Gait & posture最新文献

{"title":"Examining the gait pattern in terms of spatio-temporal, kinematic and kinetic parameters during gait initiation in MS patients","authors":"Narges Jahantigh Akbari, Mohammad Yousefi","doi":"10.1016/j.gaitpost.2023.07.110","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.110","url":null,"abstract":"MS is an autoimmune disease of the central nervous system (1). Postural balance impairment is frequently depicted as one of the initial symptoms of MS and one of the most impairing MS symptoms (2, 3). the gait impairment is one of the most common indications of MS and influences the quality of life (4). Although investigation of the quiet stance is critical for analyzing the balance impairments, more challenging situations such as gait initiation (GI) may give a deeper knowledge into understanding of the mechanisms of dynamic postural control (5). Therefore, the aim of this study was to evaluate the gait pattern in terms of spatio-temporal, kinematic and kinetic parameters during the gait initiation phase in people with MS. What are the influencing factors on the gait pattern in gait initiation phase in MS patients? Search in PubMed, Cochrane, Science of Direct, Web of science, Scopus, and Google scholar Databases from 2019 to December 2022 was conducted. Studies were included if: individuals with multiple sclerosis disease, examination the gait initiation phase, and assessment of center of pressure(COP), anticipatory postural adjustments (APA), spatio-temporal, kinematic and kinetic parameters and muscular synergies as outcome measure were evaluated. Included studies were independently reviewed by two authors for their quality evaluation using modified Downs and Black checklist. Since meta-analysis was not possible, studies were descriptively presented. Ten articles were selected for final analysis. A total of 231 MS patients and 132 healthy subjects were included with ages ranging from 18 to 76 years old. The findings of studies showed COP position at gait initiation was more anterior and net muscular moments for each joint were significantly different during the APA phase with smoother variations in patients with MS than healthy participants. A lower amount of muscle activity during APA were reported. The first step was shorter in MS patients compared to healthy people. Gait initiation in the early stage of MS could be a useful measure to characterize balance. These results suggest that it is possible to use the gait initiation evaluation as an effective method for the rehabilitation treatment of these patients.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling of different arm swing and the effect on hip flexors and extensors","authors":"Sadegh Madadi, Mostafa Rostami, Afshin Taheri Azam","doi":"10.1016/j.gaitpost.2023.07.145","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.145","url":null,"abstract":"The human body is a complex system of interconnected muscles and joints that work together to produce movement. The hip joint is particularly important in this regard, as it is responsible for supporting the weight of the body and facilitating movement of the legs. The flexor and extensor muscles of the hip joint play a crucial role in this process, as they are responsible for moving the leg forward and backward, respectively. Does the swing of the arm affect the activity of the flexor and extensor muscles of the hip joint?Download : Download high-res image (89KB)Download : Download full-size image To investigate the relationship between different swings of the arm and the effect on the flexor and extensor muscles of the hip joint, we utilized the OpenSim software. We created a model of the human body in OpenSim by motion capture data and used it to measuring the activity of the flexor and extensor muscles of the hip joint. sample consisted of 20 healthy adults (10 males, 10 females) between the ages of 18 and 30. All participants were free of any musculoskeletal disorders or injuries that could affect their hip joint function. Results showed that there was a significant difference in muscle activity between arm swings. Specifically, when the arm was swung forward, the activity in the flexor muscles of the hip joint was significantly higher than when the arm was swung backward (p < 0.001). Conversely, when the arm was swung backward, the activity in the extensor muscles of the hip joint was significantly higher than when the arm was swung forward (p < 0.001). We also found that the difference in muscle activity between arm swings was more pronounced in males compared to females (p = 0.03). This suggests that there may be gender-specific differences in the way the hip joint muscles are activated during arm swings. We studied the three types of long, short and normal swing (p = 0.02). These findings provide valuable insight into the relationship between arm swings and hip joint muscle activation, which can be useful for individuals seeking to optimize their hip joint function. This study provides insight into the relationship between different arm swings and the activity of the flexor and extensor muscles of the hip joint. Arm swings can have a significant effect on the activation of these muscles, and this effect may differ between males and females. This information can be useful for individuals seeking to optimize their hip joint function, such as athletes or those undergoing rehabilitation after hip joint injuries.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel method for tracking movements of backpack’s centre of mass in dynamic activities","authors":"Qiang Zhang, Leichao Liang, Weiping Zhu, Xie Wu","doi":"10.1016/j.gaitpost.2023.07.274","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.274","url":null,"abstract":"Postural compensations with backpack may cause considerable body strains, resulting in fatigue, pain, and injury [1]. Backpack’s position can influence carrier’s posture and dynamic performance [2]. Characterizing the backpack’s position, namely the position of its centre of mass (COM) with respect to the carrier’s body, allows modelling its dynamic loading towards revealing the moment and moment of inertia it renders on the carrier. These knowledges will provide novel insights into the carrier’s postural compensations and musculoskeletal injury [3]. Despite of the importance, there is a lack of an easy approach that can determine and track the movement of a backpack’s COM during dynamic activities. How to determine the position of a backpack’s COM and track its movements in walking with the backpack? A backpack was tightly filled with sandbags, resulting in a total weight of 10 kg. Using a 3D motion capture system (Vicon, UK), we created the backpack’s local coordinate system (CS) with the three reflective markers attached on it. A directional cosine matrix was established for coordinate transformations between the backpack’s and the lab’s CS. A mannequin was then placed on an integrated force plate (Kistler, Switzerland), and its weight and centre of pressure were measured. This measurement was repeated after placing the backpack on the mannequin (two positions, Fig. 1a), and the horizontal coordinates of the backpack’s COM were calculated according to the Varignon's Theorem. Fig. 1. Experiments and outcomes: a) Measuring centre of pressure in backpack’s two postures; b) Displacement of backpack’s and subject’s COM during walking. Download : Download high-res image (81KB)Download : Download full-size image As the coordinates of the backpack’s COM in the backpack’s local CS remained unchanged, an equation could be established to calculate the vertical coordinate of the backpack’s COM with its horizontal coordinates. Finally, the coordinates of the backpack’s COM in the backpack’s local CS were determined through coordinate transformation. Afterwards, a healthy young subject was instrumented with full-body marker set, and then performed walking with the backpack at 5 km/h. Using Visual 3D (C-Motion, USA), a virtual marker was created according to above outcomes, and the marker’s movements were computed from the gait trials. The results indicated that the vertical displacement magnitude of backpack’s and subject’s COM was similar (Fig. 1b), with a small temporal difference. In the mediolateral direction, the displacement of the backpack’s COM was much greater than that of the subject’s COM. A clear lag effect was observed in their mediolateral displacement during walking, where the backpack’s COM reached its ultimate mediolateral positions later than the subject’s COM did. Our approach can be applied to easily determine a backpack’s COM in 3D motion analysis, towards quantifying backpack’s loading effects and studying carrier’s postural adaptation","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip rotation obtained via conventional and functional knee joint axis calibration in the context of femoral derotation osteotomy","authors":"Arik Rehani Musagara, Marco Götze, Sebastian I. Wolf","doi":"10.1016/j.gaitpost.2023.07.206","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.206","url":null,"abstract":"Transversally measured hip rotation can add valuable information in the indication of femoral derotation osteotomy (FDO) (Dreher 2007), which serves as the gold standard in the treatment of internally rotated gait. Typically, studies on gait analyses in the context of FDO relied on the conventional calibration of the knee joint axis (KJA) based on palpation of the epicondyles. However, researchers regularly face discrepancies between planned FDO angle, pre-post changes in anteversion and pre-post changes in hip rotation (Böhm 2015, Putz 2016). Apart from previously discussed factors, we hypothesized that a functional calibration of the KJA might lead to smaller differences between aforementioned parameters and therefore provide more coherent results than the conventional method. Does a functional KJA calibration allow for smaller differences between intraoperative FDO angle and pre-post changes in mean hip rotation in stance (mHipRotSt)? 14 patients (mean age at surgery: 16.2 ± 9.5 years) scheduled for FDO were examined retrospectively in this study. 3D gait analysis including functional KJA calibration and rotational MRIs (available in 8 of 14 patients) for estimating anteversion were measured pre- (1 day) and post-FDO (11.7 ± 3.1 months). Functional calibration included three unassisted, unloaded knee flexion-extension movements in single limb stance and were repeated for both legs. Subsequently the SARA algorithm (Ehrig 2007) was applied. Conventional estimation of the KJA was done with the Knee Alignment Device method. FDO angle was documented during surgery and was measured intraoperatively with a goniometer. Postoperative mHipRotSt was significantly smaller (p <0.001) for both conventional and functional method than before surgery (Table 1). A significant, high correlation was observed between the pre-post FDO change of conventionally measured mHipRotSt and intraoperative external FDO angle (r = 0.62, p < 0.01). For the functionally measured change in mHipRotSt a non-significant, moderate correlation (r = 0.41, p = 0.1) was found. Discrepancies between change in mHipRotSt and mean FDO angle/ change in anteversion were 3.4°/ 1.6° conventionally and 10.4°/ 8.4° functionally measured. Correlation analysis between preoperative Range of motion (ROM) during calibration movement and the change in mHipRotSt revealed a weak, non-significant correlation (r = 0.16, p = 0.549).Download : Download high-res image (110KB)Download : Download full-size image The conventional method is more in alignment with the aimed intraoperative FDO and therefore appears as the preferable option in the decision-making process in the context of FDO. Also changes in the anteversion were closer to conventionally measured values. Analysis on the presumably more restricted ROM did not indicate that it had a strong influence on the differences between pre- and postoperative mHipRotSt.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acetabular orientation measured in the Lewinnek plane is not adequate for adult spinal deformity patients with high pelvic retroversion","authors":"Elena Jaber, Rami El Rachkidi, Elma Ayoub, Ali Rteil, Maria Saade, Celine Chaaya, Rami Rhayem, Ismat Ghanem, Abir Massaad, Ayman Assi","doi":"10.1016/j.gaitpost.2023.07.108","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.108","url":null,"abstract":"Patients with adult spinal deformity (ASD) are known to compensate by retroverting their pelvis and flexing their knees in order to maintain postural stability [1]. Increased pelvic retroversion in patients with ASD is associated with alteration of acetabular orientation both in standing and during walking, increasing the risk of hip osteoarthritis usually treated by total hip replacement [2,3]. A safe zone is targeted during cup positioning where acetabular orientation is calculated relatively to the invariant morphological Lewinnek plane, unruled by the patient’s position. Changes in hip positioning encountered in daily life activities were associated with higher rates of prosthesis instability in ASD patients. To evaluate the mismatch between Lewinnek and positional acetabular measurements in variable patient’s postures. 121 primary ASD and 32 controls (age and sex matched: 54 years, 73% F) underwent biplanar X-rays in both standing and sitting positions. 3D acetabular parameters (anteversion, abduction, anterior coverage, posterior coverage) were calculated in both the Lewinnek and radiological positional planes (frontal, sagittal and horizontal). The mismatch between Lewinnek and positional acetabular measurements (Δ=Lewinnek-Positional) was evaluated. Radiographic pelvic tilt (PT) adjusted to pelvic incidence (PI) was calculated (adj.PT=0.37*PI-7°). Patients having a high adjusted PT (>2 SD in controls) were grouped as ASD-HighPT, otherwise as ASD-NormPT. 42 ASD had a high PT and 79 a normal PT. Although all 3 groups had similar PI (average: 52°), ASD-HighPT had a decreased lumbar lordosis (L1S1=33°, PT=31°) and decompensated sagittal malalignment (SVA=76 mm). In standing position, ASD-HighPT showed an increased planes mismatch of their acetabular parameters (Δanteversion=-12 vs 2°, Δabduction=-8 vs 0°, ∆anterior coverage=13 vs 0°, Δposterior coverage=-8 vs -1°, all p<0.001), compared to other groups. In the sitting position, ASD-HighPT showed an increased planes mismatch of their acetabular parameters (Δanteversion=-16 vs -10°, Δabduction=-12 vs -8°, ∆anterior coverage=16 vs 11°, Δposterior coverage=-12 vs -8°, all p<0.001), but to a lesser extent than the standing position. PT was strongly correlated to Δanteversion (r=-0.74) and Δanterior coverage (r=0.67, Fig. 1) in the standing position, and moderately correlated in the sitting position (r=-0.40 & 0.28 resp., all p<0.001). This study showed that the Lewinnek plane is not representative of the positional acetabular orientation in the presence of sagittal malalignment. This emphasizes the importance to consider the variation of the acetabular orientation between different postures. It is then necessary to determine a patient-specific functional safe zone in the preoperative planning of total hip replacement to avoid cup instability. Fig. 1: Correlation between pelvic tilt and planes mismatch of acetabular orientation.Download : Download high-res image (91KB)Download : Download full-size ","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postural and kinematic changes in the transition from sit-to-stand position in adolescent idiopathic scoliosis","authors":"Nabil Nassim, Elio Mekhael, Rami El Rachkidi, Carlo El Khoury, Pascal El Braidy, Mohamad Karam, Abir Massaad, Bilal Ramadan, Ismat Ghanem, Ayman Assi","doi":"10.1016/j.gaitpost.2023.07.168","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.168","url":null,"abstract":"","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of knee joint reaction force for the back and front leg during the forward jump in soccer","authors":"Meroeh Mohammadi, Javad Kalantari, Ali Mohammadi, Reza Najarpour, Fatemeh Bagheri, Abolfazl Panahi, Mahdi Barnamehei, Setayesh Asadollahi, Sara Salehimojarad","doi":"10.1016/j.gaitpost.2023.07.160","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.160","url":null,"abstract":"Non-contact anterior cruciate ligament (ACL) injuries often happen during the forward jump-landings in soccer [1]. Two main parts of the forward head jump are jumping and landing. Usually, one leg locates front, and another leg locates back during jumping and landing phases [2-4]. The ground reaction force, which presents the impact loads, affects the knee joint reaction loads and can grow biomechanical stress on the anterior cruciate ligament [3,5–7]. Therefore, the aim of the current study was to compare knee joint reaction loads between the back and front leg during the soccer forward jump. What are the differences in knee joint reaction loads between the back and front leg during the soccer forward jump? Twenty elite soccer athletes (68.3±7.5 kg, 178±5.3 cm, 27.5±4.5 years) participated in the current study [8]. Ten Vicon motion captures (Vicon MX, Oxford, UK, 200 Hz) were used to measure the kinematics variables [6,9,10]. EMG activity in the rectus femoris, vastus lateral, vastus medial, tibialis anterior, gastrocnemius medial, gastrocnemius lateral, soleus, biceps femoris, and semitendinosus was recorded by the Myon wireless EMG system [11,12]. Raw EMG signals were full-wave rectified and linear enveloped using a dual-pass fourth-order low-pass Butterworth filter at 4 Hz [13]. A musculoskeletal model with a total of 10 bodies and 92 muscles was used to estimate joint reaction loads in OpenSim [4,14,15]. The inverse kinematics, static optimization, and joint reaction analysis were used to estimate angles, muscle loads, and joint loads, respectively [16,17]. Fig. 1 presents the mean of knee joint reaction forces in anterior-posterior, medial-lateral, and superior-inferior directions during the forward jumping and landing for the back and front leg. Significant differences of knee joint reaction were found between back and front leg.Download : Download high-res image (131KB)Download : Download full-size image Fig. 1: Mean of knee joint reaction forces in anterior-posterior, medial-lateral, and superior-inferior directions during the forward jumping and landing for back and front leg. This study compared the knee joint reaction loads during the soccer forward jump for the back and front leg by a previously described musculoskeletal model. In general, the forces experienced at the knee joint were not of similar magnitude.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of cognitive impairment on gait in Parkinson's disease","authors":"Radim Krupicka, Christiane Malá, Slávka Neťuková, Tereza Duspivová, Anna Vážná, None Jan Novák, Evžen Růžička, Ondřej Bezdíček","doi":"10.1016/j.gaitpost.2023.07.132","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.132","url":null,"abstract":"Gait and cognitive deficits are common symptoms of Parkinson's disease (PD) [1]. Cognitive deficits can manifest themselves in gait impairment and are tested with the gait-cognitive dual task (DT) [2]. Although a study [3] showed that the cognitive deficit represented by Montreal Cognitive Assessment (MoCA) weakly correlated with DT gait parameters, the opposite question, if worse gait performance in DT correlates with cognition in patients with PD, has not been answered. Does the performance in gait-cognitive dual task correlate with the performance in MoCa test in patients with Parkinson's disease? We examined 99 de-novo, drug-naive patients with PD (59±13 years) and 58 healthy controls (CON) (60±9 years) [4]. All subjects completed an extended Timed Up & Go Test (TUG) and Montreal Cognitive Assessment (MoCA). The TUG was performed twice and captured on a 5.15 m long and 0.9 m wide pressure walkway (GAITRite®). Participants were instructed to walk in the two different conditions: (i) at a normal pace (ST) and (ii) at a normal pace while counting down from 100 by seven (DT). Gait velocity, cadence, and stride length were selected as representative gait parameters. Cognitive costs [(DT − ST)/ST × 100] were calculated for each parameter and the first PCA component was calculated for the threshold for gait cognitive impairment. The threshold was defined as the 10th percentile of CON and filtered patients without gate-cognitive deficit. The groupwise comparison was made using the two-sample t-test. The Pearson correlation between MoCA and gait parameters was calculated for filtered PD (31 patients, 61±13 years). The t-test revealed significant differences (p<0.05) between CON and PD in velocity cost and stride length cost. PD’s MoCA moderately correlated with the velocity cost (r=0.37) and strongly correlated with the stride length cost (r=0.52) (see Figure). Figure: Visualization of results A) Distribution and differences in gait parameters of healthy controls (CON) and patients with Parkinson's disease (PD) B) Pearson’s correlation of gait parameters and MoCA presented by r and significance (*p<0.05, **p<0.01). Download : Download high-res image (419KB)Download : Download full-size image The impairment of gait performance in PD is mainly characterized by a slower velocity with a shorter stride length and a compensatory increase in walking cadence [5]. Significant changes in velocity cost and stride length cost confirm that a cognitive task accents gait impairment. Although the studies [2,3] showed a weak correlation between MoCA and DT in patients with cognitive deficits in PD, our study showed a strong correlation in stride length for PD patients with worse DT performance. This may suggest that gait performance is dependent on cognitive performance and may be improved by cognitive training.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstructing bones: using statistical shape modelling to create 3D models of the femur from ultrasound images","authors":"Alex Mitton, Jonathan Noble, Adam Shortland","doi":"10.1016/j.gaitpost.2023.07.157","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.157","url":null,"abstract":"Many children with cerebral palsy (CP) develop bony deformities of the femur that require surgical intervention to correct1. Concerns regarding the radiation exposure from CT and the cost and scan time of MRI mean patient-specific 3D models of the femur are rarely used for surgical planning in this patient group, despite evidence supporting their role in improving surgical outcomes2,3,4. Ultrasound (US) imaging presents a cheap, low-risk, and readily available means of constructing such models. However, US is only able to capture partial views of the femur. The “missing” views may be reconstructed using statistical shape modelling; a mathematical technique used to quantitatively analyse complex shapes5,6. Can patient-specific 3D models of the femur be accurately reconstructed from partial surface data acquired with simulated 3D ultrasound using statistical shape modelling? 60 3D meshes of the femur were derived from MR images of 32 young adult subjects (13 with CP, 19 typically developing (TD)). The femur meshes from the left side were flipped horizontally to match those from the right. The meshes from both groups were then used to construct a statistical shape model (SSM) of the femur. An algorithm was written which used the SSM to reconstruct a complete femur mesh from partial information. To test the effectiveness of the algorithm, a dataset of partial surfaces replicating the views possible using US was created. Complete femurs were reconstructed from this dataset, and evaluated against the original 3D meshes using a leave-one-out cross validation procedure. An average point-to-point error of 1.16 ± 0.45 mm was found for reconstructions of the femurs from the TD group, compared to 2.55 ± 0.47 mm in the CP group. Fig. 1 – “a) Example partial surface from the simulated US dataset; b) Example TD reconstruction; c) Example CP reconstruction (reconstruction in purple, original mesh in white”)Download : Download high-res image (36KB)Download : Download full-size image The relatively low error for the reconstructions of the TD femurs demonstrates a promising proof of concept for the proposed technique of creating 3D femur models from partial surface data acquired with US. Future work may develop the algorithm further to improve its performance in the presence of increased femoral deformity, as found in the CP group. With development, this technique has the potential to bring the use of 3D models for preoperative planning into common practice for this patient group, which is likely to improve surgical outcomes. Although the focus of this study has been the creation of 3D models of the femur, the technique of reconstructing US images using statistical shape modelling could be applied to other anatomical structures. Owing to the reduced risk, cost and scan time compared with CT and MRI, the application of the proposed reconstruction technique has the potential to positively impact other surgical services.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with scoliosis have dysfunctional spinal muscles, preliminary study","authors":"Mikko Mattila, Andrey Zhdanov, Juha-Pekka Kulmala","doi":"10.1016/j.gaitpost.2023.07.150","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.150","url":null,"abstract":"Etiology of idiopathic scoliosis is still unknown. Many theories have been introduced throughout the history to clarify the etiology of the scoliosis. Especially vague is the idiopathic scoliosis that apparently does not have any reasonable explanation. Due to the cosmetic appearance of the scoliotic spine, scoliosis has been mostly studied on its treatment. Because children’s vertebral column is flexible, uneven spinal muscle activity and forces may potentially play a role in the development of scoliosis. Some electromyographic (EMG) studies have reported higher activity in the convex side while other found no differences. Mixed findings may be due to fact that previous studies have analyzed absolute rather than normalized EMG results, although latter is commonly recommended. Do spinal muscles show uneven activity in scoliotic patients when examined using normalized EMG. We report results of six scoliotic patients. Multifidus (Mul), Lumbar erector spinae (Les) and thoracic erector spinae (Tes) EMG was recorded during walking and normalized to values of maximal voluntary contraction (MVC). At groups level, we found relatively little differences in the normalized EMG magnitude between concave (left) and convex (right) side; however, individual results reveal large side-to-side differences especially in the Les and Tes (Fig. 1). The peak normalized EMG values were relatively high often exceeding the 50% level of the MVC. Picture: Scoliotic spine and EMG of the spinal muscles.Download : Download high-res image (125KB)Download : Download full-size image During walking spinal muscles of the young scoliosis patients were activated asymmetrically in a patient-specific manner. While some patients showed relatively low normalized EMG values, others demonstrated high activity levels, indicating that substantial uneven forces are directed to the flexible vertebral column of these patients. Presumably, this influences the stability of the vertebra. It is evident that scoliosis already develops earlier than when it is actually diagnosed, suggesting that a large-scale EMG screening could help to detect abnormal spinal muscle function before scoliosis is manifested.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}