Wireless Multi-Sensor Integration for ACL Rehabilitation Using Biofeedback Mechanism

2012 ◽  
Author(s):  
S. M. N. Arosha Senanayake ◽  
Owais Ahmed Malik ◽  
Mohammad Iskandar
Keyword(s):  
Clinical Decision Making ◽  
Human Subjects ◽  
Cruciate Ligament ◽  
Clinical Stage ◽  
Recovery Process ◽  
Clinical Decision ◽  
Rehabilitation Process ◽  
Acl Rehabilitation ◽  
Anterior Cruciate ◽  
Analysis System

The objective of this study is to propose an integrated motion analysis system for monitoring and assisting the rehabilitation process for athletes based on biofeedback mechanism, particularly for human subjects already undergone Anterior Cruciate Ligament (ACL) injury operations and thus about to start the rehabilitation process. For this purpose, different types of parameters (kinematics and neuromuscular signals) from multi-sensors integration are combined to analyze the motion of affected athletes. Signals acquired from sensors are pre-processed in order to prepare the pattern set for intelligent algorithms to be integrated for possible implementation of effective assistive rehabilitation processing tools for athletes and sports orthopedic surgeons. Based on the characteristics of different signals invoked during the rehabilitation process, two different intelligent approaches (Elman RNN and Fuzzy Logic) have been tested. The newly introduced integrated multi-sensors approach will assist in identifying the clinical stage of the recovery process of athletes after ACL repair and will facilitate clinical decision-making during the rehabilitation process. The use of wearable wireless miniature sensors will provide an un-obstructive assessment of the kinematics and neuromuscular changes occurring after ACL reconstruction in an athlete.

scholarly journals Clinical Decision Algorithm Associated With Return to Sport After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 55 (7) ◽  
pp. 691-698
Author(s):  
Thamlya Rocha Albano ◽  
Carlos Augusto Silva Rodrigues ◽  
Antonio Kayro Pereira Melo ◽  
Pedro Olavo de Paula ◽  
Gabriel Peixoto Leão Almeida
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Clinical Decision Making ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Clinical Decision ◽  
Decision Algorithm ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Context Understanding the factors that predict return to sport (RTS) after anterior cruciate ligament reconstruction facilitates clinical decision making. Objective To develop a clinical decision algorithm that could predict RTS and non-RTS based on the differences in the variables after anterior cruciate ligament reconstruction. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants A total of 150 athletes in any sport involving deceleration, jumping, cutting, or turning enrolled in the study. All participants answered the International Knee Documentation Committee and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) questionnaires and performed balance and isokinetic tests. Main Outcome Measure(s) The classification and regression tree (CART) was used to determine the clinical decision algorithm associated with RTS at any level and RTS at the preinjury level. The diagnostic accuracy of the CART was verified. Results Of the 150 participants, 57.3% (n = 86) returned to sport at any level and 12% (n = 18) returned to sport at the preinjury level. The interactions among the peak torque extension at 300°/s >93.55 Nm, ACL-RSI score >27.05 (P = .06), and postoperative time >7.50 months were associated with RTS at any level identified by CART and were factors associated with RTS. An ACL-RSI score >72.85% was the main variable associated with RTS at the preinjury level. The interaction among an ACL-RSI score of 50.40% to 72.85%, agonist : antagonist ratio at 300°/s ≤63.6%, and anteroposterior stability index ≤2.4 in these participants was the second factor associated with RTS at the preinjury level. Conclusions Athletes who had more quadriceps strength tended to RTS at any level more quickly, even with less-than-expected psychological readiness. Regarding a return at the preinjury level, psychological readiness was the most important factor in not returning, followed by a better agonist : antagonist ratio and better balance.

scholarly journals Progressive Rehabilitation of a Professional Soccer Player After an Anterior Cruciate Ligament Reconstruction in Phase 1: Clinical Perspective with Video Demonstration

2021 ◽  
Vol 56 (10) ◽  
pp. 1132-1136
Author(s):  
Francisco Javier Núñez Sánchez ◽  
Francisco Ignacio Martínez Cabrera ◽  
Fernando Hernandez Abad ◽  
Luis Suarez-Arrones
Keyword(s):  
Anterior Cruciate Ligament ◽  
Soccer Player ◽  
Cruciate Ligament ◽  
Phase 1 ◽  
Meniscal Tear ◽  
Postoperative Phase ◽  
Rehabilitation Process ◽  
Professional Soccer ◽  
Acl Rehabilitation ◽  
Anterior Cruciate

We outline a case of success in the rehabilitation of a Romanian first-division soccer player who sustained an anterior cruciate ligament (ACL) rupture with a meniscal tear during competition in the 2012–2013 season. The ligament was reconstructed with an autologous hamstrings graft and partial meniscectomy was performed. The player returned to same-level competition in 7 months and has remained at that level, free of knee injury, to the present (6 years later). Based on postoperative phase 1 as proposed by the Royal Dutch Society for Physical Therapy, we proposed a clinical progression of exercises with video demonstrations to address body functions and structures and the level of activities and participation. All phase 1 objectives were achieved, and all criteria needed to advance to phase 2 of the ACL rehabilitation process were attained.

scholarly journals Knetex – Development of a textile-integrated sensor system for feedback-supported rehabilitation after surgery of the anterior cruciate ligament

2020 ◽  
Vol 6 (3) ◽  
pp. 368-371
Author(s):  
Julia Demmer ◽  
A. Kitzig ◽  
N. Schlage ◽  
G. Stockmanns ◽  
E. Naroska
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Sensors And Actuators ◽  
Integrated Sensor ◽  
Rehabilitation Process ◽  
Active User ◽  
Smart Textile ◽  
First Results ◽  
Anterior Cruciate ◽  
The One

AbstractPatients often report an effect after surgery of the anterior cruciate ligament which is called "giving way". This manifest itself by a drop of the knee or a felt instability. This phenomenon is difficult to measure and validate because it usually does not occur regularly and is not reproducible under laboratory conditions. The Knetex project takes up this point by trying to actively support the rehabilitation process with a bandage that can be worn in everyday life and is constructed as a smart textile using sensors and actuators. For this purpose, on the one hand it is attempted to actively record the phenomenon of the "giving way" by measuring knee angles etc. and by active user feedback. At the same time, the patient is specifically advised by means of actuators to correct incorrect posture or movement in order to make the rehabilitation process more effective and prevent further damage. Two 9-axis IMUs (inertial measurement units) form the basis of the system. These are used together with a textile strain sensor to calculate the knee angles. This paper gives an overview of the planned system, the initial experiments to measure the knee angles and the first results of the actuator study.

scholarly journals Comprehensive Rehabilitation After Reconstruction of the Anterior Cruciate Ligament

2021 ◽  
Vol 11 (8) ◽  
pp. 182-193
Author(s):  
Dawid Besztak ◽  
Karina Szczypiór-Piasecka ◽  
Alicja Mińko ◽  
Krzysztof Antczak
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
Rehabilitation Process ◽  
History Of ◽  
Comprehensive Rehabilitation ◽  
Anterior Cruciate ◽  
Two Stages ◽  
Hospital Rehabilitation

Introduction: The knee joint is the second most frequently injured joint. Anterior cruciate ligament (ACL) injury is a relatively common injury to the inner part of the knee joint, mainly related to contact sports. Its rupture leads to instability of the entire joint. Two treatment options are possible: operative or conservative. Each of them is related to an appropriate rehabilitation process. The aim of this study was to define a comprehensive rehabilitation plan in patients after ACL rupture and meniscal suturing.Materials and methods: The work was written based on the medical history of the patient who was diagnosed with complete rupture of ACL, and then reconstruction was performed with the harvesting of a semitendinous and slender muscle graft.Results: The rehabilitation process can be divided into two stages: hospital and post-hospital. Rehabilitation in hospital conditions begins on the zero day after arthroscopy. The main goals of rehabilitation include: increasing the range of mobility, no myofascial dysfunctions, no thromboembolic complications, and the ability to self-service.Conclusion: Rehabilitation is an indispensable element of the treatment of patients after ACL reconstruction. Early initiation of rehabilitation brings tangible benefits during treatment and return to full physical fitness.

scholarly journals Intra-articular Implantation of Mesenchymal Stem Cells, Part 1

2017 ◽  
Vol 5 (1) ◽  
pp. 232596711668081 ◽  
Author(s):  
Matthew J. Kraeutler ◽  
Justin J. Mitchell ◽  
Jorge Chahla ◽  
Eric C. McCarty ◽  
Cecilia Pascual-Garrido
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Platelet Rich Plasma ◽  
Human Subjects ◽  
Cruciate Ligament ◽  
Future Research ◽  
Biological Therapies ◽  
Knee Oa ◽  
Anterior Cruciate ◽  
Induced Pluripotent

Osteoarthritis (OA) after a partial or total meniscectomy procedure is a common pathology. Because of the high incidence of meniscectomy in the general population, as well as the significant burden of knee OA, there is increasing interest in determining methods for delaying postmeniscectomy OA. Biological therapies, including mesenchymal stem cells (MSCs), induced pluripotent stem cells (iPSCs), and platelet-rich plasma (PRP), have been proposed as possible therapies that could delay OA in this and other settings. Several studies in various animal models have evaluated the effect of injecting MSCs into the knee joints of animals with OA induced either by meniscal excision with or without anterior cruciate ligament transection. When compared with control groups receiving injections without progenitor cells, short-term benefits in the experimental groups have been reported. In human subjects, there are limited data to determine the effect of biological therapies for use in delaying or preventing the onset of OA after a meniscectomy procedure. The purpose of this review is to highlight the findings in the presently available literature on the use of intra-articular implantation of MSCs postmeniscectomy and to offer suggestions for future research with the goal of delaying or treating early OA postmeniscectomy with MSCs.

scholarly journals The Agony of Choice—Where to Place the Wave of BCMA-Targeted Therapies in the Multiple Myeloma Treatment Puzzle in 2022 and Beyond

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4701
Author(s):  
Irene Strassl ◽  
Martin Schreder ◽  
Normann Steiner ◽  
Jakob Rudzki ◽  
Hermine Agis ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Clinical Decision Making ◽  
Nk Cell ◽  
Clinical Stage ◽  
Proteasome Inhibitors ◽  
Treatment Strategies ◽  
Clinical Trial Data ◽  
Clinical Decision ◽  
Preclinical Development ◽  
Comprehensive Overview

Since the introduction of first-generation proteasome inhibitors and immunomodulatory agents, the multiple myeloma (MM) treatment landscape has undergone a remarkable development. Most recently, immunotherapeutic strategies targeting the B cell maturation antigen (BCMA) entered the clinical stage providing access to highly anticipated novel treatment strategies. At present, numerous different approaches investigate BCMA as an effective multi-modal target. Currently, BCMA-directed antibody–drug conjugates, bispecific and trispecific antibodies, autologous and allogeneic CAR-T cell as well as CAR-NK cell constructs are either approved or in different stages of clinical and preclinical development for the treatment of MM. This armamentarium of treatment choices raises several challenges for clinical decision making, particularly in the absence of head-to-head comparisons. In this review, we provide a comprehensive overview of BCMA-targeting therapeutics, deliver latest updates on clinical trial data, and focus on potential patient selection criteria for different BCMA-targeting immunotherapeutic strategies.

scholarly journals The Influence of Therapeutic Training on Changes in Selected Biomechanical Variables After an Anterior Cruciate Ligament Reconstruction

2013 ◽  
Vol 20 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Marta Jarocka ◽  
Adam Czaplicki
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Practical Importance ◽  
Average Power ◽  
Peak Torque ◽  
Rehabilitation Process ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

AbstractIntroduction. The number of arthroscopic reconstructions of the anterior cruciate ligament (ACL) has been increasing not only among competitive athletes, but also among recreational athletes. The monitoring of the rehabilitation process in order to determine a safe time to return to the pre-injury activity is thus of great practical importance. The aim of this paper is to analyse the changes in selected biomechanical variables which occur after the therapeutic training following an anterior cruciate ligament reconstruction. Materials and methods. Twenty nine males (age 27.3 ± 5.7 years) after the anterior cruciate ligament reconstruction participated in the study. A quadruple-stranded semitendinosus/gracilis graft was used for the reconstruction. The biomechanical evaluation of the rehabilitation process was provided by an isokinetic dynamometer Biodex System Pro-3 working at speeds of 60 deg/s and 180 deg/s during testing the knee extensor and flexor muscles. In the case of an injured limb, the absolute peak torque, relative peak torque, average power and hamstring/ quadriceps (H/Q) ratio were determined. In addition, the values of flexor and extensor torques for healthy and injured limbs were compared. The study was carried out in four stages: before the surgery, three, six and twelve months after the surgery. Results and analyses. The results showed significant differences in each value between various stages of the biomechanical rehabilitation process of the knee. The applied therapeutic training influenced significantly the changes in the values of the tested variables. The results have confirmed that the biomechanical measurements can be treated as a supplementation to the clinical evaluation of the patient after ACL reconstruction. They may also be used for the optimisation of the therapeutic training.

Evaluation of the Asymmetry of Leg Muscles Forces in the Subjects with Anterior Cruciate Ligament Reconstruction

2019 ◽  
Author(s):  
Keyvan Sharifmoradi ◽  
Mohammad Taghi Karimi ◽  
Yasin Hoseini
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Force ◽  
Cruciate Ligament ◽  
Force Production ◽  
Normal Subjects ◽  
Reduction In Force ◽  
Adductor Muscles ◽  
Hip Abductor ◽  
Anterior Cruciate ◽  
Analysis System

AbstractRunning asymmetry has not been assessed among patients with anterior cruciate ligament (ACL) deficiency. The aim of this study was to evaluate the spatiotemporal and muscle force asymmetry indexes in the subjects with ACL reconstruction (ACLR) compared with normal subjects. Eight individuals with a reconstructed ACL and eight individuals with intact ACLs were participated in this study. A Vicon motion analysis system and two Kistler force plates were used to record data. Muscle forces analysis was done by the use of OpenSim software. The results of this study showed that ACLR group had a significant weakness in hip abductor, extensor, and adductor muscles of the affected limb compared with healthy subjects (p < 0.05). In ACLR group, asymmetry of gluteus minimus muscle force was significantly greater than that of healthy group (p = 0.04). After the reconstruction of the ACL, there is still a significant asymmetry in muscle force as well as a reduction in force production of ACLR group especially in reconstructed side which put a person at high risk of reinjuries. Thus, strengthening of these muscles on the affected side to increase running performance of ACLR group is recommended.

scholarly journals Psychosocial Barriers After Anterior Cruciate Ligament Reconstruction: A Clinical Review of Factors Influencing Postoperative Success

2019 ◽  
Vol 11 (6) ◽  
pp. 528-534
Author(s):  
Julie P. Burland ◽  
Jennifer L. Toonstra ◽  
Jennifer S. Howard
Keyword(s):  
Anterior Cruciate Ligament ◽  
Clinical Review ◽  
Psychosocial Factors ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Neuromuscular Control ◽  
Ample Evidence ◽  
Rehabilitation Process ◽  
Anterior Cruciate ◽  
Return To Activity

Context: Psychosocial factors arising after anterior cruciate ligament (ACL) injury may have a direct influence on an individual’s decision to return to sport after ACL reconstruction (ACLR). While there is ample evidence to suggest that deficits in quadriceps strength, neuromuscular control, and clinical functional tasks exist after ACLR, the root and contribution of psychological dysfunction to an individual’s success or return to sport after ACLR is still largely uncertain and unexplored. Given the discrepancy between successful functional outcomes and the percentage of athletes who return to sport, it is important to thoroughly address underlying factors, aside from physical function, that may be contributing to these lower return rates. Evidence Acquisition: Articles that reported on return to sport, psychological factors, and psychosocial factors after ACLR were collected from peer-reviewed sources available on Medline (1998 through August 2018). Search terms included the following: anterior cruciate ligament OR ACL AND return-to-sport OR return-to-activity, anterior cruciate ligament OR ACL AND psychological OR psychosocial OR biopsychosocial OR fear OR kinesiophobia OR self-efficacy, return-to-activity AND psychological OR psychosocial. Study Design: Clinical review. Level of Evidence: Level 5. Results: Psychosocial factors relative to injury are important components of the rehabilitation process. To fully understand how psychosocial factors potentially influence return to sport, an athlete’s emotions, experiences, and perceptions during the rehabilitation process must be acknowledged and taken into consideration. Conclusion: Acknowledgment of these psychosocial factors allows clinicians to have a better understanding of readiness to return to sport from a psychological perspective. Merging of the current ACLR rehabilitation protocols with knowledge related to psychosocial factors creates a more dynamic, comprehensive approach in creating a positive and successful rehabilitation environment, which may help improve return-to-sport rates in individuals after ACLR.

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