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Flexion Angles (flexion + angle)
Selected AbstractsProgressive fatigue effects on manual lifting factorsHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 5 2009Anthony D. Banks The purpose of this study was to evaluate the effect of progressive fatigue on factors that previously have been associated with increased risk of low back pain in various occupational settings, during a repetitive lifting task where a freestyle lifting technique was used. A laboratory experiment was conducted to evaluate electromyography amplitude, kinematic, and kinetic parameters of repetitive freestyle lifting during a 2-hour lifting period. Subjective fatigue rating increased over time, indicating that the participant "felt" increasingly fatigued as the experiment progressed. Static composite strength decreased an average of 20% from the beginning to the end of the experiment. Effect of lifting posture (semi-squat, semi-stoop, and stoop) was observed on peak trunk flexion angle, trunk flexion angle at initiation of the lift, and knee angle at initiation of the lift indicating that, in freestyle lifting, participants assume quantitatively different lifting techniques. A significant effect of the time,posture interaction was observed on the dynamic leg lift floor to knuckle height strength, indicating that dynamic strength may change over time depending on lifting posture selected. © 2009 Wiley Periodicals, Inc. [source] Modulation of peritendinous adhesion formation by alginate solution in a rabbit flexor tendon modelJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2007Jiro Namba Abstract To examine the antiadhesive effect of an alginate solution following tendon surgery, unilateral subtotal laceration of the flexor digitorum communis tendon was created in one hind limb while the other side was left intact in 32 Japanese white rabbits. The lesion was coated with alginate solution in 16 animals and not coated in the other 16. Degree of adhesion formation was assessed histologically and biomechanically by measuring the flexion angle of the first toe when the flexor digitorum tendon was pulled with a specified force at 4 weeks postoperatively. When compared with the control group, the alginate-treated group demonstrated significantly greater toe flexion, with less scar tissue formation at the repair site. Histologically, complete tendon healing with longitudinal remodeling of collagen fibers was observed in the alginate-treated group, while a random pattern of fibers was observed in the control group. Reduction in adhesion formation using alginate solution represents a novel strategy for the management of tendon injury and repair in the clinical setting. © 2006 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2007 [source] Improving vastus medialis obliquus function reduces pressure applied to lateral patellofemoral cartilageJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2009John J. Elias Abstract The current study was performed to characterize how improving vastus medialis obliquus (VMO) function influences the pressure applied to patellofemoral cartilage. An additional focus was characterizing how lateral and medial cartilage lesions influence cartilage pressures. Ten knees were flexed to 40°, 60°, and 80° in vitro, and forces were applied to represent the VMO and other muscles of the quadriceps group while a thin film sensor measured joint pressures. The knees were loaded with a normal VMO force, with the VMO force decreased by approximately 50%, and with the VMO unloaded. After tests were performed with the cartilage intact, all tests were repeated with a 12-mm-diameter lesion created within the lateral cartilage, with the lateral lesion repaired with silicone, and with a medial lesion created. Based on a two-way repeated measures ANOVA and post-hoc tests, increasing the force applied by the VMO significantly (p,<,0.05) decreased the maximum lateral pressure and significantly increased the maximum medial pressure at each flexion angle. A lateral cartilage lesion significantly increased the maximum lateral pressure, while a medial lesion did not significantly influence the maximum medial pressure. Improving VMO function can reduce the pressure applied to lateral cartilage when lateral lesions are present. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 578,583, 2009 [source] A robot-assisted study of intrinsic muscle regulation on proximal interphalangeal joint stiffness by varying metacarpophalangeal joint positionJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 3 2006Zong-Ming Li Abstract The tightness of intrinsic hand muscles is a common cause of finger joint stiffness. The purposes of this study were to develop a robot-assisted methodology to obtain torque,angle data of a finger joint, and to investigate the regulation of the intrinsic muscles on finger joint stiffness. Our robot system features the integration of a low payload robot arm, a controller, and a force/torque transducer. The system provided highly reproducible torque,angle curves. Torque,angle data of the proximal interphalangeal joint with the metacarpophalangeal joint at 0 and 60 degrees were obtained from eight asymptomatic hands. The torque,angle curve shifted with the position of the metacarpophalangeal joint. As the metacarpophalangeal joint flexion angle changed from 60 to 0 degrees, the equilibrium of the proximal interphalangeal joint increased more than 20 degrees, and joint stiffness increased more than 50%. The dependence of the stiffness of the proximal interphalangeal joint on metacarpophalangeal joint position supports the regulatory role of the intrinsic muscles on finger joint mechanics. This regulatory mechanics is likely amplified in hands with intrinsic muscle tightness, justifying the commonly used Bunnell Intrinsic Tightness Test. © 2005 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 24:407,415, 2006 [source] Altered knee kinematics in ACL-deficient non-copers: A comparison using dynamic MRIJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2006Peter J. Barrance Abstract Kinematics measured during a short arc quadriceps knee extension exercise were compared in the knees of functionally unstable ACL-deficient patients, these patients' uninjured knees, and uninjured control subjects' knees. Cine phase contrast dynamic magnetic resonance imaging, in combination with a model-based tracking algorithm developed by the authors, was used to measure tibiofemoral kinematics as the subjects performed the active, supine posture knee extension exercise in the terminal 30 degrees of motion. Two determinants of tibiofemoral motion were measured: anterior/posterior location of the tibia relative to the femur, and axial rotation of the tibia relative to the femur. We hypothesized that more anterior tibial positioning, as well as differences in axial tibial rotation patterns, would be observed in ACL-deficient (ACL-D) knees when compared to uninjured knees. Multifactor ANOVA analyses were used to determine the dependence of the kinematic variables on (i) side (injured vs. uninjured, matched by subject in the control group), (ii) flexion angle measured at five-degree increments, and (iii) subject group (ACL-injured vs. control). Statistically significant anterior translation and external tibial rotation (screw home motion) accompanying knee extension were found. The ACL-D knees of the injured group exhibited significantly more anterior tibial positioning than the uninjured knees of these subjects (average difference over extension range,=,3.4,±,2.8 mm, p,<,0.01 at all angles compared), as well as the matched knees of the control subjects. There was a significant effect of interaction between side and subject group on A/P tibial position. We did not find significant differences in external tibial rotation associated with ACL deficiency. The changes to active joint kinematics documented in this entirely noninvasive study may contribute to cartilage degradation in ACL-D knees, and encourage more extensive investigations using similar methodology in the future. © 2005 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res [source] Increased tibiofemoral cartilage contact deformation in patients with anterior cruciate ligament deficiencyARTHRITIS & RHEUMATISM, Issue 12 2009Samuel K. Van de Velde Objective To investigate the in vivo cartilage contact biomechanics of the tibiofemoral joint following anterior cruciate ligament (ACL) injury. Methods Eight patients with an isolated ACL injury in 1 knee, with the contralateral side intact, participated in the study. Both knees were imaged using a specific magnetic resonance sequence to create 3-dimensional models of knee bone and cartilage. Next, each patient performed a lunge motion from 0° to 90° of flexion as images were recorded with a dual fluoroscopic system. The three-dimensional knee models and fluoroscopic images were used to reproduce the in vivo knee position at each flexion angle. With this series of knee models, the location of the tibiofemoral cartilage contact, size of the contact area, cartilage thickness at the contact area, and magnitude of the cartilage contact deformation were compared between intact and ACL-deficient knees. Results Rupture of the ACL changed the cartilage contact biomechanics between 0° and 60° of flexion in the medial compartment of the knee. Compared with the contralateral knee, the location of peak cartilage contact deformation on the tibial plateaus was more posterior and lateral, the contact area was smaller, the average cartilage thickness at the tibial cartilage contact area was thinner, and the resultant magnitude of cartilage contact deformation was increased. Similar changes were observed in the lateral compartment, with increased cartilage contact deformation from 0° to 30° of knee flexion in the presence of ACL deficiency. Conclusion ACL deficiency alters the in vivo cartilage contact biomechanics by shifting the contact location to smaller regions of thinner cartilage and by increasing the magnitude of the cartilage contact deformation. [source] Comparison of biomechanical gait parameters of young children with haemophilia and those of age-matched peersHAEMOPHILIA, Issue 2 2009D. STEPHENSEN Summary., Quality of life for children with haemophilia has improved since the introduction of prophylaxis. The frequency of joint haemorrhages has reduced, but the consequences of reduced bleeding on the biomechanical parameters of walking are not well understood. This study explored the differences in sagittal plane biomechanics of walking between a control group (Group 1) of normal age-matched children and children with haemophilia (Group 2) with a target ankle joint. A motion capture system and two force platforms were used to collect sagittal plane kinematic, kinetic and temporal,spatial data during walking of 14 age-matched normal children and 14 children with haemophilia aged 7,13 years. Group differences in maximum and minimum flexion/extension angles and moments of the hip, knee and ankle joints, ground reaction forces and temporal,spatial gait cycle parameters were analysed using one-way anova. Significant changes (P < 0.05) in kinematic and kinetic parameters but not temporal,spatial parameters were found in children with haemophilia; greater flexion angles and external moments of force at the knee, greater ankle plantarflexion external moments and lower hip flexion external moments. These results suggest that early biomechanical changes are present in young haemophilic children with a history of a target ankle joint and imply that lower limb joint function is more impaired than current clinical evaluations indicate. Protocols and quantitative data on the biomechanical gait pattern of children with haemophilia reported in this study provide a baseline to evaluate lower limb joint function and clinical progression. [source] Continuous femoral nerve block after total knee arthroplasty?ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2009L. KADIC Background: A continuous femoral nerve block is frequently used as an adjunct therapy after total knee arthroplasty (TKA). However, there is still debate on its benefits. Methods: In this prospective, randomized study, patients received a basic analgesic regimen of paracetamol and dicloflenac for the first 48 h postoperatively. In addition, the study group received a continuous femoral nerve block. A morphine patient-controlled analgesia pump was also available as a rescue analgesic to all the patients. Patients' numeric rating scores for pain, the amount of morphine consumed and its side effects during the first 48 h were recorded. Knee flexion angles achieved during the first week were registered. Three months postoperatively, patients completed Western Ontario and McMaster Universities Osteoarthritis Index and Knee Society Score. Results: The study group (n=27) had less pain (P=0.0016) during the first 48 h, was more satisfied with the analgesia (P<0.001) and used less morphine (P=0.007) compared with the control group (n=26). Fewer patients were nauseated, vomited or were drowsy in the study group (P=0.001). Also, the study group achieved better knee flexion in the first 6 days after surgery (P=0.001), with more patients reaching 90° flexion than the control group. However, after 3 months, there were no significant functional differences between the groups. Conclusion: A continuous femoral nerve block leads to better analgesia, less morphine consumption and less morphine-related side effects after TKA. Early functional recovery is improved, resulting in more patients reaching 90° knee flexion after 6 days. However, after 3 months, no significant functional benefits were found. [source] Using real-time MRI to quantify altered joint kinematics in subjects with patellofemoral pain and to evaluate the effects of a patellar brace or sleeve on joint motionJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2009Christine E. Draper Abstract Abnormal patellofemoral joint motion is a possible cause of patellofemoral pain, and patellar braces are thought to alleviate pain by restoring normal joint kinematics. We evaluated whether females with patellofemoral pain exhibit abnormal patellofemoral joint kinematics during dynamic, weight-bearing knee extension and assessed the effects of knee braces on patellofemoral motion. Real-time magnetic resonance (MR) images of the patellofemoral joints of 36 female volunteers (13 pain-free controls, 23 patellofemoral pain) were acquired during weight-bearing knee extension. Pain subjects were also imaged while wearing a patellar-stabilizing brace and a patellar sleeve. We measured axial-plane kinematics from the images. Females with patellofemoral pain exhibited increased lateral translation of the patella for knee flexion angles between 0°and 50° (p,=,0.03), and increased lateral tilt for knee flexion angles between 0° and 20° (p,=,0.04). The brace and sleeve reduced the lateral translation of the patella; however, the brace reduced lateral displacement more than the sleeve (p,=,0.006). The brace reduced patellar tilt near full extension (p,=,0.001), while the sleeve had no effect on patellar tilt. Our results indicate that some subjects with patellofemoral pain exhibit abnormal weight-bearing joint kinematics and that braces may be effective in reducing patellar maltracking in these subjects. Published by Wiley Periodicals, Inc. J Orthop Res 27: 571,577, 2009 [source] Medial collateral ligament insertion site and contact forces in the ACL-deficient kneeJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 4 2006Benjamin J. Ellis Abstract The objectives of this research were to determine the effects of anterior cruciate ligament (ACL) deficiency on medial collateral ligament (MCL) insertion site and contact forces during anterior tibial loading and valgus loading using a combined experimental-finite element (FE) approach. Our hypothesis was that ACL deficiency would increase MCL insertion site forces at the attachments to the tibia and femur and increase contact forces between the MCL and these bones. Six male knees were subjected to varus,valgus and anterior,posterior loading at flexion angles of ,0° and 30°. Three-dimensional joint kinematics and MCL strains were recorded during kinematic testing. Following testing, the MCL of each knee was removed to establish a stress-free reference configuration. An FE model of the femur,MCL,tibia complex was constructed for each knee to simulate valgus rotation and anterior translation at 0° and 30°, using subject-specific bone and ligament geometry and joint kinematics. A transversely isotropic hyperelastic material model with average material coefficients taken from a previous study was used to represent the MCL. Subject-specific MCL in situ strain distributions were used in each model. Insertion site and contact forces were determined from the FE analyses. FE predictions were validated by comparing MCL fiber strains to experimental measurements. The subject-specific FE predictions of MCL fiber stretch correlated well with the experimentally measured values (R2,=,0.95). ACL deficiency caused a significant increase in MCL insertion site and contact forces in response to anterior tibial loading. In contrast, ACL deficiency did not significantly increase MCL insertion site and contact forces in response to valgus loading, demonstrating that the ACL is not a restraint to valgus rotation in knees that have an intact MCL. When evaluating valgus laxity in the ACL-deficient knee, increased valgus laxity indicates a compromised MCL. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res [source] Kinematics of the knee at high flexion angles: An in vitro investigationJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2004Guoan Li Abstract Restoration of knee function after total knee, meniscus, or cruciate ligament surgery requires an understanding of knee behavior throughout the entire range of knee motion. However, little data are available regarding knee kinematics and kinetics at flexion angles greater than 120° (high flexion). In this study, 13° cadaveric human knee specimens were tested using an in vitro robotic experimental setup. Tibial anteroposterior translation and internal,external rotation were measured along the passive path and under simulated muscle loading from full extension to 150° of flexion. Anterior tibial translation was observed in the unloaded passive path throughout, with a peak of 31.2 ± 13.2 mm at 150°. Internal tibial rotation increased with flexion to 150° on the passive path to a maximum of 11.1 ± 6.7°. The simulated muscle loads affected tibial translation and rotation between full extension and 120° of knee flexion. Interestingly, at high flexion, the application of muscle loads had little effect on tibial translation and rotation when compared to values at 120°. The kinematic behavior of the knee at 150° was markedly different from that measured at other flexion angles. Muscle loads appear to play a minimal role in influencing tibial translation and rotation at maximal flexion. The results imply that the knee is highly constrained at high flexion, which could be due in part to compression of the posterior soft tissues (posterior capsule, menisci, muscle, fat, and skin) between the tibia and the femur. © 2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Hamstrings and iliotibial band forces affect knee kinematics and contact patternJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2000S. D. Kwak Many clinical studies have emphasized the role of the hamstrings and the iliotibial band on knee mechanics, although few biomechanical studies have investigated it. This study therefore examined two hypotheses: (a) with loading of the hamstrings, the tibia translates posteriorly and rotates externally and the tibial contact pattern shifts anteriorly; furthermore, the changes in tibial kinematics alter patellar kinematics and contact; and (b) loading the iliotibial band alters the kinematics and contact pattern of the tibiofemoral joint similarly to loading the hamstrings, and loading the iliotibial band laterally translates the patella and its contact location. Five cadaveric knee specimens were tested with a specially designed knee-joint testing machine in an open-chain configuration. At various flexion angles, the knees were tested always with a quadriceps force but with and without a hamstrings force and with and without an iliotibial band force. The results support the first hypothesis. Hence, the hamstrings may be important anterior and rotational stabilizers of the tibia, a role similar to that of the anterior cruciate ligament. The results also support the second hypothesis, although the iliotibial band force had a smaller effect on the tibia than did the hamstrings force. Both forces also changed patellar kinematics and contact, demonstrating that these structures should also be considered during the clinical management of patellar disorders. [source] | ||||||||||