Compensatory Movement Patterns Research Articles

Functional Performance and Tendon Morphology After Operative or Nonoperative Treatment of Achilles Tendon Ruptures.

While controversy remains as to the relative benefit of operative (OM) versus non-operative management (NOM) of Achilles tendon (AT) ruptures (ATR), few studies have examined the effect on high impact maneuvers such as jumping and hopping. The purpose of this study was to determine if functional performance including strength, jumping, and hopping outcomes differed between OM and NOM of acute ATR. The secondary objective was to assess the degree of association between AT morphology and performance outcomes. Retrospective cohort with a single prospective evaluation. All patients were treated at an institutional secondary care center. Eligible participants (n=12 OM; 12 NOM) who were treated with OM or NOM of ATR within three weeks of injury were evaluated a minimum 20 months following ATR. AT length, thickness and gastrocnemius muscle thickness were assessed with B-mode ultrasound. Isokinetic plantar flexor strength, hop tests and countermovement and drop jumps were completed. Two-way ANOVAS were completed on all tests with unilateral values, independent t-tests were used for bilateral outcomes, and linear regressions were completed to assess the relationship between normalized AT length and performance. Affected limb AT was elongated and thickened (p\<0.01), gastrocnemius was atrophied (p\< 0.01) and angle-specific plantar flexor torque was reduced at 120°/s when measured at 20° plantar flexion (p = 0.028). Single leg drop vertical jump was higher in OM (p = 0.015) with no difference for hop and jump tests. AT length was related to plantar flexor torque but had no relationship with hopping performance. Hop test performance was maintained despite plantarflexion weakness, gastrocnemius atrophy, and AT elongation. This may be the result of compensatory movement patterns. AT length holds limited explanatory power in plantar flexor strength, although this relationship should be evaluated further. Level III.

Modeling rehabilitation dataset to implement effective AI assistive systems

The demand for automated systems monitoring and supporting patients in their home-based recovery programs is substantial. While emerging technologies have been proposed as potential solutions to enhance at-home patient care, limited systems are in place due to their challenges in offering real-time monitoring and corrective feedback. Most proposed methodologies provide an overall measure or score for the executed movement. The proposed work involves the adaptation of an existing published dataset to cater to the needs of a system capable of remotely assisting patients, effectively acting as a virtual physical therapist able to provide corrective feedback. A dataset containing a set of three simple exercises for shoulder rehabilitation was processed. Each movement was meticulously annotated for temporal and categorical motion domains to monitor exercise execution in terms of the range of motion completeness and to evaluate compensatory movement patterns. This work carries substantial significance by offering a standardized and easily accessible model for human movement data, thus fostering the advancement of digital assistive systems designed to support home-based rehabilitation programs.

Erratum to: Compensatory Movement Patterns Are Based on Abnormal Activity of the Biceps Brachii and Posterior Deltoid Muscles in Patients with Symptomatic Rotator Cuff Tears.

Erratum to: Compensatory Movement Patterns Are Based on Abnormal Activity of the Biceps Brachii and Posterior Deltoid Muscles in Patients with Symptomatic Rotator Cuff Tears.

Lumbopelvic movement coordination during walking improves with transfemoral bone anchored limbs: Implications for low back pain

BackgroundLow back pain (LBP) is more prevalent in patients with transfemoral amputation using socket prostheses than able-bodied individuals, in part due to altered spinal loading caused by aberrant lumbopelvic movement patterns. Early evidence surrounding bone-anchored limb functional outcomes is promising, yet it remains unknown if this novel prosthesis influences LBP or movement patterns known to increase its risk. Research questionHow are self-reported measures of LBP and lumbopelvic movement coordination patterns altered when using a unilateral transfemoral bone-anchored limb compared to a socket prosthesis? MethodsFourteen patients with unilateral transfemoral amputation scheduled to undergo intramedullary hardware implantation for bone-anchored limbs due to failed socket use were enrolled in this longitudinal observational cohort study (7 F/7 M, Age: 50.2±12.0 years). The modified Oswestry Disability Index (mODI) (self-reported questionnaire) and whole-body motion capture during overground walking were collected before (with socket prosthesis) and 12-months following bone-anchored limb implantation. Lumbopelvic total range of motion (ROM) and continuous relative phase (CRP) segment angles were calculated during 10 bilateral gait cycles. mODI, total ROM, CRP and CRP variabilities were compared between time points. ResultsmODI scores were significantly reduced 12-months after intramedullary hardware implantation for the bone-anchored limb (P = 0.013). Sagittal plane trunk and pelvis total ROM during gait were reduced after implantation (P = 0.001 and P < 0.001, respectively). CRP values were increased (more anti-phase) in the sagittal plane during single limb stance and reduced (more in-phase) in the transverse plane during pre-swing of the amputated limb gait cycle (P << 0.001 and P = 0.029, respectively). No differences in CRP values were found in the frontal plane. SignificanceDecreases in mODI scores and lumbopelvic ROM, paired with the changes in lumbopelvic coordination, indicate that bone-anchored limbs may reduce LBP symptoms and reduce compensatory movement patterns for people with unilateral transfemoral amputation.

Wearable Sensor to Monitor Quality of Upper Limb Task Practice for Stroke Survivors at Home.

Many stroke survivors experience persistent upper extremity impairment that limits performance in activities of daily living. Upper limb recovery requires high repetitions of task-specific practice. Stroke survivors are often prescribed task practices at home to supplement rehabilitation therapy. A poor quality of task practices, such as the use of compensatory movement patterns, results in maladaptive neuroplasticity and suboptimal motor recovery. There currently lacks a tool for the remote monitoring of movement quality of stroke survivors' task practices at home. The objective of this study was to evaluate the feasibility of classifying movement quality at home using a wearable IMU. Nineteen stroke survivors wore an IMU sensor on the paretic wrist and performed four functional upper limb tasks in the lab and later at home while videorecording themselves. The lab data served as reference data to classify home movement quality using dynamic time warping. Incorrect and correct movement quality was labeled by a therapist. The home task practice movement quality was classified with an accuracy of 92% and F1 score of 0.95 for all tasks combined. Movement types contributing to misclassification were further investigated. The results support the feasibility of a home movement quality monitoring system to assist with upper limb rehabilitation post stroke.

Restoring natural upper limb movement through a wrist prosthetic module for partial hand amputees

BackgroundMost partial hand amputees experience limited wrist movement. The limited rotational wrist movement deteriorates natural upper limb system related to hand use and the usability of the prosthetic hand, which may cause secondary damage to the musculoskeletal system due to overuse of the upper limb affected by repetitive compensatory movement patterns. Nevertheless, partial hand prosthetics, in common, have only been proposed without rotational wrist movement because patients have various hand shapes, and a prosthetic hand should be attached to a narrow space.MethodsWe hypothesized that partial hand amputees, when using a prosthetic hand with a wrist rotation module, would achieve natural upper limb movement muscle synergy and motion analysis comparable to a control group. To validate the proposed prototype design with the wrist rotation module and verify our hypothesis, we compared a control group with partial hand amputees wearing hand prostheses, both with and without the wrist rotation module prototype. The study contained muscle synergy analysis through non-negative matrix factorization (NMF) using surface electromyography (sEMG) and motion analyses employing a motion capture system during the reach-to-grasp task. Additionally, we assessed the usability of the prototype design for partial hand amputees using the Jebsen-Taylor hand function test (JHFT).ResultsThe results showed that the number of muscle synergies identified through NMF remained consistent at 3 for both the control group and amputees using a hand prosthesis with a wrist rotation module. In the motion analysis, a statistically significant difference was observed between the control group and the prosthetic hand without the wrist rotation module, indicating the presence of compensatory movements when utilizing a prosthetic hand lacking this module. Furthermore, among the amputees, the JHFT demonstrated a greater improvement in total score when using the prosthetic hand equipped with a wrist rotation module compared to the prosthetic hand without this module.ConclusionIn conclusion, integrating a wrist rotation module in prosthetic hand designs for partial hand amputees restores natural upper limb movement patterns, reduces compensatory movements, and prevent the secondary musculoskeletal. This highlights the importance of this module in enhancing overall functionality and quality of life.

Kinematic analysis of movement patterns during a reach-and-grasp task in stroke patients.

This study aimed to evaluate the kinematic movement patterns during a reach-and-grasp task in post-stroke patients according to the upper extremity impairment severity. Subacute stroke patients (n = 46) and healthy controls (n = 20) were enrolled in this study. Spatiotemporal and kinematic data were obtained through 3D motion analysis during the reach-and-grasp task. Stroke patients were grouped using the Fugl-Meyer Assessment (FMA) scale, and a comparison of the groups was performed. The severe group showed a significantly longer movement time, lower peak velocity, and higher number of movement units than the mild group during the reach-and-grasp task (p < 0.05). Characteristic compensatory movement patterns, such as shoulder abduction, thoracic posterior tilting, and upward and external rotation were significantly greater during the forward transporting phase in the severe group than in the mild group (p < 0.05). The FMA score was significantly associated with the movement time during the forward transporting phase, number of movement units during the reaching phase, range of shoulder abduction-adduction and wrist flexion-extension movements during the reaching phase, and range of thoracic internal-external rotation during the backward transporting phase (p < 0.05). Post-stroke patients have unique spatiotemporal and kinematic movement patterns during a reach-and grasp-task according to the impairment severity.

Combining spinal neuromodulation and activity based neurorehabilitation therapy improves sensorimotor function in cerebral palsy.

Motor dysfunction in individuals with cerebral palsy (CP) such as the inability to initiate voluntary movements, walking with compensatory movement patterns, and debilitating spasticity is due to the aberrant neural connectivity between the brain and spinal cord. We tested the efficacy of noninvasive spinal cord neuromodulation (SCiP™, SpineX Inc.) with activity-based neurorehabilitation therapy (ABNT) in improving the sensorimotor function in six children with CP. Children received 8 weeks of either SCiP™ or sham therapy with ABNT (n = 3 per group). At the end of 8 weeks, all participants received 8 weeks of SCiP™ therapy with ABNT. Follow up assessments were done at week 26 (10 weeks after the last therapy session). Sensorimotor function was measured by the Gross Motor Function Measure 88 (GMFM88) test. We observed minimal change in sham group (mean 6% improvement), however, eight weeks of SCiP™ therapy with ABNT resulted in statistically and clinically relevant improvement in GMFM88 scores (mean 23% increase from baseline). We also observed reduced scores on the modified Ashworth scale only with SCiP™ therapy (-11% vs. +5.53% with sham). Similar improvements were observed in sham group but only after the cross over to SCiP™ therapy group at the end of the first eight weeks. Finally, sixteen weeks of SCiP™ therapy with ABNT resulted in further improvement of GMFM88 score. The improvement in GMFM88 scores were maintained at week 26 (10 weeks after the end of therapy), suggesting a sustained effect of SCiP™ therapy.

Above knee socket prosthesis use changes proximal femur morphology.

Patients with transfemoral amputation (TFA) are up to six times more likely to develop hip osteoarthritis (OA) in either or both the intact and residual limb, which is primarily attributed to habitually altered joint loading due to compensatory movement patterns. However, joint loading patterns differ between limbs, which confounds the understanding of loading-induced OA etiology across limbs. It remains unknown if altered loading due to amputation results in bony shape changes at the hip, which is a known etiological factor in the development of hip OA. Retrospective computed tomography images were collected of the residual limb for 31 patients with unilateral TFA (13F/18M; age: 51.7±9.9 y/o; time since amputation: 13.7±12.4years) and proximal femur for a control group of 29 patients (13F/16M; age: 42.0±12.27years) and used to create 3D geometries of the proximal femur. Femoral 3D geometric variation was quantified using statistical shape modeling (SSM), a computational tool which placed 2048 corresponding particles on each geometry. Independent modes of variation were created using principal component analysis. 2D radiographic measures of the proximal femur, including common measures such as α-angle, head neck offset, and neck shaft angle, were quantified on digitally reconstructed radiographs (DRRs). SSM results were then compared to 2D measures using Pearson correlation coefficients (r). Two-sample t-tests were used to determine if there were significant differences between the TFA and control group means of 2D radiographic measurements (p<0.05). Patients with TFA had greater femoral head asphericity within the SSM, which was moderately correlated to head-neck offset (r=-0.54) and α-angle (r=0.63), as well as greater trochanteric torsion, which was strongly correlated to the novel radiographic measure of trochanteric torsion (r=-0.78), compared to controls. For 2D measures, the neck-shaft angle was smaller in the TFA group compared to the control group (p=0.01) while greater trochanter height was larger in the TFA group compared to the control group (p=0.04). These results indicate altered loading from transfemoral prosthesis use changes proximal femur bony morphology, including femoral head asphericity and greater trochanter changes. Greater trochanter morphologic changes, though not a known factor to OA, affect moment arm and line of action of the primary hip abductors, the major muscles which contribute to joint loading and hip stability. Thus, chronic altered loading of the amputated limb hip, whether under- or overloading, results in bony changes to the proximal femur which may contribute to the etiological progression and development of OA.

Displaced center of pressure on the treated side in individuals with essential tremor after radiofrequency ablation: a longitudinal case-control study.

Essential tremor (ET) is a common involuntary movement disorder (IMD). Radiofrequency ablation (RFA) targeting the ventral intermediate nucleus (Vim) of the thalamus is a stereotactic neurosurgery performed in individuals with ET when pharmacotherapy is no longer effective. Though the reasons remain largely unclear, certain adverse events are known to appear post-RFA. These may be due to functional changes in the Vim, related to RFA-induced tremor reduction, or an adverse reaction to compensatory movement patterns used to perform movements in the presence of tremor symptoms. This study aimed to understand the characteristics of post-RFA symptoms in individuals with ET. In a longitudinal case-control study, we compared post-RFA symptoms between individuals with ET who underwent Vim-targeted RFA and those with IMD who underwent non-Vim-targeted RFA. Symptoms were compared preoperatively and 1-week and 1-month postoperatively. Quantitative assessments included center-of-pressure (COP) parameters, grip strength, Mini-Mental State Examination, two verbal fluency tests, and three types of physical performance assessments (upper extremity ability, balance ability, and gait ability). Individuals with ET after RFA showed horizontal displacements of the COP to the treated side (the dominant side of the RFA target's hemisphere) at 1-week postoperatively compared to the preoperative period. The horizontal COP displacement was associated with balance dysfunction related to postural stability post-RFA. Other COP parameters did not significantly differ between the ET and IMD groups. COP displacement to the treated side may be due to a time lag in adjusting postural holding strategies to the long-standing lateral difference in tremor symptoms associated with tremor improvement after RFA.

Determining factors for compensatory movements of the left arm and shoulder in violin playing.

Despite a large number of available ergonomic aids and recommendations regarding instrument positioning, violin players at any proficiency level still display a worrying incidence of task-specific complaints of incompletely understood etiology. Compensatory movement patterns of the left upper extremity form an integral part of violin playing. They are highly variable between players but remain understudied despite their relevance for task-specific health problems. This study investigated individual position effects of the instrument and pre-existing biomechanical factors likely determining the degree of typical compensatory movements in the left upper extremity: (1) left elbow/upper arm adduction ("Reference Angle α", deviation from the vertical axis), (2) shoulder elevation ("Coord x", in mm), and (3) shoulder protraction ("Coord y", in mm). In a group of healthy music students (N = 30, 15 m, 15 f, mean age = 22.5, SD = 2.6), "Reference Angle α" was measured by 3D motion capture analysis. "Coord x" and "Coord y" were assessed and ranked by a synchronized 2D HD video monitoring while performing a pre-defined 16-s tune under laboratory conditions. These three primary outcome variables were compared between four typical, standardized violin positions varying by their sideward orientation ("LatAx-CSP") and/or inclination ("LoAx-HP") by 30°, as well as the players' usual playing position. Selected biomechanical hand parameter data were analyzed as co-factors according to Wagner's Biomechanical Hand Measurement (BHM). Mean "Reference Angle α" decreased significantly from 24.84 ± 2.67 to 18.61 ± 3.12° (p < 0.001), "Coord x" from 22.54 ± 7.417 to 4.75 ± 3.488 mm (p < 0.001), and "Coord y" from 5.66 ± 3.287 to 1.94 ± 1.901) mm (p < 0.001) when increasing LatAx-CSP and LoAx-HP by 30°. Concerning the biomechanical co-factors, "Reference Angle α", "Coord y", but not "Coord x", were found to be significantly increased overall, with decreasing passive supination range (r = -0.307, p = <0.001 for "Passive Supination 250 g/16Ncm", and r = -0.194, p = <0.001 for "Coord y"). Compensatory movements were larger during tune sections requiring high positioning of the left hand and when using the small finger. Results may enable to adapt individually suitable instrument positions to minimize strenuous and potentially unhealthy compensation movements of the left upper extremity.

Adaptations in equine appendicular muscle activity and movement occur during induced fore- and hindlimb lameness: An electromyographic and kinematic evaluation.

The relationship between lameness-related adaptations in equine appendicular motion and muscle activation is poorly understood and has not been studied objectively. The aim of this study was to compare muscle activity of selected fore- and hindlimb muscles, and movement of the joints they act on, between baseline and induced forelimb (iFL) and hindlimb (iHL) lameness. Three-dimensional kinematic data and surface electromyography (sEMG) data from the fore- (triceps brachii, latissimus dorsi) and hindlimbs (superficial gluteal, biceps femoris, semitendinosus) were bilaterally and synchronously collected from clinically non-lame horses (n = 8) trotting over-ground (baseline). Data collections were repeated during iFL and iHL conditions (2-3/5 AAEP), induced on separate days using a modified horseshoe. Motion asymmetry parameters and continuous joint and pro-retraction angles for each limb were calculated from kinematic data. Normalized average rectified value (ARV) and muscle activation onset, offset and activity duration were calculated from sEMG signals. Mixed model analysis and statistical parametric mapping, respectively, compared discrete and continuous variables between conditions (α= 0.05). Asymmetry parameters reflected the degree of iFL and iHL. Increased ARV occurred across muscles following iFL and iHL, except non-lame side forelimb muscles that significantly decreased following iFL. Significant, limb-specific changes in sEMG ARV, and activation timings reflected changes in joint angles and phasic shifts of the limb movement cycle following iFL and iHL. Muscular adaptations during iFL and iHL are detectable using sEMG and primarily involve increased bilateral activity and phasic activation shifts that reflect known compensatory movement patterns for reducing weightbearing on the lame limb. With further research and development, sEMG may provide a valuable diagnostic aid for quantifying the underlying neuromuscular adaptations to equine lameness, which are undetectable through human observation alone.

A low-cost virtual coach for 2D video-based compensation assessment of upper extremity rehabilitation exercises

BackgroundThe increasing demands concerning stroke rehabilitation and in-home exercise promotion grew the need for affordable and accessible assistive systems to promote patients’ compliance in therapy. These assistive systems require quantitative methods to assess patients’ quality of movement and provide feedback on their performance. However, state-of-the-art quantitative assessment approaches require expensive motion-capture devices, which might be a barrier to the development of low-cost systems.MethodsIn this work, we develop a low-cost virtual coach (VC) that requires only a laptop with a webcam to monitor three upper extremity rehabilitation exercises and provide real-time visual and audio feedback on compensatory motion patterns exclusively from image 2D positional data analysis. To assess compensation patterns quantitatively, we propose a Rule-based (RB) and a Neural Network (NN) based approaches. Using the dataset of 15 post-stroke patients, we evaluated these methods with Leave-One-Subject-Out (LOSO) and Leave-One-Exercise-Out (LOEO) cross-validation and the F_1 score that measures the accuracy (geometric mean of precision and recall) of a model to assess compensation motions. In addition, we conducted a pilot study with seven volunteers to evaluate system performance and usability.ResultsFor exercise 1, the RB approach assessed four compensation patterns with a F_1 score of 76.69 %. For exercises 2 and 3, the NN-based approach achieved a F_1 score of 72.56 % and 79.87 %, respectively. Concerning the user study, they found that the system is enjoyable (hedonic value of 4.54/5) and relevant (utilitarian value of 4.86/5) for rehabilitation administration. Additionally, volunteers’ enjoyment and interest (Hedonic value perception) were correlated with their perceived VC performance (rho = 0.53).ConclusionsThe VC performs analysis on 2D videos from a built-in webcam of a laptop and accurately identifies compensatory movement patterns to provide corrective feedback. In addition, we discuss some findings concerning system performance and usability.

Current Clinical Concepts: Management of Common Lumbar Spine Posterior Column Disorders in Young, Active Individuals.

Although posterior column disorders, such as spondylolysis and spondylolisthesis, are not commonly encountered in the general population, athletic trainers frequently see these conditions in athletic and active individuals due to the repetitive spinal extension and rotational loads placed on the pars interarticularis while participating in sport. Athletic trainers can successfully evaluate patients with posterior column disorders by performing a complete and comprehensive clinical examination to identify the location of pain, test spinal stability, and recognize compensatory movement patterns. Conservative management typically leads to a successful outcome in this population, with rest, bracing, and the use of therapeutic exercise having the best supporting evidence. In this Current Clinical Concepts review, we outlined the etiology and risk factors frequently associated with disorders of the posterior column. Additionally, we synthesized the literature for common evaluation techniques and interventions associated with the posterior column and provided a proposed rehabilitation progression to use in a younger, athletic population.

Development of Duchenne Video Assessment scorecards to evaluate ease of movement among those with Duchenne muscular dystrophy.

BackgroundPatients with Duchenne muscular dystrophy (DMD) adopt compensatory movement patterns as muscles weaken. The Duchenne Video Assessment (DVA) measures patient ease of movement through identification of compensatory movement patterns. The DVA directs caregivers to video record patients performing specific movement tasks at home using a secure mobile application, and DVA-certified physical therapists (PTs) score the videos using scorecards with prespecified compensatory movement criteria. The goal of this study was to develop and refine the DVA scorecards.MethodsTo develop the initial scorecards, 4 PTs collaboratively created compensatory movement lists for each task, and researchers structured the lists into scorecards. A 2-round modified Delphi process was used to gather expert opinion on the understandability, comprehensiveness, and clinical meaningfulness of the compensatory movements on the scorecards. Eight PTs who had evaluated ≥50 patients with DMD and participated in ≥10 DMD clinical trials were recruited for the panel. In Round 1, panelists evaluated compensatory movement criteria understandability via questionnaire and tested the scorecards. In Round 2, panelists participated in an in-person meeting to discuss areas of disagreement from Round 1 and reach consensus (≥75% agreement) on all revisions to the scorecards.ResultsDuring the Round 1 revisions to the scorecards, there were 67 changes (44%) to the wording of 153 original compensatory movement criteria and 3 criteria were removed. During the Round 2 revisions to the scorecards, there were 47 changes (31%) to the wording of 150 compensatory movement criteria, 20 criteria were added, and 30 criteria were removed. The panel reached 100% agreement on all changes made to scorecards during Round 2.ConclusionPTs with extensive experience evaluating patients with DMD confirmed that the compensatory movement criteria included in the DVA scorecards were understandable, comprehensive, and clinically meaningful.

Effective Interventions for Improving Functional Movement Screen Scores Among "High-Risk" Athletes: A Systematic Review.

BackgroundThe Functional Movement ScreenTM (FMSTM) is a tool designed to screen a series of movements that aids in the identification of compensatory fundamental movement patterns, functional limitations, and asymmetrical movement patterns. A previous systematic review and meta-analysis has shown that athletes with an FMSTM score <13-14 are considered “high-risk” and are more likely to be injured. There are discrepancies regarding the efficacy of physical intervention programs in improving FMSTM scores.PurposeThe aim of this systematic review was to assess the role of physical intervention programs in increasing functional movement in “high-risk” athletes as measured by the FMSTM.Study DesignSystematic ReviewMethodsA computerized search was performed in 2019 according to PRISMA guidelines searching Embase, Science Direct, Ovid, and PubMed. The studies were assessed for quality and risk of bias using the Modified Downs and Black checklist. Participant demographics, intervention routines, and FMSTM scores were extracted from the included studies.ResultsSix studies met the inclusion criteria and demonstrated a fair methodological quality. Comparisons across all studies revealed significant improvement in FMSTM scores following implementation of a variety of physical intervention programs. These programs included those that utilized functional training, foot muscle strengthening, Pilates, core stability training, and resistance movements. Despite variations in the corrective exercises performed, the number of training sessions, and the length of the intervention program, all studies demonstrated an increase in the total FMSTM score following program implementation.ConclusionThe included intervention programs significantly improved total FMSTM scores in “high-risk” athletes. Despite variations in the corrective exercises (interventions) performed, the number of training sessions, and the length of the program, all studies demonstrated a significant increase in the total FMSTM score following program implementation.

Effects of Stroke Lesions and Timing of Rehabilitation on the Compensatory Movement Patterns During Stroke Recovery.

The aims of this study were to distinguish between behavioral compensation and behavioral recovery and to determine the role of stroke lesions and the optimal timing of rehabilitation in true recovery. Single pellet reaching test has been performed to analyze both quantitative and qualitative measures of forelimb function in a stroke animal model with lesions in the motor cortex, somatosensory cortex, or sensorimotor cortex. The four gestures of compensatory movement patterns that comprised a reach were head lift, limb withdrawal, pellet chasing, and phantom grasp. Functional recovery improved in all the stroke groups after rehabilitation ( P < 0.001). However, the compensatory movement patterns of the motor cortex and somatosensory cortex stroke groups initially increased and subsequently decreased ( P = 0.0054), whereas those of the sensorimotor cortex stroke group increased and persisted ( P = 0.0063). In the sensorimotor cortex stroke group, compensatory movement patterns significantly decreased when training was initiated 5 and 14 days after stroke ( P = 0.0083, P = 0.0226, respectively), while they increased and persisted when training was initiated 1 day after stroke. These findings suggest that true recovery by task-specific training after stroke depends, probably, on the lesion size and the timing of rehabilitation.

Assessment of Dysfunctional Movements and Asymmetries in Children and Adolescents Using the Functional Movement Screen-A Narrative Review.

The Functional Movement Screen (FMS) is a screening tool that identifies dysfunctional movements in seven test items requiring an interplay of cognitive, perceptual, proprioceptive, and motor functions that involve muscular strength/endurance, flexibility, mobility, coordination, and balance. The results of the FMS include an overall composite score, scores on the individual test items, and identification of compensatory movement patterns and left-right asymmetries on 5 bilateral test items. Although there is a plethora of literature on the use of the FMS in adults, there is a growing body of evidence indicating its use in children. The available research in children involves school children and young athletes in at least 20 different sports in over 20 countries and comparisons between pre- and post-pubescent children, and normal weight, overweight, and obese children. Studies that include measures of adiposity and physical activity levels, or report prevalence of asymmetries and dysfunctional movement patterns are not well represented in the children’s literature. The purpose of this paper is to synthesize the currently available literature in children and suggest potential uses of the FMS by coaches, physical educators, and other health/fitness professionals, appropriate interpretation of results, and future research in children.

Compensatory movement patterns of head, withers and pelvis following diagnostic analgesia on the straight and during lungeing on hard and soft surfaces

Compensatory movement patterns of head, withers and pelvis following diagnostic analgesia on the straight and during lungeing on hard and soft surfaces

Weight Distribution Progression During Bilateral Squatting Tasks Post-Anterior Cruciate Ligament Reconstruction

PURPOSE: The purpose of this study was to compare force distribution in patients with ACLR during a squatting task at two time points post ACLR. METHODS: Thirty patients with primary, unilateral, and uncomplicated ACLR (19 M/11F, 22.2 ± 10.2 yr, 174 ± 10.2 cm, 76.4 ± 14.9 kg, 4.70 ± 1.66 months post ACLR) were evaluated at 2 visits (V1 and V2) 2 months apart and before release to unrestricted physical activity. Patients stood with feet shoulder width apart, each foot on independent, instrumented pressure mat performing three sets of squats at a standardized pace. Changes in pressure were converted to force for analysis. Force distribution between limbs was recorded and LSI between limbs during each frame of the trial was calculated. Then, we calculated average number of frames where pressures exceeded 90% side-side symmetry were divided by the total frame number for each 3-squat trial. A higher %LSI value represents more time squatting with symmetric side-side force distribution. %LSI values at V1 and V2 post ACLR were compared using a paired samples t-tests. Cohen’s D effect sizes were calculated. Alpha level was 0.05. RESULTS: %LSI at V1 (0.25 ± 0.17%) was not statistically significantly different compared to V2 (0.19 ± 0.16%), p = 0.07, Cohen’s d = 0.34. Ten patients improve their %LSI values from V1 to V2 (See Figure 1.). CONCLUSION: No significant differences in %LSI were observed, on average in patients with ACLR over time. However, it is clinically relevant to observe a lower proportion of patients performing repetitive squats less symmetrically later in the phases of rehabilitation. Future work should identify potential sources of compensatory movement patterns that may influence symmetry during functional movements.Figure 1