Total ankle prosthesis as a surgical solution in the case of end-stage osteoarthritis has seen a considerable increase in the last two decades. This study protocol arises from the need to understand ...the in vivo kinematics of mobile-bearing, flat tibial component total ankle replacement, evaluating the real range of motion and the reciprocal relationships between the components during normal motor tasks through the use of model-based radio-stereometric analysis (MB-RSA). In addition, pre- and post-operative evaluation of walking kinematics with inertial motion sensors, proprioception through a dedicated workstation, and clinical outcomes are discussed. We expect that based on our study protocol researchers will be able to improve future prosthetic designs and validate the setup of MB-RSA, as well as to understand “how an ankle prosthesis moves” once implanted in the patient.
Physical inactivity, a leading risk factor for chronic diseases and premature death, is prevalent worldwide. This study focuses on participant profiles and factors influencing continued participation ...and physical activity (PA) levels in the “Moving Parks” PA intervention in Bologna, Italy. This intervention offers free group activities in city parks during the summer. A questionnaire was administered to participants in 2022, gathering data on socio-demographic information, chronic diseases, participation in previous iterations, and PA levels. Out of 596 respondents, 85% were women, and the average age was 50. About 56% held a university degree, and 73% exercised regularly in the winter. Continuous participation was linked to older age, higher education, and chronic conditions. Prior participation predicted higher winter PA levels. Notably, the majority of participants were educated, physically active women. While the project continually engages individuals with higher education and chronic conditions, it needs further tailoring to reach less represented populations.
We performed a retrospective clinical and radiographic evaluation of 83 nonconsecutive patients operated in our institute between February 1996 and March 2003 with a mean follow-up of 60 months to ...assess the efficiency of unicompartmental knee replacement (UKR) performed with a minimally invasive technique. The aim of this study was to correlate the clinical outcome with the pre- and post-operative alignment and with implant positioning on coronal and sagittal plane. Eighty-three nonconsecutive patients (60 males, 23 females) underwent cemented UKR (De Puy Preservation Uni with all-poly tibial component), for both medial OA (80 patients) and AVN of the medial femoral condyle (3 patients). All patients were available at final follow-up evaluation, and they all presented an evident varus alignment at pre-operative clinical and radiographic evaluation. At radiographic measurement, we considered a knee with femoro-tibial angle (FTA) > 175° as varus knee, 170° < FTA < 175° as normal knee and a knee with a FTA < 170° as a valgus knee. Moreover, we considered a tibial plateau angle (TPA) > 90° for valgus knee and a TPA < 90° for varus knee. According to Hospital for Special Surgery (HSS) scoring system, at a mean follow-up of 60 months, 61 (74%) cases were excellent (100-85 points), 15 (18%) cases were good (84-70 points) and 7 cases (8%) had fair results (<70 points). In our series, patients with an excellent clinical result presented a mean varus deformity of 7.2° (3.6°–10.8°) pre-operatively. According to literature, we demonstrated that a small amount of undercorrection with a small amount of residual varus deformity of 3°–5° is the goal to be reached in order to avoid both rapid degeneration of the nonreplaced compartment and the premature loosening of the replaced compartment. We performed a mean axial correction of 5° (SD 3.9°), leaving a mean axial varus deformity of 2.2° in the excellent group. In our series, the group with excellent results also showed a post-operative PTS of 7° (2.4°–11.6°), while mean pre-operative PTS was 6.5° (2.7°–10.3°). In this study, results have shown that minimally invasive UKR producing a small amount of varus undercorrection in selected patients with medial tibio-femoral osteoarthritis or moderate avascular necrosis of the medial femoral condyle provides excellent clinical and functional results. Overcorrection of varus malalignment with a UKR may produce both rapid degeneration of the lateral tibio-femoral compartment and the early failure of the replaced compartment.
PurposeExoskeleton can assist individuals with spinal cord injuries (SCI) with simple movements and transform their lives by enhancing strength and mobility. Nonetheless, the current utilization ...outside of rehabilitation contexts is limited. To promote the widespread adoption of exoskeletons, it is crucial to consider the acceptance of these devices for both rehabilitation and functional purposes. This systematic review aims to identify the barriers or facilitators of the use of lower limbs exoskeletons, thereby providing strategies to improve interventions and increase the adoption of these devices.MethodsA comprehensive search was conducted in EMBASE, Web of Science, Scopus, Cochrane, and PubMed. Studies reporting barriers and facilitators of exoskeleton use were included. The studies’ quality was assessed using the Mixed Methods Appraisal Tool and undertook a thematic content analysis for papers examining the barriers and facilitators.ResultsFifteen articles met the inclusion criteria. These revealed various factors that impact the utilization of exoskeletons. Factors like age, engagement in an active lifestyle, and motivation were identified as facilitators, while fear of falling and unfulfilled expectations were recognized as barriers. Physical aspects such as fatigue, neuropathic discomfort, and specific health conditions were found to be barriers.ConclusionThis systematic review provides a comprehensive overview of the barriers and facilitators to the use of exoskeleton technology. There are therefore still challenges to be faced, efforts must be made to improve its design, functionality, and accessibility. By addressing these barriers, exoskeletons can significantly improve the quality of life of people with SCI.
Muscle Synergy Assessment During Single-Leg Stance Ghislieri, Marco; Knaflitz, Marco; Labanca, Luciana ...
IEEE transactions on neural systems and rehabilitation engineering,
2020-Dec., Letnik:
28, Številka:
12
Journal Article
Recenzirano
Odprti dostop
In the study of muscle synergies during the maintenance of single-leg stance there are several methodological issues that must be taken into account before muscle synergy extraction. In particular, ...it is important to distinguish between epochs of surface electromyography (sEMG) signals corresponding to "well-balanced" and "unbalanced" single-leg stance, since different motor control strategies could be used to maintain balance. The aim of this work is to present and define a robust procedure to distinguish between "well-balanced" and "unbalanced" single-leg stance to be chosen as input for the algorithm used to extract muscle synergies. Our results demonstrate that the proposed approach for the selection of sEMG epochs relative to "well-balanced" and "unbalanced" single-leg stance is robust with respect to the selection of the segmentation threshold, revealing a high consistency in the number of muscle synergies and high similarity among the weight vectors (correlation values range from 0.75 to 0.97). Moreover, differences in terms of average recruitment levels and balance control strategies were detected, suggesting a slightly different modular organization between "well-balanced" and "unbalanced" single-leg stance. In conclusion, this approach can be successfully used as a pre-processing step before muscle synergy extraction, allowing for a better assessment of motor control strategies during the single-leg stance task.
Modifiable (biomechanical and neuromuscular) anterior cruciate ligament (ACL) injury risk factors have been identified in laboratory settings. These risk factors were subsequently used in ACL injury ...prevention measures. Due to the lack of ecological validity, the use of on-field data in the ACL injury risk screening is increasingly advocated. Though, the kinematic differences between laboratory and on-field settings have never been investigated. The aim of the present study was to investigate the lower-limb kinematics of female footballers during agility movements performed both in laboratory and football field environments. Twenty-eight healthy young female talented football (soccer) players (14.9 ± 0.9 years) participated. Lower-limb joint kinematics was collected through wearable inertial sensors (Xsens Link) in three conditions: (1) laboratory setting during unanticipated sidestep cutting at 40-50°; on the football pitch (2) football-specific exercises (F-EX) and (3) football games (F-GAME). A hierarchical two-level random effect model in Statistical Parametric Mapping was used to compare joint kinematics among the conditions. Waveform consistency was investigated through Pearson's correlation coefficient and standardized z-score vector. In-lab kinematics differed from the on-field ones, while the latter were similar in overall shape and peaks. Lower sagittal plane range of motion, greater ankle eversion, and pelvic rotation were found for on-field kinematics (p < 0.044). The largest differences were found during landing and weight acceptance. The biomechanical differences between lab and field settings suggest the application of context-related adaptations in female footballers and have implications in ACL injury prevention strategies.
Highlights
Talented youth female football players showed kinematical differences between the lab condition and the on-field ones, thus adopting a context-related motor strategy.
Lower sagittal plane range of motion, greater ankle eversion, and pelvic rotation were found on the field. Such differences pertain to the ACL injury mechanism and prevention strategies.
Preventative training should support the adoption of non-linear motor learning to stimulate greater self-organization and adaptability.
It is recommended to test football players in an ecological environment to improve subsequent primary ACL injury prevention programmes.
Micromotion of the tibial component in 40 knee arthroplasties for gonarthrosis was studied rising Roentgen stereophotogrammetric analysis. The stability of this component was assessed for 2 years' ...postoperatively. in all arthroplasties, an attempt was made to reconstruct the preoperative posterior slope. Posterior cruciate-retaining (CR) and posterior-stabilized (PS) components showed at 2 years a maximum total point motion of 0.6 +/- 0.4 mm and 0.7 +/- 0.5 mm, respectively. Whereas 92.5% of the implants were determined to be stable, 1 of the CR group and 2 of the PS group displayed migration between the first and the second year of at least 0.2 mm. A negative correlation between subsidence of the tibial component at 2 years of follow-up and the difference between preoperative and postoperative tibial slope was found. Consequently, we suggest that restoring the original posterior slope of the tibial plateau must be a goal of tibial component implantation.
•Proprioception response is due to multiple and complex neurophysiological processes.•The knee is the most investigated joint in term of proprioception.•Proprioception changes before and after total ...knee arthroplasty are not clear.•Structured protocols should be applied for evaluating TKA effects on proprioception.•Rehabilitation could also improve proprioception post-TKA.
Proprioception is one of the most significant factors in balance, joint stability, graceful movement, coordination, and injury prevention. It involves a wide set of receptors located within joints, muscles, and tendons. Given the neurophysiological processes involved in proprioception response are multiple and complex, there is not one single method to measure it. Particularly, proprioception of the knee joint, whether it is healthy, affected by osteoarthritis, or after replacement, is the most investigated by in literature.
This review addresses the analysis of proprioception in the knee joint before and after total knee arthroplasty (TKA). The aim is to obtain an overview of the proprioceptive skills in subjects who suffered from osteoarthritis and were subjected to knee replacement, evaluating changes in proprioception before and after the surgery.
The research was conducted within four databases: Web of Science®, PubMed Central®, Cochrane®, and PEDro®, between January 2008 and February 2018. Accurate exclusion criteria and selection strategy were applied to screen the 170 articles found.
Ultimately, 13 papers were fully evaluated and included in this review, divided into two classes: i) works directly measuring proprioception, ii) studies indirectly evaluating proprioception. Contrasting results emerged from the analysis, and no consensus was found in the literature about the improvement or worsening in proprioception before and after TKA.
Since currently there is high variability in methods, protocol and parameters used to evaluate knee proprioception, further investigations based on a consistent dataset, a well-defined protocol, measurable outcomes, timeline follow-ups, and rehabilitation programs should be performed in order to obtain reliable results on the effects of TKA on knee proprioception and balance.
Purpose
To explore in vivo kinematical behavior of the same total knee arthroplasty (TKA) cruciate-retaining (CR) femoral design with either medial-congruent (MC) or ultra-congruent (UC) inlay using ...model-based dynamic radiostereometric analysis (RSA). The hypothesis was that there would be comparable kinematics between the two groups.
Methods
A cohort of 16 randomly selected patients (8 MC Persona Zimmer, 8 UC Persona Zimmer) was evaluated through dynamic radiostereometric analysis (RSA) at a minimum of 9 months after TKA, during the execution of a sit-to-stand. The antero-posterior (AP) translation of the femoral component and the AP translation of the low point of medial and lateral femoral compartments were compared through Student’s
t
test (
p
< 0.05).
Results
Both groups showed a medial pivot behavior, with a significantly greater anterior translation of the Low Point of the lateral compartment with respect to the medial compartment (MC medial range: 2.4 ± 2.4 mm; MC lateral range: 7.7 ± 3.0 mm;
p
< 0.001 – UC medial range: 3.3 ± 3.3 mm; UC lateral range: 8.0 ± 3.2 mm;
p
< 0.001). A statistically significant greater degree of flexion was clinically recorded at follow-up visit in the MC group respect to the UC group (126° vs 101°—
p
= 0.003).
Conclusion
The present study did not show difference in the medial pivot behavior between ultra-congruent and medial-congruent total knee arthroplasty when implanted with mechanical alignment; however, the MC group demonstrated a greater degree of flexion. The MC design examined is a valid alternative to the UC design, allowing to achieve a screw-home movement restoration combined with a high flexion.
Level of evidence
IV.
Lateral movements are challenging for 2D video-analysis and are therefore often omitted in functional tests for Anterior Cruciate Ligament (ACL) injury risk assessment. The purpose of the present ...study was to investigate the association between frontal and transverse plane angles obtained from 2D video-analysis and knee abduction moment (KAM) from gold standard 3D motion capture in a 180° lateral cut task. The hypothesis was that 2D angles other than the knee joint effectively explain variations in KAM.
Thirty-four healthy football players (age 22.8 ± 4.1 years) performed a series of 180° lateral cut (lateral shuffles) tasks. The peak KAM was collected through a 3D motion capture system. A 2D video-analysis movement assessment identified frontal and transverse plane joint kinematics: foot projection angle (FPA), Frontal Plane Knee Projection Angle (FPKPA), Pelvis tilt angle (PA), and Trunk tilt angle (TA). A forward stepwise regression model was used to assess significant 2D predictors of KAM (p < 0.05).
FPA and PA were the only significant predictors (R2-ajdusted = 9.2%, p < 0.001), with external foot rotation and contralateral pelvic drop associated with higher KAM. Based on the regression model, the “High FPA & PA group” was defined and showed higher KAM than the rest of the cohort (p = 0.012, ES = 0.71).
The external foot rotation and the contralateral pelvic drop from 2D video-analysis were associated with higher peak KAM during the 180° lateral cut. A qualitative assessment of the 180° lateral cut could offer precious insights on ACL injury risk mitigation.
Descriptive Laboratory Study.
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