45 research outputs found

    Continuous versus discrete data analysis for gait evaluation of horses with induced bilateral hindlimb lameness

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    Background Gait kinematics measured during equine gait analysis are typically evaluated by analysing (asymmetry-based) discrete variables (eg, peak values) obtained from continuous kinematic signals (eg, timeseries of datapoints). However, when used for the assessment of complex cases of lameness, such as bilateral lameness, discrete variable analysis might overlook relevant functional adaptations. Objectives The overall aim of this paper is to compare continuous and discrete data analysis techniques to evaluate kinematic gait adaptations to lameness. Study design Method comparison. Methods Sixteen healthy Shetland ponies, enrolled in a research programme in which osteochondral defects were created on the medial trochlear ridges of both femurs, were used in this study. Kinematic data were collected at trot on a treadmill before and at 3 and 6 months after surgical intervention. Statistical parametric mapping and linear mixed models were used to compare kinematic variables between and within timepoints. Results Both continuous and discrete data analyses identified changes in pelvis and forelimb kinematics. Discrete data analyses showed significant changes in hindlimb and back kinematics, where such differences were not found to be significant by continuous data analysis. In contrast, continuous data analysis provided additional information on the timing and duration of the differences found. Main limitations A limited number of ponies were included. Conclusions The use of continuous data provides additional information regarding gait adaptations to bilateral lameness that is complementary to the analysis of discrete variables. The main advantage lies in the additional information regarding time dependence and duration of adaptations, which offers the opportunity to identify functional adaptations during all phases of the stride cycle, not just the events related to peak values

    The effect of asymmetric movement support on muscle activity during Lokomat guided gait in able-bodied individuals

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    BACKGROUND: To accommodate training for unilaterally affected patients (e.g. stroke), the Lokomat (a popular robotic exoskeleton-based gait trainer) provides the possibility to set the amount of movement guidance for each leg independently. Given the interlimb couplings, such asymmetrical settings may result in complex effects, in which ipsilateral activity co-depends on the amount of guidance offered to the contralateral leg. To test this idea, the effect of asymmetrical guidance on muscle activity was explored. METHODS: 15 healthy participants walked in the Lokomat at two speeds (1 and 2 km/h) and guidance levels (30% and 100%), during symmetrical (both legs receiving 30% or 100% guidance) and asymmetrical conditions (one leg receiving 30% and the other 100% guidance) resulting in eight unique conditions. Activity of the right leg was recorded from Erector Spinae, Gluteus Medius, Biceps Femoris, Semitendinosus, Vastus Medialis, Rectus Femoris, Medial Gastrocnemius and Tibialis Anterior. Statistical Parametric Mapping was used to assess whether ipsilateral muscle activity depended on guidance settings for the contralateral leg. RESULTS: Muscle output amplitude not only depended on ipsilateral guidance settings, but also on the amount of guidance provided to the contralateral leg. More specifically, when the contralateral leg received less guidance, ipsilateral activity of Gluteus Medius and Medial Gastrocnemius increased during stance. Conversely, when the contralateral leg received more guidance, ipsilateral muscle activity for these muscles decreased. These effects were specifically observed at 1 km/h, but not at 2 km/h. CONCLUSIONS: This is the first study of asymmetrical guidance on muscle activity in the Lokomat, which shows that ipsilateral activity co-depends on the amount of contralateral guidance. In therapy, these properties may be exploited e.g. to promote active contributions by the more affected leg. Therefore, the present results urge further research on the use of asymmetrical guidance in patient groups targeted by Lokomat training

    Critical friendship as a contribution to master’s‐level work in an international programme of study

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    This article reports on an action research project in which the value of criticalfriendship for students doing research and writing their dissertations within aninternational master’s course has been explored. This course is run jointly byRoehampton University (London, UK), Charles University (Prague, CzechRepublic) together with Fontys OSO (Tilburg, the Netherlands). It describes theprocess and the results of working with the concept of critical friendship in thismaster’s course since its start in 2005. Data were collected by means of variousqualitative instruments and data sources: evaluation forms after tutorial sessions,reflective logs and focus interviews. The results show that the process of engagingwith the research they did was enhanced and supported by the development ofcritical friendship groups. A number of recommendations have been formulated,such as the importance of discussing the concept of critical friend and itsphilosophy with the participants and of defining roles and tasks as clearly aspossible. Teaching and Teacher Learning (ICLON

    Adaptation strategies of the Icelandic horse with induced forelimb lameness at walk, trot and tölt

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    Background and objective Lameness assessment in the gaited Icelandic horse is complex. We aimed to describe their kinematic and temporal adaptation strategies in response to forelimb lameness at walk, trot and tolt.Study designIn vivo experiment.Methods Ten clinically non-lame Icelandic horses were measured before and after reversible forelimb lameness induction. Upper body and limb kinematics were measured using 11 inertial measurement units mounted on the poll, withers, pelvis (tubera sacrale) and all four limbs and hoofs (Equimoves (R), 500 Hz). Horses were measured on a straight line at walk and trot in-hand and at walk, trot and tolt while ridden. Linear mixed models were used to compare baseline and lame conditions (random factor = 'horse'), and results are presented as the difference in estimated marginal means or percentage of change.Results Lameness induction significantly (p < 0.05) increased head vertical movement asymmetry at walk (HDmin/HDmaxHAND: 18.8/5.7 mm, HDmin/HDmaxRIDDEN: 9.8/0.3 mm) and trot (HDmin/HDmaxHAND: 18.1/7.8 mm, HDmin/HDmaxRIDDEN: 24.0/9.3 mm). At the tolt, however, HDmin did not change significantly (1.1 mm), but HDmax increased by 11.2 mm (p < 0.05). Furthermore, pelvis vertical movement asymmetry (PDmax) increased by 4.9 mm, sound side dissociation decreased (-8.3%), and sound diagonal dissociation increased (6.5%). Other temporal stride variables were also affected, such as increased stance duration of both forelimbs at walk, tolt and in-hand trot.Main limitations Only one degree of lameness (mild) was induced with an acute lameness model.Conclusions Classical forelimb lameness metrics, such as vertical head and withers movement asymmetry, were less valuable at tolt compared to walk and trot, except for HDmax. Therefore, it is advised to primarily use the walk and trot to detect and quantify forelimb lameness in the Icelandic horse

    Orthotopic equine study confirms the pivotal importance of structural reinforcement over the pre-culture of cartilage implants

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    In articular cartilage (AC), the collagen arcades provide the tissue with its extraordinary mechanical properties. As these structures cannot be restored once damaged, functional restoration of AC defects remains a major challenge. We report that the use of a converged bioprinted, osteochondral implant, based on a gelatin methacryloyl cartilage phase, reinforced with precisely patterned melt electrowritten polycaprolactone micrometer-scale fibers in a zonal fashion, inspired by native collagen architecture, can provide long-term mechanically stable neo-tissue in an orthotopic large animal model. The design of this novel implant was achieved via state-of-the-art converging of extrusion-based ceramic printing, melt electrowriting, and extrusion-based bioprinting. Interestingly, the cell-free implants, used as a control in this study, showed abundant cell ingrowth and similar favorable results as the cell-containing implants. Our findings underscore the hypothesis that mechanical stability is more determining for the successful survival of the implant than the presence of cells and pre-cultured extracellular matrix. This observation is of great translational importance and highlights the aptness of advanced 3D (bio)fabrication technologies for functional tissue restoration in the harsh articular joint mechanical environment.</p

    Timing of Vertical Head, Withers and Pelvis Movements Relative to the Footfalls in Different Equine Gaits and Breeds

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    Simple Summary Movement symmetry of the head and pelvis are used to measure lameness in horses in trot. Although head, pelvis and limb movements have been described, less is known about the temporal relationships between them. This information is needed to understand how the movements change with lameness. This is particularly relevant in gaited horses, such as the Icelandic horse that perform gaits such as tolt and pace, which are challenging to evaluate. This study used inertial measurement units to investigate head, withers and pelvis motion relative to limb movements in Icelandic, Warmblood and Iberian horses. Limb movements, together with vertical movements and lowest/highest positions of the head, withers and pelvis were calculated, and the relative timing of the events was compared across breeds. Additionally, data for tolt and pace were collected and evaluated in ridden Icelandic horses. For all gaits except walk and pace, the lowest/highest positions of the head/withers/pelvis were closely temporally related to midstance and hoof-off, respectively. Pelvic and withers total range of motion differed between all breeds. The Icelandic horses showed shorter stride duration and smaller movements of the upper body than the other breeds at trot, which may explain why lameness evaluation in this breed is challenging. Knowledge of vertical motion patterns of the axial body segments is a prerequisite for the development of algorithms used in automated detection of lameness. To date, the focus has been on the trot. This study investigates the temporal synchronization between vertical motion of the axial body segments with limb kinematic events in walk and trot across three popular types of sport horses (19 Warmbloods, 23 Iberians, 26 Icelandics) that are known to have different stride kinematics, and it presents novel data describing vertical motion of the axial body segments in tolting and pacing Icelandic horses. Inertial measurement unit sensors recorded limb kinematics, vertical motion of the axial body at all symmetrical gaits that the horse could perform (walk, trot, tolt, pace). Limb kinematics, vertical range of motion and lowest/highest positions of the head, withers and pelvis were calculated. For all gaits except walk and pace, lowest/highest positions of the pelvis and withers were found to be closely related temporally to midstance and start of suspension of the hind/fore quarter, respectively. There were differences in pelvic/withers range of motion between all breeds where the Icelandic horses showed the smallest motion, which may explain why lameness evaluation in this breed is challenging

    Adaptations in equine axial movement and muscle activity occur during induced fore- and hindlimb lameness: a kinematic and electromyographic evaluation during in-hand trot

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    Background: The inter-relationship between equine thoracolumbar motion and muscle activation during normal locomotion and lameness is poorly understood. Objective: To compare thoracolumbar and pelvic kinematics and longissimus dorsi (longissimus) activity of trotting horses between baseline and induced forelimb (iFL) and hindlimb (iHL) lameness. Study design: Controlled experimental cross-over study. Methods: Three-dimensional kinematic data from the thoracolumbar vertebrae and pelvis, and bilateral surface electromyography (sEMG) data from longissimus at T14 and L1, were collected synchronously from clinically nonlame horses (n = 8) trotting overground during a baseline evaluation, and during iFL and iHL conditions (2–3/5 AAEP), induced on separate days using a lameness model (modified horseshoe). Motion asymmetry parameters, maximal thoracolumbar flexion/extension and lateral bending angles, and pelvis range of motion (ROM) were calculated from kinematic data. Normalised average rectified value (ARV) and muscle activation onset, offset and activity duration were calculated from sEMG signals. Mixed model analysis and statistical parametric mapping compared discrete and continuous variables between conditions (α = 0.05). Results: Asymmetry parameters reflected the degree of iFL and iHL. Maximal thoracolumbar flexion and pelvis pitch ROM increased significantly following iFL and iHL. During iHL, peak lateral bending increased towards the nonlame side (NLS) and decreased towards the lame side (LS). Longissimus ARV significantly increased bilaterally at T14 and L1 for iHL, but only at LS L1 for iFL. Longissimus activation was significantly delayed on the NLS and precipitated on the LS during iHL, but these clear phasic shifts were not observed in iFL. Main limitations: Findings should be confirmed in clinical cases. Conclusions: Distinctive, significant adaptations in thoracolumbar and pelvic motion and underlying longissimus activity occur during iFL and iHL and are detectable using combined motion capture and sEMG. For iFL, these adaptations occur primarily in a cranio-caudal direction, whereas for iHL, lateral bending and axial rotation are also involved

    Comparison of risk prediction scores for venous thromboembolism in cancer patients:A prospective cohort study

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    In ambulatory patients with solid cancer, routine thromboprophylaxis to prevent venous thromboembolism is not recommended. Several risk prediction scores to identify cancer patients at high risk of venous thromboembolism have been proposed, but their clinical usefulness remains a matter of debate. We evaluated and directly compared the performance of the Khorana, Vienna, PROTECHT, and CONKO scores in a multinational, prospective cohort study. Patients with advanced cancer were eligible if they were due to undergo chemotherapy or had started chemotherapy in the previous three months. The primary outcome was objectively confirmed symptomatic or incidental deep vein thrombosis or pulmonary embolism during a 6-month followup period. A total of 876 patients were enrolled, of whom 260 (30%) had not yet received chemotherapy. Fifty-three patients (6.1%) developed venous thromboembolism. The c-statistics of the scores ranged from 0.50 to 0.57. At the conventional positivity threshold of 3 points, the scores classified 13-34% of patients as high-risk; the 6-month incidence of venous thromboembolism in these patients ranged from 6.5% (95% CI: 2.8-12) for the Khorana score to 9.6% (95% CI: 6.6-13) for the PROTECHT score. High-risk patients had a significantly increased risk of venous thromboembolism when using the Vienna (subhazard ratio 1.7; 95% CI: 1.0-3.1) or PROTECHT (subhazard ratio 2.1; 95% CI: 1.23.6) scores. In conclusion, the prediction scores performed poorly in predicting venous thromboembolism in cancer patients. The Vienna CATS and PROTECHT scores appear to discriminate better between low-and high-risk patients, but further improvements are needed before they can be considered for introduction into clinical practice

    Adaptations in equine appendicular muscle activity and movement occur during induced fore- and hindlimb lameness: An electromyographic and kinematic evaluation

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    The relationship between lameness-related adaptations in equine appendicular motion and muscle activation is poorly understood and has not been studied objectively. The aim of this study was to compare muscle activity of selected fore- and hindlimb muscles, and movement of the joints they act on, between baseline and induced forelimb (iFL) and hindlimb (iHL) lameness. Three-dimensional kinematic data and surface electromyography (sEMG) data from the fore- (triceps brachii, latissimus dorsi) and hindlimbs (superficial gluteal, biceps femoris, semitendinosus) were bilaterally and synchronously collected from clinically non-lame horses ( n = 8) trotting over-ground (baseline). Data collections were repeated during iFL and iHL conditions (2-3/5 AAEP), induced on separate days using a modified horseshoe. Motion asymmetry parameters and continuous joint and pro-retraction angles for each limb were calculated from kinematic data. Normalized average rectified value (ARV) and muscle activation onset, offset and activity duration were calculated from sEMG signals. Mixed model analysis and statistical parametric mapping, respectively, compared discrete and continuous variables between conditions (α= 0.05). Asymmetry parameters reflected the degree of iFL and iHL. Increased ARV occurred across muscles following iFL and iHL, except non-lame side forelimb muscles that significantly decreased following iFL. Significant, limb-specific changes in sEMG ARV, and activation timings reflected changes in joint angles and phasic shifts of the limb movement cycle following iFL and iHL. Muscular adaptations during iFL and iHL are detectable using sEMG and primarily involve increased bilateral activity and phasic activation shifts that reflect known compensatory movement patterns for reducing weightbearing on the lame limb. With further research and development, sEMG may provide a valuable diagnostic aid for quantifying the underlying neuromuscular adaptations to equine lameness, which are undetectable through human observation alone

    Timing of Vertical Head, Withers and Pelvis Movements Relative to the Footfalls in Different Equine Gaits and Breeds

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    Knowledge of vertical motion patterns of the axial body segments is a prerequisite for the development of algorithms used in automated detection of lameness. To date, the focus has been on the trot. This study investigates the temporal synchronization between vertical motion of the axial body segments with limb kinematic events in walk and trot across three popular types of sport horses (19 Warmbloods, 23 Iberians, 26 Icelandics) that are known to have different stride kinematics, and it presents novel data describing vertical motion of the axial body segments in tölting and pacing Icelandic horses. Inertial measurement unit sensors recorded limb kinematics, vertical motion of the axial body at all symmetrical gaits that the horse could perform (walk, trot, tölt, pace). Limb kinematics, vertical range of motion and lowest/highest positions of the head, withers and pelvis were calculated. For all gaits except walk and pace, lowest/highest positions of the pelvis and withers were found to be closely related temporally to midstance and start of suspension of the hind/fore quarter, respectively. There were differences in pelvic/withers range of motion between all breeds where the Icelandic horses showed the smallest motion, which may explain why lameness evaluation in this breed is challenging
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