Motor imagery training speeds up gait recovery and decreases the risk of falls in patients submitted to total knee arthroplasty

With Motor imagery (MI), movements are mentally rehearsed without overt actions; this procedure has been adopted in motor rehabilitation, primarily in brain-damaged patients. Here we rather tested the clinical potentials of MI in purely orthopaedic patients who, by definition, should maximally benefit of mental exercises because of their intact brain. To this end we studied the recovery of gait after total knee arthroplasty and evaluated whether MI combined with physiotherapy could speed up the recovery of gait and even limit the occurrence of future falls. We studied 48 patients at the beginning and by the end of the post-surgery residential rehabilitation program: half of them completed a specific MI training supported by computerized visual stimulation (experimental group); the other half performed a non-motoric cognitive training (control group). All patients also had standard physiotherapy. By the end of the rehabilitation, the experimental group showed a better recovery of gait and active knee flexion-extension movements, and less pain. The number of falls or near falls after surgery was significantly lower in the experimental group. These results show that MI can improve gait abilities and limit future falls in orthopaedic patients, without collateral risks and with limited costs

Validation of the AnyBody full body musculoskeletal model in computing lumbar spine loads at L4L5 level

In the panorama of available musculoskeletal modeling software, AnyBody software is a commercial tool that provides a full body musculoskeletal model which is increasingly exploited by numerous researchers worldwide. In this regard, model validation becomes essential to guarantee the suitability of the model in representing the simulated system. When focusing on lumbar spine, the previous works aimed at validating the AnyBody model in computing the intervertebral loads held several limitations, and a comprehensive validation is to be considered as lacking. The present study was aimed at extensively validating the suitability of the AnyBody model in computing lumbar spine loads at L4L5 level. The intersegmental loads were calculated during twelve specific exercise tasks designed to accurately replicate the conditions during which Wilke et al. (2001) measured in vivo the L4L5 intradiscal pressure. Motion capture data of one volunteer subject were acquired during the execution of the tasks and then imported into AnyBody to set model kinematics. Two different approaches in computing intradiscal pressure from the intersegmental load were evaluated. Lumbopelvic rhythm was compared with reference in vivo measurements to assess the accuracy of the lumbopelvic kinematics. Positive agreement was confirmed between the calculated pressures and the in vivo measurements, thus demonstrating the suitability of the AnyBody model. Specific caution needs to be taken only when considering postures characterized by large lateral displacements. Minor discrepancy was found assessing lumbopelvic rhythm. The present findings promote the AnyBody model as an appropriate tool to non-invasively evaluate the lumbar loads at L4L5 in physiological activities