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Quang, Huu-Hieu, Yoshifumi Morita, and Makoto Takekawa. "Digital Testing Device for Active Range of Motion of Finger Joints Utilizing Artificial Neural Network." Proceedings of International Conference on Artificial Life and Robotics 26 (January 21, 2021): 445–48. http://dx.doi.org/10.5954/icarob.2021.gs6-1.
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&NA;. "Joint Range of Motion and Muscle Length Testing, 2nd Edition." Medicine & Science in Sports & Exercise 45, no. 12 (December 2013): 2387. http://dx.doi.org/10.1249/01.mss.0000436238.73199.d1.
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Bösch, Nadja, Martin Hofstetter, Alexander Bürki, Beatriz Vidondo, Fenella Davies, and Franck Forterre. "Effect of Facetectomy on the Three-Dimensional Biomechanical Properties of the Fourth Canine Cervical Functional Spinal Unit: A Cadaveric Study." Veterinary and Comparative Orthopaedics and Traumatology 30, no. 06 (2017): 430–37. http://dx.doi.org/10.3415/vcot-17-03-0043.
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Abstract Objective To study the biomechanical effect of facetectomy in 10 large breed dogs (>24 kg body weight) on the fourth canine cervical functional spinal unit. Methods Canine cervical spines were freed from all muscles. Spines were mounted on a six-degrees-of-freedom spine testing machine for three-dimensional motion analysis. Data were recorded with an optoelectronic motion analysis system. The range of motion wasdetermined inall threeprimary motionsaswellasrange of motion of coupled motions on the intact specimen, after unilateral and after bilateral facetectomy. Repeated-measures analysis of variance models were used to assess the changes of the biomechanical properties in the three treatment groups considered. Results Facetectomy increased range of motion of primary motions in all directions. Axial rotation was significantly influenced by facetectomy. Coupled motion was not influenced by facetectomy except for lateral bending with coupled motion axial rotation. The coupling factor (coupled motion/primary motion) decreased after facetectomy. Symmetry of motion was influenced by facetectomy in flexion–extension and axial rotation, but not in lateral bending. Clinical Significance Facet joints play a significant role in the stability of the cervical spine and act to maintain spatial integrity. Therefore, cervical spinal treatments requiring a facetectomy should be carefully planned and if an excessive increase in range of motion is expected, complications should be anticipated and reduced via spinal stabilization.
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Al-Qattan, M. M. "The exploded hand syndrome: a report of five industrial injury cases." Journal of Hand Surgery (European Volume) 38, no. 8 (November 27, 2012): 880–87. http://dx.doi.org/10.1177/1753193412468577.
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The term ‘exploded hand syndrome’ refers to a specific type of crush injury to the hand in which a high compressive force excessively flattens the hand leading to thenar muscle extrusion through burst lacerations. Out of 89 crushed hands seen over a period of seven years, only five had exploded hand syndrome. They were all male industrial workers ranging in age between 24 and 55 years. All patients had thenar muscle extrusion. Other concurrent injuries included fractures/dislocations, compartment syndrome, and ischaemia. All patients were treated by excision of the extruded intrinsic muscles, as well as primary management of concurrent injuries. All patients had functional assessment including: motor power and sensory testing, range of motion of hand joints, and the quick DASH score. Objective testing showed reduced sensibility in the thumb, reduced grip strength (mean 52% of contralateral hand), reduced pinch strength (mean of 27% of contralateral hand), reduced thumb opposition (the mean Kapandji Score was 5 out of 10), and deficits in the range of motion of the metacarpophalangeal and interphalangeal joints of the thumb. The quick DASH score ranged from 11 to 49 and only two patients were able to go back to regular manual work.
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Henderson, Jeffrey, Joan Condell, James Connolly, Daniel Kelly, and Kevin Curran. "Reliability and Validity of Clinically Accessible Smart Glove Technologies to Measure Joint Range of Motion." Sensors 21, no. 5 (February 24, 2021): 1555. http://dx.doi.org/10.3390/s21051555.
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Capturing hand motions for hand function evaluations is essential in the medical field. For many allied health professionals, measuring joint range of motion (ROM) is an important skill. While the universal goniometer (UG) is the most used clinical tool for measuring joint ROM, developments in current sensor technology are providing clinicians with more measurement possibilities than ever. For rehabilitation and manual dexterity evaluations, different data gloves have been developed. However, the reliability and validity of sensor technologies when used within a smart device remain somewhat unclear. This study proposes a novel electronically controlled sensor monitoring system (ECSMS) to obtain the static and dynamic parameters of various sensor technologies for both data gloves and individual sensor evaluation. Similarly, the ECSMS was designed to closely mimic a human finger joint, to have total control over the joint, and to have an exceptionally high precision. In addition, the ECSMS device can closely mimic the movements of the finger from hyperextension to a maximum ROM beyond any person’s finger joint. Due to the modular design, the ECSMS’s sensor monitoring board is independent and extensible to include various technologies for examination. Additionally, by putting these sensory devices through multiple tests, the system accurately measures the characteristics of any rotary/linear sensor in and out of a glove. Moreover, the ECSMS tracks the movement of all types of sensors with respect to the angle values of finger joints. In order to demonstrate the effectiveness of sensory devices, the ECSMS was first validated against a recognised secondary device with an accuracy and resolution of 0.1°. Once validated, the system simultaneously determines real angles alongside the hand monitoring device or sensor. Due to its unique design, the system is independent of the gloves/sensors that were tested and can be used as a gold standard to realise more medical equipment/applications in the future. Consequently, this design greatly enhances testing measures within research contact and even non-contact systems. In conclusion, the ECSMS will benefit in the design of data glove technologies in the future because it provides crucial evidence of sensor characteristics. Similarly, this design greatly enhances the stability and maintainability of sensor assessments by eliminating unwanted errors. These findings provide ample evidence for clinicians to support the use of sensory devices that can calculate joint motion in place of goniometers.
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Agarwal, Priyanshu, Youngmok Yun, Jonas Fox, Kaci Madden, and Ashish D. Deshpande. "Design, control, and testing of a thumb exoskeleton with series elastic actuation." International Journal of Robotics Research 36, no. 3 (March 2017): 355–75. http://dx.doi.org/10.1177/0278364917694428.
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We present an exoskeleton capable of assisting the human thumb through a large range of motion. Our novel thumb exoskeleton has the following unique features: (i) an underlying kinematic mechanism that is optimized to achieve a large range of motion, (ii) a design that actuates four degrees of freedom of the thumb, and (iii) a series elastic actuation based on a Bowden cable, allowing for bidirectional torque control of each thumb joint individually. We present a kinematic model of the coupled thumb exoskeleton system and use it to maximize the range of motion of the thumb. Finally, we carry out tests with the designed device on four subjects to evaluate its workspace and kinematic transparency using a motion capture system and torque control performance. Results show that the device allows for a large workspace with the thumb, is kinematically transparent to natural thumb motion to a high degree, and is capable of accurate torque control.
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Almusawi, Husam, and Géza Husi. "Design and Development of Continuous Passive Motion (CPM) for Fingers and Wrist Grounded-Exoskeleton Rehabilitation System." Applied Sciences 11, no. 2 (January 16, 2021): 815. http://dx.doi.org/10.3390/app11020815.
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Impairments of fingers, wrist, and hand forearm result in significant hand movement deficiencies and daily task performance. Most of the existing rehabilitation assistive robots mainly focus on either the wrist training or fingers, and they are limiting the natural motion; many mechanical parts associated with the patient’s arms, heavy and expensive. This paper presented the design and development of a new, cost-efficient Finger and wrist rehabilitation mechatronics system (FWRMS) suitable for either hand right or left. The proposed machine aimed to present a solution to guide individuals with severe difficulties in their everyday routines for people suffering from a stroke or other motor diseases by actuating seven joints motions and providing them repeatable Continuous Passive Motion (CPM). FWRMS approach uses a combination of; grounded-exoskeleton structure to provide the desired displacement to the hand’s four fingers flexion/extension (F/E) driven by an indirect feed drive mechanism by adopting a leading screw and nut transmission; and an end-effector structure to provide angular velocity to the wrist flexion/ extension (F/E), wrist radial/ulnar deviation (R/U), and forearm supination/pronation (S/P) driven by a rotational motion mechanism. We employed a single dual-sided actuator to power both mechanisms. Additionally, this article presents the implementation of a portable embedded controller. Moreover, this paper addressed preliminary experimental testing and evaluation process. The conducted test results of the FWRMS robot achieved the required design characteristics and executed the motion needed for the continuous passive motion rehabilitation and provide stable trajectories guidance by following the natural range of motion (ROM) and a functional workspace of the targeted joints comfortably for all trainable movements by FWRMS.
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de Solminihac, Diego Zanolli, Emilio Wagner, Pablo Wagner, Cristian Ortiz, Andres Keller Díaz, Ruben Radkievich, Felipe Palma, and Rodrigo Guzman-Venegas. "Development of a cadaveric Hallux Rigidus model. Biomechanical testing." Foot & Ankle Orthopaedics 2, no. 3 (September 1, 2017): 2473011417S0004. http://dx.doi.org/10.1177/2473011417s000426.
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Category: Bunion Introduction/Purpose: Hallux Rigidus (HR) is characterized initially by a decrease in Hallux metatarsophalangeal joint (MTPJ) dorsiflexion, decreasing the total range of motion. To be able to study different surgical treatment options, a cadaveric model has to be developed that recreates the limited range of motion. Our objective was to develop an Hallux Rigidus cadaveric model by shortening the plantar fascia (PF). Hallux MTPJ range of motion and joint stiffness were evaluated. Methods: 8 cadaveric foot- ankle – distal tibia specimens were prepared, identifying all extensor and flexor tendons proximally. The skin and subcutaneous tissue was kept intact. Each specimen was mounted on a special frame and luminous markers were attached to the skin (Oxford Foot Model). A dead weight equal to 50% of the stance phase force was applied to each tendon, except for the Achilles tendon and the posterior tibialis. 10 Hallux MTPJ dorsiflexion-plantarflexion cycles were performed by pulling the Extensor Hallucis longus tendon using an tensile testing machine (Kinetecnics). A Hallux Rigidus model was then developed by shortening the PF by 6 mm using a triple fiberwire suture technique. The same 10 cycles were repeated with a shortened PF. Each specimen served as its own control. Hallux metatarsophalangeal stiffness and kinematics were tested using a tensile testing machine and high definition cameras. Results: The group with a shortened PF significantly reduced the hallux dorsiflexion (18.6 degrees) compared to the native foot (23.7 degress) (p<0.05). No significant difference in joint stiffness was seen between groups: 3.3 N per degree for the native foot and 4.3 N per degree for the Hallux Rigidus model (P>0.05). Conclusion: To create a HR model is vital to allow further understanding of the pathology. The cadaveric model should not alter the joint stability (intact periarticular soft tissues) but has to limit Hallux range of motion. The model we present successfully recreates HR by limiting MTPJ dorsiflexion. The absence of stiffness change shows that joint congruity and isometry were not modified. There are a few reports that state a PF shortening as the first stage in HR. This would lead to a hinge-like MTPJ dorsiflexion, creating a dorsal metatarsal head impingement that could evolve to a dorsal exostosis.
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Golik-Perić, Dragana. "Izokinetički trening." Aktuelno u praksi: bilten za strucna pitanja u fizickoj kulturi 25, no. 2 (2015): 33–38. http://dx.doi.org/10.5937/aup1501033p.
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Human body movement is a complex process which depends on many factors. Insufficient power or disturbed balance of power between muscle groups which move certain parts of the body causing shortness of movement, overload of articular cartilage and ligaments, arthritis, joint pain and immobility, and often of the whole body. Isokinetic functional testing on the isokinetic dynamometer is the most objective method for detailed diagnostics of muscles and joints, as it provides a detailed insight into the state of the locomotor apparatus of each person. The research that was carried out was aimed to determine the effects of four weeks of isokinetic training on morphological characteristics and isokinetic capabilities. The training program on the isokinetic apparatus consisted of maximum intensity exercise, the resistance of which is gradually increased, at different angular velocities, from the first to the fourth week. Training on the isokinetic apparatus enables targeted, faster, better and more efficiently increase of force of deficient upper knee musculature muscle groups. Muscle is dynamically activated to its full capacity, constantly, during the entire range of motion and no load of associated joints, so the work on the knee joint mobility is higher.
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Smith, S. L., D. Dowson, and A. A. J. Goldsmith. "The effect of femoral head diameter upon lubrication and wear of metal-on-metal total hip replacements." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 215, no. 2 (February 1, 2001): 161–70. http://dx.doi.org/10.1243/0954411011533724.
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It has been found that a remarkable reduction in the wear of metal-on-metal hip joints can be achieved by simply increasing the diameter of the joint. A tribological evaluation of metal-on-metal joints of 16, 22,225, 28 and 36 mm diameter was conducted in 25 per cent bovine serum using a hip joint simulator. The joints were subject to dynamic motion and loading cycles simulating walking for both lubrication and wear studies. For each size of joint in the lubrication study, an electrical resistivity technique was used to detect the extent of surface separation through a complete walking cycle. Wear of each size of joint was measured gravimetrically in wear tests of at least 2 × 106 cycles duration. Joints of 16 and 22.225mm diameter showed no surface separation in the lubrication study. This suggested that wear would be proportional to the sliding distance and hence joint size in this boundary lubrication regime. A 28 mm diameter joint showed only limited evidence of surface separation suggesting that these joints were operating in a mixed lubrication regime. A 36 mm diameter joint showed surface separation for considerable parts of each walking cycle and hence evidence of the formation of a protective lubricating film. Wear testing of 16 and 22.225mm diameter metal-on-metal joints gave mean wear rates of 4.85 and 6.30mm3/106 cycles respectively. The ratio of these wear rates, 0.77, is approximately the same as the joint diameters ratio, 16/22.225 or 0.72, as expected from simple wear theory for dry or boundary lubrication conditions. No bedding-in was observed with these smaller diameter joints. For the 28 mm diameter joint, from 0 to 2 × 106 cycles, the mean wear rate was 1.62 mm3/106 cycles as the joints bedded-in. Following bedding-in, from 2.0 × 106 to 4.7 × 106 cycles, the wear rate was 0.54mm3/106 cycles. As reported previously by Goldsmith in 2000 [1], the mean steady state wear rate of the 36 mm diameter joints was lower than those of all the other diameters at 0.07 mm3/106 cycles. For a range of joints of various diameters, subjected to identical test conditions, mean wear rates differed by almost two orders of magnitude. This study has demonstrated that the application of sound tribological principles to prosthetic design can reduce the wear of metal-on-metal joints, using currently available materials, to a negligible level.
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Zobitz, M. E., A. M. Halder, L. J. Berglund, S. G. Kuhl, and Kai-Nan An. "MEASUREMENT OF INTRINSIC ARTICULAR JOINT STABILITY." Journal of Musculoskeletal Research 05, no. 03 (September 2001): 185–91. http://dx.doi.org/10.1142/s0218957701000556.
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Concavity-compression is an important mechanism for keeping a joint centered despite a large range of motion. The purpose of this study was to explain how the results of a test measuring the joint intrinsic stability can be interpreted and related to joint architecture. As an example, the method was demonstrated for the glenohumeral joint although the versatility allows any articulating joint, whether natural or prosthetic, to be analyzed. The initial slope from the central point was relatively steep, indicating a large resistance to translation. The peak translation force occurred within the first 5 mm of displacement for the glenohumeral joint, indicating a high congruence between the humerus and glenoid surfaces. Stability ratio, calculated as the maximum translation force divided by the applied joint compressive force, makes it possible to compare the stabilizing effect under different compressive loads for different anatomical directions. In hanging arm position, the joint stability ratio ranged from 30.5% to 60.1%. Finally, the effective depth of the concavity and the maximum range of joint translation can be measured by completely dislocating the joint. For the glenohumeral specimen, the smallest glenoid concavity depth, 3.8 mm, occurred in the anterior direction. The joint translation limit was smallest in the anterior-posterior direction (28.0 mm). The methodology presented in this study will allow consistent testing parameters between different trials, easily allowing parametric studies to gain a more complete understanding of articular joints.
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Lindsey, Derek P., Robin Parrish, Mukund Gundanna, Jeremi Leasure, Scott A. Yerby, and Dimitriy Kondrashov. "Biomechanics of unilateral and bilateral sacroiliac joint stabilization: laboratory investigation." Journal of Neurosurgery: Spine 28, no. 3 (March 2018): 326–32. http://dx.doi.org/10.3171/2017.7.spine17499.
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OBJECTIVEBilateral symptoms have been reported in 8%–35% of patients with sacroiliac (SI) joint dysfunction. Stabilization of a single SI joint may significantly alter the stresses on the contralateral SI joint. If the contralateral SI joint stresses are significantly increased, degeneration may occur; alternatively, if the stresses are significantly reduced, bilateral stabilization may be unnecessary for patients with bilateral symptoms. The biomechanical effects of 1) unilateral stabilization on the contralateral SI joint and 2) bilateral stabilization on both SI joints are currently unknown. The objectives of this study were to characterize bilateral SI joint range of motion (ROM) and evaluate and compare the biomechanical effects of unilateral and bilateral implant placement for SI joint fusion.METHODSA lumbopelvic model (L5–pelvis) was used to test the ROM of both SI joints in 8 cadavers. A single-leg stance setup was used to load the lumbar spine and measure the ROM of each SI joint in flexion-extension, lateral bending, and axial rotation. Both joints were tested 1) while intact, 2) after unilateral stabilization, and 3) after bilateral stabilization. Stabilization consisted of lateral transiliac placement of 3 triangular titanium plasma-sprayed (TPS) implants.RESULTSIntact testing showed that during single-leg stance the contralateral SI joint had less ROM in flexion-extension (27%), lateral bending (32%), and axial rotation (69%) than the loaded joint. Unilateral stabilization resulted in significant reduction of flexion-extension ROM (46%) on the treated side; no significant ROM changes were observed for the nontreated side. Bilateral stabilization resulted in significant reduction of flexion-extension ROM of the primary (45%) and secondary (75%) SI joints.CONCLUSIONSThis study demonstrated that during single-leg loading the ROMs for the stance (loaded) and swing (unloaded) SI joints are significantly different. Unilateral stabilization for SI joint dysfunction significantly reduces the ROM of the treated side, but does not significantly reduce the ROM of the nontreated contralateral SI joint. Bilateral stabilization is necessary to significantly reduce the ROM for both SI joints.
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Harris, Edwin J., Katherine E. Schimka, and Russell M. Carlson. "Complex Regional Pain Syndrome of the Pediatric Lower Extremity." Journal of the American Podiatric Medical Association 102, no. 2 (March 1, 2012): 99–104. http://dx.doi.org/10.7547/1020099.
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Background: Complex regional pain syndrome (CRPS) type 1 is a disorder of the extremities characterized by pain, edema, limited range of motion, integument changes, and vasomotor instability often after an inciting event. In the pediatric population, CRPS may be misdiagnosed, or missed entirely, as CRPS literature for this patient population is lacking. Methods: Twenty-seven pediatric patient medical records with the diagnosis of CRPS type 1 from the institutional and private practices of the principal investigator (E.J.H.) were reviewed for demographics, inciting event, lower-extremity clinical examination, ancillary testing, previous treatments, time to diagnosis, treatment after diagnosis, and time to resolution of symptoms. Results: Females composed 85.2% of the patient population (n = 23) (mean age of females, 11.11 years). An inciting event preceded pain in 74.1% of patients (n = 20). On physical examination, more than 50% of patients were identified as having changes in skin color and temperature, edema to the affected lower extremity, painful or decreased range of motion in affected joints, and intact lower-extremity motor function. The average time to resolution of symptoms was 6.8 weeks for the entire population. Conclusions: Diagnosis of CRPS type 1 should be considered in a preadolescent female complaining of pain out of proportion after an inciting event with a physical examination demonstrating change in skin color, decrease in skin temperature, edema, and painful or diminished range of motion in affected joints. Prompt diagnosis can decrease the time to resolution of symptoms. (J Am Podiatr Med Assoc 102(2): 99–104, 2012)
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Lidtke, Roy H., and Joe George. "Anatomy, Biomechanics, and Surgical Approach to Synovial Folds Within the Joints of the Foot." Journal of the American Podiatric Medical Association 94, no. 6 (November 1, 2004): 519–27. http://dx.doi.org/10.7547/0940519.
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The presence of synovial folds in various joints of the foot has been previously documented. The function and clinical significance of these structures within the joint have not been established. Histologically they are considered anatomically different from a meniscus primarily owing to their makeup of loose connective tissue with nerve fibrils and several synovial cell layers. We hypothesize that the function of these folds is similar to that of the menisci: to increase joint congruity and stability. We further hypothesize that these folds will be present in joints of the foot that require greater stability. To demonstrate this, 41 fixated cadaveric feet were sectioned in the sagittal plane and the incidence and locations of the synovial folds were documented. Three fixated cadaveric feet were evaluated using a materials testing machine. The first metatarsophalangeal joint was incised, and the presence of the synovial fold was documented. The joint was then taken through its range of motion with and without the synovial fold while data on the force and displacement were collected. The steps were then repeated for the ankle joint. The results showed statistically stiffer ankle and first metatarsophalangeal joints with the synovial fold present, as determined by the stress-strain curve. On the basis of the presence and location of these synovial folds, we demonstrated arthroscopic surgical approaches to many of the documented joints that contain these folds. Because the folds contain synovial cells and vascular tissue, damage to them can result in considerable pain. In such cases, arthroscopic surgery would be of benefit. Further research may indicate whether they need to be salvaged during joint procedures to facilitate normal joint function or should be removed to reduce postoperative complications. (J Am Podiatr Med Assoc 94(6): 519–527, 2004)
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Brigham, Christopher R. "Measuring Shoulder Motion." Guides Newsletter 15, no. 6 (November 1, 2010): 3–4. http://dx.doi.org/10.1001/amaguidesnewsletters.2010.novdec02.
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Abstract Measuring and documenting shoulder motion is important for many reasons, including diagnosis, determining the severity and progression of a disorder, assessing the results of treatment, and evaluating impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition provides guidance for the process of assessing abnormal motion of the shoulder, specifically Section 15.7a, Clinical Measurements of Motion, and Section 15.7g, Shoulder Motion. The shoulder has greater mobility than any other joint of the body, and movement there usually is composite rather than in a single plane; as a result, single movements are difficult to isolate. In the AMA Guides, universal goniometers with long arms are used to measure shoulder range of motion (ROM). Measurements of joint motion must be performed and recorded consistently because interrater reliability is reduced if instruments are incorrectly placed or if overlying soft tissue distorts the measurement. Active motion is obtained with full muscle force and cooperation after warm-up, and the ROM examination is performed by recording the active measurements from three separate ROM efforts. Patients may self-limit during the assessment of active range of motion or exert submaximal effort on manual strength testing because of pain and/or apprehension, so all measurements should fall within 10° of the mean and both sides should be tested.
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Rigoni, Gill, Babazadeh, Elsewaisy, Gillies, Nguyen, Pathirana, and Page. "Assessment of Shoulder Range of Motion Using a Wireless Inertial Motion Capture Device—A Validation Study." Sensors 19, no. 8 (April 13, 2019): 1781. http://dx.doi.org/10.3390/s19081781.
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(1) Background: Measuring joint range of motion has traditionally occurred with a universal goniometer or expensive laboratory based kinematic analysis systems. Technological advances in wearable inertial measurement units (IMU) enables limb motion to be measured with a small portable electronic device. This paper aims to validate an IMU, the ‘Biokin’, for measuring shoulder range of motion in healthy adults; (2) Methods: Thirty participants completed four shoulder movements (forward flexion, abduction, and internal and external rotation) on each shoulder. Each movement was assessed with a goniometer and the IMU by two testers independently. The extent of agreement between each tester’s goniometer and IMU measurements was assessed with intra-class correlation coefficients (ICC) and Bland-Altman 95% limits of agreement (LOA). Secondary analysis compared agreement between tester’s goniometer or IMU measurements (inter-rater reliability) using ICC’s and LOA; (3) Results: Goniometer and IMU measurements for all movements showed high levels of agreement when taken by the same tester; ICCs > 0.90 and LOAs < ±5 degrees. Inter-rater reliability was lower; ICCs ranged between 0.71 to 0.89 and LOAs were outside a prior defined acceptable LOAs (i.e., > ±5 degrees); (4) Conclusions: The current study provides preliminary evidence of the concurrent validity of the Biokin IMU for assessing shoulder movements, but only when a single tester took measurements. Further testing of the Biokin’s psychometric properties is required before it can be confidently used in routine clinical practice and research settings.
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Roukis, Thomas S., Adam S. Landsman, James B. Ringstrom, Peter Kirschner, and Markus Wuenschel. "Distally Based Capsule-Periosteum Interpositional Arthroplasty for Hallux Rigidus." Journal of the American Podiatric Medical Association 93, no. 5 (September 1, 2003): 349–66. http://dx.doi.org/10.7547/87507315-93-5-349.
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Twelve patients (15 feet) with severe hallux rigidus underwent distally based capsule-periosteum interpositional arthroplasty of the first metatarsophalangeal joint (mean ± SD follow-up, 16.8 ± 7.0 months). Subjective evaluation was based on a modified version of the American Orthopaedic Foot and Ankle Society’s 100-point Hallux Metatarsophalangeal-Interphalangeal Joint Scale. Objective evaluation consisted of preoperative and postoperative physical examinations (first metatarsophalangeal joint range of motion and axial grind testing) and radiographic evaluations (joint space width). The short-term results of this novel procedure showed subjective patient improvement and satisfaction, increased first metatarsophalangeal joint dorsal range of motion, maintained hallux plantar range of motion and power, and improved joint space width on anteroposterior and lateral radiographs. None of the patients developed a hallux hammer toe or extensus deformity or lesser metatarsalgia, and none required further surgical intervention. After describing the indications of the procedure and the surgical technique, the authors compare the results with those of the various other procedures available for the surgical treatment of hallux rigidus. (J Am Podiatr Med Assoc 93(5): 349-366, 2003)
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Brigham, Christopher R. "Clinical Update: Measuring Shoulder Joint Motion." Guides Newsletter 3, no. 5 (September 1, 1998): 4–5. http://dx.doi.org/10.1001/amaguidesnewsletters.1998.sepoct02.
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Abstract Accurate measurement of shoulder motion is critical in assessing impairment following shoulder disorders. To this end, measuring and recording joint motion are important steps in diagnosing, determining the severity and progression of a disorder, assessing the results of treatment, and evaluating impairment. Shoulder movement usually is composite rather than in a single plane, so isolating single movements is challenging. Universal goniometers with long arms are used to measure shoulder motion, and testing must be performed and recorded consistently. Passive motion may be carried out cautiously by the examiner; two measurements of the same patient by the same examiner should lie within 10° of each other. Shoulder extension and flexion are illustrated. Maximal flexion of the shoulder also includes slight external rotation and abduction, and controlling or eliminating these components during evaluation is challenging. Abduction and adduction are illustrated. Deficits in external rotation may occur in patients who have undergone reconstructive procedures with an anterior approach; deficits in internal rotation may result from issues with shoulder instability. The authors recommend recording the shoulder's range of motion measurements according to the Upper Extremity Impairment Evaluation Record in the AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition.
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Ngan, Jim M. W., Daniel H. K. Chow, Andrew D. Holmes, Malcolm H. Pope, and Alon Lai. "In-vitro Kinematic Testing of Porcine Cervical Spine: A Rotational Manipulation Model." Prosthetics and Orthotics International 33, no. 1 (January 2009): 89–98. http://dx.doi.org/10.1080/03093640802698923.
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Although spinal manipulation is widely used in the management of neck and pain, its exact mechanisms and biomechancial effects are not clear. A porcine model was used to study the relative movements of intervertebral joints under spinal rotation maneuvers with different input angular displacements and thrust velocities. Ten porcine spines (C2/4) were fixed and mounted in a material testing machine. Rotational maneuvers with different input angular displacements (0.8, 1.5, 2 and 3°) and thrust velocities (0.1 – 200°/s) were applied to C2 with C4 fixed. Angular displacement induced at the adjacent level was measured and expressed as percentage of the applied angular displacement. For all the tested conditions, angular deformation at the adjacent level could not be avoided when an angular thrust was applied to the target level. The percentage of the angular displacement induced at the adjacent level was found to be dependent on both the input angular displacement and thrust velocity. If rapid thurst of manipulation is used to direct the input energy and motion at the target level with minimal interference at the adjacent levels, the applied angular displacement should not be too large and the thrust velocity should be within a medium velocity range.
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Layton, Robin B., Neil Messenger, and Todd D. Stewart. "Analysis of hip joint cross-shear under variable activities using a novel virtual joint model within Visual3D." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 235, no. 10 (June 25, 2021): 1197–204. http://dx.doi.org/10.1177/09544119211025869.
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Cross-shear forces occur between bearing surfaces at the hip and have been identified as a key contributor to prosthesis wear. Understanding the variation in relative motion paths between both individuals and activities, is a possible explanation for increased revision rates for younger patients and could assist in improved pre-clinical testing regimes. Additionally, there is little information for the pre-clinical testing of cartilage substitution therapies for younger more active individuals. The calculation of motion paths has previously relied on computational modelling software which can be complex and time-consuming. The aim of this study was to determine whether the motion paths calculations could be integrated into gait analysis software to improve batch processing, reduce analysis time and ultimately improve the efficiency of the analysis of cross-shear variation for a broader range of activities. A novel Virtual Joint model was developed within Visual3D for calculating motion paths. This model was compared to previous computational methods and found to provide a competitive solution for cross shear analysis (accuracy <0.01 mm error between methods). The virtual hip model was subsequently applied to 13 common activities to investigate local aspect ratio’s, velocities and accelerations. Surprisingly walking produced the harshest cross shear motion paths in subjects. Within walking, of additional interest was that the localised change in acceleration for subjects was six times greater compared to the same point on an equivalent smoothed simulator cycle. The Virtual hip developed in Visual 3D provides a time saving technique for visualising and processing large data sets directly from motion files. The authors postulate that rather than focussing on a generalised smoothed cross-shear model that pre-clinical testing of more delicate structures should consider localised changes in acceleration as these may be more important in the assessment of cartilage substitutes sensitive to shear.
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Mohd, Yunus R., A. A. Ahmad, and A. R. Ahmad. "THUMB TUBERCULOSIS: A CASE REPORT." Orthopaedic Journal of Sports Medicine 8, no. 5_suppl5 (May 1, 2020): 2325967120S0006. http://dx.doi.org/10.1177/2325967120s00068.
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Tuberculosis is caused by Mycobacterium tuberculosis, occurs in about 2 billion people. Approximately 8 million people/year develop the active form.1,2 Tuberculosis in the hand is manifested as osteomyelitis in carpals, metacarpals and phalanges.1 Musculoskeletal tuberculosis occurs, in most cases, through haematogenous dissemination from the primary focus. In immunosuppression circumstances, it is reactivated. Methods: 47 years old lady, who had underlying pulmonary tuberculosis on anti-TB medications since June 2018, presented to us for swelling over right thumb. Associated with tender, erythematous skin and limited range of motion of right thumb. Results: Plain radiograph demonstrated soft tissue swelling, joint space narrowing, mottled lucency of the proximal phalanx and cystic degenerative changes. MRI shows osteomylities proximal phalanx of right thumb. Patient underwent wound debridement of right thumb, culture and sensitivity shows Mycobacterium tuberculosis infections. Post debridement, range of motion of MCP joint of right thumb was improved and anti-TB medications to restart. Discussions: Tuberculosis involvement of the metacarpals and phalanges is a rare presentation of extrapulmonary TB. The radiographic features of osseous tuberculosis are present in conditions such as inflammatory arthritis, pyogenic osteomyelitis, osteopenia, softtissue swelling with minimal periosteal reaction, narrowing of the joint space, cysts in bone adjacent to joints, and subchondral erosions. The gold standard to diagnose is culture of Mycobacterium tuberculosis from bone tissue. Current treatment is a 2 month initial phase of isoniazid, rifampin, pyrazinamide, and ethambutol followed by a 6 to 12 month regimen of isoniazid and rifampin. Conclusion: Finger swelling is a rare presenting sign of disseminated tuberculosis. Early biopsy and appropriate microbiologic testing can avoid diagnostic delay. References: Malaviya AN, et al. Best Pract Res Clin Rheumatol. 2003;17:319–43. Fortún J, et al. Mycobacterium tuberculosis infection? Medicine. 2010;10:3808–19. DOI: 10.1016/S0304-5412(10)70119-0.
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Barrey, Cédric, Thomas Mosnier, Jérôme Jund, Gilles Perrin, and Wafa Skalli. "In vitro evaluation of a ball-and-socket cervical disc prosthesis with cranial geometric center." Journal of Neurosurgery: Spine 11, no. 5 (November 2009): 538–46. http://dx.doi.org/10.3171/2009.6.spine0949.
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Object Few biomechanical in vitro studies have reported the effects of disc replacement on motion and kinematics of the cervical spine. The purpose of this study was to analyze motion through 3D load-displacement curves before and after implantation of a ball-and-socket cervical disc prosthesis with cranial geometric center; special focus was placed on coupled motion, which is a well-known aspect of normal cervical spine kinematics. Methods Six human cervical spines were studied. There were 3 male and 3 female cadaveric specimens (mean age at death 68.5 ± 5 years [range 54–74 years]). The specimens were evaluated sequentially in 2 different conditions: first they were tested intact; then the spinal specimens were tested after implantation of a ball-and-socket cervical disc prosthesis, the Discocerv, at the C5–6 level. Pure moment loading was applied in flexion/extension, left and right axial rotation, and left and right lateral bending. All tests were performed under load control with a 3D measurement system. Results No differences were found to be statistically significant after comparison of range of motion between intact and instrumented spines for all loading conditions. The mean range of motion for intact spines was 10.3° in flexion/extension, 5.6° in lateral bending, and 5.4° in axial rotation; that for instrumented spines was 10.4, 5.2, and 4.8°, respectively. No statistical difference was observed for the neutral zone nor stiffness between intact and instrumented spines. Finally, the coupled motions were also preserved during axial rotation and lateral bending, with no significant difference before and after implantation. Conclusions This study demonstrated that, under specific testing conditions, a ball-and-socket joint with cranial geometrical center can restore motion in the 3 planes after discectomy in the cervical spine while maintaining physiological coupled motions during axial rotation and lateral bending.
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Poomsalood, Somruthai, Karthik Muthumayandi, and Karen Hambly. "Can stretch sensors measure knee range of motion in healthy adults?" Biomedical Human Kinetics 11, no. 1 (January 1, 2019): 1–8. http://dx.doi.org/10.2478/bhk-2019-0001.
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AbstractStudy aim: There are currently limited methods available to access dynamic knee range of motion (ROM) during free-living activities. This type of method would be valuable for monitoring and progressing knee rehabilitation. Therefore, the aim of this study was to evaluate the functioning of stretch sensors for the measurement of knee ROM and to assess the level of the measurement error. Material and methods: Nine healthy participants were included in the study. Three stretch sensors (StretchSense™, Auckland, NZ) were attached on the participants’ right knees by Kinesiotape®. A Cybex dynamometer was used to standardise movement speed of the knee joint. Data was recorded through the StretchSense™ BLE application. Knee angles were obtained from the video clips recorded during the testing and were analysed by MaxTraq® 2D motion analysis software. The knee angles were then synchronised with the sensor capacitance through R programme. Results: Seven out of the nine participants presented with high coefficient of determination (R2) (>0.98) and low root mean square error (RMSE) (<5°) between the sensor capacitance and knee angle. Two participants did not confirm good relationship between capacitance and knee angle as they presented high RMSE (>5°). The equations generated from these 7 participants’ data were used individually to predict knee angles. Conclusions: The stretch sensors can be used to measure knee ROM in healthy adults during a passive, non-weight-bearing movement with a clinically acceptable level of error. Further research is needed to establish the validity and reliability of the methodology under different conditions before considered within a clinical setting.
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Fowler, N. K., and A. C. Nicol. "Long-term measurement of metacarpophalangeal joint motion in the normal and rheumatoid hand." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 215, no. 6 (June 1, 2001): 549–53. http://dx.doi.org/10.1243/0954411011536154.
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Low-profile flexible goniometers were used in an instrumented glove to monitor metacarpophalangeal (MCP) joint usage in patients with rheumatoid arthritis and control subjects over 3 days. Statistical analysis of the results provided descriptors of total joint motion per hour, the number of movements per hour and their duration, amplitude and angular velocity. The results show the patient group to have less overall joint usage than the control group, with movements being slower and smaller and with a restricted range. Yearly rates of joint usage were derived; these values are considerably higher than predicted in prosthetic joint testing protocols.
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Lee, Hyojeong, Kyunghi Hong, and Yejin Lee. "Compression pants with differential pressurization: Kinetic and kinematical effects on stability." Textile Research Journal 87, no. 13 (July 5, 2016): 1554–64. http://dx.doi.org/10.1177/0040517516657056.
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Clothing pressure is a very important variable in compression garments that is frequently omitted in other studies, despite the possibility of altering the experimental design and results. Most studies focus on testing the effects of released products rather than on how to design them. The aim of this study is to identify methods to increase stability of an extremity by developing compression pants with a design that assigns differential pressurization. CP1 (clothing pressure knee region: 0.95–1.03 kPa), which reinforces the knee joint, and CP2 (clothing pressure knee region: 1.67–2.12 kPa), which reinforces the knee joint and hamstring, are developed. In addition, CCP (clothing pressure knee region: 0.44–0.58 kPa) was developed as a control garment. Seven subjects wearing CP1, CP2, or CCP, performed single-leg landing from 40 cm height, for motion analysis. As a result, the angular velocity of the hip and knee, as well as the knee joint range of motion was increased significantly when CP1 are worn. Therefore, CP1 is efficient in absorbing the energy of the impact, making it much practical in terms of stability. The peak vertical ground reaction force showed little difference when different design of compression pants were tested. Meanwhile, CP2 significantly increases the knee moment. It is important to add that even a subtle manipulation of the level, location, or the method of pressurization significantly changes the stability of joints and the performance of exercise. This research shows that the functions of compression garments differ according to the level of pressurization and differential pressurization.
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WIŚNIEWSKI, Tomasz, Adrian MRÓZ, Janusz MAGDA, and Agnieszka WIELOWIEJSKA-GIERTUGA. "STAND FOR TRIBOLOGICAL TESTING OF HIP ENDOPROSTHESES." Tribologia 270, no. 6 (December 31, 2016): 167–77. http://dx.doi.org/10.5604/01.3001.0010.6936.
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The paper presents a new construction of hip-joint simulator. The SBT-01.2 simulator is designed for conducting tribological testing of hip endoprostheses based on ISO 14242-1, which specifies the requirements for the range of motion and load characteristics of the friction pair (femoral head vs. acetabular cup) during one test cycle. The construction of the simulator is based on the anatomical structure of the human hip joint. The prosthesis acetabulum is mounted in the upper part of the mounting head while maintaining the inclination angle relative to the axis of the socket to the direction of the loading force. The head of the prosthesis is mounted on a pin embedded in the bottom, movable base. After placing a special sleeve on the lower base, liquid lubricant is applied on the head-cup tribological system. The employed software enables continuous control, online visualization, and data recording. During testing, parameters such as lubricant temperature, instantaneous loading force, friction torque, and the number of cycles are recorded.
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Phatak, Ishan Vivekanand, Sujit Ramesh Chavan, and Sandeep Babasaheb Shinde. "Correlation between Motor Strategies of Balance Control and Causes of Fall in Post-Operative Elderly Individuals." Journal of Evolution of Medical and Dental Sciences 10, no. 20 (May 17, 2021): 1469–73. http://dx.doi.org/10.14260/jemds/2021/308.
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BACKGROUND Falls are very much common in elderly. Fall in geriatric population is one of the common reasons for hospitalization, which may put financial burden on the patient and family. Fall in geriatric population many a times causes fracture and it may lead to serious complications which can threaten life. It may lead to disability and patient may become a handicap. In our study, we identified the correlation between motor strategies of balance control and causes of fall in post-operative elderly individuals. METHODS In this observational study, a total of 100 post-operative elderly individuals who had a fall and who underwent surgery for fracture correction were included. Both males and females in age group of 60 years and above were included. Outcome measures used were balance tests, manual muscle tests and goniometry. RESULTS 28 % individuals had fall due to low level of motor control at ankle joint and 40 % individuals at hip joint. In 16 % of individuals reaching strategy was affected. Suspensory strategy was affected in 10 % of individuals while stepping strategy was affected in 6 % of elderly. Elderly had fall due to weak musculature at hip joint (35 %), knee joint (15 %), ankle joint (30 %) and spine (25 %) irrespective of the individual’s gender. CONCLUSIONS Impairment in motor strategies of balance control such as, hip strategy, stepping strategy, reaching strategy, suspensory strategy, ankle strategy leads to fall in elderly. On the basis of assessment of manual muscle testing (MMT), range of motion and motor strategies of balance control, we concluded that impairment in motor strategies of balance, and reduced joint range of motion lead to falls. KEY WORDS Motor Strategies for Balance Control, Balance Tests, Manual Muscle Testing, Range of Motion
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Nekhanevich, Oleg, Vyktoriya Bakuridze-Manina, Eugene Kanyuka, Maksym Radzetsky, and Viktor Chernysh. "JUSTIFICATION OF THE DIFFERENTIATED APPROACH IN PHYSICAL CLASSES EDUCATION OF STUDENTS FROM HYPERMOBILITY OF JOINTS." Sports Bulletin of the Dnieper 1 (2020): 352–59. http://dx.doi.org/10.32540/2071-1476-2019-1-352.
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Introduction. Experts point to a decrease in the level of health of youth with manifestations of connective tissue dysplasia. One of the most common signs of connective tissue dysplasia is joint hypermobility (JH). In the JH understands the excess of range of motion in one or several joints compared with the average norm. JH is accompanied by disharmonious changes in physical development, a decrease in functional indicators, muscle hypotension occurs, leading to frequent injuries. Therefore, it is necessary to organize the educational process in physical education, in such a way as to provide the necessary healing and educational effect in physical education classes. The research hypothesis is that the application of a differentiated approach in physical education classes will help to increase the effectiveness of the educational process and improve the physical condition of female students with different levels of severity of joint hypermobility. The purpose of the study: substantiate a differentiated approach in the physical education of female students with hypermobility of joints to improve their physical condition. Materials and methods: analysis of literary sources, questionnaires, anthropometry, methods for studying the functional state of the body and assessing physical health, performance assessment, pedagogical testing, pedagogical experiment, methods of mathematical statistics. The research involved 155 students aged 17-20 years, who studied at the State Institution "Dnepropetrovsk Medical Academy of the Ministry of Health of Ukraine." Results: The results of the study indicate a positive effect of a differentiated approach in physical education classes on the physical condition of female students with hypermobility of the joints. This gives grounds to recommend it for practical use in the process of physical education of university students. Conclusions. 1. The use of a differentiated approach in physical education classes in accordance with the functional capabilities of students with different levels of joint hypermobility contributed to improved results in cardiovascular and respiratory systems, dynamometry of the right hand, back muscle strength (p <0.05). 2. The number of female students who have a low level of somatic health has decreased and an increase in performance and adaptive capacity has been established, and physical fitness has been promoted. Key words: physical condition, female students, hypermobility of joints, physical education.
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Lephart, Scott M., Mininder S. Kocher, Freddie H. Fu, Paul A. Borsa, and Christopher D. Harner. "Proprioception Following Anterior Cruciate Ligament Reconstruction." Journal of Sport Rehabilitation 1, no. 3 (August 1992): 188–96. http://dx.doi.org/10.1123/jsr.1.3.188.
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Injury to the anterior cruciate ligament (ACL) is thought to disrupt joint afferent sensation and result in proprioceptive deficits. This investigation examined proprioception following ACL reconstruction. Using a proprioceptive testing device designed for this study, kinesthetic awareness was assessed by measuring the threshold to detect passive motion in 12 active patients, who were 11 to 26 months post-ACL reconstruction, using arthroscopic patellar tendon autograft (n=6) or allograft (n=6) techniques. Results revealed significantly decreased kinesthetic awareness in the ACL reconstructed knee versus the uninvolved knee at the near-terminal range of motion and enhanced kinesthetic awareness in the ACL reconstructed knee with the use of a neoprene orthotic. Kinesthesia was enhanced in the near-terminal range of motion for both the ACL reconstructed knee and the contralateral uninvolved knee. No significant between-group differences were observed with autograft and allograft techniques.
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Stoffel, Michael, Christoph Koch, Christina Precht, Maja Waschk, Alexander Bürki, and Franck Forterre. "Comparative anatomy and biomechanical properties of atlanto-axial ligaments in equine, bovine, and canine cadaveric specimens." Veterinary and Comparative Orthopaedics and Traumatology 30, no. 03 (2017): 219–22. http://dx.doi.org/10.3415/vcot-16-09-0131.
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Summary Objectives: Atlantoaxial instability has been reported in humans, dogs, equids and ruminants. The functional role of the atlantoaxial ligaments has only been described rudimentarily in equids and ruminants. The goal of the present cadaveric study was to compare the anatomy between the different species and to comparatively assess the role of the stabilizing ligaments of the atlantoaxial joint under sagittal shear loading in canine, equine, and bovine cervical spines. Methods: Three equine, bovine, and canine cadaveric specimens were investigated. Biomechanical testing was performed using a purpose built shear-testing device driven by a uniaxial servo-hydraulic testing machine. Three cycles in a dorsoventral direction with a constant quasi-static velocity of 0.2 mm/s up to a limiting force of 50 N (canine) or 250 N (bovine, equine), respectively, were performed for each specimen tested. Load and linear displacement were measured by the displacement sensor and load cell of the testing system at a sampling rate of 20 Hz. Tests were performed and the range of motion determined with both intact and transected atlantoaxial ligaments. Results: The range of motion was significantly increased after transection of the ligaments only in the canine specimens. The bovine atlantoaxial joint was biomechanically more stable than in equids. Clinical significance: Species-specific anatomical and biomechanical differences of the atlantoaxial ligaments in canines, equids, and bovines were detected. The significance of these differences and their impact on the pathogenesis of atlantoaxial subluxations and subsequent treatment remain open questions.
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Abouel Nasr, Emad, Abdurahman Mushabab Al-Ahmari, Hazem Alkhawashki, Abdulsalam Altamimi, and Mohammed Alkhuraisi. "Developing a methodology for analysis and manufacturing of proximal interphalangeal (PIP) joint using rapid prototyping technique." Rapid Prototyping Journal 21, no. 4 (June 15, 2015): 449–60. http://dx.doi.org/10.1108/rpj-11-2013-0118.
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Purpose – The purpose of this paper is to design and analyze four proximal interphalangeal joint (PIP) prosthesis thorough finite element analysis (FEA) and fabricate them using rapid prototyping (RP) technique. Arthritis of the finger joints is an important pathology of the hand. Major complaints in arthritis are stiffness, deformity and severe pain. The pain is due to the inflammatory process that occurs due to pathology, which involves joint degeneration, synovial swelling and ligament and muscle stiffness. Among the surgical treatment of arthritis is Arthroplasty which involves replacing the diseased joint with an artificial joint. Design/methodology/approach – In this paper, four proximal interphalangeal joint (PIP) prostheses are designed, analyzed using FEA and fabricated using rapid prototyping technique. Four different prostheses “BM”, “IMP”, “IMP2” and “FINS” are designed using CATIA software and tested by normal daily functions such as grasp, key pinch and tip pinch tests using FEA to analyze the results based on their stress and deformation. Finally, the prostheses are fabricated using electron beam melting technology. Findings – This paper examined and analyzed the relative motion of PIP designs using FEA by applying varying loads to check the stability and range of motion of the PIP implant. The ANSYS summary results were analyzed depending on the minimal results of equivalent stress and deformation from the taken tests that have happened on the designed prosthesis. The results conclude that, in the grasp test, the minimal equivalent stress and deformation have happened on the “BM” and “IMP2” implants. Furthermore, in the key pinch test, minimal equivalent stress and deformation occurred on the “FINS” implant, and finally, in the tip pinch, minimal equivalent stress occurred on the “FINS” and minimal deformation has happened on the “IMP2” implant. Research limitations/implications – These results conclude that both “IMP2” and “FINS” share the minimum results in the taken tests, and this shows that these implants may be further studied brainstormed upon to aid innovation of a better implant design that shares both of these implants’ features and shape. Nevertheless, testing in an in vivo or in vitro model to prove more of the effectiveness of these implants should be taken into consideration, and to test how the prostheses will function in an actual environment, a simulated hand can be designed and made to discover the true forces and mechanics of the fingers and the hands with the prosthesis that is implanted, as well as to know if the hand works properly. Originality/value – This paper examined and analyzed the relative motion of PIP designs using FEA by applying varying loads to check the stability and range of motion of the PIP implant.
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Martin, Lewis P., Jennifer S. Wayne, Timothy J. Monahan, and Robert S. Adelaar. "Elongation Behavior of Calcaneofibular and Cervical Ligaments during Inversion Loads Applied in an Open Kinetic Chain." Foot & Ankle International 19, no. 4 (April 1998): 232–39. http://dx.doi.org/10.1177/107110079801900409.
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The cervical ligament plays a significant role in lateral stability of the subtalar joint but has received little attention compared with other ankle and subtalar joint ligaments. The purpose of this research was twofold. First, the elongation behavior of the cervical ligament was assessed with the calcaneofibular ligament intact and cut during two different types of inversion loads (manual and mechanical). Second, inversion range of motion was determined concomitantly with inversion loading and the difference in inversion range of motion between the calcaneofibular ligament intact to cut state was compared. The mean elongation of the cervical ligament with the calcaneofibular intact was 0.58 mm (± 0.33 mm) and 0.46 mm (± 0.23 mm) for manual and mechanical methods, respectively, and 0.88 mm (± 0.37 mm) and 0.78 mm (± 0.37 mm), respectively, for the same methods in the absence of the calcaneofibular ligament. This difference was statistically significant ( P < 0.05 manually and P < 0.02 mechanically). An average increase in the inversion range of motion was noted with both methods [7.5° manually (± 2.75°) and 7.7° mechanically (± 2.95°)] after lesioning of the calcaneofibular ligament. This difference was statistically significant ( P < 0.001) for both manual and mechanical range of motion testing. The results of this study indicate that there is a significant increase in elongation of the cervical ligament in the absence of the calcaneofibular ligament during manual and mechanically applied inversion loads in a open kinetic chain. Clinical and theoretical implications of this data are discussed.
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Bürgi, Simon, Judith Roost, Marco R. Hitz, Peter Schwilch, William R. Taylor, and Silvio Lorenzetti. "A Fast Testing Method to Objectively Quantify the Stiffness of Stability Boots." Applied Bionics and Biomechanics 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/595708.
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Stability boots can protect the ankle ligaments from overloading after serious injury and facilitate protected movement in order to aid healing of the surrounding soft tissue structures. For comparing different stability shoe designs and prototypes, a reliable and fast testing method (FTM) is required. The aim of this study was to assess the reliability of a novel custom-built device. Six different stability boots were tested in a novel device that allowed body weight to be taken into account using a pneumatic actuator. The fixation of the boots was controlled using two air pad pressure sensors. The range of motion (RoM) was then assessed during 5 trials at physiological ankle joint torques during flexion/extension and inversion/eversion. Furthermore the intraclass correlation coefficient ICC was determined to assess the repetitive reliability of the testing approach. The measured ankle angles ranged from 3.4° to 25° and proved to be highly reliable (ICC=0.99), with standard deviations <9.8%. Comparing single trials to one another resulted in a change of 0.01° joint angle, with a mean error of 0.02°. The FTM demonstrates that it is possible to reliably measure the ankle joint RoM in both the sagittal and frontal planes at controlled torque levels, together with the application of body weight force.
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Bloemker, Katherine H., Trent M. Guess, Lorin Maletsky, and Kevin Dodd. "Computational Knee Ligament Modeling Using Experimentally Determined Zero-Load Lengths." Open Biomedical Engineering Journal 6, no. 1 (April 2, 2012): 33–41. http://dx.doi.org/10.2174/1874120701206010033.
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This study presents a subject-specific method of determining the zero-load lengths of the cruciate and collateral ligaments in computational knee modeling. Three cadaver knees were tested in a dynamic knee simulator. The cadaver knees also underwent manual envelope of motion testing to find their passive range of motion in order to determine the zero-load lengths for each ligament bundle. Computational multibody knee models were created for each knee and model kinematics were compared to experimental kinematics for a simulated walk cycle. One-dimensional non-linear spring damper elements were used to represent cruciate and collateral ligament bundles in the knee models. This study found that knee kinematics were highly sensitive to altering of the zero-load length. The results also suggest optimal methods for defining each of the ligament bundle zero-load lengths, regardless of the subject. These results verify the importance of the zero-load length when modeling the knee joint and verify that manual envelope of motion measurements can be used to determine the passive range of motion of the knee joint. It is also believed that the method described here for determining zero-load length can be used for in vitro or in vivo subject-specific computational models.
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Alkady, Eman A. M., Marwa Mahmoud Abdelaziz, Dalia Abdelwahed, and Safaa A. Mahran. "Falls in Rheumatoid Patients: Does Ankle and Foot Ultrasonography have a Predictive Role? A Single-blind Study." Aktuelle Rheumatologie 46, no. 04 (February 16, 2021): 406–15. http://dx.doi.org/10.1055/a-1353-4415.
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ABSTRACT Background Rheumatoid arthritis (RA) patients have a higher prevalence of falls compared with the healthy population. Several risk factors of falls in RA have been postulated, including high disease activity, low balance, muscle weakness and non-treatment with biologics. Aim of the work We investigated our hypothesis that the sonographically detected ankle and foot changes in RA patients can predict falls in this population. To our knowledge, no previous study had investigated this before. Methods In a total of 101 RA patients, we performed assessments of disease activity, disability level, gait speed, balance status, clinical examination of ankle and foot and an MSUS assessment of the ankle and foot joints and tendons as possible risk factors of falls. Results The Berg balance test had the highest fall-predicting power (71.3%), followed by a gait speed test and restricted range of motion (ROM) of the Rt. subtalar joint, each with a predictive power of 70.3%. Of the sonographic findings, erosion of the first metatarsophalangeal (MTP) joint was the most accurate fall predictor, followed by erosion of the talonavicular joint and tenosynovitis of the ankle dorsal flexors with an area under the curve of 0.656, 0.642 and 0.614, respectively. Conclusion The use of the MSUS as an adjunct objective method for predicting falls in RA patients has not been studied before. It was found that clinical foot and balance testing was a superior and easier way of predicting falls in RA patients than using ultrasonography.
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Lim, Dohyung, Hansol Seo, TaeJin Shin, and Sungwook Jung. "Evaluation of Total Ankle Arthroplasty Design Considered Motion Characteristics of Ankle Joint for Responding to Sudden Tilting Perturbation." Foot & Ankle Orthopaedics 2, no. 3 (September 1, 2017): 2473011417S0002. http://dx.doi.org/10.1177/2473011417s000262.
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Category: Ankle, Ankle Arthritis Introduction/Purpose: Total Ankle Arthroplasty (TAA) has been introduced as one of treatment methods for the arthritis of the ankle joint. Traditional TAAs have been generally designed considering the anatomical geometry and motion characteristics of the ankle joint for responding to general activities of daily living (ADLs). However, traditional TAA designs do not well consider the anatomical geometry and motion characteristics for responding to a sudden perturbation although the ankle joint contributes partially to human balance to prevent falling induced by a sudden perturbation. The aims of the current study were therefore to identify the anatomical geometry and motion characteristics of the ankle joint during sudden tilting perturbations, to reflect the motion characteristics in the design of TAA, and to evaluate the design. Methods: Following Institutional Review Board approval (IRB No SJU-2015-002), seven healthy participants with no sign of musculoskeletal pathology (gender: 7male, 25.5±1.7 years, height: 173.9±6.4 cm, weight: 71.3±6.5 kg) were tested to identify the motion characteristics of the ankle joint during sudden tilting perturbations. Eight sudden tilting perturbations were then implemented by the tilting perturbation simulator developed by our research group. The motion characteristics were measured by using a three-dimensional motion capture system with eight infrared cameras (T-10 s, VICON Motion System Ltd., UK). The motion characteristics, particular in the range of motion (ROM) and motion trajectory, were reflected in the design of TAA. The evaluation of the design of TAA was conducted using finite element (FE) analysis in accordance with the international testing standard ASTM F2665, F1223 and F1814. Results: Dorsi/plantar flexion, inversion/eversion and abduction/adduction were ranged from 11.2±1.5° to -9.3±3.5°, 7.0±4.0° to - 7.8±4.9°, and 0.7±0.2° to -1.0±0.2°, respectively, for the sudden tilting perturbations. Dorsi/plantar flexion of TAA designed newly were 1.5 times larger than that measured from the experiment above, with no interference. Inversion/eversion and internal/external rotation of TAA designed newly were favorably compared to those measured from the experiment above. The motion trajectories were different a little compared to those measured from the experiment above. Maximum von mises stresses predicted from FE analysis with the international test conditions were not exceed a yielding strength of the material used for TAA designed newly and no dislocations among the TAA components were identified. Conclusion: The results indicated that a realization of the natural ankle joint motion trajectory should be improved although TAA design suggested in the current study might well present ROMs for responding to sudden tilting perturbations and have a proper structural stability corresponded to the standard criterion recommended from the international testing standard. The TAA design will be, therefore, modified more considering advanced anatomical and biomechanical parameters, particular in the characteristics of the ankle joint motion trajectory, in our ongoing study. The current study may be, however, valuable to suggesting new TAA design for responding to a sudden perturbation to prevent falling.
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Talmage, James B. "Tools and Resources: Instrumentation for Upper Extremity Impairment Assessment." Guides Newsletter 4, no. 3 (May 1, 1999): 7–8. http://dx.doi.org/10.1001/amaguidesnewsletters.1999.mayjun04.
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Abstract The primary methods of evaluating impairment in the upper extremity are range of motion testing and neurological examination. For certain conditions that do not cause motion or neurological deficits yet leave the extremity significantly impaired, the editors of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, provided Section 3.1m, Impairment Due to Other Disorders of the Upper Extremity. The AMA Guides emphasizes that the criteria described in these “other disorders” should be applied only when the other criteria have not adequately encompassed the extent of the impairments. The evaluator must carefully read the criteria for rating each derangement to ensure the rating is correct and not duplicative. Table 26, Upper Extremity Impairment Due to Carpal Instability Patterns, includes values based on radiographic findings, and Table 27, Impairment of the Upper Extremity after Arthroplasty of Specific Bones or Joints, features ratings for resection arthroplasty and implant arthroplasty. Tables 28, 29, and 30 for musculotendinous impairments require that the percent of digit impairment be multiplied by the relative value of the digit according to Table 18. The AMA Guides does not assign a large role to functional measurements such as pinch and grip strength tests because they are influenced by subjective factors that are difficult to control.
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Xu, Hai Jun, Cun Yun Pan, Dai Bing Zhang, and Xiang Zhang. "Design and Analysis of Hydraulic-Driven Bionic Joint for Undulating Thruster." Advanced Materials Research 479-481 (February 2012): 2355–60. http://dx.doi.org/10.4028/www.scientific.net/amr.479-481.2355.
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Undulate fin is the main propelling organ of MPF mode fish, which could produce propelling wave continually and controllabily while swimming, and this propelling mode has characteristics of high efficiency and low disturbance to fluid field. In this paper, biological structure of “Nilotic Ghost” fish’s long flexible fin(Undulate Fin) is studied with physiological anatomizing and X-ray perspectiving means. Then motion characteristics of the undulate fin are revealed with pictures from fish’s swimming video. Under the bionical conclusions, a hydraulic-driven bionic joint for undulating thruster is designed, including a pair of restoration springs. At last some calculating simulation and testing experiments are carried out, so as to analyze and verify this bionic joint’s characteristics. Results show that, bionic joint driven by hydraulic system could immitate the flexible movements of natural rib in undulate fin, which are described as position restoration, changing of swaying range as well as frequency.
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Wagner, Emilio, Diego Zanolli de Solminihac, Pablo Wagner, Cristian Ortiz, Andres Keller Díaz, Ruben Radkievich, Oscar Valencia, and Rodrigo Guzman-Venegas. "Biomechanical evaluation of metatarsal osteotomies for Hallux Rigidus. A cadaveric testing." Foot & Ankle Orthopaedics 2, no. 3 (September 1, 2017): 2473011417S0003. http://dx.doi.org/10.1177/2473011417s000399.
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Category: Basic Sciences/Biologics, Midfoot/Forefoot Introduction/Purpose: Metatarsal osteotomies for Hallux Rigidus (HR) is a treatment option when neither a cheilectomy nor an arthrodesis are indicated. Different osteotomies exist that elevate, shorten or depress the metatarsal head. No biomechanical information exists that evaluates the effect of osteotomies on hallux range of motion (ROM) and stiffness. Our objective was to evaluate, in a cadaveric model, the first metatarsophalangeal joint (MTPJ) stiffness and kinematics changes, after three different metatarsal osteotomies. Methods: 8 cadaveric foot-ankle–distal tibia specimens were prepared, identifying all extensor and flexor tendons proximally. The skin and subcutaneous tissue was kept intact. Each specimen was mounted on a special frame and luminous markers were attached to the skin (Oxford Foot Model). A dead weight equal to 50% of the stance phase force was applied to each tendon, except for the Achilles tendon and the posterior tibialis. Each specimen served as its own control, testing hallux dorsiflexion when pulling the extensor hallucis longus tendon. 10 cycles were performed for every condition: control (A), and three different metatarsal extraarticular neck osteotomies: vertical osteotomy with 5 mm of depression (B), 5 mm of shortening (C) and 5 mm of shortening and depression (D). All osteotomies were performed on a Hallux Rigidus cadaveric model. We registered the MTPJ stiffness and kinematic changes after each intervention using a tensile testing machine and high definition cameras. Results: B and C were significantly stiffer than group A and D (p<0.05). D was the only condition with a similar stiffness to the control group (A) (p>0.05). Groups B, C and D achieved similar kinematics (range of motion) to group A (p>0.05). Conclusion: Different metatarsal osteotomies exist for HR. The osteotomy of choice, should be one that recreates the healthy MTPJ motion and stiffness. According to our study, the osteotomy of choice should be one that results in metatarsal head depression and shortening. A possible explanation to our finding, is that a pure shortening or depression osteotomy is really elevating or depressing the head respectively, hence altering the tendon pull and relative head position. Only with metatarsal shortening and depression, the Hallux MTPJ biomechanics in a Hallux Rigidus cadaver model, returns to a healthy state.
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Ellenbecker, Todd S., David M. Dines, Per A. Renstrom, and Gary S. Windler. "Visual Observation of Apparent Infraspinatus Muscle Atrophy in Male Professional Tennis Players." Orthopaedic Journal of Sports Medicine 8, no. 10 (October 1, 2020): 232596712095883. http://dx.doi.org/10.1177/2325967120958834.
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Background: Previous studies have reported visually observed apparent muscle atrophy in the infraspinous fossa of the dominant arm of overhead athletes. Several mechanisms have been proposed as etiological factors, including eccentric overload, compressive spinoglenoid notch paralabral cysts, and cumulative tensile suprascapular neurapraxia. Purpose: To report the prevalence of apparent infraspinatus atrophy in male professional tennis players and to determine whether the suspected atrophy correlates with objectively measured weakness of external rotation. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 153 male professional tennis players underwent a musculoskeletal screening examination that included visual inspection of the infraspinous fossa. Infraspinatus atrophy was defined as hollowing or loss of soft tissue bulk inferior to the scapular spine in the infraspinous fossa of one extremity that was visibly different from the contralateral extremity. This finding was observed and independently agreed upon by both an orthopaedic surgeon and a physical therapist during the examination. Also assessed were rotator cuff instrument-assisted manual muscle testing, visual observation of scapular kinesis (or motion), and glenohumeral joint range of motion for internal and external rotation and horizontal adduction. Results: In the 153 players, dominant-arm infraspinatus atrophy was observed in 92 players (60.1%), and only 1 player (0.7%) was identified with nondominant infraspinatus atrophy. A Pearson correlation showed a significant relationship between the presence of dominant-arm infraspinatus atrophy and dominant-arm external rotation strength measured in neutral abduction/adduction (at the side) ( P = .001) as well as between the presence of dominant-arm infraspinatus atrophy and bilateral external rotation strength measured at 90° of glenohumeral joint abduction ( P = .009 for dominant arm and .002 for nondominant arm). No significant correlation was found with scapular dyskinesis, glenohumeral range of motion, or instrument-assisted manual muscle testing of the supraspinatus (empty-can test). Conclusion: Visually observed infraspinatus muscle atrophy is a common finding in the dominant shoulder of asymptomatic male professional tennis players and is significantly correlated with external rotation weakness. This condition is present in uninjured players without known shoulder pathology and is not related to glenohumeral joint internal rotation, total rotation range of motion, or scapular dysfunction. Players with visually observed infraspinatus atrophy should be evaluated for external rotation strength and may require preventive strengthening.
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Cunningham, Bryan W., Paul D. Sponseller, Ashley A. Murgatroyd, Jun Kikkawa, and P. Justin Tortolani. "A comprehensive biomechanical analysis of sacral alar iliac fixation: an in vitro human cadaveric model." Journal of Neurosurgery: Spine 30, no. 3 (March 2019): 367–75. http://dx.doi.org/10.3171/2018.8.spine18328.
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OBJECTIVEThe objective of the current study was to quantify and compare the multidirectional flexibility properties of sacral alar iliac fixation with conventional methods of sacral and sacroiliac fixation by using nondestructive and destructive investigative methods.METHODSTwenty-one cadaveric lumbopelvic spines were randomized into 3 groups based on reconstruction conditions: 1) S1–2 sacral screws; 2) sacral alar iliac screws; and 3) S1–iliac screws tested under unilateral and bilateral fixation. Nondestructive multidirectional flexibility testing was performed using a 6-degree-of-freedom spine simulator with moments of ± 12.5 Nm. Flexion-extension fatigue loading was then performed for 10,000 cycles, and the multidirectional flexibility analysis was repeated. Final destructive testing included an anterior flexural load to construct failure. Quantification of the lumbosacral and sacroiliac joint range of motion was normalized to the intact spine (100%), and flexural failure loads were reported in Newton-meters.RESULTSNormalized value comparisons between the intact spine and the 3 reconstruction groups demonstrated significant reductions in segmental flexion-extension, lateral bending, and axial rotation motion at L4–5 and L5–S1 (p < 0.05). The S1–2 sacral reconstruction group demonstrated significantly greater flexion-extension motion at the sacroiliac junction than the intact and comparative reconstruction groups (p < 0.05), whereas the sacral alar iliac group demonstrated significantly less motion at the sacroiliac joint in axial rotation (p < 0.05). Absolute value comparisons demonstrated similar findings. Under destructive anterior flexural loading, the S1–2 sacral group failed at 105 ± 23 Nm, and the sacral alar iliac and S1–iliac groups failed at 119 ± 39 Nm and 120 ± 28 Nm, respectively (p > 0.05).CONCLUSIONSAlong with difficult anatomy and weak bone, the large lumbosacral loads with cantilever pullout forces in this region are primary reasons for construct failure. All reconstructions significantly reduced flexibility at the L5–S1 junctions, as expected. Conventional S1–2 sacral fixation significantly increased sacroiliac motion under all loading modalities and demonstrated significantly higher flexion-extension motion than all other groups, and sacral alar iliac fixation reduced motion in axial rotation at the sacroiliac joint. Based on comprehensive multidirectional flexibility testing, the sacral alar iliac fixation technique reduced segmental motion under some loading modalities compared to S1–iliac screws and offers potential advantages of lower instrumentation profile and ease of assembly compared to conventional sacroiliac instrumentation techniques.
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Johnson, G. R., D. A. Carus, G. Parrini, SScattareggia Marchese, and R. Valeggi. "The design of a five-degree-of-freedom powered orthosis for the upper limb." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 215, no. 3 (March 1, 2001): 275–84. http://dx.doi.org/10.1243/0954411011535867.
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In response to the need for a sophisticated powered upper-limb orthosis for use by people with disabilities and/or limb weakness or injury, the MULOS (motorized upper-limb orthotic system) has been developed. This is a five-degree-of-freedom electrically powered device having three degrees of freedom at the shoulder, one at the elbow and one to provide pronation/supination. The shoulder mechanism consists of a serial linkage having an equivalent centre of rotation close to that of the anatomical shoulder; this is a self-contained module in which power transmission is provided by tensioned cables. The elbow and pronation/supination modules are also self-contained. The system has been designed to operate under three modes of control: 1. As an assistive robot attached directly to the arm to provide controlled movements for people with severe disability. In this case, it can be operated by a variety of control interfaces, including a specially designed five-degree-of-freedom joystick. 2. Continuous passive motion for the therapy of joints after injury. The trajectory of the joints is selected by ‘walk-through’ programming and can be replayed for a given number of cycles at a chosen speed. 3. As an exercise device to provide strengthening exercises for elderly people or those recovering from injury or surgery. This mode has not been fully implemented at this stage. In assistive mode, prototype testing has demonstrated that the system can provide the movements required for a range of simple tasks and, in continuous passive motion (CPM) mode, the programming system has been successfully implemented. Great attention has been paid to all aspects of safety. Future work is required to identify problems of operation, and to develop new control interfaces.
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Petrova, L., A. Shevtsov, A. Petrov, and D. Yakhin. "THE DEVELOPMENT OF A PASSIVE EXOSKELETON FOR REHABILITATION OF THE LOWER EXTREMITIES IN CHILDREN WITH CEREBRAL PALSY." Human Sport Medicine 19, S2 (March 20, 2020): 103–9. http://dx.doi.org/10.14529/hsm19s214.
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Aim. The purpose of the article is to conduct a comprehensive therapy using various means of rehabilitation, which will allow to correct the existing motor dysfunction. Materials and methods. The research was conducted at the Research Center for Sports Science (Institute of Sport, Tourism and Service, South Ural State University, Chelyabinsk) from September 2019 to December 2019. In total, 15 children aged from 4 to 8 years participated in the study after providing their voluntary consent. To determine the range of motion in the joints of the lower extremities, the BioDex robotic equipment was used. Rotational angles of the knee ( ), hip ( ), and ankle joint ( ) were obtained. SolidWorks software was used to develop a 3D model of the product. Results. Anthropometric data of healthy people aged from 4 to 8 years were obtained and statistically processed. Using this data, the basic linear and spatial parameters of the elements of the designed device were calculated. Computer simulation of the exoskeleton was performed in the SolidWorks computer-aided design system with the ability to change the basic parameters of the device in accordance with the anthropometric data of a particular patient. Conclusion. A prototype exoskeleton was made using 3D printing technology for further testing. If necessary, a 3D model of the exoskeleton will be adjusted to test this device in practice for the rehabilitation of patients with cerebral palsy
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Hsu, Ar-Tyan, Tom Hedman, Jia Hao Chang, Chuong Vo, Larry Ho, Sally Ho, and Guan-Liang Chang. "Changes in Abduction and Rotation Range of Motion in Response to Simulated Dorsal and Ventral Translational Mobilization of the Glenohumeral Joint." Physical Therapy 82, no. 6 (June 1, 2002): 544–56. http://dx.doi.org/10.1093/ptj/82.6.544.
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AbstractBackground and Purpose. Translational mobilization techniques are frequently used by physical therapists as an intervention for patients with limited ranges of motion (ROMs). However, concrete experimental support for such practice is lacking. The purpose of the study was to evaluate the effect of simulated dorsal and ventral translational mobilization (DTM and VTM) of the glenohumeral joint on abduction and rotational ROMs. Methods. Fourteen fresh frozen shoulder specimens from 5 men and 3 women (mean age=77.3 years, SD=10.1, range=62–91) were used for this study. Each specimen underwent 5 repetitions of DTM and VTM in the plane of scapula simulated by a material testing system (MTS) in the resting position (40° of abduction in neutral rotation) and at the end range of abduction with 100 N of force. Abduction and rotation were assessed as the main outcome measures before and after each mobilization procedure performed and monitored by the MTS (abduction, 4 N·m) and by a servomotor attached to the piston of the actuator of the MTS (medial and lateral rotation, 2 N·m). Results. There were increases in abduction ROM for both DTM (X̄=2.10°, SD=1.76°) and VTM (X̄=2.06°, SD=1.96°) at the end-range position. No changes were found in the resting position following the same procedure. Small increases were also found in lateral rotation ROM after VTM in the resting position (X̄=0.90°, SD=0.92°, t=3.65, P=.003) and in medial rotation ROM after DTM (X̄=0.97°, SD=1.45°, t=2.51, P=.026) at the end range of abduction. Discussion and Conclusion. The results indicate that both DTM and VTM procedures applied at the end range of abduction improved glenohumeral abduction range of motion. Whether these changes would result in improved function could not be determined because of the use of a cadaver model.
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Мratskova, Galina, Damyan Petrov, and Nedko Dimitrov. "SHORT TERM EFFECTS OF LOW-FREQUENCY AND LOW INTENSITY ELECTROSTATIC FIELD IN PATIENTS WITH KNEE JOINT OSTEOARTHRITIS." Knowledge International Journal 28, no. 2 (December 10, 2018): 547–51. http://dx.doi.org/10.35120/kij2802547m.
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Introduction: Osteoarthritis (OA) is a widespread disease among adult population and is one of the major public health problems. OA is leading cause of disability the joints of lower limbs: knee and hip. As global life expectancy increases, it predicted that OA will be the leading cause of damage resulting in permanent disability. In cases of OA a reduction in cartilage tissue is observed, which is radiographically demonstrated by narrowing of the joint space and bone changes, osteophytes and subchondral bone sclerosis. However, a significant proportion of patients with radiological evidence of gonarthritis do not report joint pain. It is important to evaluate the changes occurring in the surrounding tissues. Muscle weakness of m. quadriceps femoris may occur before pain and impaired joint function. The development and application of new non-pharmacological methods in the rehabilitation of degenerative joint diseases is particularly important.Purpose: To establish the short-term therapeutic effects of treatment with Low-frequency and Low-intensive electrostatic field, applied through Deep Oscillation® method and complex of therapeutic exercises in rehabilitation of patients with osteoarthritis of the knee.Materials and methods: We conducted a one-year observational study involving 23 patients with clinical symptoms and radiologically proven II and III stage according Kellgren-Lawrence gonarthritis, aged between 42 and 78 years, were observed. 15 of them were women average age 61.73±12.9 years vs 8 - males average age 61.75±9.6 years (p=0.997). The duration of the current pain-episode was 1.7±0.7 months. The treatment was conducted in 10 sessions and included: Low-frequency and Low-intensity electrostatic field and complex therapeutic exercises.Results: The results were evaluated before and after completion of therapeutic course by assessing pain (VAS) at rest, when walking, climbing and descending on stairs, Manual Muscle Testing, Measurment of the knee joint circumference, Test Range of Motion and WOMAC Osteoarthritis Index, V.LK 3.1. were tracked. For processing statistical data SPSS v.13 was used. There was a statistically significant reduction of pain syndrome at rest (p<0.001), walking (p<0.001), descending stairs (p<0.001), climbing (p<0.001). Reduction of knee joint circumference (p<0.001). Increasing the range of flexion before Ме (Range) from 105º (90º-120º) versus 120º (100º-125º) after therapy. Reduced deficiency at an extension from 3.48 ± 4.38 before therapy to recovery of the extension. Improved total WOMAC Index (p<0.001), Stiffness (p<0.001) and Function (p<0.001).Conclusion: The short-term effects of the application of Low-frequency and Low-intensive electrostatic field in complex with therapeutic exercises show reduction of clinical symptoms and improvement of daily functional activity in patients with knee joint osteoarthritis. Reduction of pain of rest and physical activity (walking, descending and climbing stairs) is observed, oedema is reduced, joint range of motion increases, immediately after completion of the therapeutic course. Because of the small number of patients included in the study for better objectifying of the effects of the low-frequency and low-intensity electrostatic field, the studies should continue.
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Stanek, Justin, Taylor Sullivan, and Samantha Davis. "Comparison of Compressive Myofascial Release and the Graston Technique for Improving Ankle-Dorsiflexion Range of Motion." Journal of Athletic Training 53, no. 2 (February 1, 2018): 160–67. http://dx.doi.org/10.4085/1062-6050-386-16.
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Context: Restricted dorsiflexion (DF) at the ankle joint can cause acute and chronic injuries at the ankle and knee. Myofascial release and instrument-assisted soft tissue mobilization (IASTM) techniques have been used to increase range of motion (ROM); however, evidence directly comparing their effectiveness is limited. Objective: To compare the effects of a single session of compressive myofascial release (CMR) or IASTM using the Graston Technique (GT) on closed chain ankle-DF ROM. Design: Randomized controlled trial. Setting: Laboratory. Patients or Other Participants: Participants were 44 physically active people (53 limbs) with less than 30° of DF. Intervention(s): Limbs were randomly assigned to 1 of 3 groups: control, CMR, or GT. Both treatment groups received one 5-minute treatment that included scanning the area and treating specific restrictions. The control group sat for 5 minutes before measurements were retaken. Main Outcome Measure(s): Standing and kneeling ankle DF were measured before and immediately after treatment. Change scores were calculated for both positions, and two 1-way analyses of variance were conducted. Results: A difference between groups was found in the standing (F2,52 = 13.78, P = .001) and kneeling (F2,52 = 5.85, P = .01) positions. Post hoc testing showed DF improvements in the standing position after CMR compared with the GT and control groups (both P = .001). In the kneeling position, DF improved after CMR compared with the control group (P = .005). Conclusions Compressive myofascial release increased ankle DF after a single treatment in participants with DF ROM deficits. Clinicians should consider adding CMR as a treatment intervention for patients with DF deficits.
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Behm, David G., Anthony J. Blazevich, Anthony D. Kay, and Malachy McHugh. "Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review." Applied Physiology, Nutrition, and Metabolism 41, no. 1 (January 2016): 1–11. http://dx.doi.org/10.1139/apnm-2015-0235.
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Recently, there has been a shift from static stretching (SS) or proprioceptive neuromuscular facilitation (PNF) stretching within a warm-up to a greater emphasis on dynamic stretching (DS). The objective of this review was to compare the effects of SS, DS, and PNF on performance, range of motion (ROM), and injury prevention. The data indicated that SS- (–3.7%), DS- (+1.3%), and PNF- (–4.4%) induced performance changes were small to moderate with testing performed immediately after stretching, possibly because of reduced muscle activation after SS and PNF. A dose–response relationship illustrated greater performance deficits with ≥60 s (–4.6%) than with <60 s (–1.1%) SS per muscle group. Conversely, SS demonstrated a moderate (2.2%) performance benefit at longer muscle lengths. Testing was performed on average 3–5 min after stretching, and most studies did not include poststretching dynamic activities; when these activities were included, no clear performance effect was observed. DS produced small-to-moderate performance improvements when completed within minutes of physical activity. SS and PNF stretching had no clear effect on all-cause or overuse injuries; no data are available for DS. All forms of training induced ROM improvements, typically lasting <30 min. Changes may result from acute reductions in muscle and tendon stiffness or from neural adaptations causing an improved stretch tolerance. Considering the small-to-moderate changes immediately after stretching and the study limitations, stretching within a warm-up that includes additional poststretching dynamic activity is recommended for reducing muscle injuries and increasing joint ROM with inconsequential effects on subsequent athletic performance.
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Manal, Kurt, Justin D. Cowder, and Thomas S. Buchanan. "A Hybrid Method for Computing Achilles Tendon Moment Arm Using Ultrasound and Motion Analysis." Journal of Applied Biomechanics 26, no. 2 (May 2010): 224–28. http://dx.doi.org/10.1123/jab.26.2.224.
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In this article, we outline a method for computing Achilles tendon moment arm. The moment arm is computed from data collected using two reliable measurement instruments: ultrasound and video-based motion capture. Ultrasound is used to measure the perpendicular distance from the surface of the skin to the midline of the tendon. Motion capture is used to determine the perpendicular distance from the bottom of the probe to the ankle joint center. The difference between these two measures is the Achilles tendon moment arm. Unlike other methods, which require an angular change in joint position to approximate the moment arm, the hybrid method can be used to compute the moment arm directly at a specific joint angle. As a result, the hybrid method involves fewer error-prone measurements and the moment arm can be computed at the limits of the joint range of motion. The method is easy to implement and uses modalities that are less costly and more accessible than MRI. Preliminary testing using a lamb shank as a surrogate for a human ankle revealed good accuracy (3.3% error). We believe the hybrid method outlined here can be used to measure subject-specific moment arms in vivo and thus will potentially benefit research projects investigating ankle mechanics.
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Kshettry, Varun R., Andrew T. Healy, Robb Colbrunn, Dylan T. Beckler, Edward C. Benzel, and Pablo F. Recinos. "Biomechanical evaluation of the craniovertebral junction after unilateral joint-sparing condylectomy: implications for the far lateral approach revisited." Journal of Neurosurgery 127, no. 4 (October 2017): 829–36. http://dx.doi.org/10.3171/2016.7.jns16293.
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OBJECTIVEThe far lateral transcondylar approach to the ventral foramen magnum requires partial resection of the occipital condyle. Early biomechanical studies suggest that occipitocervical (OC) fusion should be considered if 50% of the condyle is resected. In clinical practice, however, a joint-sparing condylectomy has often been employed without the need for OC fusion. The biomechanics of the joint-sparing technique have not been reported. Authors of the present study hypothesized that the clinically relevant joint-sparing condylectomy would result in added stability of the craniovertebral junction as compared with earlier reports.METHODSMultidirectional in vitro flexibility tests were performed using a robotic spine-testing system on 7 fresh cadaveric spines to assess the effect of sequential unilateral joint-sparing condylectomy (25%, 50%, 75%, 100%) in comparison with the intact state by using cardinal direction and coupled moments combined with a simulated head weight “follower load.”RESULTSThe percent change in range of motion following sequential condylectomy as compared with the intact state was 5.2%, 8.1%, 12.0%, and 27.5% in flexion-extension (FE); 8.4%, 14.7%, 39.1%, and 80.2% in lateral bending (LB); and 24.4%, 31.5%, 49.9%, and 141.1% in axial rotation (AR). Only values at 100% condylectomy were statistically significant (p < 0.05). With coupled motions, however, −3.9%, 6.6%, 35.8%, and 142.4% increases in AR+F and 27.3%, 32.7%, 77.5%, and 175.5% increases in AR+E were found. Values for 75% and 100% condyle resection were statistically significant in AR+E.CONCLUSIONSWhen tested in the traditional cardinal directions, a 50% joint-sparing condylectomy did not significantly increase motion. However, removing 75% of the condyle may necessitate fusion, as a statistically significant increase in motion was found when E was coupled with AR. Clinical correlation is ultimately needed to determine the need for OC fusion.
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Mirza, Ather, Justin Mirza, Chris Healy, Vishaaq Mathew, and Brian Lee. "Radiographic and Clinical Assessment of Intramedullary Nail Fixation for the Treatment of Unstable Metacarpal Fractures." HAND 13, no. 2 (March 15, 2017): 184–89. http://dx.doi.org/10.1177/1558944717695747.
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Background: The purpose of the article was to evaluate clinical and radiographic outcomes in a case series of unstable metacarpal fractures treated with flexible intramedullary nail (IMN) fixation. Methods: A total of 55 patients with unstable metacarpal fractures between 2003 and 2010 were treated with IMN fixation and followed for a minimum of 1 year. The outcomes were assessed via a radiological study of longitudinal and angular collapse, Disabilities of the Arm, Shoulder, and Hand (DASH) score, total active range of motion (ROM) of the wrist, and grip strength testing. Results: In the 55 patients, metacarpal fractures were healed by clinical and radiographic assessment at an average of 12.7 weeks. IMNs were removed in all cases at an average of 13.9 weeks. Patients regained full finger ROM at the final follow-up and were capable of 72.4% of motion at 2 weeks postoperatively. The mean DASH score at the final follow-up was 6.5. Complications included 3 cases of extensor tendon irritation that resolved without functional impairment and 2 cases of “backing out” that required reoperation to replace the pin. In one case, a bony exostosis formed on the affected metacarpal that led to tendon irritation and required operative excision. Conclusions: We found that this technique allowed for the stabilization of fractures, early ROM, resumption of usual activities, reduced immobilization, and minimal complications. A removable orthosis, instead of a cast, allowed for earlier mobilization of the wrist, metacarpophalangeal, and proximal interphalangeal joints.