Biomechanical Compensation Mechanisms During Stair Climbing –The effect of leg length inequalities

Author(s):  
Hannah Lena Siebers ◽  
Jörg Eschweiler ◽  
Roman Michalik ◽  
Filippo Migliorini ◽  
Markus Tingart ◽  
...  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Hannah Lena Siebers ◽  
Jörg Eschweiler ◽  
Filippo Migliorini ◽  
Valentin Michael Quack ◽  
Markus Tingart ◽  
...  

Abstract Muscle imbalances are a leading cause of musculoskeletal problems. One example are leg length inequalities (LLIs). This study aimed to analyze the effect of different (simulated) LLIs on back and leg muscles in combination with kinematic compensation mechanics. Therefore, 20 healthy volunteers were analyzed during walking with artificial LLIs (0–4 cm). The effect of different amounts of LLIs and significant differences to the reference condition without LLI were calculated of maximal joint angles, mean muscle activity, and its symmetry index. While walking, LLIs led to higher muscle activity and asymmetry of back muscles, by increased lumbar lateral flexion and pelvic obliquity. The rectus femoris showed higher values, independent of the amount of LLI, whereas the activity of the gastrocnemius on the shorter leg increased. The hip and knee flexion of the long leg increased significantly with increasing LLIs, like the knee extension and the ankle plantarflexion of the shorter leg. The described compensation mechanisms are explained by a dynamic lengthening of the short and shortening of the longer leg, which is associated with increased and asymmetrical muscle activity. Presenting this overview is important for a better understanding of the effects of LLIs to improve diagnostic and therapy in the future.


Author(s):  
Nicholas A. Garcia ◽  
Keith S. Jones ◽  
Benjamin P. Widlus

Summary Observers can perceive others’ action capabilities. These actions include observers’ abilities to perceive the maximum height that an actor can sit, step across a gap, climb in a bipedal manner, or reach an object (Stoffregen et al., 1999; Mark, 2007; Ramenzoni et al., 2008a, 2008b). While observers’ abilities to perceive others’ action capabilities have been widely studied, researchers debate the information to which observers attend when making such judgments. Some have argued observers attend to actor-environment relations when perceiving others’ action capabilities (e.g., Stoffregen et al., 1999; Mark, 2007; Ramenzoni et al., 2008a). From this perspective, observers attend to relations between relevant characteristics of the actor’s body (e.g., leg length) and their environment (e.g., step height) to perceive actors’ action capabilities (e.g., stair-climbing ability). This perspective has empirical support. For example, observers differentiated short and tall actors’ maximum sitting heights but only when the actors and sitting apparatus were presented in the same scale (Stoffregen et al., 1999). Others have argued observers attend to observer-environment relations when perceiving others’ capabilities (e.g., Knoblich & Sebanz, 2006; Ramenzoni et al., 2008b; Gallese & Sinigaglia, 2011). From this perspective, observers perceive their own action capabilities (Step 1), which serve as a model for the actor’s action capabilities and then adjust that model (Step 2) to account for observer-actor differences (Knoblich & Sebanz, 2006; Gallese & Sinigaglia, 2011). This perspective also has empirical support. For example, observers wearing ankle weights underestimated actors’ maximum jump-to-reach heights (Ramenzoni et al., 2008b). The present study further investigated whether observers attend to observer-environment relations when perceiving others’ maximum reach capabilities. Participants ( n = 34) made judgments about a confederate’s maximum reach capability while participants’ arms were held either freely by their sides (Unrestricted Condition) or placed behind their back (Restricted Condition). Widlus and Jones (2017) demonstrated that such arm restriction led to more erroneous judgments about one’s own reaching capabilities. To make judgments, participants directed the confederate to the farthest point from a hanging object that would still afford the confederate the ability to reach the object. If observers attend to observer-environment relations when judging the confederate’s maximum reach capability, then 1) judgment error would be greater in the Restricted condition than in the Unrestricted condition, 2) judgments would align with observers’ capabilities better than with the confederate’s, and 3) judgment error would positively correlate with the degree of dissimilarity between observers’ and the confederate’s action capabilities. The experiment used a within-subjects design. The independent variable was observer arm exploration, which consisted of two levels: unrestricted and restricted arm exploration. The dependent variable was the participant’s judgment of the farthest distance the confederate could reach. This was operationalized as the distance between the confederate’s clavicle and the to-be-reached object, once participants had directed the confederate to the position where they believed the confederate could just reach the object. Those judgments served as the basis for several measures. The present study’s results suggested arm restriction did not increase judgment error. Second, judgments did not align with observers’ capabilities better than with the confederate’s. Third, judgment error did not positively correlate with the degree of dissimilarity between observers’ and the confederate’s action capabilities. Collectively, these outcomes provide consistent evidence that observers did not base their judgments of the confederate’s reaching capabilities on observer-environment relations. Instead, these results are consistent with previous studies that support the possibility that observers based their judgments on actor-environment relations (Stoffregen et al., 1999; Ramenzoni et al., 2008a). Understanding how observers judge others’ action capabilities allows us to better predict errors that may occur in operational settings, e.g., whether a firefighter will inaccurately judge whether their partner can accomplish a given task. Human factors professionals can then develop solutions to mitigate such errors, e.g., equipment redesign to better reveal actor-environment relations.


2021 ◽  
Author(s):  
Roman Michalik ◽  
Viola Rissel ◽  
Filippo Miglorini ◽  
Hannah Siebers ◽  
Marcel Betsch

Abstract BackgroundLeg length inequalities (LLIs) are a frequent condition in every population. It is common clinical practice to consider LLIs of 2cm and more as relevant and to treat those. However, the amount of LLIs that need treatment is not clearly defined in literature and the effect of real LLIs on the musculoskeletal system above and below 2cm have not been studied biomechanically before.Research question: Are the spine and pelvis affected differently in patients with LLIs <2cm and ≥2cm.MethodsBy using surface topography, we evaluated 32 patients (10 females, 22 male) with real LLIs of ≥2cm (mean: 2.72cm; n=10) and compared their pelvic position and spinal posture to patients with LLIs <2cm (mean: 1.24cm; n=22) while standing and walking. All patients were measured with a surface topography system during standing and while walking on a treadmill. To compare patient groups, we used Student t-tests for independent samples.ResultsPelvic obliquity was significantly higher in patients with LLI ≥2cm during the standing trial (p=0.045) and during the midstance phase of the longer leg (p=0.023) while walking. Further measurements did not reveal any significant differences (p=0.06-0.706).ConclusionThe results of our study suggest that relevant LLIs of ≥2cm mostly affect pelvic obliquity and do not lead to significant alterations in the spinal posture during a standing trial. Additionally, we demonstrated that LLIs are better compensated when walking, showing almost no significant differences in pelvic and spinal posture between patients with LLIs smaller and greater than 2 cm. This study shows that LLIs ≥2cm can still be compensated; however, we do not know if the compensation mechanisms may lead to long-term clinical pathologies.


2012 ◽  
Author(s):  
Keith S. Jones ◽  
Elizabeth A. Schmidlin ◽  
Noah J. Wheeler
Keyword(s):  

2018 ◽  
Vol 33 (8) ◽  
pp. 1195-1201
Author(s):  
Dorothée Altmeier ◽  
Otmar Bock ◽  
Daniel Memmert

Author(s):  
Han-Jun Lee ◽  
Seong Hwan Kim ◽  
Nicolas Pujol ◽  
Yong-Beom Park

AbstractThe purpose of this study is to compare perception of leg length discrepancy (LLD) and clinical results of total knee arthroplasties (TKA) in patients with or without previous ipsilateral hip arthroplasty. Between 2008 and 2015, navigation-assisted TKA was performed in 43 patients with previous hip arthroplasty after hip fracture. After 1:3 propensity score matching was performed, 108 patients of primary navigation-assisted TKA (group 1) and 36 patients with hip arthroplasty (group 2) were included. Knee Society (KS) scores, Western Ontario and McMaster Universities Index (WOMAC) scores, and patients' satisfaction including perception of LLD were evaluated. Radiographic evaluation included mechanical axis, component position, and LLD. Logistic regression analysis was performed to find the factors that affect the clinical outcomes. No significant differences in radiologic and clinical evaluations, except for KS function score, patient's satisfaction and LLD (p< 0.001), were detected between the groups. LLD and its perception were significantly higher in group 2 (1.8 ± 3.4 mm in group 1 and 9.7 ± 4.1 mm in group 2, p = 0.000). Risk factors for the low KS function score were found as LLD (odds ratio [OR]: 1.403, p = 0.008) and previous hip arthroplasty itself (OR: 15.755, p = 0.002), but much higher OR was found in previous hip arthroplasty. Although the outcomes of TKA in patients with ipsilateral hip arthroplasty are comparable to those of primary TKA, LLD was high and patient's satisfaction and functional outcomes were low in patients with previous ipsilateral hip arthroplasty. Care should be taken when considering TKA in patients with previous hip arthroplasty. This is a Level III, case control study.


2012 ◽  
pp. 83-88
Author(s):  
A. Zolotov ◽  
M. Mukhanov

А new approach to policy-making in the field of economic reforms in modernizing countries (on the sample of SME promotion) is the subject of this article. Based on summarizing the ten-year experience of de-bureaucratization policy implementation to reduce the administrative pressure on SME, the conclusion of its insufficient efficiency and sustainability is made. The alternative possibility is the positive reintegration approach, which provides multiparty policy-making process, special compensation mechanisms for the losing sides, monitoring and enforcement operations. In conclusion matching between positive reintegration principles and socio-cultural factors inherent in modernization process is provided.


ROBOT ◽  
2010 ◽  
Vol 32 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Bo HUANG ◽  
Jianwen ZHAO ◽  
Lining SUN

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