Ageing effects on knee and ankle joint angles at key events and phases of the gait cycle

The objective of this research was to determine whether joint angles at critical gait events and during major energy generation/absorption phases of the gait cycle would reliably discriminate age-related degeneration during unobstructed walking. The gaits of 24 healthy adults (12 young and 12 elderly) were analysed using the PEAK Motus motion analysis system. The elderly participants showed significantly greater single (60.3% versus 62.3%, p < 0.01) and double ( p < 0.05) support times, reduced knee flexion (47.7° versus 43.0°, p < 0.05) and ankle plantarflexion (16.8° compared to 3.3°, p = 0.053) at toe off, reduced knee flexion during push-off and reduced ankle dorsiflexion (16.8° compared to 22.0°, p < 0.05) during the swing phase. The plantarflexing ankle joint motion during the stance to swing phase transition (A₂) for the young group (31.3°) was about twice ( p < 0.05) that of the elderly (16.9°). Reduced knee extension range of motion suggests that the elderly favoured a flexed-knee gait to assist in weight acceptance. Reduced dorsiflexion by the elderly in the swing phase implies greater risk of toe contact with obstacles. Overall, the results suggest that joint angle measures at critical events/phases in the gait cycle provide a useful indication of age-related degeneration in the control of lower limb trajectories during unobstructed walking.     

利用2D-3D自动注册技术研究TKA术后胫股关节运动

目的重建全膝置换(total knee arthroplasty,TKA)膝关节三维运动,研究后稳定型假体之间的运动和接触。方法以16例TKA膝关节为研究对象,获取动态X线透视图像和假体三维模型,建立2D-3D自动注册算法,重建膝关节的三维运动,计算运动学参数并测量假体之间的接触位置。结果单幅X线图像注册时间小于30 s,图像平面内重复性注册精度为0.4 mm和0.5°。高屈曲垫片对膝关节屈曲度和胫骨内外旋无明显改进。股骨假体在胫骨垫片的外侧接触点后移范围大于内侧。稳定柱后方的接触发生在屈膝约30°以后,平均接触范围小于9 mm。结论 2D-3D自动注册技术在精度和效率上达到TKA膝关节在体三维运动测量要求,测量结果对TKA膝关节生物力学研究和改进假体设计具有参考意义。     

A comparison between flexible electrogoniometers,inclinometers and three-dimensional video analysis system for recording neck movement

This study compared neck range of movement recording using three different methods goniometers (EGM), inclinometers (INC) and a three-dimensional video analysis system (IMG) in simultaneous and synchronized data collection. Twelve females performed neck flexion-extension, lateral flexion, rotation and circumduction. The differences between EGM, INC, and IMG were calculated sample by sample. For flexion-extension movement, IMG underestimated the amplitude by 13%; moreover, EGM showed a crosstalk of about 20% for lateral flexion and rotation axes. In lateral flexion movement, all systems showed similar amplitude and the inter-system differences were moderate (4–7%). For rotation movement, EGM showed a high crosstalk (13%) for flexion-extension axis. During the circumduction movement, IMG underestimated the amplitude of flexion-extension movements by about 11%, and the inter-system differences were high (about 17%) except for INC–IMG regarding lateral flexion (7%) and EGM–INC regarding flexion-extension (10%). For application in workplace, INC presents good results compared to IMG and EGM though INC cannot record rotation. EGM should be improved in order to reduce its crosstalk errors and allow recording of the full neck range of movement. Due to non-optimal positioning of the cameras for recording flexion–extension, IMG underestimated the amplitude of these movements.     

Screw-Home Movement of the Tibiofemoral Joint during Normal Gait: Three-Dimensional Analysis

Background

The purpose of this study was to evaluate the screw-home movement at the tibiofemoral joint during normal gait by utilizing the 3-dimensional motion capture technique.

Methods

Fifteen young males and fifteen young females (total 60 knee joints) who had no history of musculoskeletal disease or a particular gait problem were included in this study. Two more markers were attached to the subject in addition to the Helen-Hayes marker set. Thus, two virtual planes, femoral coronal plane (P_f) and tibial coronal plane (P_t), were created by Skeletal Builder software. This study measured the 3-dimensional knee joint movement in the sagittal, coronal, and transverse planes of these two virtual planes (P_f and P_t) during normal gait.

Results

With respect to kinematics and kinetics, both males and females showed normal adult gait patterns, and the mean difference in the temporal gait parameters was not statistically significant (p > 0.05). In the transverse plane, the screw-home movement occurred as expected during the pre-swing phase and the late-swing phase at an angle of about 17°. However, the tibia rotated externally with respect to the femur, rather than internally, while the knee joint started to flex during the loading response (paradoxical screw-home movement), and the angle was 6°.

Conclusions

Paradoxical screw-home movement may be an important mechanism that provides stability to the knee joint during the remaining stance phase. Obtaining the kinematic values of the knee joint during gait can be useful in diagnosing and treating the pathological knee joints.     

Kinematic Analysis of a Posterior-stabilized Knee Prosthesis

Background:The goal of total knee arthroplasty (TKA) is to restore knee kinematics.Knee prosthesis design plays a very important role in successful restoration.Here,kinematics models of normal and pros...     

膝骨关节炎患者的三维运动解析

背景　膝骨关节炎（KOA）患者发生膝关节变形、活动受限、步态异常等改变,预示KOA是与运动学、动力学等生物力学因素关系密切的一种疾病。而目前临床上缺乏对这些运动学、动力学指标的客观定量评定指标。目的　应用VICON三维运动捕捉系统解析KOA患者的病情,为临床医生治疗、康复计划的制定和实施提供新的重要参考依据。方法　2010年10月-2017年6月,选择上海交通大学医学院附属瑞金医院门诊及住院的双KOA患者10例作为KOA组,另外招募无膝关节疼痛的健康中老年人10例作为对照组。采用英国VICON三维运动捕捉系统对两组受试者进行行走测试,并分析受试者的步行情况和膝关节的生物力学（运动学、动力学）特征。结果　与正常人比较,KOA患者存在明显的步态和生物力学特征：步频、跛行指数、步长、步幅、步速均缩短,双足支撑期、单足支撑期、一步时间、步行周期均延长（P<0.05）;膝关节屈曲角峰值,冠状面最初角度,矢状面、冠状面、水平面膝关节最大活动范围均减小（P<0.05）;膝关节角速度、膝关节角加速度峰值和平均值均减小（P<0.05）;膝关节伸展力矩峰值减小（P<0.05）;Y轴和Z轴方向地板反作用力峰值减小（P<0.05）。结论　KOA患者关节内及其周围生物力学环境发生了明显变化,同时下肢运动出现了异常。而采用VICON运动捕捉系统对KOA患者和正常人进行三维步态分析,有助于更好地了解膝关节运动学和动力学等指标,为KOA诊断、治疗及研究提供重要的参考依据。     

Motion characteristics of the lumbar spinous processes with degenerative disc disease and degenerative spondylolisthesis

Objective

Recently, interspinous process devices have attracted much attention since they can be implanted between the lumbar spinous processes (LSP) of patients with degenerative disc disease (DDD) and degenerative spondylolisthesis (DLS) using a minimally invasive manner. However, the motion characters of the LSP in the DLS and DDD patients have not been reported. This study is aimed at investigating the kinematics of the lumbar spinous processes in patients with DLS and DDD.

Methods

Ten patients with DDD at L4–S1 and ten patients with DLS at L4–L5 were studied. The positions of the vertebrae (L2–L5) at supine, standing, 45° trunk flexion, and maximal extension positions were determined using MRI-based models and dual fluoroscopic images. The shortest ISP distances were measured and compared with those of healthy subjects that have been previously reported.

Results

The shortest distance of the interspinous processes (ISP) gradually decreased from healthy subjects to DDD and to DLS patients when measured in the supine, standing, and extension positions. During supine-standing and flexion–extension activities, the changes in the shortest ISP distances in DDD patients were 2 ± 1.2 and 4.8 ± 2.1 mm at L4–L5; in DLS patients they were 0.5 ± 0.4 and 2.8 ± 1.7 mm at L4–L5, respectively. The range of motion is increased in DDD patients but decreased in DLS patients when compared with those of the healthy subjects. No significantly different changes were detected at L2–L3 and L3–L4 levels.

Conclusion

At the involved level, the hypermobility of the LSP was seen in DDD and hypomobility of the LSP in DLS patients. The data may be instrumental for improving ISP surgeries that are aimed at reducing post-operative complications such as bony fracture and device dislocations.     

Kinematics of fast wrist movements in manic-depressive illness chronically treated with lithium carbonate

Abstract

Lithium salts have been shown to impair kinematics of fast voluntary movements during acute intoxication. The aim of the present study was to determine whether lithium carbonate affected the kinematics of fast movements in patients chronically treated and who did not exhibit signs of neurotoxicity. We analysed fast wrist flexion movements in 6 healthy subjects, in 5 patients presenting a manic-depressive illness without treatment, and in 8 patients receiving lithium carbonate for a manic-depressive disease. The mean duration of treatment was 3.9±4.1 years, the mean daily dose 837±341 mg and the mean serum level 0.95±0. 15 mEq/l. Although mean movement amplitudes were similar in the 3 groups, the variability of fast movements was increased in patients receiving lithium salts. The ratio of maximum to average velocities (VmNaveJ was significantly higher in patients treated, and their movements were temporally asymmetrical, with a ratio ofacceleration duration divided by deceleration duration being lower than in the 2 other groups. These kinematic abnormalities show that a chronic treatment with lithium salts is associated with an impairment of the cerebellar control of fast single-joint movements. [Neural Res 1998; 20: 320-326]     

Comparison of glenohumeral and humerothoracical range of motion in healthy controls,osteoarthritic patients and patients after total shoulder arthroplasty performing different activities of daily living

PurposeThe purpose of this study was to examine how total shoulder arthroplasty improves performance of activities of daily living compared to patients with glenohumeral osteoarthritis and how they perform compared to healthy controls.MethodsGlenohumeral and humerothoracical elevation used by patients with primary osteoarthritis (12 participants, 16 shoulders), after total shoulder arthroplasty (16 participants, 24 shoulders) and healthy controls (11 participants, 22 shoulders) for four different activities of daily living were assessed using 3D motion analysis. Analysis of range of motion and angle time series was performed.ResultsRange of motion used for activities of daily living was better in patients treated with anatomical total shoulder arthroplasty than in patients with primary glenohumeral osteoarthritis. Although it was still reduced compared to healthy individuals. Angle time series showed improved kinematics in patients with total shoulder arthroplasty compared to patients with glenohumeral osteoarthritis. Both glenohumeral and humerothoracical elevation kinematic time series were in almost all cases in between the control group’s and the osteoarthritis group’s.ConclusionTotal shoulder arthroplasty improves performance of activities of daily living in patients with primary glenohumeral osteoarthritis but cannot restore the full range of Motion compared to healthy controls. A prospective study with pre- and postoperative examinations is necessary to understand to understand how preoperative status influences the postoperative results.