Evaluation of Mandibular Movements in Patients with Bell's Palsy Using Kinematic Variables.

Background: Since the function of muscles, and subsequently the mandibular joint, is affected in patients with Bell's palsy, therefore, the evaluation of facial muscles and mandibular function in these patients can be effective in diagnosis, prevention, and treatment planning. The present study aimed to evaluate the degree of displacement and range of motion (ROM) of the mandible and the ability of the facial symmetrical muscles of patients with Bell's palsy. Methods: This was a quasi-experimental comparative study. The variables evaluated were mandibular movement in a vertical direction and side-to-side displacement. Ten patients with Bell's palsy and 10 healthy eligible volunteers participated in the present study. Three mobile video cameras (to record jaw movements), 9 color markers, Kinovea software, House-Brackmann index, Toledo protocol, and a specialized patient questionnaire were used. Descriptive and inferential statistics were used for data analysis, the Kolmogorov-Smirnov test was used to investigate the normality of data distribution, and independent samples the t test and paired samples t test were used to compare means. Results: The maximum lateral on the sound side was 12.40 and 4.49 mm during lateral movements of the patients' mandible, while this value was between 12.30 and 3 mm on the involved side. There is a difference between the affected side and the nonaffected side in terms of the mean lateral movements of the patients' mandible. However, this difference in the mean ROM on both sides is not statistically significant. The maximum mouth opening in healthy individuals during mandibular movements was between 40 and 60 mm, while this value was between 25 and 50 mm in the patients with Bell's palsy. This study shows a significant difference (P = 0.007) between patients and healthy individuals in terms of the mean of maximum mouth opening ( P < 0.05). Conclusion: The results of this study showed that the ROM of temporomandibular joint (TMJ) of the patient is the same as that of normal subjects, but the side-to-side motion is more than normal which should be considered in rehabilitation treatments. The present study emphasizes the need to implement a mandibular kinematic evaluation protocol in patients with bell's palsy to prevent damage to the TMJ in the long term.

The relationship between vertical stiffness during bilateral and unilateral hopping tests performed with different strategies and vertical jump performances.

Vertical stiffness has been highlighted as a potential determinant of performance and may be estimated across a range of different performance tasks. The aim of the current study was to investigate the relationship between vertical stiffness determined during 9 different hopping tests and performance of vertical jumps. Twenty healthy, active males performed vertical hopping tests with three different strategies (self-selected, maximal, and controlled) and three different limb configurations (bilateral, unilateral preferred, and unilateral non-preferred), resulting in nine different variations, during which vertical stiffness was determined. In addition, participants performed squat jump (SQJ) and countermovement jump (CMJ) during which jump height, CMJ stiffness, and eccentric utilization ratio (EUR) were determined. Vertical stiffness in bilateral and unilateral preferred tasks performed with a self-selected and maximal, but not controlled, strategy was associated with stiffness in the CMJ (r = 0.61-0.64; p < 0.05). However, stiffness obtained during unilateral preferred and non-preferred hopping with self-selected strategy was negatively associated with performance in SQJ and CMJ tasks (r = -0.50 to -0.57; p < 0.05). These findings suggest that high levels of vertical stiffness may be disadvantageous to static vertical jumping performance. In addition, unilateral hopping with a self-selected strategy may be the most appropriate task variation if seeking to determine relationships with vertical jumping performance.Highlights Stiffness obtained during unilateral hopping with a preferred strategy was negatively associated with vertical jumping performancesStiffness obtained during hopping with preferred and maximal strategies was associated with stiffness obtained during a countermovement jumpIn this population, hopping stiffness may therefore be reflective of an individual's countermovement jump strategyHigh levels of stiffness may be disadvantageous to static-start vertical jumping.

The effect of hyper-pronated foot on postural control and ankle muscle activity during running and cutting movement / El efecto del pie hiperpronado sobre el control postural y la actividad de los músculos del tobillo durante el movimiento de carrera y cambio de dirección / O efeito do pé hiper-pronado no controlo postural e actividade muscular no tornozelo durante a corrida e movimentos cortantes

Objective: The aim of this study was to examine the effect of hyper pronated foot on postural control and ankle muscle activity during running and cutting movement (v-cut).Methods: In this Cross-Sectional study, 42 young physically active (exercising three times per week regularly) males participated in this study, including 21 with hyper-pronated feet and 21 with normal feet. Each participant completed a running and cutting task. Body postural control was measured using a force platform (1000Hz) which was synchronized with surface electromyography of selected ankle muscles. MATLAB software was used to process and analyze the data. One-away ANOVA was used to identify any differences between groups.Results: Differing muscle activation patterns in the surrounding ankle musculature (tibialis anterior, peroneus longus) through to reduced postural stability in the medial-lateral direction and increased vertical ground reaction forces were observed between groups.Conclusion: According to the obtained results it seems that subtalar hyper-pronation can be regarded as a factor affecting the biomechanics of cutting by changing activation patterns of the muscles surrounding the ankle, and reducing postural control of the body in medial-lateral direction, but not in anterior-posterior direction. (AU)

Objetivo: El objetivo de este estudio fue examinar el efecto del pie hiperpronado sobre el control postural y la actividad de los músculos del tobillo durante el movimiento de carrera y cambio de dirección.Métodos: En este estudio transversal, participaron 42 hombres jóvenes físicamente activos (ejercitándose tres veces por semana con regularidad), incluidos 21 con pies hiperpronados y 21 con pies normales. Cada participante completó una tarea de correr y cambiar de dirección. El control de la postura corporal se midió utilizando una plataforma de fuerza (1000 Hz) que se sincronizó con la electromiografía de superficie de los músculos seleccionados del tobillo. Se utilizó el software MATLAB para procesar y analizar los datos. Se utilizó un ANOVA de una distancia para identificar las diferencias entre los grupos.Resultados: Se observaron diferentes patrones de activación muscular en la musculatura del tobillo (tibial anterior, peroneo largo) con estabilidad postural reducida en la dirección medial-lateral y un aumento de las fuerzas de reacción vertical del suelo entre los grupos.Conclusión: De acuerdo con los resultados obtenidos, parece que la hiperpronación puede ser considerada como un factor que afecta la biomecánica del cambio de dirección al modificar los patrones de activación de los músculos que del tobillo y reducir el control postural del cuerpo en dirección medial-lateral, pero no en dirección anteroposterior. (AU)

Objetivo: O objetivo deste estudo é examinar o efeito do pé hiper-pronado no controlo postural e actividade muscular no tornozelo durante a corrida e movimentos cortantes.Métodos: Neste estudo seccionado, 42 rapazes fisicamente ativos (exercitam regularmente 3 vezes por semana) participaram neste estudo, incluindo 21 com pé hyper-pronated. Cada participante completou um desafio de corrida e corte. A postural corporal foi medida usando uma plataforma com potência de 1000Hz, cujo fora sincronizada com uma eletromiografia superficial do músculos do tornozelo seleccionados. O software MATLAB foi utilizado para processar e analisar os dados. ANOVA foi utilizado para identificar quaisquer diferenciações entre grupos.Resultados: Padrões divergentes de ativação por volta do músculo do tornozelo (tibialis anterior peroneus longus) pela redução de estabilidade postural na direção medial-lateral e foi observado um aumento de reacções verticais térreas entre grupos.Conclusão: De acordo com os resultados obtidos, parece que a hyper-pronation pode ser observada como um factor que afecta os biomecânica de corte através da mudança e ativação dos padrões dos músculos à volta do tornozelo, reduzindo assim o controlo do corpo na direção médio-lateral mas não na direção anterior-posterior. (AU)

Center of pressure excursion and muscle activation during gait initiation in individuals with and without chronic ankle instability.

The aim of the current study was to determine differences in center of pressure (COP)excursion and muscle activation during gait initiation (GI) in those with and without chronic ankle instability (CAI). Thirty-four participants, 17 per group, volunteered to participate. Participants were asked to stand barefoot on a force plate before initiating gait upon hearing an auditory cue. Reaction time, anticipatory postural adjustment phase time, as well as normalized peak COP excursion during the anticipatory postural adjustment phase was calculated. Response time of Soleus and Tibialis Anterior muscles were concurrently recorded via electromyography. The results demonstrate a longer reaction time and shorter anticipatory postural adjustment phase time in the CAI group (p < 0.05). No significant between group differences in peak normalized COP excursion were noted (p > 0.05). Muscle onset patterns differed between groups as those with CAI demonstrated earlier Soleus activation compared to the control group (p < 0.05). The results suggest that those with CAI have an altered GI motor control strategy as evidenced by reduced or absent Soleus muscle inhibition during APA phase of GI relative to controls. The APA phase is controlled by the secondary motor area, therefore, the presence of motor control alterations in CAI patients may be due to a supra-spinal alterations.

The effects of general fatigue induced by incremental exercise test and active recovery modes on energy cost, gait variability and stability in male soccer players.

The aerobic endurance is considered an important physiological capacity of soccer players which is examined by Incremental Exercise Test (IET). However, it is not clear how general fatigue induced by IET influences physiological and biomechanical gait features in soccer players and how players recover optimally at post-IET. Here, the effect of general fatigue induced by IET on energy cost, gait variability and stability in soccer players was investigated. To identify an optimal recovery mode, the effect of walking at Preferred Walking Speed (PWS), running at Individual Ventilation Threshold (IVT) (two active recovery modes), and Rest (a passive recovery mode) on aforementioned features were studied. Nine male players walked 4-min at PWS on a treadmill prior IET (PreT), which was followed by four 4-min walking trials (PosT-0, 1, 2, and 3) with three 4-min recovery intervals (PWS, IVT, or Rest) between them, in three sessions (one for each recovery mode) in a random order. Energy cost, gait variability and stability were examined at PreT (baseline), and at PosT-0, 1, 2, and 3 (intervals of respectively 0-4, 8-12, 16-20, 24-28 min at post-IET). Gait variability was assessed by the standard deviation of trunk angle and gait stability was assessed by the local dynamic stability of trunk angular velocity. Gait stability was not affected by IET, despite increases in gait variability and energy cost. Different from IVT, PWS and Rest recovery modes reduced energy cost at post-IET. Gait variability and energy cost recovered at PosT-1 and PosT-2, suggesting that 8-12 and 16-20 min recovery intervals, respectively, were required for returning to their baselines. No preference for active over passive recovery was found in terms of gait variability and energy cost.

Comparison of four methods for determining the cut-off frequency of accelerometer signals in able-bodied individuals and ACL ruptured subjects.

BACKGROUND: Selecting the appropriate cut-off frequency to filter triaxial accelerometric data is a challenging issue in gait analyses. It reduces soft tissues artifacts and the variability in the kinematic data waveform from able-bodied and physically impaired gaits. RESEARCH QUESTION: Are cut-off frequencies estimated by four filtering methods similar along each axis of a triaxial accelerometer and for able-bodied subjects and those with an anterior cruciate ligament rupture (ACLR)? METHODS: After walking on a treadmill, the cut-off frequency for the tibial accelerations was calculated using 95 and 99 per cent of the energy spectrum (E), residual analysis (RA) and, the method (Yu) proposed by Yu et al. [1]. The coefficient of variation was used to express the variability of the cut-off frequencies estimated by the four methods. t-Test and repeated measure ANOVA were applied to examine the effects of healthiness and acceleration axis on cut-off frequencies. RESULTS: On average, E95 and E99 gave the lowest and the highest cut-off frequencies respectively. The results demonstrated the effect of ACL injury and axes on the cut-off frequencies, especially on the RA method. There was a significant difference in the cut-off frequencies between healthy and ACLR subjects for the vertical axis with the RA method and for the anterior-posterior (AP) axis with the Yu method. Similar cut-off frequencies were obtained for all axes with the E99 method for within groups' comparison. The E95 and E99 methods gave the least and most variable outputs respectively. Significant within group differences between cut off frequencies calculated by four methods, led to disappearing peaks in the more fluctuating portion of the acceleration data. SIGNIFICANCE: A single cut-off frequency is not recommended for all individuals and axes. In cases where a single cut-off frequency is necessary for all individuals or axes, RA or E99 methods are suggested respectively.

Investigating the anticipatory postural adjustment phase of gait initiation in different directions in chronic ankle instability patients.

OBJECTIVE: The main objective of the present study was to analyze how supra spinal motor control mechanisms are altered in different directions during anticipatory postural phase of gait initiation in chronic ankle instability patients. It seems that supra spinal pathways modulate anticipatory postural adjustment phase of gait initiation. Yet, there is a dearth of research on the effect of chronic ankle instability on the anticipatory postural adjustment phase of gait initiation in different directions. METHOD: A total of 20 chronic ankle instability participants and 20 healthy individuals initiated gait on a force plate in forward, 30° lateral, and 30° medial directions. RESULTS: According to the results of the present study, the peak lateral center of pressure shift decreased in forward direction compared to that in other directions in both groups. Also, it was found that the peak lateral center of pressure shift and the vertical center of mass velocity decreased significantly in chronic ankle instability patients, as compared with those of the healthy individuals. CONCLUSION: According to the results of the present study, it seems that chronic ankle instability patients modulate the anticipatory postural adjustment phase of gait initiation, compared with healthy control group, in order to maintain postural stability. These changes were observed in different directions, too.

Multivariate analysis of 200-m front crawl swimming performance in young male swimmers.

The aim of the present study was to evaluate the biomechanical (stroke rate, stroke length, and stroke index), anthropometrical (body height, body mass, body mass index, arm span, shoulders width, thigh, leg and upper arm lengths), and muscle architectural (muscle thickness, pennation angle, and fascicle length) parameters as predictors of 200-m front crawl swimming performance in young male swimmers. Twenty-two county level male swimmers (mean ±SD: age: 14.52 ± 0.77 years; body height: 173 ± 5 m; body mass: 60.5 ± 5.7 kg) performed a 200-m front crawl swimming test in a 25-m pool. Stepwise regression analysis revealed that biomechanical parameters (87%) characterized best 200-m front crawl swimming performance, followed by anthropometrical (82%) and muscle architectural (72%) parameters. Also, stroke length (R2 = 0.623), body height (R2 = 0.541), fascicle length of Triceps Brachii (R2 = 0.392) were the best single predictors that together explained 92% of the variability of the 200-m front crawl swimming performance in these swimmers. As a conclusion, with respect to higher performance prediction power of biomechanical parameters, technique should represent the core of the training program at these ages. In addition, these findings could be used for male young swimmers selection and talent identification.

Effect of Three-year Multi-Component Exercise Training on Bone Mineral Density and Content in a Postmenopausal Woman with Osteoporosis: A Case Report.

The purpose of the present study was to examine the effect of 3-years of moderate multi-component exercise training on bone mineral density and bone mineral content in a female subject with osteoporosis. A 57-year-old postmenopausal woman, a known case of osteoporosis following an accident, participated in this study. Bone mineral density and bone mineral content was measured in the femoral neck area and the lumbar spine by dual energy X-ray absorptiometry. The measurements lasted four years, first year without any exercise training and three succeeding years with exercise intervention. After three years of exercise training, bone mineral density and bone mineral content were improved in both regions, despite the increase in age and decrease in weight. This case highlights the importance of exercise training in maintaining and increasing bone mineral density and bone mineral content of the spine and hip in post-menopausal women. Considering its positive effects, regular and lifelong exercise training must be incorporated into peoples' life due to the chronic nature of bone loss in aging process.

The relationship between biomechanical-anthropometrical parameters and the force exerted on the head when heading free kicks in soccer.

BACKGROUND: Soccer is a contact sport in which the players are frequently faced with the risk of injury. It has been shown that the force exerted on the head during heading can be as much as 500-1200 Newton (N). OBJECTIVES: The main objective of this study was to determine whether there was any relationship between the force exerted on the head and several biomechanical and anthropometrical parameters related to heading free kicks. PATIENTS AND METHODS: A total of 16 semi-professional soccer players with at least 5 years experience participated in this study. The mean age, height, and weight of the study participants were 21.36 ± 5.67, 178 ± 5.99 cm, and 70.55 ± 8.55 kg, respectively. To measure the force exerted on the heads of the players, a pressure gauge was installed on their foreheads. Each participant was asked to defend the ball using the heading technique three times. A camera with a sampling frequency of 150 frames per second was used to record the moment of impact between the ball and head during each heading event. For each participant and replicate, the ball and head velocity (m/s) as well as the angular body changes (degrees) were calculated using MATLAB and AutoCAD softwares, respectively. Descriptive statistics, including means and standard deviations were used to describe the data. Pearson correlation coefficient (alpha = 0.05) was used to examine potential relationships between the variables of interest. RESULTS: Significant correlations existed between the force exerted on the head during heading, participant age, body mass, body fat percentage, and head perimeter (P < 0.05). CONCLUSIONS: The study revealed the significance of anthropometric variables related to heading, such as age and head perimeter. Therefore, it was concluded that these variables should be considered when teaching and practicing the heading technique with players of different ages and anthropometric sizes.

Effect of foot orthoses on magnitude and timing of rearfoot and tibial motions, ground reaction force and knee moment during running.

Changes in magnitude and timing of rearfoot eversion and tibial internal rotation by foot orthoses and their contributions to vertical ground reaction force and knee joint moments are not well understood. The objectives of this study were to test if orthoses modify the magnitude and time to peak rearfoot eversion, tibial internal rotation, active ground reaction force and knee adduction moment and determine if rearfoot eversion, tibial internal rotation magnitudes are correlated to peak active ground reaction force and knee adduction moment during the first 60% stance phase of running. Eleven healthy men ran at 170 steps per minute in shod and with foot orthoses conditions. Video and force-plate data were collected simultaneously to calculate foot joint angular displacement, ground reaction forces and knee adduction moments. Results showed that wearing semi-rigid foot orthoses significantly reduced rearfoot eversion 40% (4.1 degrees ; p=0.001) and peak active ground reaction force 6% (0.96N/kg; p=0.008). No significant time differences occurred among the peak rearfoot eversion, tibial internal rotation and peak active ground reaction force in both conditions. A positive and significant correlation was observed between peak knee adduction moment and the magnitude of rearfoot eversion during shod (r=0.59; p=0.04) and shod/orthoses running (r=0.65; p=0.02). In conclusion, foot orthoses could reduce rearfoot eversion so that this can be associated with a reduction of knee adduction moment during the first 60% stance phase of running. Finding implies that modifying rearfoot and tibial motions during running could not be related to a reduction of the ground reaction force.

Reliability of a computer-aided color-coded video-based system for clinical assessment of the foot.

UNLABELLED: There is a need for a user-friendly system that can provide quick and reliable assessment of foot disorders. The study described in this report was undertaken to determine the inter-rater and intra-rater reliability of a computer-aided, color-coded, video-based system developed for the assessment of foot alignment in patients with and without pes cavus deformity. Initially, 15 pedal angles were repetitively measured 7 times on 6 color-coded images of both feet, in 20 healthy adults. From the 7 repetitive measurements, the intra-class correlation was calculated and analysis of variance was used to estimate the minimum number of trials that would be necessary to identify a statistically significant difference in the measurements. To determine intra-rater reliability, 5 examiners evaluated a single set of data taken from 10 subjects. Additionally, data were obtained for 20 subjects with pes cavus deformity. The average intra-class correlation coefficient (ICC) for the anglular measurements for 2 to 7 trials was 0.98 +/- 0.06, while the intra-rater reliability was 0.90 +/- 0.14. No statistically significant differences were observed between right and left foot angles in able-bodied subjects; whereas, in the pes cavus group, 8 different angular measurements were observed to be statistically significantly different. The results of this investigation indicate that a computer-aided, color-coded, video-based system can be used to make reliable measurements of postural alignment in patients with and without pes cavus. LEVEL OF CLINICAL EVIDENCE: 5.

Bracing has no effect on standing balance in females with adolescent idiopathic scoliosis.

BACKGROUND: Since trunk morphology and curve types were reported to affect standing in adolescent idiopathic scoliosis (AIS), it is reasonable to assume that bracing could perturb standing balance in this population. The objective here was to use time- and frequency-domain analyses to test if the Boston brace affects balance in AIS. MATERIAL/METHODS: Fifteen AIS girls were fitted with a Boston brace. At the four-month follow-up, standing balance was assessed using center of pressure (COP) displacements measured from a force plate. The subjects were tested with and without the brace. RESULTS: The mean position of the COP and the sway area were similar with and without the brace. Though the first peak in the power spectra was not statistically significant, the second peak was statistically smaller with the brace in the antero-posterior direction (p=0.012) and larger along the medio-lateral axis (p=0.022). In the antero-posterior direction there was a statistically significant shift towards higher mean (p=0.012) and median (p=0.003) frequencies with the brace, whereas no difference was noted in the medio-lateral direction. Time-domain parameters did not prove useful in differentiating between the in- and out-of-brace conditions in AIS individuals. The second peak in the power spectra could be associated with an inverse double-pendulum motion. CONCLUSIONS: The time-dependent parameters used in this study did not prove useful in differentiating between in-brace and out-of-brace conditions. Spectral analysis highlighted increased stiffness in the antero-posterior direction and less control in the medio-lateral axis in standing balance between in-brace and out-of-brace conditions in AIS.

Simultaneous, bilateral, and three-dimensional gait analysis of elderly people without impairments.

OBJECTIVE: The main objectives of this study were to determine if the right and left lower limbs in the gait of elderly people developed similar muscle moment and power patterns and to determine whether their associated mechanical energies were different during two consecutive gait cycles. DESIGN: A total of 18 able-bodied male subjects aged 71 +/- 6.8 yrs participated in this study. Data were collected using three Optotrak position sensors and two AMTI force platforms. RESULTS: The peak muscle powers were very similar in the sagittal plane and reflected gait symmetry, except for greater and significant differences produced by the hip extensors. Differences in the frontal and transverse planes were mainly attributed to the actions taken by the muscles, leading the lower limbs to compensate and to dynamically balance and propel the body forward during two consecutive gait cycles. In terms of mechanical energy, 13% greater positive work was done in the left limb and was associated with asymmetrical behavior of the lower limbs to propel the body forward. The total negative work was similar for both limbs, and substantial work was done in the frontal plane by the hip, indicating the role of muscle activity in this plane to control the pelvis and trunk against gravitational forces. CONCLUSIONS: In addition to the importance of a balance-control function in the gait of healthy, elderly subjects, muscle activity made an important contribution to propelling the body forward. Gait asymmetry in elderly subjects seems to be related to different degrees of energy generated by the lower limbs for the propulsion function, whereas both limbs contribute similarly to the balance-control function.

Continuous curve registration as an intertrial gait variability reduction technique.

Timing in peak values shifts slightly between gait trials. When gait data are averaged, part of the standard deviation could be associated with this intertrial variability unless normalization is carried out beforehand. The objective of this study was to determine how continuous curve registration, an alignment technique, can reduce intersubject variability in gait data without altering the original curve characteristics. Gait data were obtained by means of a four-camera high-speed video system synchronized to a force plate. The data for 60 gait trials were collected from 20 young, healthy subjects. Curve registration was applied to hip angular displacement, net moment, and power curves generated in the sagittal plane. Following registration, the peak values increased by an average of 1.2% (0.11 +/- 0.26 degrees) for angular displacement, and by 11.2% (0.11 +/- 0.09 W/kg) for power, while there were no changes for moments. First and second derivatives of the unregistered and registered curves did not display significant differences, and the harmonics were barely affected. Continuous curve registration would thus be an appropriate technique for application prior to any statistical analysis using able-bodied gait patterns.

Local or global asymmetry in gait of people without impairments.

Using two consecutive gait cycles, simultaneous and bilateral kinetic gait data, the main objectives of this study were (a) to identify the main functional roles of ankle, knee and hip extensors/flexors, and (b) to determine whether the action taken by these muscle groups appears to be symmetric or not. Gait of our able-bodied subjects appears to be asymmetric with significant differences noted between each two corresponding peak muscle moment values. Using principal component analysis (PCA) as a curve structure detection method, task discrepancies were recognized when comparisons were made between each two corresponding representative moment curves at each joint (local asymmetry). Muscle moment behaved symmetrically when the right limb representative curve was compared to its corresponding principal component (PC) at the contralateral limb. Gait of able-bodied subjects appears to be symmetric, while control and propulsion were recognized as two major roles of the extensors and flexors (global gait asymmetry). Symmetrical behavior of the lower limbs should be considered a consequence of local asymmetry which indicates different levels of within and between muscle activities developed at each joint during gait cycles.

Relations between standing stability and body posture parameters in adolescent idiopathic scoliosis.

STUDY DESIGN: A retrospective study of standing imbalance and body posture in 71 able-bodied girls and subjects with adolescent idiopathic scoliosis was conducted. OBJECTIVE: To test the hypothesis that postural parameters are related to standing stability parameters. SUMMARY OF BACKGROUND DATA: Spinal deformity not only modifies the shape of the trunk, but also changes the relations between body segments affecting posture in scoliotic children. These postural adaptations to the scoliotic curve progression could be linked in part to increased body sway in upright standing. This has not yet been related to specific postural parameters involving the head, trunk, and pelvis in nontreated idiopathic scoliosis. METHODS: The head, trunk, and pelvis orientations of each subject were measured by a Flock of Bird system. An AMTI force platform was used to assess quiet standing stability and to monitor the position and displacement of the center of pressure (COP). The center of mass (COM) excursion was estimated from a biomechanical model using force plate information only. Analyses of variance (ANOVAS) were performed to determine the statistical differences between the scoliotic and nonscoliotic subjects, and backward stepwise multiple regression analyses were performed to identify any correlation between measures of quiet standing stability and body postural parameters RESULTS: The scoliotic group was characterized by a decrease in standing stability. There was an increase in the sway areas measured by the variations of the COP and COM. From the backward stepwise multiple regression analysis, it appears that for the able-bodied girls, the body posture parameters were correlated only with the mean anteroposterior center of pressure (COP(AP)) position. For the scoliotic group, the sway areas and the mean position of the centers of pressure and the COP(AP)-COM(AP) were correlated significantly with body posture parameters. The higher COP-COM differences for the scoliotic group were attributed to a greater neuromuscular demand to maintain standing balance. The coefficients of correlation of the multiple regression analyses ranged from 0.64 to 0.85 for the nonscoliotic group and from 0.55 to 0.72 for the scoliotic group. CONCLUSIONS: The use of backward stepwise multiple correlations highlighted the interaction between several body parameters and their relation to standing stability in both able-bodied girls and scoliotic subjects. The scoliotic group displayed a much larger number of correlations between standing stability and body posture parameters than the nonscoliotic group. Standing imbalance was related to altered body posture parameters measured in the frontal and horizontal planes only. Although the correlation coefficients were relatively high, factors other than body posture parameters appeared related to standing imbalance in adolescent idiopathic scoliosis. These findings support the concept of either a primary or a secondary dysfunction in the postural regulation system of scoliotic subjects.

Relationship between ankle frontal muscle powers and three-d gait patterns.

OBJECTIVE: This study was undertaken to demonstrate that the ankle frontal muscle power absorption and generation at push-off are related to the foot's initial position at heel-strike with respect to the body center of mass. DESIGN: Nineteen able-bodied male subjects participated in this study and were divided into two groups according to ankle frontal plane power generation or absorption at push-off. RESULTS: At heel-strike, the group that absorbed had a center of pressure that was located on average 25% more anteriorly and 36% more laterally to the body center of mass. Moreover, at push-off, the center of pressure was closer (26%) to the center of mass than in the generating group. The absorbing group compensated by increasing their sagittal plane hip energy by 30% to pull the lower limb forward and their knee power absorption by 47% to slow down the leg before the subsequent heel-strike. CONCLUSIONS: The foot's initial position at heel-strike explains in part the ankle frontal power generation or absorption at push-off. Increasing hip and knee sagittal joint powers and mechanical energies were the main contributors in compensating and providing a broader base of support and frontal plane ankle power absorption.