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42 result(s) for "Milani, Thomas L."
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Integrating a Potentiometer into a Knee Brace Shows High Potential for Continuous Knee Motion Monitoring
Continuous monitoring of knee motion can provide deep insights into patients’ rehabilitation status after knee injury and help to better identify their individual therapeutic needs. Potentiometers have been identified as one possible sensor type for continuous monitoring of knee motion. However, to verify their use in monitoring real-life environments, further research is needed. We aimed to validate a potentiometer-embedded knee brace to measure sagittal knee kinematics during various daily activities, as well as to assess its potential to continuously monitor knee motion. To this end, the sagittal knee motion of 32 healthy subjects was recorded simultaneously by an instrumented knee brace and an optoelectronic reference system during activities of daily living to assess the agreement between these two measurement systems. To evaluate the potentiometer’s behavior during continuous monitoring, knee motion was continuously recorded in a subgroup (n = 9) who wore the knee brace over the course of a day. Our results show a strong agreement between the instrumented knee brace and reference system across all investigated activities as well as stable sensor behavior during continuous tracking. The presented potentiometer-based sensor system demonstrates strong potential as a device for measuring sagittal knee motion during daily activities as well as for continuous knee motion monitoring.
The Effect of the Accelerometer Operating Range on Biomechanical Parameters: Stride Length, Velocity, and Peak Tibial Acceleration during Running
Previous studies have used accelerometers with various operating ranges (ORs) when measuring biomechanical parameters. However, it is still unclear whether ORs influence the accuracy of running parameters, and whether the different stiffnesses of footwear midsoles influence this accuracy. The purpose of the present study was to systematically investigate the influence of OR on the accuracy of stride length, running velocity, and on peak tibial acceleration. Twenty-one recreational heel strike runners ran on a 15-m indoor track at self-selected running speeds in three footwear conditions (low to high midsole stiffness). Runners were equipped with an inertial measurement unit (IMU) affixed to the heel cup of the right shoe and with a uniaxial accelerometer at the right tibia. Accelerometers (at the tibia and included in the IMU) with a high OR of ±70 g were used as the reference and the data were cut at ±32, ±16, and at ±8 g in post-processing, before calculating parameters. The results show that the OR influenced the outcomes of all investigated parameters, which were not influenced by tested footwear conditions. The lower ORs were associated with an underestimation error for all biomechanical parameters, which increased noticeably with a decreasing OR. It can be concluded that accelerometers with a minimum OR of ±32 g should be used to avoid inaccurate measurements.
The ‘Ride’ Feeling during Running under Field Conditions—Objectified with a Single Inertial Measurement Unit
Foot rollover and the ‘ride’ feeling that occurs during heel–toe transition during running have been investigated mostly in laboratory settings due to the technical requirements of ‘golden standard’ measurement devices. Hence, the purpose of the current study was to investigate ‘ride’ and rollover with a heel cap-mounted inertial measurement unit (IMU) when running under field conditions to get realistic results. Twenty athletes ran on a 1 km outdoor track with five different shoe conditions, only differing in their midsole bending stiffness. The peak angular velocity (PAV) in the sagittal plane of the shoe was analyzed. The subjective evaluation of the ‘ride’ perception during heel–toe transition was rated on a visual analogue scale. The results revealed that PAV and ‘ride’ varied for the different shoes. The regression analysis showed that PAV has a significant impact on the ‘ride’ rating (R2 = 0.952; p = 0.005). The shoe with a medium midsole bending stiffness had the lowest value for PAV (845.6 deg/s) and the best rating of perceived ‘ride’ on average. Our results show that IMU can be used as a low-cost method to investigate the heel–toe transition during field-running. In addition, we found that midsole bending stiffness influenced PAV and the subjective feeling of ‘ride’.
Vibration Perception Thresholds of Skin Mechanoreceptors Are Influenced by Different Contact Forces
Determining vibration perception thresholds (VPT) is a central concern of clinical research and science to assess the somatosensory capacity of humans. The response of different mechanoreceptors to an increasing contact force has rarely been studied. We hypothesize that increasing contact force leads to a decrease in VPTs of fast-adapting mechanoreceptors in the sole of the human foot. VPTs of 10 healthy subjects were measured at 30 Hz and 200 Hz at the heel of the right foot using a vibration exciter. Contact forces were adjusted precisely between 0.3 N–9.6 N through an integrated force sensor. Significant main effects were found for frequency and contact force. Furthermore, there was a significant interaction for frequency and contact force, meaning that the influence of an increasing contact force was more obvious for the 30 Hz condition. We presume that the principles of contrast enhancement and spatial summation are valid in Meissner and Pacinian corpuscles, respectively. In addition to spatial summation, we presume an effect on Pacinian corpuscles due to their presence in the periosteum or interosseous membrane.
Anticipatory Postural Adjustments and Compensatory Postural Responses to Multidirectional Perturbations—Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s Disease
Background: Postural instability is one of the most restricting motor symptoms for patients with Parkinson’s disease (PD). While medication therapy only shows minor effects, it is still unclear whether medication in conjunction with deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves postural stability. Hence, the aim of this study was to investigate whether PD patients treated with medication in conjunction with STN-DBS have superior postural control compared to patients treated with medication alone. Methods: Three study groups were tested: PD patients on medication (PD-MED), PD patients on medication and on STN-DBS (PD-MED–DBS), and healthy elderly subjects (HS) as a reference. Postural performance, including anticipatory postural adjustments (APA) prior to perturbation onset and compensatory postural responses (CPR) following multidirectional horizontal perturbations, was analyzed using force plate and electromyography data. Results: Regardless of the treatment condition, both patient groups showed inadequate APA and CPR with early and pronounced antagonistic muscle co-contractions compared to healthy elderly subjects. Comparing the treatment conditions, study group PD-MED–DBS only showed minor advantages over group PD-MED. In particular, group PD-MED–DBS showed faster postural reflexes and tended to have more physiological co-contraction ratios. Conclusion: medication in conjunction with STN-DBS may have positive effects on the timing and amplitude of postural control.
Running and Jumping After Muscle Fatigue in Subjects with a History of Knee Injury: What Are the Acute Effects of Wearing a Knee Brace on Biomechanics?
The knee is one of the most frequently injured joints, involving various structures. To prevent reinjury after rehabilitation, braces are commonly used. However, most studies on knee supports focus on subjects with anterior cruciate ligament (ACL) injuries and do not account for muscle fatigue, which typically occurs during prolonged intense training and can significantly increase the risk of injury. Hence, this study investigates the acute effects of wearing a knee brace on biomechanics in subjects with a history of various unilateral knee injuries or pain under muscle fatigue. In total, 50 subjects completed an intense fatigue protocol and then performed counter-movement jumps and running tests on a force plate while tracking kinematics with a marker-based 3D motion analysis system. Additionally, subjects filled out a visual analog scale (VAS) to assess knee pain and stability. Tests were conducted on the injured leg with and without a knee brace (Sports Knee Support, Bauerfeind AG, Zeulenroda-Triebes, Germany) and on the healthy leg. Results indicated that wearing the knee brace stabilized knee movement in the frontal plane, with a significant reduction in maximal medio-lateral knee acceleration and knee abduction moment during running and jumping. The brace also normalized loading on the injured leg. We observed higher maximal knee flexion moments, which were associated with increased vertical ground reaction forces, segment velocities, and knee flexion angles. Subjects reported less pain and greater stability while wearing the knee brace. Therefore, we confirm that wearing a knee brace on the injured leg improves joint biomechanics by enhancing stability and kinematics and reducing pain during running and jumping, even with muscle fatigue. Consequently, wearing a knee brace after a knee joint injury may reduce the risk of reinjury.
Immediate Effects of Wearing an Ankle Bandage on Fine Coordination, Proprioception, Balance and Gait in the Subacute Phase of Ankle Sprains
Ankle sprains are the most frequently occurring musculoskeletal injuries among recreational athletes. Ankle support through bandages following the initial orthotic treatment might be beneficial for rehabilitation purposes. However, the literature is sparse regarding the use of an ankle support directly after the acute phase of an ankle sprain. Therefore, this study investigates the hypothesis that wearing an ankle bandage immediately after an acute ankle sprain improves motor performance, stability and reduces pain. In total, 70 subjects with acute unilateral supination trauma were tested. Subjects were tested five weeks post-injury to assess immediate effects of the ankle bandage. On the testing day, subjects completed rating questionnaires and underwent comprehensive biomechanical assessments. Biomechanical investigations included fine coordination and proprioception tests, single leg stances, the Y-Balance test, and gait analysis. All biomechanical investigations were conducted for the subject’s injured leg with and without a bandage (MalleoTrain® Bauerfeind AG, Zeulenroda-Triebes, Germany) and the healthy leg. Results indicated moderate to strong improvements in ankle stability and pain relief while wearing the bandage. Wearing the bandage significantly normalized single leg stance performance (p < 0.001), stance phase duration (p < 0.001), and vertical ground reaction forces during walking (p < 0.05). However, the bandage did not have a clear effect on fine coordination and proprioception. The findings of our study suggest that ankle bandages may play a crucial role in early-stage rehabilitation by enhancing motor performance and reducing pain.
Vertical contact forces affect vibration perception in human hairy skin
Background Skin is the largest organ of the human body and fulfills many important functions, like detecting mechanical stimuli. Skin can be divided into glabrous (non-hairy) and hairy skin. These two skin types differ with regard to their mechanical properties and in the distribution of mechanoreceptors. Although many investigations focus on glabrous skin, hairy skin still plays a fundamental role in various activities, e.g., with regard to the perception of pleasantness or for developing wearable vibrotactile devices for pattern recognition in persons with disabilities. Unfortunately, investigations on influencing factors, like vertical contactor force, are scarce for hairy skin. Similarly, it would also be interesting to investigate whether regional vibratory sensitivity differences are present across the human torso. Hence, this study investigated the effects of vertical contactor forces and different anatomical locations on vibration perception. Four anatomical torso regions were studied. Based on findings in glabrous skin, we generally hypothesized improved vibration perception with increasing contactor forces and regional sensitivity differences between the anatomical locations. Methods Forty young and healthy individuals participated (23.0 ± 2.0 yrs), and vibration perception thresholds (VPTs) were determined at 30 Hz for three vertical force levels (0.6, 2.4, and 4.8 N) at four torso locations (sternum, deltoid/shoulder, lower back, middle lateral torso side). Results Higher contactor forces resulted in lower VPTs corresponding to improved vibration perception, regardless of anatomical location. In addition, the sternum region was more sensitive than the remaining three regions, regardless of force level. The reasons for these findings may be a varying number and activation pattern of afferents activated under the different conditions. The findings of this study complement the understanding of vibrotactile sensitivity in hairy skin and may offer implications when developing vibrotactile devices or clothing/textiles, for example.
An Investigation of Running Kinematics with Recovered Anterior Cruciate Ligament Reconstruction on a Treadmill and In-Field Using Inertial Measurement Units: A Preliminary Study
Anterior cruciate ligament reconstruction (ACLR) may affect movement even years after surgery. The purpose of this study was to determine possible interlimb asymmetries due to ACLR when running on a treadmill and in field conditions, with the aim of contributing to the establishment of objective movement assessment in real-world settings; moreover, we aimed to gain knowledge on recovered ACLR as a biomechanical risk factor. Eight subjects with a history of unilateral ACLR 5.4 ± 2.8 years after surgery and eight healthy subjects ran 1 km on a treadmill and 1 km on a concrete track. The ground contact time and triaxial peak tibial accelerations were recorded using inertial measurement units. Interlimb differences within subjects were tested and compared between conditions. There were no significant differences between limbs in the ACLR subjects or in healthy runners for any of the chosen parameters on both running surfaces. However, peak tibial accelerations were higher during field running (p-values < 0.01; Cohen’s d effect sizes > 0.8), independent of health status. To minimize limb loading due to higher impacts during field running, this should be considered when choosing a running surface, especially in rehabilitation or when running with a minor injury or health issues.
Pelvic Belt Effects on Health Outcomes and Functional Parameters of Patients with Sacroiliac Joint Pain
The sacroiliac joint (SIJ) is a common source of low back pain. However, clinical and functional signs and symptoms correlating with SIJ pain are widely unknown. Pelvic belts are routinely applied to treat SIJ pain but without sound evidence of their pain-relieving effects. This case-control study compares clinical and functional data of SIJ patients and healthy control subjects and evaluates belt effects on SIJ pain. 17 SIJ patients and 17 healthy controls were included in this prospective study. The short-form 36 survey and the numerical rating scale were used to characterize health-related quality of life in patients in a six-week follow-up and the pain-reducing effects of pelvic belts. Electromyography data were obtained from the gluteus maximus, biceps femoris, rectus femoris and medial vastus. Alterations of muscle activity, variability and gait patterns were compared in patients and controls along with the belts' effects in a dynamic setting when walking. Significant improvements were observed in the short-form 36 survey of the SIJ patients, especially in the physical health subscores. Minor declines were also observed in the numerical rating scale on pain. Belt-related changes of muscle activity and variability were similar in patients and controls with one exception: the rectus femoris activity decreased significantly in patients with belt application when walking. Further belt effects include improved cadence and gait velocity in patients and controls. Pelvic belts improve health-related quality of life and are potentially attributed to decreased SIJ-related pain. Belt effects include decreased rectus femoris activity in patients and improved postural steadiness during locomotion. Pelvic belts may therefore be considered as a cost-effective and low-risk treatment of SIJ pain. ClinicalTrials.gov NCT02027038.