that dynamic properties of muscles or tendons might be better candidates for locomotor optimization. Regardless, general principles explaining why species choose particular joint orientations during locomotion are lacking, raising the question of whether such general principles exist or if clades evolve different patterns (e.g., weighting of muscle force–length or force–velocity properties in selecting postures. This leaves theoretical studies of muscle moment arms estimated for extinct animals at an impasse until studies of extant taxa answer these questions. Finally, we compare our model’s results against those of two prior studies of ostrich limb muscle moment arms, finding general agreement for many muscles. Some flexor and extensor muscles exhibit self-stabilization patterns (posture-dependent switches between flexor/extensor action that ostriches may use to coordinate their locomotion. However, some conspicuous areas of disagreement in our

  20. Spectroscopy at the solar limb. I. Average off-limb profiles and Doppler shifts of Ca II H

    Science.gov (United States)

    Beck, C. A. R.; Rezaei, R.

    2011-07-01

    Aims: We present constraints on the thermodynamical structure of the chromosphere from ground-based observations of the Ca ii H line profile near and off the solar limb. Methods: We obtained a slit-spectrograph data set of the Ca ii H line with a high signal-to-noise ratio in a field of view extending 20'' across the limb. We analyzed the spectra for the characteristic properties of average and individual off-limb spectra. We used various tracers of the Doppler shifts, such as the location of the absorption core, the ratio of the two emission peaks H2V and H2R, and intensity images at a fixed wavelength. Results: The average off-limb profiles show a smooth variation with increasing limb distance. The line width increases up to a height of about 2 Mm above the limb. The profile shape is fairly symmetric with nearly identical H2V and H2R intensities; at a height of 5 Mm, it changes into a single Gaussian without emission peaks. We find that all off-limb spectra show large Doppler shifts that fluctuate on the smallest resolved spatial scales. The variation is more prominent in cuts parallel to the solar limb than on those perpendicular to it. As far as individual structures can be unequivocally identified at our spatial resolution, we find a specific relation between intensity enhancements and Doppler shifts: elongated brightenings are often flanked all along their extension by velocities in opposite directions. Conclusions: The average off-limb spectra of Ca ii H present a good opportunity to test static chromospheric atmosphere models because they lack the photospheric contribution that is present in disk-center spectra. We suggest that the observed relation between intensity enhancements and Doppler shifts could be caused by waves propagating along the surfaces of flux tubes: an intrinsic twist of the flux tubes or a wave propagation inclined to the tube axis would cause a helical shape of the Doppler excursions, visible as opposite velocity at the sides of the

  1. 21 CFR 890.3475 - Limb orthosis.

    Science.gov (United States)

    2010-04-01

    ... PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3475 Limb orthosis. (a) Identification. A limb orthosis (brace) is a device intended for medical purposes that is worn on the upper or lower... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Limb orthosis. 890.3475 Section 890.3475 Food and...

  2. From fins to limbs to fins: limb evolution in fossil marine reptiles.

    Science.gov (United States)

    Caldwell, Michael W

    2002-10-15

    Limb osteology and ontogenetic patterns of limb ossification are reviewed for extinct lineages of aquatically adapted diapsid reptiles. Phylogenies including these fossil taxa show that paddle-like limbs were independently derived, and that the varied limb morphologies were produced by evolutionary modifications to different aspects of the limb skeleton. Ancient marine reptiles modify the limb by reducing the relative size of the epipodials, modifying the perichondral and periosteal surface of elements distal to the propodials, and evolving extremes of hyperphalangy and hyperdactyly. Developmental genetic models illuminate gene systems that may have controlled limb evolution in these animals. Copyright 2002 Wiley-Liss, Inc.

  3. Expressing epistemic stance in University lectures and TED talks: a contrastive corpu-based analysis

    Directory of Open Access Journals (Sweden)

    Giuditta Caliendo

    2014-07-01

    Full Text Available Abstract – This study explores the web-mediated genre of TED (Technology, Entertainment, Design talks, speech events whereby experts in their field disseminate knowledge from different domains (e.g. science, technology, design, global issues addressing an audience of both co-present participants and web-users all over the world. The aim of this study is to investigate the way academics convey epistemic stance (Conrad, Biber 2000 and build up their image as experts on the TED stage. To this purpose, a contrastive analysis was carried out comparing two corpora of spoken discourse, i.e. a corpus of TED talks and a corpus of MICASE university lectures from different disciplines. Although in both genres the speaker is an academic, both the communicative purpose and audience expectations differ substantially in the two contexts under scrutiny. This comparison highlights some distinguishing traits of TED talks and provides a better insight into this genre. Adopting a corpus-based approach, attention is first paid to the most recurrent epistemic lexical verbs (ELVs and to the use of first and second person pronouns in the two corpora. The qualitative analysis then focuses on similarities and differences in the discourse functions of the four most frequent ELVs (see, show, know, think and of their clusters when they combine with first and second person pronouns in the two corpora. Previous studies in the field of English for Academic Purposes (Rounds 1987; Fortanet 2004; Walsh 2004; Artiga León 2006; Bamford 2009 are referred to as a starting point to investigate a novel, unexplored pragmatic space (i.e. that of TED wherein academics accomplish purposes other than merely disseminating knowledge and training students, such as promoting their research and building up their image as experts. Keywords: Languages for Special Purposes, popularization, web-mediated genres, evidentiality, epistemic stance  Abstract – I generi mediati dalla rete svolgono un

  4. Limb development: a paradigm of gene regulation.

    Science.gov (United States)

    Petit, Florence; Sears, Karen E; Ahituv, Nadav

    2017-04-01

    The limb is a commonly used model system for developmental biology. Given the need for precise control of complex signalling pathways to achieve proper patterning, the limb is also becoming a model system for gene regulation studies. Recent developments in genomic technologies have enabled the genome-wide identification of regulatory elements that control limb development, yielding insights into the determination of limb morphology and forelimb versus hindlimb identity. The modulation of regulatory interactions - for example, through the modification of regulatory sequences or chromatin architecture - can lead to morphological evolution, acquired regeneration capacity or limb malformations in diverse species, including humans.

  5. Changes in input-output relations in the corticospinal pathway to the lower limb muscles during robot-assisted passive stepping.

    Science.gov (United States)

    Kamibayashi, Kiyotaka; Nakajima, Tsuyoshi; Takahashi, Makoto; Nakazawa, Kimitaka

    2011-01-01

    We investigated input (stimulus)-output (response) relations of the corticospinal pathway in the lower limb muscles during passive stepping using a robotic driven gait orthosis. Nine healthy adult subjects passively stepped with 40% body weight unloading (ground stepping) and 100% body weight unloading in the air (air stepping). During passive stepping, the motor evoked potentials (MEPs) of the lower limb muscles elicited by transcranial magnetic stimulation (TMS) were recorded at late-stance, early-, and late-swing phases of 2 stepping conditions. The input-output relation at each phase of the stepping conditions was obtained by increasing stimulus intensity in 5% increments from 40% to 70% of maximal stimulator output. The slopes of input-output relations were steeper at the early-swing phase in the rectus femoris muscle and at the late-stance and late-swing phases in the biceps femoris muscle in both stepping conditions. There were no significant differences in the MEP responses of the rectus femoris and biceps femoris muscles at each phase between the 2 conditions. Low muscle activity was seen at the late-stance phase of ground stepping in the soleus muscle and the MEP amplitude at this phase became larger. The slopes in the tibialis anterior muscle were steep at the early- and late-swing phases of ground stepping. There was a significant difference in the MEPs of the tibialis anterior muscle between the late-swing phases in ground and air stepping. The present study indicates that corticospinal excitability to the lower limb muscles is modulated by sensory inputs elicited by passive stepping.

  6. Investigation of Anticipatory Postural Adjustments during One-Leg Stance Using Inertial Sensors: Evidence from Subjects with Parkinsonism

    Directory of Open Access Journals (Sweden)

    Gianluca Bonora

    2017-07-01

    Full Text Available The One-Leg Stance (OLS test is a widely adopted tool for the clinical assessment of balance in the elderly and in subjects with neurological disorders. It was previously showed that the ability to control anticipatory postural adjustments (APAs prior to lifting one leg is significantly impaired by idiopathic Parkinson’s disease (iPD. However, it is not known how APAs are affected by other types of parkinsonism, such as frontal gait disorders (FGD. In this study, an instrumented OLS test based on wearable inertial sensors is proposed to investigate both the initial anticipatory phase and the subsequent unipedal balance. The sensitivity and the validity of the test have been evaluated. Twenty-five subjects with iPD presenting freezing of gait (FOG, 33 with iPD without FOG, 13 with FGD, and 32 healthy elderly controls were recruited. All subjects wore three inertial sensors positioned on the posterior trunk (L4–L5, and on the left and right frontal face of the tibias. Participants were asked to lift a foot and stand on a single leg as long as possible with eyes open, as proposed by the mini-BESTest. Temporal parameters and trunk acceleration were extracted from sensors and compared among groups. The results showed that, regarding the anticipatory phase, the peak of mediolateral trunk acceleration was significantly reduced compared to healthy controls (p < 0.05 in subjects with iPD with and without FOG, but not in FGD group (p = 0.151. Regarding the balance phase duration, a significant shortening was found in the three parkinsonian groups compared to controls (p < 0.001. Moreover, balance was significantly longer (p < 0.001 in iPD subjects without FOG compared to subjects with FGD and iPD subjects presenting FOG. Strong correlations between balance duration extracted by sensors and clinical mini-BESTest scores were found (ρ > 0.74, demonstrating the method’s validity. Our findings support the validity of the proposed

  7. Electromyographic analysis of the gluteus medius in five weight-bearing exercises.

    Science.gov (United States)

    Krause, David A; Jacobs, Rebecca S; Pilger, Katie E; Sather, Becky R; Sibunka, Seth P; Hollman, John H

    2009-12-01

    Weight-bearing exercises are frequently used to train and strengthen muscles of the hip. These exercises have been advocated in the rehabilitation of a variety of hip and knee dysfunctions. Limited evidence is available to describe the level of muscle activation occurring with specific weight-bearing exercises. The purpose of this study was to investigate the level of activation of the gluteus medius muscle as measured by electromyographic (EMG) signal amplitude in 5 weight-bearing exercises. Twenty healthy subjects aged 21 to 30 years participated in the study. The EMG surface electrodes were positioned over the muscle belly of the gluteus medius. Subjects performed 5 exercises that consisted of bilateral stance, single limb stance, single limb stance on both a firm surface and an Airex cushion, and single limb squat on a firm surface and an Airex cushion. Statistical differences (rho gluteus medius EMG values were found between single limb stance as compared with double limb stance, and single limb squat as compared with single limb stance. Single limb stance places more demands on the gluteus medius than double limb stance, whereas single limb squats are more demanding than single limb stance. Although exercises performed on an Airex cushion produced greater EMG values as compared with a firm surface, the difference was not statistically significant. The results, however, suggest that if the goal is to increase the challenge to the gluteus medius, dynamic, single limb exercises performed on unstable surfaces, such as a balance cushion, may place greater demands on the gluteus medius than similar exercises performed on stable surfaces.

  8. Pedunculopontine nucleus area oscillations during stance, stepping and freezing in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Valerie Fraix

    Full Text Available The pedunculopontine area (PPNa including the pedunculopontine and cuneiform nuclei, belongs to the mesencephalic locomotor region. Little is known about the oscillatory mechanisms underlying the function of this region in postural and gait control. We examined the modulations of the oscillatory activity of the PPNa and cortex during stepping, a surrogate of gait, and stance in seven Parkinson's disease patients who received bilateral PPNa implantation for disabling freezing of gait (FOG. In the days following the surgery, we recorded behavioural data together with the local field potentials of the PPNa during sitting, standing and stepping-in-place, under two dopaminergic medication conditions (OFF and ON levodopa. Our results showed that OFF levodopa, all subjects had FOG during step-in-place trials, while ON levodopa, stepping was effective (mean duration of FOG decreasing from 61.7±36.1% to 7.3±10.1% of trial duration. ON levodopa, there was an increase in PPNa alpha (5-12 Hz oscillatory activity and a decrease in beta (13-35 Hz and gamma (65-90 Hz bands activity. PPNa activity was not modulated during quiet standing and sitting. Our results confirm the role of the PPNa in the regulation of gait and suggest that, in Parkinson disease, gait difficulties could be related to an imbalance between low and higher frequencies.

  9. Mechanisms underlying center of pressure displacements in obese subjects during quiet stance

    Directory of Open Access Journals (Sweden)

    Priano Lorenzo

    2011-04-01

    Full Text Available Abstract Objective the aim of this study was to assess whether reduced balance capacity in obese subjects is secondary to altered sensory information. Design cross sectional study. Subjects 44 obese (BMI = 40.6 ± 4.6 kg/m2 , age = 34.2 ± 10.8 years, body weight: 114,0 ± 16,0 Kg, body height 167,5 ± 9,8 cm and 20 healthy controls (10 females, 10 males, BMI: 21.6 ± 2.2 kg/m2, age: 30.5 ± 5.5 years, body weight: 62,9 ± 9,3 Kg, body height 170,1 ± 5,8 cm were enrolled. Measurements center of pressure (CoP displacements were evaluated during quiet stance on a force platform with eyes open (EO and closed (EC. The Romberg quotient (EC/EO was computed and compared between groups. Results we found statistically significant differences between obese and controls in CoP displacements (p 0.08. Conclusion the increased CoP displacements in obese subjects do not need an hypothesis about altered sensory information. The integration of different sensory inputs appears similar in controls and obese. In the latter, the increased mass, ankle torque and muscle activity may probably account for the higher CoP displacements.

  10. Influence of affective auditory stimuli on balance control during static stance.

    Science.gov (United States)

    Chen, Xingyu; Qu, Xingda

    2017-03-01

    The main purpose of this study was to examine the effects of affective auditory stimuli on balance control during static stance. Twelve female and 12 male participants were recruited. Each participant completed four upright standing trials including three auditory stimuli trials and one baseline trial (ie no auditory stimuli). The three auditory stimuli trials corresponded to the pleasant, neutral and unpleasant sound conditions. Center of pressure (COP) measures were used to quantify balance control performance. It was found that unpleasant auditory stimuli were associated with larger COP amplitude in the AP direction compared to the rest testing conditions. There were no significant interaction effects between 'auditory stimuli' and gender. These findings suggested that some specificities presented by auditory stimuli are important for balance control, and the effects of auditory stimuli on balance control were dependent on their affective components. Practitioner Summary: Findings from this study can aid in better understanding of the relationship between auditory stimuli and balance control. In particular, unpleasant auditory stimuli were found to result in poorer balance control and higher fall risks. Therefore, to prevent fall accidents, interventions should be developed to reduce exposures to unpleasant sound.

  11. The Effect of First-Step Techniques from the Staggered Stance in American Football

    DEFF Research Database (Denmark)

    Knudsen, Nikolas Sten; Andersen, Thomas Bull

    2017-01-01

    The purpose of this study was to evaluate 3 different starting techniques from the staggered stance with regards to sprint time, reaction time, linear impulse and power. 11 male amateur American football players volunteered to participate in a testing session consisting of twelve 5 m sprints, 4...... in each technique (normal (NORM), backwards false step (BFS) and forwards false step (FFS)) in random order. Sprint starts were performed on force plates to investigate ground reaction forces, reaction time and total sprint time. Analysis showed significant differences in sprint times, with NORM (1.......77±0.10 s) being faster than FFS (1.81±0.12 s) and BFS (2.01±0.13 s), and FFS being faster than BFS, although no differences were found in reaction time. In terms of mean force and power, NORM (331.1±39.2N, 542.2±72.3W) and FFS (320.8±43.2N, 550.9±81.4W) were significantly larger than BFS (256.9±36.2N, 443...

  12. Development and the evolvability of human limbs.

    Science.gov (United States)

    Young, Nathan M; Wagner, Günter P; Hallgrímsson, Benedikt

    2010-02-23

    The long legs and short arms of humans are distinctive for a primate, the result of selection acting in opposite directions on each limb at different points in our evolutionary history. This mosaic pattern challenges our understanding of the relationship of development and evolvability because limbs are serially homologous and genetic correlations should act as a significant constraint on their independent evolution. Here we test a developmental model of limb covariation in anthropoid primates and demonstrate that both humans and apes exhibit significantly reduced integration between limbs when compared to quadrupedal monkeys. This result indicates that fossil hominins likely escaped constraints on independent limb variation via reductions to genetic pleiotropy in an ape-like last common ancestor (LCA). This critical change in integration among hominoids, which is reflected in macroevolutionary differences in the disparity between limb lengths, facilitated selection for modern human limb proportions and demonstrates how development helps shape evolutionary change.

  13. Continuum limbed robots for locomotion

    Science.gov (United States)

    Mutlu, Alper

    This thesis focuses on continuum robots based on pneumatic muscle technology. We introduce a novel approach to use these muscles as limbs of lightweight legged robots. The flexibility of the continuum legs of these robots offers the potential to perform some duties that are not possible with classical rigid-link robots. Potential applications are as space robots in low gravity, and as cave explorer robots. The thesis covers the fabrication process of continuum pneumatic muscles and limbs. It also provides some new experimental data on this technology. Afterwards, the designs of two different novel continuum robots - one tripod, one quadruped - are introduced. Experimental data from tests using the robots is provided. The experimental results are the first published example of locomotion with tripod and quadruped continuum legged robots. Finally, discussion of the results and how far this technology can go forward is presented.

  14. The OMPS Limb Profiler Instrument: Two-Dimensional Retrieval Algorithm

    Science.gov (United States)

    Rault, Didier F.

    2010-01-01

    radiances within a non-uniform atmosphere and evaluate 2D analytical partial derivatives) and (2) an optimal estimator inversion routine. The algorithm uses the typically sparse nature of the kernel matrices as well as fast matrix inversion techniques to allow for fast inversion of limb data with efficient memory management (as was done for MIPAS data processing). While the method has so far only been developed in the context of Single Scatter, the paper will show how the CPU intensive Multiple Scatter modeling can be implemented using parallel CPU processing. Initial results will be presented in terms of retrieved ozone profiles and code performance.

  15. Human limb-specific and non-limb-specific brain representations during kinesthetic illusory movements of the upper and lower extremities.

    Science.gov (United States)

    Naito, Eiichi; Nakashima, Tokuro; Kito, Tomonori; Aramaki, Yu; Okada, Tomohisa; Sadato, Norihiro

    2007-06-01

    Sensing movements of the upper and lower extremities is important in controlling whole-body movements. We have shown that kinesthetic illusory hand movements activate motor areas and right-sided fronto-parietal cortices. We investigated whether illusions for the upper and lower extremities, i.e. right or left hand or foot, activate the somatotopical sections of motor areas, and if an illusion for each limb engages the right-sided cortices. We scanned the brain activity of 19 blindfolded right-handed participants using functional magnetic resonance imaging (fMRI) while they experienced an illusion for each limb elicited by vibrating its tendon at 110 Hz (ILLUSION). As a control, we applied identical stimuli to the skin over a nearby bone, which does not elicit illusions (VIBRATION). The illusory movement (ILLUSION vs. VIBRATION) of each immobile limb activated limb-specific sections of the contralateral motor cortex (along with somatosensory area 3a), dorsal premotor cortex (PMD), supplementary motor area (SMA), cingulate motor area (CMA), and the ipsilateral cerebellum, which normally participate in execution of movements of the corresponding limb. We found complex non-limb-specific representations in rostral parts of the bilateral SMA and CMA, and illusions for all limbs consistently engaged concentrated regions in right-sided fronto-parietal cortices and basal ganglia. This study demonstrated complete sets of brain representations related to kinesthetic processing of single-joint movements of the four human extremities. The kinesthetic function of motor areas suggests their importance in somatic perception of limb movement, and the non-limb-specific representations indicate high-order kinesthetic processing related to human somatic perception of one's own body.

  16. Use of a virtual integrated environment in prosthetic limb development and phantom limb pain.

    Science.gov (United States)

    Alphonso, Aimee L; Monson, Brett T; Zeher, Michael J; Armiger, Robert S; Weeks, Sharon R; Burck, J M; Moran, C; Davoodie, R; Loeb, G; Pasquina, Paul F; Tsao, Jack W

    2012-01-01

    Patients face two major difficulties following limb loss: phantom limb pain (PLP) in the residual limb and limited functionality in the prosthetic limb. Many studies have focused on decreasing PLP with mirror therapy, yet few have examined the same visual ameliorating effect with a virtual or prosthetic limb. Our study addresses the following key questions: (1) does PLP decrease through observation of a 3D limb in a virtual integration environment (VIE) and (2) can consistent surface electromyography (sEMG) signals from the VIE drive an advanced modular prosthetic limb (MPL)? Recorded signals from the residual limb were correlated to the desired motion of the phantom limb, and changes in PLP were scored during each VIE session. Preliminary results show an overall reduction in PLP and a trend toward improvement in signal-to-motion accuracy over time. These signals allowed MPL users to perform a wide range of hand motions.

  17. Standardized Approach to Quantitatively Measure Residual Limb Skin Health in Individuals with Lower Limb Amputation

    Science.gov (United States)

    Rink, Cameron L.; Wernke, Matthew M.; Powell, Heather M.; Tornero, Mark; Gnyawali, Surya C.; Schroeder, Ryan M.; Kim, Jayne Y.; Denune, Jeffrey A.; Albury, Alexander W.; Gordillo, Gayle M.; Colvin, James M.; Sen, Chandan K.

    2017-01-01

    Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial (n = 5) and transfemoral (n = 5) amputation were compared to able-limb controls (n = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance). Results: A standardized methodology that employs noninvasive imaging and probe-based approaches to measure residual limb skin health are described. Compared to able-limb controls, individuals with transtibial and transfemoral amputation have significantly lower transcutaneous oxygen tension, higher transepidermal water loss, and higher surface electrical capacitance in the residual limb. Innovation: Residual limb health as a critical component of prosthesis rehabilitation for individuals with lower limb amputation is understudied in part due to a lack of clinical measures. Here, we present a standardized approach to measure residual limb health in people with transtibial and transfemoral amputation. Conclusion: Technology advances in noninvasive imaging and probe-based measures are leveraged to develop a standardized approach to quantitatively measure residual limb health in individuals with lower limb loss. Compared to able-limb controls, resting residual limb physiology in people that have had transfemoral or transtibial amputation is characterized by lower transcutaneous oxygen tension and poorer skin barrier function. PMID:28736682

  18. Standardized Approach to Quantitatively Measure Residual Limb Skin Health in Individuals with Lower Limb Amputation.

    Science.gov (United States)

    Rink, Cameron L; Wernke, Matthew M; Powell, Heather M; Tornero, Mark; Gnyawali, Surya C; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Albury, Alexander W; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

    2017-07-01

    Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial ( n  = 5) and transfemoral ( n  = 5) amputation were compared to able-limb controls ( n  = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance). Results: A standardized methodology that employs noninvasive imaging and probe-based approaches to measure residual limb skin health are described. Compared to able-limb controls, individuals with transtibial and transfemoral amputation have significantly lower transcutaneous oxygen tension, higher transepidermal water loss, and higher surface electrical capacitance in the residual limb. Innovation: Residual limb health as a critical component of prosthesis rehabilitation for individuals with lower limb amputation is understudied in part due to a lack of clinical measures. Here, we present a standardized approach to measure residual limb health in people with transtibial and transfemoral amputation. Conclusion: Technology advances in noninvasive imaging and probe-based measures are leveraged to develop a standardized approach to quantitatively measure residual limb health in individuals with lower limb loss. Compared to able-limb controls, resting residual limb physiology in people that have had transfemoral or transtibial amputation is characterized by lower transcutaneous oxygen tension and poorer skin barrier function.

  19. Early regulation of axolotl limb regeneration.

    Science.gov (United States)

    Makanae, Aki; Satoh, Akira

    2012-10-01

    Amphibian limb regeneration has been studied for a long time. In amphibian limb regeneration, an undifferentiated blastema is formed around the region damaged by amputation. The induction process of blastema formation has remained largely unknown because it is difficult to study the induction of limb regeneration. The recently developed accessory limb model (ALM) allows the investigation of limb induction and reveals early events of amphibian limb regeneration. The interaction between nerves and wound epidermis/epithelium is an important aspect of limb regeneration. During early limb regeneration, neurotrophic factors act on wound epithelium, leading to development of a functional epidermis/epithelium called the apical epithelial cap (AEC). AEC and nerves create a specific environment that inhibits wound healing and induces regeneration through blastema formation. It is suggested that FGF-signaling and MMP activities participate in creating a regenerative environment. To understand why urodele amphibians can create such a regenerative environment and humans cannot, it is necessary to identify the similarities and differences between regenerative and nonregenerative animals. Here we focus on ALM to consider limb regeneration from a new perspective and we also reported that focal adhesion kinase (FAK)-Src signaling controlled fibroblasts migration in axolotl limb regeneration. Copyright © 2012 Wiley Periodicals, Inc.

  20. Employing Questionnaires in terms of a Constructivist Epistemological Stance: Reconsidering Researchers' Involvement in the Unfolding of Social Life

    Directory of Open Access Journals (Sweden)

    Norma R. A. Romm D Litt et Phil

    2013-02-01

    Full Text Available In this article, I delve into what it might mean to employ questionnaires without regarding them simply as a way of attempting to discern relationships of correlation or causality between defined variables (as in positivist and post-positivist conceptions of questionnaires. I shall consider the implications of researchers using questionnaires on the basis of alternative paradigmatic orientations. I shall discuss, in particular, interpretivist stances and more constructively-oriented stances (as qualitatively-oriented paradigmatic positions with reference to different understandings of questionnaire use. I shall also reflect on how qualitative positions that embrace a constructivist epistemological stance can lead to a redirection of questionnaires in relation to more “usual” (post-positivist-directed usages. In the course of the discussion I make a case, drawing on a version of constructivism, for researchers taking responsibility for their involvement—no matter what methods are used—in the unfolding of the social worlds of which research is a part. Taking into account the constructivist epistemological understanding that questionnaires—as well as other research methods—contribute to the construction of responses rather than merely “finding” responses from research participants, I suggest that some responsibility needs to be taken by those employing questionnaires for the potential social impact of these on research participants as well as wider audiences.

  1. The effect of voluntary lateral trunk bending on balance recovery following multi-directional stance perturbations.

    Science.gov (United States)

    Küng, U M; Horlings, C G C; Honegger, F; Allum, J H J

    2010-05-01

    Stabilising shifts of the centre of mass (COM) are observed during balance recovery when subjects simultaneously execute voluntary unilateral knee flexion or unilateral arm raising. Here, we examined whether voluntary lateral trunk bending provided more beneficial stabilising effects, and how motor programs of balance corrections are combined with those of the focal voluntary action. The upright balance of 24 healthy young subjects (19-33 years of age) was perturbed using multi-directional rotations of the support-surface. The perturbations consisted of combined pitch and roll rotations (7.5 degrees and 60 degrees/s) presented randomly in six different directions. Three conditions were tested: perturbation of stance only (PO); combined balance perturbation and cued uphill bending of the trunk (CONT); and combined perturbation and cued downhill bending of the trunk (IPS). For comparison, subjects were required to perform trunk bending alone (TO). Outcome measures were biomechanical responses and surface EMG activity of several muscles. Calculated predicted outcomes (PO + TO) were compared with combined measures (CONT or IPS). CONT trunk bending uphill showed two phases of benefit in balance recovery for laterally but, in contrast to voluntary knee bending, not for posterior directed components of the perturbations. IPS trunk bending had negative effects on balance. Early balance correcting muscle responses were marginally greater than PO responses. Prominent secondary balance correcting responses, having a similar timing as voluntary responses observed under TO conditions, were seen under CONT only in trunk muscles. These, and later stabilising, responses had amplitudes as expected from PO + TO conditions being significantly greater than PO responses. The ability with which different muscle synergies for balance corrections and voluntary trunk bending were integrated into one indicates a flexible adjustment of the CNS programs to the demands of both tasks.

  2. Lower Limb Neuromuscular Asymmetry in Volleyball and Basketball Players

    Directory of Open Access Journals (Sweden)

    Fort-Vanmeerhaeghe Azahara

    2016-04-01

    Full Text Available The primary objective of the present study was to evaluate the agreement between the dominant leg (DL (determined subjectively and the stronger leg (SL (determined via a functional test in a group of basketball and volleyball players. The secondary objective was to calculate lower limb neuromuscular asymmetry when comparing the DL vs the non-dominant leg (NDL and the SL vs the weaker (WL leg in the whole group and when differentiating by sex. Seventy-nine male and female volleyball and basketball players (age: 23.7 ± 4.5 years performed three single-leg vertical countermovement jumps (SLVCJ on a contact mat. Vertical jump height and an inter-limb asymmetry index (ASI were determined. Only 32 (40% of the subjects had a concordance between the perception of their dominant leg and the limb reaching the highest jump height. Using the DL as the discriminating variable, significant (p<0.05 inter-limb differences were found in the total group of players. When comparing between sexes, significant differences (p<0.05 arose in the female group only. With regard to the WL vs. the SL, significant (p<0.05 differences were noted in the whole group and when stratified into males and females. The mean ASI ranged from 9.31% (males to 12.84% (females and from 10.49% (males to 14.26% (females, when comparing the DL vs. the NDL and the SL vs. the WL, respectively. Subjective expression of leg dominance cannot be used as a predictor of limb jump performance. Vertical jump asymmetry of 10-15% exists and this can be considered as a reference value for male and female basketball and volleyball players.

  3. Development and the evolvability of human limbs

    OpenAIRE

    Young, Nathan M.; Wagner, Günter P.; Hallgrímsson, Benedikt

    2010-01-01

    The long legs and short arms of humans are distinctive for a primate, the result of selection acting in opposite directions on each limb at different points in our evolutionary history. This mosaic pattern challenges our understanding of the relationship of development and evolvability because limbs are serially homologous and genetic correlations should act as a significant constraint on their independent evolution. Here we test a developmental model of limb covariation in anthropoid primate...

  4. Diagnosis and treatment of upper limb apraxia

    OpenAIRE

    Dovern, A.; Fink, G. R.; Weiss, P. H.

    2012-01-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients’ everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients’ prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed...

  5. PTSD in Limb Trauma and Recovery

    Science.gov (United States)

    2012-10-01

    physical capabilities of above knee amputees with short residual limbs. With a shorter limb, the individual has both less muscle mass and a shorter lever ...of Biomechanics 2012. ANNUAL REPORT 10/16/2012 VIRTUAL REALITY AND MOTION ANALYSIS TO CHARACTERIZE DISABILITIES IN LOWER LIMB INJURY PI...D’Andrea, Brown University. Computer Navigation as an Investigational Tool for ACL Reconstruction. 36th Annual American Society of Biomechanics Meeting

  6. Hybrid endograft solution for complex iliac anatomy: Zenith body and Excluder limbs.

    Science.gov (United States)

    Bos, Wendy T; Tielliu, Ignace F; Sondakh, Arthur O; Vourliotakis, Georgios; Bracale, Umberto M; Verhoeven, Eric L

    2010-01-01

    The purpose of this study was to evaluate single-center results with selective use of Gore Excluder limbs (W.L. Gore & Associates, Flagstaff, AZ) in a Cook Zenith body (Cook Inc, Bloomington, IN) for elective endovascular abdominal aortic aneurysm (AAA) repair. A prospectively held database for patients with AAA, who were treated endovascularly between March 1999 and July 2008, was queried for patients treated with a Cook Zenith body and one or two Gore Excluder limbs. Indication, technical success, late limb occlusion, and disconnection were evaluated. From 276 patients who were treated with a Zenith body, 29 underwent repair with hybrid graft components with, in total, 41 Gore Excluder limbs. The indication was always complex iliac anatomy. The primary technical success rate in this group was 89% (26 of 29 patients), with a primary assisted technical success rate of 100%. Mortality at 30 days was 0%. The mean follow-up was 19.4 months (range 2-64 months). Late mortality was 13.8% (4 of 29), with no aneurysm-related death. No graft limb occlusion or disconnection occurred during follow-up. No reintervention was needed in the hybrid endograft group. The use of a Cook Zenith body with Gore Excluder limb(s) in case of adverse iliac anatomy is feasible and showed no adverse effects at the midterm follow-up.

  7. Radiologic analysis of congenital limb anomalies

    International Nuclear Information System (INIS)

    Chung, Hong Jun; Kim, Ok Hwa; Shinn, Kyung Sub; Kim, Nam Ae

    1994-01-01

    Congenital limb anomalies are manifested in various degree of severity and complexity bearing conclusion for description and nomenclature of each anomaly. We retrospectively analyzed the roentgenograms of congenital limb anomalies for the purpose of further understanding of the radiologic manifestations based on the embryonal defect and also to find the incidence of each anomaly. Total number of the patients was 89 with 137 anomalies. Recently the uniform system of classification for congenital anomalies of the upper limb was adopted by International Federation of Societies for Surgery of the Hand (IFSSH), which were categorized as 7 classifications. We used the IFSSH classification with some modification as 5 classifications; failure of formation of parts, failure of differentiation of parts, duplications, overgrowth and undergrowth. The patients with upper limb anomalies were 65 out of 89(73%), lower limb were 21(24%), and both upper and lower limb anomalies were 3(4%). Failure of formation was seen in 18%, failure of differentiation 39%, duplications 39%, overgrowth 8%, and undergrowth in 12%. Thirty-five patients had more than one anomaly, and 14 patients had intergroup anomalies. The upper limb anomalies were more common than lower limb. Among the anomalies, failure of differentiation and duplications were the most common types of congenital limb anomalies. Patients with failure of formation, failure of differentiation, and undergrowth had intergroup association of anomalies, but duplication and overgrowth tended to be isolated anomalies

  8. The importance of orthoses on activities of daily living in patients with unilateral lower limb amputations.

    Science.gov (United States)

    Onat, Sule Sahin; Ünsal-Delialioğlu, Sibel; Özel, Sumru

    2017-01-01

    The role of the selected prothesis on activities of daily living (ADL). To evaluate the impact of prothesis on ADL in patients with lower-limb amputations. The data of 500 patients with unilateral lower limb amputation were recorded. The activity level was defined based on the Medicare Functional Classification Level. Old and new prescribed prosthesis were recorded. Nottingham Extended Activities of daily living activities Daily Living Scale was used to evaluate ADL. Amputation levels were transfemoral (TF) in 268 (53.6%), transtibial (TT) in 178 (35.6%), knee disarticulation (KD) in 54 (10.8%). In patients with TF and KD amputation active vacuum system, pin modular system, hydraulic system and mechanical modular prosthesis were replaced with the swing stance phase microprocessor-controlled prostheses. In patients with TT amputation pin modular system, hydraulic system and mechanical modular prosthesis were converted to active vacuum system prostheses. Prescribed new prosthesis has caused a statistically significant increase in all amputation levels in ADL of patients (p≤ 0.05). We observed that there was significant improvement in ADL when conventional prostheses replaced with advanced technology prostheses in unilateral lower extremity amputation patients.

  9. Desempenho do membro não-acometido em pacientes com reconstrução do ligamento cruzado anterior Performance of uninjured lower limb after anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Maria Isabel de Noronha Neta

    2010-09-01

    had ACL reconstruction, and 22 control subjects were assessed as to knee flexor and extensor torque during concentric isokinetic contraction at 60o/s with an isokinetic dynamometer, mean speed of centre of pressure swing during single-limb stance, and submitted to two hop tests to assess functional performance. Results showed no significant differences between uninjured side and healthy subjects lower limbs at all assessed variables (p>0.05. These findings suggest that the uninjured limb may be safely used as reference in studies to assess post-ACL patients.

  10. The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

    Directory of Open Access Journals (Sweden)

    Mehmet Burak Çildağ

    2017-01-01

    Full Text Available Objective. The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI and those who have Charchot neuroarthropathy (CN accompanied by CLI. Methods. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. Results. There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups (p>0.05. Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences (p<0.005. Conclusion. This study showed that CLI can accompany CN in patients with diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

  11. The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty.

    Science.gov (United States)

    Çildağ, Mehmet Burak; Köseoğlu, Ömer Faruk Kutsi

    2017-01-01

    The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups ( p > 0.05). Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences ( p diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

  12. Origin of directionally tuned responses in lower limb muscles to unpredictable upper limb disturbances

    OpenAIRE

    Forghani, Ali; Milner, Theodore E.

    2017-01-01

    Unpredictable forces which perturb balance are frequently applied to the body through interaction between the upper limb and the environment. Lower limb muscles respond rapidly to these postural disturbances in a highly specific manner. We have shown that the muscle activation patterns of lower limb muscles are organized in a direction specific manner which changes with lower limb stability. Ankle muscles change their activity within 80 ms of the onset of a force perturbation applied to the h...

  13. Core stability training on lower limb balance strength.

    Science.gov (United States)

    Dello Iacono, Antonio; Padulo, Johnny; Ayalon, Moshe

    2016-01-01

    This study aimed to assess the effects of core stability training on lower limbs' muscular asymmetries and imbalances in team sport. Twenty footballers were divided into two groups, either core stability or control group. Before each daily practice, core stability group (n = 10) performed a core stability training programme, while control group (n = 10) did a standard warm-up. The effects of the core stability training programme were assessed by performing isokinetic tests and single-leg countermovement jumps. Significant improvement was found for knee extensors peak torque at 3.14 rad · s(-1) (14%; P strength asymmetries in core stability group (-71.4%; P = 0.02) while a concurrent increase was seen in the control group (33.3%; P lower limbs strength balance development in young soccer players.

  14. Mechanobiology of embryonic limb development.

    Science.gov (United States)

    Nowlan, Niamh C; Murphy, Paula; Prendergast, Patrick J

    2007-04-01

    Considerable evidence exists to support the hypothesis that mechanical forces have an essential role in healthy embryonic skeletal development. Clinical observations and experimental data indicate the importance of muscle contractions for limb development. However, the influence of these forces is seldom referred to in biological descriptions of bone development, and perhaps this is due to the fact that the hypothesis that mechanical forces are essential for normal embryonic skeletal development is difficult to test and elaborate experimentally in vivo, particularly in humans. Computational modeling has the potential to address this issue by simulating embryonic growth under a range of loading conditions but the potential of such models has yet to be fully exploited. In this article, we review the literature on mechanobiology of limb development in three main sections: (a) experimental alteration of the mechanical environment, (b) mechanical properties of embryonic tissues, and (c) the use of computational models. Then we analyze the main issues, and suggest how experimental and computational fields could work closer together to enhance our understanding of mechanobiology of the embryonic skeleton.

  15. Effects of a leaf spring structured midsole on joint mechanics and lower limb muscle forces in running.

    Science.gov (United States)

    Wunsch, Tobias; Alexander, Nathalie; Kröll, Josef; Stöggl, Thomas; Schwameder, Hermann

    2017-01-01

    To enhance running performance in heel-toe running, a leaf spring structured midsole shoe (LEAF) has recently been introduced. The purpose of this study was to investigate the effect of a LEAF compared to a standard foam midsole shoe (FOAM) on joint mechanics and lower limb muscle forces in overground running. Nine male long-distance heel strike runners ran on an indoor track at 3.0 ± 0.2 m/s with LEAF and FOAM shoes. Running kinematics and kinetics were recorded during the stance phase. Absorbed and generated energy (negative and positive work) of the hip, knee and ankle joint as well as muscle forces of selected lower limb muscles were determined using a musculoskeletal model. A significant reduction in energy absorption at the hip joint as well as energy generation at the ankle joint was found for LEAF compared to FOAM. The mean lower limb muscle forces of the m. soleus, m. gastrocnemius lateralis and m. gastrocnemius medialis were significantly reduced for LEAF compared to FOAM. Furthermore, m. biceps femoris showed a trend of reduction in running with LEAF. The remaining lower limb muscles analyzed (m. gluteus maximus, m. rectus femoris, m. vastus medialis, m. vastus lateralis, m. tibialis anterior) did not reveal significant differences between the shoe conditions. The findings of this study indicate that LEAF positively influenced the energy balance in running by reducing lower limb muscle forces compared to FOAM. In this way, LEAF could contribute to an overall increased running performance in heel-toe running.

  16. Effects of a leaf spring structured midsole on joint mechanics and lower limb muscle forces in running.

    Directory of Open Access Journals (Sweden)

    Tobias Wunsch

    Full Text Available To enhance running performance in heel-toe running, a leaf spring structured midsole shoe (LEAF has recently been introduced. The purpose of this study was to investigate the effect of a LEAF compared to a standard foam midsole shoe (FOAM on joint mechanics and lower limb muscle forces in overground running. Nine male long-distance heel strike runners ran on an indoor track at 3.0 ± 0.2 m/s with LEAF and FOAM shoes. Running kinematics and kinetics were recorded during the stance phase. Absorbed and generated energy (negative and positive work of the hip, knee and ankle joint as well as muscle forces of selected lower limb muscles were determined using a musculoskeletal model. A significant reduction in energy absorption at the hip joint as well as energy generation at the ankle joint was found for LEAF compared to FOAM. The mean lower limb muscle forces of the m. soleus, m. gastrocnemius lateralis and m. gastrocnemius medialis were significantly reduced for LEAF compared to FOAM. Furthermore, m. biceps femoris showed a trend of reduction in running with LEAF. The remaining lower limb muscles analyzed (m. gluteus maximus, m. rectus femoris, m. vastus medialis, m. vastus lateralis, m. tibialis anterior did not reveal significant differences between the shoe conditions. The findings of this study indicate that LEAF positively influenced the energy balance in running by reducing lower limb muscle forces compared to FOAM. In this way, LEAF could contribute to an overall increased running performance in heel-toe running.

  17. Explaining modified 2-min walk test outcomes in male Veterans with traumatic or nontraumatic lower-limb amputation.

    Science.gov (United States)

    Loyd, Brian J; Fields, Thomas T; Stephenson, Ryan O; Stevens-Lapsley, Jennifer; Christiansen, Cory L

    2016-01-01

    Little evidence exists to support the presence of differences in spatiotemporal gait parameters and ambulation ability between those individuals with traumatic and nontraumatic lower-limb amputation (LLA). We conducted an exploratory study of 81 male Veterans with unilateral amputation to quantify differences in spatiotemporal gait parameters and ambulatory mobility between Veterans with traumatic and nontraumatic LLA. Furthermore, we identified variables that significantly contributed to the explanation of variability in modified 2-min walk test distance. All participants completed the modified 2-min walk test and a spatiotemporal gait analysis using an instrumented walkway during a routine physical therapy visit. Veterans with nontraumatic LLA walked significantly shorter mean distances during a modified 2-min walk test than Veterans with traumatic LLA. Variables identified as significant contributors to modified 2-min walk test variability were amputated limb stance time, amputated limb step length, and percentage of the gait cycle spent in double support. These findings demonstrate that differences in spatiotemporal gait parameters and ambulatory mobility exist between Veterans with traumatic and nontraumatic LLA and identify important spatiotemporal parameters of gait contributing to this decline. These parameters should be considered as targets for intervention and future investigation.

  18. Neuromuscular asymmetries in the lower limbs of elite female youth basketball players and the application of the skillful limb model of comparison.

    Science.gov (United States)

    Fort-Vanmeerhaeghe, Azahara; Montalvo, Alicia M; Sitjà-Rabert, Mercè; Kiefer, Adam W; Myer, Gregory D

    2015-11-01

    Compare the ability of commonly used comparison models to detect neuromuscular asymmetries. A secondary purpose was to determine which neuromuscular task(s) has the greatest sensitivity to identify asymmetries based on the ASI (asymmetry index) calculation. Elite female youth basketball players (N = 29, age = 15.7 ± 1.34 y) performed the single leg countermovement jump in vertical, horizontal, and lateral directions, the star excursion balance test in the anterior, posteromedial, and posterolateral directions, and the sprint test with change of direction. Paired t-tests compared right and left limbs, the dominant (DL) and non-dominant (NDL) limbs, and the more/less skillful limbs. The coincident identification between the more skillful leg and the leg subjectively described as the DL was low for all of the tasks performed (35%-52%). There were significant differences between the more and less skillful legs for all tasks, while performances between the right and left limbs and DL and NDL differed significantly for only one task each. The largest ASI detected in this study was found in the vertical single leg countermovement jump (14.11%). The skillful limb model of comparison may be more useful than other models to detect neuromuscular asymmetries. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Genomic features of human limb specific enhancers.

    Science.gov (United States)

    Ali, Shahid; Amina, Bibi; Anwar, Saneela; Minhas, Rashid; Parveen, Nazia; Nawaz, Uzma; Azam, Syed Sikandar; Abbasi, Amir Ali

    2016-10-01

    To elucidate important cellular and molecular interactions that regulate patterning and skeletal development, vertebrate limbs served as a model organ. A growing body of evidence from detailed studies on a subset of limb regulators like the HOXD cluster or SHH, reveals the importance of enhancers in limb related developmental and disease processes. Exploiting the recent genome-wide availability of functionally confirmed enhancer dataset, this study establishes regulatory interactions for dozens of human limb developmental genes. From these data, it appears that the long-range regulatory interactions are fairly common during limb development. This observation highlights the significance of chromosomal breaks/translocations in human limb deformities. Transcriptional factor (TF) analysis predicts that the differentiation of early nascent limb-bud into future territories entail distinct TF interaction networks. Conclusively, an important motivation for annotating the human limb specific regulatory networks is to pave way for the systematic exploration of their role in disease and evolution. Copyright © 2016. Published by Elsevier Inc.

  20. A Dynamic Model for Limb Selection

    NARCIS (Netherlands)

    Cox, R.F.A; Smitsman, A.W.

    2008-01-01

    Two experiments and a model on limb selection are reported. In Experiment 1 left-handed and right-handed participants (N = 36) repeatedly used one hand for grasping a small cube. After a clear switch in the cube’s location, perseverative limb selection was revealed in both handedness groups. In

  1. Update on embryology of the upper limb.

    Science.gov (United States)

    Al-Qattan, Mohammad M; Kozin, Scott H

    2013-09-01

    Current concepts in the steps of upper limb development and the way the limb is patterned along its 3 spatial axes are reviewed. Finally, the embryogenesis of various congenital hand anomalies is delineated with an emphasis on the pathogenetic basis for each anomaly. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Limb-segment selection in drawing behaviour

    NARCIS (Netherlands)

    Meulenbroek, R G; Rosenbaum, D A; Thomassen, A.J.W.M.; Schomaker, L R

    How do we select combinations of limb segments to carry out physical tasks? Three possible determinants of limb-segment selection are hypothesized here: (1) optimal amplitudes and frequencies of motion for the effectors; (2) preferred movement axes for the effectors; and (3) a tendency to continue

  3. LIMB-SEGMENT SELECTION IN DRAWING BEHAVIOR

    NARCIS (Netherlands)

    MEULENBROEK, RGJ; ROSENBAUM, DA; THOMASSEN, AJWM; SCHOMAKER, LRB; Schomaker, Lambertus

    How do we select combinations of limb segments to carry out physical tasks? Three possible determinants of limb-segment selection are hypothesized here: (1) optimal amplitudes and frequencies of motion for the effectors; (2) preferred movement axes for the effectors; and (3) a tendency to continue

  4. NECROTIZING FASCIITIS OF LIMB: A CASE REPORT

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    Dhaarna

    2015-11-01

    Full Text Available Necrotizing fasciitis is a severe, rare, potentially lethal, soft tissue infection that tends to develop in scrotum, perineum, abdominal wall or the extremities. It is a medical emergency that threatens both patient’s limb and life. Necrotizing fasciitis has the potential to become quite severe - in such cases a radical debridement amounting to amputation of the limb may be required to save the patient’s life. Early diagnosis requires a high index of suspicion. We describe a case of a 49-year-old obese woman who developed necrotizing fasciitis in her left lower limb for which she underwent multiple radical surgical debridement, followed by skin grafting for reconstruction of the limb defects. Our main focus was to salvage the limb with the help of antibiotics and multiple debridements. This report emphasizes the need to have a relook at the use of Parenteral Crystalline Penicillin and diligent management of wounds resulting from repeated debridements.

  5. Limb Regeneration in Xenopus laevis Froglet

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    Makoto Suzuki

    2006-01-01

    Full Text Available Limb regeneration in amphibians is a representative process of epimorphosis. This type of organ regeneration, in which a mass of undifferentiated cells referred to as the “blastema” proliferate to restore the lost part of the amputated organ, is distinct from morphallaxis as observed, for instance, in Hydra, in which rearrangement of pre-existing cells and tissues mainly contribute to regeneration. In contrast to complete limb regeneration in urodele amphibians, limb regeneration in Xenopus, an anuran amphibian, is restricted. In this review of some aspects regarding adult limb regeneration in Xenopus laevis, we suggest that limb regeneration in adult Xenopus, which is pattern/tissue deficient, also represents epimorphosis.

  6. Kinematic analysis of knee varus and rotation movements at the initial stance phase with severe osteoarthritis of the knee.

    Science.gov (United States)

    Fukaya, Takashi; Mutsuzaki, Hirotaka; Wadano, Yasuyoshi

    2015-06-01

    The purposes of this study were to understand the kinematics changes in the frontal and horizontal planes with severe medial knee OA at the stance phase and to examine the relationship between varus and rotational movements. The OA group comprised 18 knees in 12 subjects (five men, seven women) with a Kellgren-Lawrence grade of three or four in at least one knee. From the results of gait analysis, we calculated Spearman rank-correlation coefficients for the following items: varus angle at initial contact (IC); varus angle at loading response (LR); amount of varus thrust from IC to LR; rotational angle at IC; rotational angle at LR and amount of rotational angle change from IC to LR. The results indicated that, as the external rotation angle at IC and internal rotational movement from IC to LR increased, the maximum varus angle to LR showed a tendency to become large. In addition, varus thrust showed a tendency to become larger as the external rotation angles increased at IC and LR. The subjects with severe knee OA showed a strong correlation between the knee varus angle at IC and at LR. Furthermore, an increase in movement to internal rotation of the knee during the initial stance phase increased the knee varus angle at LR. The control of the rotational movement according to the extent of varus thrust during the initial stance phase may have possible effects to decrease the load on the medial compartment of the knee. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Plantar pressures are higher in cases with diabetic foot ulcers compared to controls despite a longer stance phase duration.

    Science.gov (United States)

    Fernando, Malindu E; Crowther, Robert G; Lazzarini, Peter A; Sangla, Kunwarjit S; Wearing, Scott; Buttner, Petra; Golledge, Jonathan

    2016-09-15

    Current international guidelines advocate achieving at least a 30 % reduction in maximum plantar pressure to reduce the risk of foot ulcers in people with diabetes. However, whether plantar pressures differ in cases with foot ulcers to controls without ulcers is not clear. The aim of this study was to assess if plantar pressures were higher in patients with active plantar diabetic foot ulcers (cases) compared to patients with diabetes without a foot ulcer history (diabetes controls) and people without diabetes or a foot ulcer history (healthy controls). Twenty-one cases with diabetic foot ulcers, 69 diabetes controls and 56 healthy controls were recruited for this case-control study. Plantar pressures at ten sites on both feet and stance phase duration were measured using a pre-established protocol. Primary outcomes were mean peak plantar pressure, pressure-time integral and stance phase duration. Non-parametric analyses were used with Holm's correction to correct for multiple testing. Binary logistic regression models were used to adjust outcomes for age, sex and body mass index. Median differences with 95 % confidence intervals and Cohen's d values (standardised mean difference) were reported for all significant outcomes. The majority of ulcers were located on the plantar surface of the hallux and toes. When adjusted for age, sex and body mass index, the mean peak plantar pressure and pressure-time integral of toes and the mid-foot were significantly higher in cases compared to diabetes and healthy controls (p diabetic foot ulcers despite having a longer stance phase duration which would be expected to lower plantar pressure. Whether plantar pressure changes can predict ulcer healing should be the focus of future research. These results highlight the importance of offloading feet during active ulceration in addition to before ulceration.

  8. Periodic Limb Movements in Tetraplegia.

    Science.gov (United States)

    Peters, Annemieke Emma Josina; van Silfhout, Lysanne; Graco, Marnie; Schembri, Rachel; Thijssen, Dick; Berlowitz, David J

    2017-05-02

    To establish the prevalence of Periodic Limb Movements during Sleep (PLMS) in patients with tetraplegia, controlling for obstructive sleep apnea. To explore whether demographic and injury characteristics affect PLMS. Retrospective cohorts. One hundred seventy-three participants with acute (12 months) tetraplegia who underwent full overnight diagnostic sleep studies. Two hundred sixty-two sleep study recordings were included. A randomly selected subgroup of 21 studies was assessed for PLM during wakefulness. Data were analysed according to the current American Academy of Sleep Medicine guidelines. Of the participants, 41.6% (43(15.7) years and 14.9% female) had a motor and sensory complete lesion. Sleep was poor with both OSA (87.8% with apnea hypopnoea index ≥ 5) and PLMS (58.4% with PLMS per hour PLMSI > 15) highly prevalent. There was no difference in the PLMSI between those with OSA (36.3(39.8)) or without (42.2(37.7), P = 0.42). PLMS were evident during REM and NREM sleep in all of the 153 patients with PLMSI > 15. All 21 participants in the subgroup of studies analysed for the PLM during quiet wakefulness, exhibited limb movements. None of the modelled variables (injury completeness, gender, OSA severity or time since injury) significantly predicted a PLMSI > 15 (P = 0.343). In conclusion, this study confirms the high prevalence of PLM in tetraplegia and the presence of leg movements in NREM and REM sleep along with wakefulness after controlling for OSA. No associations between the presence of PLMS and patient characteristics or injury specific aspects were found.

  9. Using Argument-Driven Inquiry to enhance students' argument sophistication when supporting a stance in the context of Socioscientific Issues

    Science.gov (United States)

    Grooms, Jonathon A.

    This quasi-experimental study assesses the extent to which the Argument-Driven Inquiry (ADI) instructional model enhances undergraduate students' abilities to generate quality arguments supporting their stance in the context of a Socioscientific Issue (SSI) as compared to students experiencing a traditional style of instruction. Enhancing the quality of undergraduate students' arguments in the context of SSI can serve as an indirect measure of their scientific literacy and their ability to make sound decisions on issues that are inherently scientific but also involve social implications. Data collected in this study suggest that the undergraduate students experiencing the ADI instruction more readily provide rationales in their arguments supporting their decisions regarding two SSI-tasks as compared to a group of undergraduate students experiencing traditional instruction. This improvement in argument quality and gain in scientific literacy was achieved despite the overall lower SSI related content knowledge of the ADI students. Furthermore, the gap between the argument quality of those students with high versus low SSI related content knowledge was closed within the ADI group, while the same gap persisted post-intervention within the traditional instruction students. The role of students' epistemological sophistication was also investigated, which showed that neither instructional strategy was effective at shifting students' epistemological sophistication toward an evaluativist stance. However, the multiplists within the ADI group were able to significantly increase the sophistication of their arguments whereas the traditional students were not. There were no differences between the quality of arguments generated by the evaluativist students with either the treatment or comparison groups. Finally, the nature of the justifications used by the students revealed that the students (both comparison and treatment groups) did not invoke science-based justifications when

  10. Limb Laterality Recognition Score: A Reliable Clinical Measure Related to Phantom Limb Pain.

    Science.gov (United States)

    Wong, Christopher Kevin; Wong, Caitlin Kimberly

    2017-08-24

    To explore the usefulness of the limb laterality recognition score as a clinical measure of phantom limb pain, regarding test-retest reliability and association of limb laterality recognition scores with phantom limb pain measures. Retrospective cohort. Community support group. Eleven adults who averaged 4.8 years since lower limb amputation due to vascular pathologies (N = 9), trauma (N = 1), and cancer (N = 1). Subjects self-reported amputated limb pain using the sensation subsection of the Prosthetic Evaluation Questionnaire and back and sound limb pain. Using numbered iPads that corresponded to the self-reports, subjects played the Recognise Foot game to assess limb laterality recognition ability. Subjects identified the laterality of 20 foot images, within two seconds each. The software collected accuracy and speed scores in basic, vanilla, and context conditions for two rounds in random order. Basic showed feet against black backgrounds, vanilla showed feet with various monochromatic backgrounds, and context showed feet in clothed or environmental contexts. So that greater accuracy in less time meant a better score, accuracy scores were divided by completion speed. Intraclass correlation coefficient (ICC)3,1 assessed test-retest reliability. Correlations between accuracy/speed and phantom limb pain measures were assessed with Spearman's rho (categorical) and Pearson coefficients (continuous). Accuracy/speed test-retest reliability was strong (ICC = 0.72) and inversely associated with phantom limb pain frequency (context rho = 0.72). Limb laterality recognition accuracy/speed in the context condition had good test-retest reliability and correlated strongly with phantom limb pain frequency. Accuracy/speed limb laterality recognition ability relates to phantom limb pain and may be a valid clinical or research measure. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  11. Experimental muscle pain challenges the postural stability during quiet stance and unexpected posture perturbation.

    Science.gov (United States)

    Hirata, Rogério Pessoto; Ervilha, Ulysses Fernandes; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas

    2011-08-01

    Musculoskeletal pain impairs postural control and stability. Nine subjects stood as quietly as possible on a moveable force platform before, during, and after experimental pain in the right leg muscles. A moveable force platform was used to measure the center of pressure and provided unexpected perturbations. Lower limb muscle activity, joint angles, and foot pressure distributions were measured. Hypertonic saline was used to induce pain in the vastus lateralis, vastus medialis, or biceps femoris muscle of the right leg. Compared to baseline and control sessions, pain in the knee extensor muscles during quiet standing evoked: 1) larger sway area, greater medial-lateral center of pressure displacement and higher speed (P Pain provoked longer time to return to an equilibrium posture after forward EMG activity for, and pain in vastus medialis muscle decreased the time for the maximum hip flexion during this perturbation (P pain impairs postural stability during quiet standing and after unexpected perturbation, which suggest that people suffering from leg muscle pain are more vulnerable to falls. This article presents the acute responses to leg muscle pain on the postural control. This measure could potentially help clinicians who seek to assess how pain responses may contribute to patient's postural control and stability during quiet standing and after recovering from unexpected perturbations. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  12. AbobotulinumtoxinA: A Review in Pediatric Lower Limb Spasticity.

    Science.gov (United States)

    Syed, Yahiya Y

    2017-08-01

    AbobotulinumtoxinA (Dysport ® ) is currently the only botulinum toxin A formulation approved by the US FDA for the treatment of lower limb spasticity in pediatric patients aged ≥2 years. Intramuscular abobotulinumtoxinA was approved based on the results of a pivotal phase 3 trial in children with lower limb spasticity due to cerebral palsy. In this trial, a single treatment cycle with abobotulinumtoxinA 10-15 U/kg/leg injected into the gastrocnemius and soleus muscles significantly improved ankle plantar flexor muscle tone (primary endpoint), with abobotulinumtoxinA recipients showing a significant response to treatment relative to placebo. AbobotulinumtoxinA treatment also improved spasticity grade. The improvements in muscle tone and spasticity were associated with an improved ability to attain functional goals. Clinical benefits of abobotulinumtoxinA treatment lasted for 16-22 weeks in most patients, and were maintained with multiple treatment cycles during 1 year in an open-label extension study. AbobotulinumtoxinA was generally well tolerated, with a relatively low incidence of treatment-related adverse events. In summary, abobotulinumtoxinA is an effective and generally well tolerated treatment option for children with lower limb spasticity.

  13. Effect of plyometric training on lower limb biomechanics in females.

    Science.gov (United States)

    Baldon, Rodrigo de Marche; Moreira Lobato, Daniel F; Yoshimatsu, Andre P; dos Santos, Ana Flávia; Francisco, Andrea L; Pereira Santiago, Paulo R; Serrão, Fábio V

    2014-01-01

    To verify the effects of plyometric training on lower limb kinematics, eccentric hip and knee torques, and functional performance. Cohort study. Research laboratory. Thirty-six females were divided into a training group (TG; n = 18) that carried out the plyometric training for 8 weeks, and a control group (CG; n = 18) that carried out no physical training. Twenty-four plyometric training sessions during approximately 8 weeks with 3 sessions per week on alternate days. Lower limb kinematics (maximum excursion of hip adduction, hip medial rotation, and knee abduction during the single leg squat), eccentric hip (abductor, adductor, medial, and lateral rotator) isokinetic peak torques and knee (flexor and extensor) isokinetic peak torques, and functional performance (triple hop test and the 6-m timed hop test). After 8 weeks, only the TG significantly reduced the values for the maximum excursion of knee abduction (P = 0.01) and hip adduction (P Plyometric training alters lower limb kinematics and increases eccentric hip torque and functional performance, suggesting the incorporation of these exercises in preventive programs for ACL injuries.

  14. Lower Limb Neuromuscular Asymmetry in Volleyball and Basketball Players.

    Science.gov (United States)

    Fort-Vanmeerhaeghe, Azahara; Gual, Gabriel; Romero-Rodriguez, Daniel; Unnitha, Viswanath

    2016-04-01

    The primary objective of the present study was to evaluate the agreement between the dominant leg (DL) (determined subjectively) and the stronger leg (SL) (determined via a functional test) in a group of basketball and volleyball players. The secondary objective was to calculate lower limb neuromuscular asymmetry when comparing the DL vs the non-dominant leg (NDL) and the SL vs the weaker (WL) leg in the whole group and when differentiating by sex. Seventy-nine male and female volleyball and basketball players (age: 23.7 ± 4.5 years) performed three single-leg vertical countermovement jumps (SLVCJ) on a contact mat. Vertical jump height and an inter-limb asymmetry index (ASI) were determined. Only 32 (40%) of the subjects had a concordance between the perception of their dominant leg and the limb reaching the highest jump height. Using the DL as the discriminating variable, significant (pjump performance. Vertical jump asymmetry of 10-15% exists and this can be considered as a reference value for male and female basketball and volleyball players.

  15. Changes of Gait Parameters and Lower Limb Dynamics in Recreational Runners with Achilles Tendinopathy

    Directory of Open Access Journals (Sweden)

    SungJoong Kim, JaeHo Yu

    2015-06-01

    Full Text Available This study aimed to clarify the mechanical gait changes caused by achilles tendinopathy by comparing gait parameters and changes in hip, knee, and ankle moments between an experimental group (EG and a control group (CG. Twenty runners with achilles tendinopathy were included in the EG (male/female: 10/10, age: 27.00 ± 4.63, and 20 CG (male/female: 10/10, age: 27.25 ± 4.33 participants were recruited. Subjects walked a 13-m distance at their normal walking speed 5 times to obtain motion analysis and joint moment data. Gait parameter analysis showed significant differences in double-limb support (EG: 22.65 ± 4.26%, CG: 20.37 ± 4.46%, step length (EG: 0.58 ± 0.0 7m, CG: 0.64 ± 0.08 m, step width (EG: 0.16 ± 0.04 m, CG: 0.14 ± 0.05 m, stride time (EG: 1.09 ± 0.10 second, CG: 1.05 ± 0.08 second, and walking speed (EG: 1.09±0.18 m·s-1, CG: 1.23 ± 0.17 m·s-1 between the 2 groups (p < 0.05. Significant differences were found in hip joint moment for initial contact, mid-stance, terminal stance, and pre-swing phases; knee joint moment for initial contact and pre-swing phases; and ankle joint moment for pre-swing and terminal swing phases (p < 0.05. Gait parameters and hip, knee, and ankle moments were altered in runners with achilles tendinopathy. Thus, clinical features of gait changes should be understood for optimal treatment of achilles tendinopathy; further research is required in this field.

  16. Does a single session of high-intensity interval training provoke a transient elevated risk of falling in seniors and adults?

    Science.gov (United States)

    Donath, Lars; Kurz, Eduard; Roth, Ralf; Hanssen, Henner; Schmidt-Trucksäss, Arno; Zahner, Lukas; Faude, Oliver

    2015-01-01

    Balance and strength training can reduce seniors' fall risk up to 50%. Available evidence suggests that acute bouts of neuromuscular and endurance exercise deteriorate postural control. High-intensity endurance training has been successfully applied in different populations. Thus, it seemed valuable to examine the acute effects of high-intensity interval training (HIIT) on neuromuscular performance in seniors and young adults. The acute impact of a HIIT session on balance performance and muscle activity after exercise cessation and during post-exercise recovery was examined in young and old adults. We intended to investigate whether a transient exercise-induced fall-risk may occur in both groups. 20 healthy seniors (age 70 (SD 4) years) and young adults (age 27 (SD 3) years) were examined on 3 days. After exhaustive ramp-like treadmill testing in order to determine maximal heart rate (HRmax) on the first day, either a 4 × 4 min HIIT at 90% of HRmax or a control condition (CON) was randomly performed on the second and third day, respectively. Balance performance (postural sway) was assessed during single limb stance with open eyes (SLEO) and double limb stance with closed eyes (DLEC). EMG was recorded for the soleus (SOL), anterior tibialis (TIB), gastrocnemius (GM) and peroneus longus (PL) muscles at the dominant leg. All measures were collected before, immediately as well as 10, 30 and 45 min after HIIT and CON, respectively. Compared to CON, HIIT induced significant increases of postural sway immediately after exercise cessation during SLEO in both groups (adults: p HIIT (post: p = 0.003, Δ = +14% sway, 10 min post: p = 0.004, Δ = +18% sway). Muscle activity was increased during SLEO for TIB until 10 min post in seniors (0.008 HIIT in adults (p HIIT training may cause an acute 'open-fall-window' with a transient impairment of balance performance for at least 10 min after exercise cessation in both groups. Occluded vision in seniors seems to prolong this period

  17. The mangled limb: salvage versus amputation.

    Science.gov (United States)

    Wolinsky, Philip R; Webb, Lawrence X; Harvey, Edward J; Tejwani, Nirmal C

    2011-01-01

    A mangled extremity is defined as a limb with injury to three of four systems in the extremity. The decision to salvage or amputate the injured limb has generated much controversy in the literature, with studies to support advantages of each approach. Various scoring systems have proved unreliable in predicting the need for amputation or salvage; however, a recurring theme in the literature is that the key to limb viability seems to be the severity of the soft-tissue injury. Factors such as associated injuries, patient age, and comorbidities (such as diabetes) also should be considered. Attempted limb salvage should be considered only if a patient is hemodynamically stable enough to tolerate the necessary surgical procedures and blood loss associated with limb salvage. For persistently hemodynamically unstable patients and those in extremis, life comes before limb. Recently, the Lower Extremity Assessment Project study attempted to answer the question of whether amputation or limb salvage achieves a better outcome. The study also evaluated other factors, including return-to-work status, impact of the level of and bilaterality of the amputation, and economic cost. There appears to be no significant difference in return to work, functional outcomes, or the cost of treatment (including the prosthesis) between the two groups. A team approach with different specialties, including orthopaedics, plastic surgery, vascular surgery and trauma general surgery, is recommended for treating patients with a mangled extremity.

  18. Cross-limb interference during motor learning.

    Directory of Open Access Journals (Sweden)

    Benedikt Lauber

    Full Text Available It is well known that following skill learning, improvements in motor performance may transfer to the untrained contralateral limb. It is also well known that retention of a newly learned task A can be degraded when learning a competing task B that takes place directly after learning A. Here we investigate if this interference effect can also be observed in the limb contralateral to the trained one. Therefore, five different groups practiced a ballistic finger flexion task followed by an interfering visuomotor accuracy task with the same limb. Performance in the ballistic task was tested before the training, after the training and in an immediate retention test after the practice of the interference task for both the trained and the untrained hand. After training, subjects showed not only significant learning and interference effects for the trained limb but also for the contralateral untrained limb. Importantly, the interference effect in the untrained limb was dependent on the level of skill acquisition in the interfering motor task. These behavioural results of the untrained limb were accompanied by training specific changes in corticospinal excitability, which increased for the hemisphere ipsilateral to the trained hand following ballistic training and decreased during accuracy training of the ipsilateral hand. The results demonstrate that contralateral interference effects may occur, and that interference depends on the level of skill acquisition in the interfering motor task. This finding might be particularly relevant for rehabilitation.

  19. Computational stability of human knee joint at early stance in Gait: Effects of muscle coactivity and anterior cruciate ligament deficiency.

    Science.gov (United States)

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

    2017-10-03

    As one of the most complex and vulnerable structures of body, the human knee joint should maintain dynamic equilibrium and stability in occupational and recreational activities. The evaluation of its stability and factors affecting it is vital in performance evaluation/enhancement, injury prevention and treatment managements. Knee stability often manifests itself by pain, hypermobility and giving-way sensations and is usually assessed by the passive joint laxity tests. Mechanical stability of both the human knee joint and the lower extremity at early stance periods of gait (0% and 5%) were quantified here for the first time using a hybrid musculoskeletal model of the lower extremity. The roles of muscle coactivity, simulated by setting minimum muscle activation at 0-10% levels and ACL deficiency, simulated by reducing ACL resistance by up to 85%, on the stability margin as well as joint biomechanics (contact/muscle/ligament forces) were investigated. Dynamic stability was analyzed using both linear buckling and perturbation approaches at the final deformed configurations in gait. The knee joint was much more stable at 0% stance than at 5% due to smaller ground reaction and contact forces. Muscle coactivity, when at lower intensities (knee joint at the heel strike. It also markedly diminishes forces in lateral hamstrings (by up to 39%) and contact forces on the lateral plateau (by up to 17%). Current work emphasizes the need for quantification of the lower extremity stability margin in gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Predictive Value of Upper Limb Muscles and Grasp Patterns on Functional Outcome in Cervical Spinal Cord Injury.

    Science.gov (United States)

    Velstra, Inge-Marie; Bolliger, Marc; Krebs, Jörg; Rietman, Johan S; Curt, Armin

    2016-05-01

    To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), best predict upper limb function and independence in activities of daily living (ADLs) and to assess the predictive value of qualitative grasp movements (QlG) on upper limb function in individuals with acute tetraplegia. As part of a Europe-wide, prospective, longitudinal, multicenter study ISNCSCI, GRASSP, and Spinal Cord Independence Measure (SCIM III) scores were recorded at 1 and 6 months after SCI. For prediction of upper limb function and ADLs, a logistic regression model and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used. Results: Logistic regression and URP-CTREE revealed that a combination of ISNCSCI and GRASSP muscles (to a maximum of 4) demonstrated the best prediction (specificity and sensitivity ranged from 81.8% to 96.0%) of upper limb function and identified homogenous outcome cohorts at 6 months. The URP-CTREE model with the QlG predictors for upper limb function showed similar results. Prediction of upper limb function can be achieved through a combination of defined, specific upper limb muscles assessed in the ISNCSCI and GRASSP. A combination of a limited number of proximal and distal muscles along with an assessment of grasping movements can be applied for clinical decision making for rehabilitation interventions and clinical trials. © The Author(s) 2015.

  1. The effectiveness of a work style intervention and a lifestyle physical activity intervention on the recovery from neck and upper limb symptoms in computer workers

    NARCIS (Netherlands)

    Bernaards, C.M.; Ariëns, G.A.M.; Knol, D.L.; Hildebrandt, V.H.

    2007-01-01

    This study assessed the effectiveness of a single intervention targeting work style and a combined intervention targeting work style and physical activity on the recovery from neck and upper limb symptoms. Computer workers with frequent or long-term neck and upper limb symptoms were randomised into

  2. Physical Performance Measures of Flexibility, Hip Strength, Lower Limb Power and Trunk Endurance in Healthy Navy Cadets: Normative Data and Differences Between Sex and Limb Dominance.

    Science.gov (United States)

    Lopes, Thiago Jambo Alves; Simic, Milena; Alves, Daniel de Souza; Bunn, Priscila Dos Santos; Rodrigues, Allan Inoue; Terra, Bruno de Souza; Lima, Maicom da Silva; Ribeiro, Fabrício Miranda; Vilão, Patrick; Pappas, Evangelos

    2018-01-17

    The objectives were to provide normative data on commonly used physical performance tests that may be associated with musculoskeletal injuries in Navy cadets, and assess for sex and limb dominance differences. A large cohort of Navy cadets were assessed for physical performance tests of flexibility (ankle dorsiflexion range of motion and sit and reach), isometric hip strength, lower limb power (single leg hop), and trunk endurance (plank and side plank tests). Besides providing normative data tables, sex and limb dominance differences were assessed by a two-way mixed ANOVA. A total of 545 Brazilian Navy cadets (394 males) representing 79% of the cadets in the Academy participated. Normative reference values were reported as mean±SD, 95%CI and percentiles. For tests of muscle strength, power and endurance, males performed better than females (prisk for injury.

  3. Muscle Selection for Focal Limb Dystonia.

    Science.gov (United States)

    Karp, Barbara Illowsky; Alter, Katharine

    2017-12-29

    Selection of muscles for botulinum toxin injection for limb dystonia is particularly challenging. Limb dystonias vary more widely in the pattern of dystonic movement and involved muscles than cervical dystonia or blepharospasm. The large variation in how healthy individuals perform skilled hand movements, the large number of muscles in the hand and forearm, and the presence of compensatory actions in patients with dystonia add to the complexity of choosing muscles for injection. In this article, we discuss approaches to selecting upper and lower extremity muscles for chemodenervation treatment of limb dystonia.

  4. Muscle Selection for Focal Limb Dystonia

    Directory of Open Access Journals (Sweden)

    Barbara Illowsky Karp

    2017-12-01

    Full Text Available Selection of muscles for botulinum toxin injection for limb dystonia is particularly challenging. Limb dystonias vary more widely in the pattern of dystonic movement and involved muscles than cervical dystonia or blepharospasm. The large variation in how healthy individuals perform skilled hand movements, the large number of muscles in the hand and forearm, and the presence of compensatory actions in patients with dystonia add to the complexity of choosing muscles for injection. In this article, we discuss approaches to selecting upper and lower extremity muscles for chemodenervation treatment of limb dystonia.

  5. Radiography of syndactylous limbs of cattle

    International Nuclear Information System (INIS)

    Taura, Y.; Takeuchi, A.; Uchino, T.

    1985-01-01

    Fore and hind limbs of 4-month-old Holstein-Friesian cattle ♀ (No.I) and those of 1-month-old Holstein-Friesian×Japanese Black cattle ♀ (No.II) suffering from syndactyly were dissected by means of radiographic examinations. The details were reported as follows. 1. The phalanges of both fore and left hind limbs of No.II cattle were completely fused. But, all the phalanges of left fore limb and proximal phalanges of right fore limb in No.I and the distal phalanges of right hind limb in No.II were normal, the others being of partial synostosis. 2. The distal parforating canal was absent in the metacarpus and the right metatarsus in No.II cattle. Also, in No.II on the distal part of the metacarpal or metatarsal, bone vestiges were noted, not only of the fifth and second metacarpus or metatarsus, but also the mutually jointed phalanges. 3. In No.I cattle, the left fore limb and 4 proximal sesamoid bones and 2 distal sesamoid bones, but the right limb had 4 sesamoid bones and 0 distal one. In No.II cattle, the fore limbs had 2 proximal and 0 distal sesamoid bones, left hind limb had 3 proximal and 0 distal ones, right hind limb had 3 proximal and 1 distal ones. 4. The arteries accommodated the syndactylous deformities. The median and radial arteries were fixed to be descended on to the palmar side of the metacarpus and mutually anastomosed to form a deep palmar arch. arising from the deep palmar arch, two branches (palmar proper digital aa. III and IV) were terminated by the lateral and medial palmar surfaces of the digit, where some anastomosing arches were formed by them. The arteries of the hind limbs were also similar to those of the fore limbs. 5. In radiographic examinations of syndactyly (in No.II) after 7-month feeding, hoof and digital bones were noted to have been developed, but distal phalanges were destructed and left in suspicion of bad prognosis

  6. Customizable Rehabilitation Lower Limb Exoskeleton System

    Directory of Open Access Journals (Sweden)

    Riaan Stopforth

    2012-10-01

    Full Text Available Disabled people require assistance with the motion of their lower limbs to improve rehabilitation. Exoskeletons used for lower limb rehabilitation are highly priced and are not affordable to the lowerincome sector of the population. This paper describes an exoskeleton lower limb system that was designed keeping in mind that the cost must be as low as possible. The forward kinematic system that is used must be a simplified model to decrease computational time, yet allow the exoskeleton to be adjustable according to the patient's leg dimensions.

  7. Gravity large field phlebography of the limbs

    Energy Technology Data Exchange (ETDEWEB)

    Roy, P.; Robillard, P.; Fontaine, A.; Galand, C. (Hotel-Dieu de Montreal, Quebec (Canada))

    1983-06-01

    For the last two decades the most common method of radiographic study of the venous system of the lower limbs has been ascending phlebography, by injection of contrast material in a superficial vein on the dorsum of the foot. We report our own experience with another approach, using a large field technique on recumbent patients, with elevation of the limbs, thus taking advantage of gravity. The contrast injection is usually made in a more distal superficial vein of the foot after a tiny cut-down. Excellent results are consistently obtained in demonstrating all the deep veins, including the iliac vessels. The same principles may be applied to upper limb phlebography.

  8. Gravity large field phlebography of the limbs

    International Nuclear Information System (INIS)

    Roy, Paul; Robillard, Pierre; Fontaine, Andre; Galand, Claude

    1983-01-01

    For the last two decades the most common method of radiographic study of the venous system of the lower limbs has been ascending phlebography, by injection of contrast material in a superficial vein on the dorsum of the foot. We report our own experience with another approach, using a large field technique on recumbent patients, with elevation of the limbs, thus taking advantage of gravity. The contrast injection is usually made in a more distal superficial vein of the foot after a tiny cut-down. Excellent results are consistently obtained in demonstrating all the deep veins, including the iliac vessels. The same principles may be applied to upper limb phlebography

  9. Incidence of support limb laminitis in horses treated with half limb, full limb or transfixation pin casts: a retrospective study of 113 horses (2000-2009).

    Science.gov (United States)

    Virgin, J E; Goodrich, L R; Baxter, G M; Rao, S

    2011-11-01

    To determine the incidence of support limb laminitis among horses treated with half limb, full limb or transfixation pin casts and determine potential risk factors. Medical records of 113 horses treated with half limb, full limb or transfixation pin casts at an equine referral hospital from 2000 to 2009 were reviewed. Associations between potential risk factors and development of support limb laminitis were evaluated by bivariable and multivariable logistic regression analyses. Of the 113 horses that received casts, 14 (12%) developed confirmed support limb laminitis. The bodyweight of the horse and duration of casting in weeks were significantly associated with support limb laminitis. Horses requiring full limb casts or transfixation pin casts were more likely to develop this complication than horses requiring half limb casts. There were no significant associations between developing support limb laminitis and weightbearing capacity on presentation to the hospital, the limb affected (fore- or hind), whether there was a fracture present or breed of horse. Support limb laminitis is a relatively common complication among horses treated with half limb, full limb and transfixation pin casts. Greater durations of casting and higher bodyweights increase the likelihood of developing this complication. Support limb laminitis may occur secondary to any painful unilateral lameness and is not necessarily more likely to develop in horses with severe orthopaedic conditions such as fractures. However, heavier horses, those requiring casts for longer periods of time and those that require a full limb or transfixation pin cast as opposed to a half limb cast should be considered to have an increased risk for developing support limb laminitis post operatively. © 2011 EVJ Ltd.

  10. Smartphone supported upper limb prosthesis

    Directory of Open Access Journals (Sweden)

    Hepp D.

    2015-09-01

    Full Text Available State of the art upper limb prostheses offer up to six active DoFs (degrees of freedom and are controlled using different grip patterns. This low number of DoFs combined with a machine-human-interface which does not provide control over all DoFs separately result in a lack of usability for the patient. The aim of this novel upper limb prosthesis is both offering simplified control possibilities for changing grip patterns depending on the patients’ priorities and the improvement of grasp capability. Design development followed the design process requirements given by the European Medical Device Directive 93/42 ECC and was structured into the topics mechanics, software and drive technology. First user needs were identified by literature research and by patient feedback. Consequently, concepts were evaluated against technical and usability requirements. A first evaluation prototype with one active DoF per finger was manufactured. In a second step a test setup with two active DoF per finger was designed. The prototype is connected to an Android based smartphone application. Two main grip patterns can be preselected in the software application and afterwards changed and used by the EMG signal. Three different control algorithms can be selected: “all-day”, “fine” and “tired muscle”. Further parameters can be adjusted to customize the prosthesis to the patients’ needs. First patient feedback certified the prosthesis an improved level of handling compared to the existing devices. Using the two DoF test setup, the possibilities of finger control with a neural network are evaluated at the moment. In a first user feedback test, the smartphone based software application increased the device usability, e.g. the change within preselected grip patterns and the “tired muscle” algorithm. Although the overall software application was positively rated, the handling of the prosthesis itself needs to be proven within a patient study to be

  11. Lower Limb and Trunk Biomechanics After Fatigue in Competitive Female Irish Dancers.

    Science.gov (United States)

    Wild, Catherine Y; Grealish, Avril; Hopper, Diana

    2017-07-01

      Because of the increasing popularity of participation in Irish dance, the incidence of lower limb injuries is high among this competitive population.   To investigate the effects of fatigue on the peak lower limb and trunk angles as well as the peak lower limb joint forces and moments of competitive female Irish dancers during the performance of a dance-specific single-limb landing.   Cross-sectional study.   Laboratory.   Fourteen healthy, female, competitive Irish dancers (age = 19.4 ± 3.7 years, height = 165.3 ± 5.9 cm, mass = 57.9 ± 8.2 kg).   Participants performed an Irish dance-specific leap before and after a dance-specific fatigue protocol. During each landing movement, 3-dimensional lower limb kinematics (250 Hz) and ground reaction forces (1000 Hz) were collected. Paired t tests were performed to determine the differences (P ≤ .05) in lower limb and trunk biomechanics prefatigue and postfatigue.   Peak lower limb and trunk angles as well as peak lower limb joint reaction forces and external moments.   Compared with the prefatigue trials, dancers landed with reduced ankle plantar flexion (P = .003) and hip external rotation (P = .007) and increased hip-adduction alignment (P = .034) postfatigue. Dancers displayed greater anterior shear (P = .003) and compressive (P = .024) forces at the ankle and greater external knee-flexion moments (P = .024) during the postfatigue compared with the prefatigue landing trials.   When fatigued, dancers displayed a decline in landing performance in terms of aesthetics as well as increased ankle- and knee-joint loading, potentially exposing them to a greater risk of injuries.

  12. Evaluation of Genes Involved in Limb Development, Angiogenesis, and Coagulation as Risk Factors for Congenital Limb Deficiencies

    Science.gov (United States)

    Browne, Marilyn L.; Carter, Tonia C.; Kay, Denise M.; Kuehn, Devon; Brody, Lawrence C.; Romitti, Paul A.; Liu, Aiyi; Caggana, Michele; Druschel, Charlotte M.; Mills, James L.

    2012-01-01

    We conducted a population-based case-control study of single nucleotide polymorphisms (SNPs) in selected genes to find common variants that play a role in the etiology of limb deficiencies (LD)s. Included in the study were 389 infants with LDs of unknown cause and 980 unaffected controls selected from all births in New York State (NYS) for the years 1998 to 2005. We used cases identified from the NYS Department of Health (DOH) Congenital Malformations Registry. Genotypes were obtained for 132 SNPs in genes involved in limb development (SHH, WNT7A, FGF4, FGF8, FGF10, TBX3, TBX5, SALL4, GREM1, GDF5, CTNNB1, EN1, CYP26A1, CYP26B1), angiogenesis (VEGFA, HIF1A, NOS3), and coagulation (F2, F5, MTHFR). Genotype call rates were >97% and SNPs were tested for departure from Hardy-Weinberg expectations by race/ethnic subgroups. For each SNP, odds ratios (OR)s and confidence intervals (CI)s were estimated and corrected for multiple comparisons for all LDs combined and for LD subtypes. Among non-Hispanic white infants, associations between FGF10 SNPs rs10805683 and rs13170645 and all LDs combined were statistically significant following correction for multiple testing (OR=1.99; 95% CI=1.43-2.77; uncorrected p=0.000043 for rs10805683 heterozygous genotype, and OR=2.37; 95% CI=1.48-3.78; uncorrected p=0.00032 for rs13170645 homozygous minor genotype). We also observed suggestive evidence for associations with SNPs in other genes including CYP26B1 and WNT7A. Animal studies have shown that FGF10 induces formation of the apical ectodermal ridge and is necessary for limb development. Our data suggest that common variants in FGF10 increase the risk for a wide range of non-syndromic limb deficiencies. PMID:22965740

  13. A Cognitive Overview of Limb Apraxia.

    Science.gov (United States)

    Bartolo, Angela; Ham, Heidi Stieglitz

    2016-08-01

    Since the first studies on limb apraxia carried out by Hugo Liepmann more than a century ago, research interests focused on the way humans process manual gestures by assessing gesture production after patients suffered neurologic deficits. Recent reviews centered their attention on deficits in gesture imitation or processing object-related gestures, namely pantomimes and transitive gestures, thereby neglecting communicative/intransitive gestures. This review will attempt to reconcile limb apraxia in its entirety. To this end, the existing cognitive models of praxis processing that have been designed to account for the complexity of this disorder will be taken into account, with an attempt to integrate in these models the latest findings in the studies of limb apraxia, in particular on meaningful gestures. Finally, this overview questions the very nature of limb apraxia when other cognitive deficits are observed.

  14. Limb-Girdle Muscular Dystrophy (LGMD)

    Science.gov (United States)

    ... Program Funding Opportunities Contact our Research Team For Families Clinical Trials Finder Tool Get Involved How to ... with LGMD normally encode proteins that play vital roles in muscle function, ... genders are affected equally. When limb-girdle muscular dystrophy ...

  15. Obstacle crossing in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A.H.; van Keeken, H.G.; Schoppen, Tanneke; Otten, Egbert; Halbertsma, J.P.; Hof, A.L.; Postema, K.

    2007-01-01

    Objective: To study limitations in function and adjustment strategies in lower limb amputees during obstacle crossing. Design: Observational cohort study. Subjects: Transfemoral and transtibial amputees and able-bodied control subjects. Methods: In a motion analysis laboratory unimpeded and obstacle

  16. Gait termination in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A. H.; van Keeken, H. G.; Schoppen, T.; Otten, E.; Halbertsma, J. P. K.; Hof, A. L.; Postema, K.

    Objective: To study the limitations in function and adjustment strategies of lower limb amputees in gait termination. Design: Observational cohort study. Setting: University Medical Centre. Participants: Unilateral transfemoral and transtibial amputees, and able-bodied control subjects. Main outcome

  17. [Limb-sparing surgical treatment in osteosarcoma].

    Science.gov (United States)

    Kolarz, K; Treder, M; Ziółkowski, W

    2001-01-01

    From 1998 we performed limb-sparing surgery in 6 patients with osteosarcoma. No evidence of disease or local recurrence was noted in any of the patients after a mean follow-up period of 13 months. Age at the time of operation ranged from 8 to 14 years. Wide resection margins were achieved in all patients. The results of functional evaluation according to Enneking were excellent in 5 cases and poor in one. Bony defects created by limb-sparing procedures may be reconstructed by many methods. In growing children, limb-sparing surgery needs special consideration to avoid later limb-length discrepancy and expandable prostheses have been used to anticipate this problem.

  18. Fingernails Yield Clues to Limb Regeneration

    Science.gov (United States)

    ... Spotlight on Research Fingernails Yield Clues to Limb Regeneration By Kirstie Saltsman, Ph.D. | January 5, 2014 ... Diseases has uncovered chemical signals that drive the regeneration of lost digit tips in mice. The findings, ...

  19. Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury.

    Science.gov (United States)

    Wellsandt, Elizabeth; Failla, Mathew J; Snyder-Mackler, Lynn

    2017-05-01

    Study Design Prospective cohort. Background The high risk of second anterior cruciate ligament (ACL) injuries after return to sport highlights the importance of return-to-sport decision making. Objective return-to-sport criteria frequently use limb symmetry indexes (LSIs) to quantify quadriceps strength and hop scores. Whether using the uninvolved limb in LSIs is optimal is unknown. Objectives To evaluate the uninvolved limb as a reference standard for LSIs utilized in return-to-sport testing and its relationship with second ACL injury rates. Methods Seventy athletes completed quadriceps strength and 4 single-leg hop tests before anterior cruciate ligament reconstruction (ACLR) and 6 months after ACLR. Limb symmetry indexes for each test compared involved-limb measures at 6 months to uninvolved-limb measures at 6 months. Estimated preinjury capacity (EPIC) levels for each test compared involved-limb measures at 6 months to uninvolved-limb measures before ACLR. Second ACL injuries were tracked for a minimum follow-up of 2 years after ACLR. Results Forty (57.1%) patients achieved 90% LSIs for quadriceps strength and all hop tests. Only 20 (28.6%) patients met 90% EPIC levels (comparing the involved limb at 6 months after ACLR to the uninvolved limb before ACLR) for quadriceps strength and all hop tests. Twenty-four (34.3%) patients who achieved 90% LSIs for all measures 6 months after ACLR did not achieve 90% EPIC levels for all measures. Estimated preinjury capacity levels were more sensitive than LSIs in predicting second ACL injuries (LSIs, 0.273; 95% confidence interval [CI]: 0.010, 0.566 and EPIC, 0.818; 95% CI: 0.523, 0.949). Conclusion Limb symmetry indexes frequently overestimate knee function after ACLR and may be related to second ACL injury risk. These findings raise concern about whether the variable ACL return-to-sport criteria utilized in current clinical practice are stringent enough to achieve safe and successful return to sport. Level of Evidence

  20. [Domestic external fixator application in the treatment of limb deformities: 7 289 cases application report].

    Science.gov (United States)

    Qin, S H; Guo, B F; Zheng, X J; Jiao, S F; Xia, H T; Peng, A M; Pan, Q; Zang, J C; Wang, Z J

    2017-09-01

    Objective: To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs. Methods: A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator. The Ilizarov, hybrid and monobrachial external fixator were used in 67, 65 and 0 patients on the upper limbs and in 2 665, 4 616 and 57 patients on the lower limbs. There were 3 028 patients operated on the left limbs, 3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs. The top three types of diseases were sequelae of poliomyelitis, cerebral palsy and post-traumatic stress disorder peromely. Deformity types inclued talipes equinovarus, knee flexion deformity, cavus foot and so on. Results: All the patients were followed up for a period of 2.5 months to 22.4 years, with an average follow-up time of 5.4 years. All of the external fixators were used for single once, and there was no substitute for external fixator quality problem. All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy. The common complications included wire or pin infection and joint movement limitation and so on. Conclusions: The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability. The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical

  1. 21 CFR 890.3500 - External assembled lower limb prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External assembled lower limb prosthesis. 890.3500... External assembled lower limb prosthesis. (a) Identification. An external assembled lower limb prosthesis... the lower extremity. Examples of external assembled lower limb prostheses are the following: Knee...

  2. Goniometry and Limb Girth in Miniature Dachshunds

    OpenAIRE

    Thomovsky, Stephanie A.; Chen, Annie V.; Kiszonas, Alecia M.; Lutskas, Lori A.

    2016-01-01

    Purpose. To report the mean and median pelvic limb joint angles and girth measurements in miniature Dachshunds presenting with varying degrees of pelvic limb weakness secondary to thoracolumbar intervertebral disc extrusion. Methods. 15 miniature Dachshunds who presented to WSU-VTH for thoracolumbar disc extrusion. Dachshunds varied in neurologic status from ambulatory paraparetic to paraplegic at the time of measurements. Results. There were no significant differences in joint angles or girt...

  3. Muscle Selection for Focal Limb Dystonia

    OpenAIRE

    Barbara Illowsky Karp; Katharine Alter

    2017-01-01

    Selection of muscles for botulinum toxin injection for limb dystonia is particularly challenging. Limb dystonias vary more widely in the pattern of dystonic movement and involved muscles than cervical dystonia or blepharospasm. The large variation in how healthy individuals perform skilled hand movements, the large number of muscles in the hand and forearm, and the presence of compensatory actions in patients with dystonia add to the complexity of choosing muscles for injection. In this artic...

  4. Hybrid Endograft Solution for Complex Iliac Anatomy : Zenith Body and Excluder Limbs

    NARCIS (Netherlands)

    Bos, Wendy T.; Tielliu, Ignace F.; Sondakh, Arthur O.; Vourliotakis, Georgios; Bracale, Umberto M.; Verhoeven, Eric L.

    2010-01-01

    The purpose of this study was to evaluate single-center results with selective use of Gore Excluder limbs (W.L. Gore & Associates, Flagstaff, AZ) in a Cook Zenith body (Cook Inc, Bloomington, IN) for elective endovascular abdominal aortic aneurysm (AAA) repair. A prospectively held database for

  5. Randomized controlled trial of surface peroneal nerve stimulation for motor relearning in lower limb hemiparesis

    NARCIS (Netherlands)

    Sheffler, L.R.; Taylor, P.N.; Gunzler, D.D.; Buurke, Jaap; IJzerman, Maarten Joost; Chae, J.

    2013-01-01

    Objective: To compare the motor relearning effect of a surface peroneal nerve stimulator (PNS) versus usual care on lower limb motor impairment, activity limitation, and quality of life among chronic stroke survivors. Design: Single-blinded randomized controlled trial. Setting: Teaching hospital of

  6. Changes in muscle contractile characteristics and jump height following 24 days of unilateral lower limb suspension

    NARCIS (Netherlands)

    Horstman, A.M.; de Ruiter, C.J.; van Duinhoven, N.T.L.; Hopman, M.T.E.; de Haan, A.

    2012-01-01

    We measured changes in maximal voluntary and electrically evoked torque and rate of torque development because of limb unloading. We investigated whether these changes during single joint isometric muscle contractions were related to changes in jump performance involving dynamic muscle contractions

  7. Changes in muscle contractile characteristics and jump height following 24 days of unilateral lower limb suspension.

    NARCIS (Netherlands)

    Horstman, A.M.; Ruiter, C.J. de; Duijnhoven, N.T.L. van; Hopman, M.T.E.; Haan, A. de

    2012-01-01

    We measured changes in maximal voluntary and electrically evoked torque and rate of torque development because of limb unloading. We investigated whether these changes during single joint isometric muscle contractions were related to changes in jump performance involving dynamic muscle contractions

  8. Effects of different lower-limb sensory stimulation strategies on postural regulation?A systematic review and meta-analysis

    OpenAIRE

    Woo, Mei Teng; Davids, Keith; Liukkonen, Jarmo; Orth, Dominic; Chow, Jia Yi; Jaakkola, Timo

    2017-01-01

    Systematic reviews of balance control have tended to only focus on the effects of single lower-limb stimulation strategies, and a current limitation is the lack of comparison between different relevant stimulation strategies. The aim of this systematic review and meta-analysis was to examine evidence of effects of different lower-limb sensory stimulation strategies on postural regulation and stability. Moderate- to high- pooled effect sizes (Unbiased (Hedges’ g) standardized mean differences ...

  9. Mathematical modeling of vertebrate limb development.

    Science.gov (United States)

    Zhang, Yong-Tao; Alber, Mark S; Newman, Stuart A

    2013-05-01

    In this paper, we review the major mathematical and computational models of vertebrate limb development and their roles in accounting for different aspects of this process. The main aspects of limb development that have been modeled include outgrowth and shaping of the limb bud, establishment of molecular gradients within the bud, and formation of the skeleton. These processes occur interdependently during development, although (as described in this review), there are various interpretations of the biological relationships among them. A wide range of mathematical and computational methods have been used to study these processes, including ordinary and partial differential equation systems, cellular automata and discrete, stochastic models, finite difference methods, finite element methods, the immersed boundary method, and various combinations of the above. Multiscale mathematical modeling and associated computational simulation have become integrated into the study of limb morphogenesis and pattern formation to an extent with few parallels in the field of developmental biology. These methods have contributed to the design and analysis of experiments employing microsurgical and genetic manipulations, evaluation of hypotheses for limb bud outgrowth, interpretation of the effects of natural mutations, and the formulation of scenarios for the origination and evolution of the limb skeleton. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. LOWER LIMB ASYMMETRIES IN RHYTHMIC GYMNASTICS ATHLETES.

    Science.gov (United States)

    Frutuoso, Anderson Simas; Diefenthaeler, Fernando; Vaz, Marco Aurélio; Freitas, Cintia de la Rocha

    2016-02-01

    Different limb training demands and limb preference may determine anthropometric and muscle force inter-limb asymmetries in Rhythmic Gymnastics (RG) athletes. The purpose of this study was to evaluate the influence of lateral preference of the lower extremity on anthropometric, range of motion, and isokinetic torque measurements of RG athletes. Cross sectional study. Lower limb anthropometric measurements (girth, estimated anatomical cross-sectional area), hip, knee and ankle range of motion, flexor and extensor isokinetic torques (angular velocities = 60, 180, e 240 °·s(-1)) and bilateral asymmetry index were evaluated in 11 international level Rhythmic Gymnastics athletes (17.9 ± 4.0 years of age; 9.1 ± 5,1 years of experience; 26.8 ± 6.0 weekly training hours). The preferred limb showed larger thigh girth and anatomical cross-sectional area, higher ankle dorsiflexor range of motion, higher hip flexor torque at 60 °·s(-1) and higher plantarflexor torque at 180 °·s(-1) compared to the non-preferred limb. The observed differences seem to be strictly related to lateral preference and rhythmic gymnastics training. 3.

  11. LIMB Demonstration Project Extension and Coolside Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Goots, T.R.; DePero, M.J.; Nolan, P.S.

    1992-11-10

    This report presents results from the limestone Injection Multistage Burner (LIMB) Demonstration Project Extension. LIMB is a furnace sorbent injection technology designed for the reduction of sulfur dioxide (SO[sub 2]) and nitrogen oxides (NO[sub x]) emissions from coal-fired utility boilers. The testing was conducted on the 105 Mwe, coal-fired, Unit 4 boiler at Ohio Edison's Edgewater Station in Lorain, Ohio. In addition to the LIMB Extension activities, the overall project included demonstration of the Coolside process for S0[sub 2] removal for which a separate report has been issued. The primary purpose of the DOE LIMB Extension testing, was to demonstrate the generic applicability of LIMB technology. The program sought to characterize the S0[sub 2] emissions that result when various calcium-based sorbents are injected into the furnace, while burning coals having sulfur content ranging from 1.6 to 3.8 weight percent. The four sorbents used included calcitic limestone, dolomitic hydrated lime, calcitic hydrated lime, and calcitic hydrated lime with a small amount of added calcium lignosulfonate. The results include those obtained for the various coal/sorbent combinations and the effects of the LIMB process on boiler and plant operations.

  12. Effects of clouds on limb radiative transfer in the infrared

    Science.gov (United States)

    Ewen, G. B.; Grainger, R. G.; Lambert, A.

    2003-04-01

    A forward model (known as McClouds_FM; the Monte carlo Cloud scattering Forward Model) is developed to predict the influence of cirrus clouds on radiances measured by an infrared limb sounding instrument e.g. MIPAS (Michelson Interferometer Passive Atmospheric Sounder). Areverse method three-dimensional Monte Carlo transfer model is combined with a forward model for radiative transfer through the non-cloudy atmosphere (i.e. the RFM; Reference Forward Model to explicitly account for the effects of multiple scattering by the clouds. The ice cloud microphysics are characterised by a size distribution of randomly oriented ice aggregate crystals, with the single scattering properties of the distribution obtained from T-matrix calculations. McClouds_FM can also be adapted to simulate multiple scattering by water clouds by characterising the cloud microphysics by a size distribution of spheroids and using single scattering properties calculated using Mie theory. Initial results are presented comparing McCloudS_FM simulations and real MIPAS spectra of cirrus showing good agreement. Of particular interest are several noticeable spectral features (i.e. inverted H_2O lines) in the data which are replicated in the simulations and can only be explained by tropospheric radiation scattered into the line of sight by the cloud ice particles. McClouds_FM will be used in a retrieval scheme to determine cloud optical properties from both MIPAS and HIRDLS (HIgh Resolution Dynamic Limb Sounder) infrared limb observations. The RFM was developed by Dr Anu Dudhia at the Department of Atmospheric, Oceanic and Planetary Physics, University of Oxford - http://www.atm.ox.ac.uk/RFM)

  13. Sensory feedback for upper limb prostheses.

    Science.gov (United States)

    Hsiao, Steven S; Fettiplace, Michael; Darbandi, Bejan

    2011-01-01

    In this chapter, we discuss the neurophysiological basis of how to provide sensory feedback to users with an upper limb prosthesis and discuss some of the theoretical issues that need to be considered when directly stimulating neurons in the somatosensory system. We focus on technologies that are currently available and discuss approaches that are most likely to succeed in providing natural perception from the artificial hand to the user. First, we discuss the advantages and disadvantages of providing feedback by stimulating directly the remaining afferents that originally innervated the arm and hand. In particular, we pay close attention to the normal functional roles that the peripheral afferents play in perception. What are the consequences and implications of stimulating these afferents? We then discuss whether it is reasonable to stimulate neurons in the ascending pathways that carry the information from the afferents to the cortex or directly in neurons in the primary somatosensory cortex. We show that for some modalities there are advantages for stimulating in the spinal cord, while for others it is advantageous to stimulate directly in the somatosensory cortex. Finally, we discuss results from a current experiment in which we used electrical stimuli in primary somatosensory cortex to restore the percept of the intensity of a mechanical probe indented into the hand. The results suggest that the simple percept of stimulus intensity can be provided to the animal from a single finger using four electrodes. We propose that significantly more electrodes will be needed to reproduce more complex aspects of tactile perception. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Limb apraxia in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Rapaić Dragan

    2014-01-01

    Full Text Available Background/Aim. There are almost no studies on apraxia in people with multiple sclerosis. Although the white matter is damaged in MS, it is not the only location in which the pathological changes are present. Demyelinated lesions in the cortex have recently been recognized as important components of multiple sclerosis pathology. The aim of this study was to determine whether apraxia is present among people with MS, and the importance of demographic characteristics and impairment of functional systems at conceptualization and execution of movements. Methods. The experimental group consisted of 30 patients, mean age 51.34 ± 7.70 years. The patients in the experimental group were diagnosed with MS according to the McDonald criteria. The control group consisted of 30 healthy subjects, mean age 50.30 ± 10.47 years. For research purposes, we used the following instruments: Questionnaire for Collecting Demographic Data, Kurtzke Functional Systems Scores, Waterloo-Sunnybrook Apraxia Battery (WatAB. Execution of motion tasks that are a part of the Watwere incorporated in the System for the Observation and Analysis of Motor Behavior. Results. Our study showed that limb apraxia was common in people with MS. Apraxia was present during pantomime in 26.70% of the patients, and during the imitation of movements in 44.80% of the patients. Gender, age, education level, duration of disease and a form of MS did not determine the quality of conceptualization and execution of movements. The time elapsed from the last exacerbation was a determinant of quality of executed movements. Impairments of functional systems predicted impairments of movement execution. The expanded disability scale score correlated with the severity of apraxia. Conclusion. Our study confirm the presence of apraxia in MS. It is necessary to carry out further studies using functional magnetic resonance imaging, as well as the conduct longitudinal studies to determine the precise structure of

  15. Predictors of secondary amputation in patients with grade IIIC lower limb injuries: A retrospective analysis of 35 patients.

    Science.gov (United States)

    Song, Wenhao; Zhou, DongSheng; Dong, Jinlei

    2017-06-01

    The aim of this study was to identify risk factors for failure of limb salvage surgery in grade IIIC lower extremity injuries.A single-institution, retrospective review was performed of all patients with grade IIIC lower limb injuries presenting from January 2009 to April 2014. We gathered the data on each patient who underwent limb salvage and analyzed the final outcome for these patients (limb salvage vs secondary amputation).Grade IIIC lower limb injuries were identified in 41 patients. Primary amputation was performed in 6 patients (15%) as the initial procedure. Thirty-five patients (85%) underwent vascular reconstruction and other surgical procedures to salvage the limb. Limb salvage was successful in 23 patients (66%); 12 patients (34%) ultimately underwent secondary amputation. The median time from injury to secondary amputation was 22.5 days (range 4-380 days). The mean Mangled Extremity Severity Score (MESS) was 7.2 ± 1.5 (range 5-10). The MESS was significantly higher in the secondary amputation group compared with the limb salvage group. Additionally, statistical testing revealed that the limb ischemia time, complex fractures, rate of fasciotomy, and number of vascular reconstruction were significantly higher in the secondary amputation group. Muscle necrosis and extensive soft tissue defect were the main reasons for secondary amputation.The findings indicate that MESS of 7 or greater, complex fractures, limb ischemia time equal to or greater than 6 hours, and osteofascial compartment syndrome were associated with an increased risk of delayed amputation. The MESS is highly prognostic but not perfect; decision-making in patients with an MESS of 7 or greater should be re-evaluated for clinical use.

  16. Effects of external loads on postural sway during quiet stance in adults aged 20-80 years.

    Science.gov (United States)

    Hill, M W; Duncan, M J; Oxford, S W; Kay, A D; Price, M J

    2018-01-01

    The purpose of this study was to investigate the effects of holding external loads on postural sway during upright stance across age decades. Sixty-five healthy adults (females, n = 35), aged 18-80 years were assessed in four conditions; (1) standing without holding a load, holding a load corresponding to 5% body mass in the (2) left hand, (3) right hand and (4) both hands. The centre of pressure (COP) path length and anteroposterior and mediolateral COP displacement were used to indirectly assess postural sway. External loading elicited reductions in COP measures of postural sway in older age groups only (P  0.05). Holding external loads during standing is relevant to many activities of daily living (i.e. holding groceries). The reduction in postural sway may suggest this type of loading has a stabilising effect during quiet standing among older adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Determinants of limb preference for initiating compensatory stepping poststroke.

    Science.gov (United States)

    Mansfield, Avril; Inness, Elizabeth L; Lakhani, Bimal; McIlroy, William E

    2012-07-01

    To investigate the determinants of limb preference for initiating compensatory stepping poststroke. Retrospective chart review. Inpatient rehabilitation. Convenience sample of individuals admitted to inpatient rehabilitation with poststroke hemiparesis. Not applicable. Compensatory stepping responses were evoked using a lean-and-release postural perturbation. The limb used to initiate compensatory stepping was determined. The relationships between stepping with the paretic limb and premorbid limb dominance, weight bearing on the paretic limb in quiet standing, ability to bear weight on the paretic limb, preperturbation weight bearing on the paretic limb, and lower-limb motor recovery scores were determined. The majority (59.1%) of responses were steps initiated with the nonparetic limb. Increased lower-limb motor recovery scores and preperturbation weight bearing on the nonparetic limb were significantly related to increased frequency of stepping with the paretic limb. When the preferred limb was physically blocked, an inappropriate response was initiated in 21% of trials (ie, nonstep responses or an attempt to step with the blocked limb). This study reveals the challenges that individuals with poststroke hemiparesis face when executing compensatory stepping responses to prevent a fall after a postural perturbation. The inability or challenges to executing a compensatory step with the paretic limb may increase the risk for falls poststroke. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Effect of two Backpack Designs on Cop Displacement and Plantar Force Distribution in Children during Upright Stance

    Directory of Open Access Journals (Sweden)

    Mastalerz Andrzej

    2016-09-01

    Full Text Available Introduction. Many studies have compared different backpack designs and their influence on the carrier; however, no data referring to school students aged 7-8 years are currently available. Therefore, the aim of the research was to assess the influence of backpack design on centre of pressure (COP displacement and plantar force distribution in children during an upright stance. Material and methods. Nineteen school students (9 males and 10 females volunteered for the study. Two Polish backpacks intended for school use were evaluated: backpack A, which had two main compartments, and backpack B, which had one main compartment. The backpack load was composed of books, binders, and regular school equipment. During the measurements, the subjects were asked to look ahead with the head straight and arms at the sides in a comfortable position and to stand barefoot on the F-Scan® sensors (Tekscan, F-Scan® attached to the force platform (Kistler, carrying a load corresponding to 10% of their body mass. Results. The study found insignificant differences between the two backpack designs. Moreover, COP parameters increased significantly during an upright stance while carrying backpack B in comparison to the empty backpack condition. Additionally, we observed significantly higher values of plantar force distribution in the heel region for the condition without load and insignificantly higher ones for carrying backpack A. Conclusions. The results of the current study suggest that the differences between the two backpack designs are too marginal to be detected through COP displacement. Disturbances in plantar force distribution suggest a lack of posture control and a lower stability of the standing position with a backpack, but these disturbances were significant only when the backpack with one main compartment was used.

  19. Repeatability of stance phase kinematics from a multi-segment foot model in people aged 50 years and older.

    Science.gov (United States)

    Arnold, John B; Mackintosh, Shylie; Jones, Sara; Thewlis, Dominic

    2013-06-01

    Confidence in 3D multi-segment foot models has been limited by a lack of repeatability data, particularly in older populations that may display unique functional foot characteristics. This study aimed to determine the intra and inter-observer repeatability of stance phase kinematic data from a multi-segment foot model described by Leardini et al. [2] in people aged 50 years or older. Twenty healthy adults participated (mean age 65.4 years SD 8.4). A repeated measures study design was used with data collected from four testing sessions on two days from two observers. Intra (within-day and between-day) and inter-observer coefficient of multiple correlations revealed moderate to excellent similarity of stance phase joint range of motion (0.621-0.975). Relative to the joint range of motion (ROM), mean differences (MD) between sessions were highest for the within-day comparison for all planar ROM at the metatarsus-midfoot articulation (sagittal plane ROM 5.2° vs. 3.9°, MD 3.1°; coronal plane ROM 3.9 vs. 3.1°, MD 2.3°; transverse plane ROM 6.8° vs. 5.16°, MD 3.5°). Consequently, data from the metatarsus-midfoot articulation in the Istituto Ortopedico Rizzoli (IOR) foot model in adults aged over 50 years needs to be considered with respect to the findings of this study. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

  20. The functional anatomy of suggested limb paralysis.

    Science.gov (United States)

    Deeley, Quinton; Oakley, David A; Toone, Brian; Bell, Vaughan; Walsh, Eamonn; Marquand, Andre F; Giampietro, Vincent; Brammer, Michael J; Williams, Steven C R; Mehta, Mitul A; Halligan, Peter W

    2013-02-01

    Suggestions of limb paralysis in highly hypnotically suggestible subjects have been employed to successfully model conversion disorders, revealing similar patterns of brain activation associated with attempted movement of the affected limb. However, previous studies differ with regard to the executive regions involved during involuntary inhibition of the affected limb. This difference may have arisen as previous studies did not control for differences in hypnosis depth between conditions and/or include subjective measures to explore the experience of suggested paralysis. In the current study we employed functional magnetic resonance imaging (fMRI) to examine the functional anatomy of left and right upper limb movements in eight healthy subjects selected for high hypnotic suggestibility during (i) hypnosis (NORMAL) and (ii) attempted movement following additional left upper limb paralysis suggestions (PARALYSIS). Contrast of left upper limb motor function during NORMAL relative to PARALYSIS conditions revealed greater activation of contralateral M1/S1 and ipsilateral cerebellum, consistent with the engagement of these regions in the completion of movements. By contrast, two significant observations were noted in PARALYSIS relative to NORMAL conditions. In conjunction with reports of attempts to move the paralysed limb, greater supplementary motor area (SMA) activation was observed, a finding consistent with the role of SMA in motor intention and planning. The anterior cingulate cortex (ACC, BA 24) was also significantly more active in PARALYSIS relative to NORMAL conditions - suggesting that ACC (BA 24) may be implicated in involuntary, as well as voluntary inhibition of prepotent motor responses. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. The role of limb perfusion studies in the paediatric ischaemic limb ...

    African Journals Online (AJOL)

    The causes of limb ischaemia were meningococcal septicaemia (n=9), septic shock (n=6), hypovolaemic shock due to gastroenteritis (n=4), and electrical burns (n=1). The clinical, scan and surgical findings correlated in 40/48 imaged limbs. In one leg the findings did not correlate, but the perfusion scan results predicted the ...

  2. Reacting while moving: influence of right limb movement on left limb reaction.

    Science.gov (United States)

    Kennedy, Deanna M; Wang, Chaoyi; Shea, Charles H

    2013-09-01

    An experiment was designed to determine whether the activation of a muscle group (flexors or extensors) used to produce an ongoing movement of one limb influenced the reaction time and associated initiation of elbow flexion or extension movements of the contralateral limb. Right-handed participants in the bimanual groups were asked to produce a pattern of flexion/extension movements defined by a sine wave (period = 2 s, amplitude = 16°) with the right limb. While performing the right limb movement, participants were instructed that they were to react as quickly as possible by making a flexion or extension movement with their left limb when the cursor they were using to track the sine wave changed color. Participants in the unimanual groups performed the left limb reaction time task but were not asked to make right limb movements. The reaction time stimulus occurred once in each trial and was presented at one of six locations on one of the six cycles comprising the sinusoidal waveform. Participants performed 7 blocks of 6 test trials. Reaction time was calculated as the time interval between the color change of the cursor and the initiation of the response with the left limb. Movement time was calculated as the interval of time between the initiation of the response and the left limb cursor crossing the upper or lower boundary line. Mean reaction of the left limb was significantly influenced by the concurrent type of movement (flexion/extension) of the right limb. Reaction times were shorter on trials in which both limbs were initiating movement with homologous muscles as compared to trials in which the limbs were initiating movement with non-homologous muscles. No differences were detected when the stimuli were presented during the ballistic phase of the right limb movement, and no differences at any position were detected for the unimanual groups. This result is consistent with the notion that neural crosstalk can influence the time required to react to a

  3. Experimental Induction of a Perceived “Telescoped” Limb Using a Full-Body Illusion

    Science.gov (United States)

    Schmalzl, Laura; Ehrsson, H. Henrik

    2011-01-01

    Phantom limbs refer to the sensation that an amputated or missing limb is still attached to the body. Phantom limbs may be perceived as continuous with the stump so as to resemble a normal limb, or as “telescoped” with the more distal portion of the phantom being perceived as having withdrawn within the stump. Telescoping tends to be related to increased levels of phantom pain, making it a clinically relevant phenomenon to investigate. In the current study we show that a full-body illusion can be used to induce the sensation of a telescoped limb in healthy individuals. For the induction of the full-body illusion, participants saw the body of a mannequin from a first person perspective while being subjected to synchronized visuo-tactile stimulation through stroking. Crucially, the mannequin was missing its left hand so as to resemble an amputee. By manipulating the positioning of the strokes applied to the mannequin's stump with respect to the participants’ hand we were able to evoke the sensation of the participants’ hand being located either below the stump or, more crucially, “inside” the stump, i.e., telescoped. In three separate experiments these effects were supported by complementary subjective data from questionnaires, verbally reported perceived location of the hand, and manual pointing movements indicating hand position (proprioceptive drift). Taken together our results show that healthy individuals can experience the body of an upper limb amputee as their own, and that this can be associated with telescoping sensations. This is a theoretically important observation as it shows that ownership of an entire body can be evoked in the context of gross anatomical incongruence for a single limb, and that telescoping sensations occur as a consequence of the body representation system trying to reduce this incongruence. Furthermore, the present study might provide a new platform for future studies of the relationship between telescoping and phantom

  4. Experimental induction of a perceived telescoped limb using a full-body illusion

    Directory of Open Access Journals (Sweden)

    Laura eSchmalzl

    2011-04-01

    Full Text Available Phantom limbs refer to the sensation that an amputated or missing limb is still attached to the body. Phantom limbs may be perceived as continuous with the stump so as to resemble a normal limb, or as telescoped with the more distal portion of the phantom being perceived as having withdrawn within the stump. Telescoping tends to be related to increased levels of phantom pain, making it a clinically relevant phenomenon to investigate. In the current study we show that a full-body illusion can be used to induce the sensation of a telescoped limb in healthy individuals. For the induction of the full-body illusion, participants saw the body of a mannequin from a first person perspective while being subjected to synchronized visuo-tactile stimulation through stroking. Crucially, the mannequin was missing its left hand so as to resemble an amputee. By manipulating the positioning of the strokes applied to the mannequin’s stump with respect to the participants’ hand we were able to evoke the sensation of the participants’ hand being located either below the stump or, more crucially, inside the stump, i.e. telescoped. In three separate experiments these effects were supported by complementary subjective data from questionnaires, verbally reported perceived location of the hand, and manual pointing movements indicating hand position (proprioceptive drift. Taken together our results show that healthy individuals can experience the body of an upper limb amputee as their own, and that this can be associated with telescoping sensations. This is a theoretically important observation as it shows that ownership of an entire body can be evoked in the context of gross anatomical incongruence for a single limb, and that telescoping sensations occur as a consequence of the body representation system trying to reduce this incongruence. Furthermore, the present study might provide a new platform for future studies of the relationship between telescoping and

  5. Supernumerary and absent limbs and digits of the lower limb: a review of the literature.

    Science.gov (United States)

    Klaassen, Zachary; Shoja, Mohammadali M; Tubbs, R Shane; Loukas, Marios

    2011-07-01

    Anatomical history over centuries includes description of a wide variety of malformations involving the lower limbs. This article offers an organized review of these diverse abnormalities, including new understanding of mechanisms through recent discoveries in genetics and molecular biology. In 19th century Europe, a number of unique anomalies were reported, as well as evidence of foot amputations occurring in ancient Peruvian culture. Embryologically, the limbs develop early, with the lower limb being recognizable for the first time at stage 13 of development. By stage 23, the toes are clearly defined and by birth, although the legs appear bowed, the tibia and fibula are straight. Removal of the apical ectodermal ridge results in cessation of limb development, conversely, a second apical ectodermal ridge results in duplication of distal structures. Supernumerary limbs have been documented to occur as part of a teratoma with unique morphology and accompanying blood supply. Additionally, many examples of polydactyly occur in the foot postulating that deletion of chromosome 22q11 is involved in postaxial polydactyly. Such deletions occur near the middle of the chromosome at a location designated q11.2 (i.e., on the long arm of one of the pair of chromosomes 22) and this syndrome is also referred to as DiGeorge syndrome, which has a prevalence estimated at 1:4,000. Absence of the lower limbs has also been noted, with hypoplasia of the fibula being the most common manifestation of congenital bone absences in the lower limb. In addition to fibular aplasia, cases of tibial aplasia have been reported. This article is important for surgeons attempting correctional repair of lower limb anomalies, as well as providing analysis of the historical, anatomical and clinical aspects of supernumerary and absent limbs and digits for the lower limb. Copyright © 2011 Wiley-Liss, Inc.

  6. Effect of lower limb rehabilitation robot on lower limb motor function of hemiplegic patients after stroke

    Directory of Open Access Journals (Sweden)

    Jian-liang LU

    2017-07-01

    Full Text Available Objective To observe the rehabilitation effect of lower limb rehabilitation robot training on the lower limb motor function of hemiplegic patients after stroke. Methods A total of 60 stroke patients (duration < 6 months accepted conventional rehabilitation training combined with body weight support treadmill training (BWSTT group, N = 30 or conventional rehabilitation training combined with lower limb rehabilitation robot training (Robot group, N = 30. Fugl - Meyer Assessment Scale for Lower Extremity (FMA-LE was used to evaluate lower limb motor function. Berg Balance Scale (BBS was used to evaluate balance function. Lower limb rehabilitation robot torque feedback system was used to evaluate lower limb muscle strength. All evaluations were performed before and after 8-week training.   Results Compared with before training, the FMA-LE score (P = 0.000, BBS score (P = 0.000, hemiplegic side of hip joint feedback torque value (HJTV, P = 0.000 and knee joint feedback torque value (KJTV, P = 0.000 were increased in both groups after 8-week training. Compared with BWSTT group, the hemiplegic side of HJTV (P = 0.000 and KJTV (P = 0.000 were increased in Robot group after 8-week training, while the FMA-LE score (P = 0.118 and BBS score (P = 0.159 had no statistically significant difference between 2 groups.  Conclusions The lower limb rehabilitation robot or body weight support treadmill training combined with conventional rehabilitation training could improve the lower limb motor function of hemiplegic patients after stroke. The lower limb rehabilitation robot training was better than body weight support treadmill training on the recovery of lower limb muscle strength. DOI: 10.3969/j.issn.1672-6731.2017.05.004  

  7. Surgical correction of limb malalignment for instability of the patella: a comparison of 2 techniques.

    Science.gov (United States)

    Paulos, Lonnie; Swanson, Stephen C; Stoddard, Gregory J; Barber-Westin, Sue

    2009-07-01

    Although patients considered "successful" at longer-term follow-up no longer exhibited patellar instability, those with more severe malalignment issues had other, gradually worsening symptoms such as activity-related pain, crepitation, swelling with activities, and pain with weather changes. Improvement of patellar tracking by correction of the tubercle-sulcus angle and related ligament deficiencies will result in good to excellent results, regardless of the technique employed. Cohort study; Level of evidence, 3. Twenty-five patients with dislocating patellae and significant lower leg deformity were treated; 12 patients (group 1) underwent a derotational high tibial osteotomy and 13 patients (group 2) underwent an Elmslie-Trillat-Fulkerson proximal-distal realignment. All were prospectively evaluated a minimum of 24 months postoperatively with a physical examination, validated outcome questionnaires, radiographs, and computerized axial tomography scans. Postoperative 3-dimensional bilateral gait analyses were performed on all subjects walking on a 3-dimensional force treadmill to measure stance kinematics, foot progression angle, knee flexion, knee valgus-varus, hip flexion, and patella angle. Contralateral limbs with similar preoperative alignment were used as controls. Group 1 patients significantly improved over their preoperative status in all primary subjective and functional outcome parameters, and were significantly better than group 2 patients. Group 2 patients improved, but not to the degree of group 1 patients. Gait analysis revealed group 1 patients had more symmetrical gait patterns, with less variability and less compensatory gait changes, than group 2 patients. The original hypothesis proved to be incorrect. The simultaneous correction of ligament imbalance, excessive tubercle-sulcus angle, and lower limb torsional deformity produced significantly better results than conventional proximal-distal realignment.

  8. Relationships between lower-limb kinematics and block phase performance in a cross section of sprinters.

    Science.gov (United States)

    Bezodis, Neil Edward; Salo, Aki Ilkka Tapio; Trewartha, Grant

    2015-01-01

    This study investigated lower-limb kinematics to explain the techniques used to achieve high levels of sprint start performance. A cross-sectional design was used to examine relationships between specific technique variables and horizontal external power production during the block phase. Video data were collected (200 Hz) at the training sessions of 16 sprinters who ranged in 100 m personal best times from 9.98 to 11.6 s. Each sprinter performed three 30 m sprints and reliable (all intraclass correlation coefficients, ICC(2,3) ≥ 0.89) lower-limb kinematic data were obtained through manual digitising. The front leg joints extended in a proximal-to-distal pattern for 15 sprinters, and a moderate positive relationship existed between peak front hip angular velocity and block power (r = 0.49, 90% confidence limits = 0.08-0.76). In the rear leg, there was a high positive relationship between relative push duration and block power (r = 0.53, 90% confidence limits = 0.13-0.78). The rear hip appeared to be important; rear hip angle at block exit was highly related to block power (r = 0.60, 90% confidence limits = 0.23-0.82), and there were moderate positive relationships with block power for its range of motion and peak angular velocity (both r = 0.49, 90% confidence limits = 0.08-0.76). As increased block power production was not associated with any negative aspects of technique in the subsequent stance phase, sprinters should be encouraged to maximise extension at both hips during the block phase.

  9. Developing a technique to measure intra-limb coordination in gait: applicable to children with cerebral palsy.

    Science.gov (United States)

    Farmer, Sybil E; Pearce, Gillian; Stewart, Caroline

    2008-08-01

    Lower limb intra-limb coordination was investigated using sagittal plane kinematic data extracted from gait data recorded using a Vicon system (Vicon Motion Systems Ltd., Oxford, UK) of 20 normal (N) and 20 children with cerebral palsy (CP). Walking speed, maximum and minimum flexion and range of motion (ROM) were calculated. The repeatability of the data was checked by calculating the coefficient of multiple correlation. Data were also processed to determine angular velocity of hip and knee joints. A logical spreadsheet was devised to determine when both joints moved in the same direction (in-phase), in different directions (antiphase, AP) or if either joint was immobile (JS). In-phase joint motion was further subdivided into in-phase flexion (IPF) and in-phase extension (IPE), which comprises in-phase during stance phase (IPEst) and in-phase during swing phase (IPEsw). Data were processed using two threshold values for angular velocity below which the joint was considered to be immobile. The threshold values used were 0.05 degrees /% of gait cycle and 0.025 degrees /% of gait cycle. Children with cerebral palsy had reduced ROM and walked more slowly than normal children. There are significant differences between N and cerebral palsy coordination phases with marginally greater significance at the 0.05 degrees /% threshold for most component parameters; the exception being in-phase flexion. It is therefore suggested that this threshold value (0.05 degrees /%) is used for future work.

  10. Progressive Loss of Function in a Limb Enhancer during Snake Evolution

    Energy Technology Data Exchange (ETDEWEB)

    Kvon, Evgeny Z.; Kamneva, Olga K.; Melo, Uirá S.; Barozzi, Iros; Osterwalder, Marco; Mannion, Brandon J.; Tissières, Virginie; Pickle, Catherine S.; Plajzer-Frick, Ingrid; Lee, Elizabeth A.; Kato, Momoe; Garvin, Tyler H.; Akiyama, Jennifer A.; Afzal, Veena; Lopez-Rios, Javier; Rubin, Edward M.; Dickel, Diane E.; Pennacchio, Len A.; Visel, Axel

    2016-10-20

    The evolution of body shape is thought to be tightly coupled to changes in regulatory sequences, but specific molecular events associated with major morphological transitions in vertebrates have remained elusive. In this paper, we identified snake-specific sequence changes within an otherwise highly conserved long-range limb enhancer of Sonic hedgehog (Shh). Transgenic mouse reporter assays revealed that the in vivo activity pattern of the enhancer is conserved across a wide range of vertebrates, including fish, but not in snakes. Genomic substitution of the mouse enhancer with its human or fish ortholog results in normal limb development. In contrast, replacement with snake orthologs caused severe limb reduction. Synthetic restoration of a single transcription factor binding site lost in the snake lineage reinstated full in vivo function to the snake enhancer. Our results demonstrate changes in a regulatory sequence associated with a major body plan transition and highlight the role of enhancers in morphological evolution.

  11. The effect of acute irradiation on the development of limbs in sheep

    International Nuclear Information System (INIS)

    Rajtova, V.; Horak, J.

    1976-01-01

    The effect of acute irradiation on the limb development in sheep was studied. The pelvic area of a pregnant sheep was irradiated locally on the 28th, 29th and 30th days after fertilization. The fetus was removed on the 15th day after irradiation and treated histologically. A single exposure with 250 R (higher exposures killed the fetus) was found to cease the limb development on the 28th day after irradiation (the critical period of the sheep limb development), to induce persistence of the intermedial ray on the 29th and 30th days, an early disappearance of the side finger rays, an early disappearance, fusion or deformation of some carpal and tarsal elements on the 29th and the 30th days after irradiation. (author)

  12. Short-latency stretch reflexes do not contribute to premature calf muscle activity during the stance phase of gait in spastic patients

    NARCIS (Netherlands)

    Niet, M. de; Latour, H.; Hendricks, H.T.; Geurts, A.C.H.; Weerdesteijn, V.G.M.

    2011-01-01

    de Niet M, Latour H, Hendricks H, Geurts AC, Weerdesteyn V. Short-latency stretch reflexes do not contribute to premature calf muscle activity during the stance phase of gait in spastic patients. OBJECTIVE: To identify whether a relationship exists between stretch and activity of the calf muscles

  13. Computerized identification and classification of stance phases as made by front og hind feet of walking cows based on 3-dimensional ground reaction forces

    DEFF Research Database (Denmark)

    Skjøth, F; Thorup, Vivi Mørkøre; do Nascimento, Omar Feix

    2013-01-01

    Lameness is a frequent disorder in dairy cows and in large dairy herds manual lameness detection is a time-consuming task. This study describes a method for automatic identification of stance phases in walking cows, and their classification as made by a front or a hind foot based on ground reacti...

  14. The dynamics of postural sway cannot be captured using a one-segment inverted pendulum model: a PCA on segment rotations during unperturbed stance

    NARCIS (Netherlands)

    Pinter, I.J.; van Swigchem, R.; van Soest, A.J.; Rozendaal, L.A.

    2008-01-01

    Research on unperturbed stance is largely based on a one-segment inverted pendulum model. Recently, an increasing number of studies report a contribution of other major joints to postural control. Therefore this study evaluates whether the conclusions originating from the research based on a

  15. Pattern Formation in Vertebrate Limbs

    Science.gov (United States)

    1995-05-08

    with several modifications. Dreisch separated the firs t two cel l s of sea urchins by agi t ation, and the development of the s urviving cell s...the fate of a cell is a function of the position of the cell in the embryo has emerged as one of the main components of c urrent pattern formation...the relevance of s pecific divisions of the cyt oplasm during development. Driesch found that the single factor, calcium was necessary for deve

  16. A Neuromotor Device for Reducing Phantom Limb Pain in Individuals with Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Cui Lei

    2016-01-01

    Full Text Available Phantom Limb Pain is a disorder that can be experienced by individuals after amputation or spinal cord injury. In spinal cord injury the paralysis or paresis is often bilateral, thus limiting the application of apparent movement as a therapeutic model for phantom limb pain. This project aimed to develop a robotic rehabilitation device that replicated apparent movement to apply the same therapeutic principles with individuals with lower limb phantom pain that have bilateral paralysis of paresis. The proposed device achieved lower limb planar motion of the knee by a six-bar linkage of a single degree of freedom (DOF. It is driven by a linear actuator while the ankle motion is achieved by a gear motor, reaching an effective 70° range of motion for both joints. The system features closed loop control using feedback from surface electromyography sensors, limit switches and position sensors with an Arduino microcontroller as the control unit. This device will be used to further our understanding of the disorder and create opportunities for robot aided treatment for individuals with phantom limb pain as a result of spinal cord injury.

  17. How accurate is anatomic limb alignment in predicting mechanical limb alignment after total knee arthroplasty?

    Science.gov (United States)

    Lee, Seung Ah; Choi, Sang-Hee; Chang, Moon Jong

    2015-10-27

    Anatomic limb alignment often differs from mechanical limb alignment after total knee arthroplasty (TKA). We sought to assess the accuracy, specificity, and sensitivity for each of three commonly used ranges for anatomic limb alignment (3-9°, 5-10° and 2-10°) in predicting an acceptable range (neutral ± 3°) for mechanical limb alignment after TKA. We also assessed whether the accuracy of anatomic limb alignment was affected by anatomic variation. This retrospective study included 314 primary TKAs. The alignment of the limb was measured with both anatomic and mechanical methods of measurement. We also measured anatomic variation, including the femoral bowing angle, tibial bowing angle, and neck-shaft angle of the femur. All angles were measured on the same full-length standing anteroposterior radiographs. The accuracy, specificity, and sensitivity for each range of anatomic limb alignment were calculated and compared using mechanical limb alignment as the reference standard. The associations between the accuracy of anatomic limb alignment and anatomic variation were also determined. The range of 2-10° for anatomic limb alignment showed the highest accuracy, but it was only 73 % (3-9°, 65 %; 5-10°, 67 %). The specificity of the 2-10° range was 81 %, which was higher than that of the other ranges (3-9°, 69 %; 5-10°, 67 %). However, the sensitivity of the 2-10° range to predict varus malalignment was only 16 % (3-9°, 35 %; 5-10°, 68 %). In addition, the sensitivity of the 2-10° range to predict valgus malalignment was only 43 % (3-9°, 71 %; 5-10°, 43 %). The accuracy of anatomical limb alignment was lower for knees with greater femoral (odds ratio = 1.2) and tibial (odds ratio = 1.2) bowing. Anatomic limb alignment did not accurately predict mechanical limb alignment after TKA, and its accuracy was affected by anatomic variation. Thus, alignment after TKA should be assessed by measuring mechanical alignment rather than anatomic

  18. Outcomes of the Bobath concept on upper limb recovery following stroke.

    Science.gov (United States)

    Luke, Carolyn; Dodd, Karen J; Brock, Kim

    2004-12-01

    To determine the effectiveness of the Bobath concept at reducing upper limb impairments, activity limitations and participation restrictions after stroke. Electronic databases were searched to identify relevant trials published between 1966 and 2003. Two reviewers independently assessed articles for the following inclusion criteria: population of adults with upper limb disability after stroke; stated use of the Bobath concept aimed at improving upper limb disability in isolation from other approaches; outcomes reflecting changes in upper limb impairment, activity limitation or participation restriction. Of the 688 articles initially identified, eight met the inclusion criteria. Five were randomized controlled trials, one used a single-group crossover design and two were single-case design studies. Five studies measured impairments including shoulder pain, tone, muscle strength and motor control. The Bobath concept was found to reduce shoulder pain better than cryotherapy, and to reduce tone compared to no intervention and compared to proprioceptive neuromuscular facilitation (PNF). However, no difference was detected for changes in tone between the Bobath concept and a functional approach. Differences did not reach significance for measures of muscle strength and motor control. Six studies measured activity limitations, none of these found the Bobath concept was superior to other therapy approaches. Two studies measured changes in participation restriction and both found equivocal results. Comparisons of the Bobath concept with other approaches do not demonstrate superiority of one approach over the other at improving upper limb impairment, activity or participation. However, study limitations relating to methodological quality, the outcome measures used and contextual factors investigated limit the ability to draw conclusions. Future research should use sensitive upper limb measures, trained Bobath therapists and homogeneous samples to identify the influence of

  19. Lower limb mechanics during moderate high-heel jogging and running in different experienced wearers.

    Science.gov (United States)

    Fu, Fengqin; Zhang, Yan; Shu, Yang; Ruan, Guoqing; Sun, Jianjun; Baker, Julien S; Gu, Yaodong

    2016-08-01

    The aim of this study is to investigate the differences in lower limb kinematics and kinetics between experienced (EW) and inexperienced (IEW) moderate high-heel wearers during jogging and running. Eleven experienced female wearers of moderate high-heel shoes and eleven matched controls participated in jogging and running tests. A Vicon motion analysis system was used to capture kinematic data and a Kistler force platform was used to collect ground reaction force (GRF). There were no significant differences in jogging and running speed respectively. Compared with IEW, EW adopted larger stride length (SL) with lower stride frequency (SF) at each corresponding speed. During running, EW enlarged SL significantly while IEW increased both SL and SF significantly. Kinematic data showed that IEW had generally larger joint range of motion (ROM) and peak angles during stance phase. Speed effect was not obvious within IEW. EW exhibited a significantly increased maximal vertical GRF (Fz2) and vertical average loading rate (VALR) during running, which was potentially caused by overlong stride. These suggest that both EW and IEW are at high risk of joint injuries when running on moderate high heels. For wearers who have to do some running on moderate high heels, it is crucial to control joint stability and balance SL and SF consciously. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Results of the IRIS UV Burst Survey, Part I: Active Regions Tracked Limb to Limb

    Science.gov (United States)

    Madsen, C. A.; DeLuca, E.

    2017-12-01

    We present results from the first phase of an effort to thoroughly characterize UV bursts within the Interface Region Imaging Spectrograph (IRIS) data catalogue. The observational signatures of these phenomena include dramatically intensified and broadened NUV/FUV emission line profiles with absorption features from cool metallic ions. These properties suggest that UV bursts originate from plasma at transition region temperatures (≥ 80,000 K) which is deeply embedded in the cool lower chromosphere ( 5,000 K). Rigorously characterizing the energetic and dynamical properties of UV bursts is crucial since they have considerable potential to heat active region chromospheres and could provide critical constraints for models of magnetic reconnection in these regions. The survey first focuses on IRIS observations of active regions tracked from limb to limb. All observations consist of large field-of-view raster scans of 320 or 400 steps each, which allow for widespread detection of many burst profiles at the expense of having limited short-term time evolution information. We detect bursts efficiently by applying a semi-automated single-Gaussian fitting technique to Si IV 1393.8 Å emission profiles that isolates the distinct burst population in a 4-D parameter space. The robust sample of NUV/FUV burst spectra allows for precise constraints of properties critical for modeling reconnection in the chromosphere, including outflow kinetic energy, density estimates from intensity ratios of Si IV 1402.8 Å and O IV 1401.2 Å emission lines, and coincident measures of emission in other wavelengths. We also track burst properties throughout the lifetimes of their host active regions, noting changes in detection rate and preferential location as the active regions evolve. Finally, the tracked active region observations provide a unique opportunity to investigate line-of-sight effects on observed UV burst spectral properties, particularly the strength of Ni II 1393.3 Å absorption

  1. [WHICH IN SURGERY OF LOWER LIMB AMPUTATION].

    Science.gov (United States)

    Mezzetti, Roberto

    2015-01-01

    Lower limb amputation is in effect decisive surgery in the treatment of ischemic gangrene whether nature of post-traumatic or secondary to arterial disease of the lower limbs. The amputation is not however to be considered debulking surgery. The demolition regards the limb behind which we do not have the presence scotomize amputee who requires to be accompanied in dealing with a new life that has as its main objective the autonomy scope family and society. The search for a good level of amputation surgery then makes reconstructive surgery. The level of amputation will allow in fact the use ofprincipals able to guarantee the total autonomy. After an analysis of surgical techniques the author will then analyze the latest devices available in the permit to pursue the best possible level of amputation even in cases where the disease is starting to discourage the doctor.

  2. Goniometry and Limb Girth in Miniature Dachshunds

    Directory of Open Access Journals (Sweden)

    Stephanie A. Thomovsky

    2016-01-01

    Full Text Available Purpose. To report the mean and median pelvic limb joint angles and girth measurements in miniature Dachshunds presenting with varying degrees of pelvic limb weakness secondary to thoracolumbar intervertebral disc extrusion. Methods. 15 miniature Dachshunds who presented to WSU-VTH for thoracolumbar disc extrusion. Dachshunds varied in neurologic status from ambulatory paraparetic to paraplegic at the time of measurements. Results. There were no significant differences in joint angles or girth among the three groups (ambulatory paraparetic, nonambulatory paraparetic, or paraplegic (P>0.05. When group was disregarded and values for extension, flexion, and girth combined, no differences existed. Conclusions. Goniometry and limb girth measurements can successfully be made in the miniature Dachshund; however, the shape of the Dachshund leg makes obtaining these values challenging. There were no differences in joint angle or girth measurements between dogs with varying neurologic dysfunction at the time of measurement.

  3. Goniometry and Limb Girth in Miniature Dachshunds.

    Science.gov (United States)

    Thomovsky, Stephanie A; Chen, Annie V; Kiszonas, Alecia M; Lutskas, Lori A

    2016-01-01

    Purpose. To report the mean and median pelvic limb joint angles and girth measurements in miniature Dachshunds presenting with varying degrees of pelvic limb weakness secondary to thoracolumbar intervertebral disc extrusion. Methods. 15 miniature Dachshunds who presented to WSU-VTH for thoracolumbar disc extrusion. Dachshunds varied in neurologic status from ambulatory paraparetic to paraplegic at the time of measurements. Results. There were no significant differences in joint angles or girth among the three groups (ambulatory paraparetic, nonambulatory paraparetic, or paraplegic) (P > 0.05). When group was disregarded and values for extension, flexion, and girth combined, no differences existed. Conclusions. Goniometry and limb girth measurements can successfully be made in the miniature Dachshund; however, the shape of the Dachshund leg makes obtaining these values challenging. There were no differences in joint angle or girth measurements between dogs with varying neurologic dysfunction at the time of measurement.

  4. Vascular access in critical limb ischemia.

    Science.gov (United States)

    Kang, Won Yu; Campia, Umberto; Ota, Hideaki; Didier, Romain J; Negi, Smita I; Kiramijyan, Sarkis; Koifman, Edward; Baker, Nevin C; Magalhaes, Marco A; Lipinski, Michael J; Escarcega, Ricardo O; Torguson, Rebecca; Waksman, Ron; Bernardo, Nelson L

    2016-01-01

    Currently, percutaneous endovascular intervention is considered a first line of therapy for treating patients with critical limb ischemia. As the result of remarkable development of techniques and technologies, percutaneous endovascular intervention has led to rates of limb salvage comparable to those achieved with bypass surgery, with fewer complications, even in the presence of lower rates of long-term patency. Currently, interventionalists have a multiplicity of access routes including smaller arteries, with both antegrade and retrograde approaches. Therefore, the choice of the optimal access site has become an integral part of the success of the percutaneous intervention. By understanding the technical aspects, as well as the advantages and limitations of each approach, the interventionalists can improve clinical outcomes in patients with severe peripheral arterial disease. This article reviews the access routes in critical limb ischemia, their advantages and disadvantages, and the clinical outcomes of each. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. [Treatment of critical lower limb ischemia].

    Science.gov (United States)

    Salomon du Mont, L; Déglise, S; Dubuis, C; Saucy, F; Doenz, F; Calanca, L; Qanadli, S; Mazzolai, L; Corpataux J M

    2014-10-22

    Critical limb ischemia is a major public health problem in our western countries due to the epidemia of (diabesity). The outcome of patients suffering from critical limb ischemia reains poor with an amputation free survival rate at one year of about 50%. The treatment should be multidiciplinary and done in emergency in specialized centers to ensure the limb salvage: this management should be centered aroud 3 axis: the screening of the cardiovascular risk factors, the best medical treatment and the invasive approaches. Due to multiple endovascular technical innovations, more frail patients with com plex diseases can be treated with good results. Therefore, the endovascular treatment is essential in the management of such patients by vascular surgeons.

  6. Stump ulcers and continued prosthetic limb use.

    Science.gov (United States)

    Salawu, A; Middleton, C; Gilbertson, A; Kodavali, K; Neumann, V

    2006-12-01

    Stump ulcers are common problems in amputees. Temporary discontinuation of prosthetic limb use is frequently employed to facilitate healing. Inevitably, this limits activity and may, for instance, prevent an amputee from going to work. A survey of clinical practice was carried out based on the premise that controlled continued prosthetic limb use in patients with stump ulcers will not adversely affect the ulcer nor prevent healing. The survey would also form a basis for developing future guidelines in the management of stump ulcers. All consecutive patients attending the Chapel Allerton Hospital prosthetic clinic between January 2003 and May 2004 with stump ulcers were recruited into the study. Primary outcome measures were changes in the surface area of the ulcers and in clinical photographs taken on 2 occasions 6 weeks apart. Some 102 patients with a mean age 60 years (range 18 - 88 years) were recruited. Eight patients who were established prosthetic limb users did not complete the study and were excluded from the analysis. Of the patients 52 were newly referred patients with delayed surgical wound healing while 42 were established prosthetic limb users for at least 1 year. Continued prosthetic limb was associated with a significant reduction in ulcer size (p prosthetic limb wearing despite the presence of stump ulceration. This observational study found that, despite prosthetic use, 60 (64%) cases healed completely within the six-week study period and 23 (25%) ulcers reduced in size. The ulcers were unchanged in 2% of the cases. Deterioration was observed in nine (9%) cases. This survey suggests that the current practice of allowing patients to use their prostheses is safe. A clinical trial is now needed to establish whether this practice alters healing rate or has any other disadvantages for new or established amputees.

  7. [Partial replantation following proximal limb injury].

    Science.gov (United States)

    Dubert, T; Malikov, S A; Dinh, A; Kupatadze, D D; Oberlin, C; Alnot, J Y; Nabokov, B B

    2000-11-01

    Proximal replantation is a technically feasible but life-threatening procedure. Indications must be restricted to patients in good condition with a good functional prognosis. The goal of replantation must be focused not only on reimplanting the amputated limb but also on achieving a good functional outcome. For the lower limb, simple terminalization remains the best choice in many cases. When a proximal amputation is not suitable for replantation, the main aim of the surgical procedure must be to reconstruct a stump long enough to permit fitting a prosthesis preserving the function of the adjacent joint. If the proximal stump beyond the last joint is very short, it may be possible to restore some length by partial replantation of spared tissues from the amputated part. We present here the results we obtained following this policy. This series included 16 cases of partial replantations, 14 involving the lower limb and 2 the upper limb. All were osteocutaneous microsurgical transfers. For the lower limb, all transfers recovered protective sensitivity following tibial nerve repair. The functional calcaeoplantar unit was used in 13 cases. The transfer of this specialized weight bearing tissue provided a stable distal surface making higher support unnecessary. In one case, we raised a 13-cm vascularized tibial segment covered with foot skin for additional length. For the upper limb, the osteocutaneous transfer, based on the radial artery, was not reinnervated, but this lack of sensitivity did not impair prosthesis fitting. One vascular failure was finally amputated. This was the only unsuccessful result. For all other patients, the surgical procedure facilitated prosthesis fitting and preserved the proximal joint function despite an initially very proximal amputation. The advantages of partial replantation are obvious compared with simple terminalization or secondary reconstruction. There is no secondary donor site and, because there is no major muscle mass in the

  8. Peak medial (but not lateral) hamstring activity is significantly lower during stance phase of running. An EMG investigation using a reduced gravity treadmill.

    Science.gov (United States)

    Hansen, Clint; Einarson, Einar; Thomson, Athol; Whiteley, Rodney

    2017-09-01

    The hamstrings are seen to work during late swing phase (presumably to decelerate the extending shank) then during stance phase (presumably stabilizing the knee and contributing to horizontal force production during propulsion) of running. A better understanding of this hamstring activation during running may contribute to injury prevention and performance enhancement (targeting the specific role via specific contraction mode). Twenty active adult males underwent surface EMG recordings of their medial and lateral hamstrings while running on a reduced gravity treadmill. Participants underwent 36 different conditions for combinations of 50%-100% altering bodyweight (10% increments) & 6-16km/h (2km/h increments, i.e.: 36 conditions) for a minimum of 6 strides of each leg (maximum 32). EMG was normalized to the peak value seen for each individual during any stride in any trial to describe relative activation levels during gait. Increasing running speed effected greater increases in EMG for all muscles than did altering bodyweight. Peak EMG for the lateral hamstrings during running trials was similar for both swing and stance phase whereas the medial hamstrings showed an approximate 20% reduction during stance compared to swing phase. It is suggested that the lateral hamstrings work equally hard during swing and stance phase however the medial hamstrings are loaded slightly less every stance phase. Likely this helps explain the higher incidence of lateral hamstring injury. Hamstring injury prevention and rehabilitation programs incorporating running should consider running speed as more potent stimulus for increasing hamstring muscle activation than impact loading. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Cocaine-associated lower limb ischemia.

    LENUS (Irish Health Repository)

    Collins, Chris G

    2011-07-25

    Cocaine-associated thrombosis has been reported in the literature with reports of vascular injuries to cardiac, pulmonary, intestinal, placental, and musculoskeletal vessels; however, injury of the pedal vessels is rare. We report on a 31-year-old man who presented 2 months following a cocaine binge with limb-threatening ischemia without an otherwise identifiable embolic source. Angiography confirmed extensive occlusive disease of the tibioperoneal vessels. The patient improved following therapy with heparin and a prostacyclin analogue. Cocaine-induced thrombosis should be considered in patients presenting with acute arterial insufficiency in the lower limb without any other identifiable cause.

  10. Deciphering skeletal patterning: clues from the limb.

    Science.gov (United States)

    Mariani, Francesca V; Martin, Gail R

    2003-05-15

    Even young children can distinguish a Tyrannosaurus rex from a Brontosaurus by observing differences in bone size, shape, number and arrangement, that is, skeletal pattern. But despite our extensive knowledge about cartilage and bone formation per se, it is still largely a mystery how skeletal pattern is established. Much of what we do know has been learned from studying limb development in chicken and mouse embryos. Based on the data from such studies, models for how limb skeletal pattern is established have been proposed and continue to be hotly debated.

  11. Cross-limb Interference during motor learning

    DEFF Research Database (Denmark)

    Lauber, Benedikt; Jensen, Jesper Lundbye; Keller, Martin

    2013-01-01

    the training, after the training and in an immediate retention test after the practice of the interference task for both the trained and the untrained hand. After training, subjects showed not only significant learning and interference effects for the trained limb but also for the contralateral untrained limb...... to the trained hand following ballistic training and decreased during accuracy training of the ipsilateral hand. The results demonstrate that contralateral interference effects may occur, and that interference depends on the level of skill acquisition in the interfering motor task. This finding might...... be particularly relevant for rehabilitation....

  12. Genetic interactions between Shox2 and Hox genes during the regional growth and development of the mouse limb.

    Science.gov (United States)

    Neufeld, Stanley J; Wang, Fan; Cobb, John

    2014-11-01

    The growth and development of the vertebrate limb relies on homeobox genes of the Hox and Shox families, with their independent mutation often giving dose-dependent effects. Here we investigate whether Shox2 and Hox genes function together during mouse limb development by modulating their relative dosage and examining the limb for nonadditive effects on growth. Using double mRNA fluorescence in situ hybridization (FISH) in single embryos, we first show that Shox2 and Hox genes have associated spatial expression dynamics, with Shox2 expression restricted to the proximal limb along with Hoxd9 and Hoxa11 expression, juxtaposing the distal expression of Hoxa13 and Hoxd13. By generating mice with all possible dosage combinations of mutant Shox2 alleles and HoxA/D cluster deletions, we then show that their coordinated proximal limb expression is critical to generate normally proportioned limb segments. These epistatic interactions tune limb length, where Shox2 underexpression enhances, and Shox2 overexpression suppresses, Hox-mutant phenotypes. Disruption of either Shox2 or Hox genes leads to a similar reduction in Runx2 expression in the developing humerus, suggesting their concerted action drives cartilage maturation during normal development. While we furthermore provide evidence that Hox gene function influences Shox2 expression, this regulation is limited in extent and is unlikely on its own to be a major explanation for their genetic interaction. Given the similar effect of human SHOX mutations on regional limb growth, Shox and Hox genes may generally function as genetic interaction partners during the growth and development of the proximal vertebrate limb. Copyright © 2014 by the Genetics Society of America.

  13. The Mouse Limb Anatomy Atlas: An interactive 3D tool for studying embryonic limb patterning

    Directory of Open Access Journals (Sweden)

    DeLaurier April

    2008-09-01

    Full Text Available Abstract Background The developing mouse limb is widely used as a model system for studying tissue patterning. Despite this, few references are available that can be used for the correct identification of developing limb structures, such as muscles and tendons. Existing textual references consist of two-dimensional (2D illustrations of the adult rat or mouse limb that can be difficult to apply when attempting to describe the complex three-dimensional (3D relationship between tissues. Results To improve the resources available in the mouse model, we have generated a free, web-based, interactive reference of limb muscle, tendon, and skeletal structures at embryonic day (E 14.5 http://www.nimr.mrc.ac.uk/3dlimb/. The Atlas was generated using mouse forelimb and hindlimb specimens stained using immunohistochemistry to detect muscle and tendon. Limbs were scanned using Optical Projection Tomography (OPT, reconstructed to make 3D models and annotated using computer-assisted segmentation tools in Amira 3D Visualisation software. The annotated dataset is visualised using Java, JAtlasView software. Users click on the names of structures and view their shape, position and relationship with other structures within the 3D model and also in 2D virtual sections. Conclusion The Mouse Limb Anatomy Atlas provides a novel and valuable tool for researchers studying limb development and can be applied to a range of research areas, including the identification of abnormal limb patterning in transgenic lines and studies of models of congenital limb abnormalities. By using the Atlas for "virtual" dissection, this resource offers an alternative to animal dissection. The techniques we have developed and employed are also applicable to many other model systems and anatomical structures.

  14. The two domain hypothesis of limb prepattern and its relevance to congenital limb anomalies.

    Science.gov (United States)

    Tao, Hirotaka; Kawakami, Yasuhiko; Hui, Chi-Chung; Hopyan, Sevan

    2017-07-01

    Functional annotation of mutations that cause human limb anomalies is enabled by basic developmental studies. In this study, we focus on the prepatterning stage of limb development and discuss a recent model that proposes anterior and posterior domains of the early limb bud generate two halves of the future skeleton. By comparing phenotypes in humans with those in model organisms, we evaluate whether this prepatterning concept helps to annotate human disease alleles. WIREs Dev Biol 2017, 6:e270. doi: 10.1002/wdev.270 For further resources related to this article, please visit the WIREs website. © 2017 Wiley Periodicals, Inc.

  15. The fascia of the limbs and back – a review

    Science.gov (United States)

    Benjamin, Mike

    2009-01-01

    Although fasciae have long interested clinicians in a multitude of different clinical and paramedical disciplines, there have been few attempts to unite the ensuing diverse literature into a single review. The current article gives an anatomical perspective that extends from the gross to the molecular level. For expediency, it deals only with fascia in the limbs and back. Particular focus is directed towards deep fascia and thus consideration is given to structures such as the fascia lata, thoracolumbar fascia, plantar and palmar fascia, along with regional specializations of deep fascia such as retinacula and fibrous pulleys. However, equal emphasis is placed on general aspects of fascial structure and function, including its innervation and cellular composition. Among the many functions of fascia considered in detail are its ectoskeletal role (as a soft tissue skeleton for muscle attachments), its importance for creating osteofascial compartments for muscles, encouraging venous return in the lower limb, dissipating stress concentration at entheses and acting as a protective sheet for underlying structures. Emphasis is placed on recognizing the continuity of fascia between regions and appreciating its key role in coordinating muscular activity and acting as a body-wide proprioceptive organ. Such considerations far outweigh the significance of viewing fascia in a regional context alone. PMID:19166469

  16. Dominant limb asymmetry associated with prospective injury ...

    African Journals Online (AJOL)

    The purpose of the study was to identify associations between dominant lower limb asymmetry in unanticipated agility performance and prospective injury occurrence. Female netball players (N=24) performed unanticipated 180° turn agility sprints on both the dominant and non-dominant legs interspersed with an additional ...

  17. Limb body wall complex: A rare anomaly

    Directory of Open Access Journals (Sweden)

    Panduranga Chikkannaiah

    2013-01-01

    Full Text Available We present autopsy findings of a case of limb body wall complex (LBWC. The fetus had encephalocele, genitourinary agenesis, skeletal anomalies and body wall defects. The rare finding in our case is the occurrence of both cranial and urogenital anomalies. The presence of complex anomalies in this fetus, supports embryonal dysplasia theory of pathogenesis for LBWC.

  18. Diagnosis and treatment of upper limb apraxia.

    Science.gov (United States)

    Dovern, A; Fink, G R; Weiss, P H

    2012-07-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients' prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed and ill-treated entity. Based on a systematic literature search, this review summarizes the current tools of diagnosis and treatment strategies for upper limb apraxia. It furthermore provides clinicians with graded recommendations. In particular, a short screening test for apraxia, and a more comprehensive diagnostic apraxia test for clinical use are recommended. Although currently only a few randomized controlled studies investigate the efficacy of different apraxia treatments, the gesture training suggested by Smania and colleagues can be recommended for the therapy of apraxia, the effects of which were shown to extend to activities of daily living and to persist for at least 2 months after completion of the training. This review aims at directing the reader's attention to the ecological relevance of apraxia. Moreover, it provides clinicians with appropriate tools for the reliable diagnosis and effective treatment of apraxia. Nevertheless, this review also highlights the need for further research into how to improve diagnosis of apraxia based on neuropsychological models and to develop new therapeutic strategies.

  19. Limb reduction anomaly after failed misoprostol abortion

    African Journals Online (AJOL)

    and/or treatment of peptic ulcer disease caused by prostaglandin synthetase inhibitors. It is also an effective abortifacient, both alone and following pretreatment with. RU-486.' Its widespread use in Brazil2. •. 5 resulted in the identification of teratogenic effects," particularly limb reduction defects' such as was seen in our ...

  20. Radiographic anatomy of developing canine pectoral limb

    International Nuclear Information System (INIS)

    Charjan, R.Y.; Bhamburkar, V.R.; Dalvi, R.S.; Banubakode, S.B.

    2006-01-01

    Age period for the appearance of the ossification centre that appear after birth in the limb bones of the dog were determined by radiography, at set intervals in 3 German Shepherd, Pomeranian and Non-descript. The ossification centres appeared in the same chronological order, but the ages at which they appear, showed variation

  1. Return to work after lower limb amputation.

    Science.gov (United States)

    Burger, Helena; Marincek, Crt

    2007-09-15

    To review the literature on return to work after lower limb amputation. A comprehensive review of literature on return to work after lower limb amputation was carried out, searching MEDLINE and PubMED. Most authors found return-to-work rate to be about 66%. Between 22 and 67% of the subjects retained the same occupation, while the remainder had to change occupation. Post-amputation jobs were generally more complex with a requirement for a higher level of general educational development and were physically less demanding. The return to work depends on: general factors, such as age, gender and educational level; factors related to impairments and disabilities due to amputation (amputation level, multiple amputations, comorbidity, reason for amputation, persistent stump problems, the time from the injury to obtaining a permanent prosthesis, wearing comfort of the prosthesis, walking distance and restrictions in mobility); and factors related to work and policies (salary, higher job involvement, good support from the implementing body and the employer and social support network). Subjects have problems returning to work after lower limb amputation. Many have to change their work and/or work only part-time. Vocational rehabilitation and counselling should become a part of rehabilitation programme for all subjects who are of working age after lower limb amputation. Better cooperation between professionals, such as rehabilitation team members, implementing bodies, company doctors and the employers, is necessary.

  2. The good, the bad and the ugly: The shifting ethical stance of Malaysian consumers The good, the bad and the ugly: The shifting ethical stance of Malaysian consumers The good, the bad and the ugly: The shifting ethical stance of Malaysian consumers

    Directory of Open Access Journals (Sweden)

    Teck-Chai Lau

    2010-10-01

    Full Text Available Due to the recent business ethical problems in Malaysia such as tax fraud, deceptive advertising, production of unsafe products and copyright piracy, the current research aim to examine ethical issues in the marketplace from the perspective of consumers. There are three objectives of this research. The first objective is to investigate the effect of moral ideologies and Machiavellianism on consumer ethical beliefs. The second objective is to determine which of these ideologies exert the greatest influence on consumer ethical beliefs and the third objective is to discover whether Malaysian consumers have evolved in their ethical stance over the last ten years. The dependent variable in this research is the recently modified consumer ethics scale developed by Vitell and Muncy (2005. An online survey was adopted as data collection method as it was inexpensive, fast and could ensure high response rates. However it has several limitations such as the possible non-representativeness of Internet respondents to the Malaysian population and higher non-response error. The results indicated that idealism exerted the greatest influence on all the four dimensions of consumer ethics. It was also revealed that Malaysian consumers had evolved over the past ten years in their moral ideology: from relativism to idealism.Due to the recent business ethical problems in Malaysia such as tax fraud, deceptive advertising, production of unsafe products and copyright piracy, the current research aim to examine ethical issues in the marketplace from the perspective of consumers. There are three objectives of this research. The first objective is to investigate the effect of moral ideologies and Machiavellianism on consumer ethical beliefs. The second objective is to determine which of these ideologies exert the greatest influence on consumer ethical beliefs and the third objective is to discover whether Malaysian consumers have evolved in their ethical stance over the

  3. An analysis of chick limb bud intercellular adhesion underlying the establishment of cartilage aggregates in suspension culture.

    Science.gov (United States)

    Bee, J A; von der Mark, K

    1990-07-01

    To examine the mechanism of intercellular adhesion in the establishment of limb skeletal elements we have investigated the process of limb bud cell aggregation in vitro. Limb bud cells are aggregation-competent immediately after their trypsin:collagenase dissociation in the absence of calcium. This aggregation is largely Ca2(+)-independent (CI) and is completely and reversibly inhibited by cycloheximide. In contrast, when limb bud cells are first allowed to recover from Ca2(+)-free trypsin:collagenase dissociation, aggregation of the surviving population is exclusively Ca2(+)-dependent (CD) and completely and reversibly inhibited by cycloheximide. The presence of exogenous calcium during initial cell dissociation retains a functional CD aggregation mechanism. However, incubation of such cells with EGTA releases the CD component and converts the cells to a predominantly CI aggregation. Rabbits were immunized with limb bud cells exhibiting the recovered CD aggregation mechanism and the resulting immune sera were screened for their effect on cell aggregation. Relative to pre-immune sera, intact immune IgG agglutinated dissociated limb bud cells whilst immune Fab fragments inhibited their aggregation. The aggregation-inhibiting antiserum recognizes five major limb bud cell surface components with apparent molecular weights of 72K, 50K, 23K, 14.5K and 8.5K (K = 10(3) Mr), respectively. Limb bud cell surface plasma membranes were isolated by sucrose gradient density centrifugation and detergent-solubilized proteins coupled to Sepharose 4B with cyanogen bromide. Equivalent cell surface plasma membrane proteins were 125I-iodinated and applied to the affinity column. Limb bud cell surface protein affinity chromatography in the presence of exogenous calcium yields a single protein with an apparent molecular weight of approximately 8.5 K. This protein molecule elutes at 0.6 M NaCl, indicating a high affinity, is recognized by the aggregation-inhibiting antiserum, and is

  4. "Not Brain-washed, but Heart-washed": A Qualitative Analysis of Benevolent Sexism in the Anti-Choice Stance.

    Science.gov (United States)

    Duerksen, Kari N; Lawson, Karen L

    2017-12-01

    In recent years, anti-choice dialog has shifted from a focus on the fetus to a focus on the woman. This new movement constructs itself as positive and pro-woman, while perpetuating harmful stereotypes about women and the effects of abortion. Research has shown a relationship between benevolent sexism (beliefs that women are morally pure creatures in need of protection and nurturing) and restrictive attitudes towards abortion, although no research has qualitatively explored this relationship. The present study seeks to explore this by interpreting the content of one-on-one interviews with Canadian individuals holding an anti-choice stance through the theoretical framework of benevolent sexism. Thematic analysis of the interviews revealed three main themes: (1) protective paternalism, (2) complementary gender differentiation, and (3) the categorization of women. These themes connect strongly with benevolent sexism, providing evidence that abortion is still a stigmatized procedure. This stigma has shifted from viewing women who have abortions in an overtly negative way to viewing them as pitiable and poor decision makers.

  5. Understanding developing country stances on post-2012 climate change negotiations: Comparative analysis of Brazil, China, India, Mexico, and South Africa

    International Nuclear Information System (INIS)

    Rong Fang

    2010-01-01

    An essential issue in future climate negotiations is how to bring developing countries on board. This paper proposes and applies the two-level interest-based model to analyze the factors that affect the likely stances of the 'Plus Five' countries (Brazil, China, India, Mexico, and South Africa) on international climate negotiations. This study finds mitigation capability to be a crucial factor which consists of at least such sub-factors as per capita income, energy endowment, and economic structure, while ecological vulnerability does not seem to play an important role which includes reductions in agricultural outputs, sea-level rise, climate-related natural disasters, and others. The paper proposes six options in an ascending order of stringency that the Plus Five are likely to adopt. The paper suggests that the 'Basic Four' (the Plus Five excluding Mexico), particularly China and India, are less likely to adopt a voluntary commitment to an emissions cap on the national economy in the near future than Mexico, which has the highest mitigation capability among all five. The Basic Four are likely to adopt more stringent climate polices with increasing mitigation capabilities, suggesting the importance of effective international financial and technology transfer mechanisms and further tighten emission reduction targets from developed countries.

  6. A systematic review of the relationship between physical activities in sports or daily life and postural sway in upright stance.

    Science.gov (United States)

    Kiers, Henri; van Dieën, Jaap; Dekkers, Henk; Wittink, Harriët; Vanhees, Luc

    2013-11-01

    In many sports, maintaining balance is necessary to compete at a high level. Also, in many health problems, balance is impaired. Postural sway (PS) is often used as an indicator of upright balance control, and physical activity (PA) might enhance balance control. However, the relationship between PS and PA has never been systematically reviewed. Our objective was to summarize the evidence regarding the relationship between PS in upright bipedal and unipedal standing and PA. We conducted a literature search in MEDLINE, EmBase, CINAHL, the Cochrane Database, and PEDro, up to March 2012, with no limit on the starting date. Characteristics and methodological aspects of each article were extracted by two reviewers. We used centre of pressure (CoP) velocity, and variables related to the CoP area, to compare studies. A total of 39 articles were reviewed from an initial yield of 2,058. Of these 39 studies, 37 used a comparative design, one was a cohort study, and one was a randomized controlled trial. The main conclusion was that in general, sport practitioners sway less than controls, and high-level athletes sway less than low-level athletes. Additionally, we identified specific effects dependent on the use of vision, sport-specific postures, and frequency and duration of the (sports) activity. PS in unperturbed bipedal stance appears to have limited sensitivity to detect subtle differences between groups of healthy people.

  7. Comparison of three definitions of the mid-stance and mid-swing events of the gait cycle in children.

    Science.gov (United States)

    Gibson, T; Jeffery, R S; Bakheit, A M O

    2006-05-30

    Different criteria are used to define the terms mid-stance (MST) and mid-swing (MSW) when describing the gait cycle. None of these definitions is universally accepted. This causes difficulties with the interpretation of gait analysis data and hinders the comparison between the different studies. The aim of the present study was to compare three definitions of MST and MSW by examining the gait of a group of healthy children. A prospective comparison of three commonly used definitions of the MST and MSW events of the gait cycle. The timing of the temporal, kinematic and kinetic MST and MSW of the gait cycle. Thirty healthy 8 - 10-year-old children were studied. There was no consistent correlation between the timing of the chosen definitions of MST and MSW. However, there was a tendency for the timing of the temporal and kinetic MST and MSW to occur, respectively, at approximately 30 and 80% of the gait cycle. The temporal definition of MST and MSW as the midpoints in time of the respective phases of the gait cycle appears to be more appropriate than other definitions. The use of this definition may prevent misunderstanding and permit comparison of the results of the different gait analysis studies.

  8. A Study on the Defensive Stance and Position of Handball Goalkeepers: Facing a Forward Jump Shot Made from 9 Meters.

    Science.gov (United States)

    Yang, Jong Hyun; Lee, Young Suk

    2016-10-01

    The purpose of this study was to find the defensive stance and calculate an optimal defense position for goalkeepers while blocking forward jump shots made from a distance of 9 m. Nine men's handball matches were recorded and 78 video clips were selected for analysis. These are the top class goalkeepers, which included players from the national team and reserve team of Korea. The goalkeeper's actual defensive position was significantly different from instructional suggestions; the width of both feet of the goalkeeper was approximately 2.5 times the width of the shoulders, and the hands were at waist height. The goalkeeper's actual defense position was about 1.10 (± 0.3) m from the goal line and also significantly different than instructional material (0.75 m). The optimal defense position, which was calculated from the goalkeeper's actual movement, was 1.44 m from the goal line, because the ratio of goalkeeper's defensive area in relation to the total area to be defended is highest at this point. In summary, we recommended that handball goalkeepers move forward, about a half step (0.34 m), when defending a forward jump shot made from 9 m, and instructional material should be modified according to the findings from this study.

  9. Using the Technology of the Confessional as an Analytical Resource: Four Analytical Stances Towards Research Interviews in Discourse Analysis

    Directory of Open Access Journals (Sweden)

    Brendan K. O'Rourke

    2007-05-01

    Full Text Available Among the various approaches that have developed from FOUCAULT's work is an Anglophone discourse analysis that has attempted to combine FOUCAULTian insights with the techniques of Conversation Analysis. An important current methodological issue in this discourse analytical approach is its theoretical preference for "naturally occurring" rather than research interview data. A FOUCAULTian perspective on the interview as a research instrument, questions the idea of "naturally-occurring discourse". The "technology of the confessional" operates, not only within research interviews, but permeates other interactions as well. Drawing on FOUCAULT does not dismiss the problems of the interview as research instrument rather it shows they cannot be escaped by simply switching to more "natural" interactions. Combining these insights with recent developments within discourse analysis can provide analytical resources for, rather than barriers to, the discourse analysis of research interviews. To aid such an approach, we develop a four-way categorisation of analytical stances towards the research interview in discourse analysis. A demonstration of how a research interview might be subjected to a discourse analysis using elements of this approach is then provided. URN: urn:nbn:de:0114-fqs070238

  10. Understanding developing country stances on post-2012 climate change negotiations: Comparative analysis of Brazil, China, India, Mexico, and South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Rong Fang, E-mail: rongfang98@hotmail.co [Laboratory on International Law and Regulation, School of International Relations and Pacific Studies, University of California, San Diego, 92093 (United States); Center for Industrial Development and Environmental Governance, School of Public Policy and Management, Tsinghua University, Beijing 100084 (China)

    2010-08-15

    An essential issue in future climate negotiations is how to bring developing countries on board. This paper proposes and applies the two-level interest-based model to analyze the factors that affect the likely stances of the 'Plus Five' countries (Brazil, China, India, Mexico, and South Africa) on international climate negotiations. This study finds mitigation capability to be a crucial factor which consists of at least such sub-factors as per capita income, energy endowment, and economic structure, while ecological vulnerability does not seem to play an important role which includes reductions in agricultural outputs, sea-level rise, climate-related natural disasters, and others. The paper proposes six options in an ascending order of stringency that the Plus Five are likely to adopt. The paper suggests that the 'Basic Four' (the Plus Five excluding Mexico), particularly China and India, are less likely to adopt a voluntary commitment to an emissions cap on the national economy in the near future than Mexico, which has the highest mitigation capability among all five. The Basic Four are likely to adopt more stringent climate polices with increasing mitigation capabilities, suggesting the importance of effective international financial and technology transfer mechanisms and further tighten emission reduction targets from developed countries.

  11. Understanding developing country stances on post-2012 climate change negotiations. Comparative analysis of Brazil, China, India, Mexico, and South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Rong, Fang [Laboratory on International Law and Regulation, School of International Relations and Pacific Studies, University of California, San Diego, 92093 (United States); Center for Industrial Development and Environmental Governance, School of Public Policy and Management, Tsinghua University, Beijing 100084 (China)

    2010-08-15

    An essential issue in future climate negotiations is how to bring developing countries on board. This paper proposes and applies the two-level interest-based model to analyze the factors that affect the likely stances of the Plus Five countries (Brazil, China, India, Mexico, and South Africa) on international climate negotiations. This study finds mitigation capability to be a crucial factor which consists of at least such sub-factors as per capita income, energy endowment, and economic structure, while ecological vulnerability does not seem to play an important role which includes reductions in agricultural outputs, sea-level rise, climate-related natural disasters, and others. The paper proposes six options in an ascending order of stringency that the Plus Five are likely to adopt. The paper suggests that the Basic Four (the Plus Five excluding Mexico), particularly China and India, are less likely to adopt a voluntary commitment to an emissions cap on the national economy in the near future than Mexico, which has the highest mitigation capability among all five. The Basic Four are likely to adopt more stringent climate polices with increasing mitigation capabilities, suggesting the importance of effective international financial and technology transfer mechanisms and further tighten emission reduction targets from developed countries. (author)

  12. Activation of the gluteus medius according to load during horizontal hip abduction in a one-leg stance.

    Science.gov (United States)

    Lee, Jae-Woong; Kim, Yeong-Ju; Koo, Hyun-Mo

    2015-08-01

    [Purpose] This study researched the influences of different loads on muscle activity of the posterior fibers of the gluteus medius in a one-leg standing position. [Subjects] Twenty-four healthy adult men participated in this study. [Methods] All participants performed the one-leg standing position under four conditions: the standard no-load condition, in which the non-weight-bearing leg was lifted and kept parallel to the back and then pelvic or lumbar rotation was performed without thorax rotation, and the 0 kg, 1 kg, and 3 kg load conditions, in which horizontal shoulder abduction was performed with a load of 0 kg, 1 kg, or 3 kg added to the hand. The electromyographic activity of the posterior fibers of the gluteus medius was measured using a wireless surface electromyography under all conditions. The electromyographic activity of each muscle under the four conditions during the one-leg stance was analyzed using one-way analysis of variance. [Results] The electromyographic activity of the posterior fiber of the gluteus medius was significantly increased under the 3 kg load condition compared with the no-load, 0 kg load, and 1 kg load conditions. [Conclusion] These findings indicated that muscle activation is affected by increases in load in the one-leg standing position. The load on the upper extremity influences the muscle activity of the contralateral lower extremity.

  13. Characteristics of multiple sclerosis patient stance control disorders, measured by means of posturography and related to brainstem lesions

    Directory of Open Access Journals (Sweden)

    Dario Alpini

    2012-01-01

    Full Text Available Balance disorders are commonly observed during the course of multiple sclerosis (MS. The aim of this study is to report characteristics of MS patient stance control disorders, measured by means of posturography and related to the brainstem lesions. Thirty-eight patients affected by MS, mildly to moderately disable according to Kurtzke’s Expanded Disability Status Scale, underwent a complete clinical neurological and vestibular evaluation and brain MRI scanning. All patients were then tested on a static posturography platform (Tetrax, Israel in four conditions: eyes open and eyes closed standing on a firm surface and on a foam pad. Clinical and/or magnetic resonance imaging evidence of brainstem involvement was observed in 55.3% of patients. When brainstem lesion was detected, Fourier analysis showed a typical pattern characterized by inversion of the 0- 0.1 Hz and 0.1-0.25 Hz frequency bands. In conclusion, MS leads to pervasive postural disturbances in the majority of subjects, including the visuo-vestibular loops and proprioception involving vestibulospinal pathways in at least 55.3% of patients. Our results may also suggest the presence of Fourier inversion in patients with brainstem lesions.

  14. Genetic Regulation of Embryological Limb Development with Relation to Congenital Limb Deformity in Humans

    OpenAIRE

    Barham, Guy; Clarke, Nicholas M. P.

    2008-01-01

    Over the last 15 years, great improvements in genetic engineering and genetic manipulation strategies have led to significant advances in the understanding of the genetics governing embryological limb development. This field of science continues to develop, and the complex genetic interactions and signalling pathways are still not fully understood. In this review we will discuss the roles of the principle genes involved in the three-dimensional patterning of the developing limb and will discu...

  15. Internal models of limb dynamics and the encoding of limb state

    Science.gov (United States)

    Hwang, Eun Jung; Shadmehr, Reza

    2005-09-01

    Studies of reaching suggest that humans adapt to novel arm dynamics by building internal models that transform planned sensory states of the limb, e.g., desired limb position and its derivatives, into motor commands, e.g., joint torques. Earlier work modeled this computation via a population of basis elements and used system identification techniques to estimate the tuning properties of the bases from the patterns of generalization. Here we hypothesized that the neural representation of planned sensory states in the internal model might resemble the signals from the peripheral sensors. These sensors normally encode the limb's actual sensory state in which movement errors occurred. We developed a set of equations based on properties of muscle spindles that estimated spindle discharge as a function of the limb's state during reaching and drawing of circles. We then implemented a simulation of a two-link arm that learned to move in various force fields using these spindle-like bases. The system produced a pattern of adaptation and generalization that accounted for a wide range of previously reported behavioral results. In particular, the bases showed gain-field interactions between encoding of limb position and velocity, very similar to the gain fields inferred from behavioral studies. The poor sensitivity of the bases to limb acceleration predicted behavioral results that were confirmed by experiment. We suggest that the internal model of limb dynamics is computed by the brain with neurons that encode the state of the limb in a manner similar to that expected of muscle spindle afferents.

  16. Immersive VR in Phantom Limb Pain Therapy of Amputee Patients Due to Critical Limb Ischemia

    Directory of Open Access Journals (Sweden)

    Zanfir Ana-Maria

    2017-09-01

    Full Text Available Introduction: Phantom limb pain (PLP occurs in approximately 75% of patients who undergo limb amputation. In identifying the etiopathogenic mechanisms, multidisciplinary approaches are increasingly important in explaining the causality based on neurological and psychological factors. PLP has many negative effects on the amputee's physical and mental integrity, which is why a variety of treatments have been conceived, whose effectiveness is rather limited.

  17. Pattern Of Lower Limb Amputations In Eku | Akhator | Ebonyi ...

    African Journals Online (AJOL)

    Below knee amputation constituted 57.4% of the cases and above knee amputation constituted 35.2%, with diabetic foot gangrene being the most common indication for amputation. The pattern of lower limb amputation in Eku is ... facilities for lower limb prosthesis is recommended. Keywords: Lower limb; amputation; ...

  18. 21 CFR 890.3410 - External limb orthotic component.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External limb orthotic component. 890.3410 Section... (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3410 External limb orthotic component. (a) Identification. An external limb orthotic component is a device...

  19. The axolotl limb blastema: cellular and molecular mechanisms driving blastema formation and limb regeneration in tetrapods

    Science.gov (United States)

    McCusker, Catherine; Bryant, Susan V.

    2015-01-01

    Abstract The axolotl is one of the few tetrapods that are capable of regenerating complicated biological structures, such as complete limbs, throughout adulthood. Upon injury the axolotl generates a population of regeneration‐competent limb progenitor cells known as the blastema, which will grow, establish pattern, and differentiate into the missing limb structures. In this review we focus on the crucial early events that occur during wound healing, the neural−epithelial interactions that drive the formation of the early blastema, and how these mechanisms differ from those of other species that have restricted regenerative potential, such as humans. We also discuss how the presence of cells from the different axes of the limb is required for the continued growth and establishment of pattern in the blastema as described in the polar coordinate model, and how this positional information is reprogrammed in blastema cells during regeneration. Multiple cell types from the mature limb stump contribute to the blastema at different stages of regeneration, and we discuss the contribution of these types to the regenerate with reference to whether they are “pattern‐forming” or “pattern‐following” cells. Lastly, we explain how an engineering approach will help resolve unanswered questions in limb regeneration, with the goal of translating these concepts to developing better human regenerative therapies. PMID:27499868

  20. Effects of prosthetic limb prescription on 3-year mortality among Veterans with lower-limb amputation.

    Science.gov (United States)

    Kurichi, Jibby E; Kwong, Pui; Vogel, W Bruce; Xie, Dawei; Cowper Ripley, Diane; Bates, Barbara E

    2015-01-01

    Our objective was to determine the relationship between receipt of a prescription for a prosthetic limb and 3 yr mortality postsurgery among Veterans with lower-limb amputation (LLA). We conducted a retrospective observational study that included 4,578 Veterans hospitalized for LLA and discharged in fiscal years 2003 and 2004. The outcome was time to all-cause mortality from the amputation surgical date up to the 3 yr anniversary of the surgical date. Of the Veterans with LLA, 1,300 (28.4%) received a prescription for a prosthetic limb within 1 yr after the surgical amputation. About 46% (n = 2,086) died within 3 yr of the surgical anniversary. Among those who received a prescription for a prosthetic limb, only 25.2% died within 3 yr of the surgical anniversary. After adjustment, Veterans who received a prescription for a prosthetic limb were less likely to die after the surgery than Veterans without a prescription, with a hazard ratio of 0.68 (95% confidence interval: 0.60-0.77). Findings demonstrated that Veterans with LLA who received a prescription for a prosthetic limb within 1 yr after the surgical amputation were less likely to die within 3 yr of the surgical amputation after controlling for patient-, treatment-, and facility-level characteristics.

  1. Botulinum toxin treatment for limb spasticity in childhood cerebral palsy

    Directory of Open Access Journals (Sweden)

    Vito ePavone

    2016-02-01

    Full Text Available CP is the most common cause of chronic disability in childhood occurring in 2 to 2.5/1000 births. It is a severe disorder and a significant number of patients present cognitive delay and difficulty in walking. The use of botulinum toxin (BTX has become a popular treatment for CP especially for spastic and dystonic muscles while avoiding deformity and pain. Moreover, the combination of physiotherapy, casting, orthotics and injection of BTX may delay or decrease the need for surgical intervention while reserving single-event, multi-level surgery for fixed musculotendinous contractures and bony deformities in older children. This report highlights the utility of BTX in the treatment of cerebral palsy in children. We include techniques for administration, side effects and possible resistance as well as specific use in the upper and lower limbs muscles

  2. A quick and effective method of limb preparation with health, safety and efficiency benefits.

    Science.gov (United States)

    Naderi, N; Maw, K; Thomas, M; Boyce, D E; Shokrollahi, K

    2012-03-01

    Pre-operative limb preparation (PLP) usually involves lifting the limb and holding it in a fixed 'static' posture for several minutes. This is hazardous to theatre staff. Furthermore, 'painting' the limb can be time consuming and difficult areas such as between toes and fingers may remain unsterile. We demonstrate the time efficiency and asepsis achieved using the 'sterile bag' preparation technique. An additional advantage is the ability to prepare and anaesthetise a limb prior to theatre, increasing efficiency substantially for units with a large throughput of cases, such as day-case hand surgery lists. We monitored the duration of PLP in 20 patients using the 'sterile bag' technique compared to 20 patients using a conventional 'painting' method. Additionally, microbiology samples acquired from prepared upper limbs of 27 sequential patients operated on by a single surgeon over a two-month period were sent for culture immediately prior to commencement of surgery. The mean duration of the 'sterile bag' PLP was significantly lower than that of the conventional method (24 seconds vs 85 seconds, p=0.045). The technique can take as little as ten seconds (n=1). Final microbiology reports showed no growth for any of the 27 patients from whom a culture sample was taken. The sterile bag technique is effective in achieving asepsis, has the potential to increase theatre efficiency and reduces manual handling hazards compared to the conventional method. It is now taught to all theatre staff in our hospital during manual handling training. It can be undertaken in approximately ten seconds with practice for the upper limb.

  3. Comparison of three tools to measure improvements in upper-limb function with poststroke therapy.

    Science.gov (United States)

    Thompson-Butel, Angelica G; Lin, Gaven; Shiner, Christine T; McNulty, Penelope A

    2015-05-01

    Functional ability is regularly monitored poststroke to assess improvement and the efficacy of clinical trials. The balance between implementation times and sensitivity has led to multidomain tools that aim to assess upper-limb function comprehensively. This study implemented 3 common multidomain tools to investigate their suitability across a broad spectrum of movement ability after stroke. Forty-nine hemiparetic patients (18 females), aged 22 to 83 years and 24.7 ± 39.2 months poststroke, were assessed before and after a 14-day upper-limb rehabilitation program of Wii-based Movement Therapy. Assessments included the upper-limb motor subscale of the Fugl-Meyer Assessment (F-M), the Wolf Motor Function Test (WMFT), and the Motor Assessment Scale (MAS) upper-limb sections 6 to 8. The MAS was analyzed both with and without the hierarchical system. Patients were stratified with low, moderate, or high motor-function. Upper-limb function improved significantly for the pooled cohort for all assessments (P < .001), although ceiling effects were evident for the F-M, floor effects for the WMFT, and both floor and ceiling effects for MAS. When analyzed by stratified subgroup these improvements were significant for all groups with the F-M, for the moderate and high motor-function groups with both the WMFT and the MAS scored without hierarchical system, but only for the high motor-function group with the hierarchically scored MAS. These results suggest that no single test is suitable for measuring function and improvement across the spectrum of poststroke upper-limb dysfunction and that assessment tool selection should be based on the level of residual motor-function of individual patients. © The Author(s) 2014.

  4. The influence of lower-limb dominance on postural balance

    Directory of Open Access Journals (Sweden)

    Angélica Castilho Alonso

    Full Text Available CONTEXT AND OBJECTIVE: Maintainance of postural balance requires detection of body movements, integration of sensory information in the central nervous system and an appropriate motor response. The purpose of this study was to evaluate whether lower-limb dominance has an influence on postural balance. DESIGN AND SETTING: This was a cross-sectional study conducted at Faculdade de Medicina da Universidade de São Paulo (FMUSP and at Hospital do Coração (HCor. METHODS: Forty healthy sedentary males aged 20 to 40 years, without any injuries, were evaluated. A single-foot balance test was carried out using the Biodex Balance System equipment, comparing the dominant leg with the nondominant leg of the same individual. The instability protocols used were level 8 (more stable and level 2 (less stable, and three instability indices were calculated: anteroposterior, mediolateral and general. RESULTS: The volunteers' mean age was 26 ± 5 years (range: 20-38, mean weight 72.3 ± 11 kg (range: 46-107 and mean height 176 ± 6 cm (range: 169-186. Thirty-four of them (85% presented right-leg dominance (defined according to which leg they used for kicking and six (15% had left-leg dominance. There were no significant differences between the dominant and nondominant legs at the two levels of stability (eight and two, for any of the instability indices (general, anteroposterior and mediolateral. CONCLUSION: The lower-limb dominance did not influence single-foot balance among sedentary males.

  5. Effect of Upper Limb Deformities on Gross Motor and Upper Limb Functions in Children with Spastic Cerebral Palsy

    Science.gov (United States)

    Park, Eun Sook; Sim, Eun Geol; Rha, Dong-wook

    2011-01-01

    The aims of this study were to investigate the nature and extent of upper limb deformities via the use of various classifications, and to analyze the relationship between upper limb deformities and gross motor or upper limb functionality levels. Upper extremity data were collected from 234 children with spastic cerebral palsy (CP) who were…

  6. Increased slow transport in axons of regenerating newt limbs after a nerve conditioning lesion made prior to amputation

    Energy Technology Data Exchange (ETDEWEB)

    Maier, C.E.

    1989-01-01

    The first part of this study shows that axonal density is constant in the limb stump of the next proximal to the area of traumatic nerve degeneration caused by limb amputation. The results of the second part of this work reveal that a nerve conditioning lesion made two weeks prior to amputation is associated with accelerated limb regeneration and that this accelerated limb regeneration is accompanied by an earlier arrival of axons. This is the first demonstration of naturally occurring limb regeneration being enhanced. In this study SCb cytoskeletal proteins were identified and measured using SDS-PAGE and liquid scintillation counting. Proteins were measured at 7, 14, 21, and 28 days after {sup 35}S-methionine injection and the normal rate of SCb transport determined to be 0.19 mm/day. A single axotomy does not enhance the rate of SCb transport but does increase the amount of labeled SCb proteins that are transported. When a conditioning lesion is employed prior to limb amputation and SCb proteins are measured at 7, 14, and 21 days after injection, there is a twofold acceleration in the rate of SCb transport and an increase in the amount of SCb proteins transported in conditioned axons.

  7. Kinesio taping effect on quadriceps strength and lower limb function of healthy individuals: A blinded, controlled, randomized, clinical trial.

    Science.gov (United States)

    Fernandes de Jesus, Julio; de Almeida Novello, Aline; Bezerra Nakaoka, Gustavo; Curcio Dos Reis, Amir; Fukuda, Thiago Yukio; Fernandes Bryk, Flavio

    2016-03-01

    To analyze kinesio taping (KT) effect on quadriceps strength and lower limb function over a 7-day period. Blind randomized clinical trial. Hospital's Physical Therapy Department. Sixty healthy individuals (30 men and 30 women) were randomly distributed into three groups: Control--without KT application; Placebo--placebo KT application and Experimental--A KT application designed to stimulate quadriceps femoris activity. The quadriceps strength was measured using a manual dynamometer whereas lower limb function was assessed using the Single Hop Test for Distance. Evaluations occurred at five time-points: baseline; immediately, 3 and 5 days after KT application; and 72 h post KT withdrawal. There was no significant interaction between time-points and groups for muscle strength: dominant (P = 0.13) and non-dominant (P = 0.41) and lower limb function: dominant (P = 0.09) and non-dominant (P = 0.53); but lower limb function within-group comparisons showed improvements in all groups at the evolution of all time-points analyzed for both limbs (P = 0.001). This is possibly due to a learning effect as the participants became more familiar with executing the assessment tests. KT did not improve quadriceps strength and lower limb function of healthy individuals and its application with these objectives should be reconsidered. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. A characterization of the effect of limb position on EMG features to guide the development of effective prosthetic control schemes.

    Science.gov (United States)

    Radmand, A; Scheme, E; Englehart, K

    2014-01-01

    Electromyogram (EMG) pattern recognition has long been used for the control of upper limb prostheses. More recently, it has been shown that variability induced during functional use, such as changes in limb position and dynamic contractions, can have a substantial impact on the robustness of EMG pattern recognition. This work further investigates the reasons for pattern recognition performance degradation due to the limb position variation. The main focus is on the impact of limb position variation on features of the EMG, as measured using separability and repeatability metrics. The results show that when the limb is moved to a position different from the one in which the classifier is trained, both the separability and repeatability of the data decrease. It is shown how two previously proposed classification methods, multiple position training and dual-stage classification, resolve the position effect problem to some extent through increasing either separability or repeatability but not both. A hybrid classification method which exhibits a compromise between separability and repeatability is proposed in this work. It is shown that, when tested with the limb in 16 different positions, this method increases classification accuracy from an average of 70% (single position training) to 89% (hybrid approach). This hybrid method significantly (p<;0.05) outperforms multiple position training (an average of 86%) and dual-stage classification (an average of 85%).

  9. Plantar-flexion of the ankle joint complex in terminal stance is initiated by subtalar plantar-flexion: A bi-planar fluoroscopy study.

    Science.gov (United States)

    Koo, Seungbum; Lee, Kyoung Min; Cha, Young Joo

    2015-10-01

    Gross motion of the ankle joint complex (AJC) is a summation of the ankle and subtalar joints. Although AJC kinematics have been widely used to evaluate the function of the AJC, the coordinated movements of the ankle and subtalar joints are not well understood. The purpose of this study was to accurately quantify the individual kinematics of the ankle and subtalar joints in the intact foot during ground walking by using a bi-planar fluoroscopic system. Bi-planar fluoroscopic images of the foot and ankle during walking and standing were acquired from 10 healthy subjects. The three-dimensional movements of the tibia, talus, and calcaneus were calculated with a three-dimensional/two-dimensional registration method. The skeletal kinematics were quantified from 9% to 86% of the full stance phase because of the limited camera speed of the X-ray system. At the beginning of terminal stance, plantar-flexion of the AJC was initiated in the subtalar joint on average at 75% ranging from 62% to 76% of the stance phase, and plantar-flexion of the ankle joint did not start until 86% of the stance phase. The earlier change to plantar-flexion in the AJC than the ankle joint due to the early plantar-flexion in the subtalar joint was observed in 8 of the 10 subjects. This phenomenon could be explained by the absence of direct muscle insertion on the talus. Preceding subtalar plantar-flexion could contribute to efficient and stable ankle plantar-flexion by locking the midtarsal joint, but this explanation needs further investigation. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Sp6 and Sp8 Transcription Factors Control AER Formation and Dorsal-Ventral Patterning in Limb Development

    Science.gov (United States)

    Haro, Endika; Delgado, Irene; Junco, Marisa; Yamada, Yoshihiko; Mansouri, Ahmed; Oberg, Kerby C.; Ros, Marian A.

    2014-01-01

    The formation and maintenance of the apical ectodermal ridge (AER) is critical for the outgrowth and patterning of the vertebrate limb. The induction of the AER is a complex process that relies on integrated interactions among the Fgf, Wnt, and Bmp signaling pathways that operate within the ectoderm and between the ectoderm and the mesoderm of the early limb bud. The transcription factors Sp6 and Sp8 are expressed in the limb ectoderm and AER during limb development. Sp6 mutant mice display a mild syndactyly phenotype while Sp8 mutants exhibit severe limb truncations. Both mutants show defects in AER maturation and in dorsal-ventral patterning. To gain further insights into the role Sp6 and Sp8 play in limb development, we have produced mice lacking both Sp6 and Sp8 activity in the limb ectoderm. Remarkably, the elimination or significant reduction in Sp6;Sp8 gene dosage leads to tetra-amelia; initial budding occurs, but neither Fgf8 nor En1 are activated. Mutants bearing a single functional allele of Sp8 (Sp6−/−;Sp8+/−) exhibit a split-hand/foot malformation phenotype with double dorsal digit tips probably due to an irregular and immature AER that is not maintained in the center of the bud and on the abnormal expansion of Wnt7a expression to the ventral ectoderm. Our data are compatible with Sp6 and Sp8 working together and in a dose-dependent manner as indispensable mediators of Wnt/βcatenin and Bmp signaling in the limb ectoderm. We suggest that the function of these factors links proximal-distal and dorsal-ventral patterning. PMID:25166858

  11. RESIDUAL LIMB VOLUME CHANGE: SYSTEMATIC REVIEW OF MEASUREMENT AND MANAGEMENT

    Science.gov (United States)

    Sanders, JE; Fatone, S

    2014-01-01

    Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. The purpose of this systematic review was to assess what is known about measurement and management of residual limb volume change in persons with lower-limb amputation. Publications that met inclusion criteria were grouped into three categories: (I) descriptions of residual limb volume measurement techniques; (II) studies on people with lower-limb amputation investigating the effect of residual limb volume change on clinical care; and (III) studies of residual limb volume management techniques or descriptions of techniques for accommodating or controlling residual limb volume. The review showed that many techniques for the measurement of residual limb volume have been described but clinical use is limited largely because current techniques lack adequate resolution and in-socket measurement capability. Overall, there is limited evidence regarding the management of residual limb volume, and the evidence available focuses primarily on adults with trans-tibial amputation in the early post-operative phase. While we can draw some insights from the available research about residual limb volume measurement and management, further research is required. PMID:22068373

  12. Effects of tuning of ankle foot orthoses-footwear combination using wedges on stance phase knee hyperextension in children with cerebral palsy - preliminary results.

    Science.gov (United States)

    Jagadamma, Kavi C; Coutts, Fiona J; Mercer, Thomas H; Herman, Janet; Yirrel, Jacqueline; Forbes, Lyndsay; Van Der Linden, Marietta L

    2009-11-01

    This pilot study investigated the feasibility of reducing stance phase knee hyperextension in children with cerebral palsy by tuning the ankle foot orthoses-footwear combination (AFO-FC) using different sizes of wedges. Five children with cerebral palsy underwent three dimensional gait analysis and tuning of their AFO-FC using wedges. Data analysis was carried out by comparing relevant gait parameters between the non-tuned and tuned prescription. Knee hyperextension during stance significantly decreased, and the shank to vertical angle was closer to normal after tuning. Although none of the other parameters showed statistically significant changes, the wide confidence intervals and lack of power indicated the likelihood of a type II error. Further, it was noted that the influence of tuning on temporal-spatial parameters was different between children with diplegia and those with hemiplegia. It was estimated that a sample size of 15 is required to detect significant changes at p = 0.05 and power of 0.8. The findings of this study clearly indicate the potential clinical utility of tuning using wedges to correct knee hyperextension during the stance phase in children with cerebral palsy. However, observations support the need for an adequately powered study to assess the long-term effects of tuning on gait parameters, activity level and quality of life.

  13. (Positive) Power to the Child: The Role of Children's Willing Stance toward Parents in Developmental Cascades from Toddler Age to Early Preadolescence

    Science.gov (United States)

    Kochanska, Grazyna; Kim, Sanghag; Boldt, Lea J.

    2015-01-01

    In contrast to once dominant views of children as passive in the parent-led process of socialization, they are now seen as active agents who can considerably influence that process. But those newer perspectives typically focus on the child's antagonistic influence, due either to a difficult temperament or aversive, resistant, negative behaviors that elicit adversarial responses from the parent and lead to future coercive cascades in the relationship. Children's capacity to act as receptive, willing, even enthusiastic, active socialization agents is largely overlooked. Informed by attachment theory and other relational perspectives, we depict children as able to adopt an active willing stance and to exert robust positive influence in the mutually cooperative socialization enterprise. A longitudinal study of 100 community families (mothers, fathers, and children) demonstrates that willing stance (a) is a latent construct, observable in diverse parent-child contexts parallel at 38, 52, and 67 months, and longitudinally stable, (b) originates within an early secure parent-child relationship at 25 months, and (c) promotes a positive future cascade toward adaptive outcomes at age 10. The outcomes include the parent's observed and child-reported positive, responsive behavior, as well as child-reported internal obligation to obey the parent and parent-reported low level of child behavior problems. The construct of willing stance has implications for basic research in typical socialization and in developmental psychopathology, and for prevention and intervention. PMID:26439058

  14. A Secure Base from which to Cooperate: Security, Child and Parent Willing Stance, and Adaptive and Maladaptive Outcomes in two Longitudinal Studies.

    Science.gov (United States)

    Goffin, Kathryn C; Boldt, Lea J; Kochanska, Grazyna

    2017-10-17

    Early secure attachment plays a key role in socialization by inaugurating a long-term mutual positive, collaborative interpersonal orientation within the parent-child dyad. We report findings from Family Study (community mothers, fathers, and children, from age 2 to 12, N = 102, 51 girls) and Play Study (exclusively low-income mothers and children, from age 3.5 to 7, N = 186, 90 girls). We examined links among observed secure attachment at toddler age, child and parent receptive, willing stance to each other, observed in parent-child contexts at early school age, and developmental outcomes. The developmental outcomes included parent-rated child antisocial behavior problems and observed positive mutuality with regard to conflict issues at age 12 in Family Study, and mother-rated child antisocial behavior problems and observed child regard for rules and moral self at age 7 in Play Study. In mother-child relationships, the child's willing stance mediated indirect effects of child security on positive mutuality in Family Study and on all outcomes in Play Study. In father-child relationships, both the child's and the parent's willing stance mediated indirect effects of child security on both outcomes. Early security initiates an adaptive developmental cascade by enlisting the child and the parent as active, willingly receptive and cooperative agents in the socialization process. Implications for children's parenting interventions are noted.

  15. (Positive) power to the child: The role of children's willing stance toward parents in developmental cascades from toddler age to early preadolescence.

    Science.gov (United States)

    Kochanska, Grazyna; Kim, Sanghag; Boldt, Lea J

    2015-11-01

    In a change from the once-dominant view of children as passive in the parent-led process of socialization, children are now seen as active agents who can considerably influence that process. However, these newer perspectives typically focus on the child's antagonistic influence, due either to a difficult temperament or aversive, resistant, negative behaviors that elicit adversarial responses from the parent and lead to future coercive cascades in the relationship. Children's capacity to act as receptive, willing, even enthusiastic, active socialization agents is largely overlooked. Informed by attachment theory and other relational perspectives, we depict children as able to adopt an active willing stance and to exert robust positive influence in the mutually cooperative socialization enterprise. A longitudinal study of 100 community families (mothers, fathers, and children) demonstrates that willing stance (a) is a latent construct, observable in diverse parent-child contexts, parallel at 38, 52, and 67 months and longitudinally stable; (b) originates within an early secure parent-child relationship at 25 months; and (c) promotes a positive future cascade toward adaptive outcomes at age 10. The outcomes include the parent's observed and child-reported positive, responsive behavior, as well as child-reported internal obligation to obey the parent and parent-reported low level of child behavior problems. The construct of willing stance has implications for basic research in typical socialization and in developmental psychopathology as well as for prevention and intervention.

  16. Sample entropy characteristics of movement for four foot types based on plantar centre of pressure during stance phase.

    Science.gov (United States)

    Mei, Zhanyong; Zhao, Guoru; Ivanov, Kamen; Guo, Yanwei; Zhu, Qingsong; Zhou, Yongjin; Wang, Lei

    2013-10-10

    Motion characteristics of CoP (Centre of Pressure, the point of application of the resultant ground reaction force acting on the plate) are useful for foot type characteristics detection. To date, only few studies have investigated the nonlinear characteristics of CoP velocity and acceleration during the stance phase. The aim of this study is to investigate whether CoP regularity is different among four foot types (normal foot, pes valgus, hallux valgus and pes cavus); this might be useful for classification and diagnosis of foot injuries and diseases. To meet this goal, sample entropy, a measure of time-series regularity, was used to quantify the CoP regularity of four foot types. One hundred and sixty five subjects that had the same foot type bilaterally (48 subjects with healthy feet, 22 with pes valgus, 47 with hallux valgus, and 48 with pes cavus) were recruited for this study. A Footscan® system was used to collect CoP data when each subject walked at normal and steady speed. The velocity and acceleration in medial-lateral (ML) and anterior-posterior (AP) directions, and resultant velocity and acceleration were derived from CoP. The sample entropy is the negative natural logarithm of the conditional probability that a subseries of length m that matches pointwise within a tolerance r also matches at the next point. This was used to quantify variables of CoP velocity and acceleration of four foot types. The parameters r (the tolerance) and m (the matching length) for sample entropy calculation have been determined by an optimal method. It has been found that in order to analyze all CoP parameters of velocity and acceleration during the stance phase of walking gait, for each variable there is a different optimal r value. On the contrary, the value m=4 is optimal for all variables.Sample entropies of both velocity and acceleration in AP direction were highly correlated with their corresponding resultant variables for r>0.91. The sample entropy of the velocity in

  17. Emulating Upper Limb Disorder for Therapy Education

    Directory of Open Access Journals (Sweden)

    Noor Ayuni binti Che Zakaria

    2014-11-01

    Full Text Available Robotics not only contributes to the invention of rehabilitation devices, it can also enhance the quality of medical education. In recent years, the use of patient simulators and part-task trainers in the medical education field has brought meaningful improvements in the training of medical practitioners. Nevertheless, in the context of therapy training for upper limb disorders, trainee therapists still have to engage directly with the patients to gain experience of the rehabilitation of physical diseases. In this work, a high-fidelity part-task trainer that is able to reproduce the stiffness of spasticity and rigidity symptoms of the upper limb, such as those observed in post-stroke patients and Parkinson's disease patients, has been developed. Based on the evaluation carried out by two experienced therapists, the developed part-task trainer is able to simulate different patient cases and help trainee therapists gain pre-clinical experience in a safe and intuitive learning environment.

  18. A Brief History of Limb Lengthening.

    Science.gov (United States)

    Birch, John G

    2017-09-01

    In the last 35 years, orthopaedic surgeons have witnessed 3 major advances in the technique of limb lengthening: "distraction osteogenesis" facilitated by Gavriil Ilizarov method and infinitely-adaptable circular fixator with fine-wire bone fragment fixation; the introduction of the "6-strut" computer program-assisted circular fixators to effect complex deformity correction simultaneously; and the development of motorized intramedullary lengthening nails. However, the principles and associated complications of these techniques are on the basis of observations by Codivilla, Putti, and Abbott from as much as 110 years ago. This review notes the contribution of these pioneers in limb lengthening, and the contribution of Thor Heyerdahl principles of tolerance and diversity to the dissemination of Ilizarov principles to the Western world.

  19. Rehabilitation protocol in upper limb lymphedema.

    Science.gov (United States)

    Leduc, O; Leduc, A

    2002-01-01

    Edema of the upper limb is, frequently, very invalidating. The physical treatment for edema of the upper limb consists on a combination of different therapies: manual lymphatic drainage (MLD), intermittent sequential pressotherapy (IPP) with a very low intensity, multilayer bandages (MLB), and compression sleeves. Patients are not hospitalized. In the first step of physical treatment, the patients are treated daily during 2 or 3 weeks with different therapies (MLD, IPP and MLB). During the second step, bandages are no more used. The compression garments are applied after this 2 or 3 weeks period. The physical treatment consist now in: manual lynphatic drainage and intermittent sequential pressotherapy (with low intensity). The frequency of the physical treatment is progressively decreased.

  20. Lower limb vascular dysfunction in cyclists

    Directory of Open Access Journals (Sweden)

    Thiago Ayala Melo Di Alencar

    2013-06-01

    Full Text Available Sports-related vascular insufficiency affecting the lower limbs is uncommon, and early signs and symptoms can be confused with musculoskeletal injuries. This is also the case among professional cyclists, who are always at the threshold between endurance and excess training. The aim of this review was to analyze the occurrence of vascular disorders in the lower limbs of cyclists and to discuss possible etiologies. Eighty-five texts, including papers and books, published from 1950 to 2012, were used. According to the literature reviewed, some cyclists receive a late diagnosis of vascular dysfunction due to a lack of familiarity of the medical team with this type of dysfunction. Data revealed that a reduced blood flow in the external iliac artery, especially on the left, is much more common than in the femoral and popliteal arteries, and that vascular impairment is responsible for the occurrence of early fatigue and reduced performance in cycling.

  1. Lethal neonatal short-limbed dwarfism

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ok Hwa; Yim, Chung Ik; Bahk, Yong Whee [Catholic Medical College, Seoul (Korea, Republic of)

    1986-02-15

    We have detailed our experiences on 6 cases of neonatal lethal short-limbed dwarfism and reviewed the articles. They include, achondrogenesis, thanatophoric dysplasia, asphyxiating thoracic dysplasia, osteogenesis imperfect a congenita, and hypophosphatasia lethals. Five babies were born alive but died soon after birth and one was a stillbirth. The main cause of failure to thrive was respiratory insufficiency. Each case was having quite characteristic radiologic findings, even if the general appearances were similar to the achondroplasts clinically. Precise diagnosis is very important for genetic counselling of the parents and alarm to them the possibility of bone dysplasias to the next offsprings. For this purpose, the radiologists play major role for the correct diagnosis. We stress that when the baby is born with short-limbed dwarfism, whole body radiogram should be taken including lateral view and postmortem radiogram is also very precious.

  2. Lower-Limb Rehabilitation Robot Design

    Science.gov (United States)

    Bouhabba, E. M.; Shafie, A. A.; Khan, M. R.; Ariffin, K.

    2013-12-01

    It is a general assumption that robotics will play an important role in therapy activities within rehabilitation treatment. In the last decade, the interest in the field has grown exponentially mainly due to the initial success of the early systems and the growing demand caused by increasing numbers of stroke patients and their associate rehabilitation costs. As a result, robot therapy systems have been developed worldwide for training of both the upper and lower extremities. This paper investigates and proposes a lower-limb rehabilitation robot that is used to help patients with lower-limb paralysis to improve and resume physical functions. The proposed rehabilitation robot features three rotary joints forced by electric motors providing linear motions. The paper covers mechanism design and optimization, kinematics analysis, trajectory planning, wearable sensors, and the control system design. The design and control system demonstrate that the proposed rehabilitation robot is safe and reliable with the effective design and better kinematic performance.

  3. A comparison of hemisphere-specific training pattern in Inter-limb Learning Transfer (ILT) for stroke patients with hemiparesis.

    Science.gov (United States)

    Yoo, In-gyu; Jung, Min-ye; Yoo, Eun-young; Park, Ji-hyuk; Kang, Dae-hyuk; Lee, Jin

    2014-01-01

    Stroke patients have major problems with impaired upper-extremity function. Unfortunately, many patients do not experience a full recovery from movement deficits in the upper extremities. The purpose of this study was to compare the effectiveness of inter-limb learning transfer (ILT) to the contralateral upper limb after both hemisphere-specific and -unspecific ipsilateral upper limb training for stroke patients with hemiparesis. Twenty-four stroke patients with hemiparesis participated. The hemisphere-specific training group performed reaching movements in a customized training setting in which non-dominant limb training participants began from a single starting location and proceeded to one of three target locations (1S3T condition); the dominant limb training participants started from one of three starting locations and proceeded to a single target location (3S1T condition). The hemisphere-unspecific training group performed these movements starting under reverse-start and target conditions. The non-dominant to dominant limb transfer, the hemisphere-specific training group performance time decreased significantly as compared with the pre-training session (p training session in the biceps brachii muscles and increased significantly in the upper trapezius muscles (p transfer in the hemisphere-specific training group significantly increased RMS amplitudes from the pre-training session in the biceps brachii and triceps muscles (p training session in the biceps brachii muscles and decreased significantly in the upper trapezius muscles (p training group showed no significant differences in inter-limb learning transfer (ILT). The transfer of hemisphere-specific training from one arm to the other had a more positive influence on functional recovery than did hemisphere-unspecific training for patients with stroke and hemiparesis.

  4. The Effect of Continuous and Discretized Presentations of Concurrent Augmented Visual Biofeedback on Postural Control in Quiet Stance.

    Directory of Open Access Journals (Sweden)

    Carmen D'Anna

    Full Text Available The purpose of this study was to evaluate the effect of a continuous and a discretized Visual Biofeedback (VBF on balance performance in upright stance. The coordinates of the Centre of Pressure (CoP, extracted from a force plate, were processed in real-time to implement the two VBFs, administered to two groups of 12 healthy participants. In the first group, a representation of the CoP was continuously shown, while in the second group, the discretized VBF was provided at an irregular frequency (that depended on the subject's performance by displaying one out of a set of five different emoticons, each corresponding to a specific area covered by the current position of the CoP. In the first case, participants were asked to maintain a white spot within a given square area, whereas in the second case they were asked to keep the smiling emoticon on. Trials with no VBF were administered as control. The effect of the two VBFs on balance was studied through classical postural parameters and a subset of stabilogram diffusion coefficients. To quantify the amount of time spent in stable conditions, the percentage of time during which the CoP was inside the stability area was calculated. Both VBFs improved balance maintainance as compared to the absence of any VBF. As compared to the continuous VBF, in the discretized VBF a significant decrease of sway path, diffusion and Hurst coefficients was found. These results seem to indicate that a discretized VBF favours a more natural postural behaviour by promoting a natural intermittent postural control strategy.

  5. The Effect of Continuous and Discretized Presentations of Concurrent Augmented Visual Biofeedback on Postural Control in Quiet Stance.

    Science.gov (United States)

    D'Anna, Carmen; Schmid, Maurizio; Bibbo, Daniele; Bertollo, Maurizio; Comani, Silvia; Conforto, Silvia

    2015-01-01

    The purpose of this study was to evaluate the effect of a continuous and a discretized Visual Biofeedback (VBF) on balance performance in upright stance. The coordinates of the Centre of Pressure (CoP), extracted from a force plate, were processed in real-time to implement the two VBFs, administered to two groups of 12 healthy participants. In the first group, a representation of the CoP was continuously shown, while in the second group, the discretized VBF was provided at an irregular frequency (that depended on the subject's performance) by displaying one out of a set of five different emoticons, each corresponding to a specific area covered by the current position of the CoP. In the first case, participants were asked to maintain a white spot within a given square area, whereas in the second case they were asked to keep the smiling emoticon on. Trials with no VBF were administered as control. The effect of the two VBFs on balance was studied through classical postural parameters and a subset of stabilogram diffusion coefficients. To quantify the amount of time spent in stable conditions, the percentage of time during which the CoP was inside the stability area was calculated. Both VBFs improved balance maintainance as compared to the absence of any VBF. As compared to the continuous VBF, in the discretized VBF a significant decrease of sway path, diffusion and Hurst coefficients was found. These results seem to indicate that a discretized VBF favours a more natural postural behaviour by promoting a natural intermittent postural control strategy.

  6. Optimizing ankle performance when taped: Effects of kinesiology and athletic taping on proprioception in full weight-bearing stance.

    Science.gov (United States)

    Long, Zhi; Wang, Renwei; Han, Jia; Waddington, Gordon; Adams, Roger; Anson, Judith

    2017-03-01

    To explore the effects of kinesiology taping (KT) and athletic taping (AT) on ankle proprioception when tested in functional, full weight-bearing stance. Cross-sectional study. Twenty-four healthy university students participated. Proprioception was measured using the Active Movement Extent Discrimination Apparatus (AMEDA). The three testing conditions: no-taping, KT, AT, and foot tested were randomly assigned. Perceived comfort, support and proprioceptive performance under two taping conditions were recorded. Proprioceptive discrimination scores with 95% CIs for no-taping, KT and AT were 0.81 (0.79-0.84), 0.81 (0.79-0.83), and 0.79 (0.77-0.81). Repeated measures ANOVA showed neither any significant difference associated with taping compared with no-taping (p=0.30), nor any difference between KT and AT (p=0.19). The group was then divided, according to their no-taping scores, into two sub-groups: with scores below the no-taping mean (n=13), and above the mean (n=11). ANOVA revealed a significant interaction (p=0.008) indicating that above-average no-taping performers proprioception scores were worse when taped, whereas below-average performers improved. For both KT and AT, only ratings of perceived comfort when taped were significantly associated with actual proprioceptive performance (both r>0.44, p≤0.03). Other perception ratings (support and performance) were significantly inter-correlated (both r>0.42, p0.31). Taping of the foot and ankle may amplify sensory input in a way that enhances proprioception of poor performers but produces an input overload that impairs proprioception in those who originally performed well when no-taping. Screening of ankle proprioception may identify those who would benefit most from taping. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  7. [Timed up and go right and left unipodal stance results in Chilean older people with different degrees of disability].

    Science.gov (United States)

    Mancilla S, Eladio; Valenzuela H, José; Escobar C, Máximo

    2015-01-01

    The Preventive Health Examination of older people in Chile incorporates the timed up and go (TUG) and right and left unipodal stance test (RUPS and LUPS) as functional assessment methods. To assess if TUG and LUPS discriminate older people with different degrees of disability. TUG, RUPS and LUPS were assessed in 860 participants aged 71.3 ± 6.9 years (591 females) attending a primary health care clinic. The results of the three tests were expressed in seconds. Participants were classified as non-disabled without any risk, non-disabled with risk and in risk of dependence, using the Functional Assessment of Older People of EFAM (the Spanish acronym), previously validated for Chilean older people. In all participants TUG, LUPS and RUPS values were 8.9 ± 3.6, 10 ± 10.6 and 9.7 ± 10.3 seconds (sec) respectively. Among non-disabled participants without risk, the values for TUG, RUPS and LUPS were: 7.9 ± 2.3, 12.7 ± 11.1 and 12.2 ± 10.9 sec respectively. The figures for non-disabled participants with risk were 8.4 ± 2.6, 8.8 ± 9.8 and 8.9 ± 9.8 sec respectively. The figures for participants in risk of dependence were 11.7 ± 5.3, 5.1 ± 7.8 and 4.5 ± 7.1 sec, respectively. In this group of older participants there is an association between the degree of disability and the results of TUG, RUPS and LUPS.

  8. Evidence in Support of the Independent Channel Model Describing the Sensorimotor Control of Human Stance Using a Humanoid Robot

    Directory of Open Access Journals (Sweden)

    Jantsje H. Pasma

    2018-03-01

    Full Text Available The Independent Channel (IC model is a commonly used linear balance control model in the frequency domain to analyze human balance control using system identification and parameter estimation. The IC model is a rudimentary and noise-free description of balance behavior in the frequency domain, where a stable model representation is not guaranteed. In this study, we conducted firstly time-domain simulations with added noise, and secondly robot experiments by implementing the IC model in a real-world robot (PostuRob II to test the validity and stability of the model in the time domain and for real world situations. Balance behavior of seven healthy participants was measured during upright stance by applying pseudorandom continuous support surface rotations. System identification and parameter estimation were used to describe the balance behavior with the IC model in the frequency domain. The IC model with the estimated parameters from human experiments was implemented in Simulink for computer simulations including noise in the time domain and robot experiments using the humanoid robot PostuRob II. Again, system identification and parameter estimation were used to describe the simulated balance behavior. Time series, Frequency Response Functions, and estimated parameters from human experiments, computer simulations, and robot experiments were compared with each other. The computer simulations showed similar balance behavior and estimated control parameters compared to the human experiments, in the time and frequency domain. Also, the IC model was able to control the humanoid robot by keeping it upright, but showed small differences compared to the human experiments in the time and frequency domain, especially at high frequencies. We conclude that the IC model, a descriptive model in the frequency domain, can imitate human balance behavior also in the time domain, both in computer simulations with added noise and real world situations with a

  9. Endovascular Management of Acute Limb Ischemia.

    LENUS (Irish Health Repository)

    Hynes, Brian G

    2011-09-14

    Despite major advances in pharmacologic and endovascular therapies, acute limb ischemia (ALI) continues to result in significant morbidity and mortality. The incidence of ALI may be as high as 13-17 cases per 100,000 people per year, with mortality rates approaching 18% in some series. This review will address the contemporary endovascular management of ALI encompassing pharmacologic and percutaneous interventional treatment strategies.

  10. Lower Limb Disabilities Following Motorcyle Crashes | Kortor ...

    African Journals Online (AJOL)

    The commonest complication after treatment was joint stiffness (21.4%) followed by malunion (7.1%), wound infection (5.0%), joint deformity (3.6%), limb length discrepancy (2.9%) and non union (1.4%). 45.6% of patients at 12th month of follow up had physical impairment while only 23.8 percent of them had psychosocial ...

  11. OMPS Limb Profiler Instrument Performance Assessment

    Science.gov (United States)

    Jaross, Glen R.; Bhartia, Pawan K.; Chen, Grace; Kowitt, Mark; Haken, Michael; Chen, Zhong; Xu, Philippe; Warner, Jeremy; Kelly, Thomas

    2014-01-01

    Following the successful launch of the Ozone Mapping and Profiler Suite (OMPS) aboard the Suomi National Polar-orbiting Partnership (SNPP) spacecraft, the NASA OMPS Limb team began an evaluation of instrument and data product performance. The focus of this paper is the instrument performance in relation to the original design criteria. Performance that is closer to expectations increases the likelihood that limb scatter measurements by SNPP OMPS and successor instruments can form the basis for accurate long-term monitoring of ozone vertical profiles. The team finds that the Limb instrument operates mostly as designed and basic performance meets or exceeds the original design criteria. Internally scattered stray light and sensor pointing knowledge are two design challenges with the potential to seriously degrade performance. A thorough prelaunch characterization of stray light supports software corrections that are accurate to within 1% in radiances up to 60 km for the wavelengths used in deriving ozone. Residual stray light errors at 1000nm, which is useful in retrievals of stratospheric aerosols, currently exceed 10%. Height registration errors in the range of 1 km to 2 km have been observed that cannot be fully explained by known error sources. An unexpected thermal sensitivity of the sensor also causes wavelengths and pointing to shift each orbit in the northern hemisphere. Spectral shifts of as much as 0.5nm in the ultraviolet and 5 nm in the visible, and up to 0.3 km shifts in registered height, must be corrected in ground processing.

  12. Limb Lengthening in Patients with Achondroplasia.

    Science.gov (United States)

    Park, Kwang-Won; Garcia, Rey-an Niño; Rejuso, Chastity Amor; Choi, Jung-Woo; Song, Hae-Ryong

    2015-11-01

    Although bilateral lower-limb lengthening has been performed on patients with achondroplasia, the outcomes for the tibia and femur in terms of radiographic parameters, clinical results, and complications have not been compared with each other. We proposed 1) to compare the radiological outcomes of femoral and tibial lengthening and 2) to investigate the differences of complications related to lengthening. We retrospectively reviewed 28 patients (average age, 14 years 4 months) with achondroplasia who underwent bilateral limb lengthening between 2004 and 2012. All patients first underwent bilateral tibial lengthening, and at 9-48 months (average, 17.8 months) after this procedure, bilateral femoral lengthening was performed. We analyzed the pixel value ratio (PVR) and characteristics of the callus of the lengthened area on serial radiographs. The external fixation index (EFI) and healing index (HI) were computed to compare tibial and femoral lengthening. The complications related to lengthening were assessed. The average gain in length was 8.4 cm for the femur and 9.8 cm for the tibia. The PVR, EFI, and HI of the tibia were significantly better than those of the femur. Fewer complications were found during the lengthening of the tibia than during the lengthening of the femur. Tibial lengthening had a significantly lower complication rate and a higher callus formation rate than femoral lengthening. Our findings suggest that bilateral limb lengthening (tibia, followed by femur) remains a reasonable option; however, we should be more cautious when performing femoral lengthening in selected patients.

  13. Radiographic anatomy of juvenile bovine limbs.

    Science.gov (United States)

    Hoey, S E; Biedrzycki, A H; Livesey, M J; Drees, R

    2016-11-26

    Juvenile bovine patients who present with clinical signs of lameness are commonly evaluated using radiographic techniques both within a hospital setting and in a farm environment. The radiographic development of the juvenile bovine skeleton is currently poorly documented. In this study, the limbs of four heifer calves were sequentially radiographed to assess development of the juvenile bovine appendicular skeleton in the first 12 months of life. Images were acquired at three weeks, three months, six months, nine months and one year of age. The normal radiographic anatomy of the fore limbs and hindlimbs and the changes over the first 12 months are described. The majority of physes remain open throughout this period, with the exception of the proximal physes of the proximal and middle phalanges, the proximal radial physis, and the proximal humeral physis which close radiographically between 9 months and 12 months of age, and fusion of the fourth and central tarsal bones occurs between 9 months and 12 months of age. The results of this study may aid in differentiating normal and abnormal anatomy in the juvenile bovine limb. British Veterinary Association.

  14. Life without limbs: Technology to the rescue.

    Science.gov (United States)

    Cooke, Deirdre M; Ames, Matthew; Geffen, Saul

    2016-08-01

    This article reports a rare and inspirational case of a four-limb amputee, the range of integrated technology solutions that enable him to be a productive member of his family and the process and pitfalls of seeking technology solutions. A complex case of bilateral transhumeral amputation and bilateral transfemoral amputation with residual upper limbs too short to oppose is presented. The multiple 'high-tech' and 'low-tech' devices used on a daily basis to move around his house and community, control his environment, communicate and feed himself without the use of limbs, prostheses or a second person are outlined. Recent advances in electronics, computing and telecommunications technologies provide him with capabilities not possible 10 years ago. The process and pitfalls in sourcing technology solutions and the innovative solutions to meet the unique functional needs of this individual provide guidance to those with similarly severe and profound limitations to independence. Descriptions of technology solutions to improve independent functioning of those with quadruple amputation without prostheses as well as those with high-level spinal cord injury are of value to occupational therapists, patients and families alike. © The International Society for Prosthetics and Orthotics 2015.

  15. An Adaptive Neuromuscular Controller for Assistive Lower-Limb Exoskeletons: A Preliminary Study on Subjects with Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Amy R. Wu

    2017-06-01

    Full Text Available Versatility is important for a wearable exoskeleton controller to be responsive to both the user and the environment. These characteristics are especially important for subjects with spinal cord injury (SCI, where active recruitment of their own neuromuscular system could promote motor recovery. Here we demonstrate the capability of a novel, biologically-inspired neuromuscular controller (NMC which uses dynamical models of lower limb muscles to assist the gait of SCI subjects. Advantages of this controller include robustness, modularity, and adaptability. The controller requires very few inputs (i.e., joint angles, stance, and swing detection, can be decomposed into relevant control modules (e.g., only knee or hip control, and can generate walking at different speeds and terrains in simulation. We performed a preliminary evaluation of this controller on a lower-limb knee and hip robotic gait trainer with seven subjects (N = 7, four with complete paraplegia, two incomplete, one healthy to determine if the NMC could enable normal-like walking. During the experiment, SCI subjects walked with body weight support on a treadmill and could use the handrails. With controller assistance, subjects were able to walk at fast walking speeds for ambulatory SCI subjects—from 0.6 to 1.4 m/s. Measured joint angles and NMC-provided joint torques agreed reasonably well with kinematics and biological joint torques of a healthy subject in shod walking. Some differences were found between the torques, such as the lack of knee flexion near mid-stance, but joint angle trajectories did not seem greatly affected. The NMC also adjusted its torque output to provide more joint work at faster speeds and thus greater joint angles and step length. We also found that the optimal speed-step length curve observed in healthy humans emerged for most of the subjects, albeit with relatively longer step length at faster speeds. Therefore, with very few sensors and no predefined

  16. An Adaptive Neuromuscular Controller for Assistive Lower-Limb Exoskeletons: A Preliminary Study on Subjects with Spinal Cord Injury.

    Science.gov (United States)

    Wu, Amy R; Dzeladini, Florin; Brug, Tycho J H; Tamburella, Federica; Tagliamonte, Nevio L; van Asseldonk, Edwin H F; van der Kooij, Herman; Ijspeert, Auke J

    2017-01-01

    Versatility is important for a wearable exoskeleton controller to be responsive to both the user and the environment. These characteristics are especially important for subjects with spinal cord injury (SCI), where active recruitment of their own neuromuscular system could promote motor recovery. Here we demonstrate the capability of a novel, biologically-inspired neuromuscular controller (NMC) which uses dynamical models of lower limb muscles to assist the gait of SCI subjects. Advantages of this controller include robustness, modularity, and adaptability. The controller requires very few inputs (i.e., joint angles, stance, and swing detection), can be decomposed into relevant control modules (e.g., only knee or hip control), and can generate walking at different speeds and terrains in simulation. We performed a preliminary evaluation of this controller on a lower-limb knee and hip robotic gait trainer with seven subjects ( N = 7, four with complete paraplegia, two incomplete, one healthy) to determine if the NMC could enable normal-like walking. During the experiment, SCI subjects walked with body weight support on a treadmill and could use the handrails. With controller assistance, subjects were able to walk at fast walking speeds for ambulatory SCI subjects-from 0.6 to 1.4 m/s. Measured joint angles and NMC-provided joint torques agreed reasonably well with kinematics and biological joint torques of a healthy subject in shod walking. Some differences were found between the torques, such as the lack of knee flexion near mid-stance, but joint angle trajectories did not seem greatly affected. The NMC also adjusted its torque output to provide more joint work at faster speeds and thus greater joint angles and step length. We also found that the optimal speed-step length curve observed in healthy humans emerged for most of the subjects, albeit with relatively longer step length at faster speeds. Therefore, with very few sensors and no predefined settings for

  17. Advanced upper limb prosthetic devices: implications for upper limb prosthetic rehabilitation.

    Science.gov (United States)

    Resnik, Linda; Meucci, Marissa R; Lieberman-Klinger, Shana; Fantini, Christopher; Kelty, Debra L; Disla, Roxanne; Sasson, Nicole

    2012-04-01

    The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Predictive value of upper limb muscles and grasp patterns on functional outcome in cervical spinal cord injury

    NARCIS (Netherlands)

    Velstra, Inge-Marie; Bolliger, M.; Krebs, J.; Rietman, Johan Swanik; Curt, A.

    2015-01-01

    Objective: To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP),

  19. Effects of different lower-limb sensory stimulation strategies on postural regulation-a Systematic review and metaanalysis

    NARCIS (Netherlands)

    Woo, Mei Teng; Davids, Keith; Liukkonen, Jarmo; Orth, Dominic; Chow, Jia Yi; Jaakkola, Timo

    2017-01-01

    Systematic reviews of balance control have tended to only focus on the effects of single lower-limb stimulation strategies, and a current limitation is the lack of comparison between different relevant stimulation strategies. The aim of this systematic review and meta-analysis was to examine

  20. Comparison of a laboratory grade force platform with a Nintendo Wii balance board in measurement of postural control in single-legged stance balance tasks

    NARCIS (Netherlands)

    Huurnink, A.; Fransz, D.P.; Kingma, I.; van Dieen, J.H.

    2013-01-01

    Training and testing of balance have potential applications in sports and medicine. Laboratory grade force plates (FP) are considered the gold standard for the measurement of balance performance. Measurements in these systems are based on the parameterization of center of pressure (CoP)

  1. Comparison of a laboratory grade force platform with a Nintendo Wii balance board in measurement of postural control in single-legged stance balance tasks

    OpenAIRE

    Huurnink, A.; Fransz, D.P.; Kingma, I.; van Dieen, J.H.

    2013-01-01

    Training and testing of balance have potential applications in sports and medicine. Laboratory grade force plates (FP) are considered the gold standard for the measurement of balance performance. Measurements in these systems are based on the parameterization of center of pressure (CoP) trajectories. Previous research validated the inexpensive, widely available and portable Nintendo Wii Balance Board (WBB). The novelty of the present study is that FP and WBB are compared on CoP data that was ...

  2. Energy expenditure during walking in amputees after disarticulation of the hip. A microprocessor-controlled swing-phase control knee versus a mechanical-controlled stance-phase control knee.

    Science.gov (United States)

    Chin, T; Sawamura, S; Shiba, R; Oyabu, H; Nagakura, Y; Nakagawa, A

    2005-01-01

    We have compared the energy expenditure during walking in three patients, aged between 51 and 55 years, with unilateral disarticulation of the hip when using the mechanical-controlled stance-phase control knee (Otto Bock 3R15) and the microprocessor-controlled pneumatic swing-phase control knee (Intelligent Prosthesis, IP). All had an endoskeletal hip disarticulation prosthesis with an Otto Bock 7E7 hip and a single-axis foot. The energy expenditure was measured when walking at speeds of 30, 50, and 70 m/min. Two patients showed a decreased uptake of oxygen (energy expenditure per unit time, ml/kg/min) of between 10.3% and 39.6% when using the IP compared with the Otto Bock 3R15 at the same speeds. One did not show any significant difference in the uptake of oxygen at 30 m/min, but at 50 and 70 m/min, a decrease in uptake of between 10.5% and 11.6% was found when using the IP. The use of the IP decreased the energy expenditure of walking in these patients.

  3. VACTERL (vertebral defects, anal atresia, tracheoesophageal fistula with esophageal atresia, cardiac defects, renal and limb anomalies) association: disease spectrum in 25 patients ascertained for their upper limb involvement.

    Science.gov (United States)

    Carli, Diana; Garagnani, Lorenzo; Lando, Mario; Fairplay, Tracy; Bernasconi, Sergio; Landi, Antonio; Percesepe, Antonio

    2014-03-01

    To review the clinical characteristics in a series of 25 patients with VACTERL (vertebral defects, anal atresia, tracheoesophageal fistula with esophageal atresia, cardiac defects, renal and limb anomalies) association who were ascertained for upper limb involvement. The study involved a review of clinical and radiologic data from patients with VACTERL association collected by a hand surgery clinic between 2004 and 2013. Radial axis involvement was found in all 25 patients (100%), with severe thumb function impairment in 79% and complete absence of the radius in roughly 33%. Costovertebral anomalies were the most frequent feature, found in 23 patients (92%). All 3 core features (anal atresia, tracheoesophageal fistula with esophageal atresia, and costovertebral anomalies) were present in only 12% of the patients. Twelve patients (48%) had abnormalities not part of the VACTERL spectrum, showing a specific pattern of non-VACTERL-type malformations, including genitourinary abnormalities (12%), single umbilical artery (8%), and tethered cord (8%). Previously unreported clinical findings were concurrent hypoplasia of both the odontoid process and the coccyx in 2 patients and an isolated sacral dimple in 2 patients. Upper limb involvement in VACTERL association is a specific feature of the radial axis that occurs in monolateral form in approximately 75% of cases and, when bilateral, always occurs in a nonsymmetrical fashion. Odontoid and coccygeal hypoplasia and sacral dimple are newly reported malformations of the VACTERL phenotype. Copyright © 2014 Mosby, Inc. All rights reserved.

  4. Phantom Limbs, Neuroprosthetics, and the Developmental Origins of Embodiment.

    Science.gov (United States)

    Blumberg, Mark S; Dooley, James C

    2017-10-01

    Amputees who wish to rid themselves of a phantom limb must weaken the neural representation of the absent limb. Conversely, amputees who wish to replace a lost limb must assimilate a neuroprosthetic with the existing neural representation. Whether we wish to remove a phantom limb or assimilate a synthetic one, we will benefit from knowing more about the developmental process that enables embodiment. A potentially critical contributor to that process is the spontaneous activity - in the form of limb twitches - that occurs exclusively and abundantly during active (REM) sleep, a particularly prominent state in early development. The sensorimotor circuits activated by twitching limbs, and the developmental context in which activation occurs, could provide a roadmap for creating neuroprosthetics that feel as if they are part of the body. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Upper and lower limb muscle activation is bidirectionally and ipsilaterally coupled.

    Science.gov (United States)

    Huang, Helen J; Ferris, Daniel P

    2009-09-01

    There are neural connections between the upper and lower limbs of humans that enable muscle activation in one limb pair (upper or lower) to modulate muscle activation in the other limb pair (lower or upper, respectively). The aims of this study were to extend previous findings regarding submaximal exercise to maximal effort exercise and determine whether there is an ipsilateral or contralateral bias to the neural coupling during a rhythmic locomotor-like task. We measured upper and lower limb muscle activity, joint kinematics, and limb forces in neurologically intact subjects (n = 16) as they performed recumbent stepping using different combinations of upper and lower limb efforts. We found increased muscle activation in passive lower limbs during active upper limb effort compared with passive upper limb effort. Likewise, increased muscle activation in passive upper limbs occurred during active lower limb effort compared with passive lower limb effort, suggesting a bidirectional effect. Maximal muscle activation in the active lower limbs was not different between conditions with active upper limb effort and conditions with passive upper limb movement. Similarly, maximal muscle activation in the active upper limbs was not different between conditions with active lower limb effort and conditions with passive lower limb movement. Further comparisons revealed that neural coupling was primarily from active upper limb muscles to passive ipsilateral lower limb muscles. These findings indicate that interlimb neural coupling affects muscle recruitment during maximal effort upper and lower limb rhythmic exercise and provides insight into the architecture of the neural coupling.

  6. Marker-based method to measure movement between the residual limb and a transtibial prosthetic socket.

    Science.gov (United States)

    Childers, Walter Lee; Siebert, Steven

    2016-12-01

    Limb movement between the residuum and socket continues to be an underlying factor in limb health, prosthetic comfort, and gait performance yet techniques to measure this have been underdeveloped. Develop a method to measure motion between the residual limb and a transtibial prosthetic socket. Single subject, repeated measures with mathematical modeling. The gait of a participant with transtibial amputation was recorded using a motion capture system using a marker set that included arrays on the anterior distal tibia and the lateral epicondyle of the femur. The proximal or distal translation, anterior or posterior translation, and angular movements were quantified. A random Monte Carlo simulation based on the precision of the motion capture system and a model of the bone moving under the skin explored the technique's accuracy. Residual limb tissue stiffness was modeled as a linear spring based on data from Papaioannou et al. Residuum movement relative to the socket went through ~30 mm, 18 mm, and 15° range of motion. Root mean squared errors were 5.47 mm, 1.86 mm, and 0.75° when considering the modeled bone-skin movement in the proximal or distal, anterior or posterior, and angular directions, respectively. The measured movement was greater than the root mean squared error, indicating that this method can measure motion between the residuum and socket. The ability to quantify movement between the residual limb and the prosthetic socket will improve prosthetic treatment through the evaluation of different prosthetic suspensions, socket designs, and motor control of the prosthetic interface. © The International Society for Prosthetics and Orthotics 2015.

  7. Predicting mobility outcome in lower limb amputees with motor ability tests used in early rehabilitation.

    Science.gov (United States)

    Spaan, Matthijs H; Vrieling, Aline H; van de Berg, Pim; Dijkstra, Pieter U; van Keeken, Helco G

    2017-04-01

    Retrospective cohort study. Persons with a lower limb amputation can regain mobility using a prosthetic device. For fast and adequate prescription of prosthetic components, it is necessary to predict the mobility outcome early in rehabilitation. Currently, prosthetic prescription is primarily based on empirical knowledge of rehabilitation professionals. In this study, we explored motor ability tests, to be completed without a prosthetic device, which have predictive value for mobility outcome at the end of rehabilitation. For this study, data of 82 patients with a lower limb amputation were included. The Single-limb standing balance test (Balance test), the Lower-Extremity Motor Coordination Test and the Amputee Mobility Predictor Assessment Tool (AMPnoPRO) were used as measures for motor ability. Mobility outcome was measured using the Timed Up and Go Test, the Two-Minute Walking Test and K levels were used. The explained variance of the Balance test, the Lower-Extremity Motor Coordination Test and the AMPnoPRO was, respectively, 0.603, 0.534 and 0.649 on the Two-Minute Walking Test (linear regression); 0.597, 0.431 and 0.624 on the Timed Up and Go Test (linear regression); and 0.432, 0.420 and 0.526 on the K levels (logistic regression). The AMPnoPRO predicted mobility outcome statistically (largest amount of explained variance). Clinical relevance This study explored the possibility of statistically predicting mobility outcome in lower limb amputees at the end of rehabilitation, using motor ability tests conducted in early rehabilitation. This study suggests the use of the AMPnoPRO to predict mobility outcome in lower limb amputees.

  8. Three-Dimensional Trunk and Lower Limbs Characteristics during Gait in Patients with Huntington's Disease

    Directory of Open Access Journals (Sweden)

    Elzbieta Mirek

    2017-10-01

    Full Text Available Objective: A number of studies on gait disturbances have been conducted, however, no clear pattern of gait disorders was described. The aim of the study was to characterize the gait pattern in HD patients by conducting analysis of mean angular movement changes the lower limb joints and trunk (kinematics parameters.Methods: The study group consisted of 30 patients with HD (17 women and 13 men. The reference data include the results of 30 healthy subjects (17 women and 13 men. Registration of gait with the Vicon 250 system was performed using passive markers attached to specific anthropometric points directly on the skin, based on the Golem biomechanical model (Oxford Metrics Ltd.. The research group and the control group were tested once.Results: Statistically significant (p < 0.05 angular changes in gait cycle for HD patients were observed in: insufficient plantar flexion during Loading Response and Pre-swing phases; insufficient flexion of the knee joint during Initial Swing and Mid Swing phases; excessive flexion of the hip in Terminal Stance and Pre-swing phases and over-normative forward inclination of the trunk in all gait phases. It should be noted that the group of patients with HD obtained, for all the mean angular movement changes higher standard deviation.Conclusion: A characteristic gait disorder common to all patients with HD occurring throughout the whole duration of the gait cycle is a pathological anterior tilt of the trunk. The results will significantly contribute to programming physiotherapy for people with HD, aimed at stabilizing the trunk in a position of extension during gait.

  9. Spirituality and Quality of Life in Limb Amputees

    OpenAIRE

    Peirano, Amanda H.; Franz, Randall W.

    2012-01-01

    Limb amputation is a life-changing event that signifies long-term physical, social, psychological, and environmental change. Spiritual well-being in patients plays a significant role in coping and may affect outcomes of patients with limb loss. The objective of this study was to describe the role of spirituality in individuals with limb amputation and to determine whether spirituality is related to the quality of life (QOL) in this sample. Study participants were recruited through prosthetist...

  10. Possibilities of prosthetic upper limb fitting in cycling

    OpenAIRE

    Doležalová, Hana

    2011-01-01

    Bachelor thesis give an overview of possible solutions in upper limbs prosthetic fitting which is suitable for cycling. And provide enough information on modifications that should be performed on a bicycle so that it can be used by humans with upper extremity prostheses. It can be an essential guide for anyone looking for a solution that would allow a person with an amputated upper limb again sit on the bike. Keywords: amputation, upper limb prosthesis, prosthetic fitting, cycling

  11. [May physicians amputate a healthy limb?].

    Science.gov (United States)

    Denys, Damiaan

    2014-01-01

    A recent article in the Dutch Journal of Medicine describes two cases of patients with body integrity identity disorder (BIID), a disorder in which patients might resort to self-amputation in order to create the body they wish for. The authors wonder if medical professionals should provide elective amputations in BIID patients in order to prevent them from harm and death. The amputation of a healthy limb in BIID in a medical context is currently under discussion. Doctors struggle to proceed to elective amputation of a healthy body part in BIID. An analogy with gender dysphoria or euthanasia might shed a different light on this dilemma.

  12. Computer simulations of neural mechanisms explaining upper and lower limb excitatory neural coupling

    Directory of Open Access Journals (Sweden)

    Ferris Daniel P

    2010-12-01

    Full Text Available Abstract Background When humans perform rhythmic upper and lower limb locomotor-like movements, there is an excitatory effect of upper limb exertion on lower limb muscle recruitment. To investigate potential neural mechanisms for this behavioral observation, we developed computer simulations modeling interlimb neural pathways among central pattern generators. We hypothesized that enhancement of muscle recruitment from interlimb spinal mechanisms was not sufficient to explain muscle enhancement levels observed in experimental data. Methods We used Matsuoka oscillators for the central pattern generators (CPG and determined parameters that enhanced amplitudes of rhythmic steady state bursts. Potential mechanisms for output enhancement were excitatory and inhibitory sensory feedback gains, excitatory and inhibitory interlimb coupling gains, and coupling geometry. We first simulated the simplest case, a single CPG, and then expanded the model to have two CPGs and lastly four CPGs. In the two and four CPG models, the lower limb CPGs did not receive supraspinal input such that the only mechanisms available for enhancing output were interlimb coupling gains and sensory feedback gains. Results In a two-CPG model with inhibitory sensory feedback gains, only excitatory gains of ipsilateral flexor-extensor/extensor-flexor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 26%. In a two-CPG model with excitatory sensory feedback gains, excitatory gains of contralateral flexor-flexor/extensor-extensor coupling produced reciprocal upper-lower limb bursts and enhanced output up to 100%. However, within a given excitatory sensory feedback gain, enhancement due to excitatory interlimb gains could only reach levels up to 20%. Interconnecting four CPGs to have ipsilateral flexor-extensor/extensor-flexor coupling, contralateral flexor-flexor/extensor-extensor coupling, and bilateral flexor-extensor/extensor-flexor coupling could enhance

  13. Upper limb movements can be decoded from the time-domain of low-frequency EEG.

    Science.gov (United States)

    Ofner, Patrick; Schwarz, Andreas; Pereira, Joana; Müller-Putz, Gernot R

    2017-01-01

    How neural correlates of movements are represented in the human brain is of ongoing interest and has been researched with invasive and non-invasive methods. In this study, we analyzed the encoding of single upper limb movements in the time-domain of low-frequency electroencephalography (EEG) signals. Fifteen healthy subjects executed and imagined six different sustained upper limb movements. We classified these six movements and a rest class and obtained significant average classification accuracies of 55% (movement vs movement) and 87% (movement vs rest) for executed movements, and 27% and 73%, respectively, for imagined movements. Furthermore, we analyzed the classifier patterns in the source space and located the brain areas conveying discriminative movement information. The classifier patterns indicate that mainly premotor areas, primary motor cortex, somatosensory cortex and posterior parietal cortex convey discriminative movement information. The decoding of single upper limb movements is specially interesting in the context of a more natural non-invasive control of e.g., a motor neuroprosthesis or a robotic arm in highly motor disabled persons.

  14. Foot posture influences the electromyographic activity of selected lower limb muscles during gait

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2009-11-01

    Full Text Available Abstract Background Some studies have found that flat-arched foot posture is related to altered lower limb muscle function compared to normal- or high-arched feet. However, the results from these studies were based on highly selected populations such as those with rheumatoid arthritis. Therefore, the objective of this study was to compare lower limb muscle function of normal and flat-arched feet in people without pain or disease. Methods Sixty adults aged 18 to 47 years were recruited to this study. Of these, 30 had normal-arched feet (15 male and 15 female and 30 had flat-arched feet (15 male and 15 female. Foot posture was classified using two clinical measurements (the arch index and navicular height and four skeletal alignment measurements from weightbearing foot x-rays. Intramuscular fine-wire electrodes were inserted into tibialis posterior and peroneus longus under ultrasound guidance, and surface EMG activity was recorded from tibialis anterior and medial gastrocnemius while participants walked barefoot at their self-selected comfortable walking speed. Time of peak amplitude, peak and root mean square (RMS amplitude were assessed from stance phase EMG data. Independent samples t-tests were performed to assess for significant differences between the normal- and flat-arched foot posture groups. Results During contact phase, the flat-arched group exhibited increased activity of tibialis anterior (peak amplitude; 65 versus 46% of maximum voluntary isometric contraction and decreased activity of peroneus longus (peak amplitude; 24 versus 37% of maximum voluntary isometric contraction. During midstance/propulsion, the flat-arched group exhibited increased activity of tibialis posterior (peak amplitude; 86 versus 60% of maximum voluntary isometric contraction and decreased activity of peroneus longus (RMS amplitude; 25 versus 39% of maximum voluntary isometric contraction. Effect sizes for these significant findings ranged from 0.48 to 1

  15. Adjustments to amputation and an artificial limb in lower limb amputees.

    Science.gov (United States)

    Sinha, Richa; van den Heuvel, Wim J A; Arokiasamy, Perianayagam

    2014-04-01

    Positive adjustments to amputation and an artificial limb play important roles in the rehabilitation process. To study the different facets of adjustments to amputation and an artificial limb in lower limb amputees and to assess the possible role of different background and amputation-related factors that could potentially influence these adjustments. Cross-sectional. Adult unilateral and non-congenital lower limb amputees (n = 368) met the inclusion/exclusion criteria. Face-to-face interviews were conducted using structured questionnaires including patient's background, amputation and the Trinity Amputation and Prosthesis Experience Scales. Amputees were on average satisfied with the functioning of the prosthesis, moderately psychosocially adjusted and not restricted in performing functional and social activities, except for athletic activities. Age, employment, daily use of prosthesis and assistive device use were the most important factors associated with adjustments to amputation and prosthesis, followed by gender, co-morbidity and amputation level. Evaluation of employment status and measures to curb unemployment through vocational rehabilitation and providing assistance for placement should be intrinsic to the rehabilitation programme. Future studies are envisaged to understand the underlying factors determining the extent of daily use of prosthesis and the reasons for the use of assistive devices by the amputees. Clinical relevance Proper appraisal and measures to alleviate employment and co-morbidity, related issues, routine evaluation of daily use of prosthesis and providing appropriate gait training might facilitate immediate and long-term adjustment.

  16. Origin of directionally tuned responses in lower limb muscles to unpredictable upper limb disturbances.

    Directory of Open Access Journals (Sweden)

    Ali Forghani

    Full Text Available Unpredictable forces which perturb balance are frequently applied to the body through interaction between the upper limb and the environment. Lower limb muscles respond rapidly to these postural disturbances in a highly specific manner. We have shown that the muscle activation patterns of lower limb muscles are organized in a direction specific manner which changes with lower limb stability. Ankle muscles change their activity within 80 ms of the onset of a force perturbation applied to the hand which is earlier than the onset of changes in ground reaction force, ankle angle or head motion. The latency of the response is sensitive to the perturbation direction. However, neither the latency nor the magnitude of the response is affected by stiffening the arm even though this alters the magnitude and timing of motion of the body segments. Based on the short latency, insensitivity of the change in ankle muscle activation to motion of the body segments but sensitivity to perturbation direction we reason that changes in ankle muscle activation are most likely triggered by sensory signals originating from cutaneous receptors in the hand. Furthermore, evidence that the latency of changes in ankle muscle activation depends on the number of perturbation directions suggests that the neural pathway is not confined to the spinal cord.

  17. Origin of directionally tuned responses in lower limb muscles to unpredictable upper limb disturbances.

    Science.gov (United States)

    Forghani, Ali; Milner, Theodore E

    2017-01-01

    Unpredictable forces which perturb balance are frequently applied to the body through interaction between the upper limb and the environment. Lower limb muscles respond rapidly to these postural disturbances in a highly specific manner. We have shown that the muscle activation patterns of lower limb muscles are organized in a direction specific manner which changes with lower limb stability. Ankle muscles change their activity within 80 ms of the onset of a force perturbation applied to the hand which is earlier than the onset of changes in ground reaction force, ankle angle or head motion. The latency of the response is sensitive to the perturbation direction. However, neither the latency nor the magnitude of the response is affected by stiffening the arm even though this alters the magnitude and timing of motion of the body segments. Based on the short latency, insensitivity of the change in ankle muscle activation to motion of the body segments but sensitivity to perturbation direction we reason that changes in ankle muscle activation are most likely triggered by sensory signals originating from cutaneous receptors in the hand. Furthermore, evidence that the latency of changes in ankle muscle activation depends on the number of perturbation directions suggests that the neural pathway is not confined to the spinal cord.

  18. Origin of directionally tuned responses in lower limb muscles to unpredictable upper limb disturbances

    Science.gov (United States)

    Forghani, Ali; Milner, Theodore E.

    2017-01-01

    Unpredictable forces which perturb balance are frequently applied to the body through interaction between the upper limb and the environment. Lower limb muscles respond rapidly to these postural disturbances in a highly specific manner. We have shown that the muscle activation patterns of lower limb muscles are organized in a direction specific manner which changes with lower limb stability. Ankle muscles change their activity within 80 ms of the onset of a force perturbation applied to the hand which is earlier than the onset of changes in ground reaction force, ankle angle or head motion. The latency of the response is sensitive to the perturbation direction. However, neither the latency nor the magnitude of the response is affected by stiffening the arm even though this alters the magnitude and timing of motion of the body segments. Based on the short latency, insensitivity of the change in ankle muscle activation to motion of the body segments but sensitivity to perturbation direction we reason that changes in ankle muscle activation are most likely triggered by sensory signals originating from cutaneous receptors in the hand. Furthermore, evidence that the latency of changes in ankle muscle activation depends on the number of perturbation directions suggests that the neural pathway is not confined to the spinal cord. PMID:29095888

  19. Prenatal imaging of distal limb abnormalities using OCT in mice

    Science.gov (United States)

    Larina, Irina V.; Syed, Saba H.; Dickinson, Mary E.; Overbeek, Paul; Larin, Kirill V.

    2012-01-01

    Congenital abnormalities of the limbs are common birth defects. These include missing or extra fingers or toes, abnormal limb length, and abnormalities in patterning of bones, cartilage or muscles. Optical Coherence Tomography (OCT) is a 3-D imaging modality, which can produce high-resolution (~8 μm) images of developing embryos with an imaging depth of a few millimeters. Here we demonstrate the capability of OCT to perform 3D imaging of limb development in normal embryos and a mouse model with congenital abnormalities. Our results suggest that OCT is a promising tool to analyze embryonic limb development in mammalian models of congenital defects.

  20. Hemodynamic study of ischemic limb by velocity measurement in foot

    International Nuclear Information System (INIS)

    Shionoya, S.; Hirai, M.; Kawai, S.; Ohta, T.; Seko, T.

    1981-01-01

    By means of a tracer technique with 99mTc-pertechnetate, provided with seven zonal regions of interest, 6 mm in width, placed at equal spaces of 18 mm, from the toe tip to the midfoot at a right angle to the long axis of the foot, arterial flow velocity in the foot during reactive hyperemia was measured. The mean velocity in the foot was 5.66 +/- 1.78 cm/sec in 14 normal limbs, 1.58 +/- 1.07 cm/sec in 29 limbs with distal thromboangiitis obliterans (TAO), 0.89 +/- 0.61 cm/sec in 13 limbs with proximal TAO, and 0.97 +/- 0.85 cm/sec in 15 limbs with arteriosclerosis obliterans (ASO). The velocity returned to normal in all 12 limbs after successful arterial reconstruction, whereas the foot or toe blood pressure remained pathologic in 9 of the 12 limbs postoperatively; the velocity reverted to normal in 4 of 13 limbs after lumbar sympathectomy. When the velocity was normalized after operation, the ulceration healed favorably, and the ischemic limb was salvaged. The most characteristic feature of peripheral arterial occlusive disease of the lower extremity was a stagnation of arterial circulation in the foot, and the flow velocity in the foot was a sensitive predictive index of limb salvage

  1. Crash simulation of lower limb with motorcycle basket.

    Science.gov (United States)

    How, C K; Megat Ahmad, M M; Radin Umar, R S; Hamouda, A M; Harwant, S

    2001-03-01

    Lower limb injuries are the main cause of temporary and permanent disability among motorcyclists in Malaysia. They cause non-fatal but serious injuries requiring hospitalisation. Detailed studies on factors influencing lower limb injuries are justified in an attempt to reduce the occurrence of these injuries. This study presents a computer simulation of the crash behaviour of the basket of a small-engined motorcycle with the lower limb using finite element (FE) methods. The results suggest that the extensive deformation of the motorcycle basket may reduce the risk of injury to the lower limb. The behaviour of the basket during collision is analogous to the crumple zone of automobiles.

  2. Sirenomelia: four further cases with discussion of associated upper limb defects.

    Science.gov (United States)

    Moosa, Shahida; Lambie, Lindsay Ann; Krause, Amanda

    2012-07-01

    Sirenomelia, also known as the 'mermaid malformation/syndrome', is a rare, serious congenital anomaly characterized by variable degrees of fusion of the lower limbs and associated severe malformations of the lower vertebral and genitourinary systems. In this report, we describe a series of African patients with sirenomelia. We present the clinical and radiological features of four black South African patients and illustrate some of the rarer associated abnormalities, which include asymmetrical upper limb defects, not confined to the radial ray. The clinical phenotypic overlap between caudal dysgenesis, VACTERL association and sirenomelia in our patients is highlighted, lending support to the theory that these entities may be different manifestations of a single pathogenic process.

  3. Short-latency stretch reflexes do not contribute to premature calf muscle activity during the stance phase of gait in spastic patients.

    Science.gov (United States)

    de Niet, Mark; Latour, Hilde; Hendricks, Henk; Geurts, Alexander C; Weerdesteyn, Vivian

    2011-11-01

    To identify whether a relationship exists between stretch and activity of the calf muscles during the stance phase of gait in patients with upper motor neuron syndrome (UMNS), while taking into account the physiologic phase shift between these entities. Survey. Ambulatory care and general community. Patients with UMNS (n=15; 9 patients with stroke, 6 patients with hereditary spastic paraparesis) with premature calf muscle activity during the stance phase of gait and healthy controls (n=13). Not applicable. Timing of optimal association (phase shift) between the lengthening velocity of the gastrocnemius muscle and its electromyographic activity as revealed by cross-correlation analyses. Although premature calf muscle activity was evident in the patient groups, the phase shift between calf muscle stretch and its activity did not correspond with the monosynaptic stretch reflex latency (40- to 80-ms time window). However, there was a main effect of group on the phase shifts (F(3,33)=3.23, P=.035). Post hoc analysis revealed that in the paretic leg of stroke patients, the electromyographic activity preceded the lengthening velocity by 9 ± 54ms, whereas in the control group, the electromyographic activity followed the pattern of the muscle-lengthening velocity with a delay of 61 ± 54ms (P=.029). Short-latency stretch reflexes do not significantly contribute to premature calf muscle activity in the stance phase of (spastic) gait. This notion questions the validity of the clinical assessment of hyperreflexia and clonus of the calf as a predictor of calf muscle spasticity during gait. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Non-linear stimulus-response behavior of the human stance control system is predicted by optimization of a system with sensory and motor noise.

    Science.gov (United States)

    van der Kooij, Herman; Peterka, Robert J

    2011-06-01

    We developed a theory of human stance control that predicted (1) how subjects re-weight their utilization of proprioceptive and graviceptive orientation information in experiments where eyes closed stance was perturbed by surface-tilt stimuli with different amplitudes, (2) the experimentally observed increase in body sway variability (i.e. the "remnant" body sway that could not be attributed to the stimulus) with increasing surface-tilt amplitude, (3) neural controller feedback gains that determine the amount of corrective torque generated in relation to sensory cues signaling body orientation, and (4) the magnitude and structure of spontaneous body sway. Responses to surface-tilt perturbations with different amplitudes were interpreted using a feedback control model to determine control parameters and changes in these parameters with stimulus amplitude. Different combinations of internal sensory and/or motor noise sources were added to the model to identify the properties of noise sources that were able to account for the experimental remnant sway characteristics. Various behavioral criteria were investigated to determine if optimization of these criteria could predict the identified model parameters and amplitude-dependent parameter changes. Robust findings were that remnant sway characteristics were best predicted by models that included both sensory and motor noise, the graviceptive noise magnitude was about ten times larger than the proprioceptive noise, and noise sources with signal-dependent properties provided better explanations of remnant sway. Overall results indicate that humans dynamically weight sensory system contributions to stance control and tune their corrective responses to minimize the energetic effects of sensory noise and external stimuli.

  5. Postural instability detection: aging and the complexity of spatial-temporal distributional patterns for virtually contacting the stability boundary in human stance.

    Directory of Open Access Journals (Sweden)

    Melissa C Kilby

    Full Text Available Falls among the older population can severely restrict their functional mobility and even cause death. Therefore, it is crucial to understand the mechanisms and conditions that cause falls, for which it is important to develop a predictive model of falls. One critical quantity for postural instability detection and prediction is the instantaneous stability of quiet upright stance based on motion data. However, well-established measures in the field of motor control that quantify overall postural stability using center-of-pressure (COP or center-of-mass (COM fluctuations are inadequate predictors of instantaneous stability. For this reason, 2D COP/COM virtual-time-to-contact (VTC is investigated to detect the postural stability deficits of healthy older people compared to young adults. VTC predicts the temporal safety margin to the functional stability boundary ( =  limits of the region of feasible COP or COM displacement and, therefore, provides an index of the risk of losing postural stability. The spatial directions with increased instability were also determined using quantities of VTC that have not previously been considered. Further, Lempel-Ziv-Complexity (LZC, a measure suitable for on-line monitoring of stability/instability, was applied to explore the temporal structure or complexity of VTC and the predictability of future postural instability based on previous behavior. These features were examined as a function of age, vision and different load weighting on the legs. The primary findings showed that for old adults the stability boundary was contracted and VTC reduced. Furthermore, the complexity decreased with aging and the direction with highest postural instability also changed in aging compared to the young adults. The findings reveal the sensitivity of the time dependent properties of 2D VTC to the detection of postural instability in aging, availability of visual information and postural stance and potential applicability as a

  6. Acupuncture Points of the Horse’s Distal Thoracic Limb: A Neuroanatomic Approach to the Transposition of Traditional Points

    Directory of Open Access Journals (Sweden)

    Lisa S. Lancaster

    2012-09-01

    Full Text Available Veterinary acupuncture charts were developed based on the concept of transpositional points whereby human acupuncture maps were adapted to animal anatomy. Transpositional acupuncture points have traditionally been placed in specific locations around the horse’s coronet and distal limb believed to be the closest approximation to the human distal limb points. Because the horse has a single digit and lacks several structures analogous to the human hand and foot, precisely transposing all of the human digital points is not anatomically possible. To date there is no published research on the effect of acupuncture treatment of the equine distal limb points. This paper presents a modified approach to equine distal limb point selection based on what is known from research on other species about the neuroanatomic method of acupuncture. A rationale is presented for modification of traditional equine ting points as well as additional points around the hoof and distal limb that do not appear in the standard textbooks of equine acupuncture. The anatomy and physiology of the equine foot likely to be affected by acupuncture are briefly reviewed. Modified neuroanatomic points are proposed that may be more accurate as transpositional points. As an example of clinical application, a neuroanatomic approach to acupuncture treatment of equine laminitis is presented.

  7. Limb Regeneration in Axolotl: Is It Superhealing?

    Directory of Open Access Journals (Sweden)

    Stéphane Roy

    2006-01-01

    Full Text Available The ability of axolotls to regenerate their limbs is almost legendary. In fact, urodeles such as the axolotl are the only vertebrates that can regenerate multiple structures like their limbs, jaws, tail, spinal cord, and skin (the list goes on throughout their lives. It is therefore surprising to realize, although we have known of their regenerative potential for over 200 years, how little we understand the mechanisms behind this achievement of adult tissue morphogenesis. Many observations can be drawn between regeneration and other disciplines such as development and wound healing. In this review, we present new developments in functional analysis that will help to address the role of specific genes during the process of regeneration. We also present an analysis of the resemblance between wound healing and regeneration, and discuss whether axolotls are superhealers. A better understanding of these animals' regenerative capacity could lead to major benefits by providing regenerative medicine with directions on how to develop therapeutic approaches leading to regeneration in humans.

  8. Hemiplegic limb synergies in stroke patients.

    Science.gov (United States)

    Welmer, Anna-Karin; Holmqvist, Lotta Widén; Sommerfeld, Disa K

    2006-02-01

    To describe the extent to which the voluntary movements of hemiparetic stroke patients are restricted to the hemiplegic limb synergies (which are marked by the inability to master individual joint movements) described by Brunnström. The study also aimed to describe the extent to which the synergies are related to functioning. In a prospective observational study design, 64 consecutive hemiparetic stroke patients were assessed with Brunnström's hemiplegic limb synergies, the modified Ashworth scale for spasticity, the Rivermead mobility index, and the Barthel ADL index. Three months after stroke, 8 of the 64 patients were moving completely or partly within the synergies. All patients whose movements were restricted to the synergies also exhibited spasticity. Hemiparetic patients whose movements were restricted to the synergies had significantly worse functioning scores than hemiparetic patients whose movements were not restricted to the synergies although severe disabilities were seen in both groups. Three months after stroke, the voluntary movements of only 13% of hemiparetic stroke patients were restricted to the synergies. The synergies were associated with spasticity and activity limitations. The use of the synergies might only be suitable for a small fraction of hemiparetic patients-namely, those displaying spasticity.

  9. Altitude Registration of Limb-Scattered Radiation

    Science.gov (United States)

    Moy, Leslie; Bhartia, Pawan K.; Jaross, Glen; Loughman, Robert; Kramarova, Natalya; Chen, Zhong; Taha, Ghassan; Chen, Grace; Xu, Philippe

    2017-01-01

    One of the largest constraints to the retrieval of accurate ozone profiles from UV backscatter limb sounding sensors is altitude registration. Two methods, the Rayleigh scattering attitude sensing (RSAS) and absolute radiance residual method (ARRM), are able to determine altitude registration to the accuracy necess