Total wrist fusion is a surgical procedure used to manage pain in late-stage arthritis, though it results in a complete loss of wrist mobility. This loss can lead to compensatory movement patterns in other upper limb joints, which may increase the risk of secondary musculoskeletal disorders. This study investigated scapular kinematics in wrist fusion patients compared to healthy controls. Eighteen participants (nine wrist fusion patients, nine age- and sex-matched controls) were recruited. Scapular motion was tracked using motion capture during seven functional tasks. Bilateral scapular kinematics (upward rotation, internal rotation and anterior tilt) were analyzed at 30° increments of humeral elevation. Kinematic outcomes were assessed using linear mixed models with group and side (fusion or non-fusion) as independent factors. Participants with wrist fusion demonstrated greater scapular internal rotation, upward rotation, and anterior tilt for both arms as compared with the control group. Upward rotation was greater on the fusion side than the non-fusion side in the surgery group. These findings suggest that scapular kinematics are altered to compensate for wrist immobility during daily living and functional tasks. Understanding these compensatory patterns is important to guide post-surgical rehabilitation strategies and help prevent secondary upper limb injuries.
The determination of the optimal prosthesis alignment for maximum patient comfort is an important rehabilitation goal, especially for lower limb amputees, where the assessment of biomechanics is complex. Despite this, quantitative gait analysis is rarely used in clinical practice, and the influence of prosthesis alignment on gait kinematics remains unclear. This study explores the use of an IMU-based motion capture system to assess the impact of prosthesis alignment on gait biomechanics. A transtibial amputee's gait was analyzed with various prosthetic foot alignments in the sagittal and frontal planes. Key gait parameters were measured, including joint flexion/extension angles, body tilt and center of mass (COM) oscillation. Deviations in joint angles from reference values reached 30°, and gait speed varied by up to 0.5 m/s depending on alignment. Notably, prosthesis alignment had minimal impact on the healthy leg's kinematics but significantly influenced gait asymmetry, also reflected in COM movement. The study confirms that prosthesis alignment can markedly affect amputee gait biomechanics. The proposed method enables clinicians to evaluate alignment suitability and make data-driven adjustments.
The head-mounted laser is commonly used in clinical proprioceptive tests, but its ability to measure movement across three planes of motion has not been investigated. Therefore, this study evaluated the head-mounted laser against a validated gold standard multi-sensor inertial measurement unit (IMU) (XsensTM) in measuring cervicocephalic movement across three planes. Fourteen healthy adults (seven males and seven females) performed six repetitions each of active cervical flexion, extension, lateral flexion and rotation, whilst instructed to maintain the laser beam within a bullseye corresponding to 4.5° of movement. Primary plane means XsensTM range of motion (ROM) was used to evaluate if movement remained less than 4.5°. During flexion, extension and rotation movements, mean ROM in the primary plane using XsensTM remained within the 4.5° threshold (2.97°-3.57°), indicating that the head-mounted laser corresponded with the IMU (p ≤ 0.01). However, XsensTM mean lateral flexion movement reached 11.34° and 12.10° for left and right lateral flexion, indicating poor correspondence (p = 0.95 and 0.97). The head-mounted laser is appropriate for clinical movement assessment in the sagittal and transverse planes but not recommended for the coronal plane. Other devices should be considered for complete clinical assessment of cervical position sense.
Achilles tendinopathy (AT) is common among runners and typically presents with Achilles tendon pain. Neuromotor alterations have been reported in AT during demanding tasks such as running; however, alterations during functional tasks such as walking remain poorly understood. Such information may be relevant and inform rehabilitation targets. Therefore, this exploratory study investigated lower limb neuromotor control during walking and running in people with AT compared with healthy controls (CO). Twenty-four male runners participated (AT = 12, CO = 12) and completed walking (WALK), perturbed walking (PERTWALK), running (RUN), and perturbed running (PERTRUN) on a custom split-belt treadmill. Lower limb muscle activity was recorded using electromyography to assess activity onset, offset, and duration during unperturbed tasks, and reflex latency and amplitude during perturbed tasks. A MANOVA (α = 0.05) examined group effects (AT/CO). During WALK, AT showed delayed onset of tibialis anterior, peroneus longus, and vastus medialis (p < 0.05). During RUN, gastrocnemius medialis duration was longer, while gluteus maximus onset was delayed and shorter in AT (p < 0.05). During PERTWALK, tibialis anterior reflex latency was delayed in AT (p < 0.05), whereas reflex amplitudes and all PERTRUN outcomes were not significant. These findings indicate potential neuromotor differences in AT.
In this pilot randomized controlled trial, we assessed the effects of a core-lower limb coordinated Pilates exercise on gait and postural balance in women with bilateral flexible pes planus. Twenty-two women aged 34.64 ± 9.59 years with bilateral navicular drop ≥10 mm assessed by the navicular drop test (NDT) were randomly assigned to either a Pilates training group or a control group. Gait parameters - including foot off, step time, stride time, walking speed, and cadence - were assessed using a validated three-dimensional motion analysis system. Postural balance was quantified as center of pressure (COP) sway in both anterior - posterior (AP) and mediolateral (ML) directions, including range, velocity, and root mean square (RMS), using a force plate. Gait and balance were evaluated at baseline and after the 8-week intervention. Significant improvements were observed in step-time (p = .014), stride-time (p = .045), and cadence (p = .033), as well as postural balance variables, particularly in ML-RMS (p = .003), for the Pilates group compared to the control group. These results suggest that Pilates exercise may benefit gait and postural balance in individuals with flexible pes planus.
