Maximum Range Of Motion Research Articles

Reliability and Validity of Clinically Accessible Smart Glove Technologies to Measure Joint Range of Motion.

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.

Range of Motion Outcomes Post Cruciate-Retaining vs Posterior Stabilized Total Knee Arthroplasty: A Retrospective Multi-Centre Cohort Study

Background: The outcome for TKA (total knee arthroplasty) upon whether the posterior cruciate ligament is preserved with cruciate retaining (CR) prostheses or sacrificed with posterior stabilized (PS) prostheses are still debated between studies. Materials and Methods: We included a total of 144 knees operated with cemented fixed bearing primary CR or PS TKAs. Independent t-tests were conducted for the outcomes and possible confounding variables between groups where relevant, with analyses using Chi-squared tests for nominal data. Results: Operation on patients with age of lower than 65 years predicts increased intraoperative bleeding volume (p = 0.037), pre-operative range of motion (ROM) of less than 90 degrees was a predictor for better improved post-operative ROM (p 0.001) and PS prostheses is superior to CR in terms of ROM improvement (p = 0.04), however with both groups achieving similar maximum ROM (p = 0.308). Conclusion: Improvement of ROM is increased by the use of PS prostheses compared to CS prostheses, with pre-operative ROM as a possible confounding factor and the maximum ROM achieved for both prostheses being similar. Lower age of the operation is also related to increased intraoperative bleeding

Does passive hip stiffness or range of motion correlate with spinal curvature and posture during quiet standing?

BackgroundIt has been postulated that hip muscle stiffness can be inferred from postural assessment, and that predictable relationships exist between passive stiffness of opposing muscles. Despite a lack of evidence to demonstrate such relationships, manual therapy textbooks continue to direct clinicians to treat hip muscles following postural analysis. Research QuestionDo significant correlations exist between standing posture, and hip muscle stiffness and range of motion? Methods20 participants volunteered for this observational study. Passive hip stiffness was calculated as the derivative of the moment-angle curve measured during leg raising in a variety of lying postures. Stiffness was measured during hip flexion, extension, abduction and adduction. Stiffness data was obtained during the first degree and at ROM, and at the highest common angle achieved by participants in each posture Spinal curvature and other postural components were measured using a motion tracking device. Spearman rank coefficients were determined to assess any correlations between passive stiffness, range of motion, spinal curvature and other postural components. ResultsConsistent relationships were found between maximum range of motion and hip stiffness at the common angles (P < 0.01), but not at maximum stiffness (P > 0.05). Consistent correlations were found between abductor stiffness and Q-angle (P < 0.05). Hip extensor range of motion correlated with lumbar lordosis (r = -0.472, P = 0.036). Other correlations were reported, but typically lacked consistency between left and right sides. Spinal curvature did not correlate with hip stiffness in frontal or sagittal planes (P > 0.05). SignificanceSignificant correlations were few compared with where correlations lacked statistical significance. This study demonstrates that overly simplistic assumptions about spinal posture and hip stiffness cannot be supported. Hip muscle stiffness should only be targeted in treatments where testing has demonstrated a direct need, and not assumed based upon postural assessment alone.

A Randomized Controlled Trial of Psychological Intervention to Improve Satisfaction for Patients with Depression Undergoing TKA: A 2-Year Follow-up.

The overall satisfaction of patients after total knee arthroplasty (TKA) is approximately 80%, and current studies have demonstrated that patients with depression may have lower patient satisfaction. The purpose of this study was to determine whether perioperative psychological intervention in patients with depression improves the clinical outcomes and patient satisfaction in patients undergoing TKA. Six hundred patients who underwent primary TKA from May 2016 to January 2018 were prospectively screened for eligibility. A preoperative psychological evaluation was conducted by a psychiatrist to evaluate each patient's psychological status. Patients who were diagnosed with depression were randomly divided into 2 groups: the intervention group (patients received psychological interventions that were administered by a psychiatrist at the first visit before surgery and from then on) and the control group (patients received routine TKA care without psychological interventions). The primary outcome was patient satisfaction at 6 months postoperatively. The secondary outcomes were patient satisfaction at 2 years postoperatively as well as the Hospital for Special Surgery (HSS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and range of motion at 6 months and 2 years postoperatively. Fifty-three patients with depression were identified. Fifty-one patients were enrolled in the randomized controlled trial. Two patients were lost to follow-up at 6 months after surgery. Therefore, 49 patients (25 in the intervention group and 24 in the control group) remained in the final analysis. At 6 months postoperatively, statistical differences in patient satisfaction were identified between the 2 groups (88.0% in the intervention group compared with 62.5% in the control group; odds ratio = 4.40; 95% confidence interval, 1.02 to 18.99). There was a significant improvement in the Self-Rating Depression Scale (SDS) score (the reduction rate was 51.97% in the intervention group compared with 17.35% in the control group) and the Symptom Checklist 90 Revised (SCL-90-R) subscore for depression (the reduction rate was 44.66% in the intervention group compared with 15.73% in the control group). The clinical outcomes, including the WOMAC scores, the HSS scores, and maximal range of motion, in the intervention group had improved significantly more compared with those in the control group. Psychological interventions during the perioperative period can improve patient satisfaction in patients with depression who undergo TKA. Therefore, psychological intervention and management may be beneficial for patients with depression who are planning to undergo TKA. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Achilles Tendon Region Defects: Delayed Composite Anterolateral Thigh Flap With Stripping of Fascia Lata: A Case Series

The purpose of this study was to evaluate the functional and physical functioning score out-comes of patients following microsurgical reconstruction of the yarrow region, using a combination of objective, subjective, and semi-subjective measurements. Between 2007 and 2018, 15 patients underwent delayed Achilles tendon region reconstruction with different anterolateral thigh flap types. Seven (7) patients underwent tendon and soft tissue re-construction with a chimeric anterolateral thigh flap (ALT) and rolled-up fascia lata, and 8 patients underwent soft tissue reconstruction and only tendon coverage with fascia lata. Follow-up assessments included maximal range of motion (MROM) (plantarflexion and dorsiflexion), the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale score, and the Med-ical Outcomes Study 36-item Short-Form Health Survey physical functioning subscore. A total of 15 patients (11 males and 4 females with a mean age of 39.86 years) were evaluated during a mean follow-up time of 23 months (SD = 7.12). The MROM for plantarflexion and dorsiflexion was 42.71 degrees (SD = 2.9) and 24.8 degrees (SD = 4.29), respectively, in patients who underwent composite ALT with a rolled-up fascia lata. The MROM for plantarflexion and dorsiflexion was 43 degrees (SD = 5.37) and 27.37 degrees (SD = 3.2), respectively, in patients who underwent fasciocutaneous ALT. The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score was 82 for the first group and 86.87 for the second, whereas the mean Medical Outcomes Study 36-item Short-Form Health Survey scores were 82.57 and 81.5, respectively, for the 2 groups. Statistical analysis showed no significant difference between the 2 groups. The results of this case series suggest that the single-stage composite reconstruction with a fasciocutaneous flap with or without a strip of fascia lata is a safe and reliable strategy for composite reconstruction of the Achilles tendon region. Additional studies to evaluate these outcomes and instruments to evaluate functioning are necessary.

Design of a High-Speed Prosthetic Finger Driven by Peano-HASEL Actuators.

Current designs of powered prosthetic limbs are limited by the nearly exclusive use of DC motor technology. Soft actuators promise new design freedom to create prosthetic limbs which more closely mimic intact neuromuscular systems and improve the capabilities of prosthetic users. This work evaluates the performance of a hydraulically amplified self-healing electrostatic (HASEL) soft actuator for use in a prosthetic hand. We compare a linearly-contracting HASEL actuator, termed a Peano-HASEL, to an existing actuator (DC motor) when driving a prosthetic finger like those utilized in multi-functional prosthetic hands. A kinematic model of the prosthetic finger is developed and validated, and is used to customize a prosthetic finger that is tuned to complement the force-strain characteristics of the Peano-HASEL actuators. An analytical model is used to inform the design of an improved Peano-HASEL actuator with the goal of increasing the fingertip pinch force of the prosthetic finger. When compared to a weight-matched DC motor actuator, the Peano-HASEL and custom finger is 10.6 times faster, has 11.1 times higher bandwidth, and consumes 8.7 times less electrical energy to grasp. It reaches 91% of the maximum range of motion of the original finger. However, the DC motor actuator produces 10 times the fingertip force at a relevant grip position. In this body of work, we present ways to further increase the force output of the Peano-HASEL driven prosthetic finger system, and discuss the significance of the unique properties of Peano-HASELs when applied to the field of upper-limb prosthetic design. This approach toward clinically-relevant actuator performance paired with a substantially different form-factor compared to DC motors presents new opportunities to advance the field of prosthetic limb design.

Robotic Adrenalectomy: Updates on Lateral Transperitoneal Approach

Adrenal tumor surgery is routinely performed by minimal invasive surgery.Our aim to overview of updates on lateral approach for robotic adrenalectomy. Through online research we obtained more than 30 articles in this review. In the era of robotic surgery with the feasibility and the ability to provide the surgeon of three-dimensional view which allows maximum range of motion and precision with the different approaches in adrenalectomy the lateral robotic approach was the most frequently performed. Robotic system is safe and effective approach that can be used for adrenalectomy and can be alternative to laparoscopic depending on the condition of the case and other factors.

Clincal observation of non-absorbable suture cerclage combined with patella claw fixation for treatment of inferior patella fractures

To investigate the effectiveness of non-absorbable suture cerclage combined with patella claw fixation for the treatment of inferior patella fractures. Between September 2016 and January 2019, 22 patients with inferior patella fractures were treated. There were 12 males and 10 females, with a mean age of 49.1 years (range, 32-67 years). The causes of injury were traffic accident in 8 cases, falling in 12 cases, and other causes in 2 cases. The interval from injury to operation was 3-7 days (mean, 4.4 days). For the operation, 3 or 4 longitudinal tunnels were drilled backward from the surface of the proximal fracture fragment with Kirschner wires; under the guidance of lumbar puncture needles and steel wires, non-absorbable suture passed through the tunnels and encircled the inferior fracture fragment, then tighten to achieve a satisfactory reduction of the fracture; finally, the patella claw was used to strengthen the fixation. During the follow-up, complications were observed, maximum motion range of the knee joint was measured, X-ray examination was performed and fracture healing time was recorded. The knee function was evaluated according to Böstman scores. All the 22 patients were followed up 12-36 months (mean, 19.4 months). No infection, joint stiffness, bone nonunion, loss of reduction, or displacement of internal fixation occurred. All fractures were clinically healed, and the bone healing time was 2-3 months (mean, 2.6 months). At last follow-up, the maxium motion range of knee joint was 130°-135°, with an average of 132.6°. The Böstman score of the affected knee was 28-30 (mean, 29.2). All cases were graded as excellent results. Non-absorbable suture cerclage combined with patella claw fixation for inferior patella fractures has the advantages of simple operation, reliable fixation, and few complications, and the clinical results are satisfactory.

Inclusion of the Acetabular Labrum Reduces Simulated Range of Motion of the Hip Compared With Bone Contact Models

PurposeTo determine whether inclusion of the acetabular labrum affects the maximum range of motion (ROM) during simulation of the flexion–adduction–internal rotation impingement examination.MethodsThree-dimensional surface reconstructions of the femur, hemi-pelvis, and labrum from computed tomography arthrography images of 19 participants were used to simulate maximum ROM during the flexion–adduction–internal rotation examination. Simulations were conducted for positions between 70° and 110° flexion and 0° and 20° adduction at 10° increments to measure maximum internal rotation and the position of contact between the femur and acetabular rim (bone-to-bone) or the femur and labrum (bone-to-labrum). Internal rotation angles and clock-face position values were compared between the 2 contact scenarios for each position.ResultsThe ROM in the bone-to-labrum contact model was significantly less than that of the bone-to-bone contact model for all evaluated positions (P ≤ .001, except at 110° flexion and 20° adduction, P = .114). The inclusion of the labrum reduced internal rotation by a median [interquartile range] of 18 [15, 25]° while altering the position of contact on the acetabular clock-face by –0:01 [–0:27, 0:16]. The variability in contact location for the bone-to-labrum contact scenario was nearly double that of the bone-to-bone contact scenario, as indicated by the interquartile range.ConclusionsInclusion of the anatomy of the acetabular labrum in collision models used to simulate impingement examinations reduced the internal rotation ROM by approximately 20° and increased variability in the location of contact relative to the acetabular rim.Clinical RelevanceWhile standard bone-to-bone contact ROM simulations may be informative with respect to the relative change in ROM based on a surgical intervention (e.g., pre- and post-osteochondroplasty for cam-type femoroacetabular impingement), they may not accurately represent the clinical ROM of the joint or the kinematic position at which damage may occur due to shape mismatch between the femur and acetabulum.

Effects of Dynamic Stretching Velocity on Joint Range of Motion, Muscle Strength, and Subjective Fatigue.

Mizuno, T. Effects of dynamic stretching velocity on joint range of motion, muscle strength, and subjective fatigue. J Strength Cond Res 36(9): 2440-2447, 2022-The purpose of this study was to determine the effects of 2 different dynamic stretching (DS) velocities on joint range of motion (ROM), isometric muscle strength, and subjective fatigue during DS. Fifteen healthy male subjects performed DS at 2 different velocities: maximal active ankle plantar flexion-dorsiflexion velocity (DS100) and 50% of maximal velocity (DS50). A passive dorsiflexion test and isometric maximal voluntary contractions (MVCs) of the ankle plantar flexors and dorsiflexors were performed before and after DS. During the passive dorsiflexion test, ankle ROM and passive torque were measured when the ankle was passively dorsiflexed at 1°·s -1 to its maximal ROM. The DS consisted of 4 sets of 10 ankle plantar flexions/dorsiflexions. For DS100, subjects flexed and extended their ankle as quickly as possible, whereas for DS50 the rhythm of the DS was controlled by a metronome. Subjective fatigue during DS was assessed using a visual analog scale. Maximal ankle ROM and passive torque at the maximal dorsiflexion angle were significantly increased after both DS100 and DS50 ( p < 0.05), although there was no significant difference between these trials. The passive torque at submaximal angles and the isometric MVC of the ankle plantar flexors and dorsiflexors were not changed in either condition. However, there was a greater difference in subjective fatigue from prestretching to after 4 sets after DS100 than DS50 ( p < 0.05). These results indicate that DS velocity did not influence subsequent joint flexibility. However, DS of moderate speed is recommended because faster DS seems to be associated with greater fatigue.

Functional outcome of flexible nailing in unstable fractures of both bones of forearm in paediatric population

Aim and Objective: Antebrachium fractures are one of the common fractures in paediatric population. Fractures of forearm comprises of about 40% in the fractures of paediatric population [1]. These fractures usually have a high degree of remodelling potential and are usually managed non operatively by closed reduction and maintaining it in a plaster cast. Nowadays the trend for management of these fractures changes towards operative management because of increasing complications by nonoperative methods. The aim of this study is to evaluate the functional outcomes of unstable both bone forearm fractures treated operatively using titanium elastic nailing. Materials and Methods: Study was conducted in the department of orthopaedics at Rajah Muthiah Medical College and Hospital. Total of 20 patients aged were treated using TENS. Closed reduction with internal fixation under c-arm guidance was done in 13 cases and open reduction with internal fixation was done in 7 cases.Results: Patients were followed up for a period of 6 months. Results were analysed with respect to union of fracture, symptoms with activities, range of motion of joints adjacent to the fracture using Price et al. criteria and Anderson et al. criteria. In all cases fractures united at an average of 8 - 10 weeks without any malunion. All 20 cases had excellent outcomes. 3 patient had nail prominence on the ulnar entry side leading to superficial pin site infection.Conclusion: Fixation of both bone fractures of forearm using titanium elastic nailing systems showed many advantages over the conventional plating methods, in terms of smaller incision, minimal soft tissue meddling during fracture fixation, prompt osseous healing, maximum range of motion at the earliest, decrease in complication rate with excellent clinical and radiological results. Thus, titanium elastic nailing used intramedullary is an effective treatment option for the treatment of unstable both bone forearm fractures in paediatric population.

Minimally invasive (Titanium elastic nailing system) operative technique in pediatric both bone forearm fractures

Background: Both bone forearm fracture in paediatric population is one of the most common fractures encountered. Here we present a prospective study conducted to evaluate radiographic & functional outcome of paediatric both bone forearm fractures treated with titanium elastic nailing systems. Methods: In our prospective study we included 18 patients who were between 6 – 15 years, admitted during October 2019 to June 2020 in Chamarajanagar institute of medical sciences & Karwar institute of medical sciences, patients were included according to inclusion & exclusion criteria. All patients were operated under appropriate anaesthesia. Outcome was evaluated using price et al. criteria. All the patients were operated using minimally invasive system (titanium elastic nailing). Results: we included 18 patients, out of which 13 (72.2%) were male & 5(27.7%) were female with male predominance, 10 (55.5%) patients had displaced fracture, 8 (44.4%) had loss of reduction due to unstable & irreducible fracture. 15 (83.3%) patients had right side involvement & 3(16.7%) had left side involvement, closed reduction & internal fixation done in 14 (77.7%) patients were as 4 (22.2%) patients were treated with minimal open reduction & internal fixation, due to irreducibility. Depending on location of fracture 16(88.8%) were in middle 1/3rd, 2(11.1%) were in distal 1/3rd. patients were analysed depending on Price et al. criteria in whom 15 had excellent, 2 had good, 1 had fair result due to local infection & implant prominence. Patients were regularly evaluated at 4, 8 & 12 weeks, finally at 6 months. Union was seen in an average around 4 – 6 weeks. Conclusions: Minimally invasive technique (Titanium elastic nails) for paediatric forearm fractures revealed several advantages, a small incision for insertion, a low rate of complications, good bone healing, and good clinical and radiological results thus achieving maximum range of motion at the earliest.

The Effectiveness of Trunk Stabilization Exercise Combined with Vibration for Adolescent Patients with Nonspecific Low Back Pain.

There are many adolescent patients complaining of low back pain, but research on it is lacking. The purpose of this study was to investigate the effects of trunk stabilization exercise combined with vibration on the pain, proprioception, and kinematics of the lumbar spine (LS) during sit to stand (STS) in adolescent patients with nonspecific low back pain (LBP). Fifty LBP patients were recruited and were randomly divided into two groups: Vibration group (n = 25) and placebo group (n = 25). All participants underwent 36-sessions of training consisting of six exercises. The Vibration group provided vibration stimulation during exercise, but the placebo group did not. The Numeric Pain Rating Scale (NPRS) and digital dual inclinometer were used to measure pain intensity and proprioception. The kinematics of the lumbar spine during STS were measured by motion capture system. After training, the pain and proprioception in the vibration group improved significantly greater than the placebo group (p < 0.05). The mobility of LS (maximum range of motion, angular velocity, lumbar to hip movement ratios) and lumbar-hip coordination during STS in the vibration group were significantly improved compared to the placebo group (p < 0.05). Thus, trunk stabilization exercise combined with vibration may be used to improve the pain, proprioception, and kinematic of the lumbar spine during sit to stand in adolescent patients with LBP.

Pattern-specific hypotheses based on multiple joint gait patterns to identify the optimal candidates for selective dorsal rhizotomy

It has been postulated that hip muscle stiffness can be inferred from postural assessment, and that predictable relationships exist between passive stiffness of opposing muscles. Despite a lack of evidence to demonstrate such relationships, manual therapy textbooks continue to direct clinicians to treat hip muscles following postural analysis.Do significant correlations exist between standing posture, and hip muscle stiffness and range of motion?20 participants volunteered for this observational study. Passive hip stiffness was calculated as the derivative of the moment-angle curve measured during leg raising in a variety of lying postures. Stiffness was measured during hip flexion, extension, abduction and adduction. Stiffness data was obtained during the first degree and at ROM, and at the highest common angle achieved by participants in each posture Spinal curvature and other postural components were measured using a motion tracking device. Spearman rank coefficients were determined to assess any correlations between passive stiffness, range of motion, spinal curvature and other postural components.Consistent relationships were found between maximum range of motion and hip stiffness at the common angles (P < 0.01), but not at maximum stiffness (P > 0.05). Consistent correlations were found between abductor stiffness and Q-angle (P < 0.05). Hip extensor range of motion correlated with lumbar lordosis (r = -0.472, P = 0.036). Other correlations were reported, but typically lacked consistency between left and right sides. Spinal curvature did not correlate with hip stiffness in frontal or sagittal planes (P > 0.05).Significant correlations were few compared with where correlations lacked statistical significance. This study demonstrates that overly simplistic assumptions about spinal posture and hip stiffness cannot be supported. Hip muscle stiffness should only be targeted in treatments where testing has demonstrated a direct need, and not assumed based upon postural assessment alone.

Biomechanical function requirements of the wrist. Circumduction versus flexion/abduction range of motion

The biomechanical function of the wrist is widely assessed by measuring the range of motion (RoM) in two separate orthogonal planes: flexion–extension (FE) and radioulnar deviation (RUD). However, the two motions are coupled. The aim of this study is to compare wrist circumduction with FE and RUD RoM in terms of representativeness of the kinematic requirements for performing activities of daily living (ADL). To this end, the wrist motion of healthy participants was measured while performing maximum RoM in FE and in RUD, circumduction, and thirty-two representative ADL. Active and functional RoM (ARoM and FRoM) were computed in each plane, the evolving circumduction curves were adjusted to ellipses, and intensity maps representing the frequency of the coupling angles in ADL were plotted, both per ADL and globally for both hands. Ellipses representing different percentages of coupling angles in ADL were also plotted. Wrist circumduction fits the coupling angles measured in ADL better than ARoM or FRoM. As a novelty, quantitative data for both circumduction and the coupling angles required in ADL are provided, shedding light on the real biomechanical function requirements of the wrist. Results might be used to quantify mobility reduction and its impact on the performance of ADL, globally and per ADL, to enhance rehabilitation strategies, as well as in clinical decision-making, robotics, and prostheses.

Effects of Several Warm-Up Protocols (Static, Dynamic, No Stretching, Greek Traditional Dance) on Motor Skill Performance in Primary School Students

The aim of this study was to compare the effects of four warm-up protocols on agility, strength, as well as static and dynamic flexibility in primary school students. The participants were forty-four students of a primary school (aged 11.7±0.47 years old, 19 boys and 25 girls). All of them carried out, in four different days, one of the following protocols: (a) 3 minutes of jogging followed by 5 minutes of static stretching, (b) 3 minutes of jogging followed by 5 minutes of dynamic stretching, (c) 3 minutes of jogging followed by a 5-minute break (no-stretching protocol), and (d) 8 minutes of Greek traditional dances. On the completion of the protocols, the participants did the following tests: the agility shuttle run test (4x10m), the standing long jump test, the sit & reach test, and the active straight leg raise test (dynamic flexibility). According to the results of the repeated measures analysis of variance (ANOVA), the static stretching protocol showed significantly better scores on static flexibility compared to no-stretching and dance protocols. Regarding long jump the dynamic stretching performed significantly better compared to static stretching and no-stretching. In reference to dynamic flexibility, there were no significant differences between the four warm-up protocols. In relation to agility, the dance protocol performed significantly better compared to static stretching. Moreover, girls performed better in sit & reach test compared to boys. In conclusion, the static protocol is proposed for lessons that require a maximal range of motion (flexibility). On the other hand, it seems that dynamic stretching is more suitable than the other protocols when the lesson requires lower extremity strength. Moreover, it seems that the dance protocol is adequate for lessons requiring agility. Therefore, teachers should use different stretching protocols according to the content of the lesson.

Persistence Of Altered Kinematics Following A Typical Training Run At 24hrs

Running participation has increased since the 1970’s, concomitant with the rise in popularity has been the rise in running related injuries. Epidemiological studies have reported 2.5 to 33.0 injuries for every 1000 hours of running, with most common injuries being overuse knee injuries. There is a common consensus that altered hip and knee kinematics are risk factors for developing overuse injuries. Previously we demonstrated altered gait kinematics as result of fatigue following a high intensity interval training run (HIIT). These fatigue induced alterations in kinematics could place runners at greater risk of developing an overuse injury. To date, the time course of recovery for gait kinematics is unknown. If these gait changes remain at the onset of the next training run this could be a precursor to overuse injury. PURPOSE: To examine the time course of kinematic changes immediately after and 24hr post HIIT. METHODS: Twenty (10F, 10M) healthy recreational runners performed a HIIT session consisting of six repetitions of 800 meters, each run at 1km.h-1 under the speed at VO2 max, with a 1:1 work: rest ratio. Kinematics were examined during a 6-minute, medium intensity run, performed at halfway between the speeds at lactate threshold and lactate turnpoint. The 6-min run was performed pre, post, and 24hr post HIIT. Maximum angle and range of motion (RoM) of the hip and knee during ground contact were analysed in sagittal and frontal planes. One way repeated measures ANOVA was performed to assess changes over time. RESULTS: Hip frontal angles were significantly increased with time for both maximum angles (P < 0.001) and RoM (P = 0.001). Post hoc analysis revealed a significant increase in maximum hip adduction angle immediately post (P < 0.001, d = 0.91) and at 24hr post (P < 0.001, d = 0.86) compared to pre. Hip frontal RoM was also increased significantly at post (P < 0.001, d = 0.85) and at 24hr (P < 0.001, d = 0.74). Knee kinematics were affected by time for maximum angle of knee frontal plane (P = 0.046) and sagittal plane knee RoM (P = 0.015). However, there was no presence of altered knee kinematics at 24hr. CONCLUSION: The HIIT session induced kinematic alterations to the hip frontal angles. In some runners these alterations were still present 24 hours after HIIT. For these runners, this could increase the risk of developing overuse injuries.

Static Platform Model Evaluation For Study Of Sudden Ankle Movement.

PURPOSE: Ankle sprains are very common in sports and can cause joint instability with clinical and performance consequences. The sudden ankle inversion platform that simulates the sprain movement evaluates the movements performed associated with the electromyography of the fibular and anterior tibial muscles. The aim of this research is to develop a sudden ankle inversion platform limited to 15° medial rotation, 20° plantar flexion, 20° inversion, and to evaluate the mechanical sprain movement associated with the electromyographic response of the fibular and anterior tibial muscles of soccer players. METHODS: A total of 30 soccer players between 16 and 19 years old without history of ankle sprain were studied at the ankle assessment platform. Each athlete was randomly subjected to ankle sprain movement on the platform for 10 repetitions (five on each limb), associated with electromyography of the anterior tibial and fibular muscles. Friedman statistical tests were performed with related samples of nonparametric quantitative data, in cases where there was significance (p<0.05) Dunn's post-test was performed. RESULTS: There was no statistical difference (p>0.05) between latency of movement (0.9 ± 0.2 ms) and to reach the maximum range of motion during plantar flexion (78 ± 4 .2 ms) and medial rotation (120 ± 2.3 ms) . There was an increase in the angular velocity of inversion (p<0.05) during the attempts (230 ± 20.6 °/s) . There was no difference (p>0.05) in latency time of the anterior tibial (25± 5.2 ms) and fibular muscles (33 ± 4.1 ms). CONCLUSION: The sudden static platform was reliable to evaluate the movements performed by the ankle during mechanical sprain, with no difference in the mechanical and electromyographic behavior evaluated during the 10 repetitions.

Lower-Limb Flexibility Profile Analysis in Youth Competitive Inline Hockey Players.

During puberty, the growth of the bones is faster than that of the muscles, which may result in muscular tightness. Muscular tightness and asymmetry have been associated with an increase in injury incidence. The assessment of a joint range of motion (ROM) could help to identify athletes classified as high injury risk. The objectives of the present study were to describe the lower-extremity flexibility profile (LEFP) of youth competitive inline hockey players using the ROM-SPORT battery (I) and to identify muscular tightness and asymmetry (II). Seventy-four young players were examined for maximum passive ankle, knee, and hip ROMs. Muscle asymmetry or tightness was classified according to cutoff scores previously described. The LEFP of the 74 players was 10.8° for hip extension, 26° for hip adduction, 33.6° for ankle dorsiflexion, 38.6° for ankle dorsiflexion with knee flexed, 36.7° for hip abduction, 46° for hip internal rotation, 60.6° for hip external rotation, 65.1° for hip abduction with the hip flexed, 66.3° for hip flexion with the knee extended, 119.7° for knee flexion, and 133.7° for hip flexion. The individual analysis of the flexibility values identified tightness in all players for one or more movement, except for hip abduction. A low prevalence of asymmetries was observed (range: 5.4% to 17.6% of players) depending on the ROM.

Identification of arthropathy and myopathy of the temporomandibular syndrome by biomechanical facial features

BackgroundTemporomandibular disorders (TMDs) are pathological conditions affecting the temporomandibular joint and/or masticatory muscles. The current diagnosis of TMDs is complex and multi-factorial, including questionnaires, medical testing and the use of diagnostic methods, such as computed tomography and magnetic resonance imaging. The evaluation, like the mandibular range of motion, needs the experience of the professional in the field and as such, there is a probability of human error when diagnosing TMD. The aim of this study is therefore to develop a method with infrared cameras, using the maximum range of motion of the jaw and four types of classifiers to help professionals to classify the pathologies of the temporomandibular joint (TMJ) and related muscles in a quantitative way, thus helping to diagnose and follow up on TMD.MethodsForty individuals were evaluated and diagnosed using the diagnostic criteria for temporomandibular disorders (DC/TMD) scale, and divided into three groups: 20 healthy individuals (control group CG), 10 individuals with myopathies (MG), 10 individuals with arthropathies (AG). A quantitative assessment was carried out by motion capture. The TMJ movement was captured with camera tracking markers mounted on the face and jaw of each individual. Data was exported and analyzed using a custom-made software. The data was used to identify and place each participant into one of three classes using the K-nearest neighbor (KNN), Random Forest, Naïve Bayes and Support Vector Machine algorithms.ResultsSignificant precision and accuracy (over 90%) was reached by KNN when classifying the three groups. The other methods tested presented lower values of sensitivity and specificity.ConclusionThe quantitative TMD classification method proposed herein has significant precision and accuracy over the DC/TMD standards. However, this should not be used as a standalone tool but as an auxiliary method for diagnostic TMDs.