A pilot investigation using global positioning systems into the outdoor activity of people with severe traumatic brain injury

Background: Little is known about the post-discharge outdoor activities of people who have incurred severe traumatic brain injury (TBI). This study used a body-worn global positioning system (GPS) device to determine the outdoor activity per day performed by this population. Additionally, this study examined the association that mobility, time since injury and injury severity had with levels of outdoor physical activity. Findings. Seventeen people with TBI and 15 control subjects wore a GPS device for between 3-7 days to monitor their outdoor activity. Based on the individual's location and speed of movement the outdoor physical activity in minutes per day was derived. Assessments of duration of outdoor activity between groups, and the relationship that duration of outdoor activity had with results on the high-level mobility assessment tool, length of post-traumatic amnesia, and time since injury were performed. No significant (p = 0.153, effect size = 0.26) difference in time spent in outdoor physical activity was observed between the TBI (median[IQR] = 19[3-43]mins) and control (median[IQR] = 50[18-65]mins) group. Interestingly, 35% of TBI subjects performed <10 mins of outdoor activity per day compared to 13% of the control group. The TBI group also recorded three of the four highest values for outdoor physical activity. Higher levels of mobility were associated with more outdoor activity (Spearman's rho = 0.443, p = 0.038). No other significant associations were observed. Conclusions: While preliminary, our results indicate that a sub-group of people with TBI exists who restrict their outdoor activities. GPS has potential as an activity tracking tool, with implications for rehabilitation and exercise prescription. © 2014 Clark et al.; licensee BioMed Central Ltd

Supplemental Material - The prevalent causes of death in patients with peripheral artery disease undergoing revascularisation or amputation

Supplemental Material for The prevalent causes of death in patients with peripheral artery disease undergoing revascularisation or amputation by Stacey Telianidis and Sarah Joy Aitken in Vascular</p

Diminished sub-maximal quadriceps force control in anterior cruciate ligament reconstructed patients is related to quadriceps and hamstring muscle dyskinesia

The aim of this study was to determine the effects of anterior cruciate ligament reconstruction (ACLR) on sub-maximal quadriceps force control with respect to quadriceps and hamstring muscle activity. Thirty ACLR individuals together with 30 healthy individuals participated. With real-time visual feedback of muscle force output and electromyographic electrodes attached to the quadriceps and hamstring muscles, subjects performed an isometric knee extension task where they increased and decreased their muscle force output at 0.128 Hz within a range of 5–30% maximum voluntary capacity. The ACLR group completed the task with more error and increased medial hamstring and vastus medialis activation (p < 0.05). Moderate negative correlations (p < 0.05) were observed between quadriceps force control and medial (Spearman’s rho = −0.448, p = 0.022) and lateral (Spearman’s rho = −0.401, p = 0.034) hamstring activation in the ACLR group. Diminished quadriceps sub-maximal force control in ACLR subjects was reflective of medial quadriceps and hamstring dyskinesia (i.e., altered muscle activity patterns and coordination deficits). Within the ACLR group however, augmented hamstring co-activation was associated with better quadriceps force control. Future studies should explore the convergent validity of quadriceps force control in ACLR patients

Impaired voluntary quadriceps force control following anterior cruciate ligament reconstruction: relationship with knee function

Impairments in quadriceps force control and altered quadriceps and hamstring muscle activation strategies have been observed following anterior cruciate ligament reconstruction; however, the functional implications of these impairments are unclear. This study examined the cross-sectional associations between quadriceps force control, quadriceps activation, hamstring coactivation and clinically assessed knee function following anterior cruciate ligament reconstruction with a hamstring graft.Sixty-six patients (18 +/- 3 months following surgery) and 41 uninjured individuals participated. Quadriceps force control was assessed using an isometric knee extension task. Participants cyclically increased and decreased quadriceps force at slow speeds between 5 and 30 % maximum voluntary isometric contraction matching a moving target displayed on a screen. Quadriceps activation and hamstring coactivation were assessed concurrently using surface electromyography. Knee function was assessed with the Cincinnati Knee Rating Scale and three single-leg hop tests.The reconstructed group completed the task with 48 % greater root-mean-square error (RMSE), indicating significantly worse quadriceps force control (p < 0.001). In a multivariable model adjusted for sex, greater RMSE and greater lateral hamstring coactivation were significantly associated with worse knee function that is greater odds of scoring < 85 % on one or more knee functional assessment.Less-accurate quadriceps force output and greater hamstring coactivation are associated with worse knee joint function following anterior cruciate ligament reconstruction and may contribute to irregular knee joint loading and the onset or progression of knee osteoarthritis. Impairments in quadriceps force control and altered muscle activation strategies may be modifiable through neuromuscular training, and this is an area for future research.Case-control study, Level III