THE CHALLENEGE OF NEW APPROACHES IN BIOMECHANICS

The target of our biomechanical research is to analyze the mechanics of motion, focusing especially on the behavior of the muscle-tendon complex during dynamic human movements. In our quest to better understand human motion, we have developed the several research methodologies. In the keynote lecture, I will discuss some of the techniques we have used and what we have learned from them. Specifically I will focus on the following: 1. Ultrasonography 2. Computer Simulation 3. Optical vs Inertial Sensor Analysis

Biomechanical analysis of the relation between movement time and joint moment development during a sit-to-stand task

<p>Abstract</p> <p>Background</p> <p>Slowness of movement is a factor that may cause a decrease of quality of daily life. Mobility in the elderly and people with movement impairments may be improved by increasing the quickness of fundamental locomotor tasks. Because it has not been revealed how much muscle strength is required to improve quickness, the purpose of this study was to reveal the relation between movement time and the required muscle strength in a sit to stand (STS) task. Previous research found that the sum of the peak hip and knee joint moments was relatively invariant throughout a range of movement patterns (Yoshioka et al., 2007, Biomedical Engineering Online 6:26). The sum of the peak hip and knee joint moment is an appropriate index to evaluate the muscle strength required for an STS task, since the effect of the movement pattern variation can be reduced, that is, the results can be evaluated purely from the viewpoint of the movement times. Therefore, the sum of the peak hip and knee joint moment was used as the index to indicate the required muscle strength.</p> <p>Methods</p> <p>Experimental kinematics data were collected from 11 subjects. The time at which the vertical position of the right shoulder fell outside three standard deviations of the vertical positions during the static initial posture was regarded as the start time. The time at which the vertical position fell within three standard deviations of the vertical positions during static upright standing posture was regarded as the finish time. Each movement time of the experimental movements was linearly lengthened and shortened through post-processing. Combining the experimental procedure and the post-processing, movements having various movement patterns and a wide range of movement times were obtained. The joint moment and the static and inertial components of the joint moment were calculated with an inverse dynamics method. The static component reflects the gravitational and/or external forces, while the inertial component reflects the acceleration of the body.</p> <p>Results</p> <p>The quantitative relation between the movement time and the sum of the peak hip and knee joint moments were obtained. As the STS movement time increased, the joint moments decreased exponentially and converged to the static component (1.51 ~ 1.54 N.m/kg). When the movement time was the longest (movement time: 7.0 seconds), the joint moments (1.57 N.m/kg) closely corresponded to the minimum of 1.53 N.m/kg as reported by Yoshioka et al..</p> <p>Conclusion</p> <p>The key findings of this study are as follows. (1) The minimum required joint moment for an STS task is essentially equivalent to the static component of the joint moment. (2) For fast and moderate speed movements (less than 2.5 seconds), joint moments increased exponentially as the movement speed increased. (3) For slow movements greater than 2.5 seconds, the joint moments were relatively constant. The results of this STS research has practical applications, especially in rehabilitations and exercise prescription where improved movement time is an intended target, since the required muscle strength can be quantitatively estimated.</p

INVESTIGATING THE SEATED DOUBLE POLING CYCLE: IDENTIFYING BASELINE MEASURES FOR THE PREPARATION PHASE

The purpose of this study was to identify baseline measures (BM) for the preparation phase (PREP) within the linear stroking cycle for the sport of sledge hockey. The addition of this phase to seated double poling is unclear biomechanically; full arm extension to pick-plant. A validated solid-static prototype mimicking the average single-armed adult male with dynamic shoulder joint was used to determine BM in 3 dimensions and initial pick-impact forces (GRF). Results indicated that average peak GRF occurred prior to 5.0x10-3s post initial contact; Fy=179N, Fz=515N and Fx=573N. Evidence indicated PREP should initiate slightly below the horizon in order to produce the greatest non-contracting force for sledge propulsion. Isolated data provides insight to the biomechanics of the dynamic limb within PREP assisting with its importance to the complete cycle

“Are you doing your pelvic floors?” An ethnographic exploration of discussions between women and health professionals about pelvic floor muscle exercises during pregnancy

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordICS 2019: International Continence Society 49th Annual Meeting, 3-6 September 2019, Gothenburg, SwedenNational Institute for Health Research (NIHR

Grazing prevalence and associations with eating and general psychopathology, body mass index, and quality of life in a middle-income country

Research from high-income countries has shown that grazing is a common but problematic eating pattern, particularly when associated with a sense of loss of control. However, it is unclear whether these patterns hold globally. Thus, the goal of this study was to extend previous research by examining the prevalence and clinical correlates of compulsive grazing (CG) and non-compulsive grazing (NCG) in a middle-income country. Participants (N = 2297) comprised adult residents from Rio de Janeiro, Brazil. Recruitment of this population-based household survey occurred from September 2019 to February 2020. The short inventory of grazing was used to operationalise grazing subtypes. Chi-square analyses, logistic regression, and univariate tests were conducted using the complex samples procedure. The point prevalence of regular CG was 10.2% (n = 239) and was consistent with high-income countries, while NCG was 29.8% (n = 679) and was less frequent than reported in high-income countries. Additionally, similar to high-income countries, CG was associated with a higher body mass index and higher odds of eating disorders, eating disorder symptomatology, depression, anxiety, and a lower physical and mental health-related quality of life, than no grazing and NCG. Overall, this study demonstrated that grazing patterns in high-income countries extend to middle-income countries

Grazing is associated with ADHD symptoms, substance use, and impulsivity in a representative sample of a large metropolitan area in Brazil

Grazing is a clinically relevant eating behaviour, especially when it presents with a sense of loss of control (compulsive grazing). There is evidence that other disordered eating patterns are associated with problematic substance use and impulsivity-related conditions, such as attention-deficit/hyperactivity disorder (ADHD). This overlap contributes to higher psychopathology and treatment complications. Less is known about grazing, and most information originates in high-income countries. Hence, we sought to investigate relationships between grazing, tobacco and alcohol use, ADHD, and impulsivity in a large representative sample from Brazil. Data were collected by trained interviewers from adults (N = 2297) through an in-person household survey based on a stratified and clustered probability sample. We found significant associations between compulsive grazing and problematic alcohol use (OR = 3.02, 95% CI: 1.65, 5.53), ADHD (OR = 8.94, 95% CI: 5.11, 15.63), and smoking (OR = 1.67, 95% CI: 1.12, 2.47), with impulsivity contributing to the first two relationships. The substantial association with ADHD suggests that other executive functions may promote disordered eating, possibly expressed through difficulties in adhering to regular meals. Clinically, these findings highlight the importance of assessing problematic eating patterns, such as compulsive grazing, in those presenting with difficulties with substance use or impulsivity, and vice versa

Effectiveness and cost-effectiveness of biofeedback-assisted pelvic floor muscle training for female urinary incontinence: a multicentre randomised controlled trial

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordICS 2019: International Continence Society 49th Annual Meeting, 3-6 September 2019, Gothenburg, SwedenNational Institute for Health Research (NIHR

Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: protocol for a critical interpretive synthesis

This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change. METHODS: Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change. DISCUSSION: The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42016042792.The APPEAL project is funded by a National Institute for Health Research (NIHR) programme grant for applied research (RP-PG-0514-20002). MP and SD were supported in their contribution to the development of the research proposal by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula. CM is part-funded by the CLAHRC West Midlands, and DB is part-funded by the CLAHRC South London

Promoting adherence to pelvic floor muscle exercises: analysis of exercise prescription, prompts to exercise, and predictors of exercise diary return, during a randomised controlled trial

This is the author accepted manuscript. The final version is available from Springer via the DOI in this recordPaper 286 at IUGA 46th Virtual Annual MeetingNational Institute for Health Research (NIHR

Implementing pelvic floor muscle training in women's childbearing years: A critical interpretive synthesis of individual, professional, and service issues

Antenatal pelvic floor muscle training (PFMT) may be effective for the prevention and treatment of urinary and fecal incontinence both in pregnancy and postnatally, but it is not routinely implemented in practice despite guideline recommendations. This review synthesizes evidence that exposes challenges, opportunities, and concerns regarding the implementation of PFMT during the childbearing years, from the perspective of individuals, healthcare professionals (HCPs), and organizations.MethodsCritical interpretive synthesis of systematically identified primary quantitative or qualitative studies or research syntheses of women's and HCPs attitudes, beliefs, or experiences of implementing PFMT.ResultsFifty sources were included. These focused on experiences of postnatal urinary incontinence (UI) and perspectives of individual postnatal women, with limited evidence exploring the views of antenatal women and HCP or wider organizational and environmental issues. The concept of agency (people's ability to effect change through their interaction with other people, processes, and systems) provides an over?arching explanation of how PFMT can be implemented during childbearing years. This requires both individual and collective action of women, HCPs, maternity services and organizations, funders and policymakers.ConclusionNumerous factors constrain women's and HCPs capacity to implement PFMT. It is unrealistic to expect women and HCPs to implement PFMT without reforming policy and service delivery. The implementation of PFMT during pregnancy, as recommended by antenatal care and UI management guidelines, requires policymakers, organizations, HCPs, and women to value the prevention of incontinence throughout women's lives by using low?risk, low?cost, and proven strategies as part of women's reproductive health