[Kinematic and kinetic features of normal level walking in athletes with tightness of gastrocnemius-soleus complex: more than a sagittal plane alteration]

Background: A shortened Gastrocnemius soleus underlies many biomechanical interactions which is a contributing factor to the development of movement impairment syndromes. So, the present study was done to assess the impact of shortened gastrocnemius soleus muscle on kinetic and kinematic variables in athletes to identify the compensatory movement patterns done in system. Knee and ankle torque, range of motion and ground reaction forces recorded by gait analysis system. Independent T test was used to compare parameters between two groups

Methods: This descriptive analytical study was carried out on 10 athletes which suffered from gastrocnemius soleus muscle shortness and ten healthy male athletes

Results: Shortness group displayed an increased knee flexion in swing phase, increased maximum adduction and extension of knee in stance phase, and increased maximum eversion in loading response of gait cycle. Athletes with limited dorsiflexion also displayed a reduced dorsiflexion range of motion, knee flexion angle in stance phase. Also, whole eversion time of ankle in loading response, knee flexion angle of heel contact were reduced in athletes with ankle dorsiflexion limitation. Finally, the mean external rotation and extensor torque of knee in stance phase and maximum torque of plantar flexion in loading response were increased in athletes with gastrocnemius soleus shortness group

Conclusion: Restricted DF ROM may alter movement mechanics in a manner that predisposes athletes to muscle skeletal injury. Therefore, the attention focused on the rehabilitation of gastrocnemius-soleus complex with an emphasis on motor control is important

Electromyographical activity of erector spinae and glutens medius muscles in patients with adolescent idiopathic scoliosis during gait

Background and Objectives: Understanding the muscle activity during gait in patients with adolescent idiopathic scoliosis [AIS] is clinically important. The objectives of this study was to analyze electrical activity of erector spinae muscles at T6 [ESj[6]X T10 [ES[t]10] and L3 [ESu] levels as well as glutens medius [GM] muscle during walking in female adolescents with and without idiopathic scoliosis

Materials and Methods: Twenty female adolescents with right thoracic scoliosis and 18 healthy adolescent control females [all 11 to 17 years old] participated in this study. An imaging system synchronized with a MA300-16 electromyography system and bipolar surfece electrodes were used to measure electrical activities of ES[t6], ESno, ESu and GM muscles during gait. Repeated measure analysis of variance and MANOVA were used for the comparisons within and between groups

Results: During the right stance phase, the activity of right ESroand left GM muscles in scoliotic patients were significantly [1.8 and 1.4 times] greater than that of control group [P=0.03]. In the left stance phase, scoliosis group showed higher activity at right and left GM muscles than control group [NX04]. In the right and left swing phase, the EMG activity of right GM and right ES[t6] muscles of scoliotic patients was respectively greater than that of controls. The right over left ratio of ES[t6] muscle activity for scoliosis group was higher than that for control group at all phases of gait cycle excqit for the right swing phase

Conclusion: AIS patients displayed greater activity in the right ESt6 and the right and left GM muscles during walking. AIS patients presented asymmetrical muscle activity in ES-ra muscle. EMG assessment during gait might have clinical importance in the detection of scoliotic curvature progression

[Effect of knee isokinetic extension training with maximum lateral tibial rotation on vastus amplitudes in patellofemoral pain syndrome patients]

Objective: Patellofemoral pain syndrome [PFPS] is one of the most common knee chronic disorders especially among females that is closely related to forces imbalance of vastus medial is oblique [VMO] and vastus lateral is [VL] muscles. The purpose of study was to examine the effect of knee isokinetic extension in maximum lateral tibia rotation on VMO and VL amplitudes in PFPS patients

Materials and Methods: Thirty-six women with PFPS participated voluntarily in this study and were randomly placed in one of three groups included the VMO selective isokinetic strengthening exercise, quadriceps general strengthening and control groups. Each exercise was performed for 8 weeks. Muscle RMS of VMO and VL and VMO/VL RMS ratio were recorded and calculated before and after training using of an 8-channels electromyography system. Data analysis was made by analyses of variance with repeated measures

Results: In baseline, VMO amplitude was less than VL in all groups [P0.05]. Yet, after interventions, VMO amplitude and VMO/VL amplitude ratio were more in selective group than in general and control groups [P

Conclusion: According to the study results, isokinetic extension training with maximum lateral tibia rotation and in close to knee full extension can be recommended as an appropriate training for improving VMO/VL electrical activity ratio and decreasing imbalance between lateral and medial vastus muscles amplitudes in patients with PFPS

Design and implementation of an emotional learning controller for force control of a robotic laparoscopic instrument

Force control of robotic instruments is a difficult task due to the uncertainties caused by changes in the instrument's geometrical and mechanical characteristics during surgery as well as the nonlinear dynamics of the instrument. A new approach based on an intelligent controller is developed to control the force interactions of a robotic surgical instrument with delicate soft tissues. This feature assists the surgeon by providing a safe grasp of soft tissues during dissection or suturing. Besides, by controlling and optimizing the magnitude of the instrument/tissue contact forces, controlled grasp will significantly reduce the surgery trauma. The controller is devised using a neuro-fuzzy regulator that receives the tracking error and its derivative as inputs, and a PD critic that evaluates the actual pinch force and produces an emotional signal. The controller tunes its parameters by means of minimizing the critic's output signal, i.e., stress, so that the force tracking error is reduced. Numerical simulations and experimental tests were performed to evaluate the controller. Simulation tests revealed that the controller can effectively adapt its rules when the instrument's geometry and frictional behavior changes. The experiments revealed a settling time of 0.7 s with 3.1% overshoot. In comparison with a PID, the proposed controller reduced the mean squared error [MSE] by 94% for a target constant force, and 24% for a target sinusoidal trajectory. The proposed controller showed a superior performance in force control of tissue in safe grasp in comparison with a PID particularly for constant target forces

Aggregation operators enhance the classification of ACL-ruptured knees using arthrometric data

Many people suffer from the anterior cruciate ligament [ACL] injury, which can lead to knee instability associated with damage to other knee structures Purpose: In this study we present a classification method based on aggregation operators, using Adaptive Network-based Fuzzy Inference System [ANFIS] and Multilayer Perceptron [MLP] neural network to differentiate between arthrometric data of normal and ACL-ruptured knees. Methods: The data involves 132 samples consisting of 59 patients with injured knee and 73 normal subjects. ANFIS hybrid training algorithm is implemented using Fuzzy C-Means [FCM] and subtractive data clustering. The Levenberg–Marquardt [LM] training algorithm is used for MLP neural network. The results of ANFIS and MLP are then combined using aggregation operators. Results: The best accuracy [96%] is obtained by applying Choquet integral to the outputs of ANFIS classifier with the antecedent parameters selected using FCM algorithm. Conclusion: The experimental results show that aggregation operators enhance the outcomes of ANFIS and MLP classifiers in discriminating between ACL raptured knees and normal subjects.

Comparing the operational related outcomes of a robotic camera holder and its human counterpart in laparoscopic ovarian cystectomy: a randomized control trial

Purpose: Glioblastoma Multiforme [GBM] brain tumor is heterogeneous in nature; so, its quantification depends on how to accurately segment different parts of the tumor, i.e. active tumor, edema and necrosis. This procedure becomes more effective when physiological information like diffusion-weighted-imaging [DWI] and perfusion-weighted-imaging [PWI] are incorporated with the anatomical MRI. In this preliminary tumor quantification work, the idea is to characterize different regions of the GBM tumors in an MRI-based multi-parametric approach to achieve more accurate characterization of pathological regions, which cannot be obtained by using individual modalities. Methods: For this purpose, three MR sequences, namely T2-weighted imaging [anatomical MR imaging], PWI and DWI of five GBM patients were acquired. To enhance the delineation of the boundaries of each pathological region [peri-tumoral edema, tumor and necrosis], the spatial fuzzy C-means [FCM] algorithm is combined with the region growing [RG] method. Results: The results show that exploiting the multi-parametric approach along with the proposed segmentation method can improve characterization of tumor cells, edema and necrosis in comparison to mono-parametric imaging approach. Conclusion: The proposed MRI-based multi-parametric segmentation approach has the potential to accurately segment tumorous regions, leading to an efficient design of the treatment planning, e.g. in radiotherapy