Clinical Biomechanics最新文献

{"title":"Kinetic and kinematic effects of using a walker during the sit-to-stand transfer after lumbar spinal fusion: A cross-sectional, within-subjects study","authors":"Jason L. Shaw ,&nbsp;James M. Hackney ,&nbsp;Renee E. Anderson ,&nbsp;Ryan B. Birchell ,&nbsp;Ryan R. Clements ,&nbsp;Austin C. Gibbs ,&nbsp;Andrew M. Ludwig","doi":"10.1016/j.clinbiomech.2025.106601","DOIUrl":"10.1016/j.clinbiomech.2025.106601","url":null,"abstract":"<div><h3>Background</h3><div>High pain levels after lumbar spinal fusion surgery often alter sit-to-stand kinematics, including reducing forward trunk inclination. These adaptations can lead to long-term kinematic deviations and chronic pain. Interventions are needed to facilitate sit-to-stand kinematics resembling those of healthy individuals while minimizing post-surgical pain. This study compared the effects of using both hands on a walker during sit-to-stand to pushing up from the sitting surface on several kinetic and kinematic variables.</div></div><div><h3>Methods</h3><div>Fifteen participants (mean age 52.3 ± 14.1 years), on average 10 days after lumbar spinal fusion, performed alternating sit-to-stand trials. Data were collected using 3D motion capture and force plates to analyze differences between the two hand placement conditions.</div></div><div><h3>Findings</h3><div>Using a walker did not significantly reduce trunk-pelvis external flexion moment (mean difference = 4.1 Nm, <em>P</em> = .582) when modeling the trunk as a rigid segment, but reduced ground reaction forces (−312.1 N), promoted a less acute trunk-pelvis angle (+6.9°), and decreased hip flexion moment (−71.3 Nm; all <em>P</em> &lt; .001). Contrary to common concerns, no walker tipping occurred during the 45 sit-to-stand trials.</div></div><div><h3>Interpretation</h3><div>Using hands on a walker for sit-to-stand after recent lumbar spinal fusion appears safe for individuals with presumably intact cognition. The lack of reduction in trunk-pelvis external flexion moments may reflect adaptive movement patterns employed to complete the task when the trunk is unsupported. Lower hip moments and a less acute trunk-pelvis angle when using the walker may support early mobilization by reducing joint loading and motion demands, potentially lessening pain.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106601"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549612","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}

{"title":"EFORT Michael Freeman Award 2020: Knee biomechanics before and after total knee arthroplasty with either a medial pivot or posterior stabilized implants","authors":"Erik Kowalski ,&nbsp;Danilo S. Catelli ,&nbsp;Alexandre R.M. Pelegrinelli ,&nbsp;Geoffrey Dervin ,&nbsp;Mario Lamontagne","doi":"10.1016/j.clinbiomech.2025.106604","DOIUrl":"10.1016/j.clinbiomech.2025.106604","url":null,"abstract":"<div><h3>Background</h3><div>Can the design of a total knee replacement affect how patients walk and their reported outcomes compared to healthy adults, considering age and body mass index (BMI)? Many studies have produced conflicting results, often not including a pre-operative assessment and relying on discrete measurements.</div></div><div><h3>Methods</h3><div>Twenty-eight patients randomly received either a medial-ball-and-socket (<em>n</em> = 14, age = 62.7(5.8) years, BMI = 27.0(3.8)kg/m², females = 6) or posterior-stabilized (n = 14, age = 64.5(8.1) years, BMI = 29.8(3.4)kg/m², females = 6) implant and completed a gait analysis before and 12 months following total knee arthroplasty and were compared to 14 healthy controls (age = 64.4(5.6) years, BMI = 24.9(2.1) kg/m², females = 7). Temporospatial, knee biomechanics and patient-reported outcome measures were measured during five gait trials. Knee biomechanical measures were evaluated across the gait cycle using statistical parametric mapping.</div></div><div><h3>Findings</h3><div>Preoperatively, the medial-ball-and-socket and posterior-stabilized were similar, with no differences in age, BMI, patient-reported outcome measures, or knee biomechanics (<em>P</em> &gt; .05). Pre-operatively, compared to controls, both medial-ball-and-socket and posterior-stabilized had different movement patterns, primarily in stance and swing phase knee flexion angles (<em>P</em> &lt; .05). Postoperatively the medial-ball-and-socket had less knee flexion angle during stance phase compared to the controls (<em>P</em> &lt; .05), whereas the posterior-stabilized walked with less knee flexion angle than the controls during stance and swing phase (<em>P</em> &lt; .05).</div></div><div><h3>Interpretation</h3><div>The medial-ball-and-socket group demonstrated a gait pattern more closely resembling that of the controls compared to the PS group, exhibiting fewer differences in sagittal knee angles. Although both groups showed post-operative improvement across all patient-reported outcome measures, no significant differences were detected between them.</div><div><strong>Trial registration</strong>: <span><span>NCT02589197</span><svg><path></path></svg></span>, October 28, 2015.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106604"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523514","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}

{"title":"Characterization of anticipatory postural adjustments in patients with post-stroke hemiplegia using smartphones","authors":"Ryo Onuma ,&nbsp;Fumihiko Hoshi ,&nbsp;Hiroshi R. Yamasaki ,&nbsp;Yuki Soutome ,&nbsp;Tomoko Sakai ,&nbsp;Tetsuya Jinno","doi":"10.1016/j.clinbiomech.2025.106603","DOIUrl":"10.1016/j.clinbiomech.2025.106603","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to measure anticipatory postural adjustment characteristics of patients with stroke hemiplegia during one-leg standing using a smartphone.</div></div><div><h3>Methods</h3><div>Participants included 20 patients with stroke hemiplegia and 10 healthy age-matched controls. A smartphone was attached to the pelvis (L5), and one-leg standing movement was measured. The main data were the mediolateral component of the acceleration built into the smartphone. The time (peak latency) and amount of movement up to the maximum value (peak magnitude) of the acceleration in the stance direction were analyzed as the anticipatory postural adjustment feature quantities.</div></div><div><h3>Findings</h3><div>Patients with stroke hemiplegia showed a decrease in peak magnitude compared with controls. Additionally, the peak magnitude was lower when lifting the paretic leg than the non-paretic leg, and the peak latency was slower when lifting the non-paretic leg than the paretic leg. Peak latency of non-paretic leg elevation correlated with Fugl-Meyer Assessment and Mini-BESTest scores.</div></div><div><h3>Interpretation</h3><div>This study revealed decreased anticipatory postural adjustments and asymmetry in the motor strategies of patients with stroke hemiplegia. From the perspective of hemiplegic motor and balance functions, the timing of the shift in the center of gravity to the paretic leg when lifting the non-paretic leg is important.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106603"},"PeriodicalIF":1.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502609","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}

{"title":"Effects of prefabricated and custom foot orthoses on the biomechanics of the lower limbs of individuals with a posterior tibialis tendon dysfunction during stair climbing.","authors":"Dominic Chicoine ,&nbsp;Gabriel Moisan ,&nbsp;Marc Bouchard ,&nbsp;Simon Laurendeau ,&nbsp;Étienne Belzile ,&nbsp;Philippe Corbeil","doi":"10.1016/j.clinbiomech.2025.106602","DOIUrl":"10.1016/j.clinbiomech.2025.106602","url":null,"abstract":"<div><h3>Background</h3><div>Posterior tibialis tendon dysfunction is a chronic musculoskeletal disorder characterized by a progressive flatfoot deformity which negatively impacts health-related quality of life. Custom foot orthoses modify walking biomechanics in individuals with posterior tibialis tendon dysfunction, but no studies have investigated their effects on stair climbing biomechanics in this population. This cross-sectional study aimed to compare the effects of prefabricated foot orthoses and two models of custom foot orthoses on the biomechanics of individuals with posterior tibialis tendon dysfunction during stair climbing.</div></div><div><h3>Methods</h3><div>Fourteen individuals with painful posterior tibialis tendon dysfunction were recruited to undertake a stair climbing task under four experimental conditions: shoes alone, prefabricated foot orthoses, neutral custom foot orthoses and custom varus foot orthoses with a 5° medial wedge and a 4 mm medial heel skive. Hip, knee, ankle and foot angles and moments were compared between conditions, using one-dimensional statistical non-parametric mapping.</div></div><div><h3>Findings</h3><div>Forefoot dorsiflexion was decreased for neutral custom foot orthoses compared to shoes (<em>P</em> &lt; 0.001). Both custom foot orthoses decreased hindfoot eversion compared to shoes (<em>P</em> &lt; 0.001). Greater ankle eversion moments were observed for both custom foot orthoses compared to shoes (<em>P</em> &lt; 0.001) and prefabricated foot orthoses (neutral custom: <em>P</em> &lt; 0.001).</div></div><div><h3>Interpretation</h3><div>Neutral custom and custom varus foot orthoses seem appropriate to attenuate biomechanical deficits in individuals with posterior tibialis tendon dysfunction. Longer-term effects of foot orthoses on lower limb biomechanics and clinical meaningfulness of these changes remain to be determined.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106602"},"PeriodicalIF":1.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481592","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}

{"title":"Greater external negative mechanical work is accompanied by a greater metabolic cost of walking for socket-suspended versus bone-anchored prosthesis users with transfemoral limb loss","authors":"Gauri A. Desai ,&nbsp;John R. Pope ,&nbsp;Chioma Ezeajughi ,&nbsp;Jae Kun Shim ,&nbsp;Ross H. Miller","doi":"10.1016/j.clinbiomech.2025.106598","DOIUrl":"10.1016/j.clinbiomech.2025.106598","url":null,"abstract":"<div><h3>Background</h3><div>Bone-anchored prostheses may address the high metabolic cost of walking in transfemoral (i.e., above-knee) amputees if they mitigate the mechanical energy dissipated due to socket use, reflecting a lower metabolic cost of walking than socket-suspended prosthesis users. Therefore, we compared external mechanical work between socket-suspended and bone-anchored transfemoral prosthesis users during walking and identified if these differences are accompanied by those in their metabolic costs of walking. We hypothesized that socket users would perform more net and negative external mechanical work in their prosthetic limb over the gait cycle and exhibit a higher metabolic cost of walking than bone-anchored prosthesis users.</div></div><div><h3>Methods</h3><div>High-functioning (Medicare K-level ≥ 3, no dysvascular limb loss) transfemoral amputees with a socket-suspended or bone-anchored prosthesis were recruited (<em>N</em> = 12 per group). Participants walked at 1.0 m/s on a treadmill as pulmonary gases were measured for metabolic cost estimates and overground as ground reaction forces were measured to calculate net and negative external mechanical work across the gait cycle. Metabolic cost and prosthetic-limb external mechanical work outcomes were compared between groups using independent samples <em>t</em>-tests (α &lt; 0.05) corrected for multiple comparisons.</div></div><div><h3>Findings</h3><div>Net mechanical work done by the prosthetic limb was not significantly different between groups (<em>p</em> = 0.93, g = 0.64). However, socket users showed greater external negative mechanical work (<em>p</em> = 0.005, g = 1.17), which was accompanied by a 10.13 % greater metabolic cost of walking than bone-anchored prosthesis users (<em>p</em> = 0.03, g = 0.54).</div></div><div><h3>Interpretation</h3><div>Bone-anchored prostheses may address the high metabolic costs of transfemoral amputee walking by mitigating socket-related energy loss.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106598"},"PeriodicalIF":1.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470804","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}

{"title":"Enhancing tremor classification: Transformer-based analysis of biomechanics patterns for Parkinson's and essential tremor","authors":"Muhammad Izzuddin Mahali ,&nbsp;Jenq-Shiou Leu ,&nbsp;Cries Avian ,&nbsp;Jeremie Theddy Darmawan ,&nbsp;Muhamad Faisal ,&nbsp;Nur Achmad Sulistyo Putro ,&nbsp;Setya Widyawan Prakosa","doi":"10.1016/j.clinbiomech.2025.106599","DOIUrl":"10.1016/j.clinbiomech.2025.106599","url":null,"abstract":"<div><h3>Background</h3><div>Differentiating Essential Tremor and Parkinson's Disease is challenging due to overlapping tremor characteristics, including similar frequency ranges (4–8 Hz) and kinetic manifestations that defy conventional clinical differentiation. This study aimed to develop a multiclass differentiation system for Essential Tremor, Parkinson's Disease, and Healthy Controls by employing deep learning to decode distinct biomechanical patterns from multi-sensor movement data during dynamic motor tasks.</div></div><div><h3>Methods</h3><div>Tremor severity was assessed using accelerometers positioned on the thumb, index finger, metacarpal, and wrist during four protocols: two static (rest, postural) and two dynamic (free motion, motion with object). We employed a Transformer-based model with multi-head attention to capture spatiotemporal movement patterns. Two analytical approaches were compared: (1) feature extraction followed by Transformer processing, and (2) direct Transformer processing of raw signals.</div></div><div><h3>Findings</h3><div>The feature-based approach achieved perfect classification accuracy (100 %) for postural holding (utilizing integrated absolute value and other derived features) and free motion (employing mean power and additional features). The raw signal approach similarly attained 100 % accuracy in classifying free motion (200-sample window) and motion with object (200- and 300-sample windows). Integration of multi-protocol dynamic tasks (free motion and motion with object) yielded 99.32 % overall accuracy. Crucially, dynamic protocols demonstrated consistent superiority over static protocols in diagnostic performance.</div></div><div><h3>Interpretation</h3><div>The Transformer model with multi-head attention effectively identified disease-specific biomechanical patterns. Its high accuracy in distinguishing Essential Tremor, Parkinson's Disease, and Healthy Control participants, particularly during dynamic tasks, positions it as a promising tool for enhancing clinical decision-making and artificial intelligence-assisted monitoring of neurodegenerative disorders.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106599"},"PeriodicalIF":1.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490244","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}

{"title":"Measurement of gait by an in-shoe motion sensor system: feasibility and potential application in healthy adults and patients with orthopedic diseases","authors":"Keiko Asakura ,&nbsp;Sachie Mori ,&nbsp;Aya Yoshida ,&nbsp;Norihito Etoh ,&nbsp;Katsunori Fukutake ,&nbsp;Hideyuki Aoki ,&nbsp;Eisuke Orito ,&nbsp;Azusa Furukawa ,&nbsp;Hiroaki Nakano ,&nbsp;Hiroshi Takahashi ,&nbsp;Yuji Nishiwaki","doi":"10.1016/j.clinbiomech.2025.106597","DOIUrl":"10.1016/j.clinbiomech.2025.106597","url":null,"abstract":"<div><h3>Background</h3><div>Gait varies in accordance with several factors, including age, gender, and the presence of disease. A recently developed system allows the convenient measurement of gait using in-shoe motion sensors and a smartphone application. Here, this system was used to measure seven gait parameters in 40 healthy adults and 45 patients with orthopedic disorders.</div></div><div><h3>Methods</h3><div>For the healthy volunteers, gait monitoring was performed for one month. This monitoring was also performed at home before and one year after surgery in patients with knee or spine disorders, and at hospital at four time points before and after surgery to monitor changes in gait. The relationship between participant characteristics and gait was assessed among the healthy volunteers, and change of gait in the perioperative period was described among the patients.</div></div><div><h3>Findings</h3><div>In the healthy volunteers, being in one's 80s was significantly related with worse gait conditions, such as slower walking speed and shorter stride length, than being in one's 40s. Also, higher height was associated with longer stride length. In the patients with knee disorders, many gait parameters worsened from before to one month after surgery, and then tended to improve up to one year post-surgery. In contrast, patients with spinal disorders showed improvement even at one month post-surgery, with continued improvement up to three months post-surgery.</div></div><div><h3>Interpretation</h3><div>Measurement in daily life was feasible, and thought to accurately reflect the gait of each participant. Further studies are needed to investigate the relationship between the gait parameters and health outcomes.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106597"},"PeriodicalIF":1.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330282","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}

{"title":"Dynamic balance and mobility during pregnancy","authors":"Breanna R. Dumke ,&nbsp;Lauren H. Theilen ,&nbsp;Janet M. Shaw ,&nbsp;K. Bo Foreman ,&nbsp;Leland E. Dibble ,&nbsp;Peter C. Fino","doi":"10.1016/j.clinbiomech.2025.106596","DOIUrl":"10.1016/j.clinbiomech.2025.106596","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 25 % of pregnant people fall during the course of their pregnancy. While most falls during pregnancy occur during complex, dynamic movements, prior research on balance in pregnant people has largely focused on static posture. The present study aims to investigate dynamic balance and mobility throughout gestation by examining relatively more complex movements than traditional assessments of gait and balance in pregnant people. It is the first study to quantify two common clinical tests, the tandem gait test and the Timed Up and Go test, that assess mobility and fall risk via IMUs within pregnancy.</div></div><div><h3>Methods</h3><div>A total of 30 pregnant people (1st trimester: <em>n</em> = 10, 2nd trimester: n = 10, 3rd trimester: n = 10) and 10 healthy nonpregnant control females completed a tandem gait test and the Timed Up and Go test. Time to completion and measures of movement quality such as smoothness, peak turning speed, and mediolateral sway via the root mean square of center of mass acceleration, obtained through inertial measurement units (Opal v2, APDM Inc.), were compared between groups.</div></div><div><h3>Findings</h3><div>Overall, pregnant individuals completed both tests slower as gestational age increased. Pregnant people also demonstrated a similar movement quality, to healthy controls, rather than maintaining movement speed.</div></div><div><h3>Interpretation</h3><div>We speculate that reduced movement speed may be a compensatory strategy used during pregnancy to safely move despite increased mass and limited thoracopelvic rotations. Altogether, these findings contribute to a deeper understanding of the context-dependent effects of pregnancy on dynamic balance and mobility.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106596"},"PeriodicalIF":1.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336046","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}

{"title":"Oral frailty and fall risk: A systematic review and meta-analysis in adults aged 45 and over","authors":"Prakasini Satapathy ,&nbsp;Shilpa Gaidhane ,&nbsp;Ashok Kumar Bishoyi ,&nbsp;Subbulakshmi Ganesan ,&nbsp;V. Kavita ,&nbsp;Swati Mishra ,&nbsp;Manpreet Kaur ,&nbsp;Ganesh Bushi ,&nbsp;Muhammed Shabil ,&nbsp;Rukshar Syed ,&nbsp;Sonam Puri ,&nbsp;Sunil Kumar ,&nbsp;Sabah Ansar ,&nbsp;Sanjit Sah ,&nbsp;Lovely Jain","doi":"10.1016/j.clinbiomech.2025.106595","DOIUrl":"10.1016/j.clinbiomech.2025.106595","url":null,"abstract":"<div><h3>Background</h3><div>Oral health plays a vital role in overall well-being among older adults. Oral frailty—characterized by impaired chewing ability, reduced saliva production, and tooth loss—has been linked to an increased risk of physical decline, particularly falls. Falls are a major health concern in aging populations due to their impact on independence and healthcare burden. This study investigates the association between oral frailty and the occurrence of falls to inform prevention strategies and health policy.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using PubMed, EMBASE, and Web of Science to identify studies examining the relationship between oral frailty and falls among individuals aged 45 years and older. Study quality was assessed using the National Institute of Health assessment tool. Statistical analyses, including meta-analysis and assessments of heterogeneity and publication bias, were performed using R Studio and Review Manager.</div></div><div><h3>Findings</h3><div>From 1563 records identified, 12 studies met the eligibility criteria. The combined analysis demonstrated a significant association between oral frailty and falls, with individuals experiencing oral frailty having nearly twice the risk of falling compared to those without (pooled odds ratio 1.86). Subgroup analysis showed a stronger association among adults aged 65 years and older (odds ratio 2.03), suggesting increased vulnerability with advancing age.</div></div><div><h3>Interpretation</h3><div>There is a clear association between oral frailty and increased risk of falls among older adults. Integrating oral health into geriatric care can help reduce fall-related injuries and associated healthcare costs. These findings support expanding access to dental care as part of preventive health coverage for the aging population.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106595"},"PeriodicalIF":1.4,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366026","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}

{"title":"Retrograde intramedullary headless compression screw fixation for distal fibular fractures","authors":"Joseph Bellapianta ,&nbsp;Scott Winnier ,&nbsp;George Anastasios Souflis ,&nbsp;Michael K. Viggiano","doi":"10.1016/j.clinbiomech.2025.106593","DOIUrl":"10.1016/j.clinbiomech.2025.106593","url":null,"abstract":"<div><h3>Background</h3><div>Although intramedullary headless compression screw fixation for distal fibular fractures has been described, its biomechanical properties remain underexplored in orthopedic literature. Distal fibular fractures are commonly treated with plate-and-screw constructs; however, complications related to hardware prominence, soft tissue irritation, and hardware removal are frequent. Retrograde intramedullary headless compression screw fixation may offer a biomechanically stable, minimally invasive alternative.</div></div><div><h3>Objective</h3><div>To biomechanically compare retrograde intramedullary headless compression screw fixation with traditional 7-hole one-third tubular plate and lag screw fixation in simulated Weber B distal fibular fractures using cadaveric models.</div></div><div><h3>Methods</h3><div>Twenty match-paired cadaver fibulas were artificially fractured and repaired with either intramedullary screw or plate fixation. The specimens underwent four-point bending and torsional tests to assess biomechanical stability. Paired <em>t</em>-tests were used for comparisons, with effect sizes and confidence intervals reported.</div></div><div><h3>Findings</h3><div>Intramedullary headless compression screw fixation demonstrated greater stability during compression testing, but this difference was not statistically significant (<em>p</em> = 0.1326). The mean difference in maximum compressive load was 28.108 N (95 % CI [−11.43, 67.65]). No significant differences were observed in torsion testing, with a mean difference of −14.411 N·cm (95 % CI [−35.70, 6.88]). The study had low statistical power (0.052) to detect differences.</div></div><div><h3>Interpretations</h3><div>Retrograde intramedullary screw fixation provides comparable or superior biomechanical stability to plate-and-screw constructs in a cadaveric model. This technique may be a viable alternative in select fracture patterns, warranting further clinical investigation.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"127 ","pages":"Article 106593"},"PeriodicalIF":1.4,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314545","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}