Assessment of Range of Motion and Lower Limb Muscle Activity in Parkinson Patients and Normal Elderly Subject (a case study)

Objective: Parkinson Disease (PD) is a progressive deficit of central nervous system. This disease can affect gait performance. The objective of this study was to assessment the range of motion and muscle activity of lower limbs in a PD patient and a normal elderly subject. &nbsp; Methods: one patient with PD (height=173 cm, weight=63 kg, age 53 years) and one normal elderly subject (height=172cm, weight=70kg, age 51years) participated in this study. VICON motion analysis system was used to measure kinematic variables. Moreover, MA300-16 was used to measure EMG activity of lower limbs muscles. Data were evaluated using Independent t-test with significant point set at p < 0.05. &nbsp; Results: The duration of mid stance and terminal swing phase of PD patient was greater than that in the normal elderly subject in right limb 20.3% and 11.6 % and in the left limb 19.4% and 2.3% respectively. The intensity and duration of muscle activity of tibialis anterior, vastusmedius and biceps femoris was significantly increased in the PD patient compared to the normal elderly. &nbsp; Conclusion: The timing percent of gait cycle phases changes in PD patients. The intensity of muscle activity increases in PD patients which means that PD patients&rsquo; muscles are weaker, thus strengthening of ankle plantar-flexor, knee and hip extensor must be considered in rehabilitation programs

Assessment of the Symmetry of the Ground Reaction Forces in Patient with ACL Rupture during Vertical Jump

Objectives: The aim of this study was to assess the symmetry of ground reaction forces in patient with ACL rupture during vertical jump. Methods: Six men with ACLD (anterior cruciate ligament disease) participated in this study. Ground reaction forces components were assessed during Sargent jump by Kistler force plate. Data were analyzed running dependent Samples T-test and Repeated Measure in at p&le;0.05. Result: Peak anterior posterior ground reaction forces were significantly greater in sound limb compared to the affected limb during landing phase (P=0.04). During landing, vertical (p=0.00) and anterior posterior (p=0.01) impulse in sound limb were significantly greater than those of affected limb. There were no significant differences between loading and unloading rates between both side in take-off and landing phases (p<0.05). Conclusion: The pattern of vertical jump ground reaction forces changes in landing phase after ACL rupture. Also, there is no difference in the impact between injured and uninjured leg in take-off phase, but there is a meaningful difference between two sides in landing phase. It is proposed that people with ACL rupture avoid repeated jumping performance because the increased impact on sound leg can put the sound leg in risk of injury. Thereafter the possibility of ACL rupture of sound leg will decrease

The Effects of External Focus of Attention on Shoulder Muscle Activities during Forehand Drive in Table Tennis

Objective: The aim of this study was to evaluate the impact of the external focus of attention on the rotator cuff muscle activity for the timely hit forehand drive by table tennis players. Methods: Twelve professional table tennis players with mean age of 26.5 years voluntarily participated in this study. The electrical activities of the muscles of the shoulder girdle using M.A 300 machine and bipolar electrodes surface under two conditions .First with external focus of attention and then without such attention were recorded, first without any guidance blows forehand drive was carried out by subjects (without focus). Then such subject was asked to focus their attention on the area marked for the ball landing (external focus of attention). &nbsp;&nbsp;&nbsp;&nbsp; Muscle activities in both preparation and tapping phases were analyzed the three &ndash;dimensional (200 Hz, Vicon, with four camera series T) motion analysis system was used to obtain the data. Data was analyzed by running reported measures ANOVA at a significance level of p<05. Results: In without external attention situation, muscle activity did not change significantly compared with the external focus of attention situation (p>0.05) but the different between the intensity of muscle activity was meaningful. This suggests that there is a mutual influence between the two attention factors and muscles (p=0.03), that is, orientation can have a significant effect on the severity of muscle contraction. Intensities of muscle contraction in the preparation and tapping were different (p<0.05). Conclusion: On the forehand drive technique, the anterior deltoid muscle has the most activity. The type of focus and attention had a significant impact on the change of activity of muscles relative to each other, and the greatest impact is on the reduction of activity of the infraspinatus muscle. This type of focus delays fatigue and results in an increase in the efficiency of neuromuscular in the activities of skills

Effect of Hemipelvectomy Amputation on Kinematics and Muscle Force Generation of Lower Limb While Walking

Objective Hemipelvectomy amputation is a surgical procedure in which the lower limb and a portion of pelvic are removed. There are a few studies on the performance of this group of patients while walking. The aim of this paper was to evaluate the effect of hemipelvectomy amputation on kinematics and muscle force generation of the lower limb while walking with Canadian prosthesis. Materials & Methods A subject who underwent hemipelvectomy amputation on his left side and whose mass, height, and age were 75 kg, 1.75 m, and 39 years, respectively, was involved in this study. Qualisys motion analysis system with seven cameras and force-plate system were used to record marker tracking and ground reaction forces. Twenty reflective markers were attached to the subject&rsquo;s body. As the subject walked , the data was recorded. The mean of five trials was used for statistical computing. The data was collected with the frequency of 120 Hz and filtered with 10 Hz low-pass filter. Muscloskeletal modeling was conducted by Visual 3D and OpenSim software. All data were analyzed using the SPSS 19 software at &alpha;=0.05. Results There were significant differences between knee and ankle joint kinematic pattern at Loading, Mid-stance, Terminal stance, and Pre-swing phases of gait (P<0.05).&nbsp; In weight acceptance phase and mid-stance phase, ankle plantar flexion and dorsi-flexion range of motion, respectively, were significantly lower in the patient compared to a healthy subject (P=0.00). At the end of the stance phase, ankle range of motion was significantly different in the patient compared to the healthy subject (P=0.00). In the pre-swing phase, ankle plantar flexion was 11.5 degrees greater than that of the healthy subject. In mid-swing phase, patients showed more ankle dorsi-flexion compared to the healthy subject. In weight acceptance phase, knee flexion of patient (P=0.00) was significantly greater than that of the healthy subject, and in mid-stance phase, knee extension of patient was significantly greater (P=0.04). In pre-swing phase (P=0.00) and initial swing (P=0.02), there were significant differences between knee flexion of patients and healthy subjects. The pattern of hip range of motion during gait cycle was the same for the patient and the healthy subject (P>0.05). Force generation of the hip abductor, hip extensor, and knee extensor along with tibialis anterior and posterior of the patients in the sound leg were significantly more than that of the normal subject (P<0.05). Conclusion The kinematics pattern of the patient&rsquo;s lower limb during gait is different. Kinematic changes are associated with a significant increase in lower limb muscle generation that can have a degenerative effect on the knee joint. So the importance of this subject should be considered by rehabilitation experts

The Interaction of Knee, Hip and L5-S1 Joint Contact Forces and Spatiotemporal Variables Between Sound and Prosthetic Leg in Patients with Unilateral Below-Knee Amputation During Walking

Background: There is little knowledge that explains how forces are applied on knee, hip and L5-S1 joint between the sound and prosthetic leg in unilateral Below-Knee Amputation (BKA), therefore the aim of this study was to assess the interaction of knee, hip and L5-S1 joint contact forces between sound and prosthetic leg in patients with unilateral BKA during walking. Methods: Five patients with BKA were recruited in this study. A Qualisys motion system captured with seven cameras and a Kistler force plate were used to record kinematics and kinetics variables of walking. The forces applied on knee, hip and L5-S1 joint contact forces (JCF) were calculated by using OpenSIM software. SPSS software was used to analyze data at an alpha set point of 0.05. Results: The propulsive and second peaks of ground reaction forces applied on sound leg were significantly higher than on prosthetic leg (P<0.05). Although the forces applied on hip, knee and L5-S1 joint in the sound leg were higher compared to prosthetic leg, the interaction between side and joint factor was not significant (P>0.05). Conclusion: The results of this study showed that the meaningful JCF applied on the sound leg was more than that of prosthetic leg. Insignificant increases in JCF on the sound leg during life can create cumulative forces on the knee and low-back and endanger these joints of the risk of knee OA and chronic low-back pain. Balanced forces applied on sound and prosthetic leg is important, if this is the case, so indicating using a proper application of socket pin and prosthetic feet may have beneficial impact on sound side loads

Design a New Orthosis and Assessment of Its Effects on Knee Joint Kinetics and Kinematics During Gait

Objective: The number of people suffering from Osteoarthritis (OA) is increasing. Treatment of OA can be done with or without surgery. The most common treatment is using orthosis. However, most patients with OA prefer not to use orthosis because of downward transition. Therefore, the objective of this study was to design new orthosis and to assess its effects on knee joint kinetics and kinematics during gait. Methods: Ten subjects without any neuromuscular disease participated in this study. New orhosis with the same structure of Scottish rite orthosis was designed. Qualysis system analyses with seven cameras as well as a Kistler force plate were used to measure the kinematics and kinetics variables during the gait with and without orthosis. For statistical analysis independent student-t test was used. The significance level was set at p<0.05. Results: Mean walking speed with and without orthosis was not significantly different (p=0.42). Peak anterior- posterior forces applied on knee in the first half of stance phase and propulsion phase was the same during walking with and without orthosis (p>0.05). There was significant difference between peak medio-lateral forces applied on knee during walking with and without orthosis (p<0.05). Conclusion: The new orthosis decreases the adductor moment on knee joint therefore, it can decrease the forces applied on medial compartment of the knee joint. This orthosis improves walking because it does not let inferior transition. This orthosis can improve femur alignment. It is recommended that physiotherapist prescribe this orthosis in order to decrease pain in patients with OA

An assessment of gait spatiotemporal and ground reaction force characteristics of patients with Parkinson compared with normal elderly

Introduction: Parkinson disease (PD) is associated with abnormalities in movements, including in gait. Yet, there is lack of information about kinetic aspects of gait in PD. The objectives of this study were to evaluate the temporal variables and ground reaction forces during gait in PD patients and control group. Materials and Methods: twelve patients with PD and 15 normal elderly subjects of between 50-75 years of age participated in this study. A Vicon motion analysis system with four cameras and as well as two Kistler force plates were used to measure the temporal variables and ground reaction forces (GRF) during the gait. For statistical analysis independent student-t test was used. The type one error was set at α<0.05. Results: Walking speed, stride length, second pick of vertical ground reaction force, and posterior-anterior (propulsive) forces in patients were significantly smaller than that of in normal subjects (p 0.05). GRF in both groups were symmetrical. Conclusion: Reduced walking speed, increased double support time in PD patients could be due to a neuromuscular adaptation to compensate balance deficit. The second peak of the vertical GRF and the propulsive force (posterior-anterior) GRF are related and the decreased GRF in PD might be due to the reduction of the walking speed. However, this pattern may result in a muscle weakness in long term.  Key words: Parkinson’s Disease, gait, kinetic