Abstract In clinical settings, the cervical range of motion (ROM) is commonly used to assess cervical spine function. This study aimed at assessing cervical spine mobility based on head and thorax ...kinematics measured with a wearable inertial system (WS). Sequences of imposed active head movements (lateral bending, axial rotation and flexion–extension) were recorded in ten controls and 13 patients who had undergone an arthrodesis. Orientation of the head relative to the thorax was computed in terms of 3D helical angles and compared with the values obtained using an optoelectronic reference system (RS). Movement patterns from WS and RS showed excellent concurrent validity (CMC up to 1.00), but presented slight differences of bias (mean bias < 2.5°) and dispersion (mean dispersion < 4.2°). ROM obtained using WS also showed some differences compared to RS (mean difference < 5.7°), within the range of those reported in literature. WS enabled the observation of the same significant differences between controls and patients as RS. Moreover, ROM from WS presented good test–retest repeatability (ICC between 0.63 and 0.99 and SEM < 6.2°). In conclusion, WS can provide angles and ROM comparable to those obtained with RS and relevant for the cervical assessment after treatment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK
Cervical stiffness is a clinical feature commonly appraised during the functional examination of cervical spine. Measurements of cervical stiffness in axial rotation have not been reported for ...patients with neck pain. The purpose of this study was to investigate cervical spine stiffness in axial rotation among neck pain patients and asymptomatic subjects, and to analyze the impact of osteopathic management.
Thirty-five individuals (17 patients) were enrolled. Measurements were carried out for left-right axial rotation using a torque meter device, prior and after intervention. Passive range of motion, stiffness, and elastic-and neutral zone magnitudes were analyzed. Pain intensity was also collected for patients. The intervention consisted in one single session of non-manipulative osteopathic treatment performed in both groups.
A significant main effect of intervention was found for total range of motion and neutral zone. Also, treatment by group interaction was demonstrated for neutral-, elastic zone, stiffness in right axial rotation, and for total neutral zone. Significant changes were observed in the clinical group after intervention, indicating elastic zone decrease and neutral zone increase. In contrast, no significant alteration was detected for the control group.
Stiffness characteristics of the cervical spine in axial rotation are prone to be altered in patients with neck pain, but seem to be relieved after a session of non-manipulative manual therapeutic techniques. Further investigations, including randomized clinical trials with various clinical populations and therapeutic modalities, are needed to confirm these preliminary findings.
•Cervical stiffness was tested in axial rotation for neck pain and healthy subjects.•Effect of osteopathic non-manipulative techniques on the stiffness was assessed.•Range of motion and neutral zone were altered in patients compared to healthy subjects.•Stiffness features and pain were improved for neck pain patients•Cervical stiffness in axial rotation could provide relevant clinical information.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK, ZRSKP
Purpose
Semitendinosus and gracilis muscles whose tendons are used in surgical reconstruction of the anterior cruciate ligament maintain their contractile ability, but the peak torque angle of ...hamstring muscles shifted to a shallow angle postoperatively.
The goal was to quantify the influence of the myofascial structures on instantaneous moment arms of knee muscles to attempt explaining the above-mentioned post-surgical observations.
Methods
Hamstring harvesting procedures were performed by a senior orthopaedic surgeon on seven lower limbs from fresh-frozen specimens. Femoro-tibial kinematics and tendons excursion were simultaneously recorded at each step of the surgery.
Results
No significant difference was demonstrated for instantaneous moment arm of gracilis during anterior cruciate ligament surgery (84% of the maximum intact values;
P
≥ 0.05). The first significant semitendinosus moment arm decrease was observed after tendon harvesting (61% of the maximum intact values;
p
≤ 0.005). After hamstring harvesting, the maximum and minimum moment arm (both gracilis and semi tendinosus) shifted to a shallow angle and 90°, respectively.
Conclusion
Moment arm modifications by paratenons and the loose connective tissue release are essential to understand the peak torque obtained to a shallow angle.
Level of evidence
: Basic science study, biomechanics.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
Over the last years, the definition of quadriceps femoris (QF) has evolved somewhat and some authors now define a fifth head: the tensor of vastus intermedius (TVI). Descriptions of the different ...components of QF in textbooks and recent findings remain confusing. Therefore, the aim of this study is to obtain more information on this possible fifth head.
Twenty lower limbs of 10 embalmed cadavers, six females and four males, were investigated by macro-dissection. The dissection and separation of the different heads were performed with the fingers and a distinction between the different parts of the quadriceps was noted only if it was possible to separate the heads without scalpel to avoid artificial separation of muscle parts.
In 9 lower limbs we found a QF as classically described in textbook. TVI was found in only 7 limbs and in 4 cases we were not able to differentiate VI and VM or VI and VL (triceps femoris as described by Testut). These results, and the diversity of descriptions found in the literature have led us to review the definition of an isolated muscle.
In this study, the presence of TVI was not demonstrated in all limbs unlike previously published studies on the subject. Harmonisation of dissection techniques, but also a clear definition of a muscle is required in order to be able to compare studies and draw clear conclusions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPUK, ZAGLJ, ZRSKP
Biomedical science and its allied disciplines are entering a new era in which computational methods and technologies are poised to play a prevalent role in supporting collaborative investigation of ...the human body. Within Europe, this has its focus in the virtual physiological human (VPH), which is an evolving entity that has emerged from the EuroPhysiome initiative and the strategy for the EuroPhysiome (STEP) consortium. The VPH is intended to be a solution to common infrastructure needs for physiome projects across the globe, providing a unifying architecture that facilitates integration and prediction, ultimately creating a framework capable of describing Homo sapiens in silico. The routine reliance of the biomedical industry, biomedical research and clinical practice on information technology (IT) highlights the importance of a tailor-made and robust IT infrastructure, but numerous challenges need to be addressed if the VPH is to become a mature technological reality. Appropriate investment will reap considerable rewards, since it is anticipated that the VPH will influence all sectors of society, with implications predominantly for improved healthcare, improved competitiveness in industry and greater understanding of (patho)physiological processes. This paper considers issues pertinent to the development of the VPH, highlighted by the work of the STEP consortium.
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BFBNIB, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
•Breathing pattern or pulmonary pathologies influence the balance.•There is a lack of tool to easily assess balance under various inspiratory loads.•Wii Balance Board has not been validated yet in ...this context.•WBB can be used detect the effect of breathing on the balance of young healthy subjects.
There is a link between breathing and balance and posture. When the inspiratory loads are increased by pathologies, there is a decrease of postural control. The increase of the inspiratory load on respiratory muscles is a common feature in various chronic pulmonary pathologies. Consequently, the balance of those patients is likely affected.
The aim of this study is to validate the use of the Nintendo Wii Balance Board (WBB) to assess balance modifications induced by increased respiratory loads in healthy subjects.
Thirty-seven healthy young participants (25 ± 4 years old, 17 women) participated in this study. Five different conditions were tested: without anything (control), throughout a mouthpiece, and throughout three inspiratory threshold loads (ITL) at 10% (low), 40% (mid) and 60% (high) of the maximal inspiratory pressure. Each trial lasted for 60 s. Nine parameters were extracted based on center of pressure displacement based on a previously-validated method. ANOVA tests were used to compare the different conditions followed by Bonferroni’s corrections.
Highly statistically significant differences (all p < 0.01) and large effect sizes (all ω2 > 0.24) were obtained for all parameters between the different loads and the mouthpiece condition. There is a linear relationship between the load and balance perturbation.
In this study, we demonstrated the validity of the WBB to detect the effect of the inspiratory load on balance in young healthy subjects. Further studies are needed to determine if such a kind of evaluation can be used in clinics with patients suffering from chronic respiratory disease.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPUK, ZAGLJ, ZRSKP
Spinal manipulative techniques are commonly used in manual therapies but quantified descriptive and reliability data are lacking considering supine thoracic thrust manipulation.
The purpose of this ...study is to explore and compare kinetic parameters during supine thoracic thrust manipulation performed at two different thoracic regions. Intra-rater task repeatability and influence of practitioners were estimated.
Exploratory and agreement study.
Kinetic parameters were assessed by examining reaction force magnitude and orientation (on the basis of the zenithal angle) using force platforms. Manipulative procedure (consisting in the application of 3 preloads followed by one thrust adjustment) at both intervertebral and costovertebral region was performed by different practitioners at three sessions. Application of thrust was allowed for experienced practitioners only. Preload force, peak force magnitude and vector force orientation were compared between anatomical sites, sessions and practitioners, and bias with limit of agreement were estimated.
Repeatability analysis showed that practitioners achieved similar preload and peak force independent of the session, with comparable force orientation. Differences between practitioners were observed for preload and peak force but not regarding the zenithal angle during the thrust phase.
The present study is the first that explores kinetic parameters for supine thoracic thrust manipulation applied on two different regions of the thorax. Results confirm consistency of performance among practitioners for supine manipulative techniques at intervertebral and costovertebral region. While task repeatability was confirmed, several differences were observed between practitioners. Further investigations would examine velocity, acceleration and potential neurophysiological effect of such manipulative technique.
•Reaction force was measured during supine thoracic thrust manipulation•Preload represent 50% of the peak force during supine thoracic thrust manipulations•Repeatability of manipulation was observed among practitioners•Reaction force magnitude depends partly on the location of the manipulation•Reaction force orientation was similar between practitioners and anatomical sites
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK, ZRSKP
Abstract Background Evaluation of cervical spine mobility after surgery is mainly based on the measurement of the range of motion during imposed movements. It can thus be questionable if this ...assessment represents the mobility experienced during daily life. The goal of this study was to propose a new evaluation tool based on the monitoring of cervical spine movement during daily activities. Methods The detection of cervical movement and the determination of primary motion component (lateral bending, axial rotation or flexion–extension), using two inertial sensors, were first validated in laboratory settings. Fifteen patients who underwent a cervical arthrodesis and nine healthy control subjects were monitored during their daily activity for half a day. The frequency of cervical movement was quantified according to posture, i.e. static and walking periods. The amplitude and velocity of cervical movement were evaluated using the median and cumulative distribution function. Findings The movement detection and classification showed an excellent performance (sensitivity and specificity > 94%). For the daily monitoring, the patients presented a movement frequency similar to controls, whereas the amplitude and velocity in patients were lower than in controls ( P < 0.05). The differences between patients and controls were larger for the velocity parameters (effect sizes > 0.37 and > 0.54 for static and walking periods respectively) than for the amplitude parameters. Interpretation Body-worn inertial sensors enable the quantitative evaluation of global cervical movement. The movement amplitude and velocity during free-living conditions can be used as objective parameters to evaluate the cervical spine mobility after treatment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK
Abstract Objectives To evaluate the effect of neurodynamics mobilization (NDM) on an artificially induced edema in the median nerve at the level of the carpal tunnel in unembalmed cadavers and to ...assess whether NDM tensioning techniques (TT) and NDM sliding techniques (SLT) induce similar effects on intraneural fluid dispersion. Design Fourteen upper extremities of seven unembalmed cadavers were used in this study. A biomimetic solution was injected directly under the epineurium of the median nerve at the level of the proximal transverse carpal ligament. The initial dye spread was allowed to stabilize and measured with a digital caliper. Tensioning and sliding techniques were applied following a randomized crossover design to each upper extremity and were performed for a total of 5 min each. Post-intervention dye spread measurements were taken after each technique. Results After the first mobilization, the mean longitudinal dye spread (7.5 ± 6.6 mm) was significantly greater (p = 0.024) compared to the stabilized dye spread. There was a significant longitudinal diffusion effect with both, TT (p = 0.018) and SLT (p = 0.016), with no statistically significant difference between techniques (p = 0.976). The order in which techniques were administered did not influence the diffusion. Conclusion Five minute of passive NDM in the form of tensioning or sliding technique induced significant fluid dispersion in the median nerve at the carpal tunnel of unembalmed human cadavers. This study provides support for clinical mechanism of NDM in reducing intraneural edema.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK, ZRSKP
