Trunk Inclination During Squatting is a Better Predictor of the Knee-Extensor Moment Than Shank Inclination

2020 ◽  
pp. 1-6
Author(s):  
Rachel K. Straub ◽  
Adam J. Barrack ◽  
Jordan Cannon ◽  
Christopher M. Powers
Keyword(s):  
Repeated Measures ◽  
Knee Flexion ◽  
Stepwise Regression ◽  
Knee Extensor ◽  
Healthy Individuals ◽  
Cross Sectional ◽  
Trunk Inclination ◽  
Trunk Posture ◽  
The Individual ◽  
Segment Orientation

Context: A limitation of previous studies on squatting mechanics is that the influence of trunk and shank inclination on the knee-extensor moment (KEM) has been studied in isolation. Objective: The purpose of the current study was to determine the influence of segment orientation on the KEM during freestanding barbell squatting. Design: Repeated-measures cross sectional. Setting: University research laboratory. Participants: Sixteen healthy individuals (8 males and 8 females). Intervention: Each participant performed 8 squat conditions in which shank and trunk inclinations were manipulated. Main Outcome Measures: 3D kinematic and kinetic data were collected at 250 and 1500 Hz, respectively. Regression analysis was conducted to identify the individual relationships between the KEM and the trunk and shank inclination at 60° and 90° of knee flexion. To identify the best predictor(s) of the KEM, stepwise regression was implemented. Results: Increased shank inclination increased the KEM (P < .001, R2 = .21–.25). Conversely, increased trunk inclination decreased the KEM (P < .001, R2 = .49–.50). For the stepwise regression, trunk inclination entered first and explained the greatest variance in the KEM (all P < .001, R2 = .49–.50). Shank inclination entered second (all P < .010, R2 = .53–.54) and explained an additional 3% to 5% of the variance. Conclusions: Our results confirm that inclination of the trunk and shank have an opposing relationship with the KEM. Increased forward shank posture increases the KEM, while increased forward trunk posture decreases the KEM. However, when viewed in combination, the trunk was the superior predictor of the KEM, highlighting the fact that increased quadriceps demand created by a forward shank can be offset by trunk inclination.

scholarly journals ESTILO DE VIDA E SUAS RELAÇÕES COM HIPERTENSÃO ARTERIAL SISTÊMICA E DIABETES MELLITUS

2018 ◽  
Vol 7 (1) ◽  
pp. 361-373
Author(s):  
Elias Ferreira Porto ◽  
Claudia Kumpel ◽  
Anselmo Cordeiro de Souza ◽  
Izabel Maria de Oliveira ◽  
Karoline Mayara de Aquiles Bernardo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
General Health ◽  
Healthy Lifestyle ◽  
Cross Sectional Study ◽  
Health Perception ◽  
Control Group ◽  
Healthy Individuals ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Individual

Avaliar o estilo de vida e percepção do estado geral de saúde em pacientes com Diabetes Mellitus tipo 2 - DM, Hipertensão Arterial Sistêmica - HAS e indivíduos saudáveis. Métodos: Estudo transversal, com grupo controle. Avaliado estilo de vida com Questionário Fantástico, e percepção geral de saúde via uma pergunta âncora de diabéticos do tipo 2 (n = 37), hipertensos (n = 60), e indivíduos saudáveis (n = 43). Análise estatística descritiva, analise de variância, e razão de chance (Odds Rattio – OR). Resultados: Verificou-se diferença significante (p0,0001) na pontuação do Questionário Fantástico entre os indivíduos saudáveis em relação DM e HAS. O pior desempenho no estilo de vida para os três grupos foi nos domínios de atividade física e alimentação. O risco do indivíduo com HAS afirmar que sua saúde é pior do que indivíduos da mesma faixa etária foi OR 1.8 (1.415 a 2.419) e para os indivíduos diabéticos OR de 2.8 (1.776 a 4.579) em relação a indivíduos saudáveis. Conclusão: Diabéticos e hipertensos têm um pior estilo de vida e percepção geral de saúde do que indivíduos saudáveis. Assim o estilo de vida saudável pode reduzir a prevalência e auxiliar no controle de doenças já estabelecidas.Palavras-chave: Estilo de vida. Hipertensão Arterial. Diabetes Mellitus. ABSTRACT: To evaluate the lifestyle and perception of general health status in patients with type 2 diabetes mellitus - DM, systemic arterial hypertension - SAH and healthy individuals. Methods: Cross-sectional study with control group. (N = 37), hypertensive (n = 60), and healthy subjects (n = 43) were assessed using a Fantastic Questionnaire, and general health perception via an anchor question. Descriptive statistical analysis, analysis of variance, and odds ratio (Odds Rattio - OR). Results: There was a significant difference (p 0.0001) in the score of the Fantastic Questionnaire among healthy individuals in relation to DM and SAH. The worst lifestyle performance for the three groups was in the physical activity and feeding domains. The risk of the individual with SAH to state that their health is worse than individuals of the same age group was OR 1.8 (1.415 to 2.419) and for the diabetic individuals OR of 2.8 (1.776 to 4.579) in relation to healthy individuals. Conclusion: Diabetics and hypertensives have a worse lifestyle and overall health perception than healthy individuals. Thus the healthy lifestyle can reduce the prevalence and help in the control of already established diseases.Keywords: Lifestyle. Hypertension. Diabetes Mellitus.

Electromyography Activation Levels of the 3 Gluteus Medius Subdivisions During Manual Strength Testing

2015 ◽  
Vol 24 (3) ◽  
pp. 244-251
Author(s):  
Roald Otten ◽  
Johannes L. Tol ◽  
Per Holmich ◽  
Rodney Whiteley
Keyword(s):  
Study Design ◽  
Repeated Measures ◽  
Gluteus Medius ◽  
Strength Testing ◽  
Cross Sectional ◽  
Physically Active ◽  
Rehabilitation Programs ◽  
Significant Difference ◽  
The Individual ◽  
Hip Internal Rotation

Study Design:Cross-sectional.Context:Gluteus medius (GM) muscle dysfunction is associated with overuse injury. The GM is functionally composed of 3 separate subdivisions: anterior, middle, and posterior. Clinical assessment of the GM subdivisions is relevant to detect strength and activation deficits and guide specific rehabilitation programs. However, the optimal positions for assessing the strength and activation of these subdivisions are unknown.Objective:The first aim was to establish which strength-testing positions produce the highest surface electromyography (sEMG) activation levels of the individual GM subdivisions. The second aim was to evaluate differences in sEMG activation levels between the tested and contralateral (stabilizing) leg.Method:Twenty healthy physically active male subjects participated in this study. Muscle activity using sEMG was recorded for the GM subdivisions in 8 different strength-testing positions and analyzed using repeated-measures analysis of variance.Results:Significant differences between testing positions for all 3 GM subdivisions were found. There were significant differences between the tested and the contralateral anterior and middle GM subdivisions (P < .01). The posterior GM subdivision showed no significant difference (P = .154).Conclusion:Side-lying in neutral and side-lying with hip internal rotation are the 2 positions recommended to evaluate GM function and guide specific GM rehabilitation.

scholarly journals Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding

2016 ◽  
Vol 51 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Shawn Hanlon ◽  
Jaclyn Caccese ◽  
Christopher A. Knight ◽  
Charles “Buz” Swanik ◽  
Thomas W. Kaminski
Keyword(s):  
Knee Flexion ◽  
Emg Activity ◽  
Complex Motion ◽  
Cross Sectional ◽  
Anterior Drawer ◽  
Anterior Displacement ◽  
Emg Amplitude ◽  
Ankle Complex ◽  
Talar Tilt ◽  
The Individual

 Several factors affect the reliability of the anterior drawer and talar tilt tests, including the individual clinician's experience and skill, ankle and knee positioning, and muscle guarding.Context:  To compare gastrocnemius activity during the measurement of ankle-complex motion at different knee positions, and secondarily, to compare ankle-complex motion during a simulated trial of muscle guarding.Objectives:  Cross-sectional study.Design:  Research laboratory.Setting:  Thirty-three participants aged 20.2 ± 1.7 years were tested.Patients or Other Participants:  The ankle was loaded under 2 test conditions (relaxed, simulated muscle guarding) at 2 knee positions (0°, 90° of flexion) while gastrocnemius electromyography (EMG) activity was recorded.Intervention(s):  Anterior displacement (mm), inversion-eversion motion (°), and peak EMG amplitude values of the gastrocnemius (μV).Main Outcome Measure(s):  Anterior displacement did not differ between the positions of 0° and 90° of knee flexion (P = .193). Inversion-eversion motion was greater at 0° of knee flexion compared with 90° (P &lt; .001). Additionally, peak EMG amplitude of the gastrocnemius was not different between 0° and 90° of knee flexion during anterior displacement (P = .101). As expected, the simulated muscle-guarding trial reduced anterior displacement compared with the relaxed condition (0° of knee flexion, P = .008; 90° of knee flexion, P = .016) and reduced inversion-eversion motion (0° of knee flexion, P = .03; 90° of knee flexion, P &lt; .001).Results:  In a relaxed state, the gastrocnemius muscle did not appear to affect anterior ankle laxity at the 2 most common knee positions for anterior drawer testing; however, talar tilt testing may be best performed with the knee in 0° of knee flexion. Finally, our outcomes from the simulated muscle-guarding condition suggest that clinicians should use caution and be aware of reduced perceived laxity when performing these clinical examination techniques immediately postinjury.Conclusions:

scholarly journals A Biomechanical Investigation of A Single-Limb Squat: Implications for Lower Extremity Rehabilitation Exercise

2008 ◽  
Vol 43 (5) ◽  
pp. 477-482 ◽  
Author(s):  
Jim Richards ◽  
Dominic Thewlis ◽  
James Selfe ◽  
Andrew Cunningham ◽  
Colin Hayes
Keyword(s):  
Repeated Measures ◽  
Knee Flexion ◽  
Knee Extensor ◽  
Rectus Femoris ◽  
Knee Extensors ◽  
Emg Activity ◽  
Repeated Measures Design ◽  
Biomechanical Investigation ◽  
Rehabilitative Intervention ◽  
Integrated Emg

Abstract Context: Single-limb squats on a decline angle have been suggested as a rehabilitative intervention to target the knee extensors. Investigators, however, have presented very little empirical research in which they have documented the biomechanics of these exercises or have determined the optimum angle of decline used. Objective: To determine the involvement of the gastrocnemius and rectus femoris muscles and the external ankle and knee joint moments at 60° of knee flexion while performing a single-limb squat at different decline angles. Design: Participants acted as their own controls in a repeated-measures design. Patients or Other Participants: We recruited 10 participants who had no pain, injury, or neurologic disorder. Intervention(s): Participants performed single-limb squats at different decline angles. Main Outcome Measure(s): Angle-specific knee and ankle moments were calculated at 60° of knee flexion. Angle-specific electromyography (EMG) activity was calculated at 60° of knee flexion. Integrated EMG also was calculated to determine the level of muscle activity over the entire squat. Results: An increase was seen in the knee moments (P &lt; .05) and integrated EMG in the rectus femoris (P &lt; .001) as the decline angle increased. A decrease was seen in the ankle moments as the decline angle increased (P  =  .001), but EMG activity in the gastrocnemius increased between 16° and 24° (P  =  .018). Conclusions: As the decline angle increased, the knee extensor moment and EMG activity increased. As the decline angle increased, the ankle plantar-flexor moments decreased; however, an increase in the EMG activity was seen with the 24° decline angle compared with the 16° decline angle. This indicates that decline squats at an angle greater than 16° may not reduce passive calf tension, as was suggested previously, and may provide no mechanical advantage for the knee.

scholarly journals Quality of Knee Strengthening Exercises Performed at Home Deteriorates After One Week

2021 ◽  
Author(s):  
Ulrike H. Mitchell ◽  
Hyunwook Lee ◽  
Hayden E. Dennis ◽  
Matthew K. Seeley
Keyword(s):  
Repeated Measures ◽  
Knee Flexion ◽  
High Speed ◽  
External Rotation ◽  
Cross Sectional Study ◽  
Older Individuals ◽  
Middle Aged ◽  
Cross Sectional ◽  
Hip Abduction ◽  
Straight Leg Raise

Abstract Background: To compare the performance (as determined by lower extremity kinematics) of knee exercises in healthy middle-aged and older individuals immediately after instruction and one week later. Methods: This is a cross-sectional study in a laboratory setting. Nineteen healthy volunteers (age [y] 63.1 ± 8.6, mass [kg] 76.3 ± 14.7, height [m] 1.7 ± 0.1) participated in this study. High speed video and reflective markers were used to track motion during four exercises. The exercises were knee flexion, straight leg raise, and “V“ in supine position, and hip abduction in side lying position. All participants received verbal and tactile cues during the training phase and the therapist observed and, if necessary, corrected the exercises. Upon return a week later the participants performed the same exercises without any further instructions. Knee and hip sagittal and rotational angles were extracted from the motion capture. A repeated measures t-test was used to compare the motions between two visits. Results: Participants demonstrated more knee flexion during straight leg raise and “V in” exercises at the 2nd visit compared to the 1st visit (both p < 0.05). During the “V out” exercise, they performed more external rotation (p < 0.05) while they showed more internal rotation during the “V in” exercise at the 2nd visit compared to the 1st visit. Conclusions: Exercise performance declined significantly in healthy middle-aged and older individuals one week after instruction. This decline occurred despite an instructional exercise sheet being given to every participant. Improper execution of exercise programs might prolong the rehabilitation time and increase levels of pain and impairment unnecessarily.

scholarly journals The extensor efficiency of unicompartmental, bicompartmental, and total knee arthroplasty

2021 ◽  
Vol 10 (1) ◽  
pp. 1-9
Author(s):  
Amy Garner ◽  
Oliver Dandridge ◽  
Andrew A. Amis ◽  
Justin P. Cobb ◽  
Richard J. van Arkel
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Repeated Measures ◽  
Daily Activity ◽  
Knee Flexion ◽  
Knee Extensor ◽  
Or Efficiency ◽  
Repeated Measures Analysis ◽  
Total Knee ◽  
Bicompartmental Knee Arthroplasty

Aims Unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BCA) have been associated with improved functional outcomes compared to total knee arthroplasty (TKA) in suitable patients, although the reason is poorly understood. The aim of this study was to measure how the different arthroplasties affect knee extensor function. Methods Extensor function was measured for 16 cadaveric knees and then retested following the different arthroplasties. Eight knees underwent medial UKA then BCA, then posterior-cruciate retaining TKA, and eight underwent the lateral equivalents then TKA. Extensor efficiency was calculated for ranges of knee flexion associated with common activities of daily living. Data were analyzed with repeated measures analysis of variance (α = 0.05). Results Compared to native, there were no reductions in either extension moment or efficiency following UKA. Conversion to BCA resulted in a small decrease in extension moment between 70° and 90° flexion (p < 0.05), but when examined in the context of daily activity ranges of flexion, extensor efficiency was largely unaffected. Following TKA, large decreases in extension moment were measured at low knee flexion angles (p < 0.05), resulting in 12% to 43% reductions in extensor efficiency for the daily activity ranges. Conclusion This cadaveric study found that TKA resulted in inferior extensor function compared to UKA and BCA. This may, in part, help explain the reported differences in function and satisfaction differences between partial and total knee arthroplasty. Cite this article: Bone Joint Res 2021;10(1):1–9.

Health Status of Senior Citizens: A Cross-sectional study

2020 ◽  
Vol 11 (01) ◽  
Author(s):  
Priyanka Beniwal ◽  
Chandrakala Singh
Keyword(s):  
Health Status ◽  
Senior Citizens ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Age Group ◽  
Poor Health Status ◽  
Cross Sectional ◽  
Males And Females ◽  
The Individual ◽  
Average Health

Aging is a series of processes that begin with life and continue throughout the lifecycle. It represents the closing period in the lifespan, a time when the individual looks back on life, lives on past accomplishments and begins to finish off his life course. It represents the accumulation of changes in person over time. The study aims to investigate the health status of senior citizens. The present study was carried out in Hisar and Sirsa district of Haryana state. A total of 400 elderly equally representing both males and females of age group 65-70 years were selected randomly for the study. Modified inventory developed by Khan and Lal (2011) was used to assess health status of senior citizens. The results of the study elucidated that health status of senior citizens depicted that 54.25 per cent of the total respondents had average health status followed by good (25.25%) and poor health status (20.50%). The most common health problems reported by the senior citizens were joint pains, back pains, blood pressure, and chest pain etc. Gender wise comparison of total sample further pointed out that females were poor in their health against males.

A cross-sectional survey among physicians on Internet use for epilepsy-related information (Preprint)

2019 ◽  
Author(s):  
Francesco Brigo ◽  
Simona Lattanzi ◽  
Giorgia Giussani ◽  
Laura Tassi ◽  
Nicola Pietrafusa ◽  
...  
Keyword(s):  
Internet Use ◽  
The Internet ◽  
Online Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Information ◽  
Internet Users ◽  
Therapeutic Decisions ◽  
The Individual ◽  
The Web

BACKGROUND The Internet has become one of the most important sources of health information, accessed daily by an ever-growing number of both patients and physicians, seeking medical advice and clinical guidance. A deeper insight into the current use of the Web as source of information on epilepsy would help in clarifying the individual attitude towards this medium by Internet users. OBJECTIVE We investigated views towards the Internet in a sample of Italian healthcare specialists involved in epilepsy field, to explore factors which explained the influence of information found on the internet. METHODS This study was a self-administered survey conducted in a group of members of the Italian Chapter of the International League Against Epilepsy (ILAE) in January 2018. RESULTS 184 questionnaires were analyzed. 97.8% of responders reported to seek online information on epilepsy. The Internet was most frequently searched to obtain new information (69.9%) or to confirm a diagnostic or therapeutic decision (37.3%). The influence of consulting the Internet on clinical practice was associated with registration to social network(s) (OR: 2.94; 95%CI: 1.28-6.76; p=0.011), higher frequency of Internet use (OR: 3.66; 95%CI: 1.56-9.21; p=0.006) and higher confidence in reliability of online information (OR: 2.61; 95%CI: 1.09-6.26; p=0.031). No association was found with age, sex, years in epilepsy practice or easiness to find online information. CONCLUSIONS Internet is frequently used among healthcare professionals involved in the epilepsy to obtain information about this disease. The attitude of being influenced by the Internet for diagnostic and/or therapeutic decisions in epilepsy is independent on age and years of experience in epilepsy, and probably reflects an individual approach towards the Web.

Reliability and Concurrent Validity of Shoulder Tissue Irritability Classification

2021 ◽  
Author(s):  
Stephen M Kareha ◽  
Philip W McClure ◽  
Alicia Fernandez-Fernandez
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Repeated Measures ◽  
Concurrent Validity ◽  
Reliability And Validity ◽  
Strong Relationship ◽  
Rating System ◽  
Roc Curve Analysis ◽  
Cross Sectional

Abstract Objective Rating tissue irritability has been recommended to aid decision making in several recent clinical practice guidelines. An explicit method for rating tissue irritability was proposed as part of the Staged Algorithm for Rehabilitation Classification: Shoulder Disorders (STAR-Shoulder), but the reliability and validity of this classification are unknown. The purpose of this study was to examine the reliability and concurrent validity of shoulder tissue irritability ratings as part of a system designed to guide appropriate treatment strategy and intensity. Methods A clinical measurement, prospective repeated-measures cross-sectional design was used. The 101 consecutive participants with primary complaints of shoulder pain were assessed by pairs of blinded raters (24 raters in total) and rated for tissue irritability. Patients completed 3 patient-rated outcome (PRO) measures reflecting both pain and disability, and these scores were compared with ratings of tissue irritability. Paired ratings of irritability were analyzed for reliability with prevalence-adjusted, bias-adjusted Kappa for ordinal scales (PABAK-OS). Analysis of variance (ANOVA) was used to compare PRO measures across different levels of irritability. Receiver operating characteristic (ROC) curve analysis was utilized to derive cut-off scores for 3 PRO instruments. Results Interrater reliability was 0.69 (95% CI = 0.59–0.78), with 67% agreement. All PRO measures were significantly different among 3 levels of tissue irritability. Conclusion There appear to be acceptable reliability and a strong relationship between PRO measures and therapist-rated tissue irritability, supporting the use of the STAR-Shoulder irritability rating system. Impact Several clinical practice guidelines have recommended that clinicians rate tissue irritability as part of their examination. This study provides important new information supporting the reliability and validity of the STAR-Shoulder tissue irritability rating system.

scholarly journals The trends of complementary alternative medicine use among cancer patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdul Rahman Jazieh ◽  
Khadega A. Abuelgasim ◽  
Husam I. Ardah ◽  
Mohammad Alkaiyat ◽  
Omar B. Da’ar
Keyword(s):  
Alternative Medicine ◽  
Cancer Patients ◽  
Clinical Information ◽  
Cross Sectional Study ◽  
Complementary Alternative Medicine ◽  
Cultural Changes ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Cam Use ◽  
The Individual

Abstract Background The use of complementary and alternative medicine (CAM) is common among cancer patients and it may reflect the individual and societal beliefs on cancer therapy. Our study aimed to evaluate the trends of CAM use among patients with cancer between 2006 and 2018. Methods We included 2 Cohorts of patients with cancer who were recruited for Cohort 1 between 2006 and 2008 and for Cohort 2 between 2016 and 2018. The study is a cross-sectional study obtaining demographic and clinical information and inquiring about the types of CAM used, the reasons to use them and the perceived benefits. We compared the changes in the patterns of CAM use and other variables between the two cohorts. Results A total of 1416 patients were included in the study, with 464 patients in Cohort 1 and 952 patients in Cohort 2. Patients in Cohort 2 used less CAM (78.9%) than Cohort 1 (96.8%). Cohort 1 was more likely to use CAM to treat cancer compared to Cohort 2 (84.4% vs. 73%, respectively, p < 0.0001,); while Cohort 2 used CAM for symptom management such as pain control and improving appetite among others. Disclosure of CAM use did not change significantly over time and remains low (31.6% in Cohort 1 and 35.7% for Cohort 2). However, physicians were more likely to express an opposing opinion against CAM use in Cohort 2 compared to Cohort 1 (48.7% vs. 19.1%, p < 0.001, respectively). Conclusion There is a significant change in CAM use among cancer patients over the decade, which reflects major societal and cultural changes in this population. Further studies and interventions are needed to improve the disclosure to physicians and to improve other aspects of care to these patients.

Sign in / Sign up

Export Citation Format

Share Document