Clinical Biomechanics最新文献

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The impact of age on muscle and kinematic responses following an unpredictable forward slip while walking 年龄对行走时不可预测的前滑后肌肉和运动学反应的影响。
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1016/j.clinbiomech.2026.106779
Steven Phu , Daina L. Sturnieks , Stephen R. Lord , Yoshiro Okubo
{"title":"The impact of age on muscle and kinematic responses following an unpredictable forward slip while walking","authors":"Steven Phu ,&nbsp;Daina L. Sturnieks ,&nbsp;Stephen R. Lord ,&nbsp;Yoshiro Okubo","doi":"10.1016/j.clinbiomech.2026.106779","DOIUrl":"10.1016/j.clinbiomech.2026.106779","url":null,"abstract":"<div><h3>Background</h3><div>Slips lead to many falls in older adults. This study aimed to determine the impact of age on muscle and kinematic responses following an unpredictable forward slip while walking.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 127 adults (25 young and 102 older) exposed to a single unpredictable forward slip, induced at foot-strike while walking. Bilateral lower limb muscle activity was measured via electromyography and gait kinematics were measured via motion capture.</div></div><div><h3>Findings</h3><div>Compared to young, older adults displayed greater relative muscle activity and higher relative centre of mass during walking prior to the slip onset (<em>P</em> &lt; 0.05). Following the slip, older adults experienced slips with greater velocity, displayed longer muscle onset latency and time to peak activity of the hamstrings on the non-slipped (contralateral) limb and greater peak activity magnitudes of the gastrocnemius bilaterally (<em>P</em> &lt; 0.05). Older adults also spent more time in double-limb stance (<em>P</em> = 0.001), took a slower second recovery step (<em>P</em> = 0.006), and displayed greater harness loading (<em>P</em> = 0.005).</div></div><div><h3>Interpretation</h3><div>Older adults had inferior muscle and kinematic responses to an unpredictable forward slip compared to young. Delayed activation of the contralateral limb knee flexors and hip extensors may lead to greater instability, more severe slips and an increased risk of falls in older adults.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106779"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Simulated wrist fractures displace in well molded casts and splints under fall simulation forces: A cadaveric study 模拟手腕骨折移位在良好的铸造和夹板下坠落模拟力:一项尸体研究
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-16 DOI: 10.1016/j.clinbiomech.2026.106752
Joshua T. Bram , Julia S. Retzky , Kathleen N. Meyers , Olivia C. Tracey , Nicolas Pascual-Leone , Keza R. Levine , Margaret V. Darko , Erikson Nichols , Emily R. Dodwell
{"title":"Simulated wrist fractures displace in well molded casts and splints under fall simulation forces: A cadaveric study","authors":"Joshua T. Bram ,&nbsp;Julia S. Retzky ,&nbsp;Kathleen N. Meyers ,&nbsp;Olivia C. Tracey ,&nbsp;Nicolas Pascual-Leone ,&nbsp;Keza R. Levine ,&nbsp;Margaret V. Darko ,&nbsp;Erikson Nichols ,&nbsp;Emily R. Dodwell","doi":"10.1016/j.clinbiomech.2026.106752","DOIUrl":"10.1016/j.clinbiomech.2026.106752","url":null,"abstract":"<div><h3>Background</h3><div>Distal radius fractures are commonly treated with cast/splint immobilization, but variations exist in activity restrictions.</div></div><div><h3>Methods</h3><div>Fractures of the distal radius/ulna were created in cadaveric forearms. A force was applied through the long axis of the forearm simulating a ground-level fall. Each sample underwent testing in a short-arm well-molded fiberglass cast and a commercial fracture splint. Initial and final position lateral radiographs at 0 N and 400 N of force and dynamic fluoroscopy were taken for calculation of the primary outcome, change in volar tilt. Secondary outcomes were change in radial height and inclination, with comparison of these parameters between cast and splint testing. Statistical analysis employed paired <em>t</em>-tests.</div></div><div><h3>Findings</h3><div>Ten adult cadaveric forearms (6 female, mean age 58.5 ± 17.4 years, BMI 25.7 ± 5.9) were included. Mean overall change in volar tilt, radial height, and radial inclination was 13.3°, 6.3 mm, and 0.5°, respectively. Alignment was similar pre-and-post testing between casted and splinted specimens across all forces. Change in dorsal angulation of fractures from 0 to 400 N of force was comparable when casted and splinted (13.3 ± 9.2° vs 13.2 ± 8.7°, <em>P</em> = 0.945). Fracture displacement reached &gt;10° of dorsal tilt in both groups at 29.2% and 40.8% of idealized adult (70 kg) and adolescent (50 kg) body weights, respectively.</div></div><div><h3>Interpretation</h3><div>Mean change in volar tilt suggests immobilized fractures in cast or splint may displace with ground-level fall mechanisms. Fracture displacement was similar between short-arm casts and wrist splints. Clinical practice guidelines should be developed for patients with cast-immobilized healing fractures.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106752"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An in vitro parametric study of maxillary sinus ventilation using transparent 3D-printed sinonasal models 使用透明3d打印鼻窦模型进行上颌窦通气的体外参数研究。
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.clinbiomech.2026.106772
Amr Seifelnasr , Xiuhua April Si , Jinxiang Xi
{"title":"An in vitro parametric study of maxillary sinus ventilation using transparent 3D-printed sinonasal models","authors":"Amr Seifelnasr ,&nbsp;Xiuhua April Si ,&nbsp;Jinxiang Xi","doi":"10.1016/j.clinbiomech.2026.106772","DOIUrl":"10.1016/j.clinbiomech.2026.106772","url":null,"abstract":"<div><h3>Background</h3><div>Impaired maxillary sinus ventilation promotes secretion stasis and infection risk. How anatomical parameters (ostial diameter (D), length (L), and sinus volume (V)) interact with breathing pattern to shape ventilation has not been systematically studied in anatomically realistic settings.</div></div><div><h3>Methods</h3><div>Fifteen transparent sinonasal casts were 3D printed spanning three levels of D, L, and V (D1-D3, L1-L3, V1-V3). <em>E</em>-vapor was used to visualize and quantity sinus ventilation under three conditions: breath-hold, quiet breathing, and panting. Two time metrics were quantified: (i) total vapor escape-settling time; and (ii) escape time for the vapor cloud to reach a reference line. Full factorial ANOVA assessed the main effects of anatomical factors and breathing modes and their interactions.</div></div><div><h3>Findings</h3><div>Breathing mode was the strongest determinant of total clearance (<em>p</em> &lt; 0.001), with panting markedly reducing the ventilation time than quiet breathing and breath-hold (by &gt; two-thirds). Longer canals and larger sinus volumes prolonged retention. For early-stage transport (time to reference line), ostial length had the most influential main effect (<em>p</em> &lt; 0.001), followed by breathing mode, ostial diameter, and sinus volume. Significant two-way interactions were observed, whereas higher-order interactions were limited. Visualizations and pooled distributions (violin plots) corroborated these hierarchies across the parametric space.</div></div><div><h3>Interpretation</h3><div>Maxillary sinus ventilation reflects coupled anatomical and physiological constraints. Breathing mode dominates sinus ventilation, whereas ostial canal length most strongly governs early escape near the ostium. These results have implications for surgical planning to increase ostial patency and for optimizing breathing maneuvers to promote sinus aeration and clearance.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106772"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of elbow posture on biceps function at the shoulder in brachial plexus birth injuries: A computational sensitivity analysis 臂丛出生损伤时肘部姿势对肩部二头肌功能的影响:计算敏感性分析。
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-30 DOI: 10.1016/j.clinbiomech.2026.106761
T.R. Goins , Jane E. Sullivan , John Fox , Cindy Servello , Katherine Saul
{"title":"The effect of elbow posture on biceps function at the shoulder in brachial plexus birth injuries: A computational sensitivity analysis","authors":"T.R. Goins ,&nbsp;Jane E. Sullivan ,&nbsp;John Fox ,&nbsp;Cindy Servello ,&nbsp;Katherine Saul","doi":"10.1016/j.clinbiomech.2026.106761","DOIUrl":"10.1016/j.clinbiomech.2026.106761","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with a brachial plexus birth injury have changes in optimal muscle length of affected muscles and diminished motion at the elbow and shoulder, impacting active shoulder elevation. The long head of the biceps, a bi-articular muscle, is of particular interest in this population due to its reduced optimal muscle length and simultaneous shortening at the shoulder and elbow during active shoulder elevation. Prior studies have shown immobilization of a joint may improve the moment-generating capacity of a biarticular muscle crossing that joint. The aim of this study was to investigate the impact of joint stabilization on shoulder elevation isometric moment-generating capacity and active and passive fiber force of the long head of the biceps in simulated elbow postures and altered optimal fiber length of the biceps.</div></div><div><h3>Methods</h3><div>Simulations, via a musculoskeletal model, were used to predict maximum isometric shoulder elevation moment, active-fiber force, and passive-fiber force versus shoulder elevation in stabilized elbow postures from 10° to 120° with a range of optimal muscle lengths from typical to reduced longitudinal length by 30%, 20%, and 10% to the long head of the biceps.</div></div><div><h3>Findings</h3><div>The highest shoulder elevation moment was produced with optimal fiber length reduced 30% for biceps long head and the elbow stabilized in 30°, causing lower active fiber force, but higher passive fiber force.</div></div><div><h3>Interpretation</h3><div>Understanding the biomechanical advantage of immobilizing the elbow in a specified posture that improves shoulder elevation in this population, establishes future directions for therapeutic interventions for birth brachial plexus injuries.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106761"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fear of movement, obesity and physical activity in knee osteoarthritis 膝关节骨性关节炎患者害怕运动、肥胖和体力活动
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-25 DOI: 10.1016/j.clinbiomech.2026.106770
Huaning Liu , Lauren Straatman , Kathryn F. Webster , Patrick Ippersiel , Daniel J. Currie , Dalia Grad , Emily G. Wiebenga , Kaylena Ehgoetz Martens , Stacey M. Acker , Monica R. Maly
{"title":"Fear of movement, obesity and physical activity in knee osteoarthritis","authors":"Huaning Liu ,&nbsp;Lauren Straatman ,&nbsp;Kathryn F. Webster ,&nbsp;Patrick Ippersiel ,&nbsp;Daniel J. Currie ,&nbsp;Dalia Grad ,&nbsp;Emily G. Wiebenga ,&nbsp;Kaylena Ehgoetz Martens ,&nbsp;Stacey M. Acker ,&nbsp;Monica R. Maly","doi":"10.1016/j.clinbiomech.2026.106770","DOIUrl":"10.1016/j.clinbiomech.2026.106770","url":null,"abstract":"<div><h3>Background</h3><div>Fear of movement is common in knee osteoarthritis but its role in reducing physical activity, and how it interacts with pain, remain unclear. The purpose of this study was to investigate how fear of movement affects the relationships between daily step count with each of pain intensity and pain sensitivity in symptomatic knee osteoarthritis.</div></div><div><h3>Methods</h3><div>Thirty-one participants with symptomatic knee osteoarthritis were included (17 female, 14 male, 0 intersex; age 65.3 [7.0] years, body mass index (BMI) 30.0 [5.0] kg/m^2). Mean daily step count was captured using a commercial 3-axis accelerometer over 7 days. Pain intensity was measured with the pain subscale of the Knee Injury and Osteoarthritis Outcome Score. Pain sensitivity was measured with pressure pain threshold. Fear of movement was self-reported on the Brief Fear of Movement Scale. After adjusting for covariates (age, BMI), regressions tested the associations between step count and pain intensity without, then with, fear of movement and its interactions. The analysis was repeated using pain sensitivity.</div></div><div><h3>Findings</h3><div>Step count was not significantly associated with pain intensity (R<sup>2</sup> = 0.199, <em>p</em> = 0.107) nor with pain sensitivity (R<sup>2</sup> = 0.217, <em>p</em> = 0.091). After adding fear of movement and its interactions to the model, the BMI x fear of movement interaction (<em>p</em> = 0.003) explained variance in step count (R<sup>2</sup> = 0.512, <em>p</em> = 0.011). Those with greater fear of movement and larger BMI completed fewer steps compared to their peers.</div></div><div><h3>Interpretation</h3><div>Managing fear of movement may enhance rehabilitation to promote physical activity in knee osteoarthritis.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106770"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicted effects of hip distraction on knee ligament mechanics following total knee arthroplasty: A finite element analysis 全膝关节置换术后髋关节撑开对膝关节韧带力学的预测影响:有限元分析
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-24 DOI: 10.1016/j.clinbiomech.2026.106763
Sophia Soehnlen , Yogesh Kumaran , Sara Sadeqi , Sudharshan Tripathi , Angela C. Collins , Carmen E. Quatman
{"title":"Predicted effects of hip distraction on knee ligament mechanics following total knee arthroplasty: A finite element analysis","authors":"Sophia Soehnlen ,&nbsp;Yogesh Kumaran ,&nbsp;Sara Sadeqi ,&nbsp;Sudharshan Tripathi ,&nbsp;Angela C. Collins ,&nbsp;Carmen E. Quatman","doi":"10.1016/j.clinbiomech.2026.106763","DOIUrl":"10.1016/j.clinbiomech.2026.106763","url":null,"abstract":"<div><h3>Background</h3><div>Hip distraction is essential for hip arthroscopy and other orthopaedic surgeries, but high traction forces often lead to complications like nerve injury and soft tissue impairment. Patients with total knee arthroplasties (TKAs) may face increased risk due to altered joint mechanics; however, the impact of specific TKA configurations on knee behavior during distraction is poorly understood.</div></div><div><h3>Methods</h3><div>A validated finite element model of the pelvis and lower extremity was developed from patient CT and MRI data. Three configurations were modeled: bi-cruciate retaining (BCR), posterior-cruciate retaining (PCR; lacking ACL), and posterior-stabilized (PS; lacking both cruciates). Hip distraction was simulated with axial traction forces (100–500 N) applied to the distal tibia/fibula with the pelvis fixed proximally. Knee and hip joint displacement and ligament strains were evaluated.</div></div><div><h3>Findings</h3><div>The BCR model demonstrated the highest knee stiffness. ACL removal (PCR) reduced stiffness more compared to PCL removal. While the amount of hip distraction was consistent across models, PCR and PS knees experienced excessive knee distraction (&gt;12 mm) and ligament strains exceeding 20% before achieving 10 mm of hip distraction. Conversely, the BCR model remained under 10 mm of knee distraction and 15% strain at equivalent hip distraction levels.</div></div><div><h3>Interpretation</h3><div>Finite element analysis revealed that PCR and PS configurations exhibit knee instability, exceeding soft tissue injury thresholds (&gt;20% strain) within standard clinical traction ranges (250–350 N). The ACL contributed greater to knee complex stiffness in axial traction compared to the PCL. Standard traction forces may pose an iatrogenic risk to PCR and PS patients, suggesting a need for TKA-specific distraction protocols to prevent soft tissue failure<em>.</em></div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106763"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of a contoured foot orthosis versus a flat sham insert on plantar loading in midfoot osteoarthritis 轮廓足部矫形器与平面假植入物对足中部骨关节炎足底负荷的影响。
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-20 DOI: 10.1016/j.clinbiomech.2026.106764
Yuet Yee Or , Hylton B. Menz , Shannon E. Munteanu , Karl B. Landorf , Michelle R. Kaminski , Polly Q.X. Lim
{"title":"Effects of a contoured foot orthosis versus a flat sham insert on plantar loading in midfoot osteoarthritis","authors":"Yuet Yee Or ,&nbsp;Hylton B. Menz ,&nbsp;Shannon E. Munteanu ,&nbsp;Karl B. Landorf ,&nbsp;Michelle R. Kaminski ,&nbsp;Polly Q.X. Lim","doi":"10.1016/j.clinbiomech.2026.106764","DOIUrl":"10.1016/j.clinbiomech.2026.106764","url":null,"abstract":"<div><h3>Background</h3><div>Midfoot osteoarthritis is common and results in pain and disability. We compared the effects of an arch contouring foot orthosis and a flat sham insert on plantar loading in people with midfoot osteoarthritis.</div></div><div><h3>Methods</h3><div>Plantar loading was collected while walking with: (i) shoe-only, and either (ii) a flat sham insert or (iii) an arch contouring orthosis. Differences within groups were tested using paired samples <em>t</em>-tests, and differences between groups were tested using analyses of covariance. Effect sizes for within-group comparisons were calculated using Cohen's <em>d</em>.</div></div><div><h3>Findings</h3><div>Forty-two adults were analysed (38 women and 4 men, mean ± SD age 66.3 ± 6.7 years). The arch contouring orthosis significantly increased contact area (adjusted mean difference [MD] 3.0 cm<sup>2</sup>, 95% confidence interval [95% CI] 0.0 to 5.9; <em>p</em> = 0.047) and maximum force (MD 30.3 N, 95% CI 16.0 to 44.7; <em>p</em> &lt; 0.001) at the medial midfoot, decreased maximum force at the lateral forefoot (MD <strong>-</strong>28.2 N, 95% CI <strong>-</strong>42.9 to <strong>−</strong>13.5; <em>p</em> &lt; 0.001), decreased peak pressure at the heel (MD <strong>-</strong>36.2 kPa, 95% CI <strong>-</strong>65.1 to <strong>−</strong>7.4; <em>p</em> = 0.015) and increased peak pressure at the medial midfoot (MD 19.8 kPa, 95% CI 7.0 to 32.5; p = 0.003). Within the arch contouring orthosis group, increases in maximum force and peak pressure at the medial midfoot were large and very large (<em>d</em> = 0.90 and 1.21, respectively).</div></div><div><h3>Interpretation</h3><div>The arch contouring orthosis increased plantar loading at the medial midfoot and decreased loading at the heel. Further studies are required to investigate if these effects are related to symptomatic improvements.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106764"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postural control anomalies and gait dysfunction in Tourette's syndrome: a systematic review and meta-analysis 图雷特综合征的姿势控制异常和步态功能障碍:系统回顾和荟萃分析
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-13 DOI: 10.1016/j.clinbiomech.2026.106750
Giorgio Guido , Fabio Zeoli , Giorgia Carlin , Alessio Sarnataro , Vittorio Oteri , Sagari Betté
{"title":"Postural control anomalies and gait dysfunction in Tourette's syndrome: a systematic review and meta-analysis","authors":"Giorgio Guido ,&nbsp;Fabio Zeoli ,&nbsp;Giorgia Carlin ,&nbsp;Alessio Sarnataro ,&nbsp;Vittorio Oteri ,&nbsp;Sagari Betté","doi":"10.1016/j.clinbiomech.2026.106750","DOIUrl":"10.1016/j.clinbiomech.2026.106750","url":null,"abstract":"<div><h3>Background</h3><div>Alongside typical manifestations such as motor and vocal tics, recent research has unveiled abnormalities in postural control and gait in patients with Tourette's syndrome (TS).</div></div><div><h3>Methods</h3><div>To investigate abnormalities in postural control and gait in patients with TS an extensive search of the literature was performed on PubMed, EMBASE, and Cochrane Library, following PRISMA guidelines. The ROBINS-I tool was used for risk of bias assessment. The Newcastle Ottawa scale was used to evaluate the certainty of evidence. Meta-analysis was conducted using a random-effects model to calculate the Standardized Mean Difference of Center of Pressure velocity and range across four clinical studies comparing children with TS to healthy controls.</div></div><div><h3>Findings</h3><div>Six case-control studies were included. Analysis of the selected studies revealed consistent findings of subclinical postural control deficits in patients with TS, characterized by increased sway area and increased range and velocity of center of pressure displacements. Reduced postural stability was found upon altered sensory or attention-demanding tasks. Minor gait dysfunctions were also found, including irregular step length and a larger step length differential. Importantly, these abnormalities appeared to be independent of tic severity, medications and comorbidities, suggesting their intrinsic nature in the context of TS.</div></div><div><h3>Interpretation</h3><div>Postural control deficit and gait dysfunction may be additional phenotypic correlates of cortical connectivity abnormalities in TS. Consequently, testing these domains in the overall assessment of patients with TS is warranted, also to develop effective and targeted therapeutic interventions addressing these aspects of the disease.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106750"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prospective fall risk screening in people who use a transtibial or transfemoral prosthesis: Cut-off times from an exploratory cohort study 使用经胫骨或经股骨假体的患者的前瞻性跌倒风险筛查:来自探索性队列研究的截止时间
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-17 DOI: 10.1016/j.clinbiomech.2026.106751
M.G. Finco , Cody L. McDonald , Sarah C. Moudy
{"title":"Prospective fall risk screening in people who use a transtibial or transfemoral prosthesis: Cut-off times from an exploratory cohort study","authors":"M.G. Finco ,&nbsp;Cody L. McDonald ,&nbsp;Sarah C. Moudy","doi":"10.1016/j.clinbiomech.2026.106751","DOIUrl":"10.1016/j.clinbiomech.2026.106751","url":null,"abstract":"<div><h3>Background</h3><div>Over 52% of people who use a lower-limb prosthesis fall once a year. Despite this knowledge, few studies have identified parameters that could help screen fall risk in clinical practice. We sought to determine if any clinical outcome measure could significantly distinguish 6-month prospective fallers from non-fallers.</div></div><div><h3>Methods</h3><div>In this exploratory cohort study, participants completed seven clinical outcome measures, walked on level-ground at their self-selected pace, completed a 12-month fall history, and reported falls every two weeks over a 6-month period. Participants were grouped by level of prosthesis use (transtibial, transfemoral), and were classified as prospective fallers or non-fallers based on whether they reported a fall over the 6-month follow-up period. Mann-Whitney <em>U</em> tests assessed statistical significance between 6-month prospective fallers and non-fallers. For parameters that were significant, area under the curve (AUC) analyses assessed clinical applicability.</div></div><div><h3>Findings</h3><div>Twenty-one individuals who use a unilateral prosthesis participated (age 57.6 ± 14.1 years). For transtibial (<em>n</em> = 14), the Four Square Step Test (FSST) and walking speed were significantly different with large effect sizes and clinical applicability (FSST <em>p</em> = 0.022, <em>g</em> = −1.122, AUC = 0.883, cut-off = 12.83 s; walking speed <em>p</em> = 0.022, <em>g</em> = −0.961, AUC = 0.883, cut-off = 1.28 m/s). For transfemoral (<em>n</em> = 7), the Timed Up and Go (TUG) was statistically significant with large effect size and clinical applicability (<em>p</em> = 0.029, <em>g</em> = −1.642, AUC = 1.000, cut-off = 9.44 s).</div></div><div><h3>Interpretation</h3><div>Cut-off times for the FSST (≥12.83 s) and walking speed (≥1.28 m/s) in transtibial prosthesis users, as well as the TUG (≥9.44 s) for transfemoral prosthesis users, may be useful to distinguish 6-month prospective fallers from non-fallers.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106751"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Novel measures of frontal plane knee wobbling predict anterior cruciate ligament injury in Japanese female basketball players: A prospective pilot study 日本女子篮球运动员前交叉韧带损伤的新测量方法:一项前瞻性先导研究
IF 1.4 3区 医学
Clinical Biomechanics Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1016/j.clinbiomech.2026.106768
Akino Aoki , Kohei Koresawa , Yumi No , Masashi Sadakiyo , Satoshi Kubota , Szu-Ping Lee , Kazuyoshi Gamada
{"title":"Novel measures of frontal plane knee wobbling predict anterior cruciate ligament injury in Japanese female basketball players: A prospective pilot study","authors":"Akino Aoki ,&nbsp;Kohei Koresawa ,&nbsp;Yumi No ,&nbsp;Masashi Sadakiyo ,&nbsp;Satoshi Kubota ,&nbsp;Szu-Ping Lee ,&nbsp;Kazuyoshi Gamada","doi":"10.1016/j.clinbiomech.2026.106768","DOIUrl":"10.1016/j.clinbiomech.2026.106768","url":null,"abstract":"<div><h3>Background</h3><div>To prospectively examine how lower extremity movement patterns during single-leg landings predict anterior cruciate ligament (ACL) injuries in adolescent Japanese basketball players during a 3-year follow-up period.</div></div><div><h3>Methods</h3><div>44 female basketball players, whose knee kinematics were measured using 2-dimensional video analysis during single-leg jump landings from a box 30 cm high. Peak knee valgus angle and knee wobbling during the landing task were primary measures of injury risk. Knee wobbling, defined as repeated knee valgus/varus movement, was calculated from relative frontal to sagittal motions (RFM) at 6, 12, 18, 24, and 30° of knee flexion. Higher RFM indicates that knee frontal movement is large compared to changes in knee flexion during landing. Knee valgus angle and RFM were compared prospectively between ACL-injured and uninjured athletes during a 3-year follow-up period.</div></div><div><h3>Findings</h3><div>Peak knee valgus angles at initial contact for injured and uninjured athletes were not significantly different (12.3 ± 2.4° vs. 14.8 ± 4.1°; <em>p</em> = 0.15). Five of six ACL-injured knees (83.3%) presented knee wobbling during landing. RFM at 18° knee flexion was significantly greater in injured athletes (0.42 ± 0.52) compared to uninjured athletes (0.10 ± 0.31; <em>p</em> = 0.02).</div></div><div><h3>Interpretation</h3><div>While peak knee valgus angle did not predict subsequent ACL injuries, RFM at 18° knee flexion could find the difference between groups. This study suggests that frontal plane knee wobbling may be indicative of impaired lower extremity control and thus a potential screening tool and intervention target for ACL injury prevention in female basketball players.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"133 ","pages":"Article 106768"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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