3-D range of motion envelopes reveal interacting degrees of freedom in avian hind limb joints.

In evolutionary biomechanics, musculoskeletal computer models of extant and extinct taxa are often used to estimate joint range of motion (ROM) and muscle moment arms (MMAs), two parameters which form the basis of functional inferences. However, relatively few experimental studies have been performed to validate model outputs. Previously, we built a model of the short-beaked echidna (Tachyglossus aculeatus) forelimb using a traditional modelling workflow, and in this study we evaluate its behaviour and outputs using experimental data. The echidna is an unusual animal representing an edge-case for model validation: it uses a unique form of sprawling locomotion, and possesses a suite of derived anatomical features, in addition to other features reminiscent of extinct early relatives of mammals. Here we use diffusible iodine-based contrast-enhanced computed tomography (diceCT) alongside digital and traditional dissection to evaluate muscle attachments, modelled muscle paths, and the effects of model alterations on the MMA outputs. We use X-ray Reconstruction of Moving Morphology (XROMM) to compare ex vivo joint ROM to model estimates based on osteological limits predicted via single-axis rotation, and to calculate experimental MMAs from implanted muscles using a novel geometric method. We also add additional levels of model detail, in the form of muscle architecture, to evaluate how muscle torque might alter the inferences made from MMAs alone, as is typical in evolutionary studies. Our study identifies several key findings that can be applied to future models. 1) A light-touch approach to model building can generate reasonably accurate muscle paths, and small alterations in attachment site seem to have minimal effects on model output. 2) Simultaneous movement through multiple degrees of freedom, including rotations and translation at joints, are necessary to ensure full joint ROM is captured; however, single-axis ROM can provide a reasonable approximation of mobility depending on the modelling objectives. 3) Our geometric method of calculating MMAs is consistent with model-predicted MMAs calculated via partial velocity, and is a potentially useful tool for others to create and validate musculoskeletal models. 4) Inclusion of muscle architecture data can change some functional inferences, but in many cases reinforced conclusions based on MMA alone.

Surgical intervention is a common option for the treatment of wrist joint arthritis and traumatic wrist injury. Whether this surgery is arthrodesis or a motion preserving procedure such as arthroplasty, wrist joint biomechanics are inevitably altered. To evaluate effects of surgery on parameters such as range of motion, efficiency and carpal kinematics, repeatable and controlled motion of cadaveric specimens is required. This study describes the development of a device that enables cadaveric wrist motion to be simulated before and after motion preserving surgery in a highly controlled manner. The simulator achieves joint motion through the application of predetermined displacements to the five major tendons of the wrist, and records tendon forces. A pilot experiment using six wrists aimed to evaluate its accuracy and reproducibility. Biplanar X-ray videoradiography (BPVR) and X-Ray Reconstruction of Moving Morphology (XROMM) were used to measure overall wrist angles before and after total wrist arthroplasty. The simulator was able to produce flexion, extension, radioulnar deviation, dart thrower's motion and circumduction within previously reported functional ranges of motion. Pre- and post-surgical wrist angles did not significantly differ. Intra-specimen motion trials were repeatable; root mean square errors between individual trials and average wrist angle and tendon force profiles were below 1° and 2 N respectively. Inter-specimen variation was higher, likely due to anatomical variation and lack of wrist position feedback. In conclusion, combining repeatable intra-specimen cadaveric motion simulation with BPVR and XROMM can be used to determine potential effects of motion preserving surgeries on wrist range of motion and biomechanics.

Geometrical analysis of hip and knee joint mobility in cerebral palsied children.

To determine the maximum amount of flexion and extension of the carpal, tarsal, metacarpophalangeal, and metatarsophalangeal joints and the percentage duration of the stance and swing phases of the stride for horses walking on an underwater treadmill in various water depths. 9 healthy adult horses. Zinc oxide markers were placed on the forelimbs and hind limbs of the horses. Video was recorded of horses walking (0.9 m/s) on an underwater treadmill during baseline conditions (< 1 cm of water) or in various amounts of water (level of the metatarsophalangeal, tarsal, and stifle joints). Maximum amount of joint flexion and extension, range of motion (ROM), and the percentage durations of the stance and swing phases of the stride were determined with 2-D motion analysis software. The ROM was greater for all evaluated joints in any amount of water versus ROM for joints in baseline conditions (primarily because of increases in amount of joint flexion). The greatest ROM for carpal joints was detected in a tarsal joint water depth, for tarsal joints in a stifle joint water depth, and for metacarpophalangeal and metatarsophalangeal joints in metatarsophalangeal and tarsal joint water depths. As water depth increased, the percentage durations of the stance and swing phases of the stride significantly decreased and increased, respectively. Results of this study suggested that exercise on an underwater treadmill is useful for increasing the ROM of various joints of horses during rehabilitation and that the depth of water affects the amount of flexion and extension of joints.

AB1113 Characteristics of Physical Disability in Patients with Long-Standing Rheumatoid Arthritis: Baseline Analysis of Multicenter Prospective Cohort Study for Evaluation of Joint Reconstructive Procedure

BackgroundHorses commonly show asymmetries that manifest as left (L)-right (R) differences in vertical excursion of axial body segments. Moving on a circle confounds inherent individual asymmetries. Our goals were to evaluate individual and group asymmetry patterns and compare objective data with subjective impressions of side preference/laterality in horses walking on L and R circles.MethodsFifteen horses walked on L and R circles unridden and ridden on long and short reins. Optical motion capture (150 Hz) tracked skin-fixed markers. Variables were trunk horizontal angle; neck-to-trunk angle; vertical range of motion (ROM) for the head, withers and sacrum; ROM for pelvic roll, pitch, and yaw; mean pelvic pitch; and ROM for hip, stifle and tarsal joints. Differences between inside and outside hind steps were determined for vertical minima and maxima of the head (HMinDiff/HMaxDiff), withers (WMinDiff/WMaxDiff) and sacrum (PMinDiff/PMaxDiff). Subjective laterality was provided by owners. Data analysis used mixed models, first without and then with subjective laterality. Iterative k-means cluster analysis was used to associate biomechanical variables with subjective laterality.ResultsPMaxDiff, PMinDiff and WMaxDiff indicated R limb asymmetry in both directions. WMinDiff indicated L (inside) fore asymmetry for L direction but was close to zero for R direction. Hip ROM was significantly smaller for the inside limb in both directions (L inside/outside: 16.7° vs. 20.6°; R: 17.8° vs. 19.4°). Stifle ROM was significantly larger for the inside limb in both directions (L: 43.1° vs. 39.0°; R: 41.9° vs. 40.4°). Taking the general direction effect into account the R hip and L stifle had larger ROM. Adding laterality to the models (seven horses L- vs. six horses R-hollow), PMaxDiff R hind asymmetry was more obvious for L-hollow horses than for R-hollow horses. L-hollow horses had greater pelvic roll ROM moving in L vs. R direction. L-hollow horses had smaller inside and greater outside hip joint ROM in L vs. R direction. R-hollow horses had a significant difference in HMinDiff between L (0 mm) and R (−14 mm) directions, indicating less head lowering at outside forelimb midstance in R direction, and larger outside tarsal ROM in R (38.6°) vs. L (37.4°) direction (p ≤ 0.05). The variables that agreed most frequently with subjective laterality in cluster analysis were pelvic roll ROM, followed by HMinDiff and PMaxDiff.ConclusionDifferences between horses walking in L and R directions were found both at group and individual levels, as well as evidence of associations with subjective laterality. Horses maintained more symmetric hip and stifle ROM and withers vertical motion when walking on the R circle. Findings suggest that left and right lateralised horses may not be perfect mirror images. Pelvic roll ROM emerged as a promising variable to determine laterality in walk as perceived by the rider, especially when considered together with other variables.

Objective: To explore the characteristics of functional impairment in patients with established rheumatoid arthritis (RA) based on the range of motion (ROM) of joints in a prospective observational study of RA patients undergoing joint surgery.Methods: We collected data on demographics, Health Assessment Questionnaire Disability Index (HAQ-DI), and the ROM of large joints including the shoulder, elbow, wrist, hip, knee, and ankle. Associations between the ROM of each joint and disability in the eight HAQ-DI categories were determined using receiver operating characteristic (ROC) and logistic regression analyses. ROM cut-off values of each joint for the absence of disability in each HAQ-DI category were determined using ROC curves.Results: A total of 460 patients were enrolled and analyzed in this study. Based on ROC analysis, the ROM of each joint was significantly associated with disability in each category. After adjusting for disease activity, age, and sex, shoulder abduction had the highest independent impact on disability in activity [cut-off: 139 degrees (OR: 5.26)], elbow flexion-extension in dressing [121 degrees (OR: 2.22)], wrist flexion-extension in reach [86 degrees (OR: 2.71)], hip flexion-extension in walking [126 degrees (OR: 3.42)], and knee flexion-extension in walking [134 degrees (OR: 2.97)].Conclusions: Limited ROM of multiple joints was significantly associated with functional impairment in patients with long-standing RA. Motion in daily activity involves multiple joints, and at least two joints were independently involved in disability.

The midfoot is instrumental to foot function; however, quantifying its roles in human movement has been difficult. A forceful dynamic activity like landing may help elucidate the midfoot's contribution to foot energetics and function. The main purpose of this study was to measure midtarsal joint kinematics and kinetics during a barefoot single-leg landing task. A secondary aim of this study was to explore the relationship between static foot posture and dynamic midfoot function. In a cross-sectional study design, 48 females (age = 20.4 ± 1.8 yr, body mass index = 21.6 ± 1.7 kg·m) performed drop landings from a height of 0.4 m onto split force platforms. Subjects hung from wooden rings and landed on their dominant leg. Midtarsal joint kinematic and kinetic data were recorded using a 14-camera optical motion capture system in conjunction with two in-ground force platforms and a custom kinetic three-segment foot model. Foot structure was measuring using the arch height index (AHI) and the static midtarsal joint angle from motion capture. Kinematic data revealed an average sagittal plane midtarsal joint range of motion of 27° through the landing phase. Kinetic data showed that between 7% and 22% of the total lower extremity joint, work during the landing was performed by the midtarsal joint. Both standing AHI and static midtarsal joint angle (static MA) were correlated with sagittal plane midtarsal joint range of motion (standing AHI: r = -0.320, P = 0.026; static MA: r = 0.483, P < 0.001) and with midtarsal joint work (standing AHI: r = 0.332, P = 0.021; static MA: r = -0.323, P = 0.025). The midfoot contributes substantially to landing mechanics during a barefoot single-leg landing task. Static foot posture measures have limited value in predicting midfoot kinematics and kinetics during sportlike landings.

Purpose. To determine the relationship between body functions, comorbidity and cognitive functioning on the one side and limitations in activities on the other, in elderly patients with osteoarthritis (OA) of the hip or knee.Method. A cross-sectional cohort study was conducted in which 288 patients with hip or knee OA were included. Patients were recruited from rehabilitation centres and hospitals (Departments of Orthopedics, Rheumatology or Rehabilitation). Apart from demographic and clinical data, information about limitations in activities, body functions (pain, muscle strength, range of joint motion), comorbidity and cognitive functioning was collected by questionnaires and tests. Statistical analyses included univariate and stepwise multivariate regression analysis.Results. Self-reported limitations in activities (Western Ontario and McMaster Universities Osteoarthritis Index) were significantly associated with pain, muscle strength knee extension, range of motion (ROM) hip flexion and morbidity count. Performance-based limitations in activities (timed walking test) were significantly associated with ROM (knee flexion, hip flexion and knee extension), muscle strength hip abduction, pain, cognitive functioning and age.Conclusions. Self-reported limitations in activities in hip or knee OA are largely dependent on pain and to a lesser extent on range of joint motion, muscle strength and comorbidity. Performance-based limitations in activities are largely dependent on range of joint motion and muscle strength, and to a lesser extent on pain, cognitive functioning and other factors. These findings point to the role of body functions in limitations in activities in OA of the hip or knee. Although less important, comorbidity and cognitive functioning play a role as well.

The functional morphology and kinematics of the elbow joint remain relatively understudied in squamates. Previous investigations of lizard elbow morphology and kinematics suggest long-axis rotation (LAR) of the radius and ulna during stance allows the manus to remain pronated during forelimb retraction. Using XROMM (X-ray Reconstruction of Moving Morphology), we explored the range of 3D movements and kinematics of the humerus, radius, and ulna in three adult male Central bearded dragons (Pogona vitticeps) during trackway walking. Our data indicate that the elbow joint of P. vitticeps experiences significant rotations in all three dimensions and that the radius and ulna adduct and rotate laterally on their long axes relative to the elbow joint and to one another during stance. These movements allow the distal ends of the radius and ulna to remain in a configuration necessary for manus pronation. These data support previous inferences that the radius and ulna of lizards move independently at the wrist joint. We suggest that independent LAR of the radius and ulna relative to the elbow joint and to one another may be an ancestral mechanism in lizards and perhaps more broadly across non-avian reptiles.

Rheumatoid arthritis (AR) is one of the joint diseases commonly experienced by people with complaints of pain and limited range of joint motion. Management for patients who experience joint stiffness and pain can be done through exercise. Knee streecing exercise (KSE) is an activity of stretching the muscles in the knee area to increase muscle flexibility and range of joint motion. The purpose of this study was to determine the effect of giving Knee Stretching Exercise (KSE) on achieving range of motion (ROM) and Pain Intensity in Rheumatoid Arthritis Patients. This research design is quantitative with pre-experimental design using one group pretest and posttest design approach. The sample in this study were 45 elderly who suffer from rheumatoid arthritis (RA) according to inclusion and exclusion criteria. The instruments used in this study were the gionometer and numerical rating scale (NRS). Data were analyzed using the Wilcoxon rank test. Statistical test results showed that there was an effect of Knee Stretching Exercise (KSE) on the intensity of Pain and Achievement of Range of Motion in Reumathoid Athritis patients with a p value of 0.0001 (p &lt;0.05). A decrease in the intensity of pain experienced by respondents after being given KSE training. The range of joint motion in the respondents increased to full flexion (1350) and full extension (0-10). It is suggested that the community routinely conduct KSE training because it is easy and simple to do. Keyword : Knee streecing exercise (KSE); range of motion; pain intensity

To assess differences in sagittal plane joint kinematics and ground reaction forces between lean and obese adult dogs of similar sizes at 2 trotting velocities. 16 adult dogs. Dogs with body condition score (BCS) of 8 or 9 (obese dogs; n = 8) and dogs with BCS of 4 or 5 (lean dogs; 8) on a 9-point scale were evaluated. Sagittal plane joint kinematic and ground reaction force data were obtained from dogs trotting at 1.8 and 2.5 m/s with a 3-D motion capture system, a force platform, and 12 infrared markers placed on bony landmarks. Mean stride lengths for forelimbs and hind limbs at both velocities were shorter in obese than in lean dogs. Stance phase range of motion (ROM) was greater in obese dogs than in lean dogs for shoulder (28.2° vs 20.6°), elbow (23.6° vs 16.4°), hip (27.2° vs 22.9°), and tarsal (38.9° vs 27.9°) joints at both velocities. Swing phase ROM was greater in obese dogs than in lean dogs for elbow (61.2° vs 53.7°) and hip (34.4° vs 29.8°) joints. Increased velocity was associated with increased stance ROM in elbow joints and increased stance and swing ROM in hip joints of obese dogs. Obese dogs exerted greater peak vertical and horizontal ground reaction forces than did lean dogs. Body mass and peak vertical ground reaction force were significantly correlated. Greater ROM detected during the stance phase and greater ground reaction forces in the gait of obese dogs, compared with lean dogs, may cause greater compressive forces within joints and could influence the development of osteoarthritis.

Background Little data are available on changes that occur with age in joint range of motion in dancers and nondancers. Hypothesis In dancers, joint range of motion will increase with age, whereas it will decrease in nondancers, independent of the joint studied. Study Design Cross-sectional study; Level of evidence, 3. Methods The study population included 1320 female dancers, aged 8 to 16 years, who participated in different types of dancing classes (classical ballet, modern dance, jazz, etc) and 226 nondancers of similar age. Range of motion was measured for the hip, knee, ankle, foot, and spinal joints. Results The pattern of differences in range of motion with age varied in different joints and types of movement. (1) For combined ankle and foot plantar flexion (pointe), ankle plantar flexion, and hip external rotation, there was no change in range of motion in dancers, whereas range of motion diminished with age in the nondancers. (2) For ankle dorsiflexion, neither group showed any change with age, and range of motion was significantly greater in the nondancer group. (3) For knee flexion, hip flexion, and hip internal rotation, range of motion decreased with age in both groups. (4) For hip abduction, range of motion decreased with age in dancers and remained constant in the nondancers. (5) For hip extension, range of motion increased in both groups. (6) For lower back and hamstrings, range of motion increased among dancers with age and remained constant among nondancers. Conclusion Dancers and teachers should realize that passive joint range of motion is unlikely to improve with age. Therefore, the major goal of a dancing program should focus on exercises that retain the natural flexibility of the dancers’ joints rather than trying to improve them.

There have been many studies on range of motion (ROM) of joint at home and abroad, but they were generally measured on a certain age group, a certain group of people, and a certain area. So far, no large-scale measurement research on Chinese adults has been carried out systematically. Based on the regional characteristics of China, this study selected three places of Hangzhou, Xi'an, and Dalian as sampling points, and 818 Chinese adults’ data of ROM were collected whose age ranged from 18 to 67 years old. And their careers involved university teachers, staff, undergraduate students, graduate students, farmers, workshop workers, etc. Forty parameters of ROM were measured including shoulder, elbow, wrist, fingers, neck, spine, hip, knee, ankle, etc. After analyzing the effects of age, gender, BMI index, region and labor intensity to the ROM, it was found that the most females’ ROM were larger than males’. In generally, female’s neck, wrist, hip, shoulder, ulna and finger joints were more flexible than male’s. There was no obvious difference in flexibility between men and women about spine thoracolumbar, elbow, knee and ankle joints. The effect of age on ROM was more obvious. The overall trend was that the ROM decreased with age, and the smallest reduction was hip adduction, by 2.1%, and the largest reduction was wrist radial flexion, by 25.2%. The smallest degree reduction also was hip adduction (0.6°), and the largest was wrist flexion (13.2°). Among the 40 parameters measured, 33 parameters decreased with the increase of BMI index. The largest decrease was elbow extension (29.1%), and the smallest decrease was shoulder abduction (2.7%). The ROM of each joint varied greatly in different regions, ranging from 2° to 19.4°. The smallest was shoulder abduction (2°), and the largest was shoulder internal rotation (19.4°). By analyzing the data of subjects with different labor intensity, it could be found that as the labor intensity increase, the ROM become smaller.KeywordsRange of motion (ROM)AdultGenderAgeBMIRegionLabor intensity

Introduction: The surgical procedure for myocardial revascularization (MRI) may compromise chest stability, compliance and range of motion (ROM) of the shoulder joint due to sternotomy and knee joint due to saphenectomy. Objective: To evaluate the impact of myocardial revascularization surgery on upper and lower limb ROM Methodology: This is a prospective cohort study, performed with a group of patients submitted to cardiac surgery. In the preoperative period the ROM was evaluated through a goniometer, for flexion, horizontal abduction and vertical abduction of the right and left shoulder, as well as evaluation of the flexo-extension movement of the right knee. On the day of discharge from the Intensive Care Unit, the patients were reassessed. Results:Twenty patients were evaluated during the time of the study. The majority were men 14 (70%), with a mean age of 60 ± 10 years. Regarding ROM, it was verified that all the movements presented a significant reduction in the postoperative period. The right shoulder flexion (75 ± 11ºvs66 ± 8º, p = 0, p &lt;0.01), right shoulder abduction (155 ± 17º vs127 ± 22º, p &lt; (P = 0.02), right vertical abduction (142 ± 24º vs117 ± 22º, p &lt;0.01), left vertical abduction (142 ± 24º vs121 ± 22º, p = 0), left horizontal abduction (79 ± 9º vs70 ± 5º, p=0,02), Knee flexion (100 ± 14º vs75 ± 19º, p &lt;0.01) and knee extension (94 ± 13º vs79 ± 15º, p &lt;0.01). Conclusion: It can be concluded that the surgery promote reduction of the range of joint motion in this sample of patients submitted to myocardial revascularization.