Musculoskeletal Rehabilitation and Clinical Biomechanics

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (30 January 2024) | Viewed by 24033

Special Issue Editors

IRCCS Rizzoli Orthopaedic Institute, University of Bologna,40126 Bologna, Italy
Interests: gait analysis; dynamic electromyography; joint biomechanics
IRCCS Rizzoli Orthopaedic Institute, University of Bologna,40126 Bologna, Italy
Interests: rehabilitation; sports medicine; musculoskeletal diseases; arthrogenic muscle inhibition; neuromuscular electrical stimulation
Istituto Ortopedico Rizzoli, University of Bologna,40126 Bologna, Italy
Interests: orthopedic and rehabilitation

Special Issue Information

Dear Colleagues,

Clinical biomechanics helps us to understand the causes or contributing factors underlying musculoskeletal impairment.

Today, advanced instrumental technologies are available to measure joints, muscles and the overall human performance, with the aim of reducing the complexity of the musculoskeletal system.

However, the clinical biomechanics findings provided by research are often poorly translated in daily clinical practice to improve impairment and disability outcome in rehabilitation.

Biomechanical research is commonly based on the collection, processing and analysis of complex data during several motor tasks, or simply just describing the biomechanical assessment of a single musculoskeletal district such as the shoulder, the spine or the knee. A greater effort should be made to direct clinical biomechanics studies to the solution of clinical problems in order to guide clinical decisions. The reliability, validity and responsiveness of measurements are also to be considered, because they can be used for clinical purposes.

Furthermore, musculoskeletal disorders in the domain of rehabilitation have a complex multi-dimensional nature, which, besides the physical (biomechanical), also includes psychological, cognitive, lifestyle, social and neuro-physiological factors.

Strengthening the link between clinical biomechanical research and the rehabilitation of the musculoskeletal system is a major issue to enhance the management of musculoskeletal diseases.

This Special Issue of Applied Sciences, “Musculoskeletal rehabilitation and clinical biomechanics”, aims to cover recent advances in the field of clinical biomechanics through the use of instrumental assessment measures to inform clinical practice in musculoskeletal rehabilitation. Papers should address innovative solutions in this field, including motion analysis, studies on soft tissues’ biomechanical properties and evidence-based kinesiological approaches for exercise.

Some topics include, but are not limited to, clinical biomechanical applications in the following fields:

  • Rehabilitation of the spine (scoliosis, low back pain);
  • Sport rehabilitation;
  • Rehabilitation in Cerebral Palsy;
  • Rehabilitation in the elderly;
  • Orthopedic rehabilitation;
  • Prevention of risk of fall;
  • Muscle, tendon and joint diseases. 

Prof. Dr. Maria Grazia Benedetti
Dr. Luciana Labanca
Dr. Danilo Donati
Guest Editors

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Published Papers (12 papers)

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13 pages, 902 KiB  
Article
Improved Physical Function following a Three-Month, Home-Based Resistance Training Program for Fragile Patients with Poor Recovery Years after Femoral Neck Fracture—A Prospective Cohort Study
by Christina Frølich Frandsen, Inger Mechlenburg, Sara Birch, Lone Lundager, Torben Bæk-Hansen and Maiken Stilling
Appl. Sci. 2024, 14(2), 552; https://doi.org/10.3390/app14020552 - 08 Jan 2024
Viewed by 580
Abstract
Patients sustaining a hip fracture experience reduced function and an increased risk of recurrent falls and institutionalization following surgical treatment. Rehabilitation programs that are feasible for home-based training could improve patient-reported outcomes and physical function while lowering the care need and social dependency [...] Read more.
Patients sustaining a hip fracture experience reduced function and an increased risk of recurrent falls and institutionalization following surgical treatment. Rehabilitation programs that are feasible for home-based training could improve patient-reported outcomes and physical function while lowering the care need and social dependency of this patient group. In the present study, we designed and tested a home-based resistance training program on a group of patients with a femoral neck fracture (FNF) selected according to their poor post-operative functional recovery following an FNF. The results showed that the training program was feasible to perform for the patients, and after three months of training, the patients’ walking, physical activity, and patient-reported outcome measures improved. The patients were encouraged to continue walking and performing the training program, but twelve months after the FNF, the results were comparable to the baseline. Background: Femoral neck fracture (FNF) is associated with reduced function, often leading to an increased care need and a greater risk of recurrent falls. Thus, rehabilitation should be a priority. The present study investigated the training potential among fragile FNF patients with poor functional performance treated with total hip arthroplasty. Methods: In a prospective cohort study, 32 participants were included based on poor functional recovery following an FNF fracture. The participants completed a three-month, physiotherapy-guided, home-based resistance training program. At the baseline and three-month follow-up, physiotherapists performed functional tests and measured spatiotemporal parameters, muscle strength, and muscle mass. The Oxford hip score (OHS) questionnaire was administered and physical activity measurements were performed at baseline and at three-month and 12-month follow-ups. Results: Walking distance, step length, walking speed, and muscle strength increased at the three-month follow-up (p < 0.05). OHS scores increased from the baseline to the 12-month follow-up. Physical activity after three months showed more time spent standing (p = 0.02) and walks of 5–10 min (p = 0.002) compared to the baseline. At the 12-month follow-up, physical activity was similar to the baseline. Conclusions: Fragile patients with low functional performance following FNF displayed training potential with an improvement in function, strength, and physical activity. However, continued training is necessary in order to maintain the positive effects. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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11 pages, 911 KiB  
Article
Feasibility of Shoulder Kinematics Assessment Using Magnetic Inertial Measurement Units in Hemiplegic Patients after Stroke: A Pilot Study
by Maria Longhi, Danilo Donati, Monica Mantovani, Silvia Casarotti, Lucia Calbucci, Giulia Puglisi, Daniela Platano and Maria Grazia Benedetti
Appl. Sci. 2023, 13(21), 11900; https://doi.org/10.3390/app132111900 - 31 Oct 2023
Viewed by 646
Abstract
Scapulothoracic movements are altered after stroke, with resulting shoulder dysfunction. The scapulohumeral rhythm (SHR) is complex and poorly studied. Magnetic inertial measurement units (MIMUs) allow a rapid and accurate analysis of shoulder kinematics. MIMUs were used to assess the SHR during active shoulder [...] Read more.
Scapulothoracic movements are altered after stroke, with resulting shoulder dysfunction. The scapulohumeral rhythm (SHR) is complex and poorly studied. Magnetic inertial measurement units (MIMUs) allow a rapid and accurate analysis of shoulder kinematics. MIMUs were used to assess the SHR during active shoulder flexion and abduction of over 60°. SHR values obtained from the hemiplegic shoulders of stroke patients (n = 7) were compared with those from healthy controls (n = 25) and correlated with clinical–functional measurements. The impairment of paretic arms was assessed using the Fugl-Meyer Assessment (FMA). We found that in paretic shoulders, the scapular tilt was significantly lower at maximal arm flexion and at 60° and 90° of arm abduction. On the paretic side, the SHR was also consistently lower for all measured arm movements. The FMA was correlated with the scapular anterior–posterior tilt at 60° and 90° of shoulder abduction (Rho = 0.847, p = 0.016, and Rho = 0.757, p = 0.049, respectively). This pilot study demonstrates the feasibility of MIMUs in assessing SHR in stroke patients and confirms previous findings on scapular dysfunction in stroke patients. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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11 pages, 1023 KiB  
Article
EMG Signs of Motor Units’ Enlargement in Stroke Survivors
by Talita P. Pinto, Andrea Turolla, Marco Gazzoni, Michela Agostini and Taian M. Vieira
Appl. Sci. 2023, 13(4), 2680; https://doi.org/10.3390/app13042680 - 19 Feb 2023
Viewed by 1336
Abstract
The degeneration of lower motoneurons has often been reported in stroke survivors, with possible collateral reinnervation from the surviving motoneurons to the denervated muscle fibers. Under this assumption, a stroke would be expected to increase the size of motor units in paretic muscles. [...] Read more.
The degeneration of lower motoneurons has often been reported in stroke survivors, with possible collateral reinnervation from the surviving motoneurons to the denervated muscle fibers. Under this assumption, a stroke would be expected to increase the size of motor units in paretic muscles. We indirectly address this issue with electrical stimulation and surface electromyography, asking whether stroke leads to greater variations in the amplitude of M waves elicited in paretic muscles than in contralateral, non-paretic muscles. Current pulses at progressively greater intensities were applied to the musculocutaneous nerve, stimulating motoneurons supplying the biceps brachii of eight stroke patients. The size of increases in the amplitude of M waves elicited consecutively, hereafter defined as increments, was considered to evaluate changes in the innervation ratio of biceps brachii motor units following stroke. Our findings showed that patients presented significantly (p = 0.016) greater increments in muscles of paretic than in non-paretic limbs. This result corroborates the notion that collateral reinnervation takes place after stroke, enlarging motor units’ size and the magnitude of the muscle responses. Therefore, the non-invasive analysis proposed here may be useful for health professionals to assess disease progression by tracking for neuromuscular changes likely associated with clinical outcomes in stroke survivors, such as in the muscles’ strength. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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11 pages, 858 KiB  
Article
The Relationship between Gait Velocity and Walking Pattern in Hemiplegic Patients
by Barbara Nesi, Antonio Taviani, Lucia D’Auria, Roberta Bardelli, Giuseppe Zuccarello, Daniela Platano, Maria Grazia Benedetti and Francesco Benvenuti
Appl. Sci. 2023, 13(2), 934; https://doi.org/10.3390/app13020934 - 10 Jan 2023
Cited by 1 | Viewed by 5824
Abstract
Background Gait speed represents a functional predictor and an impairment severity index in stroke survivors; gait analysis parameters are descriptors of walking strategies used to compensate for the muscle impairment such as vaulting, circumduction and hip hiking. The aim of this study was [...] Read more.
Background Gait speed represents a functional predictor and an impairment severity index in stroke survivors; gait analysis parameters are descriptors of walking strategies used to compensate for the muscle impairment such as vaulting, circumduction and hip hiking. The aim of this study was to assess if there is a relationship between the gait compensatory strategy and gait speed of progression. Methods A sample of 30 patients with post-stroke hemiparesis was assessed for gait compensatory patterns through gait analysis and videorecording. BMI, pain-VAS, Barthel Index, Nottingham Extended ADL Scale, Motricity Index, lower limb muscles strength and aROMs were also included in the assessment. Results In 19 patients it was possible to identify one or more compensatory strategies; in 11 patients no specific gait pattern was found. The vaulting and hip hiking combined gait strategy had an effect on gait speed. Gait speed was directly related to Barthel Index, Nottingham Extended ADL Scale, Motricity Index of the paretic side and in particular with quadriceps and iliopsoas strength and hip extension aROM. Gender, age and paretic side did not influence gait speed. Conclusion Compensatory gait strategies influence gait speed but studies with larger sample size are needed to better highlight their impact. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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13 pages, 1251 KiB  
Article
A Comparison of Hip Muscle Mass, Muscle Power, and Clinical Outcomes with Long-Term Follow-Up in Patients with Metal-on-Metal Hip Arthroplasty Compared to Metal-on-Polyethylene Hip Arthroplasty
by Mette Holm Hjorth, Inger Mechlenburg, Frederik Nicolai Foldager, Marianne Tjur and Maiken Stilling
Appl. Sci. 2022, 12(24), 12772; https://doi.org/10.3390/app122412772 - 13 Dec 2022
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Abstract
(1) Background: Metal-on-metal (MoM) total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) was presumed to provide superior functional outcomes compared to metal-on-polyethylene (MoP) THA. (2) Methods: We compared muscle mass, power, step test asymmetry, and patient-reported outcomes between MoM THA/HRA and MoP [...] Read more.
(1) Background: Metal-on-metal (MoM) total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) was presumed to provide superior functional outcomes compared to metal-on-polyethylene (MoP) THA. (2) Methods: We compared muscle mass, power, step test asymmetry, and patient-reported outcomes between MoM THA/HRA and MoP THA. A total of 51 MoM THA/HRAs and 23 MoP THAs participated in the cross-sectional study at a mean of 6.5 (2.4–12.5) years postoperatively. Muscle mass was measured by Dual energy X-ray Absorption (DXA) scans and muscle power in a Leg Extensor Power Rig. Step test asymmetry was obtained with an Inertial Measurement Unit (IMU). The patients completed the Harris Hip Score (HHS) and the Copenhagen Hip and Groin Outcome Score (HAGOS). (3) Results: The MoM THA/HRA group had a greater inter-limb difference in hip muscle mass compared to the MoP THA group (p = 0.02). Other inter-limb differences in muscle mass and power were similar (p > 0.05). Muscle mass of the thigh and calf area and muscle power in both legs were higher in MoM THA/HRA compared to MoP THA (p < 0.009). Step test time asymmetry when ascending was lower in MoM THA/HRA compared to MoP THA (p = 0.03). HHS and HAGOS scores were similar between groups (p > 0.05). (4) Conclusion: Overall, we could not verify the hypothesis that MoM THA/HRA contributes to superior functional outcomes compared to MoP THA. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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11 pages, 550 KiB  
Article
Skeletal Muscle Symptoms in Students of Health Majors with Dependence on Mobile Devices: An Observational Descriptive Study
by Claudia F. Giraldo-Jiménez, Ana M. Jembuel-Giraldo, Juan C. Galeano-Zapata, Arleidis M. Quintana-Caro, Alejandro Botero-Carvajal, Augusto Valderrama-Aguirre and Juan C. Millán-Estupiñan
Appl. Sci. 2022, 12(17), 8736; https://doi.org/10.3390/app12178736 - 31 Aug 2022
Cited by 1 | Viewed by 1343
Abstract
In the world, there are more mobile phone lines than people. These numbers have been increasing, especially in university students, due to the academic and social demands of a globalized and interconnected world in social networks, raising concerns about the health effects of [...] Read more.
In the world, there are more mobile phone lines than people. These numbers have been increasing, especially in university students, due to the academic and social demands of a globalized and interconnected world in social networks, raising concerns about the health effects of mobile device overuse. The goal of this study was to establish the relationship between musculoskeletal symptoms in students at the health department of an institution of higher education and their dependence on mobile devices. An observational, descriptive study in which 334 interviews were presented, of which 244 were selected, corresponding to students with dependence on mobile devices. We find most symptoms in the neck (56.3%), followed by the dorsal region with (49.4%), wrist (42.6%), shoulder (33.9%), and elbow (9.6%). Study correlations were low for the back (Rho: 0.274) and wrist (Rho: 0.200) and very low for the neck (Rho: 0.171) and shoulder (Rho: 0.142). The presence of musculoskeletal symptoms, mainly in the neck, back, and wrist in university students with dependence on mobile devices belonging to the health department associated with academic programs in phonoaudiology, physiotherapy, and medicine, is common; however, the correlation was found to be low between dependency level and pain in the back and wrist and very low between dependency level and pain in the neck. Our results suggest that university wellness programs should focus on the neck, dorsal region of the back, wrist, and shoulder and that contrary to what was previously thought, there is a low correlation between dependence on cell phone use and musculoskeletal symptoms. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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10 pages, 753 KiB  
Article
Reliability and Validity of IMU-Based Foot Progression Angle Measurement under Different Gait Retraining Strategies
by Francine C. A. Urbanus, Jane Grayson, Jaap Harlaar and Milena Simic
Appl. Sci. 2022, 12(13), 6519; https://doi.org/10.3390/app12136519 - 27 Jun 2022
Cited by 2 | Viewed by 1349
Abstract
Load modifying gait retraining strategies, such as changing the foot progression angle (FPA) to toe-in and toe-out gait, are used for people with medial knee osteoarthritis. The FPA can be measured using a pressure sensitive walkway (PSW), but inertial measurement units (IMUs) are [...] Read more.
Load modifying gait retraining strategies, such as changing the foot progression angle (FPA) to toe-in and toe-out gait, are used for people with medial knee osteoarthritis. The FPA can be measured using a pressure sensitive walkway (PSW), but inertial measurement units (IMUs) are considered more suitable for clinical use. This study evaluated the reliability and validity of an IMU system, to measure FPA under different gait retraining strategies. Twenty healthy participants walked a 10-m-long path using different gait strategies (natural (2), toe-out gait (1), toe-in gait (1)) during four 90-s trials. FPA was measured simultaneously with IMUs and a PSW, the latter considered the reference standard. There was good and excellent reliability for the IMUs and PSW FPA measurements, respectively (ICC: IMU, 0.89; PSW, 0.97). Minimal detectable change (MDC) was 4.5° for the IMUs and 2.7° for the PSW. Repeated measures ANOVA indicated a significant effect of gait type on FPA (p < 0.001), but not the measurement instrument (p = 0.875). Bland–Altman plots demonstrated the good agreement of both systems for the baseline condition, though the IMUs seemed to consistently overestimate the FPA value compared to the PSW. In conclusion, IMUs are a reliable and valid measurement system for measuring FPA under different gait retraining strategies. The differences between the systems are significant for all gait strategies, so the systems should not be used interchangeably. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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10 pages, 529 KiB  
Article
Dispersion of Knee Helical Axes during Walking after Maximal versus Resistant Strength Training in Healthy Subjects
by Paola Adamo, Francesco Oddenino, Davide De Leo, Miriana Agnelli, Corrado Cescon, Federico Temporiti and Roberto Gatti
Appl. Sci. 2022, 12(12), 5850; https://doi.org/10.3390/app12125850 - 08 Jun 2022
Cited by 1 | Viewed by 1194
Abstract
Knee joint stability can be estimated during functional tasks through the analysis of the helical axes (HAs) dispersion. The study aimed at investigating (1) the test–retest reliability of knee HAs dispersion during walking and (2) the effects of maximal versus resistant strength training [...] Read more.
Knee joint stability can be estimated during functional tasks through the analysis of the helical axes (HAs) dispersion. The study aimed at investigating (1) the test–retest reliability of knee HAs dispersion during walking and (2) the effects of maximal versus resistant strength training on knee HAs dispersion during walking. Thirty healthy subjects (age: 22.6 ± 2.1 years) randomized into a maximal training (MT) group and a resistance training (RT) group underwent a 2-week quadricep–hamstring strength training at 90% or 30% of the maximum voluntary contraction, respectively. Participants walked on a treadmill with clusters of retro-reflective markers placed on thighs and shanks to detect knee kinematics with an optoelectronic system. Knee HAs dispersion was assessed using mean distance (MD) and mean angle (MA) at 1 week before training start, before and after the first training session, and before and after the last training session. Moderate to excellent reliability was found for MD and MA on the sagittal plane (ICCs ≥ 0.70). No differences over time were found for MD and MA between MT and RT. HAs dispersion indexes resulted in reliable parameters for the quantification of knee stability on the sagittal plane during walking. Maximal and resistance strength training induced no knee HAs dispersion changes during walking. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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10 pages, 1099 KiB  
Article
Sagittal Balance in Children: Reference Values of the Sacral Slope for the Roussouly Classification and of the Pelvic Incidence for a New, Age-Specific Classification
by Stefano Negrini, Fabio Zaina, Claudio Cordani and Sabrina Donzelli
Appl. Sci. 2022, 12(8), 4040; https://doi.org/10.3390/app12084040 - 16 Apr 2022
Cited by 1 | Viewed by 1690
Abstract
Background: The Roussouly classification, based on the functional parameter sacral slope (SS), describes the normal sagittal balance in adults and has proved useful for surgery. Reference values in children should be defined, since they are an important treatment target of conservative treatment. Moreover, [...] Read more.
Background: The Roussouly classification, based on the functional parameter sacral slope (SS), describes the normal sagittal balance in adults and has proved useful for surgery. Reference values in children should be defined, since they are an important treatment target of conservative treatment. Moreover, during growth, there are few correlations between sagittal parameters, and we hypothesize that a new classification based on the anatomical parameter pelvic incidence (PI) could also be useful. We performed a cross-sectional study to identify the reference values for the Roussouly classification during growth and to develop a new classification based on PI in children. Methods: Correlations between sagittal parameters and age were searched in 222 healthy subjects at the first consultation (6–18 years old). A new classification, based on PI, and comprising three types, is defined and compared to the Roussouly classification. Results: With age, correlations among sagittal balance parameters increase, as well as SS and PI, but with different cut-offs. The distribution of Roussouly types do not correspond to that in adulthood; thus, we defined new reference cut-offs. We defined a PI-based classification in three types, not overlapping Roussouly’s. We found a uniform and balanced distribution of cases among the nine possible combinations. Conclusions: In children, we need to use new thresholds for the Roussouly types. The new classification based on PI is correlated with the Roussouly classification, but it is also clearly different. Future studies will determine its validity. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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12 pages, 935 KiB  
Article
Effect of Forefoot–Rearfoot and Pelvic–Scapular Weight Shifts on Lower-Limb and Lumbar Muscle Activity during Static Wall-Squat Exercises
by Andrea Biscarini, Cristina V. Dieni, Raffaele Losavio, Roberto Panichi and Samuele Contemori
Appl. Sci. 2022, 12(8), 4037; https://doi.org/10.3390/app12084037 - 16 Apr 2022
Cited by 1 | Viewed by 3859
Abstract
(1) Background: The static body-weight wall-squat (SBWS) exercise is often included in the early rehabilitation stages of the lower limb. To establish its effectiveness and optimise its application, it is important to precisely quantify the muscle contribution to different versions of this exercise. [...] Read more.
(1) Background: The static body-weight wall-squat (SBWS) exercise is often included in the early rehabilitation stages of the lower limb. To establish its effectiveness and optimise its application, it is important to precisely quantify the muscle contribution to different versions of this exercise. (2) Methods: We analysed the electromyographic activity of lower limb and lumbar muscles during the SBWS with knees flexed at 45° by manipulating three different variables: horizontal distance of the ankles from the wall; scapular or pelvic location of the centre of pressure Cwall of the force exerted by the wall on the back; rearfoot or forefoot location of the centre of pressure CGR of the ground reaction force. (3) Results: The forefoot-to-rearfoot CGR shift significantly increased the vastus medialis, vastus lateralis, and tibialis anterior activity up to 23%, 26%, and 44% of the maximum voluntary isometric contraction (MVIC). The lumbar muscle activity was maximised (23% MVIC) shifting CGR at the forefoot, Cwall at the scapular zone, and placing the feet far from the wall. (4) Conclusions: These SBWS methods might be effective for quadriceps, tibialis anterior, and lumbar muscles strengthening in the early phase of rehabilitation intervention as soon as the patient can tolerate partial weight-bearing. The exercise appears suitable for patients with low back pain and limited lumbar muscle endurance, or quadriceps weakness and inhibition secondary to a knee injury. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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13 pages, 1101 KiB  
Article
Strength, Flexibility and Postural Control of the Trunk and Lower Body in Participants with and without Patellofemoral Pain
by Denisa Manojlović, Martin Zorko, Darjan Spudić and Nejc Šarabon
Appl. Sci. 2022, 12(7), 3238; https://doi.org/10.3390/app12073238 - 22 Mar 2022
Cited by 3 | Viewed by 2166
Abstract
Patellofemoral pain (PFP) is a frequent knee condition. The aim of this study was to investigate strength, flexibility and postural control in people with and without PFP. Fifty-five participants between 14 and 54 years of age (PFP = 18, control group = 37) [...] Read more.
Patellofemoral pain (PFP) is a frequent knee condition. The aim of this study was to investigate strength, flexibility and postural control in people with and without PFP. Fifty-five participants between 14 and 54 years of age (PFP = 18, control group = 37) were included. Strength and flexibility for all trunk, hip, knee and ankle muscle groups were measured along with postural control outcomes. Analyses were conducted based on the “affected” and “non-affected” leg within-group and between-groups. Between-groups analysis demonstrated a statistically lower strength of trunk muscles (range: 35.8–29.3%, p < 0.001), knee extensors (20.8%, p = 0.005) and knee flexors (17.4%, p = 0.020) in PFP participants. Within-group analysis proved an 8.7% (p = 0.018) greater hip internal rotation strength and ankle extension flexibility (p = 0.032) of the “affected side” in PFP participants. This was, to our knowledge, the first study to investigate the strength of all trunk muscle groups. The results indicate that participants with PFP exhibit impaired strength of trunk muscle groups, along with knee muscle deficits, which may present a rehabilitation target. Clinicians should consider implementing trunk strengthening exercises into PFP programs along with knee-targeting exercise programs. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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9 pages, 515 KiB  
Brief Report
Reference Values for Daily Physical Activity Measured with Accelerometers in a Danish Background Population between 18 and 80 Years of Age
by Christine Krogsgaard Schrøder, Lisa Urup Tønning, Marianne Tjur, Pia Kjær Kristensen and Inger Mechlenburg
Appl. Sci. 2023, 13(3), 1443; https://doi.org/10.3390/app13031443 - 21 Jan 2023
Viewed by 1154
Abstract
Physical activity provides essential information to assess general health and evaluate the outcome of interventions. However, evaluation of physical activity necessitates reference values for comparison. The current study aimed to present reference values for accelerometer-based data on physical activity in a background population. [...] Read more.
Physical activity provides essential information to assess general health and evaluate the outcome of interventions. However, evaluation of physical activity necessitates reference values for comparison. The current study aimed to present reference values for accelerometer-based data on physical activity in a background population. We conducted a population-based cross-sectional study using accelerometer-based data on physical activity and self-reported data on demographics and health from a cohort of randomly selected individuals of 18–80 years of age registered in the Danish Civil Registration System (CRS) (n = 242). Participants took an average of 6095 daily steps, had an average cadence of 98.5, spent 3.7 h standing, 1.4 h walking, 3.8 min cycling, 7.0 h in sedentary activities, and had 43 sit to stand transfers. The results varied when examining sex and individual age groups. Our findings are important to clinical practice and research, as they provide sex- and age-specific reference values to enable comparison of daily physical activity levels. Full article
(This article belongs to the Special Issue Musculoskeletal Rehabilitation and Clinical Biomechanics)
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