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Clinical Biomechanics

Jessica D Thompson, Prudence Plummer, Jason R Franz
BACKGROUND: Inspired by a reliance on visual feedback for movement control in older age, optical flow perturbations provide a unique opportunity to study the neuromuscular mechanisms involved in walking balance control, including aging and falls history effects on the response to environmental balance challenges. Specifically, antagonist leg muscle coactivation, which increases with age during walking, is considered a neuromuscular defense against age-associated deficits in balance control...
September 8, 2018: Clinical Biomechanics
Rami M A Al-Dirini, Saulo Martelli, Daniel Huff, Ju Zhang, John G Clement, Thor Besier, Mark Taylor
BACKGROUND: Restoring the original femoral offset is desirable for total hip replacements as it preserves the original muscle lever arm and soft tissue tensions. This can be achieved through lateralised stems, however, the effect of variation in the hip centre offset on the primary stability remains unclear. METHODS: Finite element analysis was used to compare the primary stability of lateralised and standard designs for a cementless femoral stem (Corail®) across a representative cohort of male and female femora (N = 31 femora; age from 50 to 80 years old)...
September 5, 2018: Clinical Biomechanics
Aurélie Sarcher, Sylvain Brochard, François Hug, Guy Letellier, Maxime Raison, Brigitte Perrouin-Verbe, Morgan Sangeux, Raphaël Gross
BACKGROUND: The aim of this study was two-fold: (1) to quantify the variability of upper limb electromyographic patterns during elbow movements in typically developing children and children with unilateral spastic cerebral palsy, and to compare different amplitude normalization methods; (2) to develop a method using this variability to detect (a) deviations in the patterns of a child with unilateral spastic cerebral palsy from the average patterns of typically developing children, and (b) changes after treatment to reduce muscle activation...
September 5, 2018: Clinical Biomechanics
B Santos, C Quental, J Folgado, M Sarmento, J Monteiro
BACKGROUND: New implant designs, such as resurfacing and stemless implants, have been developed to improve the long-term outcomes of the shoulder arthroplasty. However, it is not yet fully understood if their influence on the bone load distribution can compromise the long-term stability of the implant due to bone mass changes. Using three-dimensional finite element models, the aim of the present study was to analyse the bone remodelling process of the humerus after the introduction of resurfacing and stemless implants based on the Global C...
September 5, 2018: Clinical Biomechanics
Michelle Jones, William Stanish, Derek Rutherford
BACKGROUND: Contra-lateral knee joint function in individuals with moderate knee osteoarthritis is not well understood, despite the functional burden of bilateral osteoarthritis on end stage clinical management. The purpose of this study was to determine whether co-activation and joint biomechanics are altered in the contra-lateral limb compared to age-matched controls. METHODS: 20 Individuals with moderate knee osteoarthritis and 20 asymptomatic individuals walked on an instrumented dual belt treadmill at a self-selected speed...
September 5, 2018: Clinical Biomechanics
Jan Kottner, Joyce Black, Evan Call, Amit Gefen, Nick Santamaria
Pressure ulcers are caused by sustained mechanical loading and deformation of the skin and subcutaneous layers between internal stiff anatomical structures and external surfaces or devices. In addition, the skin microclimate (temperature, humidity and airflow next to the skin surface) is an indirect pressure ulcer risk factor. Temperature and humidity affect the structure and function of the skin increasing or lowering possible damage thresholds for the skin and underlying soft tissues. From a pressure ulcer prevention research perspective, the effects of humidity and temperature next to the skin surface are inextricably linked to concurrent soft tissue deformation...
September 5, 2018: Clinical Biomechanics
Elena Bueno-Gracia, Albert Pérez-Bellmunt, Carlos López-de-Celis, Michael Shacklock, Ainhoa Salas-López, Mathias Simon, Pedro Álvarez-Díaz, José Miguel Tricás-Moreno
STUDY DESIGN: Cross-sectional study. BACKGROUND: The carpal tunnel is a clinically important fibro-osseous conduit for the median nerve and associated tendons. It is mechanically dynamic and therapeutic manual techniques that appear to move and change tunnel shape is part of clinical practice. OBJECTIVES: To measure changes in dimensions of the carpal tunnel and median nerve with manual mobilization of the carpal bones in cadavers. METHODS: A total of 20 cryopreserved upper extremities from cadaveric specimens were used in the study...
September 3, 2018: Clinical Biomechanics
Masumeh Bagherzadeh Cham, Mohammad Ali Mohseni-Bandpei, Mahmood Bahramizadeh, Saeed Kalbasi, Akbar Biglarian
BACKGROUND: The first aim of this study was to determine the effect of a vibro-medical insole on pressure sensation and the second was to measure the effects of a vibro-medical insole with and without random noise on plantar pressure distribution in diabetic patients with mild-to-moderate peripheral neuropathy. METHODS: Twenty patients with mild-to-moderate diabetic neuropathy were recruited in the clinical trial pre-test, post-test study. A medical insole was made for each participant and a vibratory system was inserted into it...
August 18, 2018: Clinical Biomechanics
T Vendeuvre, M Grunberg, A Germaneau, F Maloubier, J-P Faure, L-E Gayet, P Rigoard, C Brèque
BACKGROUND: Schatzker type II tibial plateau fractures necessitate the least invasive treatment possible. Arthroscopic reduction by bone tamp followed by osteosynthesis is the current gold standard for this type of tibial plateau fracture. The objective of this study was to compare this technique to anterior approach tuberoplasty with balloon reduction. The comparison criteria were residual articular step off, metaphyseal cavity volume formed during reduction, and mechanical strength to separation and to depression displacement...
August 11, 2018: Clinical Biomechanics
Nise Ribeiro Marques, Deborah Hebling Spinoso, Bruna Carvalho Cardoso, Vinicius Christianini Moreno, Marina Hiromi Kuroda, Marcelo Tavella Navega
BACKGROUND: Gait kinematic parameters have been reported as an important clinical tool to assess the risk of falls in older adults. However, the ability of these parameters to predict falls in the older population is still unclear. OBJECTIVE: To identify the ability that gait kinematic parameters present to predict fall in older adults. METHODS: Data from 102 older adults, who live in a community setting, were considered for this study. For data collection, older subjects had to walk on a 14 meter-walkway in their preferred gait speed...
August 11, 2018: Clinical Biomechanics
Toshiki Kobayashi, Michael S Orendurff, Grace Hunt, Fan Gao, Nicholas LeCursi, Lucas S Lincoln, K Bo Foreman
BACKGROUND: Resistance is a key mechanical property of an ankle-foot orthosis that affects gait in individuals post-stroke. Triple Action® joints allow independent adjustment of plantarflexion resistance and dorsiflexion resistance of an ankle-foot orthosis. Therefore, the aim of this study was to investigate the effects of incremental changes in dorsiflexion and plantarflexion resistance of an articulated ankle-foot orthosis with the Triple Action joints on lower limb joint kinematics and kinetics in individuals post-stroke during gait...
August 10, 2018: Clinical Biomechanics
Wen-Ming Chen, Jie Jin, Taehyung Park, Kyeong-Sik Ryu, Sung-Jae Lee
BACKGROUND: Postoperative alterations in cervical spine curvature (i.e. loss of lordotic angle) are frequently observed following total disc replacement surgery. However, it remains unclear whether such changes in lordotic angle are due to preoperative spinal deformities and/or prostheses design limitations. The objective of the study is to investigate strain and segmental biomechanics of the malaligned cervical spine following total disc replacement. METHODS: Three disc prostheses were chosen, namely a metal-on-polyethylene, a metal-on-metal, and an elastomeric prosthesis, which feature different geometrical and material design characteristics...
August 10, 2018: Clinical Biomechanics
Sarah J Holmes, Anita J Mudge, Elizabeth A Wojciechowski, Matthias W Axt, Joshua Burns
BACKGROUND: Children with cerebral palsy are at risk of developing muscle contractures, often contributing to pain, structural deformities and mobility limitations. With the increasing use of gait indices to summarise the findings of three dimensional gait analysis (3DGA), the purpose of this study is to determine whether there is a relationship between multilevel joint contractures and the Gait Profile Score in children with cerebral palsy. METHODS: The Gait Profile Score, calculated from 3D gait analysis, and passive range of motion, strength and spasticity of the hips, knees and ankles in the sagittal plane were measured in 145 children with cerebral palsy (mean age:11 years,4 months; SD:2 years,10 months) (83 males) enrolled in the NSW Paediatric Gait Analysis Service Research Registry from 2011 to 2016...
August 8, 2018: Clinical Biomechanics
Derek Rutherford, Lindsey Buckingham, Janice Moreside, Ivan Wong, Glen Richardson
BACKGROUND: Knee function is impaired in individuals with moderate hip osteoarthritis. How this extends to those undergoing total hip arthroplasty is unknown despite the common requirement for knee arthroplasty in this population. The study purpose was to determine whether sagittal plane knee joint movements and quadriceps and hamstring activation patterns differ between individuals with either moderate or severe unilateral hip osteoarthritis, and between ipsilateral and contralateral knees...
August 8, 2018: Clinical Biomechanics
James J Carollo, Kate Worster, Zhaoxing Pan, Julie Ma, Frank Chang, Joanne Valvano
BACKGROUND: The purpose of this retrospective study was to explore lower limb intersegmental coordination as a clinically important indicator of motor control mechanisms in individuals with cerebral palsy exhibiting stiff-knee gait. We used the relative phase of thigh and foot segments around foot-off to describe motor control, given the relevance of the pre-swing phase of gait to the existence of stiff-knee gait. METHODS: Traditional gait parameters and thigh/foot intersegmental coordination were calculated using pre-and postoperative kinematic data from a cohort of 54 subjects (92 legs) with spastic cerebral palsy...
August 6, 2018: Clinical Biomechanics
Lynne E Bilston, Barclay Morrison
No abstract text is available yet for this article.
July 11, 2018: Clinical Biomechanics
Kenton R Kaufman, Kathie A Bernhardt, Kevin Symms
BACKGROUND: The benefits of a microprocessor-controlled knee are well documented in transfemoral amputees who are unlimited community ambulators. There have been suggestions that transfemoral amputees with limited community ambulation will also benefit from a microprocessor-controlled knee. Current medical policy restricts microprocessor-controlled knees to unlimited community ambulators and, thereby, potentially limits function. This clinical trial was performed to determine if limited community ambulators would benefit from a microprocessor-controlled knee...
October 2018: Clinical Biomechanics
Li Zhongyou, Jiang Wentao, Yuan Ding, Chen Yu, Tian Xiaobao, Zhou Zhihong
OBJECTIVE: To study the feasibility of using two stents (a combination of multilayer stent [MS] and stent graft [SG]) in the treatment of a juxtarenal aortic aneurysm that involves a significant branch artery and to determine the advantages and disadvantages of using SGs upstream and downstream from the aneurysm so as to provide some theoretical guidance for preoperative clinical decision-making in the future. METHODS: Four ideal geometric models were established for numerical computation: case 1 refers to an aneurysm without the use of stents, case 2 represents the implantation of two MSs in an aneurysm, and case 3 (SG + MS) and case 4 (MS + SG) both involve the treatment of an aneurysm by using a combination of SG and MG...
October 2018: Clinical Biomechanics
Harald Böhm, Philipp Wanner, Roman Rethwilm, Leonhard Döderlein
BACKGROUND: Running is a fundamental movement skill and a prerequisite for children to participate in numerous daily activities. The prevalence of the ability to run in people with Cerebral Palsy and the role of their impairments on running ability are unknown. Therefore, the aim of this study is to determine the prevalence of the ability to run and to identify contributing factors. METHODS: In this study, 280 children and adolescents with spastic Cerebral Palsy, Gross Motor Function Classification System level II were included...
October 2018: Clinical Biomechanics
Ziad Bakouny, Ayman Assi, Fares Yared, Nour Khalil, Elie Mansour, Jean Jacques Yaacoub, Wafa Skalli, Ismat Ghanem
BACKGROUND: Hip instability is frequent in patients with Down syndrome. Recent studies have suggested that skeletal hip alterations are responsible for this instability; however, there are currently no studies simultaneously assessing femoral and acetabular anatomy in subjects with Down syndrome in the standing position. The aim was to analyze the three-dimensional anatomy of the Down syndrome hip in standing position. METHODS: Down syndrome subjects were age and sex-matched to asymptomatic controls...
October 2018: Clinical Biomechanics
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