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Sample records for voluntary knee extension

  1. Voluntary Movement Frequencies in Submaximal One- and Two-Legged Knee Extension Exercise and Pedaling.

    Science.gov (United States)

    Stang, Julie; Wiig, Håvard; Hermansen, Marte; Hansen, Ernst Albin

    2016-01-01

    Understanding of behavior and control of human voluntary rhythmic stereotyped leg movements is useful in work to improve performance, function, and rehabilitation of exercising, healthy, and injured humans. The present study aimed at adding to the existing understanding within this field. To pursue the aim, correlations between freely chosen movement frequencies in relatively simple, single-joint, one- and two-legged knee extension exercise were investigated. The same was done for more complex, multiple-joint, one- and two-legged pedaling. These particular activities were chosen because they could be considered related to some extent, as they shared a key aspect of knee extension, and because they at the same time were different. The activities were performed at submaximal intensities, by healthy individuals (n = 16, thereof eight women; 23.4 ± 2.7 years; 1.70 ± 0.11 m; 68.6 ± 11.2 kg). High and fair correlations (R-values of 0.99 and 0.75) occurred between frequencies generated with the dominant leg and the nondominant leg during knee extension exercise and pedaling, respectively. Fair to high correlations (R-values between 0.71 and 0.95) occurred between frequencies performed with each of the two legs in an activity, and the two-legged frequency performed in the same type of activity. In general, the correlations were higher for knee extension exercise than for pedaling. Correlations between knee extension and pedaling frequencies were of modest occurrence. The correlations between movement frequencies generated separately by each of the legs might be interpreted to support the following working hypothesis, which was based on existing literature. It is likely that involved central pattern generators (CPGs) of the two legs share a common frequency generator or that separate frequency generators of each leg are attuned via interneuronal connections. Further, activity type appeared to be relevant. Thus, the apparent common rhythmogenesis for the two legs appeared

  2. Voluntary movement frequencies in submaximal one- and two-legged knee extension exercise and pedaling

    Directory of Open Access Journals (Sweden)

    Julie Sørbø Stang

    2016-02-01

    Full Text Available Understanding of behavior and control of human voluntary rhythmic stereotyped leg movements is useful in work to improve performance, function, and rehabilitation of exercising, healthy, and injured humans. The present study aimed at adding to the existing understanding within this field. To pursue the aim, correlations between freely chosen movement frequencies in relatively simple, single-joint, one- and two-legged knee extension exercise were investigated. The same was done for more complex, multiple-joint, one- and two-legged pedaling. These particular activities were chosen because they could be considered related to some extent, as they shared a key aspect of knee extension, and because they at the same time were different. The activities were performed at submaximal intensities, by healthy individuals (n=16, thereof 8 women; 23.4±2.7 years; 1.70±0.11 m; 68.6±11.2 kg.High and fair correlations (R-values of 0.99 and 0.75 occurred between frequencies generated with the dominant leg and the nondominant leg during knee extension exercise and pedaling, respectively. Fair to high correlations (R-values between 0.71 and 0.95 occurred between frequencies performed with each of the two legs in an activity, and the two-legged frequency performed in the same type of activity. In general, the correlations were higher for knee extension exercise than for pedaling. Correlations between knee extension and pedaling frequencies were of modest occurrence.The correlations between movement frequencies generated separately by each of the legs might be interpreted to support the following working hypothesis, which was based on existing literature. It is likely that involved central pattern generators (CPGs of the two legs share a common frequency generator or that separate frequency generators of each leg are attuned via interneuronal connections. Further, activity type appeared to be relevant. Thus, the apparent common rhythmogenesis for the two legs

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

    Science.gov (United States)

    Park, Jihong; Hopkins, J Ty

    2013-01-01

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

  4. Characteristics of fast voluntary and electrically evoked isometric knee extensions during 56 days of bed rest with and without exercise countermeasure.

    NARCIS (Netherlands)

    Mulder, E.R.; Gerrits, K.H.; Rittweger, J.; Felsenberg, D.; Stegeman, D.F.; Haan, A. de

    2008-01-01

    The contractile characteristics of fast voluntary and electrically evoked unilateral isometric knee extensions were followed in 16 healthy men during 56 days of horizontal bed rest and assessed at bed rest days 4, 7, 10, 17, 24, 38 and 56. Subjects were randomized to either an inactive control group

  5. Effect of antagonist muscle fatigue on knee extension torque.

    Science.gov (United States)

    Beltman, J G M; Sargeant, A J; Ball, D; Maganaris, C N; de Haan, A

    2003-09-01

    The effect of hamstring fatigue on knee extension torque was examined at different knee angles for seven male subjects. Before and after a dynamic flexion fatigue protocol (180 degrees s(-1), until dynamic torque had declined by 50%), maximal voluntary contraction extension torque was measured at four knee flexion angles (90 degrees, 70 degrees, 50 degrees and 30 degrees ). Maximal torque generating capacity and voluntary activation of the quadriceps muscle were determined using electrical stimulation. Average rectified EMG of the biceps femoris was determined. Mean dynamic flexion torque declined by 48+/-11%. Extensor maximal voluntary contraction torque, maximal torque generating capacity, voluntary activation and average rectified EMG at the four knee angles were unaffected by the hamstring fatigue protocol. Only at 50 degrees knee angle was voluntary activation significantly lower (15.7%) after fatigue ( P<0.05). In addition, average rectified EMG before fatigue was not significantly influenced by knee angle. It was concluded that a fatigued hamstring muscle did not increase the maximal voluntary contraction extension torque and knee angle did not change coactivation. Three possible mechanisms may explain the results: a potential difference in recruited fibre populations in antagonist activity compared with the fibres which were fatigued in the protocol, a smaller loss in isometric torque generating capacity of the hamstring muscle than was expected from the dynamic measurements and/or a reduction in voluntary activation.

  6. Traumatic knee extension deficit (the locked knee)

    DEFF Research Database (Denmark)

    Helmark, I C; Neergaard, K; Krogsgaard, M R

    2007-01-01

    In the present study we investigated the validity of magnetic resonance imaging (MRI) and arthroscopy in knees with acute, traumatic extension deficit (the "locked knee"), and evaluated whether arthroscopy of knees with no mechanical pathology could be avoided by MRI evaluation. The study consisted...... of 50 patients who had an acute, traumatic extension deficit of the knee. All patients were submitted to MRI prior to arthroscopy. Following MRI and surgery, standardized forms were filled out, attempting to objectify the findings. The orthopaedic surgeon was not aware of the MRI result prior to surgery......, the following results were calculated for the overall appearance of a lesion able to cause locking: Positive predictive value = 0.85, negative predictive value = 0.77, sensitivity = 0.95, specificity = 0.53. Two knees were erroneously evaluated with no mechanical locking at MRI (one bucket-handle lesion and one...

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

    Becker, R; Awiszus, F

    2001-05-01

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

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

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

    2014-09-01

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

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

    Science.gov (United States)

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

    2009-09-01

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

  12. Loss of knee-extension strength is related to knee swelling after total knee arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Kristensen, Morten T; Bencke, Jesper;

    2010-01-01

    To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA).......To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA)....

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

    Science.gov (United States)

    Spring, Alexander; Kofman, Jonathan; Lemaire, Edward

    2011-01-01

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

  14. Simultaneous Knee Extensor Muscle Action Induces an Increase in Voluntary Force Generation of Plantar Flexor Muscles.

    Science.gov (United States)

    Suzuki, Takahito; Shioda, Kohei; Kinugasa, Ryuta; Fukashiro, Senshi

    2017-02-01

    Suzuki, T, Shioda, K, Kinugasa, R, and Fukashiro, S. Simultaneous knee extensor muscle action induces an increase in voluntary force generation of plantar flexor muscles. J Strength Cond Res 31(2): 365-371, 2017-Maximum activation of the plantar flexor muscles is required for various sporting activities that involve simultaneous plantar flexion and knee extension. During a multi-joint movement, activation of the plantar flexor muscles is affected by the activity of the knee extensor muscles. We hypothesized that coactivation of the plantar flexor muscles and knee extensor muscles would result in a higher plantar flexion torque. To test this hypothesis, 8 male volunteers performed maximum voluntary isometric action of the plantar flexor muscles with and without isometric action of the knee extensor muscles. Surface electromyographic data were collected from 8 muscles of the right lower limb. Voluntary activation of the triceps surae muscles, evaluated using the interpolated twitch technique, significantly increased by 6.4 percentage points with intentional knee extensor action (p = 0.0491). This finding is in line with a significant increase in the average rectified value of the electromyographic activity of the vastus lateralis, fibularis longus, and soleus muscles (p = 0.013, 0.010, and 0.045, respectively). The resultant plantar flexion torque also significantly increased by 11.5% of the predetermined maximum (p = 0.031). These results suggest that higher plantar flexor activation coupled with knee extensor activation facilitates force generation during a multi-joint task.

  15. Twitch potentiation induced by stimulated and voluntary isometric contractions at various torque levels in human knee extensor muscles.

    Science.gov (United States)

    Miyamoto, Naokazu; Yanai, Toshimasa; Kawakami, Yasuo

    2011-03-01

    The purpose of this study was to compare the extent of twitch potentiation (TP) after stimulated or voluntary contractions at identical intensities for the human knee extensor muscles. Isometric knee extensions of 10 s were performed at 20%, 40%, and 60% of maximal voluntary contraction (MVC) torque level, through percutaneous electrical stimulation of the quadriceps at 80 Hz or voluntary contraction. Twitch responses were evoked by stimulating the femoral nerve percutaneously with supramaximal intensity. The extent of TP after the stimulated contraction was greater than that after the voluntary contraction at the 20% MVC torque level, whereas a stimulated contraction induced a smaller extent of TP than did a voluntary contraction at contraction intensities higher than 40% MVC. We suggest that this contraction intensity dependence of differences in TP after stimulated and voluntary isometric conditioning contractions is responsible for differences in the recruitment pattern of motor units during the conditioning contractions.

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

    Science.gov (United States)

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

    2016-01-01

    The knee range of motion is an important outcome of total knee arthroplasty (TKA). According to previous studies, the knee range of motion temporarily decreases for approximately 1 month after TKA due to postoperative pain and quadriceps dysfunction following surgical invasion into the knee extensor mechanism. We describe our experience with a knee-extension training program based on a single-joint hybrid assistive limb (HAL-SJ, Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after TKA. HAL-SJ is a wearable robot suit that facilitates the voluntary control of knee joint motion. A 76-year-old man underwent HAL-SJ-based knee-extension training, which enabled him to perform knee function training during the acute phase after TKA without causing increased pain. Thus, he regained the ability to fully extend his knee postoperatively. HAL-SJ-based knee-extension training can be used as a novel post-TKA rehabilitation modality.

  17. Kinesio Taping effects on knee extension force among soccer players

    Directory of Open Access Journals (Sweden)

    Maysa V. G. B. Serra

    2015-04-01

    Full Text Available Background : Kinesio Taping (KT is widely used, however the effects of KT on muscle activation and force are contradictory. Objective : To evaluate the effects of KT on knee extension force in soccer players. Method: This is a clinical trial study design. Thirty-four subjects performed two maximal isometric voluntary contractions of the lower limbs pre, immediately post, and 24 hours after tape application on the lower limbs. Both lower limbs were taped, using K-Tape and 3M Micropore tape randomly on the right and left thighs of the participants. Isometric knee extension force was measured for dominant side using a strain gauge. The following variables were assessed: peak force, time to peak force, rate of force development until peak force, time to peak rate of force development, and 200 ms pulse. Results : There were no statistically significant differences in the variables assessed between KT and Micropore conditions (F=0.645, p=0.666 or among testing sessions (pre, post, and 24h after (F=0.528, p=0.868, and there was no statistical significance (F=0.271, p=0.986 for interaction between tape conditions and testing session. Conclusion: KT did not affect the force-related measures assessed immediately and 24 hours after the KT application compared with Micropore application, during maximal isometric voluntary knee extension.

  18. Effect of remote voluntary contractions on knee extensor torque and rate of velocity development.

    Science.gov (United States)

    Cherry, Emily A; Brown, Lee E; Coburn, Jared W; Noffal, Guillermo J

    2010-09-01

    Remote voluntary contractions (RVCs) are described as a muscle action of the prime mover while performing a simultaneous muscle action with another part of the body. Previous studies have shown that RVCs may elicit augmented performance of the prime mover. The purpose of this study was to evaluate the effect of RVCs on knee extensor rate of velocity development (RVD) and peak torque. Fourteen men and 16 women who were regularly active and free of any knee pathology for the past year took part in this study. Subjects performed 3 maximal dynamic knee extensions at 3 velocities with and without an RVC condition. The RVC condition consisted of holding hand dynamometers in each hand and maximally gripping while performing a maximal knee extension movement. The NO-RVC condition was the same only without gripping. Men produced greater peak torque and RVD than did women across speeds and conditions. Analysis demonstrated that RVC had no effect on knee extension peak torque, but RVD decreased in the RVC condition (NO-RVC 2,012.07 [46.52] degrees xs-1xs-1; RVC 1,882.61 [51.84] degrees xs-1xs-1). Grip strength of the left hand at 180 degrees xs-1decreased from 42.03 (14.40) to 38.83 (14.65) kg in the RVC condition. In conclusion, RVC should not be used when attempting to maximize RVD, because it may hinder results when performing a single joint movement.

  19. Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females.

    Directory of Open Access Journals (Sweden)

    K M Hicks

    Full Text Available To investigate whether there is a sex difference in exercise induced muscle damage.Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets, Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20-90°. Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage.Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (p0.05. Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (p<0.05, and remained higher when maximal voluntary eccentric knee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (p<0.05.Based on isometric torque loss, there is no sex difference in exercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage.

  20. Knee extension torque variability after exercise in ACL reconstructed knees.

    Science.gov (United States)

    Goetschius, John; Kuenze, Christopher M; Hart, Joseph M

    2015-08-01

    The purpose of this study was to compare knee extension torque variability in patients with ACL reconstructed knees before and after exercise. Thirty two patients with an ACL reconstructed knee (ACL-R group) and 32 healthy controls (control group) completed measures of maximal isometric knee extension torque (90° flexion) at baseline and following a 30-min exercise protocol (post-exercise). Exercise included 30-min of repeated cycles of inclined treadmill walking and hopping tasks. Dependent variables were the coefficient of variation (CV) and raw-change in CV (ΔCV): CV = (torque standard deviation/torque mean x 100), ΔCV = (post-exercise - baseline). There was a group-by-time interaction (p = 0.03) on CV. The ACL-R group demonstrated greater CV than the control group at baseline (ACL-R = 1.07 ± 0.55, control = 0.79 ± 0.42, p = 0.03) and post-exercise (ACL-R = 1.60 ± 0.91, control = 0.94 ± 0.41, p = 0.001). ΔCV was greater (p = 0.03) in the ACL-R group (0.52 ± 0.82) than control group (0.15 ± 0.46). CV significantly increased from baseline to post-exercise (p = 0.001) in the ACL-R group, while the control group did not (p = 0.06). The ACL-R group demonstrated greater knee extension torque variability than the control group. Exercise increased torque variability more in the ACL-R group than control group.

  1. Oxygenation and EMG in the proximal and distal vastus lateralis during submaximal isometric knee extension

    DEFF Research Database (Denmark)

    Crenshaw, Albert G.; Bronee, Lars; Krag, Ida

    2010-01-01

    /or (2) fatigue development. Nine males performed 2-min sustained isometric knee extensions at 15% and 30% maximum voluntary contraction during which oxygenation and EMG were recorded simultaneously from proximal and distal locations of the vastus lateralis muscle. Near infrared spectroscopy variables...

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  3. Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females.

    Science.gov (United States)

    Hicks, K M; Onambélé, G L; Winwood, K; Morse, C I

    2016-01-01

    To investigate whether there is a sex difference in exercise induced muscle damage. Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets), Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20-90°). Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage. Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (pexercise induced muscle damage (p>0.05). Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (peccentric knee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (pexercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage.

  4. Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females

    Science.gov (United States)

    2016-01-01

    Aim To investigate whether there is a sex difference in exercise induced muscle damage. Materials and Method Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets), Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20–90°). Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage. Results Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (ptorque loss and muscle soreness post exercise induced muscle damage (p>0.05). Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (pknee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (ptorque loss, there is no sex difference in exercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage. PMID:26986066

  5. Neuromuscular function during knee extension exercise after cold water immersion.

    Science.gov (United States)

    Wakabayashi, Hitoshi; Wijayanto, Titis; Tochihara, Yutaka

    2017-06-23

    Human adaptability to cold environment has been focused on in the physiological anthropology and related research area. Concerning the human acclimatization process in the natural climate, it is necessary to conduct a research assessing comprehensive effect of cold environment and physical activities in cold. This study investigated the effect of cold water immersion on the exercise performance and neuromuscular function during maximal and submaximal isometric knee extension. Nine healthy males participated in this study. They performed maximal and submaximal (20, 40, and 60% maximal load) isometric knee extension pre- and post-immersion in 23, 26, and 34 °C water. The muscle activity of the rectus femoris (RF) and vastus lateralis (VL) was measured using surface electromyography (EMG). The percentages of the maximum voluntary contraction (%MVC) and mean power frequency (MPF) of EMG data were analyzed. The post-immersion maximal force was significantly lower in 23 °C than in 26 and 34 °C conditions (P water temperature conditions at 40 and 60% maximal intensities (P muscle fibers conduction velocity. To compensate for the impairment of each muscle fibers function, more muscle fibers might be recruited to maintain the working load. This might result in the greater amplitude of EMG after the cold immersion.

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

    Science.gov (United States)

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

    2009-08-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  8. Effect of knee joint icing on knee extension strength and knee pain early after total knee arthroplasty: a randomized cross-over study

    DEFF Research Database (Denmark)

    Holm, Bente; Husted, Henrik; Kehlet, Henrik

    2012-01-01

    Objective: To investigate the acute effect of knee joint icing on knee extension strength and knee pain in patients shortly after total knee arthroplasty.Design: A prospective, single-blinded, randomized, cross-over study.Setting: A fast-track orthopaedic arthroplasty unit at a university hospital...

  9. Knee and ankle joint torque-angle relationships of multi-joint leg extension.

    Science.gov (United States)

    Hahn, Daniel; Olvermann, Matthias; Richtberg, Jan; Seiberl, Wolfgang; Schwirtz, Ansgar

    2011-07-28

    The force-length-relation (F-l-r) is an important property of skeletal muscle to characterise its function, whereas for in vivo human muscles, torque-angle relationships (T-a-r) represent the maximum muscular capacity as a function of joint angle. However, since in vivo force/torque-length data is only available for rotational single-joint movements the purpose of the present study was to identify torque-angle-relationships for multi-joint leg extension. Therefore, inverse dynamics served for calculation of ankle and knee joint torques of 18 male subjects when performing maximum voluntary isometric contractions in a seated leg press. Measurements in increments of 10° knee angle from 30° to 100° knee flexion resulted in eight discrete angle configurations of hip, knee and ankle joints. For the knee joint we found an ascending-descending T-a-r with a maximum torque of 289.5° ± 43.3 Nm, which closely matches literature data from rotational knee extension. In comparison to literature we observed a shift of optimum knee angle towards knee extension. In contrast, the T-a-r of the ankle joint vastly differed from relationships obtained for isolated plantar flexion. For the ankle T-a-r derived from multi-joint leg extension subjects operated over different sections of the force-length curve, but the ankle T-a-r derived from isolated joint efforts was over the ascending limb for all subjects. Moreover, mean maximum torque of 234.7 ± 56.6 Nm exceeded maximal strength of isolated plantar flexion (185.7 ± 27.8 Nm). From these findings we conclude that muscle function between isolated and more physiological multi-joint tasks differs. This should be considered for ergonomic and sports optimisation as well as for modelling and simulation of human movement.

  10. A new modification of KAFO for assistance in knee extension.

    Science.gov (United States)

    Sarikaya, Selda; Basaran, Aynur; Ortancil, Ozgur; Balbaloglu, Ozlem

    2007-01-01

    In this paper, a dynamic knee-ankle-foot orthosis (KAFO) extension assisted with elastic support, has been described which contributes to stance phase stability and swing phase freedom. The temporal distance factors including velocity, cadence, stride length, and clinical gait assessment score (CGAS) with bare foot and orthosis have been documented. The orthosis enables walking without fully immobilizing the knee.

  11. Isokinetic knee extension and vertical jumping: are they related?

    Science.gov (United States)

    Iossifidou, Anna; Baltzopoulos, Vasilios; Giakas, Giannis

    2005-10-01

    The aim of this study was to examine joint power generation during a concentric knee extension isokinetic test and a squat vertical jump. The isokinetic test joint power was calculated using four different methods. Five participants performed concentric knee extensions at 0.52, 1.57, 3.14 and 5.23 rad x s(-1) on a Lido isokinetic dynamometer. The squat vertical jump was performed on a Kistler force plate. Kinematic data from both tests were collected and analysed using an ELITE optoelectronic system. An inverse dynamics model was applied to measure knee joint moment in the vertical jump. Knee angular position data from the kinematic analysis in the isokinetic test were used to derive the actual knee angular velocity and acceleration, which, in turn, was used to correct the dynamometer moment for inertial effects. Power was measured as the product of angular velocity and moment at the knee joint in both tests. Significant differences (P knee joint power in the two tests (squat vertical jump: 2255 +/- 434 W; isokinetic knee extension: 771 +/- 81 W). Correlation analysis revealed that there is no relationship between the peak knee joint power during the vertical jump and the slow velocity isokinetic tests. Higher isokinetic velocity tests show better relationships with the vertical jump but only if the correct method for joint power calculation is used in the isokinetic test. These findings suggest that there are important differences in muscle activation and knee joint power development that must be taken into consideration when isokinetic tests are used to predict jumping performance.

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

    Science.gov (United States)

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

    2012-12-01

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

  13. Fast unilateral isometric knee extension torque development and bilateral jump height.

    Science.gov (United States)

    de Ruiter, Cornelis J; Van Leeuwen, Daniel; Heijblom, Arjan; Bobbert, Maarten F; de Haan, Arnold

    2006-10-01

    We hypothesized that the initial rate (first 40 ms) of unilateral knee extensor torque development during a maximally fast isometric contraction would depend on the subjects' ability for fast neural activation and that it would predict bilateral jumping performance. Nine males (21.8 +/- 0.9 yr, means +/- SD) performed unilateral fast isometric knee extensions (120 degrees knee angle) without countermovement on a dynamometer and bilateral squat jumps (SJ) and countermovement jumps (CMJ) starting from 90 and 120 degrees knee angles (full extension = 180 degrees ). The dynamometer contractions started either from full relaxation or from an isometric pre-tension (15% maximal isometric torque, Tmax). Torque time integral for the first 40 ms after torque onset (TTI-40, normalized to Tmax) and averaged normalized rectified knee extensor EMG for 40 ms before fast torque onset (EMG-40) were used to quantify initial torque rise and voluntary muscle activation. TTI-40 without pre-tension (range: 0.02-0.19% Tmax per second) was significantly lower than TTI-40 with pre-tension, and both were significantly (r = 0.81 and 0.80) related to EMG-40. During jumping, similar significant positive relations were found between jump height and knee extensor EMG during the first 100 ms of the rise in ground reaction force. There also were significant positive linear relations between dynamometer TTI-40 and jump height (r = 0.75 (SJ 90), 0.84 (SJ 120), 0.76 (CMJ 90), and 0.86 (CMJ 120)) but not between dynamometer Tmax and jump height (-0.16 < r < 0.02). One-legged TTI-40 to a large extent explained the variation in jump height. The ability to produce a high efferent neural drive before muscle contraction seemed to dominate performance in both the simple single-joint isometric task and the complex multijoint dynamic task.

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

    Science.gov (United States)

    Remaud, Anthony; Cornu, Christophe; Guével, Arnaud

    2009-06-01

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

  15. Complex surgical treatment of extension contractures of the knee joint

    Directory of Open Access Journals (Sweden)

    Murodjon Irismetov

    2011-03-01

    Full Text Available The article describes experience with using new surgical treatment of patients with extensive contracture of the knee in the sport trauma department of Research Institute Traumatology and Orthopedics (Uzbekistan. Since 1998 to 2007 this method was used in treatment of 52 patient at age from 17 to 60. Follow-up results of the operative treatment at periods from 6 months up to 1.5 years studied in 43 patients. Good results were observed in 41 patients.

  16. Comparison of different passive knee extension torque-angle assessments.

    Science.gov (United States)

    Freitas, Sandro R; Vaz, João R; Bruno, Paula M; Valamatos, Maria J; Mil-Homens, Pedro

    2013-11-01

    Previous studies have used isokinetic dynamometry to assess joint torques and angles during passive extension of the knee, often without reporting upon methodological errors and reliability outcomes. In addition, the reliability of the techniques used to measure passive knee extension torque-angle and the extent to which reliability may be affected by the position of the subjects is also unclear. Therefore, we conducted an analysis of the intra- and inter-session reliability of two methods of assessing passive knee extension: (A) a 2D kinematic analysis coupled to a custom-made device that enabled the direct measurement of resistance to stretch and (B) an isokinetic dynamometer used in two testing positions (with the non-tested thigh either flexed at 45° or in the neutral position). The intra-class correlation coefficients (ICCs) of torque, the slope of the torque-angle curve, and the parameters of the mathematical model that were fit to the torque-angle data for the above conditions were measured in sixteen healthy male subjects (age: 21.4 ± 2.1 yr; BMI: 22.6 ± 3.3 kg m(-2); tibial length: 37.4 ± 3.4 cm). The results found were: (1) methods A and B led to distinctly different torque-angle responses; (2) passive torque-angle relationship and stretch tolerance were influenced by the position of the non-tested thigh; and (3) ICCs obtained for torque were higher than for the slope and for the mathematical parameters that were fit to the torque-angle curve. In conclusion, the measurement method that is used and the positioning of subjects can influence the passive knee extension torque-angle outcome.

  17. Effects of Series Elasticity on the Human Knee Extension Torque-Angle Relationship in Vivo

    Science.gov (United States)

    Kubo, Keitaro; Ohgo, Kazuya; Takeishi, Ryuichi; Yoshinaga, Kazunari; Tsunoda, Naoya; Kanehisa, Hiroaki; Fukunaga, Tetsuo

    2006-01-01

    The purpose of this study was to investigate the effects of series elasticity on the torque-angle relationship of the knee extensors in vivo. Forty-two men volunteered to take part in the present study. The participants performed maximal voluntary isometric contractions at eight knee-joint angles (40, 50, 60, 70, 80, 90, 100, 110[degree]). The…

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

    Science.gov (United States)

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

    2010-09-01

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

  19. In vivo knee laxity in flexion and extension: a radiographic study in 30 older healthy subjects.

    NARCIS (Netherlands)

    Heesterbeek, P.J.; Verdonschot, N.J.J.; Wymenga, A.B.

    2008-01-01

    In order to determine how "tight" a total knee prosthesis should be implanted, it is important to know the amount of laxity in a healthy knee. The objective of this study was to determine knee laxity in extension and flexion in healthy, non-arthritic knees of subjects similar in age to patients unde

  20. Left ventricular twist mechanics during incremental cycling and knee extension exercise in healthy men.

    Science.gov (United States)

    Beaumont, Alexander; Hough, John; Sculthorpe, Nicholas; Richards, Joanna

    2017-01-01

    The objective of the present study was to investigate left ventricular (LV) twist mechanics in response to incremental cycling and isometric knee extension exercises. Twenty-six healthy male participants (age = 30.42 ± 6.17 years) were used to study peak twist mechanics at rest and during incremental semi-supine cycling at 30 and 60% work rate maximum (W max) and during short duration (15 s contractions) isometric knee extension at 40 and 75% maximum voluntary contraction (MVC), using two-dimensional speckle tracking echocardiography. Data presented as mean ± standard deviation or median (interquartile range). LV twist increased from rest to 30% W max (13.21° ± 4.63° to 20.04° ± 4.76°, p  0.05), whilst twisting velocity increased (rest 89.15° ± 21.77° s(-1) to 75% MVC 124.32° ± 34.89° s(-1), p  0.05) then increased from 40 to 75% MVC [-98.44 (43.54)° s(-1) to -138.42 (73.29)° s(-1), p < 0.01]. Apical rotations and rotational velocities were greater than basal during all conditions and intensities (all p < 0.01). Cycling increased LV twist to 30% W max which then remained unchanged thereafter, whereas twisting velocities showed further increases to greater intensities. A novel finding is that LV twist was unaffected by incremental knee extension, yet systolic and diastolic twisting velocities augmented with isometric exercise.

  1. Vastus lateralis muscle architecture to estimate knee extension moment of older individuals

    Directory of Open Access Journals (Sweden)

    Guilherme Auler Brodt

    2015-12-01

    Full Text Available Abstract The aim of this study was to compare the knee extension moment of older individuals with the muscle moment estimated through a biomechanical model. This was accomplished by using (1 the specific muscle architecture data of individuals, and (2 the generic muscle architecture available in the literature. The muscle force estimate was determined using a model with the muscle architecture from cadavers and the individual vastus lateralis muscle architecture of sixteen older volunteers. For the muscle moment comparison, all of the volunteers performed maximal voluntary isometric contractions (MVIC in five different knee extension position angles. The architectural data was acquired using both resonance and ultrasound imaging. Both estimated muscle moments (generic and individual were higher than the experimental. The architecture of the other vastii may be necessary to make the model more accurate for the older population. Although other factors inherent to ageing, such as co-contractions, fiber type percentage, and passive forces are not considered in the model, they could be responsible for the differences between moments in older people.

  2. The effectiveness of posterior knee capsulotomies and knee extension osteotomies in crouched gait in children with cerebral palsy.

    Science.gov (United States)

    Taylor, Daveda; Connor, Justin; Church, Chris; Lennon, Nancy; Henley, John; Niiler, Tim; Miller, Freeman

    2016-11-01

    Crouched gait is common in children with cerebral palsy (CP), and there are various treatment options. This study evaluated the effectiveness of single-event multilevel surgery including posterior knee capsulotomy or distal femoral extension osteotomy to correct knee flexion contracture in children with CP. Gait analyses were carried out to evaluate gait preoperatively and postoperatively. Significant improvements were found in physical examination and kinematic measures, which showed that children with CP and crouched gait who develop knee flexion contractures can be treated effectively using single-event multilevel surgery including a posterior knee capsulotomy or distal femoral extension osteotomy.

  3. The hip and knee replacement operation: an extensive life event.

    Science.gov (United States)

    Gustafsson, Birgitta Åkesdotter; Ekman, Sirkka-Liisa; Ponzer, Sari; Heikkilä, Kristiina

    2010-12-01

    A total hip replacement and a total knee replacement have shown to effectively reduce pain and disability in patients with osteoarthritis of the hip and knee joint despite associated risks. Even though the intervention primarily concerns older people with additional health problems, the patients stand on their feet the day after the operation and are discharged a few days later. Previous research indicates that reflections about life are related to the operation. The aim of this study was to illuminate the meaning of reflections related to hip and knee replacement surgery. A phenomenological hermeneutical approach with a longitudinal design was chosen in order to study the participants' experiences of the hip and knee replacement intervention across the entire perioperative period. Four themes emerged from the structural analysis; choosing the challenge, past memories connect to the current situation, moving from happiness to ordinary everyday life and moving from despair towards reluctant acceptance of unexpected bad conditions for everyday life. There was inner negotiations about having surgery or not, and existential anxiety that reminded people that life cannot be taken for granted. Our findings indicate the operation was seen as an extensive life event including reflections about life and death and about hope and fear. Previous bad experiences of care seemed to influence the way patients dealt with fear and hope. Fear had to be overcome by inner negotiations about undergoing surgery or not. Relief was expressed about surviving the actual operation, but soon after fears arose about how to manage on the actual road to recovery. Hope for a good life grew either stronger or weaker, depending on the progress following the operation. The outcome eventually generated a transition from happiness to ordinary everyday life, or a transition from despair towards reluctant acceptance of unfulfilled expectations. © 2010 The Authors. Scandinavian Journal of Caring Sciences

  4. The role of agonist and antagonist muscles in explaining isometric knee extension torque variation with hip joint angle.

    Science.gov (United States)

    Bampouras, Theodoros M; Reeves, Neil D; Baltzopoulos, Vasilios; Maganaris, Constantinos N

    2017-08-12

    The biarticular rectus femoris (RF), operating on the ascending limb of the force-length curve, produces more force at longer lengths. However, experimental studies consistently report higher knee extension torque when supine (longer RF length) compared to seated (shorter RF length). Incomplete activation in the supine position has been proposed as the reason for this discrepancy, but differences in antagonistic co-activation could also be responsible due to altered hamstrings length. We examined the role of agonist and antagonist muscles in explaining the isometric knee extension torque variation with changes in hip joint angle. Maximum voluntary isometric knee extension torque (joint MVC) was recorded in seated and supine positions from nine healthy males (30.2 ± 7.7 years). Antagonistic torque was estimated using EMG and added to the respective joint MVC (corrected MVC). Submaximal tetanic stimulation quadriceps torque was also recorded. Joint MVC was not different between supine (245 ± 71.8 Nm) and seated (241 ± 69.8 Nm) positions and neither was corrected MVC (257 ± 77.7 and 267 ± 87.0 Nm, respectively). Antagonistic torque was higher when seated (26 ± 20.4 Nm) than when supine (12 ± 7.4 Nm). Tetanic torque was higher when supine (111 ± 31.9 Nm) than when seated (99 ± 27.5 Nm). Antagonistic co-activation differences between hip positions do not account for the reduced MVC in the supine position. Rather, reduced voluntary knee extensor muscle activation in that position is the major reason for the lower MVC torque when RF is lengthened (hip extended). These findings can assist standardising muscle function assessment and improving musculoskeletal modelling applications.

  5. Thigh and knee circumference, knee-extension strength, and functional performance after fast-track total hip arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Kristensen, Morten Tange; Husted, Henrik;

    2011-01-01

    OBJECTIVE: To (1) quantify changes in knee-extension strength and functional-performance at discharge after fast-track total hip arthroplasty (THA) and (2) investigate whether these changes correlate to changes in thigh and knee circumference (ie, swelling) or pain. DESIGN: A prospective......, descriptive, hypothesis-generating study. SETTING: A special unit for fast-track hip and knee arthroplasty operations at a university hospital. PARTICIPANTS: Twenty-four patients (20 women and 4 men; ages 69 ± 6.1 years) scheduled for primary unilateral THA. METHODS: All patients were evaluated before surgery...... and on the day of hospital discharge. MAIN OUTCOME MEASURES: Knee-extension strength, thigh and knee joint circumference, hip pain, and functional performance (Timed Up & Go, 30-Second Chair Stand, and 10-Meter Walk tests). RESULTS: All investigated variables changed significantly from before to after surgery...

  6. Lower extremity extension force and electromyography properties as a function of knee angle and their relation to joint torques: implications for strength diagnostics.

    Science.gov (United States)

    Hahn, Daniel

    2011-06-01

    The purpose of this study was to evaluate whether and how isometric multijoint leg extension strength can be used to assess athletes' muscular capability within the scope of strength diagnosis. External reaction forces (Fext) and kinematics were measured (n = 18) during maximal isometric contractions in a seated leg press at 8 distinct joint angle configurations ranging from 30 to 100° knee flexion. In addition, muscle activation of rectus femoris, vastus medialis, biceps femoris c.l., gastrocnemius medialis, and tibialis anterior was obtained using surface electromyography (EMG). Joint torques for hip, knee, and ankle joints were computed by inverse dynamics. The results showed that unilateral Fext decreased significantly from 3,369 ± 575 N at 30° knee flexion to 1,015 ± 152 N at 100° knee flexion. Despite maximum voluntary effort, excitation of all muscles as measured by EMG root mean square changed with knee flexion angles. Moreover, correlations showed that above-average Fext at low knee flexion is not necessarily associated with above-average Fext at great knee flexion and vice versa. Similarly, it is not possible to deduce high joint torques from high Fext just as above-average joint torques in 1 joint do not signify above-average torques in another joint. From these findings, it is concluded that an evaluation of muscular capability by means of Fext as measured for multijoint leg extension is strongly limited. As practical recommendation, we suggest analyzing multijoint leg extension strength at 3 distinct knee flexion angles or at discipline-specific joint angles. In addition, a careful evaluation of muscular capacity based on measured Fext can be done for knee flexion angles ≥ 80°. For further and detailed analysis of single muscle groups, the use of inverse dynamic modeling is recommended.

  7. The Effects of Hamstring Stretching on Leg Rotation during Knee Extension.

    Science.gov (United States)

    Kimura, Atsushi

    2013-06-01

    [Purpose] This study investigated the effects of hamstring stretching on leg rotation during active knee extension. [Subjects] Subjects were 100 bilateral legs of 50 healthy women without articular disease. [Methods] Hamstring hardness, leg rotation and muscle activities of the knee extensors during active knee extension were measured before and after hamstring stretching. [Results] Hamstring hardness was significantly decreased after hamstring stretching. The leg rotation angle, variation in leg rotation angle, variation in leg external rotation angle, and muscle activities of the vastus lateralis and rectus femoris were significantly increased after hamstring stretching. A moderate positive correlation was found between variation in leg rotation and variation in muscle hardness in hamstring. [Conclusion] Leg rotation during active knee extension was increased by hamstring stretching. Hamstring stretching would be effective as a pretreatment for restoring proper leg rotation when knee extension is conducted as a therapeutic exercise.

  8. [Sincerity of effort: isokinetic evaluation of knee extension].

    Science.gov (United States)

    Colombo, R; Demaiti, G; Sartorio, F; Orlandini, D; Vercelli, S; Ferriero, G

    2008-01-01

    The aim of this study was to find a reliable method to evaluate the sincerity of the muscular maximal effort performed in a dynamometric isokinetic test of knee flexion-extension. The coefficient of variation of the peak torque (CV) and 3 new indices were analysed: (1) the average coefficient of variation calculated on the complete peak torque curve (CVM); (2) the slope of the regression line in an endurance test (PRR); (3) the correlation coefficient of the peak torques in the same endurance test (CCR). Twenty healthy subjects underwent assessment in two different trials, maximal (MX) and 50% submaximal (SMX), with 20 minutes of rest between trials. Each trial consisted of 4 tests, each of 3 repetitions, at angular speed of 30, 180, 30, and 180 degrees/s, respectively, and 1 test of 15 repetitions at 240 degrees/s. Our findings confirmed the ability of CV to detect a high percentage of sincere efforts: at 30 degrees/s Sensibility (Sns)=100% and Specificity (Spc)=70%; at 180 degrees/s Sns=75%, Spc=95%. The 3 new indices here proposed showed high characteristics of Sns and Spc, generally better than those of CV. CVM showed at 180 degrees/s Sns=90% and Spc=100%, while at 30 degrees/s Sns=90%, Spc=75%. PRR was the best index identifying all the efforts, except one (Sns=100%, Spc=95%). The CCR coefficient showed Sns and Spc values both of 90%.

  9. Quasi-stiffness of the knee joint in flexion and extension during the golf swing.

    Science.gov (United States)

    Choi, Ahnryul; Sim, Taeyong; Mun, Joung Hwan

    2015-01-01

    Biomechanical understanding of the knee joint during a golf swing is essential to improve performance and prevent injury. In this study, we quantified the flexion/extension angle and moment as the primary knee movement, and evaluated quasi-stiffness represented by moment-angle coupling in the knee joint. Eighteen skilled and 23 unskilled golfers participated in this study. Six infrared cameras and two force platforms were used to record a swing motion. The anatomical angle and moment were calculated from kinematic and kinetic models, and quasi-stiffness of the knee joint was determined as an instantaneous slope of moment-angle curves. The lead knee of the skilled group had decreased resistance duration compared with the unskilled group (P knee was lower than that of the trail knee in the skilled group (P knee of the skilled golfers had greater flexible excursion duration than the trail knee of the skilled golfers, and of both the lead and trail knees of the unskilled golfers. These results provide critical information for preventing knee injuries during a golf swing and developing rehabilitation strategies following surgery.

  10. Local architecture of the vastus intermedius is a better predictor of knee extension force than that of the other quadriceps femoris muscle heads.

    Science.gov (United States)

    Ando, Ryosuke; Saito, Akira; Umemura, Yoshihisa; Akima, Hiroshi

    2015-09-01

    The purpose of this study was to determine whether the muscle architecture of each head of the quadriceps femoris (QF) at multiple regions can be used to predict knee extension force. Muscle thickness and pennation angle were measured using sonographic images from multiple regions on each muscle of the QF with the knee flexed to 90°. The fascicle lengths of the rectus femoris (RF), vastus lateralis (VL) and vastus intermedius (VI) muscles were estimated based on sonographic images taken along the length of the thigh. The muscle architecture of the vastus intermedius was determined in two separate locations using sonographic images of the anterior (ant-VI) and lateral portions (lat-VI). The maximal voluntary contraction (MVC) was measured during isometric knee extension at a knee joint angle of 90°. The relationship between MVC force and muscle architecture was examined using a stepwise linear regression analysis with MVC force as the dependent variable. The muscle thickness of the ant-VI was selected as an independent variable in the first step of the linear regression analysis (R(2) = 0.66, Parchitecture of the VI is the best predictor of knee extension force.

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

    Science.gov (United States)

    Katsavelis, Dimitrios; Threlkeld, A Joseph

    2014-08-01

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

  12. Preliminary analysis of knee stress in Full Extension Landing

    Directory of Open Access Journals (Sweden)

    Majid Davoodi Makinejad

    2013-09-01

    Full Text Available OBJECTIVE: This study provides an experimental and finite element analysis of knee-joint structure during extended-knee landing based on the extracted impact force, and it numerically identifies the contact pressure, stress distribution and possibility of bone-to-bone contact when a subject lands from a safe height. METHODS: The impact time and loads were measured via inverse dynamic analysis of free landing without knee flexion from three different heights (25, 50 and 75 cm, using five subjects with an average body mass index of 18.8. Three-dimensional data were developed from computed tomography scans and were reprocessed with modeling software before being imported and analyzed by finite element analysis software. The whole leg was considered to be a fixed middle-hinged structure, while impact loads were applied to the femur in an upward direction. RESULTS: Straight landing exerted an enormous amount of pressure on the knee joint as a result of the body's inability to utilize the lower extremity muscles, thereby maximizing the threat of injury when the load exceeds the height-safety threshold. CONCLUSIONS: The researchers conclude that extended-knee landing results in serious deformation of the meniscus and cartilage and increases the risk of bone-to-bone contact and serious knee injury when the load exceeds the threshold safety height. This risk is considerably greater than the risk of injury associated with walking downhill or flexion landing activities.

  13. Normalized knee-extension strength or leg-press power after fast-track total knee arthroplasty

    DEFF Research Database (Denmark)

    Aalund, Peter K; Larsen, Kristian; Hansen, Torben Bæk

    2013-01-01

    and dynamic leg presses to determine their body-mass normalized knee extension strength and leg press power, respectively. The 10-m fast speed walking and 30-s chair stand tests were used to determine performance-based function, while the Western Ontario McMaster University Osteoarthritis Index (WOMAC...

  14. Strategies utilized to transfer weight during knee flexion and extension with rotation for individuals with a total knee replacement.

    Science.gov (United States)

    Ferris, Lauren A; Denney, Linda M; Maletsky, Lorin P

    2013-02-01

    Functional activities in daily life can require squatting and shifting body weight during transverse plane rotations. Stability of the knee can be challenging for people with a total knee replacement (TKR) due to reduced proprioception, nonconforming articular geometry, muscle strength, and soft tissue weakness. The objective of this study was to identify strategies utilized by individuals with TKR in double-stance transferring load during rotation and flexion. Twenty-three subjects were recruited for this study: 11 TKR subjects (age: 65 ± 6 years; BMI 27.4 ± 4.1) and 12 healthy subjects (age: 63 ± 7; BMI 24.6 ± 3.8). Each subject completed a novel crossover button push task where rotation, flexion, and extension of the knee were utilized. Each subject performed two crossover reaching tasks where the subject used the opposite hand to cross over their body and press a button next to either their shoulder (high) or knee (low), then switched hands and rotated to press the opposite button, either low or high. The two tasks related to the order they pressed the buttons while crossing over, either low-to-high (L2H) or high-to-low (H2L). Force platforms measured ground reaction forces under each foot, which were then converted to lead force ratios (LFRs) based on the total force. Knee flexion angles were also measured. No statistical differences were found in the LFRs during the H2L and L2H tasks for the different groups, although differences in the variation of the loading within subjects were noted. A significant difference was found between healthy and unaffected knee angles and a strong trend between healthy and affected subject's knee angles in both H2L and L2H tasks. Large variations in the LFR at mid-task in the TKR subjects suggested possible difficulties in maintaining positional stability during these tasks. The TKR subjects maintained more of an extended knee, which is a consistent quadriceps avoidance strategy seen by other researchers in

  15. Effects of hamstring stretching on passive muscle stiffness vary between hip flexion and knee extension maneuvers.

    Science.gov (United States)

    Miyamoto, N; Hirata, K; Kanehisa, H

    2017-01-01

    The purpose of this study was to examine whether the effects of hamstring stretching on the passive stiffness of each of the long head of the biceps femoris (BFl), semitendinosus (ST), and semimembranosus (SM) vary between passive knee extension and hip flexion stretching maneuvers. In 12 male subjects, before and after five sets of 90 s static stretching, passive lengthening measurements where knee or hip joint was passively rotated to the maximal range of motion (ROM) were performed. During the passive lengthening, shear modulus of each muscle was measured by ultrasound shear wave elastography. Both stretching maneuvers significantly increased maximal ROM and decreased passive torque at a given joint angle. Passive knee extension stretching maneuver significantly reduced shear modulus at a given knee joint angle in all of BFl, ST, and SM. In contrast, the stretching effect by passive hip flexion maneuver was significant only in ST and SM. The present findings indicate that the effects of hamstring stretching on individual passive muscles' stiffness vary between passive knee extension and hip flexion stretching maneuvers. In terms of reducing the muscle stiffness of BFl, stretching of the hamstring should be performed by passive knee extension rather than hip flexion. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Yoo, Won-Gyu

    2013-10-01

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

  17. Antagonist muscle moment is increased in ACL deficient subjects during maximal dynamic knee extension

    DEFF Research Database (Denmark)

    Alkjær, Tine; Simonsen, Erik B; Magnusson, S Peter

    2012-01-01

    INTRODUCTION: Coactivation of the hamstring muscles during dynamic knee extension may compensate for increased knee joint laxity in anterior cruciate ligament (ACL) deficient subjects. This study examined if antagonist muscle coactivation during maximal dynamic knee extension was elevated...... in subjects with anterior cruciate ligament (ACL) deficiency compared to age-matched healthy controls. METHODS: Electromyography (EMG) and net knee joint moments were recorded during maximal concentric quadriceps and eccentric hamstring contractions, performed in an isokinetic dynamometer (ROM: 90......-10°, angular speed: 30°/s). Hamstring antagonist EMG recorded during concentric quadriceps contraction was converted into antagonist moment based on the EMG-moment relationship observed during eccentric agonist contractions. RESULTS: The magnitude of antagonist hamstring EMG was 65.5% higher in ACL deficient...

  18. Skinfold thickness affects the isometric knee extension torque evoked by Neuromuscular Electrical Stimulation.

    Science.gov (United States)

    Medeiros, Flávia V A; Vieira, Amilton; Carregaro, Rodrigo L; Bottaro, Martim; Maffiuletti, Nicola A; Durigan, João L Q

    2015-01-01

    Subcutaneous adipose tissue may influence the transmission of electrical stimuli through to the skin, thus affecting both evoked torque and comfort perception associated with neuromuscular electrical stimulation (NMES). This could seriously affect the effectiveness of NMES for either rehabilitation or sports purposes. To investigate the effects of skinfold thickness (SFT) on maximal NMES current intensity, NMES-evoked torque, and NMES-induced discomfort. First, we compared NMES current intensity, NMES-induced discomfort, and NMES-evoked torque between two subgroups of subjects with thicker (n=10; 20.7 mm) vs. thinner (n=10; 29.4 mm) SFT. Second, we correlated SFT to NMES current intensity, NMES-induced discomfort, and NMES-evoked knee extension torque in 20 healthy women. The NMES-evoked torque was normalized to the maximal voluntary contraction (MVC) torque. The discomfort induced by NMES was assessed with a visual analog scale (VAS). NMES-evoked torque was 27.5% lower in subjects with thicker SFT (p=0.01) while maximal current intensity was 24.2% lower in subjects with thinner SFT (p=0.01). A positive correlation was found between current intensity and SFT (r=0.540, p=0.017). A negative correlation was found between NMES-evoked torque and SFT (r=-0.563, p=0.012). No significant correlation was observed between discomfort scores and SFT (rs=0.15, p=0.53). These results suggest that the amount of subcutaneous adipose tissue (as reflected by skinfold thickness) affected NMES current intensity and NMES-evoked torque, but had no effect on discomfort perception. Our findings may help physical therapists to better understand the impact of SFT on NMES and to design more rational stimulation strategies.

  19. Skinfold thickness affects the isometric knee extension torque evoked by Neuromuscular Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Flávia V. A. Medeiros

    2015-12-01

    Full Text Available BACKGROUND: Subcutaneous adipose tissue may influence the transmission of electrical stimuli through to the skin, thus affecting both evoked torque and comfort perception associated with neuromuscular electrical stimulation (NMES. This could seriously affect the effectiveness of NMES for either rehabilitation or sports purposes. OBJECTIVE: To investigate the effects of skinfold thickness (SFT on maximal NMES current intensity, NMES-evoked torque, and NMES-induced discomfort. METHOD: First, we compared NMES current intensity, NMES-induced discomfort, and NMES-evoked torque between two subgroups of subjects with thicker (n=10; 20.7 mm vs. thinner (n=10; 29.4 mm SFT. Second, we correlated SFT to NMES current intensity, NMES-induced discomfort, and NMES-evoked knee extension torque in 20 healthy women. The NMES-evoked torque was normalized to the maximal voluntary contraction (MVC torque. The discomfort induced by NMES was assessed with a visual analog scale (VAS. RESULTS: NMES-evoked torque was 27.5% lower in subjects with thicker SFT (p=0.01 while maximal current intensity was 24.2% lower in subjects with thinner SFT (p=0.01. A positive correlation was found between current intensity and SFT (r=0.540, p=0.017. A negative correlation was found between NMES-evoked torque and SFT (r=-0.563, p=0.012. No significant correlation was observed between discomfort scores and SFT (rs=0.15, p=0.53. CONCLUSION: These results suggest that the amount of subcutaneous adipose tissue (as reflected by skinfold thickness affected NMES current intensity and NMES-evoked torque, but had no effect on discomfort perception. Our findings may help physical therapists to better understand the impact of SFT on NMES and to design more rational stimulation strategies.

  20. Skeletal muscle oxygen uptake in obese patients: functional evaluation by knee-extension exercise.

    Science.gov (United States)

    Lazzer, Stefano; Salvadego, Desy; Porcelli, Simone; Rejc, Enrico; Agosti, Fiorenza; Sartorio, Alessandro; Grassi, Bruno

    2013-08-01

    We hypothesized, in a group of obese women (OB), a more significant impairment of aerobic metabolism during knee extension (KE) exercise vs. that described during cycle ergometer exercise, lending support to the role of skeletal muscles in limiting exercise tolerance in OB. Eleven OB (age 29.5 ± 5.5 years, body mass index 43.2 ± 5.4 kg m(-2)) and 10 non-obese controls (CTRL) women were tested. Fat-free mass of a lower-limb (FFMLL) was assessed by a densitometer. Heart rate (HR) and pulmonary O2 uptake (VO2) were determined during incremental exercise tests to voluntary exhaustion carried out on a custom-built KE ergometer and on a cycle ergometer (CE). FFMLL and maximal isometric force of KE muscles were higher in OB vs. CTRL (+42.4 and +46.2 %, respectively). Peak work rate was significantly lower in OB (-18.4 %) vs. CTRL in CE, but not in KE. Expressed in mL min(-1), peak VO2 was not different in OB vs. CTRL in CE and in KE. After it was divided per unit of FFM involved in the exercises, peak VO2 was significantly lower in OB vs. CTRL, both for CE (-19 %) and KE (-33 %). Expressed per unit of exercising muscle mass, peak oxidative function is impaired in OB. The impairment is more pronounced after limitations related to cardiovascular O2 delivery are reduced. In OB muscle hypertrophy and the increased muscle force allow to preserve exercise tolerance during aerobic exercises carried out by relatively small muscle masses.

  1. Multijoint kinetic chain analysis of knee extension during the soccer instep kick.

    Science.gov (United States)

    Naito, Kozo; Fukui, Yosuke; Maruyama, Takeo

    2010-04-01

    Although previous studies have shown that motion-dependent interactions between adjacent segments play an important role in producing knee extension during the soccer instep kick, detailed knowledge about the mechanisms underlying those interactions is lacking. The present study aimed to develop a 3-D dynamical model for the multijoint kinetic chain of the instep kick in order to quantify the contributions of the causal dynamical factors to the production of maximum angular velocity during knee extension. Nine collegiate soccer players volunteered to participate in the experiment and performed instep kicking movements while 3-D positional data and the ground reaction force were measured. A dynamical model was developed in the form of a linked system containing 8 segments and 18 joint rotations, and the knee extension/flexion motion was decomposed into causal factors related to muscular moment, gyroscopic moment, centrifugal force, Coriolis force, gravity, proximal endpoint linear acceleration, and external force-dependent terms. The rapid knee extension during instep kicking was found to result almost entirely from kicking leg centrifugal force, trunk rotation muscular moment, kicking leg Coriolis force, and trunk rotation gyroscopic-dependent components. Based on the finding that rapid knee extension during instep kicking stems from multiple dynamical factors, it is suggested that the multijoint kinetic chain analysis used in the present study is more useful for achieving a detailed understanding of the cause of rapid kicking leg movement than the previously used 2-D, two-segment kinetic chain model. The present results also indicated that the centrifugal effect due to the kicking hip flexion angular velocity contributed substantially to the generation of a rapid knee extension, suggesting that the adjustment between the kicking hip flexion angular velocity and the leg configuration (knee flexion angle) is more important for effective instep kicking than other

  2. Percutaneous quadriceps tendon pie-crusting release of extension contracture of the knee.

    Science.gov (United States)

    Liu, H X; Wen, H; Hu, Y Z; Yu, H C; Pan, X Y

    2014-05-01

    To release extension contracture of the knee, the authors used a minimally invasive technique: percutaneous quadriceps tendon pie-crusting release. Percutaneous pie-crusting release was performed using an 18-gauge needle to puncture the stiff fibrous band of the distal and lateral quadriceps tendon under maximum knee flexion. Quadriceps contracture was gradually released by multiple needle punctures. A knee brace was prescribed for one week and knee flexion exercises were performed on the first postoperative day. This technique was performed in seven post-traumatic stiff knees and five stiff total knee arthroplasties. Mean maximum flexion increased from 37° preoperatively to 50° after arthrolysis and 107(o) after pie-crusting. At a mean follow-up of eight months, mean maximum flexion was 103°. There were no major complications. The technique of quadriceps tendon pie-crusting release is a simple, minimally invasive and effective treatment for knee extension contracture. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Relation of selective voluntary motor control of the lower extremity and extensor strength of the knee joint in children with spastic diplegia.

    Science.gov (United States)

    Kusumoto, Yasuaki; Takaki, Kenji; Matsuda, Tadamitsu; Nitta, Osamu

    2016-06-01

    [Purpose] The aim of this study was to investigate differences in selective voluntary motor control of the lower extremities by objective assessment and determine the relationship between selective voluntary motor control and knee extensor strength in children with spastic diplegia. [Subjects and Methods] Forty individuals who had spastic cerebral palsy, with Gross Motor Function Classification System levels ranging from I to III, were assessed using the Selective Control Assessment of the Lower Extremity and by testing the maximum knee extensor strength. The unaffected side was defined as the lower limb with the higher score, and the affected side was defined as the lower limb with the lower score. [Results] The Selective Control Assessment of the Lower Extremity score on the affected side had a lower average than that on the unaffected side. The scores showed a significant inverse correlation with the maximum knee extensor strength. [Conclusion] There was bilateral difference in the selective voluntary motor control of the lower extremities in children with spastic diplegia, and the selective voluntary motor control of the lower extremity was related to maximum knee extensor strength.

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

    OpenAIRE

    Yoo, Won-gyu

    2013-01-01

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

  5. Maneuverability and usability analysis of three knee-extension propelled wheelchairs.

    Science.gov (United States)

    Bloswick, D S; Erickson, J; Brown, D R; Howell, G; Mecham, W

    The purpose of this study was to evaluate the maneuverability and usability of three knee-extension propelled wheelchairs. The maneuverability of the knee-extension propelled wheelchairs was determined in a controlled test representing five standard wheelchair activities. The usability of the wheelchairs was evaluated in a field test with elderly residents of an extended care facility in Salt Lake City. The results indicate that the wheelchair designs using a swinging (four-bar linkage) or sliding belt mechanism are preferred to a sliding plate design. The use of knee-extension propelled wheelchairs is a feasible alternative to hand propelled wheelchairs. Further development and research is needed to address power requirements, maneuverability, and entrance/egress from the chairs.

  6. Hand-held dynamometry in patients with haematological malignancies: Measurement error in the clinical assessment of knee extension strength

    Directory of Open Access Journals (Sweden)

    Uebelhart Daniel

    2009-03-01

    Full Text Available Abstract Background Hand-held dynamometry is a portable and inexpensive method to quantify muscle strength. To determine if muscle strength has changed, an examiner must know what part of the difference between a patient's pre-treatment and post-treatment measurements is attributable to real change, and what part is due to measurement error. This study aimed to determine the relative and absolute reliability of intra and inter-observer strength measurements with a hand-held dynamometer (HHD. Methods Two observers performed maximum voluntary peak torque measurements (MVPT for isometric knee extension in 24 patients with haematological malignancies. For each patient, the measurements were carried out on the same day. The main outcome measures were the intraclass correlation coefficient (ICC ± 95%CI, the standard error of measurement (SEM, the smallest detectable difference (SDD, the relative values as % of the grand mean of the SEM and SDD, and the limits of agreement for the intra- and inter-observer '3 repetition average' and the 'highest value of 3 MVPT' knee extension strength measures. Results The intra-observer ICCs were 0.94 for the average of 3 MVPT (95%CI: 0.86–0.97 and 0.86 for the highest value of 3 MVPT (95%CI: 0.71–0.94. The ICCs for the inter-observer measurements were 0.89 for the average of 3 MVPT (95%CI: 0.75–0.95 and 0.77 for the highest value of 3 MVPT (95%CI: 0.54–0.90. The SEMs for the intra-observer measurements were 6.22 Nm (3.98% of the grand mean (GM and 9.83 Nm (5.88% of GM. For the inter-observer measurements, the SEMs were 9.65 Nm (6.65% of GM and 11.41 Nm (6.73% of GM. The SDDs for the generated parameters varied from 17.23 Nm (11.04% of GM to 27.26 Nm (17.09% of GM for intra-observer measurements, and 26.76 Nm (16.77% of GM to 31.62 Nm (18.66% of GM for inter-observer measurements, with similar results for the limits of agreement. Conclusion The results indicate that there is acceptable relative reliability

  7. Quadriceps femoris electromyogram during concentric, isometric and eccentric phases of fatiguing dynamic knee extensions.

    Science.gov (United States)

    Pincivero, Danny M; Gandhi, Varsha; Timmons, Mark K; Coelho, Alan J

    2006-01-01

    The objective of this study was to examine the superficial quadriceps femoris (QF) muscle electromyogram (EMG) during fatiguing knee extensions. Thirty young adults were evaluated for their one-repetition maximum (1RM) during a seated, right-leg, inertial knee extension. All subjects then completed a single set of repeated knee extensions at 50% 1RM, to failure. Subjects performed a knee extension (concentric phase), held the weight with the knee extended for 2s (isometric phase), and lowered the weight in a controlled manner (eccentric phase). Raw EMG of the vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF) muscles were full-wave rectified, integrated and normalized to the 1RM EMG, for each respective phase and repetition. The EMG median frequency (f(med)) was computed during the isometric phase. An increase in QF muscle EMG was observed during the concentric phase across the exercise duration. VL EMG was greater than the VM and RF muscles during the isometric phase, in which no significant changes occurred in any of the muscles across the exercise duration. A significant decrease in EMG across the exercise duration was observed during the eccentric phase, with the VL EMG greater than the VM and RF muscles. A greater decrease in VL and RF muscle f(med) during the isometric phase, than the VM muscle, was observed with no gender differences. The findings demonstrated differential recruitment of the superficial QF muscle, depending on the contraction mode during dynamic knee extension exercise, where VL muscle dominance appears to manifest across the concentric-isometric-eccentric transition.

  8. Effects of trunk stability on isometric knee extension muscle strength measurement while sitting.

    Science.gov (United States)

    Hirano, Masahiro; Gomi, Masahiro; Katoh, Munenori

    2016-09-01

    [Purpose] This study aimed to investigate the effect of trunk stability on isometric knee extension muscle strength measurement while sitting by performing simultaneous measurements with a handheld dynamometer (HHD) and an isokinetic dynamometer (IKD) in the same seated condition. [Subjects and Methods] The subjects were 30 healthy volunteers. Isometric knee extension muscle strength was simultaneously measured with a HHD and an IKD by using an IKD-specific chair. The measurement was performed twice. Measurement instrument variables and the number of measurements were examined by using the analysis of variance and correlation tests. [Results] The measurement instrument variables and the number of measurements were not significantly different. The correlation coefficients between the HHD and IKD measurements were ≥0.96. [Conclusion] Isometric knee extension muscle strength measurement using the HHD in the sitting position resulted in a lower value than that using the IKD, presumably because of the effect of trunk stability on the measurement. In the same seated posture with trunk stability, no significant difference in measurement values was observed between the HHD and IKD. The present findings suggest that trunk stability while seated during isometric knee extension muscle strength measurement influenced the HHD measurement.

  9. On the role of the patella, ACL and joint contact forces in the extension of the knee.

    Directory of Open Access Journals (Sweden)

    Daniel J Cleather

    Full Text Available Traditional descriptions of the knee suggest that the function of the patella is to facilitate knee extension by increasing the moment arm of the quadriceps muscles. Through modelling and evidence from the literature it is shown in this paper that the presence of the patella makes the ability of the quadriceps to rotate the thigh greater than their ability to rotate the tibia. Furthermore, this difference increases as the knee is flexed, thus demonstrating a pattern that is consistent with many human movements. This paper also shows that the anterior cruciate ligament plays a previously unheralded role in extending the shank and that translation at the tibiofemoral and patellofemoral joints is important in improving the capacity for thigh rotation when the knee is flexed. This study provides new insights as to how the structure of the knee is adapted to its purpose and illustrates how the functional anatomy of the knee contributes to its extension function.

  10. On the Role of the Patella, ACL and Joint Contact Forces in the Extension of the Knee

    Science.gov (United States)

    Cleather, Daniel J.; Southgate, Dominic F. L.; Bull, Anthony M. J.

    2014-01-01

    Traditional descriptions of the knee suggest that the function of the patella is to facilitate knee extension by increasing the moment arm of the quadriceps muscles. Through modelling and evidence from the literature it is shown in this paper that the presence of the patella makes the ability of the quadriceps to rotate the thigh greater than their ability to rotate the tibia. Furthermore, this difference increases as the knee is flexed, thus demonstrating a pattern that is consistent with many human movements. This paper also shows that the anterior cruciate ligament plays a previously unheralded role in extending the shank and that translation at the tibiofemoral and patellofemoral joints is important in improving the capacity for thigh rotation when the knee is flexed. This study provides new insights as to how the structure of the knee is adapted to its purpose and illustrates how the functional anatomy of the knee contributes to its extension function. PMID:25536067

  11. Immediate effects of whole body vibration on patellar tendon properties and knee extension torque.

    Science.gov (United States)

    Rieder, F; Wiesinger, H-P; Kösters, A; Müller, E; Seynnes, O R

    2016-03-01

    Reports about the immediate effects of whole body vibration (WBV) exposure upon torque production capacity are inconsistent. However, the changes in the torque-angle relationship observed by some authors after WBV may hinder the measurement of torque changes at a given angle. Acute changes in tendon mechanical properties do occur after certain types of exercise but this hypothesis has never been tested after a bout of WBV. The purpose of the present study was to investigate whether tendon compliance is altered immediately after WBV, effectively shifting the optimal angle of peak torque towards longer muscle length. Twenty-eight subjects were randomly assigned to either a WBV (n = 14) or a squatting control group (n = 14). Patellar tendon CSA, stiffness and Young's modulus and knee extension torque-angle relationship were measured using ultrasonography and dynamometry 1 day before and directly after the intervention. Tendon CSA was additionally measured 24 h after the intervention to check for possible delayed onset of swelling. The vibration intervention had no effects on patellar tendon CSA, stiffness and Young's modulus or the torque-angle relationship. Peak torque was produced at ~70° knee angle in both groups at pre- and post-test. Additionally, the knee extension torque globally remained unaffected with the exception of a small (-6%) reduction in isometric torque at a joint angle of 60°. The present results indicate that a single bout of vibration exposure does not substantially alter patellar tendon properties or the torque-angle relationship of knee extensors.

  12. Adaptive control of functional neuromuscular stimulation-induced knee extension exercise.

    Science.gov (United States)

    Ezenwa, B N; Glaser, R M; Couch, W; Figoni, S F; Rodgers, M M

    1991-01-01

    An automated system for exercising the paralyzed quadriceps muscles of spinal cord injured patients using functional neuromuscular stimulation (FNS) has been developed. It induces smooth concentric and eccentric contractions in both limbs to enable bilateral 70 degree knee extensions in an asynchronous pattern. External load resistance is applied at the ankle level to "overload" the muscles and bring about training effects. The system uses adaptive control methods to adjust FNS current output (threshold level and the ramp slope) to the quadriceps muscles to maintain performance as the muscles fatigue. Feedback control signals for limb movement and knee extension angle are used to continuously adjust the FNS current parameters so that the external load is moved through the preset zero to 70 degree angle range. Typically, the threshold current level and the FNS current increase as the muscles fatigue to maintain performance with repetitive contractions. Fatigue is defined as the inability to extend the knee to 50 percent of the 70 degree target angle. When this occurs, FNS is automatically terminated for the fatigued leg, while the functioning leg continues to exercise. The automated nature of this system appears to be advantageous as compared to a manually operated system for subject safety, convenience, and uniformity of exercise bouts. Simulated safety problems, such as hyperextension of the knee joint, open circuitry, muscle spasms, and low battery power, were successfully detected by the logic circuitry, and the system followed appropriate safety procedures to minimize risk.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  14. Use of Knee Extension Device During Rehabilitation of a Patient with Type 3 Arthrofibrosis after ACL Reconstruction.

    Science.gov (United States)

    Biggs, Angie; Shelbourne, K Donald

    2006-08-01

    Arthrofibrosis is a frequent complication following rehabilitation of a patient with anterior cruciate ligament (ACL) reconstruction. Although prevention is the best treatment, little information exists within the literature regarding the management and rehabilitation intervention for arthrofibrosis. In this case report a rehabilitation program in the treatment of a patient with arthrofibrosis is described. To identify the importance of discrete measures of knee range of motion in the knee of a patient following ACL reconstruction in order to help prevent postoperative complications. The patient was an 18-year-old female who sustained an ACL and medial collateral ligament (MCL) injury in a basketball game and underwent an ACL reconstruction with an ipsilateral patellar tendon graft. The patient developed arthrofibrosis and, despite traditional physical therapy of therapeutic exercise and manual therapy, the patient continued to complain of pain, stiffness, limited activities of daily living, and the inability to participate in competitive sports. This patient used a knee extension device as part of her rehabilitation program. The patient was able to obtain knee extension and flexion equal to her opposite normal knee. Upon completion of the rehabilitation program, the patient returned to full activities of daily living and competitive sports. Increasing and maintaining knee extension that is equal to the opposite normal knee is an important component in the successful outcome for the patient after ACL reconstruction. The use of a knee extension device may provide an effective rehabilitation intervention in the treatment of arthrofibrosis.

  15. The influence of electromyographic biofeedback therapy on knee extension following anterior cruciate ligament reconstruction: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Christanell Franz

    2012-11-01

    Full Text Available Abstract Background Loss of knee extension and a deficit in quadriceps strength are frequently found following anterior cruciate ligament (ACL reconstruction. The aim of this study was to investigate whether the addition of Eletromyographic Biofeedback (EMG BFB therapy for the vastus medialis muscle to the in the early phase of the standard rehabilitation programme could improve the range of knee extension and strength after ACL reconstruction more than a standard rehabilitation programme. The correlation between EMG measurement and passive knee extension was also investigated. Method Sixteen patients, all of whom underwent endoscopic ACL reconstruction using patellar tendon autograft, were randomly assigned to two groups: • Control group (8 patients: standard rehabilitation protocol; with full weight-bearing postoperative, knee brace (0° extension, 90° flexion, electrical stimulation, aquatics and proprioceptive training. • The EMG BFB group (8 patients: EMG BFB was added to the standard rehabilitation protocol within the first postoperative week and during each session for the next 6 weeks. Each patent attended a total of 16 outpatient physiotherapy sessions following surgery. High-Heel-Distance (HHD Test, range of motion (ROM and integrated EMG (iEMG for vastus medialis were measured preoperatively, and at the 1, 2, 4 and 6-week follow ups. Additionally, knee function, swelling and pain were evaluated using standardized scoring scales. Results At 6 weeks, passive knee extension (p  0.01 differences were found between the two groups for the assessment of knee function, swelling and pain. Conclusion The results indicate that EMG BFB therapy, in the early phase of rehabilitation after ACL reconstruction, is useful in enhancing knee extension. Improved innervation of the vastus medialis can play a key role in the development of postoperative knee extension. EMG BFB therapy is a simple, inexpensive and valuable adjunct to conventional

  16. Defining the knee joint flexion-extension axis for purposes of quantitative gait analysis: an evaluation of methods.

    Science.gov (United States)

    Schache, Anthony G; Baker, Richard; Lamoreux, Larry W

    2006-08-01

    Minimising measurement variability associated with hip axial rotation and avoiding knee joint angle cross-talk are two fundamental objectives of any method used to define the knee joint flexion-extension axis for purposes of quantitative gait analysis. The aim of this experiment was to compare three different methods of defining this axis: the knee alignment device (KAD) method, a method based on the transepicondylar axis (TEA) and an alternative numerical method (Dynamic). The former two methods are common approaches that have been applied clinically in many quantitative gait analysis laboratories; the latter is an optimisation procedure. A cohort of 20 subjects performed three different functional tasks (normal gait; squat; non-weight bearing knee flexion) on repeated occasions. Three-dimensional hip and knee angles were computed using the three alternative methods of defining the knee joint flexion-extension axis. The repeatability of hip axial rotation measurements during normal gait was found to be significantly better for the Dynamic method (pknee varus-valgus kinematic profile and the degree of knee joint angle cross-talk were smallest for the Dynamic method across all functional tasks. The Dynamic method therefore provided superior results in comparison to the KAD and TEA-based methods and thus represents an attractive solution for orientating the knee joint flexion-extension axis for purposes of quantitative gait analysis.

  17. Development of estimation system of knee extension strength using image features in ultrasound images of rectus femoris

    Science.gov (United States)

    Murakami, Hiroki; Watanabe, Tsuneo; Fukuoka, Daisuke; Terabayashi, Nobuo; Hara, Takeshi; Muramatsu, Chisako; Fujita, Hiroshi

    2016-04-01

    The word "Locomotive syndrome" has been proposed to describe the state of requiring care by musculoskeletal disorders and its high-risk condition. Reduction of the knee extension strength is cited as one of the risk factors, and the accurate measurement of the strength is needed for the evaluation. The measurement of knee extension strength using a dynamometer is one of the most direct and quantitative methods. This study aims to develop a system for measuring the knee extension strength using the ultrasound images of the rectus femoris muscles obtained with non-invasive ultrasonic diagnostic equipment. First, we extract the muscle area from the ultrasound images and determine the image features, such as the thickness of the muscle. We combine these features and physical features, such as the patient's height, and build a regression model of the knee extension strength from training data. We have developed a system for estimating the knee extension strength by applying the regression model to the features obtained from test data. Using the test data of 168 cases, correlation coefficient value between the measured values and estimated values was 0.82. This result suggests that this system can estimate knee extension strength with high accuracy.

  18. Identifying the Functional Flexion-extension Axis of the Knee: An In-Vivo Kinematics Study.

    Directory of Open Access Journals (Sweden)

    Li Yin

    Full Text Available This study aimed to calculate the flexion-extension axis (FEA of the knee through in-vivo knee kinematics data, and then compare it with two major anatomical axes of the femoral condyles: the transepicondylar axis (TEA defined by connecting the medial sulcus and lateral prominence, and the cylinder axis (CA defined by connecting the centers of posterior condyles.The knee kinematics data of 20 healthy subjects were acquired under weight-bearing condition using bi-planar x-ray imaging and 3D-2D registration techniques. By tracking the vertical coordinate change of all points on the surface of femur during knee flexion, the FEA was determined as the line connecting the points with the least vertical shift in the medial and lateral condyles respectively. Angular deviation and distance among the TEA, CA and FEA were measured.The TEA-FEA angular deviation was significantly larger than that of the CA-FEA in 3D and transverse plane (3.45° vs. 1.98°, p < 0.001; 2.72° vs. 1.19°, p = 0.002, but not in the coronal plane (1.61° vs. 0.83°, p = 0.076. The TEA-FEA distance was significantly greater than that of the CA-FEA in the medial side (6.7 mm vs. 1.9 mm, p < 0.001, but not in the lateral side (3.2 mm vs. 2.0 mm, p = 0.16.The CA is closer to the FEA compared with the TEA; it can better serve as an anatomical surrogate for the functional knee axis.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  20. Increased patellar tendon microcirculation and reduction of tendon stiffness following knee extension eccentric exercises.

    Science.gov (United States)

    Yin, Nai-Hao; Chen, Wen-Shiang; Wu, Ying-Tai; Shih, Tiffany Tingfang; Rolf, Christer; Wang, Hsing-Kuo

    2014-04-01

    Controlled laboratory study. To measure and compare patellar tendon stiffness and microcirculation in college tennis players and nonathletic students when performing eccentric knee extension exercises that do and do not reduce tendon stiffness. Previous studies suggest that tendon microcirculation response during exercises may vary based on the tendon's plastic properties. Methods The study included 3 groups of college-age male students: tennis players who performed 4 sets of either 40 (n = 12) or 80 (n = 13) repetitions of eccentric knee extension exercise and nonathletic students (n = 14) who performed 4 sets of 40 repetitions. Tendon stiffness was measured before and after exercise completion. Changes in total hemoglobin and oxygen saturation (OSat) were analyzed while performing the 4 sets. Comparisons were made within and between the groups. The level of association between tendon microcirculation and stiffness reduction was assessed. The 2 groups (player/4 × 80 and student/4 × 40) exhibiting patellar tendon stiffness reductions (Pexercise levels, in the fourth set compared to the first set of exercises (Pknee extension eccentric exercises that resulted in a reduction in tendon stiffness.

  1. Discrepancy between femoral and capillary blood flow kinetics during knee extension exercise.

    Science.gov (United States)

    Schlup, S J; Ade, C J; Broxterman, R M; Barstow, T J

    2015-12-01

    Capillary blood flow (QCAP) kinetics have previously been shown to be significantly slower than femoral artery (QFA) kinetics following the onset of dynamic knee extension exercise. If the increase in QCAP does not follow a similar time course to QFA, then a substantial proportion of the available blood flow is not distributed to the working muscle. One possible explanation for this discrepancy is that blood flow also increases to the nonworking lower leg muscles. Therefore, the present study aimed to determine if a reduction in lower limb blood flow, via arterial occlusion below the knee, alters the kinetics of QFA and QCAP during knee extension exercise, and thus provide insight into the potential mechanisms controlling the rapid increase in QFA. Subjects performed a ramp max test to determine the work rate at which gas exchange threshold (GET) occurred. At least four constant work rate trials with and without below-knee occlusion were conducted at work rates eliciting ∼ 80% GET. Pulmonary gas exchange, near-infrared spectroscopy and QFA measurements were taken continuously during each exercise bout. Muscle oxygen uptake (VO2m) and deoxy[hemoglobin+myoglobin] were used to estimate QCAP. There was no significant difference between the uncuffed and cuffed conditions in any response (P>0.05). The mean response times (MRT) of QFA were 18.7 ± 14.2s (uncuffed) and 24.6 ± 14.9s (cuffed). QCAP MRTs were 51.8 ± 23.4s (uncuffed) and 56.7 ± 23.2s (cuffed), which were not significantly different from the time constants (τ) of VO2m (39.7 ± 23.2s (uncuffed) and 46.3 ± 24.1s (cuffed). However, the MRT of QFA was significantly faster (P<0.05) than the MRT of QCAP and τVO2m. τVO2m and MRT QCAP were significantly correlated and estimated QCAP kinetics tracked VO2m following exercise onset. Cuffing below the knee did not significantly change the kinetics of QFA, QCAP or VO2m, although an effect size of 1.02 suggested that a significant effect on QFA may have been hidden

  2. Chronic Knee Injuries Impair the Voluntary Activation of Quadriceps Femoris%陈旧性膝关节运动损伤者股四头肌随意动员能力下降

    Institute of Scientific and Technical Information of China (English)

    徐刚; 黄力平; 周石; 王昭君; 李猛; 敖铭; 王聪; 赵美苓; 梁军

    2012-01-01

    目的:观察陈旧性膝关节运动损伤股四头肌随意动员能力的变化.方法:60名天津体育学院学生,自愿参加测试,根据其是否有陈旧性膝关节运动损伤分为2组,损伤组(有训练史)30人,对照组(无训练史)30人.应用股四头肌随意动员能力评定系统测定分析股四头肌最大随意等长肌力(MVC)、随意动员能力(MA)和力量上升速率(RFD).结果:对照组两侧股四头肌MVC、MA和RFD无显著差异(P>0.05),损伤组两侧股四头肌MVC无显著性差异(P>0.05).对照组右侧股四头肌MVC、RFD值显著低于损伤组未损伤侧(P<0.05,P< 0.01),损伤组膝关节损伤侧MA、RFD值显著低于未损伤侧(P< 0.05,P< 0.01).结论:即使陈旧性膝关节运动损伤者股四头肌肌肉力量已恢复到未损伤侧水平,其随意动员能力和力量上升速率依然较低,膝关节神经肌肉控制仍较差,这可能是影响陈旧性膝关节运动损伤功能状态的主要因素之一.股四头肌随意动员能力评价系统可检测这一变化.%Objective To determine whether voluntary activation of quadriceps femoris persons with chronic knee injuries is impaired. Methods Thirty participants with knee injuries and thirty healthy participants voluntarily participated in the study. Muscle strength in maximum voluntary contraction (MVC) .muscle activation (MA),and the rate of force development (RFD) in isometric knee extension were assessed for both legs using a custom-built dynamometer. Independent-Samples T test was used to compare the mean values between the two groups or/and both legs. Results No significant differences were found in the measured variables between the two legs in the healthy control group. There was no significant difference in the MVC between legs in the injury group(P>0.05). The MVC and RFD of the right leg in the control group were lower than the uninjured left side in the injury group (P<0.05,P< 0.01). The MA and RFD of the injured side in

  3. The bilateral leg strength deficit is present in old, young and adolescent females during isokinetic knee extension and flexion.

    Science.gov (United States)

    Kuruganti, Usha; Seaman, Kenneth

    2006-06-01

    The bilateral limb deficit (BLD) describes the difference in maximal or near maximal force generating capacity of muscles when they are contracted alone or in combination with the contralateral muscles. A deficit occurs when the summed unilateral force is greater than the bilateral force. This study examined the presence of the BLD during isokinetic knee extensions and flexions in a group of adolescent females (n=8, mean of 15+/-1 years) and compared with previously reported data by this researcher of adult and older females. Data were collected from subjects during slow (45 deg/s) isokinetic knee extensions and flexions and it was found that a BLD exists during both extension and flexion regardless of age. Furthermore, this study is the first to examine the presence of the deficit in an adolescent population. Myoelectric signal (MES) data showed that there is no difference between bilateral and unilateral isokinetic knee extensions and flexions regardless of age group.

  4. Preoperative methylprednisolone does not reduce loss of knee-extension strength after total knee arthroplastyA randomized, double-blind, placebo-controlled trial of 61 patients

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Viktoria; Bandholm, Thomas Q; Zilmer, Camilla Kampp

    2017-01-01

    of knee-extension strength at discharge after fast-track TKA. Patients and methods - 70 patients undergoing elective unilateral TKA were randomized (1:1) to preoperative intravenous (IV) MP 125 mg (group MP) or isotonic saline IV (group C). All procedures were performed under spinal anesthesia without......-group differences were similar for knee circumference, TUG test, and pain scores. MP reduced the inflammatory response (CRP) at 24 hours postoperatively; group MP 33 (IQR 21-50) mg/L vs. group C 72 (IQR 58-92) mg/L (p

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

    Science.gov (United States)

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

    2009-11-01

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

  6. THE INFLUENCE OF BODY POSITION ON LOAD RANGE DURING ISOKINETIC KNEE EXTENSION/FLEXION

    Directory of Open Access Journals (Sweden)

    Brian W. Findley

    2006-09-01

    Full Text Available Isokinetic range of motion (ROM has three distinct phases: rate of velocity development (RVD, load range (LR, and deceleration (DCC. The purpose of this study was to determine if differences in isokinetic knee extension/flexion LR exist between body positions. Ten subjects (4 males and 6 females, age 29.3 ± 5.4 yrs, ht 1.71 ± 0.10 m, wt 71.9 ± 12.9 kg volunteered to participate in the seated vs. prone investigation and nine different subjects (4 males and 5 females, age 29.5 ± 6.9 yrs, ht 1.72 ± 0.09 m, wt 69.0 ± 13.8 kg volunteered to participate in the seated vs. supine study. Each subject completed 3 maximal reciprocal concentric/concentric repetitions of dominant knee extension/flexion on a Biodex System 2 isokinetic dynamometer at 60, 120, 180, 240 and 360 deg·sec-1 in the supine or prone and seated positions. Repeated measures ANOVA revealed that only seated flexion at 360 deg·sec-1 (57.6 ± 1.7 degrees elicited significantly (p < 0.05 greater LR than prone (49.2 ± 2.8 degrees. No significant differences in LR extension or flexion existed at any velocity between the supine vs. seated positions. ANOVA also demonstrated differences between seated vs. prone torque, work and power at most velocities while there was no difference between seated vs. supine. LR is the only phase of an isokinetic repetition where quantifiable resistance is maintained and this data appears to support that it may not be position-dependent but position may alter traditional performance variables

  7. A lower-extremity exoskeleton improves knee extension in children with crouch gait from cerebral palsy.

    Science.gov (United States)

    Lerner, Zachary F; Damiano, Diane L; Bulea, Thomas C

    2017-08-23

    The ability to walk contributes considerably to physical health and overall well-being, particularly in children with motor disability, and is therefore prioritized as a rehabilitation goal. However, half of ambulatory children with cerebral palsy (CP), the most prevalent childhood movement disorder, cease to walk in adulthood. Robotic gait trainers have shown positive outcomes in initial studies, but these clinic-based systems are limited to short-term programs of insufficient length to maintain improved function in a lifelong disability such as CP. Sophisticated wearable exoskeletons are now available, but their utility in treating childhood movement disorders remains unknown. We evaluated an exoskeleton for the treatment of crouch (or flexed-knee) gait, one of the most debilitating pathologies in CP. We show that the exoskeleton reduced crouch in a cohort of ambulatory children with CP during overground walking. The exoskeleton was safe and well tolerated, and all children were able to walk independently with the device. Rather than guiding the lower limbs, the exoskeleton dynamically changed the posture by introducing bursts of knee extension assistance during discrete portions of the walking cycle, a perturbation that resulted in maintained or increased knee extensor muscle activity during exoskeleton use. Six of seven participants exhibited postural improvements equivalent to outcomes reported from invasive orthopedic surgery. We also demonstrate that improvements in crouch increased over the course of our multiweek exploratory trial. Together, these results provide evidence supporting the use of wearable exoskeletons as a treatment strategy to improve walking in children with CP. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  8. EVALUATION OF BILATERAL ASYMMETRY OF CONCENTRIC AND ISOMETRIC KNEE EXTENSION- FLEXION STRENGTH IN MALE FENCERS

    Directory of Open Access Journals (Sweden)

    Yusuf ŞAHİN

    2016-08-01

    Full Text Available Fencing is an Olympic combat sport in which two athletes fight through their weapons such as epee, foil and sabre. During the competition, athletes hold the weapon with their dominant arm and stay in defense or attack positions by stepping forward, behind or right/left with dominant leg in front. Depending upon chronic applications structural and/or functional asymmetries between dominant and non-dominant extremities are shown with cross-sectional area and performance measurements. The aim of this study was to compare dominant and non-dominant knee flexion-extension strength values of epee fencers. The study was conducted on nine athletes whose age average was 18,1± 1,4 years. Strength measurements of dominant and non-dominant knees were carried out by using concentric and isometric modules of isokinetic dynamometers (Cybex II. Angular velocities were determined as 240- 180- 120- 60⁰/s and 5 repetitions were done at each velocity. The highest value was accepted as the maximal strength. Isometric contraction was carried out at 60⁰ knee joint angle (when full extension is accepted as 0⁰ during 5 seconds. Ratios of Hamstrings/ Quadriceps were calculated with ratios of strength of flexor and extensor muscles at every angular velocity. Results were analyzed with independent sample t-test and data were given as ±SEM. Strength values of dominant leg were found statistically significantly higher than those of non-dominant leg in 240⁰/s, 180⁰/s, 120⁰/s extension movement and isometric contraction (p<0.05. When examining flexion movement, it was recorded that strength of dominant leg was higher than that of non-dominant leg at 240⁰/s velocity and during isometric contraction (p<0.05. There was no meaningful difference in H/ Q ratios between dominant and non dominant legs (p<0.05. These findings suggest that, there is an important difference in terms of dominant and non-dominant leg strength in high level fencers, though ratio of H/Q is

  9. A rare case of extensive diffuse nonpigmented villonodular synovitis as a cause of total knee arthroplasty failure.

    Science.gov (United States)

    Tosun, Hacı Bayram; Uludağ, Abuzer; Serbest, Sancar; Gümüştaş, Seyitali; Erdoğdu, Ibrahim Halil

    2014-01-01

    Nonpigmented villonodular synovitis (non-PVNS) is a benign proliferative disease involving the synovium. It is a rare condition that is little recognized. Non-PVNS has been reported as a cause of total knee replacement failure. We report a case of extensive diffuse non-PVNS in a patient with tibial component loosening after total knee replacement and review the related literature. It is reported that pigmented villonodular synovitis (PVNS) occurs less frequently than non-PVNS after knee replacement. However, there are many more case reports of PVNS than non-PVNS after knee arthroplasty in the English-language literature. Previously, there were no reported cases of extensive diffuse non-PVNS after total knee arthroplasty (TKA). This case study highlights an unusual case of non-PVNS as a cause of TKA failure. We propose that non-PVNS should be considered as a differential diagnosis in patients after TKA who present with recurrent pain and effusion/hemarthrosis of the knee, and that it is one of the causes of implant loosening after TKA. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Measurement of perioperative flexion-extension mechanics of the knee joint.

    Science.gov (United States)

    Giori, N J; Giori, K L; Woolson, S T; Goodman, S B; Lannin, J V; Schurman, D J

    2001-10-01

    Perioperative knee mechanics currently are evaluated Perioperative knee mechanics currently are evaluated by measuring range of motion. This is an incomplete measurement, however, because the torque applied to achieve the motion is not measured. We hypothesized that a custom goniometer and force transducer could measure the torque required to passively flex a knee through its full range of motion. This measurement was done in the operating room immediately before and after surgery in 20 knees having total knee arthroplasty and 9 having surgery on another limb. Surgery changed the mechanics of 8 knees, whereas unoperated knees remained unchanged. This measurement technique is safe, easy, and repeatable. It improves on the current standard of perioperative knee measurement and can be applied to investigate the effects of surgery and rehabilitation on ultimate knee motion.

  11. Composition Measurements near the Second Knee with the Telescope Array Low-Energy Extension (TALE)

    Science.gov (United States)

    Belz, J.

    Cosmic rays with energies between 1016.5 and 1018.5 eV exhibit a rich range of features. The energy spectrum changes index at at least two points, known as the "second knee" and the "ankle". There appears to be a composition change in this energy regime as well, which may indicate a shift in predominance from galactic to extragalactic sources. The Telescope Array Low-Energy Extension - planned for construction in Millard County, Utah, USA - stands well poised to make decisive simultaneous measurements of cosmic ray energy spectra and composition in this transition region. Here, we present the results of simulation studies relevant to the design of the TALE detectors, and estimate the sensitivity of TALE to composition changes in the 1017 eV decade.

  12. Control of the Extension-Flexion Cycle of Human Knees During Bicycle Riding by a Synergy of Solitary Muscular Excitations and Contractions

    OpenAIRE

    Gojkovic, Zoran; Ivancevic, Tijana

    2016-01-01

    A Hill-type model is proposed for the extension-flexion cycle of human knees during bicycle riding. The extension-flexion cycle is controlled by a synergy of muscular excitations and contractions of the knee musculature. Muscular action potentials are modeled by Sine-Gordon kinks, while titin-influenced actomyosin contractionsare modeled by Korteweg-de Vries solitons. As an application, the total knee arthroplasty is discussed.

  13. The Effects of Load and Effort-Matched Concentric and Eccentric Knee Extension Training in Recreational Females

    Directory of Open Access Journals (Sweden)

    Fisher James

    2014-09-01

    Full Text Available Purpose. The purpose of this study was to compare the effects of load and intensity of effort-matched concentric and eccentric knee extension training on isometric strength. Methods. Unilateral isometric torque was measured using a MedX knee extension after which eleven recreationally trained females performed both concentric-only (CONC and eccentric-only (ECC unilateral knee extension exercise once per week for 8 weeks. Participants performed a single set of both CONC and ECC exercise loadmatched at 80% of maximum isometric torque for each condition. All participants exercised to repetition maximum in both CONC and ECC conditions at a pace of ~3 s duration for each muscle action. This ensured that participants exercised to the same intensity of effort for both CONC and ECC training interventions. Results. Analyses revealed significant increases in isometric torque for both CONC (14.8% and ECC (13.0% conditions (p 0.05. Effect sizes are reported as 0.60 (CONC and 0.53 (ECC. In addition, analyses revealed significantly greater mean total training volume for ECC compared with CONC conditions (15903 vs. 8091, respectively; p < 0.001. Conclusions. The present findings indicate that, when matched for intensity of effort, both CONC and ECC knee extension exercise can significantly improve strength to the same extent. This supports previous research that load and repetitions are not as important as intensity of effort in resistance exercise.

  14. Tourniquet versus no tourniquet on knee-extension strength early after fast-track total knee arthroplasty; a randomized controlled trial

    DEFF Research Database (Denmark)

    Harsten, Andreas; Bandholm, Thomas Quaade; Kehlet, Henrik

    2015-01-01

    tourniquet during surgery was more effective than using a thigh tourniquet in preserving knee-extension strength 48h after fast-track TKA. METHODS: A total of 64 patients undergoing TKA were randomized (1:1) to the use of tourniquet (T-group) or no tourniquet (NT-group). In the T-group the tourniquet cuff...... pressure was based on the patient's systolic pressure and a margin of 100mmHg. It was inflated immediately before surgery and deflated as soon as surgery ended. The primary outcome was the change in knee-extension strength from pre-surgery to 48h after surgery (primary end point). Secondary outcomes were...... pain, nausea, length of hospital stay (LOS) and periarticular swelling. RESULTS: Knee-extension strength 48h after surgery was substantially reduced by about 90% in both groups, with no statistically significant difference between groups (mean difference 1.5N/kg, 95% CI 1.3-1.6). Among the secondary...

  15. Flexion-extension gap in cruciate-retaining versus posterior-stabilized total knee arthroplasty: a cadaveric study.

    Science.gov (United States)

    Matthews, Joshua; Chong, Alexander; McQueen, David; O'Guinn, Justin; Wooley, Paul

    2014-05-01

    We re-examined experimental model results using half-body specimens with intact extensor mechanisms and navigation to evaluate cruciate-retaining (CR) and posterior stabilized (PS) total knee arthroplasty (TKA) component gaps through an entire range of motion. Six sequential testing regimens were conducted with the knee intact, with a CR TKA in place, and with a PS TKA in place, with and without 22 N traction in place at each stage. Each of 10 knees was taken through six full ranges of motion from 0° to 120° at every stage using a navigated knee system to record component gapping. No significant difference was found between loaded and unloaded component gaps, and no significant differences were found in component gapping between CR and PS TKAs throughout a full range of motion. Flexion-extension gap measurements were significantly different from previously published data (at 90° flexion). No difference was found in kinematics when comparing CR and PS TKA component designs. Our results suggest that intact extensor mechanisms may be required to perform proper kinematic studies of TKA. Our findings provide evidence that the extensor mechanism may play a major role in the flexion-extension gaps in cadaveric knees.

  16. High-intensity mechanical therapy for loss of knee extension for worker's compensation and non-compensation patients

    Directory of Open Access Journals (Sweden)

    Dempsey Amanda L

    2010-10-01

    Full Text Available Abstract Background Knee flexion contractures have been associated with increased pain and a reduced ability to perform activities of daily living. Contractures can be treated either surgically or conservatively, but these treatment options may not be as successful with worker's compensation patients. The purposes of retrospective review were to 1 determine the efficacy of using adjunctive high-intensity stretch (HIS mechanical therapy to treat flexion contractures, and 2 compare the results between groups of worker's compensation and non-compensation patients. Methods Fifty-six patients (19 women, 37 men, age = 51.5 ± 17.0 years with flexion contractures were treated with HIS mechanical therapy as an adjunct to outpatient physical therapy. Mechanical therapy was only prescribed for those patients whose motion had reached a plateau when treated with physical therapy alone. Patients were asked to perform six, 10-minute bouts of end-range stretching per day with the ERMI Knee Extensionater(r (ERMI, Inc., Atlanta, GA. Passive knee extension was recorded during the postoperative visit that mechanical therapy was prescribed, 3 months after beginning mechanical therapy, and at the most recent follow-up. We used a mixed-model 2 × 3 ANOVA (group × time to evaluate the change in passive knee extension between groups over time. Results Regardless of group, the use of adjunctive HIS mechanical therapy resulted in passive knee extension deficits that significantly improved from 10.5° ± 5.2° at the initial visit to 2.6° ± 3.5° at the 3 month visit (p Conclusions We conclude that the adjunctive use of HIS mechanical therapy is an effective treatment option for patients with knee flexion contractures, regardless of whether the patient is being treated as part of a worker's compensation claim or not.

  17. Tissue temperature transients in resting contra-lateral leg muscle tissue during isolated knee extension.

    Science.gov (United States)

    Kenny, Glen P; Reardon, Frank D; Ducharme, Michel B; Reardon, Mark L; Zaleski, Wytek

    2002-12-01

    This study was designed to evaluate the role of non-active tissue in the retention and dissipation of heat during and following intense isolated muscle activity. Six subjects performed an incremental isotonic test (constant angular velocity, increases in force output) on a KIN-COM isokinetic apparatus to determine their maximal oxygen consumption during single knee extensions (VO2sp). In a subsequent session, a thin wire multi-sensor temperature probe was inserted into the left vastus medialis under ultrasound guidance at a specific internal marker. The deepest temperature sensor (tip, Tmu10) was located approximately 10 mm from the femur and deep femoral artery with 2 additional sensors located at 15 (Tmu25) and 30 (Tmu40) mm from the tip. Implant site was midway between and medial to a line joining the anterior superior iliac spine and base of patella. Esophageal temperature (Tes) temperature was measured as an index of core temperature. Subjects rested in a supine position for 60 min followed by 30 min of seated rest in an ambient condition of 22 degree C. Subjects then performed 15 min of isolated single right knee extensions against a dynamic resistance on a KIN COM corresponding to 60% of VO2sp at 60 degree x sec(-1). Exercise was followed by 60 min of seated rest. Resting Tes was 37 degree C while Tmu10, Tmu25, and Tmu40 were 36.58, 36.55 and 36.45 degree C, respectively. Exercise resulted in a Tes increase of 0.31 C above pre-exercise resting. Tmu of the non-exercising leg increased 0.23, 0.19 and 0.09 degree C for Tmu10, Tmu25, and Tmu40, respectively. While Tes decreased to baseline values within approximately 15 min of end-exercise, Tmu10 reached resting values following approximately 40 min of recovery. These results suggest that during isolated muscle activity, convective heat transfer by the blood to non-active muscle tissue may have a significant role in maintaining resting core temperature.

  18. Increase in rate of force development with skin cooling during isometric knee extension.

    Science.gov (United States)

    Shimose, Ryota; Ushigome, Nobuyuki; Tadano, Chigaya; Sugawara, Hitoshi; Yona, Masae; Matsunaga, Atsuhiko; Muro, Masuo

    2014-12-01

    Rate of force development (RFD) plays an important role when performing rapid and forceful movements. Cold-induced afferent input with transient skin cooling (SC) can modulate neural drive. However, the relationship between RFD and SC is unknown. The purpose of this study was to investigate whether SC increases RFD during isometric knee extension. Fifteen young healthy men (25 ± 8 yrs old) contracted their quadriceps muscle as fast and forcefully as possible with or without SC. Skin cooling was administered to the front of the thigh. Torque and electromyographic activity were measured simultaneously. Peak torque was not affected by SC. Skin cooling induced a significant increase in RFD at the phase 0-30 and 0-50 ms. The root mean square of the electromyography of vastus medialis, rectus femoris and vastus lateralis at the phases 0-30-50-100 ms increased significantly or tended to increase with SC. These results suggest that SC may increase neural drive and improve RFD in the very early phases of contraction.

  19. Obliteration of Intercondylar Notch Mimicking Flexion-Extension Gap Imbalance in a Cruciate Retaining Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Harun Resit Gungor

    2015-01-01

    Full Text Available Following total knee arthroplasty (TKA, the most frequent cause of extension deficit and limitation of range of motion in early postoperative period is related to improper tensioning of soft tissues and failure to balance extension and flexion gaps. If a cruciate retaining (CR prosthesis is the planned implant, then attention should be given to balancing the posterior cruciate ligament (PCL, and any factor that alters this balance may also cause deterioration of knee balance in postoperative period. Here, we report on an unusual case referred from another hospital because of continuous pain and restriction of knee motion in early postoperative period following CR-designed TKA that was initially thought to be due to flexion-extension imbalance. However, during the revision procedure, extruded cement to the intercondylar notch was found to be both mechanically blocking terminal extension and limiting flexion by possible mechanism of irritation of the synovial nerve endings around the stretched anterior fibers of PCL during flexion. This case was successfully treated by removal of extruded cement from intercondylar notch to decompress PCL, polyethylene exchange, and secondary patellar resurfacing.

  20. Differential glucose uptake in quadriceps and other leg muscles during one-legged dynamic submaximal knee-extension exercise

    OpenAIRE

    Kari eKalliokoski; Robert eBoushel; Henning eLangberg; Celena eScheede-Bergdahl; Ann Kathrine Ryberg; Simon eDoessing; Andreas eKjaer; Michael eKjaer

    2011-01-01

    One-legged dynamic knee-extension exercise (DKE) is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron emission tomography (PET) determined uptake of [18F]-fluoro-deoxy-glucose (GU) during DKE. Five healthy male subjects performed DKE at 25 W for 35 min and both the contracting and contralateral resti...

  1. Differential glucose uptake in quadriceps and other leg muscles during one-legged dynamic submaximal knee-extension exercise

    OpenAIRE

    Kari eKalliokoski; Robert eBoushel; Henning eLangberg; Celena eScheede-Bergdahl; Ann Kathrine Ryberg; Simon eDoessing; Andreas eKjaer; Michael eKjaer

    2011-01-01

    One-legged dynamic knee-extension exercise (DKE) is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron emission tomography (PET) determined uptake of [18F]-fluoro-deoxy-glucose (GU) during DKE. Five healthy male subjects performed DKE at 25 W for 35 min and both the contracting and contralateral resti...

  2. ANALYSIS OF ISOKINETIC KNEE EXTENSION / FLEXION IN MALE ELITE ADOLESCENT WRESTLERS

    Directory of Open Access Journals (Sweden)

    Sanli Sadi Kurdak

    2005-12-01

    Full Text Available Wrestling requires strength of the upper and lower body musculature which is critical for the athletic performance. Evaluation of the adolescent's skeletal muscle is important to understand body movement, especially including those involved in sports. Strength, power and endurance capacity are defined as parameters of skeletal muscle biomechanical properties. The isokinetic dynamometer is an important toll for making this type of evaluation. However, load range phase of range of motion has to be considered to interpret the data correctly. With this in mind we aimed to investigate the lover body musculature contractile characteristics of adolescent wrestlers together with detailed analyses of load range phase of motion. Thirteen boys aged 12 - 14 years participated to this study. Concentric load range torque, work and power of knee extension and flexion were measured by a Cybex Norm dynamometer at angular velocities from 450°/sec to 30°/sec with 30°/sec decrements for each set. None of the wrestlers were able to attain load range for angular velocities above 390°/sec and 420°/sec for extension and flexion respectively. Detailed analyses of the load range resulted in statistically significant differences in the normalized load range peak torque for extension at 270°/sec (1.44 ± 0.28 Nm·kg-1 and 1.14 ± 0.28 Nm·kg-1 for total and load range peak torque respectively, p < 0.05, and for flexion at 300°/sec (1.26 ± 0.28 Nm·kg-1 and 1.03 ± 0.23 Nm·kg-1 for total and load range peak torque respectively, p < 0.05, compared to total peak torque data. Similarly, the significant difference was found for the work values at 90°/sec (1.91 ± 0.23 Nm·kg-1 and 1.59 ± 0.24 Nm·kg-1 for total and load range work respectively for extension and 1.73 ± 0.21 Nm·kg-1 and 1.49 ± 0.19 Nm·kg-1 for total and load range work respectively for flexion, p < 0.05, and was evident at higher angular velocities (p < 0.001 for both extension and flexion. At

  3. Knee extension isometric torque production differences based on verbal motivation given to introverted and extroverted female children.

    Science.gov (United States)

    McWhorter, J Wesley; Landers, Merrill; Young, Daniel; Puentedura, E Louie; Hickman, Robbin A; Brooksby, Candi; Liveratti, Marc; Taylor, Lisa

    2011-08-01

    To date, little research has been conducted to test the efficacy of different forms of motivation based on a female child's personality type. The purpose of this study was to evaluate the ability of female children to perform a maximal knee extension isometric torque test with varying forms of motivation, based on the child's personality type (introvert vs. extrovert). The subjects were asked to perform a maximal isometric knee extension test under three different conditions: 1) with no verbal motivation, 2) with verbal motivation from the evaluator only, and 3) with verbal motivation from a group of their peers and the evaluator combined. A 2×3 mixed ANOVA was significant for an interaction (F 2,62=17.530; pintroverted group showed that scores without verbal motivation were significantly higher than with verbal motivation from the evaluator or the evaluator plus the peers. The extroverted group revealed that scores with verbal motivation from the evaluator or the evaluator plus the peers were significantly higher than without verbal motivation. Results suggest that verbal motivation has a varying effect on isometric knee extension torque production in female children with different personality types. Extroverted girls perform better with motivation, whereas introverted girls perform better without motivation from others.

  4. Rehabilitation treatment of ankylosis after relaxing and plastic operation of adhesion of knee extension apparatus%伸膝装置粘连松解成形术后康复治疗膝关节僵直

    Institute of Scientific and Technical Information of China (English)

    史桂秋; 尹中华

    2002-01-01

    Background:Ankylosis is the result of adhesion of knee extension apparatus that is often the complications of trauma of femoral shaft and knee .Because ankylosis will impair the flexion of knee joint,postoperational exercise is the key to rebuild flexing function of knee joint.

  5. Posterior Dislocation of the Hinge-Post Extension in a Rotating Hinge Total Knee Prosthesis

    Directory of Open Access Journals (Sweden)

    Givenchy Manzano

    2013-01-01

    Full Text Available The rotating hinge knee prosthesis is a popular intervention in patients lacking stability with highly constrained total knee arthroplasty. Despite improvements in design, nonmechanical and mechanical complications continue to be a problem. Dislocation of the hinge has been widely described, mainly due to the component fracture. Few reports describe isolated dislocation of the rotating stem. We report a case of isolated disengagement of the rotating hinge mechanism, due to severe flexion gap imbalance, leading to subsequent posterior dislocation of the hinge and anterior knee dislocation, in a patient with a history of multiple total knee arthroplasty revisions. This case suggests the importance of the soft tissue balancing, the adequate patellar tracking, and use of a long cylindrical, minimally tapered rotating stem in hinge arthroplasty to minimize hinge dislocation.

  6. Percutaneous quadriceps tendon pie-crusting release of extension contracture of the knee

    National Research Council Canada - National Science Library

    Liu, H X; Wen, H; Hu, Y Z; Yu, H C; Pan, X Y

    2014-01-01

    ...: percutaneous quadriceps tendon pie-crusting release. Percutaneous pie-crusting release was performed using an 18-gauge needle to puncture the stiff fibrous band of the distal and lateral quadriceps tendon under maximum knee flexion...

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

    Directory of Open Access Journals (Sweden)

    Barbora Strejcová

    2012-09-01

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

  8. 应用缝匠肌治疗伸膝功能障碍%The application of sartorius muscle for treatment of extension disorders of knee

    Institute of Scientific and Technical Information of China (English)

    陈秋生; 李松建; 余斌; 陈霞; 朱立新; 杨建成

    2002-01-01

    Objective Sartorius muscle was applied to treat dislocation or subluxation of patella and extension disorder of knee resulted from poliomyelitis,patellectomy and quadriceps femoris injury.Method The distal one third part or two thirds part of sartorius muscle excluded its insertion was freed,then transposed and threaded to the front surface of patella.Result 30 cases(37 knees)with dislocation or subluxation of patella were treated and 25 cases(28 knees)were followed up(mean followed up time 4 years).pain in the patello femeral joint disappeared without any recurrence of dislocation.75 with weak extensor of knee were treated and 50 were followed up for mean 2 years and 1 month.The extensor strength in the patients with poliomyelitis increased from 0.89 preoperatively to 2.76 postoperatively.The joint movement in the patients with extension stiffness of knee increased from 15° preoperatively to 102° postoperatively.The extensor strength in the patients with patellectomy increased by 2 grades postoperatively,which enable the patients to complete the last 10° to 15° extension movement of knee.Conclusion The authors modified the usual surgery methods,by which the results were far from perfect,in treatment of the lateral displacement of patella and advanced a new treatment for the patients with extension stiffness of knee and the patients with weak extensor strength after patellectomy.

  9. Slope of the lateral density function of extensive air showers around the knee region as an indicator of shower age

    CERN Document Server

    Dey, Rajat K

    2016-01-01

    Analyzing simulated extensive air shower (EAS) events generated with the Monte Carlo code CORSIKA, this paper critically studies the characteristics of lateral distribution of electrons in EAS around the knee energy region of the energy spectrum of primary cosmic rays. The study takes into account the issue of lateral shower age parameter as indicator of the stage of development of showers in the atmosphere. The correlation of lateral shower age parameter with other EAS observables is examined, using simulated data in the context of its possible use in a multi-parameter study of EAS, with a view to obtaining information about the nature of the shower initiating primaries at sea level EAS experiments. It is shown that the observed slope of the lateral density function in the 3-dimensional plot at least for the KASCADE data supports the idea of a transition from light to heavy mass composition around the knee.

  10. Slope of the lateral density function of extensive air showers around the knee region as an indicator of shower age

    Science.gov (United States)

    Dey, Rajat K.; Dam, Sandip

    2016-11-01

    Analyzing simulated extensive air shower (EAS) events generated with the Monte Carlo code CORSIKA, this paper critically studies the characteristics of lateral distribution of electrons in EAS around the knee energy region of the energy spectrum of primary cosmic rays. The study takes into account the issue of the lateral shower age parameter as an indicator of the stage of development of showers in the atmosphere. The correlation of the lateral shower age parameter with other EAS observables is examined, using simulated data in the context of its possible use in a multi-parameter study of EAS, with a view to obtaining information about the nature of the shower initiating primaries at sea level EAS experiments. It is shown that the observed slope of the lateral density function in the 3-dimensional plot, at least for the KASCADE data, supports the idea of a transition from light to heavy mass composition around the knee.

  11. THE INFLUENCE OF VELOCITY OVERSHOOT MOVEMENT ARTIFACT ON ISOKINETIC KNEE EXTENSION TESTS

    Directory of Open Access Journals (Sweden)

    Fabiano Peruzzo Schwartz

    2010-03-01

    Full Text Available Exercise on an isokinetic device involves three distinct movement phases: acceleration, constant velocity, and deceleration. Inherent in these phases are unique occurrences that may confound test data and, thereby, test interpretation. Standard methods of data reduction like windowing and other techniques consist of removing the acceleration and deceleration phases in order to assure analysis under constant velocity conditions. However, none of these techniques adequately quantify the velocity overshoot (VO movement artifact which is a result of the devices resistance imposed to the limb. This study tested the influence of VO on isokinetic data interpretation. A computational algorithm was developed to accurately identify each movement phase and to delineate the VO segment. Therefore, the VO was then treated as a fourth and independent phase. A total of sixteen healthy men (26.8 ± 4.7 yrs, 1.76 ± 0.05 m, and 79.2 ± 9.4 kg performed two sets of ten maximal concentric extension repetitions of their dominant knee (at 60º·s-1 and 180º·s-1, on separate days and in a counterbalanced order, on a Biodex System 3 Pro dynamometer. All the phases of the isokinetic exercise were measured in terms of their biomechanical descriptors and according to the developed algorithm, the windowing method, and a data reduction technique that eliminates the first and last 10º of the total range of motion. Results showed significant differences (p < 0.05 between the constant velocity phases found by each method: the largest segment was obtained with the windowing method; the second one, with the algorithm; and the smallest, with data reduction technique. The point of peak torque was not affected by none of the techniques, but significant differences (p < 0.05 were found between the data including and not including the VO phase, concerning total work, time interval, and average length of load range: VO represents more than 10% of the amount calculated in constant

  12. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome.

    Science.gov (United States)

    Fairclough, John; Hayashi, Koji; Toumi, Hechmi; Lyons, Kathleen; Bydder, Graeme; Phillips, Nicola; Best, Thomas M; Benjamin, Mike

    2006-03-01

    Iliotibial band (ITB) syndrome is a common overuse injury in runners and cyclists. It is regarded as a friction syndrome where the ITB rubs against (and 'rolls over') the lateral femoral epicondyle. Here, we re-evaluate the clinical anatomy of the region to challenge the view that the ITB moves antero-posteriorly over the epicondyle. Gross anatomical and microscopical studies were conducted on the distal portion of the ITB in 15 cadavers. This was complemented by magnetic resonance (MR) imaging of six asymptomatic volunteers and studies of two athletes with acute ITB syndrome. In all cadavers, the ITB was anchored to the distal femur by fibrous strands, associated with a layer of richly innervated and vascularized fat. In no cadaver, volunteer or patient was a bursa seen. The MR scans showed that the ITB was compressed against the epicondyle at 30 degrees of knee flexion as a consequence of tibial internal rotation, but moved laterally in extension. MR signal changes in the patients with ITB syndrome were present in the region occupied by fat, deep to the ITB. The ITB is prevented from rolling over the epicondyle by its femoral anchorage and because it is a part of the fascia lata. We suggest that it creates the illusion of movement, because of changing tension in its anterior and posterior fibres during knee flexion. Thus, on anatomical grounds, ITB overuse injuries may be more likely to be associated with fat compression beneath the tract, rather than with repetitive friction as the knee flexes and extends.

  13. Differential Glucose Uptake in Quadriceps and Other Leg Muscles During One-Legged Dynamic Submaximal Knee-Extension Exercise

    OpenAIRE

    Kalliokoski, Kari K.; Boushel, Robert; Langberg, Henning; Scheede-Bergdahl, Celena; Ryberg, Ann Kathrine; Døssing, Simon; Kjær, Andreas; Kjær, Michael

    2011-01-01

    One-legged dynamic knee-extension exercise (DKE) is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron emission tomography (PET) determined uptake of [18F]-fluoro-deoxy-glucose (GU) during DKE. Five healthy male subjects performed DKE at 25 W for 35 min and both the contracting and contralateral restin...

  14. Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis: a cross-sectional study.

    Science.gov (United States)

    Kierkegaard, Signe; Jørgensen, Peter Bo; Dalgas, Ulrik; Søballe, Kjeld; Mechlenburg, Inger

    2015-09-01

    During movement tasks, patients with medial compartment knee osteoarthritis use compensatory strategies to minimise the joint load of the affected leg. Movement strategies of the knees and trunk have been investigated, but less is known about movement strategies of the pelvis during advancing functional tasks, and how these strategies are associated with leg extension power. The aim of the study was to investigate pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis compared with controls. 57 patients (mean age 65.6 years) scheduled for medial uni-compartmental knee arthroplasty, and 29 age and gender matched controls were included in this cross-sectional study. Leg extension power was tested with the Nottingham Leg Extension Power-Rig. Pelvic range of motion was derived from an inertia-based measurement unit placed over the sacrum bone during walking, stair climbing and stepping. Patients had lower leg extension power than controls (20-39 %, P 0.06). Furthermore, an inverse association (coefficient: -0.03 to -0.04; R (2) = 13-22 %) between leg extension power and pelvic range of motion during stair and step descending was found in the patients. Compared to controls, patients with medial compartment knee osteoarthritis use greater pelvic movements during advanced functional performance tests, particularly when these involve descending tasks. Further studies should investigate if it is possible to alter these movement strategies by an intervention aimed at increasing strength and power for the patients.

  15. The contribution of leg press and knee extension strength and power to physical function in people with knee osteoarthritis: A cross-sectional study.

    Science.gov (United States)

    Tevald, Michael A; Murray, Amanda M; Luc, Brittney; Lai, Kafai; Sohn, David; Pietrosimone, Brian

    2016-12-01

    The purposes of this study were to 1) determine the additional contributions of leg press and knee extensor power, over and above that of strength, to the performance of physical function tasks in people with knee osteoarthritis, and 2) compare the ability of bilateral leg press to unilateral knee extensor strength and power to predict functional task performance.

  16. Comparison of Proximally Versus Distally Placed Spatially Distributed Sequential Stimulation Electrodes in a Dynamic Knee Extension Task.

    Science.gov (United States)

    Laubacher, Marco; Aksöz, Efe A; Binder-Macleod, Stuart; Hunt, Kenneth J

    2016-06-13

    Spatially distributed sequential stimulation (SDSS) has demonstrated substantial power output and fatigue benefits compared to single electrode stimulation (SES) in the application of functional electrical stimulation (FES). This asymmetric electrode setup brings new possibilities but also new questions since precise placement of the electrodes is one critical factor for good muscle activation. The aim of this study was to compare the power output, fatigue and activation properties of proximally versus distally placed SDSS electrodes in an isokinetic knee extension task simulating knee movement during recumbent cycling. M. vastus lateralis and medialis of seven able-bodied subjects were stimulated with rectangular bi-phasic pulses of constant amplitude of 40 mA and at an SDSS frequency of 35 Hz for 6 min on both legs with both setups (i.e. n=14). Torque was measured during knee-extension movement by a dynamometer at an angular velocity of 110 deg/s. Mean power, peak power and activation time were calculated and compared for the initial and final stimulation phases, together with an overall fatigue index. Power output values (Pmean, Ppeak) were scaled to a standardised reference input pulse width of 100 μs (Pmean,s, Ppeak,s). The initial evaluation phase showed no significant differences between the two setups for all outcome measures. Ppeak and Ppeak,s were both significantly higher in the final phase for the distal setup (25.4 ± 8.1 W vs. 28.2 ± 6.2 W, p=0.0062 and 34.8 ± 9.5 W vs. 38.9 ± 6.7 W, p=0.021, respectively). With distal SDSS, there was modest evidence of higher Pmean and Pmean,s (p=0.071, p=0.14, respectively) but of longer activation time (p=0.096). The rate of fatigue was similar for both setups. For practical FES applications, distal placement of the SDSS electrodes is preferable.

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

    Science.gov (United States)

    Logerstedt, David; Sennett, Brian J

    2007-07-01

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

  18. Effects of Proprioceptive Neuromuscular Facilitation Stretching and Kinesiology Taping on Pelvic Compensation During Double-Knee Extension.

    Science.gov (United States)

    Lee, Seung-Woong; Lee, Jung-Hoon

    2015-12-22

    Shortened hamstrings are likely to restrict the anterior pelvic tilt and induce a slumped posture due to the posterior pelvic tilt. This study was conducted to compare the effects of proprioceptive neuromuscular facilitation (PNF) stretching and modified anterior pelvic tilt taping (APTT) on hamstring shortness-associated pelvic compensation while executing seated double-knee extension. Male college students (28 healthy young adults; mean age: 21.4 ± 2.1 years) with hamstring shortness were recruited as study subjects and randomly assigned to either the PNF stretching group (control group) or the APTT group (experimental group). In all the subjects, changes in the movement distance of the centre of gluteal pressure (COGP) as well as rectus abdominis (RA) and semitendinosus (SEM) muscle activities were measured during seated double-knee extension while the respective intervention method was applied. Both groups showed significant decreases in COGP distance and RA muscle activity compared with their respective baseline values (p < 0.05), however, no significant changes were observed in SEM muscle activity. We can infer that not only a direct intervention on the hamstring, such as PNF stretching, but also a modified APTT-mediated pelvic intervention may be used as a method for reducing pelvic compensation induced by hamstring shortness.

  19. Knee flexion with quadriceps cocontraction: A new therapeutic exercise for the early stage of ACL rehabilitation.

    Science.gov (United States)

    Biscarini, Andrea; Contemori, Samuele; Busti, Daniele; Botti, Fabio M; Pettorossi, Vito E

    2016-12-08

    Quadriceps strengthening exercises designed for the early phase of anterior cruciate ligament (ACL) rehabilitation should limit the anterior tibial translation developed by quadriceps contraction near full knee extension, in order to avoid excessive strain on the healing tissue. We hypothesize that knee-flexion exercises with simultaneous voluntary contraction of quadriceps (voluntary quadriceps cocontraction) can yield considerable levels of quadriceps activation while preventing the tibia from translating forward relative to the femur. Electromyographic activity in quadriceps and hamstring muscles was measured in 20 healthy males during isometric knee-flexion exercises executed near full knee extension with maximal voluntary effort of quadriceps cocontraction and external resistance (R) ranging from 0% to 60% of the 1-repetition maximum (1RM). Biomechanical modeling was applied to derive the shear (anterior/posterior) tibiofemoral force developed in each exercise condition. Isometric knee-flexion exercises with small external resistance (R=10% 1RM) and maximal voluntary effort of quadriceps cocontraction yielded a net posterior (ACL-unloading) tibial pull (P=0.005) and levels of activation of 32%, 50%, and 45% of maximum voluntary isometric contraction, for the rectus femoris, vastus medialis, and vastus lateralis, respectively. This exercise might potentially rank as one of the most appropriate quadriceps strengthening interventions in the early phase of ACL rehabilitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Knee-extension strength, postural control and function are related to fracture type and thigh edema in patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, Morten T; Bandholm, Thomas; Bencke, Jesper

    2008-01-01

    BACKGROUND: Post-surgery thigh edema, loss of knee-extension strength, and reduced physical performance are common following a hip fracture. It is not known if knee-extension strength and physical performance are related to the edema and fracture type. The aim of this study was to examine...... the influence of fracture type and post-surgery edema on physical performances in patients with hip fracture. METHODS: Fifteen women and five men admitted from their own home to an acute orthopedic hip fracture unit were examined. Ten had cervical and ten had intertrochanteric fractures. Correlations between...... fracture type and thigh edema in the fractured limb (% non-fractured) to physical performances of basic mobility, postural control (sway), and isometric knee-extension strength were examined. All measures, except those of basic mobility, were conducted at the time of discharge, 8.5 days post...

  1. Lifestyle-Related Factors Contributing to Decline in Knee Extension Strength among Elderly Women: A Cross-Sectional and Longitudinal Cohort Study.

    Directory of Open Access Journals (Sweden)

    Narumi Kojima

    Full Text Available This cross-sectional and 4-year longitudinal cohort study aimed to clarify how various lifestyle-related variables affect knee extension strength in elderly Japanese women. The participants were community-dwelling women (n = 575 living in the Itabashi Ward of Tokyo, Japan aged 75-85 years at baseline (in 2008 who returned for a follow-up examination 4 years later (in 2012. Maximum isometric knee extension strength in the dominant leg was measured during comprehensive medical check-ups at baseline and follow-up. Interviews with participants included questions on their history of 11 diseases and lifestyle-related factors such as physical activity as well as dietary, smoking, and drinking habits. Cross-sectional and longitudinal analyses yielded inconsistent results regarding the associations between lifestyle-related factors and knee extension strength. While going out more frequently and regular physical exercise positively affected baseline knee extension strength, they did not affect knee extension strength in the longitudinal analysis. The longitudinal analysis revealed that more frequent intake of soy products or green and yellow vegetables at baseline decreased age-related knee extension strength decline. The inconsistent results from the cross-sectional and longitudinal analyses indicate that conducting both types of analyses is crucial for researching this type of subject. The present study demonstrates that the age-related decline in muscle strength is lower in those who frequently eat soy products or green and yellow vegetables. Thus, recommending higher intake of soy products, and green and yellow vegetables for the elderly might help maintain their muscle health.

  2. The Influence of Oral L-Glutamine Supplementation on Muscle Strength Recovery and Soreness Following Unilateral Knee Extension Eccentric Exercise.

    Science.gov (United States)

    Legault, Zachary; Bagnall, Nicholas; Kimmerly, Derek S

    2015-10-01

    The study aimed to examine the effects that L-glutamine supplementation has on quadriceps muscle strength and soreness ratings following eccentric exercise. It was hypothesized that glutamine ingestion would quicken the recovery rate of peak force production and decrease muscle soreness ratings over a 72-hr recovery period. Sixteen healthy participants (8♀/8♂; 22 ± 4 years) volunteered in a double-blind, randomized, placebo-controlled crossover study. Supplement conditions consisted of isoenergetic placebo (maltodextrin, 0.6 g·kg-1·day-1) and L-glutamine (0.3 g·kg-1·day-1 + 0.3 g·kg-1·day-1 maltodextrin) ingestion once per day over 72 hr. Knee extensor peak torque at 0°, 30°, and 180° per second and muscle soreness were measured before, immediately following, 24, 48, and 72 hr posteccentric exercise. Eccentric exercise consisted of 8 sets (10 repetitions/set) of unilateral knee extension at 125% maximum concentric force with 2-min rest intervals. L-glutamine resulted in greater relative peak torque at 180°/sec both immediately after (71 ± 8% vs. 66 ± 9%), and 72 hr (91 ± 8% vs. 86 ± 7%) postexercise (all, p eccentric exercise. The effect of L-glutamine on muscle force recovery may be greater in men than women.

  3. Study of Cherenkov light lateral distribution function around the knee region in extensive air showers

    Directory of Open Access Journals (Sweden)

    Al-Rubaiee A.

    2015-01-01

    Full Text Available The Cherenkov light lateral distribution function (LDF was simulated with the CORSIKAcode in the energy range (1013 - 1016 eV. This simulation was performed for conditions and configurations of the Tunka EAS Cherenkov array for the two primary particles (p and Fe. Basing on the simulated results, many approximated functions are structured for two primary particles and different zenith angles. This allowed us to reconstruct the EAS events, which is, to determine the type and energy of the primary particles that produced showers from signal amplitudes of Cherenkov radiation measured by the Tunka Cherenkov array experiment. Comparison of the calculated LDF of Cherenkov radiation with that measured at the Tunka EAS array shows the ability to identify the primary particle that initiated the EAS cascades by determining its primary energy around the knee region of the cosmic ray spectrum.

  4. Study of Cherenkov Light Lateral Distribution Function around the Knee Region in Extensive Air Showers

    CERN Document Server

    Al-Rubaiee, A A; M., Marwah; Al-Douri, Y

    2015-01-01

    The Cherenkov light lateral distribution function (LDF) was simulated with the CORSIKA code, in the energy range (10^13-10^16) eV. This simulation was performed for conditions and configurations of the Tunka EAS Cherenkov array for two primary particles (p and Fe). Basing on the simulated results, many approximated functions are structured for two primary particles and different zenith angles. This allowed us to reconstruct the EAS events, which is, to determine the type and energy of the primary particles that produced showers from signal amplitudes of Cherenkov radiation which measured with Tunka Cherenkov array experiment. Comparison of the calculated LDF of Cherenkov radiation with that measured at the Tunka EAS array shows the ability for identifying of the primary particle that initiated the EAS cascades determining of its primary energy around the knee region of the cosmic ray spectrum.

  5. Association between regional quadriceps oxygenation and blood oxygen saturation during normoxic one-legged dynamic knee extension

    DEFF Research Database (Denmark)

    Esaki, Kazuki; Hamaoka, Takafumi; Rådegran, Göran;

    2005-01-01

    one-legged dynamic knee extension exercise (1L-KEE). Five healthy male subjects (age 25+/-2 year, height 177.8+/-4.8 cm, body weight 67.1 +/- 5.0 kg; mean +/- SD) performed 1L-KEE at 20, 40, and 60% of peak work rate (WR-peak) each for 4 min. S(fv)o2 was measured at rest and during the 3rd minute......It is not clear whether muscle oxygenation (O(2-NIRS)) measured by near-infrared spectroscopy (NIRS) correlates with femoral venous SO2 (S(fv)o2) during normoxic exercise. Therefore, the purpose of this study was to compare physiologically calibrated O(2-NIRS) with S(fv)o2 in subjects performing...

  6. Differential glucose uptake in quadriceps and other leg muscles during one-legged dynamic submaximal knee-extension exercise

    DEFF Research Database (Denmark)

    Kalliokoski, Kari K; Boushel, Robert; Langberg, Henning;

    2011-01-01

    One-legged dynamic knee-extension exercise (DKE) is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron...... in the vastus intermedius (VI) and lowest in the vastus lateralis (VL; VI vs VL, p muscles in the exercising leg was 35 ± 9%. Compared...... to mean GU in QF (=100%), GU was on average 73% in VL, 84% in rectus femoris, 115% in vastus medialis, and 142% in VI. Variable activation of hamstring muscles and muscles of the lower leg was also observed. These results show that GU of different muscles of quadriceps muscle group as well as between...

  7. Estimations of One Repetition Maximum and Isometric Peak Torque in Knee Extension Based on the Relationship Between Force and Velocity.

    Science.gov (United States)

    Sugiura, Yoshito; Hatanaka, Yasuhiko; Arai, Tomoaki; Sakurai, Hiroaki; Kanada, Yoshikiyo

    2016-04-01

    We aimed to investigate whether a linear regression formula based on the relationship between joint torque and angular velocity measured using a high-speed video camera and image measurement software is effective for estimating 1 repetition maximum (1RM) and isometric peak torque in knee extension. Subjects comprised 20 healthy men (mean ± SD; age, 27.4 ± 4.9 years; height, 170.3 ± 4.4 cm; and body weight, 66.1 ± 10.9 kg). The exercise load ranged from 40% to 150% 1RM. Peak angular velocity (PAV) and peak torque were used to estimate 1RM and isometric peak torque. To elucidate the relationship between force and velocity in knee extension, the relationship between the relative proportion of 1RM (% 1RM) and PAV was examined using simple regression analysis. The concordance rate between the estimated value and actual measurement of 1RM and isometric peak torque was examined using intraclass correlation coefficients (ICCs). Reliability of the regression line of PAV and % 1RM was 0.95. The concordance rate between the actual measurement and estimated value of 1RM resulted in an ICC(2,1) of 0.93 and that of isometric peak torque had an ICC(2,1) of 0.87 and 0.86 for 6 and 3 levels of load, respectively. Our method for estimating 1RM was effective for decreasing the measurement time and reducing patients' burden. Additionally, isometric peak torque can be estimated using 3 levels of load, as we obtained the same results as those reported previously. We plan to expand the range of subjects and examine the generalizability of our results.

  8. Comparison of Proximally Versus Distally Placed Spatially Distributed Sequential Stimulation Electrodes in a Dynamic Knee Extension Task

    Science.gov (United States)

    Laubacher, Marco; Aksöz, Efe A.; Binder-Macleod, Stuart; Hunt, Kenneth J.

    2016-01-01

    Spatially distributed sequential stimulation (SDSS) has demonstrated substantial power output and fatigue benefits compared to single electrode stimulation (SES) in the application of functional electrical stimulation (FES). This asymmetric electrode setup brings new possibilities but also new questions since precise placement of the electrodes is one critical factor for good muscle activation. The aim of this study was to compare the power output, fatigue and activation properties of proximally versus distally placed SDSS electrodes in an isokinetic knee extension task simulating knee movement during recumbent cycling. M. vastus lateralis and medialis of seven able-bodied subjects were stimulated with rectangular bi-phasic pulses of constant amplitude of 40 mA and at an SDSS frequency of 35 Hz for 6 min on both legs with both setups (i.e. n=14). Torque was measured during knee-extension movement by a dynamometer at an angular velocity of 110 deg/s. Mean power, peak power and activation time were calculated and compared for the initial and final stimulation phases, together with an overall fatigue index. Power output values (Pmean, Ppeak) were scaled to a standardised reference input pulse width of 100 μs (Pmean,s, Ppeak,s). The initial evaluation phase showed no significant differences between the two setups for all outcome measures. Ppeak and Ppeak,s were both significantly higher in the final phase for the distal setup (25.4 ± 8.1 W vs. 28.2 ± 6.2 W, p=0.0062 and 34.8 ± 9.5 W vs. 38.9 ± 6.7 W, p=0.021, respectively). With distal SDSS, there was modest evidence of higher Pmean and Pmean,s (p=0.071, p=0.14, respectively) but of longer activation time (p=0.096). The rate of fatigue was similar for both setups. For practical FES applications, distal placement of the SDSS electrodes is preferable. PMID:27478563

  9. Comparison of proximally versus distally placed spatially distributed sequential stimulation electrodes in a dynamic knee extension task

    Directory of Open Access Journals (Sweden)

    Marco Laubacher

    2016-06-01

    Full Text Available Spatially distributed sequential stimulation (SDSS has demonstrated substantial power output and fatigue benefits compared to single electrode stimulation (SES in the application of functional electrical stimulation (FES. This asymmetric electrode setup brings new possibilities but also new questions since precise placement of the electrodes is one critical factor for good muscle activation. The aim of this study was to compare the power output, fatigue and activation properties of proximally versus distally placed SDSS electrodes in an isokinetic knee extension task simulating knee movement during recumbent cycling. M. vastus lateralis and medialis of seven able-bodied subjects were stimulated with rectangular bi-phasic pulses of constant amplitude of 40 mA and at an SDSS frequency of 35 Hz for 6 min on both legs with both setups (i.e. n=14. Torque was measured during knee-extension movement by a dynamometer at an angular velocity of 110 deg/s. Mean power, peak power and activation time were calculated and compared for the initial and final stimulation phases, together with an overall fatigue index. Power output values (Pmean, Ppeak were scaled to a standardised reference input pulse width of 100 μs (Pmean,s, Ppeak,s. The initial evaluation phase showed no significant differences between the two setups for all outcome measures. Ppeak and Ppeak,s were both significantly higher in the final phase for the distal setup (25.4 ± 8.1 W vs. 28.2 ± 6.2 W, p=0.0062 and 34.8 ± 9.5 W vs. 38.9 ± 6.7 W, p=0.021, respectively. With distal SDSS, there was modest evidence of higher Pmean and Pmean,s (p=0.071, p=0.14, respectively but of longer activation time (p=0.096. The rate of fatigue was similar for both setups. For practical FES applications, distal placement of the SDSS electrodes is preferable.

  10. Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture

    DEFF Research Database (Denmark)

    Kronborg, Lise; Bandholm, Thomas; Palm, Henrik

    2017-01-01

    QUESTION: Is acute in-hospital physiotherapy with additional progressive knee-extension strength training (ST) of the fractured limb more effective in reducing knee-extension strength deficit at follow-up compared to physiotherapy without strength training in patients with a hip fracture? DESIGN......: Assessor blinded, randomised controlled trial with intention-to-treat analysis. PARTICIPANTS: 90 patients with a hip fracture admitted to an acute orthopaedic Hip Fracture Unit at a university hospital between October 2013 and May 2015. INTERVENTION: Daily physiotherapy with or without progressive knee...... strength training from baseline to follow-up. In the per-protocol analysis of non-missing data, significant between-group improvements by 10.5% (95% CI 0.3; 20.7) were found in favour of additional ST. No significant between-group differences were found in any secondary outcome. CONCLUSION: Physiotherapy...

  11. Neuromuscular performance of maximal voluntary explosive concentric contractions is influenced by angular acceleration.

    Science.gov (United States)

    Hahn, D; Bakenecker, P; Zinke, F

    2016-12-28

    Torque production during maximal voluntary explosive contractions is considered to be a functionally more relevant neuromuscular measure than steady-state torque, but little is known about accelerated concentric contractions. This study investigated torque, muscle activity, and fascicle behavior during isometric and fast concentric contractions of quadriceps femoris. Ten participants performed maximal voluntary explosive isometric, isovelocity, and additional concentric knee extensions at angular accelerations ranging from 700 to 4000° s(-2) that resulted in an angular velocity of 300° s(-1) at 40° knee flexion. Concentric torque at 40° knee flexion was corrected for inertia, and the corresponding isometric torque was matched to the time when the target knee angle of 40° was reached during concentric contractions. Electromyography of quadriceps femoris and hamstrings and ultrasound of vastus lateralis were measured to determine muscle activity, fascicle length, and fascicle velocity (FV). The faster the acceleration, the more torque was produced during concentric contractions at 40° knee flexion, which was accompanied by a reduction in FV. In comparison with isometric conditions, concentric quadriceps muscle activity was increased and torque during accelerations ≥3000° s(-2) equaled the time-matched isometric torque. Our results provide novel evidence that acceleration influences torque production during maximal voluntary explosive concentric contractions. This is suggested to be due to series elasticity and reduced force depression.

  12. Knee joint angle affects EMG-force relationship in the vastus intermedius muscle.

    Science.gov (United States)

    Saito, Akira; Akima, Hiroshi

    2013-12-01

    It is not understood how the knee joint angle affects the relationship between electromyography (EMG) and force of four individual quadriceps femoris (QF) muscles. The purpose of this study was to examine the effect of the knee joint angle on the EMG-force relationship of the four individual QF muscles, particularly the vastus intermedius (VI), during isometric knee extensions. Eleven healthy men performed 20-100% of maximal voluntary contraction (MVC) at knee joint angles of 90°, 120° and 150°. Surface EMG of the four QF synergists was recorded and normalized by the root mean square during MVC. The normalized EMG of the four QF synergists at a knee joint angle of 150° was significantly lower than that at 90° and 120° (P knee joint angle of 150°. Furthermore, the neuromuscular activation of the VI was the most sensitive to change in muscle length among the four QF synergistic muscles.

  13. Differential glucose uptake in quadriceps and other leg muscles during one-legged dynamic submaximal knee-extension exercise

    Directory of Open Access Journals (Sweden)

    Kari eKalliokoski

    2011-10-01

    Full Text Available One-legged dynamic knee-extension exercise (DKE is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron emission tomography (PET determined uptake of [18F]-fluoro-deoxy-glucose (GU during DKE. Five healthy male subjects performed DKE at 25 W for 35 min and both the contracting and contralateral resting leg were scanned with PET from mid-thigh and distally. On average, exercise GU was the highest in the vastus intermedius (VI and lowest in the vastus lateralis (VL (VI vs VL, p<0.05, whereas the coefficient of variation was highest in VL (VL vs VI, p<0.05. Coefficient of variation between the mean values of the four QF muscles in the exercising leg was 35±9%. Compared to mean GU in QF (=100%, GU was on average 73% in VL, 84% in rectus femoris, 115% in vastus medialis, and 142% in VI. Variable activation of hamstring muscles and muscles of the lower leg was also observed. These results show that GU of different muscles of quadriceps muscle group as well as between individuals vary greatly during DKE, and suggests that muscle activity is not equal between quadriceps muscles in this exercise model. Furthermore, posterior thigh muscles and lower leg muscles are more active than hitherto thought even during this moderate exercise intensity.

  14. Differential glucose uptake in quadriceps and other leg muscles during one-legged dynamic submaximal knee-extension exercise.

    Science.gov (United States)

    Kalliokoski, Kari K; Boushel, Robert; Langberg, Henning; Scheede-Bergdahl, Celena; Ryberg, Ann Kathrine; Døssing, Simon; Kjær, Andreas; Kjær, Michael

    2011-01-01

    One-legged dynamic knee-extension exercise (DKE) is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron emission tomography (PET) determined uptake of [(18)F]-fluoro-deoxy-glucose (GU) during DKE. Five healthy male subjects performed DKE at 25 W for 35 min and both the contracting and contralateral resting leg were scanned with PET from mid-thigh and distally. On average, exercise GU was the highest in the vastus intermedius (VI) and lowest in the vastus lateralis (VL; VI vs VL, p muscles in the exercising leg was 35 ± 9%. Compared to mean GU in QF (=100%), GU was on average 73% in VL, 84% in rectus femoris, 115% in vastus medialis, and 142% in VI. Variable activation of hamstring muscles and muscles of the lower leg was also observed. These results show that GU of different muscles of quadriceps muscle group as well as between individuals vary greatly during DKE, and suggests that muscle activity is not equal between quadriceps muscles in this exercise model. Furthermore, posterior thigh muscles and lower leg muscles are more active than hitherto thought even during this moderate exercise intensity.

  15. Measurement of knee joint gaps without bone resection: "physiologic" extension and flexion gaps in total knee arthroplasty are asymmetric and unequal and anterior and posterior cruciate ligament resections produce different gap changes.

    Science.gov (United States)

    Nowakowski, Andrej Maria; Majewski, Martin; Müller-Gerbl, Magdalena; Valderrabano, Victor

    2012-04-01

    General agreement is that flexion and extension gaps should be equal and symmetrical in total knee arthroplasty (TKA) procedures. However, comparisons using a standard TKA approach to normal knee joints that have not undergone bone resection are currently unavailable. Since bony preparation can influence capsule and ligament tension, our purpose was to perform measurements without this influence. Ten normal cadaveric knees were assessed using a standard medial parapatellar TKA approach with patellar subluxation. Gap measurements were carried out twice each alternating 100 and 200 N per compartment using a prototypical force-determining ligament balancer without the need for bony resection. Initial measurements were performed in extension, followed by 908 of flexion. The ACL was then resected, and finally the PCL was resected, and measurements were carried out in an analogous fashion. In general, the lateral compartment could be stretched further than the medial compartment, and the corresponding flexion gap values were significantly larger. ACL resection predominantly increased extension gaps, while PCL resection increased flexion gaps. Distraction force of 100 N per compartment appeared adequate; increasing to 200 N did not improve the results.

  16. Extension gap needs more than 1-mm laxity after implantation to avoid post-operative flexion contracture in total knee arthroplasty.

    Science.gov (United States)

    Okamoto, Shigetoshi; Okazaki, Ken; Mitsuyasu, Hiroaki; Matsuda, Shuichi; Mizu-Uchi, Hideki; Hamai, Satoshi; Tashiro, Yasutaka; Iwamoto, Yukihide

    2014-12-01

    In total knee arthroplasty (TKA), a high soft-tissue tension in extension at the time of operation would cause a post-operative flexion contracture. However, how tight the extension gap should be during surgery to avoid a post-operative flexion contracture remains unclear. The hypothesis is that some laxity in the intraoperative extension gap is necessary to avoid the post-operative flexion contracture. A posterior-stabilized TKA was performed for 75 osteoarthritic knees with a varus deformity. The intraoperative extension gap was measured using a tensor device that provides the gap length and the angle between the femoral component and the tibial cut surface. The medial component gap was defined as the gap calculated by subtracting the selected thickness of the tibial component, including the polyethylene liner, from the extension gap at the medial side. Then, the patients were divided into three groups according to the medial component gap, and post-operative extension angle measured 1 year after the surgery was compared between each groups. One year post-operatively, a flexion contracture of more than 5° was found in 0/34 patients when the medial component gap was more than 1 mm, in 2/26 (8%) patients when the gap was between 0 and 1 mm, and in 3/15 (20%) patients when the gap was contracture. As a clinical relevance, this study clarified the optimal extension gap to avoid the post-operative flexion contracture. Prospective comparative study, Level II.

  17. Modelling the maximum voluntary joint torque/angular velocity relationship in human movement.

    Science.gov (United States)

    Yeadon, Maurice R; King, Mark A; Wilson, Cassie

    2006-01-01

    The force exerted by a muscle is a function of the activation level and the maximum (tetanic) muscle force. In "maximum" voluntary knee extensions muscle activation is lower for eccentric muscle velocities than for concentric velocities. The aim of this study was to model this "differential activation" in order to calculate the maximum voluntary knee extensor torque as a function of knee angular velocity. Torque data were collected on two subjects during maximal eccentric-concentric knee extensions using an isovelocity dynamometer with crank angular velocities ranging from 50 to 450 degrees s(-1). The theoretical tetanic torque/angular velocity relationship was modelled using a four parameter function comprising two rectangular hyperbolas while the activation/angular velocity relationship was modelled using a three parameter function that rose from submaximal activation for eccentric velocities to full activation for high concentric velocities. The product of these two functions gave a seven parameter function which was fitted to the joint torque/angular velocity data, giving unbiased root mean square differences of 1.9% and 3.3% of the maximum torques achieved. Differential activation accounts for the non-hyperbolic behaviour of the torque/angular velocity data for low concentric velocities. The maximum voluntary knee extensor torque that can be exerted may be modelled accurately as the product of functions defining the maximum torque and the maximum voluntary activation level. Failure to include differential activation considerations when modelling maximal movements will lead to errors in the estimation of joint torque in the eccentric phase and low velocity concentric phase.

  18. An analytical model of the knee for estimation of internal forces during exercise.

    Science.gov (United States)

    Zheng, N; Fleisig, G S; Escamilla, R F; Barrentine, S W

    1998-10-01

    An analytical model of the knee joint was developed to estimate the forces at the knee during exercise. Muscle forces were estimated based upon electromyographic activities during exercise and during maximum voluntary isometric contraction (MVIC), physiological cross-sectional area (PCSA), muscle fiber length at contraction and the maximum force produced by an unit PCSA under MVIC. Tibiofemoral compressive force and cruciate ligaments' tension were determined by using resultant force and torque at the knee, muscle forces, and orientations and moment arms of the muscles and ligaments. An optimization program was used to minimize the errors caused by the estimation of the muscle forces. The model was used in a ten-subject study of open kinetic chain exercise (seated knee extension) and closed kinetic chain exercises (leg press and squat). Results calculated with this model were compared to those from a previous study which did not consider muscle length and optimization. Peak tibiofemoral compressive forces were 3134 +/- 1040 N during squat, 3155 +/- 755 N during leg press and 3285 +/- 1927 N during knee extension. Peak posterior cruciate ligament tensions were 1868 +/- 878 N during squat, 1866 +/- 383 N during leg press and 959 +/- 300 N for seated knee extension. No significant anterior cruciate ligament (ACL) tension was found during leg press and squat. Peak ACL tension was 142 +/- 257 N during seated knee extension. It is demonstrated that the current model provided better estimation of knee forces during exercises, by preventing significant overestimates of tibiofemoral compressive forces and cruciate ligament tensions.

  19. Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery.

    Science.gov (United States)

    Ageberg, Eva; Roos, Harald P; Silbernagel, Karin Grävare; Thomeé, Roland; Roos, Ewa M

    2009-02-01

    Hamstring muscles play a major role in knee-joint stabilization after anterior cruciate ligament (ACL) injury. Weakness of the knee extensors after ACL reconstruction with patellar tendon (PT) graft, and in the knee flexors after reconstruction with hamstring tendons (HT) graft has been observed up to 2 years post surgery, but not later. In these studies, isokinetic muscle torque was used. However, muscle power has been suggested to be a more sensitive and sport-specific measures of strength. The aim was to study quadriceps and hamstring muscle power in patients with ACL injury treated with surgical reconstruction with PT or HT grafts at a mean of 3 years after surgery. Twenty subjects with PT and 16 subjects with HT grafts (mean age at follow up 30 years, range 20-39, 25% women), who were all included in a prospective study and followed the same goal-based rehabilitation protocol for at least 4 months, were assessed with reliable, valid, and responsive tests of quadriceps and hamstring muscle power at 3 years (SD 0.9, range 2-5) after surgery. The mean difference between legs (injured minus uninjured), the hamstring to quadriceps (H:Q, hamstring divided by quadriceps) ratio, and the limb symmetry index (LSI, injured leg divided by uninjured and multiplied by 100) value, were used for comparisons between the groups (analysis of variance). The mean difference between the injured and uninjured legs was greater in the HT than in the PT group for knee flexion power (-21.3 vs. 7.7 W, p = 0.001). Patients with HT graft had lower H:Q ratio in the injured leg than the patients with PT graft (0.63 vs. 0.77, p = 0.012). They also had lower LSI for knee flexion power than those in the PT group (88 vs. 106%, p knee extension power. The lower hamstring muscle power, and the lower hamstring to quadriceps ratio in the HT graft group than in the PT graft group 3 years (range 2-5) after ACL reconstruction, reflect imbalance of knee muscles after reconstruction with HT graft that

  20. Differences in twitch potentiation between voluntary and stimulated quadriceps contractions of equal intensity.

    Science.gov (United States)

    Jubeau, M; Gondin, J; Martin, A; Van Hoecke, J; Maffiuletti, N A

    2010-02-01

    This study compared the extent of twitch and M-wave potentiation (POT) between voluntary and stimulated quadriceps contractions performed at the same intensity. Sixteen healthy men completed 10-s isometric knee extensions at 40% of the maximal voluntary contraction torque under electrical stimulation and voluntary conditions. Single stimuli were delivered to the femoral nerve to evoke twitches before (PRE) and from 3 to 600 s after the end of each conditioning contraction. Changes in twitch contractile properties and M-wave characteristics were compared between the conditions. The extent of twitch peak torque POT was smaller for the stimulated (122+/-20% of PRE) than for the voluntary condition (133+/-20% of PRE). The magnitude of POT for the maximal rate of twitch torque development was also smaller for the stimulated trial. Rectus femoris M-wave amplitude was potentiated by the voluntary but not by the stimulated contraction. It was concluded that stimulated contractions resulted in smaller twitch and M-wave POT than voluntary contractions, despite equivalent torque output and duration. The spatially and temporally fixed recruitment of motor units with electrical stimulation and therefore the lower number of activated motor units compared with voluntary actions of equal intensity could explain the present findings.

  1. Operant Variability and Voluntary Action

    Science.gov (United States)

    Neuringer, Allen; Jensen, Greg

    2010-01-01

    A behavior-based theory identified 2 characteristics of voluntary acts. The first, extensively explored in operant-conditioning experiments, is that voluntary responses produce the reinforcers that control them. This bidirectional relationship--in which reinforcer depends on response and response on reinforcer--demonstrates the functional nature…

  2. Peak torque and average power at flexion/extension of the shoulder and knee when using a mouth guard in adults with mild midline discrepancy.

    Science.gov (United States)

    Lee, Sang-Yeol; Hong, Min-Ho; Choi, Seung-Jun

    2014-07-01

    [Purpose] This study was conducted to investigate the changes in torque and power during flexion and extension of the shoulder and the knee joints caused by midline correction using mouth guards made from different materials in adults with mild midline discrepancy. [Subjects] The subjects of this study were males (n=12) in their 20s who showed a 3-5 mm difference between the midlines of the upper and lower teeth but had normal masticatory function. [Methods] The torque and average power of the lower limb and upper limb were measured during flexion and extension according to various types of mouth guard. [Results] There were significant differences in relative torque and average power between three conditions (no mouth guard, soft-type mouth guard, and hard-type mouth guard) at shoulder flexion and extension. There were no significant differences in relative torque and average power between the three conditions at knee flexion and extension. [Conclusions] These results suggest that use of a mouth guard is a method by which people with a mild midline discrepancy can improve the stability of the entire body.

  3. Reliability of Concentric, Eccentric and Isometric Knee Extension and Flexion when using the REV9000 Isokinetic Dynamometer

    DEFF Research Database (Denmark)

    de Carvalho Froufe Andrade, Alberto César Pereira; Caserotti, Paolo; de Carvalho, Carlos Manuel Pereira

    2013-01-01

    The aim of this study was to assess the reliability of isokinetic and ISO knee extensor and flexor muscle strength when using the REV9000 (Technogym) isokinetic dynamometer. Moreover, the reliability of several strength imbalance indices and bilateral ratios were also examined. Twenty......). The results of this study showed a high reproducibility in eccentric (0.95-0.97), concentric (0.95-0.96) and isometric (0.93-0.96), isokinetic strength for knee extensor and flexor muscles, thus indicating that the REV9000 isokinetic dynamometer can be used in future sports performance studies. A low...

  4. Rehabilitation and functional outcomes after extensive surgical debridement of a knee infected by fusobacterium necrophorum: a case report.

    Science.gov (United States)

    Naylor, Andrew R; Briggs, Matthew S; Kegelmeyer, Deborah K; Kloos, Anne D

    2013-06-01

    Joint infection is a rare but serious complication after knee injury that should be part of a physical therapist's differential diagnosis. This case report presents the care of a 17 year-old female athlete with septic arthritis from a Fusobacterium infection after sustaining a right lateral meniscus tear. Joint pathology combined with the aggressive infectious agent led to arthrofibrosis of her knee joint and resultant activity limitations and participation restrictions. The purpose of this case report is to highlight a rare and unique pathology, the serious effects that a joint infection can have on musculoskeletal function, and the challenges encountered during the rehabilitation process. The subject was a 17 year-old volleyball player who injured her right knee while playing volleyball. Within 7 days, the subject developed a severe joint infection that spread into surrounding gluteal, quadriceps, and gastrocnemius musculature. The infection was surgically debrided eight times during a 10-week inpatient hospital stay. A manipulation under anesthesia was performed to restore range of motion in her knee joint. Outpatient physical therapy was initiated 4 days later in order to restore musculoskeletal function. Over eight months of physical therapy services were utilized to address the impairments and activity limitations caused by her joint dysfunction. She met her physical therapy goals and made significant improvements on the Knee Outcome Survey and the Lower Extremity Functional Scale. Success in physical therapy and completion of additional strength training exercise allowed this subject to return to competitive softball at the club level during her freshman year of college. Though rare after musculoskeletal injury, joint infection can lead to soft tissue damage, partial or complete degradation of articular cartilage, and arthrofibrosis causing significant disability. Physical therapists must incorporate evidence-based treatment principles including eccentric

  5. MYOELECTRIC ALTERATIONS AFTER VOLUNTARY INDUCED HIGH - AND LOW - FREQUENCY FATIGUE

    Directory of Open Access Journals (Sweden)

    Vojko Strojnik

    2008-06-01

    Full Text Available The aim of the study was to find whether voluntary induced high- and low-frequency peripheral fatigue exhibit specific alteration in surface EMG signal (SEMG during evoked and maximum voluntary contractions. Ten male students of physical education performed 60 s long stretch-shortening cycle (SSC exercise with maximal intensity and 30 s long concentric (CON exercise with maximal intensity. To verify voluntary induced peripheral fatigue, knee torques during low- (T20 and high-frequency electrical stimulation (T100 of relaxed vastus lateralis muscle (VL were obtained. Contractile properties of the VL were measured with passive twitch and maximal voluntary knee extension test (MVC. Changes in M-waves and SEMG during MVC test were used to evaluate the differences in myoelectrical signals. T100/T20 ratio decreased by 10.9 ± 8.4 % (p < 0.01 after the SSC exercise and increased by 35.9 ± 17.5 % (p < 0.001 after the CON exercise. Significant SEMG changes were observed only after the CON exercise where peak to peak time of the M-waves increased by 9.2 ± 13.3 % (p < 0.06, SEMG amplitude during MVC increased by 32.9 ± 21.6 % (p < 0.001 and SEMG power spectrum median frequency decreased by 11.0 ± 10.5 % (p < 0.05. It is concluded that high frequency fatigue wasn't reflected in SEMG, however the SEMG changes after the CON seemed to reflect metabolic changes due to acidosis

  6. REHABILITATION AND FUNCTIONAL OUTCOMES AFTER EXTENSIVE SURGICAL DEBRIDEMENT OF A KNEE INFECTED BY FUSOBACTERIUM NECROPHORUM: A CASE REPORT

    Science.gov (United States)

    Briggs, Matthew S.; Kegelmeyer, Deborah K.; Kloos, Anne D.

    2013-01-01

    Background and Purpose: Joint infection is a rare but serious complication after knee injury that should be part of a physical therapist's differential diagnosis. This case report presents the care of a 17 year‐old female athlete with septic arthritis from a Fusobacterium infection after sustaining a right lateral meniscus tear. Joint pathology combined with the aggressive infectious agent led to arthrofibrosis of her knee joint and resultant activity limitations and participation restrictions. The purpose of this case report is to highlight a rare and unique pathology, the serious effects that a joint infection can have on musculoskeletal function, and the challenges encountered during the rehabilitation process. Case Description: The subject was a 17 year‐old volleyball player who injured her right knee while playing volleyball. Within 7 days, the subject developed a severe joint infection that spread into surrounding gluteal, quadriceps, and gastrocnemius musculature. The infection was surgically debrided eight times during a 10‐week inpatient hospital stay. A manipulation under anesthesia was performed to restore range of motion in her knee joint. Outpatient physical therapy was initiated 4 days later in order to restore musculoskeletal function. Outcome: Over eight months of physical therapy services were utilized to address the impairments and activity limitations caused by her joint dysfunction. She met her physical therapy goals and made significant improvements on the Knee Outcome Survey and the Lower Extremity Functional Scale. Success in physical therapy and completion of additional strength training exercise allowed this subject to return to competitive softball at the club level during her freshman year of college. Discussion: Though rare after musculoskeletal injury, joint infection can lead to soft tissue damage, partial or complete degradation of articular cartilage, and arthrofibrosis causing significant disability. Physical therapists must

  7. Angle- and gender-specific quadriceps femoris muscle recruitment and knee extensor torque.

    Science.gov (United States)

    Pincivero, Danny M; Salfetnikov, Yuliya; Campy, Robert M; Coelho, Alan J

    2004-11-01

    The objectives were to examine knee angle-, and gender-specific knee extensor torque output and quadriceps femoris (QF) muscle recruitment during maximal effort, voluntary contractions. Fourteen young adult men and 15 young adult women performed three isometric maximal voluntary contractions (MVC), in a random order, with the knee at 0 degrees (terminal extension), 10 degrees, 30 degrees, 50 degrees, 70 degrees, and 90 degrees flexion. Knee extensor peak torque (PT), and average torque (AT) were expressed in absolute (N m), relative (N m kg(-1)) and allometric-modeled (N m kg(-n)) units. Vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) muscle EMG signals were full-wave rectified and integrated over the middle 3 s of each contraction, averaged over the three trials at each knee angle, and normalized to the activity recorded at 0 degrees. Muscle recruitment efficiency was calculated as the ratio of the normalized EMG of each muscle to the allometric-modeled average torque (normalized to the values at 0 degrees flexion), and expressed as a percent. Men generated significantly greater knee extensor PT and AT than women in absolute, relative and allometric-modeled units. Absolute and relative PT and AT were significantly highest at 70 degrees, while allometric-modeled values were observed to increase significantly across knee joint angles 10-90 degrees. VM EMG was significantly greater than the VL and RF muscles across all angles, and followed a similar pattern to absolute knee extensor torque. Recruitment efficiency improved across knee joint angles 10-90 degrees and was highest for the VL muscle. VM recruitment efficiency improved more than the VL and RF muscles across 70-90 degrees flexion. The findings demonstrate angle-, and gender-specific responses of knee extensor torque to maximal-effort contractions, while superficial QF muscle recruitment was most efficient at 90 degrees, and less dependent on gender.

  8. Total knee arthroplasty for extension ankylosis of the knee:an analysis of 1 3 cases%膝关节置换治疗膝关节伸直位强直13例

    Institute of Scientific and Technical Information of China (English)

    张有伟; 郭礼跃

    2015-01-01

    Objective:To investigate the treatment method and curative effect of total knee arthroplasty for extension ankylosis of the knee. Methods:Total knee arthroplasty was performed to 13 patients with extension anky-losis of the knee from March 2008 to February 2014,including 6 male and 7 female patients with an average age of 41.4 years(36.0 -63.0 years),among whom 3 patients had rheumatoid arthritis and 10 patients had trauma around the knee joint. Before surgery,the range of motion was (0 ±0)°,the score of HSS and the Lysholm function score were(38 ±13.80)points and (15 ±13.29)points. Results:All of the 13 patients received total knee arthroplasty.The average follow-up was 48.7 months (9.0 -78.0 months). In the last follow-up,the range of motion was (96 ±12.17)°,the score of HSS and the Lysholm function score were (85 ±7.15)points and (82 ±6.94)points, indicating there were statistically significant differences before and after operation. The postoperative complications included patellar fracture in 1 patient,patellar tendon avulsion in 1 patient,part of incision necrosis in 2 patients and superficial infection in 1 patient. They were all cured after treatment,however,extension lag occurred in 3 pa-tients with degrees of 5°,10°and 15°respectively.Conclusion:Total knee arthroplasty for extension ankylosis of the knee can achieve satisfactory clinical results,but the operation is difficult and the chance of complications is high, and rehabilitation exercise is very important.%目的:探讨膝关节置换治疗膝关节伸直位强直的方法和疗效。方法:2008年3月至2014年2月,笔者采用膝关节置换治疗膝关节伸直位强直患者13例,男6例,女7例,平均年龄41.4岁(36.0~63.0岁),其中类风湿性关节炎3例,膝关节周围创伤10例;术前膝关节活动度(0±0)°,HSS评分(38±13.80)分,膝关节功能Lysholm评分(15±13.29)分。结果:全部病例行膝关节置换,平均随访48.7

  9. Resistance Exercise with concurrent whole body vibration preserves isometric knee extension strength during 8 weeks of horizontal bed rest

    Science.gov (United States)

    Mulder, E. R.; Stegeman, D. F.; Gerrits, K.; Rittweger, J.; Felsenberg, D.; de Haan, A.

    2005-08-01

    Changes in the quadriceps femoris (QF) muscle with respect to anatomical cross sectional area (CSA), neural activation level and isometric maximal voluntary torque (MVT) were determined in 18 healthy men subjected to 8 weeks of horizontal bed rest (BR) with (n = 9) and without (Ctrl; n = 9) 6 days/week resistance exercise concurrent with whole body vibration (RVE). For Ctrl, mean QF CSA decreased linearly over time to a reduction of 14.3 ± 4.9% at the end of BR. For RVE, exercise during BR significantly mitigated this reduction (3.9 ± 4.4%). Prior to and seven times during BR, MVT values were obtained together with neural activation levels, the latter by means of a superimposed stimulation technique. MVT was maintained for RVE during BR, whereas for Ctrl, MVT was significantly reduced by 14.2 ± 8.1% after 8 weeks. In contrast to previous reports, the maximal voluntary activation remained unaltered for both groups throughout the study. For Ctrl, the absence of a change in neural activation might be related to the repeated testing during the bed rest, which had presumably resulted in a habituation to the task. When both groups were pooled, a significant positive correlation (R= 0.62; P < 0.01) was observed between changes in CSA and changes in MVT.

  10. Voluntary Slavery

    Directory of Open Access Journals (Sweden)

    Danny Frederick

    2014-06-01

    Full Text Available The permissibility of actions depends upon facts about the flourishing and separateness of persons. Persons differ from other creatures in having the task of discovering for themselves, by conjecture and refutation, what sort of life will fulfil them. Compulsory slavery impermissibly prevents some persons from pursuing this task. However, many people may conjecture that they are natural slaves. Some of these conjectures may turn out to be correct. In consequence, voluntary slavery, in which one person welcomes the duty to fulfil all the commands of another, is permissible. Life-long voluntary slavery contracts are impermissible because of human fallibility; but fixed-term slavery contracts should be legally enforceable. Each person has the temporarily alienable moral right to direct her own life.

  11. Voluntary Slavery

    Directory of Open Access Journals (Sweden)

    Danny Frederick

    2014-06-01

    Full Text Available The permissibility of actions depends upon facts about the flourishing and separateness of persons. Persons differ from other creatures in having the task of discovering for themselves, by conjecture and refutation, what sort of life will fulfil them. Compulsory slavery impermissibly prevents some persons from pursuing this task. However, many people may conjecture that they are natural slaves. Some of these conjectures may turn out to be correct. In consequence, voluntary slavery, in which one person welcomes the duty to fulfil all the commands of another, is permissible. Life-long voluntary slavery contracts are impermissible because of human fallibility; but fixed-term slavery contracts should be legally enforceable. Each person has the temporarily alienable moral right to direct her own life.

  12. Monitoring muscle metabolic indexes by time-domain near-infrared spectroscopy during knee flex-extension induced by functional electrical stimulation

    Science.gov (United States)

    Ferrante, Simona; Contini, Davide; Spinelli, Lorenzo; Pedrocchi, Alessandra; Torricelli, Alessandro; Molteni, Franco; Ferrigno, Giancarlo; Cubeddu, Rinaldo

    2009-07-01

    A noninvasive methodology, combining functional electrical stimulation and time-domain near-infrared spectroscopy (TD-NIRS), is developed to verify whether stroke-altered muscular metabolism on postacute patients. Seven healthy subjects and nine postacute stroke patients undergo a protocol of knee flex-extension induced by quadricep electrical stimulation. During the protocol, TD-NIRS measurements are performed on both rectus femoris to investigate whether significant differences arise between able-bodied and stroke subjects and between patients' paretic and healthy legs. During baseline, metabolic parameters do not show any significant differences among subjects. During stimulation, paretic limbs produce a knee angle significantly lower than healthy legs. During recovery, patients' healthy limbs show a metabolic behavior correlated to able-bodied subjects. Instead, the correlation between the metabolic behavior of the paretic and able-bodied legs allows the definition of two patients' subgroups: one highly correlated (R>0.87) and the other uncorrelated (Rmuscle, but the metabolic dysfunction seems to be local and unilateral. It is crucial to enlarge the sample size of the two subgroups before making these preliminary results a general finding.

  13. 伸直位骨性强直膝的全膝关节置换术%Total knee arthroplasty in the treatment of knees with bony ankylosis in extension

    Institute of Scientific and Technical Information of China (English)

    童培建; 何帮剑; 储小兵; 厉驹; 叶福生; 肖鲁伟

    2012-01-01

    Objective To explore the clinical results of total knee arthroplasty (TKA) in the treatment of knees with bony ankylosis in extension.Methods From June 2000 to June 2007,10 patients had knees with bony ankylosis in extension were treated with TKA,including 4 males and 6 females,with an average age of 49 years (range,29 to 63 years).The primary diseases were as follows:ankylosing spondylitis in 3 cases,rheumatoid arthritis in 2 cases,hemophilic arthritis in 1 care,traumatic arthritis in 3 cases and pyogenic arthritis in 1 case.The range of motion (ROM) was 0° in all knees,and the average HSS (the Hospital for Special Surgery) score before operation was 32.5±10.26.Two patients underwent bilateral TKA,and 8 underwent unilateral TKA.Results All patients were followed up for 3 to 10 years (average,5.3 years).The average HSS score was improved to 87.75±6.45 at the last follow-up,and there was significant difference compared with that before operation (t=18.668,P=0.000).The average ROM was improved to 97.08°±11.57°at the last follow-up,and there was remarkable difference compared with that before operation (t=29.063,P=0.000).The postoperative complications included cutaneous necrosis in 2 cases,deep venous thrombosis of lower limb in 1 case,periprosthetic fracture in 1 case,and deep prosthetic infection in 1 case who underwent revised TKA later.The postopertative X-ray showed no looseness of the prostheses.Conclusion TKA through medial parapatellar approach,with dissection of the rectus femoris,secondary osteotomy and soft tissue balance intraoperatively is effective in the treatment of knees with bony ankylosis in extension,which can correct the ankylosed knee deformitis successfully.Combining with the correct rehabilitation exercise,it is possible to improve significantly the function of knee and life quality in these patients.%目的 探讨伸直位骨性强直膝全膝关节置换术的手术方法与临床疗效.方法 2000年6月至2007年6月,对10例伸直

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

    Science.gov (United States)

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

    2016-01-01

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

  15. A Feasibility Study of Fuzzy FES Controller Based on Cycle-to-Cycle Control: An Experimental Test of Knee Extension Control

    Science.gov (United States)

    Watanabe, Takashi; Masuko, Tomoya; Arifin, Achmad; Yoshizawa, Makoto

    Functional Electrical Stimulation (FES) can be effective in assisting or restoring paralyzed motor functions. The purpose of this study is to examine experimentally the fuzzy controller based on cycle-to-cycle control for FES-induced gait. A basic experimental test was performed on controlling maximum knee extension angle with normal subjects. In most of control trials, the joint angle was controlled well compensating changes in muscle responses to electrical stimulation. The results show that the fuzzy controller would be practical in clinical applications of gait control by FES. An automatic parameter tuning would be required practically for quick responses in reaching the target and in compensating the change in muscle responses without causing oscillating responses.

  16. An estimation of the influence of force decrease on the mean power spectral frequency shift of the EMG during repetitive maximum dynamic knee extensions.

    Science.gov (United States)

    Karlsson, J S; Ostlund, N; Larsson, B; Gerdle, B

    2003-10-01

    Frequency analysis of myoelectric (ME) signals, using the mean power spectral frequency (MNF), has been widely used to characterize peripheral muscle fatigue during isometric contractions assuming constant force. However, during repetitive isokinetic contractions performed with maximum effort, output (force or torque) will decrease markedly during the initial 40-60 contractions, followed by a phase with little or no change. MNF shows a similar pattern. In situations where there exist a significant relationship between MNF and output, part of the decrease in MNF may per se be related to the decrease in force during dynamic contractions. This study estimated force effects on the MNF shifts during repetitive dynamic knee extensions. Twenty healthy volunteers participated in the study and both surface ME signals (from the right vastus lateralis, vastus medialis, and rectus femoris muscles) and the biomechanical signals (force, position, and velocity) of an isokinetic dynamometer were measured. Two tests were performed: (i) 100 repetitive maximum isokinetic contractions of the right knee extensors, and (ii) five gradually increasing static knee extensions before and after (i). The corresponding ME signal time-frequency representations were calculated using the continuous wavelet transform. Compensation of the MNF variables of the repetitive contractions was performed with respect to the individual MNF-force relation based on an average of five gradually increasing contractions. Whether or not compensation was necessary was based on the shape of the MNF-force relationship. A significant compensation of the MNF was found for the repetitive isokinetic contractions. In conclusion, when investigating maximum dynamic contractions, decreases in MNF can be due to mechanisms similar to those found during sustained static contractions (force-independent component of fatigue) and in some subjects due to a direct effect of the change in force (force-dependent component of fatigue

  17. Knee Bursitis

    Science.gov (United States)

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

  18. Knee Replacement

    Science.gov (United States)

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

  19. Estimation of the forces acting on the tibiofemoral joint during knee extension exercises performed on an open kinetic chain strength-training machine

    Directory of Open Access Journals (Sweden)

    Jefferson Fagundes Loss

    2008-01-01

    Full Text Available The objectives of this study were to: (1 evaluate the resistive torque of an open kinetic chain strength-training machine for performing knee extensions, and (2 perform an analysis estimating internal forces in the tibiofemoral joint. During a fi rst phase of the study, measurements were taken of the machine under analysis (external forces, and then calculations were performed to estimate forces on the lower limb (internal forces. Equations were defi ned to calculate human force (HF, and the moment of muscular force (MMF. Perpendicular muscular force (MFp and joint force (JFp, axial muscular force (MF” and joint force (JF”, and total muscular force (MF and joint force (JF were all calculated. Five knee angles were analyzed (zero, 30, 45, 60, and 90 degrees. A reduction was observed in HF at higher knee angles, while MF and JF also increased at the same time. HF was always lower than the load selected on the machine, which indicates a reduced overload imposed by the machine. The reduction observed in MFp and JFp at higher knee angles indicates a lower tendency to shear the tibia in relation to the femur. At the same time, there was an increase in JF” due to higher MF”. The biomechanical model proposed in this study has shown itself adequate for the day-to-day needs of professionals who supervise orient strength training. resumo Os objetivos do presente estudo foram: (1 avaliar o torque de resistência (TR de uma máquina de musculação para a realização do exercício de extensão dos joelhos em cadeia cinética aberta e (2 realizar um ensaio teórico a partir do comportamento do TR com o intuito de estimar as forças internas na articulação tíbio-femoral. O estudo foi realizado em dois momentos: (1 medições da máquina utilizada e (2 estimativa das forças externas (na máquina e internas (no membro inferior. Foram utilizadas equações baseadas em um modelo mecânico bi-dimensional para o cálculo das componentes perpendiculares

  20. Reliability of Isometric Knee Extension Muscle Strength Measurements of Healthy Elderly Subjects Made with a Hand-held Dynamometer and a Belt.

    Science.gov (United States)

    Katoh, Munenori; Isozaki, Koji

    2014-12-01

    [Purpose] The purpose of this study was to examine the reliability of three isometric knee extension strength measurements (IKE) made with a hand-held dynamometer (HHD) and a belt of healthy elderly living in the community as subjects. [Subjects] The subject cohort consisted of 186 healthy elderly people, aged 65 to 79 years, living in local communities. [Methods] IKE of the leg subjects used to kick a ball was measured. IKE of each subject was measured three times using an HHD-belt at intervals of 30 seconds. The reliability of the larger of the first two measurements (LV2) as well as the third measurement (3V) was investigated. [Results] The intraclass correlation coefficients [ICC (1, 1)] for LV2 and 3V were 0.955. Bland-Altman analysis showed a fixed bias, and the limits of agreement ranged from -5.6 to 4.6. [Conclusion] The ICC results show that the test-retest reproducibility of IKE measurements of healthy elderly subjects using an HHD-belt is high. However, Bland-Altman analysis showed a fixed bias, suggesting the need for three measurements.

  1. Relationships between the extent of apnea-induced bradycardia and the vascular response in the arm and leg during dynamic two-legged knee extension exercise.

    Science.gov (United States)

    Nishiyasu, Takeshi; Tsukamoto, Rina; Kawai, Katsuhito; Hayashi, Keiji; Koga, Shunsaku; Ichinose, Masashi

    2012-02-01

    Our aim was to test the hypothesis that apnea-induced hemodynamic responses during dynamic exercise in humans differ between those who show strong bradycardia and those who show only mild bradycardia. After apnea-induced changes in heart rate (HR) were evaluated during dynamic exercise, 23 healthy subjects were selected and divided into a large response group (L group; n = 11) and a small response group (S group; n = 12). While subjects performed a two-legged dynamic knee extension exercise at a work load that increased HR by 30 beats/min, apnea-induced changes in HR, cardiac output (CO), mean arterial pressure (MAP), arterial O(2) saturation (Sa(O(2))), forearm blood flow (FBF), and leg blood flow (LBF) were measured. During apnea, HR in the L group (54 ± 2 beats/min) was lower than in the S group (92 ± 3 beats/min, P leg vascular conductance (LVC), and total vascular conductance (TVC) were all reduced, and MAP was increased in both groups, although the changes in CO, TVC, LBF, LVC, and MAP were larger in the L group than in the S group (P muscle regions.

  2. Knee Problems

    Science.gov (United States)

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

  3. The effect of hypoxia on pulmonary O2 uptake, leg blood flow and muscle deoxygenation during single-leg knee-extension exercise.

    Science.gov (United States)

    DeLorey, Darren S; Shaw, Colin N; Shoemaker, J Kevin; Kowalchuk, John M; Paterson, Donald H

    2004-05-01

    The effect of hypoxic breathing on pulmonary O(2) uptake (VO(2p)), leg blood flow (LBF) and O(2) delivery and deoxygenation of the vastus lateralis muscle was examined during constant-load single-leg knee-extension exercise. Seven subjects (24 +/- 4 years; mean +/-s.d.) performed two transitions from unloaded to moderate-intensity exercise (21 W) under normoxic and hypoxic (P(ET)O(2)= 60 mmHg) conditions. Breath-by-breath VO(2p) and beat-by-beat femoral artery mean blood velocity (MBV) were measured by mass spectrometer and volume turbine and Doppler ultrasound (VingMed, CFM 750), respectively. Deoxy-(HHb), oxy-, and total haemoglobin/myoglobin were measured continuously by near-infrared spectroscopy (NIRS; Hamamatsu NIRO-300). VO(2p) data were filtered and averaged to 5 s bins at 20, 40, 60, 120, 180 and 300 s. MBV data were filtered and averaged to 2 s bins (1 contraction cycle). LBF was calculated for each contraction cycle and averaged to 5 s bins at 20, 40, 60, 120, 180 and 300 s. VO(2p) was significantly lower in hypoxia throughout the period of 20, 40, 60 and 120 s of the exercise on-transient. LBF (l min(-1)) was approximately 35% higher (P > 0.05) in hypoxia during the on-transient and steady-state of KE exercise, resulting in a similar leg O(2) delivery in hypoxia and normoxia. Local muscle deoxygenation (HHb) was similar in hypoxia and normoxia. These results suggest that factors other than O(2) delivery, possibly the diffusion of O(2,) were responsible for the lower O(2) uptake during the exercise on-transient in hypoxia.

  4. Dissociation between the time courses of femoral artery blood flow and pulmonary VO2 during repeated bouts of heavy knee extension exercise in humans.

    Science.gov (United States)

    Fukuba, Yoshiyuki; Ohe, Yukie; Miura, Akira; Kitano, Asami; Endo, Masako; Sato, Hironori; Miyachi, Motohiko; Koga, Shunsaku; Fukuda, Osamu

    2004-05-01

    It has frequently been demonstrated that prior heavy cycling exercise facilitates pulmonary O(2) kinetics at the onset of subsequent heavy exercise. This might be due to improved muscle perfusion via acidosis-induced vasodilating effects. However, it is difficult to measure the blood flow (BF) to the working muscles (via the femoral artery) during cycling exercise. We therefore selected supine knee extension (KE) exercise as an alternative, and investigated whether the faster O(2) kinetics in the 2nd bout was matched by proportionally faster BF kinetics to the exercising muscle. Nine healthy subjects (aged 21-44 years) volunteered to participate in this study. The protocol consisted of two consecutive 6-min KE exercise bouts in a supine position (work rate: 70-75% of peak power) separated by a 6-min baseline rest (EX1 to EX2). During the protocol, a pulsed Doppler ultrasound technique was utilized to continuously measure the BF in the right femoral artery. The protocol was repeated at least 6 times to characterize the precise kinetics. In agreement with previous studies using cycling exercise, the O(2) kinetics in the 2nd bout were facilitated compared with that in the 1st bout [mean +/-s.d. of the 'effective' time constant (tau): EX1, 68.6 +/- 15.9, versus EX2, 58.0 +/- 14.4 s. Phase II-tau: EX1, 48.7 +/- 9.0, versus EX2, 41.2 +/- 13.3 s. Empirical index of the slow component (Delta O(2(6-3))): EX1, 78 +/- 44, versus EX2, 57 +/- 36 ml min(-1) (P 0.05)]. It was concluded that the faster pulmonary O(2) kinetics during heavy KE exercise following prior heavy exercise was not associated with a similar modulation in the BF to the working muscles.

  5. Exercise-induced muscle fatigue in the unaffected knee joint and its influence on postural control and lower limb kinematics in stroke patients

    Directory of Open Access Journals (Sweden)

    Sun Wook Park

    2017-01-01

    Full Text Available This study aimed to investigate the effects of exercise-induced muscle fatigue in the unaffected knee joint on postural control and kinematic changes in stroke patients. Forty participants (20 stroke patients, 20 age-matched healthy participants were recruited. To induce fatigue, maximum voluntary isometric contractions were performed in the unaffected knee joint in a Leg Extension Rehab exercise machine using the pneumatic resistance. We measured static and dynamic balance and lower-limb kinematics during gait. Changes in postural control parameters anteroposterior sway speed and total center of pressure distance differed significantly between the stroke and control groups. In addition, changes in gait kinematic parameters knee and ankle angles of initial contact differed significantly between stroke (paretic and non-paretic and control groups. Muscle fatigue in the unaffected knee and ankle impaired postural control and debilitates kinematic movement of ipsilateral and contralateral lower limbs, and may place the fatigued stroke patients at greater risk for falls.

  6. Whole-body vibration does not influence knee joint neuromuscular function or proprioception.

    Science.gov (United States)

    Hannah, R; Minshull, C; Folland, J P

    2013-02-01

    This study examined the acute effects of whole-body vibration (WBV) on knee joint position sense and indices of neuromuscular function, specifically strength, electromechanical delay and the rate of force development. Electromyography and electrically evoked contractions were used to investigate neural and contractile responses to WBV. Fourteen healthy males completed two treatment conditions on separate occasions: (1) 5 × 1 min of unilateral isometric squat exercise on a synchronous vibrating platform [30 Hz, 4 mm peak-to-peak amplitude] (WBV) and (2) a control condition (CON) of the same exercise without WBV. Knee joint position sense (joint angle replication task) and quadriceps neuromuscular function were assessed pre-, immediately-post and 1 h post-exercise. During maximum voluntary knee extensions, the peak force (PF(V)), electromechanical delay (EMD(V)), rate of force development (RFD(V)) and EMG of the quadriceps were measured. Twitch contractions of the knee extensors were electrically evoked to assess EMD(E) and RFD(E). The results showed no influence of WBV on knee joint position, EMD(V), PF(V) and RFD(V) during the initial 50, 100 or 150 ms of contraction. Similarly, electrically evoked neuromuscular function and neural activation remained unchanged following the vibration exercise. A single session of unilateral WBV did not influence any indices of thigh muscle neuromuscular performance or knee joint proprioception.

  7. Low-intensity eccentric contractions attenuate muscle damage induced by subsequent maximal eccentric exercise of the knee extensors in the elderly.

    Science.gov (United States)

    Chen, Trevor C; Tseng, Wei-Chin; Huang, Guan-Ling; Chen, Hsin-Lian; Tseng, Kou-Wei; Nosaka, Kazunori

    2013-04-01

    This study investigated whether low-intensity eccentric contractions of the knee extensors would attenuate the magnitude of muscle damage induced by maximal eccentric exercise of the same muscle performed 7 days later using elderly individuals. Healthy older men (66.4 ± 4.6 years) were assigned to control or experimental (Exp) group (n = 13 per group). The control group performed six sets of ten maximal eccentric contractions (MaxECC) of the knee extensors of non-dominant leg. The Exp group performed six sets of ten low-intensity eccentric contractions of the knee extensors on a leg extension machine by lowering a weight of 10 % maximal voluntary isometric knee extension strength (10 %ECC) 7 days prior to MaxECC. Changes in maximal voluntary isokinetic concentric torque (MVC-CON), angle at peak torque, range of motion (ROM), upper thigh circumference, muscle soreness, plasma creatine kinase activity and myoglobin (Mb) concentration and B-mode ultrasound echo-intensity before and for 5 days after MaxECC were compared between groups by a mixed factor ANOVA. No significant changes in any variables were observed following 10 %ECC. Following MaxECC, all variables changed significantly, and changes in all variables except for angle at peak torque were significantly different between groups. MVC-CON and ROM decreased smaller and recovered faster (P eccentric contractions was effective for attenuating muscle damage induced by subsequent MaxECC of the knee extensors for elderly individuals.

  8. Voluntary Environmental Governance Arrangements

    NARCIS (Netherlands)

    van der Heijden, J.

    2012-01-01

    Voluntary environmental governance arrangements have focal attention in studies on environmental policy, regulation and governance. The four major debates in the contemporary literature on voluntary environmental governance arrangements are studied. The literature falls short of sufficiently

  9. Voluntary Environmental Governance Arrangements

    NARCIS (Netherlands)

    van der Heijden, J.

    2012-01-01

    Voluntary environmental governance arrangements have focal attention in studies on environmental policy, regulation and governance. The four major debates in the contemporary literature on voluntary environmental governance arrangements are studied. The literature falls short of sufficiently specify

  10. Voluntary Service System (VSS)

    Data.gov (United States)

    Department of Veterans Affairs — Voluntary Service System (VSS) is a national-level application which replaced the site-based Voluntary Timekeeping System (VTK). VTK was used for many years at the...

  11. Knee Bursitis

    Science.gov (United States)

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

  12. Experimental knee pain reduces muscle strength

    DEFF Research Database (Denmark)

    Henriksen, Marius; Rosager, Sara; Aaboe, Jens

    2011-01-01

    Pain is the principal symptom in knee pathologies and reduced muscle strength is a common observation among knee patients. However, the relationship between knee joint pain and muscle strength remains to be clarified. This study aimed at investigating the changes in knee muscle strength following...... experimental knee pain in healthy volunteers, and if these changes were associated with the pain intensities. In a crossover study, 18 healthy subjects were tested on 2 different days. Using an isokinetic dynamometer, maximal muscle strength in knee extension and flexion was measured at angular velocities 0....... Knee pain reduced the muscle strength by 5 to 15% compared to the control conditions (P muscle strength was positively correlated to the pain intensity. Experimental knee pain significantly reduced knee extension...

  13. Influence of Isometric Exercise Training on Quadriceps Muscle Architecture and Strength in Obese Subjects with Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Waleed S Mahmoud

    2017-03-01

    Full Text Available Obese individuals have reduced quadriceps muscle strength relative to body mass that may increase the rate of progression of knee osteoarthritis (OA. The purpose of this study was to evaluate the effects of isometric exercise training on quadriceps muscle architecture and strength in obese subjects with knee osteoarthritis. Methods: Fortyfour obese male subjects aged 40–65 years diagnosed with knee osteoarthritis were randomly assigned into group A (n=32 and group B (n=12. Group A subjects performed a 12-week isometric exercise program. Group B subjects did not participate in any exercise program and maintained their ordinary activities for the same period. Both groups received the same conventional physical therapy program including hot packs and therapeutic ultrasonic. Muscle thickness, pennation angles and fascicle length of the vastus lateralis (VL muscle of the affected knee were measured at rest by B-mode ultrasonography. Maximal voluntary isometric knee extension torque (MVIC of the affected knee was measured using an isokinetic dynamometer. Knee pain and function were evaluated using visual analogue pain scale (VAS and Western Ontario and McMaster Universities Arthritis Index (WOMAC. All variables were evaluated before and the end of the intervention period for both groups. Results: at the end of the program, group A subjects showed significant improvements compared with group B subjects regarding MVIC and muscle architecture parameters (p<0.05. Also, there was significant improvement in post-test VAS and WOMAC scores in group A subjects compared to group B subjects (p<0.05. Conclusion: A 12-week quadriceps isometric training program improves knee pain and quadriceps muscle strength and architecture in obese subjects with knee OA. These results indicate that isometric training should be regarded as a proper exercise intervention for obese patients with knee OA.

  14. Tibia valga morphology in osteoarthritic knees: importance of preoperative full limb radiographs in total knee arthroplasty.

    Science.gov (United States)

    Alghamdi, Ahmed; Rahmé, Michel; Lavigne, Martin; Massé, Vincent; Vendittoli, Pascal-André

    2014-08-01

    Osteoarthritis of the knee is associated with deformities of the lower limb. Tibia valga is a contributing factor to lower limb alignment in valgus knees. We evaluated 97 valgus knees and 100 varus knees. Long-leg films were taken in weight bearing with both knees in full extension. For valgus knees, 52 knees (53%) had a tibia valga deformity. Average tibia valgus deformation was 5.0°. For varus knees, there was only 1 case of tibia valga (1%), with a deformation of 2.5°. The aim of this study was to assess the prevalence of primary tibia valga in valgus and varus knees and understand how it affects our approach to total knee arthroplasty (TKA). We recommend having full-leg length films when planning for TKA in valgus knees.

  15. An analysis of the biomechanical characteristics of knee joints when they are doing flexion and extension underwater%膝关节水中屈伸运动时的生物力学特征分析

    Institute of Scientific and Technical Information of China (English)

    杨林

    2013-01-01

      为观察目前普遍使用的膝关节水下康复训练法过程中下肢肌肉功能以及膝关节运动学特点,以体育院校的20名健康大学生为研究对象(女10名、男10名),采用表面肌电仪记录受试者分别进行单次膝关节最大屈伸运动和连续多次重复性屈伸运动时股四头肌(股内侧肌、股外侧肌)和腘绳肌(股二头肌、半腱肌)的肌电信号,同时采用常速摄像机在水下记录膝关节运动(拍摄频率25 Hz)。结果表明在膝关节进行连续重复性屈伸运动时,在运动初始阶段拮抗肌的肌电活动低于主动肌,随后拮抗肌活动逐渐升高直到最大。而在膝关节单次屈伸运动中,主动肌的肌电活动在膝关节产生运动前激活达到最大,并且在整个运动范围内单次屈伸运动时拮抗肌肌电活动都比连续重复性屈伸运动时低,但是在运动范围的后期单次运动时主动肌的肌电活动水平要高于重复运动时。在两种康复训练模式下,膝关节角速度曲线模式以及峰值角速度值都相似。结果说明:水下单次屈伸运动有利于锻炼主动肌,在重复性连续多次屈伸膝关节时,主动肌活动逐渐减弱,拮抗肌增强,这种训练模式有利于前交叉韧带损伤病人的康复。%In order to observe the functions of lower limb muscles and the kinematic characteristics of knee joints during underwater knee joint rehabilitation training universally used nowadays, the author selected 20 healthy college students (10 female students and 10 male students) as his research subjects from a physical education institute, recorded the electromy-ographic signals of the quadriceps femoris muscles (vastus medialis muscle, vastus lateralis muscle) and hamstring mus-cles (biceps femoris muscle, semitendinosus muscle) of the testees by using a surface electromyography when the testees were doing one time maximum knee joint flexion and extension and

  16. Knee Injuries

    Science.gov (United States)

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

  17. Custom Knee Device for Knee Contractures After Internal Femoral Lengthening.

    Science.gov (United States)

    Bhave, Anil; Shabtai, Lior; Ong, Peck-Hoon; Standard, Shawn C; Paley, Dror; Herzenberg, John E

    2015-07-01

    The development of knee flexion contractures is among the most common problems and complications associated with lengthening the femur with an internal device or external fixator. Conservative treatment strategies include physical therapy, serial casting, and low-load prolonged stretching with commercially available splinting systems. The authors developed an individually molded, low-cost custom knee device with polyester synthetic conformable casting material to treat knee flexion contractures. The goal of this study was to evaluate the results of treatment with a custom knee device and specialized physical therapy in patients who had knee flexion contracture during femoral lengthening with an intramedullary lengthening femoral nail. This retrospective study included 23 patients (27 limbs) who underwent femoral lengthening with an internal device for the treatment of limb length discrepancy. All patients had a knee flexion contracture raging from 10° to 90° during the lengthening process and were treated with a custom knee device and specialized physical therapy. The average flexion contracture before treatment was 36°. The mean amount of lengthening was 5.4 cm. After an average of 3.8 weeks of use of the custom knee device, only 2 of 27 limbs (7.5%) had not achieved complete resolution of the flexion contracture. The average final extension was 1.4°. Only 7 of 27 limbs (26%) required additional soft tissue release. The custom knee device is an inexpensive and effective method for treating knee flexion contracture after lengthening with an internal device.

  18. Plyometric training improves voluntary activation and strength during isometric, concentric and eccentric contractions.

    Science.gov (United States)

    Behrens, Martin; Mau-Moeller, Anett; Mueller, Karoline; Heise, Sandra; Gube, Martin; Beuster, Nico; Herlyn, Philipp K E; Fischer, Dagmar-C; Bruhn, Sven

    2016-02-01

    This study investigated effects of plyometric training (6 weeks, 3 sessions/week) on maximum voluntary contraction (MVC) strength and neural activation of the knee extensors during isometric, concentric and eccentric contractions. Twenty-seven participants were randomly assigned to the intervention or control group. Maximum voluntary torques (MVT) during the different types of contraction were measured at 110° knee flexion (180°=full extension). The interpolated twitch technique was applied at the same knee joint angle during isometric, concentric and eccentric contractions to measure voluntary activation. In addition, normalized root mean square of the EMG signal at MVT was calculated. The twitch torque signal induced by electrical nerve stimulation at rest was used to evaluate training-related changes at the muscle level. In addition, jump height in countermovement jump was measured. After training, MVT increased by 20Nm (95% CI: 5-36Nm, P=0.012), 24Nm (95% CI: 9-40Nm, P=0.004) and 27Nm (95% CI: 7-48Nm, P=0.013) for isometric, concentric and eccentric MVCs compared to controls, respectively. The strength enhancements were associated with increases in voluntary activation during isometric, concentric and eccentric MVCs by 7.8% (95% CI: 1.8-13.9%, P=0.013), 7.0% (95% CI: 0.4-13.5%, P=0.039) and 8.6% (95% CI: 3.0-14.2%, P=0.005), respectively. Changes in the twitch torque signal of the resting muscle, induced by supramaximal electrical stimulation of the femoral nerve, were not observed, indicating no alterations at the muscle level, whereas jump height was increased. Given the fact that the training exercises consisted of eccentric muscle actions followed by concentric contractions, it is in particular relevant that the plyometric training increased MVC strength and neural activation of the quadriceps muscle regardless of the contraction mode. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  19. Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery

    DEFF Research Database (Denmark)

    Ageberg, Eva; Roos, Harald; Silbernagel, Karin

    2008-01-01

    to 2 years post surgery, but not later. In these studies, isokinetic muscle torque was used. However, muscle power has been suggested to be a more sensitive and sport-specific measures of strength. The aim was to study quadriceps and hamstring muscle power in patients with ACL injury treated...... for at least 4 months, were assessed with reliable, valid, and responsive tests of quadriceps and hamstring muscle power at 3 years (SD 0.9, range 2-5) after surgery. The mean difference between legs (injured minus uninjured), the hamstring to quadriceps (H:Q, hamstring divided by quadriceps) ratio....... The lower hamstring muscle power, and the lower hamstring to quadriceps ratio in the HT graft group than in the PT graft group 3 years (range 2-5) after ACL reconstruction, reflect imbalance of knee muscles after reconstruction with HT graft that may have a negative effect on dynamic knee...

  20. Comparison of three formal methods used to estimate the functional axis of rotation: an extensive in-vivo analysis performed on the knee joint.

    Science.gov (United States)

    Colle, Francesca; Lopomo, Nicola; Visani, Andrea; Zaffagnini, Stefano; Marcacci, Maurilio

    2016-01-01

    Estimating the main axis of rotation (AoR) of a human joint represents an important issue in biomechanics. This study compared three formal methods used to estimate functional AoR, namely a cylindrical fitting method, a mean helical axis transformation, and a symmetrical axis approach. These methods were tested on 106 subjects undergoing navigated total knee arthroplasty. AoR orientation in 3D and in the frontal and coronal planes provided by each method was compared to the transepicondylar axis direction. Although all the methods resulted effective, significant differences were identified among them, relatively to the orientation in 3D and in the frontal plane projection. This was probably due to the presence of secondary rotations during the first degrees of knee flexion.

  1. Effects on hamstring muscle extensibility, muscle activity, and balance of different stretching techniques.

    Science.gov (United States)

    Lim, Kyoung-Il; Nam, Hyung-Chun; Jung, Kyoung-Sim

    2014-02-01

    [Purpose] The purpose of this study was to investigate the effects of two different stretching techniques on range of motion (ROM), muscle activation, and balance. [Subjects] For the present study, 48 adults with hamstring muscle tightness were recruited and randomly divided into three groups: a static stretching group (n=16), a PNF stretching group (n=16), a control group (n=16). [Methods] Both of the stretching techniques were applied to the hamstring once. Active knee extension angle, muscle activation during maximum voluntary isometric contraction (MVC), and static balance were measured before and after the application of each stretching technique. [Results] Both the static stretching and the PNF stretching groups showed significant increases in knee extension angle compared to the control group. However, there were no significant differences in muscle activation or balance between the groups. [Conclusion] Static stretching and PNF stretching techniques improved ROM without decrease in muscle activation, but neither of them exerted statistically significant effects on balance.

  2. Effects on Hamstring Muscle Extensibility, Muscle Activity, and Balance of Different Stretching Techniques

    Science.gov (United States)

    Lim, Kyoung-Il; Nam, Hyung-Chun; Jung, Kyoung-Sim

    2014-01-01

    [Purpose] The purpose of this study was to investigate the effects of two different stretching techniques on range of motion (ROM), muscle activation, and balance. [Subjects] For the present study, 48 adults with hamstring muscle tightness were recruited and randomly divided into three groups: a static stretching group (n=16), a PNF stretching group (n=16), a control group (n=16). [Methods] Both of the stretching techniques were applied to the hamstring once. Active knee extension angle, muscle activation during maximum voluntary isometric contraction (MVC), and static balance were measured before and after the application of each stretching technique. [Results] Both the static stretching and the PNF stretching groups showed significant increases in knee extension angle compared to the control group. However, there were no significant differences in muscle activation or balance between the groups. [Conclusion] Static stretching and PNF stretching techniques improved ROM without decrease in muscle activation, but neither of them exerted statistically significant effects on balance. PMID:24648633

  3. A Maximum Muscle Strength Prediction Formula Using Theoretical Grade 3 Muscle Strength Value in Daniels et al.'s Manual Muscle Test, in Consideration of Age: An Investigation of Hip and Knee Joint Flexion and Extension

    Science.gov (United States)

    Matsumura, Masashi; Ichikawa, Kazuna; Takei, Hitoshi

    2017-01-01

    This study attempted to develop a formula for predicting maximum muscle strength value for young, middle-aged, and elderly adults using theoretical Grade 3 muscle strength value (moment fair: Mf)—the static muscular moment to support a limb segment against gravity—from the manual muscle test by Daniels et al. A total of 130 healthy Japanese individuals divided by age group performed isometric muscle contractions at maximum effort for various movements of hip joint flexion and extension and knee joint flexion and extension, and the accompanying resisting force was measured and maximum muscle strength value (moment max, Mm) was calculated. Body weight and limb segment length (thigh and lower leg length) were measured, and Mf was calculated using anthropometric measures and theoretical calculation. There was a linear correlation between Mf and Mm in each of the four movement types in all groups, excepting knee flexion in elderly. However, the formula for predicting maximum muscle strength was not sufficiently compatible in middle-aged and elderly adults, suggesting that the formula obtained in this study is applicable in young adults only. PMID:28133549

  4. A Maximum Muscle Strength Prediction Formula Using Theoretical Grade 3 Muscle Strength Value in Daniels et al.'s Manual Muscle Test, in Consideration of Age: An Investigation of Hip and Knee Joint Flexion and Extension.

    Science.gov (United States)

    Usa, Hideyuki; Matsumura, Masashi; Ichikawa, Kazuna; Takei, Hitoshi

    2017-01-01

    This study attempted to develop a formula for predicting maximum muscle strength value for young, middle-aged, and elderly adults using theoretical Grade 3 muscle strength value (moment fair: Mf )-the static muscular moment to support a limb segment against gravity-from the manual muscle test by Daniels et al. A total of 130 healthy Japanese individuals divided by age group performed isometric muscle contractions at maximum effort for various movements of hip joint flexion and extension and knee joint flexion and extension, and the accompanying resisting force was measured and maximum muscle strength value (moment max, Mm ) was calculated. Body weight and limb segment length (thigh and lower leg length) were measured, and Mf was calculated using anthropometric measures and theoretical calculation. There was a linear correlation between Mf and Mm in each of the four movement types in all groups, excepting knee flexion in elderly. However, the formula for predicting maximum muscle strength was not sufficiently compatible in middle-aged and elderly adults, suggesting that the formula obtained in this study is applicable in young adults only.

  5. A Maximum Muscle Strength Prediction Formula Using Theoretical Grade 3 Muscle Strength Value in Daniels et al.’s Manual Muscle Test, in Consideration of Age: An Investigation of Hip and Knee Joint Flexion and Extension

    Directory of Open Access Journals (Sweden)

    Hideyuki Usa

    2017-01-01

    Full Text Available This study attempted to develop a formula for predicting maximum muscle strength value for young, middle-aged, and elderly adults using theoretical Grade 3 muscle strength value (moment fair: Mf—the static muscular moment to support a limb segment against gravity—from the manual muscle test by Daniels et al. A total of 130 healthy Japanese individuals divided by age group performed isometric muscle contractions at maximum effort for various movements of hip joint flexion and extension and knee joint flexion and extension, and the accompanying resisting force was measured and maximum muscle strength value (moment max, Mm was calculated. Body weight and limb segment length (thigh and lower leg length were measured, and Mf was calculated using anthropometric measures and theoretical calculation. There was a linear correlation between Mf and Mm in each of the four movement types in all groups, excepting knee flexion in elderly. However, the formula for predicting maximum muscle strength was not sufficiently compatible in middle-aged and elderly adults, suggesting that the formula obtained in this study is applicable in young adults only.

  6. Abnormal coactivation of knee and ankle extensors is related to changes in heteronymous spinal pathways after stroke

    Directory of Open Access Journals (Sweden)

    Bourbonnais Daniel

    2011-08-01

    Full Text Available Abstract Background Abnormal coactivation of leg extensors is often observed on the paretic side of stroke patients while they attempt to move. The mechanisms underlying this coactivation are not well understood. This study (1 compares the coactivation of leg extensors during static contractions in stroke and healthy individuals, and (2 assesses whether this coactivation is related to changes in intersegmental pathways between quadriceps and soleus (Sol muscles after stroke. Methods Thirteen stroke patients and ten healthy individuals participated in the study. Levels of coactivation of knee extensors and ankle extensors were measured in sitting position, during two tasks: maximal isometric voluntary contractions in knee extension and in plantarflexion. The early facilitation and later inhibition of soleus voluntary EMG evoked by femoral nerve stimulation were assessed in the paretic leg of stroke participants and in one leg of healthy participants. Results Coactivation levels of ankle extensors (mean ± SEM: 56 ± 7% of Sol EMG max and of knee extensors (52 ± 10% of vastus lateralis (VL EMG max during the knee extension and the ankle extension tasks respectively were significantly higher in the paretic leg of stroke participants than in healthy participants (26 ± 5% of Sol EMG max and 10 ± 3% of VL EMG max, respectively. Early heteronymous facilitation of Sol voluntary EMG in stroke participants (340 ± 62% of Sol unconditioned EMG was significantly higher than in healthy participants (98 ± 34%. The later inhibition observed in all control participants was decreased in the paretic leg. Levels of coactivation of ankle extensors during the knee extension task were significantly correlated with both the increased facilitation (Pearson r = 0.59 and the reduced inhibition (r = 0.56 in the paretic leg. Measures of motor impairment were more consistently correlated with the levels of coactivation of biarticular muscles than those of monoarticular

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

    Science.gov (United States)

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

    2015-02-01

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

  8. Variable stiffness actuated prosthetic knee to restore knee buckling during stance: a modeling study

    NARCIS (Netherlands)

    Wentink, E.C.; Koopman, H.F.J.M.; Stramigioli, S.; Rietman, J.S.; Veltink, P.H.

    2013-01-01

    Most modern intelligent knee prosthesis use dampers to modulate dynamic behavior and prevent excessive knee flexion, but they dissipate energy and do not assist in knee extension. Energy efficient variable stiffness control (VSA) can reduce the energy consumption yet effectively modulate the dynamic

  9. Effect of prosthesis selection on flexion-extension function after total knee arthroplasty%人工全膝关节置换术假体选择对患者膝关节屈伸功能的影响

    Institute of Scientific and Technical Information of China (English)

    郭克锋; 关菊香; 杨文清; 朱银星; 吴群强; 张建设

    2005-01-01

    , First Hospital of Xi'an Jiaotong University.PARTICIPANTS: Thirty-six patients(24 males and 12 females) who received TKA in the Department of Orthopaedics, First Hospital of Xi'an Jiaotong University during February 2000 to September 2003 were included in this study.METHODS: A retrospective study was carried out. Thirty-six patients(48knees) underwent total knee replacement, and the knee joint function was evaluated with American John N Install scoring system. The post-operation effect was evaluated by comparing the scores of each diseased knee before and after the operation.MAIN OUTCOME MEASURES: The function of knees and the score of every knee before and after operation were evaluated.RESULTS: The mean score before operation was 39, but it was 85 after follow-up visit. Totally 95% of them were up to the standard. The pain was reduced after the operation. The flexion-extension function and mobility of the knee joints improved obviously.CONCLUSION: TKA with posterior stabilized prosthesis and resection of posterior cruciate ligament(PCL) improved the function of the diseased knees after the operation. And the operation was simple and without complications. The key factors that affect the curative effect include the mechanical balance of the soft tissues during the operation, perioperative anticoagulant treatment for the prevention of deep vein thrombosis(DVT) and postoperative rehabilitation training. Peripheral tissue of knee joints should be released adequately; otherwise, it may cause unstable joint or limitation of joint activity.

  10. Analysis On Isokinetic Test Of Flexion And Extension Muscle Strength Of Knee Joints In Young Fencers%青少年击剑运动员膝关节屈伸肌群等速肌力测试分析

    Institute of Scientific and Technical Information of China (English)

    宣磊; 江海魁

    2011-01-01

    By using the methods of documentary、 experiments and statistics,the article analyzes isokinetic strength of flexion and extension muscle of lower extremities knee in youth fencers of Anhui,and objectively evaluates the differences in bilateral peak torque of flexors and extensors of knee between adult and youth fencers.Besides,the author also offers the theory basis and puts forward suggestions and countermeasures in special force training for the young fencers.%运用文献资料法、实验法、数据统计法,对安徽省击剑队青少年运动员下肢膝关节屈伸肌群等速肌力进行分析研究,客观评价青少年与成年击剑运动员在下肢膝关节屈伸肌群力量特征方面存在的差异,同时为青少年击剑专项力量训练提供理论依据和针对性建议。

  11. ARTHROFIBROSIS FOLLOWING TOTAL KNEE ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Ravi B. Solanki

    2014-11-01

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

  12. Prosthetic knee design by simulation

    Energy Technology Data Exchange (ETDEWEB)

    Hollerbach, K; Hollister, A

    1999-07-30

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

  13. Comparison of knee gait kinematics of workers exposed to knee straining posture to those of non-knee straining workers.

    Science.gov (United States)

    Gaudreault, Nathaly; Hagemeister, Nicola; Poitras, Stéphane; de Guise, Jacques A

    2013-06-01

    Workers exposed to knee straining postures, such as kneeling and squatting, may present modifications in knee gait kinematics that can make them vulnerable to osteoarthritis. In this study, knee kinematics of workers exposed to occupational knee straining postures (KS workers) were compared to those of non-knee straining (non-KS) workers. Eighteen KS workers and 20 non-KS workers participated in the study. Three-dimensional gait kinematic data were recorded at the knee using an electromagnetic motion tracking system. The following parameters were extracted from flexion/extension, adduction/abduction and internal/external rotation angle data and used for group comparisons: knee angle at initial foot contact, peak angles, minimal angles and angle range during the entire gait cycle. Group comparisons were performed with Student t-tests. In the sagittal plane, KS workers had a greater knee flexion angle at initial foot contact, a lower peak knee flexion angle during the swing phase and a lower angle range than non-KS workers (p<0.05). In the frontal plane, all parameters indicated that KS workers had their knees more adducted than non-KS workers. External/internal rotation range was greater for KS workers. This study provides new knowledge on work related to KS postures and knee kinematics. The results support the concept that KS workers might exhibit knee kinematics that are different from those of non-KS workers.

  14. Voluntary attention increases perceived spatial frequency.

    Science.gov (United States)

    Abrams, Jared; Barbot, Antoine; Carrasco, Marisa

    2010-08-01

    Voluntary covert attention selects relevant sensory information for prioritized processing. The behavioral and neural consequences of such selection have been extensively documented, but its phenomenology has received little empirical investigation. Involuntary attention increases perceived spatial frequency (Gobell & Carrasco, 2005), but involuntary attention can differ from voluntary attention in its effects on performance in tasks mediated by spatial resolution (Yeshurun, Montagna, & Carrasco, 2008). Therefore, we ask whether voluntary attention affects the subjective appearance of spatial frequency--a fundamental dimension of visual perception underlying spatial resolution. We used a demanding rapid serial visual presentation task to direct voluntary attention and measured perceived spatial frequency at the attended and unattended locations. Attention increased the perceived spatial frequency of suprathreshold stimuli and also improved performance on a concurrent orientation discrimination task. In the control experiment, we ruled out response bias as an alternative account by using a lengthened interstimulus interval, which allows observers to disengage attention from the cued location. In contrast to the main experiment, the observers showed neither increased perceived spatial frequency nor improved orientation discrimination at the attended location. Thus, this study establishes that voluntary attention increases perceived spatial frequency. This phenomenological consequence links behavioral and neurophysiological studies on the effects of attention.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2011-02-01

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

  17. Rethinking voluntary euthanasia.

    Science.gov (United States)

    Stoyles, Byron J; Costreie, Sorin

    2013-12-01

    Our goal in this article is to explicate the way, and the extent to which, euthanasia can be voluntary from both the perspective of the patient and the perspective of the health care providers involved in the patient's care. More significantly, we aim to challenge the way in which those engaged in ongoing philosophical debates regarding the morality of euthanasia draw distinctions between voluntary, involuntary, and nonvoluntary euthanasia on the grounds that drawing the distinctions in the traditional manner (1) fails to reflect what is important from the patient's perspective and (2) fails to reflect the significance of health care providers' interests, including their autonomy and integrity.

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

    Science.gov (United States)

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

    2016-12-01

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

  19. Knee Replacement

    Science.gov (United States)

    ... need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some ... a total living space on one floor since climbing stairs can be difficult. Install safety bars or a ...

  20. Knee Arthroscopy

    Science.gov (United States)

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

  1. Runner's Knee

    Science.gov (United States)

    ... Over the summer he bought a pair of running shoes and took up jogging. He started with ... bending the knee — when walking, kneeling, squatting, or running, for example. Walking or running downhill or even ...

  2. Voluntary Public Unemployment Insurance

    DEFF Research Database (Denmark)

    O. Parsons, Donald; Tranæs, Torben; Bie Lilleør, Helene

    Denmark has drawn much attention for its active labor market policies, but is almost unique in offering a voluntary public unemployment insurance program requiring a significant premium payment. A safety net program – a less generous, means-tested social assistance plan – completes the system...

  3. MUSCLE ACTIVITY DURING KNEE‐EXTENSION STRENGTHENING EXERCISE PERFORMED WITH ELASTIC TUBING AND ISOTONIC RESISTANCE

    Science.gov (United States)

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

    2012-01-01

    Background/Purpose: While elastic resistance training, targeting the upper body is effective for strength training, the effect of elastic resistance training on lower body muscle activity remains questionable. The purpose of this study was to evaluate the EMG‐angle relationship of the quadriceps muscle during 10‐RM knee‐extensions performed with elastic tubing and an isotonic strength training machine. Methods: 7 women and 9 men aged 28‐67 years (mean age 44 and 41 years, respectively) participated. Electromyographic (EMG) activity was recorded in 10 muscles during the concentric and eccentric contraction phase of a knee extension exercise performed with elastic tubing and in training machine and normalized to maximal voluntary isometric contraction (MVC) EMG (nEMG). Knee joint angle was measured during the exercises using electronic inclinometers (range of motion 0‐90°). Results: When comparing the machine and elastic resistance exercises there were no significant differences in peak EMG of the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM) during the concentric contraction phase. However, during the eccentric phase, peak EMG was significantly higher (p70% nEMG) quadriceps muscle activity during the concentric contraction phase, but slightly lower during the eccentric contraction phase, as knee extensions performed using an isotonic training machine. During the concentric contraction phase the two different conditions displayed reciprocal EMG‐angle patterns during the range of motion. Level of Evidence: 5 PMID:23316424

  4. The associations between quadriceps muscle strength, power, and knee joint mechanics in knee osteoarthritis: A cross-sectional study.

    Science.gov (United States)

    Murray, Amanda M; Thomas, Abbey C; Armstrong, Charles W; Pietrosimone, Brian G; Tevald, Michael A

    2015-12-01

    Abnormal knee joint mechanics have been implicated in the pathogenesis and progression of knee osteoarthritis. Deficits in muscle function (i.e., strength and power) may contribute to abnormal knee joint loading. The associations between quadriceps strength, power and knee joint mechanics remain unclear in knee osteoarthritis. Three-dimensional motion analysis was used to collect peak knee joint angles and moments during the first 50% of stance phase of gait in 33 participants with knee osteoarthritis. Quadriceps strength and power were assessed using a knee extension machine. Strength was quantified as the one repetition maximum. Power was quantified as the peak power produced at 40-90% of the one repetition maximum. Quadriceps strength accounted for 15% of the variance in peak knee flexion angle (P=0.016). Quadriceps power accounted for 20-29% of the variance in peak knee flexion angle (Pknee adduction moment (P=0.05). These data suggest that quadriceps power explains more variance in knee flexion angle and knee adduction moment during gait in knee osteoarthritis than quadriceps strength. Additionally, quadriceps power at multiple loads is associated with knee joint mechanics and therefore should be assessed at a variety of loads. Taken together, these results indicate that quadriceps power may be a potential target for interventions aimed at changing knee joint mechanics in knee osteoarthritis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Knee Injuries and Disorders

    Science.gov (United States)

    Your knee joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty ...

  6. The spinal reflex cannot be perceptually separated from voluntary movements.

    Science.gov (United States)

    Ghosh, Arko; Haggard, Patrick

    2014-01-01

    Both voluntary and involuntary movements activate sensors in the muscles, skin, tendon and joints. As limb movement can result from a mixture of spinal reflexes and voluntary motor commands, the cortical centres underlying conscious proprioception might either aggregate or separate the sensory inputs generated by voluntary movements from those generated by involuntary movements such as spinal reflexes. We addressed whether healthy volunteers could perceive the contribution of a spinal reflex during movements that combined both reflexive and voluntary contributions. Volunteers reported the reflexive contribution in leg movements that were partly driven by the knee-jerk reflex induced by a patellar tendon tap and partly by voluntary motor control. In one condition, participants were instructed to kick back in response to a tendon tap. The results were compared to reflexes in a resting baseline condition without voluntary movement. In a further condition, participants were instructed to kick forwards after a tap. Volunteers reported the perceived reflex contribution by repositioning the leg to the perceived maximum displacement to which the reflex moved the leg after each tendon tap. In the resting baseline condition, the reflex was accurately perceived. We found a near-unity slope of linear regressions of perceived on actual reflexive displacement. Both the slope value and the quality of regression fit in individual volunteers were significantly reduced when volunteers were instructed to generate voluntary backward kicks as soon as they detected the tap. In the kick forward condition, kinematic analysis showed continuity of reflex and voluntary movements, but the reflex contribution could be estimated from electromyography (EMG) recording on each trial. Again, participants' judgements of reflexes showed a poor relation to reflex EMG, in contrast to the baseline condition. In sum, we show that reflexes can be accurately perceived from afferent information. However

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

    Science.gov (United States)

    Schmitz, Randy J.; Westwood, Kevin C.

    2001-12-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  9. Unusual Cause of Knee Locking

    Directory of Open Access Journals (Sweden)

    Gazi Huri

    2013-01-01

    Full Text Available We report a case of partial intrasubstance tear of popliteus tendon as an unusual cause of pseudolocking of the knee. A 13-year-old semiprofessional soccer player applied to our clinic with a locked right knee in spite of the therapy applied (cold pack, NSAID, and immobilization in another institution 20 days after the injury. Significant extension loss was observed in his right knee with 30∘–90∘ ROM. Magnetic resonance imaging (MRI and arthroscopy confirmed the intrasubstance tear of popliteus tendon and synovitis. The ruptured part of the tendon was debrided, and the inflammatory tissue around the tendon, which may lead to pseudolocking, was gently removed with a shaver in order to regain the normal ROM. The patient was discharged with full ROM and weight bearing first day after the surgery. To our knowledge, this is the first case demonstrating intrasubstance tear of popliteus tendon causing pseudolocking of the knee.

  10. Muscle oxygenation of superficial and deep regions in knee extensor and plantar flexor muscles during repeated isometric contractions.

    Science.gov (United States)

    Kubo, K

    2015-04-01

    The purpose of this study was to investigate changes in muscle oxygenation of knee extensor and plantar flexor muscles during repeated muscle contractions under the same condition. In addition, we compared changes in muscle oxygenation between superficial and deep regions of both muscles. Eleven healthy males participated in this study. During repeated knee extensions and plantar flexions (50 repetitions at 50% of the isometric maximum voluntary contraction for 3 s with 3 s relaxations), blood volume and oxygen saturation (StO₂) of the vastus lateralis and medial gastrocnemius muscles (superficial and deep region of each muscle) were measured using near infrared spectroscopy. The decrement of StO₂at the end of exercises was greater in plantar flexor muscle than in knee extensor muscle (Pmuscles, the decrement of StO₂at the end of exercises was greater in the deep region than in the superficial one (both Pmuscle and deep regions of each muscle were higher than that of knee extensor muscle and superficial regions of each muscle.

  11. Accuracy of model-based tracking of knee kinematics and cartilage contact measured by dynamic volumetric MRI.

    Science.gov (United States)

    Kaiser, Jarred; Monawer, Arezu; Chaudhary, Rajeev; Johnson, Kevin M; Wieben, Oliver; Kijowski, Richard; Thelen, Darryl G

    2016-10-01

    The purpose of this study was to determine the accuracy of knee kinematics and cartilage contact measured by volumetric dynamic MRI. A motor-actuated phantom drove femoral and tibial bone segments through cyclic 3D motion patterns. Volumetric images were continuously acquired using a 3D radially undersampled cine spoiled gradient echo sequence (SPGR-VIPR). Image data was binned based on position measured via a MRI-compatible rotary encoder. High-resolution static images were segmented to create bone models. Model-based tracking was performed by optimally registering the bone models to the volumetric images at each frame of the SPGR-VIPR series. 3D tibiofemoral translations and orientations were reconstructed, and compared to kinematics obtained by tracking fiducial markers. Imaging was repeated on a healthy subject who performed cyclic knee flexion-extension. Cartilage contact for the subject was assessed by measuring the overlap between articular cartilage surfaces. Model-based tracking was able to track tibiofemoral angles and translations with precisions less than 0.8° and 0.5mm. These precisions resulted in an uncertainty of less than 0.5mm in cartilage contact location. Dynamic SPGR-VIPR imaging can accurately assess in vivo knee kinematics and cartilage contact during voluntary knee motion performed in a MRI scanner. This technology could facilitate the quantitative investigation of links between joint mechanics and the development of osteoarthritis.

  12. KNEE-JOINT LOADING IN KNEE OSTEOARTHRITIS: INFLUENCE OF ABDOMINAL AND THIGH FAT

    Science.gov (United States)

    Messier, Stephen P.; Beavers, Daniel P.; Loeser, Richard F.; Carr, J. Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J.; Hunter, David J.; DeVita, Paul

    2014-01-01

    Purpose Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee-joint loads in older overweight and obese adults with knee osteoarthritis (OA). Methods Fat depots were quantified using computed tomography and total lean and fat mass determined with dual energy x-ray absorptiometry in 176 adults (age = 66.3 yr., BMI = 33.5 kg·m−2) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Results Higher total body mass was significantly associated (p ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (p < 0.0001), patellofemoral forces (p< 0.006), and knee extensor moments (p = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (p = 0.0001), shear (p < 0.001), and patellofemoral forces (p = 0.01) and knee extension moment (p = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (p = 0.002). A regression model that included total thigh and total abdominal fat found both were significantly associated with knee compressive and shear forces (p ≤ 0.04). Thigh fat was associated with the knee abduction (p = 0.03) and knee extension moment (p = 0.02). Conclusions Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA. PMID:25133996

  13. Agreement and Reliability of Functional Performance and Muscle Power in Patients with Advanced Osteoarthritis of the Hip or Knee

    DEFF Research Database (Denmark)

    Villadsen, Allan; Roos, Ewa M; Overgaard, Søren;

    2012-01-01

    assessed for test-retest reliability and agreement on two occasions 1 wk apart. The outcomes were maximal single-joint muscle power (hip extension/abduction and knee extension/flexion), maximal muscle power during multijoint leg extension press, and functional performance measures (20-m walk, five......, single-joint knee extension, chair stands, and knee bending) to good (CVws, 0.81, single-joint knee extension, knee flexion, hip abduction, 20-m walk, and chair stands) reliability. CONCLUSIONS: Isolated muscle power over the hip and knee can safely be evaluated with poor to good agreement and good...

  14. Cardiovascular responses to voluntary and nonvoluntary static exercise in humans.

    Science.gov (United States)

    Friedman, D B; Peel, C; Mitchell, J H

    1992-11-01

    We have measured the cardiovascular responses during voluntary and nonvoluntary (electrically induced) one-leg static exercise in humans. Eight normal subjects were studied at rest and during 5 min of static leg extension at 20% of maximal voluntary contraction performed voluntarily and nonvoluntarily in random order. Heart rate (HR), mean arterial pressure (MAP), and cardiac output (CO) were determined, and peripheral vascular resistance (PVR) and stroke volume (SV) were calculated. HR increased from approximately 65 +/- 3 beats/min at rest to 80 +/- 4 and 78 +/- 6 beats/min (P voluntary and nonvoluntary contractions, respectively. CO increased from 5.1 +/- 0.7 to 6.0 +/- 0.8 and 6.2 +/- 0.8 l/min (P voluntary and nonvoluntary contractions, respectively. PVR and SV did not change significantly during voluntary or nonvoluntary contractions. Thus the cardiovascular responses were not different between voluntary and electrically induced contractions. These results suggest that the increases in CO, HR, SV, MAP, and PVR during 5 min of static contractions can be elicited without any contribution from a central neural mechanism (central command). However, central command could still have an important role during voluntary static exercise.

  15. Intrinsic muscle strength and voluntary activation of both lower limbs and functional performance after stroke.

    Science.gov (United States)

    Horstman, Astrid M; Beltman, Marijke J; Gerrits, Karin H; Koppe, Peter; Janssen, Thomas W; Elich, Peter; de Haan, Arnold

    2008-07-01

    The objective of this study was to assess the nature of muscle weakness in both legs after stroke compared with able-bodied control individuals and to examine whether there is a relationship between the degree of muscle weakness and coactivation of knee extensors and flexors as well as voluntary activation capacity of knee extensors of both paretic and non-paretic legs and indices of functional performance. Maximal voluntary isometric torques of knee extensors (MVCe) and flexors (MVCf) were determined in 14 patients (bilaterally) and 12 able-bodied controls. Simultaneous measurements were made of torque and surface EMG from agonist and antagonist muscles. Coactivation was calculated. Supramaximal triplets were evoked with electrical stimulation to estimate maximal torque capacity and degree of voluntary activation of knee extensors. MVCs, activation and coactivation parameters were correlated to scores of seven functional performance tests. MVCe, MVCf and voluntary activation were lower in paretic lower limb (PL) compared with both non-paretic lower limb (NL) and control. Besides, all these parameters of NL were also lower than control. Electrically evoked torque capacity of knee extensors of PL was about 60% of both NL and control, which were not significantly different from each other. Strong significant correlations between strength, as well as voluntary activation, and functional performance were found. Coactivation did not correlate well with functional performance. Thus, whereas for NL activation failure can explain weakness, for PL both activation failure and reduced intrinsic torque capacity are responsible for the severe weakness. Activation capacity and muscle strength correlated strongly to functional performance, while coactivation did not.

  16. Total Knee Arthroplasty in the Combined Contracture

    Directory of Open Access Journals (Sweden)

    O.J. Voskresensky

    2009-09-01

    Full Text Available We have offered modified access to a knee to work out a method for restoration of extensive apparatus of the knee. 91 patients with degenerative damages of the knee were under out su-pervision. All patients were differentiated in groups according to the form of access and pa-thology of the knee. At all stages of studying the following method of investigation were made: goniometry — for estimation of the knee functional condition; electroneiromyography — for reveling deficiency of muscular activity and determination of its kind. Patient's satisfac-tion by operation was defined by means of WOMAC scale subjective indexes. The received digital material was subjected to statistical processing. Thus, it has been proved that applica-tion of the modified access to a knee offered by us in total knee arthroplasty in patients with combined contracture in comparison with traditionally applied technologies of extensive ap-paratus releasing allows in short terms to restore the volume and force of movements in a knee that reduces time of rehabilitation and improves quality of patient's life

  17. Water on the Knee

    Science.gov (United States)

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

  18. Knee pain (image)

    Science.gov (United States)

    ... front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage as ... knee. Overall knee pain can be due to bursitis, arthritis, tears in the ligaments, osteoarthritis of the ...

  19. Knee microfracture surgery

    Science.gov (United States)

    Cartilage regeneration - knee ... Three types of anesthesia may be used for knee arthroscopy surgery: Medicine to relax you, and shots of painkillers to numb the knee Spinal (regional) anesthesia General anesthesia (you will be ...

  20. Preventing Knee Injuries

    Science.gov (United States)

    ... Our Newsletter Donate Blog Skip breadcrumb navigation Preventing Knee Injuries Knee injuries in children and adolescent athletes ... this PDF Share this page: WHAT ARE COMMON KNEE INJURIES? Pain Syndromes One of the most common ...

  1. An improved OpenSim gait model with multiple degrees of freedom knee joint and knee ligaments.

    Science.gov (United States)

    Xu, Hang; Bloswick, Donald; Merryweather, Andrew

    2015-08-01

    Musculoskeletal models are widely used to investigate joint kinematics and predict muscle force during gait. However, the knee is usually simplified as a one degree of freedom joint and knee ligaments are neglected. The aim of this study was to develop an OpenSim gait model with enhanced knee structures. The knee joint in this study included three rotations and three translations. The three knee rotations and mediolateral translation were independent, with proximodistal and anteroposterior translations occurring as a function of knee flexion/extension. Ten elastic elements described the geometrical and mechanical properties of the anterior and posterior cruciate ligaments (ACL and PCL), and the medial and lateral collateral ligaments (MCL and LCL). The three independent knee rotations were evaluated using OpenSim to observe ligament function. The results showed that the anterior and posterior bundles of ACL and PCL (aACL, pACL and aPCL, pPCL) intersected during knee flexion. The aACL and pACL mainly provided force during knee flexion and adduction, respectively. The aPCL was slack throughout the range of three knee rotations; however, the pPCL was utilised for knee abduction and internal rotation. The LCL was employed for knee adduction and rotation, but was slack beyond 20° of knee flexion. The MCL bundles were mainly used during knee adduction and external rotation. All these results suggest that the functions of knee ligaments in this model approximated the behaviour of the physical knee and the enhanced knee structures can improve the ability to investigate knee joint biomechanics during various gait activities.

  2. Effects of Lumbosacral Manipulation on Isokinetic Strength of the Knee Extensors and Flexors in Healthy Subjects: A Randomized, Controlled, Single-Blind Crossover Trial

    Science.gov (United States)

    Sanders, Grant D.; Nitz, Arthur J.; Abel, Mark G.; Symons, T. Brock; Shapiro, Robert; Black, W. Scott; Yates, James W.

    2015-01-01

    Objective The purpose of this study was to investigate the effect of manual manipulations targeting the lumbar spine and/or sacroiliac joint on concentric knee extension and flexion forces. Torque production was measured during isometric and isokinetic contractions. Methods This was a randomized, controlled, single-blind crossover design with 21 asymptomatic, college-aged subjects who had never received spinal manipulation. During 2 separate sessions, subjects’ peak torques were recorded while performing maximal voluntary contractions on an isokinetic dynamometer. Isometric knee extension and flexion were recorded at 60° of knee flexion, in addition to isokinetic measurements obtained at 60°/s and 180°/s. Baseline measurements were acquired before either treatment form of lumbosacral manipulation or sham manipulation, followed by identical peak torque measurements within 5 and 20 minutes posttreatment. Data were analyzed with a repeated measures analysis of variance. Results A statistically significant difference did not occur between the effects of lumbosacral manipulation or the sham manipulation in the percentage changes of knee extension and flexion peak torques at 5 and 20 minutes posttreatment. Similar, nonsignificant results were observed in the overall percentage changes of isometric contractions (spinal manipulation 4.0 ± 9.5 vs sham 1.2 ± 6.3, P = .067), isokinetic contractions at 60°/s (spinal manipulation − 4.0 ± 14.2 vs sham − 0.3 ± 8.2, P = .34), and isokinetic contractions at 180°/s (spinal manipulation − 1.4 ± 13.9 vs sham − 5.5 ± 20.0, P = .18). Conclusion The results of the current study suggest that spinal manipulation does not yield an immediate strength-enhancing effect about the knee in healthy, college-aged subjects when measured with isokinetic dynamometry. PMID:26793035

  3. Voluntary Simplicity: A Lifestyle Option.

    Science.gov (United States)

    Pestle, Ruth E.

    This guide provides practical ideas for incorporating the concept of voluntary simplicity into home economics classes. Discussed in the first chapter are the need to study voluntary simplicity, its potential contributions to home economics, and techniques and a questionnaire for measuring student attitudes toward the concept. The remaining…

  4. Toward voluntary parenthood.

    Science.gov (United States)

    Scarr, S

    2000-06-01

    David Lykken's proposal to license married parents for child rearing, and to deny the same opportunity to single and inept parents, springs from his deep concern for millions of youngsters cruelly subjected to abusive and neglectful rearing circumstances. Children from such inadequate homes grow up to have high rates of school failure, criminality, and drug addiction. The problem is clear, but Lykken's remedies of mandated marriage and parental licensure are unacceptable in U.S. society, where our reproductive rights are fortunately protected by our Constitution. As a devoted proponent of reproductive rights, I propose a legally and morally acceptable proposal to the same end. Increasing women's effective control of reproduction and moving toward entirely voluntary parenthood will accomplish the same goals without compromising our civil liberties.

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Arthroscopic knee debridement can delay total knee replacement in painful moderate haemophilic arthropathy of the knee in adult patients.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos; Gomez-Cardero, Primitivo

    2016-09-01

    The role of arthroscopic debridement of the knee in haemophilia is controversial in the literature. The purpose of this study is to describe the results of arthroscopic knee debridement (AKD), with the aim of determining whether it is possible to delay total knee replacement (TKR) for painful moderate haemophilic arthropathy of the knee in adult patients. In a 14-year period (1998-2011), AKD was performed for moderate haemophilic arthropathy of the knee in 27 patients with haemophilia A. Their average age at operation was 28.6 years (range 26-39 years). Indications for surgery were as follows: more than 90° of knee flexion, flexion deformity less than 30°, good axial alignment of the knee, good patellar alignment, and pain above >60 points in a visual analogue scale [0 (no pain) to 100 points]. Secondary haematological prophylaxis and rehabilitation (physiotherapy) was given for at least 3 months after surgery. Follow-up was for an average of 7.5 years (range 2-14 years). We assessed the clinical outcome before surgery and at the time of latest follow-up using the Knee Society pain and function scores, the range of motion, and the radiological score of the World Federation of Haemophilia. Knee Society pain scores improved from 39 preoperatively to 66 postoperatively, and function scores improved from 36 to 52. Range of motion improved on an average from -15° of extension and 90° of flexion before surgery, to -5° of extension and 110° of flexion at the last follow-up. A radiological deterioration of 2.8 points on average was found. There were two (7.4%) postoperative complications (haemarthroses resolved by joint aspiration). One patient (3.7%) required a TKR 12.5 years later. AKD should be considered in painful moderate haemophilic arthropathy of the knee in adult patients to delay TKR.

  7. Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

    Science.gov (United States)

    Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

    2015-02-15

    During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents.

  8. Análise eletromiográfica do quadríceps durante a extensão do joelho em diferentes velocidades Electromyographical analysis of the quadriceps during knee extension at different speeds

    Directory of Open Access Journals (Sweden)

    Daniel Cury Ribeiro

    2005-01-01

    electromyography, the interference of angular speed and different ways of fixing the elastic tube on the quadriceps activity. Ten male subjects without any kind of muscle or joint injury participated in this study. Subjects with a Q angle value out of 10-15° were excluded from this study. The elastic tube was fixed parallel and oblique to the subjects' body. Knee extensions were performed at 60°/sec and 120°/sec. No selective activity of the VMO was found. By comparing the levels of muscular activity, there was an increase of the electromyographic activity level in all portions of the quadriceps at the two angular speeds, only for parallel-fixed elastic tubes. These results suggest a synergic activity between VMO and the other portions of the quadriceps.

  9. Knee kinetic pattern during gait and anterior knee pain before and after rehabilitation in patients with patellofemoral pain syndrome.

    Science.gov (United States)

    Claudon, B; Poussel, M; Billon-Grumillier, C; Beyaert, C; Paysant, J

    2012-05-01

    Patellofemoral pain is likely due to compressive force acting on the patella related in turn to knee extension moment. The latter variable was assumed to be (i) reduced during short-distance free walking in case of patellofemoral pain syndrome and (ii) increased after therapeutic pain reduction. Peak knee extension moment at beginning of stance phase was recorded by three-dimensional gait analysis in 22 controls and in 23 patients with patellofemoral pain syndrome before and after rehabilitation of knee extensors and flexors to reduce the pain. Pain would occur mainly in stressful activities such as stair negotiation or squatting and was quantified by the anterior knee pain scale. Peak knee extension moment was significantly reduced in all the patients before treatment (n=23) compared to controls, although no one had pain during free walking. In the 17 patients who experienced significant post-rehabilitation pain reduction in their stressful activities, the peak knee extension moment was significantly reduced before treatment compared to controls and significantly increased after treatment, reaching values similar to control values. The peak knee extension moment during free walking appears to be a good kinetic variable related to a compensatory mechanism limiting or avoiding anterior knee pain and may be of interest in assessing knee dynamics alteration in patients with PFPS.

  10. No difference in gait between posterior cruciate retention and the posterior stabilized design after total knee arthroplasty

    NARCIS (Netherlands)

    van den Boom, Lennard G. H.; Halbertsma, Jan P. K.; van Raaij, Jos J. A. M.; Brouwer, Reinoud W.; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge

    2014-01-01

    In the present study, knee joint kinematics (e.g. knee flexion/extension) and kinetics (e.g. knee flexion moments) are assessed after total knee arthroplasty (TKA) between patients implanted with either a unilateral posterior stabilized (PS) and a posterior cruciate-retaining (PCR) design. It was hy

  11. No difference in gait between posterior cruciate retention and the posterior stabilized design after total knee arthroplasty

    NARCIS (Netherlands)

    van den Boom, Lennard G. H.; Halbertsma, Jan P. K.; van Raaij, Jos J. A. M.; Brouwer, Reinoud W.; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge

    2014-01-01

    In the present study, knee joint kinematics (e.g. knee flexion/extension) and kinetics (e.g. knee flexion moments) are assessed after total knee arthroplasty (TKA) between patients implanted with either a unilateral posterior stabilized (PS) and a posterior cruciate-retaining (PCR) design. It was hy

  12. Analyzing voluntary medical incident reports.

    Science.gov (United States)

    Gong, Yang; Richardson, James; Zhijian, Luan; Alafaireet, Patricia; Yoo, Illhoi

    2008-11-06

    Voluntary medical incident reports lacking consistency and accuracy impede the ultimate use of the reports for patient safety research. To improve this, two coders examined harm score usage in a voluntary medical incident reporting system where the harm scores were selected from a predefined list by different reporters. The two coders inter-rater agreement percent was 82%. The major categories and reviewed harm score jointly demonstrate that this process is critical and necessary in preparing the voluntary reports for further content and semantics analysis.

  13. Cooling Does Not Affect Knee Proprioception

    OpenAIRE

    Ozmun, John C.; Thieme, Heather A.; Ingersoll, Christopher D; Knight, Kenneth L

    1996-01-01

    The effect of cooling on proprioception of the knee has not been studied extensively. In this study, we investigated the movement reproduction (timing and accuracy) aspect of proprioception. Subjects were tested under two conditions: a 20-minute application of ice and control. Proprioceptive accuracy and timing were measured by passively moving the knee, then comparing the subject's active reproduction of the passive movement. Subjects were blindfolded, then tested in three sectors of the kne...

  14. Comparison of elasticity of human tendon and aponeurosis in knee extensors and ankle plantar flexors in vivo.

    Science.gov (United States)

    Kubo, Keitaro; Kanehisa, Hiroaki; Fukunaga, Tetsuo

    2005-05-01

    The purposes of this study were to compare the elasticity of tendon and aponeurosis in human knee extensors and ankle plantar flexors in vivo and to examine whether the maximal strain of tendon was correlated to that of aponeurosis. The elongation of tendon and aponeurosis during isometric knee extension (n = 23) and ankle plantar flexion (n = 22), respectively, were determined using a real-time ultrasonic apparatus, while the participants performed ramp isometric contractions up to voluntary maximum. To calculate the strain values from the measured elongation, we measured the respective length of tendon and aponeurosis. For the knee extensors, the maximal strain of aponeurosis (12.1 +/- 2.8 %) was significantly greater than that of the patella tendon (8.3 +/- 2.4 %), p aponeurosis in ankle plantar flexors (2.7 +/- 1.4 %), p plantar flexors there was no significant correlation between maximal strain of tendon and aponeurosis. These results would be important for understanding the different roles of tendon and aponeurosis during human movements and for more accurate muscle modeling.

  15. Functional imaging of muscle oxygenation and oxygen consumption in the knee extensor muscles during isometric contractions by spatially resolved near-infrared spectroscopy

    Science.gov (United States)

    Kek, Khai Jun; Miyakawa, Takahiro; Kudo, Nobuki; Yamamoto, Katsuyuki

    2007-02-01

    In this study, we showed that exercise type- and intensity-dependent regional differences in muscle oxygenation and oxygen consumption rate (Vo II) of the knee extensor muscles could be imaged in real time with a multi-channel spatially resolved near-infrared spectroscopy (SR-NIRS) imaging device. Healthy subjects performed isometric knee extension exercise for 30 s (without- or with-leg-press action) at different exercise intensities [10%, 40% and 70% of maximum voluntary contraction (MVC)]. "Separation-type" probes were attached to the skin over the major knee extensor muscles: vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM). Placement of the probes enabled simultaneously measurement of 12 sites over a skin area of about 30 cm2 (temporal resolution = 0.25 s). Local Vo II of each muscle, resting Vo II (Vo II, rest) and recovery Vo II (Vo II, rec ), were determined with arterial occlusion before the start and after the end of contraction, respectively. There was no significant difference between the values of Vo II rest, in the muscles. However, during knee extension exercise without-leg-press action, Vo II rec, value of the RF was significantly greater than the values of the VL and VM at all exercise intensities. In contrast, during exercise with-leg-press action, Vo II rec, values of the RF and VM were greater than those of the VL, especially during exercise at 40% and 70% MVC. In summary, the regional differences in muscle oxygenation and Vo II of the knee extensor muscles, probably due to the differences in relative contributions of muscles to exercise and in muscle architecture, were imaged using SR-NIRS.

  16. The Study of Isokinetic Concentration of Flexion and Extension Muscle Groups of Knee joints in North Lion player%北狮运动员膝关节屈伸肌群等速向心收缩生物力学特性的研究

    Institute of Scientific and Technical Information of China (English)

    雷志军; 杨小波; 宋乐军; 凡婷; 陈伊琳; 郑澜

    2012-01-01

    Objective: In order to reveal the characteristics of knee joint' s muscle contraction in lion dancing player and provide experimental basis for Scientific training, we explored nine lion dancing players' bilateral knee joint in Hunan Normal University by isokinetie machine. Method: The isokinetie explortion was carried out in lion dancing player' S knee joint' s flexion and extension muscle groups in Hunan Normal university with BIODEX SYSTEM 3. The explortion index are peak torque, peak torque to body weight, flexion and extension peak torque ratio, average power and work fatigue. Result: I } the peak torque and relative peak torque of the lion dancing player' s bilateral knee flexion and extension muscles increase with the explortion speed; 2 } there was no signifi- cant difference in average power and in working fatigue between lion head and lion -tail' s knee joints. 3 } there was no significant difference in the same muscle' s strength of lion head or lion tailed between left and right knee joints . Conclusion : Lion athletes knee muscle peak torque changes in the rate of increase with the reduction of ve- locity in testing, Changes of average power increases with velocity up to a certain speed and then decrease. Key words: Lion Dance; Knee Joint; Isokinetie Muscle Strength; Coneeutrie Contraction.%目的:通过对湖南师范大学9名北狮运动员双侧膝关节屈伸肌群进行等速测试,为揭示该项运动膝关节肌群收缩的生物力学特性提供实验依据。方法:采用BIODEX SYSTEM3等速测试系统对湖南师范大学北狮运动员膝关节屈伸肌群进行等速测试,测试指标为峰力矩、相对峰力矩、屈伸肌峰力矩比、平均功率及做功疲劳度。结果:1)北狮运动员双侧膝关节屈伸肌峰力矩和相对峰力矩随测试速度的增加呈递减趋势;2)狮头狮尾屈伸肌群峰力矩比值和做功疲劳度无显著性差异;3)狮头狮尾左右膝关节

  17. The Notion of Voluntary Unemployment.

    Science.gov (United States)

    Standing, Guy

    1981-01-01

    Considers the distinction between voluntary and involuntary unemployment by analyzing six behavioral characteristics attributed to groups of workers suspected of indulging in the former, and the labor market mechanisms supposedly encouraging them. (Author/CT)

  18. Analysis on Concentric Isokinetic Test of Flexion and Extension Muscle Strength of Knee Joints in Chon-dromalacia Patellae%髌骨软骨病患者的膝屈伸肌群等速向心肌力分析

    Institute of Scientific and Technical Information of China (English)

    徐卫华; 赵彦; 王鸿; 王家祥; 孙强

    2015-01-01

    目的::运用等速肌力测试方法分析髌骨软骨病患者的膝关节屈伸肌群等速向心肌力特征,为髌骨软骨病的防治和康复提供参考。方法:对30例髌骨软骨病单膝患者和与之相应的年龄、体型相差不大的24位正常成人进行双膝等速向心肌力测试,测得其在60°/s的峰力矩,运用统计学方法分析。结果:患膝屈伸肌峰力矩均减弱,与健侧及正常人双膝相比,P<0.01,具有统计学意义;伸肌PT值下降更为明显,双侧同名伸肌差异比,显著( P<0.05)高于髌骨软骨病组的屈肌和正常对照组的屈伸肌;同时患侧 H/Q 比值也显著( P<0.05)高于健侧及对照组。结论:髌骨软骨病患者的患膝屈伸肌群力量减弱、主动肌与拮抗肌比例失衡、双膝同名伸肌力量差异明显,提示髌骨软骨病患者的诊断和康复治疗应注意峰力矩、拮抗比和双侧差异的检测以及患膝关节肌肉力量和平衡的恢复。%Objective An analysis of flexion and extension muscle strength characters of knee in Chondromalacia Pa-tellae( CP) by means of isokinetic test was performed to provide a basis for CP prevention and rehabilitation. Meth-ods 30 patients with CP and 24 matched controls who cor-responding age,size finished the concentric isokinetic test of knee flexion and extension,using statistical methods to analyze its peak torque measured at 60°/s. Results Peak torques of flexion and extension muscles of the patient knee are reduced, and are statistically significant by P<0. 01 compared with the healthy side and normal knee;PT of extension decreased more significantly, and difference ratio of bilateral homonymous extensor muscle is significantly ( P<0. 05 ) higher than flexor of chondro-malacia patellae group and flexor and extensor of normal control group;At the same time,the H/Q ratio of the pa-tient side was significantly higher than that of the control group ( P<0. 05 ) . Conclusion The flexion and

  19. INFLUENCE OF FLEXION POSITION OF THE KNEE ON LIMB ALIGNMENT

    Institute of Scientific and Technical Information of China (English)

    蒋雷生

    2003-01-01

    Objective To verify the influence of flexion position of the knee on limb alignment,the change of the standing femorotibial angle(FTA)with knee flexion was radiologically investigated. MethodsRadiographs were taken on each left knee of 47 volunteers with seldom complaints in a one-leg standing position,The standing femorotibial angles(FTA)in full knee extension were compared with the corresponding ones in different angles of knee flexion,and the relationship between the FTA and the flexion angle was investigated. Results Standing FTAs in knee flexion were always smaller than the corresponding ones in full knee extension.With the increment of the flexion angle,the FTA decreased.Positive correlation was found between the difference(△FTA)of the standing FTA in full extension and in flexion and the flexion angle of the knee.Conclusion In the preoperative planning of knee surgeries such as high tibial osteotomy and arthroplasty,the influence of flexion contracture on limb alignment should be taken into consideration to avoid overcorrection or undercorrection.

  20. Knee Muscles Power Evolution in Patients with Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Ileana Monica BORDA

    2012-09-01

    Full Text Available Purpose: To measure changes in muscle power from before to 6 months after total knee arthroplasty and to compare outcomes with those from a control group of healthy adults. Material and Methods: 26 patients who underwent a total knee replacement were compared with 12 healthy age-matched adults in a prospective cohort study. Patients’ assessment was performed preoperatively, as well as at 1, 2 and 6 months postoperatively, by the isokinetic method. Healthy adults were assessed once by the same method. Isokinetic evaluation of knee extensor and flexor muscles was performed using a Gimnex Iso 2 dynamometer. After a warm-up protocol, measurements were done at angular velocities of 90 and 180°/sec. Results: Compared to healthy adults, patients performed significantly worse at all evaluation times, for both extensors and flexors of the knee, except for the 6-month evaluation at 180°/sec. One month postoperatively losses from preoperative levels were registered in patients, but without statistically significance, except for extension at 180°/sec. At 6 months postoperatively patients surpassed the preoperative levels, with statistical significance at 180°/sec. Conclusions: Power is an important parameter to follow after TKA, in parallel with peak torque. Increasing muscle power should be one of the central issues to address during postoperative rehabilitation.

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

    Science.gov (United States)

    Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

    2016-11-01

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

  2. Severe COPD Alters Muscle Fiber Conduction Velocity During Knee Extensors Fatiguing Contraction.

    Science.gov (United States)

    Boccia, Gennaro; Coratella, Giuseppe; Dardanello, Davide; Rinaldo, Nicoletta; Lanza, Massimo; Schena, Federico; Rainoldi, Alberto

    2016-10-01

    The aim of this study was to assess the changes in muscle fiber conduction velocity (CV), as a sign of fatigue during knee extensor contraction in patients with chronic obstructive pulmonary disease (COPD) as compared with healthy controls. Eleven male patients (5 with severe and 6 with moderate COPD; age 67 ± 5 years) and 11 age-matched healthy male controls (age 65 ± 4 years) volunteered for the study. CV was obtained by multichannel surface electromyography (EMG) from the vastus lateralis (VL) and medialis (VM) of the quadriceps muscle during isometric, 30-second duration knee extension at 70% of maximal voluntary contraction. The decline in CV in both the VL and VM was steeper in the severe COPD patients than in healthy controls (for VL: severe COPD vs. controls -0.45 ± 0.07%/s; p < 0.001, and for VM: severe COPD vs. controls -0.54 ± 0.09%/s, p < 0.001). No difference in CV decline was found between the moderate COPD patients and the healthy controls. These findings suggest that severe COPD may impair muscle functions, leading to greater muscular fatigue, as expressed by CV changes. The results may be due to a greater involvement of anaerobic metabolism and a shift towards fatigable type II fibers in the muscle composition of the severe COPD patients.

  3. Is co-contraction responsible for the decline in maximal knee joint torque in older males?

    Science.gov (United States)

    Billot, Maxime; Duclay, Julien; Simoneau-Buessinger, Emilie M; Ballay, Yves; Martin, Alain

    2014-04-01

    While it is often reported that muscular coactivation increases with age, the mechanical impact of antagonist muscles, i.e., the antagonist torque, remains to be assessed. The aim of this study was to determine if the mechanical impact of the antagonist muscles may contribute to the age-related decline in the resultant torque during maximal voluntary contraction in knee flexion (KF) and knee extension (KE). Eight young (19-28 years old) and eight older (62-81 years old) healthy males participated in neuromuscular testing. Maximal resultant torque was simultaneously recorded with the electromyographic activity of quadriceps and hamstring muscles. The torque recorded in the antagonist muscles was estimated using a biofeedback technique. Resultant torques significantly decreased with age in both KF (-41 %, p torques were significantly reduced in KF (-44 %, p torque elicited by double twitch stimulation (-37 %, p torques were not responsible for age-related declines in KF and KE resultant torques. Therefore, decreased resultant torques with age, in particular in KE, can primarily be explained by impairments of the peripheral factors (excitation-contraction coupling) as well as by decreased neural agonist activation.

  4. Comparing Voluntary and Mandatory Gameplay

    Directory of Open Access Journals (Sweden)

    Esther Kuindersma

    2016-09-01

    Full Text Available Gameplay is commonly considered to be a voluntary activity. Game designers generally believe that voluntary gameplay is essentially different from mandatory gameplay. Such a belief may be a challenge for serious games, as instruction is usually mandatory. The article describes the outcomes of two experiments on the impact of voluntariness on the learning effect and enjoyment of a serious game. In the first experiment freedom of choosing to play a serious game was studied, with participants who had volunteered to participate. The results suggested that, contrary to the opinion of many game designers, being required to play a serious game does not automatically take the fun out of the game. The second experiment had voluntary participants and mandatory participants, who had to participate as part of a homework assignment. The outcomes show that mandatory participants enjoyed the game as much as the voluntary participants, even if they had to play the game for a minimum required time. These studies indicate that mandatory gameplay does not reduce enjoyment and learning effect.

  5. Voluntary organisation and adult education

    Directory of Open Access Journals (Sweden)

    Konrad Elsdon

    1998-12-01

    Full Text Available The author starts by offering a definition of voluntary organisations. He then discusses their importance and role, focusing on the issue of adult education wi­ thin these organisations. He also wells upon learning and change of voluntary organisation members, making use of the results of a study he conducted together with his collaborators. One of their fin­dings has been that voluntary organisati­ons, due to their organisational targets li­ke painting, singing or caring for people in need, lead their members to learning, i.e. essentially content learning. Moreo­ver, voluntary organisations offer a fair number of opportunities for social lear­ning and change. ln spite of the fact that the respondents were mostly not aware of the outcomes of their learning and change, careful listeners conducting the interview made them understand the im­portance of the learning they had gone through. The author concludes by poin­ ting out that formal education of adults can get its inspiration in learning in voluntary organisations. On the other hand, such learning would benefit greatly from findings and methods of formal education of adults.

  6. Interlimb reflexes following ipsilateral knee joint rotations are suppressed in an unstable walking environment

    DEFF Research Database (Denmark)

    Stevenson, Andrew James Thomas; Geertsen, Svend Sparre; Sinkjær, Thomas;

    2015-01-01

    . To test this, interlimb reflexes were elicited in participants (n = 6) by either iKnee extension rotations during the late stance phase (50%) of the gait cycle or iKnee flexion rotations during the mid-swing phase (80%). The iKnee perturbations were applied while the participants walked normally...

  7. Analysis of Interrelationships among Voluntary and Prosthetic Leg Joint Parameters Using Cyclograms

    Directory of Open Access Journals (Sweden)

    Nur Azah Hamzaid

    2017-04-01

    Full Text Available The walking mechanism of a prosthetic leg user is a tightly coordinated movement of several joints and limb segments. The interaction among the voluntary and mechanical joints and segments requires particular biomechanical insight. This study aims to analyze the inter-relationship between amputees' voluntary and mechanical coupled leg joints variables using cyclograms. From this analysis, the critical gait parameters in each gait phase were determined and analyzed if they contribute to a better powered prosthetic knee control design. To develop the cyclogram model, 20 healthy able-bodied subjects and 25 prosthesis and orthosis users (10 transtibial amputees, 5 transfemoral amputees, and 10 different pathological profiles of orthosis users walked at their comfortable speed in a 3D motion analysis lab setting. The gait parameters (i.e., angle, moment and power for the ankle, knee and hip joints were coupled to form 36 cyclograms relationship. The model was validated by quantifying the gait disparities of all the pathological walking by analyzing each cyclograms pairs using feed-forward neural network with backpropagation. Subsequently, the cyclogram pairs that contributed to the highest gait disparity of each gait phase were manipulated by replacing it with normal values and re-analyzed. The manipulated cyclograms relationship that showed highest improvement in terms of gait disparity calculation suggested that they are the most dominant parameters in powered-knee control. In case of transfemoral amputee walking, it was identified using this approach that at each gait sub-phase, the knee variables most responsible for closest to normal walking were: knee power during loading response and mid-stance, knee moment and knee angle during terminal stance phase, knee angle and knee power during pre-swing, knee angle at initial swing, and knee power at terminal swing. No variable was dominant during mid-swing phase implying natural pendulum effect of the

  8. Microprocessor prosthetic knees.

    Science.gov (United States)

    Berry, Dale

    2006-02-01

    This article traces the development of microprocessor prosthetic knees from early research in the 1970s to the present. Read about how microprocessor knees work, functional options, patient selection, and the future of this prosthetic.

  9. Prosthetic Knee Systems

    Science.gov (United States)

    ... Facebook Google Bookmarks Technorati Yahoo MyWeb Prosthetic Knee Systems Translated into plain language by Helen Osborne of ... Consulting Original article by Bill Dupes Prosthetic knee systems are among the most complex of all components. ...

  10. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  11. Knee braces - unloading

    Science.gov (United States)

    ... most people talk about the arthritis in their knees, they are referring to a type of arthritis ... is caused by wear and tear inside your knee joints. Cartilage, the firm, rubbery tissue that cushions ...

  12. Knee arthroscopy - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100117.htm Knee arthroscopy - series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The knee is a complex joint made up of the ...

  13. Knee joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series—Normal anatomy To use the ... to slide 4 out of 4 Overview The knee is a complex joint. It contains the distal ...

  14. Cosmic ray air showers in the knee energy region

    Indian Academy of Sciences (India)

    S Sanyal

    2003-03-01

    The cosmic ray extensive air showers in the knee energy region have been studied by the North Bengal University array. The differential size spectra at different atmospheric depths show a systematic shift of the knee towards smaller shower size with the increase in atmospheric depth. The measured values of spectral indices at below and above the knee are -2.45± 0.03 and -2.91± 0.05 respectively. Measurements at different atmospheric depths correspond to the same values within the error limits both for below and above the knee. The present experimental results have been compared with similar such experiments.

  15. Thompson′s quadricepsplasty for stiff knee

    Directory of Open Access Journals (Sweden)

    Kundu Z

    2007-01-01

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

  16. A new method to measure post-traumatic joint contractures in the rabbit knee.

    Science.gov (United States)

    Hildebrand, Kevin A; Holmberg, Michael; Shrive, Nigel

    2003-12-01

    A new device and method to measure rabbit knee joint angles are described. The method was used to measure rabbit knee joint angles in normal specimens and in knee joints with obvious contractures. The custom-designed and manufactured gripping device has two clamps. The femoral clamp sits on a pinion gear that is driven by a rack attached to a materials testing system. A 100 N load cell in series with the rack gives force feedback. The tibial clamp is attached to a rotatory potentiometer. The system allows the knee joint multiple degrees-of-freedom (DOF). There are two independent DOF (compression-distraction and internal-external rotation) and two coupled motions (medial-lateral translation coupled with varus-valgus rotation; anterior-posterior translation coupled with flexion-extension rotation). Knee joint extension-flexion motion is measured, which is a combination of the materials testing system displacement (converted to degrees of motion) and the potentiometer values (calibrated to degrees). Internal frictional forces were determined to be at maximum 2% of measured loading. Two separate experiments were performed to evaluate rabbit knees. First, normal right and left pairs of knees from four New Zealand White (NZW) rabbits were subjected to cyclic loading. An extension torque of 0.2 Nm was applied to each knee. The average change in knee joint extension from the first to the fifth cycle was 1.9 deg +/- 1.5 deg (mean +/- sd) with a total of 49 tests of these eight knees. The maximum extension of the four left knees (tested 23 times) was 14.6 deg +/- 7.1 deg, and of the four right knees (tested 26 times) was 12.0 deg +/- 10.9 deg. There was no significant difference in the maximum extension between normal left and right knees. In the second experiment, nine skeletally mature NZW rabbits had stable fractures of the femoral condyles of the right knee that were immobilized for five, six or 10 weeks. The left knee served as an unoperated control. Loss of knee joint

  17. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise. Trea...

  18. Combined application of neuromuscular electrical stimulation and voluntary muscular contractions.

    Science.gov (United States)

    Paillard, Thierry

    2008-01-01

    Electromyostimulation (EMS) and voluntary muscle contraction (VC) constitute different modes of muscle activation and induce different acute physiological effects on the neuromuscular system. Long-term application of each mode of muscle activation can produce different muscle adaptations. It seems theoretically possible to completely or partially cumulate the muscle adaptations induced by each mode of muscle activation applied separately. This work consisted of examining the literature concerning the muscle adaptations induced by long-term application of the combined technique (CT) [i.e. EMS is combined with VC - non-simultaneously] compared with VC and/or EMS alone in healthy subjects and/or athletes and in post-operative knee-injured subjects. In general, CT induced greater muscular adaptations than VC whether in sports training or rehabilitation. This efficiency would be due to the fact that CT can facilitate cumulative effects of training completely or partially induced by VC and EMS practiced alone. CT also provides a greater improvement of the performance of complex dynamic movements than VC. However, EMS cannot improve coordination between different agonistic and antagonistic muscles and thus does not facilitate learning the specific coordination of complex movements. Hence, EMS should be combined with specific sport training to generate neuromuscular adaptations, but also allow the adjustment of motor control during a voluntary movement. Likewise, in a therapeutic context, CT was particularly efficient to accelerate recovery of muscle contractility during a rehabilitation programme. Strength loss and atrophy inherent in a traumatism and/or a surgical operation would be more efficiently compensated with CT than with VC. Furthermore, CT also restored more functional abilities than VC. Finally, in a rehabilitation context, EMS is complementary to voluntary exercise because in the early phase of rehabilitation it elicits a strength increase, which is necessary

  19. The effect of knee joint angle on torque control.

    Science.gov (United States)

    Sosnoff, Jacob J; Voudrie, Stefani J; Ebersole, Kyle T

    2010-01-01

    The purpose of the author's investigation was to examine the effect of knee joint angle on torque control of the quadriceps muscle group. In all, 12 healthy adults produced maximal voluntary contractions and submaximal torque (15, 30, and 45% MVC [maximal voluntary contraction]) at leg flexion angles of 15 degrees , 30 degrees , 60 degrees , and 90 degrees below the horizontal plane. As expected, MVC values changed with respect to joint angle with maximum torque output being greatest at 60 degrees and least at 15 degrees . During the submaximal tasks, participants appropriately scaled their torque output to the required targets. Absolute variability (i.e., standard deviation) of torque output was greatest at 60 degrees and 90 degrees knee flexion. However, relative variability as indexed by coefficient of variation (CV) decreased as joint angle increased, with the greatest CV occurring at 15 degrees . These results are congruent with the hypothesis that joint angle influences the control of torque.

  20. In vivo determination of total knee arthroplasty kinematics

    Energy Technology Data Exchange (ETDEWEB)

    Komistek, Richard D [ORNL; Mahfouz, Mohamed R [ORNL; Bertin, Kim [Utah Bone & Joint Center, Salt Lake City, Utah (USA); Rosenberg, Aaron [Rush-Presbyterian-St. Luke' s Med Center, Chicago IL (USA); Kennedy, William [Kennedy-White Orthopaedic Center, Sarasota, FL (USA)

    2008-01-01

    The objective of this study was to determine if consistent posterior femoral rollback of an asymmetrical posterior cruciate retaining (PCR) total knee arthroplasty was mostly influenced by the implant design, surgical technique, or presence of a well-functioning posterior cruciate ligament (PCL). Three-dimensional femorotibial kinematics was determined for 80 subjects implanted by 3 surgeons, and each subject was evaluated under fluoroscopic surveillance during a deep knee bend. All subjects in this present study having an intact PCL had a well-functioning PCR knee and experienced normal kinematic patterns, although less in magnitude than the normal knee. In addition, a surprising finding was that, on average, subjects without a PCL still achieved posterior femoral rollback from full extension to maximum knee flexion. The findings in this study revealed that implant design did contribute to the normal kinematics demonstrated by subjects having this asymmetrical PCR total knee arthroplasty.

  1. Knee Arthrodesis after failure of Knee Arthroplasty

    DEFF Research Database (Denmark)

    Gottfriedsen, Tinne B; Morville Schrøder, Henrik; Odgaard, Anders

    2016-01-01

    BACKGROUND: Arthrodesis is considered a salvage procedure after failure of a knee arthroplasty. Data on the use of this procedure are limited. The purpose of this study was to identify the incidence, causes, surgical techniques, and outcomes of arthrodesis after failed knee arthroplasty...... in a nationwide population. METHODS: Data were extracted from the Danish Civil Registration System, the Danish National Patient Register, and the Danish Knee Arthroplasty Register. A total of 92,785 primary knee arthroplasties performed in Denmark from 1997 to 2013 were identified by linking the data using....... Differences in cumulative incidence were compared with the Gray test. RESULTS: A total of 164 of the 165 arthrodeses were performed for causes related to failed knee arthroplasty. The 15-year cumulative incidence of arthrodesis was 0.26% (95% confidence interval, 0.21% to 0.31%). The 5-year cumulative...

  2. β-alanine supplementation improves isometric endurance of the knee extensor muscles

    Directory of Open Access Journals (Sweden)

    Sale Craig

    2012-06-01

    Full Text Available Abstract Background We examined the effect of four weeks of β-alanine supplementation on isometric endurance of the knee extensors at 45% maximal voluntary isometric contraction (MVIC. Methods Thirteen males (age 23 ± 6 y; height 1.80 ± 0.05 m; body mass 81.0 ± 10.5 kg, matched for pre-supplementation isometric endurance, were allocated to either a placebo (n = 6 or β-alanine (n = 7; 6.4 g·d-1 over 4 weeks supplementation group. Participants completed an isometric knee extension test (IKET to fatigue, at an intensity of 45% MVIC, before and after supplementation. In addition, two habituation tests were completed in the week prior to the pre-supplementation test and a further practice test was completed in the week prior to the post-supplementation test. MVIC force, IKET hold-time, and impulse generated were recorded. Results IKET hold-time increased by 9.7 ± 9.4 s (13.2% and impulse by 3.7 ± 1.3 kN·s-1 (13.9% following β-alanine supplementation. These changes were significantly greater than those in the placebo group (IKET: t(11 = 2.9, p ≤0.05; impulse: t(11 = 3.1, p ≤ 0.05. There were no significant changes in MVIC force in either group. Conclusion Four weeks of β-alanine supplementation at 6.4 g·d-1 improved endurance capacity of the knee extensors at 45% MVIC, which most likely results from improved pH regulation within the muscle cell as a result of elevated muscle carnosine levels.

  3. Voluntary euthanasia: a utilitarian perspective.

    Science.gov (United States)

    Singer, Peter

    2003-10-01

    Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life--if they are able to swallow and digest them. But despite President Bush's oft-repeated statements that his philosophy is to 'trust individuals to make the right decisions' and his opposition to 'distant bureaucracies', his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician-assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia.

  4. Social Cohesion and Voluntary Associations

    Science.gov (United States)

    Heuser, Brian L.

    2005-01-01

    Voluntary organizations exert great influence over how social norms and ethical codes are guided into action. As such, they have a significant impact on societal levels of social cohesion. Although social capital involves generalized trust becoming manifest as spontaneous sociability, social cohesion is determined by how that sociability is…

  5. Voluntary Incentive Early Retirement Programs.

    Science.gov (United States)

    Research Dialogues, 1988

    1988-01-01

    Arrangements in educational institutions for voluntary early retirement programs are discussed. Retirement at any age can be a profound and stressful lifetime change; and it can also represent a welcome transition into newly satisfying and rewarding opportunities. The focus is on: mandatory retirement (exceptions and the new meaning of "early");…

  6. Voluntary disclosure: Evidence from UK

    NARCIS (Netherlands)

    N.S. Zourarakis (Nicolaos)

    2009-01-01

    textabstractThis paper investigates the voluntary disclosure of Intellectual Capital (IC) of British firms and provides some evidence on an unexplored area of the literature; that of the association of Corporate Governance (CG) with IC disclosure. Inconsistent with expectations, the results show tha

  7. Highly conforming polyethylene inlays reduce the in vivo variability of knee joint kinematics after total knee arthroplasty.

    Science.gov (United States)

    Daniilidis, Kiriakos; Skwara, Adrian; Vieth, Volker; Fuchs-Winkelmann, Susanne; Heindel, Walter; Stückmann, Volker; Tibesku, Carsten O

    2012-08-01

    The use of highly conforming polyethylene inlays in total knee arthroplasty (TKA) provides improved anteroposterior stability. The aim of this fluoroscopic study was to investigate the in vivo kinematics during unloaded and loaded active extension with a highly conforming inlay and a flat inlay after cruciate retaining (CR) total knee arthroplasty (TKA). Thirty one patients (50 knees) received a fixed-bearing cruciate retaining total knee arthroplasty (Genesis II, Smith & Nephew, Schenefeld, Germany) for primary knee osteoarthritis. Twenty two of them received a flat polyethylene inlay (PE), nine a deep dished PE and 19 were in the control group (physiological knees). The mean age at the time of surgery was 62 years. Dynamic examination with fluoroscopy was performed to assess the "patella tendon angle" in relation to the knee flexion angle (measure of anteroposterior translation) and the "kinematic index" (measure of reproducibility). Fluoroscopy was performed under active extension and flexion, during unloaded movement, and under full weight bearing, simulated by step climbing. No significant difference was observed between both types of polyethylene inlay designs and the physiological knee during unloaded movement. Anteroposterior (AP) instability was found during weight-bearing movement. The deep-dish inlay resulted in lower AP translation and a non-physiological rollback. Neither inlay types could restore physiological kinematics of the knee. Despite the fact that deep dished inlays reduce the AP translation, centralisation of contact pressure results in non-physiological rollback. The influence of kinematic pattern variability on clinical results warrants further investigation.

  8. Evaluation of total knee mechanics using a crouching simulator with a synthetic knee substitute.

    Science.gov (United States)

    Lowry, Michael; Rosenbaum, Heather; Walker, Peter S

    2016-05-01

    Mechanical evaluation of total knees is frequently required for aspects such as wear, strength, kinematics, contact areas, and force transmission. In order to carry out such tests, we developed a crouching simulator, based on the Oxford-type machine, with novel features including a synthetic knee including ligaments. The instrumentation and data processing methods enabled the determination of contact area locations and interface forces and moments, for a full flexion-extension cycle. To demonstrate the use of the simulator, we carried out a comparison of two different total knee designs, cruciate retaining and substituting. The first part of the study describes the simulator design and the methodology for testing the knees without requiring cadaveric knee specimens. The degrees of freedom of the anatomic hip and ankle joints were reproduced. Flexion-extension was obtained by changing quadriceps length, while variable hamstring forces were applied using springs. The knee joint was represented by three-dimensional printed blocks on to which the total knee components were fixed. Pretensioned elastomeric bands of realistic stiffnesses passed through holes in the block at anatomical locations to represent ligaments. Motion capture of the knees during flexion, together with laser scanning and computer modeling, was used to reconstruct contact areas on the bearing surfaces. A method was also developed for measuring tibial component interface forces and moments as a comparative assessment of fixation. The method involved interposing Tekscan pads at locations on the interface. Overall, the crouching machine and the methodology could be used for many different mechanical measurements of total knee designs, adapted especially for comparative or parametric studies.

  9. A magnetorheological fluid-based controllable active knee brace

    Science.gov (United States)

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

    2007-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Ming Wu, PhD

    2010-04-01

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

  11. Voluntary sterilization in Serbia: Unmet need?

    OpenAIRE

    Rašević Mirjana M.

    2002-01-01

    Is voluntary sterilization as a birth control method accepted in Serbia? This is certainly a question that is being imposed for research, regardless of the fact that voluntary sterilization is neither accessible nor promoted. Most importantly because there is no understanding in the social nor political sphere for legalization of voluntary sterilization as a form of birth control, apart from the clear necessity for this, first, step. They are: the recognition that voluntary sterilization is a...

  12. How effective is multiple needle puncturing for medial soft tissue balancing during total knee arthroplasty? A cadaveric study.

    Science.gov (United States)

    Koh, In Jun; Kwak, Dai-Soon; Kim, Tae Kyun; Park, In Joo; In, Yong

    2014-12-01

    We investigated the quantitative effect and risk factors for over-release during multiple needle puncturing (MNP) for medial gap balancing in varus total knee arthroplasty (TKA). Of the ten pairs of cadaveric knees, one knee from each pair was randomly assigned to undergo MNP in extension (E group), while the other knee underwent MNP in flexion (F group). The increased extension and 90° flexion gaps after every five needle punctures were measured until over-release occurred. The extension gap (knee, a narrow MCL, and severe osteoarthritis were associated with a smaller number of MNPs required to over-release.

  13. A Model for Evaluating eXtension Communities of Practice

    Science.gov (United States)

    Kelsey, Kathleen D.; Stafne, Eric T.

    2012-01-01

    As Americans shift their work and leisure activities online, Extension seeks to remain viable by delivering programs through a website known as eXtension. eXtension is predicated on the voluntary labor of Extension specialists and educators who form Communities of Practice to create and deliver content through the website. Evaluation of eXtension…

  14. 22 CFR 513.210 - Voluntary exclusion.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Voluntary exclusion. 513.210 Section 513.210... GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (GRANTS) Effect of Action § 513.210 Voluntary exclusion. Persons who accept voluntary exclusions under § 513.315 are excluded in accordance with the terms of...

  15. Série fracionada da extensão de joelho proporciona maiores respostas cardiovasculares que séries contínuas Discontinuous sets of knee extensions induce higher cardiovascular responses in comparison to continuous ones

    Directory of Open Access Journals (Sweden)

    Marcos Doederlein Polito

    2008-06-01

    them, without compromising the strength production. OBJECTIVE: To compare the acute cardiovascular responses of systolic arterial pressure (SAP, diastolic arterial pressure (DAP, heart rate (HR and double product (DP during the unilateral knee extension (four series of 8 maximum repetitions performed continuously or discontinuously. Both protocols involved a 2-minute interval between the series and the discontinuous protocol had an extra interval of 2 seconds between the 4th and the 5th repetitions. METHODS: Eight healthy men trained in muscular strength (aged 26± 6 years participated in the data collection and were randomly divided in two non-consecutive days. The cardiovascular responses were measured by photoplethysmography (Finapres, Ohmeda, Louisville, CO, USA at rest, at the end of each series and 2 minutes after the performance of each protocol. RESULTS: The discontinuous series showed significantly higher values when compared to the protocol of the continuous series for: SAP (mmHg at the 2nd (173.1± 5.4 vs 152.0± 4.0; p=0.001, 3rd (188.9± 8.6 vs 162.4± 6.0; p=0.000 and 4th series (193.1± 8.1 vs 161.6± 5.9; p=0.000; DAP (mmHg at the 3rd (103.8± 4.1 vs 86.1± 3.3; p=0.000 and 4th series (104.1± 2.7 vs 83.4± 3.3; p=0.000; DP (mmHg.bpm at the 2nd (17,907.5± 1,350.7 vs 14,541.9± 1,848.0; p=0.03, 3rd (19,687.3± 1,444.3 vs 15,612.1± 1,180.3; p=0.008 and 4th series (21,271.0± 1,794.2 vs 15,992.0± 1,093.4; p=0.001. CONCLUSION: The discontinuous protocol promoted higher increase in pressure responses when compared to the continuous one. However, due to the characteristics of the study design, further studies are necessary to support these findings.

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

    Directory of Open Access Journals (Sweden)

    Tokifumi Majima

    2011-01-01

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

  17. Cooling does not affect knee proprioception.

    Science.gov (United States)

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

    1996-01-01

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

  18. International Voluntary Renewable Energy Markets (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, J.

    2012-06-01

    This presentation provides an overview of international voluntary renewable energy markets, with a focus on the United States and Europe. The voluntary renewable energy market is the market in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. In 2010, the U.S. voluntary market was estimated at 35 terawatt-hours (TWh) compared to 300 TWh in the European market, though key differences exist. On a customer basis, Australia has historically had the largest number of customers, pricing for voluntary certificates remains low, at less than $1 megawatt-hour, though prices depend on technology.

  19. Predicting the Functional Roles of Knee Joint Muscles from Internal Joint Moments

    DEFF Research Database (Denmark)

    Flaxman, Teresa E; Alkjær, Tine; Simonsen, Erik B

    2017-01-01

    to the activation of individual muscles. RESULTS: Rectus femoris and tensor fasciae latae were classified as moment actuators for knee extension and hip flexion. Hamstrings were classified as moment actuators for hip extension and knee flexion. Gastrocnemius and hamstring muscles were classified as specific joint...

  20. Novel knee joint mechanism of transfemoral prosthesis for stair ascent.

    Science.gov (United States)

    Inoue, Koh; Wada, Takahiro; Harada, Ryuchi; Tachiwana, Shinichi

    2013-06-01

    The stability of a transfemoral prosthesis when walking on flat ground has been established by recent advances in knee joint mechanisms and their control methods. It is, however, difficult for users of a transfemoral prosthesis to ascend stairs. This difficulty is mainly due to insufficient generation of extension moment around the knee joint of the prosthesis to lift the body to the next step on the staircase and prevent any unexpected flexion of the knee joint in the stance phase. Only a prosthesis with an actuator has facilitated stair ascent using a step-over-step gait (1 foot is placed per step). However, its use has issues associated with the durability, cost, maintenance, and usage environment. Therefore, the purpose of this research is to develop a novel knee joint mechanism for a prosthesis that generates an extension moment around the knee joint in the stance phase during stair ascent, without the use of any actuators. The proposed mechanism is based on the knowledge that the ground reaction force increases during the stance phase when the knee flexion occurs. Stair ascent experiments with the prosthesis showed that the proposed prosthesis can realize stair ascent without any undesirable knee flexion. In addition, the prosthesis is able to generate a positive knee joint moment power in the stance phase even without any power source.

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

    Science.gov (United States)

    Yakimovich, Terris; Kofman, Jonathan; Lemaire, Edward

    2005-01-01

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

  2. Does patella position influence ligament balancing in total knee arthroplasty?

    Science.gov (United States)

    Yoon, Jung-Ro; Oh, Kwang-Jun; Wang, Joon Ho; Yang, Jae-Hyuk

    2015-07-01

    In vivo comparative gap measurements were performed in three different patella positions (reduced, subluxated and everted) using offset-type-force-controlled-spreader-system. Prospectively, 50 knees were operated by total knee arthroplasty using a navigation-assisted gap-balancing technique. The offset-type-force-controlled-spreader-system was used for gap measurements. This commercially available instrument allows controllable tension in patella-reduced position. The mediolateral gaps of knee extension (0°) and flexion (90°) angle were recorded in three different patella positions; reduced, subluxated and everted. Any gap differences of more than 3 mm were considered as a meaningful difference. Correlation between the difference with the demographic data, preoperative radiologic alignment and intraoperative data was analysed. For statistical analysis, ANOVA and Pearson's correlation test were used. The gaps in patella eversion demonstrated smaller gaps both in knee extension and flexion position compared to the gaps of patella reduction position. The amount of decreased gaps was more definite in knee flexion position. Statistically significant difference was observed for the lateral gap of patella eversion compared to gap of patella reduction in knee flexion position (p patella subluxation and 33 (66 %) knees of patella evertion demonstrated either increased or decreased gaps in knee flexion position compared to the gaps of patella reduction position. The gaps in patella eversion demonstrated smaller gaps both in knee extension and flexion position compared to the gaps of patella reduction position. The amount of decreased gaps was more definite in knee flexion position. Therefore, the intraoperative patellar positioning has influence on the measurement of the joint gap. Keeping the patella in reduced position is important during gap balancing. I.

  3. Imaging of knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 825 Northern Blvd., Great Neck, NY 11021 (United States)]. E-mail: TMiller@NSHS.edu

    2005-05-01

    Knee replacement surgery, either with unicompartmental or total systems, is common. The purpose of this manuscript is to review the appearance of normal knee arthroplasty and the appearances of complications such as infection, polyethylene wear, aseptic loosening and particle-induced osteolysis, patellofemoral abnormalities, axial instability, and periprosthetic and component fracture. Knowledge of the potential complications and their imaging appearances will help the radiologist in the diagnostic evaluation of the patient with a painful knee arthroplasty.

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

    Science.gov (United States)

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

    2010-12-01

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

  5. Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics

    Directory of Open Access Journals (Sweden)

    Sadegh Norouzi

    2013-01-01

    Full Text Available A safe rehabilitation exercise for anterior cruciate ligament (ACL injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (. During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (. It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise.

  6. Factors associated with stair climbing ability in patients with knee osteoarthritis and knee arthroplasty: a systematic review.

    Science.gov (United States)

    Whitchelo, Tara; McClelland, Jodie A; Webster, Kate E

    2014-01-01

    People with knee osteoarthritis (OA) report ongoing limitations in climbing stairs, even after total knee arthroplasty (TKA). The aim of this systematic review was to synthesise the available evidence of factors affecting stair climbing ability in patients with knee OA before and after TKA. A systematic search was conducted of common electronic databases. All English language abstracts where stair-climbing was assessed in patients with either knee OA or at least 6 months after TKA, and a relationship to any physical, psychological or demographic factors was reported. Thirteen studies were included in the final review, nine investigated a knee OA population, and four investigated a TKA population. For patients with knee OA there was consistent and convincing evidence that greater stair-climbing ability was related to stronger lower limb muscles and less knee pain. For patients with TKA there was much less research, and no conclusions could be reached. For people with knee OA there is evidence that some physical, demographic and psychosocial factors are related to stair-climbing ability. However, the evidence for similar relationships in the TKA population is scarce and needs more extensive research. Implications for Rehabilitation People with knee osteoarthritis experience difficulty when climbing stairs, and this remains challenging even after knee replacement. For people with knee osteoarthritis, a range of physical, demographic and psychosocial factors contribute to stair-climbing ability, however, evidence for similar relationships in the TKA population is scarce. Rehabilitation that is multi-faceted may be the best approach to improve stair-climbing in people with knee osteoarthritis.

  7. Arthrofibrosis of the knee following ligament surgery.

    Science.gov (United States)

    DeHaven, Kenneth E; Cosgarea, Andrew J; Sebastianelli, Wayne J

    2003-01-01

    Arthrofibrosis of the knee is one of the most serious complications that can result from ligament surgery. Reported incidence of arthrofibrosis following anterior cruciate ligament reconstruction ranges from 4% to 35%. The loss of motion caused by arthrofibrosis can be even more disabling than the instability for which the reconstruction was performed, often requiring extensive physical therapy and/or surgical lysis of adhesions. With aggressive rehabilitation and modifications in the bracing of knees undergoing ligament reconstruction, the incidence of this complication has decreased significantly. Additionally, delaying anterior cruciate ligament reconstruction until the acute inflammatory period has resolved has also been shown to be a significant factor in the reduction of postoperative knee stiffness.

  8. Botulinum toxin injection improved voluntary motor control in selected patients with post-stroke spasticity

    Institute of Scientific and Technical Information of China (English)

    Shuo-Hsiu Chang; Gerald E Francisco; Sheng Li

    2012-01-01

    The effect of botulinum toxin type A injection on voluntary grip control was examined in a 53-year-old female, who sustained a hemorrhagic right middle cerebral artery stroke 3 years previously, which resulted in finger flexor spasticity and residual weak finger/wrist extension. The patient received 50 units of botulinum toxin type A injection each to the motor points (2 sites/muscle) of the left flexor digitorum superficialis and flexor digitorum profundus, respectively. Botulinum toxin injection led to weakness and tone reduction in the spastic finger flexors, but improved grip release time in grip initiation/release reaction time tasks. Improved release time was accompanied by shortened extensor electromyography activity, and improved release time likely correlated with blocked co-contraction of finger flexors during voluntary finger extension. This case report demonstrated that botulinum toxin injection improved voluntary motor control of the hand in a chronic stroke patient with residual finger extension.

  9. Microcirculation of the juvenile knee in chronic arthritis

    DEFF Research Database (Denmark)

    Bünger, Cody; Bülow, J; Tøndevold, E

    1986-01-01

    In order to investigate pathogenetic factors in growth abnormalities of the knee in hemophilic arthropathy and juvenile rheumatoid arthritis, the hemodynamic changes of the knee following chronic synovial inflammation and elevated joint pressure were studied in puppies. Unilateral arthritis was i....... The growth plates formed borders for the extension of these changes. The increased permeability and surface area between blood and bone in arthritis may accelerate the resorption and subsequent destruction of subchondral bone in chronic arthropathies of the juvenile knee.......In order to investigate pathogenetic factors in growth abnormalities of the knee in hemophilic arthropathy and juvenile rheumatoid arthritis, the hemodynamic changes of the knee following chronic synovial inflammation and elevated joint pressure were studied in puppies. Unilateral arthritis...

  10. The Knee injury and Osteoarthritis Outcome Score (KOOS)

    DEFF Research Database (Denmark)

    Roos, Ewa M.; Lohmander, L Stefan

    2003-01-01

    The Knee injury and Osteoarthritis Outcome Score (KOOS) was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales......: Pain, other Symptoms, Function in daily living (ADL), Function in Sport and Recreation (Sport/Rec), and knee-related Quality of Life (QOL). The KOOS has been validated for several orthopaedic interventions such as anterior cruciate ligament reconstruction, meniscectomy and total knee replacement...... be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved....

  11. Interpolation function for approximating knee joint behavior in human gait

    Science.gov (United States)

    Toth-Taşcǎu, Mirela; Pater, Flavius; Stoia, Dan Ioan

    2013-10-01

    Starting from the importance of analyzing the kinematic data of the lower limb in gait movement, especially the angular variation of the knee joint, the paper propose an approximation function that can be used for processing the correlation among a multitude of knee cycles. The approximation of the raw knee data was done by Lagrange polynomial interpolation on a signal acquired using Zebris Gait Analysis System. The signal used in approximation belongs to a typical subject extracted from a lot of ten investigated subjects, but the function domain of definition belongs to the entire group. The study of the knee joint kinematics plays an important role in understanding the kinematics of the gait, this articulation having the largest range of motion in whole joints, in gait. The study does not propose to find an approximation function for the adduction-abduction movement of the knee, this being considered a residual movement comparing to the flexion-extension.

  12. The rectangular flexion gap is associated with an increased knee flexion angle in a cruciate-sacrificing rotating platform mobile-bearing total knee arthroplasty.

    Science.gov (United States)

    Tsukeoka, Tadashi; Tsuneizumi, Yoshikazu; Yoshino, Kensuke

    2017-03-01

    The knee flexion angle after a total knee arthroplasty is an important indicator of clinical outcome. However, there is little appropriate information about the correlation between the ligament balancing and knee flexion angle after total knee arthroplasty. The purpose of this study was to investigate the effect of the ligamentous balance in extension and flexion on knee flexion angle one year after posterior cruciate ligament sacrificing rotating platform total knee arthroplasty. Eighty-five total knee arthroplasties in 71 patients were investigated in this study. The postoperative knee flexion angle and the percentage of improvement in the balanced group in which the difference between varus and valgus was less than 2° and the unbalanced group in extension and the rectangular group in which the asymmetry of the flexion gap was within 2° and the trapezoidal group in flexion were compared. The factors affecting postoperative knee flexion angle were also investigated in a forced entry multiple regression analysis. The mean flexion angle improved significantly from 116.2° to 122.5° in the rectangular group. By contrast, in the trapezoidal group, no significant improvement was seen (from 115.5° to 117.4°). The statistically significant difference was found between the rectangular and trapezoidal group in flexion in terms of the improvement of the knee flexion angle while there was no difference between the balanced and unbalanced group in extension. The multiple regression analysis showed that the asymmetry of the flexion gap was a predictor of the postoperative knee flexion angle. Asymmetric flexion gap affected negatively the postoperative knee flexion angle after posterior cruciate ligament sacrificing rotating platform total knee arthroplasty. A gap balancing technique is recommended for this type of implant. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  13. Use of a turndown quadriceps tendon flap for rupture of the patellar tendon after total knee arthroplasty.

    Science.gov (United States)

    Lin, Po-Chun; Wang, Jun-Wen

    2007-09-01

    Patellar tendon rupture is a devastating complication after total knee arthroplasty. The results of surgical treatment of this complication were discouraging in most of the reports. We describe a case of rupture of patellar tendon 7 weeks after total knee arthroplasty treated with a turndown quadriceps flap and circumferential wiring. Two years and 6 months after operation, the patient had no extension lag of the knee and knee flexion to 110 degrees .

  14. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement.

    Science.gov (United States)

    Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A; Cates, Harold E; Zhang, Songning

    2016-01-01

    Total knee replacement (TKR) is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF) and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (pforces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups.

  15. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement.

    Directory of Open Access Journals (Sweden)

    Robert Rasnick

    Full Text Available Total knee replacement (TKR is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (p<0.05. No differences were observed for peak joint compressive forces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups.

  16. 78 FR 49382 - Voluntary Education Programs

    Science.gov (United States)

    2013-08-14

    ... English, reading, writing, speaking, mathematics, and computer skills that are essential to successful job... education advisor: Education Services Specialist, Education Services Officer (ESO), Voluntary...

  17. Pneumatic osteoarthritis knee brace.

    Science.gov (United States)

    Stamenović, Dimitrije; Kojić, Milos; Stojanović, Boban; Hunter, David

    2009-04-01

    Knee osteoarthritis is a chronic disease that necessitates long term therapeutic intervention. Biomechanical studies have demonstrated an improvement in the external adduction moment with application of a valgus knee brace. Despite being both efficacious and safe, due to their rigid frame and bulkiness, current designs of knee braces create discomfort and difficulties to patients during prolonged periods of application. Here we propose a novel design of a light osteoarthritis knee brace, which is made of soft conforming materials. Our design relies on a pneumatic leverage system, which, when pressurized, reduces the excessive loads predominantly affecting the medial compartment of the knee and eventually reverses the malalignment. Using a finite-element analysis, we show that with a moderate level of applied pressure, this pneumatic brace can, in theory, counterbalance a greater fraction of external adduction moment than the currently existing braces.

  18. Musculoskeletal MR: knee

    Energy Technology Data Exchange (ETDEWEB)

    Staebler, A.; Glaser, C.; Reiser, M. [Dept. of Diagnostic Radiology, Klinikum Grosshadern, Ludwig-Maximilian Universitaet Muenchen (Germany)

    2000-02-01

    Magnetic resonance imaging is the most sensitive, specific, and accurate noninvasive method for diagnosing internal derangement of the knee. During the past 15 years knowledge of pathologic conditions of the knee had evolved significantly. Beyond the basic principles of imaging knee injuries great impact was made on the understanding of indirect or collateral findings, even in rare diseases. In this article the spectrum of disorders of the knee are reviewed and an overview of the current literature is given. This includes considerations about how to achieve a high-standard MR imaging study of the knee, and principles of imaging anterior cruciate ligament and meniscal tears. A focus is put on distinct diseases including intra-articular and intraosseous ganglion cysts, iliotibial band friction syndrome, transient osteoporosis, osteonecrosis, osteochondritis dissecans, and imaging of the articular cartilage. (orig.)

  19. Dynamics of Voluntary Cough Maneuvers

    Science.gov (United States)

    Naire, Shailesh

    2008-11-01

    Voluntary cough maneuvers are characterized by transient peak expiratory flows (PEF) exceeding the maximum expiratory flow-volume (MEFV) curve. In some cases, these flows can be well in excess of the MEFV, generally referred to as supramaximal flows. Understanding the flow-structure interaction involved in these maneuvers is the main goal of this work. We present a simple theoretical model for investigating the dynamics of voluntary cough and forced expiratory maneuvers. The core modeling idea is based on a 1-D model of high Reynolds number flow through flexible-walled tubes. The model incorporates key ingredients involved in these maneuvers: the expiratory effort generated by the abdominal and expiratory muscles, the glottis and the flexibility and compliance of the lung airways. Variations in these allow investigation of the expiratory flows generated by a variety of single cough maneuvers. The model successfully reproduces PEF which is shown to depend on the cough generation protocol, the glottis reopening time and the compliance of the airways. The particular highlight is in simulating supramaximal PEF for very compliant tubes. The flow-structure interaction mechanisms behind these are discussed. The wave speed theory of flow limitation is used to characterize the PEF. Existing hypotheses of the origin of PEF, from cough and forced expiration experiments, are also tested using this model.

  20. Do knee concentric and eccentric strength and sagittal-plane knee joint biomechanics differ between jumpers and non-jumpers in landing?

    Science.gov (United States)

    Wu, Xie; Zhang, Songning; Liu, Yu; Zhang, Dongbin; Xie, Bin

    2013-12-01

    The purpose of this study was to investigate the differences of knee concentric and eccentric strength and impact related knee biomechanics between jumpers and non-jumpers during step-off landing tasks. Ten male college swimming athletes (non-jumpers) and 10 track and volleyball athletes (jumpers) were recruited to participate in two test sessions: a muscle strength testing session of concentric and eccentric extension for dominant knee joint at 60°/s and 180°/s and a landing testing session. The participants performed five trials of step-off landing in each of four conditions: soft and stiff landing from 0.4m and 0.6m landing heights. The three-dimensional kinematics and ground reaction force were recorded simultaneously during step-off landing conditions. The results showed that the jumpers had significantly greater peak knee eccentric extension and concentric flexion torques compared to the non-jumpers. No significant group effects were found for peak vertical ground reaction force and knee range of motion during landing. The jumpers had significantly greater knee contact flexion angle, maximum knee flexion angle and initial knee extension moment compared to the non-jumpers. These results suggest that these athletes adopted a favorable impact attenuation strategy that is related to the greater knee eccentric muscle strength and training. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Avaliação comparativa da perda de extensão entre acessos cirúrgicos para revisão de artroplastia total do joelho Comparative assessment of extension loss among different surgical approaches to the revision of total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Alfredo Marques Villardi

    2008-04-01

    Full Text Available OBJETIVO: Avaliar a possibilidade de perda de extensão do joelho, após artroplastias de revisão, realizadas com acessos do tipo quadriceps snip e osteotomia do tubérculo anterior da tíbia (TAT, comparativamente, entre ambos e com um grupo controle, em que foi utilizado o acesso parapatelar medial convencional. MÉTODO: Este estudo foi aprovado pelo Comitê de Ética em Pesquisa do INTO. A perda de extensão do joelho foi avaliada em pacientes submetidos a artroplastias de revisão, unilaterais, realizadas pelo Grupo de Joelho do Instituto Nacional de Traumatologia e Ortopedia - INTO, em que foram utilizados um dos seguintes acessos: convencional - parapatelar medial, snip do quadríceps ou osteotomia do tubérculo anterior da tíbia. A amostra foi composta por 26 indivíduos, cuja idade variou entre 52 e 80 anos, distribuídos em três grupos: grupo I: acesso parapatelar medial convencional (n = 10; grupo II: quadriceps snip (n = 8; e grupo III: osteotomia do TAT (n = 8. O tempo de seguimento médio foi de 18,57 meses. A perda da extensão do joelho foi determinada pela diferença entre o grau de extensão ativa pré e pós-operatória. Na avaliação estatística, foi utilizado o teste de análise de variância ANOVA, de fator único, com o nível de significância a = 0,05 (5%. RESULTADOS: A perda média de extensão da série foi igual a 8,57º, variando entre 2º e 30º. O p-valor obtido foi igual a 0,112, o que permite assumir a hipótese de igualdade entre os grupos. CONCLUSÃO: No presente estudo, não foi observada diferença significativa entre os grupos compostos pelos três tipos de acesso utilizados para as revisões de artroplastias, no que tange ao parâmetro perda de extensão.OBJECTIVE: To assess the possibility of extension loss of the knee after revision arthroplasties performed with approaches like quadriceps snip and TAT osteotomy, comparing the two methods and using a control group in who the conventional medial

  2. An investigation of reflex elicited by percutaneous stimulation of the medial and lateral ligaments of the human knee

    Directory of Open Access Journals (Sweden)

    Soheil Mokhtari

    2016-11-01

    Full Text Available Introduction: Disease and injury of joints are major causes of pain and disability in the population. The principal purpose of this study was to extend our knowledge of reflexes associated with joint. Methods: Seventeen subjects were seated on a testing bench and hip angle was 90 degrees. The maximal voluntary contractions of the quadriceps were measured at 180o of knee extension. This was then used to set the magnitude of subsequent sub-maximal contractions at 5, 10 and 20% of MVC. An identical stimulation sequence was delivered during sustained contractions. Electrodes were placed over the lateral and medial knee ligaments separately and the ligaments were stimulated by 3 pulses of 1 msec duration at 100 HZ. The stimulation intensity was the ranged of 0-45 mamps. The muscles selected were Rectus Femoris, Vastus Medialis and Vastus Lateralis. Results: No reflexes were elicited in very low current, effects have started in 20 ma. The pattern of the muscle response was relevant to the stimulation intensity. By increasing the stimulation intensity the EMG waves became bigger. In addition, the magnitudes of the responses were increased. Reflexes elicited following MCL and LCL stimulation artifact. Inhibition and excitation reflexes elicited and there was no significant difference between responses after MCL and LCL stimulation. The mean latency of early inhibition after LCL stimulation was 66+7 (ms and After MCL stimulation was 68+12 (ms. The difference was not significant (P=0.26. Conclusion: It may be concluded that that reflexes may be elicited following enough electrical stimulation of the MCL and LCL and the muscles develop a sustained contraction. There was also no evidence to suggest that the reflexes are changed by movement from a seated to a standing posture. Stimulation of MCL and LCL seems to elicit reflexes widely in the limb and to affect muscles acting above and below the knee.

  3. The natural history of a newly developed flexion contracture following primary total knee arthroplasty.

    Science.gov (United States)

    Anania, Andres; Abdel, Matthew P; Lee, Yuo-yu; Lyman, Stephen; González Della Valle, Alejandro

    2013-10-01

    We investigated the incidence, natural history, and functional consequences of a newly developed flexion contracture after total knee arthroplasty (TKA). Forty patients with full knee extension preoperatively who developed a postoperative flexion contracture were match-paired 1:2 with 80 patients who had full extension. The incidence of a newly developed flexion contracture, ROM, and Knee Society scores (KSS) at six weeks, four months, and one year were analysed. The incidence of a new flexion contracture at six weeks was 14%, but diminished to 5% and 0.3% at four months and one year, respectively. One year after surgery, there was no difference in the KSS (p = 0.5). This study showed that the majority of patients who developed a new flexion contracture after TKA have full knee extension one year postoperatively. Moreover, knee extension and KSS at one year are equivalent to those patients who did not developed a flexion contracture.

  4. Tibiofemoral conformity and kinematics of rotating-bearing knee prostheses.

    Science.gov (United States)

    D'Lima, D D; Trice, M; Urquhart, A G; Colwell, C W

    2001-05-01

    Increasing tibiofemoral articular conformity theoretically increases articular contact area and reduces contact stresses in total knee arthroplasty. Fixed-bearing knee designs possess relatively low tibiofemoral conformity, in part to allow tibiofemoral rotation without generating excessive stresses at the articulation or the implant-bone interface. This study analyzed knee kinematics of mobile-bearing designs in a closed chain dynamic knee extension model in posterior cruciate-retaining design with high- and low tibiofemoral conformity and posterior cruciate-substituting designs with and without rotational constraint. Overall, for all conditions, the mobile-bearing insert rotated with the femur in the presence of tibiofemoral axial rotation. In addition, the correlation of bearing rotation with femoral rotation was stronger for the high-conformity and rotationally-constrained designs than for the low-conformity designs and strongest for the posterior cruciate-retaining high-conformity condition. Changes in conformity or rotational constraint did not appear to affect femoral roll back, tibiofemoral axial rotation, or varus-valgus angulation. The results suggest that mobile-bearing inserts rotate with the femur and increasing conformity or rotational constraint in mobile-bearing design knee prostheses does not affect knee kinematics adversely, at least under closed chain knee extension conditions in vitro.

  5. New concepts in revision total knee arthroplasty.

    Science.gov (United States)

    Vince, Kelly G; Droll, Kurt; Chivas, Dan

    2008-01-01

    Revision knee arthroplasty should be regarded as a discipline separate from primary surgery. A disciplined approach to diagnosis is mandatory in which the following categories for failure are useful: (a) sepsis, (b) extensor mechanism rupture, (c) stiffness, (d) instability, (e) periprosthetic fracture, (f) aseptic loosening and osteolysis, (g) patellar complications and malrotation, (h) component breakage, and (i) no diagnosis. In the event of no coherent explanation for pain and disability, the possibilities of chronic regional pain syndrome, hip or spine pathology, and inability of current technology to meet patient expectations should be considered and revision surgery should be avoided. Revision arthroplasty cannot be performed as if it were a primary procedure and indeed will be eight (or more) different surgeries depending on the cause of failure. Though perhaps counterintuitive, there is a logical rationale and empirical evidence to support complete revision in virtually every case. In general, revision implant systems are required. The early dependence on the "joint line" is inadequate, failing as it does to recognize that the level of the articulation is a three-dimensional concept and not simply a "line." The key to revision surgery technique is that the flexion gap is determined by femoral component size and the extension gap by proximal distal component position. Accordingly, a general technical pathway of three steps can be recommended: 1) tibial platform; 2) stabilization of the knee in flexion with (a) femoral component rotation and (b) size selected with evaluation of (c) patellar height as an indication of "joint line" in flexion only; and 3) stabilization of the knee in extension, an automatic step. Stem extensions improve fixation and, if they engage the diaphysis, may be used as a guide for positioning. Porous metals designed as augments for bone defects may prove more important as "modular fixation interfaces." It is postulated that with the

  6. Biomechanical analysis of stair descent in patients with knee osteoarthritis.

    Science.gov (United States)

    Igawa, Tatsuya; Katsuhira, Junji

    2014-05-01

    [Purpose] The purposes of this study were to investigate the lower extremity joint kinematics and kinetics of patients with the knee osteoarthritis (knee OA) during stair descent and clarify the biomechanical factors related to their difficulty in stair descent. [Subjects and Methods] Eight healthy elderly persons and four knee OA patients participated in this study. A 3-D motion analysis system and force plates were employed to measure lower extremity joint angles, ranges of motion, joint moments, joint powers, and ratios of contribution for the joint powers while descending stairs. [Results] Knee joint flexion angle, extension moment, and negative power during the early stance phase in the knee OA group were smaller than those in the healthy subjects group. However, no significant changes in these parameters in the ankle joint were observed between the two subject groups. [Conclusion] Knee OA patients could not use the knee joint to absorb impact during the early stance phase of stair descent. Hence, they might compensate for the roles played by the intact knee joint by mainly using ipsilateral ankle kinematics and kinetics.

  7. Effectiveness of an Articulated Knee Hyperextension Orthosis in Genu Recurvatum

    Directory of Open Access Journals (Sweden)

    Rahul ASRM

    2014-08-01

    Full Text Available Genu Recurvatum is a deformity of knee joint that tends to push it backwards by excessive extension in tibio-femoral joints. This poses a significant challenge because of technical difficulties and a high incidence of recurrence. This report describes a 63 years old male diagnosed as post-polio residual paralysis who showed excessive genu recurvatum of his left knee during long standing and walking. An Articulated Knee Hyperextension Orthosis (KAFO was tried to check its effectiveness in terms of gait and energy expenditure.

  8. Ligament balancing in total knee arthroplasty—Medial stabilizing technique

    Directory of Open Access Journals (Sweden)

    Shuichi Matsuda

    2015-10-01

    Full Text Available Ligament balancing is one of the most important surgical techniques for successful total knee arthroplasty. It has traditionally been recommended that medial and lateral as well as flexion and extension gaps are equal. This article reviews the relevant literature and discusses the clinical importance of the aforementioned gaps. Current evidence indicates that achieving medial stability throughout the range of motion should be a high priority in ligament balancing in total knee arthroplasty. Finally, the medial stabilising surgical technique, which aims to achieve good medial stability in posterior cruciate-retaining total knee arthroplasty, is introduced.

  9. Early recovery after fast-track Oxford unicompartmental knee arthroplasty

    DEFF Research Database (Denmark)

    Munk, Stig; Dalsgaard, Jesper; Bjerggaard, Karin

    2012-01-01

    trauma. We investigated changes in leg-extension power (LEP) in the first month after MIS Oxford UKA and its relation to pain, knee motion, functional performance, and knee function. Patients and methods In 35 consecutive Oxford UKA patients, LEP was measured 1 week before and 1 month after surgery...... supervision in the first month after discharge. Interpretation Fast-track MIS Oxford UKA with discharge on the day after surgery is safe and leads to early recovery of knee motion and strength even when no physiotherapy is used....

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

    Directory of Open Access Journals (Sweden)

    José Wanderley Vasconcelos

    2013-06-01

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

  11. Knee synovial cyst presenting as iliotibial band friction syndrome.

    Science.gov (United States)

    Costa, M L; Marshall, T; Donell, S T; Phillips, H

    2004-06-01

    We present the case of a 28-year-old competitive runner with iliotibial band (ITB) friction syndrome associated with a synovial cyst. Magnetic resonance imaging (MRI) did not demonstrate a fluid collection. However, open exploration revealed a large cyst beneath the ITB arising from the capsule of the knee proximal to the lateral meniscus. The cyst disappeared on extension. The pre-operative MRI scan may have revealed the cyst, if it had been taken with the knee flexed.

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

    Science.gov (United States)

    Borgbjerg, Jens; Madsen, Frank; Odgaard, Anders

    2017-03-01

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

  13. The Change in Knee Angle during the Gait by Applying Elastic Tape to the Skin

    Science.gov (United States)

    Yamamoto, Hiroyuki

    2014-01-01

    [Purpose] The aim of this study was to verify how the application of elastic tape to the anterior surface of the thigh changes the knee angle pattern during gait. [Subjects] The subjects were 10 people who showed an abnormal knee angle change pattern during usual walking. They did not show the so-called double knee action. [Methods] Subjects were asked to walk as usual, and then to walk with elastic tape attached to the anterior surface of the thigh. The knee angle was measured during gait with an electronic goniometer. We graphed the temporal changes of the knee angle and compared them with the normal gait pattern. [Results] The knee angle gait pattern of six of the 10 subjects improved after application of the tape and became like a normal gait pattern. The changes in the knee angle resulted from a stimulus via the skin, rather than voluntary muscular adjustment, suggesting that the changes may have originated due to differences in reflexive tensile strength. [Conclusion] In normal speed gait, it is suggested that the knee angle was altered such that it exhibited a normal pattern by applying elastic tape to the anterior surface of the thigh. We suspect that application of the elastic tape may change the muscle tonus. PMID:25140100

  14. Total Knee Arthroplasty in Patients with Blount Disease or Blount-Like Deformity.

    Science.gov (United States)

    Natoli, Roman M; Nypaver, Chrissy M; Schiff, Adam P; Hopkinson, William J; Rees, Harold W

    2016-01-01

    Blount disease is associated with complex deformity of the proximal tibia, and some patients will develop knee osteoarthritis. Five patients (eight knees) with Blount disease or Blount-like deformity underwent total knee arthroplasty. Mean proximal tibial metaphyseal-diaphyseal angle was 20.75°. Each patient had substantial posteromedial tibial bony defects and six knees required extensive medial releases. Two knees required increased constraint at index procedure. One patient has undergone bilateral revision surgery with rotating hinge prostheses. Mean WOMAC scores were 13.5 and Knee Society scores were 212.5 at average 75.2 month follow-up. Despite technical challenges, patients with these deformities can have successful outcomes after total knee arthroplasty. Surgeons should be prepared to address posteromedial tibial bony defects and consider constrained arthroplasty at the index procedure.

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

    OpenAIRE

    Lissa Fahlman; Emmeline Sangeorzan; Nimisha Chheda; Daphne Lambright

    2014-01-01

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

  16. 75 FR 47504 - Voluntary Education Programs

    Science.gov (United States)

    2010-08-06

    ... America. TTT helps relieve teacher shortages, especially in math, science, special education, and other... of the Secretary 32 CFR Part 68 RIN 0790-AI50 Voluntary Education Programs AGENCY: Office of the... for the operation of voluntary education programs within DoD. Included are: Procedures for Service...

  17. Pedagogical Aspects of Voluntary School Work

    Science.gov (United States)

    Mária Jármai, Erzsébet; Palányi, Ildikó Zsupanekné

    2015-01-01

    The economic importance of voluntary work has been exceedingly appreciated in the last few decades. This is not surprising at all, because it is highly profitable according to the related estimated data. There are 115,9 million people doing voluntary work only in Europe, which means that they would create the world's 7th biggest economy with EUR…

  18. 14 CFR 234.7 - Voluntary reporting.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Voluntary reporting. 234.7 Section 234.7 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS AIRLINE SERVICE QUALITY PERFORMANCE REPORTS § 234.7 Voluntary reporting. (a) In addition to the...

  19. Changing Dynamics in the Voluntary Market (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, J.

    2014-12-01

    Voluntary green power markets are those in which consumers and institutions voluntarily purchase renewable energy to match their electricity needs. This presentation, presented at the Renewable Energy Markets Conference in December 2014, outlines the voluntary market in 2013, including community choice aggregation and community solar.

  20. 12 CFR 546.4 - Voluntary dissolution.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Voluntary dissolution. 546.4 Section 546.4... ASSOCIATIONS-MERGER, DISSOLUTION, REORGANIZATION, AND CONVERSION § 546.4 Voluntary dissolution. A Federal savings association's board of directors may propose a plan for dissolution of the association. The plan...

  1. Preoperative Strength Training for Elderly Patients Awaiting Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    D. M. van Leeuwen

    2014-01-01

    Full Text Available Objective. To investigate the feasibility and effects of additional preoperative high intensity strength training for patients awaiting total knee arthroplasty (TKA. Design. Clinical controlled trial. Patients. Twenty-two patients awaiting TKA. Methods. Patients were allocated to a standard training group or a group receiving standard training with additional progressive strength training for 6 weeks. Isometric knee extensor strength, voluntary activation, chair stand, 6-minute walk test (6MWT, and stair climbing were assessed before and after 6 weeks of training and 6 and 12 weeks after TKA. Results. For 3 of the 11 patients in the intensive strength group, training load had to be adjusted because of pain. For both groups combined, improvements in chair stand and 6MWT were observed before surgery, but intensive strength training was not more effective than standard training. Voluntary activation did not change before and after surgery, and postoperative recovery was not different between groups (P>0.05. Knee extensor strength of the affected leg before surgery was significantly associated with 6-minute walk (r=0.50 and the stair climb (r−=0.58, P<0.05. Conclusion. Intensive strength training was feasible for the majority of patients, but there were no indications that it is more effective than standard training to increase preoperative physical performance. This trial was registered with NTR2278.

  2. Between voluntary agreement and legislation

    DEFF Research Database (Denmark)

    Gwozdz, Wencke; Hedegaard, Liselotte; Reisch, Lucia

    2009-01-01

    Voluntary agreements and self-imposed standards are broadly applied to restrict the influence food advertising exerts on children’s food choices – yet their effects are unknown. The current project will therefore investigate whether and, if yes, how the Danish Code for Responsible Food Marketing...... Communication towards Children (hereafter: CODE) – with its dependence on a supportive institutional environment and acceptance of as well as dynamics between involved key stakeholders like consumers, political actors and firms – contributes to fighting the obesity pandemic.Thus, we explore within this article...... what information about the process of implementing the CODE as well as about the evolved dynamics between key stakeholders is already available. Here, the recently published report of the PolMark project sheds light on the dynamics between the key stakeholders in relation to the current Danish...

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

    Directory of Open Access Journals (Sweden)

    Markus A. Wimmer

    2015-01-01

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

  4. The repeated bout effect of eccentric exercise is not associated with changes in voluntary activation.

    Science.gov (United States)

    Kamandulis, Sigitas; Skurvydas, Albertas; Brazaitis, Marius; Skikas, Laimutis; Duchateau, Jacques

    2010-04-01

    The aim of this study was to compare the possible changes in muscle activation level between a first and second bout of damaging eccentric exercise performed at 2 weeks interval (i.e. repeated bout effect). To that purpose, ten physically active males took part in this study. The eccentric exercise consisted of 10 sets of 12 maximal voluntary contractions (MVC) produced by the knee extensors during movements performed at a constant speed of 160 degrees s(-1). Changes in voluntary and electrically evoked torque in concentric and/or isometric conditions were assessed at the following time points: pre-exercise, and 2 min, 1 and 24 h after each eccentric exercise. At the same time points, voluntary activation was quantified by the superimposed electrical stimulation technique. Muscle soreness and plasma CK activity were measured within 48 h after the eccentric exercise. The results showed that the decrease in eccentric peak torque was linear throughout the exercise protocol. At the end of bouts 1 and 2, torque was significantly reduced by 27.7 +/- 9.1 and 23.4 +/- 11.2, respectively, with no difference between bouts (P > 0.05). At 24 h post-exercise, a lower reduction (P eccentric exercise appears to reduce muscle damage, but does not influence the level of voluntary activation.

  5. Measurement of voluntary activation based on transcranial magnetic stimulation over the motor cortex.

    Science.gov (United States)

    Todd, Gabrielle; Taylor, Janet L; Gandevia, Simon C

    2016-09-01

    This article reviews the use of transcranial magnetic stimulation (TMS) over the motor cortex to make estimates of the level of voluntary drive to muscles. The method, described in 2003 (Todd et al. J Physiol 551: 661-671, 2003), uses a TMS pulse to produce descending corticospinal volleys that synaptically activate motoneurons, resulting in a muscle twitch. Linear regression of the superimposed twitch amplitude and voluntary force (or torque) can generate an "estimated" resting twitch for muscles involved in a task. This procedure has most commonly been applied to elbow flexors but also to knee extensors and other muscle groups. Data from 44 papers using the method were tabulated. We identify and discuss five major technical challenges, and the frequency with which they are addressed. The technical challenges include inadvertent activation of the cortical representation of antagonist muscles, the role of antagonist torques at the studied joint, uncertainty about the effectiveness of the TMS pulse in activating the motoneuron pool, the linearity of the voluntary force (or torque) and superimposed twitch relationship, and variability in the TMS-evoked EMG and force/torque responses. The ideal situation in which the descending corticospinal volleys recruit all of the agonist motoneurons and none of the antagonist motoneurons is unlikely to ever occur, and hence results must be carefully examined to assess the authenticity of the voluntary activation estimates in the context of the experimental design. A partial compromise lies in the choice of stimulus intensity. We also identify aspects of the procedure that require further investigation.

  6. Muscle strategies for leg extensions on a "Reformer" apparatus.

    Science.gov (United States)

    Cantergi, Débora; Loss, Jefferson Fagundes; Jinha, Azim; Brodt, Guilherme Auler; Herzog, Walter

    2015-04-01

    Considering the kinematics of leg extensions performed on a Reformer apparatus, one would expect high activation of hip and knee extensor muscle groups. However, because of the bi-articular nature of some lower limb muscles, and the possibility to vary the direction of force application on the Reformer bar, muscles can be coordinated theoretically in a variety of ways and still achieve the desired outcome. Hence, the aim of this study was to determine the knee and hip moments during leg extensions performed on the Reformer apparatus and to estimate the forces in individual muscles crossing these joints using static optimization. Fifteen subjects performed leg extensions exercises on the Reformer apparatus using an individually chosen resistance. To our big surprise, we found that subjects performed the exercise using two conceptually different strategies (i) the first group used simultaneous hip and knee extension moments, (ii) while the second group used simultaneous hip flexion and knee extension moments to perform the exercise. These different strategies were achieved by changing the direction of the resultant force applied by the subject's feet on the Reformer bar. While leg extensions on the Reformer apparatus have been thought to strengthen the hip and knee extensors muscles, our results demonstrate that patients can perform the exercise in a different and unexpected way. In order to control the hip and knee moments and achieve the desired outcome of the exercise, the direction of force application on the Reformer bar must be controlled carefully.

  7. The effects of a prophylactic knee brace and two neoprene knee sleeves on the performance of healthy athletes: a crossover randomized controlled trial.

    Science.gov (United States)

    Mortaza, Niyousha; Ebrahimi, Ismail; Jamshidi, Ali Ashraf; Abdollah, Vahid; Kamali, Mohammad; Abas, Wan Abu Bakar Wan; Osman, Noor Azuan Abu

    2012-01-01

    Knee injury is one of the major problems in sports medicine, and the use of prophylactic knee braces is an attempt to reduce the occurrence and/or severity of injuries to the knee joint ligament(s) without inhibiting knee mobility. The aim of the present study was to examine the effect of one recently designed prophylactic knee brace and two neoprene knee sleeves upon performance of healthy athletes. Thirty-one healthy male athletes (age = 21.2 ± 1.5) volunteered as participants to examine the effect of prophylactic knee brace/sleeves on performance using isokinetic and functional tests. All subjects were tested in four conditions in a random order: 1. nonbraced (control) 2. using a neoprene knee sleeve 3. using a knee sleeve with four bilateral metal supports and 4. using a prophylactic knee brace. The study design was a crossover, randomized, controlled trial. Subjects completed single leg vertical jump, cross-over hop, and the isokinetic knee flexion and extension (at 60, 180, 300°/sec). Data were collected from the above tests and analyzed for jump height, cross-over hop distance, peak torque to body weight ratio and average power, respectively. Comparisons of these variables in the four testing conditions revealed no statistically significant difference (p>0.05). The selected prophylactic brace/sleeves did not significantly inhibit athletic performance which might verify that their structure and design have caused no complication in the normal function of the knee joint. Moreover, it could be speculated that, if the brace or the sleeves had any limiting effect, our young healthy athletic subjects were well able to generate a mean peak torque large enough to overcome this possible restriction. Further studies are suggested to investigate the long term effect of these prophylactic knee brace and sleeves as well as their possible effect on the adjacent joints to the knee.

  8. The effects of a prophylactic knee brace and two neoprene knee sleeves on the performance of healthy athletes: a crossover randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Niyousha Mortaza

    Full Text Available Knee injury is one of the major problems in sports medicine, and the use of prophylactic knee braces is an attempt to reduce the occurrence and/or severity of injuries to the knee joint ligament(s without inhibiting knee mobility. The aim of the present study was to examine the effect of one recently designed prophylactic knee brace and two neoprene knee sleeves upon performance of healthy athletes. Thirty-one healthy male athletes (age = 21.2 ± 1.5 volunteered as participants to examine the effect of prophylactic knee brace/sleeves on performance using isokinetic and functional tests. All subjects were tested in four conditions in a random order: 1. nonbraced (control 2. using a neoprene knee sleeve 3. using a knee sleeve with four bilateral metal supports and 4. using a prophylactic knee brace. The study design was a crossover, randomized, controlled trial. Subjects completed single leg vertical jump, cross-over hop, and the isokinetic knee flexion and extension (at 60, 180, 300°/sec. Data were collected from the above tests and analyzed for jump height, cross-over hop distance, peak torque to body weight ratio and average power, respectively. Comparisons of these variables in the four testing conditions revealed no statistically significant difference (p>0.05. The selected prophylactic brace/sleeves did not significantly inhibit athletic performance which might verify that their structure and design have caused no complication in the normal function of the knee joint. Moreover, it could be speculated that, if the brace or the sleeves had any limiting effect, our young healthy athletic subjects were well able to generate a mean peak torque large enough to overcome this possible restriction. Further studies are suggested to investigate the long term effect of these prophylactic knee brace and sleeves as well as their possible effect on the adjacent joints to the knee.

  9. Determinants and features of voluntary disclosure in the Chinese stock market

    Directory of Open Access Journals (Sweden)

    Yang Lan

    2013-12-01

    Full Text Available This paper offers in-depth analysis of the determinants and features of voluntary disclosure based on information in the annual reports of 1066 Chinese firms listed on the Shanghai and Shenzhen Stock Exchanges. This extensive sample represents about 80% of all public companies in China. Our findings suggest that voluntary disclosure in China is positively related to firm size, leverage, assets-in-place, and return on equity and is negatively related to auditor type and the level of maturity or sophistication of the intermediary and legal environments. We also find some evidence to suggest a quadratic convex association between state ownership and voluntary disclosure. However, our analysis provides no evidence that extensive disclosure benefits public companies in China in the form of a lower cost of equity.

  10. Determinants and features of voluntary disclosure in the Chinese stock market

    Institute of Scientific and Technical Information of China (English)

    Yang; Lan; Lili; Wang; Xueyong; Zhang

    2013-01-01

    This paper offers in-depth analysis of the determinants and features of voluntary disclosure based on information in the annual reports of 1066 Chinese firms listed on the Shanghai and Shenzhen Stock Exchanges. This extensive sample represents about 80% of all public companies in China. Our findings suggest that voluntary disclosure in China is positively related to firm size,leverage, assets-in-place, and return on equity and is negatively related to auditor type and the level of maturity or sophistication of the intermediary and legal environments. We also find some evidence to suggest a quadratic convex association between state ownership and voluntary disclosure. However, our analysis provides no evidence that extensive disclosure benefits public companies in China in the form of a lower cost of equity.

  11. Effect of anterior cruciate ligament rupture on hamstring∶quadriceps ratio during isokinetic knee extension and flexion at 30 degrees of flexion%膝关节30闭时前交叉韧带断裂对等速屈伸肌力比值的影响

    Institute of Scientific and Technical Information of China (English)

    黄红拾; 蒋艳芳; 杨洁; 于媛媛; 王懿; 徐雁; 敖英芳

    2015-01-01

    目的:研究膝关节30°时前交叉韧带(anterior cruciate ligament,ACL)断裂对股四头肌(quadriceps,Q)和腘绳肌(hamstring,H)的肌力及其动态平衡的影响。方法:应用等速肌力测试系统(Con-Trex MJ)对25例男性单侧单纯ACL断裂患者在60°/s进行开链向心(concentric,c)和离心(eccentric,e)测试。选择膝关节30°时股四头肌或腘绳肌的等速向心和离心平均力矩,并计算其比值,包括股四头肌离心和向心比值( Qe∶Qc)、腘绳肌离心和向心比值( He∶Hc)、腘绳肌与股四头肌的向心比值( Hc∶Qc)、腘绳肌离心与股四头肌向心比值( He∶Qc)、腘绳肌向心与股四头肌离心比值( Hc∶Qe)。采用配对符号秩检验分析ACL断裂对上述参数的影响,结果以中位数(最小值~最大值)表示。结果:ACL断裂侧和未伤侧相比:(1)等速向心时,股四头肌平均力矩显著下降[61.2(20.0~100.1) N· m vs.84.0(32.3~127.7) N· m,P<0.001];(2)等速离心时,股四头肌平均力矩显著下降[55.3(31.3~114.1) N· m vs.71.7(24.5~149.7) N· m,P=0.04],腘绳肌平均力矩亦显著下降[55.3(3.1~119.2) N· m vs.80.3(17.2~127.4) N· m,P=0.002];(3)Hc∶Qc、He∶Qc和Qe∶Qc均显著增大(P<0.05)。结论:60°/s等速开链模式膝关节30°时H∶Q比值是评定ACL断裂患者大腿肌肉功能的新方法,ACL 断裂侧的股四头肌力矩显著降低, Hc∶Qc、He∶Qc和Qe∶Qc显著增加。%Objective:To evaluate the change in hamstring ( H ):quadriceps ( Q ) ratio following anterior cruciate ligament ( ACL) rupture during isokinetic knee extension and flexion at 30 degrees of flexion which is important for knee dynamic function .Methods:A study was performed in 25 male com-plete unilateral ACL ruptures .Isokinetic concentric and eccentric

  12. Knee MRI scan

    Science.gov (United States)

    MRI - knee ... radiologist see certain areas more clearly. During the MRI, the person who operates the machine will watch ... less anxious. Your provider may suggest an "open" MRI, in which the machine is not as close ...

  13. Runners knee (image)

    Science.gov (United States)

    ... forces on the knee, such as a misaligned patella. Chondromalacia is treated with rest or immobilization and nonsteroidal anti-inflammatory drugs for pain. Physical therapy, especially ... alignment of the patella that cannot be corrected with therapy.

  14. Osteotomy of the knee

    Science.gov (United States)

    Proximal tibial osteotomy; Lateral closing wedge osteotomy; High tibial osteotomy; Distal femoral osteotomy ... There are two types of surgery: Tibial osteotomy is surgery done on ... osteotomy is surgery done on the thigh bone above the knee ...

  15. Dashboard (in the) knee

    National Research Council Canada - National Science Library

    Patel, M S; Qureshi, A A; Green, T P

    2015-01-01

    We present the case of a 19-year-old individual presenting to an orthopaedic outpatient clinic several months following a dashboard knee injury during a road traffic accident with intermittent mechanical symptoms...

  16. Total Knee Replacement

    Science.gov (United States)

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

  17. Partial knee replacement

    Science.gov (United States)

    ... al. American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (nonarthroplasty). J Am Acad ... Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  18. Prevalent knee pain and sport

    DEFF Research Database (Denmark)

    Hahn, Thomas; Foldspang, Anders

    1998-01-01

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

  19. The effect of knee joint angle on plantar flexor power in young and old men.

    Science.gov (United States)

    Dalton, Brian H; Allen, Matti D; Power, Geoffrey A; Vandervoort, Anthony A; Rice, Charles L

    2014-04-01

    Human adult aging is associated with a loss of strength, contractile velocity and hence, power. The principal plantar flexors, consisting of the bi-articular gastrocnemeii and the mono-articular soleus, appear to be affected differently by the aging process. However, the age-related effect of knee joint angle on the torque-angular velocity relationship and power production of this functionally important muscle group is unknown. The purpose was to determine whether flexing the knee, thereby reducing the gastrocnemius contribution to plantar flexion, would exacerbate the age-related decrements in plantar flexion power, or shift the torque-angular velocity relationship differently in older compared with young men. Neuromuscular properties were recorded from 10 young (~25 y) and 10 old (~78 y) men with the knee extended (170°) and flexed (90°), in a randomized order. Participants performed maximal voluntary isometric contractions (MVCs), followed by maximal velocity-dependent shortening contractions at pre-set loads, ranging from 15 to 75% MVC. The young men were ~20-25% stronger, ~12% faster and ~30% more powerful than the old for both knee angles (Ptorque was ~17% greater in the extended than flexed knee position, with no differences in voluntary activation (>95%). The young men produced 7-12% faster angular velocities in the extended knee position for loads ≤30% MVC, but no differences at higher loads; whereas there were no detectable differences in angular velocity between knee positions in the old across all relative loads. For both knee angles, young men produced peak power at 43.3±9.0% MVC, whereas the old men produced peak power at 54.8±7.9% MVC. These data indicate that the young, who have faster contracting muscles compared with the old, can rely more on velocity than torque for generating maximal power.

  20. Taking care of your new knee joint

    Science.gov (United States)

    Knee arthroplasty - precautions; Knee replacement - precautions ... After you have knee replacement surgery , you will need to be careful about how you move your knee, especially for the first few ...

  1. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    OpenAIRE

    Vigotsky, Andrew D.; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three h...

  2. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    OpenAIRE

    Vigotsky, Andrew D.; Lehman, Gregory J; Bret Contreras; Chris Beardsley; Bryan Chung; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three he...

  3. Exercise Alters Gait Pattern but Not Knee Load in Patients with Knee Osteoarthritis

    Science.gov (United States)

    Lin, Yi-Jia; Chang, Chao-Chin; Chou, You-Cai

    2016-01-01

    Six female patients with bilateral medial knee OA and 6 healthy controls were recruited. Patients with knee OA received a 6-week physiotherapist-supervised and home-based exercise program. Outcome measures, including the Western Ontario and McMaster Universities Arthritis Index and Short Form-36 Health Survey as well as objective biomechanical indices were obtained at baseline and follow-up. After treatment, no significant difference was observed in the knee abductor moment (KAM), lever arm, and ground reaction force. We, however, observed significantly improved pain and physical function as well as altered gait patterns, including a higher hip flexor moment and hip extension angle with a faster walking speed. Although KAM was unchanged, patients with bilateral knee OA showed an improved walking speed and altered the gait pattern after 6 weeks of supervised exercise. This finding suggests that the exercise intervention improves proximal joint mechanics during walking and can be considered for patients with bilateral knee OA. Non-weight-bearing strengthening without external resistance combined with stretching exercise may be an option to improve pain and function in individuals with OA who cannot perform high resistance exercises owing to pain or other reasons. PMID:27725941

  4. Exercise Alters Gait Pattern but Not Knee Load in Patients with Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Ssu-Yu Chang

    2016-01-01

    Full Text Available Six female patients with bilateral medial knee OA and 6 healthy controls were recruited. Patients with knee OA received a 6-week physiotherapist-supervised and home-based exercise program. Outcome measures, including the Western Ontario and McMaster Universities Arthritis Index and Short Form-36 Health Survey as well as objective biomechanical indices were obtained at baseline and follow-up. After treatment, no significant difference was observed in the knee abductor moment (KAM, lever arm, and ground reaction force. We, however, observed significantly improved pain and physical function as well as altered gait patterns, including a higher hip flexor moment and hip extension angle with a faster walking speed. Although KAM was unchanged, patients with bilateral knee OA showed an improved walking speed and altered the gait pattern after 6 weeks of supervised exercise. This finding suggests that the exercise intervention improves proximal joint mechanics during walking and can be considered for patients with bilateral knee OA. Non-weight-bearing strengthening without external resistance combined with stretching exercise may be an option to improve pain and function in individuals with OA who cannot perform high resistance exercises owing to pain or other reasons.

  5. The effect of different intensity of fast knee extension exercise on the stock four muscle′s MPF and the output power%不同强度快速伸膝运动对股四头肌肌电图平均功率频率和输出功率的影响磁

    Institute of Scientific and Technical Information of China (English)

    董雪芬

    2014-01-01

    It was studied the effect of fast knee extension exercises with different intensity on the MPF decline rate of quadriceps sEMG signal and the descending rate of knee extensor average output power, as well as their correlation, the central control theory of dynamic muscle movement was also disscussed.17 male college student participations completed 30 pedal movement with the fastest speed under the leg load of 105.8, 140.9, 176.4 kg, respectively, sEMG signals, time and distance of quadriceps′actions were collected.The effect of 3 loads on MPF and output power of quadriceps ( lateral) , quadriceps ( medial) and rectus femoris were also detected.The results showed that MPF of sEMG signals declined with the exercises number under different intensity of knee extension exercises, which was consistent with the previous static investigation.MPF descending slopes had no difference, while the descending slopes of average output power were different.Av-erage output power of 3 different loads had trends of rising, constant and decreasing respectively.%为研究不同强度快速伸膝运动对股四头肌群表面肌电信号( surface electromyography,sEMG)的平均功率频率( mean power frequency,MPF)下降率和伸膝平均输出功率下降率的影响及相关性,探讨了动态肌肉运动的中枢控制理论,以17名男性大学生为研究对象,让他们下肢负荷分别为105.8,140.9,176.4 kg时,以最快速度完成30次蹬踏运动.采集股四头肌sEMG信号和每次动作时间、距离,考察了3种负荷对股四头肌(外侧)、股四头肌(内侧)和股直肌MPF及输出功率的影响.结果显示:不同强度快速伸膝运动下股四头肌sEMG信号MPF随次数而下降,与以往静态研究相一致;MPF下降斜率没有差异;平均输出功率下降斜率有差异,在短时爆发力运动中,3个负荷输出功率分别呈现上升、不变和下降的趋势.

  6. AN ECONOMETRIC APPROACH ABOUT VOLUNTARY TURNOVER

    Directory of Open Access Journals (Sweden)

    ADALET EREN

    2013-06-01

    Full Text Available This study analyzes individual and organizational variables that affect voluntary turnover are determined in the special defence and security companies. A binomial logistic regression model is used to estimate voluntary turnover.  Binomial Logistic regression, reliability test (scale alfa, variance (ANOVA, Post-hoc/Tukey, correlation (Pearson and other basic statistical techniques  with SPSS 13 statistical packet program was used in the analyzes ofresearch data. The study finds that; situation of suppose working, number of child, number of death child, number of home’s moving, support of rent, total monthly income of household, last work’s region, number of prizes, affect voluntary turnover are determined.

  7. Does post-operative knee awareness differ between knees in bilateral simultaneous total knee arthroplasty?

    DEFF Research Database (Denmark)

    Nielsen, Katrine Abildgaard; Thomsen, Morten Grove; Latifi Yaghin, Roshan;

    2016-01-01

    PURPOSE: To evaluate the difference in post-operative knee awareness between knees in patients undergoing bilateral simultaneous total knee arthroplasty (TKA) and to assess factors predicting high or low knee awareness. METHODS: This study was conducted on 99 bilateral simultaneous TKAs performed...... at our institution from 2008 to 2012. All patients received one set of questionnaires [Forgotten Joint Score (FJS) and Oxford Knee Score (OKS)] for each knee. Based on the FJS, the patients' knees were divided into two groups: "best" and "worst" knees. The median of the absolute difference in FJS and OKS...... within each patient was calculated. Multivariate linear regression was performed to identify factors affecting FJS. RESULTS: The difference between knees was 1 point (CI 0-5) for the FJS and 1 point (CI 0-2) for the OKS. The FJS for females increased (decreasing awareness) with increasing age. Males had...

  8. Effects of Neuromuscular Electrical Stimulation and Resistance Training on Knee Extensor/Flexor Muscles.

    Science.gov (United States)

    Pantović, Milan; Popović, Boris; Madić, Dejan; Obradović, Jelena

    2015-07-01

    Neuromuscular electrical stimulation (NMES) has recently drawn a lot of attention as means for strengthening of voluntary muscle contraction both in sport and rehabilitation. NMES training increases maximal voluntary contraction (MVC) force output through neural adaptations. On the other hand, positive effects of resistance training (RT) on muscle strength are well known. The aim of this study was to investigate effects of a 5-week program of NMES compared to RT program of same duration. Sample of 15 students' of faculty of sport and physical education (age 22 ± 2) were randomized in two groups: NMES (N = 7) and RT (N = 8). NMES group performed NMES superimposed over voluntary muscle contraction, RT group performed resistance training with submaximal loads. Subjects were evaluated for knee isokinetic dynamometry on both sides (60° and 180° s). After intervention no significant difference between groups were observed in isokinetic dynamometry (p = 0.177). However, applying pair sample t test within each group revealed that peak torque increased in NMES-group (p = 0.002 for right knee extensors muscles, p = 0.003 for left, respectively, at 60° and p = 0.004 for left knee extensors muscles, at angular velocity 180°). In RT group (p = 0.033 for right knee extensors muscles, p = 0.029 for right knee flexor muscles, at angular velocity 60°). Our results indicate that NMES has equal potential if not in some way better than classical RT having in mind that overload on locomotor apparatus during NMES is minimal and force of muscle contraction is equal on both sides, for enhancement of knee muscles concentric peak torque.

  9. Knee osteoarthritis image registration: data from the Osteoarthritis Initiative

    Science.gov (United States)

    Galván-Tejada, Jorge I.; Celaya-Padilla, José M.; Treviño, Victor; Tamez-Peña, José G.

    2015-03-01

    Knee osteoarthritis is a very common disease, in early stages, changes in joint structures are shown, some of the most common symptoms are; formation of osteophytes, cartilage degradation and joint space reduction, among others. Based on a joint space reduction measurement, Kellgren-Lawrence grading scale, is a very extensive used tool to asses radiological OA knee x-ray images, based on information obtained from these assessments, the objective of this work is to correlate the Kellgren-Lawrence score to the bilateral asymmetry between knees. Using public data from the Osteoarthritis initiative (OAI), a set of images with different Kellgren-Lawrencescores were used to determine a relationship of Kellgren-Lawrence score and the bilateral asymmetry, in order to measure the asymmetry between the knees, the right knee was registered to match the left knee, then a series of similarity metrics, mutual information, correlation, and mean squared error where computed to correlate the deformation (mismatch) of the knees to the Kellgren-Lawrence score. Radiological information was evaluated and scored by OAI radiologist groups. The results of the study suggest an association between Radiological Kellgren-Lawrence score and image registration metrics, mutual information and correlation is higher in the early stages, and mean squared error is higher in advanced stages. This association can be helpful to develop a computer aided grading tool.

  10. Chondropathia patellae and knee muscle control. An electromyographic study.

    Science.gov (United States)

    Hess, T; Gleitz, M; Egert, S; Hopf, T

    1996-01-01

    The activity of knee-related muscles was registered via exercising on a bicycle ergometer by 17 patients with clinically diagnosed chondropathia patellae. M. quadriceps activity was shorter and the hamstring activity longer in the chondropathy group compared with a matched healthy control group. The changes in m. quadriceps occurred to an almost equal extent in lateral and medial sections. In five patients with unilateral complaints, the electromyographic changes were nevertheless noted on both sides. The study shows that chondropathia patellae involves a change in muscle control affecting not only the knee extensors but also the hamstrings. Through the changed innervation pattern the coactivation phase, i.e. the phase of simultaneous activation of knee flexors and extensors at the end of the extension phase, takes place at a higher angle of flexion. Physiotherapy should involve all knee-related muscles and should include not only isometric but also dynamic exercises.

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

    Science.gov (United States)

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

    2014-11-01

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

  12. Neuronal correlates of voluntary facial movements.

    Science.gov (United States)

    Krippl, Martin; Karim, Ahmed A; Brechmann, André

    2015-01-01

    Whereas the somatotopy of finger movements has been extensively studied with neuroimaging, the neural foundations of facial movements remain elusive. Therefore, we systematically studied the neuronal correlates of voluntary facial movements using the Facial Action Coding System (FACS, Ekman et al., 2002). The facial movements performed in the MRI scanner were defined as Action Units (AUs) and were controlled by a certified FACS coder. The main goal of the study was to investigate the detailed somatotopy of the facial primary motor area (facial M1). Eighteen participants were asked to produce the following four facial movements in the fMRI scanner: AU1+2 (brow raiser), AU4 (brow lowerer), AU12 (lip corner puller) and AU24 (lip presser), each in alternation with a resting phase. Our facial movement task induced generally high activation in brain motor areas (e.g., M1, premotor cortex, supplementary motor area, putamen), as well as in the thalamus, insula, and visual cortex. BOLD activations revealed overlapping representations for the four facial movements. However, within the activated facial M1 areas, we could find distinct peak activities in the left and right hemisphere supporting a rough somatotopic upper to lower face organization within the right facial M1 area, and a somatotopic organization within the right M1 upper face part. In both hemispheres, the order was an inverse somatotopy within the lower face representations. In contrast to the right hemisphere, in the left hemisphere the representation of AU4 was more lateral and anterior compared to the rest of the facial movements. Our findings support the notion of a partial somatotopic order within the M1 face area confirming the "like attracts like" principle (Donoghue et al., 1992). AUs which are often used together or are similar are located close to each other in the motor cortex.

  13. Neuronal correlates of voluntary facial movements

    Directory of Open Access Journals (Sweden)

    Martin eKrippl

    2015-10-01

    Full Text Available Whereas the somatotopy of finger movements has been extensively studied with neuroimaging, the neural foundations of facial movements remain elusive. Therefore, we systematically studied the neuronal correlates of voluntary facial movements using the Facial Action Coding System (FACS,Ekman et al., 2002. The facial movements performed in the MRI scanner were defined as Action Units (AUs and were controlled by a certified FACS coder. The main goal of the study was to investigate the detailed somatotopy of the facial primary motor area (facial M1. Eighteen participants were asked to produce the following four facial movements in the fMRI scanner: AU1+2 (brow raiser, AU4 (brow lowerer, AU12 (lip corner puller and AU24 (lip presser, each in alternation with a resting phase.Our facial movement task induced generally high activation in brain motor areas (e.g. M1, premotor cortex, SMA, putamen, as well as in the thalamus, insula and visual cortex. BOLD activations revealed overlapping representations for the four facial movements. However, within the activated facial M1 areas, we could find distinct peak activities in the left and right hemisphere supporting a rough somatotopic upper to lower face organization within the right facial M1 area, and a somatotopic organization within the right M1 upper face part. In both hemispheres, the order was an inverse somatotopy within the lower face representations. In contrast to the right hemisphere, in the left hemisphere the representation of AU 4 was more lateral and anterior compared to the rest of the facial movements. Our findings support the notion of a partial somatotopic order within the M1 face area confirming the like attracts like principle (Donoghue et al., 1992 . AUs which are often used together or are similar are located close to each other in the motor cortex.

  14. Anticipatory signatures of voluntary memory suppression.

    Science.gov (United States)

    Hanslmayr, Simon; Leipold, Philipp; Pastötter, Bernhard; Bäuml, Karl-Heinz

    2009-03-04

    Voluntary memory suppression can keep unwanted memories from entering consciousness, inducing later forgetting of the information. In the present study, we searched for the existence of anticipatory processes, mediating such voluntary memory suppression. Using the think/no-think paradigm, subjects received a cue whether to prepare to think of a previously studied cue-target pair or whether to not let a previously studied cue-target pair enter consciousness. Examining event-related potentials, we identified two electrophysiological processes of voluntary memory suppression: (1) an early anticipatory process operating before the memory cue for a to-be-suppressed memory was provided, and (2) a later process operating after memory cue presentation. Both ERP effects were due to a decreased right frontal and left parietal positivity. They were positively related and predicted later forgetting. The results point to the existence of anticipatory processes, mediating voluntary memory suppression.

  15. Pedagogical Aspects of Voluntary School Work

    Directory of Open Access Journals (Sweden)

    Mária Jármai Erzsébet

    2015-03-01

    Full Text Available The economic importance of voluntary work has been exceedingly appreciated in the last few decades. This is not surprising at all, because it is highly profitable according to the related estimated data. There are 115,9 million people doing voluntary work only in Europe, which means that they would create the world's 7th biggest economy with EUR 282 billion value creation if they formed an individual state. The organizations know that voluntary work has several advantages apart from the economic benefits. It is profitable both for the society and for the individuals as well. Several researches have proven that voluntary work positively influences the development of the personality, because the key-competencies - such as: co-operation, empathy, solidarity, conflict handling, problem solving, etc. - expected in the labor market can be improved.

  16. Managing voluntary turnover through challenging assignments

    NARCIS (Netherlands)

    Preenen, P.T.Y.; Pater, I.E. de; Vianen, A.E.M. van; Keijzer, L.

    2011-01-01

    This study examines employees' challenging assignments as manageable means to reduce turnover intentions, job search behaviors, and voluntary turnover. Results indicate that challenging assignments are negatively related to turnover intentions and job search behaviors and that these relationships

  17. Corticospinal excitability in human voluntary movement

    NARCIS (Netherlands)

    Elswijk, G.A.F. van

    2008-01-01

    The research described in this thesis addressed the neurophysiologic changes in the human corticospinal system during preparation and execution of voluntary hand movements. The experiments involved transcranial magnetic stimulation (TMS) of the motor cortex combined with electromyography (EMG) and e

  18. Contemplated Suicide Among Voluntary and Involuntary Retirees

    Science.gov (United States)

    Peretti, Peter O.; Wilson, Cedric

    1978-01-01

    This study explored anomic and egoistic dimensions of contemplated suicide among voluntary and involuntary retired males. Results indicated a direct relationship between anomie and egoism on the one hand, and contemplation of suicide on the other. (Author)

  19. A Free Market Requires Voluntary Actions

    DEFF Research Database (Denmark)

    Sløk-Madsen, Stefan Kirkegaard

    are essential to the construct of consumer sovereignty. Understanding the degree of voluntary actions in a given commercial setting has implications for both business strategy and policy making. This paper thus aims to contribute to explain why restricted markets become crony capitalism.......This paper draws attention to the importance of the understanding of voluntary actions in the free market construct. Failing to understand the role of voluntary actions in the free market construct will often result in discussions of capitalism versus socialism focusing on asset ownership...... and not consumer sovereignty. I argue that asset ownership is less important than true consumer sovereignty, which again is the essential argument for why capitalism is the superior mode of resource allocation and social organization. The paper analyzes how our understanding of markets and voluntary actions...

  20. Contemplated Suicide Among Voluntary and Involuntary Retirees

    Science.gov (United States)

    Peretti, Peter O.; Wilson, Cedric

    1978-01-01

    This study explored anomic and egoistic dimensions of contemplated suicide among voluntary and involuntary retired males. Results indicated a direct relationship between anomie and egoism on the one hand, and contemplation of suicide on the other. (Author)

  1. How to quantify knee function after total knee arthroplasty?

    NARCIS (Netherlands)

    Boonstra, M.C.; Waal Malefijt, M.C. de; Verdonschot, N.J.J.

    2008-01-01

    Total knee arthroplasty (TKA) is being undertaken in a younger population than before and as a result the functional demands on the knee are likely to be increasing. As a consequence, it is important to define quantitative functional knee tests that can monitor any increase. A valuable functional

  2. Pull factors of Finland and voluntary work

    OpenAIRE

    Jurvakainen, Janika

    2016-01-01

    This thesis studies pull factors of Finland and voluntary work. The aim of this study is to understand the pull factors of Finland from the perspective of young travelers. Which pull factors attract to choose Finland as their destination? In addition, which pull factors attract young travelers to participate in international voluntary work? The commissioner of this thesis is Allianssi Youth Exchange. The thesis is research-based and includes a quantitative Webropol survey and some qualit...

  3. The effect of heating and cooling on time course of voluntary and electrically induced muscle force variation.

    Science.gov (United States)

    Brazaitis, Marius; Skurvydas, Albertas; Vadopalas, Kazys; Daniusevičiūtė, Laura; Senikienė, Zibuoklė

    2011-01-01

    The aim of this study was to investigate the effect of heating and cooling on time course of voluntary and electrically induced muscle force variation. Ten volunteers performed 50 maximal voluntary and electrically induced contractions of the knee extensors at an angle of 120 degrees under the control conditions and after passive lower body heating and cooling in the control, heating, and cooling experiments. Peak torque, torque variation, and half-relaxation time were assessed during the exercise. Passive lower body heating increased muscle and core temperatures, while cooling lowered muscle temperature, but did not affect core temperature. We observed significantly lower muscle fatigue during voluntary contraction compared with electrically induced contractions. Body heating (opposite to cooling) increased involuntarily induced muscle force, but caused greater electrically induced muscle fatigue. In the middle of the exercise, the coefficient of correlation for electrically induced muscle torque decreased significantly as compared with the beginning of the exercise, while during maximal voluntary contractions, this relation for torque remained significant until the end of the exercise. It was shown that time course of voluntary contraction was more stable than in electrically induced contractions.

  4. Design, construction, and evaluation of "sensor lock": an electromechanical stance control knee joint.

    Science.gov (United States)

    Arazpour, Mokhtar; Ahmadi Bani, Monireh; Baniasad, Mina; Samadian, Mohammad; Golchin, Navid

    2017-03-28

    Most currently-available stance control knee ankle foot orthoses (SCKAFOs) still need full knee extension to lock the knee joint, and they are still noisy, bulky, and heavy. Therefore, the aim of this study was to design, construct, and evaluate an original electromechanical SCKAFO knee joint that could feasibly solve these problems, and thus address the problems of current stance control knee joints with regards to their structure, function, cosmesis, and cost. Ten able-bodied (AB) participants and two (knee ankle foot orthosis) KAFO users were recruited to participate in the study. A custom SCKAFO with the same set of components was constructed for each participant. Lower limb kinematics were captured using a 6-camera, video-based motion analysis system. For AB participants, significant differences were found between normal walking and walking with the SCKAFO for temporal-spatial parameters and between orthoses with two modes of knee joints in the healthy subjects. Walking with stance control mode produced greater walking speed and step length, greater knee flexion during swing, and less pelvic obliquity than walking with a locked knee, for both AB and KAFO users. The feasibility of this new knee joint with AB people was demonstrated. Implications for rehabilitation Stance control knee ankle foot orthoses (SCKAFOs) are designed to stop knee flexion in stance phase and provide free knee movement during swing phase of walking. Due to their high cost, size, excessive weight, and poor performance, few SCKAFO were optimal clinically and commercially. The feasibility of the new knee joint with able-bodied people and poliomyelitis subjects was demonstrated.

  5. Knee Injuries in Downhill Skiers

    OpenAIRE

    Shea, Kevin G.; Archibald-Seiffer, Noah; Murdock, Elizabeth; Grimm, Nathan L.; Jacobs, John C.; Willick, Stuart; Van Houten, Heather

    2014-01-01

    Background: Knee injuries account for approximately one third of injuries in skiers. Researchers have proposed several mechanisms of knee injury in skiers. However, the frequencies of these mechanisms have varied in different studies. Purpose: To identify the most common knee injury mechanisms in recreational downhill skiers and to assess injury frequencies across several demographics. Study Design: Descriptive epidemiology study. Methods: Over 6 ski seasons, 541 patients with acute knee inju...

  6. 47 CFR 80.310 - Watch required by voluntary vessels.

    Science.gov (United States)

    2010-10-01

    ... Watches § 80.310 Watch required by voluntary vessels. Voluntary vessels not equipped with DSC must.... Voluntary vessels equipped with VHF-DSC equipment must maintain a watch on 2182 kHz and on either 156.525... used to communicate. Voluntary vessels equipped with MF-HF DSC equipment must have the radio turned...

  7. Anterior knee pain: an update of physical therapy.

    Science.gov (United States)

    Werner, Suzanne

    2014-10-01

    Anterior knee pain is one of the most common knee problems in physically active individuals. The reason for anterior knee pain has been suggested to be multifactorial with patella abnormalities or extensor mechanism disorder leading to patellar malalignment during flexion and extension of the knee joint. Some patients complain mostly of non-specific knee pain, while others report patellar instability problems. The patients present with a variety of symptoms and clinical findings, meaning that a thorough clinical examination is the key for optimal treatment. Weakness of the quadriceps muscle, especially during eccentric contractions, is usually present in the majority of anterior knee pain patients. However, irrespective of whether pain or instability is the major problem, hypotrophy and reduced activity of the vastus medialis are often found, which result in an imbalance between vastus medialis and vastus lateralis. This imbalance needs to be corrected before quadriceps exercises are started. The non-operative rehabilitation protocol should be divided into different phases based on the patient's progress. The goal of the first phase is to reduce pain and swelling, improve the balance between vastus medialis and vastus lateralis, restore normal gait, and decrease loading of the patello-femoral joint. The second phase should include improvement of postural control and coordination of the lower extremity, increase of quadriceps strength and when needed hip muscle strength, and restore good knee function. The patient should be encouraged to return to or to start with a suitable regular physical exercise. Therefore, the third phase should include functional exercises. Towards the end of the treatment, single-leg functional tests and functional knee scores should be used for evaluating clinical outcome. A non-operative treatment of patients with anterior knee pain should be tried for at least 3 months before considering other treatment options.

  8. IN VIVO KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT DEFICIENT KNEE DURING WIDE-BASED SQUAT USING A 2D/3D REGISTRATION TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Takeshi Miyaji

    2012-12-01

    Full Text Available Anterior cruciate ligament (ACL deficiency increases the risk of early osteoarthritis (OA. Studies of ACL deficient knee kinematics would be important to reveal the disease process and therefore to find mechanisms which would potentially slow OA progression. The purpose of this study was to determine if in vivo kinematics of the anterior cruciate ligament deficient (ACLD knee during a wide-based squat activity differ from kinematics of the contralateral intact knee. Thirty-three patients with a unilateral ACLD knee consented to participate in this institutional review board approved study with the contralateral intact knee serving as the control. In vivo knee kinematics during the wide-based squat were analyzed using a 2D/3D registration technique utilizing CT-based bone models and lateral fluoroscopy. Comparisons were performed using values between 0 and 100° flexion both in flexion and extension phases of the squat activity. Both the ACLD and intact knees demonstrated increasing tibial internal rotation with knee flexion, and no difference was observed in tibial rotation between the groups. The tibia in the ACLD knee was more anterior than that of the contralateral knees at 0 and 5° flexion in both phases (p < 0.05. Tibiofemoral medial contact points of the ACLD knees were more posterior than that of the contralateral knees at 5, 10 and 15° of knee flexion in the extension phase of the squat activity (p < 0.05. Tibiofemoral lateral contact points of the ACLD knees were more posterior than that of the contralateral knees at 0° flexion in the both phases (p < 0.05. The kinematics of the ACLD and contralateral intact knees were similar during the wide-based squat except at the low flexion angles. Therefore, we conclude the wide-based squat may be recommended for the ACLD knee by avoiding terminal extension

  9. An algorithmic approach to rehabilitation following arthroscopic surgery for arthrofibrosis of the knee: A case series.

    Science.gov (United States)

    Eckenrode, Brian J

    2017-09-01

    Loss of knee range of motion (ROM) has been reported as the most common complication following anterior cruciate ligament reconstruction (ACLR). Arthrofibrosis of the knee, or specifically Cyclops syndrome, has been described as the formation of a scar tissue nodule adjacent to the tibial tunnel of the anterior cruciate ligament (ACL) graft. This lesion often results in loss of knee extension ROM, pain, and impaired function. Three consecutive patients were referred to physical therapy following arthroscopic knee surgery for lysis of adhesions of a Cyclops lesion from a previous ACLR. Arthroscopic debridement was performed between 3 and 12 months post ACLR. An algorithmic progression of extension ROM was the initial focus of physical therapy, which then advanced to strengthening, neuromuscular reeducation, and sport specific training. Following knee surgery for debridement of the Cyclops lesion, mean knee joint ROM at the initial physical therapy evaluation was 7.0° ± 8.6° to 118.3° ± 7.6° that progressed to -1.0° ± 1.7° to 127° ± 2.6° at discharge. Mean numeric pain rating improved from 3.0 ± 1.0 at the evaluation to 0.7 ± 1.1 at discharge. Mean Lower Extremity Functional Scale (LEFS) improved from 56.3 ± 13.6 to 77.0 ± 4.3 at discharge. Arthroscopic debridement of knee joint arthrofibrosis after ACLR in conjunction with a postoperative physical therapy algorithmic approach to maximizing knee joint extension ROM can be beneficial in gaining symmetrical knee extension range of motion and improved function. Further studies may help to understand the optimal mode, frequency, and duration of stretching to achieve full symmetrical knee extension in this population.

  10. Win-stay-lose-learn promotes cooperation in the prisoner's dilemma game with voluntary participation.

    Science.gov (United States)

    Chu, Chen; Liu, Jinzhuo; Shen, Chen; Jin, Jiahua; Shi, Lei

    2017-01-01

    Voluntary participation, demonstrated to be a simple yet effective mechanism to promote persistent cooperative behavior, has been extensively studied. It has also been verified that the aspiration-based win-stay-lose-learn strategy updating rule promotes the evolution of cooperation. Inspired by this well-known fact, we combine the Win-Stay-Lose-Learn updating rule with voluntary participation: Players maintain their strategies when they are satisfied, or players attempt to imitate the strategy of one randomly chosen neighbor. We find that this mechanism maintains persistent cooperative behavior, even further promotes the evolution of cooperation under certain conditions.

  11. Avoiding a fate worse than death: an argument for legalising voluntary physician-based euthanasia.

    Science.gov (United States)

    Werren, Julia; Yuksel, Necef; Smith, Saxon

    2012-09-01

    The legalisation of voluntary physician-based euthanasia is currently the subject of much political, social and ethical debate and there is evidence in Australia of growing support for its implementation. In addressing many of the issues that surround legalisation, the article looks at some overseas jurisdictions that have legalised euthanasia to determine whether the social, political and ethical concerns prominent in the Australian debate have proved problematic in other jurisdictions. In addition, the article examines the report on the Dying with Dignity Bill 2009 (Tas) which commented extensively on the issues relating to voluntary physician-based euthanasia.

  12. In vivo six-degree-of-freedom knee-joint kinematics in overground and treadmill walking following total knee arthroplasty.

    Science.gov (United States)

    Guan, Shanyuanye; Gray, Hans A; Schache, Anthony G; Feller, Julian; de Steiger, Richard; Pandy, Marcus G

    2016-10-22

    No data are available to describe six-degree-of-freedom (6-DOF) knee-joint kinematics for one complete cycle of overground walking following total knee arthroplasty (TKA). The aims of this study were firstly, to measure 6-DOF knee-joint kinematics and condylar motion for overground walking following TKA; and secondly, to determine whether such data differed between overground and treadmill gait when participants walked at the same speed during both tasks. A unique mobile biplane X-ray imaging system enabled accurate measurement of 6-DOF TKA knee kinematics during overground walking by simultaneously tracking and imaging the joint. The largest rotations occurred for flexion-extension and internal-external rotation whereas the largest translations were associated with joint distraction and anterior-posterior drawer. Strong associations were found between flexion-extension and adduction-abduction (R(2)  = 0.92), joint distraction (R(2)  = 1.00), and anterior-posterior translation (R(2)  = 0.77), providing evidence of kinematic coupling in the TKA knee. Although the measured kinematic profiles for overground walking were grossly similar to those for treadmill walking, several statistically significant differences were observed between the two conditions with respect to temporo-spatial parameters, 6-DOF knee-joint kinematics, and condylar contact locations and sliding. Thus, caution is advised when making recommendations regarding knee implant performance based on treadmill-measured knee-joint kinematic data. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  13. The Training Effect of Early Intervention with a Hybrid Assistive Limb after Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Takashi Fukaya

    2017-01-01

    Full Text Available After total knee arthroplasty (TKA, it is important for patients to show early improvements in knee joint function and walking to regain independence in performing the activities of daily life. We conducted for 4 weeks an intervention one week after TKA using a hybrid assistive limb (HAL: unilateral leg type as an exoskeleton robotic device to facilitate knee joint function and walking. The intervention improved the range of knee extension movement safely and without pain compared to preoperation. In addition, we found that training with the HAL improved walking ability, speed, and rate, as well as the time taken to perform the timed up and go (TUG test compared to preoperation. The strength of the quadriceps muscle did not improve with training; however, the patient was able to induce a knee extensor moment during the initial stance phase, as measured by kinetics and kinematics, and these actions could be performed without pain. HAL training soon after TKA improved knee joint function in a 76-year-old patient who presented with OA of the knee. The improvements in knee extension lag and knee extensor moment allowed the patient to walk without pain and regain ADL in comparison with preoperation.

  14. A cadaver knee simulator to evaluate the biomechanics of rectus femoris transfer.

    Science.gov (United States)

    Anderson, Michael C; Brown, Nicholas A T; Bachus, Kent N; Macwilliams, Bruce A

    2009-07-01

    A cadaver knee simulator has been developed to model surgical transfer of the rectus femoris. The simulator allows knee specimens six degrees of freedom and is capable of modeling both the swing and stance phases of human gait. Experiments were conducted using a mechanical hinge analog of the knee to verify that time, flexion angle, and knee extension force measurements recorded when using the simulator were not influenced by its design or operation. A ballistic double pendulum model was used to model the swing phase of gait, and the contributions of hip and ankle torques and hamstrings cocontraction were included when modeling the stance phase of gait. When modeling swing, range of motion and time to peak knee flexion in swing for the hinge knee were similar to those of in vivo test subjects. Measurements of hinge knee extension force when modeling stance under various biomechanical conditions matched those predicted using an analytical model. Future studies using cadaver knee specimens will apply techniques described in this paper to further our understanding of changes in knee biomechanics caused by rectus femoris transfer surgery.

  15. Dynamic loading of the knee and hip joint and compensatory strategies in children and adolescents with varus malalignment.

    Science.gov (United States)

    Stief, Felix; Böhm, Harald; Schwirtz, Ansgar; Dussa, Chakravarthy Ugandhar; Döderlein, Leonhard

    2011-03-01

    Three-dimensional gait analysis is a diagnostic tool that can be used to gain a better understanding of the relationship between joint loading and the onset or progression of articular cartilage degeneration in subjects with varus malalignment. The purpose of the present study was to investigate knee and hip joint angles and moments in children and adolescents with pathological varus alignment of the knee without signs of knee osteoarthritis (OA). Moreover, we wanted to know if compensatory mechanisms are present in this young patient group. Fourteen, otherwise healthy patients with varus malalignment of the knee and 15 healthy control subjects were analysed. Patients showed a reduced knee extension and a significantly lower maximum knee extension moment in terminal stance compared to controls. The maximum knee adduction moment in mid and terminal stance and the maximum hip abduction moment in loading response were significantly higher in the patient group. In the transverse plane, abnormally increased knee internal rotation and hip external rotation moments were present in patients with varus malalignment. These findings imply that varus malalignment is not an isolated problem in the frontal plane. In contrast to adult patients with established medial knee OA, the young patients assessed in the present study did not show typical compensatory mechanisms such as increased foot progression angle or reduced walking speed. This suggests that children and adolescents with varus malalignment of the knee probably do not need to alter their spatio-temporal gait parameters in order to decrease knee joint loading.

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

    Science.gov (United States)

    Nozaki, Daichi; Nakazawa, Kimitaka; Akai, Masami

    2005-09-01

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

  17. Less indication of muscle damage in the second than initial electrical muscle stimulation bout consisting of isometric contractions of the knee extensors.

    Science.gov (United States)

    Aldayel, Abdulaziz; Jubeau, Marc; McGuigan, Michael R; Nosaka, Kazunori

    2010-03-01

    This study compared the first and second exercise bouts consisting of electrically evoked isometric contractions for muscle damage profile. Nine healthy men (31 +/- 4 years) had two electrical muscle stimulation (EMS) bouts separated by 2 weeks. The knee extensors of one leg were stimulated by biphasic rectangular pulses (75 Hz, 400 mus, on-off ratio 5-15 s) at the knee joint angle of 100 degrees (0 degrees , full extension) to induce 40 isometric contractions, while the current amplitude was increased to maintain maximal force generation. Maximal voluntary isometric contraction (MVC) torque of the knee extensors at 100 degrees , muscle soreness, pressure pain threshold and plasma creatine kinase (CK) activity were used as indirect markers of muscle damage, and measured before and 1, 24, 48, 72 and 96 h after EMS bout, and the changes over time were compared between bouts. The torque produced during exercise was approximately 30% of MVC, and no significant difference between bouts was evident for the changes in peak and average torque over 40 contractions. MVC decreased significantly (P < 0.05) by 26% immediately and 1 h after both bouts, but the recovery was significantly (P < 0.05) faster after the second bout (100% at 96 h) compared with the first bout (81% at 96 h). Development of muscle soreness and tenderness, and increases in plasma CK activity were significantly (P < 0.05) smaller after the second than the first bout. These results show that changes in muscle damage markers were attenuated in the second EMS bout compared with the initial EMS bout.

  18. [Management of Flexion Contracture in Primary Total Knee Arthroplasty].

    Science.gov (United States)

    Hube, R; Mayr, H O; Pfitzner, T; von Roth, P

    2015-06-01

    Flexion contracture is a common deformity of the arthritic knee. The present publication describes causes, clinical relevance and surgical technique in the presence of flexion contractures in total knee arthroplasty. Flexion contracture can be attributed to different causes. Basically it is a mismatch between flexion and extension gaps. Moderate and severe deformities have to be corrected by additional surgical interventions. In most cases soft tissue techniques with release of contracted structures, the removal of osteophytes and additional distal femoral bone resection are necessary. The goal of these interventions is to achieve full extension of the knee. During rehabilitation attention has to be paid to maintain it with intensive physical therapy. A remaining flexion contracture is associated with inferior functional outcome and persistent pain. Georg Thieme Verlag KG Stuttgart · New York.

  19. Knee joint kinematics during walking influences the spatial cartilage thickness distribution in the knee.

    Science.gov (United States)

    Koo, Seungbum; Rylander, Jonathan H; Andriacchi, Thomas P

    2011-04-29

    The regional adaptation of knee cartilage morphology to the kinematics of walking has been suggested as an important factor in the evaluation of the consequences of alteration in normal gait leading to osteoarthritis. The purpose of this study was to investigate the association of spatial cartilage thickness distributions of the femur and tibia in the knee to the knee kinematics during walking. Gait data and knee MR images were obtained from 17 healthy volunteers (age 33.2 ± 9.8 years). Cartilage thickness maps were created for the femoral and tibial cartilage. Locations of thickest cartilage in the medial and lateral compartments in the femur and tibia were identified using a numerical method. The flexion-extension (FE) angle associated with the cartilage contact regions on the femur, and the anterior-posterior (AP) translation and internal-external (IE) rotation associated with the cartilage contact regions on the tibia at the heel strike of walking were tested for correlation with the locations of thickest cartilage. The locations of the thickest cartilage had relatively large variation (SD, 8.9°) and was significantly associated with the FE angle at heel strike only in the medial femoral condyle (R(2)=0.41, pknee kinematics and contact surface shapes seem to affect the functional adaptation of knee articular cartilage morphology. The sensitivity of cartilage morphology to kinematics at the knee during walking suggests that regional cartilage thickness variations are influenced by both loading and the number of loading cycles. Thus walking is an important consideration in the analysis of the morphological variations of articular cartilage, since it is the dominant cyclic activity of daily living. The sensitivity of cartilage morphology to gait kinematics is also important in understanding the etiology and pathomechanics of osteoarthritis.

  20. Effects of 24-week Tai Chi exercise on the knee and ankle proprioception of older women.

    Science.gov (United States)

    Chang, Shuwan; Zhou, Jihe; Hong, Youlian; Sun, Wei; Cong, Yan; Qin, Meiqin; Lian, Jianhua; Yao, Jian; Li, Weiping

    2016-01-01

    This study examined the effects of regular Tai Chi (TC) exercise on the kinaesthesia of the knee and ankle joints of older women. A total of 43 women aged 55-68 years participated in this study. In a 24-week study period, the TC group (n = 22) underwent an organized TC exercise, whereas the control group (n = 21) maintained a sedentary lifestyle. Customized instruments were used to measure the threshold for the detection of the passive motion of the knee and ankle joints. After 24 weeks, the TC group showed a significantly smaller threshold for the detection of passive motion of knee extension (31.4%, p = 0.009), knee flexion (27.0%, p = 0.044), and ankle dorsal flexion (28.9%, p = 0.014) than the control group. Other comparisons showed no significant differences. The 24-week TC exercise benefited the lower-limb kinaesthesia of the knee joint flexion and extension and ankle dorsal flexion.

  1. Interlimb reflexes following ipsilateral knee joint rotations are suppressed in an unstable walking environment

    DEFF Research Database (Denmark)

    Stevenson, Andrew James Thomas; Geertsen, Svend Sparre; Sinkjær, Thomas

    2015-01-01

    Knee) extension rotations during walking contribute to slowing the forward progression of the body in order to maintain dynamic stability following the perturbation (Stevenson et al., 2015). However, little is known about how such interlimb reflexes are modulated in an unstable walking environment. Based....... To test this, interlimb reflexes were elicited in participants (n = 6) by either iKnee extension rotations during the late stance phase (50%) of the gait cycle or iKnee flexion rotations during the mid-swing phase (80%). The iKnee perturbations were applied while the participants walked normally......) in the unstable walking condition following both types of iKnee perturbations, while the cSOL reflexes remained unchanged. Consistent with previous studies, these preliminary results suggest that challenging dynamic stability during walking leads to specific changes in reflex amplitudes that are not related...

  2. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, J B; Juhl, C B; Roos, E M;

    2015-01-01

    OBJECTIVE: To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Pain and physical function....... RESULTS: The search identified nine trials assessing the benefits of knee arthroscopic surgery in middle aged and older patients with knee pain and degenerative knee disease. The main analysis, combining the primary endpoints of the individual trials from three to 24 months postoperatively, showed a small...... included symptomatic deep venous thrombosis (4.13 (95% confidence interval 1.78 to 9.60) events per 1000 procedures), pulmonary embolism, infection, and death. CONCLUSIONS: The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time...

  3. Bilateral knee replacements for treatment of acute septic arthritis in both knees.

    Science.gov (United States)

    Ashraf, Muhammad Omer; Asumu, Theophilus

    2013-11-01

    A case report of bilateral acute septic arthritis of knees is presented, which was managed with staged total knee replacements for both knees. A literature review on septic arthritis treated with knee arthroplasty is also presented.

  4. Anterior knee pain

    Science.gov (United States)

    ... Armstrong B. Rehabilitation of the knee following sports injury. Clin Sports Med. 2010;29:81-106. PMID: 19945588 www. ... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ... and Disorders Browse the Encyclopedia A.D.A. ...

  5. Unicompartmental knee arthroplasty

    NARCIS (Netherlands)

    Kort, Nanne Pieter

    2007-01-01

    This thesis concerns technical aspects of unicompartmental knee arthroplasty. Recent years have witnessed a resurgence of interest in unicompartmental arthroplasty, particularly with the introduction of the minimally invasive technique. In the light of the excellent long-term results of the total kn

  6. Knee injuries in football

    African Journals Online (AJOL)

    estimated 240 million (in 2000)1 to 265 million (in 2006)2 players ... injuries during a season, but due to variations in the definition of ... a risk for a major knee injury, with 20% of illegal activity-related ... Rob Collins is a lecturer in the Section Sports Medicine at the University of .... full return to football is between 6 and 9.

  7. Influence of Total Knee Arthroplasty on Gait Mechanics of the Replaced and Non-Replaced Limb During Stair Negotiation.

    Science.gov (United States)

    Standifird, Tyler W; Saxton, Arnold M; Coe, Dawn P; Cates, Harold E; Reinbolt, Jeffrey A; Zhang, Songning

    2016-01-01

    This study compared biomechanics during stair ascent in replaced and non-replaced limbs of total knee arthroplasty (TKA) patients with control limbs of healthy participants. Thirteen TKA patients and fifteen controls performed stair ascent. Replaced and non-replaced knees of TKA patients were less flexed at contact compared to controls. The loading response peak knee extension moment was greater in control and non-replaced knees compared with replaced. The push-off peak knee abduction moment was elevated in replaced limbs compared to controls. Loading and push-off peak hip abduction moments were greater in replaced limbs compared to controls. The push-off peak hip abduction moment was greater in non-replaced limbs compared to controls. Future rehabilitation protocols should consider the replaced knee and also the non-replaced knee and surrounding joints.

  8. Efeito do intervalo de recuperação entre séries de extensões isocinéticas de joelho em homens jovens destreinados Effect of recovery interval between sets of isokinetic knee extensions among untrained young men

    Directory of Open Access Journals (Sweden)

    R Celes

    2009-08-01

    Full Text Available OBJETIVO: Avaliar o efeito de dois diferentes Intervalos de Recuperação (IR entre séries de extensões isocinéticas de joelho no Pico de Torque (PT e no Trabalho Total (TT em jovens destreinados. MÉTODOS: Dezoito homens (24,22±2,58 anos; 80,42±11,41 kg realizaram três séries de 10 extensões isocinéticas com o joelho direito a 60° e 180°/s. O IR entre as séries foram de 1 e 2 minutos, contrabalanceados entre os dois dias de teste, separados por, no mínimo, 48 horas. A taxa de trabalho-recuperação foi de 1:3 e 1:6 para 60°/s e 1:6 e 1:12 para 180°/s. Os voluntários não participavam de programas de treinamento resistido há pelo menos 6 meses. A análise estatística foi a ANOVA de medidas repetidas 2 x 3 [IR (1 e 2 minutos x série (1ª, 2ª e 3ª]. O nível de significância foi aOBJECTIVE: To assess the effect of two recovery intervals (RIs between sets of isokinetic knee extension exercises on peak torque (PT and total work (TW, among untrained young men. METHODS: Eighteen men (24.22±2.58 years; 80.42±11.41 kg performed three sets of ten isokinetic extensions of the right knee, at 60° and 180°/s. The RIs between the sets were one and two minutes long, spread over two test days separated by a minimum of 48 hours. The work-to-recovery ratio was 1:3 and 1:6 for 60°/s, and 1:6 and 1:12 for 180°/s. The subjects had not participated in any resistance training programs within the last six months. The statistical analysis consisted of 2 x 3 repeated-measures ANOVA [RI (one or two minutes x set (1st, 2nd or 3rd]. The significance level was a<0.05. RESULTS: Neither one minute nor two minutes RIs maintained the PT and TW throughout the three sets (p<0.05. However, at 60°/s, two minutes RIs enabled better PT and TW in the second and third sets than one minute RIs (p<0.05. At 180°/s, two minutes RIs were only better (p<0.05 than one minute RIs for TW in the third set. CONCLUSION: This study indicated that, during an isokinetic

  9. Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability

    Science.gov (United States)

    Gustafson, Jonathan A.; Gorman, Shannon; Fitzgerald, G. Kelley; Farrokhi, Shawn

    2017-01-01

    Increased walking knee joint stiffness has been reported in patients with knee osteoarthritis (OA) as a compensatory strategy to improve knee joint stability. However, presence of episodic self-reported knee instability in a large subgroup of patients with knee OA may be a sign of inadequate walking knee joint stiffness. The objective of this work was to evaluate the differences in walking knee joint stiffness in patients with knee OA with and without self-reported instability and examine the relationship between walking knee joint stiffness with quadriceps strength, knee joint laxity, and varus knee malalignment. Overground biomechanical data at a self-selected gait velocity was collected for 35 individuals with knee OA without self-reported instability (stable group) and 17 individuals with knee OA and episodic self-reported instability (unstable group). Knee joint stiffness was calculated during the weight-acceptance phase of gait as the change in the external knee joint moment divided by the change in the knee flexion angle. The unstable group walked with lower knee joint stiffness (p=0.01), mainly due to smaller heel-contact knee flexion angles (pknee flexion excursions (pknee stable counterparts. No significant relationships were observed between walking knee joint stiffness and quadriceps strength, knee joint laxity or varus knee malalignment. Reduced walking knee joint stiffness appears to be associated with episodic knee instability and independent of quadriceps muscle weakness, knee joint laxity or varus malalignment. Further investigations of the temporal relationship between self-reported knee joint instability and walking knee joint stiffness are warranted. PMID:26481256

  10. Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability.

    Science.gov (United States)

    Gustafson, Jonathan A; Gorman, Shannon; Fitzgerald, G Kelley; Farrokhi, Shawn

    2016-01-01

    Increased walking knee joint stiffness has been reported in patients with knee osteoarthritis (OA) as a compensatory strategy to improve knee joint stability. However, presence of episodic self-reported knee instability in a large subgroup of patients with knee OA may be a sign of inadequate walking knee joint stiffness. The objective of this work was to evaluate the differences in walking knee joint stiffness in patients with knee OA with and without self-reported instability and examine the relationship between walking knee joint stiffness with quadriceps strength, knee joint laxity, and varus knee malalignment. Overground biomechanical data at a self-selected gait velocity was collected for 35 individuals with knee OA without self-reported instability (stable group) and 17 individuals with knee OA and episodic self-reported instability (unstable group). Knee joint stiffness was calculated during the weight-acceptance phase of gait as the change in the external knee joint moment divided by the change in the knee flexion angle. The unstable group walked with lower knee joint stiffness (p=0.01), mainly due to smaller heel-contact knee flexion angles (pknee flexion excursions (pknee stable counterparts. No significant relationships were observed between walking knee joint stiffness and quadriceps strength, knee joint laxity or varus knee malalignment. Reduced walking knee joint stiffness appears to be associated with episodic knee instability and independent of quadriceps muscle weakness, knee joint laxity or varus malalignment. Further investigations of the temporal relationship between self-reported knee joint instability and walking knee joint stiffness are warranted.

  11. Vastus medialis motor unit properties in knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Chess David G

    2011-09-01

    Full Text Available Abstract Background Maximal isometric quadriceps strength deficits have been widely reported in studies of knee osteoarthritis (OA, however little is known about the effect of osteoarthritis knee pain on submaximal quadriceps neuromuscular function. The purpose of this study was to measure vastus medialis motor unit (MU properties in participants with knee OA, during submaximal isometric contractions. Methods Vastus medialis motor unit potential (MUP parameters were assessed in 8 patients with knee OA and 8 healthy, sex and age-matched controls during submaximal isometric contractions (20% of maximum isometric torque. Unpaired t-tests were used to compare groups for demographic and muscle parameters. Results Maximum knee extension torque was ~22% lower in the OA group, a difference that was not statistically significantly (p = 0.11. During submaximal contractions, size related parameters of the needle MUPs (e.g. negative peak duration and amplitude-to-area ratio were greater in the OA group (p Conclusions Changes in MU recruitment and rate coding strategies in OA may reflect a chronic reinnervation process or a compensatory strategy in the presence of chronic knee pain associated with OA.

  12. Component rotation and anterior knee pain after total knee arthroplasty.

    Science.gov (United States)

    Barrack, R L; Schrader, T; Bertot, A J; Wolfe, M W; Myers, L

    2001-11-01

    All patients undergoing cruciate-retaining primary total knee arthroplasty for degenerative osteoarthritis at one center were studied prospectively. Clinical and radiographic followup was obtained at a minimum 5 years in 102 knees in 73 patients. Patients were asked specifically about the presence of the pain in the anterior aspect of the knee in the vicinity of the patella and rated the severity of the pain on a visual analog scale. Significant anterior knee pain rating at least 3 of 10 on the visual analog scale was present in 16 knees (13 patients). Eleven patients with 14 symptomatic knees agreed to undergo computed tomography scanning to accurately determine the rotation of the tibial and femoral components. The epicondylar axis and tibial tubercle were used as references using a previously validated technique. A control group of 11 asymptomatic patients (14 knees), matched for age, gender, and length of followup also underwent computed tomography scanning. All patients in both groups had normal axial alignment. There was a highly significant difference in tibial component rotation between the two groups with the patients with anterior knee pain averaging 6.2 degrees internal rotation compared with 0.4 degrees external rotation in the control group. There also was a significant difference in combined component rotation with the patients with anterior knee pain averaging 4.7 degrees internal rotation compared with 2.6 degrees external rotation in the control group. There was no significant difference in the degree of radiographic patellar tilt or patellar subluxation between the two groups. Patients with combined component internal rotation were more than five times as likely to experience anterior knee pain after total knee arthroplasty compared with those with combined component external rotation. Component malrotation is a significant factor in the development of anterior knee pain after total knee arthroplasty.

  13. From Voluntary Collective Action to Organized Collaboration?

    DEFF Research Database (Denmark)

    Hattke, Fabian; Blaschke, Steffen; Frost, Jetta

    2016-01-01

    internationalization. Based on our results, we suggest that, depending on the field of action, voluntary collective action and organized collaboration are substitutes with regard to performance. Our study contributes to the literature on collective action and to research on public organizations in pluralistic......Our study examines the relationship between voluntary collective action, organized collaboration, and the provision of public goods in pluralistic organizations. Using German higher education as a context, we investigate whether specialized central support structures contribute to performance...... in three fields of action: the training of young scientists, internationalization, and gender diversity. The findings indicate that organized collaboration may lead to improved performance in the training of young scientists and gender diversity. Conversely, voluntary collective action enhances...

  14. Voluntary reporting of greenhouse gases, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    The Voluntary Reporting Program for greenhouse gases is part of an attempt by the U.S. Government to develop innovative, low-cost, and nonregulatory approaches to limit emissions of greenhouse gases. It is one element in an array of such programs introduced in recent years as part of the effort being made by the United States to comply with its national commitment to stabilize emissions of greenhouse gases under the Framework Convention on Climate Change. The Voluntary Reporting Program, developed pursuant to Section 1605(b) of the Energy Policy Act of 1992, permits corporations, government agencies, households, and voluntary organizations to report to the Energy Information Administration (EIA) on actions taken that have reduced or avoided emissions of greenhouse gases.

  15. The effect of knee-flexion angle on wheelchair turning.

    Science.gov (United States)

    MacPhee, A H; Kirby, R L; Bell, A C; MacLeod, D A

    2001-05-01

    The increasingly popular hyperflexed knee-flexion angle was evaluated to determine its effects on wheelchair turning. Twenty able-bodied subjects were tested comparing the effect of full knee extension and full knee flexion on a number of parameters. We empirically measured the angular velocity of subjects spinning 720 degrees in place, subjects' perceived ease of wheelchair turning, the overall length of the wheelchair, the anteroposterior position of the center of mass (COM), rolling resistance, turning resistance and rear-wheel traction. The combined moment of inertia of the wheelchair and system was modeled. We found that, in comparison with full extension, fully flexing the knees increased angular velocity by 40% and was perceived to be 66% easier by subjects. Overall length decreased by 39%, COM moved rearward 38%, rolling and turning resistance decreased by 21% and 17% respectively, rear-wheel traction increased by 12% and moment of inertia decreased by 42%. All empirically tested parameters were statistically significant (pwheelchair turning. The implications of these findings for wheelchair design and prescription will need to be validated on actual wheelchair users and for smaller increments in knee-flexion range.

  16. Biomechanics of medial unicondylar in combination with patellofemoral knee arthroplasty.

    Science.gov (United States)

    Heyse, Thomas J; El-Zayat, Bilal F; De Corte, Ronny; Scheys, Lennart; Chevalier, Yan; Fuchs-Winkelmann, Susanne; Labey, Luc

    2014-01-01

    Modular bicompartmental knee arthroplasty (BKA) for treatment of medio-patellofemoral osteoarthritis (OA) should allow for close to normal kinematics in comparison with unicondylar knee arthroplasty (UKA) and the native knee. There is so far no data to support this. Six fresh frozen full leg cadaver specimens were prepared and mounted in a kinematic rig with six degrees of freedom for the knee joint. Three motion patterns were applied with the native knee and after sequential implantation of medial UKA and patellofemoral joint replacement (PFJ): passive flexion-extension, open chain extension, and squatting. During the loaded motions, quadriceps and hamstrings muscle forces were applied. Infrared cameras continuously recorded the trajectories of marker frames rigidly attached to femur, tibia and patella. Prior computer tomography allowed identification of coordinate frames of the bones. Strains in the collateral ligaments were calculated from insertion site distances. UKA led to a less adducted and internally rotated tibia and a more strained medial collateral ligament (MCL). Addition of a patellofemoral replacement led to a more posterior position of both femoral condyles, a more dorsally located tibiofemoral contact point and higher MCL strain with squatting. In comparison to UKA modular BKA leads to a more dorsal tibial contact point, a medial femoral condyle being located more posteriorly, and more MCL strain. Mainly the changes to the trochlear anatomy as introduced by PFJ may account for these differences. © 2014 Elsevier B.V. All rights reserved.

  17. Importance of the different posterolateral knee static stabilizers: biomechanical study

    Directory of Open Access Journals (Sweden)

    Rodrigo Campos Pace Lasmar

    2010-01-01

    Full Text Available PURPOSE: The purpose of this study was to evaluate the relative importance of the different static stabilizers of the posterolateral corner of the knee in cadavers. METHODS: Tests were performed with the application of a varus and external rotation force to the knee in extension at 30 and 60 degrees of flexion using 10 cadaver knees. The forces were applied initially to an intact knee and then repeated after a selective sectioning of the ligaments into the following: section of the lateral collateral ligament; section of the lateral collateral ligament and the popliteofibular complex; and section of the lateral collateral ligament, the popliteofibular complex and the posterolateral capsule. The parameters studied were the angular deformity and stiffness when the knees were submitted to a 15 Newton-meter varus torque and a 6 Newton-meter external tibial torque. Statistical analysis was performed using the ANOVA (Analysis of Variance and Tukey's tests. RESULTS AND CONCLUSION: Our findings showed that the lateral collateral ligament was important in varus stability at 0, 30 and 60 degrees. The popliteofibular complex was the most important structure for external rotation stability at all angles of flexion and was also important for varus stability at 30 and 60 degrees. The posterolateral capsule was important for varus stability at 0 and 30 degrees and for external rotation stability in extension. Level of evidence: Level IV (cadaver study.

  18. Hemochromatosis Patients as Voluntary Blood Donors

    Directory of Open Access Journals (Sweden)

    Tara E Power

    2004-01-01

    Full Text Available The present study was designed to investigate hemochromatosis patients' suitability as blood donors as well as their perceptions and experience with the current public donation system. Participants were gathered from a list of current hemochromatosis patients (n=120 and members of the Canadian Hemochromatosis Society (n=1000. Of the 1120 surveys mailed out to these groups, 801 surveys were returned completed. The sample respondents had a mean age of 57.44 years (SD=12.73; range 19 to 87 years, and 57% were men. It was found that 20% (160 of the respondents have donated blood since their diagnosis; however, only 12% of the respondents indicated that they use voluntary blood donation as a means of maintaining their iron levels. Forty per cent of the respondents indicated that they had been refused from voluntary donation. Despite the fact that in May 2001 the Canadian Blood Services, in collaboration with the Canadian Hemochromatosis Society, began a promotion campaign to encourage hemochromatosis patients to become voluntary blood donors, the present study found that 15% of the respondents reported having been refused from the voluntary blood donation service due to the diagnosis of hemochromatosis. With respect to quality of life, it was found that individuals who donate blood were generally healthier with respect to physical functioning and bodily pain, however, these findings may indicate that hemochromatosis patients who are healthier are better able to donate at public blood banks, rather than that voluntary blood donation has an effect on the donors' physical functioning over phlebotomy clinic users. These study findings suggest that although there may be other medical factors limiting individuals from donating, hemochromatosis patients are interested in being voluntary blood donors and this potential resource is currently under-used.

  19. 21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint tibial (hemi-knee) metallic resurfacing... Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis is a device intended to be...

  20. 21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellar (hemi-knee) metallic... § 888.3580 Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis is a device made...

  1. Quantitative analysis of the reversibility of knee flexion contractures with time: an experimental study using the rat model

    OpenAIRE

    Trudel, Guy; Uhthoff, Hans K.; Goudreau, Louis; Laneuville, Odette

    2014-01-01

    Background Knee flexion contractures prevent the full extension of the knee joint and cause disability. The etiology is not well defined. Extended periods of immobilization of joints lead to contractures difficult to completely reverse by rehabilitation treatments. Recovery of the complete range of motion without intervention has not been studied but is of importance to optimize clinical management. This study was designed to quantify the spontaneous reversibility of knee flexion contractures...

  2. CURBSIDE CONSULTATION IN KNEE ARTHROPLASTY: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Craig J. Della Vale

    2008-12-01

    Full Text Available A user- friendly reference for decision making in complicated cases of knee arthroplasty desingned in a question and answers format composed of articles containing current concepts and preferences of experts in total knee replacement surgery, enhanced by several images, diagrams and references and written in the form of a casual advice by Craig J. Della Vale, MD. and his collaborators. PURPOSE By this practical reference of knee arthroplasty, the editor and the contributors have aimed providing straightforward and brief answers, evidence-based advices, their preference and opinions containing current concepts for unanswered questions about complicated cases in total knee replacement surgery which are often controversial and not addressed clearly in traditional knee arthroplasty references. FEATURES There are 49 subjects each written by a different expert designed in 4 sections in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected including indications, unicompartmental osteoarthritis of the knee, patient with vascular problems, donating blood, bilateral arthroplasty, patellar resurfacing, range of motion, bearing surface, contraindications, teaching class for patients prior surgery. The second section is about intraoperative questions including skin incision, patella femoral maltracking, femoral component rotation, tibial component rotation, lateral release, femoral component sizing, flexion instability, varus deformity, and valgus deformity, tightness in extension, iatrogenic MCL injury, antibiotic-loaded cement, and perioperative pain. The third section subjects postoperative questions including wound drainage, preventing tromboembolic events, vascular complications, foot drop, manipulation under anesthesia, patella fractures, supracondylar femur fractures, acute extensor mechanism disruptions. In the fourth

  3. The institutional dynamics of voluntary organisations

    DEFF Research Database (Denmark)

    Aagaard, Peter

    this theoretical frame to analyse case studies of three voluntary organisations.  As a part of the analysis I describe four sets of institutional settings that can influence voluntary organisations ability to create institutional dynamic: institutionalization, moderation, self-organisation and loose-coupling....... organisations. I establish a theoretical frame of institutional dynamic, build primarily on J.G. March's theory on exploration and exploitation. I focus on two organisational arrangements drawn from the theory: The degree of strategic decision-making and the degree of diversity among the volunteers. I use...

  4. Does knee awareness differ between different knee arthroplasty prostheses?

    DEFF Research Database (Denmark)

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

    2016-01-01

    BACKGROUND: Low knee awareness after Total Knee Arthroplasty (TKA) has become the ultimate goal in trying to achieve a natural feeling knee that meet patient expectations. To accommodate this manufacturers of TKAs have developed new prosthetic designs that potentially could give patients a more...... natural feeling knee during activities. The purpose af this study was to compare the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) of patients treated with a previous generation standard Cruciate Retaining (CR) TKA to the scores obtained by patients treated with a newer generation CR TKA...... and pre- and postoperative knee alignment. Patients were asked to complete the FJS and OKS questionnaires. Of the 316 patients completing the survey 64 standard CR TKAs to 35 new generation CR TKAs and 121 standard CR TKAs to 68 mobile bearing TKAs were matched. The FJS and OKS scores of the three TKA...

  5. Cosmetic effect of knee joint in a knee disarticulation prosthesis

    OpenAIRE

    2015-01-01

    Despite numerous advantages, knee disarticulations (KDs) are rarely performed because of the anticipated KD prosthesis fitting problems that include the positioning of the knee joint distally from the KD socket. This results in lengthening of the thigh and subsequent shortening of the shank. The objective of this study was to assess the cosmetic effect of the knee joint in a KD prosthesis by determining the extent of the lengthening of the thigh and the shortening of the shank. This lengtheni...

  6. Impairment of voluntary control of finger motion following stroke: role of inappropriate muscle coactivation.

    Science.gov (United States)

    Kamper, D G; Rymer, W Z

    2001-05-01

    Subjects with chronic hemiplegia following stroke attempted to perform voluntary isometric, isokinetic, and free contractions of the extensor muscles of the metacarpophalangeal (MCP) joints. We recorded torque, metacarpophalangeal joint angle and velocity, and electromyographic (EMG) activity of the extrinsic extensors and flexors and the first dorsal interosseous (FDI). We found that voluntary MCP joint extension in hemiparetic subjects was greatly impaired in comparison with control subjects: only two of the 11 stroke subjects were able to generate even 0.21 N-m of isometric extension torque, only two could produce positive finger extension with no load, and none could develop an isokinetic concentric extension. Deficits seemed to result from a combination of coactivation of the finger flexor and extensor muscles and decreased voluntary excitation of the extensors, as normalized flexor and FDI EMG activity were greater for stroke than for control subjects (P < 0.001), but normalized extensor activity was reduced (P < 0.001). Copyright 2001 John Wiley & Sons, Inc.

  7. Longitudinal changes in knee joint biomechanics during level walking following anterior cruciate ligament reconstruction surgery.

    Science.gov (United States)

    Webster, Kate E; Feller, Julian A; Wittwer, Joanne E

    2012-06-01

    Following anterior cruciate ligament reconstruction (ACL) patients have altered movement patterns in the reconstructed knee during walking. There is limited information about these alterations over an extended period of time. This study was designed to present a longitudinal analysis of gait patterns following ACL reconstruction surgery. Assessments of level walking were undertaken in 16 participants at a mean 10 months (initial assessment) and again at 3 years (follow-up assessment) after ACL reconstruction surgery. Kinematic and kinetic variables were analysed using a two factor (time, limb) repeated measures ANOVA. Kinematic data showed that patients were able to achieve greater extension about the reconstructed knee at follow-up than at initial assessment. The reconstructed knee was significantly less internally rotated than the contralateral knee at the initial assessment but not at follow-up. Kinetic data showed a significant increase in the external knee extension moment for the reconstructed limb over time. There were also significant increases in the external knee adduction moment for both limbs at the follow-up assessment. The external knee adduction moment was however smaller in the reconstructed knee than the contralateral knee at both assessments. The results indicate that gait variables do change over time and that measurement at a single time point may not reflect the long term outcome of ACL reconstruction surgery. The changes were however small and may not be clinically relevant. However, the consistently reduced external knee adduction moment seen about the reconstructed knee in this study may suggest that factors other than joint moments influence degenerative change over time. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Do Psychosocial Factors Predict Muscle Strength, Pain, or Physical Performance in Patients With Knee Osteoarthritis?

    Science.gov (United States)

    Baert, Isabel A C; Meeus, Mira; Mahmoudian, Armaghan; Luyten, Frank P; Nijs, Jo; Verschueren, Sabine M P

    2017-09-01

    The aim of this study was to examine the relationship of psychosocial factors, namely, pain catastrophizing, kinesiophobia, and maladaptive coping strategies, with muscle strength, pain, and physical performance in patients with knee osteoarthritis (OA)-related symptoms. A total of 109 women (64 with knee OA-related symptoms) with a mean age of 65.4 years (49-81 years) were recruited for this study. Psychosocial factors were quantified by the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Pain Coping Inventory. Clinical features were assessed using isometric and isokinetic knee muscle strength measurements, visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, and functional tests. Associations were examined using correlation and regression analysis. In knee OA patients, pain catastrophizing, kinesiophobia, and coping strategy explained a significant proportion of the variability in isometric knee extension and flexion strength (6.3%-9.2%), accounting for more overall variability than some demographic and medical status variables combined. Psychosocial factors were not significant independent predictors of isokinetic strength, knee pain, or physical performance. In understanding clinical features related to knee OA, such as muscle weakness, pain catastrophizing, kinesiophobia, and coping strategy might offer something additional beyond what might be explained by traditional factors, underscoring the importance of a biopsychosocial approach in knee OA management. Further research on individual patient characteristics that mediate the effects of psychosocial factors is, however, required in order to create opportunities for more targeted, personalized treatment for knee OA.

  9. Contribution of mechanical unloading to trabecular bone loss following non-invasive knee injury in mice.

    Science.gov (United States)

    Anderson, Matthew J; Diko, Sindi; Baehr, Leslie M; Baar, Keith; Bodine, Sue C; Christiansen, Blaine A

    2016-10-01

    Development of osteoarthritis commonly involves degeneration of epiphyseal trabecular bone. In previous studies, we observed 30-44% loss of epiphyseal trabecular bone (BV/TV) from the distal femur within 1 week following non-invasive knee injury in mice. Mechanical unloading (disuse) may contribute to this bone loss; however, it is unclear to what extent the injured limb is unloaded following injury, and whether disuse can fully account for the observed magnitude of bone loss. In this study, we investigated the contribution of mechanical unloading to trabecular bone changes observed following non-invasive knee injury in mice (female C57BL/6N). We investigated changes in gait during treadmill walking, and changes in voluntary activity level using Open Field analysis at 4, 14, 28, and 42 days post-injury. We also quantified epiphyseal trabecular bone using μCT and weighed lower-limb muscles to quantify atrophy following knee injury in both ground control and hindlimb unloaded (HLU) mice. Gait analysis revealed a slightly altered stride pattern in the injured limb, with a decreased stance phase and increased swing phase. However, Open Field analysis revealed no differences in voluntary movement between injured and sham mice at any time point. Both knee injury and HLU resulted in comparable magnitudes of trabecular bone loss; however, HLU resulted in considerably more muscle loss than knee injury, suggesting another mechanism contributing to bone loss following injury. Altogether, these data suggest that mechanical unloading likely contributes to trabecular bone loss following non-invasive knee injury, but the magnitude of this bone loss cannot be fully explained by disuse. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1680-1687, 2016.

  10. Adaptations in muscular activation of the knee extensor muscles with strength training in young and older adults.

    Science.gov (United States)

    Knight, C A; Kamen, G

    2001-12-01

    The purpose of this study was to compare the extent of muscular activation during maximal voluntary knee extension contractions in old and young individuals and to examine the effects of resistance training on muscular activation in each group. The interpolated twitch technique was used to estimate muscular activation during two pre-training baseline tests, and after two and six weeks of resistance training. Throughout the study, the older group was 30% less strong than the young group (p=0.02). The training protocol was effective in both groups with overall isometric strength gains of 30 and 36% in the older (p=0.01) and young (pmuscular activation between groups (p=0.3) did not explain the large disparity in strength. Muscular activation increased by 2% in both groups throughout training (pmuscular strength in the older group, muscular activation was greater than 95% of maximum and appears to be equal in both young and older individuals. Both groups demonstrated similar but small increases in muscular activation throughout training.

  11. Knee Replacement: What you can Expect

    Science.gov (United States)

    ... improves function lessen with each additional surgery. Artificial knees can wear out Another risk of knee replacement ... replacement surgery to last about two hours. After knee replacement surgery After surgery, you're wheeled to ...

  12. Evidence of residual force enhancement for multi-joint leg extension.

    Science.gov (United States)

    Hahn, Daniel; Seiberl, Wolfgang; Schmidt, Susanne; Schweizer, Katrin; Schwirtz, Ansgar

    2010-05-28

    Force enhancement is a well accepted property of skeletal muscle and has been observed at all structural levels ranging from single myofibrils to voluntarily activated m. quadriceps femoris in vivo. However, force enhancement has not been studied for multi-joint movements like human leg extension; therefore knowledge about its relevance in daily living remains limited. The purpose of this study was to determine whether there is force enhancement during maximal voluntary multi-joint leg extension. Human leg extension was studied (n=22) on a motor driven leg press dynamometer where external reaction forces under the feet as well as activity of 8 lower extremity muscles were measured. In addition, torque in the ankle and knee joints was calculated using inverse dynamics. The steady-state isometric force, joint torques, and muscle activation after active stretch (20 degrees stretch amplitude at 60 degrees/s) were compared with the corresponding values obtained during isometric reference contractions. There was consistent force enhancement during and following stretch for both forces and joint torques. Potentiation during stretch reached values between 26% and 30%, while a significant force enhancement of 10.5-12.3% and 4.3-7.4% remained 0.5-1 and 2.5-3s after stretch, respectively. During stretch, EMG signals of m. gastrocnemius medialis and lateralis were significantly increased, while following stretch all analyzed muscles showed the same activity as during the reference contractions. We conclude from these results that force enhancement exists in everyday movements and should be accounted for when analyzing or modelling human movement.

  13. Estimating the Mechanical Behavior of the Knee Joint During Crouch Gait: Implications for Real-Time Motor Control of Robotic Knee Orthoses.

    Science.gov (United States)

    Lerner, Zachary F; Damiano, Diane L; Bulea, Thomas C

    2016-06-01

    Individuals with cerebral palsy frequently exhibit crouch gait, a pathological walking pattern characterized by excessive knee flexion. Knowledge of the knee joint moment during crouch gait is necessary for the design and control of assistive devices used for treatment. Our goal was to 1) develop statistical models to estimate knee joint moment extrema and dynamic stiffness during crouch gait, and 2) use the models to estimate the instantaneous joint moment during weight-acceptance. We retrospectively computed knee moments from 10 children with crouch gait and used stepwise linear regression to develop statistical models describing the knee moment features. The models explained at least 90% of the response value variability: peak moment in early (99%) and late (90%) stance, and dynamic stiffness of weight-acceptance flexion (94%) and extension (98%). We estimated knee extensor moment profiles from the predicted dynamic stiffness and instantaneous knee angle. This approach captured the timing and shape of the computed moment (root-mean-squared error: 2.64 Nm); including the predicted early-stance peak moment as a correction factor improved model performance (root-mean-squared error: 1.37 Nm). Our strategy provides a practical, accurate method to estimate the knee moment during crouch gait, and could be used for real-time, adaptive control of robotic orthoses.

  14. Arthrography of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Keyl, W.; Jaeger, M.

    1981-10-01

    The standardized examination technique and the clinical problems of the arthrographic mehtod applied on the knee joint is explained by the results obtained in 3000 examinations. Whereas the accuracy of the knee-joint arthrography provides a high degree in cases of meniscus lesions, computer tomography presents in chondral and capsular ligament lesions, and sonography in popliteal cysts better diagnostic information; but in any case arthroscopy gains more and more importance in knee-joint diagnostics.

  15. 77 FR 72941 - Voluntary Education Programs

    Science.gov (United States)

    2012-12-07

    ... decision will be made by the selected DoD contractor for the complete `third party review' process. Comment... seeks to enhance the educational opportunities to Service members who may have difficulty in completing... transitions to second careers in teaching. Voluntary education programs. Continuing, adult, or...

  16. Decentralized trade with bargaining and voluntary matching

    DEFF Research Database (Denmark)

    Tranæs, Torben; Sloth, Birgitte; Hendon, Ebbe

    1994-01-01

    Rubinstein and Wolinsky (1990) study a market with one seller, two buyers, and voluntary matching. Both the competitive outcomepc and the bilateral bargaining outcomepb are possible in subgame perfect equilibrium. We consider two variations. First, if there is a cost larger thanpc−pc to the seller...

  17. Social orienting: reflexive versus voluntary control.

    Science.gov (United States)

    Hill, Julia L; Patel, Saumil; Gu, Xue; Seyedali, Nassim S; Bachevalier, Jocelyne; Sereno, Anne B

    2010-09-24

    Many studies have shown that the direction of gaze of a face covertly facilitates the response to a target presented in the matching direction. In this study we seek to determine whether there exist separate reflexive and voluntary forms of such covert social orienting and how they interact with each other. We measured the effect of the predictive value of a gaze cue on manual choice reaction times. When the predictive value of the gaze cue was zero, a facilitatory cueing effect was still observed which peaked at a cue onset to target onset delay (CTD) of 150ms and largely diminished beyond a CTD of 500ms. When the gaze cue was 100% predictive of the future location of the target, at CTDs greater than 200, the predictive cue resulted in a significantly greater facilitation of response than occurred with a non-predictive cue. These results suggest that given enough time (about 200ms), the social cue is interpreted and a willful or voluntary spatially-specific social cueing effect occurs. In addition, we found that a predictive cue resulted in a significant slowing of the observer's responses up to a CTD of 200ms. These findings show that, similar to non-social spatial orienting, there appear to be two forms of social orienting including a reflexive component and voluntary component. We suggest a model of social orienting in which the voluntary social orienting system modulates tonic inhibition of the reflexive social orienting system. Published by Elsevier Ltd.

  18. Equality, self‐respect and voluntary separation

    NARCIS (Netherlands)

    M.S. Merry

    2012-01-01

    This paper argues that self‐respect constitutes an important value, and further, an important basis for equality. It also argues that under conditions of inequality‐producing segregation, voluntary separation in schooling may be more likely to provide the resources necessary for self‐respect. A prim

  19. School Ethical Climate and Teachers' Voluntary Absence

    Science.gov (United States)

    Shapira-Lishchinsky, Orly; Rosenblatt, Zehava

    2010-01-01

    Purpose: This paper aims to offer a theoretical framework for linking school ethical climate with teachers' voluntary absence. The paper attempts to explain this relationship using the concept of affective organizational commitment. Design/methodology/approach: Participants were 1,016 school teachers from 35 high schools in Israel. Data were…

  20. Voluntary Oral Administration of Losartan in Rats.

    Science.gov (United States)

    Diogo, Lucília N; Faustino, Inês V; Afonso, Ricardo A; Pereira, Sofia A; Monteiro, Emília C; Santos, Ana I

    2015-09-01

    Gavage is a widely performed technique for daily dosing in laboratory rodents. Although effective, gavage comprises a sequence of potentially stressful procedures for laboratory animals that may introduce bias into experimental results, especially when the drugs to be tested interfere with stress-dependent parameters. We aimed to test vehicles suitable for drug delivery by voluntary ingestion in rats. Specifically, Male Wistar rats (age, 2 to 3 mo) were used to test nut paste (NUT), peanut butter (PB), and sugar paste (SUG) as vehicles for long-term voluntary oral administration of losartan, an angiotensin II receptor blocker. Vehicles were administered for 28 d without drug to assess effects on the glucose level and serum lipid profile. Losartan was mixed with vehicles and either offered to the rats or administered by gavage (14 d) for subsequent quantification of losartan plasma levels by HPLC. After a 2-d acclimation period, all rats voluntarily ate the vehicles, either alone or mixed with losartan. NUT administration reduced blood glucose levels. The SUG group had higher concentrations of losartan than did the gavage group, without changes in lipid and glucose profiles. Our results showed that NUT, PB, and SUG all are viable for daily single-dose voluntary ingestion of losartan and that SUG was the best alternative overall. Drug bioavailability was not reduced after voluntary ingestion, suggesting that this method is highly effective for chronic oral administration of losartan to laboratory rodents.

  1. Staff's perceptions of voluntary assertiveness skills training.

    Science.gov (United States)

    McVanel, Sarah; Morris, Beth

    2010-01-01

    Clinicians' ability to be assertive when unsure or concerned about procedures, treatment modalities, or patients' symptoms is key in reducing risk and preventing sentinel events. In this article, the authors provide a framework for generic, voluntary assertiveness communication skills workshops that any educator can implement.

  2. Voluntary Organizations: Commitment, Leadership, and Organizational Effectiveness

    Science.gov (United States)

    Ekeland, Terry P.

    2004-01-01

    Voluntary organizations offer a unique opportunity to interpret participant relationships, leadership influences, and organizational effectiveness unencumbered by employment relationships. Regardless of organizational structure or purpose, all organizations are affected to some degree by their leadership and their membership. Based on the…

  3. Environmental Voluntary Agreements in the Dutch Context

    NARCIS (Netherlands)

    Bressers, Johannes T.A.; de Bruijn, Theo; Croci, Edoardo

    2005-01-01

    This paper describes and analyses the use of environmental voluntary agreements, or covenants, in Dutch environmental policy. Covenants have become a widely used policy instrument in the Netherlands. This trend reinforces the strong neo-corporatist traits of Dutch society with its tendency towards

  4. Voluntary Community Organisations in Metropolitan Development

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    While short-term enrolling of citizens in urban regeneration projects often has proven quite successful, permanent embedding of projects in voluntary community-based settings seems to be much more difficult to obtain. This has implications for long term sustainability of urban regeneration projec...

  5. Electromyographic analysis of hip and knee musculature during running.

    Science.gov (United States)

    Montgomery, W H; Pink, M; Perry, J

    1994-01-01

    The purpose of this study was to describe the firing pattern of 11 hip and knee muscles during running. Thirty recreational runners volunteered to run at 3 different paces with indwelling electromyographic electrodes while being filmed at 100 frames per second. Results demonstrated that medial and lateral vasti muscles acted together for knee extension during terminal swing and loading response, possibly providing a patella stabilizing role. The vastus intermedius muscle functioned with the other vasti, plus eccentrically controlled knee flexion during swing phase. The rectus femoris muscle fired with the vastus intermedius muscle and assisted the iliacus muscle with hip flexion. The hamstrings fired primarily to eccentrically control hip flexion. The adductor magnus, tensor fascia lata, and gluteus maximus muscles afforded pelvic stabilization while assisting with hip flexion and extension. Forward propulsion was provided mainly by hip flexion and knee extension, which is contrary to the view that posterior calf muscles provide propulsion during toe off. Faster running paces lead to increased activity in the muscles. This may lead to more injuries, primarily in the muscles that were contracting eccentrically.

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

    Science.gov (United States)

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

    2015-04-01

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

  7. Treatment of knee osteoarthritis.

    Science.gov (United States)

    Ringdahl, Erika; Pandit, Sandesh

    2011-06-01

    Knee osteoarthritis is a common disabling condition that affects more than one-third of persons older than 65 years. Exercise, weight loss, physical therapy, intra-articular corticosteroid injections, and the use of nonsteroidal anti-inflammatory drugs and braces or heel wedges decrease pain and improve function. Acetaminophen, glucosamine, ginger, S-adenosylmethionine (SAM-e), capsaicin cream, topical nonsteroidal anti-inflammatory drugs, acupuncture, and tai chi may offer some benefit. Tramadol has a poor trade-off between risks and benefits and is not routinely recommended. Opioids are being used more often in patients with moderate to severe pain or diminished quality of life, but patients receiving these drugs must be carefully selected and monitored because of the inherent adverse effects. Intra-articular corticosteroid injections are effective, but evidence for injection of hyaluronic acid is mixed. Arthroscopic surgery has been shown to have no benefit in knee osteoarthritis. Total joint arthroplasty of the knee should be considered when conservative symptomatic management is ineffective.

  8. Eligibility and Exclusion of Hemochromatosis Patients as Voluntary Blood Donors

    Directory of Open Access Journals (Sweden)

    M Levstik

    1998-01-01

    Full Text Available BACKGROUND: Hereditary hemochromatosis patients are excluded in many countries as voluntary blood donors. In 1991, changes in the Canadian Red Cross policy allowed healthy hemochromatosis patients to become voluntary donors.

  9. Results of the global survey on Voluntary Sustainability Standards

    OpenAIRE

    Lernoud, Julia

    2015-01-01

    Results of the global survey on Voluntary Sustainability Standards: - Voluntary Sustainability Standards (VSS) area worldwide and selected commodities - Cocoa: Area growth by VSS 2008-2014 - Growth of VSS compliant area worldwide 2008-2013 (selected crops)

  10. China Initiates Voluntary Certification of Public Security Products

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    @@ Reporters learned from the Certification and Accreditation Administration of China(CNCA)that burglar-proof door became the first batch of voluntary certification product in public security products.China has formally initiated voluntary certification of public security products.

  11. Voluntary sterilization in Serbia: Unmet need?

    Directory of Open Access Journals (Sweden)

    Rašević Mirjana M.

    2002-01-01

    Full Text Available Is voluntary sterilization as a birth control method accepted in Serbia? This is certainly a question that is being imposed for research, regardless of the fact that voluntary sterilization is neither accessible nor promoted. Most importantly because there is no understanding in the social nor political sphere for legalization of voluntary sterilization as a form of birth control, apart from the clear necessity for this, first, step. They are: the recognition that voluntary sterilization is an efficient and safe birth control method, respectability of basic human as well as sexual and reproductive rights, spreading of sterilization as a form of birth control among population of both developed and developing countries and an epidemic diffusion of repeated induced abortions in Serbia. Thus individual recognition of the advantages of relying on voluntary sterilization, in a non-encouraging atmosphere, certainly represents one more argument to enable couples to prevent conception by sterilization. Since it was impossible to carry out a representative research among the population of men and women who are at risk for conception, an attempt was made to obtain a reply to the set question among women who decided to induce abortion. It was done out of at least two reasons. The first being that women with induced abortion in their reproductive history were the target group for voluntary sterilization. The second reason was based on the assumption that bringing a decision on induced abortion is preceded by the reconsideration of an earlier adopted strategy regarding children, giving birth and contraception and thus its rational component is revealed more and therefore more easily measurable. The research was carried out in the University Clinic of Obstetrics and Gynecology 'Narodni front' in Belgrade from January 21st o March 1st 2002, and included 296 women. By comparing the social and demographic characteristics of the female respondents, as well as

  12. Effects of transcranial magnetic stimulation during voluntary and non-voluntary stepping movements in humans.

    Science.gov (United States)

    Solopova, I A; Selionov, V A; Kazennikov, O V; Ivanenko, Y P

    2014-09-05

    Here, we compared motor evoked potentials (MEP) in response to transcranial magnetic stimulation of the motor cortex and the H-reflex during voluntary and vibration-induced air-stepping movements in humans. Both the MEPs (in mm biceps femoris, rectus femoris and tibialis anterior) and H-reflex (in m soleus) were significantly smaller during vibration-induced cyclic leg movements at matched amplitudes of angular motion and muscle activity. These findings highlight differences between voluntary and non-voluntary activation of the spinal pattern generator circuitry in humans, presumably due to an extra facilitatory effect of voluntary control/triggering of stepping on spinal motoneurons and interneurons. The results support the idea of active engagement of supraspinal motor areas in developing central pattern generator-modulating therapies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2008-01-01

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

  14. Dynamic knee stability estimated by finite helical axis methods during functional performance approximately twenty years after anterior cruciate ligament injury.

    Science.gov (United States)

    Grip, Helena; Tengman, Eva; Häger, Charlotte K

    2015-07-16

    Finite helical axis (FHA) measures of the knee joint during weight-bearing tasks may capture dynamic knee stability following Anterior Cruciate Ligament (ACL) injury. The aim was to investigate dynamic knee stability during two-leg squat (TLS) and one-leg side hop (SH) in a long-term follow-up of ACL injury, and to examine correlations with knee laxity (KT-1000), osteoarthritis (OA, Kellgren-Lawrence) and knee function (Lysholm score). Participants were injured 17-28 years ago and then treated with surgery (n=33, ACLR) or physiotherapy only (n=37, ACLPT) and healthy-knee controls (n=33) were tested. Movements were registered with an optical motion capture system. We computed three FHA inclination angles, its' Anterior-Posterior (A-P) position, and an index quantifying directional changes (DI), during stepwise knee flexion intervals of ∼15°. Injured knees were less stable compared to healthy controls' and to contralateral non-injured knees, regardless of treatment: the A-P intersection was more anterior (indicating a more anterior positioning of tibia relative to femur) positively correlating with high laxity/low knee function, and during SH, the FHA was more inclined relative to the flexion-extension axis, possibly due to reduced rotational stability. During the TLS, A-P intersection was more anterior in the non-injured knee than the injured, and DI was higher, probably related to higher load on the non-injured knee. ACLR had less anterior A-P intersection than ACLPT, suggesting that surgery enhanced stability, although rotational stability may remain reduced. More anterior A-P intersection and greater inclination between the FHA and the knee flexion-extension axis best revealed reduced dynamic stability ∼23 years post-injury.

  15. Intraoperative Manipulation for Flexion Contracture During Total Knee Arthroplasty.

    Science.gov (United States)

    Matsui, Yoshio; Minoda, Yukihide; Fumiaki, Inori; Nakagawa, Sigeru; Okajima, Yoshiaki; Kobayashi, Akio

    2016-11-01

    Joint gap balancing during total knee arthroplasty (TKA) is important for ensuring postoperative joint stability and range of motion. Although the joint gap should be balanced to ensure joint stability, it is not easy to achieve perfect balancing during TKA. In particular, relative extension gap shortening can induce flexion contracture. Intraoperative manipulation is often empirically performed. This study evaluated the tension required for this manipulation and investigated the influence of intraoperative manipulation on the joint gap in cadaveric knees. Total knee arthroplasty was performed in 6 cadaveric knees from whole body cadavers. Flexion contracture was induced using an insert that was 4 mm thicker than the extension gap, and intraoperative manipulation was performed. Study measurements included the changes in the joint gap after manipulation at 6 positions, with the knee bending from extension to 120° flexion, and the manipulation tension that was required to create a 4-mm increase in the gap. The manipulation tension needed to create a 4-mm increase in the extension gap was 303±17 N. The changes in the joint gap after manipulation were 0.4 mm, 0.6 mm, 0.2 mm, -0.2 mm, -0.4 mm, and -0.6 mm at 0°, 30°, 45°, 60°, 90°, and 120° flexion, respectively. Therefore, the joint gap was not significantly changed by the manipulation. Intraoperative manipulation does not resolve flexion contracture. Therefore, if flexion contracture occurs during TKA, treatment with additional bone cutting and soft tissue release is likely more appropriate than manipulation. [Orthopedics. 2016; 39(6):e1070-e1074.]. Copyright 2016, SLACK Incorporated.

  16. Moving from voluntary euthanasia to non-voluntary euthanasia: equality and compassion.

    Science.gov (United States)

    Amaraskekara, Kumar; Bagaric, Mirko

    2004-09-01

    The recent Dutch law legalising active voluntary euthanasia will reignite the euthanasia debate. An illuminating method for evaluating the moral status of a practice is to follow the implications of the practice to its logical conclusion. The argument for compassion is one of the central arguments in favour of voluntary active euthanasia. This argument applies perhaps even more forcefully in relation to incompetent patients. If active voluntary euthanasia is legalised, arguments based on compassion and equality will be directed towards legalising active non-voluntary euthanasia in order to make accelerated termination of death available also to the incompetent. The removal of discrimination against the incompetent has the potential to become as potent a catch-cry as the right to die. However, the legalisation of non-voluntary euthanasia is undesirable. A review of the relevant authorities reveals that there is no coherent and workable "best interests" test which can be invoked to decide whether an incompetent patient is better off dead. This provides a strong reason for not stepping onto the slippery path of permitting active voluntary euthanasia.

  17. 5 CFR 919.1020 - Voluntary exclusion or voluntarily excluded.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Voluntary exclusion or voluntarily excluded. 919.1020 Section 919.1020 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED...) Definitions § 919.1020 Voluntary exclusion or voluntarily excluded. (a) Voluntary exclusion means a person's...

  18. 37 CFR 351.2 - Voluntary negotiation period; settlement.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Voluntary negotiation period... CONGRESS COPYRIGHT ROYALTY JUDGES RULES AND PROCEDURES PROCEEDINGS § 351.2 Voluntary negotiation period..., the Copyright Royalty Judges will announce the beginning of a voluntary negotiation period and...

  19. 15 CFR 12.3 - Development of voluntary product standards.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Development of voluntary product... AND LABELING § 12.3 Development of voluntary product standards. (a) Invitation to participate in the development of a voluntary product standard. Whenever the Secretary publishes a final determination of...

  20. Cosmetic effect of knee joint in a knee disarticulation prosthesis

    NARCIS (Netherlands)

    de laat, Fred A.; van der Pluijm, Mark J.; van Kuijk, Annette A.; Geertzen, Jan H.; Roorda, Leo D.

    2014-01-01

    Despite numerous advantages, knee disarticulations (KDs) are rarely performed because of the anticipated KD prosthesis fitting problems that include the positioning of the knee joint distally from the KD socket. This results in lengthening of the thigh and subsequent shortening of the shank. The obj

  1. Radiographic and scintigraphic evaluation of total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, R.; Soudry, M.

    1986-04-01

    Various radiographic and scintigraphic methods are used to supplement clinical findings in the evaluation of total knee arthroplasty and its complications. Serial roentgenograms offer reliable information for diagnosing mechanical loosening. Wide and extensive radiolucency at the cement-bone interface and shift in position and alignment of prosthetic components can be seen in almost all cases by the time revision is necessary. Radiographic abnormalities are usually not present in acute infection, but are often present in chronic infection. Bone scanning has a high sensitivity for diagnosis of infection or loosening, but is nonspecific because increased uptake is often present around asymptomatic total knee arthroplasties with normal radiographs. Differential bone and Gallium scanning and scanning with Indium 111-labeled leukocytes have a greater specificity for diagnosis of infection than does bone or Gallium scanning alone. Routine radiographic and scintigraphic studies have shown a high incidence of deep vein thrombosis in the calf after total knee arthroplasty. Clinically significant pulmonary embolization is infrequent.

  2. Design and Characterization of a Novel Knee Articulation Mechanism

    Science.gov (United States)

    Olinski, M.; Gronowicz, A.; Handke, A.; Ceccarelli, M.

    2016-08-01

    The paper is focused on designing a novel controllable and adjustable mechanism for reproducing human knee joint's complex motion by taking into account the flexion/extension movement in the sagittal plane, in combination with roll and slide. Main requirements for a knee rehabilitation supporting device are specified by researching the knee's anatomy and already existing mechanisms. A three degree of freedom (3 DOF) system (four-bar like linkage with controlled variable lengths of rockers) is synthesised to perform the reference path of instantaneous centre of rotation (ICR). Finally, a preliminary design of the adaptive mechanism is elaborated and a numerical model is built in Adams. Numerical results are derived from simulations that are presented to evaluate the accuracy of the reproduced movement and the mechanism's capabilities.

  3. Respostas cardiovasculares agudas na extensão do joelho realizada em diferentes formas de execução Respuestas cardiovasculares agudas a la extensión de rodilla realizada en diferentes formas de ejecución Acute cardiovascular responses on knee extension at different performance modes

    Directory of Open Access Journals (Sweden)

    Marcos Doederlein Polito

    2004-06-01

    - (33 ± 11 años; 63,5 ± 11,4 kg; 168,6 ± 7,1 cm, voluntarios, saludables y con experiencia en el entrenamiento de fuerza realizaron tres series de 12 repeticiones máximas de extención de rodilla, realizadas en forma uni (UN o bilateral (BI. La presión arterial fue medida por el método auscultatorio al final de cada serie y durante 20 minutos después del ejercicio, con intérvalos de cinco minutos. La ANOVA de dos entradas con medidas repetidas mostró que la variación porcentual en relación al reposo (D% de PAS fué significativamente mayor en la 3ª série (UN = 31,7 ± 11,9%; BI = 38,5 ± 10,9% que en la 1ª (UN = 19,5 ± 12,5%; BI = 26,0 ± 10,2%. En cuanto a la PAD, el D% fue mayor en la 3ª série (UN = 48,5 ± 13,9%; BI = 51,4 ± 13,3% que en la 1ª (UN = 30,5 ± 13,0%; BI = 34,9 ± 16,0% y en la 2ª (UN = 40,9 ± 15,4%; BI = 47,3 ± 12,9%. No fueron observadas diferencias para FC y DP, así como entre los modelos de ejecución. Después del ejercicio, no fueron identificadas diferencias entre todas las variables observadas. Aparentemente, la forma de ejecución de la extensión unilateral de la rodilla no repercutiría entre las respuestas cardiovasculares agudas, durante y después del ejercicio. Con todo, la ejecución bilateral mostró una tendencia a elevar los valores de PAS e DP en relación a la ejecución unilateral, o que debe ser considerado en la prescripción para personas que necesiten de cuidados especiales.The objective of this study was to verify the systolic arterial blood pressure (PAS and diastolic arterial blood pressure (PAD, heart rate (FC and double-product (DP during and after the knee extension performed unilaterally and bilaterally until exhaustion. Eighteen healthy volunteers six - men and 12 women (33 ± 11 years old; 63.5 ± 11.4 kg; 168.6 ± 7.1 cm, experienced on strength training, performed three series of 12 maximal repetitions of knee extension unilaterally (UN and bilaterally (BI. The arterial blood pressure was

  4. Bottom-"wide" Approach to Climate Change - Typology and Analysis on Climate Vulnerability Reduction through Voluntary Actions

    Directory of Open Access Journals (Sweden)

    Kiyoto Yamaura

    2013-07-01

    Full Text Available Climate change risk is mostly and often unfairly cast upon those who are vulnerable. As one of the effective and spreadable means in reducing human vulnerability to climate change, this paper and its findings address the role, strength and limitations of voluntary actions. Through an extensive review of various climate change literature, projects and interviews among practitioners, the authors looked at thetypes of interventions and results that voluntary actions have achieved. The paperintroducesvarious types of voluntary activities such as awareness raising, community mobilization and empowerment, community-based adaptation and mitigation, and voluntary environmental regulations and schemes. Such bottom-"wide" approach to climate change is closely linked with civil environmentalism with broad focus and also scientifically strengthened by its engagement with civic science. It urges shifting the mind-set of international development agencies to flexibly accommodate and maximize the potential of voluntary, bottom-wide actions in combating climate change. Finally, the paper lists out pieces of recommendation to further improve and fully utilize voluntary actions in reducing vulnerabilityon the ground, by emphasizing long-term orientation, capacity development, monitoring and evaluation and building partnerships at the local level.

  5. Does knee awareness differ between different knee arthroplasty prostheses?

    DEFF Research Database (Denmark)

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

    2016-01-01

    BACKGROUND: Low knee awareness after Total Knee Arthroplasty (TKA) has become the ultimate goal in trying to achieve a natural feeling knee that meet patient expectations. To accommodate this manufacturers of TKAs have developed new prosthetic designs that potentially could give patients a more...... natural feeling knee during activities. The purpose af this study was to compare the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) of patients treated with a previous generation standard Cruciate Retaining (CR) TKA to the scores obtained by patients treated with a newer generation CR TKA...... or a mobile bearing CR TKA. METHODS: We identified all patients receiving a new generation CR TKA or mobile bearing TKA at our institution between 2010 and 2012. These were matched to a population of patients receiving a standard CR TKA regarding age, gender, year of surgery, Kellgren-Lawrence (KL) grade...

  6. [Knee dislocation: concurrent arthroscopic ACL and PCL reconstruction - operating technique].

    Science.gov (United States)

    Piontek, Tomasz; Ciemniewska-Gorzela, Kinga; Szulc, Andrzej

    2008-01-01

    Injuries involving knee luxation or subluxation generally result in damage to two or three out of the four major ligaments which stabilize this joint. Past treatment of this type of multiligament injuries, consisting in 6- to 12-week immobilization in a plaster cast, does not allow for restoration of the normal, anatomical course of these ligaments. A consequence of this type of healing, which involves the formation of random scars in place of ligaments, is mechanical and functional instability of the knee joint. The goal of this article is to present a classification of multiligament knee injuries and surgical treatment options. We also present our own technique of arthroscopic, concurrent reconstruction of knee joint ligaments. The study material consisted of 20 patients who underwent surgical treatment for multiligament knee injuries in the Department of Pediatric Orthopedics and Traumatology in Poznań. We performed concurrent arthroscopic reconstruction of ACL and PCL in all 20 patients. In addition, reconstruction of the medial complex was performed in 7 patients, and lateral complex was reconstructed in another 7 patients. In three cases we stitched the medial meniscus using a Smith & Nephew FasT-Fix system, and partial menisectomy was performed in 2 patients. The details of the proposed concurrent arthroscopic ACL and PCL reconstruction are extensively discussed. One of the advantages of this operating technique is the exclusive use of autogenous ST and GR tendon grafts for reconstruction of all damaged knee joint structures. The presented operating technique makes possible the reconstruction of all damaged knee joint ligaments in less than two hours, which in turn allows the surgery to be performed in an ischemic setting using an Esmarch band around the limb.

  7. Magnification bone scan of knees for knee pain evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myoung Hoon; Park, Chan H.; Yoon, Seok Nam; Hwang, Kyung Hoon [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    2001-07-01

    Knee pain is one of the common complaints of patients seen in our orthopedic clinic. Routine anterior and posterior views of whole body bone scan (WBBS) is often not sufficient in the evaluation of these patients. An ideal bone scan using pinhole collimator or single photon emission tomography (SPECT), however, is impractical and time consuming in busy nuclear medicine department with limited resources. Therefore, the aim of the study is to assess limited bone scan of knees with magnification (LNSKM) for knee pain evaluation. Technical aspect of LBSKM and diagnostic efficacy are discussed on this poster. Adult patients with knee pain were reffered for LBSKM from an orthopedic surgen specializing knees. Four hundred fifteen LBSKMs were performed since 1999. patients were given 740 MBq (20mCi) Tc-99m MDP intravenously and 3 hours later LBSKM was performed using a low energy high resolution parallel hole collimator and Siemens Orbitor camera. (Simens medical systems. Inc., Hoffman Estates, III., USA). Anterior view of the knees was taken for 5 min, without magnification and both lateral views of symptomatic knees were obtained with electronic magnification (1.25, upto 2.0) for 8 min each. Disease processes such as DJD, traumatic arthritis, P-F tendonitis, SONK, meniscus tear are detected and illustrated along with normal knee scan finding. We believe LBSKM may not be as good as SPECT or pinhole imaging of the knees in the evaluation of knee pain but superior to routine WBBS in the nuclear medicine department with limited resources of instrumentation and manpower.

  8. Voluntary low-force contraction elicits prolonged low-frequency fatigue and changes in surface electromyography and mechanomyography

    DEFF Research Database (Denmark)

    Blangsted, Anne Katrine; Sjøgaard, Gisela; Madeleine, Pascal

    2005-01-01

    ) and in particular mechanomyography (MMG) during low-force rather than high-force test contractions. Seven subjects performed static wrist extension at 10% maximal voluntary contraction (MVC) for 10 min (10%MVC10 min). Wrist force response to electrical stimulation of extensor carpi radialis muscle (ECR) quantified...

  9. Burrowing as a novel voluntary strength training method for mice : A comparison of various voluntary strength or resistance exercise methods

    NARCIS (Netherlands)

    Roemers, P; Mazzola, P N; De Deyn, P P; Bossers, W J; van Heuvelen, M J G; van der Zee, E A

    2017-01-01

    BACKGROUND: Voluntary strength training methods for rodents are necessary to investigate the effects of strength training on cognition and the brain. However, few voluntary methods are available. NEW METHOD: The current study tested functional and muscular effects of two novel voluntary strength

  10. Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl

    Energy Technology Data Exchange (ETDEWEB)

    Wen, D.W.; Rasheed, S. [KK Women' s and Children' s Hospital, Department of Diagnostic and Interventional Imaging, Singapore (Singapore); Tan, T.J. [Changi General Hospital, Department of Radiology, Singapore (Singapore)

    2016-06-15

    We report a histologically proven case of synovial haemangioma of the knee in a 14-month old girl who presented to the emergency department with an acute 1-day history of refusing to weight-bear on the right leg and a preceding 3-week history of a right knee lump. Physical examination revealed a non-tender, soft lump over the lateral infrapatellar region. Radiographs revealed a poorly defined soft tissue density over the infrapatellar fat pad and a suprapatellar joint effusion. Ultrasound was used to confirm the presence of a vascular soft tissue mass compatible with a synovial haemangioma within the infrapatellar fat pad which showed both intra-articular and extra-articular extension. There was good correlation of the ultrasound findings with magnetic resonance imaging (MRI), highlighting the potential clinical utility of ultrasound as an alternative imaging modality in establishing the pre-operative diagnosis and extent of a synovial haemangioma about the knee joint. (orig.)

  11. Prevalent knee pain and sport

    DEFF Research Database (Denmark)

    Hahn, Thomas; Foldspang, Anders

    1998-01-01

    STUDY OBJECTIVE: To estimate the prevalence of knee pain in active athletes and to investigate potential associations to type, amount and duration of sports participation. MEASUREMENTS: 339 athletes gave information about occupation, sports activity and different features of knee pain, based...... pain is a common symptom in athletes. The prevalence is associated with the type, amount and duration of sports participation....

  12. Measurement of fatigue in knee flexor and extensor muscles.

    Directory of Open Access Journals (Sweden)

    Kawabata Y

    2000-04-01

    Full Text Available In order to examine fatigue of the knee flexor and extensor muscles and to investigate the characteristics of muscular fatigue in different sports, a Cybex machine was used to measure muscle fatigue and recovery during isokinetic knee flexion and extension. Eighteen baseball players, 12 soccer players and 13 marathon runners were studied. Each subject was tested in the sitting position and made to perform 50 consecutive right knee bends and stretches at maximum strength. This was done 3 times with an interval of 10 min between each series. The peak torque to body weight ratio and the fatigue rate were determined in each case. In all subjects, the peak torque to body weight ratio was higher for extensors than flexors. Over the 3 trials, the fatigue rate of extensors showed little change, while that of flexors had a tendency to increase. In each subject, knee extensors showed a high fatigue rate but a quick recovery, while knee flexors showed a low fatigue rate but a slow recovery. As the marathon runners had the smallest fatigue rates for both flexors and extensors, we concluded that marathon runners had more stamina than baseball players and soccer players.

  13. Bilateral assessment of knee muscle relationships in healthy adults

    Directory of Open Access Journals (Sweden)

    Gislaine Regina Santos dos Santos

    2014-09-01

    Full Text Available Asymmetric performance of flexor and extensor muscles of the knee may be a risk factor for knee injuries, especially the anterior cruciate ligament. Additionally, asymmetries in power and work may have correlations with fatigue and performance during functional tasks. Among untrained individuals, such asymmetries may be of potential interest for training prescription. Here, we investigated the bilateral performance of knee flexors and extensors muscle groups of untrained individuals. We quantified the torque-angle and torque-velocity relationships, as well as work, power and asymmetry indexes in 20 untrained male (25 ± 4 years old; height 1.74 ± 0.05 m; body mass 76 ± 9 kg. No significant asymmetry was observed for torque-angle and torque-velocity relationships, work and power output for knee flexor and extensor muscle groups (p < .05. Our results suggest that untrained male present symmetry in the knee flexion and extension bilateral performance. Changes in this behavior due to physical training must be monitored.

  14. Overuse Knee Injuries in Athletes

    Directory of Open Access Journals (Sweden)

    Miroslav Kezunović

    2013-03-01

    Full Text Available According to many statistics over 55% of all sports-related injuries are incurred in the knee joint (active sportsmen and recreationists. The statistics definitely differ, depending on type of sport and specific movements habitually performed in a particular sport. Therefore, in addition to acute knee injuries overuse syndromes are common in the knee area also due to specificities of patellofemoral joint just because specific diseases like „jumper's knee“ and „runner's knee“ are related to certain sport activities. Generally speaking, these syndromes occur due to poor orientation of the knee extensor mechanism, i.e. friction of iliotibial band and patellofemoral chondromalacia. It is believed that about 45% of all overuse syndromes in the knee area occur as a result of running.

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  16. Anterior knee pain

    Energy Technology Data Exchange (ETDEWEB)

    LLopis, Eva [Hospital de la Ribera, Alzira, Valencia (Spain) and Carretera de Corbera km 1, 46600 Alzira Valencia (Spain)]. E-mail: ellopis@hospital-ribera.com; Padron, Mario [Clinica Cemtro, Ventisquero de la Condesa no. 42, 28035 Madrid (Spain)]. E-mail: mario.padron@clinicacemtro.com

    2007-04-15

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries.

  17. Voluntary reporting of greenhouse gases 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    The Voluntary Reporting of Greenhouse Gases Program, required by Section 1605(b) of the Energy Policy Act of 1992, records the results of voluntary measures to reduce, avoid, or sequester greenhouse gas emissions. In 1998, 156 US companies and other organizations reported to the Energy information Administration that, during 1997, they had achieved greenhouse gas emission reductions and carbon sequestration equivalent to 166 million tons of carbon dioxide, or about 2.5% of total US emissions for the year. For the 1,229 emission reduction projects reported, reductions usually were measured by comparing an estimate of actual emissions with an estimate of what emissions would have been had the project not been implemented.

  18. Voluntary simulation workshops in nursing education

    DEFF Research Database (Denmark)

    Selberg, Hanne; Nielsen, Mette Elisabeth

    2012-01-01

    Voluntary simulation workshops in nursing education Hanne Selberg1, Mette Elisabeth Nielsen1, Mette Wenzel Horsted2, Karen Bertelsen2, Marianne Linnet Rasmussen2,Rikke Lohmann Panton3, Copenhagen, Mette Kjeldal Jensen4 Background Changes in nursing education in Denmark towards an academic approach...... with more theory and less practical training have resulted in discussions regarding the lack of practical skills amongst novice nurses. A Danish study of students’ drop-out from the nursing education indicates that difficulties in combining theory and practice are one of the motivating factors behind...... the students’ decision to drop out (Jensen et al. 2008). Within the past year our faculty has conducted several projects with the aim of integrating simulation into the curriculum. Furthermore, voluntary simulation workshop has been carried out as an additional offer in the nursing education. The purpose has...

  19. The Political Importance of Voluntary Work.

    Science.gov (United States)

    Kunneman, Harry

    This paper aims to develop a complex articulation of the civic meaningfulness of voluntary work that clarifies its political importance as a countervailing narrative pointing beyond dominant neoliberal and consumptive articulations of a good life. To start with, it sketches a hermeneutic perspective on civic meaningfulness based on the work of Paul Ricoeur. Subsequently, it introduces the ideas of 'ethical complexity', 'epistemological complexity' and 'diapoiesis', building on insights from critical complexity thinking and relational biology. It argues that these notions can provide a bridge between hermeneutic perspectives on meaning and values, on the one hand, and questions of meaning and values on the level of scientific and technological developments and within professional organizations, on the other. Thus a broader, more complex picture emerges of the civic meaningfulness of voluntary work in our times.

  20. Voluntary Management Earnings Forecasts and Discretionary Accruals

    DEFF Research Database (Denmark)

    Gramlich, Jeffrey; Sørensen, Ole Vagn

    2004-01-01

    This paper seeks to determine whether Danish managers exercise discretionary accruals to reach earnings forecast targets they voluntarily specify in conjunction with initial public offerings (IPOs). Because the Danish accounting and legal environment is more permissive than the US, we use Denmark...... as a natural laboratory for learning how business would occur without strict rules, enforcement and sanctions. Danish managers often volunteer pro forma financial statements for results that are expected to occur subsequent to the IPO. We examine a sample of 58 Danish firms that issue voluntary management...... earnings forecasts in connection with IPOs that occur between 1984 and 1996. The evidence we uncover strongly suggests that pre-managed earnings are adjusted toward these targets. In contrast with Kasznik's (1999 Kasznik, R. (1999). On the association between voluntary disclosure and earnings management...

  1. Knees Lifted High

    Centers for Disease Control (CDC) Podcasts

    2008-08-04

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Knees Lifted High gives children fun ideas for active outdoor play.  Created: 8/4/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/5/2008.

  2. Kinematic effects of inertia and friction added by a robotic knee exoskeleton after prolonged walking.

    Science.gov (United States)

    Shirota, C; Tucker, M R; Lambercy, O; Gassert, R

    2017-07-01

    The capabilities of robotic gait assistive devices are ever increasing; however, their adoption outside of the lab is still limited. A critical barrier for the functionality of these devices are the still unknown mechanical properties of the human leg during dynamic conditions such as walking. We built a robotic knee exoskeleton to address this problem. Here, we present the effects of our device on the walking pattern of four subjects. We assessed the effects after a short period of acclimation as well as after a 1.5h walking protocol. We found that the knee exoskeleton decreased (towards extension) the peak hip extension and peak knee flexion of the leg with the exoskeleton, while minimally affecting the non-exoskeleton leg. Comparatively smaller changes occurred after prolonged walking. These results suggest that walking patterns attained after a few minutes of acclimation with a knee exoskeleton are stable for at least a couple of hours.

  3. Factors that affect voluntary vaccination of children in Japan.

    Science.gov (United States)

    Shono, Aiko; Kondo, Masahide

    2015-03-10

    Some important vaccinations are not included in the routine childhood immunization schedule in Japan. Voluntary vaccinations are usually paid as an out-of-pocket expense. Low voluntary vaccination coverage rates and high target disease incidence are assumed to be a consequence of voluntary vaccination. Therefore, this study aimed to explore factors associated with voluntary vaccination patterns in children. We conducted an online survey of 1243 mothers from a registered survey panel who had at least one child 2 months to vaccination mainly correlated positively with annual household income and mothers' positive opinions about voluntary vaccinations, but negatively with number of children. Financial support, especially for low income households and households with more than one child, may motivate parents to vaccinate their children. Communication is also an important issue. More opportunities for education and information about voluntary vaccinations should be provided to mothers without distinguishing between voluntary and routine vaccination.

  4. Startle activation is additive with voluntary cortical activation irrespective of stimulus modality.

    Science.gov (United States)

    Maslovat, Dana; Drummond, Neil M; Carter, Michael J; Carlsen, Anthony N

    2015-10-01

    When a startling acoustic stimulus (SAS) is presented during a simple reaction time (RT) task, it can trigger the prepared response through an involuntary initiation pathway. Previous research modelling the effects of presenting a SAS at various intervals following a non-startling auditory imperative signal (IS) suggested that involuntary initiation-related neural activation is additive with the voluntary initiation processes. The current study tested the predictions of this additive model when the SAS and IS are of different modalities by using a visual rather than auditory go-signal. Because voluntary RT latencies are delayed for visual stimuli compared to acoustic stimuli, it was hypothesised that the time course of additive activation would be similarly delayed. Participants performed 150 RT trials requiring a targeted 20° wrist extension task with a SAS presented 0-125 ms following a visual go-signal. Results were not different to those predicted by an additive model (p=0.979), yet were significantly different to those predicted by a horse-race model (p=0.037), indicating a joint contribution of voluntary and involuntary activation, even when the IS and SAS are of different modalities. Furthermore, the results indicated that voluntary RT differences due to stimulus modality are attributable to processes that occur prior to the increase in initiation-related activation.

  5. 21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral...

  6. Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football

    DEFF Research Database (Denmark)

    Clausen, M B; Tang, L; Zebis, M K;

    2015-01-01

    Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study...... was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15–18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS...... questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (

  7. Confiabilidade da mensuração do alinhamento pélvico no plano transverso durante o teste da ponte com extensão unilateral do joelho Reliability of transverse plane pelvic alignment measurement during the bridge test with unilateral knee extension

    Directory of Open Access Journals (Sweden)

    Juliana A. Andrade

    2012-08-01

    Full Text Available CONTEXTUALIZAÇÃO: O teste da ponte com extensão unilateral do joelho avalia a estabilidade de tronco e pelve. A avaliação dessa estabilidade pode contribuir para o entendimento da ocorrência de lesões musculoesqueléticas. OBJETIVOS: Investigar a confiabilidade intra e interexaminador de uma análise qualitativa e a confiabilidade intrateste de uma análise quantitativa do alinhamento pélvico no plano transverso durante o teste da ponte com extensão unilateral do joelho. MÉTODO: Foram avaliados 30 participantes (24,73±4,24 anos. A análise qualitativa foi realizada pelo julgamento do alinhamento pélvico no plano transverso por dois examinadores, e sua confiabilidade determinada pelo Coeficiente Kappa Ponderado (k w. A análise quantitativa foi realizada pela medida do maior ângulo de desalinhamento pélvico no plano transverso e a confiabilidade determinada pelo Coeficiente de Correlação Intraclasse (CCI; pela análise da mudança na média dos dados, utilizando-se o intervalo de confiança de 95% da média da diferença (95%IC e método de Bland-Altman; pelo dimensionamento da variabilidade entre medidas, considerando-se o erro-padrão da medida combinado (EPM e coeficiente de variação do erro típico (CV ET. Além disso, verificou-se a mudança mínima detectável (MMD95. RESULTADOS: A confiabilidade intraexaminador variou de razoável a moderada (k w=0,32-0,58 e a confiabilidade interexaminador foi substancial (k w=0,80. A confiabilidade intrateste foi excelente (CCI=0,82 e apresentou o IC95% de -0,51º a 1,99º, EPM de 2,38º e o CV ET de 28,75%. O MMD95 foi de 6,59º. CONCLUSÕES: O índice de confiabilidade interexaminador foi superior ao intraexaminador, a confiabilidade intrateste foi excelente e não apresentou erro sistemático e aleatório.BACKGROUND: The bridge test with unilateral knee extension evaluates the stability of the trunk and pelvis. The evaluation of this stability can contribute to the understanding of

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

    Science.gov (United States)

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

    2012-05-01

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

  9. Mitigating greenhouse gas emissions: Voluntary reporting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    The Voluntary Reporting Program, developed pursuant to Section 1605(b) of the Energy Policy Act of 1992, permits corporations, government agencies, households, and voluntary organizations to report on their emissions of greenhouse gases, and on actions taken that have reduced or avoided emissions or sequestered carbon, to the Energy Information Administration (EIA). This, the second annual report of the Voluntary Reporting Program, describes information provided by the participating organizations on their aggregate emissions and emissions reductions, as well as their emissions reduction or avoidance projects, through 1995. This information has been compiled into a database that includes reports from 142 organizations and descriptions of 967 projects that either reduced greenhouse gas emissions or sequestered carbon. Fifty-one reporters also provided estimates of emissions, and emissions reductions achieved, for their entire organizations. The projects described actions taken to reduce emissions of carbon dioxide from energy production and use; to reduce methane and nitrous oxide emissions from energy use, waste management, and agricultural processes; to reduce emissions of halocarbons, such as CFCs and their replacements; and to increase carbon sequestration.

  10. Voluntary Green Power Market Forecast through 2015

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Holt, E.; Sumner, J.; Kreycik, C.

    2010-05-01

    Various factors influence the development of the voluntary 'green' power market--the market in which consumers purchase or produce power from non-polluting, renewable energy sources. These factors include climate policies, renewable portfolio standards (RPS), renewable energy prices, consumers' interest in purchasing green power, and utilities' interest in promoting existing programs and in offering new green options. This report presents estimates of voluntary market demand for green power through 2015 that were made using historical data and three scenarios: low-growth, high-growth, and negative-policy impacts. The resulting forecast projects the total voluntary demand for renewable energy in 2015 to range from 63 million MWh annually in the low case scenario to 157 million MWh annually in the high case scenario, representing an approximately 2.5-fold difference. The negative-policy impacts scenario reflects a market size of 24 million MWh. Several key uncertainties affect the results of this forecast, including uncertainties related to growth assumptions, the impacts that policy may have on the market, the price and competitiveness of renewable generation, and the level of interest that utilities have in offering and promoting green power products.

  11. Strength, balance, and the modifying effects of obesity and knee pain: results from the Observational Arthritis Study in Seniors (oasis).

    Science.gov (United States)

    Jadelis, K; Miller, M E; Ettinger, W H; Messier, S P

    2001-07-01

    To examine the relationship between muscular strength and dynamic balance in a sample of older adults with knee pain and to determine the role that obesity and severity of knee pain play in the ability to maintain balance. Cross-sectional study designed to examine the association between strength and balance in a cohort of older adults with chronic knee pain. A university health and exercise science center. A cohort of 480 adults age 65 and older with knee pain. Force platform dynamic balance measure of the center of pressure excursion during a forward and subsequent backward lean. Isokinetic strength measures of concentric and eccentric knee flexion and extension and concentric ankle plantar flexion and dorsiflexion. Body mass index (BMI) and a knee pain scale were used to measure obesity and knee pain, respectively. A regression model was developed to investigate the relationship between dynamic balance and muscular strength while controlling for gender, BMI, radiographic severity, knee pain, and foot length. Knee strength alone explained 18.4% of the variability in dynamic balance. The addition of knee pain, BMI, radiographic severity, gender, and foot length explained an additional 6.7%. When the knee-ankle interaction, ankle strength, and knee strength--pain interaction variables were added to the regression model, 28.9% of the variability in dynamic balance was explained. Strength appears to play a significant role in maintaining balance in an older, osteoarthritic population. We found that mean knee strength accounted for approximately 19% of the variability in dynamic balance. Hence, greater knee strength was associated with better dynamic balance. The best dynamic balance performances occurred in participants that had a combination of strong knees and strong ankles. However, knee osteoarthritic patients with weak knee strength could still maintain high levels of dynamic balance by having strong ankle strength. Moreover, we have shown that obesity is

  12. A purpose-built dynamometer to objectively measure static and dynamic knee torque.

    Science.gov (United States)

    Ugbolue, U C; Kaliarntas, K T; Wearing, S C; Rowe, P J

    2011-05-01

    This paper reports the development of a purpose-built knee dynamometer (PBKD) to evaluate passive range of motion (ROM) and isometric muscle strength measurements of the knee. The PBKD uses a TorqSense rotary torque transducer and objectively measures isometric knee muscle strength in a valid and reliable manner and passive resistance to motion through range. The device and all associated instrumentation underwent dynamic and static calibration to ensure consistent and accurate measurements were obtained in terms of knee joint angular position, passive torque measures, and isometric torque measures. Eleven healthy male participants performed a knee flexion and extension task designed to evaluate knee function. The validation of the PBKD entailed measuring the consistency of measurement and accuracy of measurement. Accuracy of the PBKD was determined by comparing peak isometric muscle strength measurements against a KIN-COM machine. No significant differences were observed both passively and isometrically between cycles and between trials. This device can have widespread applications within the rehabilitation and clinical environment and could be used as a functional outcome measuring tool to distinguish pathological from non-pathological knees. The presented preliminary results indicate that reliable and accurate measurements of knee ROM and muscle strength can be obtained.

  13. Neglected surgically intervened bilateral congenital dislocation of knee in an adolescent

    Directory of Open Access Journals (Sweden)

    Jaswant Kumar

    2014-01-01

    Full Text Available Neglected bilateral congenital dislocation of knee is unusual. A 12 year old boy presented with inability to walk due to buckling of the knee. The symptoms were present since the child learnt walking. He preferred not to walk. Bilateral supracondylar femoral osteotomy was done at the age of 6 years. Patient had a fixed flexion deformity of both knees, 30° in the right (range of flexion from 30° to 45° and 45° fixed flexion deformity in left knee respectively (range of flexion from 45° to 65° when presented to us. The radiological examination revealed bilateral congenital dislocation of knee (CDK. No syndromic association was observed. He was planned for staged treatment. In stage I, the knee joints were distracted by Ilizarov ring fixators and this was followed by open reduction of both the knee joints in stage II. A bilateral supracondylar extension osteotomy was done 18 months after the previous surgery (stage III. The final followup visit at 4 years the patient presented with range of motion 5-100° and 5-80° on the right and left knee respectively with good functional outcome. The case is reported in view of lack of treatment guidelines for long standing neglected CDK in an adolescent child.

  14. Comparative analysis between radiographic views for knee osteoarthrosis (bipedal AP versus monopedal AP

    Directory of Open Access Journals (Sweden)

    Rodrigo Pires e Albuquerque

    2013-08-01

    Full Text Available OBJECTIVE: A comparative analysis by applying the criteria of the original classification Ahlbäck in the anteroposterior (AP bipedal knee in extension and anteroposterior (AP monopodal knee in symptomatic knee arthrosis. With this analysis we intend to observe the agreement, any advantage or difference between the incidence and degree of joint involvement between the orthopedic surgeons and radiologists with the referring physician. METHODS: From January 2012 to March 2012, was a prospective study of 60 symptomatic arthrosis knees (60 patients, clinically selected group of outpatient knee and radiographic proposals submitted to the search. Of the 60 patients, 39 were female and 21 male, mean age 64 years (ranging from 50 to 84 years. Of the 60 knees studied, 37 corresponded to the right side and 23 on the left side. Statistical analysis was performed by Kappa statistics, which evaluates the interobserver agreement for qualitative data. RESULTS: According to the scale of Ahlbäck, there was a significant agreement (p < 0.0001 intra-observer in the classification of knee osteoarthritis among the five evaluators. There was a significant agreement (p < 0.0001 with inter-observer referring physician in the incidence of AP monopodal and AP bipedal for the four raters. CONCLUSION: The study found no difference between the incidence in the AP monopodal versus AP bipedal in osteoarthritis of the knee.

  15. Stance control knee mechanism for lower-limb support in hybrid neuroprosthesis

    Directory of Open Access Journals (Sweden)

    Curtis S. To, PhD

    2011-08-01

    Full Text Available A hydraulic stance control knee mechanism (SCKM was developed to fully support the knee against flexion during stance and allow uninhibited motion during swing for individuals with paraplegia using functional neuromuscular stimulation (FNS for gait assistance. The SCKM was optimized for maximum locking torque for body-weight support and minimum resistance when allowing for free knee motion. Ipsilateral and contralateral position and force feedback were used to control the SCKM. Through bench and nondisabled testing, the SCKM was shown to be capable of supporting up to 70 N-m, require no more than 13% of the torque achievable with FNS to facilitate free motion, and responsively and repeatedly unlock under an applied flexion knee torque of up to 49 N-m. Preliminary tests of the SCKM with an individual with paraplegia demonstrated that it could support the body and maintain knee extension during stance without the stimulation of the knee extensor muscles. This was achieved without adversely affecting gait, and knee stability was comparable to gait assisted by knee extensor stimulation during stance.

  16. Do thigh circumference and mass changes alter knee biomechanics during walking?

    Science.gov (United States)

    Westlake, Carolyn G; Milner, Clare E; Zhang, Songning; Fitzhugh, Eugene C

    2013-03-01

    Obese adults walk with different biomechanics compared to healthy weight adults. Previous studies have focused on knee biomechanics because they are associated with development and progression of osteoarthritis. Changes in thigh mass and circumference that occur as body weight increases may influence gait. The purpose of this study was to determine if increases in thigh mass and circumference alter gait biomechanics. For 20 healthy weight young adults (10 male and 10 female) knee kinematic, kinetic and gait temporospatial variables were collected using a three-dimensional motion capture system and a force platform during over ground walking. Data were collected during control, increased thigh mass, increased thigh circumference, and both increased mass and circumference conditions. Increases in thigh segment parameters reflected changes expected with a 10 point increase in body mass index. Step width was wider during the added circumference and combination conditions compared to the control condition. Increases in thigh circumference associated with obesity increase step width. This suggests the greater step width observed in obese adults compared to healthy weight adults is a result of the physical constraints introduced by their wider thigh segments. Peak knee flexion angle, peak knee extension moment, peak knee adduction angle, and peak knee abduction moment were similar in all conditions. Thus, acute changes in thigh segment parameters did not result in knee biomechanics suggestive of an increased risk of knee osteoarthritis.

  17. Effect of whole body vibration exercise on muscle strength and proprioception in females with knee osteoarthritis

    DEFF Research Database (Denmark)

    Trans, T; Aaboe, J; Henriksen, M

    2009-01-01

    The purpose of this study was to assess the effect of whole body vibration (WBV) exercise on muscle strength and proprioception in female patients with osteoarthritis in the knee (knee-OA). A single blinded, randomised, controlled trial was performed in an outpatient clinic on 52 female patients...... groups trained twice a week for 8 weeks, with a progressively increasing intensity. The WBV groups performed unloaded static WBV exercise. The following were measured: knee muscle strength (extension/flexion) and proprioception (threshold for detection of passive movement (TDPM)). Self-reported disease...

  18. Progressive strength training (10 RM) commenced immediately after fast-track total knee arthroplasty: is it feasible?

    DEFF Research Database (Denmark)

    Jakobsen, Thomas Linding; Husted, Henrik; Kehlet, Henrik;

    2012-01-01

    Purpose: To explore the feasibility of progressive strength training commenced immediately after total knee arthroplasty (TKA). Methods: A pilot study was conducted at an outpatient training facility. Fourteen patients with unilateral TKA were included from a fast-track orthopedic arthroplasty unit....... They received rehabilitation including progressive strength training of the operated leg (leg press and knee-extension), using relative loads of 10 repetition maximum with three training sessions per week for 2 weeks. Rehabilitation was commenced 1 or 2 days after TKA. At each training session, knee pain, knee...... joint effusion and training load were recorded. Isometric knee-extension strength and maximal walking speed were measured before the first and last session. Results: The training load increased progressively (p strength training exercises...

  19. Cross-talk correction method for knee kinematics in gait analysis using principal component analysis (PCA: a new proposal.

    Directory of Open Access Journals (Sweden)

    Audrey Baudet

    Full Text Available In 3D gait analysis, the knee joint is usually described by the Eulerian way. It consists in breaking down the motion between the articulating bones of the knee into three rotations around three axes: flexion/extension, abduction/adduction and internal/external rotation. However, the definition of these axes is prone to error, such as the "cross-talk" effect, due to difficult positioning of anatomical landmarks. This paper proposes a correction method, principal component analysis (PCA, based on an objective kinematic criterion for standardization, in order to improve knee joint kinematic analysis.The method was applied to the 3D gait data of two different groups (twenty healthy subjects and four with knee osteoarthritis. Then, this method was evaluated with respect to three main criteria: (1 the deletion of knee joint angle cross-talk (2 the reduction of variance in the varus/valgus kinematic profile (3 the posture trial varus/valgus deformation matching the X-ray value for patients with knee osteoarthritis. The effect of the correction method was tested statistically on variabilities and cross-talk during gait.Cross-talk was lower (p<0.05 after correction (the correlation between the flexion-extension and varus-valgus kinematic profiles being annihilated. Additionally, the variance in the kinematic profile for knee varus/valgus and knee flexion/extension was found to be lower and higher (p<0.05, respectively, after correction for both the left and right side. Moreover, after correction, the posture trial varus/valgus angles were much closer to x-ray grading.The results show that the PCA correction applied to the knee joint eliminates the cross-talk effect, and does not alter the radiological varus/valgus deformation for patients with knee osteoarthritis. These findings suggest that the proposed correction method produces new rotational axes that better fit true knee motion.

  20. Exercise for knee osteoarthritis.

    Science.gov (United States)

    Baker, K; McAlindon, T

    2000-09-01

    Adverse outcomes in knee osteoarthritis include pain, loss of function, and disability. These outcomes can have devastating effects on the quality of life of those suffering from the disease. Treatments have generally targeted pain, assuming that disability would improve as a direct result of improvements in pain. However, there is evidence to suggest that determinants of pain and disability differ. In general, treatments have been more successful at decreasing pain rather than disability. Many of the factors that lead to disability can be improved with exercise. Exercise, both aerobic and strength training, have been examined as treatments for knee osteoarthritis, with considerable variability in the results. The variability between studies may be due to differences in study design, exercise protocols, and participants in the studies. Although there is variability among studies, it is notable that a majority of the studies had a positive effect on pain and or disability. The mechanism of exercise remains unclear and merits future studies to better define a concise, clear exercise protocol that may have the potential for a public health intervention.

  1. Suprachiasmatic vasopressin and the circadian regulation of voluntary locomotor behavior.

    Science.gov (United States)

    Cormier, Holly C; Della-Maggiore, Valeria; Karatsoreos, Ilia N; Koletar, Margaret M; Ralph, Martin R

    2015-01-01

    A role for arginine vasopressin in the circadian regulation of voluntary locomotor behavior (wheel running activity) was investigated in the golden hamster, Mesocricetus auratus. Spontaneous nocturnal running was suppressed in a dose-dependent manner by systemic injections of vasopressin, and also in a concentration-dependent manner by microinjections directly into the hypothalamic suprachiasmatic nucleus. Pre-injections of a vasopressin V1 receptor antagonist into the nucleus reduced the suppression of behavior by vasopressin. Ethogram analyses revealed that peripheral drug injections predominantly increased grooming, flank marking, and sleep-related behaviors. Central injections did not induce sleep, but increased grooming and periods of 'quiet vigilance' (awake but not moving). Nocturnal behavioral profiles following either peripheral or central injections were similar to those shown by untreated animals in the hour prior to the onset of nocturnal wheel running. Site control vasopressin injections into the medial preoptic area or periaqueductal gray increased flank marking and grooming, but had no significant effect on locomotion, suggesting behavioral specificity of a vasopressin target near the suprachiasmatic nucleus. Both peripheral and central administration increased FOS-like immunoreactivity in the retinorecipient core of the suprachiasmatic nucleus. The distribution of FOS-positive cells overlapped the calbindin subregion, but was more extensive, and most calbindin-positive cells did not co-express FOS. We propose a model of temporal behavioral regulation wherein voluntary behavior, such as nocturnal locomotor activity, is inhibited by the activity of neurons in the suprachiasmatic ventrolateral core that project to the posterior hypothalamus and are driven by rhythmic vasopressin input from the dorsomedial shell.

  2. Sensitivity of knee soft-tissues to surgical technique in total knee arthroplasty.

    Science.gov (United States)

    Schirm, Andreas C; Jeffcote, Benjamin O; Nicholls, Rochelle L; Jakob, Hilaire; Kuster, Markus S

    2011-06-01

    Restricted range of motion and excessive laxity are both potential complications of total knee arthroplasty (TKA). During TKA surgery, the surgeon is frequently faced with the question of how tightly to implant the prosthesis. The most common method of altering implantation tightness is to vary the thickness of the polyethylene inlay after the bone cuts have been made and the trial components inserted. We have sought to quantify how altering the polyethylene thickness may affect post-operative soft tissue tension for a range of prosthetic designs. Four different prosthetic designs were implanted into fresh-frozen cadaveric knee joints. All four designs were implanted in the standard manner, with a 100 Newton distraction force used to set soft tissue balance. The tibiofemoral force was then recorded at 15° intervals throughout the passive flexion range. After the standard implantation of each prosthesis, the tibial component was raised or lowered to mimic increasing and decreasing the polyethylene thickness by 2mm and the force measurements repeated. Tibiofemoral force in extension correlated with implantation tightness for all prosthesis designs. Between 15° and 90° of knee flexion, all four designs were insensitive to changes in implantation tightness. Beyond 90° the effect was more notable in rotating platform mobile-bearing and cruciate-retaining prostheses than in posterior-stabilised mobile-bearing designs. The findings of this research may be useful in assisting surgical decision-making during the implantation of TKA prostheses.

  3. Does a microprocessor-controlled prosthetic knee affect stair ascent strategies in persons with transfemoral amputation?

    Science.gov (United States)

    Aldridge Whitehead, Jennifer M; Wolf, Erik J; Scoville, Charles R; Wilken, Jason M

    2014-10-01

    Stair ascent can be difficult for individuals with transfemoral amputation because of the loss of knee function. Most individuals with transfemoral amputation use either a step-to-step (nonreciprocal, advancing one stair at a time) or skip-step strategy (nonreciprocal, advancing two stairs at a time), rather than a step-over-step (reciprocal) strategy, because step-to-step and skip-step allow the leading intact limb to do the majority of work. A new microprocessor-controlled knee (Ottobock X2(®)) uses flexion/extension resistance to allow step-over-step stair ascent. We compared self-selected stair ascent strategies between conventional and X2(®) prosthetic knees, examined between-limb differences, and differentiated stair ascent mechanics between X2(®) users and individuals without amputation. We also determined which factors are associated with differences in knee position during initial contact and swing within X2(®) users. Fourteen individuals with transfemoral amputation participated in stair ascent sessions while using conventional and X2(®) knees. Ten individuals without amputation also completed a stair ascent session. Lower-extremity stair ascent joint angles, moment, and powers and ground reaction forces were calculated using inverse dynamics during self-selected strategy and cadence and controlled cadence using a step-over-step strategy. One individual with amputation self-selected a step-over-step strategy while using a conventional knee, while 10 individuals self-selected a step-over-step strategy while using X2(®) knees. Individuals with amputation used greater prosthetic knee flexion during initial contact (32.5°, p = 0.003) and swing (68.2°, p = 0.001) with higher intersubject variability while using X2(®) knees compared to conventional knees (initial contact: 1.6°, swing: 6.2°). The increased prosthetic knee flexion while using X2(®) knees normalized knee kinematics to individuals without amputation during swing (88.4°, p = 0.179) but

  4. Win-stay-lose-learn promotes cooperation in the prisoner’s dilemma game with voluntary participation

    Science.gov (United States)

    Chu, Chen; Liu, Jinzhuo; Shen, Chen; Jin, Jiahua; Shi, Lei

    2017-01-01

    Voluntary participation, demonstrated to be a simple yet effective mechanism to promote persistent cooperative behavior, has been extensively studied. It has also been verified that the aspiration-based win-stay-lose-learn strategy updating rule promotes the evolution of cooperation. Inspired by this well-known fact, we combine the Win-Stay-Lose-Learn updating rule with voluntary participation: Players maintain their strategies when they are satisfied, or players attempt to imitate the strategy of one randomly chosen neighbor. We find that this mechanism maintains persistent cooperative behavior, even further promotes the evolution of cooperation under certain conditions. PMID:28182707

  5. Physiotherapy management of knee osteoarthritis.

    Science.gov (United States)

    Page, Carolyn J; Hinman, Rana S; Bennell, Kim L

    2011-05-01

    Knee osteoarthritis (OA) is a prevalent chronic joint disease causing pain and disability. Physiotherapy, which encompasses a number of modalities, is a non-invasive treatment option in the management of OA. This review summarizes the evidence for commonly used physiotherapy interventions. There is strong evidence to show short-term beneficial effects of exercise on pain and function, although the type of exercise does not seem to influence treatment outcome. Delivery modes, including individual, group or home exercise are all effective, although therapist contact may improve benefits. Attention to improving adherence to exercise is needed to maximize outcomes in the longer-term. Knee taping applied with the aim of realigning the patella and unloading soft tissues can reduce pain. There is also evidence to support the use of knee braces in people with knee OA. Biomechanical studies show that lateral wedge shoe insoles reduce knee load but clinical trials do not support symptomatic benefits. Recent studies suggest individual shoe characteristics also affect knee load and there is current interest in the effect of modified shoe designs. Manual therapy, while not to be used as a stand-alone treatment, may be beneficial. In summary, although the research is not equivocal, there is sufficient evidence to indicate that physiotherapy interventions can reduce pain and improve function in those with knee OA.

  6. Quadriceps neuromuscular function and self-reported functional ability in knee osteoarthritis.

    Science.gov (United States)

    Berger, M J; McKenzie, C A; Chess, D G; Goela, A; Doherty, T J

    2012-07-01

    The purposes of this study were to determine 1) the relationships of self-reported function scores in patients with knee osteoarthritis (OA) to both maximal isometric torque and to isotonic power at a variety of loads, and 2) the degree to which muscle volume (MV) or voluntary activation (VA) are associated with torque and power measures in this population. Isometric maximal voluntary contraction (MVC) torque and isotonic power [performed at loads corresponding to 10, 20, 30, 40, and 50% MVC, and a minimal load ("Zero Load")] were measured in 40 participants with knee OA. Functional ability was measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC) function subscale. MV was determined with magnetic resonance imaging, and VA was measured with the interpolated twitch technique. In general, power measured at lower loads (Zero Load and 10-30% MVC, r(2) = 0.21-0.28, P MVC torque (r(2) = 0.18, P MVC torque and power measures in multiple regression models (r(2) = 0.42-0.72). VA explained only 6% of the variance in MVC torque and was not significantly associated with power at any load (P > 0.05). Quadriceps MVC torque and power are associated with self-reported function in knee OA, but muscle power at lower loads is more predictive of function than MVC torque. The variance in MVC torque and power between participants is due predominantly to differences in MV and has little to do with deficits in VA.

  7. Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis

    National Research Council Canada - National Science Library

    Levinger, Pazit; Menz, Hylton B; Morrow, Adam D; Bartlett, John R; Feller, Julian A; Bergman, Neil R

    2013-01-01

    Dynamic joint loading, particularly the external knee adduction moment (KAM), is an important surrogate measure for the medio-lateral distribution of force across the knee joint in people with knee osteoarthritis (OA...

  8. Anterior knee pain: uncommon aetiologies

    Directory of Open Access Journals (Sweden)

    Q. Louw

    2003-02-01

    Full Text Available The aim of this review is to inform clinicians of less common causes of anterior knee pain. Relatively less common conditions leading to anterior knee pain include infra-patellar contracture syndrome, conditions affecting the fat pad, saphenous nerve entrapment, prepatellar neuromas, increased intraosseous pressure of the patella, ganglions of the anterior cruciate ligament and cysts. The aetiology, clinical presentation, risk factors and management  of each condition are outlined. Due to the common occurrence of anterior knee pain clinicians must remain vigilant in assessing the cause of this clinical presentation.

  9. Total knee arthroplasty for severe valgus knee deformity

    Institute of Scientific and Technical Information of China (English)

    Zhou Xinhua; Wang Min; Liu Chao; Zhang Liang; Zhou Yixin

    2014-01-01

    Background Primary total knee arthroplasty (TKA) in severe valgus knees may prove challenging,and choice of implant depends on the severity of the valgus deformity and the extent of soft-tissue release.The purpose of this study was to review 8 to 11 years (mean,10 years) follow-up results of primary TKA for varient-Ⅲ valgus knee deformity with use of different type implants.Methods Between January 2002 and January 2005,20 women and 12 men,aged 47 to 63 (mean,57.19±6.08) years old,with varient-Ⅲ valgus knees underwent primary TKA.Of the 32 patients,37 knees had varient-Ⅲ deformities.Pie crusting was carefully performed with small,multiple inside-out incisions,bone resection balanced the knee in lieu of soft tissue releases that were not used in the series.Cruciate-retaining knees (Gemini MKⅡ,Link Company,Germany) were used in 13 knees,Genesis Ⅱ (Simth & Nephew Company,USA) in 14 knees,and hinged knee (Endo-Model Company,Germany) in 10 knees.In five patients with bilateral variant-Ⅲll TKAs,three patients underwent 1-stage bilateral procedures,and two underwent 2-stage procedures.All implants were cemented and the patella was not resurfaced.The Hospital for Special Surgery (HSS) knee score was assessed.Patients were followed up from 8 to 11 years.Results The mean HSS knee score were improved from 50.33±11.60 to 90.06±3.07 (P <0.001).The mean tibiofemoral alignment were improved from valgus 32.72°±9.68° pre-operation to 4.89°±0.90° post-operation (P <0.001).The mean range of motion were improved from 93.72°±23.69° pre-operation to 116.61±16.29° post-operation (P <0.001).No patients underwent revision.One patient underwent open reduction and internal fixation using femoral condylar plates for supracondylar femoral fractures secondary to a fall at three years.Three patients developed transient peroneal nerve palsies,which resolved within nine months.Two patients developed symptomatic deep vein thrombosis that was managed with rivaroxaban

  10. Interlimb communication to the knee flexors during walking in humans

    DEFF Research Database (Denmark)

    Stevenson, Andrew James Thomas; Geertsen, Svend Sparre; Andersen, Jacob Buus;

    2013-01-01

    in the right leg following unexpected unilateral knee joint rotations during locomotion in either the flexion or extension direction. Strong reflex responses in the contralateral biceps femoris (cBF) muscle with a mean onset latency of 76 ± 6 ms were evoked only from ipsilateral knee extension joint rotations......A strong coordination between the two legs is important for maintaining a symmetric gait pattern and adapting to changes in the external environment. In humans as well as animals, receptors arising from the quadriceps muscle group influence the activation of ipsilateral muscles. Moreover, strong...... that the cBF reflex response may be a preparation of the contralateral leg for early load bearing, slowing the forward progression of the body in order to maintain dynamic equilibrium during walking....

  11. Mechanical loading of knee articular cartilage induced by muscle contraction can be assessed by measuring electrical potentials at the surface of the knee.

    Science.gov (United States)

    Zhu, Lin; Buschmann, Michael D; Savard, Pierre

    2016-02-01

    Electroarthrography (EAG) consists of recording electrical potentials on the knee surface that originate from streaming potentials within articular cartilage while the joint is undergoing compressive loading. The aim was to investigate how the contraction of specific leg muscles affects the contact force of the knee joint and, in turn, the EAG values. For six normal subjects, voluntary isometric muscle contractions were repeatedly conducted to activate four leg muscle groups while the subject was lying on his back. Two EAG signals were recorded on the medial and lateral sides of the knee, as well as four EMG signals (gastrocnemius, hamstring, quadriceps, tensor fascia latae), and the signal from a force plate fixed against the foot according to the direction of the force. The EAG and force signals were very well correlated: the median of the correlation coefficients between an EAG signal and the corresponding force signal during each loading cycle was 0.91, and 86% of the correlation coefficients were statistically significant (pmuscle contraction was possible for the gastrocnemius and hamstring, but not always for the quadriceps and tensor fascia latae. Using the clinical loading protocol which consists of a one-legged stance, the quadriceps and hamstring EMGs showed minimal activity; loading cycles with increased EAG amplitude were associated with higher EMG activity from the gastrocnemius, which is involved in antero-posterior balance. These results document the role of the EAG as a "sensor" of the knee contact force and contribute to the development of clinical loading protocols with improved reproducibility.

  12. Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain

    DEFF Research Database (Denmark)

    Henriksen, Marius; Graven-Nielsen, Thomas; Aaboe, Jens;

    2010-01-01

    Medial knee osteoarthritis (OA) is characterized by pain and associated with abnormal knee moments during walking. The relationship between knee OA pain and gait changes remains to be clarified, and a better understanding of this link could advance the treatment and prevention of disease...... progression. This study investigated changes in knee moments during walking following experimental knee pain in healthy volunteers, and whether these changes replicated the joint moments observed in medial knee OA patients....

  13. Cosmetic effect of knee joint in a knee disarticulation prosthesis

    Directory of Open Access Journals (Sweden)

    Fred A. de Laat, MD, PhD

    2015-03-01

    Full Text Available Despite numerous advantages, knee disarticulations (KDs are rarely performed because of the anticipated KD prosthesis fitting problems that include the positioning of the knee joint distally from the KD socket. This results in lengthening of the thigh and subsequent shortening of the shank. The objective of this study was to assess the cosmetic effect of the knee joint in a KD prosthesis by determining the extent of the lengthening of the thigh and the shortening of the shank. This lengthening and shortening were measured through an experimental setup using laser techniques. These measurements were made of 18 knee joints used in KD prostheses. Lengthening of the thigh varied between 23 and 92 mm, and shortening of the shank varied between 3 and 50 mm. The polycentric knees Medi KH6 and Medi KHF1 showed the least lengthening of the thigh, and the polycentric knees Teh Lin Prosthetic & Orthotic Co. Ltd Graph-Lite and Medi KP5 showed the least shortening of the shank.

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

    Science.gov (United States)

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

    2005-05-01

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

  15. The parallel programming of voluntary and reflexive saccades.

    Science.gov (United States)

    Walker, Robin; McSorley, Eugene

    2006-06-01

    A novel two-step paradigm was used to investigate the parallel programming of consecutive, stimulus-elicited ('reflexive') and endogenous ('voluntary') saccades. The mean latency of voluntary saccades, made following the first reflexive saccades in two-step conditions, was significantly reduced compared to that of voluntary saccades made in the single-step control trials. The latency of the first reflexive saccades was modulated by the requirement to make a second saccade: first saccade latency increased when a second voluntary saccade was required in the opposite direction to the first saccade, and decreased when a second saccade was required in the same direction as the first reflexive saccade. A second experiment confirmed the basic effect and also showed that a second reflexive saccade may be programmed in parallel with a first voluntary saccade. The results support the view that voluntary and reflexive saccades can be programmed in parallel on a common motor map.

  16. Voluntary energy optimisation - Taking responsibility; Verantwortungsvoll

    Energy Technology Data Exchange (ETDEWEB)

    Baettig, I.

    2006-07-01

    This interview with Konrad Kyburz, CEO of a printing shop in Dielsdorf, Switzerland, discusses how energy consumption can be reduced on a voluntary basis. The provision free-of-charge of heat recovered from the drying ovens of the printing presses to a nearby sports facility is discussed. The realisation of an energy consumption analysis and the resulting increases in the efficiency of energy usage in the printing facility are discussed. Further improvements such as the use of variable-frequency compressor drives and heating with natural gas that helped in making energy savings of well over 15% are discussed.

  17. Anterior Knee Pain (Chondromalacia Patellae).

    Science.gov (United States)

    Garrick, James G.

    1989-01-01

    This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

  18. A novel physiological testing device to study knee biomechanics in vitro.

    Science.gov (United States)

    van de Bunt, Fabian; Emanuel, Kaj S; Wijffels, Thomas; Kooren, Peter N; Kingma, Idsart; Smit, Theodoor H

    2017-08-01

    To properly study knee kinetics, kinematics and the effects of injury and surgical treatment in vitro, the knee should be constrained as little as possible, while imposing physiological loads. A novel dynamic biomechanical knee system (BKS) is presented here. The aim of this study was to test the feasibility and reproducibility of the system and demonstrate its features with an Anterior Cruciate Ligament (ACL) lesion model. Six goat knees were used in the current study. Flexion and extension simulating gait was imposed by a servo-motor, while normal joint load was applied by two artificial muscles. Intra-class correlation coefficients (ICCs) were assessed for inter-test measures, while paired t-tests were performed for comparison between intact knees and knees with ACL-lesion. The ICC's for inter-test measures based on all six goat knees were excellent: varus/valgus: ICC=0.93; rotation: ICC=0.94 (all pknees after creating an ACL-lesion (p=0.018): translation increased more than two-fold in frontal (p=0.016), side (p=0.004) and upward (p=0.018) direction. Five degrees of motion were reproducibly assessed in the intact joint, suggesting that the goat knee may find its natural pathway when loaded in the BKS. The novel five-degrees-of-freedom knee system allows a detailed study of the effect of a diversity of defects and surgical treatments on knee biomechanics under physiological loading conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Voluntary participation and cooperation in a collective-good game.

    OpenAIRE

    Kene Boun My; Benoît Chalvignac

    2009-01-01

    We study the effect of voluntary participation in the context of a collective-good experiment. We investigate whether the freedom to participate in the game or not increases contribution levels and enhances their evolution. The analysis of two voluntary participation treatments supports a positive effect of an attractive exit option on both contribution levels and their sustainability. We conclude that the voluntary contribution mechanism can provide sustainable cooperation levels and that th...

  20. Reversal of optic neuropathy secondary to voluntary globe luxation.

    Science.gov (United States)

    Yaman, Aylin; Ozturk, Taylan; Soylev, Meltem F

    2009-04-01

    Luxation of the globe is rare in the general population and may be spontaneous, voluntary, or traumatic. Spontaneous or voluntary globe luxation results from shallow orbit, floppy eyelids, lax orbital ligaments, backward displacement of orbital septum, or proptotic eyes due to orbital tumors or infiltrative processes, as in Grave's ophthalmopathy. The authors report a case with unilateral voluntary globe luxation presented with unilateral progressive visual loss.