ORCID Profile
0000-0002-4360-8310
Current Organisation
La Trobe University
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Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.CLINBIOMECH.2022.105587
Abstract: Hip muscle weakness and altered hip biomechanics during walking are often observed in people with femoroacetabular impingement syndrome, although little is known about biomechanics during higher impact tasks. The aim of our study was to explore relationships between hip muscle strength and hip biomechanics during running in people with femoroacetabular impingement syndrome, including exploring sex as an effect-modifier of this relationship. Forty-two adults with unilateral femoroacetabular impingement syndrome (20 females age 18-50 years alpha angle ≥60°) completed assessments of hip muscle strength and hip biomechanics during running. Strength was assessed using a hand-held dynamometer for the hip flexors, extensors, abductors, adductors, internal rotators, and external rotators. Hip biomechanics were assessed during overground running (3-3.5 m/s) using three-dimensional motion capture and a force plate. Linear models assessed the relationships between hip strength and hip biomechanics of the symptomatic limb, controlling for body mass and running velocity along with an interaction term (strength*sex). A significant negative relationship was observed between hip external rotator strength and hip frontal plane range of motion (i.e., excursion), independent of sex (estimate = -0.039, 95%CI -0.071 to -0.008, P = 0.02). Four sex-specific interactions were observed, with a significant positive relationship between hip external rotator strength and peak hip extension moment in women (estimate = -0.413, 95%CI -0.713 to -0.114, P = 0.01) but not in men. We found significant relationships between hip external rotator strength and stance phase running biomechanics, providing further understanding on two impaired physical measures that may inform exercise-based management strategies in femoroacetabular impingement syndrome.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.GAITPOST.2018.06.162
Abstract: Although it is well established that lower limb joint angles adapt to walking at various speeds, limited research has examined the modifications in joint angular velocity. There is currently no normative dataset for joint angular velocity during walking, which would be useful to allow comparisons for patient cohorts. Additionally, understanding normal joint angular velocity may assist clinical assessment and treatment procedures to incorporate methods that replicate the movement speed of the lower limb joints during walking. This study aimed to examine lower limb joint angles and angular velocities in a healthy population walking at various gait speeds. Thirty-six healthy adult participants underwent three-dimensional gait analysis while walking at various speeds during habitual and slowed walking. The peak joint angles and angular velocities during important phases of the gait cycle were examined for the hip, knee and ankle in the sagittal plane. Data were grouped in 0.2 m/s increments from a walking speed of 0.4 m/s to 1.6 m/s to represent the range of walking speeds reported in studies of people with gait impairments. For joint angles and angular velocities, the shape of the gait traces were consistent regardless of the walking speed. However as walking speed increased, so did the peak joint angles and angular velocities for the hip, knee and ankle. The largest angular velocity occurred when the knee joint extended at the terminal swing phase of gait. For the ankle and hip joints, the largest angular velocity occurred during the push-off phase. This study examined how lower limb joint angular velocities change with various walking speeds. These data can be used as a comparator for data from clinical cohorts, and has the potential to be used to match clinical assessment and treatment methods to joint angular velocity during walking.
Publisher: Elsevier BV
Date: 05-2020
Publisher: Informa UK Limited
Date: 02-2016
DOI: 10.3109/02699052.2015.1117657
Abstract: To determine the assessment methods for upper limb (UL) associated reactions (ARs) in people with acquired brain injury (ABI). A systematic search of 10 databases was performed for Stage 1 to identify methods that quantify ARs of the hemiplegic UL. Stage 2 searched four databases to examine the clinimetric properties and clinical utility of these methods. Two independent reviewers identified relevant articles, extracted data, assessed study methodological quality and rated the clinimetric properties and clinical utility. Eighteen articles were included. The methods used to evaluate ARs were surface electromyography (11), goniometry (5), dynamometry (5), electrogoniometry (1), subjective clinician (2) and patient rating forms (2). Electromyography, electrogoniometry and dynamometry implemented stationary, seated positions using maximal voluntary contractions of the less impaired UL as the provocative task. Standard goniometry most frequently tested ARs dynamically, using a mobility task to provoke the AR. There was limited clinimetric data available. Only half of the assessment methods were deemed clinically feasible. The most common methods were laboratory-based. There were a limited number of methods used to assess ARs in people with ABI and the measurement properties of these outcomes were largely unreported. No gold standard was identified.
Publisher: Wiley
Date: 27-10-2020
Publisher: Wiley
Date: 06-02-2018
DOI: 10.1111/APA.14228
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.JOCA.2016.08.009
Abstract: Little is known about how static standing balance changes post total knee arthroplasty (TKA). The primary aim of this study was to examine the sensitivity to change and redundancy of center of pressure (COP) variables post-TKA. The secondary aim was to compare the sensitivity of these measures to standard clinical assessments of one repetition maximum knee extension strength and fast pace gait speed. 466 participants performed instrumented double-limb standing balance tests with eyes open at 4 and 12 weeks post-TKA. Measures of COP standard deviation, litude, root mean square (RMS), path length, detrended fluctuation analysis (DFA) and signal frequency content for the medial-lateral (ML) and anterior-posterior (AP) axes were examined. Significant decreases in total path length, ML variables related to sway velocity and AP signal complexity and frequency were observed. Inter-session Cohen's d effect size (ES) revealed the strongest effect was for high velocity ML path length, with a 12% decrease in this rapid sway. This variable, along with AP mean instantaneous frequency and AP DFA, were the only ones significantly different with effect sizes >0.20 and non-redundant (Spearman's rho <0.75). The ES of COP-derived variables (maximum = 0.45) were lower than gait speed (1.40) and knee extensor strength (1.54). Increased high velocity ML sway is present at four compared to 12 weeks post-TKA. This augmented rapid sway may provide increased challenges to the postural control system at a time coinciding with reduced strength levels, which could have implications for physical function during activities of daily living.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.PTSP.2019.03.010
Abstract: To determine eccentric knee flexor strength in elite female Australian Rules Football (ARF) players with and without a history of unilateral anterior cruciate ligament reconstruction (ACLR) using an ipsilateral semitendinosus graft. Case-control. Elite ARF Women's competition. Eighty-four elite female ARF players (mean age, 25 ± 4.9 years height, 1.71 ± 0.73 m weight, 67 kg ± 7.4 kg) with (n = 12) and without (n = 72) a history of unilateral ACLR in the previous 10 years. Peak eccentric knee flexor force during the Nordic hamstring exercise (NHE). Players with a history of unilateral ACLR displayed lower levels of eccentric knee flexor strength in their surgically reconstructed limb than their uninjured contralateral limb (mean difference -53.77 N, 95% CI = -85.06 to -24.27, d = -0.51) and compared to the limbs of players with no history of injury (mean difference = -46.32 N, 95% CI = -86.65 to -11.13, d = -0.73). Elite female ARF players with a history of unilateral ACLR display deficits in eccentric knee flexor strength in their surgically reconstructed limb for up to 10 years following surgery.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.JPHYS.2016.07.002
Abstract: Motor impairments are one of the most frequently reported adverse neurodevelopmental consequences in children born < 30 weeks' gestation. Up to 15% of children born at < 30 weeks have cerebral palsy and an additional 50% have mild to severe motor impairment at school age. The first 5 years of life are critical for the development of fundamental motor skills. These skills form the basis for more complex skills that are required to competently and confidently participate in schooling, sporting and recreational activities. In children born at < 30 weeks' gestation, the trajectory of motor development from birth to 5 years is not fully understood. The neural alterations that underpin motor impairments in these children are also unclear. It is essential to determine if early clinical evaluations and neuroimaging biomarkers can predict later motor impairment and associated functional problems at 5 years of age. This will help to identify children who will benefit the most from early intervention and improve functional outcomes at school age. The primary aim of this study is to compare the prevalence of motor impairment from birth to 5 years of age between children born at < 30 weeks and term-born controls, and to determine whether persistent abnormal motor assessments in the newborn period in those born at < 30 weeks predict abnormal motor functioning at 5 years of age. Secondary aims for children born at < 30 weeks and term-born children are: 1) to determine whether novel early magnetic resonance imaging-based structural or functional biomarkers that can predict motor impairments at 5 years are detectable in the neonatal period 2) to investigate the association between motor impairments and concurrent deficits in body structure and function at 5 years of age and 3) to explore how motor impairments at 5 years (including abnormalities of gait, postural control and strength) are associated with concurrent functional outcomes, including physical activity, cognitive ability, learning ability, and behavioural and emotional problems. Prospective longitudinal cohort study. 150 preterm children (born at 36 completed weeks' gestation and weighing > 2499g) admitted to the Royal Women's Hospital, Melbourne, were recruited at birth and will be invited to participate in a 5-year follow-up study. This study will examine previously collected data (from birth to 2 years) that comprise detailed motor assessments, and structural and functional brain MRI images. At 5 years, preterm and term, children will be examined using comprehensive motor assessments, including: the Movement Assessment Battery for Children (2nd edition) and measures of gait function through spatiotemporal (assessed with the GAITRite® Walkway) and dynamic postural control (assessed with Microsoft Kinect) variables and hand grip strength (assessed with a dynamometer) and measures of physical activity (assessed using accelerometry), cognitive development (assessed with Wechsler Preschool and Primary Scale of Intelligence), and emotional and behavioural status (assessed with the Strengths and Difficulties Questionnaire and the Developmental and Wellbeing Assessment). At the 5-year assessment, parents/caregivers will be asked to complete questionnaires on demographics, physical activity, activities of daily living, behaviour, additional therapy (eg, physiotherapy and occupational therapy), and motor function (assessed with Pediatric Evaluation of Disability Inventory, Pediatric Quality of Life Questionnaire, the Little Developmental Co-ordination Questionnaire and an activity diary). For the primary aim, the prevalence of motor impairment from birth to 5 years will be compared between children born at < 30 weeks and at term, using the proportion of children classified as abnormal at each of the time points (term age, 1, 2 and 5 years). Persistent motor impairments during the neonatal period will be assessed as a predictor of severity of motor impairment at 5 years of age in children born < 30 weeks using linear regression. Models will be fitted using generalised estimating equations to allow for the clustering of multiple births. Analysis will be repeated with adjustment for predictors of motor outcome, including additional therapy, sex, brain injury and chronic lung disease. Understanding the developmental precursors of motor impairment in children born before 30 weeks is essential for limiting disruption to skill development, and potential secondary impacts on physical activity, participation, academic achievement, self-esteem and associated outcomes (such as obesity, poor physical fitness and social isolation). An improved understanding of motor skill development will enable targeting of interventions and streamlining of services to children at highest risk of motor impairments.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.PTSP.2022.02.023
Abstract: i) Compare functional task performance between football players with and without hip/groin pain. ii) Explore the relationship, and sex-specific effects, between functional tasks and the Copenhagen Hip and Groin Outcome Score (HAGOS) in players with hip/groin pain. Cross-sectional. Laboratory. 183 (38 women) football players with a self-reported history of >6months of non-time-loss hip/groin pain and a positive flexion-adduction-internal rotation test, and 61 (14 women) asymptomatic players. Participants completed the hop-for-distance (HFD), one leg rise (OLR), side bridge (SB) endurance, and HAGOS. Study aims were assessed using linear models, controlling for body mass index and age, incorporating sex-specific interaction terms. Players with hip/groin pain could not hop as far (adjusted mean difference: -9 cm, 95% CI: -15 cm to -2cm, P=0.012) and completed fewer OLR repetitions (adjusted mean difference -7, 95% confidence interval -11 to -3 repetitions, P=0.001) compared to asymptomatic players. Symptomatic women, but not symptomatic men, with worse HAGOS scores had lower SB endurance. Independent of sex, football players with worse HAGOS scores could not hop as far and completed fewer OLR repetitions. Football players with hip/groin pain demonstrated deficits in HFD and OLR with the performance of these tasks associated with their HAGOS results. The study identifies potential impairments that can be targeted as a component of rehabilitation programs for football players with hip/groin pain.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.APMR.2018.11.026
Abstract: To investigate whether a three-dimensional (3-D) camera (Microsoft Kinect) and a smartphone can be used to accurately quantify the joint angular velocity and range of motion (ROM) compared to a criterion-standard 3-D motion analysis system during a lower limb spasticity assessment. Observational, criterion-standard comparison study. Large rehabilitation center. A convenience s le of 35 controls, 35 patients with a neurologic condition, and 34 rehabilitation professionals (physiotherapists and rehabilitation doctors) participated (N=104). Not applicable. The Modified Tardieu Scale was used to assess spasticity of the quadriceps, hamstrings, soleus, and gastrocnemius. Data for each trial were collected concurrently using the criterion-standard Optitrack 3-D motion analysis (3DMA) system, Microsoft Kinect, and a smartphone. Each healthy control participant was assessed by 1 health professional and each patient with a neurological condition was assessed by 3 health professionals. Spearman correlation coefficient and intraclass correlation coefficient with 95% confidence intervals were used to report the strength of the relationships investigated. The smartphone and Microsoft Kinect demonstrated excellent concurrent validity with the 3DMA system. Overall, 74.8% of the relationships investigated demonstrated a very strong (≥0.80) correlation across all of the testing parameters. The Microsoft Kinect was superior to the smartphone for measuring joint start and end angle, the smartphone was superior for measuring joint angular velocity, and the 2 systems were comparable for measuring total joint ROM. These findings provide preliminary evidence that user-friendly, low-cost technologies can be used to facilitate accurate measurements of joint angular velocity and angles during a lower limb spasticity assessment in a clinical setting.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2019
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.JBIOMECH.2015.05.021
Abstract: The revised Xbox One Kinect, also known as the Microsoft Kinect V2 for Windows, includes enhanced hardware which may improve its utility as a gait assessment tool. This study examined the concurrent validity and inter-day reliability of spatiotemporal and kinematic gait parameters estimated using the Kinect V2 automated body tracking system and a criterion reference three-dimensional motion analysis (3DMA) marker-based camera system. Thirty healthy adults performed two testing sessions consisting of comfortable and fast paced walking trials. Spatiotemporal outcome measures related to gait speed, speed variability, step length, width and time, foot swing velocity and medial-lateral and vertical pelvis displacement were examined. Kinematic outcome measures including ankle flexion, knee flexion and adduction and hip flexion were examined. To assess the agreement between Kinect and 3DMA systems, Bland-Altman plots, relative agreement (Pearson's correlation) and overall agreement (concordance correlation coefficients) were determined. Reliability was assessed using intraclass correlation coefficients, Cronbach's alpha and standard error of measurement. The spatiotemporal measurements had consistently excellent (r≥0.75) concurrent validity, with the exception of modest validity for medial-lateral pelvis sway (r=0.45-0.46) and fast paced gait speed variability (r=0.73). In contrast kinematic validity was consistently poor to modest, with all associations between the systems weak (r<0.50). In those measures with acceptable validity, the inter-day reliability was similar between systems. In conclusion, while the Kinect V2 body tracking may not accurately obtain lower body kinematic data, it shows great potential as a tool for measuring spatiotemporal aspects of gait.
Publisher: Informa UK Limited
Date: 22-02-2022
DOI: 10.1080/09638288.2021.1887945
Abstract: To determine which potential contributing factors are associated with upper limb associated reaction (AR) expression in in iduals with acquired brain injury (ABI). Forty-two participants underwent three-dimensional motion analysis at self-selected walking speed to generate the AR outcome measure, quantifying their upper limb kinematic deviation compared to healthy controls. Clinical assessment included: upper and lower limb hypertonicity, spasticity and strength, balance, dynamic walking stability, arm and leg function, anxiety, arm pain/discomfort, and fear of falling. Significant, moderate-to-strong correlations ( Associated reactions are complex and multi-factorial. There were several significant correlations indicating that factors may influence AR severity. While positive upper motor neuron syndrome features should be prioritised for clinical assessment, these factors are not prerequisites for ARs.IMPLICATIONS FOR REHABILITATIONUpper limb associated reactions are a complex and multi-factorial phenomenon.Upper limb muscle hypertonicity and spasticity should be prioritised for assessment however, they are not prerequisites for associated reactions.Hypertonicity and spasticity should be differentiated as they may have differing relationships to associated reactions.Knee extensor hypertonicity and spasticity, postural stability, upper limb strength, and arm function may also be contributing factors to consider.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Oxford University Press (OUP)
Date: 02-2021
DOI: 10.1093/PTJ/PZAB037
Abstract: Children born & weeks of gestation have more motor impairment than do children born at term (37–42 weeks gestation), but reported outcomes have largely focused on cerebral palsy and developmental coordination disorder. The aim of this study was to compare muscle strength, motor skills, and physical activity (PA) of preschool-aged children born & weeks with those born at term. In this cohort study, 123 children born & weeks and 128 born at term were assessed. Children were aged ≥4 years, 0 months and & years, 0 months’ corrected age at the time of the assessment. Outcomes included grip strength (kg), Movement Assessment Battery for Children 2nd edition (MABC-2), Little Developmental Coordination Disorder Questionnaire, accelerometer-measured PA, and a parent-completed PA diary. Linear regression and mixed effects models were used to examine differences between children born & weeks and those born at term. Children born & weeks had poorer grip strength (preferred hand mean difference [95% CI] −0.60 kg [−1.04 to −0.15]) and poorer motor competence (Movement Assessment Battery for Children 2nd edition standard score mean difference −2.17 [−3.07 to −1.27] Little Developmental Coordination Disorder Questionnaire total score mean difference −5.5 [−9.2 to −2.8]) than term-born children. Children born & weeks also completed fewer minutes of accelerometer-measured PA (mean difference −41 minutes [−62 to −20]), more minutes of accelerometer-measured stationary behavior (mean difference 33 minutes [12 to 54]), and more minutes of parent-reported screen time (mean difference 21 minutes [10 to 32]) per day. Preschool-aged children born & weeks had poorer muscle strength, motor skills, and PA levels than term-born children. These findings suggest that preschool-aged children born & weeks may benefit from enhanced surveillance and PA promotion to improve life-long health outcomes. In our study, children born & weeks had reduced muscle strength and poorer motor skills, participated in less PA, and had more stationary and screen behavior than term-born children. These findings emphasize that awareness of multidomain motor deficits in children born & weeks’ gestation is needed in clinical practice. Given the associations between higher PA and health benefits and the recognition that PA levels can track from early childhood into adulthood, our study highlights the need for assessment and promotion of PA in preschool-aged children born & weeks’ gestation. Lay Summary. Preschool-aged children born & weeks’ gestation have poorer strength, motor skills, and physical activity behaviors than their term-born peers. Clinicians and early childhood educators should recognize that the preschool period is a critical time for the assessment and promotion of PA in children born & weeks.
Publisher: BMJ
Date: 06-04-2020
DOI: 10.1136/BJSPORTS-2019-101587
Abstract: To evaluate the effects of injury prevention programmes on injury incidence in any women’s football code explore relationships between training components and injury risk and report injury incidence for women’s football. Systematic review and meta-analysis. Nine databases searched in August 2019. Randomised controlled trials evaluating any injury prevention programme (eg, exercise, education, braces) were included. Study inclusion criteria were: ≥20 female football players in each study arm (any age, football code or participation level) and injury incidence reporting. Twelve studies, all in soccer, met inclusion criteria, with nine involving adolescent teams (aged years). All studies (except one) had a high risk of bias. Eleven studies examined exercise-based programmes, with most (9/11) including multiple (≥2) training components (eg, strength, plyometric, balance exercises). Multicomponent exercise programmes reduced overall (any reported) injuries (incidence rate ratio (IRR) 0.73, 95% CI 0.59 to 0.91) and ACL injuries (IRR 0.55, 95% CI 0.32 to 0.92). For exercise-based strategies (single-component and multicomponent), hamstring injuries were also reduced (IRR 0.40, 95% CI 0.17 to 0.95). While exercise-based strategies resulted in less knee, ankle and hip/groin injuries, and the use of multiple training components was associated with greater reductions in overall and knee injuries, further studies would be required to increase the precision of these results. The incidence of overall injuries in women’s football was 3.4 per 1000 exposure hours with ankle injuries most common. In women’s football, there is low-level evidence that multicomponent, exercise-based programmes reduce overall and ACL injuries by 27% and 45%, respectively. CRD42018093527.
Publisher: Human Kinetics
Date: 2022
Abstract: Context : Aquatic plyometric training may provide benefits due to reduced joint loading compared with land plyometric training however, the reduced loading may also limit performance gains. Objective : To systematically review the effect of aquatic plyometric training on strength, performance outcomes, soreness, and adverse events in healthy in iduals. Evidence acquisition : Five databases were searched from inception to June 2020. Quality assessment and data extraction were independently completed by 2 investigators. When similar outcome measures were used, standardized mean differences were calculated. Evidence synthesis : A total of 19 randomized controlled trials with 633 participants (mean age, range 14–30 y) were included. Aquatic plyometric training was most commonly performed in waist to chest deep water (12/19 studies), 2 to 3 times per week for 6 to 12 weeks (18/19 studies), with final program foot contacts ranging from 120 to 550. Meta-analyses were not completed due to the clinical and statistical heterogeneity between studies. Compared with land plyometric training, aquatic plyometric training exercises and dosage were replicated (15/16 studies) and showed typically similar performance gains (3/4 knee extensor strength measures, 2/4 leg extensor strength measures, 3/4 knee flexor strength measures, 7/10 vertical jump measures, 3/3 sprint measures). In total, 2 of 3 studies monitoring muscle soreness reported significantly less soreness following training in water compared with on land. Compared with no active training (no exercise control group or passive stretching), most effect sizes demonstrated a mean improvement favoring aquatic plyometric training (23/32 measures). However, these were not significant for the majority of studies measuring isokinetic knee strength, vertical jump, and sprinting. The effect sizes for both studies assessing leg press strength indicated that aquatic plyometric training is significantly more effective than no training. Conclusion : Aquatic plyometric training appears similarly effective to land plyometric exercise for improving strength, jumping, and sprinting and may be indicated when joint impact loading needs to be minimized. However, the low quality of studies limits the strength of the conclusions.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.JBIOMECH.2018.02.016
Abstract: Differences in synchronous movement between the trunk and lower limb during lifting have been reported in chronic low back pain (CLBP) patients compared to healthy people. However, the relationship between movement coordination and disability in CLBP patients has not been investigated. A cross-sectional study was conducted to compare regional lumbar and lower limb coordination between CLBP (n = 43) and control (n = 29) groups. The CLBP group was ided into high- and low-disability groups based on their Oswestry Disability Index (ODI) score. The mean absolute relative phase (MARP) angles and mean deviation phase (DP) between the (1) lumbar spine and hip, and (2) hip and knee were measured. The relationship between MARP angle and DP and ODI were investigated using linear regression. The higher-disability CLBP group demonstrated significantly greater lumbar-hip MARP angles than the lower-disability CLBP group (mean difference = 12.97, % difference = 36, p = 0.041, 95% CI [2.97, 22.98]). The higher-disability CLBP group demonstrated significantly smaller hip-knee DP than controls (mean difference = 0.11, % difference = 76, p = 0.011, 95% CI [0.03, 0.19]). There were no significant differences in lumbar-hip and hip-knee MARP and DP between the lower-disability CLBP and control groups. Lumbar-hip MARP was positively associated with ODI (R
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.GAITPOST.2018.11.029
Abstract: Three-dimensional camera systems that integrate depth assessment with traditional two-dimensional images, such as the Microsoft Kinect, Intel Realsense, StereoLabs Zed and Orbecc, hold great promise as physical function assessment tools. When combined with point cloud and skeleton pose tracking software they can be used to assess many different aspects of physical function and anatomy. These assessments have received great interest over the past decade, and will likely receive further study as the integration of depth sensing and augmented reality smartphone cameras occurs more in everyday life. The aim of this review is to discuss how these devices work, what options are available, the best methods for performing assessments and how they can be used in the future. Firstly, a review of the Microsoft Kinect devices and associated artificial intelligence, automated skeleton tracking algorithms is provided. This includes a narrative critique of the validity and clinical utility of these devices for assessing different aspects of physical function including spatiotemporal, kinematic and inverse dynamics data derived from gait and balance trials, and anatomical assessments performed using the depth sensor information. Methods for improving the accuracy of data are examined, including multiple-camera systems and sensor fusion with inertial monitoring units, model fitting, and marker tracking. Secondly, alternative hardware, including other structured light and time of flight methods, stereoscopic cameras and augmented reality leveraging smartphone and tablet cameras to perform measurements in three-dimensional space are summarised. Software options related to depth sensing cameras are then discussed, focussing on recent advances such as OpenPose and web-based methods such as PoseNet. The clinical and non-laboratory utility of these devices holds great promise for physical function assessment, and recent developments could strengthen their ability to provide important and impactful health-related data.
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.PTSP.2021.10.011
Abstract: Examine whether football players with hip and/or groin (hip/groin) pain have impaired running biomechanics when compared to pain-free players, analysing men and women independently. Cross-sectional. Biomechanics laboratory. Seventy-eight (62 men, 16 women) football players with >6months of hip/groin pain and a positive flexion-adduction-internal rotation test and 38 (25 men, 13 women) asymptomatic players. Pelvis angles and hip, knee, and ankle joint angles and moments were analysed during the stance phase of overground running at 3-3.5 m⋅s Symptomatic football players did not display significant differences in pelvis angles or lower-limb joint angles, moments, or moment impulses during the stance phase of running, when compared to asymptomatic players of the same sex. Our large s le of football players with hip/groin pain who were still participating in competitive sport displayed similar running biomechanics to asymptomatic players. Impaired running biomechanics might exist in people with worse hip/groin pain, warranting future investigation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 29-12-2018
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.GAITPOST.2018.05.033
Abstract: Three-dimensional gait analysis is often used to assess kinematics and kinetics to discriminate gait patterns and examine change over time. Test-retest reliability is therefore imperative however, many variations of gait models currently exist. This study examined the test-retest reliability of, and agreement between, two commonly used methods of gait modelling, a modified Conventional Gait Model and cluster-based model, using both six degrees-of-freedom or inverse kinematics computational methods in Visual3D. Thirty healthy participants attended two identical sessions. The data for both models were collected concurrently and analysed in Visual3D using either six degrees-of-freedom or inverse kinematics computational methods. Outcomes were taken as the peak measurements for kinematics (joint angles and angular velocity) and kinetics (joint moments and power) for the hip, knee and ankle. Intraclass correlation coefficients were used to examine reliability, with the standard error of measurement and minimal detectable change also calculated. Agreement between models was examined with Pearson correlations and intraclass correlation coefficients. Test-retest reliability was good to excellent for all models for lower limb kinematics and kinetics. The inverse kinematic models had slightly lower reliability across outcomes compared to the six degrees-of-freedom models. Agreement between the Conventional Gait Model and cluster model was mostly good to excellent. Comparison of the two modified CGMs (with six degrees-of-freedom and inverse kinematics) showed much higher agreement against the comparison of the two cluster-based models (with six degrees-of-freedom and inverse kinematics). This study provides a comprehensive assessment of the test-retest reliability and agreement between two gait models with various computational methods. Future research may use these results to guide their decision making for the gait model and outcomes of interest to be used.
Publisher: Springer Science and Business Media LLC
Date: 17-04-2014
Publisher: Elsevier BV
Date: 07-2020
Publisher: Elsevier BV
Date: 2021
DOI: 10.1016/J.JSHS.2021.09.003
Abstract: Developing context-specific, evidence-informed, and implementable injury-prevention programs is challenging. Women playing in the elite Australian Football League for Women are at high risk of serious knee injuries, and no specific injury-prevention program exists. The objective of the study was to describe the collaborative process used to create a context-specific injury-prevention program. A previously used intervention-development process was modified to incorporate a partnership with the sport's governing organization and focus on engaging program implementers. The Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) Sports Setting Matrix guided program development and implementation strategies. The 7-step process, aligned with the RE-AIM Sports Setting Matrix, was applied to develop the injury-prevention program and was titled Prep to Play PRO. The steps were: (Step 1) gaining organizational support and establishing a project partnership (Step 2) using research evidence and clinical experience (Step 3) consulting content and context experts (Step 4) engaging the organization, experts, program implementers, and end-users to concreate the intervention and develop implementation strategies (Step 5) testing the intervention acceptability and feasibility (Step 6) evaluating the intervention and implementation strategies against theory and (Step 7) obtaining feedback from early implementers and end-users. Engaging critical stakeholders at multiple ecological levels (organization, team, and athlete) throughout program development and implementation planning supported real-world use. The processes and activities described can guide future sports injury-prevention program development and implementation.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.APMR.2018.04.032
Abstract: To establish the feasibility and effectiveness of a 6-week ballistic strength training protocol in people with stroke. Randomized, controlled, assessor-blinded study. Subacute inpatient rehabilitation. Consecutively admitted inpatients with a primary diagnosis of first-ever stroke with lower limb weakness, functional ambulation category score of ≥3, and ability to walk ≥14 m were screened for eligibility to recruit 30 participants for randomization. Participants were randomized to standard therapy or ballistic strength training 3 times per week for 6 weeks. The primary aim was to evaluate feasibility and outcomes included recruitment rate, participant retention and attrition, feasibility of the exercise protocol, therapist burden, and participant safety. Secondary outcomes included measures of mobility, lower limb muscle strength, muscle power, and quality of life. A total of 30 participants (11% of those screened) with mean age of 50 years (SD 18) were randomized. The median number of sessions attended was 15 of 18 and 17 of 18 for the ballistic and control groups, respectively. Earlier than expected discharge to home (n=4) and illness (n=7) were the most common reasons for nonattendance. Participants performed the exercises safely, with no study-related adverse events. There were significant (P<.05) between-group changes favoring the ballistic group for comfortable gait velocity (mean difference [MD] 0.31m/s, 95% confidence interval [CI]: 0.08-0.52), muscle power, as measured by peak jump height (MD 8cm, 95% CI: 3-13), and peak propulsive velocity (MD 64cm/s, 95% CI: 17-112). Ballistic training was safe and feasible in select ambulant people with stroke. Similar rates of retention and attrition suggest that ballistic training was acceptable to patients. Secondary outcomes provide promising results that warrant further investigation in a larger trial.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 10-2015
Abstract: STUDY DESIGN :Controlled laboratory study. To evaluate the ability of 3 methods to assess static foot posture to predict rearfoot and midfoot kinematics during gait. Static foot posture is commonly used clinically to infer dynamic function. Limitations of static clinical assessments may be overcome through advances in technologies, including commercially available depth cameras. The Foot Posture Index (FPI) of 31 males (average age, 22.5 years) was assessed using visual observation, a 3-D motion-analysis system, and a depth camera. Pearson correlations were used to evaluate relationships between FPI items and rearfoot and midfoot kinematics during walking. The ability of the static variables to predict dynamic function was assessed using multiple linear regression. Most FPI items (85%) were not correlated with foot kinematics, regardless of assessment method. There were 6 fair to moderate correlations between visual FPI items and total rearfoot (r = -0.36 to -0.39, P<.05) and midfoot (r = 0.37 to 0.61, P<.05) motion, 2 fair correlations between 3-D motion-analysis FPI items and total midfoot (r = -0.43, P = .02) and peak rearfoot (r = -0.40, P = .03) motion, and 2 fair correlations between the depth-camera FPI items and average rearfoot (r = -0.38 to 0.44, P<.05) motion. Visual assessment of the FPI provided the best prediction model, explaining 37% of the variance in total midfoot inversion/eversion. Static measures of foot posture are weakly correlated with rearfoot or midfoot kinematics, and have limited dynamic prediction ability. Our findings suggest that the FPI may not be an accurate representation of rearfoot or midfoot movement during walking, regardless of the measurement technique employed.
Publisher: Elsevier BV
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 14-07-2023
DOI: 10.1186/S40798-023-00602-7
Abstract: The impact of activity-related joint loading on cartilage is not clear. Abnormal loading is considered to be a mechanical driver of osteoarthritis (OA), yet moderate amounts of physical activity and rehabilitation exercise can have positive effects on articular cartilage. Our aim was to investigate the immediate effects of joint loading activities on knee and hip cartilage in healthy adults, as assessed using magnetic resonance imaging. We also investigated delayed effects of activities on healthy cartilage and the effects of activities on cartilage in adults with, or at risk of, OA. We explored the association of sex, age and loading duration with cartilage changes. A systematic review of six databases identified studies assessing change in adult hip and knee cartilage using MRI within 48 h before and after application of a joint loading intervention/activity. Studies included adults with healthy cartilage or those with, or at risk of, OA. Joint loading activities included walking, hopping, cycling, weightbearing knee bends and simulated standing within the scanner. Risk of bias was assessed using the Newcastle–Ottawa Scale. Random-effects meta-analysis estimated the percentage change in compartment-specific cartilage thickness or volume and composition (T2 relaxation time) outcomes. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system evaluated certainty of evidence. Forty studies of 653 participants were included after screening 5159 retrieved studies. Knee cartilage thickness or volume decreased immediately following all loading activities investigating healthy adults however, GRADE assessment indicated very low certainty evidence. Patellar cartilage thickness and volume reduced 5.0% (95% CI 3.5, 6.4, I 2 = 89.3%) after body weight knee bends, and tibial cartilage composition (T2 relaxation time) decreased 5.1% (95% CI 3.7, 6.5, I 2 = 0.0%) after simulated standing within the scanner. Hip cartilage data were insufficient for pooling. Secondary outcomes synthesised narratively suggest knee cartilage recovers within 30 min of walking and 90 min of 100 knee bends. We found contrasting effects of simulated standing and walking in adults with, or at risk of, OA. An increase of 10 knee bend repetitions was associated with 2% greater reduction in patellar thickness or volume. There is very low certainty evidence that minimal knee cartilage thickness and volume and composition (T2 relaxation time) reductions (0–5%) occur after weightbearing knee bends, simulated standing, walking, hopping/jumping and cycling, and the impact of knee bends may be dose dependent. Our findings provide a framework of cartilage responses to loading in healthy adults which may have utility for clinicians when designing and prescribing rehabilitation programs and providing exercise advice.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.KNEE.2018.11.003
Abstract: Closed kinetic chain and plyometric exercises are commonly used in aquatic rehabilitation because they are believed to reduce joint loading whilst replicating functional tasks. However, the forces and relationship to land-based functional movement is unknown. This study aims to compare vertical ground reaction force during squats, calf raises and jumping in older adults with and without knee osteoarthritis on land and in water. Forty one participants (Healthy n = 21 Knee osteoarthritis n = 20 Age 68.5 (4.4) years) completed squats and calf raises at slow, medium and maximal speeds and jumping at maximal speed on land and in waist and chest depth water. Vertical ground reaction force and pain rating was measured in each environment. Force in all exercises was significantly greater on land than in chest depth water (p < 0.005). Peak force was significantly greater at maximal speed compared to slow speed (p < 0.001). The pattern of force in squats at slow speed in water was different to on land, with force highest at the start and end of the exercise and decreasing in the central phase. Pain ratings were significantly lower (p < 0.001) in water compared to on land in squats. Closed kinetic chain exercises offer inherently different loading in an aquatic environment. Body weight squats and calf raises in water could be defined as either neuromotor or low load, high velocity training. Maximal speed exercise in water produces higher relative load compared to slow speed and minimal pain providing an opportunity for clinicians to use greater speed to address power deficits.
Publisher: Wiley
Date: 24-01-2022
DOI: 10.1111/SMS.14119
Abstract: Cam morphology size and location might affect the severity of reported burden in people with femoroacetabular impingement (FAI) syndrome. We investigated the relationship between cam morphology size (i.e., alpha angle) and self‐reported hip/groin burden (i.e., scores for the International Hip Outcome Tool‐33 (iHOT‐33) and Copenhagen Hip and Groin Outcome Score (HAGOS)), examined separately for the anteroposterior pelvis (AP) and Dunn 45° radiographs in football players with FAI syndrome. In total, 118 (12 women) subelite football (soccer or Australian football) players with FAI syndrome with cam morphology (alpha angle ≥60°) participated. One blinded assessor quantified superior and anterosuperior cam morphology size by measuring alpha angles for the AP and Dunn 45° radiographs, respectively. Linear regression models investigated relationships between alpha angle (continuous independent variable, separately measured for the AP and Dunn 45° radiographs) and iHOT‐33 and HAGOS scores (dependent variables). Larger anterosuperior cam morphology (seen on the Dunn 45° radiograph) was associated with lower (i.e., worse) scores for the iHOT‐Total, iHOT‐Symptoms, iHOT‐Job, and iHOT‐Social subscales (unadjusted estimate range −0.553 to −0.319 [95% confidence interval −0.900 to −0.037], p = 0.002 to 0.027), but not the iHOT‐Sport ( p = 0.459) nor any HAGOS scores ( p = 0.110 to 0.802). Superior cam morphology size (measured using the AP radiograph) was not associated with any iHOT‐33 or HAGOS scores ( p = 0.085 to 0.975). Larger anterosuperior cam morphology may be more relevant to pain and symptoms in football players with FAI syndrome than superior cam morphology, warranting investigation of its effects on reported burden and hip disease over time.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2020
DOI: 10.1186/S40798-020-0234-8
Abstract: Hip arthroscopy is a common surgical intervention for young and middle-aged adults with hip-related pain and dysfunction, who have high expectations for returning to physical activity following surgery. The purpose of this review was to evaluate the impact of hip arthroscopy on physical activity post-arthroscopy. A systematic search of electronic databases was undertaken in identifying studies from January 1st 1990 to December 5th 2019. The search included English language articles reporting physical activity as an outcome following hip arthroscopy in adults aged 18-50 years. Quality assessment, data extraction and synthesis of included studies were undertaken. Full text articles ( n = 234) were assessed for eligibility following screening of titles and abstracts ( n = 2086), yielding 120 studies for inclusion. The majority (86%) of the studies were level 4 evidence. One study reported objective activity data. The most frequently occurring patient-reported outcome measure was the Hip Outcome Score-sport-specific subscale (HOS-SS, 84% of studies). Post--arthroscopy improvement was indicated by large effect sizes for patient-reported outcome measures (standard paired difference [95% confidence interval] −1.35[−1.61 to −1.09] at more than 2 years post-arthroscopy) however, the majority of outcome scores for the HOS-SS did not meet the defined level for a patient-acceptable symptom state. The current level of available information regarding physical activity for post arthroscopy patients is limited in scope. Outcomes have focused on patients’ perceived difficulties with sport-related activities with a paucity of information on the type, quality and quantity of activity undertaken. Level IV, systematic review of Level 2 through to Level 4 studies
Publisher: Springer Science and Business Media LLC
Date: 16-01-2019
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.JBIOMECH.2018.04.032
Abstract: Isometric rate of torque development examines how quickly force can be exerted and may resemble everyday task demands more closely than isometric strength. Rate of torque development may provide further insight into the relationship between muscle function and gait following stroke. Aims of this study were to examine the test-retest reliability of hand-held dynamometry to measure isometric rate of torque development following stroke, to examine associations between strength and rate of torque development, and to compare the relationships of strength and rate of torque development to gait velocity. Sixty-three post-stroke adults participated (60 years, 34 male). Gait velocity was assessed using the fast-paced 10 m walk test. Isometric strength and rate of torque development of seven lower-limb muscle groups were assessed with hand-held dynamometry. Intraclass correlation coefficients were calculated for reliability and Spearman's rho correlations were calculated for associations. Regression analyses using partial F-tests were used to compare strength and rate of torque development in their relationship with gait velocity. Good to excellent reliability was shown for strength and rate of torque development (0.82-0.97). Strong associations were found between strength and rate of torque development (0.71-0.94). Despite high correlations between strength and rate of torque development, rate of torque development failed to provide significant value to regression models that already contained strength. Assessment of isometric rate of torque development with hand-held dynamometry is reliable following stroke, however isometric strength demonstrated greater relationships with gait velocity. Further research should examine the relationship between dynamic measures of muscle strength/torque and gait after stroke.
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12984-019-0637-2
Abstract: Upper limb associated reactions (ARs) are common in people with acquired brain injury (ABI). Despite this, there is no gold-standard outcome measure and no kinematic description of this movement disorder. The aim of this study was to determine the upper limb kinematic variables most frequently affected by ARs in people with ABI compared with a healthy cohort at matched walking speed intention. A convenience s le of 36 healthy control adults (HCs) and 42 people with ABI who had upper limb ARs during walking were recruited and underwent assessment of their self-selected walking speed using the criterion-reference three dimensional motion analysis (3DMA) at Epworth Hospital, Melbourne. Shoulder flexion, abduction and rotation, elbow flexion, forearm rotation and wrist flexion were assessed. The mean angle, standard deviation (SD), peak joint angles and total joint angle range of motion (ROM) were calculated for each axis across the gait cycle. On a group level, ANCOVA was used to assess the between-group differences for each upper limb kinematic outcome variable. To quantify abnormality prevalence on an in idual participant level, the percentage of ABI participants that were outside of the 95% confidence interval of the HC s le for each variable were calculated. There were significant between-group differences for all elbow and shoulder abduction outcome variables ( p 0.01), most shoulder flexion variables (except for shoulder extension peak), forearm rotation SD and ROM and for wrist flexion ROM. Elbow flexion and shoulder abduction were the axes most frequently affected by ARs. Despite the elbow being the most prevalently affected (38/42, 90%), a large proportion of participants had abnormality, defined as ±1.96 SD of the HC mean, present at the shoulder (32/42, 76%), forearm (20/42, 48%) and wrist joints (10/42, 24%). This study provides valuable information on ARs, and highlights the need for clinical assessment of ARs to include all of the major joints of the upper limb. This may inform the development of a criterion-reference outcome measure or classification system specific to ARs.
Publisher: Public Library of Science (PLoS)
Date: 28-10-2015
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.JBIOMECH.2021.110825
Abstract: Upper limb kinematic abnormalities are prevalent in people with acquired brain injury (ABI). We examined if the Microsoft Kinect for Xbox One (Kinect) reliably (test-retest) and validly (concurrent) quantifies upper limb kinematics, and accurately classifies abnormalities (sensitivity/specificity), in an ABI cohort when compared to three-dimensional motion analysis (3DMA) and a subjective rating scale. We compared 42 adults with ABI to 36 healthy control (HC) participants. Walking trials were recorded by 3DMA and Kinect at self-selected (SSWS) and fast (FWS) walking speeds. When classifying abnormalities for 3DMA and Kinect, a 95% reference range (based on HC data) was calculated using the Kinematic Deviation Score worst axis (KDSw) values outside of this range were classified abnormal. Scores ≥ 2 in the subjective rating scale, based on International Classification of Functioning, Disability and Health Framework's Qualifiers Scale, were considered abnormal. Test-retest reliability and concurrent validity were determined using intra-class correlation coefficient (Absolute ICC
Publisher: SAGE Publications
Date: 27-11-2020
Abstract: The aim of this study is to determine inter-rater, test–retest and intra-rater reproducibility and responsiveness of subjective assessment of upper limb associated reactions in people with acquired brain injury using (1) the ‘Qualifiers Scale’ of the International Classification of Functioning, Disability and Health Framework, and (2) visually estimated elbow flexion angle during walking. Observational study. A brain injury rehabilitation centre, Melbourne, Australia. People with acquired brain injury and upper limb associated reactions and experienced neurological physiotherapists. The Qualifiers Scale applied to in idual upper limb joints and global associated reaction on a 5-point scale (0–4), a summed upper limb severity score and visually estimated elbow flexion angle. A total of 42 people with acquired brain injury (mean age: 48.4 ± 16.5 years) were videoed walking at self-selected and fast speeds. A subset of 30 chronic brain injury participants (mean time post injury: 8.2 ± 9.3 years) were reassessed one week later for retest reproducibility. Three experienced neurological physiotherapists (mean experience: 22.7 ± 9.1 years) viewed these videos and subjectively rated the upper limb associated reactions. Strong-to-very strong test–retest, intra- and inter-rater reproducibility was found for elbow flexion angle (ICC 0.86) and the Qualifiers Scale applied to global and in idual upper limb joints (ICC 0.60). Responsiveness of change from self-selected to fast walking speed (mean increase 0.46 m/s) was highest for elbow flexion angle (effect size = 0.83) and low-to-moderate for the Qualifiers Scale. Subjectively rated associated reactions during walking demonstrated strong reproducibility and moderate responsiveness to speed change. The Qualifiers Scale and elbow flexion angle can both subjectively quantify associated reactions during walking in a clinical setting.
Publisher: SAGE Publications
Date: 23-03-2022
DOI: 10.1177/19417381221076141
Abstract: It is unknown if football players with femoroacetabular impingement (FAI) syndrome report worse burden than those with other causes of hip/groin pain, and to what extent this is mediated by cartilage defects and labral tears. Football players with FAI syndrome would report worse burden than other symptomatic players, with the effect partially mediated by cartilage defects and/or labral tears. Cross-sectional study. Level 4. Football (soccer and Australian football) players (n = 165 35 women) with hip/groin pain (≥6 months and positive flexion–adduction–internal rotation test) were recruited. Participants completed 2 patient-reported outcome measures (PROMs the International Hip Outcome Tool–33 [iHOT-33] and Copenhagen Hip and Groin Outcome Score [HAGOS]) and underwent hip radiographs and magnetic resonance imaging (MRI). FAI syndrome was determined to be present when cam and/or pincer morphology were present. Cartilage defects and labral tears were graded as present or absent using MRI. Linear regression models investigated relationships between FAI syndrome (dichotomous independent variable) and PROM scores (dependent variables). Mediation analyses investigated the effect of cartilage defects and labral tears on these relationships. FAI syndrome was not related to PROM scores (unadjusted b values ranged from −4.693 ( P = 0.23) to 0.337 ( P = 0.93)) and cartilage defects and/or labral tears did not mediate its effect ( P = 0.22-0.97). Football players with FAI syndrome did not report worse burden than those with other causes of hip/groin pain. Cartilage defects and/or labral tears did not explain the effect of FAI syndrome on reported burden. FAI syndrome, cartilage defects, and labral tears were prevalent but unrelated to reported burden in symptomatic football players.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.JSAMS.2014.04.008
Abstract: Traditional methods of assessing joint range of motion (ROM) involve specialized tools that may not be widely available to clinicians. This study assesses the reliability and validity of a custom Smartphone application for assessing hip joint range of motion. Intra-tester reliability with concurrent validity. Passive hip joint range of motion was recorded for seven different movements in 20 males on two separate occasions. Data from a Smartphone, bubble inclinometer and a three dimensional motion analysis (3DMA) system were collected simultaneously. Intraclass correlation coefficients (ICCs), coefficients of variation (CV) and standard error of measurement (SEM) were used to assess reliability. To assess validity of the Smartphone application and the bubble inclinometer against the three dimensional motion analysis system, intraclass correlation coefficients and fixed and proportional biases were used. The Smartphone demonstrated good to excellent reliability (ICCs>0.75) for four out of the seven movements, and moderate to good reliability for the remaining three movements (ICC=0.63-0.68). Additionally, the Smartphone application displayed comparable reliability to the bubble inclinometer. The Smartphone application displayed excellent validity when compared to the three dimensional motion analysis system for all movements (ICCs>0.88) except one, which displayed moderate to good validity (ICC=0.71). Smartphones are portable and widely available tools that are mostly reliable and valid for assessing passive hip range of motion, with potential for large-scale use when a bubble inclinometer is not available. However, caution must be taken in its implementation as some movement axes demonstrated only moderate reliability.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 20-02-2020
DOI: 10.1249/MSS.0000000000002297
Abstract: This study aimed to evaluate the differences in lower-limb biomechanics between adult subelite competitive football players with and without hip-related pain during two contrasting tasks—walking and single-leg drop jump (SLDJ)—and to determine whether potential differences, if present, are sex dependent. Eighty-eight football players with hip-related pain (23 women, 65 men) and 30 asymptomatic control football players (13 women, 17 men) who were currently participating in competitive sport were recruited. Biomechanical data were collected for the stance phase of walking and SLDJ. Pelvis, hip, knee, and ankle angles, as well as the impulse of the external joint moments, were calculated. Differences between groups and sex-specific effects were calculated using linear regression models. Compared with their asymptomatic counterparts, football players with hip-related pain displayed a lower average pelvic drop angle during walking ( P = 0.03) and a greater average pelvic hike angle during SLDJ ( P 0.05). Men with hip-related pain displayed a smaller total range of motion (excursion) for the transverse plane pelvis angle ( P = 0.03) and a smaller impulse of the hip external rotation moment ( P 0.01) during walking compared with asymptomatic men. Women with hip-related pain displayed a greater total range of motion (excursion) for the sagittal plane knee angle ( P = 0.01) during walking compared with asymptomatic women. Overall, few differences were observed in lower-limb biomechanics between football players with and without hip-related pain, irrespective of the task. This outcome suggests that, despite the presence of symptoms, impairments in lower-limb biomechanics during function do not appear to be a prominent feature of people with hip-related pain who are still participating in sport.
Publisher: Springer Science and Business Media LLC
Date: 12-05-2017
DOI: 10.1007/S40279-017-0742-Y
Abstract: Groin injury is a common musculoskeletal complaint for athletes competing in a variety of sports. The extent to which exercise interventions incorporating external load are an appropriate option for the treatment and prevention of groin injury in athletes is not yet clear. The aim of this review was to describe and evaluate exercise therapy interventions and outcomes for the treatment and prevention of groin injury with specific attention to application of external load. The databases Medline, PubMed, SPORTDiscus, Web of Science, and Cochrane were searched on 18 April 2016. This review was registered as PROSPERO CRD42016037752 and a systematic search was conducted with the following inclusion criteria: any study design evaluating exercise interventions for the prevention or treatment of groin pain in athletes. Two independent authors screened search results, performed data extraction, assessed risk of bias using the modified Downs and Black appraisal tool and determined strength and level of evidence. Reporting standards for exercise interventions were assessed using the Consensus for Exercise Reporting Template (CERT). A total of 1320 titles were identified with 14 studies satisfying the inclusion criteria, four (29%) of which demonstrated low risk of bias. Ten (71%) studies utilised external load as a component of the exercise intervention. Reporting standards for exercise intervention scores ranged from 0 to 63%. There is limited evidence from level 2 and 3 studies indicating exercise therapy may reduce the incidence and hazard risk of sustaining a groin injury in athletes. There is strong evidence from level 4 studies indicating exercise therapy is beneficial as a treatment for groin injury in athletes in terms of symptom remission, return to sport and recurrence outcomes. However, there are limited studies with low risk of bias, and exercise interventions for the treatment of groin injury are poorly described.
Publisher: Informa UK Limited
Date: 30-12-2015
DOI: 10.3109/02699052.2014.995231
Abstract: The aim of this systematic review was to identify literature examining associations between isometric strength and gait velocity following stroke. An electronic search was performed using six online databases. Targeted searching of reference lists of included articles and three relevant journals was also performed. Two independent reviewers identified relevant articles, extracted data and assessed the methodological quality of included articles. Inclusion criteria involved studies that assessed univariate correlations between gait velocity and isometric strength of in idual lower limb muscle groups in a stroke population. Twenty-one studies were included for review. The majority of included studies had a relatively small s le size. After accounting for s le size and methodological quality, the knee extensors showed poor-to-moderate correlations with gait velocity while the ankle dorsiflexors showed the strongest association with gait velocity. Current evidence suggests that the strength of the ankle dorsiflexors has a stronger correlation to gait velocity compared with other lower limb muscle groups. Consequently, a focus on increasing ankle dorsiflexor strength to improve gait velocity following stroke may be beneficial. However, due to limitations of the research identified, further research is needed to determine the associations between lower limb strength and gait velocity following stroke.
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.GAITPOST.2015.03.005
Abstract: The Microsoft Kinect V2 for Windows, also known as the Xbox One Kinect, includes new and potentially far improved depth and image sensors which may increase its accuracy for assessing postural control and balance. The aim of this study was to assess the concurrent validity and reliability of kinematic data recorded using a marker-based three dimensional motion analysis (3DMA) system and the Kinect V2 during a variety of static and dynamic balance assessments. Thirty healthy adults performed two sessions, separated by one week, consisting of static standing balance tests under different visual (eyes open vs. closed) and supportive (single limb vs. double limb) conditions, and dynamic balance tests consisting of forward and lateral reach and an assessment of limits of stability. Marker coordinate and joint angle data were concurrently recorded using the Kinect V2 skeletal tracking algorithm and the 3DMA system. Task-specific outcome measures from each system on Day 1 and 2 were compared. Concurrent validity of trunk angle data during the dynamic tasks and anterior-posterior range and path length in the static balance tasks was excellent (Pearson's r>0.75). In contrast, concurrent validity for medial-lateral range and path length was poor to modest for all trials except single leg eyes closed balance. Within device test-retest reliability was variable however, the results were generally comparable between devices. In conclusion, the Kinect V2 has the potential to be used as a reliable and valid tool for the assessment of some aspects of balance performance.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2013
Abstract: The evaluation of foot posture in a clinical setting is useful to screen for potential injury, however disagreement remains as to which method has the greatest clinical utility. An inexpensive and widely available imaging system, the Microsoft Kinect™, may possess the characteristics to objectively evaluate static foot posture in a clinical setting with high accuracy. The aim of this study was to assess the intra-rater reliability and validity of this system for assessing static foot posture. Three measures were used to assess static foot posture traditional visual observation using the Foot Posture Index (FPI), a 3D motion analysis (3DMA) system and software designed to collect and analyse image and depth data from the Kinect. Spearman’s rho was used to assess intra-rater reliability and concurrent validity of the Kinect to evaluate foot posture, and a linear regression was used to examine the ability of the Kinect to predict total visual FPI score. The Kinect demonstrated moderate to good intra-rater reliability for four FPI items of foot posture (ρ = 0.62 to 0.78) and moderate to good correlations with the 3DMA system for four items of foot posture (ρ = 0.51 to 0.85). In contrast, intra-rater reliability of visual FPI items was poor to moderate (ρ = 0.17 to 0.63), and correlations with the Kinect and 3DMA systems were poor (absolute ρ = 0.01 to 0.44). Kinect FPI items with moderate to good reliability predicted 61% of the variance in total visual FPI score. The majority of the foot posture items derived using the Kinect were more reliable than the traditional visual assessment of FPI, and were valid when compared to a 3DMA system. In idual foot posture items recorded using the Kinect were also shown to predict a moderate degree of variance in the total visual FPI score. Combined, these results support the future potential of the Kinect to accurately evaluate static foot posture in a clinical setting.
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.PTSP.2019.08.005
Abstract: To report physical characteristics of lower-limb strength, endurance, range of motion, balance, and pain during adductor squeeze in elite female Australian Football (AF) players, and to examine the effect of limb dominance, previous AF experience, age, and previous level of sports participation on these characteristics. Cross-sectional study. Three elite AF clubs. Eighty-five female players. All were aged ≥18, contracted for the 2018 season, and participated in pre-season training. The physical characteristic assessments included pain on adductor squeeze, weight-bearing lunge, side bridge, isometric hip abduction and adduction strength, and the modified star excursion balance test. The adductor squeeze had low pain scores, with 93% of players scoring ≤2 on the numerical rating scale. Other assessment results were (mean ± SD): 10.8 ± 2.7 cm for weight-bearing lunge, 95 ± 39s for side bridge, 1.85 ± 0.23 and 1.85 ± 0.36Nm/kg for hip abduction and adduction strength respectively, and 92 ± 8% for the modified star excursion balance test. There was no clinically relevant effect of limb dominance, previous AF experience, age, or previous level of sports on physical characteristics. Physical characteristics for five assessments are reported. These data can be used for comparison purposes in the screening and clinical management of elite female AF players.
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.GAITPOST.2021.11.027
Abstract: Children born very preterm (< 32 weeks' gestation) are at greater risk of motor impairment and executive/attentional dysfunctions than term-born children however, little is known about how functional tasks, including walking, may be affected by very preterm birth. How does the gait pattern of preschool-age children born < 30 weeks compare with term-born controls under a variety of walking conditions? In this prospective cohort study, children born < 30 weeks and at term were assessed at 4.5-5 years' corrected age, blinded to birth group. Four walking conditions were assessed using the GAITRite® system: preferred speed, cognitive dual-task, motor dual-task, and tandem walking. Gait variables analysed included speed, cadence, step length, step time, base of support (BOS), and single and double support time. Spatiotemporal variables were compared between groups using linear regression, adjusting for lower-limb length, corrected age at assessment, and number of trials. 224 children (112 < 30 weeks and 112 term-born) were assessed. Gait variables of children born < 30 weeks did not differ from their term-born peers when walking at their preferred speed, except for higher BOS variability (mean difference [MD] = 0.19 cm, 95% confidence interval [CI] 0.10, 0.27, p < 0.001). Under the motor dual-task condition, children born < 30 weeks walked faster (MD= 3.06 cm/s, 95% CI 0.14, 5.97, p = 0.040), with a longer step length (MD= 1.10 cm, 95%CI 0.19, 2.01, p = 0.018), and a wider BOS (MD= 0.37 cm, 95%CI 0.06, 0.67, p = 0.019). In cognitive dual-task and tandem conditions, children born < 30 weeks walked with a wider BOS compared with term-born peers (MD= 0.43 cm, 95%CI 0.05, 0.81, p = 0.028 and MD= 0.30 cm, 95%CI 0.09, 0.51, p = 0.005, respectively). This research highlights the need to consider the walking performance of preschool-age children born < 30 weeks under challenging conditions, such as dual-task or tandem walking, when assessing gait patterns and planning interventions.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.APMR.2017.06.021
Abstract: To determine whether resistance training to improve mobility outcomes after stroke adheres to the American College of Sports Medicine (ACSM) guidelines, and whether adherence was associated with better outcomes. Online databases searched from 1975 to October 30, 2016. Randomized controlled trials examining the effectiveness of lower limb strength training on mobility outcomes in adult participants with stroke. Two independent reviewers completed data extraction. Quality of trials was determined using the Cochrane Risk of Bias Tool. Trials were scored based on their protocol's adherence to 8 ACSM recommendations. To determine if a relation existed between total adherence score and effect size, Spearman ρ was calculated, and between in idual recommendations and effect size, Mann-Whitney U or Kruskal-Wallis tests were used. Thirty-nine trials met the inclusion criteria, and 34 were scored on their adherence to the guidelines. Adherence was high for frequency of training (100% of studies), but few trials adhered to the guidelines for intensity (32%), specificity (24%), and training pattern (3%). Based on the small number of studies that could be included in pooled analysis (n=12), there was no relation between overall adherence and effect size (Spearman ρ=-.39, P=.21). Adherence to the ACSM guidelines for resistance training after stroke varied widely. Future trials should ensure strength training protocols adhere more closely to the guidelines, to ensure their effectiveness in stroke can be accurately determined.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 13-10-2017
Abstract: Study Design Prospective cohort. Background Quadriceps strength is associated with hop distance and jump height in persons who have undergone anterior cruciate ligament (ACL) reconstruction. However, it is unknown whether the ability to rapidly generate quadriceps torque in the early phase of recovery is associated with future hopping and jumping performance in this population. Objective To evaluate the prospective associations among quadriceps strength and rate of torque development (RTD) and single-leg hop for distance, vertical jump height, vertical ground reaction force (vGRF), and vertical force loading rate during a landing task in persons who have undergone ACL reconstruction. Methods Seventy patients with unilateral ACL reconstruction participated. At 6 weeks post ACL reconstruction, isometric quadriceps strength and RTD were measured using a dynamometer. At 6 months following ACL reconstruction, patients performed the single-leg hop for distance test. Patients also performed the single-leg vertical jump test on a force plate that measured maximum jump height, vGRF, and average loading rate during landing. Results Both quadriceps strength and RTD at 6 weeks post ACL reconstruction were associated with all hopping and jumping measures at 6 months post ACL reconstruction (P≤.04). Single-leg hop distance was associated more closely with quadriceps strength than with quadriceps RTD (P = .05), and vertical jump height and vGRF measures were associated more closely with quadriceps RTD than with quadriceps strength (P = .05 and P<.01, respectively). Both quadriceps measures were associated with loading rate. Conclusion Quadriceps strength and RTD are complementary but distinct predictors of future hopping and jumping performance in persons who have undergone ACL reconstruction. These findings may contribute to improved rehabilitation of patients who are at risk for poor jumping/hopping performance and abnormal knee loading. J Orthop Sports Phys Ther 2017 (11):845-852. Epub 13 Oct 2017. doi:10.2519/jospt.2017.7133.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.JSAMS.2016.06.008
Abstract: Firstly to describe the reliability of assessing maximal isometric strength of the hip abductor and adductor musculature using a hand held dynamometry (HHD) protocol with simultaneous wireless surface electromyographic (sEMG) evaluation of the gluteus medius (GM) and adductor longus (AL). Secondly, to describe the correlation between isometric strength recorded with the HHD protocol and a laboratory standard isokinetic device. Reliability and correlational study. A s le of 24 elite, male, junior, rugby league athletes, age 16-20 years participated in repeated HHD and isometric Kin-Com (KC) strength testing with simultaneous sEMG assessment, on average (range) 6 (5-7) days apart by a single assessor. Strength tests included unilateral hip abduction (ABD) and adduction (ADD) and bilateral ADD assessed with squeeze (SQ) tests in 0 and 45° of hip flexion. HHD demonstrated good to excellent inter-session reliability for all outcome measures (ICC Isometric strength testing of the hip ABD and ADD musculature using HHD may be measured reliably in elite, junior rugby league athletes. Due to the poor inter-session reliability of sEMG measures, it is not recommended for athlete screening purposes if using the techniques implemented in this study.
Publisher: Elsevier BV
Date: 04-2022
DOI: 10.1016/J.JSAMS.2021.10.009
Abstract: The purpose of this study was to investigate the effectiveness of an isometric neck strengthening program to improve isometric neck strength in elite women's football-code athletes. Randomised controlled trial. Elite female soccer (n = 10) and Australian football (n = 30) players were randomised into either a control (n = 20) or experimental (n = 20) group for a 12-week intervention study during their respective seasons. While both groups undertook their prescribed strength and conditioning programs, the experimental group also performed isometric neck strengthening exercises three times per week prior to training. Isometric neck strength of the extensors, flexors, lateral flexors, and rotators were assessed pre, mid (Week 7), and post (Week 13) intervention with a hand-held dynamometer during early to mid-competition season. A mixed design analysis of variance was performed for statistical analysis. No significant group-by-time interactions in isometric neck strength were observed. All strength variables displayed a significant change over time throughout the 12-week period (p < 0.05). No significant between group differences in isometric neck strength variables were observed except for lateral left flexion (F(1, 38) =5.064, p = 0.030, η The addition of isometric neck strengthening exercises did not improve neck strength beyond a standard strength and conditioning program for elite women's football-code athletes. While this specific program may not improve neck strength in elite women's football-code athletes, further investigation is needed to determine whether sport-specific neck strength exercises may improve neck strength or if lower-level competition athletes may still benefit from an isometric neck strengthening program.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.APMR.2017.09.117
Abstract: To integrate the literature investigating factors associated with post-stroke physical activity. A search was conducted from database inception to June 2016 across 9 databases: Cochrane, MEDLINE, ProQuest, Web of Science, PsycINFO, Scopus, Embase, CINAHL, and Allied and Complementary Medicine Database. The reference lists of included articles were screened for secondary literature. Cohort and cross-sectional studies were included if they recruited community-dwelling stroke survivors and measured factors associated with physical activity. Risk of bias was evaluated using the Quality in Prognosis Studies checklist. A meta-analysis was conducted for correlates where there were at least 2 studies that reported a correlation value. Correlation values were used in an effect size measure and converted to a standardized unit with Fisher r to z transformation and conversion back to r method. Results were described qualitatively for studies that could not be pooled. There were 2161 studies screened and 26 studies included. Age (meta r=-.17 P≤.001) and sex (meta r=-.01 P=.02) were the nonmodifiable factors that were found to be associated with post-stroke physical activity. The modifiable factors were physical function (meta r=.68-.73 P<.001), cardiorespiratory fitness (meta r=.35 P≤.001), fatigue (meta r=-.22 P=.01), falls self-efficacy (meta r=-.33 P<.001), balance self-efficacy (meta r=.37 P<.001), depression (meta r=-.58 to .48 P<.001), and health-related quality of life (meta r=.38-.43 P<.001). The effect of side of infarct, neglect, and cognition on post-stroke physical activity was inconclusive. Age, sex, physical function, depression, fatigue, self-efficacy, and quality of life were factors associated with post-stroke physical activity. The cause and effect of these relations are unclear, and the possibility of reverse causality needs to be addressed.
Publisher: Informa UK Limited
Date: 03-2018
DOI: 10.1080/02640414.2018.1445439
Abstract: The Microsoft Xbox One Kinect™ (Kinect V2) contains a depth camera that can be used to manually identify anatomical landmark positions in three-dimensions independent of the standard skeletal tracking, and therefore has potential for low-cost, time-efficient three-dimensional movement analysis (3DMA). This study examined inter-session reliability and concurrent validity of the Kinect V2 for the assessment of coronal and sagittal plane kinematics for the trunk, hip and knee during single leg squats (SLS) and drop vertical jumps (DVJ). Thirty young, healthy participants (age = 23 ± 5yrs, male/female = 15/15) performed a SLS and DVJ protocol that was recorded concurrently by the Kinect V2 and 3DMA during two sessions, one week apart. The Kinect V2 demonstrated good to excellent reliability for all SLS and DVJ variables (ICC ≥ 0.73). Concurrent validity ranged from poor to excellent (ICC = 0.02 to 0.98) during the SLS task, although trunk, hip and knee flexion and two-dimensional measures of knee abduction and frontal plane projection angle all demonstrated good to excellent validity (ICC ≥ 0.80). Concurrent validity for the DVJ task was typically worse, with only two variables exceeding ICC = 0.75 (trunk and hip flexion). These findings indicate that the Kinect V2 may have potential for large-scale screening for ACL injury risk, however future prospective research is required.
Publisher: Wiley
Date: 10-2018
DOI: 10.1111/JPC.14149
Abstract: Developmental co-ordination disorder is a motor skill disorder that affects an estimated 5-6% of children but lacks recognition and understanding, leading to under-diagnosis. Essential for diagnosis is a marked impairment in motor co-ordination that significantly impacts daily living, including education. Although 'clumsiness' is often dismissed, the impact of this disorder is significant and extends beyond motor skills into physical and psychological health and educational and vocational success. This is discussed here with regard to the framework of the International Classification of Functioning, Disability and Health. This review also discusses the importance of an accurate, early diagnosis and factors that inhibit this dual diagnosis with comorbid neurodevelopmental disorders the multidisciplinary approach to diagnosis and the role of the paediatrician within this and current evidence regarding the most effective interventions.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.GAITPOST.2017.12.022
Abstract: The use of force platform technologies to assess standing balance is common across a range of clinical areas. Numerous researchers have evaluated the low-cost Wii Balance Board (WBB) for its utility in assessing balance, with variable findings. This review aimed to systematically evaluate the reliability and concurrent validity of the WBB for assessment of static standing balance. Articles were retrieved from six databases (Medline, SCOPUS, EMBASE, CINAHL, Web of Science, Inspec) from 2007 to 2017. After independent screening by two reviewers, 25 articles were included. Two reviewers performed the data extraction and quality assessment. Test-retest reliability was investigated in 12 studies, with intraclass correlation coefficients or Pearson's correlation values showing a range from poor to excellent reliability (range: 0.27 to 0.99). Concurrent validity (i.e. comparison with another force platform) was examined in 21 studies, and was generally found to be excellent in studies examining the association between the same outcome measures collected on both devices. For studies reporting predominantly poor to moderate validity, potentially influential factors included the choice of 1) criterion reference (e.g. not a common force platform), 2) test duration (e.g. <30 s for double leg), 3) outcome measure (e.g. comparing a centre of pressure variable from the WBB with a summary score from the force platform), 4) data acquisition platform (studies using Apple iOS reported predominantly moderate validity), and 5) low s le size. In conclusion, evidence suggests that the WBB can be used as a reliable and valid tool for assessing standing balance. Protocol registration number: PROSPERO 2017: CRD42017058122.
Publisher: SAGE Publications
Date: 15-07-2021
DOI: 10.1177/03635465211027180
Abstract: The International Hip Outcome Tool–33 (iHOT-33) was developed to evaluate patients seeking surgery for hip and/or groin (hip/groin) pain and may not be appropriate for those seeking nonsurgical treatment. To evaluate the psychometric properties of the iHOT-33 total (iHOT-Total) score and all subscale scores in adults with hip/groin pain who were not seeking surgery. Cohort study (diagnosis) Level of evidence, 3. Patients with hip/groin pain who were not seeking surgery were recruited from 2 ongoing studies in Australia. Semistructured one-on-one interviews assessed content validity. Construct validity was assessed by testing hypothesized correlations between iHOT-33 and Copenhagen Hip and Groin Outcome Score (HAGOS) subscale scores. Test-retest reliability was assessed in patients not undertaking treatment and who reported “no change” in their Global Rating of Change (GROC) score at 6-month follow-up. Scores were reliable at group and in idual levels if intraclass correlation coefficients (ICCs) were ≥0.80 and ≥0.90, respectively. Scores were responsive if Spearman rank correlations (ρ) between the change in the iHOT-33 score and the GROC score were ≥0.40. In total, 278 patients with hip/groin pain (93 women mean age, 31 years) and 55 pain-free control participants (14 women mean age, 29 years) were recruited. The iHOT-33 demonstrated acceptable content validity. Construct validity was acceptable, with all hypothesized strong positive correlations between iHOT-33 and HAGOS subscale scores confirmed ( r range, 0.60-0.76 P .001), except for one correlation between the iHOT-Sport and HAGOS-Sport ( r = .058 P .001). All scores were reliable at the group level, except for the iHOT-33 job subscale (iHOT-Job) (ICC range, 0.78-0.88 [95% CI, 0.60-0.93]). None of the subscales met the criteria for adequate reliability for use at the in idual level (all ICCs .90). Minimal detectable change values (group level) ranged from 2.3 to 3.7 (95% CI, 1.7-5.0). All iHOT-33 subscale scores were responsive (ρ range, 0.40-0.58 P≤ .001), except for the iHOT-Job in patients not undertaking treatment (ρ = 0.27 P = .001). All iHOT-33 subscale scores were valid for use in patients with hip/groin pain who were not seeking surgery. Acceptable test-retest reliability was found for all subscale scores at the group level, except the iHOT-Job. All subscale scores, excluding the iHOT-Job, were responsive, regardless of undertaking physical therapist–led treatment or no treatment.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.APMR.2016.08.472
Abstract: To investigate the effectiveness of aquatic exercise in improving lower limb strength in people with musculoskeletal conditions. A systematic search used 5 databases, including MEDLINE, CINAHL, Embase, SPORTDiscus, and The Cochrane Library. Randomized controlled trials evaluating aquatic exercise with a resistance training component for adults with musculoskeletal conditions compared with no intervention or land-based exercise were identified. Fifteen studies from the initial yield of 1214 met these criteria. Data related to participant demographics, study design, and methods, interventions, and outcomes, including numerical means and SDs, were extracted independently by 2 reviewers. Nine of the 15 studies were of high quality, scoring at least 6 on the Physiotherapy Evidence Database Scale. Limited consideration of the prescription of resistance in the aquatic exercise and application of resistance training principles existed. Low- or very low-quality evidence indicates there was no difference in average effect between aquatic exercise and no exercise in improving hip abductor strength (standardized mean difference [SMD], .28 95% confidence interval [CI], -.04 to .59), knee extensor strength (SMD, .18 95% CI, -.03 to .40), knee flexor strength (SMD, .13 95% CI, -.20 to .45), or lower limb endurance (SMD, .35 95% CI, -.06 to .77). Low-quality evidence indicates no difference in average effect between aquatic and land exercise for knee extensor (SMD, -.24 95% CI, -.49 to .02) or flexor strength (SMD, -.15 95% CI, -.53 to .22). It is likely that the inadequate application of resistance in water is a significant contributor to the limited effectiveness of aquatic exercise interventions in improving hip and knee muscle strength in people with musculoskeletal conditions. Future research is needed to quantify resistance with aquatic exercises and to determine if using opportunities for greater resistance in aquatic rehabilitation and appropriate resistance training principles can be more effective in improving muscle strength.
Publisher: SAGE Publications
Date: 11-07-2023
DOI: 10.1177/02692155231187203
Abstract: To investigate whether tailoring the speed of the Modified Tardieu Scale to reflect an in idual's joint angular velocity during walking influences spasticity assessment outcomes. Observational trial. Inpatient and outpatient neurological hospital department. Ninety adults with lower-limb spasticity. N/A. The Modified Tardieu Scale was used to assess the gastrocnemius, soleus, hamstrings and quadriceps. The V1 (slow) and V3 (fast) movements were completed as per standardised testing. Two additional assessments were completed, reflecting joint angular velocities during walking based on (i) a healthy control database (controlled velocity) and (ii) the in idual's real-time joint angular velocities during walking (matched velocity). The agreement was compared using Cohen's and Weighted Kappa statistics, sensitivity and specificity. There was poor agreement when rating trials as spastic or not spastic at the ankle joint (Cohen's Kappa = 0.01–0.17). Trials were classified as spastic during V3 and not spastic during the controlled conditions in 81.6–85.1% of trials when compared to stance phase dorsiflexion angular velocities and 48.0–56.4% when compared to swing phase dorsiflexion angular velocities. The severity of muscle reaction demonstrated poor agreement at the ankle (Weighted Kappa = 0.01–0.28). At the knee, there was a moderate-excellent agreement between the V3 and controlled conditions when rating a trial as spastic or not spastic (Cohen's Kappa = 0.66–0.84) and excellent agreement when comparing severity (Weighted Kappa = 0.73–0.94). The speed of assessment impacted spasticity outcomes. It is possible that the standardised protocol may overestimate the impact spasticity has on walking, especially at the ankle.
Publisher: BMJ
Date: 02-2023
DOI: 10.1136/BMJOPEN-2022-068040
Abstract: Running is one of the most popular recreational activities worldwide, due to its low cost and accessibility. However, little is known about the impact of running on knee joint health in runners with and without a history of knee surgery. The primary aim of this longitudinal cohort study is to compare knee joint structural features on MRI and knee symptoms at baseline and 4-year follow-up in runners with and without a history of knee surgery. Secondary aims are to explore the relationships between training load exposures (volume and/or intensity) and changes in knee joint structure and symptoms over 4 years explore the relationship between baseline running biomechanics, and changes in knee joint structure and symptoms over 4 years. In addition, we will explore whether additional variables confound, modify or mediate these associations, including sex, baseline lower-limb functional performance, knee muscle strength, psychological and sociodemographic factors. A convenience s le of at least 200 runners (sex/gender balanced) with (n=100) and without (n=100) a history of knee surgery will be recruited. Primary outcomes will be knee joint health (MRI) and knee symptoms (baseline 4 years). Exposure variables for secondary outcomes include training load exposure, obtained daily throughout the study from wearable devices and three-dimensional running biomechanics (baseline). Additional variables include lower limb functional performance, knee extensor and flexor muscle strength, biomarkers, psychological and sociodemographic factors (baseline). Knowledge and beliefs about osteoarthritis will be obtained through predefined questions and semi-structured interviews with a subset of participants. Multivariable logistic and linear regression models, adjusting for potential confounding factors, will explore changes in knee joint structural features and symptoms, and the influence of potential modifiers and mediators. Approved by the La Trobe University Ethics Committee (HEC-19524). Findings will be disseminated to stakeholders, peer-review journals and conferences.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.MSKSP.2018.06.008
Abstract: Early quadriceps muscle strength assessment after a total knee arthroplasty (TKA) provides timely information on progress, but little is known about the pain profile and predictive validity associated with common clinical muscle strength tests. This study aimed to, in patients with a recent TKA, examine the associations of isometric and isotonic quadriceps strength with gait speed, accounting for knee pain experienced during testing. A s le of 76 patients (mean age 68 years 46 women) with a recent TKA (median, 1.5 months) participated. Quadriceps strength was measured on both limbs using a knee extension machine. Isotonic strength was assessed with a one-repetition maximum test. Isometric strength was measured at 40° and 70° of knee flexion using a custom-built load cell. To allow for valid comparisons between the tests, quadriceps strength symmetry ratios were calculated. Knee pain during testing was measured using an 11-point pain scale. Fast gait speed was measured using the 10-m walk test. Compared with isotonic test, quadriceps strength ratio was higher for the 40° flexion isometric test (P = 0.01), and this difference may be explained by the lower knee pain intensity elicited during the isometric tests (P's < 0.001). All strength measures were closely associated with fast gait speed after adjustment for knee pain and covariates (P's < 0.001). Early in the post-TKA period, isometric and isotonic strength tests may be used to assess quadriceps strength but these tests are not interchangeable. Isometric quadriceps testing may be preferable to isotonic testing as it was associated with lower knee pain intensity.
Publisher: MDPI AG
Date: 31-10-2023
DOI: 10.3390/S23218855
Publisher: BMJ
Date: 2021
DOI: 10.1136/BMJOPEN-2020-044491
Abstract: Children born moderate to late preterm (MLP, 32–36 weeks’ gestation) account for approximately 85% of all preterm births globally. Compared with children born at term, children born MLP are at increased risk of poor neurodevelopmental outcomes. Despite making up the largest group of preterm children, developmental outcomes of children born MLP are less well studied than in other preterm groups. This study aimed to (1) compare neurodevelopmental, respiratory health and brain magnetic resonance imaging (MRI) outcomes between children born MLP and term at 9 years of age (2) examine the differences in brain growth trajectory from infancy to 9 years between children born MLP and term and in children born MLP (3) examine the relationship between brain development and neurodevelopment at 9 years and (4) identify risk factors for poorer outcomes at 9 years. The ”LaPrem” ( La te Pre term M RI Study) study is a longitudinal cohort study of children born MLP and term controls, born at the Royal Women’s Hospital in Melbourne, Australia, between 2010 and 2013. Participants were recruited in the neonatal period and were previously followed up at 2 and 5 years. This 9-year school-age follow-up includes neuropsychology, motor and physical activities, and lung function assessments, as well as brain MRI. Outcomes at 9 years will be compared between birth groups using linear and logistic regressions. Trajectories of brain development will be compared between birth groups using mixed effects models. The relationships between MRI and neurodevelopmental outcomes, as well as other early predictors of poor 9-year outcomes, will be explored using linear and logistic regression. This study was approved by the human research ethics committee at the Royal Children’s Hospital, Melbourne, Australia. Study outcomes will be disseminated through peer-reviewed publications, conference presentations and social media.
Publisher: Springer Science and Business Media LLC
Date: 2015
Publisher: Elsevier BV
Date: 09-2020
Publisher: Elsevier BV
Date: 09-2023
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.JBIOMECH.2013.08.011
Abstract: Spatiotemporal characteristics of gait such as step time and length are often associated with overall physical function in clinical populations, but can be difficult, time consuming and obtrusive to measure. This study assessed the concurrent validity of overground walking spatiotemporal data recorded using a criterion reference - a marker-based three-dimensional motion analysis (3DMA) system - and a low-cost, markerless alternative, the automated skeleton tracking output from the Microsoft Kinect™ (Kinect). Twenty-one healthy adults performed normal walking trials while being monitored using both systems. The outcome measures of gait speed, step length and time, stride length and time and peak foot swing velocity were derived using supervised automated analysis. To assess the agreement between the Kinect and 3DMA devices, Bland-Altman 95% bias and limits of agreement, percentage error, relative agreement (Pearson's correlation coefficients: r) overall agreement (concordance correlation coefficients: rc) and landmark location linearity as a function of distance from the sensor were determined. Gait speed, step length and stride length from the two devices possessed excellent agreement (r and rc values >0.90). Foot swing velocity possessed excellent relative (r=0.93) but only modest overall (rc=0.54) agreement. Step time (r=0.82 and rc=0.23) and stride time (r=0.69 and rc=0.14) possessed excellent and modest relative agreement respectively but poor overall agreement. Landmark location linearity was excellent (R(2)=0.991). This widely available, low-cost and portable system could provide clinicians with significant advantages for assessing some spatiotemporal gait parameters. However, caution must be taken when choosing outcome variables as some commonly reported variables cannot be accurately measured.
Publisher: Medical Journals Sweden AB
Date: 2019
Abstract: To establish the variability of fast testing velocity and joint range of motion and position when assessing lower-limb spasticity in in iduals following neurological injury. Observational study of people with lower-limb spasticity. Patients with an upper motor neurone lesion (n = 35) and clinicians experienced in spasticity assessment (n = 34) were included. The Modified Tardieu scale (MTS) was completed on the quadriceps, hamstrings (2 positions), gastrocnemius and soleus for each participant's more affected lower limb by 3 assessors. Mean absolute differences (MADs) were used to calculate variability as a measure of reliability. Variability of peak testing velocity was greater at the ankle joint compared with the knee joint. The greatest MAD for V3 (fast) inter-rater testing velocity was 119°/s in the soleus, representing 29.4% of the mean variable value, and least for the quadriceps (64.3°/s 18.5%). Inter-rater variability was higher than intra-rater variability for all testing parameters. The MAD for joint end angle ranged from 2.6° to 10.7° and joint start angle from 1.2° to 14.4°. There was a large degree of inter- and intra-rater variability in V3 testing velocity when using the MTS to assess lower limb spasticity. The inter-rater variability was approximately double the intra-rater variability.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 28-10-2021
Publisher: BMJ
Date: 04-2021
DOI: 10.1136/BMJOPEN-2020-041742
Abstract: This double-blind, randomised controlled trial (RCT) aims to estimate the effect of a physiotherapist-led intervention with targeted strengthening compared with a physiotherapist-led intervention with standardised stretching, on hip-related quality of life (QOL) or perceived improvement at 6 months in people with femoroacetabular impingement (FAI) syndrome. We hypothesise that at 6 months, targeted strengthening physiotherapist-led treatment will be associated with greater improvements in hip-related QOL or greater patient-perceived global improvement when compared with standardised stretching physiotherapist-led treatment. We will recruit 164 participants with FAI syndrome who will be randomised into one of the two intervention groups, both receiving one-on-one treatment with the physiotherapist over 6 months. The targeted strengthening physiotherapist-led treatment group will receive a personalised exercise therapy and education programme. The standardised stretching physiotherapist-led treatment group will receive standardised stretching and personalised education programme. Primary outcomes are change in hip-related QOL using International Hip Outcome Tool-33 and patient-perceived global improvement. Secondary outcomes include cost-effectiveness, muscle strength, range of motion, functional task performance, biomechanics, hip cartilage structure and physical activity levels. Statistical analyses will make comparisons between both treatment groups by intention to treat, with all randomised participants included in analyses, regardless of protocol adherence. Linear mixed models (with baseline value as a covariate and treatment condition as a fixed factor) will be used to evaluate the treatment effect and 95% CI at primary end-point (6 months). The study protocol was approved (La Trobe University Human Ethics Committee (HEC17-080)) and prospectively registered with the Australian New Zealand Clinical Trials Registry. The findings of this RCT will be disseminated through peer reviewed scientific journals and conferences. Patients were involved in study development and will receive a short summary following the completion of the RCT. ACTRN12617001350314
Publisher: Elsevier BV
Date: 2021
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.JSAMS.2018.07.005
Abstract: Accurately measuring speed and acceleration during walking, running and sprinting has important implications for rehabilitation, planning training and talent identification in sporting and clinical populations. Light detection and ranging laser technology provides a continuous stream of distance data. It has the potential to allow rapid and precise measurement and may be advantageous compared with discrete methods of assessment, such as stopwatches and timing gates, which may be inaccurate over short distances. Therefore, the aim of this study was to assess the validity of a novel, low-cost and easy to implement laser-based system during walking and running trials. Cross-sectional study. Thirty-two healthy adults performed walking and running trials from flying and static starts while monitored concurrently with reference standard three-dimensional motion analysis and laser systems. Velocity was calculated over short (0.5m) and longer (3m) intervals using both systems. Validity was assessed using absolute agreement intraclass correlation coefficients (ICC All intraclass correlation coefficients and correlations were excellent (ICC>0.88, R>0.89). For the longer interval, all mean absolute errors were <0.03m/s (0.24-1.31%). Slightly higher mean absolute error values were reported for the shorter interval (3.16-5.10%), with the highest error of 0.184m/s evident for the flying start running trial. These results indicate that a low-cost and accessible laser system can be used to accurately assess walking and running speed. To aid implementation and further research, freely available hardware design descriptions and downloadable software can be accessed at www.rehabtools.org/LIDAR.
Publisher: Human Kinetics
Date: 2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-08-2020
Start Date: 2014
End Date: 2014
Funder: Australian Catholic University
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