Hip extension power and abduction power asymmetry as independent predictors of walking speed in individuals with unilateral lower-limb amputation.

BACKGROUND: Preferred walking speed (PWS) is an indicator of walking ability, prosthetic walking potential, and function following a lower-limb amputation (LLA). There is a link between lower-limb muscle performance and PWS in individuals with LLA. However, the ability of select hip muscle performance parameters to determine PWS in these individuals still needs to be thoroughly investigated. RESEARCH QUESTION: Which hip muscle and joint torque parameters best determine PWS in persons with LLA? METHODS: Seventeen patients with LLA (6 transfemoral, 4 knee disarticulation, and 7 transtibial; 16 men, 1 woman; mean age ± standard deviation, 56 ± 15yr) participated in this cross-sectional study. Maximal joint torque and power were evaluated unilaterally, for both amputated and intact limbs, in isometric and isokinetic conditions during hip flexion/extension (60°/s and 180°/s) and abduction/adduction (30°/s and 90°/s). PWS was measured at habitual walking speed over a 10-m distance. Pearson's correlation coefficient was used to verify the degree of association between each torque parameter and PWS and multiple regression analysis was performed to identify the best predictors of PWS. The level of significance was p < 0.05. RESULTS: Correlations between hip muscle performance parameters and PWS were found in most cases (r = 0.51-0.82; p ≤ 0.036-0.0005). The multiple regression model revealed that the best independent predictors of PWS were hip extension power at 180°/s on the amputated side (r² = 0.672; p < 0.0005) and the asymmetry of hip abduction power at 30°/s (r² = -0.147; p < 0.008), accounting together for 82% of the variance in PWS. SIGNIFICANCE: Lesser hip extension power on the amputated side and greater hip abduction power asymmetry between limbs are detrimental to PWS in persons with LLA. These muscle groups and performance parameters should be considered during gait rehabilitation to assist individuals with LLA in achieving functional waking speed.

Excess body weight and gait influence energy cost of walking in older adults.

PURPOSE: The objective of this investigation is to study how excess body weight influences the energy cost of walking (Cw) and determine whether overweight and obese older adults self-select stride frequency to minimize Cw. METHODS: Using body mass index (BMI), men and women between the ages of 65 and 80 yr were separated into normal weight (NW, BMI ≤24.9 kg·m(-2), n = 13) and overweight-obese groups (OWOB, BMI ≥25.0 kg·m(-2), n = 13). Subjects walked at 0.83 m·s on an instrumented treadmill that recorded gait parameters and completed three 6-min walking trials; at a preferred stride frequency (PSF), at +10% PSF, and at -10% PSF. Cw was determined by indirect calorimetry. Repeated-measures ANOVA was used to compare groups, and associations were tested with Pearson correlations, α = 0.05. RESULTS: OWOB had 62% greater absolute Cw (301 ± 108 vs 186 ± 104 J·m, P < 0.001) and 20% greater relative Cw(kg) (3.48 ± 0.95 vs 2.91 ± 0.94 J·kg(-1)·m(-1), P = 0.046) than NW. Although PSF was not different between OWOB and NW (P = 0.626), Cw was 8% greater in OWOB at +10% PSF (P < 0.001). At PSF, OWOB spent less time in single-limb support (33.1% ± 1.5% vs. 34.9% ± 1.6 % gait cycle, P = 0.021) and more time in double-limb support (17.5% ± 1.6% vs 15.4% ± 1.4% gait cycle, P = 0.026) than NW. In OWOB, at PSF, Cw was correlated to impulse (r = -0.57, P = 0.027) and stride frequency (r = 0.51, P = 0.046). CONCLUSIONS: Excess body weight is associated with greater Cw in older adults, possibly contributing to reduced mobility in overweight and obese older persons.

Electromyographic activity of trunk muscles during exercises with flexible and non-flexible poles.

OBJECTIVE: Hand-held flexible poles which are brought into oscillation to cause alternating forces on trunk, are advocated as training devices that are supposed to solicit increased levels of stabilizing trunk muscle activity. The aim of this study was to verify this claim by comparing electromyographic (EMG) activity of trunk muscles during exercises performed with a flexible pole and a rigid pole. METHODS: Twelve healthy females performed three different exercises with flexible and rigid poles. EMG activity of iliocostalis lumborum (IL), multifidus (MU), rectus abdominis (RA), external oblique (EO) and internal oblique (IO), and was continuously measured. The EMG signals were analyzed in time domain by calculation of the Root Mean Square (RMS) amplitudes over 250 ms windows. The mean RMS-values over time were normalized by the maximum RMS obtained for each muscle. RESULTS: The IO showed a 72% greater EMG activity during the exercises performed with the flexible pole than with the rigid pole (p=0.035). In exercises performed in standing, the IO was significantly more active than when sitting (p=0.006). CONCLUSION: As intended, the cyclic forces induced by the oscillating pole did increase trunk muscle activation. However, the effect was limited and significant for the IO muscle only.

Electromyographic activity of shoulder muscles during exercises performed with oscillatory and non-oscillatory poles.

BACKGROUND: Pain and dysfunction of the shoulder complex are commonly found physiotherapy practice. These musculoskeletal abnormalities are related to instability and inadequate kinematic function, that depend on the integrity of the muscle tissues. Thus, to enhance the results of exercise therapies, and prevent and attenuate pain and dynfunction, the use of oscillatory pole has been implemented in clinical practice. OBJECTIVES: The purpose of this study was to analyze the electromyographic (EMG) activity of shoulder stabilizing muscles during exercises performed with an oscillatory and a non-oscillatory pole. METHODS: Twelve female volunteers, aged 20.4 years±1.9, participated in this study. EMG data were collected from upper trapezius (UT), lower trapezius (LT) and middle deltoid (MD) during three different exercises with an oscillatory and a non-oscillatory pole. The EMG signals were analyzed in the time domain through the calculation of Root Mean Square (RMS). The RMS values were normalized by the peak value obtained over all trials for each muscle. Statistical analysis was performed with repeated measures ANOVA and post-hoc of Bonferroni tests. RESULTS: The EMG activity of UT, LT and MD muscles were significantly higher with the oscillatory pole than the non-oscillatory pole (all p<0,001). There were no significant differences in the activation of these muscles between exercises. CONCLUSION: The results of the present study indicated that the oscillatory pole does require higher activation of the shoulder muscles and therefore, may be useful in the training of the shoulder complex.

Electromyographic activity of shoulder muscles during exercises performed with oscillatory and non-oscillatory poles / Atividade eletromiográfica dos músculos do ombro durante exercícios executados com hastes oscilatória e não oscilatória

BACKGROUND: Pain and dysfunction of the shoulder complex are commonly found physiotherapy practice. These musculoskeletal abnormalities are related to instability and inadequate kinematic function, that depend on the integrity of the muscle tissues. Thus, to enhance the results of exercise therapies, and prevent and attenuate pain and dynfunction, the use of oscillatory pole has been implemented in clinical practice. OBJECTIVES: The purpose of this study was to analyze the electromyographic (EMG) activity of shoulder stabilizing muscles during exercises performed with an oscillatory and a non-oscillatory pole. METHODS: Twelve female volunteers, aged 20.4 years±1.9, participated in this study. EMG data were collected from upper trapezius (UT), lower trapezius (LT) and middle deltoid (MD) during three different exercises with an oscillatory and a non-oscillatory pole. The EMG signals were analyzed in the time domain through the calculation of Root Mean Square (RMS). The RMS values were normalized by the peak value obtained over all trials for each muscle. Statistical analysis was performed with repeated measures ANOVA and post-hoc of Bonferroni tests. RESULTS: The EMG activity of UT, LT and MD muscles were significantly higher with the oscillatory pole than the non-oscillatory pole (all p<0,001). There were no significant differences in the activation of these muscles between exercises. CONCLUSION: The results of the present study indicated that the oscillatory pole does require higher activation of the shoulder muscles and therefore, may be useful in the training of the shoulder complex.

CONTEXTUALIZAÇÃO: A dor e a disfunção no complexo articular do ombro é comumente encontrada na prática fisioterapêutica. Essas anormalidades musculoesqueléticas estão relacionadas à instabilidade e inadequado funcionamento cinemático, que dependem da integridade dos tecidos musculares. Assim, no sentido de prevenir e reabilitar esses sintomas, o uso da haste oscilatória vem sendo implantado para melhorar os resultados de técnicas cinesioterapêuticas. OBJETIVOS: Analisar a atividade eletromiográfica (EMG) dos músculos que estabilizam a articulação do ombro durante a realização de exercícios com haste oscilatória e haste não-oscilatória. MÉTODOS: Participaram do estudo 12 voluntárias com idade de 20,4±1,9 anos. Os dados EMG foram coletados nos músculos trapézio superior (TrS), trapézio inferior (TrI) e deltoide médio (DM) durante três diferentes exercícios realizados com haste oscilatória e haste não-oscilatória. O sinal EMG foi analisado no domínio do tempo pelo cálculo do Root Mean Square (RMS). Os valores de RMS foram normalizados pelo valor de pico obtido em todas as tentativas por cada músculo. A análise estatística foi feita com os testes ANOVA para medidas repetidas e post-hoc de Bonferroni. RESULTADOS: A atividade EMG dos músculos TrS, TrI e DM foi significativamente maior nos exercícios com haste oscilatória do que com haste não-oscilatória (todos p<0,001). Não foram significativas as diferenças na ativação desses músculos entre os exercícios. CONCLUSÃO: Os resultados do presente estudo indicaram que a haste oscilatória requisitou maior atividade EMG dos músculos do ombro e, assim, pode ser um instrumento útil no treinamento desses músculos.