Range of movements of lower limb joints in cross-legged sitting posture

Cross-legged sitting posture is integral to activities of daily living in Eastern and Asian cultures. This posture has not been studied or defined in any significant detail from an orthopedic view point. The movements of right lower limb joints were measured in cross-legged sitting posture in 44 volunteers from the Indian population with no prior history of problems related to the knee or hip joint. Flexion at the hip joint ranged from 82 degrees to 100 degrees , with a mean of 91 degrees . Abduction at the hip joint ranged from 19 degrees to 57 degrees , with a mean of 39 degrees . The external rotation ranged from 42 degrees to 58 degrees , with a mean of 49 degrees . Flexion at the knee ranged from 126 degrees to 142 degrees , with a mean of 135 degrees .Equinus at the ankle ranged from 17 degrees to 34 degrees , with a mean of 29 degrees . The resultant data would be useful in understanding kinematics of the knee and hip in the healthy and post-total joint arthroplasty population. The data could be used for design features of prosthetic joints, surgical technique, and rehabilitation protocols. Such data have not been available hitherto in any relevant published literature.     

Measurement of anteriorly flexed trunk posture in Parkinson's disease (PD): a systematic review

Abstract

Background:

Anteriorly flexed posture is a common impairment with negative consequences for individuals with Parkinson's disease (PD). Identification of objective non-radiologic procedures for measuring flexed trunk posture is therefore important.

Objective:

Summarise available information on objective non-radiologic procedures for measuring anterior trunk flexion in PD.

Methods:

A systematic review using six relevant databases was conducted. Two reviewers independently examined the search output using strict inclusion and exclusion criteria. Articles determined to be relevant were abstracted for participant characteristics, measurement technique, test position and findings and were graded using a critical appraisal checklist.

Results:

Seventeen studies revealed information on objective, non-radiologic procedures for measuring sagittal plane-flexed posture in PD. Participants were primarily older adults with Hoehn and Yahr scale scores of 1–5. Five different measures were reported: linear distance between the seventh cervical vertebra and wall and body angles derived from photographs, Spinal Mouse, Debrunner's Kyphometer and electronic goniometer. Three articles reported measurement reliability (intraclass correlation coefficients?=?0.90–0.95). Among articles addressing validity; one supported criterion validity relative to the gold standard radiological measure, three addressed concurrent validity by correlating postural measures with other measures of potential interest and seven suggested responsiveness of the measures to changes accompanying a therapeutic intervention. Quality checklist scores ranged from 1 to 7 out of nine items.

Conclusion:

This systematic review showed no consensus regarding how flexed posture should be measured in PD. Further investigation of multiple measures is required before recommendations can be made for measuring flexed posture in PD.     

Influence of foot posture on the functioning of the windlass mechanism

The absence of a functioning windlass mechanism may delay re-supination of the foot during locomotion and put excess stress on the mid-tarsal joint and soft tissues of the foot. The purpose of this study was to describe the foot posture of individuals that have an impaired or absent windlass mechanism.Forty-seven individuals (34 females and 13 males) with a mean age of 26 years were recruited to participate in this study. The Foot Posture Index was used to visually assess the posture of both feet. In addition, a digital gauge was used to measure dorsal arch height and midfoot width in bilateral resting standing. Dorsal arch height and mid-foot width were also measured in non-weight bearing. Finally, for those individuals without a functioning windlass mechanism, the amount of medial wedging needed to restore its function was measured.Subjects with an “absent” or “impaired” windlass mechanism had a mean Foot Posture Index of +6.8 (sd = 2.5) compared to +2.5 (sd = 3.1) for those with a functioning windlass mechanism. A series of independent t-tests showed that individuals without a functioning windlass mechanism had a more pronated foot posture, a lower dorsal arch height and a wider mid-foot width compared to those that had a functioning windlass mechanism. Finally, an average medial wedge of 5.1 mm (sd = 2.1) was able to produce a functioning windlass mechanism in those individuals that previously lacked one.     

Spinal and temporo-mandibular disorders in male workers of the State Police

Abstract

Objective. The aims of this study are to evaluate the prevalence of disorders of the lumbar region and the temporo-mandibular district co-morbidity in drivers and workers of the State Police employed for different office activities Materials and methods. The study population included 103 drivers as cases and 100 police officers as controls. The study was carried out through questionnaire and clinical evaluation of the spine and temporo-mandibular region. Results. At clinical examination, the drivers were found to have a higher prevalence (p < 0.05) of both symptoms and clinical signs at the spine and temporo-mandibular joint (TMJ), when compared with the controls. The results also showed a higher prevalence (p < 0.05) of co-morbidity in the two districts among the drivers, when compared with the controls. Conclusions. These results confirm that morbidity related to back and TMJ and increase in co-morbidity between the two districts are higher in professional drivers.     

Postnatal Protein Malnutrition Affects Inhibitory Avoidance and Risk Assessment Behaviors in Two Models of Anxiety in Rats

Abstract

Protein malnutrition induces structural, neurochemical and functional alterations in the central nervous system, leading to alterations in behavioral function. In order to study the effects of early protein malnutrition on inhibitory avoidance and escape behaviors we used the elevated T-maze (ETM), while the risk assessment behaviors were evaluated by the canopy stretched attend posture (SAP) test. Rat pups were fed by lactating females receiving 16% (control) or 6% (malnourished) protein diets during the lactation period. After weaning the animals received the same diets until 49 days of age, when all animals started receiving a lab chow diet. Behavioral tests were started at 70 days of age. ETM results showed lower inhibitory avoidance in malnourished animals, without differences in escape behavior. SAP test results showed higher exploration and lower risk assessment behaviors in malnourished animals compared to control. These results suggest that malnourished animals are less anxious and/or more impulsive as measured by these two animal models and that malnutrition seems to affect differently behavioral strategies underlying fear and anxiety responses.     

Exercise capacity,respiratory mechanics and posture in mouth breathers

Chronic and persistent mouth or oral breathing (OB) has been associated with postural changes. Although posture changes in OB causes decreased respiratory muscle strength, reduced chest expansion and impaired pulmonary ventilation with consequences in the exercise capacity, few studies have verified all these assumptions.ObjectiveTo evaluate exercise tolerance, respiratory muscle strength and body posture in oral breathing (OB) compared with nasal breathing (NB) children.Material and methodA cross-sectional contemporary cohort study that included OB and NB children aged 8-11 years old. Children with obesity, asthma, chronic respiratory diseases, neurological and orthopedic disorders, and cardiac conditions were excluded. All participants underwent a postural assessment, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), the six-minute walk test (6MWT), and otorhinolaryngologic evaluation.ResultsThere were 107 children (45 OB and 62 NB). There was an association between abnormal cervical posture and breathing pattern: 36 (80.0%) OB and 30 (48.4%) NB presented abnormal head posture (OR=4.27 [95% CI: 1.63-11,42], p<0.001). The mean MIP and MEP were lower in OB (p=0.003 and p=0.004).ConclusionOB children had cervical spine postural changes and decreased respiratory muscle strength compared with NB.     

Quantifying work load in neck, shoulders and wrists in female dentists

Objective:?To assess the work load in neck and upper limbs of dentists. Methods:?Twelve right-handed female dentists (six with and six without a history of definite neck/shoulder disorders, pair-wise matched for age) were studied when performing authentic dental work. Electromyography (EMG) was used to quantify the muscular load of the shoulders bilaterally and of the right forearm. Positions and movements of the head and wrists were measured, using inclinometers and electrogoniometers. Results:?During work, the median load for the right upper trapezius muscle was 8.4% of the maximal voluntary EMG activity (MVE); during 90% of the time the load was ?3.3% MVE (“static” load). The figures were somewhat lower on the left side (7.0% and 2.5% MVE, respectively). Subjects with disorders had over all lower load levels for the trapezius muscles, although not statistically significant at <0.05, than those without disorders. During a standardized reference contraction for the trapezius, the load was 17% MVE, and the quotient between MVE and torque [normalized to maximal voluntary torque (MVC)] was 0.5. These figures may be used for transformations. The muscular load on the right forearm was similar to the loads on the trapezius. The head was, on average, forward tilted ?39°, and during 10% of the time ?49°. The left hand was held in more static positions, with palmar flexion and ulnar deviation, also reflected by lower angular velocities and repetitiveness, as compared with the right one, which was dorsiflexed. Conclusions:?Dentists are exposed to high load on the trapezius muscles bilaterally, and steep, prolonged forward bending of the head. Further, for the wrists the postures were constrained, but the dynamic demands were low.     

Vectorcardiographic changes during laparoscopic cholecystectomy may mimic signs of myocardial ischaemia

Background: Laparoscopic surgery involves the use of intra-ab-dominal carbon dioxide insufflation (pneumoperitoneum). The increased intra-abdominal pressure causes marked haemodyn-amic changes, which may influence electrocardiographic monitoring. The aim of the present study was to elucidate the influence of pneumoperitoneum on vectorcardiographic recordings.
Methods: Vectorcardiographic changes (QRS vector difference= QRSVD, QRS loop area, QRS magnitude, ST vector magnitude, spatial ST vector change) were recorded continuously applying computerized vectorcardiography in 12 anaesthetised cardio-vascularly healthy patients, scheduled for laparoscopic cholecystectomy.
Measurements were made before and during pneumoperitoneum in three different body positions (supine, Trendelenburg and reversed Trendelenburg), also employing transesophageal echo-cardiography and invasive blood pressure monitoring. Results: Pneumoperitoneum significantly increased QRSVD, in parallel with an enlargement in loop area and magnitude. The magnitude was significantly increased in the transversal and frontal planes and there was a tendency to increase the magnitude in the sagittal plane. The increase in QRS-VD reached levels previously associated with the development of myocardial ischaemia in patients with coronary artery disease. The ST-variables were not changed by the pneumoperitoneum. The positional changes also influenced QRSVD significantly.
Conclusions: When computerized vectorcardiography is used for ischaemia monitoring during pneumoperitoneum, the ST-variables seem reliable. However, vectorcardiographic QRS changes should be interpreted with caution, as the QRS alterations found during pneumoperitoneum mimic the changes seen during myocardial ischaemia.