Jim Richards
University of Central Lancashire, Allied Health Research unit, Faculty Member
ABSTRACT Growing ever popular within elite sports, Whole Body Cryotherapy (WBC) is the therapeutic application of extreme cold air for a short duration. Minimal evidence is available for determining the physiological effects of WBC,... more
ABSTRACT Growing ever popular within elite sports, Whole Body Cryotherapy (WBC) is the therapeutic application of extreme cold air for a short duration. Minimal evidence is available for determining the physiological effects of WBC, including observation of skin surface and core temperature changes, in particular across specific pre-determined regions of interest. METHODS • 14 male professional first team super league rugby players. • Exposed to 1, 2 and 3 minutes of WBC at -135°C. • Each WBC exposure was separated by seven days, and followed a competitive league fixture. • Core body temperature was recorded pre, immediately post and 20 minutes post WBC. • Non-contact, digital infrared thermal imaging measured skin surface temperature (Tsk). • Tsk was measured pre, immediately post and every five minutes post WBC exposure, up to 20 minutes. • Four regions of interest were defined; anterior triangle of the neck (A), torso (B), lower abdomen (C) and the back (D). RESULTS • Significant reductions (p=<0.05) in mean Tsk were noted after each exposure duration. • Average Tsk over time demonstrated significant differences (p=<0.05) between pre and immediately post exposure time points, for each exposure. • When comparing regions of interest significant differences (p=<0.05) were found in mean Tsk. • When comparing average Tsk of lower abdomen with A, B and D, significant differences (p=<0.05) were determined. DISCUSSION – CONCLUSION In all four regions of interest, Tsk was reduced following all exposure durations of WBC. The lowest Tsk recorded was 12.1°C, in the lower abdomen (ROI(C)) following a 3 minute exposure of WBC. This demonstrates the ability of WBC to achieve skin cooling within a desired therapeutic range, which is a key claim of WBC, as part of a recovery method within elite sport. The pattern of change and differences in average Tsk across C against A, B and D was interesting. In particular vascular shunting to protect vital organs in areas A and B could be a suggestion as to why Tsk differed following WBC exposures. Core temperature did not significantly fluctuate following exposures of WBC. However, a small rise was observed in all exposures, illustrating a relationship with the drop in Tsk, and the body's ability to maintain the function of vital organs. A phase of rewarming occurred following WBC exposures with post mean Tsk at 20 minutes not reaching pre exposure mean Tsk. Although lower limb Tsk was not measured in this study, these findings may have implications for clinicians deciding when it is safe to return an athlete to functional tasks following WBC, to reduce the risk of potential injury. Figure 1. Pre WBC exposure (anterior), 2. Pre WBC exposure (posterior), 3. Post WBC exposure (anterior).
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ABSTRACT Introduction Much has been published on the functional differences between Vastus Medialis (VM) and Vastus Lateralis (VL) between trained and untrained individuals with work mainly focussed on muscular onset timings using surface... more
ABSTRACT Introduction Much has been published on the functional differences between Vastus Medialis (VM) and Vastus Lateralis (VL) between trained and untrained individuals with work mainly focussed on muscular onset timings using surface electromyography (sEMG). Further exploration of the neuromuscular system can now be achieved by studying large yields of concurrently active motor unit action potential trains (MUAPT’s) and their characteristics (De Luca, 2006), using surface decomposition. This study aims to provide insight into the neuromuscular system’s mechanism of controlling Motor Units (MU’s) in trained and untrained individuals during a fatiguing protocol. Methods Trained and untrained individuals were asked to perform a 40 second trapezoid isometric knee extension task at 40% MVC, which was repeated until volitional exhaustion. Surface EMG (sEMG) signals were recorded from VM and VL using five pin surface array sensors. The raw sEMG signals were then inputted into the Precision Decomposition (PD) algorithm (Nawab et al. 2010) which decomposed the sEMG signals into their constituent motor unit action potential trains (MUAPT’s). The mean firing rate (MFR) for each detected motor unit was calculated and smoothed using a 3-s Hanning filter. Results and Discussion The untrained subject showed an increase in the VM MU firing rates during the isometric knee extension when compared to its synergistic partner VL. The trained subject did not show differences between the synergistic pair of VM and VL, instead exhibited similar MU firing rates for both muscles. The VL behaviour did not significantly differ between the fatigued and non-fatigued state or between the subjects. These finding could infers the VM is an important modifiable factor associated with training. These results, although exploratory, offer insight into the benefits of training and the effect on the neuromuscular control of synergistic muscles at the knee. The ability to conduct surface EMG decomposition is a recent technological advancement that is still being explored. However, these preliminary findings show that the application of this technology to exploring training differences can offer insight into individuals’ neuromuscular control. Conclusions The study provides some tantalizing findings and thoughts for progression with regards to the differences in neuromuscular control in training. Although exploratory at this time, the reported differences in motor unit firing rates offer some explanation to knee control during fatiguing muscles and the differences between differently trained individuals. Further investigations among individuals with various levels of training could offer further insight into the mechanisms involved.
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Background: Running is a cyclic movement requiring bilateral symmetry between the lower limbs to reduce injury risk. The assessment of side-to-side differences is often performed to detect functional deficits. Objectives: The purpose was... more
Background: Running is a cyclic movement requiring bilateral symmetry between the lower limbs to reduce injury risk. The assessment of side-to-side differences is often performed to detect functional deficits. Objectives: The purpose was to study side-to-side differences using clinical and running performance assessments in healthy runners (HR), runners with a history of lower limb injuries (RHI), and runners with a current lower limb injury (RLI). Methods: Forty-three runners were recruited, with 14 participants being allocated to the HR group, 13 to the RHI group, and 16 to the RLI group. Peak vertical ground reaction force (GRF), midfoot pressure, foot rotation, and gait variability were recorded using a Zebris FDM-T treadmill analysis system. Participants were also assessed using the navicular drop test. Dependent t-tests were used to determine if any differences existed between the lower limbs within each group. One-way ANOVAs were then used to investigate the side-to-side diff...
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The current investigation aimed to comparatively examine the effects of minimalist, maximalist and conventional footwear on Achilles tendon forces (ATF) during running. Twelve male runners (age 23.11±5.01 years, height 1.78±0.10 cm and... more
The current investigation aimed to comparatively examine the effects of minimalist, maximalist and conventional footwear on Achilles tendon forces (ATF) during running. Twelve male runners (age 23.11±5.01 years, height 1.78±0.10 cm and body mass 77.13±7.89 kg) ran at 4.0 m/s in the three footwear conditions. ATF’s were calculated using Opensim software allowing the magnitudal and temporal aspects of the ATF to be quantified. Differences between footwear were examined using one-way repeated measures ANOVA. The results showed the peak ATF was significantly larger in minimalist footwear (5.97±1.38 body weight (BW)) compared to maximalist (5.07±1.42 BW). In addition it was revealed that ATF per mile was significantly larger in minimalist (492.31±157.72 BW) in comparison to both maximalist (377.31±148.06 BW) and conventional (402.71±125.51 BW) footwear. Given the relationship between high ATF and Achilles tendon degradation, the current investigation indicated that minimalist footwear ma...
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Inertial sensors may help clinicians to assess patients’ movement and potentially support clinical decision making. Our aim was to determine whether shoulder range of motion during movement tasks measured using inertial sensors is capable... more
Inertial sensors may help clinicians to assess patients’ movement and potentially support clinical decision making. Our aim was to determine whether shoulder range of motion during movement tasks measured using inertial sensors is capable of accurately discriminating between patients with different shoulder problems. Inertial sensors were used to measure 3-dimensional shoulder motion during 6 tasks of 37 patients on the waiting list for shoulder surgery. Discriminant function analysis was used to identify whether the range of motion of different tasks could classify patients with different shoulder problems. The discriminant function analysis could correctly classify 91.9% of patients into one of the 3 diagnostic groups based. The tasks that associated a patient with a particular diagnostic group were the following: subacromial decompression: abduction, rotator cuff repair of tears ≤5 cm: flexion and rotator cuff repair of tears >5 cm: combing hair, abduction, and horizontal abduction–adduction. The discriminant function analysis showed that range of motion measured by inertial sensors can correctly classify patients and could be used as a screening tool to support surgery planning.
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Selection and training methods for showjumping horses are largely anecdotal, and performance analysis has been proposed as a method for scientifically improving competitive outcomes. To employ performance analysis in showjumping, an... more
Selection and training methods for showjumping horses are largely anecdotal, and performance analysis has been proposed as a method for scientifically improving competitive outcomes. To employ performance analysis in showjumping, an understanding of the tacit and explicit knowledge and practices of equestrians is required to identify relevant performance indicators. This study aimed to examine the knowledge and practices of equestrians with varying levels of experience (advanced and novice) for selecting horses, based on evaluation of movement, and training showjumping horses using an original questionnaire. It was hypothesised that differences would be present between advanced and novice responses. The questionnaire was composed of closed-end and follow-up open-end questions and 225 equestrians (66.7% advanced, 33.3% novice) participated. Closed-end responses from advanced and novice groups were analysed separately using Chi-Squared tests and open-end responses were subjected to thematic and content analysis. Closed-end responses showed significant within-group preferences (P<0.0001) for specific movement traits and training methods and between-group response differences <13% revealed that advanced and novice groups displayed similar preferences. Thematic analysis indicated different preferences for movement traits when selecting showjumping horses, as well as differences in the level of tacit knowledge between advanced and novice groups. Advanced equestrians placed greater emphasis on aesthetic forelimb traits than novice equestrians, who emphasised traits that they may be less capable of influencing, such as hindlimb impulsion and position of the horse at take-off. An emphasis on hindlimb movement and flatwork/non-jumping exercises for showjumping training was observed across both groups. Understanding equestrian tacit knowledge and its application is fundamental for developing research that is relevant to equestrians. Findings from this study may form a basis for research to identify relevant, objective performance indicators for performance analysis in showjumping, with the ultimate goal of improving competitive performance and welfare for equine athletes.
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Objective This study investigated the effect of patellar bracing and taping on the three-dimensional mechanics of the knee of patellofemoral pain patients during a step descent task. Method Thirteen patients diagnosed with patellofemoral... more
Objective This study investigated the effect of patellar bracing and taping on the three-dimensional mechanics of the knee of patellofemoral pain patients during a step descent task. Method Thirteen patients diagnosed with patellofemoral pain syndrome performed a slow step descent. This was conducted under three randomized conditions:(a) no intervention,(b) neutral patella taping,(c) patellofemoral bracing. A 20 cm step was constructed to accommodate an AMTI force platform. Kinematic data were collected using ...
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ABSTRACT Achilles tendon injuries are a common occurrence in the general population. Middle-aged runners are particularly prone to Achilles tendinopathy, but non-sporting individuals are also affected by these problems. Tendinopathy... more
ABSTRACT Achilles tendon injuries are a common occurrence in the general population. Middle-aged runners are particularly prone to Achilles tendinopathy, but non-sporting individuals are also affected by these problems. Tendinopathy accounts for 30–50% of sports injuries, and it has been identified as a major medical problem associated with overuse that is most prevalent in sporting and working environments. Acupuncture is widely used in the treatment of musculoskeletal disorders; however, few studies have investigated the effects of needling on the Achilles tendon. The first application of acupuncture to the Achilles tendon was recorded in ancient China. During the twentieth century, this approach evolved into the herringbone technique, but treatment has not been standardized. This paper reviews the development of acupuncture to the Achilles tendon, and describes a recently developed standardized and specific nine-needle acupuncture treatment protocol. The authors also highlight the physiologi-cal pro-inflammatory changes that occur in the Achilles tendon when this protocol is administered, and propose that such an approach can be a useful adjunct to the treatment of Achilles tendinopathy.
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Background: Little work has been undertaken on the biomechanical effects of patellofemoral taping and bracing in cycling. Objective: The purpose of the study was to assess the three-dimensional movement of the knee joint at different... more
Background: Little work has been undertaken on the biomechanical effects of patellofemoral taping and bracing in cycling. Objective: The purpose of the study was to assess the three-dimensional movement of the knee joint at different levels of resistance, across four treatment conditions, in experienced cyclists and discuss the clinical implications of the findings. Method: 15 healthy male subjects were asked to conduct four separate tests at three separate resistances on a static trainer. Each test used a different treatment modality ...
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The reliability of surface electromyography (sEMG) has not been adequately demonstrated in the equine literature and is an essential consideration as a methodology for application in clinical gait analysis. This observational study... more
The reliability of surface electromyography (sEMG) has not been adequately demonstrated in the equine literature and is an essential consideration as a methodology for application in clinical gait analysis. This observational study investigated within-session, intra-subject (stride-to-stride) and inter-subject reliability, and between-session reliability of normalised sEMG activity profiles, from triceps brachii (triceps), latissimus dorsi (latissimus), longissimus dorsi (longissimus), biceps femoris (biceps), superficial gluteal (gluteal) and semitendinosus muscles in n = 8 clinically non-lame horses during in-hand trot. sEMG sensors were bilaterally located on muscles to collect data during two test sessions (session 1 and 2) with a minimum 24-hour interval. Raw sEMG signals from ten trot strides per horse and session were DC-offset removed, high-pass filtered (40 Hz), full-wave rectified, and low-pass filtered (25 Hz). Signals were normalised to peak amplitude and percent stride ...
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This study compared muscle activity and movement between the leading (Ld) and trailing (Tr) fore- (F) and hindlimbs (H) of horses cantering overground. Three-dimensional kinematic and surface electromyography (sEMG) data were collected... more
This study compared muscle activity and movement between the leading (Ld) and trailing (Tr) fore- (F) and hindlimbs (H) of horses cantering overground. Three-dimensional kinematic and surface electromyography (sEMG) data were collected from right triceps brachii, biceps femoris, middle gluteal, and splenius from 10 ridden horses during straight left- and right-lead canter. Statistical parametric mapping evaluated between-limb (LdF vs. TrF, LdH vs. TrH) differences in time- and amplitude-normalized sEMG and joint angle–time waveforms over the stride. Linear mixed models evaluated between-limb differences in discrete sEMG activation timings, average rectified values (ARV), and spatio-temporal kinematics. Significantly greater gluteal ARV and activity duration facilitated greater limb retraction, hip extension, and stifle flexion (p < 0.05) in the TrH during stance. Earlier splenius activation during the LdF movement cycle (p < 0.05), reflected bilateral activation during TrF/LdH...
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The relationship between lameness-related adaptations in equine appendicular motion and muscle activation is poorly understood and has not been studied objectively. The aim of this study was to compare muscle activity of selected fore-... more
The relationship between lameness-related adaptations in equine appendicular motion and muscle activation is poorly understood and has not been studied objectively. The aim of this study was to compare muscle activity of selected fore- and hindlimb muscles, and movement of the joints they act on, between baseline and induced forelimb (iFL) and hindlimb (iHL) lameness. Three-dimensional kinematic data and surface electromyography (sEMG) data from the fore- (triceps brachii, latissimus dorsi) and hindlimbs (superficial gluteal, biceps femoris, semitendinosus) were bilaterally and synchronously collected from clinically non-lame horses (n= 8) trotting over-ground (baseline). Data collections were repeated during iFL and iHL conditions (2–3/5 AAEP), induced on separate days using a modified horseshoe. Motion asymmetry parameters and continuous joint and pro-retraction angles for each limb were calculated from kinematic data. Normalized average rectified value (ARV) and muscle activation...
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BACKGROUND AND AIMS.: It has been suggested that thermal imaging may provide alternative appropriate diagnostic information for Carpal Tunnel Syndrome (CTS). The aims of this study are to investigate the optimum method of data collection... more
BACKGROUND AND AIMS.: It has been suggested that thermal imaging may provide alternative appropriate diagnostic information for Carpal Tunnel Syndrome (CTS). The aims of this study are to investigate the optimum method of data collection from thermal images of subjects with CTS, establish base line thermographic reference data in subjects with CTS, measure the effect of a thermal washout on these patients and compare pre/post surgery baseline thermographic data to assess the effects of surgery. METHODS: Patients who had a diagnosis of CTS and were waiting for decompression surgery were recruited. The study involved two data collection sessions, the first immediately before decompression surgery, the second 6 weeks after the operation. A baseline image was taken, cooling using a Cryo/Cuff took place, following removal of the Cryo/Cuff temperature data were sampled during rewarming. Data from pre and post operative images were extracted by mapping three areas defined on screen by usin...
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Achilles tendon pathology is a frequently occurring musculoskeletal disorder in runners. Foot orthoses have been shown to reduce the symptoms of pain in runners but their mechanical effects are still not well understood. This study aimed... more
Achilles tendon pathology is a frequently occurring musculoskeletal disorder in runners. Foot orthoses have been shown to reduce the symptoms of pain in runners but their mechanical effects are still not well understood. This study aimed to examine differences in Achilles tendon load when running with and without orthotic intervention. Twelve male runners ran at 4.0 m·s(-1). Ankle joint moments and Achilles tendon forces were compared when running with and without orthotics. The results indicate that running with foot orthotics was associated with significant reductions in Achilles tendon load compared to without orthotics. In addition to providing insight into the mechanical effects of orthotics in runners, the current investigation suggests that via reductions in Achilles tendon load, foot orthoses may serve to reduce the incidence of chronic Achilles tendon pathologies in runners.
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ABSTRACT Stair ambulation is sometimes unavoidable for humans and canines, and changes several parameters of the gait cycle in comparison to level walking. The purpose of this paper is to review and investigate stair ambulation kinematics... more
ABSTRACT Stair ambulation is sometimes unavoidable for humans and canines, and changes several parameters of the gait cycle in comparison to level walking. The purpose of this paper is to review and investigate stair ambulation kinematics and kinetics for the human and canine when compared with gait on level surfaces. Data collected from 2 laboratories in a similar manner were analyzed to compare the ankle (tarsal) joint, knee (stifle) joint, and hip joint kinematics for level walking, stair ascent, and stair descent in dogs and humans. The comparison of humans and dogs reveals humans use a greater overall range of motion (ROM) in the hip and knee compared to dogs in all tasks. Dogs use a much greater ROM in the ankle or tarsal joint compared to humans in all tasks. The decreased amount of ROM used at the hip and stifle joints of dogs during level gait, stair climbing, and stair descent when compared to humans is likely a direct result of the increased amount of tarsal flexion dogs use when compared to people. This paper identifies the peak angles of flexion and extension, overall ranges of motion of the hindlimb during normal walking, stair ascent and descent. This information may be used to help devise rehabilitation programs for dogs that need to increase the motion in a particular hindlimb joint through targeted movement tasks.
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It is well-established that processes involving changing direction or turning in which either or both standing and walking turns are utilized involve coordination of the whole-body and stepping characteristics. However, the turn context... more
It is well-established that processes involving changing direction or turning in which either or both standing and walking turns are utilized involve coordination of the whole-body and stepping characteristics. However, the turn context and whole-body coordination have not been fully explored during different turning amplitudes. For these reasons, this present study aimed to determine the effects of turning amplitude on whole-body coordination. The findings from this study can be utilized to inform the rationale behind fall prevention factors and to help design an exercise strategy to address issues related to amplitude of turning in older adults. Twenty healthy older and twenty healthy younger adults were asked to complete standing turns on level ground using three randomly selected amplitudes, 90°, 135° and 180°, at their self-selected turn speed. Turning kinematics and stepping variables were recorded using Inertial Measurement Units. Analysis of the data was carried out using Mi...
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Background Cognitive age-related decline is linked to dementia development and gait has been proposed to measure the change in brain function. This study aimed to investigate if spatiotemporal gait variables could be used to differentiate... more
Background Cognitive age-related decline is linked to dementia development and gait has been proposed to measure the change in brain function. This study aimed to investigate if spatiotemporal gait variables could be used to differentiate between the three cognitive status groups. Methods Ninety-three older adults were screened and classified into three groups; mild cognitive impairment (MCI) (n = 32), dementia (n = 31), and a cognitively intact (n = 30). Spatiotemporal gait variables were assessed under single- and dual-tasks using an objective platform system. Effects of cognitive status and walking task were analyzed using a two-way ANCOVA. Sub-comparisons for between- and within-group were performed by one-way ANCOVA and Paired t-tests. Area Under the Curve (AUC) of Receiver Operating Characteristics (ROC) was used to discriminate between three groups on gait variables. Results There were significant effects (P < 0.05) of cognitive status during both single and dual-task walk...
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Background Different multi-segment foot models have been used to explore the effect of foot orthoses. Previous studies have compared the kinematic output of different multi-segment foot models, however, no study has explored if different... more
Background Different multi-segment foot models have been used to explore the effect of foot orthoses. Previous studies have compared the kinematic output of different multi-segment foot models, however, no study has explored if different multi-segment foot models detect similar kinematic changes when wearing a foot orthoses. The aim of this study was to compare the ability of two different multi-segment foot models to detect kinematic changes at the hindfoot and forefoot during the single and double support phases of gait when wearing a foot orthosis. Methods Foot kinematics were collected during walking from a sample of 32 individuals with and without a foot orthosis with a medial heel bar using an eight-camera motion capture system. The Oxford Foot Model (OFM) and a multi-segment foot model using the Calibrated Anatomical System Technique (CAST) were applied simultaneously. Vector field statistical analysis was used to explore the kinematic effects of a medial heel bar using the t...
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A limitation of the ability to rotate the head with respect to the upper body has been associated with turning problems; however, the extent of head constraints on whole-body coordination has not been fully determined. The aim of this... more
A limitation of the ability to rotate the head with respect to the upper body has been associated with turning problems; however, the extent of head constraints on whole-body coordination has not been fully determined. The aim of this study was to limit head on body rotation and observe the effects on whole-body coordination during standing turns at various speeds. Twelve participants completed standing turns at 180°. A Vicon motion system and a BlueGain Electrooculography system were used to record movement kinematics and measure horizontal eye movements, respectively. All participants were tested at 3 randomized speeds, and under 2 conditions with or without their head constrained using a head, neck, and chest brace which restricted neck movement. A repeated-measures analysis of variance found a significant main effect of turning speed on the onset latency of all segments, peak head–thorax angular separation, and step characteristics. Constraining the head rotation had multiple si...
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Background: Generalized joint hypermobility is an important risk factor for knee injuries, including to the anterior cruciate ligament (ACL). Examining movement patterns specific to hypermobile individuals during sport-specific movements... more
Background: Generalized joint hypermobility is an important risk factor for knee injuries, including to the anterior cruciate ligament (ACL). Examining movement patterns specific to hypermobile individuals during sport-specific movements could facilitate development of targeted recommendations and injury prevention programs for this population. Hypothesis: Asymptomatic hypermobile participants will present kinematics measures suggestive of a greater risk of noncontact knee or ACL injuries. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Forty-two (15 asymptomatic hypermobile and 27 nonhypermobile) individuals performed unanticipated side-step cutting on their dominant and nondominant legs. Ankle, knee, hip, pelvis, and trunk angles in all planes of motion were collected during the first 100 ms after initial contact using a 3-dimensional infrared system. Precontact foot-ground angles were also extracted. Data from hypermobile and nonhypermobile groups were c...
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Objectives: This study aimed to identify the most sensitive measures to assess postural stability and to detect between leg differences. Methods: Seventeen healthy volunteers participated in this University physiotherapy clinic... more
Objectives: This study aimed to identify the most sensitive measures to assess postural stability and to detect between leg differences. Methods: Seventeen healthy volunteers participated in this University physiotherapy clinic experiment. Linear segment acceleration and segment angular velocity data were collected using Inertial Measurement Units on the left and right calcanei, shanks, and pelvis. Participants performed a 30s single-leg stance on a firm surface and a balance pad on their dominant and non-dominant leg. A two factor (2x2) repeated measures analysis of variance was used to compare the two balance surfaces and the leg dominance. Results: Comparing the surfaces, both highest effect size and percentage difference were found in the pelvis angular velocity data. Apart from the anteroposterior linear acceleration of the shank, both effect size and percentage change showed that all average linear acceleration values were less sensitive to detect change between surfaces w...
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INTRODUCTION The use of motor imagery (MI) has been shown to offer significant improvements in movement performance in sports, and is now receiving a lot of attention as a relatively new therapeutic approach which can be applied in... more
INTRODUCTION The use of motor imagery (MI) has been shown to offer significant improvements in movement performance in sports, and is now receiving a lot of attention as a relatively new therapeutic approach which can be applied in rehabilitation. However, the effects of MI on the quality of movement is still unclear. This study explored the immediate effect of MI on reaching tasks in healthy subjects. METHODS 17 healthy individuals (33 ± 8.2 years) participated in the study. Surface electromyography (sEMG) and inertial measurement units (IMU) were used to identify muscle activity and angular velocity in both upper limbs. Participants performed a reach task using their dominant and non-dominant arms at their most comfortable speed, they were then asked to imagine themselves performing the same reaching task, and finally they were asked to repeat the reaching task. RESULTS Significant decreases were seen in the muscle activity between pre and post MI for Biceps Brachii, Anterior Deltoid and Triceps Brachii. In addition, a significant increase was seen in extension angular velocity post MI. DISCUSSION The results indicate that the use of MI just after physical practice appears to have an immediate effect on the muscle activity and kinematics during a reaching task, which may suggest an improved quality of movement. CONCLUSION This proof of concept study shows the potential for MI to improve the quality of performing reaching task and offers a possible therapeutic option for Stroke survivors and other neuromuscular disorders.
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ABSTRACT Purpose: This study examined relationships between vibrationsensation and joint position sense (JPS) at the knee in healthy subjects; to establish whether vibratory perception threshold (VPT) tests may be used as an alternative... more
ABSTRACT Purpose: This study examined relationships between vibrationsensation and joint position sense (JPS) at the knee in healthy subjects; to establish whether vibratory perception threshold (VPT) tests may be used as an alternative to JPS testing and to establish the minimum number of trials required to attain data stability. Relevance: Proprioceptive testing methods at the knee have been criticized for their poor reliability and variability. As both vibration sense and JPS travel through similar neurological pathways, it has been suggested that a relationship exists between JPS and VPT at the knee. Similarities between these methods may open the use of VPT testing as a convenient, cheaper alternative to JPS testing in clinical and research settings. Participants: Twenty healthy adults (11 females, 9 males; aged 26.8±8.2 years) were tested for VPT and JPS. Methods: VPT was tested at five anatomical sites at the lower limb (first metatarsophalangeal joint, medial and lateral malleoli and the medial and lateral femoral condyles) using a biothesiometer (Bio-Medical Instrument, OH). JPS was measured using active angle reproduction (AAR) at target angles of 20◦ and 60◦ of knee flexion using a Cybex Norm Isokinetic Dynamometer System (CSMI Medical Solutions). Analysis: The number of required repetitions were investigated by calculating the cumulative means and standard deviations from VPT and JPS data for all subjects at each test site. The differences between the 5 testing sites for VPT and two test angles for JPS were investigated using repeated measures analysis of variance, followed by post hoc pair-wise comparisons. Pearson product–moment correlation coefficients were used to determine the relationships between the measures of proprioception from VPT and JPS. Results: Results showed no significant correlation between VPT and the two AAR test angles (r &lt; 0.3). Intra-method assessments showed similarities in repeatability, in that VPT (all sites) and AAR 20◦ required 4 repetitions to attain data stability, whereas at AAR 60◦ five repetitions were required. There were significant differences (p &lt; 0.005) between the joints tested for VPT and no significant differences were seen within joint for VPT or between angles for JPS. Conclusions: This study supports the notion that increased numbers of repetitions are necessary for data stabilisation. This study is the first to suggest a minimum reference standard for the number of repetitions required for VPT and JPS testing. It has shown that the JPS test of AAR at 20◦ and all VPT tests required 4 repetitions to attain data stability. However, when testing AAR at 60◦ five repetitions were required to attain data stability. The lack of correlation between VPT and JPS suggests the two modalities measure different facets of proprioception. Some disorders affect one of these sensory functions while partially or completely sparing the other. Further research is required using independent methods in clinical groups such as PFPS to allow proprioceptive subgrouping. Implications: Whilst the two testing modalities are independent of each other, these findings have implications for clinicians and researchers, encouraging the use of broader proprioceptive assessments and increased repetitions to attain consistent stable data.
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Background: Use of proprioceptive knee braces to control symptomology by altering neuromuscular control mechanisms has been shown in patellofemoral pain. Although their potential in patients with knee osteoarthritis is vast, little... more
Background: Use of proprioceptive knee braces to control symptomology by altering neuromuscular control mechanisms has been shown in patellofemoral pain. Although their potential in patients with knee osteoarthritis is vast, little research has examined their efficacy. Objectives: This study examines the effect of a proprioceptive knee brace on lower limb kinematics and kinetics in healthy participants and in participants with OA. Methods: Thirteen healthy participants were asked to perform a 10-cm step-down task with and without a proprioceptive brace. Data were collected using a 10-camera Qualisys system. Individuals with osteoarthritis completed the Knee injury and Osteoarthritis Outcome Score before and after 4 weeks of intervention. Results: During step-down reductions in knee maximum internal rotation, transverse range of movement, transverse plane angular velocity and maximum internal rotation angular velocity was seen. Ankle plantar flexion and inversion angular velocity dec...
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BACKGROUND Turns are often cited as a difficult task for individuals with Parkinson's disease and often lead to falls, however targeted exercise interventions may help to reduce this problem. This study examined the effects of a... more
BACKGROUND Turns are often cited as a difficult task for individuals with Parkinson's disease and often lead to falls, however targeted exercise interventions may help to reduce this problem. This study examined the effects of a 10-week home-based exercise program focusing on turns which may be an exercise approach for improving mobility and reducing falls in individuals with Parkinson's disease. METHODS Turning and stepping characteristics were recorded using Inertial Measurement Units while participants performed a 180° standing turn. Eye movements were measured using a BlueGain electrooculography system. Clinical outcomes were assessed using the Movement Disorders Society-Unified Parkinson's Disease Rating Scale, Functional axial rotation-physical score and the Falls Efficacy Scale International. FINDINGS Twenty individuals with Parkinson's disease were matched by severity using the Modified Hoehn and Yahr scale and were randomly allocated to an exercise (n = 10) or control group (n = 10). Significant improvements were seen after 10 weeks in the exercise group only for; onset latency of body segments, step size, number of fast phase eye movements, the Movement Disorders Society-Unified Parkinson's Disease Rating Scale in motor and rigidity scores, Functional axial rotation-physical score and the Falls Efficacy Scale International. INTERPRETATION These results indicate that the home-based exercise programme targeting turning characteristics had positive effects on turning performance and clinical outcomes associated with falls in individuals with Parkinson's disease. These preliminary results support the notion that targeted home-based exercises may provide an effective intervention in this population.
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The objectives of this study were to investigate the effects of knee brace (KB) and kinesiotaping (KT) on functional performance and self-reported function in individuals six months post-ACLR who desired to return to their pre-injury... more
The objectives of this study were to investigate the effects of knee brace (KB) and kinesiotaping (KT) on functional performance and self-reported function in individuals six months post-ACLR who desired to return to their pre-injury activity levels but felt unable to do so due to kinesiophobia. This was a cross-sectional study involving 30 individuals six months post-ACLR with Tampa Kinesiophobia Scores >37. Individuals were tested under three conditions: no intervention, KB and KT in a randomized order. Isokinetic concentric quadriceps and hamstring strength tests, one leg hop test, star excursion balance test and global rating scale were assessed under the three conditions. The involved side showed that KT and KB significantly increased the hop distance (P=0.01, P=0.04) and improved balance (P=0.01, P=0.04), respectively, but only KB was found to increase the quadriceps and hamstring peak torques compared to no intervention (P<0.05). Individuals reported having better knee ...
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Supplemental material, sj-docx-1-sph-10.1177_1941738121999063 for The Influence of Asymptomatic Hypermobility on Unanticipated Cutting Biomechanics by Ivana Hanzlíková, Jim Richards, Josie Athens and Kim Hébert-Losier in Sports Health: A... more
Supplemental material, sj-docx-1-sph-10.1177_1941738121999063 for The Influence of Asymptomatic Hypermobility on Unanticipated Cutting Biomechanics by Ivana Hanzlíková, Jim Richards, Josie Athens and Kim Hébert-Losier in Sports Health: A Multidisciplinary Approach
Background Current literature proposes proprioceptive changes following cryotherapy applications due to changes in neurodynamic feedback from receptors altering knee joint position sense. However, minimal literature exists on the effect... more
Background Current literature proposes proprioceptive changes following cryotherapy applications due to changes in neurodynamic feedback from receptors altering knee joint position sense. However, minimal literature exists on the effect on skin surface sensitivity (SSS) which may be a contributing factor. This study investigated the effects of cryotherapy on knee SSS and temperature (Tsk) using monofilaments and thermal imaging in males and females. Methods SSS in 19 healthy participants mapped using a photographic knee pain map (PKPM), on the non-dominant knee following a 20-minute cryotherapy exposure used an Aesthesio Precision Tactile Sensory Evaluator (DanMic Global, USA) for measurement. Thermal imaging using a non-invasive infrared camera (ThermoVision A40M, Flir Systems, Danderyd, Sweden) measured Tsk. Data were collected pre, immediately post and at five-minute intervals up to 20-minutes. Results Statistical significant decreases in SSS are reported for superior medial sect...
Research Interests: Medicine and Cryotherapy
Objective:To estimate the rate of recurrence of deformity in patients using Dennis Brown Splint and for the description of the issues related to non-compliance of the Dennis Brown Splint. Material and Methods: It was a prospective... more
Objective:To estimate the rate of recurrence of deformity in patients using Dennis Brown Splint and for the description of the issues related to non-compliance of the Dennis Brown Splint. Material and Methods: It was a prospective descriptive case series study.70 patients with corrected Club Feet were selected from APPNA Rehabilitation Department of Benazir Bhutto Hospital. The patients were given the Dennis Brown Splints for the maintenance of the correction followed by Ponseti method. Clubfeet were graded according to the Pirani scoring system check the recurrence of the deformity. Patients were called for routine follow-up to check the rate of recurrence of the deformity and parents were interviewed for the issues related to non-compliance to the bracing program. Duration of the study was 12 months followed by the bracing. Results: It is founded that the recurrence of the deformity is about 24%. 17/70 reported with recurrence with the deformity after correction during bracing pro...
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Background: An increased load of the patellofemoral joint is often attributed to foot function in patients with patellofemoral pain. Foot orthoses are commonly prescribed for this condition; however the mechanisms by which they work are... more
Background: An increased load of the patellofemoral joint is often attributed to foot function in patients with patellofemoral pain. Foot orthoses are commonly prescribed for this condition; however the mechanisms by which they work are poorly understood. The aim of this study was to investigate the kinematics and kinetics of the knee between patellofemoral pain patients and a group of healthy subjects when using a standardised foot orthosis prescription during walking and step descent. Method: Fifteen healthy subjects and fifteen patients diagnosed with PFP with a foot posture index greater than 6, had foot orthoses moulded to their feet. They were asked to walk at a self-selected pace and complete a 20 cm step descent using customised orthoses with 3⁄4 and full length wedges. Kinematic and Kinetic data were collected and modelled using Calibrated Anatomical System Technique. Results: Significant differences were seen in both the kinematics and kinetics between the healthy group an...
Background: From high profile events such as the Tour De France and the Olympics, it is noticeable that kinesiology type taping (KTT) is used widely within elite cycling for treatment of knee pain. Taping is a clinical treatment for the... more
Background: From high profile events such as the Tour De France and the Olympics, it is noticeable that kinesiology type taping (KTT) is used widely within elite cycling for treatment of knee pain. Taping is a clinical treatment for the over-use/overload pathology of patello-femoral pain (PFP) in elite and experienced cyclists, however it is unknown as to whether it effects any biomechanical change that can be useful in a clinical setting. PFP in cycling is often referred to as cyclists’ knee or anterior knee pain, and has been reported to occur in over 25% of all cyclists. (Callaghan, 2005: Journal of Bodywork and Movement Therapies, 9, 226-236). Some cyclists are pre-disposed to excessive knee movement during the pedal stroke (Bailey et al, 2003: Journal of Sports Sciences, 21 (2), 649–657), and consequently at different power levels and cadences this movement may affect biomechanical factors at the knee. An increased understanding of taping and the biomechanics of the knee du...
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Background: The Tour de France will undoubtedly showcase various cycling related injuries in its Yorkshire opening stages in 2014. Patello-Femoral Pain (PFP) is responsible for over 25% of all road cycling injuries and over 65% of... more
Background: The Tour de France will undoubtedly showcase various cycling related injuries in its Yorkshire opening stages in 2014. Patello-Femoral Pain (PFP) is responsible for over 25% of all road cycling injuries and over 65% of injuries in the lower limb (Callaghan, 2005: Journal of Bodywork and Movement Therapies, 9, 226-236). Alongside trauma related pain it remains the main injury affecting experienced and elite cyclists and is commonly treated using taping (broadly categorised into McConnell and kinesiology type tape - KTT). To date it is unknown as to the extent and rationale behind the use of tape in cycling related knee pain. Purpose: To determine clinicians’ current use of taping in elite and experienced cyclists with cycling related knee pain in order to inform a 3D motion analysis study into current taping techniques. To date very little work has been undertaken in this area and although it is presumed that taping is used extensively throughout cycling, it is unknown ...
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Objectives: To investigate the relationship between fear of falling indicators and pedobarographic variables among non-communitydwelling elderly. Methods: Twenty-seven volunteers were recruited and assigned to three groups according to... more
Objectives: To investigate the relationship between fear of falling indicators and pedobarographic variables among non-communitydwelling elderly. Methods: Twenty-seven volunteers were recruited and assigned to three groups according to their level of fear of falling estimated using the Short FES-I score. The in-shoe foot pressure data were collected while walking 10 meters. The relative peak and mean force in different foot regions, functional gait tasks feature, and center of pressure displacement were measured. A Kruskal- Wallis test was performed to assess the differences between groups. Results: The anterior-posterior displacement of pressure center was significantly different across the groups during weight acceptance and single limb advancement phases. The different pressure regions showed significant differences in relative mean (p=0.006) and peak forces (p=0.004) in hindfoot. The relative peak force was different for a hallux (p=0.042), a first metatarsal head (p=0.026), and...
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Medial wedged foot orthoses are frequently prescribed to reduce retropatellar stress in patients with patellofemoral pain (PFP) by controlling calcaneal eversion and internal rotation of the tibia. During activities of daily living, the... more
Medial wedged foot orthoses are frequently prescribed to reduce retropatellar stress in patients with patellofemoral pain (PFP) by controlling calcaneal eversion and internal rotation of the tibia. During activities of daily living, the highest patella loads occur during stair descent, but the effect of foot orthoses during stair descent remains unclear. The purpose of this study was to compare the kinematics, kinetics and muscle activation during a step descent task in healthy volunteers using three designs of foot orthoses (insoles). Sixteen healthy subjects with a mean age of 25.7 years, BMI of 23.3, and +5 Foot Posture Index were recruited. Subjects performed a step down task from 20 cm using a 5 rearfoot medial wedge (R), a 5 rearfoot and forefoot medial wedge (R/F), and a control flat insole (C). Significant improvements in control were seen in the R and R/F insoles over the C insole in the foot and at the ankle and hip kinematics. The R and R/F insoles increased the knee addu...
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Background: Targeted intervention for subgroups is a promising approach for the management of patellofemoral pain. Hypothesis: Treatment designed according to subgroups will improve clinical outcomes in patients unresponsive to multimodal... more
Background: Targeted intervention for subgroups is a promising approach for the management of patellofemoral pain. Hypothesis: Treatment designed according to subgroups will improve clinical outcomes in patients unresponsive to multimodal treatment. Study Design: Prospective crossover intervention. Level of Evidence: Level 3. Methods: Patients with patellofemoral pain (PFP; n = 61; mean age, 27 ± 9 years) were enrolled. Patients with PFP received standard multimodal treatment 3 times a week for 6 weeks. Patients not responding to multimodal treatment were then classified into 1 of 3 subgroups (strong, weak and tight, and weak and pronated foot) using 6 simple clinical tests. They were subsequently administered 6 further weeks of targeted intervention, designed according to subgroup characteristics. Visual analog scale (VAS), perception of recovery scale (PRS), 5-Level European Quality 5 Dimensions (EQ-5D-5L), and self-reported version of the Leeds Assessment of Neuropathic Symptoms ...
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SummaryWe studied the familiarisation time required to obtain reliable sagittal plane kinematics for the elbow and stifle joints in eleven treadmill-naïve greyhounds trotting on a treadmill. Motion analysis software was used to measure... more
SummaryWe studied the familiarisation time required to obtain reliable sagittal plane kinematics for the elbow and stifle joints in eleven treadmill-naïve greyhounds trotting on a treadmill. Motion analysis software was used to measure sagittal elbow and stifle joint movements and to calculate joint angular velocities. After a twominute walking initiation period, the dogs trotted for two and a half minutes. Three trials of three seconds (27 to 30, 72 to 75 and 117 to 120 seconds) trotting, each comprising four complete strides, were analysed. The angle versus time and angular velocity versus time graphs were plotted. For each stride, angular velocity and angular velocity data at key points during the gait cycle were recorded. These angles corresponded with the flexion and extension angles and the peak angular velocities of the elbow and stifle joints during stance and swing phase. Reliable elbow and stifle joint kinematics were obtained within 30 seconds of trotting, which did not d...
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The aim of this study was to determine changes in knee biomechanics during badminton lunges due to fatigue, lunge strategy and knee bracing. Kinetic and kinematic data were collected from 16 experienced right-handed badminton players.... more
The aim of this study was to determine changes in knee biomechanics during badminton lunges due to fatigue, lunge strategy and knee bracing. Kinetic and kinematic data were collected from 16 experienced right-handed badminton players. Three factor repeated measures ANOVAs (lunge direction—fatigue—brace) were performed with Least Significant Difference pairwise comparisons. In addition, clinical assessments including; Y-balance test, one leg hop distance and ankle dorsiflexion range of motion were performed pre- and postfatigue. The knee showed significantly greater flexion during the forehand lunge compared to backhand. In contrast, the internal rotation velocity and the knee extension moment were greater during backhand. Knee angular velocity in the sagittal plane, peak knee moment and range of moment in the coronal plane and stance time showed significantly lower values postfatigue. In addition, the peak knee adduction moment showed significantly lower values in the braced conditi...
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Introduction: Movement analysis of the shoulder joint requires a system capable of analysing a complex interplay of movements in six degrees of freedom. This study was conducted to investigate the three dimensional kinematics of... more
Introduction: Movement analysis of the shoulder joint requires a system capable of analysing a complex interplay of movements in six degrees of freedom. This study was conducted to investigate the three dimensional kinematics of asymptomatic shoulders, shoulders with anterior instability and influence of surgical stabilization on kinematics. Materials and Methods: Kinematic data and clinical scores were obtained from nine asymptomatic individuals who served as the control group. Data was also obtained from five patients with recurrent anterior instability who were awaiting stabilization surgery before and at least six months after arthroscopic stabilization and rehabilitation. Abduction in coronal plane, abduction in the scapular plane, forward flexion and circumduction movements were assessed. Results: Unstable shoulders demonstrate a significant decrease in the range of movement when the shoulder is abducted in the coronal plane (p=0.002). There is a significant decrease in the area covered by the circumducting arm in instability when the movements are referenced to the trunk (p=0.002). Forward flexion (p=0.33) and scaption (p=0.075) remain unaffected in instability. Surgical stabilization failed to influence a significant change in any of the pre operative kinematic parameters [Abduction in the coronal plane (p=0.673), abduction in the scapular plane (p=0.733), forward flexion (p=0.992) or circumduction (p=0.214)]. There was a significant difference in the clinical scores between the control group and the patients with anterior instability (Constant score; p=0.03, Oxford instability score p=0.001). The Oxford instability scores demonstrated a significant improvement after surgical intervention (p=0.011), whereas the Constant score did not change (p=0.58). Conclusions: This study describes shoulder motion patterns using a non-invasive motion tracking system, which is capable of dynamic movement data capture in six degrees of freedom. There are significant differences in the kinematic characteristics and clinical scores between patients with anterior instability as compared to shoulders in healthy volunteers and the kinematic characteristics are not restored to normal after surgical stabilization and rehabilitation.
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Background: Within equestrian sports, training is commonly based on historic and anecdotal good practice. Telemetric surface electromyography (sEMG) systems facilitate assessment of muscle recruitment including mean motor unit action... more
Background: Within equestrian sports, training is commonly based on historic and anecdotal good practice. Telemetric surface electromyography (sEMG) systems facilitate assessment of muscle recruitment including mean motor unit action potential (mM-UAP). Mean EMG frequency (mEMGF) provides an objective measure of fitness levels while a shift in the median EMG frequency (MeEMGF) over time can illustrate fatigue. Aim: This study aimed to investigate if sEMG could be used in the field to evaluate muscle activity of the Gluteus superficialis in a cohort of National Hunt racehorses during one canter interval training session. Method: Sensors were secured bilaterally to horses' Gluteal superficialis prior to exercise and data were collected over a standardised 10 metre interval. A repeated measure ANOVA assessed differences in mEMGF between runs across the cohort and between runs for individual horses. A Pearson's correlation identified if mEMGF was related to perceived fitness level as assessed by the trainer. ...
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The purpose of this study was to compare lumbopelvic hip ranges of motion during the Trendelenburg, Single Leg Squat, and Corkscrew Tests to walking and to describe the 3-dimensional lumbopelvic hip motion during the tests. This may help... more
The purpose of this study was to compare lumbopelvic hip ranges of motion during the Trendelenburg, Single Leg Squat, and Corkscrew Tests to walking and to describe the 3-dimensional lumbopelvic hip motion during the tests. This may help clinicians to select appropriate tests when examining gait. An optoelectronic movement analysis tracking system was used to assess the lumbopelvic hip region of 14 healthy participants while performing Trendelenburg, Single Leg Squat, and Corkscrew Tests and walking. The lumbopelvic hip 3-dimensional ranges of movement for the clinical tests were compared with walking using a repeated-measures analysis of variance with pairwise comparisons. No significant differences were found between the pelvic obliquity during the Trendelenburg Test and walking (Trendelenburg Test: L, 11.3° ± 4.8°, R, 10.8° ± 5.0° vs walk: L, 8.3° ± 4.8°, R 8.3° ± 5.1°, L, P = .143, R, P = .068). Significant differences were found between the hip sagittal plane range of movement ...
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Research Interests: Mechanical Engineering, Psychology, Attention, Motor Control, Skills Development, and 14 moreMedicine, Intention, Sport, Humans, Mental Imagery, Male, Sports Coaching and Training, Golf, Athletes, Longitudinal Studies, Task Performance and Analysis, Environment, Motor Skills, and Biomechanical Phenomena
I read the recent article by Cimolin and Galli on ‘‘Summary measures for clinical gait analysis: A literature review’’ [1] with great interest. More and more gait laboratories use such summary measures to maximise the use of gait data but... more
I read the recent article by Cimolin and Galli on ‘‘Summary measures for clinical gait analysis: A literature review’’ [1] with great interest. More and more gait laboratories use such summary measures to maximise the use of gait data but the complexity of the underlying mathematics often intimidates the end users. A comparative evaluation of simplified measures of gait deviation facilitates better comprehension of the various methods and therefore helps gait analysts make an informed choice of method. While the authors covered most gait summary measures in detail, it is unfortunate that the Movement Deviation Profile (MDP) was omitted. Its precursors were covered in the ‘‘Other summary measures’’ section but for the benefit of readers it is important to include the main study by Barton et al. [2] for completeness. The MDP meets many of the desirable criteria of a future method Cimolin and Galli [1] described in their conclusions. While it was created and tested with the same nine joint angle variables as the Gait Deviation Index (GDI), the MDP can use any waveform type data (angles, moments, EMG, etc.) even in combination. For example, the MDP was used to quantify the deviation of patients with shoulder instability using their 13-channel EMG [3]. An important advantage of the MDP is its immunity to an inaccurately defined gait cycle [2] which becomes a potential problem when direct measurement of foot contact is not available, for example when using only one force platform or inertia sensors in unrestricted gait analysis without foot contact sensors. I would be very interested to hear the authors’ and anyone else’s views on the above.
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It has been estimated that up to 70% of runners will sustain an overuse injury during any one year period (Caspersen et al, 1984). Therefore much emphasis has been placed upon achieving optimum shock absorption through specially designed... more
It has been estimated that up to 70% of runners will sustain an overuse injury during any one year period (Caspersen et al, 1984). Therefore much emphasis has been placed upon achieving optimum shock absorption through specially designed running shoes. The introduction of springs in footwear is not a new idea; however the recent development of micro-spring technology now allows a higher density spring configuration. The effectiveness of high density micro-springs in reducing impact forces and vertical loading rates during running was initially explored. Two versions of a branded running shoe were tested; one pair remained unmodified and the other was modified with 30 high density micro-springs. 11 healthy recreational heel striker runners completed 5 running trials of approximately 20 m under each test condition at a self-selected speed. A paired t-test was conducted to determine the changes in biomechanics between the two conditions. No significant differences were seen in the peak...
The fixation of comminuted femoral fractures with intramedullary nails is commonplace but there remains little work on the mechanical ability of the different diameters of nail available to resist bending. What previous work there is has... more
The fixation of comminuted femoral fractures with intramedullary nails is commonplace but there remains little work on the mechanical ability of the different diameters of nail available to resist bending. What previous work there is has produced conflicting conclusions. The bending stiffness against the intramedullary nail diameter and the extent of the comminuted fracture is clinically important due to the impact on fracture healing and implant failure. Intramedullary nails of differing diameters (10 mm, 11 mm and 13 mm) were loaded axially in fourth generation composite femurs with increasing mid shaft bone defects, namely 3cm, 5cm, 8cm and 10cm bones. The loading versus the displacement was recorded for each nail. A one-way ANOVA analysis demonstrated a significant difference between intramedullary nail diameters and the bending stiffness, with p values of less than 0.012; 3cm mean 12.26 (CI 9.06-15.46) mm, p=0.012; 5 cm mean 10.63 (CI 8.35-12.92) mm, p=<0.001; 8 cm mean 11.0...
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ABSTRACT Background Low back pain (LBP) is widespread in all populations and is a worldwide health problem, which poses substantial challenges for clinical management. Individuals with LBP may reduce their symptoms by implementing... more
ABSTRACT Background Low back pain (LBP) is widespread in all populations and is a worldwide health problem, which poses substantial challenges for clinical management. Individuals with LBP may reduce their symptoms by implementing self-managed at-home interventions. The theoretical design of the LumbaCurve™ promotes the principles of a passive gravity-assisted traction (PGAT) stretch of the lumbar and sacral region in order to reduce LBP. This study aimed to assess the clinical effectiveness of the LumbaCurve™ in the management of LBP when compared to a control group of standardised care. Methods Following a screening form using Red Flags and STarT Back tools, 60 individuals with LBP were recruited to the 4-week intervention. Eligible participants completed a pre-intervention questionnaire and were randomly allocated to either ‘standardised care’ or ‘standardised care PLUS LumbaCurve™’ group. Intervention material was trialled for 4 weeks consecutively, followed by a post-intervention questionnaire. Pre and post assessments applied the Roland Morris Disability Questionnaire (RMDQ), Patient Reported Outcome Measures (PROMS). Results Interim results suggested RMDQ values demonstrate a trend toward the classification of ‘definite improvement’ following standardised care plus LumbaCurve™ intervention. When comparing pre/post outcomes alone for the intervention of standardised care plus LumbaCurve™, significant reductions in RMDQ results occurred (p=.014). PROMS results reported a significant decrease (p=.015) in average pain rating when comparing interventions. Conclusion Initial findings report that through a four week intervention programme, significant improvements in patient reported back pain levels are demonstrated following standardised care plus LumbaCurve™ intervention. Conflicts of interest: No conflicts of interest Sources of funding: Spark Ventures UK
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In this cross-over study, we evaluated two types of knee brace commonly used in the conservative treatment of osteoarthritis of the medial compartment. Twelve patients confirmed radiologically as having unilateral osteoarthritis of the... more
In this cross-over study, we evaluated two types of knee brace commonly used in the conservative treatment of osteoarthritis of the medial compartment. Twelve patients confirmed radiologically as having unilateral osteoarthritis of the medial compartment (Larsen grade 2 to grade 4) were studied. Treatment with a simple hinged brace was compared with that using a valgus corrective brace. Knee kinematics, ground reaction forces, pain and function were assessed during walking and the Hospital for Special Surgery scores were also determined. Significant improvements in pain, function, and loading and propulsive forces were seen with the valgus brace. Treatment with a simple brace showed only significant improvements in loading forces. Our findings suggest that although both braces improved confidence and function during gait, the valgus brace showed greater benefit.
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ABSTRACT Cryotherapy; the application of cold to achieve therapeutic objective, is the most commonly used technique in the acute management of musculoskeletal injuries. Despite superficial application, the deeper tissues are ordinarily... more
ABSTRACT Cryotherapy; the application of cold to achieve therapeutic objective, is the most commonly used technique in the acute management of musculoskeletal injuries. Despite superficial application, the deeper tissues are ordinarily the target tissues of cryotherapy application. The relationship between skin surface temperature (Tsk) and intra muscular temperature (Tim) are currently poorly understood. Following clinically relevant 15 minute application of crushed ice (CI) to the Rectus Femoris muscle, Tsk data were collected using Non-contact thermal imaging (TI), simultaneously with Tim by thermistor probe. The relationship between the 2 parameter’s was investigated. A strong negative quadratic relationship was established, suggesting that intramuscular cooling occurred as Tsk increased. The time period following removal of cold modality should therefore be considered an important part of cryotherapy treatment sessions to achieve full therapeutic benefit.
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Chapter 1 Basic Sciences Anatomy Physiology Motor control Biomechanics Chapter 2 Normal Gait Walking and gait History Terminology used in gait analysis Outline of the gait cycle The gait cycle in detail Ground reaction forces Support... more
Chapter 1 Basic Sciences Anatomy Physiology Motor control Biomechanics Chapter 2 Normal Gait Walking and gait History Terminology used in gait analysis Outline of the gait cycle The gait cycle in detail Ground reaction forces Support moment Energy consumption Optimization of energy usage Starting and stopping Other varieties of gait Changes in Gait with Age Chapter 3 Pathological and other abnormal gaits Specific gait abnormalities Walking aids Treadmill gait Chapter 4 Methods of gait analysis Visual gait analysis Temporal and Spatial Parameters during Gait Measurement of Temporal and Spatial Parameters during Gait Camera Based Motion Analysis Active marker systems Accelerometers Gyroscopes, Magnetic Fields and Motion Capture Suits Measuring Force and Pressure Pressure beneath the foot Measuring Muscle Activity Measuring Energy Expenditure Combined kinetic/kinematic systems Chapter 5 Applications of gait analysis Clinical gait assessment Conditions benefiting from gait assessment Future developments Conclusion Chapter 6 Gait assessment of neurological diseases Gait assessment in Cerebral palsy Gait assessment in Stroke Gait assessment in Parkinson's disease Gait assessment in Muscular dystrophy Chapter 7 Gait analysis in musculoskeletal conditions and prosthetics and orthotics Total hip replacement Gait analysis in knee osteoarthritis High tibial knee osteotomy Prosthetics and orthotics Amputee gait Orthotic gait Index
Research Interests: Engineering and Gait
Research Interests: History and Biomechanics
Objective This study investigated the effect of patellar bracing and taping on the three-dimensional mechanics of the knee of patellofemoral pain patients during a step descent task. Method Thirteen patients diagnosed with patellofemoral... more
Objective This study investigated the effect of patellar bracing and taping on the three-dimensional mechanics of the knee of patellofemoral pain patients during a step descent task. Method Thirteen patients diagnosed with patellofemoral pain syndrome performed a slow step descent. This was conducted under three randomized conditions:(a) no intervention,(b) neutral patella taping,(c) patellofemoral bracing. A 20 cm step was constructed to accommodate an AMTI force platform. Kinematic data were collected using ...
Research Interests: Mechanical Engineering, Biomechanics, Treatment Outcome, Knee Biomechanics, Medicine, and 15 moreGait, Humans, Movement, Female, Braces, Male, Three Dimensional Imaging, Patellofemoral Pain Syndrome, Clinical Sciences, Gait and Posture, Adult, Analysis of Variance, Clinical Study, Healthy Subjects, and Biomechanical Phenomena
Background: Whole body cryotherapy (WBC) is the therapeutic application of extreme cold air for a short duration. Minimal evidence is available for determining optimal exposure time.
Contrast therapy is the alternation of thermotherapy and cryotherapy. Commonly used modalities of contrast therapy include contrast water therapy (CWT) and cold/hot packs. Despite a lack of research, it is widely used in clinical and... more
Contrast therapy is the alternation of thermotherapy and cryotherapy. Commonly used modalities of contrast therapy include contrast water therapy (CWT) and cold/hot packs. Despite a lack of research, it is widely used in clinical and sporting settings, particularly to aid recovery. The scoping review aims to provide a comprehensive overview of research surrounding the use of contrast therapy for soft tissue injury management and recovery. Twenty-nine full text papers were included, following a search of the databases listed: PubMed, Cochrane, SPORTDiscus, EBSCO, CINHAL and MEDLINE (via OVID). The majority of research on contrast therapy focuses on recovery, using contrast water therapy. Despite a consensus for contrast therapy temperatures of 10-15 °C (cold) and 38-40 °C (hot), significant variation amongst recovery protocols still exists, with temperatures ranging from 8-15 °C and 35.5-45 °C and duration ranging from 6 to 31 min. Generally, beneficial effects are reported to subjec...
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Research Interests: Psychology and Medicine
Journal of Biomechanics, Volume 41, Issue null, Pages S320, July 2008, Authors:Dominic Thewlis; Jim Richards; Sarah Jane Hobbs.
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BACKGROUND: The number of rotator cuff repairs performed worldwide is increasing every year. However, there are still controversies regarding when rehabilitation after surgery should start. OBJECTIVES: To assess and to compare clinical... more
BACKGROUND: The number of rotator cuff repairs performed worldwide is increasing every year. However, there are still controversies regarding when rehabilitation after surgery should start. OBJECTIVES: To assess and to compare clinical and biomechanical outcomes of patients who were randomised and allocated to early or conservative rehabilitation after rotator cuff repairs. METHODS: Twenty patients were randomised to two treatment groups. The biomechanical assessments were performed before surgery and at three and six months, consisting of 3D kinematics and muscle activity from 5 muscles (upper trapezius, anterior deltoid, middle deltoid, posterior deltoid and biceps brachii) from six movement tasks. In addition, the Oxford Shoulder Score and EQ-5D-5L were also recorded. At 12 months an ultrasound scan was performed to check the repair integrity. RESULTS: Overall, both groups had similar results for function and health-related quality of life. However, at six months patients in the ...
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OBJECTIVE To evaluate the effect of different taping techniques on back muscle fatigue in people with low back pain. METHODS Sixty women with chronic non-specific low back pain were randomly assigned to four groups of 15 participants... more
OBJECTIVE To evaluate the effect of different taping techniques on back muscle fatigue in people with low back pain. METHODS Sixty women with chronic non-specific low back pain were randomly assigned to four groups of 15 participants each: control (CG), Kinesio Taping (KT) with tension (KTT), KT no tension (KTNT) and Micropore® (MP), which were applied over the erector spinae muscles. The median frequency (MF) fatigue slopes of the longissimus muscle and sustained contraction time during a trunk fatigue test (Ito test), and pain using the numerical pain rating scale (NPRS) were collected at three time points: pre-treatment, three and ten days after intervention at a university laboratory. RESULTS Significant differences were seen in the MF slopes between groups (p= 0.01, η2= 0.20), with the KTT showing a mean difference (MD = 0.31, p= 0.04) and KTNT (MD = 0.28, p= 0.04) compared with CG. Significant reductions in NPRS were seen between time points (p< 0.001, η2= 0.28), with a red...
Introduction There is limited evidence to suggest that a ‘one-size fits all’ mattress provides the appropriate support in individuals with diverse body shapes, a greater understanding of how different mattresses affect the human body is... more
Introduction There is limited evidence to suggest that a ‘one-size fits all’ mattress provides the appropriate support in individuals with diverse body shapes, a greater understanding of how different mattresses affect the human body is required. By having a more objective approach to choosing a mattress, individuals may improve quality of sleep. Materials A ten-camera infrared movement analysis system recorded Upper-Mid Thoracic, Mid-Lower Thoracic, Lower Thoracic–Upper Lumbar, Upper-Lower Lumbar and Lower Lumbar–Pelvic areas of the spine in side lying. Deviations away from a neutral position were assessed under different conditions. Three aesthetically identical mattresses were tested, internally each mattress contained a different firmness of spring unit (soft, medium, firm). In addition, height, weight, shoulder width and hip circumference measurements were taken to determine differences in body types. Results Spinal alignment was assessed on sixty healthy participants and no significant differences were seen between the different mattress configurations. However further analysis showed significant differences in spinal alignment between the different mattress conditions within different body shape subgroups. Subgroups were defined using body weight, height, BMI, shoulder width and hip circumference. Those with a higher body weight had a more neutral spinal alignment when on a firmer mattress, whereas those with a lower body weight were better suited to a softer mattress. Shorter people were better aligned on a softer mattress, and a medium mattress kept the spine in a more neutral position amongst taller individuals. Discussion This study suggests that a ‘one-size fits all’ approach to mattresses may not be appropriate and contrasting body types need different levels of support to improve overall spinal alignment. The use of simple anthropometric measurements could make the selection of the most appropriate mattress easier for the public.
Objective: To date no study exists to determine whether knee kinematics in the coronal and transverse planes during step descent are different between healthy subjects and patients with patellofemoral pain (PFP) despite patients often... more
Objective: To date no study exists to determine whether knee kinematics in the coronal and transverse planes during step descent are different between healthy subjects and patients with patellofemoral pain (PFP) despite patients often reporting pain and instability during this task. This study investigated the differences in knee kinematics between healthy subjects and patients with PFP during a step descent task. Methods: Thirty healthy subjects and 29 patients diagnosed with PFP performed a slow step descent from a 20cm step. Kinematic data were collected using a ten camera infra-red motion analysis system. Reflective markers were placed on the foot, shank and thigh using the Calibrated Anatomical Systems Technique (CAST). Results: The coronal plane knee range of motion was 2.7 degrees, 41% greater, in the PFP patients compared to healthy subjects (p=0.006), with 4 degrees greater internal rotation although this was not significant (p=0.087). A trend towards significance was also ...
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The current investigation aimed to investigate the influence of semi-custom orthoses on multi-segment foot kinematics and plantar fascia strain in recreational runners. Fifteen male runners ran at 4.0 m.s-1 with and without orthotics.... more
The current investigation aimed to investigate the influence of semi-custom orthoses on multi-segment foot kinematics and plantar fascia strain in recreational runners. Fifteen male runners ran at 4.0 m.s-1 with and without orthotics. Multi-segment foot kinematics and plantar fascia strain were obtained using a 3D motion capture system. Differences between orthotic and no-orthotic conditions were examined using paired samples t-tests. The results showed firstly that orthoses did not significantly (p>0.05) improve plantar fascia strain. Relative transverse plane ROM rearfoot-tibia articulation was however significantly (p<0.05) reduced when wearing orthotics. This indicates that there may be some benefit from orthotic intervention. However, the mean reduction in angulation between orthotic and no-orthotic conditions was very small and thus further prospective investigations regarding the clinical efficacy of semi-custom orthoses are required.
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Summary Motion analysis techniques have been used in veterinary research for the measurement of normal and pathological gait in horses since the late 19 th century. Many of the early studies involved capturing moving images in 2... more
Summary Motion analysis techniques have been used in veterinary research for the measurement of normal and pathological gait in horses since the late 19 th century. Many of the early studies involved capturing moving images in 2 dimensions, and these techniques are still commonly used in field based research and clinical practice. In recent times, more advanced methods employed in human medicine have been adopted to measure forces and motion in 3 dimensions along with other aspects of locomotion in horses. This paper describes kinematic and kinetic techniques that are currently used in equine veterinary research and reviews normative and clinical data that have been obtained using these methods. Schlusselworter: Lokomotion des Pferdes, Kinematik, Kinetik, Krafte, Pferd. Zusammenfassung Bewegungsanalyse und deren Nutzen in Pferdepraxis und -forschung Die Methoden der Bewegungsanalyse werden seit dem spaten neunzehnten Jahrhundert in der veterinarmedizinischen Forschung fur die Messun...
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INTRODUCTION Our understating of the in vivo biomechanics of the knee in the transverse plane are limited, particularly during functional tasks such as gait. Techniques such as dynamic fluoroscopy have been used to describe some... more
INTRODUCTION Our understating of the in vivo biomechanics of the knee in the transverse plane are limited, particularly during functional tasks such as gait. Techniques such as dynamic fluoroscopy have been used to describe some characteristics of transverse plane rotation following total knee arthroplasty (TKA) [1], however the there remains limited information on this topic. Cadaveric and patient based studies of ACL deficient knees have suggested that the transverse plane biomechanics of the tibiofemoral joint are associated with two key factors; 1) femoral condyle geometry and 2) the ‘winding up’ of the anterior cruciate ligament [2,3]. There are many groups who still debate the role of the ACL in control of transverse plane rotation. Currently only a single study has described the transverse plane biomechanics of the tibiofemoral joint following total knee arthroplasty, this identified that 60% of PCL retaining TKA procedures resulted in a ‘reverse screw home’ [1]. This is of p...
Objectives To investigate the effects of cryotherapy on knee skin surface sensitivity and temperature using monofilaments and thermal imaging. Methods Following a 20-minute cryotherapy exposure (crushed ice), knee skin surface sensitivity... more
Objectives To investigate the effects of cryotherapy on knee skin surface sensitivity and temperature using monofilaments and thermal imaging. Methods Following a 20-minute cryotherapy exposure (crushed ice), knee skin surface sensitivity and temperature was mapped in 19 healthy participants using infrared camera and tactile sensory evaluation. The data were collected before and up to 20 minutes after cryotherapy exposure. Results Comparing to baseline, in women, significant decrease in skin surface sensitivity in the upper medial section of photographic knee pain map was observed up to 20-minutes after cryotherapy exposure. In men, the respective difference was observed only immediately after the explosion. Conclusions Crushed ice application may reduce skin surface sensitivity around a knee medial aspect and result in impeding return to play due to affected joint position sense following cryotherapy.
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Background Back Pain is a worldwide problem that often interferes with work, daily activities and sleep. The stress and disability experienced at night by individuals with Low Back Pain (LBP) could be reduced by targeted treatments... more
Background Back Pain is a worldwide problem that often interferes with work, daily activities and sleep. The stress and disability experienced at night by individuals with Low Back Pain (LBP) could be reduced by targeted treatments designed specifically for this period. This study aimed to assess the clinical effectiveness of a spinal alignment cushion in the management of LBP when compared to a control group of standardised care. Methods & Results 71 individuals (30 males, 41 females) with LBP were recruited to the 4-week intervention after screening using the Red Flags and STarT Back tools. Participants were randomly assigned to either the control (standardised care) or intervention group (standardised care plus spinal alignment cushion). Pre and post assessments were taken using the Roland Morris Disability Questionnaire (RMDQ) (0–24), the Core Outcomes Measure Index (COMI) (0–10), and a Pain and Comfort during Sleep VAS Assessment. Each post assessment was analysed using ANCOVA ...
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Background Foam roller and vibration techniques are currently used to assist in recovery after fatigue. The main purpose of this study was to determine the effects of the use of a foam roller with and without vibration on dynamic balance,... more
Background Foam roller and vibration techniques are currently used to assist in recovery after fatigue. The main purpose of this study was to determine the effects of the use of a foam roller with and without vibration on dynamic balance, ankle dorsiflexion, hamstring and lumbar spine flexibility and perceived knee and ankle stability after an induced fatigue protocol. Methods A total of 24 healthy recreationally active participants (17 males and seven females) were recruited to a randomized cross over trial consisting of; no treatment (NT), foam roller treatment (FR) and vibration foam roller treatment (VFR). The assessments included; the Sit & Reach test, Y balance test and post-treatment perceived knee and ankle stability. Measurements were taken after a standardized warm up (baseline) and repeated following an exercise-induced muscle fatigue protocol consisting of repeated lunges until volitional fatigue. The three treatment conditions were assessed on three separate days in a r...
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Introduction Nerve conduction velocity is a common assessment of peripheral demyelinating conditions used to locate the lesions and assess severity. Considering measurements involve low frequency or single stimuli, changes due to... more
Introduction Nerve conduction velocity is a common assessment of peripheral demyelinating conditions used to locate the lesions and assess severity. Considering measurements involve low frequency or single stimuli, changes due to continuous activity would remain out of their scope. Accordingly, slowing of conduction velocity is not thought to result in weakness, but may account for loss of deep tendon reflexes leading to neural transmission failure. It has previously been shown that a decrease in temperature of 1 °C can cause a 2.4 m/s reduction in nerve conduction velocity, however little is known on the neuromuscular effects, specifically the behavior of individual Motor Units (MUs). This study explored the relationship between the MU behavior and motor-sensory nerve conduction velocities following the application of a standard therapeutic cooling technique at the elbow. Methods Eleven healthy individuals, aged 20–49, were tested using two non-invasive Nerve Conduction Studies (NCS); compound muscle action potentials of the First Dorsal Interosseous (FDI) muscle and sensory nerve action potentials, and a non-invasive investigation of the firing of MU using surface EMG decomposition (dEMG, Delsys Inc.) of FDI. Testing was performed prior to cooling, immediately after cooling and after 15 min of rewarming. Cooling was performed for 15 min using crushed ice and water to a skin temperature between 10 and 15 °C. Results Repeated measures ANOVAs with post hoc pairwise comparisons showed significant reductions in the MU firing between pre-cooling and post-cooling and between pre-cooling and re-warming (p = 0.013, p = 0.045) respectively. Similar patterns were seen in both the Motor and Sensory NCS with significant differences between pre-cooling and post-cooling, pre-cooling and re-warming, and between post-cooling and 15 min of re-warming in the Sensory assessment, although the latter is of questionable clinical importance (p Conclusion There appears to be a clear relationship between the motor and sensory NCS and the MU firing rate. In contrast to high stimulation frequencies used clinically or activity dependent conduction block, this study shows conduction dependent MUs rate block (CDRB) verifying motor deficit whilst only nerve conduction slowing is evident, and revealing the first recruited MUs are affected more than the later recruited ones. This highlights the potential for dEMG as a novel neurological assessment, which could be used when conduction velocity is difficult to measure and motor control is affected, especially early in the clinical state before axonal degeneration is evident, which is still challenging for routine neurophysiological methods.
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The purpose of this study was to investigate the characteristics of biomechanical and clinical measurements in relation to the knee adduction moment when wearing a standard shoe and a shoe design for individuals with knee osteoarthritis... more
The purpose of this study was to investigate the characteristics of biomechanical and clinical measurements in relation to the knee adduction moment when wearing a standard shoe and a shoe design for individuals with knee osteoarthritis (Flex-OA). Kinematic and kinetic data were collected from thirty-two healthy individuals (64 knees) using a ten camera motion analysis system and four force plates. Subjects performed 5 walking trials under the two conditions and the magnitude of individuals' biomechanical responses where explored in relation to the clinical assessment of the Foot Posture Index, hip rotation range, strength of hip rotators, and active ankle-foot motion, all of which have been described as possible compensation mechanisms in knee osteoarthritis. Significant reductions in the first peak of the knee adduction moment (KAM) during stance phase (9.3%) were recorded (p<0.0001). However, despite this difference, 22 of 64 knees showed either no change or an increased K...
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ABSTRACT Background: Proprioception may be defined as a specialised sensory modality that gives information about joint position sense (JPS), kinaesthesia and vibratory perception. Vibratory Perception Threshold (VPT) testing has been... more
ABSTRACT Background: Proprioception may be defined as a specialised sensory modality that gives information about joint position sense (JPS), kinaesthesia and vibratory perception. Vibratory Perception Threshold (VPT) testing has been suggested as an alternative means for assessing proprioception at the knee, as it is believed to travel through the same type of large afferent nerve fibres as JPS. Methods: This study examines the strength of relationship between vibration sense and JPS at the knee in healthy participants and determines the minimum number of trials required for each method to attain constant stable data. Stability was determined by 3 consecutive cumulative standard deviations varying less than 5%. Twenty healthy adults (11 females, 9 males) were tested for VPT at five lower limb positions and JPS at two angles of knee flexion (20° and 60°) using Active Angle Reproduction (AAR). Results: Results showed no significant correlations between VPT and JPS, suggesting the two modalities measure different facets of proprioception. VPT (at all 5 sites) and AAR 20° required 4 repetitions to attain data stability, whereas AAR 60° required five repetitions. There were significant differences (p&lt;0.005) between the five sites tested for VPT with increasing thresholds at more proximal sites. No significant differences were seen between the two angles tested for JPS. Conclusions: The two testing modalities are not interchangeable when testing proprioception, requiring at least 4 repetitions to attain consistent stable data. These findings have implications for clinicians and researchers, encouraging the use of broader proprioceptive assessments and increased repetitions.
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Braces are commonly used for prevention and treatment of ankle and knee injuries by individuals who take part in sporting activities which involve challenges to the stability of joints. However, the use of ankle and knee bracing is less... more
Braces are commonly used for prevention and treatment of ankle and knee injuries by individuals who take part in sporting activities which involve challenges to the stability of joints. However, the use of ankle and knee bracing is less common in the conservative management of joint pain and pathology which is not sporting related. In all cases, the braces are attempting to provide improved stability of the joints in the coronal and transverse plane, but there has been much debate on whether bracing offers a functional or proprioceptive effect. Much of the biomechanical testing to date has been conducted using very simple biomechanical models, which allow do not allow accurate measures of the movement and moments about the foot, ankle and knee joints in the coronal and transverse planes. From this it is safe to say that the effect of ankle and knee bracing on the coronal and transverse plane mechanics of the lower limb have not received any adequate attention in the research literature, although clinically these are the very things that such devices often claim to support and control. The importance of coronal and torsional movement and moments of the foot, ankle and knee joints has previously been identified. However, little or no work has been published to see how the torsional and coronal mechanics of the ankle and knee joints are changed during functional tasks using devices designed to control and give stability to these joints. This workshop will consider the action of several methods of orthotic management of the ankle and knee joints on a variety of conditions by considering the research evidence. In each case, advanced methods of analysis have been used to determine the biomechanical changes and how these can be related to the clinical benefits. This will highlight not just the effects about the foot and ankle but also the effects of treating the foot and ankle on the knee, hip and pelvis. The data on a variety of methods of bracing for patellofemoral pain and ankle stability will be considered, with particular attention on the nature of the functional and proprioceptive effects of each method.
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The aim was to investigate the effects of three anatomical frames using palpable anatomical landmarks of the knee on the net knee joint moments. The femoral epicondyles, femoral condyles, and tibial ridges were used to define the... more
The aim was to investigate the effects of three anatomical frames using palpable anatomical landmarks of the knee on the net knee joint moments. The femoral epicondyles, femoral condyles, and tibial ridges were used to define the different anatomical frames and the segment end points of the distal femur and proximal tibia, which represent the origin of the tibial coordinate system. Gait data were then collected using the calibrated anatomical system technique (CAST), and the external net knee joint moments in the sagittal, coronal, ...
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BACKGROUND: Most previous work on the use of knee bracing and taping has focussed on sagittal plane movement. However, most bracing and taping techniques aim to modify patellar movement in the coronal and transverse planes. OBJECTIVE:... more
BACKGROUND: Most previous work on the use of knee bracing and taping has focussed on sagittal plane movement. However, most bracing and taping techniques aim to modify patellar movement in the coronal and transverse planes. OBJECTIVE: This study investigated the effect of patellar bracing and taping on the three-dimensional mechanics of the knee during a controlled eccentric step down task. METHOD: Twelve healthy subjects were asked to conduct a slow step down exercise. The step down was conducted under ...
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Background: This study aimed to determine the effects of a standard therapeutic cooling protocol using crushed ice on the elbow to explore if changes in the motor unit (MU) firing rates in the first dorsal interosseous (FDI) muscle are... more
Background: This study aimed to determine the effects of a standard therapeutic cooling protocol using crushed ice on the elbow to explore if changes in the motor unit (MU) firing rates in the first dorsal interosseous (FDI) muscle are comparable to known changes in sensory and motor nerve conduction velocity (NCV) due to a regional temperature drop around a peripheral nerve. Methods: Twelve healthy individuals were assessed before cooling, immediately after cooling, and 15 min of rewarming. Assessments included two standard non-invasive nerve conduction velocity tests and a non-invasive investigation of the MU firing rates using surface electromyography decomposition (dEMG). Results: Repeated ANOVAs showed significant differences in the MU firing rates and NCV between time points (p = 0.01 and p < 0.001). All measures showed significant differences between pre and post cooling and between pre-cooling and 15 min of passive re-warming, however, no changes were seen between post co...
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BackgroundRocker profiles are the most commonly prescribed external therapeutic shoe modification. However, the prescription criteria for rocker profiles have historically been based on theoretical considerations with minimal scientific... more
BackgroundRocker profiles are the most commonly prescribed external therapeutic shoe modification. However, the prescription criteria for rocker profiles have historically been based on theoretical considerations with minimal scientific study and validation.
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Current restrictions on clinical visits as a consequence of the COVID-19 pandemic has increased the need for home-based exercise regimes to facilitate useful, long term patterns of behaviour in individuals with Parkinson’s disease (PD).... more
Current restrictions on clinical visits as a consequence of the COVID-19 pandemic has increased the need for home-based exercise regimes to facilitate useful, long term patterns of behaviour in individuals with Parkinson’s disease (PD). This study aimed to evaluate the effectiveness of a 10-week home-based exercise program designed to target improvements in axial rigidity and gait. The Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), motor scale and rigidity items, Functional axial rotation–physical (FAR-p), functional reach test (FRT), and time up and go (TUG) test were recorded. In addition, the 10-metre walk test, the fall efficacy scale international (FES-I) and the global rating of change score (GROC) were also recorded. Eighteen individuals were divided randomly into two groups: a home-based exercise group (n = 10) and a traditional physiotherapy control group (n = 8). Participants in the 10-week home-based exercise group showed significant impr...
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Difficulty in turning is prevalent in older adults and results in postural instability and risk of falling. Despite this, the mechanisms of turning problems have yet to be fully determined, and it is unclear if different speeds directly... more
Difficulty in turning is prevalent in older adults and results in postural instability and risk of falling. Despite this, the mechanisms of turning problems have yet to be fully determined, and it is unclear if different speeds directly result in altered posture and turning characteristics. The aim of this study was to identify the effects of turning speeds on whole-body coordination and to explore if these can be used to help inform fall prevention programs in older adults. Forty-two participants (21 healthy older adults and 21 younger adults) completed standing turns on level ground. Inertial Measurement Units (XSENS) were used to measure turning kinematics and stepping characteristics. Participants were randomly tasked to turn 180° at one of three speeds; fast, moderate, or slow to the left and right. Two factors mixed model analysis of variance (MM ANOVA) with post hoc pairwise comparisons were performed to assess the two groups and three turning speeds. Significant interaction ...
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Enabling successful and pressure resistant change to an elite performer’s technique is an important and common role for coaches. Despite this, literature to inform effective practice in skill refinement is surprisingly lacking. Therefore,... more
Enabling successful and pressure resistant change to an elite performer’s technique is an important and common role for coaches. Despite this, literature to inform effective practice in skill refinement is surprisingly lacking. Therefore, this presentation aims to provide a five stage holistic guide for coaches and applied sport science practitioners to facilitate these changes, the Five-A Model. Central to this process is its interdisciplinary nature, combining theory from motor control and sport psychology. In addition, data will be presented which highlights the current need for guidance in elite-level golf coaching and, as a crucial element to informing a coach’s decision-making, intra-individual movement variability data will be presented to show how this process can be monitored and evaluated by the coach.
Selection and training practices for jumping horses have not yet been validated using objective performance analyses. This study aimed to quantify the differences and relationships between movement and muscle activation strategies in... more
Selection and training practices for jumping horses have not yet been validated using objective performance analyses. This study aimed to quantify the differences and relationships between movement and muscle activation strategies in horses with varying jump technique to identify objective jumping performance indicators. Surface electromyography (sEMG) and three-dimensional kinematic data were collected from horses executing a submaximal jump. Kinematic variables were calculated based on equestrian-derived performance indicators relating to impulsion, engagement and joint articulation. Horses were grouped using an objective performance indicator—center of mass (CM) elevation during jump suspension (ZCM). Between-group differences in kinematic variables and muscle activation timings, calculated from sEMG data, were analyzed using one-way ANOVA. Statistical parametric mapping (SPM) evaluated between-group differences in time and amplitude-normalized sEMG waveforms. Relationships betwe...
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Selection and training practices for jumping horses have not yet been validated using objective performance analyses. This study aimed to quantify the differences and relationships between movement and muscle activation strategies in... more
Selection and training practices for jumping horses have not yet been validated using objective performance analyses. This study aimed to quantify the differences and relationships between movement and muscle activation strategies in horses with varying jump technique to identify objective jumping performance indicators. Surface electromyography (sEMG) and three-dimensional kinematic data were collected from horses executing a submaximal jump. Kinematic variables were calculated based on equestrian-derived performance indicators relating to impulsion, engagement and joint articulation. Horses were grouped using an objective performance indicator—center of mass (CM) elevation during jump suspension (ZCM). Between-group differences in kinematic variables and muscle activation timings, calculated from sEMG data, were analyzed using one-way ANOVA. Statistical parametric mapping (SPM) evaluated between-group differences in time and amplitude-normalized sEMG waveforms. Relationships betwe...
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Camera-based 3D motion analysis systems are considered to be the gold standard for movement analysis. However, using such equipment in a clinical setting is prohibitive due to the expense and time-consuming nature of data collection and... more
Camera-based 3D motion analysis systems are considered to be the gold standard for movement analysis. However, using such equipment in a clinical setting is prohibitive due to the expense and time-consuming nature of data collection and analysis. Therefore, Inertial Measurement Units (IMUs) have been suggested as an alternative to measure movement in clinical settings. One area which is both important and challenging is the assessment of turning kinematics in individuals with movement disorders. This study aimed to validate the use of IMUs in the measurement of turning kinematics in healthy adults compared to a camera-based 3D motion analysis system. Data were collected from twelve participants using a Vicon motion analysis system which were compared with data from four IMUs placed on the forehead, middle thorax, and feet in order to determine accuracy and reliability. The results demonstrated that the IMU sensors produced reliable kinematic measures and showed excellent reliability...
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Explore the effects of a 4-week intervention using semi-custom insoles in recreational runners with patellofemoral pain. Mixed methods. Seventeen (10 males and 7 females) recreational runners. Laboratory. Participants were separated into... more
Explore the effects of a 4-week intervention using semi-custom insoles in recreational runners with patellofemoral pain. Mixed methods. Seventeen (10 males and 7 females) recreational runners. Laboratory. Participants were separated into specific subgroups, then provided with a pair of semi-custom insoles, for a period of 4-weeks. Lower extremity kinetics/kinematics during running at 4.0 m/s were obtained. In addition, knee pain was examined using the Knee injury and Osteoarthritis Outcome Score-Patellofemoral scale (KOOS-PF). Data were collected before and after wearing the insoles for 4-weeks. Significant improvements were shown for KOOS-PF in both subgroups (strong: (pre) = 63.84 & (post) = 71.49 and weak and tight: (pre) = 53.03 & (post) = 72.73), although only improvements in the weak and tight group exceeded the minimum clinically important difference (MCID). In addition, significant reductions in peak patellofemoral stress were shown in both subgroups (strong: (pre) = 6.82 & ...
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Perhaps as a consequence of increased specialism in training and support, the focus on engendering and maintaining agility as a generic quality has diminished within many contemporary sports performance programmes. Reflecting this, we... more
Perhaps as a consequence of increased specialism in training and support, the focus on engendering and maintaining agility as a generic quality has diminished within many contemporary sports performance programmes. Reflecting this, we outline a rationale suggesting that such a decreased focus represents an oversight which may be detrimental to maximising the potential of performers. We present an evidence-based argument that both generic and specific elements of agility performance should be consistently emphasised within long-term performance-training programmes. We contend that prematurely early specialisation in athlete development models can diminish focus on generic movement skill development with a subsequent detriment in adult performance. Especially when this is coupled with poor primary physical education and limited movement experiences. More speculatively, we propose that generic agility can play a role in operationalising movement development through facilitating skill t...
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Forefoot stiffness has been shown to influence joint biomechanics. However, little or no data exists on metatarsophalangeal stiffness. Twenty-four healthy rearfoot strike runners were recruited from a staff and student population at the... more
Forefoot stiffness has been shown to influence joint biomechanics. However, little or no data exists on metatarsophalangeal stiffness. Twenty-four healthy rearfoot strike runners were recruited from a staff and student population at the University of Central Lancashire. Five repetitions of shod, self-selected speed level walking and jogging were performed. Kinetic and kinematic data were collected using retro-reflective markers placed on the lower limb and foot, to create a three-segment foot model using the Calibrated Anatomical System Technique. Ankle and metatarsophalangeal moments and angles were calculated. Stiffness values were calculated using a linear best fit line of moment versus of angle plots. Paired t-tests were used to compare values between walking and jogging conditions. Significant differences were seen in ankle range of motion (ROM), but not in metatarsophalangeal ROM. Maximum moments were significantly greater in the ankle during jogging, but these were not signif...
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The aim of this study was to investigate the relationship between self-reported knee outcomes and limb symmetry indices (LSIs) for hip and knee strength, postural control and single-leg hop distance in individuals who had undergone an... more
The aim of this study was to investigate the relationship between self-reported knee outcomes and limb symmetry indices (LSIs) for hip and knee strength, postural control and single-leg hop distance in individuals who had undergone an anterior cruciate ligament (ACL) reconstruction via hamstring tendon autograft (HTG). A total of 72 participants with a history of unilateral ACL reconstruction via HTG (mean ± standard deviation (SD) age: 28.0 ± 7.6 years; height: 178.4 ± 6.7 cm; mass 76.9 ± 14.9 kg) were included. International Knee Documentation Committee 2000 Subjective Knee Form (IKDC), Lysholm, Knee Osteoarthritis Outcomes Scores (KOOS) and Tampa scores were used to evaluate self-reported outcomes. Concentric and eccentric knee extensor and flexor, and hip strength, postural control and single leg hop distance were evaluated for performance-based outcomes. The relationships between the LSI scores and the performance measures were explored using the Pearson correlation coefficient...
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Medial wedged foot orthoses are frequently prescribed to reduce retropatellar stress in patients with patellofemoral pain (PFP) by controlling calcaneal eversion and internal rotation of the tibia. During activities of daily living, the... more
Medial wedged foot orthoses are frequently prescribed to reduce retropatellar stress in patients with patellofemoral pain (PFP) by controlling calcaneal eversion and internal rotation of the tibia. During activities of daily living, the highest patella loads occur during stair descent, but the effect of foot orthoses during stair descent remains unclear. The purpose of this study was to compare the kinematics, kinetics and muscle activation during a step descent task in healthy volunteers using three designs of foot orthoses (insoles). Sixteen healthy subjects with a mean age of 25.7 years, BMI of 23.3, and +5 Foot Posture Index were recruited. Subjects performed a step down task from 20 cm using a 5o rearfoot medial wedge (R), a 5o rearfoot and forefoot medial wedge (R/F), and a control flat insole (C). Significant improvements in control were seen in the R and R/F insoles over the C insole in the foot and at the ankle and hip kinematics. The R and R/F insoles increased the knee ad...
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This article verifies the effectiveness of a new brace on patellofemoral pain syndrome (PFPS) in adjunct to a specifically developed rehabilitation program. Two groups of 30 patients with PFPS were prospectively and randomly allocated... more
This article verifies the effectiveness of a new brace on patellofemoral pain syndrome (PFPS) in adjunct to a specifically developed rehabilitation program. Two groups of 30 patients with PFPS were prospectively and randomly allocated to a rehabilitation protocol, with (group A) or without (group B) the use of a specific brace. All the patients were assessed at 3, 6, and 12 months using the disease-specific Kujala scale and a visual analog scale (VAS) for pain; time to return to sport and patient satisfaction with the brace were also recorded. Kujala scale's values showed constant and progressive improvement. The mean score at 6 months was 79.8 ± 6.8 points in group A and 76.8 ± 8.6 in group B, rising at 12 months to 80.9 ± 7.5 in group A and 78.4 ± 8.3 in group B. VAS scores significantly differed ( < 0.05) between the two groups at both 6 and 12 months; the score recorded at 12 months was 0.9 ± 1.3 in the brace-treated group and 1.8 ± 1.6 in the controls. The patients w...
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Delayed effects of a 20-min crushed ice application on knee joint position sense assessed by a functional task during a re-warming period. The effect of cryotherapy on joint positioning presents conflicting debates as to whether... more
Delayed effects of a 20-min crushed ice application on knee joint position sense assessed by a functional task during a re-warming period. The effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play following cryotherapy application at the lower limb. The aim of this study was to investigate whether a 20 min application of crushed ice at the knee affects knee joint kinematics immediately post and up to 20 mins post ice removal, during a small knee bend. 17 healthy male participants took part in the study performing a functional task. Using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden), kinematics of the knee were measured during a weight bearing functional task pre and immediately post, 5, 10, 15 and 20 min post cryotherapy intervention. Skin surface temperature (T) cooling was measured via infrared non-contact thermal imaging (Flir Systems, Danderyd, Swed...
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To assess five physical signs to see whether they can assist in the screening of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and potentially lead to quicker treatment. This was a diagnostic accuracy study... more
To assess five physical signs to see whether they can assist in the screening of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and potentially lead to quicker treatment. This was a diagnostic accuracy study with inter-rater agreement assessment. Participants recruited from two National Health Service hospitals, local CFS/ME support groups and the community were examined by three practitioners on the same day in a randomised order. Two allied health professionals (AHPs) performed independent examinations of physical signs including: postural/mechanical disturbances of the thoracic spine, breast varicosities, tender Perrin's point, tender coeliac plexus and dampened cranial flow. A physician conducted a standard clinical neurological and rheumatological assessment while looking for patterns of illness behaviour. Each examination lasted approximately 20 min. Ninety-four participants were assessed, 52 patients with CFS/ME and 42 non-CFS/ME controls, aged ...
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To investigate the effects of a prophylactic knee brace on knee joint kinetics and kinematics during netball specific movements. Repeated measures. Laboratory. Twenty university first team level female netball players. Participants... more
To investigate the effects of a prophylactic knee brace on knee joint kinetics and kinematics during netball specific movements. Repeated measures. Laboratory. Twenty university first team level female netball players. Participants performed three movements, run, cut and vertical jump under two conditions (brace and no-brace). 3-D knee joint kinetics and kinematics were measured using an eight-camera motion analysis system. Knee joint kinetics and kinematics were examined using 2 × 3 repeated measures ANOVA whilst the subjective ratings of comfort and stability were investigated using chi-squared tests. The results showed no differences (p > 0.05) in knee joint kinetics. However the internal/external rotation range of motion was significantly (p < 0.05) reduced when wearing the brace in all movements. The subjective ratings of stability revealed that netballers felt that the knee brace improved knee stability in all movements. Further study is required to determine whether red...
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The aim is to critically analyse and discuss the current literature and determine the effectiveness of rehabilitation for patients after surgical repair of rotator cuff tears for range of motion (ROM), pain, functional status and retear... more
The aim is to critically analyse and discuss the current literature and determine the effectiveness of rehabilitation for patients after surgical repair of rotator cuff tears for range of motion (ROM), pain, functional status and retear rates; in addition, an update of new literature is included. Overview of systematic reviews. A search was performed with no restrictions to date of publication and language in the following databases: EBSCO, AMED, CINAHL, SPORTDiscus, EMBASE, Cochrane, LILACS, MEDLINE, PEDro, Scielo, SCOPUS and Web of Knowledge. The PRISMA guideline was followed to develop this review and the R-AMSTAR tool was used for critical appraisal of included reviews. Only systematic reviews and randomised controlled trials (RCTs) comparing the effectiveness of early with conservative rehabilitation, after surgical repair of the rotator cuff, were included. Moreover, the studies should report ROM, pain, functional status and/or retears rates before and after 3-24 months of the...
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The objective of this study was to evaluate the effect of gait imagery tasks on lower limb muscle activity with respect to body posture. The sitting and standing position and lower limb muscle activity were evaluated in 27 healthy female... more
The objective of this study was to evaluate the effect of gait imagery tasks on lower limb muscle activity with respect to body posture. The sitting and standing position and lower limb muscle activity were evaluated in 27 healthy female students (24.4 ± 1.3 years, 167.2 ± 5.2 cm, 60.10 ± 6.4 kg). Surface electromyography was assessed during rest and in three different experimental conditions using mental imagery. These included a rhythmic gait, rhythmic gait simultaneously with observation of a model, and rhythmic gait after performing rhythmic gait. The normalized root mean square EMG values with respect to corresponding rest position were compared using non-parametric statistics. Standing gait imagery tasks had facilitatory effect on proximal lower limb muscle activity. However, electromyography activity of distal leg muscles decreased for all gait imagery tasks in the sitting position, when the proprioceptive feedback was less appropriate. For subsequent gait motor imagery tasks...
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ABSTRACT AIM: The aim of this study was to compare the motor unit firing patterns of the lumbar paraspinal muscles through dEMG in the dominant and non-dominant sides in a lumbar disc herniation patient and a healthy subject. METHODS:... more
ABSTRACT AIM: The aim of this study was to compare the motor unit firing patterns of the lumbar paraspinal muscles through dEMG in the dominant and non-dominant sides in a lumbar disc herniation patient and a healthy subject. METHODS: Electromyographic signals were recorded through five cylindrical pin electrodes (0.5 mm diameter each) placed on the paraspinal muscles at level L3 (3 cm of the spinal process) on both sides of the spine using a Bagnoli EMG System (Delsys, Boston, MA), with an input at ±5 Volts, high-pass filter of 20 and low-pass filter of 450 Hz and sampling rate of 20 KHz using EMGWorks®. One healthy female (aged 25 years, BMI 21.91 kg/m²) and one female patient, diagnosed as having a lumbar disc herniation (aged 29 years, BMI 22.4 kg/m²), were evaluated during a 30 second isometric extension hold in the prone position against rigid straps at 40% of MVIC. The signal was decomposed and analyzed for its accuracy by means of an artificial intelligence algorithm. The average of firing rate was found by applying a Hanning window of 3 seconds. RESULTS: The accuracy ranged from 88.5% to 92.6%. The healthy subject presented 26 motor unit action potential trains (MUAPTs) and 30 MUAPTs, while the patient presented 13 MUAPTs and 11 MUAPTs on the right and left sides respectively. The baseline noise was low and similar for all data analyzed of healthy subject and patient. The healthy subject showed a range of firing rates of 18.07 to 21.69 pulses per second and 17.69 to 22.77, whereas the lumbar disc hernia patient showed a range from 9.58 to 13.74 and 9.89 to 15.08 for the right and left sides respectively (FIG 1). CONCLUSION: The subject with a lumbar disc hernia appears to show reduced firing rate compared with the health subjects. ACKNOWLEDGMENTS: CNPq grants # 014/2010 and Delsys EMG System.
The current investigation aimed to investigate the effects of an intervention using knee bracing on pain symptoms and patellofemoral loading in male and female recreational athletes. Twenty participants (11 males & 9 females) with... more
The current investigation aimed to investigate the effects of an intervention using knee bracing on pain symptoms and patellofemoral loading in male and female recreational athletes. Twenty participants (11 males & 9 females) with patellofemoral pain were provided with a knee brace which they wore for a period of 2weeks. Lower extremity kinematics and patellofemoral loading were obtained during three sport specific tasks, jog, cut and single leg hop. In addition their self-reported knee pain scores were examined using the Knee injury and Osteoarthritis Outcome Score. Data were collected before and after wearing the knee brace for 2weeks. Significant reductions were found in the run and cut movements for peak patellofemoral force/pressure and in all movements for the peak knee abduction moment when wearing the brace. Significant improvements were also shown for Knee injury and Osteoarthritis Outcome Score subscale symptoms (pre: male=70.27, female=73.22 & post: male=85.64, female=82....
Research Interests: Mechanical Engineering, Biomedical Engineering, Quality of life, Humans, Clinical Biomechanics, and 15 moreMovement, Female, Braces, Male, Young Adult, Athletes, Patellofemoral Pain Syndrome, Adult, Knee injuries, Weight Bearing, Knee Joint, Pain Measurement, Orthopedic Procedures, Biomechanical Phenomena, and Athletic injuries
The aims of this study were to determine the motor unit behavior of the erector spinae muscles and to assess whether differences exist between the dominant/non-dominant sides of the back muscles. Nine healthy women, aged 21.7 years... more
The aims of this study were to determine the motor unit behavior of the erector spinae muscles and to assess whether differences exist between the dominant/non-dominant sides of the back muscles. Nine healthy women, aged 21.7 years (±0.7), performed a back extension test. Surface electromyographic decomposition data were collected from both sides of the erector spinae and decomposed into individual motor unit action potential trains. The mean firing rate for each motor unit was calculated, and a regression analysis was performed against the corresponding recruitment thresholds. The mean firing rate ranged from 15.9 to 23.9 pulses per second (pps) and 15.8 to 20.6 pps on the dominant and non-dominant sides, respectively. However, the early motor unit potential s of the non-dominant lumbar erector spinae muscles were recruited at a lower firing rate. This technique may further our understanding of individuals with back pain and other underlying neuromuscular diseases. This article is ...
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The current study aimed to comparatively examine the effects of minimalist, maximalist and conventional footwear on the loads experienced by the patellofemoral joint during running. Twenty male participants ran over a force platform at... more
The current study aimed to comparatively examine the effects of minimalist, maximalist and conventional footwear on the loads experienced by the patellofemoral joint during running. Twenty male participants ran over a force platform at 4.0 m.s-1. Lower limb kinematics were collected using an 8 camera motion capture system allowing patellofemoral kinetics to be quantified using a musculoskeletal modelling approach. Differences in patellofemoral kinetic parameters were examined using one-way repeated measures ANOVA. The results showed the peak patellofemoral force and pressure were significantly larger in conventional (4.70 ± 0.91 BW & 13.34 ± 2.43 MPa) and maximalist (4.74 ± 0.88 BW & 13.59 ± 2.63 MPa) compared to minimalist footwear (3.87 ± 1.00 BW & 11.59 ± 2.63 MPa). It was also revealed that patellofemoral force per mile was significantly larger in conventional (246.81 ± 53.21 BW) and maximalist (251.94 ± 59.17 BW) as compared to minimalist (227.77 ± 58.60 BW) footwear. As excess...
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ABSTRACT Background Back pain has become a worldwide problem and excessive, repetitive rotation has been shown to cause tissue damage. A sleeping posture similar to that of the foetal position has been suggested to limit unnecessary... more
ABSTRACT Background Back pain has become a worldwide problem and excessive, repetitive rotation has been shown to cause tissue damage. A sleeping posture similar to that of the foetal position has been suggested to limit unnecessary rotation of the lumbar spine. The Rophi™ cushion, utilises this theory to provide spinal alignment and improved sleeping posture. This study aims to assess the subjective experience and biomechanical effects of the Rophi™ cushion in participants with simple mechanical lower back pain (LBP). Methods &amp; Results Fifteen participants (aged 44 ± 9.7 years) with simple mechanical LBP were recruited using the Red Flags screening form. The kinematics of the pelvis, lower limbs, lumbar and thoracic spine were analysed in six degrees of freedom whilst the participants lay in a semi-foetal position. Visual analogue scales were used to measure participant pain and discomfort levels during sleep pre and post a one week cushion intervention. Kinematic results show the main significant difference in joint angles occurred at the hip in all three planes, and between the lower lumbar region and the pelvis in the coronal plane. Subjective experience showed a reduction in the number of days with poor sleep quality and a significant reduction in frequency and intensity of lower back pain and stiffness when waking. Conclusions Through repositioning of the hips and lower lumbar spine, overall it appears the individual is moved towards a more neutral position when using the Rophi™ cushion and a one week intervention shows a significant improvement in lower back pain on waking.
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To develop and evaluate a marker cluster set for measuring sagittal and extrasagittal movement of joints in the distal portion of the forelimb in ponies. 4 ponies. 5 infrared cameras were positioned on a concrete walkway in a... more
To develop and evaluate a marker cluster set for measuring sagittal and extrasagittal movement of joints in the distal portion of the forelimb in ponies. 4 ponies. 5 infrared cameras were positioned on a concrete walkway in a frontal-sagittal arc and calibrated. Four segments were defined: hoof, middle phalanx, proximal phalanx, and metacarpus. Rigid clusters with 4 retroreflective markers were placed on each segment. A static trial was recorded with additional anatomic markers on the medial and lateral joint lines. Those anatomic markers were removed, and kinematic data were recorded at 240 Hz during walking. An ensemble mean was computed from the 4 ponies from 5 replicates of the walks. Joint kinematic variables were calculated by use of the calibrated anatomical system technique. The design and error dispersion of each marker were evaluated. Marker clusters were quasiplanar, but variation in orientation error was reduced because the mean radii were &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 10 times the largest error dispersion values. Measurements of sagittal rotations of the distal interphalangeal, proximal interphalangeal, and metacarpophalangeal joints were similar to measurements obtained with bone-fixed triads, but larger discrepancies between the 2 methods were found for extrasagittal rotations. Development of noninvasive methods for quantifying data pertaining to 3-dimensional motion in horses is important for advancement of clinical analysis. The technique used in the study enabled identification of flexion-extension motions with an acceptable degree of accuracy. Appropriate correction algorithms and improvements to the technique may enable future quantification of extrasagittal motions.
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Bilateral decline squatting has been well documented as a rehabilitation exercise, however, little information exists on the optimum angle of decline. The aim of this study was to determine the ankle and knee angle, moments, the... more
Bilateral decline squatting has been well documented as a rehabilitation exercise, however, little information exists on the optimum angle of decline. The aim of this study was to determine the ankle and knee angle, moments, the patellofemoral joint load, patellar tendon load and associated muscle activity while performing a double limb squat at different decline angles and the implications to rehabilitation. Eighteen healthy subjects performed double limb squats at 6 angles of declination: 0, 5, 10, 15, 20 and 25 degrees. The range of motion of the knee and ankle joints, external moments, the patellofemoral/patellar tendon load and integrated EMG of gastrocnemius, tibialis anterior, rectus femoris and biceps femoris were evaluated. As the decline angle increased up to 20 degrees, the range of motion possible at the ankle and knee increased. The joint moments showed a decrease at the ankle up to 15 degrees and an increase at the knee up to 25 degrees, indicating a progressive reduct...
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Background Current multimodal approaches for the management of non-specific patellofemoral pain are not optimal, however, targeted intervention for subgroups could improve patient outcomes. This study explores whether subgrouping of... more
Background Current multimodal approaches for the
management of non-specific patellofemoral pain are not
optimal, however, targeted intervention for subgroups
could improve patient outcomes. This study explores
whether subgrouping of non-specific patellofemoral pain
patients, using a series of low cost simple clinical tests,
is possible.
Method The exclusivity and clinical importance of
potential subgroups was assessed by applying à priori
test thresholds (1 SD) from seven clinical tests in a
sample of adult patients with non-specific patellofemoral
pain. Hierarchical clustering and latent profile analysis,
were used to gain additional insights into subgroups
using data from the same clinical tests.
Results 130 participants were recruited, 127 had
complete data: 84 (66%) female, mean age 26 years
(SD 5.7) and mean body mass index 25.4 (SD 5.83),
median (IQR) time between onset of pain and
assessment was 24 (7–60) months. Potential subgroups
defined by the à priori test thresholds were not mutually
exclusive and patients frequently fell into multiple
subgroups. Using hierarchical clustering and latent
profile analysis three subgroups were identified using 6
of the 7 clinical tests. These subgroups were given the
following nomenclature: (1) ‘strong’, (2) ‘weak and
tighter’ and (3) ‘weak and pronated foot’.
Conclusions We conclude that three subgroups of
patellofemoral patients may exist based on the results of
six clinical tests which are feasible to perform in routine
clinical practice. Further research is needed to validate
these findings in other data sets and, if supported by
external validation, to see if targeted interventions for
these subgroups improve patient outcomes.
management of non-specific patellofemoral pain are not
optimal, however, targeted intervention for subgroups
could improve patient outcomes. This study explores
whether subgrouping of non-specific patellofemoral pain
patients, using a series of low cost simple clinical tests,
is possible.
Method The exclusivity and clinical importance of
potential subgroups was assessed by applying à priori
test thresholds (1 SD) from seven clinical tests in a
sample of adult patients with non-specific patellofemoral
pain. Hierarchical clustering and latent profile analysis,
were used to gain additional insights into subgroups
using data from the same clinical tests.
Results 130 participants were recruited, 127 had
complete data: 84 (66%) female, mean age 26 years
(SD 5.7) and mean body mass index 25.4 (SD 5.83),
median (IQR) time between onset of pain and
assessment was 24 (7–60) months. Potential subgroups
defined by the à priori test thresholds were not mutually
exclusive and patients frequently fell into multiple
subgroups. Using hierarchical clustering and latent
profile analysis three subgroups were identified using 6
of the 7 clinical tests. These subgroups were given the
following nomenclature: (1) ‘strong’, (2) ‘weak and
tighter’ and (3) ‘weak and pronated foot’.
Conclusions We conclude that three subgroups of
patellofemoral patients may exist based on the results of
six clinical tests which are feasible to perform in routine
clinical practice. Further research is needed to validate
these findings in other data sets and, if supported by
external validation, to see if targeted interventions for
these subgroups improve patient outcomes.
Research Interests: Skeletal muscle biology, Musculoskeletal Rehabilitation, Musculoskeletal Biomechanics, Musculoskeletal Injury Prevention, Muscle strength, and 8 morePhysiological and biomechanical mechanisms of skeletal muscle function, Knee, Musculoskeletal, Musculoskeletal pain, Patellofemoral Pain Syndrome, Knee rehabilitation, Musculoskeletal Disorders, and Anterior Knee Pain
... 6: Inverse Dynamics Theory Jim RichardsChapter 7: Measurement of Force and Pressure Jim Richards and Dominic ThewlisChapter 8: Methods of Analysis of Movement Jim Richards, Dominic Thewlis and Sarah Jane HobbsChapter 9 ... Auteurs :... more
... 6: Inverse Dynamics Theory Jim RichardsChapter 7: Measurement of Force and Pressure Jim Richards and Dominic ThewlisChapter 8: Methods of Analysis of Movement Jim Richards, Dominic Thewlis and Sarah Jane HobbsChapter 9 ... Auteurs : MATHIEU Clément, LOZET Jean. ...
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Individuals who have upper limb movement problems include people with cerebral palsy (CP) and stroke victims. Both these conditions lead to difficulties in daily activities such as reaching, grasping etc. Virtual reality (VR), which could... more
Individuals who have upper limb movement problems include people with cerebral palsy (CP) and stroke victims. Both these conditions lead to difficulties in daily activities such as reaching, grasping etc. Virtual reality (VR), which could provide a repetitive multimodal task-oriented rehabilitation environment for patients to undertake self-training in safety, is considered to be a suitable tool for medical health rehabilitation.
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Research interest in barefoot running has expanded considerably in recent years, based around the notion that running without shoes is associated with a reduced incidence of chronic injuries. The aim of the current investigation was to... more
Research interest in barefoot running has expanded considerably in recent years, based around the notion that running without shoes is associated with a reduced incidence of chronic injuries. The aim of the current investigation was to examine the differences in the forces produced by different skeletal muscles during barefoot and shod running. Fifteen male participants ran at 4.0 m·s-1 (± 5%). Kinematics were measured using an eight camera motion analysis system alongside ground reaction force parameters. Differences in sagittal plane kinematics and muscle forces between footwear conditions were examined using repeated measures or Freidman's ANOVA. The kinematic analysis showed that the shod condition was associated with significantly more hip flexion, whilst barefoot running was linked with significantly more flexion at the knee and plantarflexion at the ankle. The examination of muscle kinetics indicated that peak forces from Rectus femoris, Vastus medialis, Vastus lateralis,...
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The aim was to investigate the effects of three anatomical frames using palpable anatomical landmarks of the knee on the net knee joint moments. The femoral epicondyles, femoral condyles, and tibial ridges were used to define the... more
The aim was to investigate the effects of three anatomical frames using palpable anatomical landmarks of the knee on the net knee joint moments. The femoral epicondyles, femoral condyles, and tibial ridges were used to define the different anatomical frames and the segment end points of the distal femur and proximal tibia, which represent the origin of the tibial coordinate system. Gait data were then collected using the calibrated anatomical system technique (CAST), and the external net knee joint moments in the sagittal, coronal, and transverse planes were calculated based upon the three anatomical frames. Peak knee moments were found to be significantly different in the sagittal plane by approximately 25% (p <or= 0.05), but no significant differences were seen in the coronal or transverse planes. Based on these findings it is important to consider the definition of anatomical frames and be aware that the use of numerous anatomical landmarks around the knee can have significant...
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The treadmill is an attractive device for the investigation of human locomotion, yet the extent to which lower limb kinematics differ from overground running remains a controversial topic. This study aimed to provide an extensive... more
The treadmill is an attractive device for the investigation of human locomotion, yet the extent to which lower limb kinematics differ from overground running remains a controversial topic. This study aimed to provide an extensive three-dimensional kinematic comparison of the lower extremities during overground and treadmill running. Twelve participants ran at 4.0 m/s (+/- 5%) in both treadmill and overground conditions. Angular kinematic parameters of the lower extremities during the stance phase were collected at 250 Hz using an eight-camera motion analysis system. Hip, knee, and ankle joint kinematics were quantified in the sagittal, coronal, and transverse planes, and contrasted using paired t-tests. Of the analysed parameters hip flexion at footstrike and ankle excursion to peak angle were found to be significantly reduced during treadmill running by 12 degrees (p = 0.001) and 6.6 degrees (p = 0.010), respectively. Treadmill running was found to be associated with significantly greater peak ankle eversion (by 6.3 degrees, p = 0.006). It was concluded that the mechanics of treadmill running cannot be generalized to overground running.
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Journal of Biomechanics, Volume 41, Issue null, Pages S320, July 2008, Authors:Dominic Thewlis; Jim Richards; Sarah Jane Hobbs.
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The purpose of this study was to evaluate the effect of patella taping in normal subjects. Previous work has established positive effects of patella taping on patellofemoral pain syndrome patients, but the mode of action remains unclear.... more
The purpose of this study was to evaluate the effect of patella taping in normal subjects. Previous work has established positive effects of patella taping on patellofemoral pain syndrome patients, but the mode of action remains unclear. It has been hypothesized that taping brings about subtle changes in the internal physiological environment of the joint. It could be expected that in normal joints taping would bring about a measurable change in function, as the joint is no longer operating in an optimal physiological environment. 10 normal female subject&amp;amp;#39;s (21.4+/-1.2 years) vastus medialis oblique (VMO) and vastus laterialis (VL) EMG activity and knee kinematics (peak stance flexion angle and angular velocity) were assessed during a step descent, with and without a taped patella. The effect of taping was to significantly decrease VMO and VL EMG activity. Taping also significantly reduced peak stance phase knee flexion and peak stance phase knee flexion angular velocity. In normal asymptomatic subjects patella taping created a situation in which their performance was changed to one similar to that of the pathological patellofemoral pain syndrome population. It would appear that taping caused the joint to function sub-optimally supporting the hypothesis that taping could change the functioning of the patellofemoral joint.
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Research Interests: Mechanical Engineering, Biomechanics, Treatment Outcome, Knee Biomechanics, Gait, and 14 moreHumans, Movement, Female, Braces, Male, Three Dimensional Imaging, Patellofemoral Pain Syndrome, Clinical Sciences, Gait and Posture, Adult, Analysis of Variance, Clinical Study, Healthy Subjects, and Biomechanical Phenomena
Applied research suggests that athletes and coaches need to be challenged in knowing when and how much a movement should be consciously attended to. This is exacerbated when the skill is in transition between two more stable states, such... more
Applied research suggests that athletes and coaches need to be challenged in knowing when and how much a movement should be consciously attended to. This is exacerbated when the skill is in transition between two more stable states, such as when an already well-learnt skill is being refined. Using existing theory and research, this paper highlights the potential application of movement variability as a tool to inform a coach’s decision-making process when implementing a systematic approach to technical refinement. Of particular interest is the structure of co-variability between mechanical degrees-of-freedom (e.g., joints) within the movement system’s entirety when undergoing a skill transition. Exemplar data from golf are
presented, demonstrating the link between movement variability and mental effort as an important feature of automaticity, and thus intervention design throughout the different stages of refinement. Movement variability was shown to reduce when mental effort directed towards an individual aspect of the skill was high (target variable). The opposite pattern was apparent for variables unrelated to the technical refinement. Therefore, two related indicators, movement variability and mental effort, are offered as a basis through which the evaluation of automaticity during technical refinements may be made.
presented, demonstrating the link between movement variability and mental effort as an important feature of automaticity, and thus intervention design throughout the different stages of refinement. Movement variability was shown to reduce when mental effort directed towards an individual aspect of the skill was high (target variable). The opposite pattern was apparent for variables unrelated to the technical refinement. Therefore, two related indicators, movement variability and mental effort, are offered as a basis through which the evaluation of automaticity during technical refinements may be made.
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Practice swings are commonly employed amongst golfers, presumably based on the tacit assumption that they share common psychomotor processes with real swings; however, this has not been verified by empirical research. Therefore, this... more
Practice swings are commonly employed amongst golfers, presumably based on the tacit assumption that they share common psychomotor processes with real swings; however, this has not been verified by empirical research. Therefore, this study aimed to examine whether practice swings shared equivalent levels of control to real golf swings, when attempting the same target behavior. Three PGA Professional golf coaches and six amateurs (mean handicap = 2.7, SD = 2.2) each executed 20 swings under two quasirandom conditions; 10 real swings when striking a ball and 10 practice swings without. Underpinned by the theoretical suggestions of the UnControlled Manifold (UCM) approach (Scholz & Schöner, 1999), motor control was assessed using intraindividual movement variability. Results showed the level of equivalence to be inconsistent on both an inter and intraindividual basis. Coaches should, therefore, recognize that practice swings do not share the same effect for every golfer. Optimal coaching needs to consider individual responses before committing to specific training designs if counterproductive training is to be avoided.
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When developing motor skills there are several outcomes available to an athlete depending on their skill status and needs. Whereas the skill acquisition and performance literature is abundant, an under-researched outcome relates to the... more
When developing motor skills there are several outcomes available to an athlete depending on their skill status and needs. Whereas the skill acquisition and performance literature is abundant, an under-researched outcome relates to the refinement of already acquired and well-established skills. Contrary to current recommendations for athletes to employ an external focus of attention and a representative practice design, Carson and Collins’ (2011) [Refining and regaining skills in fixation/diversification stage performers: The Five-A Model. International Review of Sport and Exercise Psychology, 4, 146–
167. doi:10.1080/1750984x.2011.613682] Five-A Model requires an initial narrowed internal focus on the technical
aspect needing refinement: the implication being that environments which limit external sources of information would be beneficial to achieving this task. Therefore, the purpose of this paper was to (1) provide a literature-based explanation for why techniques counter to current recommendations may be (temporarily) appropriate within the skill refinement process and (2) provide empirical evidence for such efficacy. Kinematic data and self-perception reports are provided from high-level golfers attempting to consciously initiate technical refinements while executing shots onto a driving range and into a close proximity net (i.e. with limited knowledge of results). It was hypothesised that greater control over intended refinements would occur when environmental stimuli were reduced in the most unrepresentative practice condition (i.e. hitting into a net). Results confirmed this, as evidenced by reduced intra-individual movement variability for all participants’ individual refinements, despite little or no difference in mental effort reported. This research offers coaches guidance when working with performers who may find conscious recall difficult during the skill refinement process.
167. doi:10.1080/1750984x.2011.613682] Five-A Model requires an initial narrowed internal focus on the technical
aspect needing refinement: the implication being that environments which limit external sources of information would be beneficial to achieving this task. Therefore, the purpose of this paper was to (1) provide a literature-based explanation for why techniques counter to current recommendations may be (temporarily) appropriate within the skill refinement process and (2) provide empirical evidence for such efficacy. Kinematic data and self-perception reports are provided from high-level golfers attempting to consciously initiate technical refinements while executing shots onto a driving range and into a close proximity net (i.e. with limited knowledge of results). It was hypothesised that greater control over intended refinements would occur when environmental stimuli were reduced in the most unrepresentative practice condition (i.e. hitting into a net). Results confirmed this, as evidenced by reduced intra-individual movement variability for all participants’ individual refinements, despite little or no difference in mental effort reported. This research offers coaches guidance when working with performers who may find conscious recall difficult during the skill refinement process.