Influence of 3-month therapy using the neuro-orthopaedic suit Atlant on gait characteristics in preschool children with spastic cerebral palsy

Different kinds of physical therapy are used in medical rehabilitation of neurological patients with motor deficiency: partial body weight-supported treadmill training, driven gait orthosis, neuromuscular electrical stimulation and neuro-orthopaedic suit therapies. Neuro-orthopaedic pneumosuit (NOPS) Atlant (Dynaforce, Russia) creates a muscle framework by dynamic proprioceptive stimulation, stabilizing the trunk and the extremities, reducing pathological synergies and normalizing patient’s motor activity. The aim of the present study was to investigate the influence of 3-month therapy using the NOPS Atlant on gait characteristics in preschool children with spastic form of cerebral palsy (CP). Six CP children with spasticity of lower extremities with (mean±SE) age of 5.2±0.8 years participated in the present study. Children had NOPS Atlant therapy sessions during three months, supervised by an experienced physiotherapist. The kinematic and kinetic characteristics of gait were measured using 3-D movement analysis system Elite Clinic (BTS S.p.A., Italy). After 3-month therapy using the NOPS Atlant, significant increase (7.9%) of the stride length of gait was found as compared with the initial data. Children with spastic CP demonstrated significant improvement of range of motion of hip joint abduction, decrease of knee joint external rotation, as well as positive changes in foot progression angle during gait. In conclusion, motor function re-activation during gait in preschool children with spasticity caused by cerebral palsy was noted after 3-month therapy using the NOPS Atlant. However, future research is needed to elucidate mechanisms of neurodynamic therapy effect on motor ability in children with CP

Altersbedingte änderungen in kontraktilen Eigenschaften der plantar Flexor Muskeln bei physisch aktiven Frauen

Twitch contractile properties of the plantar flexor muscles were compared between the groups of women of the 3rd, 5th, 6th and 8th decade participating in regular recreational physical activity. An isometric twitch was evoked by supramaximal electrical stimulation of the tibial nerve in the popliteal fossa by a rectangular pulse of 1 millisecond duration. A significant decrease was found in the twitch peak force, the maximal rates of force development and relaxation from the 6th decade onwards. A significant prolongation in twitch contraction time was observed from the 5th decade onwards. The 3rd decade group showed a significant postactivation potentiation, while the three older groups did not. No significant age-related changes were observed in the isometric twitch peak force and voluntary strength ratio, and the twitch half-relaxation time in women participating in regular recreational physical activity. It was concluded that the marked decrease in twitch force-potentiation and prolongation of the contraction time of the plantar flexor muscles in physically active women seem to begin after 40 years of age, while a reduction in the maximal voluntary and twitch force-generating capacity, and twitch contraction kinetics occurs after 50 years of age.Uvod Cilj ovog istraživanja bio je izmjeriti učinak starenja na trzajna kontraktilna svojstva skeletnih mišića kod žena uključenih u redovitu rekreacijsku tjelesnu aktivnost. Mjereni su mišići potkoljenice, plantarni fleksori stopala, koji su važni za držanje tijela i kretanje, a aktivni su u mnogobrojnim radnim i sportskim aktivnostima. Metode Ukupno je 49 žena pristalo sudjelovati u ovom istraživanju. Raspoređene su u 4 dobne skupine: skupina u 3. desetljeću života (u dobi od 20 do 25 godina, n=13), skupina u 5. desetljeću života (u dobi od 40 do 49 godina, n=12), skupina u 6. desetljeću života (u dobi od 50 do 59 godina, n=11) i skupina u 8. desetljeću života (u dobi od 70 do 77 godina, n=13). Sve su mlađe ispitanice bile fizički zdrave studentice uključene u redovitu tjelovježbu dva do tri puta tjedno u skupinama odbojke, košarke ili aerobike. Ispitanice srednje dobi vježbale su u skupinama odbojke ili aerobike dva puta tjedno, a starije ispitanice također su vježbale u skupinama aerobike dva puta tjedno. Tijekom mjerenja, ispitanice su sjedile na posebno dizajniranoj stolici, s dominantnom nogom savijenom u koljenom zglobu pod kutom od 90° i smještenom unutar metalnog okvira. Da bi se utvrdila kontraktilna svojstva mišića plantarnih fleksora tijekom izometričkog trzaja, parom samoljepljivih elektroda podraživali smo stražnji tibijalni živac. Katoda je postavljena iznad tibijalnog živca u poplitealnoj jami, a anoda je postavljena ispod stražnje medijalne strane natkoljenice. Izolirani voltažni stimulator bio je izvor supramaksimalnih pravokutnih podražaja od 1 ms. Nakon bilježenja mišićne kontrakcije u mirovanju, ispitanice su dobile uputu da 5 sekundi zadrže mišić u maksimalnoj voljnoj kontrakciji (MVC), a zatim da ga opuste. Drugi (potencirani) trzajni podražaj nastupio je unutar 1 s nakon početka relaksacije. Izračunate su sljedeće karakteristike izometričkog trzaja: vršna sila trzaja (PT) – najveća vrijednost izometričke sile, vrijeme kontrakcije (CT) – vrijeme do vršne sile trzaja, poluvrijeme relaksacije (HRT) – vrijeme polovičnog opadanja vršne sile trzaja, maksimalna brzina razvoja sile (RFD) – prva derivacija razvoja sile (dF/dt) i maksimalna brzina relaksacije (RR) kao prva derivacija opadanja sile (-dF/dt). Postotak porasta potencirane vršne sile trzaja (PT) u odnosu na vrijednost u mirovanju uzet je kao pokazatelj postaktivacijske potencijacije (PAP). Vršna sila trzaja u mirovanju izražena je kao omjer s izometričkom voljnom jakosti. Rezultati Prosječna vrijednost vršne sile trzaja u skupini žena u 3. desetljeću života bila je veća (p<0.05) od prosječnih vrijednosti u skupinama žena u 6. i 8. desetljeću. Skupina u 5. desetljeću pokazala je veću (p<0.05) vršnu silu trzaja od skupine u 8. desetljeću. Razlike u vršnoj sili trzaja između dvije mlađe i dvije starije skupine nisu bile značajne. Među skupinama nisu uočene značajne razlike u omjeru između vršne sile trzaja i voljne jakosti. Uočeno je produljenje vremena kontrakcije (CT) izometričkog trzaja s porastom dobi. Prosječna vrijednost vremena kontrakcije (CT) trzaja u najmlađoj skupini bila je manja (p<0.05) od vrijednosti triju starijih skupina. Razlike u CT trzaja između skupina u 5., 6. i 8. desetljeću nisu bile značajne. Nije bilo značajnih razlika među izmjerenim dobnim skupinama u prosječnim vrijednostima poluvremena relaksacije (HRT) trzaja. Vrijednosti maksimalne RFD i RR izometričkog trzaja smanjile su se s dobi. Vrijednost aritmetičke sredine maksimalne brzine razvoja sile trzaja (RFD) u skupini u 3. desetljeću bila je veća (p<0.05) od vrijednosti u skupinama žena u 6. i 8. desetljeću. Razlike u maksimalnoj RFD trzaja između dviju mlađih i dviju starijih skupina nisu bile značajne. Prosječna vrijednost maksimalne brzine relaksacije (RR) trzaja u skupini u 8. desetljeću bila je manja (p<0.05) od vrijednosti u dvije mlađe skupine. Maksimalna RR trzaja u skupini u 3. desetljeću bila je veća (p<0.05) u usporedbi s vrijednosti skupine u 6. desetljeću. Razlike u maksimalnoj RR trzaja između dvije mlađe skupine i dvije starije skupine nisu bile značajne. Nisu uočene značajne razlike u RR trzaja u usporedbi skupina u 6. i 5. desetljeću. Postaktivacijska potencijacija (PAP) bila je značajno izražena (p<0.05) samo u najmlađoj skupini, dok za tri starije skupine postaktivacijska potencijacija nije bila značajna. Skupina u 3. desetljeću imala je veće vrijednosti (p<0.05) PAP od skupine u 8. desetljeću, dok razlike u PAP između skupina u 3., 5. i 6. desetljeću nisu bile značajne. Vrijednost PAP u skupini u 8. desetljeću nije se značajno razlikovala od vrijednosti PAP u skupinama u 5. i 6. desetljeću. Rasprava i zaključak Ovo je istraživanje pokazalo da je značajno, s dobi povezano opadanje izometričkog maksimalnog voljnog i električno izazvanog kapaciteta stvaranja sile trzaja, kao i opadanje kinetike trzajne kontrakcije, ocijenjeno brzinama razvoja sile i relaksacije mišića plantarnih fleksora stopala, kod žena uključenih u redovitu tjelesnu aktivnost započelo nakon 50. godine. Suprotno prijašnjim istraživanjima, nisu uočene značajne promjene povezane s dobi u omjeru između vršne sile trzaja i voljne jakosti ni u poluvremenu relaksacije trzaja kod žena uključenih u redovitu rekreacijsku tjelesnu aktivnost. Mehanizmi odgovorni za trzajnu potencijaciju nakon kratke izometričke maksimalne voljne kontrakcije značajno su pod utjecajem starenja. Opadanje kapaciteta trzajne potencijacije i produljenje vremena kontrakcije mišića plantarnih fleksora stopala kod tjelesno aktivnih žena započelo je nakon 40. godine.Einzelkontraktile Eigenschaften von M. triceps surae wurden zwischen den Frauengruppen der 3., 5., 6. und 8. Lebensdekade, die regelmäßig physisch aktiv waren, verglichen. Die isometrische Einzelkontraktion wurde mit supramaximaler elektrischer Stimulation des N. tibialis in der Fossa Poplitea bei Rechteckim-pulse von 1 ms Dauerhaftigkeit erreicht. Der wesentliche Fall der Einzelkontraktion bei Maximalkraft im maximalen Kraftgradient und im Relaxiongradient wurde ab 6. Dekade und die Erscheinung der Kontrak-tionszeitverlängerung ab 5. Dekade gefunden. Bei der Gruppe der 3. Dekade erschien die wesentliche post-aktive Potensierung, bei den 3 älteren Gruppen wurde diese Erscheinung nicht gefunden. Bei körperlich aktiven Frauen wurden keine wesentlichen Alterserscheinungen sowohl bei maximaler Kraft der Einzelkon-traktionen und bei willkürlicher Kraft als auch bei Einzelkontraktion in der Halbentspannungszeit gefunden. Zusammengefasst ergibt sich daraus, dass der wesentliche Fall bei der Fähigkeit des Kraftgenerierens und die Verlängerung der Kontraktionszeit bei physisch aktiven Frauen nach dem 40. Lebensjahr erschienen, wobei der Fall der willkürlichen maximalen Kraft und bei der postaktiven Potensierung der Einzelkontrak-tion erst nach dem 50. Lebensjahr erscheint

Gait and muscle strength characteristics in total knee arthroplasty patients with patellofemoral pain syndrome before and six months after surgery

The aim of the present study was to investigate the gait and muscle strength characteristics in total knee arthroplasty (TKA) patients with patellofemoral pain syndrome (PFPS) before and six months after surgery. Eight patients (4 men and 4 women) aged 58–77 years with PFPS following unilateral TKA who had primary degenerative knee OA participated in the study before and six months after reoperation.In patients was registered the active range of motion (AROM) of knee extension and flexion, hip abduction and adduction. Isometric maximal voluntary contraction (IMVC) force of knee flexors, extensors, abductors and adductors was measured and gait kinematic characteristics and kinetic characteristics of knee joint were recorded. Knee flexion AROM in the involved leg was significantly lower (p&lt;0.05) as compared to the uninvolved leg pre- and post-surgery. The patients had greater (p&lt;0.05) hip abduction AROM and significant increase (31%, p&lt;0.05) of IMVC force of the involved legʼs hip abductors postoperatively as compared before surgery. Six months after surgery 38 H. Gapeyeva et al. a significant (p&lt;0.05) improvement of gait spatiotemporal characteristics (increase of swing time and stride length (p&lt;0.05), together with decrease of stance time and cadence, as well increase of stride length) was noted in the involved leg. In TKA patients 6 months after reoperation due to PFPS the knee joint function in involved leg was significantly improved and the positive changes in gait with comfortablevelocity took place as compared before surgery

Shoulder muscle electromyographic activity and stiffness in patients with frozen shoulder syndrome: six-month follow-up study

This study evaluated changes in shoulder muscle isometric endurance, deltoideus and trapezius muscle electromyographic activity (EMG) and stiffness in patients with frozen shoulder syndrome (FSS) before and after manipulation under general anaesthesia (MUA). Eighteen FSS patients with mean age of 53±9 years participated. Isometric endurance of shoulder muscles was characterized by endurance test time and deltoideus and trapezius muscles EMG activity that were assessed by electromyograph during weight holding in hand until exhaustion. Stiffness of deltoideus and trapezius muscles was assessed by myotonometer (MYOTON-3). Patients were screened by self-administered shoulder rating questionnaire (SRQ). Data was collected before one and six months after MUA. Six months aft er MUA endurance test time remained reduced (p&lt;0.05) for the involved extremity as compared with the uninvolved extremity. Deltoideus and trapezius muscle EMG activity decreased (p&lt;0.05) at the end of the endurance test, whereas in the beginning of the endurance test the trapezius muscle EMG was lower (p&lt;0.05) for the involved extremity. Deltoideus and trapezius muscle stiffness did not differ (p&lt;0.05). SRQ score points decreased (p&lt;0.05) one and six months aft er MUA. In conclusion, six months after MUA the shoulder muscle EMG activity and stiffness for the involved extremity was normalized in patients with FSS

Changes in electromyographic parameters during cycling exercise at constant intensity

The aim of this study was to evaluate the changes in surface electromyography (sEMG) parameters during 30-minute cycling exercise (250 W) at constant intensity in laboratory conditions. Ten male cyclists with the mean (±SE) age of 23.8±3.7 years participated. The sEMG power spectrum median frequency (MF) of rectus femoris, vastus lateralis, biceps femoris and erector spinae muscles, heart rate and the subjective rate of fatigue by Borg scale were measured in the beginning, during and at the end of exercise. Maximal voluntary contraction (MVC) force of the knee extensor muscles was assessed before and after the end of exercise. A significant decrease (p&lt;0.05) in sEMG power spectrum MF for erector spinae muscle at the end of exercise compared to the initial level was found, whereas the knee extensor and flexor muscles revealed no significant changes in this parameter. The subjective rate of fatigue increased moderately during the cycling exercise (p &lt; 0.05). The heart rate was stable during the exercise, remaining predominantly in the aerobic zone. After the exercise, MVC force was significantly (p&lt;0.05) decreased compared to the pre-exercise level.We concluded that based on sEMG power spectrum MF, 30-minute cycling exercise at constant intensity caused a marked fatigue of erector spinae muscle with no significant fatigue-induced changes in knee extensor and flexor muscles. A marked decrease of voluntary force capacity of knee extensor muscles was found after exercise. A moderate subjectively assessed fatigue was established at the end of exercise

Activity of shoulder muscles during shots of different difficulty level in more and less skilled novus players

The aim of the present study was to compare the activation of the shoulder muscles in more and less skilled novus players during shots of different difficulty level. Nineteen competitive novus players (9 more skilled and 10 less skilled) were recruited to examine bioelectrical activity of the shoulder muscles (trapezius, deltoid lateral and posterior muscles) during a striking accuracy task. Participants performed 3 series, each consisted of 10 novus shots – 10 penalties, 10 cut and 10 rebound shots. Surface EMG (sEMG) amplitude of posterior and lateral deltoid and trapezius muscle of the subjects' dominant side was measured during the shot and compared between successful versus unsuccessful shots in more skilled and less skilled players. Unsuccessful penalties and rebound strokes compared to successful ones in more and less skilled players, and unsuccessful cut shots compared to successful ones in more skilled players are characterized by higher activity in trapezius muscle. Higher activity of trapezius muscle is a characteristic feature of less skilled players' novus shots. During successful penalties, cut and rebound shots the sEMG amplitude of trapezius muscle in more skilled players was significantly lower (34%; p&lt;0.05; 19%; p&lt;0.001 and 60%; p&lt;0.01, respectively) than in less skilled players

Effect of home exercise programme on thigh muscle strength before total knee arthroplasty

The aim of the study was to assess the effect of home exercise programme (HEP) on thigh muscle strength in patients with knee osteoarthritis (OA) before unilateral total knee arthroplasty (TKA).Five female OA patients with mean age 67.8±5.9 years participated in the study. Isometric maximal voluntary contraction (MVC) force of the quadriceps femoris (QF) and hamstring (HM) muscles was measured by hand-held dynamometry. Knee active range of motion (aROM) in flexion was measured by goniometer. Knee pain score was evaluated by knee pain scale before and after HEP.A significant reduction (p&lt;0.05) in MVC force of the QF and HM muscles and aROM in flexion were noted before HEP, comparing the involved and uninvolved leg. After HEP, MVC force of the QF muscle increased significantly (p&lt;0.05) for the involved and uninvolved leg, whereas no significant differences (p&gt;0.05) were observed between the limbs. MVC force of the HM muscle and aROM in flexion remained significantly lower (p&lt;0.05) for the involved leg as compared with the uninvolved leg after HEP. Knee pain score was significantly (p&lt;0.05) higher for the involved leg before and after HEP as compared with the uninvolved leg.Two months before the operation, HEP was an effective therapeutic procedure for increasing QF muscle strength in patients who underwent TKA

Evaluation of work-related neuromuscular fatigue and discomfort in female sales workers

The aim of this study was to compare neuromuscular fatigue anddiscomfort following workday in groups of sales workers, who were working predominantly in standing or sitting position. Ten female sales workers (aged 21–66 yrs), who worked predominantly in standing position (ST) and 9 female sales workers (aged 20–54 yrs), who worked predominantly in sitting position (SI) participated in this study. Neuromuscular fatigue and discomfort after the workday immediately was subjectively evaluated by 10-point visual analogue scale (VAS) in neck, shoulder, low-back and leg regions. Visual-motor coordination was assessed by Grooved Pegboard test and hand grip strength for both arms was tested by hand dynamometer before and after the workday. The results indicated that after the workday, subjectively evaluated neuromuscular fatigue and discomfort in ST group was higher (p&lt;0.05) in posterior calf region compared with SI group. SI group felt subjectively significantly higher (p&lt;0.05) neuromuscular fatigue and discomfort in shoulder region after the workday as compared to ST group. Before the workday, the Grooved Pegboard test time was shorter (p&lt;0.05) in SI group, whereas hand grip strength for right arm was higher (p&lt;0.05) in ST group. No significant workrelated changes were found in Grooved Pegboard test time and hand grip strength in the measured groups. It was concluded that following the workday, subjectively evaluated neuromuscular fatigue and discomfort was more pronounced in ST group in posterior calf region and in SI group in shoulder muscles. No significant fatigue-induced changes in visual-motor coordination and in voluntary isometric forcegeneration capacity of hand muscles were established in female sales workers following the workday

Skeletal muscle tone and motor performance characteristics in dentists as compared to controls

ArticleThe daily work tasks of dentists are associated with repeated movements and static load during the treatment of patients. Dentists’ profession includes manual dexterity and maintaining the occupational posture for a long time. Previously it has been noted that dentists have increased muscle stress in neck, shoulder and lower back regions. The aim of the present study was to compare the muscle tone and motor performance characteristics of neck and shoulder region in dentists and representatives of other professions who do not have similar static load of long-time duration (as controls). Twenty women aged 34–55 years participated in the study: ten dentists with the age (mean and SE) of 40.2 ± 3.9 years and ten controls (bookkeepers, security guards, office workers, printing house workers, laundry and dry cleaning workers) with the age of 40.9 ± 2.4 years; working period was on the average 14 years in both groups. The tone characteristics of m. trapezius and m. extensor carpi radialis were investigated by device Myoton- 2 (Müomeetria Ltd, Estonia) at rest and at maximal voluntary contraction (MVC) in sitting position at the workplace of participants. The cervical range of motion (CROM) and the handgrip strength were measured. Significantly higher (P < 0.05) tone and elasticity characteristics of m. extensor carpi radialis and lower (P < 0.05) tone and elasticity characteristics of m. trapezius at rest were noted in dentists compared to controls. At MVC, no significant differences were found in the studied characteristics between body sides in the measured groups. Dentists had lower (P < 0.05) CROM of flexion and rotation than controls. In dentists emerged significant difference in muscle elasticity characteristics for the right body side, this is related with stretching for dentistry instruments

The acute effects of warm-up, static and dynamic stretching exercises on biceps brachii muscle function in female basketball players

Static and dynamic stretching exercises are often used in sports before competition and training sessions. Recent studies have shown different effects of dynamic and static stretching exercises on physical performance capacity. The aim of the present study was to evaluate the acute effect of warm-up, 30s static and dynamic stretching exercises on biceps brachii muscle function. Nine athletes were examined twice in different days: after performing static and dynamic stretching exercise. Isometric maximal voluntary contraction characteristics were measured using dynamometry; muscle tone, elasticity and stiffness characteristics of biceps brachii muscle were measured using myotonometer Myoton-3. All measurements were performed before and after the warm-up (5-min jogging with self-selected speed), immediately after stretching exercise and after 10 min rest. Warm-up did not cause any changes in the isometric maximal voluntary contraction, strength of elbow flexor muscle as well as in muscle tone and elasticity. Static stretching was effective to increase elasticity of biceps brachii muscle, but did not influence the isometric strength characteristics of elbow flexor muscles. Shortening of isometric contraction latency of elbow flexor muscles after dynamic stretching exercise and increase of strength after 10 min rest were noted. Therefore this type of stretching can be recommended to prepare muscles for explosive maximal exercise