Passive Moment Research Articles

Intrinsic and extrinsic contributions to the passive moment at the metacarpophalangeal joint

The purpose of this investigation was to determine whether the passive range of motion at the finger joints is restricted more by intrinsic tissues (cross a single joint) or by extrinsic tissues (cross multiple joints). The passive moment at the metacarpophalangeal (MP) joint of the index finger was modeled as the sum of intrinsic and extrinsic components. The intrinsic component was modeled only as a function of MP joint angle. The extrinsic component was modeled as a function of MP joint angle and wrist angle. With the wrist fixed in seven different positions the passive moment at the MP joint of eight subjects was recorded as the finger was rotated through its range at a constant rate. The moment-angle data were fit by the model and the extrinsic and intrinsic components were calculated for a range of MP joint angles and wrist positions. With the MP joint near its extension limit, the median percent extrinsic contribution was 94% with the wrist extended 60° and 14% with the wrist flexed 60°. These percentages were 40 and 88%, respectively, with the MP joint near its flexion limit. Our findings indicate that at most wrist angles the extrinsic tissues offer greater restraint at the limits of MP joint extension and flexion than the intrinsic tissues. The intrinsic tissues predominate when the wrist is flexed or extended enough to slacken the extrinsic tissues. Additional characteristics of intrinsic and extrinsic tissues can be deduced by examining the parameter values calculated by the model.

Passive energy return after repeated stretches of the hamstring muscle-tendon unit.

It has been shown that five repetitive static stretches of human hamstring muscle, each lasting 90 s and separated by 30 s, altered the passive properties on a short-term basis. However, a total of 7.5 min (5 x 90 s) of stretching for a single muscle group may be an unrealistic stretching program. The present investigation examined whether three repeated 45-s static stretches had a measurable effect on the passive properties of the hamstring muscle-tendon unit, in vivo. Resistance to stretch was defined as the passive moment (Nm) offered by the hamstring muscle group during passive knee extension using a KinCom dynamometer as previously described (Kinetic Communicator, Chattecx Corp., Chattanooga, TN). The static stretch exercise was administered to the left lower extremity of all subjects and consisted of a dynamic phase of passive knee extension to a predetermined final joint angle followed by a 45-s static phase. The procedure was repeated for a total of three 45-s static stretches with 30-s rest period between stretches. There was a significant decline in resistance over the 45-s the static phase in stretch 1 (20 +/- 3%) and stretch 3 (18 +/- 3%), P < 0.001. Further, the absolute or relative decline in resistance over time stretch 1 and 3 were equivalent. The mean resistance in stretch 1 and 3, expressed as the log(e) of time, yielded an equal and highly linear relationship (r2 = 0.96 +/- 0.01); the slope and intercept did not differ. In the dynamic phase of the stretch, the energy of stretch 1 and 3 were similar. These data suggest that the static stretching protocol used in the present study had no short-term effect on the viscoelastic properties of human hamstring muscle group.

Passive moment about the hip in straight leg raising

Objective. The purpose of this examine is to study the load-deformation characteristics of the hip in straight leg raising. Design. An experimental study in which passive moment about the hip was determined as a function of hip angle. Background. Straight leg raising is widely employed in clinical examination, and there is little information on its mechanical characteristics. Methods. Fourteen healthy volunteers were recruited for this study. Three trials of straight leg raise tests were performed while subjects lay supine on a plinth that was fitted with load cells. An electrogoniometer was employed to measure hip flexion during the test. Resistive moment at the hip was determined using a dynamic biomechanical model. Results. The present experimental method was shown to be highly reliable. The moment–angle curves of all subjects were shown to follow an exponential function. Conclusion. Stiffness and strain energy of posterior hip tissues could be derived from the moment–angle curves. Evaluation of such elastic properties is clinically important as they may be altered with injuries of the tissues. Relevance Clinically, contracture of hamstring muscles and other posterior hip tissues is evaluated by measuring the available range of hip flexion in straight leg raising. However, this does not provide any information on the elastic properties of the tissues. The present study reports a reliable method of evaluating such properties.

Identification of passive elastic joint moments in the lower extremities

Musculotendon actuators produce active and passive moments at the joints they span. Due to the existence of bi-articular muscles, the passive elastic joint moments are influenced by the angular positions of adjacent joints. To obtain quantitative information about this passive elastic coupling between lower limb joints, we examined the passive elastic joint properties of the hip, knee, and ankle joint of ten healthy subjects. Passive elastic joint moments were found to considerably depend on the adjacent joint angles. We present a simple mathematical model that describes these properties on the basis of a double-exponential expression. The model can be implemented in biomechanical models of the lower extremities, which are generally used for the simulation of multi-joint movements such as standing-up, walking, running, or jumping.

A dynamic model of the hand with application in functional neuromuscular stimulation.

Potential hand function in people with tetraplegia was evaluated using a three-dimensional dynamic mathematical model. The model was used to evaluate hand positioning, grasp force, and the outcome of surgeries such as tendon transfers and joint fusion, in situations typical of those encountered when using functional neuromuscular stimulation to restore function in people with tetraplegia. In the model, the hand is treated as a jointed multibody system. Each joint is subjected to muscle moments, passive joint moment, and moments due to grasp forces. Model simulations showed that function was highly dependent on both muscle strength and joint passive moments. The potential for tendon transfers, such as the Zancolli-lasso and intrinsicplasty, plasty, to improve hand function was demonstrated, but their value is subject-dependent. It was also shown that activation of multiple thumb muscles (adductor pollicis, abductor pollicis brevis, and flexor pollicis longus) without interphalangeal joint fusion can provide convenient lateral pinch posture with approximately 70% more grip force than a currently used method, which includes joint fusion but requires only one muscle. Finally, a grasp protocol was introduced and shown successful in palmar grasp and hold of movable cylindrical objects using only extrinsic muscles, provided the fingers could be extended sufficiently to enclose the object.

Physical evaluation of the peripheral nervous system in disorders of pain and dysfunction

In the clinical examination of a patient who is in pain, use can be made of the sensitization of a peripheral nerve to determine whether the disorder is neurogenic. Techniques of active and passive moment analysis, peripheral-nerve provocation tests, nerve palpation, and clinical reasoning are used in the evaluation. The technique is described and a case study is presented to support its use.

Maximumisometric moments generated by the wrist muscles in flexion-extension and radial-ulnar deviation

Maximum isometric and passive moments about the wrist were measured for a range of flexion-extension and radial-ulnar deviation angles in 10 healthy adult males. Each subject was seated in a test apparatus with his shoulder abducted 90°, elbow flexed 90°, and body and forearm constrained. Peak flexion moments ranged from 5.2 to 18.7 N m (mean = 12.2, SD = 3.7), while peak extension moments ranged from 3.4 to 9.4 N m (mean = 7.1, SD = 2.1). The average flexion moment peaked at 40° of flexion, whereas the average extension moment was relatively constant from 30° flexion to 70° extension. Peak moments generated by the radial and ulnar deviators ranged from 7.9 to 15.3 N m (mean = 11.0, SD = 2.0) and 5.9 to 11.9 N m (mean = 9.5, SD = 2.2), respectively. Passive moments in flexion-extension were near zero in the central 150° of motion, but increased at the end of the range of motion. The average passive moment was 0.5 N m in 90° flexion and 1.2 N m in 90° extension. Average passive moments about the radial-ulnar deviation axis were near zero with the wrist radially deviated and at neutral, but increased to 0.9 N m in full ulnar deviation.

A dynamic model for simulating movements of the elbow, forearm, and wrist

We developed a dynamic model of the upper extremity to simulate forearm and wrist movements. The model is based on the skeletal structure of the arm and is capable of elbow flexion/extension, forearm pronosupination, and wrist flexion/extension and radial/ulnar deviation movements. Movements are produced by activation of a Hill-type model of muscle, and limits on joint motion are imposed by passive moments modeled after experimental results. We investigated the muscle output force sensitivity, as well as wrist flexion/extension motion sensitivity to parameter variations. The tendon slack length and muscle fiber length were found to have the greatest influence on muscle output and flexion/extension wrist motion. The model captured the direction of the moment vectors at the wrist well, but predicted much higher moments than were measured by stimulating the paralyzed muscles of one tetraplegic subject.

An experimentally based nonlinear viscoelastic model of joint passive moment

Previous investigations have not converged on a generally accepted model of the dissipative part of joint passive moment. To provide a basis for developing a model, a series of measurements were performed to characterize the passive moment at the metacarpophalangeal joint of the index finger. Two measurement procedures were used, one in moment relaxation over a range of fixed joint angles and the other at a series of constant joint velocities. Fung's quasi-linear viscoelastic theory motivated the development of the passive moment model. Using this approach, it was not necessary to make restrictive assumptions regarding the viscoelastic behavior of the passive moment. The generality of the formulation allowed specific functions to be chosen based on experimental data, rather than finding coefficients which attempted to fit a preselected model of the data. It was shown that a nonlinear viscoelastic model described the passive stiffness. No significant frictional effects were found. Of particular importance was the nonlinear behavior of the dissipative part of the passive moment which was modeled by joint speed raised to a power less than one. This result could explain the differing findings among previous investigations, and may have important implications for control of limb movement.

Rational management of gait pathology in Duchenne muscular dystrophy

Because of extensor weakness, children with Duchenne muscular dystrophy (DMD) maintain internal flexion moments at the joints of the lower extremities when they walk. We believe that at the ankle, the plantar flexion moments caused by contractures may contribute significantly to the production of the net ankle flexion moment during the gait in these children. The goal of the present study is to quantify ankle plantar flexion passive moments that may be associated with the presence of flexion contractures and to estimate their contribution to the net moment during the gait of children with DMD. Kinematic and kinetic parameters were collected during gait of eleven subjects with DMD. Ankle plantar flexion passive moments were also measured experimentally during the same session. Fourteen control children participated in the study in order to have normal reference values. The presence of ankle plantar flexion contractures in children with DMD was reflected by a rigidity coefficient obtained at a common moment of −7 Nm that was higher for these children (0.75 Nm/° vs. 0.48 Nm/°; p < 0.05). The relative passive moment contribution to the net plantar flexion moments was higher for the children with DMD at the end of the lengthening phase of the plantar flexors (25% vs. 18%; p < 0.05). We believe that the passive moments can compensate for the presence of progressive muscle weakness in the children with DMD and help these children with gait.

Preserving plantar flexion strength after surgical treatment for contracture of the triceps surae: a computer simulation study.

Contractures of the triceps surae commonly are treated by surgical lengthening of the gastrocnemius aponeurosis or the Achilles tendon. Although these procedures generally relieve contractures, patients sometimes are left with dramatically decreased plantar flexion strength (i.e., decreased capacity to generate plantar flexion moment). The purpose of this study was to examine the trade-off between restoring range of motion and maintaining plantar flexion strength after surgical treatment for contracture of the triceps surae. A computer model representing the normal moment-generating characteristics of the triceps surae was altered to represent two conditions: isolated contracture of the gastrocnemius and contracture of both the gastrocnemius and the soleus. The effects of lengthening the gastrocnemius aponeurosis and the Achilles tendon were simulated for each condition. The simulations showed that nearly normal moment-generating characteristics could be restored when isolated gastrocnemius contracture was treated with lengthening of the gastrocnemius aponeurosis. However, when isolated gastrocnemius contracture was treated with lengthening of the Achilles tendon, the moment-generating capacity of the plantar flexors decreased greatly. This suggests that lengthening of the Achilles tendon should be avoided in persons with isolated gastrocnemius contracture. Our simulations also suggest that neither lengthening of the gastrocnemius aponeurosis nor lengthening of the Achilles tendon by itself is an effective treatment for combined contracture of the gastrocnemius and soleus. Lengthening the gastrocnemius aponeurosis did not decrease the excessive passive moment developed by the contracted soleus. Lengthening the Achilles tendon restored the normal passive range of motion but substantially decreased the active force-generating capacity of the muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

The passive elastic moment about the in vivo human knee joint

The passive elastic moment about the in vivo human knee joint

Functional grasp potential of the intrinsic minus hand

The functional grasp potential of a hand controlled only by extrinsic muscles or by both intrinsic and extrinsic muscles was investigated using a biomechanical model simulation. The simulation, which was based on a set of equilibrium equations, was driven by muscle-like forces. Contact with fixed objects provided external forces, which interacted with muscle forces and joint passive moments to produce finger position. It was found that functional grasps of several different sized objects could be obtained using only extrinsic muscles, but that the position of the object with respect to the hand was an important parameter. Using both intrinsic and extrinsic muscles provided additional object positions at which functional grasp could be achieved. These results could prove useful in training people using functional electrical stimulation systems to restore hand function. >

Comparison of DonJoy® Ankle Ligament Protector and Aircast® Sport-Stirrup™ Orthoses in Restricting Foot and Ankle Motion before and after Exercise

Clinicians are often faced with the task of selecting ankle orthoses for patients who have incurred an ankle sprain injury. The purpose of this study was to compare the effectiveness of the Donjoy® Ankle Ligament Protector and the Aircast® Sport-Stirrup® in limiting foot and ankle motion before and after exercise. Subjects were eight males and eight females with no history of ankle injury during the 6 months prior to testing, neurological condition, lower extremity arthritis, lower extrem ity fracture, or cardiac or balance problems. A Biodex dynamometer and computer were used to impose passive moments and to measure eversion and inversion prior to application of the ankle orthoses, following application, and following 10 minutes of figure-of-eight running and 20 unilateral toe raises. Both ankles of each subject were assessed for each ankle orthosis. Subjects also rated the orthoses for comfort, stability, and cosmetic acceptability. Both ankle orthoses significantly reduced eversion and inversion follow...

Comparison of Swede-O-Universal® Ankle Support and Aircast® Sport-Stirrup™ Orthoses and Ankle Tape in Restricting Eversion-Inversion Before and After Exercise

The purpose of this study was to compare the effectiveness of Swede-O-Universal® Ankle Support and Aircast® Sport-Stirrup® orthoses and ankle tape in restricting eversion-inversion before and after exercise. Subjects were eight males and eight females with no history of ankle injury during the six months prior to testing, neurological condition, lower extremity arthritis, lower extremity fracture, cardiac condition, or balance problems. A Biodex dynamometer and computer were used to impose passive moments and to measure eversion and inversion of an ankle support system prior to application, following application, and following 10 minutes of figure-of-eight running and 20 unilateral toe raises. Both ankles of each subject were assessed for each of the three ankle support systems. All support systems significantly reduced eversion and inversion following application and following exercise. Eversion increased significantly following exercise for all support systems, and inversion increased significantly for ...

Contribution of passive tissues to the intersegmental moments at the hip

Many anatomic structures around the hip contribute either actively (i.e., muscle contractile elements) or passively (i.e., capsule, ligaments, non-contractile portions of muscles) to the intersegmental resultant forces and moments. Investigators have often assumed that the passive elements contribute negligibly to those moments, but without substantial supporting data. We explored this assumption by measuring the ‘passive moments’ in 15 normal subjects from near full extension to 60° of hip flexion at speeds used in slow and normal walking. The data suggest that throughout most of the gait cycle and normal stair climbing, the passive structures contribute a small portion of the total moment, usually well less than 10%. Thus, for this limited range of activities, the assumption of negligible contribution of passive structures is reasonable.

Toe-walking in children with cerebral palsy: contributions of contracture and excessive contraction of triceps surae muscle.

The study was designed to provide a quantitative analysis of toe-walking in children with cerebral palsy (CP). The total internal moment developed about the ankle joint during locomotion and the passive component of this internal moment were measured. The contributions of the active and passive components were expressed as the ratio (R) between the passive moment and the total internal moment. Measurements were compared for 13 children with CP and 5 healthy children. For the data analysis, the children with CP, exhibiting apparently similar toe-walking, were divided into two groups: 1) Group CPI and 2) Group CPII. Group CPI was characterized by a small ratio R value, which indicated the presence of excessive contractions of the triceps surae muscle during locomotion. In Group CPII, the ratio R value was abnormally high, which indicated that a contracture (ie, structural change of the muscle or the tendon) was entirely or at least partly responsible for toe-walking. Each group requires a different therapeutic strategy.

Passive resistance of the human knee: The effect of immobilization

The effects of immobilization on both the circumferential dimensions of the lower limb, and the passive resistance of the knee to sinusoidal motion in the flexion-extension plane, were studied in patients immobilized after tibial fractures or ligamentous injuries of the knee. Immobilization resulted in a decrease of circumferential dimensions of the lower limb, indicating atrophy of thigh and calf musculature. The equilibrium angle of the knee, i.e. the angle at which the net passive moment equals zero, approached the angle of the knee during immobilization. At knee angles of 60° (the maximal angle imposed on the immobilized knee) and 45°, the resistance was increased, and at angles of 30° and 15°, the resistance was decreased. The passive resistances at ± 22.5, 15 and 7.5° relative to the equilibrium angle were all increased. A simple model, taking into account changes in the length of muscles at the anterior and posterior side of the knee, explains changes in passive resistance. The duration of immobilization for patients with ligamentous injuries of the knee was less than 50% of that for patients with tibial fractures, whose ankle joint was not immobilized, both resulted in a smaller muscular atrophy for patients with ligamentous injuries. Differences in passive resistance between unaffected and immobilized legs were the same in both groups of patients. Changes in passive resistance in the immobilized leg for those with ligamentous injury are probably not the effect of immobilization alone but the combined effect of immobilization and ligamentous lesions.

The passive elastic moment at the knee and its influence on human gait

The elastic component of the passive moment at the knee was measured in situ. The force needed to manually range the knee from approximately 90° of flexion to full extension was measured. Hip and ankle angle were held fixed. The passive knee moment, computed from the force and knee angle data, was compared to the total knee moment required for normal gait. This comparison suggested that the passive moment can contribute a significant portion of the total joint moment during some phases of the gait cycle.

Influence of passive elastic joint moments on human gait

Influence of passive elastic joint moments on human gait