Pelvic Motion Research Articles

Evaluating Overall Performance in High-Level Dressage Horse-Rider Combinations by Comparing Measurements from Inertial Sensors with General Impression Scores Awarded by Judges.

In the sport of dressage, one or more judges score the combined performance of a horse and rider with an emphasis on the technical correctness of the movements performed. At the end of the test, a single score is awarded for the 'general impression', which considers the overall performance of the horse and rider as a team. This study explored original measures that contributed to the general impression score in a group of 20 horse-rider combinations. Horses and riders were equipped with inertial measurement units (200 Hz) to represent the angular motion of a horse's back and the motions of a rider's pelvis and trunk. Each combination performed a standard dressage test that was recorded to video. Sections of the video were identified for straight-line movements. The videos were analyzed by two or three judges. Four components were scored separately: gaits of the horse, rider posture, effectiveness of aids, and harmony with the horse. The main contributor to the score for gaits was stride frequency (R = -0.252, p = 0.015), with a slower frequency being preferred. Higher rider component scores were associated with more symmetrical transverse-plane trunk motion, indicating that this original measure is the most useful predictor of rider performance.

Effects Of Decompression Surgery On Pelvic Movements In Patients With Degenerative Lumbar Stenosis

Abstract Objective Pelvic movements when walking should be objectively evaluated in the context of clinical data in order to understand the function of compensatory mechanisms in the onset and management of symptomatic degenerative lumbar stenosis (DLS). The purpose of this study was to compare patients treated with decompression surgery (DS) and patients with symptomatic DLS in terms of pelvic movements while walking. Materials and Methods A total of 107 participants were included in this study. 34 patients who underwent DS performed by the same surgeon were selected as the DS group, while 39 patients with DLS who required surgery were selected as the DLS group. The control group consisted of 34 age-matched healthy individuals who had no disease and no gait disorder. The BTS G-WALK sensor system (G-Walk) was used to measure pelvic movements (tilt, rotation, obliquity) and gait parameters (speed, cadence, stride length). Results DS and control groups had decreased maximum (p=0.008 and p=0.006, respectively) and minimum anterior tilt of the pelvis (p=0.015 and p=0.001, respectively) compared to the DLS group. There was no significant difference between the groups for rotation, oblique and tilt range of motion of the pelvis (p>0.05). Compared to the control group, speed during gait were significantly lower in both the DLS (p=0.012) and DS groups (p=0.016). Conclusions In this study, decompression surgery was found to affect pelvic movements. Patients with DLS walked differently from those who had no symptoms, and this difference usually disappeared following surgical decompression. Pelvic movements may serve as a helpful screening measure to identify early compensatory mechanisms. Key words: lumbar stenosis, pelvic movement, decompression surgery, spine-pelvis lower extremity, sagittal alignment

Why do children with unilateral cerebral palsy struggle with the single leg stance test? A kinematic and centre of pressure analysis

BackgroundChildren with unilateral cerebral palsy often report difficulty with balance in everyday life. The single leg stance test is a challenging task, requiring rapid sensory input and precise motor adjustment. The purpose of this study was to examine how children with cerebral palsy perform this test, compared to typically developing children. MethodsThree-dimensional kinematics of the trunk and lower limbs of 10 children with cerebral palsy and 15 children with typical development were captured as they performed a single leg stance test on their non-dominant leg on a force platform. Stance time, joint kinematics and centre of pressure sway were measured and examined. FindingsThere was evidence of shorter single leg stance performance and increased mediolateral centre of pressure sway in children with cerebral palsy. Coronal plane movement at the subtalar joint and foot was reduced (−6.0° (−10.9, −1.2°)), while proximally there was greater trunk movement in the coronal (13.5° (2.4°, 24.5°)) and transverse planes (9.9° (0.7, 19°)) and pelvis movement in the transverse plane (6.1° (1.7, 10.5°). An association existed between stance time and mediolateral centre of pressure sway (p < 0.01), with an average reduction in stance time of 0.15 s for every 1 mm/s increase in mediolateral sway. InterpretationChildren with cerebral palsy showed poor mediolateral control of centre of pressure sway, leading to shorter stance time. They have a less effective coronal foot-tilt strategy and excessive trunk and pelvis movement. Interventions aimed at improving single leg stance performance should consider addressing both ankle / foot and trunk motor control.

The accuracy of an accelerometer-based portable navigation system for total hip arthroplasty using 3D CT measurement in the supine position: a prospective multicenter study

PurposeThis multicenter prospective study aimed to evaluate the accuracy of the cup alignment of an accelerometer-based portable navigation system (AP navigation) for a total hip arthroplasty (THA) in spine position. MethodsThis study prospectively enrolled 324 THAs using supine position in 9 hospitals. An AP navigation was used for cup fixation and the intraoperative navigation data (cup alignment, pelvic tilt, and pelvic rotation) were recorded. Computed tomography (CT) of the pelvis was performed 2 weeks post-operatively and cup alignment was measured on 3D-CT images. ResultThe accuracy (absolute difference in cup alignment between the intraoperative navigation record and postoperative 3D-CT measurements) was 3 ​± ​3° (mean ​± ​standard deviation) for cup inclination and 3 ​± ​3° for cup anteversion. The pelvis tilted anteriorly in 148 hips (46%) and posteriorly in 162 hips (50%), and did not tilt in 14 hips (4%). The pelvis rotated toward the operating side in 179 hips (55%), toward the contralateral side in 112 hips (35%), and did not rotate in 33 hips (10%). Multiple regression analysis showed that the patients’ characteristics (sex, body mass index, diagnosis, Crowe classification, laterality, intraoperative pelvic tilt, intraoperative pelvic rotation, and cup size) and the surgical factors (approach, preparation time, number of screws, and institution) did not affect the accuracy of the navigation system. ConclusionsThis is the first prospective multicenter study of this navigation system. The accuracy was not affected by patient characteristics, surgical factors, or substantial pelvic movement during cup fixation.

Correlation Between Foot Posture and Hamstring Muscle Tightness.

Background The hamstring muscle is related to the lumbar spine, pelvic, and lower limb movement dysfunction, as well as low back pain and abnormal gait. The kinematic chain's distal elements dysfunctions may affect the body's proximal segments. There is a biomechanical connection between the foot and proximal segments of the body and its effect on the body's functional status, but there is a lack of research that focuses on the correlation between foot posture and hamstring muscle tightness. The study aimed to find the correlation between hamstring muscle tightness and foot posture using the foot posture index (FPI). Methods After obtaining ethical committee approval, necessary authorization was obtained from relevant authorities to proceed with participant screening. Informed consent was obtained from every participant, accompanied by a comprehensive explanation of the study. Screening of participants was conducted based on specific inclusion and exclusion criteria. These criteria were crucial for selecting a homogeneous sample and ensuring the study's objectives were met. The assessment of foot posture was carried out using FPI, and hamstring tightness was examined using an active knee extension test. Result and discussion In our study, which included 188 participants aged between 18 and 25 (mean age: 21.91±1.97), we examined the correlation between FPIand active knee extension (AKE) test results. Using Pearson's correlation coefficient, we found a statistically significant correlation between the FPI and AKE test results. For the right side, the r-value was 0.678 (p-value = 0.0001); for the left side, the r-value was 0.653 (p-value = 0.0001); and for the total, the r-value was 0.663 (p-value = 0.0001). These findings indicate a significant relationship between the FPI and AKE test results. Conclusion The findings of our study revealed a significant relationship between hamstring tightness and pronation of the foot, as measured by the FPI. Understanding this relationship is crucial as it sheds light on the potential impact of hamstring tightness on foot biomechanics. By establishing this link, our study contributes to the body of knowledge surrounding the prevention of alterations in foot biomechanics. It highlights the importance of addressing hamstring tightness to mitigate potential foot pronation issues.Moreover, the study serves as a stepping stone for future research endeavors. It lays the groundwork for further large-scale investigations that encompass a broader range of age groups.

Isolated and combined effects of EVA and TPU custom foot orthoses on constant speed, treadmill running kinematics

Introduction: We investigated the isolated and combined (HYB) effects of ethylene-vinyl acetate (EVA) and expanded thermoplastic polyurethane (TPU) custom foot orthoses (CFOs), compared to a control condition (CON; shoes only), on constant speed, treadmill running kinematics.Methods: Twenty (10 male and 10 female subjects) well-trained runners performed four 6-min bouts at the same individualized speed for each bout on a treadmill under four footwear conditions (EVA, TPU, HYB, and CON). Twenty markers and four clusters (four markers each) were placed on lower limbs and the pelvis. Lower limb and pelvis movements were tracked using a three-dimensional motion capture system with 11 cameras (Vicon MX System, Oxford, United Kingdom). Lower limb joint angles and angular velocity were normalized to 100% of the stance phase.Results: Peak ankle eversion (p &amp;lt; 0.001, η2 = 0.72), peak ankle eversion angular velocity (AV) (p &amp;lt; 0.001, η2 = 0.64), peak ankle inversion AV (p &amp;lt; 0.001, η2 = 0.60), and peak ankle internal rotation AV (p &amp;lt; 0.001, η2 = 0.49) demonstrated the largest differences between conditions. Statistical non-parametric mapping analysis revealed that HYB exhibited the largest proportions of change during the total stance phase compared to the CON.Discussion: All CFO materials caused significant reductions in peak angles and peak AVs at the ankle in the frontal plane, with more pronounced effects for harder (EVA) than softer (TPU) materials. These significant reductions occurred during large portions of the total stance phase for the angles and for the AVs. Although some effects could be found in more proximal joints such as the knee and hip, most significant effects were found at the ankle joint. Overall, combining hard EVA material in the heel and soft TPU in the forefoot (HYB) resulted in significant, more favorable changes compared to the CON that lasted for the largest proportion of stance phase when compared to wearing shoes only.

Lumbar and pelvis movement comparison between cross-court and long-line topspin forehand in table tennis: based on musculoskeletal model.

Introduction: Cross-court and the long-line topspin forehand is the common and basic stroke skill in table tennis. The purpose of this study was to investigate the differences in lumbar and pelvis movements between cross-court and long-line topspin forehand strokes in table tennis based on musculoskeletal demands using OpenSim. Materials and Methods: The eight-camera Vicon system and Kistler force platform were used to measure kinematics and kinetics in the lumbar and pelvis movement of sixteen participants (Weight: 69.89 ± 1.58kg; Height: 1.73 ± 0.03m; Age: 22.89 ± 2.03years; BMI: 23.45 ± 0.69kg/m2; Experience: 8.33 ± 0.71years) during cross-court and long-line topspin forehand play. The data was imputed into OpenSim providing the establishment of the Giat2392 musculoskeletal model for simulation. One-dimensional statistical parametric mapping and independent samples t-test was performed in MATLAB and SPSS to analyze the kinematics and kinetics. Results: The results show that the range of motion, peak moment, and maximum angle of the lumbar and pelvis movement in cross-court play were significantly higher than in the long-line stroke play. The moment of long-line in the sagittal and frontal plane was significantly higher than cross-court play in the early stroke phase. Conclusion: The lumbar and pelvis embody greater weight transfer and greater energy production mechanisms when players performed cross-court compared to long-line topspin forehand. Beginners could enhance their motor control strategies in forehand topspin skills and master this skill more easily based on the results of this study.

A robotic treadmill system to mimic overground walking training with body weight support.

Body weight support overground walking training (BWSOWT) is widely used in gait rehabilitation. However, existing systems require large workspace, complex structure, and substantial installation cost for the actuator, which make those systems inappropriate for the clinical environment. For wide clinical use, the proposed system is based on a self-paced treadmill, and uses an optimized body weight support with frame-based two-wire mechanism. The Interactive treadmill was used to mimic overground walking. We opted the conventional DC motors to partially unload the body weight and modified pelvic type harness to allow natural pelvic motion. The performance of the proposed system on the measurement of anterior/posterior position, force control, and pelvic motion was evaluated with 8 healthy subjects during walking training. We verified that the proposed system was the cost/space-effective and showed the more accurate anterior/posterior position than motion sensor, comparable force control performance, and natural pelvic motion. The proposed system is cost/space effective, and able to mimic overground walking training with body weight support. In future work, we will improve the force control performance and optimize the training protocol for wide clinical use.

Clustering trunk movements of children and adolescents with neurological gait disorders undergoing robot-assisted gait therapy: the functional ability determines if actuated pelvis movements are clinically useful

IntroductionRobot-assisted gait therapy is frequently used for gait therapy in children and adolescents but has been shown to limit the physiological excursions of the trunk and pelvis. Actuated pelvis movements might support more physiological trunk patterns during robot-assisted training. However, not every patient is expected to react identically to actuated pelvis movements. Therefore, the aim of the present study was to identify different trunk movement patterns with and without actuated pelvis movements and compare them based on their similarity to the physiological gait pattern.Methods and resultsA clustering algorithm was used to separate pediatric patients into three groups based on different kinematic reactions of the trunk to walking with and without actuated pelvis movements. The three clusters included 9, 11 and 15 patients and showed weak to strong correlations with physiological treadmill gait. The groups also statistically differed in clinical assessment scores, which were consistent with the strength of the correlations. Patients with a higher gait capacity reacted with more physiological trunk movements to actuated pelvis movements.ConclusionActuated pelvis movements do not lead to physiological trunk movements in patients with a poor trunk control, while patients with better walking functions can show physiological trunk movements. Therapists should carefully consider for whom and why they decide to include actuated pelvis movements in their therapy plan.

A Performance Evaluation of Overground Gait Training With a Mobile Body Weight Support System Using Wearable Sensors

Overground gait training under body weight support (BWS) for patients who suffer from neurological injuries has been proven practical in recovering from walking ability. Conventionally, skilled therapists or additional robots are required to assist the patient’s body weight and pelvis movement, making the rehabilitation process physically and economically burdensome. We investigate if a BWS walker using only two actuators can support the user’s body weight and simultaneously protect/assist the transverse pelvis rotation, improving natural gait with minimal motion compensation. In this paper, a BWS strategy called transverse pelvis rotation support (TPRS) is proposed to enable the BWS system to generate cable tension in the forward direction, as a purpose to support transverse pelvis rotation in addition to our previously proposed static or variable BWS. Wearable sensory devices, including instrumented shoes and harness, were developed to provide real-time ground reaction force and pelvis rotation signals simultaneously. Ten non-disabled participants were unloaded with 0% ~ 15% BWS under four different controls. Vertical ground reaction force, transverse pelvis kinematics, and user experience were compared using proposed controls. One-Way repeated measures ANOVA analysis assessed if control strategies generally affect the performance. All proposed controls enable the walker to support part of the user’s body weight. SBWS-TPRS and VBWS-TPRS control enable users to achieve a significantly improved pelvic motion and prolonged single support phase than pure static BWS or variable BWS, although users perceive a higher workload under them. The proposed BWS controls show the potential to become a complementary method in gait rehabilitation.

Low back pain oswestry disability index changes following 8-week movement proficiency exercise program – A retrospective cohort study

Chronic low back pain (CLBP) is a worldwide epidemic, with a prevalence rate of 75–84% in developed countries. With the prevalence increasing, health-care professionals must question current best practice guidelines. In 2014, spinal neurosurgeon and back pain rehabilitation specialist Dr. David Johnson developed a unique back pain rehabilitation program referred to as NearoHAB®. The program’s uniqueness is founded on the principle that effective rehabilitation must eliminate the root cause of pain symptoms. The NeuroHAB® 8-week Movement therapy program aims to reverse movement dysfunction by restoring central nervous system-derived motor patterns based on proficient spinopelvic biomechanics for bending activities of daily living. To date, no other rehabilitation methodology adopts a movement dysfunction cause-based clinical model for back pain symptoms or includes a framework for what healthy lumbar pelvic movement should resemble. Over the course of the 8-week program, each participant is gradually upskilled, developing new default movement proficiency and improved biomechanics, in efforts to downregulate pain, improve disability, and increase functional movement capacity, creating a positive feedback loop for further progress. The leading question of this study is “How does functional movement-based therapy impact chronic low back pain?” Ten sets of participant details were selected at random and retrieved from the NeuroHAB® 8-week program database of 2020. All participants presented with CLBP, and two oswestry disability index (ODI) scores were documented – the first at the beginning of the 8-week program, and the second after the NeuroHAB® intervention. ODI scores were collated and the pre- and post-program results were measured and compared quantitatively through a paired t-test to determine the statistical significance of improvement. Results showed a two-tailed P=0.05 indicating that there was a significant difference between the pre- and post-data (0.0024). The pre- and post-group intervention ODI means were 25.80 and 13.30, respectively, resulting in a difference of 12.50 (95% CI: 5.73–19.27); determining the mean data between the pre- and post-intervention decreased by 48.4496%. The results from this study support the alternative hypothesis, concluding an 8-week intervention of functional movement therapy represented by NeuroHAB® results in a significant reduction of LBP ODI scores.

Exploring pelvis and thigh movement and coordination patterns during walking in patients after total hip arthroplasty

BackgroundPatients after total hip arthroplasty (THA) have altered hip kinematics compared to healthy controls, specifically hip extension and range of motion are lower. Exploring pelvis-thigh coordination patterns and coordination variability may help to elucidate why differences in hip kinematics are evident in patients following THA. Research QuestionDo sagittal plane hip, pelvis and thigh kinematics, and pelvis-thigh movement coordination and coordination variability differ between patients following THA and healthy controls during walking? MethodsSagittal plane hip, pelvis and thigh kinematics were collected using a three-dimensional motion capture system while 10 patients who had undergone THA and 10 controls walked at a self-selected pace. A modified vector coding technique was used to quantify pelvis-thigh coordination and coordination variability patterns. Peak hip, pelvis and thigh kinematics and ranges of motion, and movement coordination and coordination variability patterns were quantified and compared between groups. ResultsPatients after THA have significantly (p ≤ .036; g ≥ 0.995) smaller peak hip extension and range of motion, and peak thigh anterior tilt and range of motion compared to controls. Additionally, patients following THA have significantly (p ≤ .037; g ≥ 0.646) more in-phase distally and less anti-phase distally dominated pelvis-thigh movement coordination patterns compared to controls. SignificanceThe smaller peak hip extension and range of motion displayed by patients following THA is due to smaller peak anterior tilt of the thigh, which in turn limits thigh range of motion. The lower sagittal plane thigh, and in turn hip, motion used by patients after THA may be due to increases in the in-phase coordination of pelvis-thigh motion patterns, which cause the pelvis and thigh to work as a singular functional unit.

Pelvic organ movements in asymptomatic nulliparous and symptomatic premenopausal women with pelvic organ prolapse in dynamic MRI: a feasibility study comparing midsagittal single-slice with multi-slice sequences

PurposeTo compare multi-slice (MS) MRI sequences of the pelvis acquired at rest and straining to dynamic midsagittal single-slice (SS) sequences for the assessment of pelvic organ prolapse (POP).MethodsThis IRB-approved prospective single-center feasibility study included 23 premenopausal symptomatic patients with POP and 22 asymptomatic nulliparous volunteers. MRI of the pelvis at rest and straining was performed with midsagittal SS and MS sequences. Straining effort, visibility of organs and POP grade were scored on both. Organ points (bladder, cervix, anorectum) were measured. Differences between SS and MS sequences were compared with Wilcoxon test.ResultsStraining effort was good in 84.4% on SS and in 64.4% on MS sequences (p = 0.003). Organ points were always visible on MS sequences, whereas the cervix was not fully visible in 31.1–33.3% on SS sequences. At rest, there were no statistically significant differences of organ point measurements between SS and MS sequences in symptomatic patients. At straining, positions of bladder, cervix, and anorectum were + 1.1 cm (± 1.8 cm), − 0.7 cm (± 2.9 cm), and + 0.7 cm (± 1.3 cm) on SS and + 0.4 mm (± 1.7 cm), − 1.4 cm (± 2.6 cm), and + 0.4 cm (± 1.3 cm) on MS sequences (p < 0.05). Only 2 cases of higher-grade POP were missed on MS sequences (both with poor straining effort).ConclusionMS sequences increase the visibility of organ points compared to SS sequences. Dynamic MS sequences can depict POP if images are acquired with sufficient straining effort. Further work is needed to optimize the depiction of the maximum straining effort with MS sequences.Graphical abstract

Transperineal pelvic floor ultrasound in male.

The pelvic floor (PF) is a highly complex structure which may be affected by various stimulating factors like decreased PF support. As ultrasound can dynamically observe the position and mobility of anatomical structures, However, there are very few studies on PF ultrasound in males. Twenty-one male patients with normal conditions underwent transperineal pelvic floor ultrasound (TPFU) examination. Ultrasound was performed in a supine lithotomy position. The probe was pressed on the sagittal plane of the perineum and adjusted till the anorectal angle, as well as bladder, were located and the median prostate and pubic symphysis were visible on the sagittal plane. TPFU was carried out to observe the patterns of pelvic floor movement during different phases, measure ultrasound parameters of the PF in men, and assess the potential applications and prospects of the male PF. Two-dimensional male PF ultrasound can detect the bladder, prostate, male urethra, anus, rectum. Resting, Valsalva, and contraction phases of the PF are clearly shown, the pelvic organs in the Valsalva phase shift to the dorsal foot side, and shift to the cephalic ventral side when the levator ani muscle (LAM) contracts. Three-dimensional male PF ultrasound can visually show the shape and structure of the levator ani muscle hiatus. It is a feasible examination tool for detecting PF disorders. However, there are still many fields to explore in the future.

Back motion in unridden horses in walk, trot and canter on a circle

Equine back function is of concern to riders, as well as to veterinarians and physiotherapists; these groups may benefit from knowledge about spinal motion on the circle. This descriptive and comparative study aimed to quantify equine neck, back and pelvic motion in walk, trot and canter on a 9 m circle. Sixteen healthy horses in training, of varying breed and conformation, were measured using optical motion capture (150 Hz), with optical markers on the poll, withers, T15, tubera coxae and lumbosacral joint. Cervicothoracic and thoracolumbar flexion–extension and lateral bending, and pelvic roll, pitch and yaw, were statistically evaluated using mixed models. Motion patterns showed distinct differences between gaits, but were generally similar between horses. The thoracolumbar back was bent towards the inside of the circle (stride mean 5-6º for all gaits). The cervicothoracic spine was more flexed in walk (18°), and more extended in canter (-4—-8°), compared to trot (6–7°), whereas the thoracolumbar spine was slightly less extended in canter than in walk. Thoracolumbar flexion–extension range of motion (ROM) increased from walk (4°) to canter (9°), as did pelvic pitch ROM (walk 7° and canter 15–16°), while back lateral bending ROM and pelvic yaw ROM were lowest in trot. Taken together, the study findings suggest that neck and back motion patterns on the circle reflect an interaction between the constraints of circular movement, and the mechanics and characteristics of each gait.

PO-2268 comparison of the pelvic movement with cone beam CT (CBCT), SGRT, and the CyberKnife x-ray cameras

PO-2268 comparison of the pelvic movement with cone beam CT (CBCT), SGRT, and the CyberKnife x-ray cameras

Impact of bilateral motion control shoes with outsole adjustment on gait asymmetry in individuals with mild leg length discrepancy

BackgroundFootwear adjustment is recommended in the management plan of leg length discrepancy. However, it is not clear how the outsole of motion control shoe adjustment influences trunk symmetry and walking performance. Research questionDoes bilateral adjustment of the outsole affect trunk and pelvis symmetry and ground reaction force during walking in individuals with leg length discrepancy? Methods20 mild leg length discrepancy participants were recruited into a cross-sectional study. All subjects performed a walking trial with their habitual shoes to determine the outsole adjustment. Four trials of walking were carried out in the order of unadjusted and bilateral adjusted motion control air-cushion shoes. Shoulder level differences and trunk and pelvic motion were assessed, while the ground reaction force at the heel strike was reported. A paired t-test was performed to compare the differences between the conditions with a significance level at p < 0.05. ResultsDuring walking trials, mild leg length discrepancy participants with the adjusted shoe displayed lower variations in the maximum shoulder height differences (p = 0.001) and trunk rotation angle (p = 0.002) than those with the unadjusted shoe. Also, there was a significant reduction in the vertical ground reaction force (p = 0.030), but not in the anteroposterior or mediolateral directions, during walking in the adjusted shoe condition compared to the unadjusted shoe condition. SignificanceThe outsole adjustment of the bilateral motion control shoes can improve trunk symmetry while decreasing the ground impact at the heel strike. The study provides additional information to prescribe or recommend footwear adjustment to improve walking symmetry in leg length discrepancy participants.

An unusual case of a Puerto Rican patient with involuntary pelvic movements, behavioral changes and mutism associated to VSP13A gene (P3-4.001)

<h3>Objective:</h3> To present a case of a Puerto Rican woman with Chorea-Acanthocytosis positive for VSP13A gene variant presenting with severe pelvic movements. <h3>Background:</h3> Chorea-Acanthocytosis is an autosomal recessive inherited neurodegenerative disorder originated from variants of the VPS13A gene. It is characterized by clinical features that may include chorea, tics, parkinsonism, dystonia, speech disturbances, and epilepsy. Most case reports of Puerto Rican descent have been reported in the United States. <h3>Design/Methods:</h3> NA <h3>Results:</h3> We present the case of a 41-year-old Puerto Rican woman with unusual involuntary movements and mutism. At onset she developed irritability and generalized choreiform movements that worsened over the years. There is family history of undiagnosed involuntary movements and family consanguinity. Clinical symptoms worsened to non-verbal communication, dysphagia, additional behavioral changes, and involuntary movements. Neurological examination showed choreiform movements, orofacial movements and blepharospasm. She presented forceful, brisk and disabling movements of the pelvis and neck present while lying down and worsened with activity. Genetic test for Huntington disease was negative, repeated blood smear did not show acanthocytes. CPK was mildly elevated, liver enzymes and serum ceruloplasmin levels were normal. CSF analysis was unremarkable. Autoimmune encephalitis was suspected and she received a course of IVIG without benefit. EEG was normal. Brain MRI showed abnormal signal intensity of bilateral gray matter involving putamen and caudate nuclei with associated ex vacuo dilation of frontal horns and lateral ventricles. Genetic testing was positive for autosomal recessive homozygous VSP13A gene variant. <h3>Conclusions:</h3> This case illustrates the variable presentation of chorea-acanthocytosis and emphasizes the importance of early recognition and timely genetic testing among Hispanic patients presenting with involuntary movements. Our patient had an uncommon initial presentation with predominant severe pelvic and neck movements making the diagnosis challenging and delayed. An accurate and early diagnosis is important to offer symptomatic treatment, identify potential future complications, and provide genetic counseling. <b>Disclosure:</b> Dr. Enriquez-Gonzalez has nothing to disclose. The institution of Dr. Serrano has received research support from Eli Lilly. The institution of Dr. Serrano has received research support from Abbvie.

Age-Related Differences in Trunk Kinematics and Interplanar Decoupling with the Pelvis during Gait in Healthy Older versus Younger Men.

This study investigated age-related differences in trunk kinematics during walking in healthy men. Secondary aims were to investigate the covarying effects of physical activity (PA) and lumbar paravertebral muscle (LPM) morphology on trunk kinematics, and the effect of age on interplanar coupling between the trunk and pelvis. Three-dimensional (3D) trunk and pelvis motion data were obtained for 12 older (67.3 ± 6.0 years) and 12 younger (24.7 ± 3.1 years) healthy men during walking at a self-selected speed along a 10 m walkway. Phase-specific differences were observed in the coronal and transverse planes, with midstance and swing phases highlighted as instances when trunk and pelvic kinematics differed significantly (p < 0.05) between the younger group and older group. Controlling for age, fewer significant positive correlations were revealed between trunk and pelvic ranges and planes of motion. LPM morphology and PA were not significant covariates of age-related differences in trunk kinematics. Age-related differences in trunk kinematics were most apparent in the coronal and transverse planes. The results further indicate ageing causes an uncoupling of interplanar upper body movements during gait. These findings provide important information for rehabilitation programmes in older adults designed to improve trunk motion, as well as enable identification of higher-risk movement patterns related to falling.

Prevalence of vertical movement asymmetries at trot in Standardbred and Swedish Warmblood foals.

Many horses, just before and during their athletic career, show vertical movement asymmetries, to the same degree as clinically lame horses. It is unknown whether these asymmetries are caused by pain or have alternative explanations, such as inherent biological variation. In the latter case, movement asymmetries would be expected to be present at a very young age. This study aimed to investigate the prevalence of movement asymmetries in foals. Motion analysis, using an inertial measurement unit-based system (Equinosis), was performed on 54 foals (31 Swedish Warmbloods, 23 Standardbreds) during straight-line trot. The foals were between 4-13 weeks old and considered sound by their owners. Differences between the vertical minimum and maximum values recorded for the head (HDmin, HDmax) and pelvis (PDmin, PDmax) between left and right stance were calculated for each stride and an average was computed for each trial. Thresholds for asymmetry were defined as absolute trial mean >6 mm for HDmin and HDmax, and >3 mm for PDmin and PDmax. These thresholds were exceeded for one or several parameters by 83% of Standardbred foals and 45% of Swedish Warmblood foals, demonstrating surprisingly high prevalence of asymmetries in young foals, although the risk of repetitive strain injuries and cumulative risk of trauma injuries was expected to be low in this age group. Standardbred foals showed similar prevalence of asymmetries to that reported previously for yearling Standardbred trotters, so relatively higher prevalence of movement asymmetries may be expected among trotters as a breed. In general, vertical head and pelvic movement asymmetries can be anticipated among foals considered sound by their owners. A better understanding of the aetiology of asymmetries is needed for correct interpretation of objective symmetry measurements in different populations of horses.