Clinical Biomechanics最新文献

{"title":"Symmetries of the vertical ground reaction force, contact time and area, and center of pressure during gait in female patients 3 weeks post-total hip arthroplasty","authors":"Namika Miura,&nbsp;Kensaku Masuhara,&nbsp;Keiichi Tagomori,&nbsp;Hisashi Ikutomo,&nbsp;Kenichi Okamura,&nbsp;Takato Okuno,&nbsp;Nanase Sakaguchi,&nbsp;Norikazu Nakagawa","doi":"10.1016/j.clinbiomech.2024.106419","DOIUrl":"10.1016/j.clinbiomech.2024.106419","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have assessed vertical ground reaction force, contact time, contact area, and center of pressure during gait in the early phase post-total hip arthroplasty. This study aimed to investigate whether these parameters are more pronounced in participants post-total hip arthroplasty compared to healthy controls.</div></div><div><h3>Methods</h3><div>We included 22 female participants who underwent total hip arthroplasty (age, 68.9 ± 7.2 years; body mass index, 22.9 ± 2.6 kg/m²) and 11 healthy female controls (age, 50.3 ± 7.8 years; body mass index, 19.4 ± 1.7 kg/m²) as controls. Vertical ground reaction force, contact time, contact area, and center of pressure during gait were measured using a force plate. Comparisons between the affected, unaffected, and control legs were conducted using one-way analysis of variance or the Kruskal–Wallis test, with additional comparisons using independent <em>t</em>-tests or the Mann–Whitney <em>U</em> test.</div></div><div><h3>Findings</h3><div>The first peak force was lower, the time to the first peak force and heel contact time were longer, and the contact area at the second peak force was significantly larger in the affected leg than in the unaffected leg or the right leg of the controls. These parameters were significantly more asymmetrical in the total hip arthroplasty cohort compared to the controls, with significant differences in the starting position and center of pressure length.</div></div><div><h3>Interpretation</h3><div>The loading timing, magnitude, and form of plantar contact during gait were more asymmetrical in the total hip arthroplasty cohort than in healthy females. Early-phase rehabilitation post-total hip arthroplasty should address these asymmetries.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106419"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900225","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":"Adaptation of functional gait parameters to a newly provided stiffness-optimized ankle-foot orthosis","authors":"Elza van Duijnhoven ,&nbsp;Katinka van der Kooij ,&nbsp;Esther Vlot ,&nbsp;Merel-Anne Brehm ,&nbsp;Niels F.J. Waterval","doi":"10.1016/j.clinbiomech.2024.106428","DOIUrl":"10.1016/j.clinbiomech.2024.106428","url":null,"abstract":"<div><h3>Background</h3><div>Clinical decisions regarding ankle-foot-orthosis stiffness in people with calf muscle weakness are based on immediate evaluations, not taking gait adaptation into account. This study examined adaptation of step length, walking speed and energy cost of walking in the 3-months post-provision and whether individuals with higher gait variability adapt more compared to individuals with lower gait variability.</div></div><div><h3>Methods</h3><div>We conducted a post-hoc analysis in eighteen stiffness-optimized ankle-foot-orthosis users with bilateral calf muscle weakness. Gait biomechanics, step length, walking speed and walking energy cost directly after provision (T1) and 3-months post-provision of the ankle-foot-orthosis (T2) were compared using paired sampled <em>t</em>-tests. Based on gait variability scores at T1, a high and low gait variability group was determined, and change scores in the functional gait parameters were compared using non-parametric independent sampled <em>t</em>-tests. A significance level of p ˂ 0.1 was used.</div></div><div><h3>Findings</h3><div>No significant differences in step length, walking speed and energy cost of walking between T1 and T2 were found (<em>p</em> &gt; 0.20). Step length increased more in people with high gait variability scores at T1 compared to those with low gait variability scores (High: +3.1 [−3.2 − +6.9], Low: +0.2 [−6.8 − +3.7] cm<em>, p</em> = 0.085), while no differences between groups were found for walking speed and energy cost of walking (<em>p</em> &gt; 0.129).</div></div><div><h3>Interpretation</h3><div>After provision of stiffness-optimized ankle-foot-orthoses in people with bilateral calf muscle weakness, no functional gait adaptations were found. However, people demonstrating high gait variability increased step length more compared to those demonstrating lower variability, which might be an indication that variability plays a role in adaptation.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106428"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of foot core exercises and minimalist footwear on foot muscle sizes, foot strength, and biomechanics: A systematic review and meta-analysis","authors":"Jean-Louis Peters-Dickie ,&nbsp;Christine Detrembleur ,&nbsp;Marina Guallar-Bouloc ,&nbsp;Marion Rastelli ,&nbsp;Sébastien Lobet ,&nbsp;Benjamin Hidalgo ,&nbsp;Kevin Deschamps","doi":"10.1016/j.clinbiomech.2024.106417","DOIUrl":"10.1016/j.clinbiomech.2024.106417","url":null,"abstract":"<div><h3>Background</h3><div>Specific foot exercises and the use of minimalist shoes during running or daily life were suggested to strengthen the intrinsic foot muscles and to modify locomotion biomechanics. We aimed to review the effectiveness of these interventions to modify foot muscle sizes, foot strength, and biomechanical outcomes.</div></div><div><h3>Method</h3><div>PubMed, Embase, Cochrane Library and SportDiscus databases were searched (last update: 12 March 2024). Randomized controlled trials with intervention duration of four weeks or more were included. A random-effect meta-analysis was performed when at least two studies were available for an outcome. Standardized mean differences and corresponding 95 % confidence intervals were reported. The certainty of the evidence was assessed by considering risk of bias, imprecision, inconsistency, and indirectness. The evidence not summarized in the meta-analysis was synthetised.</div></div><div><h3>Findings</h3><div>Twenty-eight trials (1399 participants) were included in the systematic review and seventeen meta-analyses were performed. From meta-analyses, minimalist shoes lead to greater strength of toes 2 to 5 (confidence interval = 0.02 to 0.76), and foot exercises resulted in lower medial longitudinal arch motion during running (confidence interval = 0.08 to 0.82). The certainty of the evidence was low to very low, mainly due to the limited number of available studies and high risk of bias. The systematic synthesis supported exercises and minimalist shoes to increase foot strength, but was conflicting for muscle sizes. The interventions occasionally modified walking and running biomechanical variables.</div></div><div><h3>Interpretation</h3><div>Foot exercises and minimalist shoes may be appropriate to increase foot strength and to induce biomechanical changes during dynamic tasks.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106417"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878546","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":"Analysis of posterior hip joint impingement about developmental dysplasia of the hip after total hip arthroplasty","authors":"Hideki Shozen ,&nbsp;Takeshi Shoji ,&nbsp;Shinichi Ueki ,&nbsp;Hiroki Kaneta ,&nbsp;Yosuke Kozuma ,&nbsp;Hiroyuki Morita ,&nbsp;Nobuo Adachi","doi":"10.1016/j.clinbiomech.2024.106422","DOIUrl":"10.1016/j.clinbiomech.2024.106422","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty is the preferred treatment for advanced hip osteoarthritis, yet complications like hip dislocation (0.2 %–10 %) persist due to factors such as implant design, positioning, surgical technique, and patient-specific conditions. Impingement between prosthetic components or the acetabulum and proximal femur is a primary cause of instability.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 120 patients (130 hips) undergoing total hip arthroplasty at XX Hospital (2011−2023) categorized patients by lateral center-edge angle: developmental dysplasia of the hip, borderline developmental dysplasia of the hip, and normal hip. ct imaging facilitated virtual 3D bone models for motion analysis, excluding cases with prior hip surgery or spinal fusion. Statistical analyses utilized the Mann–Whitney <em>U</em> test and one-way ANOVA.</div></div><div><h3>Findings</h3><div>The developmental dysplasia of the hip group showed the highest posterior impingement frequency, significantly affecting range of motion in flexion, adduction, and external rotation compared to borderline developmental dysplasia of the hip and normal hip groups. Variations in femoral neck anteversion, lesser trochanter version, and ischiofemoral space were notable. Posterior impingement commonly occurred between the lesser trochanter and ischial tuberosity.</div></div><div><h3>Interpretation</h3><div>Posterior bony impingement emerged as a predominant factor reducing range of motion and increasing dislocation risk, particularly in developmental dysplasia of the hip patients, challenging the conventional “safe zone” for implant positioning. Personalized surgical strategies tailored to individual bone morphology are crucial for enhancing total hip arthroplasty outcomes and minimizing complications, although limitations include the exclusion of soft tissue influences and focusing solely on range of motion until impingement occurs.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106422"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900219","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":"Kinematic and kinetic characteristics of individuals with coping lateral ankle sprain during landing and walking/running tasks: A systematic review with meta-analysis","authors":"Hyung Gyu Jeon ,&nbsp;Jiho Kang ,&nbsp;Se Jong Kim ,&nbsp;Jupil Ko ,&nbsp;Kyeongtak Song ,&nbsp;Sae Yong Lee","doi":"10.1016/j.clinbiomech.2025.106437","DOIUrl":"10.1016/j.clinbiomech.2025.106437","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to synthesize the kinematics and kinetics during landing and walking/running tasks of ankle copers compared with patients with chronic ankle instability and controls.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, CINAHL, SPORTDiscus, and Web of Science. Tri-planar lower extremity biomechanics (joint angle and moment at maximum and initial contact, and joint displacement) were synthesized using standard mean difference and 95 % confidence intervals. We assessed methodological quality, study heterogeneity, and publication bias.</div></div><div><h3>Findings</h3><div>We identified 13 studies. Pooled evidence indicated that copers had less inversion and eversion angles, and ankle frontal displacement during landing compared with patients with chronic ankle instability (|standard mean difference| 0.31–0.40). Copers revealed greater dorsiflexion, plantarflexion, and ankle sagittal displacement during landing and less plantarflexion moment during walking than patients with chronic ankle instability (|standard mean difference| 0.29–0.46); however, most ankle biomechanics of copers were not significantly different from those of controls. In the proximal joints, copers revealed less knee valgus angle at maximum and initial contact (|standard mean difference| 0.25–0.33); and less hip flexion angle at maximum and initial contact, hip external rotation angle and sagittal and frontal displacement during landing (standard mean difference 0.49–0.73) than patients with chronic ankle instability. Copers had less hip extension moment during walking and greater maximum hip adduction angle during landing than controls (|standard mean difference| 0.66–0.77).</div></div><div><h3>Interpretations</h3><div>Our results provide insight into the lower extremity biomechanics of copers during dynamic tasks, contributing injury coping mechanisms and developing rehabilitation programs to return to sports.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106437"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043273","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":"Gait changes induced by a 6-min walking exercise in individuals with myotonic dystrophy type 1: relationship with muscle strength","authors":"Barthélémy Hoerter ,&nbsp;Yosra Cherni ,&nbsp;Alain Steve Comtois ,&nbsp;Maria Vocos ,&nbsp;Louis-Nicolas Veilleux ,&nbsp;Laurent Ballaz","doi":"10.1016/j.clinbiomech.2025.106446","DOIUrl":"10.1016/j.clinbiomech.2025.106446","url":null,"abstract":"<div><h3>Background</h3><div>Myotonic dystrophy type 1 is an inherited muscular dystrophy characterized by muscle weakness, myotonia, and balance deficits, contributing to early fatigue and increased risk of fall during walking. This study investigated gait changes due to continuous walking exercise.</div></div><div><h3>Methods</h3><div>Fourteen individuals with myotonic dystrophy type 1 were included (age 42.0 ± 8.8 years, height 1.63 ± 0.10 m, mass 75.2 ± 22.2 kg). Maximal isometric hip and knee strength was measured using a handheld dynamometer. A 3D gait analysis, using a 12-camera optoelectronic system, was performed during a 6-min walking exercise on a quasi-oval track.</div></div><div><h3>Findings</h3><div>A decrease in step length (−3.4 %, <em>P</em> = 0.002), walking speed (−7.1 %, P = 0.002) and cadence (−3.4 %, <em>P</em> = 0.013) was observed following the 6-min walking exercise. Double support time increased (10.0 %, <em>P</em> = 0.032) and maximum base of support width increased (5.7 %, <em>P</em> = 0.023), while center of mass amplitude decreased (−5.3 %, <em>P</em> = 0.048). Hip and knee extensor strength positively correlated with step length at the beginning of the 6-min walking exercise (<em>P</em> = 0.010 and <em>P</em> = 0.022 respectively).</div></div><div><h3>Interpretation</h3><div>This study reveals key gait changes during a 6-min walking exercise in individuals with myotonic dystrophy type 1. Spatiotemporal changes highlight the importance of targeted interventions to manage muscle weakness and improve mobility in this population. Future studies should examine these changes over longer periods and in various conditions to better understand gait changes during typical daily activities in individuals with myotonic dystrophy type 1.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106446"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low back demands from assisting a patient with an unexpected loss of balance","authors":"Jacob J. Banks,&nbsp;Jie Zhou,&nbsp;Chelsea O. Riehle,&nbsp;Neal E. Wiggermann","doi":"10.1016/j.clinbiomech.2025.106448","DOIUrl":"10.1016/j.clinbiomech.2025.106448","url":null,"abstract":"<div><h3>Background</h3><div>To combat the high incidence of lower back musculoskeletal injuries in healthcare workers, it is important to identify potentially injurious tasks. Although risk of injury has been estimated for many clinical tasks, assisting a patient following an unexpected loss of balance or sudden fall has not been assessed. This study aimed to quantify the lower back forces of healthcare workers when assisting a patient from a standing loss of balance.</div></div><div><h3>Methods</h3><div>Peak L5/S1 intervertebral joint forces were estimated from thirteen healthcare workers in a laboratory setting as they assisted a patient from a standing loss of balance to a nearby wheelchair. The patient was a healthy male (64 kg) who simulated a loss of balance by buckling at the knees. An additional condition with 18 % of the patient's body weight unloaded was also tested.</div></div><div><h3>Findings</h3><div>In a minority of trials, lower back demands exceeded ergonomic guidelines of 3400 and 1000 N for compression and shear, respectively. Patient body weight affected both compression and resultant shear forces (<em>p</em>-values &lt; .001).</div></div><div><h3>Interpretation</h3><div>The lower back demands when assisting a 64-kg patient during a simulated loss of balance did not consistently exceed ergonomic safety guidelines. However, the results imply a high-risk task for heavier patients in simulated settings, or potentially all patients in realistic clinical settings. Several experimental design considerations and limitations may have created a best-case scenario that underestimated the lack of injury risk during the task studied. Use of safe patient handling and mobility equipment is advisable to minimize risk when ambulating patients.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106448"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can summary measures of magnitude and structure of trunk movement variability differentiate between people with and without chronic low back pain?","authors":"Florian Abu Bakar ,&nbsp;Alexis F. Homs ,&nbsp;J. Bart Staal ,&nbsp;Ryan B. Graham ,&nbsp;Christophe Demattei ,&nbsp;Pascal Kouyoumdjian ,&nbsp;Arnaud F. Dupeyron ,&nbsp;Jaap H. van Dieën","doi":"10.1016/j.clinbiomech.2024.106416","DOIUrl":"10.1016/j.clinbiomech.2024.106416","url":null,"abstract":"<div><h3>Background</h3><div>There is inconsistent evidence suggesting that people with chronic low back pain may differ in variability of repeated trunk movements compared to people without chronic low back pain. These inconsistencies may be due to low reliability and task dependence of movement variability measures, which can be addressed using multiple movement tasks and summary measures.</div></div><div><h3>Methods</h3><div>Participants with and without chronic low back pain were recruited. Measurement sessions involved 30 repetitions of movements in the sagittal, transverse, and combined planes. Kinematics of the pelvis, thorax, and lumbar spine were estimated using inertial sensors placed on the sacrum and thorax. Magnitude of movement variability was quantified as the mean standard deviation of Euler angles for the thorax, pelvis, and lumbar spine across normalized cycles for each movement axes, resulting in 27 variables. Additionally, structure of variability was assessed using Lyapunov exponents for local dynamic stability, yielding 9 additional variables. Principal Component Analysis reduced the dimensionality of each variability measure (magnitude and structure). Stepwise logistic regression with principal component scores tested for differences between groups.</div></div><div><h3>Findings</h3><div>In the magnitude of variability analysis, four principal components were retained. The first two principal components significantly differentiated between people with low back pain and controls, accounting for 32.5 % and 14 % of the total variance, respectively. In the structure of variability analysis, no principal components were found to significantly contribute to differentiating between the two groups.</div></div><div><h3>Interpretation</h3><div>Summary measures of the magnitude, but not the structure, of trunk movement variability differentiated between people with and without chronic low back pain.</div><div>Clinical trial: NCT02059317, CPP: 2013.11.09bis Sud Méditerranée III, N° RCB: 2013-A01379-36.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106416"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with Achilles tendinopathy use compensation strategies to reduce tendon load during rehabilitation exercises","authors":"Frea Deroost ,&nbsp;Davide Petrella ,&nbsp;Ine Mylle ,&nbsp;Benedicte Vanwanseele","doi":"10.1016/j.clinbiomech.2024.106403","DOIUrl":"10.1016/j.clinbiomech.2024.106403","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine differences in the Achilles tendon loading during rehabilitation exercises for Achilles tendinopathy and the ranking of these exercises, based on load, in patients with tendinopathy and controls.</div></div><div><h3>Methods</h3><div>Sixteen patients with Achilles Tendinopathy (5F &amp; 11 M, 44.1 ± 12.9 yr) and sixteen controls (4F &amp; 12 M, 39.4 ± 15.6 yr) performed rehabilitation exercises while 3D motion and ground reaction forces were measured. Musculoskeletal modeling was used to compute joint kinematics and estimate Achilles tendon load by summing the forces of individual triceps surae muscles. Subsequently, peak Achilles tendon loading, loading impulse, loading rate, loading indexes (a combination of the previous parameters), and joint angles at the time of peak loading were determined and compared between patients and controls.</div></div><div><h3>Findings</h3><div>Patients with tendinopathy exhibited significantly reduced peak Achilles tendon loading compared to controls during the exercises with the highest peak loading: unilateral heel drop with flexed knee (3.66 ± 0.90BW [AT] vs. 4.65 ± 1.10BW [Control], <em>p</em> = 0.003, d = 0.979) and walking (3.37 ± 0.49BW [AT] vs. 3.68 ± 0.33BW [Control], <em>p</em> = 0.044, d = 0.742). Additionally, during the heel drop exercise, patients with tendinopathy showed reduced ankle dorsiflexion and knee flexion. The ranking of exercises by peak loading or loading index was similar for both groups but varied depending on which loading parameter was used to define Achilles tendon loading.</div></div><div><h3>Interpretation</h3><div>During the highest load-imposing exercises, patients with tendinopathy employ compensatory strategies to reduce the load on their Achilles tendon. Clear instructions and feedback on the patient's performance are crucial as altered exercise execution influences Achilles tendon loading.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106403"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792284","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":"Upper limb kinematics in patients with neonatal brachial plexus palsy with different levels of palsy","authors":"Nathalie Maurel ,&nbsp;Amadou Diop ,&nbsp;Pauline Lallemant-Dudek ,&nbsp;Franck Fitoussi","doi":"10.1016/j.clinbiomech.2024.106394","DOIUrl":"10.1016/j.clinbiomech.2024.106394","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal brachial plexus palsy remains a frequent condition and most of those patients often present active and passive joint limitation depending of the extend of the palsy. The aim of this study was to compare during the Mallet score tasks the upper limb kinematics of those patients with a reference database of non-involved arms but also to characterize kinematics changes according to the extent of the palsy.</div></div><div><h3>Methods</h3><div>Kinematic analysis was performed using an electromagnetic device. The point of achievement position and the range of motion were analyzed. The involved arm of thirty-three patients was studied. Several groups of patients were defined depending on the level of the palsy: a C5-C8 ± T1 group (fifteen patients), a C5-C6 group (five patients) and a C5-C7 group (thirteen patients). Data from non-involved arm of thirty patients were used as control.</div></div><div><h3>Findings</h3><div>Many significant differences were found between the control and palsy groups and between the latter. When comparing the C5-C8 ± T1 and proximal groups, for all except the mouth task, at point of achievement the scapula was more in protraction and glenohumeral elevation was lower. Elbow flexion range of motion was different for all except the external rotation task, with a decreased flexion for mouth, neck and spine tasks and a higher flexion for elevation task. For mouth task, the C5-C8 ± T1 group had a lower supination range of motion than the proximal group.</div></div><div><h3>Interpretation</h3><div>This study helps to better understand the effect of the palsy on the humerothoracic, scapulothoracic, glenohumeral and elbow kinematics.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"122 ","pages":"Article 106394"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792342","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}