ORCID Profile
0000-0002-4204-0890
Current Organisations
Harbin Institute of Technology
,
Zenome.io ltd
,
Research Institute of Physical Chemical Medicine
,
University of Southampton
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Publisher: Mary Ann Liebert Inc
Date: 05-2014
Publisher: SAGE Publications
Date: 08-1992
DOI: 10.1177/026921559200600303
Abstract: Optimal rest intervals required between contractions and treatment sessions to allow recovery from fatigue after electrical stimulation of muscle are not known. In eight volunteers (aged 23-38 years), fatigue of the quadriceps was examined during and after three therapeutic stimulation protocols which were performed one week apart. Protocols consisted of 10 isometric contractions at 30% maximum voluntary force. The contractions lasted 10 seconds each, and were separated by rests of either 10, 50 or 120 seconds. Force responses to stimulation at 20 Hz and 50 Hz (for two seconds each) were used as a test to monitor recovery. All three therapeutic stimulation protocols caused significant fatigue during activity. The shorter the rest interval, the greater the fatigue and hence, less work (i.e. integrated force) completed. Recovery was also influenced by the rest intervals. One hour after activity, force at 20 Hz was approximately 50% of initial values (p 0.01), increasing to 70-80%at 24-hours, and to 90% at 48-hours. Force at 50 Hz was 68-80% after the first hour, had recovered 24-hours after the 10 second protocol but not the 50 and 120 second protocols, and full recovery had been reached by 48-hours. Persistence of both high and low frequency fatigue after these therapeutic protocols was greater than expected. Studies are required to determine whether stimulation of fatigued muscle produces therapeutic or adverse effects, and to establish the degree of recovery required for these effects.
Publisher: Elsevier BV
Date: 1992
Publisher: Oxford University Press (OUP)
Date: 05-2000
Abstract: In order to assess higher auditory processing capabilities, long-latency auditory evoked potentials (AEPs) were recorded to synthesized musical instrument tones in 22 post-comatose patients with severe brain injury causing variably attenuated behavioural responsiveness. On the basis of normative studies, three different types of spectro-temporal modulation were employed. When a continuous 'clarinet' tone changes pitch once every few seconds, N1/P2 potentials are evoked at latencies of approximately 90 and 180 ms, respectively. Their distribution in the fronto-central region is consistent with generators in the supratemporal cortex of both hemispheres. When the pitch is modulated at a much faster rate ( approximately 16 changes/s), responses to each change are virtually abolished but potentials with similar distribution are still elicited by changing the timbre (e.g. 'clarinet' to 'oboe') every few seconds. These responses appear to represent the cortical processes concerned with spectral pattern analysis and the grouping of frequency components to form sound 'objects'. Following a period of 16/s oscillation between two pitches, a more anteriorly distributed negativity is evoked on resumption of a steady pitch. Various lines of evidence suggest that this is probably equivalent to the 'mismatch negativity' (MMN), reflecting a pre-perceptual, memory-based process for detection of change in spectro-temporal sound patterns. This method requires no off-line subtraction of AEPs evoked by the onset of a tone, and the MMN is produced rapidly and robustly with considerably larger litude (usually >5 microV) than that to discontinuous pure tones. In the brain-injured patients, the presence of AEPs to two or more complex tone stimuli (in the combined assessment of two authors who were 'blind' to the clinical and behavioural data) was significantly associated with the demonstrable possession of discriminative hearing (the ability to respond differentially to verbal commands, in the assessment of a further author who was blind to the AEP findings). Behavioural and electrophysiological findings were in accordance in 18/22 patients, but no AEPs could be recorded in two patients who had clear behavioural evidence of discriminative hearing. The absence of long-latency AEPs should not, therefore, be considered indicative of complete functional deafness. Conversely, AEPs were substantially preserved in two patients without behavioural evidence of discriminative hearing. Although not necessarily indicative of conscious 'awareness', such AEP preservation might help to identify sentient patients who are prevented by severe motor disability from communicating their perception.
Publisher: Wiley
Date: 02-1995
DOI: 10.1111/J.1365-2842.1995.TB00246.X
Abstract: The present study was planned to determine the relationship between linear dimensions of human masseter muscle cross-section and cross-sectional area (CSA), and to assess symmetry between the two sides in normal young adults. Cross-sectional images of the masseter muscle were measured bilaterally by real-time ultrasound imaging in 39 healthy dentate subjects, 19 males and 20 females, aged 21-47. From stored images, CSA and two linear measurements of muscle cross-section were obtained (the shortest and the longest distance through the muscle group). Correlation and regression analyses were performed to examine the relationship between CSA and the linear dimensions (both in idually and with the linear dimensions multiplied). Symmetry of CSA between the two sides of the face was examined using the paired t-test. The significance of correlation coefficients (r) and the difference between the slopes of the regression lines were also examined. Masseter CSA was larger in males than in females. All correlation values between CSA and linear measurements were significant but muscle CSA was most accurately predicted when the linear measurements were multiplied (r = 0.97 P < 0.001). Although the correlation in this regard was high, the linear dimensions consistently overestimated the actual CSA by approximately 25%. Males showed more symmetry of CSA than females. The range of values for symmetry of masseter CSA was too large to assess abnormal asymmetry in patients with unilateral symptoms.
Publisher: MDPI AG
Date: 10-07-2019
DOI: 10.3390/MPS2030058
Abstract: The aim of the present study was to determine the validity of ultrasound (US) imaging versus magnetic resonance imaging (MRI) for measuring anterior thigh muscle, subcutaneous adipose tissue (SAT), and fascia thickness. Twenty healthy, moderately active participants (aged 49.1 ± 9.74 [36–64] years), underwent imaging of the anterior thigh, using ultrasound and MRI modalities on the same day. Images were analyzed offline to assess the level of agreement between US and MRI measurements. Pearson’s correlation coefficient showed an excellent relationship between US imaging and MRI for measuring muscle (r = 0.99, p 0.01), SAT (r = 0.99, p 0.01), and non-contractile tissue (SAT combined with perimuscular fascia) thickness (r = 0.99, p 0.01). Perimuscular fascia thickness measurement showed a poor correlation between modalities (r = 0.39, p 0.01). Intra-class correlation coefficients (ICC3,1) also showed excellent correlation of the measurements with ICC = 0.99 for muscle thickness, SAT, and non-contractile tissue, but not for perimuscular fascia, which showed poor agreement ICC = 0.36. Bland and Altman plots demonstrated excellent agreement between US imaging and MRI measurements. Criterion validity was demonstrated for US imaging against MRI, for measuring thickness of muscle and SAT, but not perimuscular fascia alone on the anterior thigh. The US imaging technique is therefore applicable for research and clinical purposes for muscle and SAT.
Publisher: Wiley
Date: 04-1985
DOI: 10.1111/J.1475-097X.1985.TB00590.X
Abstract: The mean isometric strength of the stronger quadriceps muscles of 12 healthy men in their seventies was 39% less than that of 12 healthy men in their twenties (P less than 0.001). The cross-sectional area of the quadriceps was measured at mid-thigh, by ultrasound scanning the older men's stronger quadriceps were 25% smaller (P less than 0.001). The ratio of the stronger quadriceps' strength to its cross-sectional area was very similar in the old men to values obtained previously for both old and young women, but averaged 19% less than in the young men (P less than 0.02). Quadriceps size and strength were correlated in the old men (r = 0.77, P = 0.03) but not in the young men (r = 0.15). The principal axis of the relationship between quadriceps size and strength in the old men was very similar to those previously reported for both old and young women. The quadriceps strength of some young men is greater than would be expected from the size of the muscle.
Publisher: Wiley
Date: 31-08-2010
Publisher: SAGE Publications
Date: 02-2003
DOI: 10.1191/0269215503CR582OA
Abstract: Objective: To investigate whether behavioural, motor and physiological responses of in iduals with Huntington's disease (HD) to a controlled multisensory environment (MSE) are effective as a therapeutic (sustained effects) or leisure (immediate effects) activity. Design: Pilot study – a randomized, controlled, two-group design. Setting: Specialist residential unit for people with mid-late stage HD. Subjects: Twelve patients with HD (one subject from each group dropped out during the study after week 8 due to medical complications). Interventions: Patients attended eight, 30-minute sessions over a four-week period, of multisensory stimulation (MSE, treatment group) or relaxation activities (control group). Main outcome measures: Between-group comparisons for changes between assessment sessions for two behavioural assessments: Rehabilitation Evaluation – Hall and Baker (REHAB), Behaviour and Mood Disturbance Scale (BMD) a motor assessment: the dyskinesia section of the St Hans Rating Scale (SHRS) physiological measures: blood pressure, heart rate and respiratory rate. Secondary measures during intervention sessions included behavioural assessment using the Interact. Results: There were no significant differences found between the groups for any main outcome measures made between sessions. The MSE group showed some positive effects within-sessions, with the Interact showing significant between-group differences in immediate effects on mood ( p = 0.028). There was also a significantly different change over time for within-session changes in stimulation levels ( p = 0.0002) and mood ( p = 0.0001) between the groups. No physiological effects were observed in relation to sessions in either group. Two MSE subjects underwent changes in medication during the study period.
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.ARCHGER.2015.09.011
Abstract: Age and gender effects on muscle tone and mechanical properties have not been studied using hand-held myometric technology. Monitoring changes in muscle properties with ageing in community settings may provide a valuable assessment tool for detecting those at risk of premature decline and sarcopenia. This study aimed to provide objective data on the effects of ageing and gender on muscle tone and mechanical properties of quadriceps (rectus femoris) and biceps brachii muscles. In a comparative study of 123 healthy males and females (aged 18-90 years n=61 aged 18-35 n=62 aged 65-90) muscle tone, elasticity and stiffness were measured using the MyotonPRO device. Stiffness was greater and elasticity lower in older adults for BB and RF (p<0.001). Tone was significantly greater in older adults for BB but not for RF when data for males and females were combined (p=0.28). There were no gender differences for BB in either age group. In RF, males had greater stiffness (young males 292 vs females 233 N/m older males 328 vs females 311 N/m) and tone (young 16.4 vs 13.6 Hz older 16.7 vs 14.9 Hz). Elasticity in RF was lower in young males than females but did not differ between the older groups (both males and females log decrement 1.6). Stiffness and tone increased with ageing and elasticity decreased. These findings have implications for detecting frailty using a novel biomarker. Age and gender differences are important to consider when assessing effects of pathological conditions on muscle properties in older people.
Publisher: World Scientific Pub Co Pte Lt
Date: 06-2018
DOI: 10.1142/S0218957718500100
Abstract: Purpose: This study aimed to systematically examine the influence of various muscle and experimental conditions on Myoton recordings. Methods: A cross-sectional, observational design was used to examine muscle conditions and experimental factors (different recording sites, muscle length, level of contraction and prior physical activity) that may influence reproducibility of Myoton recordings for biceps brachii (BB) and rectus femoris (RF). Fifty-three healthy adults (26 young, 27 older) aged 18–90 years were studied. Muscle stiffness, tone and elasticity were measured using the MyotonPRO device. Results: Statistically significant differences in Myoton parameters were found for aspects of all four muscle and experimental conditions compared with the control condition ([Formula: see text]). However, clinically relevant differences in tone, stiffness and elasticity were only found for contracted compared to resting muscle, with changes being greater than the minimal detectable change. Elasticity was not affected by prior activity. Conclusions: The conditions studied significantly altered Myoton parameters of BB and RF in healthy adults, but only changes in parameters during muscle contraction were clinically relevant. These findings provide evidence to support the need to consider muscle condition and experimental factors for improving the robustness of test protocols for assessing muscle mechanical properties using the MyotonPRO device.
Publisher: Springer Science and Business Media LLC
Date: 1992
DOI: 10.1007/BF00705086
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.MATH.2011.08.005
Abstract: This study aimed to design and pilot a questionnaire to survey the use of ultrasound imaging (USI) by physiotherapists in the United Kingdom (UK), the type and content of ultrasound training physiotherapists using USI had undertaken and their perceived future training needs. The use of USI by physiotherapists is becoming increasingly common but is highly operator dependent and there are safety and professional issues regarding use in physiotherapy practice. Currently there are no specific training guidelines relating to physiotherapists using USI. A questionnaire was developed, based on research literature and guidelines. Twelve experts in USI commented on the content and design. The electronic on-line questionnaire was piloted on groups that were likely to be users of USI. Forty-six respondents completed the questionnaire. Results indicated that USI is used predominantly for biofeedback and there are many unmet training needs. Respondents reported a mismatch between techniques for which they had received training and those that they used in practice and indicated a more structured training framework is required. The development and piloting of the questionnaire provides a starting point for a more extensive evaluation of how USI is being used, the training needs of physiotherapists and benefits as a biofeedback tool. Refinement is needed and replication in a larger s le. Results could assist the development of a structured formal training framework encompassing key skills.
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.MATH.2011.11.003
Abstract: The utility of rehabilitative ultrasound imaging (RUSI) for assessing trapezius muscle contractile characteristics was investigated by examining whether muscle thickness changes during contraction (CT) differed between people with and without mild shoulder pain. In 18 subjects with mild shoulder pain (aged 28±8 years) and 18 matched controls, trapezius muscle thickness change was measured in prone at rest at 0° and during isometric CTs at 90° and 120° of shoulder abduction. Images were taken at four sites using a real-time ultrasound scanner (7-MHz linear transducer, 40 mm footprint). Percentage change in muscle thickness from rest was calculated. Differences between painful and non-painful shoulders and participant groups were examined by analysis of variance (ANOVA) and t-tests. There were no significant differences between groups or sides in trapezius muscle thickness change during CT. There was no significant difference in trapezius muscle resting thickness (RT) between painful and non-painful shoulders in the same subjects. Contractile ability of the trapezius muscle, assessed using RUSI was not impaired in subjects with mild shoulder pain during the test manoeuvres used. Further research is warranted involving patients with different severity of symptoms, using other test manoeuvres before RUSI can be advocated for assessing scapular muscle dysfunction.
Publisher: Wiley
Date: 03-1993
Abstract: The frequency of the acoustic myographic (AMG) signal was examined during fresh and fatigued isometric contractions of quadriceps and during dynamic contractions of biceps brachii (BB) in healthy subjects. Recordings were obtained from quadriceps over a range of forces between 10% and 100% maximal voluntary contraction prior to, and 15 minutes after, a fatiguing exercise. Recordings from BB were obtained over a range of submaximal forces (0-8.5 kg) during concentric and eccentric contractions. The mean power frequency (MPF) of the AMG signal was analyzed during each of these contractions by fast-Fourier transform (FFT). The MPF was not significantly different (P > 0.05) during fresh and fatigued contractions of quadriceps and increased quadratically with force in both states (r = 0.81, fresh r = 0.77, fatigued). During concentric contractions of BB the MPF initially increased with force, but then decreased at the heavier loads (> 5.5 kg). The MPF of eccentric contractions did not significantly (P > 0.05) alter with force. The AMG MPF was within a similar low frequency range for both muscles, during different types of contraction, and was unaltered with fatigue.
Publisher: BMJ
Date: 12-2016
Publisher: Public Library of Science (PLoS)
Date: 29-01-2016
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.MSKSP.2017.11.010
Abstract: Cross-sectional repeated measures. To quantify the effects of posture and measurement site on the inter-recti distance (IRD) and investigate the reliability of IRD measurement using ultrasound imaging in different postures. The linea alba connects the rectus abdominis muscles anteriorly and the width is known as the IRD. The IRD is usually measured in crook-lying and is the primary outcome measure to assess for a arication of recti abdominis (DRA). The effects of posture and measurement site on the IRD have not been investigated. Ultrasound imaging was used to measure IRD in 41 women ≥8 weeks postpartum. The IRD was measured at three sites (superior-umbilicus, umbilicus and inferior-umbilicus), in three postures (crook-lying, sitting and standing), and repeated one-week later. The effects of posture and site were investigated using one-way ANOVAs. Reliability was analysed using Intraclass correlation coefficients (ICCs), Bland Altman analyses, standard error of measurement and minimal detectable change. The IRD was wider when standing vs. lying at both the superior-umbilicus and umbilicus by 0.30 cm (95% CI 0.21 to 0.39) and 0.20 cm (0.11-0.30) respectively (p < 0.001). Measurements at the inferior-umbilicus were, on average, 1.6 and 2.1 cm narrower than superior-umbilicus and umbilicus sites, respectively (p < 0.001). There was high intra-rater reliability within-session (ICC The IRD can be measured reliably at all sites and postures. The IRD is wider at superior-umbilicus and umbilicus when upright compared with lying. There is a difference in IRD between all sites measured.
Publisher: Elsevier BV
Date: 06-2010
Publisher: Portland Press Ltd.
Date: 11-1984
DOI: 10.1042/CS0670505
Abstract: 1. A patient with familial adult-onset hypophosphataemia, whose myopathy was closely related to the plasma phosphate concentration, was investigated by phosphorus nuclear magnetic resonance spectroscopy (31P n.m.r.) in vivo of the right flexor digitorum superficialis muscle. 2. During hypophosphataemia induced by stopping oral phosphate a significant reduction in measured muscle strength occurred, but the ratios of the intramyocellular levels of phosphocreatine (PCr), adenosine triphosphate (ATP) and inorganic phosphate (Pi) remained unchanged at rest. During exercise these levels changed, as did the intramyocellular pH, but they did not differ from the pattern previously recorded in normal subjects. 3. In four adults with inherited infantile-onset hypophosphataemia (vitamin D-resistant rickets, VDRR) without myopathy, the n.m.r. measurements were normal at rest and during exercise. 4. In one patient with inherited hyperphosphataemia (tumoral calcinosis) the resting PCr: Pi ratio was significantly reduced.
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.ULTRASMEDBIO.2010.04.020
Abstract: Clinical use of ultrasound imaging by physiotherapists is increasing however, the clinical setting may be problematic due to variability inherent in the environment. As transducer motion interferes with accurate measurement, this study aimed to measure handheld transducer motion, relative to the pelvis, during a clinical simulation involving typical maneuvers employed in a physiotherapy assessment of the lumbopelvic region. Transducer motion about three axes and through one plane was measured (Vicon, Oxford, UK) on 12 participants during three clinical maneuvers at four abdominal imaging sites. Data were grouped and means used to determine discrepancies in transducer and pelvic motion for each imaging site/maneuver combination. None of the conditions produced large transducer motions relative to the pelvis and all findings were within previously established guidelines for acceptable amounts of transducer motion. These findings suggest that an ultrasound transducer can be held relatively stationary in a clinical setting, for the maneuvers tested.
Publisher: Elsevier BV
Date: 04-1999
DOI: 10.1016/S0022-510X(99)00065-9
Abstract: We have assessed corticospinal function in 19 post-coma patients severely brain-injured by anoxia or physical trauma. Eleven patients were unresponsive (Category 1) and eight demonstrated minimal, non-verbal responses to simple commands (Category 2). Motor evoked potentials (MEPs) could be elicited in hand and leg muscles in nine Category 1 and all eight Category 2 patients in response to transcranial magnetic stimulation (TMS). In comparison with normal subjects, threshold to TMS was significantly elevated in Category 1 but not in Category 2. Central conduction times were within the normal range except for two patients (one in each category) in whom they were prolonged. The variability in MEP litude to constant TMS was not significantly different from normal in either category. The size of MEPs recorded simultaneously in different hand muscles were correlated in all three groups. The presence of H-reflexes in hand muscles was associated with an absence of MEPs or a high threshold to TMS. Variability of MEPs was substantially greater than that of H-reflexes. We conclude that brain injury of a severity that may preclude consciousness and voluntary movement does not invariably predicate a non-functional motor cortex and corticospinal system.
Publisher: Elsevier BV
Date: 04-2003
DOI: 10.1016/S0278-2626(03)00036-8
Abstract: Brain-computer interface (BCI) technology relies on the ability of in iduals to voluntarily and reliably produce changes in their electroencephalographic (EEG) activity. The present paper reviews research on cognitive tasks and other methods of generating and controlling specific changes in EEG activity that can be used to drive BCI systems. To date, motor imagery has been the most commonly used task. This paper explores the possibility that other cognitive tasks, including those used in imaging studies, may prove to be more effective. Other factors which influence performance are also considered in relation to selection of tasks, as well as training of subjects.
Publisher: Elsevier
Date: 2004
Publisher: MDPI AG
Date: 25-03-2021
DOI: 10.3390/JCM10071352
Abstract: A novel approach to ageing studies assessed the discriminatory ability of a combination of routine physical function tests and novel measures, notably muscle mechanical properties and thigh composition (ultrasound imaging) to classify healthy in iduals according to age and gender. The cross-sectional study included 138 community-dwelling, self-reported healthy males and females (65 young, mean age ± SD = 25.7 ± 4.8 years 73 older, 74.9 ± 5.9 years). Handgrip strength quadriceps strength respiratory peak flow timed up and go stair climbing time anterior thigh tissue thickness muscle stiffness, tone, elasticity (Myoton technology), and self-reported health related quality of life (SF36) were assessed. Stepwise feature selection using cross-validation with linear discriminant analysis was used to classify cases based on criterion variable derived from known effects of age on physical function. A model was trained and features selected using 126 cases with 0.92 accuracy (95% CI = 0.86–0.96 Kappa = 0.89). The final model included five features (peak flow, timed up and go, biceps brachii elasticity, anterior thigh muscle thickness, and percentage thigh muscle) with high sensitivity (0.82–0.96) and specificity (0.94–0.99). The most sensitive novel biomarkers require no volition, highlighting potentially useful tests for screening and monitoring effects of interventions on musculoskeletal health for vulnerable older people with pain or cognitive impairment.
Publisher: SAGE Publications
Date: 12-2003
DOI: 10.1191/0269215503CR691OA
Abstract: Objective: To investigate the effects of tilt table incline and knee flexion angle on the degree of weight bearing and forces exerted across the supporting straps. Design: A quantitative and exploratory study to investigate the effects of a mechanical procedure. Setting: Physiotherapy gymnasium. Subjects: Twelve healthy subjects (9 female, 3 male) aged 22–45 years. Interventions: Subjects stood on a tilt table, on two occasions, with simulated contractures of 10° and 40° knee flexion. Nine tilt angles, between 10° and 90°, were maintained for 1 minute each in random order. Main outcome measures: Force was recorded from single-point load cells placed under the feet, and at knee and chest straps. Results: The degree of simulated knee contracture (10° or 40°) influenced the distribution of forces at different recording sites. Weight bearing increased with table incline and was significantly less with the 40° than the 10° knee angle ( p 0.001). Conversely, forces across the knee straps were systemically higher with the 40° knee angle ( p 0.0001). The effects were accentuated by greater body weight. Forces across the chest strap also increased with tilt and were significantly larger with the 40° knee angle ( p 0.05). Conclusions: The relationships between table incline, angle of knee flexion and distribution of forces generated during tilt table standing have been quantified and described. Standing with flexed knees involved less weight bearing under the feet and greater force exerted across the supporting straps. These effects were more pronounced at the higher knee angle and with greater body weight, and could be modified by reducing table incline.
Publisher: Springer Science and Business Media LLC
Date: 03-04-2019
DOI: 10.1038/S41598-019-41860-4
Abstract: Electromyography (EMG) is the standard technology for monitoring muscle activity in laboratory environments, either using surface electrodes or fine wire electrodes inserted into the muscle. Due to limitations such as cost, complexity, and technical factors, including skin impedance with surface EMG and the invasive nature of fine wire electrodes, EMG is impractical for use outside of a laboratory environment. Mechanomyography (MMG) is an alternative to EMG, which shows promise in pervasive applications. The present study used an exerting squat-based task to induce muscle fatigue. MMG and EMG litude and frequency were compared before, during, and after the squatting task. Combining MMG with inertial measurement unit (IMU) data enabled segmentation of muscle activity at specific points: entering, holding, and exiting the squat. Results show MMG measures of muscle activity were similar to EMG in timing, duration, and magnitude during the fatigue task. The size, cost, unobtrusive nature, and usability of the MMG/IMU technology used, paired with the similar results compared to EMG, suggest that such a system could be suitable in uncontrolled natural environments such as within the home.
Publisher: BMJ
Date: 12-2019
DOI: 10.1136/BMJOPEN-2019-035210
Abstract: Technology has been placed at the centre of global health policy and has been cited as having the potential to increase efficiency and remove geographical boundaries for patients to access care. Communication technology may support patients with orthopaedic problems, which is one of the leading causes of disability worldwide. There are several ex les of technology being used in clinical research, although uptake in practice remains low. An understanding of patient preferences will support the design of a communication technology supported treatment pathway for patients undergoing orthopaedic rehabilitation. This mixed methods project will be conducted in four phases. In phase I, a systematic review of qualitative studies reporting communication technology use for orthopaedic rehabilitation will be conducted to devise a taxonomy of tasks patients’ face when using these technologies to access their care. In phase II, qualitative interviews will investigate how the work of being a patient changes during face-to-face and communication technology consultations and how these changes influence preference. In phase III, a discrete choice experiment will investigate the factors that influence preferences for the use of communication technology for orthopaedic rehabilitation consultations. Phase IV will be a practical application of these results. We will design a ‘minimally disruptive’ communication technology supported pathway for patients undergoing orthopaedic rehabilitation. The design of a pathway and underpinning patient preference will assist in understanding factors that might influence technology implementation for clinical care. This study requires ethical approval for phases II, III and IV. Approvals have been received for phase II (approval received on 4 December 2016 from the South Central-Oxford C Research Ethics Committee (IRAS ID: 255172, REC Reference 18/SC/0663)) and phase III (approval received on 18 October 2019 from the London-H stead Research Ethics Committee (IRAS ID: 248064, REC Reference 19/LO/1586)) and will be sought for phase IV. All participants will provide informed written consent prior to being enrolled onto the study. CRD42018100896.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2019
DOI: 10.11124/JBISRIR-2017-003806
Abstract: The review questions for this scoping review are:
Publisher: Human Kinetics
Date: 04-2023
Abstract: Inactive older adults tend to have decreased strength and balance compared with their more active peers. Playing golf has the potential to improve strength and balance in older adults. The aim of the study was to compare the strength and balance of recreational golfers with non-golfers, aged 65–79 years. Grip strength, single leg balance, and Y Balance Test (YBT) were assessed. Golfers ( n = 57) had significantly (right, p = .042 left, p = .047) higher maximal grip strength, than non-golfers ( n = 17). Single leg stance times were significantly longer in golfers (right, p = .021 left, p = .001). Normalized YBT reach distances were significantly greater for golfers than non-golfers for composite, posteromedial, and posterolateral directions on both right and left legs. Playing golf appears to be associated with better grip and both static and dynamic balance in 65–79 year olds, indicating that a study of the effects of playing golf is warranted through a larger, fully powered, longitudinal study.
Publisher: Elsevier
Date: 2004
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.HUMOV.2011.07.004
Abstract: The aim of the present study was to examine the acromion marker cluster (AMC) method of measuring scapular kinematics during the arm lowering, eccentric, phase. Twenty six participants completed arm elevation and lowering in the sagittal, frontal and scapular plane. The participants held their arm at 30° increments while the orientation of the scapula was recorded using an AMC and a scapular locator (SL). There were no significant differences between the AMC and SL during the lowering phase for sagittal and scapular plane arm movements. The AMC significantly underestimated upward rotation (max RMSE = 6.0°), and significantly overestimated posterior tilt (max RMSE = 7.2°) during arm lowering in the frontal plane. The reported root mean square errors, however, were within the ranges observed during the elevation phase and reported in previous literature. The AMC therefore provides a reasonable description of scapular kinematics during the arm lowering phase.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 07-2013
Abstract: Validation study. To investigate the association between changes in electromyographic (EMG) signal litude and sonographic measures of muscle thickness of 4 abdominal muscles, during 2 clinical tests, in adults with and without lumbopelvic pain. There is a trend in rehabilitation to use ultrasound imaging (USI) to determine the extent of abdominal muscle contraction. However, the literature investigating the relationship between abdominal muscle thickness change and level of activation is inconclusive and has not included clinically relevant tasks. Simultaneous recording from fine-wire EMG and USI was performed for 4 abdominal muscles, in 7 adults with lumbopelvic pain (mean ± SD age, 29.7 ± 12.0 years) and 7 adults without lumbopelvic pain (32.0 ± 10.6 years), during an active straight leg raise (ASLR) test and an abdominal drawing-in maneuver (ADIM). Cross-correlation functions and linear regression analyses were used to describe the relationship between the 2 measures. Analyses of variance were used to compare in iduals with and without lumbopelvic pain, with an alpha set at .05. Across all muscles, peak cross-correlation values were low (ASLR, r = 0.28 ± 0.09 ADIM, r = 0.35 ± 0.11), and there was large variability in associated time lags (ASLR, τ = 0.69 ± 2.56 seconds ADIM, τ = 0.53 ± 3.75 seconds). Regression analyses did not detect a systematic pattern of association between EMG signal litude and USI measurements, and analyses of variance revealed no differences between cohorts. These results suggest a weak relationship between EMG litude and abdominal muscle thickness change measured with USI during the ADIM and ASLR, and raise questions about thickness change derived from USI as a measure of muscular activity for the abdominal musculature.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 03-2004
Publisher: Elsevier
Date: 2009
Publisher: Elsevier BV
Date: 09-1995
Publisher: American Physiological Society
Date: 05-1992
DOI: 10.1152/JAPPL.1992.72.5.1908
Abstract: The relationships between force, electromyography (EMG), and muscle sounds recorded by acoustic myography (AMG) were investigated for both voluntary and stimulated isometric contractions in the adductor pollicis muscle. Voluntary activity was performed at 10, 25, 50, 75, 85, and 100% of maximal voluntary contraction (MVC) force. Stimulated contractions were produced by supramaximal electrical stimulation of the ulnar nerve at the wrist at frequencies of 10, 20, 30, 50, 70, and 100 Hz. Contractions lasted for 4 s each, and were performed in random order with a 3-min rest between each. The voluntary and stimulation studies were performed in random order between subjects. Simultaneous recordings were obtained for force, force oscillation (from the differentiated force signal), and raw and integrated AMG (IAMG) and EMG (IEMG). During voluntary contractions, IAMG increased with force up to MVC (r2 = 0.99, P less than 0.001) in a curvilinear fashion and a similar relationship was seen between force and IEMG (r2 = 0.99, P less than 0.001). Conversely, during stimulated contractions as stimulation frequency increased, IAMG decreased in a fashion mirroring the frequency-force curve. The frequency of the AMG signal matched stimulation frequency and declines in total IAMG were due to reductions in litude of the AMG signal. The stimulation frequency-oscillation of force relationship was identical to that seen for stimulation frequency and IAMG. Integrated EMG increased linearly with stimulation frequency (r = 0.99). The stimulation results suggest that muscle sounds reflect oscillation of muscle fibers and that AMG signal characteristics are determined by motor control mechanisms rather than intrinsic contractile processes.
Publisher: Informa UK Limited
Date: 2008
DOI: 10.1080/03091900701695533
Abstract: The aim of the study was to determine whether different ultrasound probe/transducer configurations produce the same measurements. Two investigators undertook 10 scans of a general purpose semi-solid multi-tissue ultrasound phantom (phantom A) using two ultrasound scanners with a linear and curvilinear probe. From those 10 scans, two measurements of cross-sectional area (CSA), width and thickness were made. These measurements were then repeated with an open-top fluid-filled phantom, with 10% ethanol solution (phantom B). Intra- and inter-rater reliability were examined using Bland and Altman plots. Agreement between measurements made with the two probe types was also assessed using Bland and Altman plots. An independent s les t-test was used to compare statistical differences between probe type configuration. There was a significant difference (p < 0.05) and a tendency for increased measurements in CSA and width, and decreased measurements in thickness when using a curvilinear probe on phantom A, and these differences were not scanner specific. When imaging phantom B there were no significant differences in measurements between probe configurations however there was a small bias for smaller CSA measurements with a curvilinear probe. In conclusion there are small differences in measurements obtained from different ultrasound probe configurations using a semi-solid phantom, but their clinical significance is unknown.
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.MEHY.2018.08.027
Abstract: Hip and groin pain is common in footballers and altering movement patterns can reduce symptoms. Observational tests of movement control are thought to identify abnormal movement patterns, but their accuracy needs yet to be confirmed by comparison with an objective measure. To assess the accuracy, using 3D motion analysis, of observational movement control tests and their ability to detect changes, and document changes in symptoms following a neuromuscular control exercise programme in an ex-footballer with hip and groin pain. A 25-year-old male with chronic bilateral hip and groin pain had their movement control ability rated and kinematic data collected using 3D motion analysis while performing Small Knee Bend (SKB) and SKB with Rotation (SKB Rot) tests pre-and post-neuromuscular control exercise training. Movement control was rated as at fault if they were unable to control specific trunk and pelvic movements during the tests. The Copenhagen Hip and Groin Outcome Score (HAGOS) was used to assess symptoms. Following the intervention, observational rating during the SKB test improved from fault to no fault for anterior pelvic tilt, which decreased by 17° and 16° during right and left leg SKB tests respectively. The HAGOS symptoms subsection improved from 36% to 61%. Observational movement screening ratings were supported by 3-D motion analysis. These findings indicate that the screening tool was accurate for detecting improvements in trunk and pelvic movement control following an exercise programme in an ex-footballer who had presented with hip and groin pain.
Publisher: Public Library of Science (PLoS)
Date: 24-09-2019
Publisher: Wiley
Date: 09-1990
DOI: 10.1111/J.1475-097X.1990.TB00828.X
Abstract: (1) The spinal reflex actions of afferents stimulated by knee joint distension have been investigated in man. (2) Cannulation of the knee and infusion of saline raised intra-articular pressure, especially during quadriceps contraction. High pressures did not induce any sensation of pain. Pressure was taken as an index of joint proprioceptor activation. (3) Increased pressure progressively depressed the quadriceps H-reflex, both at rest and during quadriceps contraction. There was no indication of a threshold pressure for this inhibitory action. (4) It is concluded that joint distension inhibits quadriceps motoneurons through spinal pathways that still operate during voluntary contraction. These pathways could thus contribute to pathological weakness after joint injury. (5) Joint distension produced spatial facilitation of non-reciprocal inhibition of quadriceps H-reflexes from afferents in the tibial nerve.
Publisher: IOP Publishing
Date: 28-03-2019
Publisher: BMJ
Date: 02-2021
DOI: 10.1136/BMJOPEN-2020-041038
Abstract: To identify, characterise and explain factors that influence patient preferences, from the perspective of patients and clinicians, for virtual consultations in an orthopaedic rehabilitation setting. Qualitative study using semi-structured interviews and abductive analysis. A physiotherapy and occupational therapy department situated within a tertiary orthopaedic centre in the UK. Patients who were receiving orthopaedic rehabilitation for a musculoskeletal problem. Occupational therapists, physiotherapists or therapy technicians involved in the delivery of orthopaedic rehabilitation for patients with a musculoskeletal problem. Twenty-two patients and 22 healthcare professionals were interviewed. The average interview length was 48 minutes. Four major factors were found to influence preference: the situation of care (the ways that patients understand and explain their clinical status, their treatment requirements and the care pathway), the expectations of care (influenced by a patients desire for contact, psychological status, previous care and perceived requirements), the demands on the patient (due to each patients respective social situation and the consequences of choice) and the capacity to allocate resources to care (these include financial, infrastructural, social and healthcare resources). This study has identified key factors that appear to influence patient preference for virtual consultations in orthopaedic rehabilitation. A conceptual model of these factors, derived from empirical data, has been developed highlighting how they combine and compete. A series of questions, based on these factors, have been developed to support identification of preferences in a clinical setting.
Publisher: Hindawi Limited
Date: 23-10-2023
DOI: 10.1155/2023/6672951
Publisher: Informa UK Limited
Date: 1985
Publisher: BMJ
Date: 09-1988
Abstract: Contractile properties of adductor pollicis muscle were examined over a range of stimulation frequencies in patients with myotonic dystrophy and normal subjects. In patients, fresh muscle demonstrated impaired relaxation, weakness at all frequencies and selective loss of force and excitation at high frequencies. During stimulated "fatiguing" activity, patients showed improvements in force and relaxation which appeared to result from normalisation of membrane excitation. Normal twitch potentiation also occurred during activity suggesting intact excitation-contraction coupling. These electrophysiological findings help to characterise and explain the "warm up" effect described by patients.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 2013
Abstract: Cross-sectional, case-control study. To measure and compare the resting thickness of the 4 abdominal wall muscles, their associated perimuscular connective tissue (PMCT), and interrecti distance (IRD) in persons with and without lumbopelvic pain (LPP), using ultrasound imaging. The muscles and PMCT of the abdominal wall assist in controlling the spine. Functional deficits of the abdominal wall muscles have been detected in populations with LPP. Investigations of the abdominal wall in those with LPP are primarily concerned with muscle, most commonly the transversus abdominis (TrA) and internal oblique (IO). Because the abdominal wall functions as a unit, all 4 abdominal muscles and their associated connective tissues should be considered concurrently. B-mode ultrasound imaging was used to measure the resting thickness of the rectus abdominis (RA), external oblique, IO, and TrA muscles the PMCT planes and IRD in 50 male and female subjects, 25 with and 25 without LPP (mean ± SD age, 36.3 ± 9.4 and 46.6 ± 8.0 years, respectively). Univariate correlation analysis was used to identify covariates. Analyses of covariance (ANCOVAs) and the Kruskal-Wallis test (IRD) were used to compare cohorts (α = .05). The LPP cohort had less total abdominal muscle thickness (LPP mean ± SD, 18.9 ± 3.0 mm control, 20.3 ± 3.0 mm ANCOVA adjusted for body mass index, P = .03), thicker PMCT (LPP, 5.5 ± 0.2 mm control, 4.3 ± 0.2 mm ANCOVA adjusted for body mass index, P = .007), and wider IRD (LPP, 11.5 ± 2.0 mm control, 8.4 ± 1.8 mm Kruskal-Wallis, P = .005). Analysis of in idual muscle thickness revealed no difference in the external oblique, IO, and TrA, but a thinner RA in the LPP cohort (LPP mean ± SD, 7.8 ± 1.5 mm control, 9.1 ± 1.2 mm ANCOVA adjusted for body mass index, P<.001). To our knowledge, this is the first study to investigate the morphological characteristics of all 4 abdominal muscles and PMCT in in iduals with LPP. The results suggest that there may be altered loading of the PMCT and linea alba secondary to an altered motor control strategy involving a reduced contribution of the RA. Further, the change in RA and connective tissue morphology may be more evident than changes in external oblique, IO, and TrA thickness in persons with LPP. The causes and functional implications of these changes warrant further investigation, as does the role of the RA muscle in the development and persistence of LPP.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2003
Publisher: MyJove Corporation
Date: 10-02-2015
DOI: 10.3791/51717
Publisher: Elsevier BV
Date: 10-1989
DOI: 10.1016/0022-510X(89)90156-1
Abstract: Contractile properties of the adductor pollicis muscle were examined in 9 normal volunteers and 7 patients with histochemically proven myophosphorylase deficiency (McArdle's disease). Fatiguing contractions were produced by supramaximal stimulation of the ulnar nerve, delivered over a range of frequencies, to allow further examination of the mechanisms responsible for the premature fatigue in patients. The excessive reductions in force, demonstrated in patients at all frequencies, were not associated at high frequencies (50 and 100 Hz) with excessive declines in excitation (measured as compound muscle action potential). These results demonstrate that, in patients, myofibrillar activation failure occurs over and above that due to excitation failure. Abnormal slowing of relaxation mechanisms was also confirmed. These findings appear consistent with the hypothesis of inhibition of various ATPases by metabolic products. The observed, clear differences between normal subjects and myophosphorylase-deficient patients constitute the basis of an objective screening procedure for this and other glycolytic disorders.
Publisher: Informa UK Limited
Date: 1986
Publisher: Informa UK Limited
Date: 22-04-2015
DOI: 10.1080/10255842.2015.1034115
Abstract: The purpose of this study is to assess changes in subjective and objective function from pre- to post-knee arthroplasty (KA) using a combined classifier technique. Twenty healthy adults (50-80 years) and 31 KA patients (39-81 years) were studied (4 weeks pre- and 6 months post-KA). Questionnaire measures of subjective pain, joint stability, activity and function were collected. Objective functional assessment included goniometry, ultrasound imaging and 3-D motion analysis/inverse modelling of gait and sit-stand. An optimal set of variables were used to classify function using the Cardiff Dempster-Shafer theory (DST) method. Out of s le accuracy of the classifiers ranged between 90% and 94% for segregating healthy in iduals and pre-KA patients. Post-KA subjective function improved with 74% classified as healthy. However, there was minimal improvement in objective measures (23% classified as healthy). The novel use of Cardiff DST segregated KA patients from healthy in iduals and estimated changes in function from pre- to post-surgery. KA patients had improved pain and function post-operation but objective knee joint measures remained different to healthy in iduals.
Publisher: Springer Science and Business Media LLC
Date: 11-09-2013
Abstract: Grip strength is widely used for estimating whole body strength but there is a lack of information relating to grip endurance. Comparison between endurance of different muscle groups has received little attention. The main aim of the present study was to determine the endurance characteristics of hand grip and quadriceps muscles in healthy young adults and then to examine the association between fatigability of the two muscle groups. Twenty one healthy participants (8 males and 13 females) aged 18–35 years were studied. A maximal intermittent endurance test, consisting of 12 isometric contractions held for 3 seconds separated by 5 second rest periods, was utilised to measure muscle endurance. A Biodex isokinetic dynamometer and Jamar dynamometer were used to assess quadriceps and hand grip respectively. The mean of first (M 1 ) and last (M 2 ) three repetitions was calculated. Fatigue index values were calculated for both muscle groups by the 1st peak torque (PT) minus the last (12th) PT, ided by the 1st PT multiplied by 100. Quadriceps torque (M 1 :197.3 ± 65.2 Nm M 2 :163.1 ± 47.6 Nm) and grip strength (M 1 :33.6 ± 9.9 Kg M 2 :25.2 ± 8.1 Kg) both declined significantly during the 12 repetitions (p 0.05). Hand grip showed a significantly higher mean fatigue index of 30% compared to 18% in the quadriceps (p 0.05). Quadriceps showed better fatigability than hand grip. The findings therefore indicate caution against using grip endurance as a surrogate measure of quadriceps endurance. Further research is warranted to confirm observed differences between genders and to study endurance in different age groups.
Publisher: Wiley
Date: 10-01-2022
DOI: 10.1111/HEX.13425
Abstract: To investigate the experiences of patients, clinicians and managers during the accelerated implementation of virtual consultations (VCs) due to COVID‐19. To understand how patient preferences are constructed and organized. Semi‐structured interviews with patients, clinicians and managerial staff at a single specialist orthopaedic centre in the United Kingdom. The interview schedule and coding frame were based on Normalisation Process Theory. Interviews were conducted over the telephone or by video call. Abductive analysis of interview transcripts extended knowledge from previous research to identify, characterize and explain how patient preferences for VC were formed and arranged. Fifty‐five participants were included (20 patients, 20 clinicians, 15 managers). Key mechanisms that contribute to the formation of patient preferences were identified. These were: (a) context for the consultation (normative expectations, relational expectations, congruence and potential) (b) the available alternatives and the implementation process (coherence, cognitive participation, collective action and reflexive monitoring). Patient preferences are mediated by the clinician and organisational preferences through the influence of the consultation context, available alternatives and the implementation process. This study reports the cumulative analysis of five empirical studies investigating patient preferences for VC before and during the COVID‐19 pandemic as VC transitioned from an experimental clinic to a compulsory form of service delivery. This study has identified mechanisms that explain how preferences for VC come about and how these relate to organisational and clinician preferences. Since clinical pathways are shaped by interactions between patient, clinicians and organisational preferences, future service design must strike a balance between patient preferences and the preferences of clinicians and organisations. The CONNECT Project Patient and Public Involvement (PPI) group provided guidance on the conduct and design of the research. This took place with remote meetings between the lead researcher and the chair of the PPI group during March and April 2020. Patient information documentation and the interview schedule were developed with the PPI group to ensure that these were accessible.
Publisher: Wiley
Date: 07-2012
DOI: 10.7863/JUM.2012.31.7.1099
Abstract: The purpose of this study was to establish reference values for abdominal and lumbar multifidus muscles at rest and while contracted in a s le of active healthy adults. Three hundred forty participants (mean age ± SD, 21.8 ± 3.9 years 96 females and 244 males) completed the study. Ultrasound imaging was used to assess the thickness of the transversus abdominis, internal and external oblique, rectus abdominis, and lumbar multifidus muscles. Additionally, the cross-sectional area of the rectus abdominis was assessed. Although males had significantly thicker muscles than females (P < .05), the relative change in thickness during specified tasks was equivalent. Overall, relative muscle thickness and symmetry were similar to previous studies using smaller s le sizes. These findings provide a robust data set of muscle thickness values measured by ultrasound imaging and can be used for comparison to those with pain, abnormal function, and pathologic conditions.
Publisher: Elsevier BV
Date: 09-1984
Publisher: BMJ
Date: 02-2016
Publisher: SAGE Publications
Date: 08-2000
DOI: 10.1191/0269215500CR328OA
Abstract: Objective: To investigate the reliability of repeated measurements of normal physiological tremor made with a multidimensional measurement system. Equipment: Measurements of postural upper limb tremor at the hand were made in 10 normal subjects using a 3Space Fastrak ® (Polhemus, Inc.) which detects movement over six degrees-of-freedom (three of the measurement directions were examined). Data collection: Reliability was assessed for two alternative upper limb postures (arm straight or bent) and data were collected on two days, twice at each session, to determine the repeatability between and within recording sessions. Data analysis: The data were split into segments and subjected to autoregressive (AR) modelling. Three parameters (one for each of the measurement directions examined) were extracted from the models and used as variables for the reliability analysis. Statistical tests: Variation within and between sessions was assessed by finding the median differences between efforts and days for each subject and then finding the overall median value and the corresponding 97.9% confidence intervals for each movement. This produced estimates of the population median value and indicated the precision of the estimates. Results: All the confidence intervals encompassed the zero median difference point indicating that, in the population, this technique would produce repeatable results. For between-efforts comparisons there was some evidence that data collected for the bent arm posture were more repeatable than for a straight arm. Conclusion: Normal physiological tremor can be measured reliably, within and between sessions, using the 3Space Fastrak system.
Publisher: Elsevier BV
Date: 02-2011
DOI: 10.1016/J.GAITPOST.2010.11.018
Abstract: Knowledge of joint forces and moments is essential for comparisons between healthy people and those with pathological conditions, with observed changes at joints providing basis for a particular intervention. Currently the literature analysing both kinematics and kinetics at the knee has been limited to small s les, typically of young subjects or those who have undergone joint arthroplasty. In this study, we examined tibiofemoral joint (TFJ) kinematics and kinetics during gait, sit-stand-sit, and step-descent in 20 healthy older subjects (aged 53-79 years) using motion capture data and inverse dynamic musculoskeletal models. Mean peak distal-proximal force in the TFJ were 3.1, 1.6, and 3.5 times body weight (N/BW) for gait, sit-stand, and step-descent respectively. There were also significant posterior-anterior forces, with sit-stand activity peaking at 1.6 N/BW. Moments about the TFJ peaked at a mean of 0.07 Nm/BW during the sit-stand activity. One of the most important findings of this study was variability found across the subjects, who spanned a wide age range, showing large standard deviations in all of the activities for both kinematics and kinetics. These data have provided an initial prediction for assessing kinematics and kinetics in the older population. Larger studies are needed to refine the database, in particular to reduce the variability in the results by studying sub-populations, to enable more robust comparisons between healthy and pathological TFJ kinematics and kinetics.
Publisher: Springer Science and Business Media LLC
Date: 1991
DOI: 10.1007/BF00868071
Publisher: Springer Science and Business Media LLC
Date: 1992
DOI: 10.1007/BF00626281
Publisher: MDPI AG
Date: 04-03-2017
Publisher: Wiley
Date: 21-07-2010
DOI: 10.1002/MUS.21725
Abstract: Muscle dimension changes on ultrasound imaging (USI) indicate contractile activity. Quadriceps force and rectus femoris (RF) dimensions were examined to assess USI for estimating contraction level. In 15 healthy males, mean age 24.8 years, isometric quadriceps force was measured in 90° knee flexion during submaximal and maximal voluntary contractions (MVCs) and at MVC in extension. Mid-thigh cross-sectional area (CSA), depth and width, and surface electromyography (EMG) of RF were recorded. Muscle width decreased curvilinearly as both force and EMG increased. At MVC, width was 3.2 ± 0.5 cm, 25% smaller than at rest (4.4 ± 0.7 cm), and similar to MVC in extension (-23%). CSA decreased linearly to -18% at MVC. RF thickness increased by only 10% (at 30% to MVC). Similar width changes at MVC in flexion and extension indicate the clinical potential of USI for assessing quadriceps contractility. Sensitivity is limited to assessing strength to within 25% of MVC in young males.
Publisher: Springer Science and Business Media LLC
Date: 06-1992
DOI: 10.1007/BF00302141
Publisher: Elsevier BV
Date: 05-1992
DOI: 10.1016/0022-510X(92)90093-Z
Abstract: Integrated acoustic myography (IAMG) and electromyography (IEMG) were recorded over rectus femoris (RF) in six healthy subjects during a series of intermittent isometric contractions of quadriceps. Contractions were held for 10 sec with 10 sec rest between each, commencing at 75% maximum voluntary contraction (MVC) force and continuing to 40% MVC. The IAMG activity initially decreased (75%-60% MVC) in a linear relationship (r = 0.9) with fatigue (i.e. force loss) but then plateaued and increased once force fell below 52% MVC. The AMG/force relationship for the whole fatiguing protocol (i.e. 75%-40% MVC) was quadratic (r = 0.87). The IEMG also showed a quadratic relationship with force (r = 0.85) but activity initially increased before decreasing. The results of the present study quantify the relationship between AMG and force in quadriceps during fatigue from intermittent contractions commencing at 75% MVC. The findings confirm previous observations that AMG decreases with fatigue during strong contractions but the quadratic relationship found in the present study differs to that for other muscles during sustained contractions. The results also suggest that simultaneous recordings of AMG and EMG may help distinguish central and peripheral fatigue. Acoustic myography may therefore be a useful non-invasive monitor of force during early fatiguing activity using the present protocol but the need to study AMG during fatigue of different muscles and force levels is stressed.
Publisher: Wiley
Date: 04-1988
DOI: 10.1111/J.1365-2125.1988.TB03323.X
Abstract: 1. In eight normal volunteers, the adductor pollicis (AP) was fatigued using intermittent trains of programmed, supramaximal stimulation at 1, 10, 20, 50, 100 and 1 Hz. Activity protocols were performed both with and without circulatory occlusion, both without and during propranolol 80 mg thrice daily in order to investigate the effects of beta-adrenoceptor blockade on 'peripheral' fatigue mechanisms. 2. The degree of beta-adrenoceptor blockade was assessed by the reduction of exercise tachycardia during cycle ergometry, e.g. pulse rates at 210 watts were reduced from 190 +/- 15 to 127 +/- 5 beats min-1 (mean +/- 1 s.d.) indicating that beta-adrenoceptor blockade was substantial and highly significant (P less than 0.001). 3. Before, during and following fatiguing activity with circulatory occlusion force declines were identical during and without beta-adrenoceptor blockade. During and following activity without occlusion, there were slight declines in force which were questionably significantly different at 20 Hz (P less than 0.05). 4. The compound muscle action potential (CMAP) litude, measured from the skin surface over the muscle, was unaltered by beta-adrenoceptor blockade before, during or after activity whether with or without circulatory occlusion. 5. The maximal relaxation rate (MRR) was not significantly reduced in previously unfatigued muscle during beta-adrenoceptor blockade. During activity, both with and without circulatory occlusion, there was no evidence that MRR was reduced significantly more during beta-adrenoceptor blockade. 6. The absence of a convincing effect of beta-adrenoceptor blockade on peripheral fatigue mechanisms may indicate that central mechanisms are involved or that impairments of peripheral force production, of a specific nature or as a result of exacerbation of limitations of circulatory oxygen transport, though small are detected during voluntary exercise and give rise to increases in motor unit recruitment and/or firing rates, and hence increased perception of fatigue.
Publisher: MDPI AG
Date: 07-02-2017
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 08-2011
Abstract: There is a growing trend in the physical therapy profession to use conventional grayscale brightness (B-mode) ultrasound imaging (USI) as a tool to assess the morphological (form and structure) and morphometric (measures of form) characteristics of muscle, and to use these findings to draw conclusions regarding muscle function. This trend is reflected in numerous published investigations. As many physical therapists may lack training in the principles and instrumentation underlying USI use, it is critical that therapists gain a clear understanding of the information that USI can, and cannot, provide about muscle function before employing the technique for either research or clinical applications. Failure to do so may result in the propagation of inaccurate terminology and beliefs. This paper aims to clarify the role that USI has in the assessment of muscle function, first, by briefly reviewing how conventional grayscale B-mode ultrasound images and clips are generated, and second, by summarizing the types of information that these images can provide. It also discusses the various factors that need to be considered when interpreting a dynamic USI assessment of muscle specifically as it relates to the assessment of muscle function.
Publisher: Informa UK Limited
Date: 27-04-2022
DOI: 10.1080/09638288.2022.2065542
Abstract: Post-stroke survivors report that feedback helps to increase training motivation. A wearable system (M-MARK), comprising movement and muscle sensors and providing feedback when performing everyday tasks was developed. The objective reported here was to create an evidence-based set of upper-limb tasks for use with the system. Data from two focus groups with rehabilitation professionals, ten interviews with stroke survivors and a review of assessment tests were synthesized. In a two-stage process, suggested tasks were screened to exclude non-tasks and complex activities. Remaining tasks were screened for suitability and entered into a categorization matrix. Of 83 suggestions, eight non-tasks, and 42 complex activities were rejected. Of the remaining 33 tasks, 15 were rejected: five required fine motor control eight were too complex to standardize one because the role of hemiplegic hand was not defined and one involved water. The review of clinical assessment tests found no additional tasks. Eleven were ultimately selected for testing with M-Mark. Using a task categorization matrix, a set of training tasks was systematically identified. There was strong agreement between data from the professionals, survivors and literature. The matrix populated by tasks has potential for wider use in upper-limb stroke rehabilitation. IMPLICATIONS FOR REHABILITATIONRehabilitation technologies that provide feedback on quantity and quality of movements can support independent home-based upper limb rehabilitation.Rehabilitation technology systems require a library of upper limb tasks at different levels for people with stroke and therapists to choose from.A user-defined and evidence-based set of upper limb tasks for use within a wearable sensor device system have been developed.
Publisher: Elsevier BV
Date: 04-1992
DOI: 10.1016/0022-510X(92)90051-L
Abstract: The sensitivity of electrical stimulation tests for detecting low frequency fatigue (LFF) and its duration were examined in the adductor pollicis muscle of ten normal subjects. Supramaximal stimulation was applied to the ulnar nerve at the wrist and values for test stimulation force ratios of 10:100 Hz, 15:100 Hz and 20:50 Hz (2 sec at each frequency with 5 min rest between each ratio) were obtained for fresh muscle. Fatigue was then induced by voluntary isometric contractions at 50% maximal voluntary force (MVC) repeated until only 30% MVC could be achieved. Contractions lasted 10 sec with 5 sec rest between each. The three test ratios were then repeated to monitor recovery at intervals up to 72 h after activity. High frequency forces returned to fresh values by 24 h but low frequency forces were all still significantly reduced. Forces at 10 and 15 Hz were still significantly reduced at 48 and 72 h (10 Hz greater than fatigue than 15 Hz). The low/high frequency ratios, calculated once 50 and 100 Hz forces had recovered, also demonstrated differences in recovery rates. Repeatability tests indicated that 10 Hz force was more variable than other frequencies and forces at all stimulation frequencies were repeatable on different days with a coefficient of variation of less than 15%. Values for the 15:100 Hz ratio from fresh muscle in 22 normal subjects were 0.48 +/- 8. The 15:100 Hz ratio is suggested as the most appropriate test ratio for detecting LFF since 15 Hz force is more sensitive than 20 Hz and more stable than 10 Hz.
Publisher: BMJ
Date: 09-2013
Publisher: Elsevier BV
Date: 03-2012
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-1993
DOI: 10.1097/00007632-199304000-00014
Abstract: In low back pain patients the paraspinal muscles demonstrate excess fatigability. Whether the cause is "central" as could result from impaired motor unit recruitment due to poor motivation or fear of pain, or "peripheral", and caused by defects in the contractile apparatus, is unknown. Using surface electromyography in conjunction with a standardized isometric fatigue test, this study investigates the mechanisms causing paraspinal muscle dysfunction in patients with both nonsurgical and postsurgical chronic low back pain. During the fatigue test normal subjects and both patient groups exhibited electromyographic increases. These were significantly greater in both patient groups, indicating increased central drive to their muscles. These findings may suggest that patients' excess fatigue is peripheral in origin, with increased central drive arising secondary to muscle wasting or denervation, although a central activation defect has not been excluded. Impaired physical performance in low back pain patients does not seem to be caused by lack of central drive.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 12-2011
Publisher: Wiley
Date: 04-1985
DOI: 10.1111/J.1475-097X.1985.TB00589.X
Abstract: We have examined the severity and duration of reflex inhibition of quadriceps activation after arthrotomy and meniscectomy, its relationship with pain, and the effect of local anaesthesia on this relationship. Fourteen men, on completion of medial meniscectomy by arthrotomy, received either 10 ml (B10 group) or 15 ml (B15 group) of 0.5% bupivacaine hydrochloride ('Marcaine Plain') into the knee, or no injection (control group). Reflex inhibition of quadriceps was measured as the percentage reduction, from the ipsilateral preoperative value, in the integrated surface electromyogram recorded during maximal voluntary isometric contractions with the knee in extension. Pain during each contraction was recorded on a linear analogue scale. Unoperated limbs showed no evidence of quadriceps inhibition. In the operated limbs, at 1-2 h post-operatively, controls had both severe inhibition (median = 62%) and severe pain on attempting a maximal quadriceps contraction. The B10 group had similar inhibition but less pain (P less than or equal to 0.005, Wilcoxon 2-s le, 1-tailed test). In the B15 group both inhibition (P less than or equal to 0.05) and pain (P less than or equal to 0.01) were less than in the controls. These effects of bupivacaine had been lost by 4-5 h post-operatively. At 3-4 days, inhibition was still severe (median = 75%) in all three groups of patients but pain was only mild or absent. At 10-15 days, median inhibition was still 35%, but there was little or no pain. We conclude that postmeniscectomy inhibition is not simply due to perceived pain but is due, at least in part, to stimuli from the knee.
Publisher: Elsevier
Date: 2009
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
DOI: 10.1097/NPT.0000000000000183
Abstract: Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors. This article addresses the need for cost-effective increased intensity of practice and suggests potential benefits of telehealth (TH) as an innovative model of care in physical therapy. We provide an overview of TH and present evidence that a web-supported program, used in conjunction with constraint-induced therapy (CIT), can increase intensity and adherence to a rehabilitation regimen. The design and feasibility testing of this web-based program, “LifeCIT,” is presented. We describe how wearable sensors can monitor activity and provide feedback to patients and therapists. The methodology for the development of a wearable device with embedded inertial and mechanomyographic sensors, algorithms to classify functional movement, and a graphical user interface to present meaningful data to patients to support a home exercise program is explained. We propose that wearable sensor technologies and TH programs have the potential to provide most-effective, intensive, home-based stroke rehabilitation.
Publisher: Informa UK Limited
Date: 12-01-2010
DOI: 10.3109/03091900903518363
Abstract: The reliability of a portable computer based system (Motor Task Manager MTM) used for the assessment of motor dysfunction needs to be assessed before being used clinically. Nine healthy males, aged 24-55 years (mean = 31.4, SD +/- 9.84) performed three unilateral MTM-prescribed reaching task paradigms. Tasks were completed three times in random order during three separate testing sessions. Speed characteristics showed excellent (Intra-class correlation coefficient ICC 0.78-0.92) and inter-session (ICC 0.86-0.92) reliability for all three tasks. Temporal parameters had fair to good reliability in the first session (ICC 0.42-0.78) which improved in sessions 2 and 3 (ICC 0.64-0.96). Inter-session reliability for temporal characteristics was better for movement time (ICC 0.57-0.84) than onset time (ICC 0.14-0.53). Spatial characteristics demonstrated poor intra- (ICC -0.09-0.63) and inter-sessions (ICC 0.15-0.61) reliability. Speed characteristics were the most robust results for the healthy population studied and recommended for measuring performance, particularly if only one test session is possible.
Publisher: Elsevier BV
Date: 2023
Publisher: Elsevier BV
Date: 11-2009
DOI: 10.1016/J.ULTRASMEDBIO.2009.05.018
Abstract: The use of ultrasound imaging (USI) by physiotherapists to assess muscle behavior in clinical settings is increasing. However, there is relatively little evidence of whether the clinical environment is conducive to valid and reliable measurements. Accurate USI measurements depend on maintaining a relatively stationary transducer position, because motion may distort the image and lead to erroneous conclusions. This would seem particularly important during dynamic studies typical of a physiotherapy assessment. What is not known is how much transducer motion can occur before error is introduced. The aim of this study is to shed some light on this question. Eight healthy volunteers (19 to 52 y) participated. USI images were taken of the lateral abdominal wall (LAW) and bladder base (midline suprapubic) at various manually induced transducer orientations (approximately -10 to 10 degrees about 3 axes of rotation), which were quantified by a digital optical motion capture system. Measurements of transversus abdominis (TrA) thickness and bladder base position (cranial /caudal and anterior osterior) were calculated. Repeated measures analysis of variance was performed to determine if the measurements obtained at the induced transducer orientations were statistically different (p<0.05) from an image corresponding to a reference or starting transducer orientation. Motion analysis data corresponding to measurements that did not differ from reference image measurements were summarized to provide a range of acceptable transducer motion (relative to the pelvis) for clockwise (CW)/counter-clockwise (CCW) rotation, cranial/caudal tilting, medial/lateral tilting and inward/outward displacement. There were no significant changes in TrA thickness measurements if CW/CCW transducer motion was <9 degrees and cranial/caudal or medial/lateral transducer tilting was <5 degrees . Further, there were no significant changes in measurements of bladder base position if CW/CCW transducer motion was <10 degrees , cranial/caudal or medial/lateral transducer tilting was <10 degrees and 8 degrees , respectively and inward/outward motion was <8 mm. These findings provide guidance on acceptable amounts of transducer motion relative to the pelvis when generating measurements of TrA thickness and bladder base position. Future sonographic studies and clinical assessment investigating these parameters could take these findings into account to improve imaging technique reliability.
Publisher: Elsevier BV
Date: 12-1988
Publisher: Springer Science and Business Media LLC
Date: 21-10-2014
DOI: 10.1007/S11517-014-1211-5
Abstract: Physical exercise is important for people living under extreme environmental conditions to stay healthy. Particularly in space, exercise can partially counteract the loss of muscle mass and muscle strength caused by microgravity. Monitoring the adaptation of the musculoskeletal system to assess muscle quality and devise in idual training programmes is highly desirable but is restricted by practical, technical and time constraints on board the International Space Station. This study aimed to test the feasibility of using myometric measurements to monitor the mechanical properties of skeletal muscles and tendons in weightlessness during parabolic flights. The mechanical properties (frequency, decrement, stiffness relaxation time and creep) of the m. gastrocnemius, m. erector spinae and Achilles tendon were assessed using the hand-held MyotonPRO device in 11 healthy participants (aged 47 ± 9 years) in normal gravity as well as in microgravity during two parabolic flight c aigns. Results showed significant (p < .05-.001) changes in all mechanical properties of both muscles and the Achilles tendon, indicating a more relaxed tissue state in microgravity. Recordings from a phantom rubber material with the device in a test rig confirmed that the device itself was not affected by gravity, as changes between gravity conditions that were too small (<1 %) to explain the changes observed in the tissues. It is concluded that myometric measurements are a feasible, easy-to-use and non-invasive approach to monitor muscle health in extreme conditions that prohibit many other methods. Real-time assessment of the quality of a muscle being exposed to the negative effect of microgravity and also the positive effects of muscular training could be achieved using Myoton technology.
Publisher: SAGE Publications
Date: 2021
Abstract: A simple tool to estimate loading on the lower limb joints outside a laboratory may be useful for people who suffer from degenerative joint disease. Here, the accelerometers on board of wearables (smartwatch, smartphone) were used to estimate the load rate on the lower limbs and were compared to data from a treadmill force plate. The aim was to assess the validity of wearables to estimate load rate transmitted through the joints. Twelve healthy participants (female n = 4, male n = 8 aged 26 ± 3 years height: 175 ± 15 cm body mass: 71 ± 9 kg) carried wearables, while performing locomotive activities on an anti-gravity treadmill with an integrated force plate. Acceleration data from the wearables and force plate data were used to estimate the load rate. The treadmill enabled 7680 data points to be obtained, allowing a good estimate of uncertainty to be examined. A linear regression model and cross-validation with 1000 bootstrap res les were used to assess the validation. Significant correlation was found between load rate from the force plate and wearables (smartphone: [Formula: see text] smartwatch: [Formula: see text]). Wearables’ accelerometers can estimate load rate, and the good correlation with force plate data supports their use as a surrogate when assessing lower limb joint loading in field environments.
Publisher: SAGE Publications
Date: 11-1989
DOI: 10.1177/026921558900300413
Abstract: Interest in the possibility of using electrically stimulated muscular contractions in rehabilitation medicine is increasing. Progress is impeded by the phenomenon of fatigue which impairs effectiveness and consistency of contractions. Various methods for minimizing fatigue have been proposed and are presently discussed. These include fibre type conversion as a result of chronic low frequency conditioning stimulation, sequential stimulation, optimization of stimulation parameters and the use of hybrid orthoses.
Publisher: MDPI AG
Date: 22-04-0004
DOI: 10.3390/JFMK3040054
Abstract: Assessing function in elderly populations predominantly aims to quantify the risk of falling. Current assessment methods do not consider changes associated with aging in movement coordination patterns and the ability to control movement. The aim of this study was to examine the intra-rater reliability of a ‘Movement Screening Test’ (MST) in females over 80 years across a range of physical activity levels, who were golfers and non-golfers. Female recreational golfers (N = 21) and non-golfers (N = 10) aged 80 to 87 years performed the MST. The MST consists of three tests: Test 1, sit to stand with arm lift Test 2, trunk lean with knee bend and opposite arm lift Test 3, chest rotation with neutral head and pelvis. Videos of the MST were analyzed and scored according to specific criteria. The videos were reviewed on two separate occasions to quantify the intra-rater reliability of scoring of the MST. Intra-rater reliability ( κ ) of the MST demonstrated substantial agreement for 11/23 criteria ( κ = 0.65 and to 0.78) and excellent agreement for 9/23 criteria ( κ = 0.81 to 1). Therefore, the reliability of the MST for women aged 80 years and over was established. The MST test and scoring system may be further refined to improve reliability. Further investigations could explore coordination patterns in older people, how these relate to various aspects of musculoskeletal function, and how they vary between different populations.
Publisher: Springer Science and Business Media LLC
Date: 06-11-2018
Publisher: Springer Science and Business Media LLC
Date: 26-08-2020
DOI: 10.1186/S12877-020-01718-1
Abstract: The European Working Group on Sarcopenia in Older People has recently defined new criteria for identifying “(probable) sarcopenia” (EWGSOP2). However, the prevalence of probable sarcopenia, defined by these guidelines, has not been determined extensively, especially in the oldest old. This study aims to determine the prevalence of probable sarcopenia in older, community-living people and its association with strength-related determinants. Handgrip strength and reported determinants (age, height, weight, osteoarthritis of hands, medications, fall history, physical activity, activities of daily living (ADL) and global cognitive function) were collected in a cross-sectional study of 219 community-living Swiss people (75 years and over). Probable sarcopenia was estimated based on cut-off values for handgrip strength as recommended by EWGSOP2. Spearman correlations, binary-regression analyses and contingency tables were used to explore relationships between variables. The prevalence of probable sarcopenia in women ( n = 137, age 84.1 ± 5.7 years) and men ( n = 82, age 82.6 ± 5.2 years) was 26.3 and 28.0%, respectively. In women, probable sarcopenia correlated positively with age and falls (r s range 0.332–0.195, p .05), and negatively with weight, cognition, physical activity, using stairs regularly, participating in sports activities and ADL performance (r s range = − 0.141 - -0.409, p .05). The only significant predictor of probable sarcopenia at the multivariate level was ADL performance (Wald(1) = 5.51, p = .019). In men, probable sarcopenia was positively correlated with age (r s = 0.33, p .05) and negatively with physical activity, participation in sports and ADL performance (r s range − 0.221 – − 0.353, p .05). ADL performance and age (Wald(1) = 4.46, p = .035 and Wald(1) = 6.30, p = .012) were the only significant predictors at the multivariate level. Men and women with probable sarcopenia were 2.8 times more likely to be dependent in ADL than those without. Probable sarcopenia affected one in every four community-living, oldest old people and was independently associated with impaired ADL performance in both sexes. This highlights the importance of detection of handgrip strength in this age group in clinical practice. Although prospective studies are required, independence in ADL might help to protect against probable sarcopenia.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.MSKSP.2016.12.010
Abstract: Postflight reconditioning of astronauts is understudied. Despite a rigorous, daily inflight exercise countermeasures programme during six months in microgravity (μG) on-board the International Space Station (ISS), physiological impairments occur and postflight reconditioning is still required on return to Earth. Such postflight programmes are implemented by space agency reconditioning specialists. Case Description and Assessments: A 38 year old male European Space Agency (ESA) crewmember's pre- and postflight (at six and 21 days after landing) physical performance from a six-month mission to ISS are described. muscle strength (squat and bench press 1 Repetition Maximum) and power (vertical jump), core muscle endurance and hip flexibility (Sit and Reach, Thomas Test). In-flight, the astronaut undertook a rigorous daily (2-h) exercise programme. The 21 day postflight reconditioning exercise concept focused on motor control and functional training, and was delivered in close co-ordination by the ESA physiotherapist and exercise specialist to provide the crewmember with comprehensive reconditioning support. Despite an intensive inflight exercise programme for this highly motivated crewmember, postflight performance showed impairments at R+6 for most parameters, all of which recovered by R+21 except muscular power (jump tests). Regardless of intense inflight exercise countermeasures and excellent compliance to postflight reconditioning, postflight performance showed impairments at R+6 for most parameters. Complex powerful performance tasks took longer to return to preflight values. Research is needed to develop optimal inflight and postflight exercise programmes to overcome the negative effects of microgravity and return the astronaut to preflight status as rapidly as possible.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-1987
Publisher: Elsevier BV
Date: 08-2003
DOI: 10.1016/S1356-689X(03)00011-0
Abstract: This methodological study examined the influence of body position when measuring multifidus muscle size using real-time ultrasound imaging. Previous studies examined multifidus with the subject prone but people with certain conditions cannot be studied in this position, so side lying was investigated as an alternative posture. In 20 normal females (aged 19-45 years), the cross-sectional area (CSA) of lumbar multifidus was measured at the level of the fifth lumbar vertebra (L5) on both the right and left sides, with the subject in prone and in side lying. Multifidus CSA was highly correlated between the two positions on both the right (r=0.90) and left (r=0.91) sides. Paired t-tests found no significant differences between the measurements made in the two scanning postures (right P=0.77 left P=0.16). Bland and Altman plots showed good agreement between the two positions, with no systematic difference. These findings demonstrate that measurements of lumbar multifidus at L5 can be made in either prone or side lying and a valid comparison of the results obtained in both positions can be made.
Publisher: MDPI AG
Date: 07-05-2019
DOI: 10.3390/JFMK4020024
Abstract: Athletes with femoroacetabular impingement syndrome (FAIS) managed arthroscopically do not always return to sport. Inability to control back elvis, hip and lower limb movements may contribute to the onset and recurrence of symptoms. Our hypothesis is that results from a battery of cognitive movement control tests can inform a cognitive movement control (neuromuscular) retraining programme for improving the clinical presentation and quality of life in an athlete with FAIS. This case report presents a female elite rower with persistent left-sided anterior hip pain, four years post-arthroscopic surgery for FAIS, whose symptoms failed to respond to conventional physical therapy. Hip and groin outcome score (HAGOS), passive and active hip flexion range of motion (ROM) workload (time training on water), hip and pelvic kinematics (3-D motion analysis) and electromyography during a seated hip flexion movement control test, and a movement control test battery to identify movement control impairments (The Foundation Matrix), were assessed pre-intervention (week 0) and immediately post-intervention (week 16). Impaired movement control was targeted in a tailored 16-week cognitive movement control retraining exercise program. All measures improved: HAGOS (all 6 sub-scales) symptoms (61/100 pre-training to 96/100 post-training) physical activities participation (13/100 to 75/100) and active hip flexion ROM increased (78 to 116 and 98 to 118 degrees, respectively) workload increased from 4 to 18 h/week and movement control impairment reduced (25/50 to 9/50). Pelvic motion on kinematic analysis were altered, and delayed activation onset of tensor fascia latae and rectus femoris muscles reduced. This proof-of-concept case report supports the hypothesis that cognitive movement control tests can inform a targeted cognitive movement control retraining program to improve symptoms, function and quality of life, in an elite rower with persistent hip pain. This training offers an alternative approach to conventional physical therapy, which has failed to restore function in FAIS, and the present study illustrates how specific cognitive movement control assessment can direct in idual training programmes.
Publisher: American Physiological Society
Date: 03-2016
DOI: 10.1152/PHYSIOLGENOMICS.00105.2015
Abstract: Despite numerous attempts to discover genetic variants associated with elite athletic performance, injury predisposition, and elite/world-class athletic status, there has been limited progress to date. Past reliance on candidate gene studies predominantly focusing on genotyping a limited number of single nucleotide polymorphisms or the insertion/deletion variants in small, often heterogeneous cohorts (i.e., made up of athletes of quite different sport specialties) have not generated the kind of results that could offer solid opportunities to bridge the gap between basic research in exercise sciences and deliverables in biomedicine. A retrospective view of genetic association studies with complex disease traits indicates that transition to hypothesis-free genome-wide approaches will be more fruitful. In studies of complex disease, it is well recognized that the magnitude of genetic association is often smaller than initially anticipated, and, as such, large s le sizes are required to identify the gene effects robustly. A symposium was held in Athens and on the Greek island of Santorini from 14–17 May 2015 to review the main findings in exercise genetics and genomics and to explore promising trends and possibilities. The symposium also offered a forum for the development of a position stand (the Santorini Declaration). Among the participants, many were involved in ongoing collaborative studies (e.g., ELITE, GAMES, Gene SMART, GENESIS, and POWERGENE). A consensus emerged among participants that it would be advantageous to bring together all current studies and those recently launched into one new large collaborative initiative, which was subsequently named the Athlome Project Consortium.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-1989
DOI: 10.1212/WNL.39.5.655
Abstract: We studied selenium metabolism in patients with Duchenne muscular dystrophy and in contrast to previous reports found no significant abnormalities in these patients. Supplementation of muscular dystrophy patients and control subjects with sodium selenite (1 mg selenium/day) induced a variable rise in the activity of the selenium-dependent enzyme glutathione peroxidase in plasma and red cells, but no significant change in muscle glutathione peroxidase activities. There was no effect of selenium supplementation on disease activity in the patients with muscular dystrophy. Thiobarbituric acid-reacting substances (an index of free radical-mediated lipid peroxidation) were elevated in the muscle of patients with Duchenne muscular dystrophy in contrast to patients with other forms of muscular dystrophy and control subjects. This elevation was unaffected by selenium supplementation.
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.MATH.2014.02.002
Abstract: Objective quantification of muscle size can aid clinical assessment when treating musculoskeletal conditions. To date the gold standard of measuring muscle morphology is magnetic resonance imaging (MRI). However, there's a growing body of evidence validating rehabilitative ultrasound imaging (RUSI) against MRI. This study aimed to validate RUSI against MRI for the linear measurements of the distal fibres of vastus medialis muscle in the thigh. Twelve healthy male participants were recruited from a local university population. The distal portion of their right vastus medialis was imaged with the participant in long-sitting, using MRI and RUSI whilst the leg was in extension and neutral hip rotation. Cross sectional area (CSA) and three linear measures were taken from the MRI and these were compared with the same linear measures from RUSI. Statistical analysis included comparison of MRI and RUSI measures using the paired t-test and intra-class correlation coefficients (ICC 3,1). Mean differences between the linear measures taken from the MRI and RUSI were -0.5 mm to 2.9 mm (95% confidence intervals -0.6-8.3 mm), which were not statistically different (p > 0.05) and were highly correlated (ICCs 3,1 0.84-0.94). Correlations between the three linear measurements and muscle CSA ranged from r = 0.23 to 0.87, the greatest being muscle thickness. Multiplying the linear measures did not improve the correlation of 0.87 found for muscle thickness. Linear measures of vastus medialis depth made using RUSI were shown to be as valid as using MRI. Muscle thickness measures using RUSI could be used within an objective assessment of this muscle.
Publisher: American Chemical Society (ACS)
Date: 13-04-2016
Abstract: In this work, ceramic ultrafiltration membranes deposited with different metal oxides (i.e., TiO2, Fe2O3, MnO2, CuO, and CeO2) of around 10 nm in thickness and similar roughness were tested for O/W emulsion treatment. A distinct membrane fouling tendency was observed, which closely correlated to the properties of the filtration-layer metal oxides (i.e., surface hydroxyl groups, hydrophilicity, surface charge, and adhesion energy for oil droplets). Consistent with the distinct bond strength of the surface hydroxyl groups, hydrophilicity of these common metal oxides is quite different. The differences in hydrophilicity consequently lead to different adhesion of these metal oxides toward oil droplets, consistent with the irreversible membrane fouling tendency. In addition, the surface charge of the metal oxide opposite to that of emulsion can help to alleviate irreversible membrane fouling in ultrafiltration. Highly hydrophilic Fe2O3 with the lowest fouling tendency could be a potential filtration-layer material for the fabrication/modification of ceramic membranes for O/W emulsion treatment. To the best of our knowledge, this is the first study clearly showing the correlations between surface properties of filtration-layer metal oxides and ceramic membrane fouling tendency by O/W emulsion.
Publisher: Informa UK Limited
Date: 1989
Publisher: World Scientific Pub Co Pte Lt
Date: 09-2019
DOI: 10.1142/S0218957719500088
Abstract: Background: An active lifestyle has many health benefits but intensive exercise and low grade repetitive trauma may impact the health of joints. Good quality, controlled movement, may reduce abnormal loading on joints and help prevent injury or when injuries do occur, prevent post-traumatic osteoarthritis. Screening tools to visually assess movement quality can be used to prescribe appropriate exercise interventions to improve movement quality. An assessment tool that focuses on hip movement control is needed for use in clinical and field environments. Purpose: To describe a new screening tool that assesses control of the hip, pelvis and lower limbs, the Hip and Lower Limb Movement Screen (HLLMS), and test its intra- and inter-rater reliability. Methods: The HLLMS includes five tests: small knee bend (SKB), standing hip flexion to [Formula: see text], side-lying hip abduction with the leg laterally rotated, SKB with trunk rotation and deep squat. Reliability was tested in two s les of young footballers aged 16–19 years intra-rater in [Formula: see text] and inter-rater reliability in [Formula: see text]4. Percentage agreement (PA) and First-Order Coefficient (AC1) were calculated. Results: Intra-rater reliability was excellent with almost perfect agreement for the overall HLLMS (PA 96% AC1 0.93), with strong inter-rater reliability (PA 88% AC1 0.82). Conclusions: The HLLMS can identify movement quality reliably in young community footballers. Poor movement patterns identified using the HLLMS are intended to inform the design of targeted exercise programs to improve movement quality and reduce injuries or prevent the progression of injuries to post-traumatic OA.
Publisher: Wiley
Date: 07-1993
DOI: 10.1111/J.1365-2842.1993.TB01618.X
Abstract: The feasibility of examining electro-mechanical activity of the human masseter muscles using non-invasive recording techniques was examined in six healthy dentate adults (aged 34-57 years). Electrical activity of the muscle was examined by surface electromyography (EMG) and the mechanical activity, in the form of muscle sounds, was examined by acoustic myography (AMG). Bilateral recordings of EMG and AMG were made simultaneously using composite probes which were placed on the skin over the masseter muscles. A standardized pressure was applied to the probes via adjustable rods attached to a safety helmet. Pressures were monitored by strain gauges placed between the ends of the rods and the probes. With the subject seated, recordings of AMG and EMG were obtained during maximal jaw clenching for 4 s and the raw signals were stored on a computer. Of three maximal contractions performed, the last two were used in the analysis. The raw lified signals underwent frequency analysis by fast Fourier Transform. Total activity was also assessed after lification, full-wave rectification and integration, and repeatability of the results was assessed. The AMG frequency range was 6-15 Hz and was similar to values for other human skeletal muscles. The integrated values for EMG and AMG were repeatable on both sides of the face (IEMG, right r = 0.99, left r = 0.99 IAMG right r = 0.70, left r = 0.71). Simultaneous recordings of AMG and EMG from the masseter muscles may be useful for assessing electro-mechanical muscle function but further validation studies are required before the technique can be used clinically.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 10-2007
Abstract: Interest in rehabilitative ultrasound imaging (RUSI) of the posterior paraspinal muscles is growing, along with the body of literature to support integration of this technique into routine physical therapy practice. This clinical commentary reviews how RUSI can be used as an evaluative and treatment tool and proposes guidelines for its use for the posterior muscles of the lumbar and cervical regions. Both quantitative and qualitative applications are described, as well as measurement reliability and validity. Measurement of morphological characteristics of the muscles (morphometry) in healthy populations and people with spinal pathology are described. Preliminary normal reference data exist for measurements of cross-sectional area (CSA), linear dimensions (muscle depth/thickness and width), and shape ratios. Compared to in iduals without low back pain, changes in muscles' size at rest and during the contracted state have been observed using RUSI in people with spinal pathology. Visual observation of the image during contraction indicates that RUSI may be a valuable biofeedback tool. Further investigation of many of these observations is required using controlled studies to provide conclusive evidence that RUSI enhances clinical practice.
Publisher: SAGE Publications
Date: 10-1998
DOI: 10.1191/026921598666172433
Abstract: Objective: To design a test rig for measuring isometric quadriceps' force which is easily adjustable, dismountable, transportable, relatively lightweight and inexpensive. Also to produce a data-acquisition software program that enables real-time feedback of the force signal, automatic analysis of maximal voluntary contraction (MVC) force, and submaximal target levels to be displayed on a computer screen, as well as acquisition of other signals such as electromyographic (EMG) activity. Methodology: A test rig was constructed using an aluminium tubing system which was fully adjustable and could be flat-packed for transportation. The data acquisition software program was written in Borland C++ and is suitable for use with an IBM-compatible PC. The interface is user friendly, and the entire testing system is relatively inexpensive compared to commercially available systems. Conclusions: The equipment is suitable for various applications in rehabilitation research and clinical testing, and is suitable for examining different muscles. Further technical details are freely available from the authors.
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1016/J.MATH.2008.12.005
Abstract: The purpose of the study was to establish the validity of Rehabilitative Ultrasound Imaging (RUSI) against Magnetic Resonance Imaging (MRI) for measuring trapezius muscle thickness. Participants were asymptomatic subjects recruited from Trinity College Dublin and associated teaching hospitals. Four MRI axial slices were made through each of the C6, T1, T5 and T8 spinous processes, with the subject supine. RUSI was performed immediately after MRI at the same vertebral levels, with the subject prone. Linear measurements of trapezius muscle thickness were made off-line on both the MRI and Ultrasound scans, in three regions: lower, middle and upper trapezius. Bland and Altman limits of agreement and Pearson's correlation coefficient were used to analyse the relationship between thickness measures taken from MRI and RUSI. Eighteen subjects (9 women) participated, (age-range 21-42 years). Results demonstrated good agreement between MRI and RUSI measurements of the lower trapezius muscle at T8 (r=0.77) and moderate agreement at T5, (r=0.62). Results were poor for the middle (T1) and upper (C6) trapezius muscles, (r=-0.22 to 0.52) but may be explained by differences in both positioning and imaging planes between the 2 modalities. It was concluded that RUSI is a valid method of measuring lower trapezius muscle thickness.
Publisher: Elsevier BV
Date: 07-1992
DOI: 10.1016/S0954-6111(06)80029-6
Abstract: The relationship between inspiratory mouth pressure and respiratory muscle activation was investigated in 20 normal non-smoking subjects (13 males). Surface electromyography (EMG) was recorded from the seventh intercostal space bilaterally during different levels of inspiratory effort monitored by a respiratory mouth pressure gauge. The mouth pressure and EMG relationship was non-linear between 20 and 100% of inspiratory effort. Quadratic regression analysis was performed between percent inspiration and percent EMG on each side of the chest. The regression equation and coefficient of determination (r2) for the right side were y = 9.73 (e0.024x-1), r2 = 0.91, and for left side were y = 10.79 (e0.023x-1), r2 = 0.88. An independent t-test did not reveal significant difference (P > 0.05) between the slopes of the regression lines from the two sides of the chest. Therefore, results of the two sides were pooled and the predictive regression equation for the combined results was y = 10.05 (e0.0236x-1). Reasons for such a non-linear relationship may include the loading mechanism of respiratory muscles, inefficiency of intercostal muscles at high levels of inspiration, their recruitment pattern and the histochemical characteristics of respiratory muscles. Since absolute EMG values cannot be used to assess changes in activation on different days, further work is required to establish the between-day repeatability of the technique described which is potentially useful for assessing respiratory muscle function pre- and post-operatively in chest surgery patients.
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.MATH.2011.07.001
Abstract: Evidence is currently lacking for guidance on ultrasound transducer configuration (shape) when imaging muscle to measure its size. This study compared measurements made of lumbar multifidus on images obtained using curvilinear and linear transducers. Fifteen asymptomatic males (aged 21-32 years) had their right lumbar multifidus imaged at L3. Two transverse images were taken with two transducers (5 MHz curvilinear and 6 MHz linear), and linear and cross-sectional area (CSA) measurements were made off-line. Reliability of image interpretation was shown using intra-class correlation coefficients (0.78-0.99). Muscle measurements were compared between transducers using Bland and Altman plots and paired t-tests. Relationships between CSA and linear measurements were examined using Pearson's Correlation Coefficients. There were no significant differences (p > 0.05) in the measurements of the two transducers. Thickness and CSA measurements had small differences between transducers, with mean differences of 0.01 cm (SDdiff = 0.21 cm) and 0.03 cm(2) (SDdiff = 0.58 cm(2)) respectively. Width measures had a mean difference of 0.14 cm, with the linear transducer giving larger measures. Significant correlations (p < 0.001) were found between all linear measures and CSA, with both transducers (r = 0.78-0.89). Measurements of multifidus at L3 were not influenced by the configuration of transducers of similar frequency. For the purposes of image interpretation, the curvilinear transducer produced better definition of the lateral muscle border, suggesting it as the preferable transducer for imaging lumbar multifidus.
Publisher: Wiley
Date: 10-1983
DOI: 10.1111/J.1365-2362.1983.TB00122.X
Abstract: Seventeen volunteers performed unilateral strength-training of the quadriceps with high-resistance, low-repetition, dynamic exercise, thrice weekly for an average of 5 weeks. Both before and after the training period, bilateral measurements were made of isometric quadriceps strength, quadriceps cross-sectional area (by ultrasound scanning), and thigh circumference. There were no significant changes in the untrained thighs. The trained quadriceps increased their isometric strength by more than they changed their cross-sectional area (mean increments = 15% and 6% respectively). Quadriceps hypertrophy was underestimated by measurements of thigh circumference and could not be predicted from them. We conclude that studies of localized muscle growth require direct measurements of the size of the muscle(s) concerned. Nevertheless, these may still underestimate the improvements in strength produced by high-resistance training.
Publisher: American Physiological Society
Date: 10-1991
DOI: 10.1152/JAPPL.1991.71.4.1422
Abstract: Sounds produced during voluntary isometric contractions of the quadriceps muscle were studied by acoustic myography (AMG) in five healthy adults. With the subject seated, isometric force, surface electromyography (EMG), and AMG were recorded over rectus femoris, and the EMG and AMG signals were integrated (IEMG and IAMG). Contractions lasting 5 s each were performed at 10, 25, 50, 60, 75, and 100% of maximum voluntary contraction (MVC) force. Fatigue was then induced by repeated voluntary contractions (10 s on, 10 s off) at 75% MVC until only 40% MVC could be sustained. After 15 min of rest, the different force levels were again tested in relation to the fresh MVC. Both before and after fatiguing activity the relationships between force and IEMG [r = 0.99 +/- 0.01 (SD), n = 10] and force and IAMG (r = 0.98 +/- 0.02) were linear. After activity, however, the slopes of the regression lines for force and IEMG increased (P less than 0.01) but those for force and IAMG remained the same (P greater than 0.05). The present results clarify the relationship between AMG and isometric force in fatigued muscle without the problem of fatigue-induced tremor, which h ered previous studies of prolonged activity. This study contributes to the validation of AMG and shows that it is a potentially useful method for noninvasive assessment of force production and fatigue. Further studies to establish the origin of AMG activity are required before AMG can be accepted for use in neuromuscular physiology or rehabilitation.
Publisher: Elsevier BV
Date: 04-1993
DOI: 10.1016/0165-0270(93)90024-L
Abstract: The effect of contact pressure on acoustic myographic (AMG) recordings was examined during voluntary isometric contractions of the human quadriceps muscle in 20 normal males. A piezoelectric disk for recording muscle sounds was placed over rectus femoris at approximately mid-thigh and secured with a rubber electromyography (EMG) strap. Contact pressure was monitored by a load cell placed between the AMG device and the strap. With the subject seated, force at different percentage levels of maximum voluntary contraction (MVC) were held for 5 s each. Both AMG and EMG recordings were full-wave rectified and integrated (IAMG and IEMG) and expressed as a percentage of activity at MVC. Two contraction series were performed with 2 different contact pressures. Pressure 1 (P1), of 180 Pa was applied in all subjects. A higher pressure of either 790 Pa (P2 in 5 subjects) or 1200 Pa (P3 in 15 subjects) was also applied. No significant changes in IAMG activity (P > 0.1) occurred between P1 and P2 but P3 produced increases in IAMG at all force levels (P < 0.05 at 10, 50 and 75% MVC). Both linear and non-linear relationships between force and IAMG were observed in different subjects but the relationship also varied with the 2 contact pressures within some subjects. The force/IEMG relationship was linear in all cases. These results provide quantitative evidence that contact pressure can influence the degree of IAMG activity if the pressure is high enough. The change in the force/IAMG relationship with pressure in some subjects suggests that the different relationships observed are not determined by physiological differences between subjects but rather by technical factors.
Publisher: National Institute for Health and Care Research
Date: 10-2014
DOI: 10.3310/EME01020
Abstract: The Alexander technique probably helps back pain but it is unclear whether or not it can be combined with physiotherapy exercise classes, how many lessons are needed and what mechanisms might be involved. To undertake a feasibility trial of the Alexander technique and supervised exercise classes and perform exploratory biomechanical and neuromuscular physiological marker analyses to better understand mediators of recovery. Feasibility parallel-group randomised controlled trial. General practices in southern England. Patients with recurrent back pain (at least 3 weeks’ duration of a current episode). Participants were allocated by an external randomisation line to four groups: (1) normal care, (2) 10 Alexander technique lessons, (3) 12 physiotherapy exercise classes, (4) Alexander technique lessons plus exercise classes. The feasibility outcomes were recruitment, acceptability and follow-up. The clinical outcomes were the Roland–Morris Disability Questionnaire (RMDQ), days in pain, the Von Korff pain and disability scale, overall improvement, fear of activity, enablement, the Oswestry Disability Index and the Aberdeen pain and function scale. Laboratory-based markers were axial muscle tone and flexibility, electrical activity, muscle tone and mechanical properties of elasticity and stiffness, trunk strength, and proprioception. In total, 83 patients consented, 69 were randomised and 56 (81%) were followed up at 6 months. Most patients had long-standing pain (median 300 days of pain). The RMDQ and other instruments were sensitive to change and the preliminary evidence suggests that the Aberdeen scale could be a useful measure. Study procedures were feasible and three methods of recruitment were successfully piloted. At 6 months the control group had changed little (RMDQ 1 point lower than at baseline) and, compared with the control group, clinically important improvements in RMDQ were seen in all groups, albeit not significant [Alexander technique −3.0, 95% confidence interval (CI) −6.7 to 0.8] exercise classes −2.9, 95% CI −6.5 to 0.8 combined Alexander technique + exercise classes −2.50, 9% CI −6.20 to 1.19]. Novel biomechanical variables strongly associated with RMDQ score at 6 months were muscle tone (0.94 increase in RMDQ per unit increase in Hz, 95% CI 0.48 to 1.40 p 0.0001), lumbar proprioception (1.48 increase in RMDQ per degree, 95% CI 0.83 to 2.12 p 0.0001) and muscle elasticity (−4.86 increase in RMDQ per unit log decrement, 95% CI −0.01 to −9.72 p 0.05). At 3 months the Alexander technique improved proprioception and exercise classes improved trunk extension strength. At 6 months the Alexander technique improved the timing of multifidus muscle onset and the active straight leg raise test and exercise classes improved multifidus muscle thickness and the ability to contract. The combined effects of the Alexander technique and exercise classes were improvements in muscle tone, elasticity and thickness and contractile ability. These observations provide possible links between intervention, proprioception, muscle tone and elasticity and outcome. In terms of harms, one patient fell in the exercise class group. The trial is feasible and the interventions may provide clinically important benefits. Exploratory analysis suggests that muscle tone, elasticity and proprioception are strongly associated with improved RMDQ score and are likely to be modified by the interventions. Current Controlled Trials ISRCTN51496752. This project was funded by the Medical Research Council through the Efficacy and Mechanism Evaluation Board.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 08-2007
Abstract: The use of ultrasound imaging by physical therapists is growing in popularity. This commentary has 2 aims. The first is to introduce the concept of rehabilitative ultrasound imaging (RUSI), provide a definition of the scope of this emerging tool in regard to the physical therapy profession, and describe how this relates to the larger field of medical ultrasound imaging. The second aim is to provide an overview of basic ultrasound imaging and instrumentation principles, including an understanding of the various modes and applications of the technology with respect to neuromusculoskeletal rehabilitation and in relation to other common imaging modalities.
Publisher: Springer Science and Business Media LLC
Date: 06-2012
DOI: 10.1007/BF03325252
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.MSKSP.2017.12.002
Abstract: In New Zealand ultrasound imaging (USI) is being used increasingly by physiotherapists. To fully understand the extent to which physiotherapists in New Zealand are using USI, it is necessary to evaluate not only the context of its clinical use but also the barriers preventing its uptake. To examine the field and scope of use of USI, the type and content of training and the barriers restricting physiotherapists from using the technique. Cross-sectional observational design utilising an Internet-based electronic survey. An electronic survey built on the design of previous research with guidance from an expert review panel. Participants were included if they were New Zealand registered physiotherapists. Of the 465 participants who responded, 433 were eligible to complete the survey. There were 415 participants who completed the survey, 24% who said they used USI whilst 76% did not. For those using USI, the uses were varied including those within a rehabilitative paradigm (i.e. biofeedback 52%) and also diagnostic (49%). USI training was also varied ranging from formal to informal. The main barriers preventing physiotherapists from using USI were lack of training, access to equipment, and equipment expense. The participants reported a variety of clinical uses of USI and levels of training. A better understanding of the clinical uses and benefits of USI would enhance both training and clinical uptake. With the identification of barriers limiting physiotherapists' use of USI, ways to overcome these in New Zealand can now be explored further.
Publisher: Elsevier BV
Date: 10-2020
Publisher: SAGE Publications
Date: 11-1992
DOI: 10.1177/026921559200600401
Abstract: The repeatability of acoustic myography (AMG) and electromyography (EMG) of the paraspinal muscles of 15 healthy subjects was investigated during a fatigue test involving a sustained horizontal hold of the upper body against gravity. The AMG and EMG signals were full-wave rectified and integrated (IAMG, IEMG). The variability of recordings made during a 60-second isometric contraction performed on three different days was assessed by analysis of variance (ANOVA) and coefficients of variation (CVs) were calculated from the ANOVA. The IAMG: IEMG ratio was calculated to assess electromechanical uncoupling during fatigue and the IAMG and I EMG values were also normalized to a percentage of initial activity. At the beginning of the fatigue test, absolute values for IAMG and the IAMG:IEMG ratio were not as repeatable between days as IEMG (CVs = IAMG 18%, IEMG 11 %, IAMG: IEMG ratio 23.5%). Absolute values at the end of the test showed similar degrees of repeatability for each variable (CVs = IAMG 21 %, IEMG 10%, IAMG: IEMG ratio 24%). Normalized values at the end of the fatigue test were repeatable (CVs = AMG 6%, EMG 6%, AMG : EMG ratio 9%), but variability was observed during the contraction. The present results indicate that absolute values of EMG are more repeatable than AMG for assessing paraspinal muscle activity on different days in healthy subjects. The changes in normalized values were variable during fatiguing activity but repeatable at the end of the test. Further control of the AMG recording technique is required to refine the fatigue test before it can be applied as a clinical assessment tool.
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.PTSP.2019.07.002
Abstract: To assess the correlation between the functional movement screen (FMS) and Y balance test (Y-BT) performance, and the self-reported hip/groin problems, and to compare healthy with hip/groin pain participants. a cross-sectional study. Sports hall in a football club. 43 elite adolescent football (soccer) players. The Copenhagen Hip and Groin Outcome Score (HAGOS), Anterior, posterolateral and posteromedial distance of Y-BT, FMS score. Y balance and FMS test kit, HAGOS questionnaire. The posterolateral, posteromedial distance and composite reach score of the Y-BT were lower in participants with hip/groin problems (p < 0.05). FMS performance was similar in healthy and hip/groin groups. There was a weak correlation (r = 0.32, p= 0.03) between the HAGOS Activities of Daily Living subscale and FMS The Y-BT and the FMS subtests were weakly or moderately correlated with self-reported hip/groin problems. Thus, these tests should be investigated further in adolescent footballers because they may have potential to predict hip and groin problems.
Publisher: Springer Science and Business Media LLC
Date: 02-10-2013
DOI: 10.1007/S40520-013-0146-2
Abstract: Sniff nasal inspiratory pressure (SNIP) and peak oral inspiratory flow (PIF) are portable, relatively new methods for indirect measurement of respiratory muscle strength. The reliability and acceptability of these measures were investigated in older adults. The study included 21 self-reported healthy adults, aged 65-84 years (mean 73.5 SD 6.4 years). Participants were tested in a sitting position on two occasions, 1 week apart. The best of three attempts for PIF measured through the mouth, and five for each nostril for SNIP were recorded. Reliability was tested using intra-class correlation coefficient (ICC), standard error of measurement, minimal detectable change (MDC) and Bland and Altman analysis. Feedback on the measures in relation to ease of completion and preference was obtained using a semi-structured interview. Between-day reliability of SNIP and PIF were ICC3,1 0.76 (95 % CI 0.49-0.9) and 0.92 (0.81-0.97), respectively. Standard error of measurement for SNIP (11.94 cmH2O) and MDC (33.10 cmH2O) were at the least 61 % higher than for PIF. The participants reported difficulties in performing SNIP, rating it as being less easy and uncomfortable to perform than PIF, with a higher rate of missing data for SNIP due to participants' dislike of the test. The wide range of SNIP readings, lower ICC value and negative user feedback are suggestive of a less robust and unacceptable clinical measure. PIF showed excellent reliability and acceptability and is therefore recommended for assessing inspiratory muscle strength in older people without known obstructive lung disease.
Publisher: Elsevier BV
Date: 05-1991
DOI: 10.1016/S0954-6111(06)80081-8
Abstract: Maximal inspiratory (PImax) and expiratory (PEmax) mouth pressures were measured in seven normal adults in both sitting and half-lying positions on 2 days. Analysis of variance did not reveal significant differences between measurements made in the two positions for either PImax or PEmax. Measurements were repeatable and the results obtained in both positions were pooled. The coefficient of variation of PImax was 4.7% between-trials and 10.3% between-days, and those for PEmax were 3.4% and 4.4%, respectively. It is suggested that measurements of PImax and PEmax made in the half-lying position after thoracic surgery can be compared to pre-operative values which are commonly obtained in sitting without any influence from a positional effect. Details of the methodology to improve the reliability of the respiratory mouth pressures technique are discussed.
Publisher: Wiley
Date: 03-1988
DOI: 10.1113/JPHYSIOL.1988.SP017020
Abstract: 1. Human adductor pollicis was fatigued using intermittent trains of programmed stimulation at 1, 10, 20, 50, 100 and 1 Hz, during activity with and without circulatory occlusion, to investigate the relationships between force generation, excitation and maximal relaxation rate (MRR). 2. The relationship between force generation and excitation was markedly dependent on stimulation frequency. Force loss was greatest at low frequencies, with little reduction in excitation, but as frequency increased force was well maintained despite marked loss of excitation. 3. Changes in MRR during activity and recovery were independent of stimulation frequency. 4. Marked increases of force at 1 Hz (pre-tetanic) and 10 Hz occurred, with little reduction in excitation, during activity with and without circulatory occlusion. This may be due to post-tetanic potentiation in addition to slowing of relaxation (MRR). 5. At high frequency a 'safety factor' may thus operate to maintain force, despite obvious loss of excitation, while at low frequencies there may be marked potentiation of force, despite unchanged excitation. These mechanisms could permit resistance to fatigue with muscle function remaining optimal over a range of conditions.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.MSKSP.2016.12.008
Abstract: Exposure to the microgravity environment induces physiological changes in the cardiovascular, musculoskeletal and sensorimotor systems in healthy astronauts. As space agencies prepare for extended duration missions, it is difficult to predict the extent of the effects that prolonged exposure to microgravity will have on astronauts. Prolonged bed rest is a model used by space agencies to simulate the effects of spaceflight on the human body, and bed rest studies have provided some insights into the effects of immobilisation and inactivity. Whilst microgravity exposure is confined to a relatively small population, on return to Earth, the physiological changes seen in astronauts parallel many changes routinely seen by physiotherapists on Earth in people with low back pain (LBP), muscle wasting diseases, exposure to prolonged bed rest, elite athletes and critically ill patients in intensive care. The medical operations team at the European Space Agency are currently involved in preparing astronauts for spaceflight, advising on exercises whilst astronauts are on the International Space Station, and reconditioning astronauts following their return. There are a number of parallels between this role and contemporary roles performed by physiotherapists working with elite athletes and muscle wasting conditions. This clinical commentary will draw parallels between changes which occur to the neuromuscular system in the absence of gravity and conditions which occur on Earth. Implications for physiotherapy management of astronauts and terrestrial patients will be discussed.
Publisher: Elsevier BV
Date: 12-1999
DOI: 10.1016/S1350-4533(00)00004-7
Abstract: A new multidimensional movement analysis system was used to record limb tremor over six degrees-of-freedom, and signal processing techniques were explored to develop a suitable classification method to distinguish between different types of tremor. The specific aims were to investigate the ability of the system to screen for differences between normal subjects and a group of neurological patients, and then to differentiate between three diagnostic groups of patients. Postural tremor at the hand was recorded in normal subjects (n=24) and patients with essential tremor (n=21), multiple sclerosis (n=17) and parkinsonism (n=19). Data were collected using a 3Space Fastrak((R)) (Polhemus, Inc.) over six degrees-of-freedom (three translational directions and three rotations). Spectral estimates produced measures of tremor frequency and litude. Mathematical models of the data, using autoregressive modelling and K-nearest neighbour classification, produced parameters used to classify, (1) the normal subjects and 24 patients (using the three rotational movements), and (2) the three patient groups (using all six movement directions). Results were given in terms of the probability of each subject belonging to the groups being classified. 70%). The diagnostic classification produced clear differences between the patient groups (60% for essential tremor, 80% for multiple sclerosis and 60% for parkinsonism). The ability of this assessment technique to distinguish between postural tremor in normal subjects and neurological patients suggests that it could be developed as a screening tool. Classification of tremors between the patients groups, with a high degree of sensitivity, indicates the potential for further development of the system as a diagnostic aid.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.MSKSP.2016.12.009
Abstract: No studies have been published on an astronaut population to assess the effectiveness of countermeasures for limiting physiological changes in the lumbopelvic region caused by microgravity exposure during spaceflight. However, several studies in this area have been done using spaceflight simulation via bed-rest. The purpose of this systematic review was to evaluate the effectiveness of countermeasures designed to limit physiological changes to the lumbopelvic region caused by spaceflight simulation by means of bed-rest. Electronic databases were searched from the start of their records to November 2014. Studies were assessed with PEDro, Cochrane Risk of Bias and a bed-rest study quality tool. Magnitude based inferences were used to assess countermeasure effectiveness. Seven studies were included. There was a lack of consistency across studies in reporting of outcome measures. Some countermeasures were found to be successful in preventing some lumbopelvic musculoskeletal changes, but not others. For ex le, resistive vibration exercise prevented muscle changes, but showed the potential to worsen loss of lumbar lordosis and intervertebral disc height. Future studies investigating countermeasures should report consistent outcomes, and also use an actual microgravity environment. Additional research with patient reported quality of life and functional outcome measures is advocated.
Publisher: Elsevier BV
Date: 10-1982
DOI: 10.1016/S0140-6736(82)90201-X
Abstract: Despite the growing number of mental health apps available for smartphones, the perceived usability of these apps from the perspectives of end users or health care experts has rarely been reported. This information is vital, particularly for self-guided mHealth interventions, as perceptions of navigability and quality of content are likely to impact participant engagement and treatment compliance. The aim of this study was to conduct a usability evaluation of a personalized, self-guided, app-based intervention for depression. Participants were administered the System Usability Scale and open-ended questions as part of a semistructured interview. There were 15 participants equally ided into 3 groups: (1) in iduals with clinical depression who were the target audience for the app, (2) mental health professionals, and (3) researchers who specialize in the area of eHealth interventions and/or depression research. The end-user group rated the app highly, both in quantitative and qualitative assessments. The 2 expert groups highlighted the self-monitoring features and range of established psychological treatment options (such as behavioral activation and cognitive restructuring) but had concerns that the amount and layout of content may be difficult for end users to navigate in a self-directed fashion. The end-user data did not confirm these concerns. Encouraging participant engagement via self-monitoring and feedback, as well as personalized messaging, may be a viable way to maintain participation in self-guided interventions. Further evaluation is necessary to determine whether levels of engagement with these features enhance treatment effects.
Publisher: Springer Science and Business Media LLC
Date: 09-2003
DOI: 10.1007/BF00233856
Publisher: Elsevier BV
Date: 07-1988
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.JBIOMECH.2011.09.009
Abstract: Pre-clinical computational testing of total knee replacements (TKRs) often only considers a single patient model with simplified applied loads. In studies of multiple patients, most only take into account geometric differences, especially in studies on the knee. Limited availability of kinetic data means that it is difficult to account for inter-patient variability. Principal component analysis (PCA) based statistical models have been used to capture the variation of a set of data and generate new instances of the data. This study presents a method to create a statistical model of kinetic waveform data. A PCA based statistical model was created of the tibiofemoral joint loads for level gait of preoperative TKR patients using data predicted from a musculoskeletal model. A reconstruction test showed that, using principal components (PCs) representing 95% variance, the median root-mean-squared (RMS) error was <0.1 body weight (BW) for the forces and <0.001 BWm for the moments. Leave-one-out tests were also performed and although the median RMS error increased for each load in comparison to the reconstruction error (maximum was 0.2 BW for the axial force and 0.012 BWm for the varus-valgus moment) these were considered within an acceptable limit. The purpose of creating a statistical model is to be able to s le a large set of data representing a population from a small set of clinical data. Such models can potentially be used in population based studies of TKRs incorporating inter-patient variability.
Publisher: Elsevier
Date: 1999
Publisher: SAGE Publications
Date: 08-1993
DOI: 10.1177/026921559300700308
Abstract: The between-limb symmetry of anterior tibial muscle size was examined in 40 healthy females, aged 18-35 years (20.7 ± 3.9). Real-time ultrasound imaging was used to measure the cross-sectional area (CSA) of the muscle group. With the subject half-lying, bilateral scans were taken and measurements of CSA were made by tracing the muscle group outline using an onscreen electronic calliper. On each scan, two CSA measurements were made and the mean of the two measurements was used in the analysis. Between-side comparisons were made by expressing the CSA of the smaller muscle as a percentage of that of the larger muscle and the mean, standard deviation and range for the 40 subjects were calculated. The paired t-test was used to compare the raw data between-sides, i.e. larger versus smaller muscle. The smaller muscle was approximately 93% of the size of the larger muscle with a mean difference of 7.2% ± 5% and a range of 0.1-20%. The differences between the raw values for CSA were significantly different ( p 0.001). The degree of symmetry of anterior tibial muscle size has been documented in a group of normal young females using real-time ultrasound scanning, which could be used to examine wasting in patients with unilateral leg injuries or pathology. The degree of normal symmetry for other subject groups of both sexes and different ages needs to be documented.
Publisher: Elsevier BV
Date: 06-2010
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.ARCHGER.2012.03.005
Abstract: The MyotonPRO (Myoton Ltd London) is a new portable device for measuring muscle mechanical properties (e.g. tone) and its reliability has yet to be established. Little is known about between-limb symmetry of mechanical properties in healthy older people, despite symmetry often being used as a measure of unilateral abnormalities in clinical assessment. Since quadriceps is important for mobility, it was selected for the present study. To investigate: (i) between-day intra-rater reliability of a novice user of MyotonPRO (ii) between-side symmetry of mechanical properties of quadriceps in older males. Twenty healthy, community dwelling, right-lower-limb-dominant males (mean age 71.7, range 65-82 years) were studied. With the participant in relaxed supine lying, the MyotonPRO applied two consecutive sets of 10 taps to induce muscle oscillations of rectus femoris, from which measurements of decrement (elasticity), frequency (tone), and stiffness were obtained. Tests were performed on two occasions at the same time and day of the week, one week apart. Repeated measurements had very high within-day (intraclass correlation coefficient, ICC 3,1>0.90) and high between-day (ICC 3,2>0.70 mean of two measurement sets) reliability. There was no statistically significant difference between muscle mechanical properties of the dominant and non-dominant muscles ( 0.05), thereby indicating symmetry. High intra-rater reliability was established for MyotonPRO measurements of quadriceps in healthy older males, which were symmetrical between sides. These findings indicate that larger studies are warranted to establish normal reference ranges of data with which to compare patients with muscle abnormalities.
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 10-2007
Abstract: Exploratory and reliability study. Shoulder dysfunction is common and often difficult to diagnose and treat. The trapezius muscle is an important stabilizer and primary mover of the scapula. The potential use of rehabilitative ultrasound imaging (RUSI) to evaluate scapular muscle function warrants investigation. To establish a procedure for imaging the thickness of the lower trapezius muscle and to examine reliability within and among investigators. In 16 asymptomatic subjects (12 female, 4 male), aged 20 to 41 years, 3 investigators used RUSI to measure the thickness of the left lower trapezius muscle with the subject at rest in prone. Investigator 1 took 3 images on each of 2 days, while the other 2 investigators took 2 images each on the second day. All measurements of lower trapezius muscle thickness were made off-line, at a point 3 cm lateral to the lateral edge of the spinous processes. To also obtain within-scan reliability, 1 image taken by investigator 1, once displayed on the scanner's screen, was measured 3 times. Investigator 1 also measured lower trapezius muscle thickness 1 cm medial to this site. Reliability was examined using intraclass correlation coefficients (ICC) and the Bland and Altman plot. The intrarater within-scan reliability at the lateral site was ICC3.3 = 0.99 (95% CI: 0.98 to 1.0). The intrarater between-scan reliability (within-day) at the lateral site, medial site, and combined sites (mean of medial and lateral) were ICC3.3 = 0.96 (95% CI: 0.90 to 0.98), ICC3.2 = 0.90 (95% CI: 0.78 to 0.96), and ICC3.2 = 0.99 (95% CI: 0.99 to 1.0), respectively. Intrarater (between-day) reliability was good for the lateral site and combined sites (ICC3.3 = 0.91, 95% CI: 0.74 to 0.96, and ICC3.3 = 0.90, 95% CI: 0.70 to 0.96, respectively) and moderate for the medial site (ICC3.3 = 0.89, 95% CI: 0.68 to 0.96). Interrater reliability (among investigators) was also moderate (ICC2.2 = 0.88, 95% CI: 0.73 to 0.96). Mean lower trapezius muscle thickness was approximately 3.1 mm (SD, 0.8 mm). Thickness of the lower trapezius muscle can be measured reliably with RUSI.
Publisher: Informa UK Limited
Date: 04-05-2018
Publisher: MDPI AG
Date: 07-10-2021
DOI: 10.3390/APP11199298
Abstract: The Hip and Lower Limb Movement Screen (HLLMS) was developed to detect altered movement patterns and asymmetry specifically related to hip, pelvic, and lower limb movement control, as the other tools, such as the Functional Movement Screen (FMS), lacked focus on the hip and pelvic area. Both screening tools contain symmetrical and asymmetrical motor tasks which are based on observation of different aspects of each task performance. One motor task is in both screening tools. Therefore, they have some common features. The present study aimed to assess the relationship between the HLLMS and FMS performance in youth football players. The study included 41 elite male football (soccer) players (age: 15.6 ± 0.50 years), and the HLLMS and FMS scores were analyzed by assessing Spearman’s rank correlation. The FMS total score and the FMSMOVE were moderately correlated with the HLLMS total score (R = −0.54 −0.53, respectively). The FMS rotatory stability task was moderately correlated with the HLLMS small knee bend with the trunk rotation task (R = −0.50). The FMS deep squat task was moderately correlated with the HLLMS deep squat task (R = −0.46). The FMS hurdle step was weakly correlated with two of the HLLMS tasks: standing hip flexion (R = −0.37) and hip abduction with external rotation (R = −0.34). There were no other relationships found (p 0.05). Out of the seven FMS tasks, only one asymmetrical (trunk rotary stability) and one symmetrical (deep squat) task were moderately related to the newly developed HLLMS tool contributing moderate relationship between the FMS total score and the HLLMS total score. Other FMS tasks were weakly or unrelated with the HLLMS. These findings indicate that these two screening tools mainly assess different aspects of movement quality in healthy youth football players.
Publisher: Elsevier BV
Date: 06-2010
Publisher: Oxford University Press (OUP)
Date: 1993
DOI: 10.1093/RHEUMATOLOGY/32.8.711
Abstract: Paraspinal muscle fatigue mechanisms were compared in 14 primary fibromyalgia patients and 14 age and sex matched normal subjects using a standardized 60-s isometric endurance test of the paraspinal muscles, during which surface integrated electromyographic (IEMG) activity was recorded. Fatigue-induced IEMG increases were similar for both groups during the initial 40 s (up to 112 +/- 20% and 111 +/- 6% of initial values in patients and normal subjects respectively). Thereafter, IEMG fell significantly in patients (P < 0.05) but only slightly in controls, so that at 58 s IEMG was 102 +/- 13% in patients and 109 +/- 12% in controls. If patients were ided according to body mass index (BMI, range 19-25 in controls) those with a BMI 26 (n = 9) showed greater IEMG declines after 40 s than either normal subjects or in the fibromyalgia group as a whole. Paraspinal muscle fatigue mechanisms appear normal in primary fibromyalgia patients. Isometric force maintenance in overweight patients, despite IEMG declines, illustrates the action of intrinsic fatigue resistance mechanisms which were presumably utilized to a greater extent in these patients to cope with the extra load.
Publisher: BMJ
Date: 22-10-1988
DOI: 10.1136/BMJ.297.6655.1014
Abstract: To examine fatigue mechanisms in an unselected series of patients with excess fatigue ("effort syndromes") their muscle function was compared with that of normal subjects. Voluntary performance was assessed with a cycle ergometer to exhaustion and by maximal isometric contractions of the quadriceps femoris. The mean maximal heart rate in patients during ergometry was 89% of the predicted rate, and quadriceps strength was either normal or was inappropriate for the available muscle, which suggested submaximal effort. Contractile performance was examined in the absence of volition with stimulated contractions of the adductor pollicis. During stimulated fatiguing activity patients were neither weaker nor more fatigable than controls thus the excess fatigue experienced by the patients was not due to a defect of the contractile apparatus. The increased perception of effort must therefore be due to impairment of central rather than peripheral mechanisms. The optimal approach to treatment of effort syndromes combines physical and psychological techniques.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-1993
DOI: 10.1097/00007632-199306000-00017
Abstract: The symmetry of lumbar multifidus size was examined in 20 patients with adolescent idiopathic scoliosis, aged 12-19 years. With the subject prone, bilateral real-time ultrasound images were obtained at the level of the 4th lumbar vertebra. Cross-sectional area and linear (horizontal and vertical) measurements were made using on-screen calipers. A pattern of asymmetry of lumbar multifidus cross-sectional area was shown to exist for the different curve types. The cross-sectional area was smaller (P < 0.0001) on the opposite side to the convexity of a primary thoracic curve, and on the convex side of a lumbar or thoracolumbar curve. The combined linear measurements (multiplied) correlated with cross-sectional area (r = 0.95) and could therefore be used for rapid clinical assessment of multifidus size. These preliminary findings provide a basis for further investigation of the role of the musculature in the pathogenesis of adolescent idiopathic scoliosis.
Publisher: Elsevier BV
Date: 10-2010
Publisher: SAGE Publications
Date: 2020
Publisher: Portland Press Ltd.
Date: 07-1984
DOI: 10.1042/CS0670007
Abstract: ‘Arthrogenous muscle weakness’ is weakness of muscles acting about an injured or inflamed joint. The weakness may be due to loss of muscle or to inability to activate the muscle (Fig. 1). Weakness of the thigh muscles, and of the quadriceps in particular, is a common and important consequence of knee trauma, surgery or arthritis. Muscle weakness contributes significantly to disability and probably also renders the joint vulnerable to further damage (Fig. 1). This review starts with a brief discussion of the contribution of atrophy to weakness. It concentrates, however, on inhibition of quadriceps activation and suggests some therapeutic implications. It does not deal with the reduced oxidative capacity and increased fatiguability of disused muscle since, although important, these have not been part of our programme of work.
Publisher: Informa UK Limited
Date: 06-1997
Publisher: IOP Publishing
Date: 22-09-2014
DOI: 10.1088/0967-3334/35/10/2165
Abstract: This study aimed to use ultrasound imaging to provide objective data on the effects of ageing and gender on relative thickness of quadriceps muscle and non-contractile tissue thickness (subcutaneous fat, SF, combined with perimuscular fascia). In 136 healthy males and females (aged 18-90 years n = 63 aged 18-35 years n = 73 aged 65-90) images of the anterior thigh (dominant) were taken in relaxed supine using B-mode ultrasound imaging. Thickness of muscle, SF and perimuscular fascia were measured, and percentage thickness of total anterior thigh thickness calculated. Independent t-tests compared groups. Correlation between tissue thickness and BMI was examined using Pearson's coefficient. Muscle thickness was: 39 ± 8 mm in young males, 29 ± 6 mm in females, 25 ± 4 mm in older males and 20 ± 5 mm in females. Percentage muscle to thigh thickness was greater in young participants (p = 0.001). Percentage SF and fascia was 17 ± 6% in young and 26 ± 8% in older males, 32 ± 7% in young and 44 ± 7% in older females. BMI was similar for age and correlated moderately with non-contractile tissue (r = 0.54 p < 0.001) and poorly with muscle (r = -0.01 p = 0.93). In conclusion, this novel application of ultrasound imaging as a simple and rapid means of assessing thigh composition (relative thickness of muscle and non-contractile tissue) may help inform health status, e.g. in older people at risk of frailty and loss of mobility, and aid monitoring effects of weight loss or gain, deconditioning and exercise.
Publisher: SAGE Publications
Date: 06-1998
DOI: 10.1191/026921598672178340
Abstract: Objective: To provide a practical guide to appropriate statistical analysis of a reliability study using real-time ultrasound for measuring muscle size as an ex le. Design: Inter-rater and intra-rater (between-scans and between-days) reliability. Subjects: Ten normal subjects (five male) aged 22–58 years. Method: The cross-sectional area (CSA) of the anterior tibial muscle group was measured using real-time ultrasonography. Main outcome measures: Intraclass correlation coefficients (ICCs) and the 95% confidence interval (CI) for the ICCs, and Bland and Altman method for assessing agreement, which includes calculation of the mean difference between measures ( d), the 95% CI for d, the standard deviation of the differences (SD diff), the 95% limits of agreement and a reliability coefficient. Results: Inter-rater reliability was high, ICC (3,1) was 0.92 with a 95% CI of 0.72 → 0.98. There was reasonable agreement between measures on the Bland and Altman test, as d was -0.63 cm 2 , the 95% CI for d was -1.4 → 0.14 cm 2 , the SD diff was 1.08 cm 2 , the 95% limits of agreement -2.73 → 1.53 cm 2 and the reliability coefficient was 2.4. Between-scans repeatability was high, ICCs (1,1) were 0.94 and 0.93 with 95% CIs of 0.8 → 0.99 and 0.75 → 0.98, for days 1 and 2 respectively. Measures showed good agreement on the Bland and Altman test: d for day 1 was 0.15 cm 2 and for day 2 it was -0.32 cm 2 , the 95% CIs for d were -0.51 → 0.81 cm 2 for day 1 and -0.98 → 0.34 cm 2 for day 2 SD diff was 0.93 cm 2 for both days, the 95% limits of agreement were -1.71 → 2.01 cm 2 for day 1 and -2.18 → 1.54 cm 2 for day 2 the reliability coefficient was 1.80 for day 1 and 1.88 for day 2. The between-days ICC (1,2) was 0.92 and the 95% CI 0.69 0.98. The d was -0.98 cm 2 , the SD diff was 1.25 cm 2 with 95% limits of agreement of -3.48 → 1.52 cm 2 and the reliability coefficient 2.8. The 95% CI for d(-1.88 → -0.08 cm 2 ) and the distribution graph showed a bias towards a larger measurement on day 2. Conclusions: The ICC and Bland and Altman tests are appropriate for analysis of reliability studies of similar design to that described, but neither test alone provides sufficient information and it is recommended that both are used.
Publisher: Wiley
Date: 08-1984
DOI: 10.1111/J.1365-2362.1984.TB01182.X
Abstract: Muscle weakness and wasting may be evaluated objectively by dynamometry and compound ultrasound imaging. We have measured the voluntary isometric strength of the quadriceps muscles of healthy women in their 70s (n = 25) and in their 20s (n = 25) and have compared it with the mid-thigh cross-sectional area of the same muscles. The two groups of women showed similar variability when strength was measured on consecutive days (coefficients of variation: 8%). The older women were 35% weaker than the young women (P less than 0.001) and their quadriceps cross-sectional area was 33% less (P less than 0.001). Quadriceps strength and cross-sectional area were correlated (r = 0.66, P less than 0.001, elderly r = 0.53, P less than 0.01, young) and the principal axis of the relationship was closely similar for the two groups of women. There is therefore no difference in the intrinsic strength of the quadriceps muscles of healthy women in their third and eighth decades. This report also provides normative data for the objective evaluation of quadriceps weakness and/or wasting in female patients. The techniques involved are straightforward, the dynamometer is easily made, and compound ultrasound imaging is widely available.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.MATH.2016.10.009
Abstract: Spaceflight and exposure to microgravity have wide-ranging effects on many systems of the human body. At the European Space Agency (ESA), a physiotherapist plays a key role in the multidisciplinary ESA team responsible for astronaut health, with a focus on the neuro-musculoskeletal system. In conjunction with a sports scientist, the physiotherapist prepares the astronaut for spaceflight, monitors their exercise performance whilst on the International Space Station (ISS), and reconditions the astronaut when they return to Earth. This clinical commentary outlines the physiotherapy programme, which was developed over nine long-duration missions. Principles of physiotherapy assessment, clinical reasoning, treatment programme design (tailored to the in idual) and progression of the programme are outlined. Implications for rehabilitation of terrestrial populations are discussed. Evaluation of the reconditioning programme has begun and challenges anticipated after longer missions, e.g. to Mars, are considered.
Publisher: Springer Science and Business Media LLC
Date: 23-10-2017
Publisher: Elsevier BV
Date: 2017
Publisher: BMJ
Date: 25-04-2019
DOI: 10.1136/BJSPORTS-2018-100193
Abstract: Physical therapists employ ultrasound (US) imaging technology for a broad range of clinical and research purposes. Despite this, few physical therapy regulatory bodies guide the use of US imaging, and there are limited continuing education opportunities for physical therapists to become proficient in using US within their professional scope of practice. Here, we (i) outline the current status of US use by physical therapists (ii) define and describe four broad categories of physical therapy US applications (ie, rehabilitation, diagnostic, intervention and research US) (iii) discuss how US use relates to the scope of high value physical therapy practice and (iv) propose a broad framework for a competency-based education model for training physical therapists in US. This paper only discusses US imaging—not ‘therapeutic’ US. Thus, ‘imaging’ is implicit anywhere the term ‘ultrasound’ is used.
Publisher: Springer Science and Business Media LLC
Date: 24-07-2017
Publisher: British Editorial Society of Bone & Joint Surgery
Date: 09-2013
DOI: 10.1302/2046-3758.29.2000176
Abstract: We aimed to examine the characteristics of deep venous flow in the leg in a cast and the effects of a wearable neuromuscular stimulator (geko FirstKind Ltd) and also to explore the participants’ tolerance of the stimulator. This is an open-label physiological study on ten healthy volunteers. Duplex ultrasonography of the superficial femoral vein measured normal flow and cross-sectional area in the standing and supine positions (with the lower limb initially horizontal and then elevated). Flow measurements were repeated during activation of the geko stimulator placed over the peroneal nerve. The process was repeated after the application of a below-knee cast. Participants evaluated discomfort using a questionnaire (verbal rating score) and a scoring index (visual analogue scale). The geko device was effective in significantly increasing venous blood flow in the lower limb both with a plaster cast (mean difference 11.5 cm/sec -1 p = 0.001 to 0.13) and without a plaster cast (mean difference 7.7 cm/sec -1 p = 0.001 to 0.75). Posture also had a significant effect on peak venous blood flow when the cast was on and the geko inactive (p = 0.003 to 0.69), although these differences were less pronounced than the effect of the geko (mean difference 3.1 cm/sec -1 (-6.5 to 10)). The geko device was well tolerated, with participants generally reporting only mild discomfort using the device. The geko device increases venous blood flow in the lower limb, offering a potential mechanical thromboprolylaxis for patients in a cast. Cite this article: Bone Joint Res 2013 :179–85.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-2004
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2000
DOI: 10.1109/86.847820
Abstract: We present an overview of our research into brain-computer interfacing (BCI). This comprises an offline study of the effect of motor imagery on EEG and an online study that uses pattern classifiers incorporating parameter uncertainty and temporal information to discriminate between different cognitive tasks in real-time.
Publisher: Springer Science and Business Media LLC
Date: 11-1989
DOI: 10.1007/BF02388329
Abstract: Previous research has shown that inhibiting emotion-expressive behavior (emotion suppression) leads to increased sympathetic activation of the cardiovascular system [Gross, J.J. and Levenson, R.W. (1993). Emotional suppression: physiology, self-report, and expressive behavior. J. Pers. Soc. Psychol. 64(6), 970-986]. Ethnic differences have been reported in how frequently suppression is used as an emotion regulation strategy [Gross, J.J. and John, O. (2003). In idual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J. Pers. Soc. Psychol. 85(2), 348-362] however, it remains unknown whether there are ethnic differences in the physiological consequences of suppression. To test this, 168 participants from four ethnic groups (African American, Chinese American, European American, Mexican American) watched a disgust-eliciting film clip half were instructed to suppress their emotions and half simply watched the film. Consistent with previous research, suppression was associated with decreased facial behavior, increased cardiovascular activation, and no impact on subjective emotional experience. Ethnicity failed to moderate these effects, indicating the generality of the cardiovascular consequences of emotion suppression across ethnic background.
Publisher: Informa UK Limited
Date: 1992
Publisher: Frontiers Media SA
Date: 03-07-2018
Publisher: Informa UK Limited
Date: 1992
Publisher: Elsevier BV
Date: 02-1991
DOI: 10.1016/0022-510X(91)90041-5
Abstract: Sounds produced during voluntary isometric contractions of the quadriceps muscle were recorded by acoustic myography (AMG) in seven healthy adults. With the subject seated, surface AMG and electromyography (EMG) were recorded over rectus femoris (RF) during isometric contractions, at different levels of maximum voluntary force. The AMG and EMG signals were lified and integrated (IAMG and IEMG). The relationships between force and IAMG (r = 0.98 +/- 0.01, mean +/- 1 SD) and force and IEMG (r = 0.99 +/- 0) were linear in all subjects. The results for EMG confirm previous reports but those for AMG differ from the relationships reported for other muscles. Physiological and technical explanations are proposed for these differences and the necessity for further validation of the AMG technique is stressed.
Publisher: MDPI AG
Date: 13-02-2021
DOI: 10.3390/DIAGNOSTICS11020298
Abstract: The abdominal drawing-in maneuver (ADIM) is a clinical tool used for identifying preferential activity of deep abdominal muscles. However, concurrent validity and reproducibility of palpation during the ADIM has not been formally investigated. The aims of this study were (1) to assess intra- and interrater reliability of manual palpation during the ADIM, and (2) to determine the concurrent validity of manual palpation during the ADIM by calculating preferential activation ratio cut-off as assessed with ultrasound imaging (RUSI). Thirty-two subjects (n = 16 patients with nonspecific low back pain and 16 comparable healthy in iduals) performed the ADIM in a supine hook-lying position. Two experienced assessors evaluated the presence or absence of preferential contraction of the deep abdominal muscles by palpation during the ADIM on 2 different days. Intrarater (test-retest) and interrater reliability of palpation were calculated using Cohen’s kappa coefficients. Muscle thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles at rest and during the ADIM were also measured. TrA-Contraction Ratio (TrA-CR), TrA-Preferential Activation Ratio (TrA-PAR), and Modified-TrA-PR (M-TrA-PAR) were calculated. The concurrent validity of manual palpation was determined using the correlation between manual palpation and imaging and by calculating ROC curve (operating characteristics curve), Youden index, and sensitivity and specificity. Intra- and interrater reliability of manual palpation during the ADIM was excellent (k: 0.82–1.00) and good to excellent (k: 0.71–1.00), respectively. Interrater reliability for muscle thickness ranged from good to excellent (ICC3,1 0.79–0.91). Manual palpation and TrA ratio showed low to moderate correlations (r: 0.36–0.60). When evaluating the diagnostic accuracy of manual palpation, the best predictive model (ROC value: 0.89 p 0.001) for correct a preferential contraction of TrA was obtained when the M-TrA-PAR was ≥0.08 (sensitivity: 0.95–1.00 specificity: 0.62). Good to excellent intra- and interrater reliability of manual palpation was found during the ADIM in both patients and healthy groups. Manual palpation showed concurrent validity for identifying the preferential activity of the TrA muscle supporting its use in clinical practice.
Publisher: Informa UK Limited
Date: 04-07-2019
Publisher: Wiley
Date: 22-07-2016
DOI: 10.1002/ACR.22794
Abstract: To explore patients' knowledge and beliefs about osteoarthritis (OA) and OA risk following anterior cruciate ligament (ACL) injury, to explore the extent to which information about these risks is provided by health professionals, and to examine associations among participant characteristics, knowledge, and risk beliefs and health professional advice. A custom-designed survey was conducted in Australian and American adults who sustained an ACL injury, with or without reconstruction, 1-5 years prior. The survey comprised 3 sections: participant characteristics, knowledge about OA and OA risk, and health professional advice. Complete data sets from 233 eligible respondents were analyzed. Most (70%, n = 164) rated themselves as being at greater risk of OA than their healthy peers, although only 56% (n = 130) were able to identify the correct OA definition. While most agreed that ACL (73%, n = 168) and/or meniscal injuries (n = 181, 78%) increase the risk of OA, 65% (n = 152) believed that ACL reconstruction reduced the risk of OA, or they did not know. A total of 27% (n = 62) recalled discussing their OA risk with a health professional. Participants who were female, younger, or had a lower body mass index or higher physical activity level were more likely to recognize meniscal tears and meniscectomy as risk factors of OA. A history of professional advice was associated with beliefs about increased OA risks. Patients sustaining an ACL injury require better education from health professionals about OA as a disease entity and their elevated risk of OA, irrespective of whether or not they undergo surgical reconstruction.
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.CLINBIOMECH.2013.07.014
Abstract: Studies have highlighted asymmetries in knee joint moments in in iduals with osteoarthritis and joint replacements. However, there is a need to investigate the forces at the knee joints to establish the extent of loading asymmetries. Twenty healthy (mean age, 62 range, 55-79 years) and 34 pre- to post-knee arthroplasty (mean age, 64 range, 39-79 years) participants performed gait and sit-stand activities in a motion capture laboratory. Knee joint forces and moments were predicted using inverse dynamics and used to calculate peak loading and impulse data which were normalized to body weight. Comparisons were made between affected and contralateral limbs, and changes from pre- to post-knee arthroplasty. Pre-knee arthroplasty peak vertical knee forces were greater in the contralateral limb compared to the affected limb during both gait 3.5 vs. 3.2 ∗ body weight and sit-stand 1.8 vs. 1.5 ∗ body weight. During gait, peak knee adduction moment asymmetries significantly changed from pre- to post-knee arthroplasty (-0.3 to 0.8 ∗ % body weight ∗ m ∗ height), although differences in vertical knee forces remained. There were no significant changes in loading during sit-stand from pre- to post-knee arthroplasty. The healthy participants showed no noteworthy asymmetries. This study showed loading asymmetries in knee forces between affected and contralateral limbs both pre- and post-knee arthroplasty. Continued over reliance of the contralateral limb could lead to pathology.
Publisher: British Editorial Society of Bone & Joint Surgery
Date: 10-2012
DOI: 10.1302/0301-620X.94B10.29035
Abstract: We systematically reviewed all the evidence published in the English language on proximal interphalangeal joint (PIPJ) replacement, to determine its effectiveness on the function of the hand and the associated post-operative complications. Original studies were selected if they reported clinical outcome with a minimum of one year’s follow-up. Quality was assessed using the Cowley systematic review criteria modified for finger-joint replacements. Of 319 articles identified, only five were adequately reported according to our quality criteria there were no randomised controlled trials. PIPJ replacements had a substantial effect size on hand pain of -23.2 (95% confidence interval (CI) -27.3 to -19.1) and grip strength 1.2 (95% CI -10.7 to 13.1), and a small effect on range of movement 0.2 (95% CI -0.4 to 0.8). A dorsal approach was most successful. Post-operative loosening occurred in 10% (95% CI 3 to 30) of ceramic and 12.5% (95% CI 7 to 21) of pyrocarbon replacements. Post-operative complications occurred in 27.8% (95% CI 20 to 37). We conclude that the effectiveness of PIPJ replacement has not been established. Small observational case studies and short-term follow-up, together with insufficient reporting of patient data, functional outcomes and complications, limit the value of current evidence. We recommend that a defined core set of patients, surgical and outcome data for this intervention be routinely and systematically collected within the framework of a joint registry.
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Location: Russian Federation
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2018
End Date: 2023
Funder: Versus Arthritis
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Funder: UK Space Agency
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Funder: Versus Arthritis
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End Date: 2011
Funder: Engineering and Physical Sciences Research Council
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Funder: Arthritis Research UK
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Funder: Economic and Social Research Council
View Funded ActivityStart Date: 2017
End Date: 2020
Funder: Federal Ministry for Economic Affairs and Energy
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