Does texting while walking really affect gait in young adults?

Abstract Background: Texting on a smartphone while walking has become a customary task among young adults. In recent literature many safety concerns on distracted walking have been raised. It is often hypothesized that the allocation of attentional resources toward a secondary task can influence dynamic stability. In the double task of walking and texting it was found that gait speed is reduced, but there is scarce evidence of a modified motor control strategy compromising stability. The aim of this study is twofold: 1) to comprehensively examine the gait modifications occurring when texting while walking, including the study of the lower limb muscle activation patterns, 2) to specifically assess the co-contraction of ankle antagonist muscles. We hypothesized that texting while walking increases co-contractions of ankle antagonist muscles when the body weight is transferred from one lower limb to the other, to improve the distal motor control and joint stabilization. Methods: From the gait data collected during an instrumented walk lasting 3 min, we calculated the spatio-temporal parameters, the ankle and knee kinematics, the muscle activation patterns of tibialis anterior, gastrocnemius lateralis, peroneus longus, rectus femoris, and lateral hamstrings, and the co-contraction (occurrence and duration) of the ankle antagonist muscles (tibialis anterior and gastrocnemius lateralis), bilaterally. Results: Young adults showed, overall, small gait modifications that could be mainly ascribable to gait speed reduction and a modified body posture due to phone handling. We found no significant alterations of ankle and knee kinematics and a slightly delayed activation onset of the left gastrocnemius lateralis. However, we found an increased co-contraction of tibialis anterior and gastrocnemius lateralis, especially during mid-stance. Conversely, we found a reduced co-contraction during terminal stance. Conclusions: Our results suggest that, in young adults, there is an adjustment of the motor control strategy aimed at increasing ankle joint stability in a specific and “critical” phase of the gait cycle, when the body weight is transferred from one leg to the other

Operative Management of Sciatic Nerve Palsy due to Impingement on the Metal Cage after Total Hip Revision: Case Report

This paper discusses a sciatic nerve palsy developed after a right total hip revision with a Burch-Schneider metal cage. A sciatalgic nerve pain appeared after surgery, while the palsy developed in about fifteen days. An electromyography showed the delay of the nerve impulse gluteal level. During the surgical exploration of the hip, a compression of the nerve on the metal cage was observed. The nerve was isolated, released from the fibrotic tissue and from the impingement, and was protected with a muscular flap. The recover from the pain was immediate, while the palsy recovered one month later

Adult Congenital Permanent Bilateral Dislocation of the Patella with Full Knee Function: Case Report and Literature Review

Congenital permanent dislocation of the patella is a rare disorder of the knee joint in which the patella is permanently displaced, even in extension and is fixed on the lateral aspect of the femoral condyle. The dislocation is irreducible without surgical techniques. This rare condition is usually detected within the first decade of life, because of inability of active extension in the knee and impaired ability during walking. This report presents an unusual case of a 51-year-old man with bilateral congenital permanent dislocation of the patella. The pathology had never been treated because there were few symptoms. The patient presented with right knee pain caused by a fall on the knee during his work. The right knee was painful on the lateral side and the clinical signs were positive for pathology of the lateral meniscus, confirmed by MRI. The clinical and the imaging findings suggested a lesion of the lateral meniscus as the probable cause of the pain. Therefore we performed a knee arthroscopy, whose intra-operative findings confirmed the MRI findings. During the surgery we performed just a selective arthroscopic meniscectomy, without correcting patella dislocation, because the condition was unusually asymptomatic before the trauma

Common Musculoskeletal Disorders in the Elderly: The Star Triad

Musculoskeletal disorders are debilitating conditions that significantly impair the state of health, especially in elderly subjects. A pathological triad of inter-related disorders that are highly prevalent in the elderly consists of the following main “components”: sarcopenia, tendinopathies, and arthritis. The aim of this review is to critically appraise the literature relative to the different disorders of this triad, in order to highlight the pathophysiological common denominator and propose strategies for personalized clinical management of patients presenting with this combination of musculoskeletal disorders. Their pathophysiological common denominator is represented by progressive loss of (focal or generalized) neuromuscular performance with a risk of adverse outcomes such as pain, mobility disorders, increased risk of falls and fractures, and impaired ability or disability to perform activities of daily living. The precise management of these disorders requires not only the use of available tools and recently proposed operational definitions, but also the development of new tools and approaches for prediction, diagnosis, monitoring, and prognosis of the three disorders and their combination

Cross-cultural adaptation and validation of the Victorian Institute of Sports Assessment for Gluteal Tendinopathy questionnaire in Italian and investigation of the association between tendinopathy-related disability and pain

Background The Victorian Institute of Sports Assessment for gluteal tendinopathy (VISA-G) questionnaire has recently been proposed as a condition-specific patient reported outcome measurement tool to assess the tendinopathy-related disability. Aim The aim was to evaluate the reliability of the Italian version of the VISA-G questionnaire and its construct validity and to investigate the association between tendinopathy-related disability and pain. Design It consists in a cross-sectional study. Setting The location of the study was a university laboratory. Population We evaluated patients with gluteal tendinopathy (N.=38) and healthy controls (N.=38). Methods Subjects were asked to fill the VISA-G questionnaire twice to evaluate its reliability. The construct validity was evaluated by comparing the VISA score with the Oswestry Disability Index score. Moreover, pain intensity, extent and location were also investigated. Results The VISA-G scores showed non-significant changes in the median values and the values of intraclass correlation coefficient showed very high correlation between the first and second administration (ICC>0.90 in both populations). No significant correlations were found between VISA-G score and either pain extent (R=-0.05, P=0.76), or resting pain intensity (R=-0.13, P=0.45), or palpation pain intensity (R= 0.01, P=0.97). Conversely, a high (and significant) negative correlation was obtained between VISA-G score and Oswestry Disability Index score (R=-0.80, P<0.0001). Conclusions These results indicated that the VISA-G Italian version presents excellent test-retest reliability. Clinical rehabilitation impact The evaluation of gluteal tendinopathy-related disability through VISA-G can be useful for the prognostic assessment and/or follow-up of tendinopathy patients in combination with the pain drawing assessment of pain extent