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PubMed | Musculoskeletal Rehabilitation Research Group, Catholic University of Leuven, University College Ghent, Cliniques Universitaires Saint Luc and Center for Molecular and Vascular Biology
Type: | Journal: Gait & posture | Year: 2016

The relationship between age and 3D rotations objectivized with multisegment foot models has not been quantified until now. The purpose of this study was therefore to investigate the relationship between age and multi-segment foot kinematics in a cross-sectional database.Barefoot multi-segment foot kinematics of thirty two typically developing boys, aged 6-20 years, were captured with the Rizzoli Multi-segment Foot Model. One-dimensional statistical parametric mapping linear regression was used to examine the relationship between age and 3D inter-segment rotations of the dominant leg during the full gait cycle.Age was significantly correlated with sagittal plane kinematics of the midfoot and the calcaneus-metatarsus inter-segment angle (p<0.0125). Age was also correlated with the transverse plane kinematics of the calcaneus-metatarsus angle (p<0.0001).Gait labs should consider age related differences and variability if optimal decision making is pursued. It remains unclear if this is of interest for all foot models, however, the current study highlights that this is of particular relevance for foot models which incorporate a separate midfoot segment.

Dingenen B.,Musculoskeletal Rehabilitation Research Group | Janssens L.,Catholic University of Leuven | Janssens L.,Cardiovascular and Respiratory Rehabilitation Research Group | Luyckx T.,University Hospitals Leuven | And 4 more authors.
Clinical Biomechanics | Year: 2015

Abstract Background An anterior cruciate ligament injury may lead to deteriorations in postural stability. The goal of this study was to evaluate postural stability during the transition from double-leg stance to single-leg stance of both legs in anterior cruciate ligament injured subjects and non-injured control subjects with a standardized methodology. Methods Fifteen control subjects and 15 anterior cruciate ligament injured subjects (time after injury: mean (SD) = 1.4 (0.7) months) participated in the study. Both groups were similar for age, gender, height, weight and body mass index. Spatiotemporal center of pressure outcomes of both legs of each subject were measured during the transition from double-leg stance to single-leg stance in eyes open and eyes closed conditions. Movement speed was standardized. Findings The center of pressure displacement after a new stability point was reached during the single-leg stance phase was significantly increased in the anterior cruciate ligament injured group compared to the control group in the eyes closed condition (P <.001). No significant different postural stability outcomes were found between both legs within both groups (P >.05). No significant differences were found during the transition itself (P >.05). Interpretation The anterior cruciate ligament injured group showed postural stability deficits during the single-leg stance phase compared to the non-injured control group in the eyes closed condition. Using the non-injured leg as a normal reference when evaluating postural stability of the injured leg may lead to misinterpretations, as no significant differences were found between the injured and non-injured leg of the anterior cruciate ligament injured group. © 2015 Elsevier Ltd. All rights reserved.

Maris A.,Neuromotor Rehabilitation Research Group | Devreese A.M.,Neuromotor Rehabilitation Research Group | D'Hoore A.,University Clinic Gasthuisberg | Penninckx F.,University Clinic Gasthuisberg | Staes F.,Musculoskeletal Rehabilitation Research Group
Colorectal Disease | Year: 2013

Aim Common problems after rectal resection are loose stools, faecal incontinence, increased frequency and evacuation difficulties, for which there are various therapeutic options. A systematic review was conducted to assess the outcome of treatment options aimed to improve anorectal function after rectal surgery. Method Publications including a therapeutic approach to improve anorectal function after rectal surgery were searched using the following databases: MEDLINE, PubMed, EMBASE, Pedro, CINAHL, Web of Science, PsychInfo and the Cochrane Library. The focus was on outcome parameters of symptomatic improvement of faecal incontinence, evaluation of defaecation and quality of life. Results The degree of agreement on eligibility and methodological quality between reviewers calculated with kappa was 0.85. Fifteen studies were included. Treatment options included pelvic floor re-education (n=7), colonic irrigation (n=2) and sacral nerve stimulation (SNS) (n=6). Nine studies reported reduced incontinence scores and a decreased number of incontinent episodes. In 10 studies an improvement in resting and squeeze pressure was observed after treatment with pelvic floor re-education or SNS. Three studies reported improved quality of life after pelvic floor re-education. Significant improvement of the Fecal Incontinence Quality of Life Scale was found in three studies after SNS. Conclusion Conservative therapies such as pelvic floor re-education and colonic irrigation can improve anorectal function. SNS might be an effective solution in selected patients. However, methodologically qualitative studies are limited and randomized controlled trials are needed to draw evidence-based conclusions. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

Malfait B.,Musculoskeletal Rehabilitation Research Group | Sankey S.,Liverpool John Moores University | Azidin R.M.F.R.,Liverpool John Moores University | Deschamps K.,Musculoskeletal Rehabilitation Research Group | And 4 more authors.
Medicine and Science in Sports and Exercise | Year: 2014

Purpose: As drop vertical jumps (DVJ) are widely used as a screening task, the assessment of the reliability of lower-limb biomechanical parameters during DVJ is important. The aim of this study was to assess the reliability of the kinematic and kinetic peak values as well as of the waveforms for lower-limb parameters obtained with the Liverpool John Moores University biomechanical model (LJMU model) during performance of DVJ. Methods: The reliability was analyzed by calculating the intertrial (o), intersession (o), and intertherapist (o) errors of hip and knee joint parameters in a repeated-measures design including two therapists and a total of six sessions. RESULTS: The results showed o that ranged from 1.1 to 3.5 for all peak kinematic parameters and from 3.6 to 12.9 N·m for all peak kinetic parameters. The o of the peak values ranged from1.9 to 5.7 for all angles and from 5.4 to 19.8 N·m for the hip and knee joint moments in all planes. The o of the peak values ranged from 2.7 to 6.4 for all angles and from 5.8 to 22.4 N·m for all moments. Most of the kinematic and kinetic peak parameters had o ≤ 2.0 and 4.3 N·m, respectively, suggesting a small extrinsic variability. Furthermore, the entire waveforms also showed a rather high o relative to other types of variability. Conclusions: The present findings indicated that DVJ kinetics and kinematics show small extrinsic variability. The reported errors are useful for clinical interpretation processes of DVJ performance as screening task for injury risk and rehabilitation outcome taking into consideration the different types of measurement error over time. © 2014 by the American College of Sports Medicine.

Dingenen B.,Musculoskeletal Rehabilitation Research Group | Malfait B.,Musculoskeletal Rehabilitation Research Group | Vanrenterghem J.,Liverpool John Moores University | Verschueren S.M.P.,Musculoskeletal Rehabilitation Research Group | Staes F.F.,Musculoskeletal Rehabilitation Research Group
Physical Therapy in Sport | Year: 2014

Objective: To investigate the reliability and validity of the measurement of lateral trunk motion (LTM) in two-dimensional (2D) video analysis of unipodal functional screening tests. Design: Observational study. Setting: Research laboratory. Participants: Forty-three injury-free female athletes. Main outcome measures: Knee valgus (KV) and lateral trunk motion (LTM) angles were measured with a standard digital camera during the single leg squat and the single leg drop vertical jump (SLDVJ). Three-dimensional motion analysis was used during the SLDVJ to measure peak external knee abduction moment (pKAM). Intraclass correlation coefficients were calculated to assess the intra- and intertester reliability of the LTM angle. Correlations between 2D angles and pKAM were calculated for the SLDVJ. Results: Excellent intraclass correlation coefficients for the LTM angle were found within (0.99-1.00) and between testers (0.98-0.99). The sum of KV and LTM was significantly correlated with the pKAM during the SLDVJ for the dominant ( r=-0.36; p=0.017) and non-dominant leg ( r=-0.32; p=0.034), while either angle alone was not. Conclusions: LTM can be measured with excellent intra- and intertester reliability. The combination of KV and LTM was moderately associated with pKAM and thus including LTM may aid assessment of movement quality and injury risk. © 2013 Elsevier Ltd.

PubMed | Shinshu University, Musculoskeletal Rehabilitation Research Group and Liverpool John Moores University
Type: Journal Article | Journal: PloS one | Year: 2016

The purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ).Fifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM),vastus lateralis(VL)}, {vastus medialis(VM),hamstring medialis(HM)}, {hamstring medialis(HM),hamstring lateralis(HL)} and the {vastus lateralis(VL),hamstring lateralis(HL)}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping.The peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (p<0.05). Small peak knee flexion angles were significantly associated with higher HM amplitudes during the preparatory and initial contact phase (p<0.001). The amplitudes of the {VM,VL} and {VL,HL} were significantly positively associated with the peak hip flexion angle during the peak loading phase (p<0.05). Small peak hip flexion angles were significantly associated with higher VL amplitudes during the peak loading phase (p = 0.001). Higher external knee abduction and flexion moments were found in participants landing with less flexed knee and hip joints (p<0.001).This study demonstrated clear associations between neuromuscular activation patterns and landing kinematics in the sagittal plane during specific parts of the landing. These findings have indicated that an erect landing pattern, characterized by less hip and knee flexion, was significantly associated with an increased medial and posterior neuromuscular activation (dominant hamstrings medialis activity) during the preparatory and initial contact phase and an increased lateral neuromuscular activation (dominant vastus lateralis activity) during the peak loading phase.

PubMed | Fontys University of Applied Sciences, Musculoskeletal Rehabilitation Research Group and TU Eindhoven
Type: | Journal: Gait & posture | Year: 2016

To determine (1) if Medial Thrust or Trunk Lean reduces the knee adduction moment (EKAM) the most during gait in patients with medial knee osteoarthritis, (2) if the best overall strategy is the most effective for each patient and (3) if these strategies affect ankle and hip kinetics.Thirty patients with symptomatic medial knee osteoarthritis underwent 3-dimensional gait analysis. Participants received verbal instructions on two gait strategies (Trunk Lean and Medial Thrust) in randomized order after comfortable walking was recorded. The peaks and impulse of the EKAM and strategy-specific kinematic and kinetic variables were calculated for all conditions.Early stance EKAM peak was significantly reduced during Medial Thrust (-29%). During Trunk Lean, early and late stance EKAM peak and EKAM impulse reduced significantly (38%, 21% and -25%, respectively). In 79% of the subjects, the Trunk Lean condition was significantly more effective in reducing EKAM peak than Medial Thrust. Peak ankle dorsi and plantar flexion, knee flexion and hip extension and adduction moments were not significantly increased.Medial Thrust and Trunk Lean reduced the EKAM during gait in patients with knee osteoarthritis. Individual selection of the most effective gait modification strategy seems vital to optimally reduce dynamic knee loading during gait. No detrimental effects on external ankle and hip moments or knee flexion moments were found for these conditions.

PubMed | Musculoskeletal Rehabilitation Research Group and Liverpool John Moores University
Type: Journal Article | Journal: PloS one | Year: 2015

An anterior cruciate ligament (ACL) injury involves a multi-planar injury mechanism. Nevertheless, unexpected multi-planar perturbations have not been used to screen athletes in the context of ACL injury prevention yet could reveal those more at risk. The objective of this study was to compare neuromuscular responses to multi-planar (MPP) and single-planar perturbations (SPP) during a stepping-down task. These results might serve as a basis for future implementation of external perturbations in ACL injury screening programs.Thirteen young adults performed a single leg stepping-down task in eight conditions (four MPP and four SPP with a specified amplitude and velocity). The amplitudes of vastus lateralis (VL), vastus medialis (VM), hamstrings lateralis (HL), hamstrings medialis (HM) EMG activity, medio-lateral and anterior-posterior centre of mass (COM) displacements, the peak knee flexion and abduction angles were compared between conditions using an one-way ANOVA. Number of stepping responses were monitored during all conditions.Significantly greater muscle activity levels were found in response to the more challenging MPP and SPP compared to the less challenging conditions (p < 0.05). No differences in neuromuscular activity were found between the MPP conditions and their equivalents in the SPP. Eighteen stepping responses were monitored in the SPP versus nine in the MPP indicating that the overall neuromuscular control was even more challenged during the SPP which was supported by greater COM displacements in the SPP.The more intense MPP and SPP evoked different neuromuscular responses resulting in greater muscle activity levels compared to small perturbations. Based on the results of COM displacements and based on the amount of stepping responses, dynamic neuromuscular control of the knee joint appeared less challenged during the MPP. Therefore, future work should investigate extensively if other neuromuscular differences (i.e. co-activation patterns and kinetics) exist between MPP and SPP. In addition, future work should examine the influence on the neuromuscular control of the magnitude of the perturbations and the magnitude of stepping height and stepping distance.

PubMed | Musculoskeletal Rehabilitation Research Group, Amsterdam Rehabilitation Research Center Reade, University of Alberta, VU University Amsterdam and 2 more.
Type: Journal Article | Journal: The Knee | Year: 2016

To compare the knee joint kinematics, kinetics and EMG activity patterns during a stepping-down task in patients with knee osteoarthritis (OA) with control subjects.33 women with knee OA (early OA, n=14; established OA n=19) and 14 female control subjects performed a stepping-down task from a 20cm step. Knee joint kinematics, kinetics and EMG activity were recorded on the stepping-down leg during the loading phase.During the stepping-down task patients with established knee OA showed greater normalized medial hamstrings activity (p=0.034) and greater vastus lateralis-medial hamstrings co-contraction (p=0.012) than controls. Greater vastus medialis-medial hamstrings co-contraction was found in patients with established OA compared to control subjects (p=0.040) and to patients with early OA (p=0.023). Self-reported knee instability was reported in 7% and 32% of the patients with early and established OA, respectively.The greater EMG co-activity found in established OA might suggest a less efficient use of knee muscles or an attempt to compensate for greater knee laxity usually present in patients with established OA. In the early stage of the disease, the biomechanical and neuromuscular control of stepping-down is not altered compared to healthy controls.

PubMed | Musculoskeletal Rehabilitation Research Group and Interuniversity Institute for Biostatistics and Statistical Bioinformatics
Type: Comparative Study | Journal: Journal of athletic training | Year: 2015

Participants with chronic ankle instability (CAI) use an altered neuromuscular strategy to shift weight from double-legged to single-legged stance. Shoes and foot orthoses may influence these muscle-activation patterns.To evaluate the influence of shoes and foot orthoses on onset times of lower extremity muscle activity in participants with CAI during the transition from double-legged to single-legged stance.Cross-sectional study.Musculoskeletal laboratory.A total of 15 people (9 men, 6 women; age = 21.8 3.0 years, height = 177.7 9.6 cm, mass = 72.0 14.6 kg) who had CAI and wore foot orthoses were recruited.A transition task from double-legged to single-legged stance was performed with eyes open and with eyes closed. Both limbs were tested in 4 experimental conditions: (1) barefoot (BF), (2) shoes only, (3) shoes with standard foot orthoses, and (4) shoes with custom foot orthoses (SCFO).The onset of activity of 9 lower extremity muscles was recorded using surface electromyography and a single force plate.Based on a full-factorial (condition, region, limb, vision) linear model for repeated measures, we found a condition effect (F(3,91.8) = 9.39, P < .001). Differences among experimental conditions did not depend on limb or vision condition. Based on a 2-way (condition, muscle) linear model within each region (ankle, knee, hip), earlier muscle-activation onset times were observed in the SCFO than in the BF condition for the peroneus longus (P < .001), tibialis anterior (P = .003), vastus medialis obliquus (P = .04), and vastus lateralis (P = .005). Furthermore, the peroneus longus was activated earlier in the shoes-only (P = .02) and shoes-with-standard-foot-orthoses (P = .03) conditions than in the BF condition. No differences were observed for the hip muscles.Earlier onset of muscle activity was most apparent in the SCFO condition for ankle and knee muscles but not for hip muscles during the transition from double-legged to single-legged stance. These findings might help clinicians understand how shoes and foot orthoses can influence neuromuscular control in participants with CAI.

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