Implementation and Validation of a Detailed 3D Inverse Dynamics Lower Extremity Model for Gait Analysis Applications Based on Optimization Technique

The goal of this research work was to introduce the whole process of developing and validating a 3D lower extremity musculoskeletal model and to test the ability of the model to predict the muscles recruitment of the different muscles involved in human locomotion as well as determining the corresponding forces and moments generated around the different joints in the lower extremity. Therefore the model can be applied in one of the important fields of orthopaedics which is joint replacement; the case study used in such application is the total knee replacement. The knee reaction forces were compared to the pattern obtained by Harrington (1992), where the hip moment components (Flexion/extension, internal/external, and abduction/adduction) were all compared to the patterns obtained from the Hip98 data base. It was shown in the different graphs of joints forces and moments that the model was able to produce very close results when comparing pattern and magnitude to the literature data. Thus, this 3D biomechanical model is sophisticated enough to be used for surgery evaluation such as in total knee replacement, where the damaged cartilage and bone are removed from the surface of the knee joint and replaced with a man-made. The case study of the second part of the research work presented involved the comparison of the gait pattern between two main knee joint types, Metallic and Allograft knee joints against normal subjects (Control group). A total of fifteen subjects participated in this study, five subjects in each group. It was concluded that based on the study conducted and the statistical evidence obtained that the introduced model can be used for applications that involves joint surgeries such as knee replacement that ultimately can be utilized in surgery evaluation

Validation of Static and Dynamic Balance Assessment Using Microsoft Kinect for Young and Elderly Populations

Reduction in balance is an indicator of fall risk, and therefore, an accurate and cost-effective balance assessment tool is essential for prescribing effective postural control strategies. This study established the validity of the Kinect v2 sensor in assessing center of mass (CoM) excursion and velocity during single-leg balance and voluntary ankle sway tasks among young and elderly subjects. We compared balance outcome measures (anteroposterior (AP) and mediolateral (ML) CoM excursion and velocity and average sway length) to a traditional three-dimensional motion analysis system. Twenty subjects (10 young: age = 20.5\pm 2.3 y, height = \,{\text{171.8}}\,\pm\, {\text{7.2}} cm, weight = \,{\text{70.7}}\,\pm\, {\text{11.6}} kg; 10 elderly: age = \,{\text{70.6}}\,\pm\, {\text{9.5}} y, height = \,{\text{169.1}}\,\pm\, {\text{8.7}} cm, weight = \,{\text{74.0}}\,\pm\, {\text{17.8}} kg), with no history of lower extremity injury, participated in this study. Subjects performed six randomized trials; four single-leg stand (SLS) and two ankle sway trials. SLS and voluntary ankle sway trials showed that consistency (ICC(2, k)) and agreement (ICC(3, k)) for all variables when all subjects were considered, as well as when the elderly and young groups were analyzed separately. Concordance between systems ranged from poor to nearly perfect depending on the group, task, and variable assessed

Conversion of Fused Hip to Total Hip Arthroplasty With Presurgical and Postsurgical Gait Studies

This case study presents a subject with a fused hip converted to total hip arthroplasty. Kinematic gait analysis was conducted on 3 occasions, presurgery, 4 months postsurgery, and 2.5 years postsurgery. Presurgery data showed decreased cadence and shorter step length; sound limb possessed increased hip, knee range of motion (ROM), and increased knee flexion during stance; the affected limb had minimal hip motion and normal knee ROM with abnormal pattern. At 4 months postsurgery, the sound limb showed decreased step length, whereas the affected limb showed increased knee extension during stance and increased hip ROM. Data obtained at 2.5 years postsurgery indicated decreased cadence and speed and increased ROM in both limbs. The total hip arthroplasty had provided relief of chronic back and affected hip pain and improved mobility. Gait-specific training is recommended

Prediction of gait kinetics using Markerless-driven musculoskeletal modeling

Video-based motion analysis systems are emerging in the biomechanics research community, yet there is limited exploration of kinetics prediction using RGB-markerless kinematics and musculoskeletal modeling. This project aimed to provide ground reaction force (GRF) and ground reaction moment (GRM) predictions during over-ground gait by introducing RGB-markerless kinematics into a musculoskeletal modeling framework. Full-body markerless kinematic inputs and musculoskeletal modeling were used to obtain GRF and GRM predictions which were compared to measured force plate values. The markerless-driven predictions yielded average root mean-squared error (RMSE) in the stance phase of 0.035 ± 0.009 N∙BW−1, 0.070 ± 0.014 N∙BW−1, and 0.155 ± 0.041 N∙BW−1 in the mediolateral (ML), anteroposterior (AP), and vertical (V) GRFs. This was accompanied by moderate to high correlations and interclass correlation coefficients (ICC) indicating moderate to good agreement between measured and predicted values (95% Confidence Inervals: ML = [0.479, 0.717], AP = [0.714, 0.856], V = [0.803, 0.905]). For ground reaction moments (GRM), average RMSE was 0.029 ± 0.013 Nm∙BWH-1, 0.014 ± 0.005 Nm∙BWH-1, and 0.005 ± 0.002 Nm∙BWH-1 in the sagittal, frontal, and transverse planes. Pearson correlations and ICCs indicated poor agreement between systems for GRMs (95% Confidence Intervals: Sagittal = [0.314, 0.608], Frontal = [0.006, 0.373], Transverse = [0.269, 0.570]). Currently, RMSE is larger than target thresholds set from studies using Kinect, inertial, or marker-based kinematic drivers; but methodological considerations highlighted in this work may help guide follow-up iterations. At this point, further use in research or clinical practice is cautioned until methodological considerations are addressed, although results are promising at this point

Hemodynamic Responses to an Exercise Stress Test in Parkinson’s Disease Patients without Orthostatic Hypotension

The presence of postganglionic sympathetic denervation is well established in Parkinsonâ s disease (PD). Denervation at cardiac and blood vessel sites may lead to abnormal cardiovascular and hemodynamic responses to exercise. The aim of the present investigation was to examine how heart rate (HR) and hemodynamics are affected by an exercise test in PD patients without orthostatic hypotension. Fourteen individuals with PD and sixteen age-matched healthy controls performed an exercise test on a cycle ergometer. HR, blood pressure, and other hemodynamic variables were measured in a fasted state during supine rest, active standing, exercise, and supine recovery. Peak HR and percent of age-predicted maximum HR (HRmax) achieved were significantly blunted in PD (pThe accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Optimal Approach to Load Progressions during Strength Training in Older Adults

Progressive resistance training (RT) is one of the most effective interventions for reducing age-related deficits in muscle mass and functional capacity. To compare four approaches to load progressions in RT for older adults to determine if an optimal method exists. Eighty-two healthy community-dwelling older adults (71.8 ± 6.2 yr) performed 11 wk of structured RT (2.5 d·wk) in treatment groups differing only by the method used to increase training loads. These included percent one repetition maximum (%1RM): standardized loads based on a percentage of the one repetition maximum (1RM); rating of perceived exertion (RPE): loads increased when perceived difficulty falls below 8/10 on the OMNI-Resistance Exercise Scale perceived exertion scale; repetition maximum (RM): loads increased when a target number of repetitions can be completed with a given load; repetitions in reserve (RiR): identical to RM except subjects must always maintain ≥1 "repetition in reserve," thus avoiding the possibility of training to temporary muscular failure. Multiple analyses of covariance indicated no significant between-group differences on any strength (chest press 1RM; leg press 1RM) or functional performance outcome (usual walking speed, maximum walking speed, 8-ft timed up-and-go, gallon jug transfer test, 30 s sit-to-stand). The RPE group found the exercise to be significantly more tolerable and enjoyable than subjects in the RiR, RM, and %1RM groups. Given the RM, RPE, %1RM, and RiR methods appear equally effective at improving muscular strength and functional performance in an older population, we conclude that the RPE method is optimal because it is likely to be perceived as the most tolerable and enjoyable, which are two important factors determining older adults' continued participation in RT

Multidirectional Walking in Hematopoietic Stem Cell Transplant Patients

The effect of a peritransplant multidirectional walking intervention to target losses in physical function and quality of life (QOL) has not been investigated. This study examined the effects of a novel multidirectional walking program on physical function and QOL in adults receiving a hematopoietic stem cell transplant (HSCT). Thirty-five adults receiving an autologous or allogeneic HSCT were randomized to a multidirectional walking (WALK) or usual care (CONT) group. The WALK group received supervised training during hospitalization; the CONT group received usual care. Patients were assessed at admission (t0), 3 to 5 d post-HSCT (t1), and 30 d post-HSCT (t2). Physical function measures included the 6-min walk test (6MWT), the Physical Performance Test, and the Timed Up and Go test. Health-related QOL was collected using the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) questionnaire. There were no significant between-group changes for physical function or QOL. However, after the intervention (t1 to t2), the WALK group showed significant improvement in aerobic capacity (6MWT, P = 0.01), physical (P < 0.01) and functional well-being (P = 0.04), and overall QOL scores (P < 0.01). The CONT group saw no significant changes in physical function or QOL. Effect sizes showed the WALK group had a larger positive effect on physical function and QOL. Minimal clinically important differences in the 6MWT and FACT-BMT were exceeded in the WALK group. A multidirectional walking program during the transplant period may be effective at increasing aerobic capacity and QOL for patients receiving HSCT compared with no structured exercise

Differences in Muscle Activation and Kinematics Between Cable-Based and Selectorized Weight Training

Signorile, JF, Rendos, NK, Heredia Vargas, HH, Alipio, TC, Regis, RC, Eltoukhy, MM, Nargund, RS, and Romero, MA. Differences in muscle activation and kinematics between cable-based and selectorized weight training. J Strength Cond Res 31(2): 313-322, 2017-Cable resistance training machines are showing resurgent popularity and allow greater number of degrees of freedom than typical selectorized equipment. Given that specific kinetic chains are used during distinct activities of daily living (ADL), cable machines may provide more effective interventions for some ADL, whereas others may be best addressed using selectorized equipment. This study examined differences in activity levels (root mean square of the EMG [rmsEMG]) of 6 major muscles (pectoralis major, PM; anterior deltoid, AD; biceps brachii, BB; rectus abdominis, RA; external obliques, EO; and triceps brachii, TB) and kinematics of multiple joints between a cable and standard selectorized machines during the biceps curl, the chest press, and the overhead press performed at 1.5 seconds per contractile stage. Fifteen individuals (9 men, 6 women; mean age ± SD, 24.33 ± 4.88 years) participated. Machine order was randomized. Significant differences favoring cable training were seen for PM and AD during biceps curl; BB, AD, and EO for chest press; and BB and EO during overhead press (p ≤ 0.05). Greater starting and ending angles were seen for the elbow and shoulder joints during selectorized biceps curl, whereas hip and knee starting and ending angles were greater for cable machine during chest and overhead presses (p < 0.0001). Greater range of motion (ROM) favoring the cable machine was also evident (p < 0.0001). These results indicate that utilization patterns of selected muscles, joint angles, and ROMs can be varied because of machine application even when similar exercises are used, and therefore, these machines can be used selectively in training programs requiring specific motor or biomechanical patterns