•Functional methods perform as well or better than conventional for KJA estimation.•Regression methods perform slightly better for KJC prediction.•DynaKAD, Gamage and Lasenby and SARA method with ...OCST are recommended.•Functional methods should be validated on populations with limited knee RoM.
Attempts to improve protocol standards of marker-based clinical gait analysis (CGA) have been one of the main focuses of research to enhance robustness and reliability outcomes since the 1990s. Determining joint centres and axes constitutes an important aspect of those protocols. Although the hip joint is more prominent in such studies, knee joint center (KJC) and axis (KJA) directly affect all outcomes.
What recommendations arise from the study of the scientific literature for determining knee joint parameters (KJP) for protocols of CGA?
A systematic, electronic search was conducted on November 2018 using three databases with the keyword combination (“functional approach” OR “functional method” OR “functional calibration”) AND (“hip joint” OR “knee joint” OR “ankle joint”) and analyzed by four reviewers. Given the existence of a recent review about the hip joint and the lack of material about the ankle joint, only papers about the knee joint were kept. The references cited in the selected papers were also screened in the final round of the search for these publications.
The quality of the selected papers was assessed and aspects regarding accuracy, repeatability, and feasibility were thoroughly considered to allow for a comparison between studies. Technical aspects, such as marker set choice, KJP determination techniques, demographics, and functional movements, were also included.
Thirty-one papers were included and on average received a rating of about 75 % according to the quality scale used. The results showed that functional methods are superior or equivalent to predictive methods to estimate the KJA, while a regression method was slightly better for KJC prediction.
Calibration methods should be applied to CGA whenever feasibility is reached. No study to date has focused on evaluating the in vivo RoM required to obtain reliable and repeatable results and future work should aim in this direction.
•We studied the vertical adaptation of the CoM in human running on uneven ground.•Runners actively adapt their CoM height in front of ground level disturbances.•It support the idea that the control ...of the CoM is a general principle in running.•The sacrum-marker method is appropriate to study the adaptations.
In running we are frequently confronted with different kinds of disturbances. Some require quick reactions and adaptations while others, like moderate changes in ground level, can be compensated passively. Monitoring the kinematics of the runner’s center of mass (CoM) in such situations can reveal what global locomotion control strategies humans use and can help to distinguish between active and passive compensation methods.
In this study single and permanent upward steps of 10cm as well as drops of the same height were used as mechanical disturbances and the adaptations in the vertical oscillation of the runners CoM were analyzed. We found that runners visually perceiving uneven ground ahead substantially adapted their CoM in preparation by lifting it about 50% of step height or lowering it by about 40% of drop height, respectively. After contact on the changed ground level different adaptations depending on the situation occur. For persisting changes the adaptation to the elevated ground is completed after the first step on the new level. For single steps part of the adaptation takes place while returning to the ground. The consistent adaptations for the different situations support the idea that controlling the CoM by adapting leg parameters is a general control principle in running.
Implants or cell carriers made of biopolymers or biodegradable polymers are well suited for the regeneration of defects in various tissues. They act as an adhesion surface for autologous cells and ...provide sufficient stability. Electrospun nonwovens have a favourable surface to volume ratio and mimic the structure of the fiber proteins of the extracellular matrix in tissues. Their high porosity ensures a sufficient supply of nutrients to the cells while maintaining high mechanical strength. In addition, drug-release functionality can be installed in biodegradable nonwovens, which can support the regeneration. Particularly promising are flakes made of electrospun nonwovens which, in an appropriate suspension, can be injected into defective areas. For the production of such flakes, laser cutting or surface structuring can be applied. Typically, ablation by ultrashort laser pulses reduces the heat-affected zones significantly in microprocessing of many polymers. In this work, the quality of processing of electrospun gelatine and poly-lactide (PLA) nonwovens was investigated for UV-solidstate lasers with pulse durations in the nano- and picosecond range. We observed comparable ablation quality of electrospun gelatine nonwovens with UV nanosecond and with UV picosecond ablation. A similar behaviour was found for electrospun PLA nonwovens. Higher pulse energy was necessary for nanosecond ablation with the same focal spot diameter. Keywords: picosecond laser, laser ablation, nanosecond laser, polylactide nanofibers, gelatine nanofibers, nanofiber scaffold, electrospinning
Arteriogenesis is a process by which a pre-existing arterioarterial anastomosis develops into a functional collateral network following an arterial occlusion. Alternatively activated macrophages ...polarized by IL10 have been described to promote collateral growth. This study investigates the effect of different levels of IL10 on hind-limb reperfusion and the distribution of perivascular macrophage activation types in mice after femoral artery ligation (FAL). IL10 and anti-IL10 were administered before FAL and the arteriogenic response was measured by Laser-Doppler-Imaging perioperatively, after 3, 7, and 14 d. Reperfusion recovery was accelerated when treated with IL10 and impaired with anti-IL10. Furthermore, symptoms of ischemia on ligated hind-limbs had the highest incidence after application of anti-IL10. Perivascular macrophages were immunohistologically phenotyped using CD163 and CD68 in adductor muscle segments. The proportion of alternatively activated macrophages (CD163
/CD68
) in relation to classically activated macrophages (CD163
/CD68
) observed was the highest when treated with IL10 and suppressed with anti-IL10. This study underlines the proarteriogenic response with increased levels of IL10 and demonstrates an in-vivo alteration of macrophage activation types in the perivascular bed of growing collaterals.
Exo-Prothesenregister Putz, C.; Alimusaj, M.; Heitzmann, D. W. W. ...
Trauma und Berufskrankheit,
06/2018, Letnik:
20, Številka:
2
Journal Article
Recenzirano
Zusammenfassung
Hintergrund
Die medizinische Notwendigkeit eines Exo-Prothesenregisters für Patienten nach Beinamputation sowie deren Versorgung begründet sich darauf, dass zwar verschiedene ...Fachrichtungen Amputationen durchführen, aber eine Standardisierung der Behandlungsabläufe von der Amputation bis zur prothetischen Versorgung noch unzureichend definiert ist.
Material und Methoden
Während des Erfassungszeitraumes 08/2013 bis 08/2017 wurden klinische Daten von Patienten nach Beinamputation prospektiv in unserem Exo-Prothesenregister erfasst. Mittels Expertenbogen und Patientenbogen werden Angaben zur Art der Amputation, zu Stumpfverhältnissen, zur Beweglichkeit und Kraft, zur Mobilität sowie zum Status der prothetischen Versorgung erfasst.
Ergebnisse
Bei 257 beinamputierten Patienten bestand in 232 Fällen (90 %) eine Major- und in 25 Fällen (10 %) eine Minoramputation, die meist Folge eines Unfalls, einer Sepsis/Infektion oder einer Durchblutungsstörung waren. Anteilig 182 Patienten hatten eine Prothese (71 %), 42 Patienten waren nicht prothetisch versorgt (16 %), und bei 33 Patienten (13 %) gab es keine Angabe hierzu. Trotz prothetischer Versorgung kamen 23 % der 182 Patienten aufgrund von Stumpfproblemen oder Passformproblemen nicht mit ihrer Prothese zurecht.
Diskussion
Die Etablierung eines Exo-Prothesenregisters und die zentrumsinterne Organisation von interdisziplinären Kolloquien sollen dazu beitragen, dass Behandlungsabläufe optimiert werden und Patienten eine zügige Rückkehr nach einer Amputation ins Berufs- und Alltagsleben ermöglicht wird. Eine multizentrische Verbreitung mit interklinischer Vergleichsmöglichkeit kann dazu beitragen, Standards und Qualitätsmerkmale interdisziplinär gemeinsam zu definieren.
Abstract Hybrid towers have become increasingly established for tall wind turbines. The concrete part of these towers consists of several stacked circular ring segments. To reduce the amount of ...fabrication and erection effort, the joints between the segments are usually designed as dry ground joints. This paper presents experimental investigations aimed at determining the torsional load-bearing capacity of such dry ground concrete joints subjected to combined loading of prestressing, bending and torsion. Based on previous investigations, a test set-up consisting of three circular ring segments was developed. The torsional load-bearing capacity was determined by monitoring the tangential joint displacements in detail. The test results demonstrate that an increasing bending load leads to a uniform decrease in the torsional load-bearing capacity. The comparison with the current calculation model shows significant differences and confirms the weaknesses of the model regarding its inadequate interaction with the bending load. In contrast, numerical simulations agree well with the test results.
Zusammenfassung
Beim Klumpfuß handelt es sich um die häufigste behandlungsbedürftige kinderorthopädische Deformität. Obwohl der klinische Eindruck v. a. bei Geburt meist sehr eindrücklich ist, ist ...die Erkrankung in der Mehrzahl der Fälle gut zu behandeln. Dieser Beitrag bietet eine Übersicht über Diagnostik, Klassifikation, Pathoanatomie und Therapie des Klumpfußes. Außerdem wird auf Alternativen zur heutzutage weit verbreiteten Ponseti-Therapie sowie auf die Beratung von Eltern mit betroffenen Kindern eingegangen.
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