Interlimb Coordination during Double Support Phase of Gait in People with and without Stroke.

This study aims to identify differences between participants with and without stroke regarding the ipsilesional and contralesional lower limbs kinematics, kinetics, muscle activity and their variability during double support phase of gait. Eleven post-stroke and thirteen healthy participants performed 10 gait trials at a self-selected speed while being monitored by an optoelectronic motion capture system, two force plates and an electromyographic system. The following outcomes were evaluated during the double support: the time and the joint position; the external mechanical work on the centre of mass; and the relative electromyographic activity. Both, contralesional/ipsilesional and dominant/non-dominant of participants with and without stroke, respectively, were evaluated during double support phase of gait in trailing or leading positions. The average value of each parameter and the coefficient of variation of the 10 trials were analysed. Post-stroke participants present bilateral decreased mechanical work on the centre of mass and increased variability, decreased contralesional knee and ankle flexion in trailing position, increased ipsilesional knee flexion in leading position and increased variability. Increased relative muscle activity was observed in post-stroke participants with decreased variability. Mechanical work on the centre of mass seems to be the most relevant parameter to identify interlimb coordination impairments in post-stroke subjects.

Swimmers' Effective Actions during the Backstroke Start Technique.

The analysis of the external forces of swimming starts has revealed how swimmers propel themselves out of the block, but data should be properly interpreted to fully understand force-generation mechanisms. This study aimed to assess horizontal and vertical forces in the backstroke start based on swimmers' structural and propulsive actions. Firstly, a simulated structural force was estimated by two transient backstroke-start inter-segmental realistic body positions: a maximally tucked position and an extended one (just before the hands-off and the take-off, respectively). Secondly, 10 competitive backstroke swimmers performed four 15 m maximal backstroke starts with the external forces estimated. Thirdly, the simulated structural force was subtracted from raw horizontal and vertical force data, measured between hands-off and take-off instants, resulting in the propulsive forces. The application of the algorithm has evidenced that backstrokers' horizontal and vertical simulated-structural-force components contributed to ~40% of total force during start propulsion (~0.2-0.12 s before the take-off), followed by the propulsive horizontal force increment and a progressive vertical component reduction (~0.05 s) with ~20° take-off angle. Based on these findings, researchers and coaches can better guide swimmers as to the proper mechanical strategies to achieve effectiveness in the backstroke start, and to improve direct transfer of resistance training programs.

Repeatability and Temporal Consistency of Lower Limb Biomechanical Variables Expressing Interlimb Coordination during the Double-Support Phase in People with and without Stroke Sequelae.

Reliable biomechanical methods to assess interlimb coordination during the double-support phase in post-stroke subjects are needed for assessing movement dysfunction and related variability. The data obtained could provide a significant contribution for designing rehabilitation programs and for their monitorisation. The present study aimed to determine the minimum number of gait cycles needed to obtain adequate values of repeatability and temporal consistency of lower limb kinematic, kinetic, and electromyographic parameters during the double support of walking in people with and without stroke sequelae. Eleven post-stroke and thirteen healthy participants performed 20 gait trials at self-selected speed in two separate moments with an interval between 72 h and 7 days. The joint position, the external mechanical work on the centre of mass, and the surface electromyographic activity of the tibialis anterior, soleus, gastrocnemius medialis, rectus femoris, vastus medialis, biceps femoris, and gluteus maximus muscles were extracted for analysis. Both the contralesional and ipsilesional and dominant and non-dominant limbs of participants with and without stroke sequelae, respectively, were evaluated either in trailing or leading positions. The intraclass correlation coefficient was used for assessing intra-session and inter-session consistency analysis. For most of the kinematic and the kinetic variables studied in each session, two to three trials were required for both groups, limbs, and positions. The electromyographic variables presented higher variability, requiring, therefore, a number of trials ranging from 2 to >10. Globally, the number of trials required inter-session ranged from 1 to >10 for kinematic, from 1 to 9 for kinetic, and 1 to >10 for electromyographic variables. Thus, for the double support analysis, three gait trials were required in order to assess the kinematic and kinetic variables in cross-sectional studies, while for longitudinal studies, a higher number of trials (>10) were required for kinematic, kinetic, and electromyographic variables.

Methodological Considerations in Assessing Interlimb Coordination on Poststroke Gait: A Scoping Review of Biomechanical Approaches and Outcomes.

Objective: To identify and summarize biomechanical assessment approaches in interlimb coordination on poststroke gait. Introduction: Interlimb coordination involves complex neurophysiological mechanisms that can be expressed through the biomechanical output. The deepening of this concept would have a significant contribution in gait rehabilitation in patients with an asymmetric neurological impairment as poststroke adults. Inclusion criteria: Poststroke adults (>19 years old), with assessment of interlimb coordination during gait, in an open context, according to the Population, Concept, Context framework. Methods: A literature search was performed in PubMed, Web of Science™, Scopus, and gray literature in Google Scholar™, according to the PRISMA-ScR recommendations. Studies written in Portuguese or English language and published between database inception and 14 November 2021 were included. Qualitative studies, conference proceedings, letters, and editorials were excluded. The main conceptual categories were "author/year", "study design", "participant's characteristics", "walking conditions", "instruments" and "outcomes". Results: The search identified 827 potentially relevant studies, with a remaining seven fulfilling the established criteria. Interlimb coordination was assessed during walking in treadmill (n = 3), overground (n = 3) and both (n = 1). The instruments used monitored electromyography (n = 2), kinetics (n = 2), and kinematics (n = 4) to assess spatiotemporal parameters (n = 4), joint kinematics (n = 2), anteroposterior ground reaction forces (n = 2), and electromyography root mean square (n = 2) outcomes. These outcomes were mostly used to analyze symmetry indices or ratios, to calculate propulsive impulse and external mechanical power produced on the CoM, as well as antagonist coactivation. Conclusions: Assessment of interlimb coordination during gait is important for consideration of natural auto-selected overground walking, using kinematic, kinetic, and EMG instruments. These allow for the collection of the main biomechanical outcomes that could contribute to improve better knowledge of interlimb coordination assessment in poststroke patients.

Modelling and Predicting Backstroke Start Performance Using Non-Linear and Linear Models.

Our aim was to compare non-linear and linear mathematical model responses for backstroke start performance prediction. Ten swimmers randomly completed eight 15 m backstroke starts with feet over the wedge, four with hands on the highest horizontal and four on the vertical handgrip. Swimmers were videotaped using a dual media camera set-up, with the starts being performed over an instrumented block with four force plates. Artificial neural networks were applied to predict 5 m start time using kinematic and kinetic variables and to determine the accuracy of the mean absolute percentage error. Artificial neural networks predicted start time more robustly than the linear model with respect to changing training to the validation dataset for the vertical handgrip (3.95 ± 1.67 vs. 5.92 ± 3.27%). Artificial neural networks obtained a smaller mean absolute percentage error than the linear model in the horizontal (0.43 ± 0.19 vs. 0.98 ± 0.19%) and vertical handgrip (0.45 ± 0.19 vs. 1.38 ± 0.30%) using all input data. The best artificial neural network validation revealed a smaller mean absolute error than the linear model for the horizontal (0.007 vs. 0.04 s) and vertical handgrip (0.01 vs. 0.03 s). Artificial neural networks should be used for backstroke 5 m start time prediction due to the quite small differences among the elite level performances.

Effect of wetted surface area on friction, pressure, wave and total drag of a kayak.

Using theoretical principles, the components of drag (friction D F, pressure D PR and wave D W) of a single-seat kayak were analysed. The purpose was to examine the effect of changes in wetted surface area due to changes in kayaker's weight and the relative contribution of D F, D PR and D W to the total passive drag as function of velocity. The total passive drag values were based on experimental data collected in a single-seat kayak. Three different kayaker simulated weights were tested - 65, 75 and 85 kg. D F was the drag component that contributed the greatest percentage (between 60 and 68% at 5.56 m/s the top velocity tested) to the total passive drag for all the velocities tested and simulated weights. D W was the most affected by the increase in kayaker's simulated weight, mainly when comparing 65/75 to 85 kg. Results support the importance of a kayak design selection that minimises the kayak's drag for the individual weight of the kayaker. Also, the results suggest that the path for better hydrodynamic kayak performance should seek changes that can reduce D F, D PR and D W with D F offering the most potential to reduce passive drag.

Portuguese version of the Swedish Occupational Fatigue Inventory (SOFI) among assembly workers: Cultural adaptation, reliability and validity.

OBJECTIVES: Reliable and valid instruments are essential for understanding fatigue in occupational settings. This study analyzed the psychometric properties of the Portuguese version of the Swedish Occupational Fatigue Inventory (SOFI). MATERIAL AND METHODS: A cross-sectional study was conducted with 218 workers from an automotive industry involved in assembly tasks for fabrication of mechanical cables. Convergent and discriminant validity, internal consistency reliability and confirmatory factor analysis were performed. RESULTS: Results showed adequate fit to data, yielding a 20-item, 5-factor structure (all intercorrelated): Chi2/df (ratio Chi2 and degrees of freedom) = 2.530, confirmatory fit index (CFI) = 0.919, goodness of fit index (GFI) = 0.845, root mean square error of approximation (RMSEA) = 0.084. The SOFI presented an adequate internal consistency, with the sub-scales and total scale presenting good reliability values (Cronbach's α values from 0.742 to 0.903 and 0.943 respectively). CONCLUSIONS: Findings suggest that the Portuguese version of the SOFI may be a useful tool to assess fatigue and prevent work-related injuries. In future research, other instruments should be used as an external criterion to correlate with the SOFI dimensions. Int J Occup Med Environ Health 2017;30(3):407-417.

The effect of different foot and hand set-up positions on backstroke start performance.

Foot and hand set-up position effects were analysed on backstroke start performance. Ten swimmers randomly completed 27 starts grouped in trials (n = 3) of each variation, changing foot (totally immersed, partially and totally emerged) and hand (lowest, highest horizontal and vertical) positioning. Fifteen cameras recorded kinematics, and four force plates collected hands and feet kinetics. Standardised mean difference and 95% confidence intervals were used. Variations with feet immersed have shown lower vertical centre of mass (CM) set-up position (0.16 m), vertical impulse exerted at the hands, horizontal and vertical impulse exerted at the feet (0.28, 0.41, 0.16 N/BW.s, respectively) than feet emerged with hands horizontal and vertically positioned. Most variations with feet partially emerged exhibited higher and lesser vertical impulse exerted at hands than feet immersed and emerged (e.g. vertical handgrip, 0.13, 0.15 N/BW.s, respectively). Variation with feet emerged and hands on the lowest horizontal handgrip depicted shorter horizontal (0.23, 0.26 m) and vertical CM positioning at flight (0.16, 0.15 m) than the highest horizontal and vertical handgrip, respectively. Start variations have not affected 15-m time. Variations with feet partially or totally emerged depicted advantages, but focusing on the entry and underwater biomechanics is relevant for a shorter start time.

Is passive drag dependent on the interaction of kayak design and paddler weight in flat-water kayaking?

Drag is one of the major factors that influences kayaking performance. To focus on the drag of the kayak's hull shape and the paddlers' weight per se, the passive drag (Dp) was measured on a flat-water sprint course for one paddler with added weights. Dp was measured by an electromechanical towing device using a load cell, at incremental and constant velocities from 2.78 to 5.56 m/s. Three kayaks of different sizes and shapes (Nelo® K1 Quattro-M, ML, and L) were used and the paddlers' body weight was adjusted with weights so the total paddler weight in the kayak was 65, 75, and 85 kg. The mean Dp increased by the power function of D = kv(n) (mean R(2) = .990; SD .006). The Dp went from 21.37 ± 1.29 N at 2.78 m/s to 89.32 ± 6.43 N at 5.56 m/s. For the two lighter weighted kayaks (65 and 75 kg), the lowest Dp was observed with different kayak sizes (M, ML, or L) depending on the target velocity. The manufacturers suggest that paddlers should select a kayak size according to their body weight to minimise drag; however, the results of this study suggest that target velocities, and thus competition distance should also be factored into kayak selection.

Effective Swimmer's Action during the Grab Start Technique.

The external forces applied in swimming starts have been often studied, but using direct analysis and simple interpretation data processes. This study aimed to develop a tool for vertical and horizontal force assessment based on the swimmers' propulsive and structural forces (passive forces due to dead weight) applied during the block phase. Four methodological pathways were followed: the experimented fall of a rigid body, the swimmers' inertia effect, the development of a mathematical model to describe the outcome of the rigid body fall and its generalization to include the effects of the inertia, and the experimental swimmers' starting protocol analysed with the inclusion of the developed mathematical tool. The first three methodological steps resulted in the description and computation of the passive force components. At the fourth step, six well-trained swimmers performed three 15 m maximal grab start trials and three-dimensional (3D) kinetic data were obtained using a six degrees of freedom force plate. The passive force contribution to the start performance obtained from the model was subtracted from the experimental force due to the swimmers resulting in the swimmers' active forces. As expected, the swimmers' vertical and horizontal active forces accounted for the maximum variability contribution of the experimental forces. It was found that the active force profile for the vertical and horizontal components resembled one another. These findings should be considered in clarifying the active swimmers' force variability and the respective geometrical profile as indicators to redefine steering strategies.

Novel doped calcium phosphate-PMMA bone cement composites as levofloxacin delivery systems.

Antibiotic-loaded acrylic bone cements (ALABCs) are well-established and cost-effective materials to control the occurrence of bone and joint infections. However, the inexistence of alternative antibiotics other than those already commercially available and the poor ability to bind to bone tissue hampering its biological function are still major drawbacks of ALABCs clinical application. The concept of this research work is to develop a novel bone cement (BC) drug delivery system composed by Mg- and Sr-doped calcium phosphate (CaP) particles as drug carriers loaded into a lactose-modified acrylic BC, which, to the best of our knowledge, has never been reported. CaP particles are known to promote bone ingrowth and current research is focused on using these carriers as antibiotic delivery systems for the treatment of bone infections, like osteomyelitis. Levofloxacin is a fluoroquinolone with anti-staphylococcal activity and adequate penetration into osteoarticular tissues and increasingly being recommended to manage bone-related infections. Also, the lactose-modified BC matrix, with a more porous structure, has already proved to enhance antibiotic release from the BC inner matrix. This novel BC composite biomaterial has shown improved mechanical integrity, biocompatibility maintenance, and sustained release of levofloxacin, with concentrations over the minimum inhibitory concentration values after a 48h while maintaining antibacterial activity over an 8-week period against Staphyloccocus aureus and Staphyloccocus epidermidis, common pathogens associated with bone infections.

Paddling Force Profiles at Different Stroke Rates in Elite Sprint Kayaking.

In sprint kayaking the role that paddling technique plays in optimizing paddle forces and resultant kayak kinematics is still unclear. The aim of this study was to analyze the magnitude and shape of the paddle force-time curve at different stroke rates, and their implications for kayak performance. Ten elite kayak paddlers (5 males and 5 females) were analyzed while performing 2000-m on-water trials, at 4 different paces (60, 80, and 100 strokes per minute, and race pace). The paddle and kayak were instrumented with strain gauges and accelerometers, respectively. For both sexes, the force-time curves were characterized at training pace by having a bell shape and at race pace by a first small peak, followed by a small decrease in force and then followed by a main plateau. The force profile, represented by the mean force/peak force ratio, became more rectangular with increasing stroke rate (F[3,40] = 7.87, P < .01). To obtain a rectangular shape to maximize performance, kayak paddlers should seek a stronger water phase with a rapid increase in force immediately after blade entry, and a quick exit before the force dropping far below the maximum force. This pattern should be sought when training at race pace and in competition.

Key-properties outlook of a levofloxacin-loaded acrylic bone cement with improved antibiotic delivery.

Antibiotic-loaded acrylic bone cements (ALABCs) are widely used to decrease the occurrence of bone infections in cemented arthroplasties and actually being considered as a more cost-effective procedure when compared to cementless implants. However, ALABCs have a major drawback, which is the incomplete release of the antibiotics and, as a result, pathogens that commonly are responsible for those infections are becoming resistant. Consequently, it is of most relevance to find new antibacterial agents to load into BC with an effective mechanism against those microorganisms. This research work intended to load levofloxacin, a fluoroquinolone with anti-staphylococcal activity and adequate penetration into osteoarticular tissues, on lactose-modified commercial bone cement (BC). This modified BC matrix exhibited increased levofloxacin release and delayed Staphylococcus aureus biofilm formation. Further insights on material-drug interaction during BC setting were investigated by density functional theory calculations. The obtained results suggested that favorable covalent and non-covalent interactions could be established between levofloxacin and the BC. Moreover, BC mechanical and biocompatibility properties were maintained. These features justify the potential of levofloxacin-loaded modified-BC as a valuable approach for local antibiotic delivery in bone infections management.

Evaluating Transportation by Comparing Several uses of Rotary Endodontic Files.

AIM: To evaluate the frequent use of ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland) systems on shaping ability of root canal utilizing Solidworks (2014, Dassault Systemes) software. MATERIALS AND METHODS: Thirty-six root canals in clear resin blocks (Dentsply-Maillefer) were allocated into six experimental groups (n = 36). Six new sets of PTN instruments (Dentsply Maillefer, Ballaigues, Switzerland) were used six times to shape the resin blocks. A #15 K-file was inserted to the working length (WL), followed by ProGlider (PG) to create a glide path. Sequential use of PTN instrumentation in a crown-down technique was used to reach size (30/07) apically. Macroscopic photos of the blocks were taken before and after instrumentation, layered by Paint Shop Pro 9 from JascSoftware, and then canal transportation was measured using Solidwork 2014. The data were analyzed by SPSS software version 22. Multivariate statistical analysis general linear model (GLM) was also applied. Bonferroni correction test was used in multiple comparisons and the statistical significance was set to 0.05. RESULTS: There was no difference in canal transportation resulted from utilizing PTN files after six multiple uses; in addition, the PTN files showed ability to maintain the original canal anatomy, especially in the apical level, where lowest total mean value of canal center displacement was seen (3 mm level) (0.019 ± 0.017). CONCLUSION: ProTaper Next files can be used to prepare single and multiple canals in a single furcated tooth. CLINICAL SIGNIFICANCE: ProTaper Next nickel-titanium (NiTi) file system is a safe instrument that respects the canal shape, allows practitioners to treat difficult cases with good results, and low risk of separation.

A novel modified acrylic bone cement matrix. A step forward on antibiotic delivery against multiresistant bacteria responsible for prosthetic joint infections.

Currently the safe and responsible use of antibiotics is a world-wide concern as it promotes prevention of the increasing emergence of multiresistant bacterial strains. Considering that there is a noticeable decline of the available antibiotic pipeline able to combat emerging resistance in serious infection a major concern grows around the prosthetic joint infections once the available commercial antibiotic loaded polymethylmethacrylate bone cements (BC) are inadequate for local antibiotic treatment, especially against MRSA, the most commonly isolated and antibiotic-resistant pathogen in bone infections. In this paper a novel modified BC matrix loaded with minocycline is proposed. A renewed interest in this tetracycline arises due to its broad-spectrum of activity against the main organisms responsible for prosthetic joint infections, especially against MRSA. The modified BC matrices were evaluated concerning minocycline release profile, biomechanical properties, solid-state characterization, antimicrobial stability and biocompatibility under in vitro conditions. BC matrix loaded with 2.5% (w/wBC) of minocycline and 10.0% (w/wBC) of lactose presented the best properties since it completely released the loaded minocycline, maintained the mechanical properties and the antimicrobial activity against representative strains of orthopedic infections. In vitro biocompatibility was assessed for the elected matrix and neither minocycline nor lactose loading enhanced BC cytotoxicity.

Three-dimensional reconstruction and characterization of human external shapes from two-dimensional images using volumetric methods.

This work presents a volumetric approach to reconstruct and characterise 3D models of external anatomical structures from 2D images. Volumetric methods represent the final volume using a finite set of 3D geometric primitives, usually designed as voxels. Thus, from an image sequence acquired around the object to reconstruct, the images are calibrated and the 3D models of the referred object are built using different approaches of volumetric methods. The final goal is to analyse the accuracy of the obtained models when modifying some of the parameters of the considered volumetric methods, such as the type of voxel projection (rectangular or accurate), the way the consistency of the voxels is tested (only silhouettes or silhouettes and photo-consistency) and the initial size of the reconstructed volume.