Motor Control in Parkinson's Disease During the Performance of Multi-Joint Reversal Movements.

We tested if the movement slowness of individuals with Parkinson's disease is related to their decreased ability to generate adequate net torques and linearly coordinate them between joints. This cross-sectional study included ten individuals with Parkinson's disease and ten healthy individuals. They performed planar movements with a reversal over three target distances. We calculated joint kinematics of the elbow and shoulder using spatial orientation. The muscle, interaction, and net torques were integrated into the acceleration/deceleration phases of the fingertip speed. We calculated the linear correlations of those torques between joints. Both groups modulated the elbow and shoulder net torques with target distances. They linearly coupled the production of torques. Both groups did not modulate the interaction torques. The movement slowness in Parkinson's disease was related to the difficulty in generating the appropriate muscle and net torques in the task. The interaction torques do not seem to play any role in movement control.

Could emotional and sensitization status affect postural sway in adults with knee osteoarthritis?

BACKGROUND AND PURPOSE: The manipulation of sensory conditions and attentional demand affect the postural sway in older adults with knee osteoarthritis (KOA). However, it is not known if emotional and sensitization status affects postural sway in this population. This study aimed to test if older adults with mild and moderate knee osteoarthritis with symptoms of depression and high sensitization would change the profile of postural sway. METHODS: Design: A cross-sectional study was undertaken. PARTICIPANTS: The center of pressure parameters of 30 older adults with mild and moderate knee osteoarthritis and 15 healthy controls were evaluated under different conditions manipulating the visual and attentional demand. We used the pressure pain threshold to measure the sensitization status. Furthermore, we applied the Beck Depression Inventory index to assess emotional status. RESULTS: Manipulating the visual demand affected the center of pressure parameters for both groups, without differences between them. Compared to the healthy control group, the knee osteoarthritis group presented with worse scores on the Beck Depression Inventory, lower pressure pain threshold scores, and the correlations between the symptoms of depression and sensitization status ranged from weak to moderate. Finally, in the knee osteoarthritis group, we observed few and weak significant associations between the center of pressure parameters and the Beck Depression Inventory and the pressure pain threshold scores. DISCUSSION: Emotional and sensitization status seem not to be more associated with the center of pressure of older adults with mild to moderate KOA than healthy adults. Thus, it suggests that this population can safely maintain postural sway, irrespective of depression symptoms and high sensitization.

Discrimination between healthy and patients with Parkinson's disease from hand resting activity using inertial measurement unit.

BACKGROUND: Parkinson's disease (PD) is a neurological disease that affects the motor system. The associated motor symptoms are muscle rigidity or stiffness, bradykinesia, tremors, and gait disturbances. The correct diagnosis, especially in the initial stages, is fundamental to the life quality of the individual with PD. However, the methods used for diagnosis of PD are still based on subjective criteria. As a result, the objective of this study is the proposal of a method for the discrimination of individuals with PD (in the initial stages of the disease) from healthy groups, based on the inertial sensor recordings. METHODS: A total of 27 participants were selected, 15 individuals previously diagnosed with PD and 12 healthy individuals. The data collection was performed using inertial sensors (positioned on the back of the hand and on the back of the forearm). Different numbers of features were used to compare the values of sensitivity, specificity, precision, and accuracy of the classifiers. For group classification, 4 classifiers were used and compared, those being [Random Forest (RF), Support Vector Machine (SVM), K-Nearest Neighbor (KNN), and Naive Bayes (NB)]. RESULTS: When all individuals with PD were analyzed, the best performance for sensitivity and accuracy (0.875 and 0.800, respectively) was found in the SVM classifier, fed with 20% and 10% of the features, respectively, while the best performance for specificity and precision (0.933 and 0.917, respectively) was associated with the RF classifier fed with 20% of all the features. When only individuals with PD and score 1 on the Hoehn and Yahr scale (HY) were analyzed, the best performances for sensitivity, precision and accuracy (0.933, 0.778 and 0.848, respectively) were from the SVM classifier, fed with 40% of all features, and the best result for precision (0.800) was connected to the NB classifier, fed with 20% of all features. CONCLUSION: Through an analysis of all individuals in this study with PD, the best classifier for the detection of PD (sensitivity) was the SVM fed with 20% of the features and the best classifier for ruling out PD (specificity) was the RF classifier fed with 20% of the features. When analyzing individuals with PD and score HY = 1, the SVM classifier was superior across the sensitivity, precision, and accuracy, and the NB classifier was superior in the specificity. The obtained result indicates that objective methods can be applied to help in the evaluation of PD.

Hyperalgesia affects muscle activity and knee range of motion during a single-limb mini squat in individuals with knee osteoarthritis: a cross-sectional study.

BACKGROUND: The effect of hyperalgesia on functionality remains uncertain for individuals with knee osteoarthritis (KOA). This study aimed examine the clinical measures and hyperalgesia's effect on muscle activity, knee range of motion (ROM) and postural control during the single-leg mini squat (SLMS) in individuals with KOA, determining the correlation between variables. METHODS: In this cross-sectional study, 60 individuals, 30 healthy (HG, 57.4 ± 6.86 years), and 30 with mild to moderate KOA (KOAG, 59.4 ± 5.46 years) were evaluated by the visual analog scale (VAS), Western Ontario and McMaster Universities Index (WOMAC), and the pressure pain threshold (PPT) in subcutaneous, myotomal, and sclerotomal structures. Muscle activity, knee ROM and postural control were assessed during a SLMS. The analyses were performed in the two phases of the SLMS. Phase 1 - during descending movement (eccentric contraction), Phase 2 - during ascending movement (concentric contraction). Analysis of covariance was applied for each variable separately, using weight as a co-variable. We used Spearman's test for determining the correlation. RESULTS: There was no difference between groups for age, height, and postural control (p > 0.059), but KOAG presented the highest values for VAS and WOMAC (p = 0.000). In addition, EMG activity was higher in KOAG for gastrocnemius medialis and tibialis anterior muscles during phase 1 (p < 0.027), and for gastrocnemius medialis and gluteus medius muscles during phase 2 (p < 0.007), and reduced values for PPT and knee ROM (p = 0.000). Also, the correlations between PPT with muscle activity and postural control were moderate (rho< 0.482), while strong relationships were observed between some PPT points with VAS and WOMAC (rho> 0.507). CONCLUSION: Hyperalgesia affects the functionality during a single-limb mini squat. There is an important correlation between hyperalgesia and muscle activity, postural control, and clinical measures in individuals with KOA.

The relationship between running kinematics and the pelvic floor muscle function of female runners.

INTRODUCTION AND HYPOTHESIS: To date, no study has investigated the correlation between pelvic floor muscle function and urinary incontinence in female runners. The aim of the study was to investigate the relationship between pelvic floor muscle function and to correlate urinary leakage as measured by the modified pad test with kinematic variables of running. METHODS: The sample consisted of 11 incontinent and 17 continent runners. On day 1, they performed a maximum velocity test on a treadmill using an incremental protocol. Their pelvic floor muscles were evaluated using vaginal palpation and manometry, and the adapted pad test was used to evaluate the severity of urinary incontinence. Then, running kinematics were evaluated on a treadmill using a circuit camera to capture vertical displacement, knee flexion during the load response phase, and the initial contact of the foot with the ground for subsequent analysis. The pad test was performed during the kinematic evaluation. RESULTS: The vaginal squeeze pressure of the continent group (mean = 43.40 mmHg, SD = 21.75) was higher in descriptive terms than that of the incontinent group (mean = 38.94 mmHg, SD = 31.08), but the difference was not statistically significant (p = 0.66). There was an association between the weekly training load and urinary leakage. No associations were found between pelvic floor muscle function or urinary leakage and the kinematic variables. CONCLUSIONS: Despite the correlation between the weekly training load and the severity of urinary leakage, no relationships were found between pelvic floor muscle functioning and the kinematics of running.

Is it possible to stabilize the trunk using rhythmic stabilization in the upper limb? A cross-sectional study of asymptomatic individuals.

Objective: The study aim was to evaluate the immediate effect of rhythmic stabilization on local and distant muscles involved in a functional reach. Method: Prospective, observational cross-sectional study. Eight right-handed and non-impaired individuals (4 females and 4 males) aged 18-24 years (21.5 ± 1.58 years) were evaluated. Bilateral electromyographic recording of the biceps brachii, triceps brachii, multifidus lumbar, and rectus abdominis muscles was performed during three different tasks. Task 1 involved functional reach, while Task 2 involved rhythmic stabilization followed by a functional reach. Task 3 was similar to Task 2, but with 3 repetitions before a functional reach. Results: The results showed no difference between the tasks or sides. However, an interaction was observed between each side and muscles, with greater activation of the right multifidus lumbar muscle. Conclusion: Rhythmic stabilization during the task of reaching promotes an increase of multifidus activity ipsilateral to its application. Thus, this particular technique of proprioceptive neuromuscular facilitation can be useful for improving stability of the trunk and can be used in clinical practice for this purpose. Level of Evidence: 5.

Kinematic and electromyographic analysis of school children gait with and without load in the backpack

AbstractIntroduction: Excessive load on the backpacks can lead to musculoskeletal injuries and gait alterations. The objective of this study was to analyze the electromyographic (EMG) activity in association to the kinematic during the stance and balance phases of gait performed with and without the use of the backpack. Methods Twelve volunteers have executed a gait cycle in 3 tasks: without the school backpack (SM), with a backpack with load equivalent to 10% (M10) and 20% (M20) of the body weight (BW). It was evaluated the ankle, knee and hip angular excursion (AE), linear displacement (LD) of the toe and ankle, knee, hip, shoulder, head and EMG activity of the tibialis anterior (TA), vastus medialis (VM), rectus abdominis (RA), gastrocnemius lateral (GL), biceps femoris (BF) and spinal erector (EE) muscles. Results In the LD in the stance phase there was an AP increase for the toe and ankle, hip and head (p<0.043). In the balance phase for VT (vertical) direction, the shoulder presented a smaller displacement as well as the toe, ankle, knee, hip, shoulder and head in the ML direction. In the AP direction, the toe displacement was smaller as well as the ankle (p < 0.038). The AE in both phases was smaller for the hip (p <0.006). In the balance phase the IEMG was higher for the RA (p = 0.034). Conclusion These results suggest that the transport of school backpacks with loads of more than 10%BW causes changes in the kinematic and in the muscular recruitment pattern.

Secondary hyperalgesia occurs regardless of unilateral or bilateral knee osteoarthritis involvement in individuals with mild or moderate level / A hiperalgesia secundária ocorre independentemente do envolvimento unilateral ou bilateral da osteoartrite de joelho em indivíduos com doença leve ou moderada

ABSTRACT Background: Secondary hyperalgesia in individuals with less severe levels of knee osteoarthritis remains unclear. The objective of this study was to measure the pressure pain threshold of individuals with mild or moderate knee osteoarthritis and compare with no osteoarthritis. Methods: Ten healthy controls and 30 individuals with mild or moderate knee osteoarthritis divided into two groups (unilateral and bilateral involvement) were included. Dermatomes in lumbar levels (L1, L2, L3, L4 and L5) and sacral level (S1 and S2), myotomes (vastus medialis, vastus lateralis, rectus femoris, adductor longus, tibialis anterior, peroneus longus, iliacus, quadratus lumborum, and popliteus muscles), and sclerotomes in lumbar levels (L1-L2, L2-L3, L3-L4, L4-L5 supraspinous ligaments), over the L5-S1 and S1-S2 sacral areas, pes anserinus bursae, and at the patellar tendon pressure pain threshold were assessed and compared between individuals with and without knee osteoarthritis. Results: Knee osteoarthritis groups (unilateral and bilateral) reported lower pressure pain threshold compared to the control group in most areas (dermatomes, myotomes, and sclerotomes). There were no between group differences in the supra-spinous ligaments and over the L5-S1 and S1-S2 sacral areas of the sclerotomes. No difference was seen between knee osteoarthritis. Conclusion: These findings suggest that individuals with mild to moderate knee osteoarthritis had primary and secondary hyperalgesia, independent of unilateral or bilateral involvement. These results suggest that the pain have to be an assertive focus in the clinical practice, independent of the level of severity or involvement of knee osteoarthritis.

RESUMO Introdução: A ocorrência de hiperalgesia secundária em indivíduos com níveis menos graves de osteoartrite de joelho ainda é incerta. O objetivo deste estudo foi medir o limiar de dor à pressão (LDP) de indivíduos com osteoartrite de joelho (OAJ) leve ou moderada e comparar com indivíduos sem osteoartrite. Métodos: Foram incluídos 10 controles saudáveis e 30 indivíduos com OAJ leve ou moderada, divididos em dois grupos (envolvimento unilateral e bilateral). Foi avaliado e comparado o LDP em dermátomos (L1, L2, L3, L4, L5, S1 e S2), miótomos (músculos vasto medial, vasto lateral, reto femoral, adutor longo, tibial anterior, fibular longo, ilíaco, quadrado lombar e poplíteo) e esclerótomos (ligamentos supraespinais L1-L2, L2-L3, L3-L4, L4-L5), sobre as áreas sacrais L5-S1 e S1-S2, bolsa anserina e tendão patelar entre os indivíduos com e sem OAJ. Resultados: Os grupos OAJ (unilateral e bilateral) relataram menor LDP em comparação com o grupo controle na maior parte das áreas (dermátomos, miótomos e esclerótomos). Não houve diferenças entre os grupos nos ligamentos supraespinais e ao longo das áreas sacrais L5-S1 e S1-S2 dos esclerótomos. Não foi observada qualquer diferença entre os indivíduos com OAJ. Conclusão: Esses achados sugerem que os indivíduos com OAJ leve a moderada tinham hiperalgesia primária e secundária, independentemente do acometimento unilateral ou bilateral. Esses resultados sugerem que a dor precisa ser um foco assertivo na prática clínica, independentemente do grau de gravidade ou envolvimento da OAJ.

Evaluation of musculoskeletal symptoms and of work ability in a higher education institution / Avaliação dos sintomas osteomusculares e da capacidade para o trabalho em uma instituição de ensino superior

Introduction Work-related musculoskeletal disorders (WMSDs) represent a significant object of study for the field of occupational health, as they can lead to absenteeism, compensation costs and different levels of functional disability. Nonetheless, there are few studies assessing WMSDs in public higher education institutions. Objective The present study aimed to investigate, describe and correlate musculoskeletal symptoms and work ability of staff members of the Federal University of Alfenas (Unifal-MG), in the state of Minas Gerais, Brazil. Materials and methods A descriptive and correlational study was conducted with 213 professors, 188 administrative technicians and 124 outsourced staff members using two self-administered questionnaires: the Work Ability Index (WAI) and the Nordic Musculoskeletal Questionnaire (NMQ). Results Most of the teaching staff presented good work ability 47.9% (n = 102). Among administrative technicians and outsourced staff, on the other hand, excellent work ability predominated, with 43.6% (n = 82 technicians) and 51.61% (n = 68 outsourced). The most affected region among professors and administrative staff was the neck/cervical area 36.15% (n = 77 professors); and 28.19% (n = 53 technicians). Among outsourced staff, the lower back was reported as the main source of pain, with 23.28% (n = 29). Conclusions The presence of pain interfered in the work ability of workers regardless of the affected region. Having another occupation outside the institution did not influence pain of self-assessed staff members. The work ability of Unifal-MG staff was classified as good or excellent; thus, we recommend preventive work for this population, directed at the physical and mental aspects of work activities in order to maintain or improve such rates. .

Introdução Os distúrbios osteomusculares relacionados ao trabalho (Dort) representam preocupação para a saúde ocupacional, uma vez que geram absenteísmo, custos com indenizações, além de diferentes graus de incapacidade funcional. Mesmo assim, são escassos os estudos que os tenham avaliado em instituições públicas de ensino superior. Objetivo Este trabalho buscou investigar, descrever e correlacionar os sintomas osteomusculares e a capacidade para o trabalho dos servidores da Universidade Federal de Alfenas (Unifal-MG), no estado de Minas Gerais. Materiais e métodos Estudo descritivo-correlacional, que caracterizou 213 professores, 188 técnicos administrativos e 124 funcionários terceirizados, por meio de dois questionários autoaplicáveis: o Índice de Capacidade para o Trabalho (ICT) e o Questionário Nórdico de Sintomas Osteomusculares (QNSO). Resultados A maioria dos professores apresentou boa capacidade para o trabalho 47,9% (n = 102). Já entre os técnicos administrativos e funcionários terceirizados, predominou ótima capacidade com 43,6% (n = 82 técnicos) e 51,61% (n = 68 terceirizados). As regiões mais acometidas por dor entre os professores e os técnicos administrativos foram o pescoço/região cervical 36,15% (n = 77 docentes); e 28,19% (n = 53 técnicos). Já a região lombar foi a que se destacou entre os terceirizados como a principal fonte de dor, 23,28% (n = 29). Conclusões A presença de dor interfere na capacidade de trabalho do indivíduo, independente da região acometida. A ocupação externa não influenciou o estado doloroso dos servidores autoavaliados. A capacidade dos colaboradores da Unifal-MG foi classificada como boa ou ótima, por isso sugere-se um trabalho preventivo, com abordagem nos aspectos físicos e mentais da atividade laboral, visando a manutenção ou melhoria desse índice. .

Is it possible to identify the gender and age group of adults from gait analysis with hip-knee cyclograms?

INTRODUCTION: Cyclograms are gait analysis tools that characterize the geometric aspect of the pattern of locomotion. Cyclograms are angle-angle diagrams that are very useful for representing cyclic patterns such as walking. This study is based on the hypothesis that parameters extracted from hip-knee cyclograms of individuals walking on a treadmill with 0° and 5° slopes can be used to determine the age group and sex of the volunteers. METHODS: In total, 40 physically active healthy adult volunteers, 20 young people (10 of each gender) and 20 elderly (10 of each gender), were divided into 4 groups, and the average value of area (A), perimeter (P) and the ratio P/√A of cyclogram were calculated, as well as the speed and cadence. RESULTS: The young male (YM) speeds were higher than the elderly male (EM) speeds (p=0.00), and the young female (YF) speeds were higher than the elderly female (EF) speeds (p=0.00). No difference in speed was found between YM and YF (p=0.59) or between EM and EF (p=0.95). The parameters extracted directly from the cyclogram allowed us to distinguish the studied groups according to age group (p<0.05), especially with the treadmill inclined at 5°, but it was not enough to determine gender (p>0.51). CONCLUSION: The hypothesis was partially confirmed because parameters extracted from the hip-knee cyclograms could differentiate volunteers by age group but not gender.

Sitting movement in elderly subjects with and without Parkinson's disease: a biomechanical study.

The aim of the present study was to compare kinetic, kinematic, and electromyographic variables during the sitting movement between healthy elderly and in those with Parkinson's disease (PD) with moderate involvement. We hypothesized that subjects with PD would show difficulty in selecting the muscles for the task and that this could be related to the co-activation pattern and would be reflected in the behavior of some biomechanical variables. Fifteen subjects participated in this study, seven healthy subjects (NN group) and eight with Parkinson's disease. Electromyography (EMG) activity of the tibialis anterior (TA), soleus (SO), vastus medialis oblique (VMO), biceps femoris (BF), and erector spinae (ES) were recorded, and biomechanical variables were calculated, during four phases of the sitting movement. Compared to healthy subjects, the subjects with PD showed more flexion at the ankle, knee, and hip joints in the initial position and lower joint velocity. However, the EMG activity and hip, knee, and ankle joint torques were not different during all phases of movement. The sitting movement in PD subjects with moderate involvement generates EMG activity and joint torques similar to healthy elderly subjects. Only a reduced movement velocity was found in PD patients during the sitting task.

Avaliação das limitações de úlcera venosa em membros inferiores / Evaluation of limitations of venous ulcers in legs

CONTEXTO: A insuficiência venosa crônica tem um impacto socioeconômico considerável nos países ocidentais devido à alta prevalência, custo das investigações e tratamento e à perda de dias trabalhados. O questionário de qualidade de vida Short Form Health Survey (SF-36), bem como a análise da ativação muscular e mobilidade da articulação tibiotársica, é um instrumento utilizado para a sua mensuração. OBJETIVO: Avaliar as limitações osteomusculares e as alterações na qualidade de vida em portadores de úlcera venosa em membros inferiores. MÉTODOS: Foram estudados dez pacientes com úlceras classificadas com Classificação de Doença Venosa Crônica (CEAP: Clinica, Eliologia, Anatomia e Fisiopatologia) 6, que responderam ao questionário SF36 e à escala analógica de dor e realizaram a goniometria, força muscular e eletromiografia. RESULTADOS: A idade média do grupo estudado foi 67,4 (±11,7), sendo 70% dos casos do sexo feminino. Não houve correlação significativa entre dor amplitude do movimento (ADM), força muscular, eletromiografia (EMG) e o tamanho da lesão. Entretanto, houve correlação entre o perfil psicológico do SF-36 e o domínio de atividades motoras, bem como do perfil psicológico com as atividades sociais e percepção de si mesmo. Também houve diferença significativa na avaliação eletromiográfica dos músculos estudados. CONCLUSÃO: A presença de úlcera venosa em membros inferiores pode gerar limitações e alterações na qualidade de vida destes indivíduos. O aspecto psicossocial demonstrou-se preponderante sobre o aspecto motor, aumentando as restrições nas atividades de vida diária.

BACKGROUND: : The chronic venous insufficiency has a considerable socioeconomic impact in western countries because of high prevalence, treatment and research cost, and loss of days worked. The health survey questionnaire Short Form Health Survey (SF36), as well as the analysis of muscle activation and mobility of tibiotarsus' articulation, is an instrument used to its valuation. OBJECTIVE: To evaluate the osteomuscular limitations and changes in life quality in bearers of venous ulcers in lower members. METHODS: Ten patients with ulcers classified as CEAP (Clinic, Etiologic, Anatomic and Fisiopatologic) 6 were studied. They answered the SF-36 questionnaire and visual analogue pain and performed goniometry, muscular strength and electromyography. RESULTS: The average age of the group studied was 67.4 (±11.7), being 70% of the cases female. There wasn't correlation statistically significant between pain, range of motion (ROM) muscular strength, electromyography (EMG) and the injury size. However, there was found correlation between the psychological profile of SF36 and the domain of motor activities, as well the psychological profile with social activities and the perception of itself. In studied muscles electromyographyc evaluation, was found significance too. CONCLUSION: The presence of venous ulcers in lower members can generate limitations and changes in the life quality of these people. The psychosocial aspect showed up preponderant over the motor aspect, increasing the restrictions in day life activities.

Avaliação funcional do joelho em portadores da síndrome da dor femoropatelar (SDFP): comparação entre as escalas KOS e IKDC / Functional evaluation of the knee in subjects with patellofemoral pain syndrome (PFPS): comparison between KOS and IKDC scales

OBJETIVO: Muitos instrumentos têm sido propostos para avaliar o joelho, tornando muitas vezes difícil a sua escolha. Entre esses instrumentos destacam-se as escalas Knee Injury and Osteoarthritis Outcome Score (KOS) e International Knee Documentation Committee (IKDC), mas ainda não é claro qual delas seria melhor para avaliar o joelho de portadores da síndrome da dor femoropatelar (SDFP). O objetivo deste estudo foi comparar as escalas de avaliação KOS e IKDC para verificar qual delas seria mais apropriada na identificação de acometimento nos portadores da SDFP. MÉTODOS: O estudo incluiu 31 portadores da SDFP, com idade entre 18 e 39 anos (24,29 ± 4,09), sendo 27 sujeitos do sexo feminino e quatro, do masculino. Todos os sujeitos foram submetidos às escalas KOS e IKDC em duas ocasiões. A segunda aplicação serviu como prova de confiabilidade (PCKOS e PCIKDEC). A análise de correlação estatística entre as duas escalas foi realizada com os testes de Spearman e Wilcoxon, considerando-se significativo p < 0,05. RESULTADOS: O teste de correlação de Spearman revelou forte correlação entre KOS e PCKOS (r = 0,99; p < 0,001) e IKDC e PCIKDC (r = 0,96; p < 0,001). Houve uma moderada correlação entre KOS e IKDC (r = 0,46; p < 0,01) e PCKOS e PCIKDC (r = 0,55; p < 0,002). O teste de Wilcoxon revelou diferença entre KOS e IKDC (p < 0,001) e entre PCKOS e PCIKDC (p < 0,001). Houve igualdade entre KOS e PCKOS (p > 0,10) e diferença entre IKDC e PCIKDC (p < 0,02). CONCLUSÃO: As escalas KOS e IKDC apresentaram-se confiáveis durante o processo de aplicação nos portadores da SDFP, recebendo a KOS a prova de maior confiabilidade quando comparada ao IKDC.

INTRODUCTION AND OBJECTIVE: Many instruments have been proposed for the knee assessment, making its choice often difficult. Among these instruments, we can mention the Knee Injury and Osteoarthritis Outcome Score (KOS) and the International Knee Documentation Committee (IKDC) scales; however, it is unclear which of them would be better to evaluate the knee of subjects with patellofemoral pain syndrome (PFPS). The objective of this study was to compare the KOS and IKDC scales evaluation to verify which of them would be more appropriate to identify impairment in patients with PFPS. METHODS: The study included 31 PFPS subjects, aged between 18 and 39 years (24.29 ± 4.09); 27 subjects were female and 4 were male. All subjects were submitted to KOS and IKDC scales on the two occasions. The second application served as reliability evidence (PCKOS and PCIKDC).The analysis of statistical correlation between the scales was done with the Spearman and Wilcoxon tests, considering significant p < 0.05. RESULTS: The Spearman correlation test presented strong correlation between KOS and PCKOS (r = 0.99, p < 0.001) and IKDC and PCIKDC (r = 0.96, p < 0.001). There was a weak correlation between KOS and IKDC (r = 0.46, p < 0.01) and PCKOS and PCIKDC (r = 0.55, p < 0.002). The Wilcoxon test revealed differences between KOS and IKDC (p < 0.001) and between PCKOS and PCIKDC (p < 0.001). There was equality between KOS and PCKOS (p > 0.10) and difference between IKDC and PCIKDC (p < 0.02). CONCLUSION: The KOS and IKDC scales were reliable during the application in patients with PFPS, where the KOS received greater reliability when compared to the IKDC.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments.

OBJECTIVE: This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). MATERIAL AND METHODS: The operators prepared one canal with RaCe rotary instruments and another with Flexo-files. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radialis, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. RESULTS: There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. CONCLUSION: The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments

OBJECTIVE: This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). MATERIAL AND METHODS: The operators prepared one canal with RaCe rotary instruments and another with Flexo-files. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radialis, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. RESULTS: There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. CONCLUSION: The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques.

The effect of the partially restricted sit-to-stand task on biomechanical variables in subjects with and without Parkinson's disease.

The aim of this study was to explore the electromyographic, kinetic and kinematic patterns during a partially restricted sit-to-stand task in subjects with and without Parkinson's disease (PD). If the trunk is partially restricted, different behavior of torques and muscle activities could be found and it can serve as a reference of the deterioration in the motor performance of subjects with PD. Fifteen subjects participated in this study and electromyography (EMG) activity of the tibialis anterior (TA), soleus (SO), vastus medialis oblique (VMO), biceps femoris (BF) and erector spinae (ES) were recorded and biomechanical variables were calculated during four phases of the movement. Subjects with PD showed more flexion at the ankle, knee and hip joints and increased knee and hip joint torques in comparison to healthy subjects in the final position. However, these joint torques can be explained by the differences in kinematic data. Also, the hip, knee and ankle joint torques were not different in the acceleration phase of movement. The use of a partially restricted sit-to-stand task in PD subjects with moderate involvement leads to the generation of joint torques similar to healthy subjects. This may have important implications for rehabilitation training in PD subjects.

Multi-joint movements with reversal in Parkinson's disease: Kinematics and electromyography.

Subjects with Parkinson's disease (PD) presented difficulties in the performance of multi-joint movements. The purpose of the study was to determine whether the slowness of such movements was caused by the generation of non-linear trajectories and/or by a reduction or a deficit in the modulation of EMG activity. Nine healthy subjects and 10 subjects with PD performed multi-joint movements involving elbow and shoulder with reversal towards three targets in the sagittal plane without any constraint. The movement kinematics were calculated using X and Y coordinates of the markers positioned on the joints. EMG signals were recorded for the muscles related to these movements. The results revealed that subjects with PD presented a lower linear speed and the differences between them and healthy subjects increased with target distance. The trajectory was found to be linear and both groups of subjects had few errors in the targets despite the slower muscle activity in subjects with PD. Another interesting finding was the EMG pattern of subjects with PD. They showed a difficulty in modulating the activity of agonists and antagonists during the different movement phases. The low speed movements of PD subjects were attributable to the low EMG activity and difficulty in modulating the bursts of muscle activity.

Estratégias para controlar movimentos complexos usando informação proprioceptiva / Strategies to control complex movements using proprioceptive information

Introdução: Nós mostramos que indivíduos neurologicamente normais usam um jogo simples de regras para modular os torques articulares e as atividades musculares durante o desempenho de movimentos complexos que usando informação visual e proprioceptiva. Objetivo: Aqui nós testamos a hipótese que este jogo simples de regras cinéticase EMG é preservado quando os sujeitos tiveram que confiar na informação proprioceptiva da articulação, sem acesso direto para a orientação de espaço da mão (informação visual) para executar movimentos. Métodos: Movimentos do membro superior com reversão sobre três distâncias do alvo foram reconstruídos. Torques do ombro e cotovelo foram calculados usando dinâmica inversa, e também foram registradas atividades EMG dos principais músculos do braço. Resultados: Os sujeitos tiveram que emparelhar específica excursão angular do cotovelo para alcançar o alvo, e a informação sobre o deslocamento de ponta do dedo e posição do alvo não foi provida. A velocidade linear da ponta do dedo, torques articulares e atividade EMG muscular aumentaram com distância do alvo, e os torques articulares e atividades EMG muscular foram acopladas. Conclusão: O uso de informação de proprioceptiva para planejar o movimento não muda as estratégias cinéticas e EMG usadas pelo sistema nervoso central para executar movimentos de braço horizontal-planar com reversão.

Introduction: We have shown that neurologically normal individuais use one simple set of rules to modulate the joint torques and muscle activities during the performance of complex movements using visual and proprioceptive information. Objective: Here, we tested the hypothesis that this sim pie set of EMG and kinetic rules is preserved when the subjects had to rely on proprioceptive information of the joint, without direct access to the spatial orientation of the hand (visual information) to perform movements. Method: Upper arm movements with reversal performed over three target distances were reconstructed. Shoulder and elbow torques were calculated using inverse-dynamics, and EMG activities of the major arm muscles were also recorded. Results: Subjects had to match specific elbow angular excursion to reach the target, and the information about the fingertip displacement and target position was not provided. The fingertip linear speed, joint torques and EMG muscle activities increased with target distance, and the joint torques and EMG muscle activities were well coupled. Conclusion: The use of proprioceptive information to plan the movement does not change the EMG and kinetic strategies used by the central nervous system to perform horizontal planararm movements with reversal.

The linear co-variance between joint muscle torques is not a generalized principle.

In 1996, Gottlieb et al. [Gottlieb GL, Song Q, Hong D, Almeida GL, Corcos DM. Coordinating movement at two joints: A principle of linear covariance. J Neurophysiol 1996;75(4):1760-4] identified a linear co-variance between the joint muscle torques generated at two connected joints. The joint muscle torques changed directions and magnitudes in a synchronized and linear fashion and called it the principle of linear co-variance. Here we showed that this principle cannot hold for some class of movements. Neurologically normal subjects performed multijoint movements involving elbow and shoulder with reversal towards three targets in the sagittal plane without any constraints. The movement kinematics was calculated using the X and Y coordinates of the markers positioned over the joints. Inverse dynamics was used to calculate the joint muscle, interaction and net torques. We found that for the class of voluntary movements analyzed, the joint muscle torques of the elbow and the shoulder were not linearly correlated. The same was observed for the interaction torques. But, the net torques at both joints, i.e., the sum of the interaction and the joint muscle torques were linearly correlated. We showed that by decoupling the joint muscle torques, but keeping the net torques linearly correlated, the CNS was able to generate fast and accurate movements with straight fingertip paths. The movement paths were typical of the ones in which the joint muscle torques were linearly correlated.

Kinematic, kinetic and EMG patterns during downward squatting.

The aim of this study was to investigate the kinematic, kinetic, and electromyographic pattern before, during and after downward squatting when the trunk movement is restricted in the sagittal plane. Eight healthy subjects performed downward squatting at two different positions, semisquatting (40 degrees knee flexion) and half squatting (70 degrees knee flexion). Electromyographic responses of the vastus medialis oblique, vastus medialis longus, rectus femoris, vastus lateralis, biceps femoris, semitendineous, gastrocnemius lateralis, and tibialis anterior were recorded. The kinematics of the major joints were reconstructed using an optoelectronic system. The center of pressure (COP) was obtained using data collected from one force plate, and the ankle and knee joint torques were calculated using inverse dynamics. In the upright position there were small changes in the COP and in the knee and ankle joint torques. The tibialis anterior provoked the disruption of this upright position initiating the squat. During the acceleration phase of the squat the COP moved posteriorly, the knee joint torque remained in flexion and there was no measurable muscle activation. As the body went into the deceleration phase, the knee joint torque increased towards extension with major muscle activities being observed in the four heads of the quadriceps. Understanding these kinematic, kinetic and EMG strategies before, during and after the squat is expected to be beneficial to practitioners for utilizing squatting as a task for improving motor function.