BACKGROUND:Hip osteoarthritis (OA) can cause pain, restricted locomotor activity and functional impairments but it remains difficult to predict functional decline over time. OBJECTIVES:The aims of this study were to identify functional decline trajectories in people with hip OA using the Hip disability and Osteoarthritis Outcome Score (HOOS) domains and to determine radiological and gait predictors of typical trajectories. METHODS:Consecutive people with hip OA with no indication for total hip replacement at baseline were included. Radiological, clinical (HOOS) and gait analyses were collected at baseline, and clinical follow-up was carried out every 6 months for 3 years. HOOS trajectories were estimated by group-based trajectory modeling. Predictive factors were identified by multivariate logistic regression, and their discriminatory power was assessed using the area under the ROC (receiver operating characteristic) curve. RESULTS:Two distinct trajectories were highlighted for all HOOS domains: Traj1 (progressor) and Traj2 (non-progressor). Using a multivariate analysis, gait speed was found to be predictive of Traj1 for HOOS symptoms/stiffness (odds ratio [OR] 0.61, 95 % CI 0.45 to 0.83, AUC (area under the curve) = 75 %) and for HOOS pain (OR = 0.72, 95 % CI 0.53 to 0.97, AUC = 72 %). Moreover, maximum hip extension was found to be predictive of Traj1 for HOOS sports and leisure (OR = 0.78, 95 % CI 0.69 to 0.89, AUC = 81 %) and HOOS quality of life (OR = 0.84, 95 % CI 0.73 to 0.95, AUC = 66 %). CONCLUSION:This study identified 2 typical trajectories of functional decline (progressor/non-progressor) for the 5 HOOS domains. It also demonstrated the predictive validity of 2 gait parameters (gait speed and maximum hip extension) for functional decline. DATABASE REGISTRATION:NCT02042586.

Local muscle vibrations (LMV) acutely and chronically affect the sensorimotor system, but their effects vary depending on application conditions. The mechanisms behind repeated LMV exposure are still debated. This study investigated the chronic effects of LMV under illusion-inducing conditions on the upper limb. Nineteen healthy participants completed 9 LMV sessions (80 Hz, 20 min) over 11 days targeting the right wrist flexors. Illusions were assessed using subjective scales and EEG (alpha band desynchronization). Neurophysiological parameters (spinal, corticospinal excitabilities, and intracortical inhibition) and grip strength were evaluated before and after a control session (20-min rest) and an LMV session, as well as after 9 LMV sessions and 5 days post-protocol. Participants consistently experienced illusions throughout the protocol, with stronger perceptions during the first 15 min. However, subjective and objective measures were found to be independent. Acute LMV significantly reduced the H-reflex (-52.3% [-69.7 ; -21.0]) but did not affect strength or other neurophysiological measures. Additionally, repeated LMV exposure induced no chronic changes in strength or neural excitabilities and inhibition. While confirming acute LMV effects under illusion conditions, this study found no evidence of chronic adaptations. It also suggests that subjective and objective (EEG-based) illusion measures reflect distinct neurophysiological mechanisms.

Sagittal balance, commonly impaired in lumbar spinal stenosis (LSS) patients, is typically assessed using the sagittal vertical axis (SVA) with EOS imaging. However, to limit X-ray exposure and medical costs, it could be interesting to evaluate the capacity of quantified motion analysis to estimate the 3D modeling of SVA in patients with symptomatic LSS. An estimation of the SVA in patients with LSS was performed with 3D motion analysis. SVA and “C7_PSI” (orthogonal horizontal distance between the vertical lines through the markers of the C7 vertebra and the middle of the posterosuperior iliac spine) were measured on 37 LSS patients using EOS radiography and postural and 3D motion analysis, respectively. Multiple stepwise linear regressions were performed with EOS SVA according to age, body mass index, C7_PSI and/or postural variables. A highly significant relationship was found between SVA and C7_PSI, mediolateral amplitude of CoP displacements and age (adjusted R²=0.69, p < 0.0001). While the postural analysis did not reveal significant relationships, the model using 3D parameters revealed significant relationships between radiographic SVA and C7_PSI and age (adjusted R²=0.65, p < 0.0001). 3D motion parameters with or without postural parameters may explain more than 65

Eccentric, compared to concentric exercise, is proposed to involve different neuro-motor processing strategies and a higher level of mental demand. This study compared eccentric and concentric cycling at matched perceived effort and torque for the mental demand and related-cortical activation patterns. Nineteen men (30 ± 6 yrs) performed four different 5-min cycling conditions at 30 RPM on a semi-recumbent isokinetic cycle ergometer: 1) concentric at a moderate perceived effort (23 on the CR100® scale) without torque feedback; 2) concentric and 3) eccentric at the same average torque produced in the first condition; and 4) eccentric at the same moderate perceived effort than the first concentric condition. The conditions 2-4 were randomised. After each condition, mental demand was monitored using the NASA Task Load Index scale. Changes in oxy-(O 2 Hb) and deoxy-(HHb) haemoglobin during exercise were meas-ured over both prefrontal cortices and the right parietal lobe from a 15-probe layout using a continuous-wave NIRS system. Mental demand was significantly higher during eccentric compared to concentric cycling (+52%, p = .012) and when the exercise intensity was fixed by the torque rather than the perceived effort (+70%, p ˂ .001). For both torque- or perceived effort-matched exercises, O 2 Hb increased significantly ( p < .001) in the left and right prefrontal cortices, and right parietal lobe, and HHb decreased in the left, and right, prefrontal cortices during eccentric compared to concentric cycling. This study supports that acute eccentric cycling, compared to concentric cycling, involves a higher mental demand and frontoparietal network activation.

Introduction Spasticity is a frequent disabling consequence following a stroke. Local muscle vibrations (LMVs) have been proposed as a treatment to address this problem. However, little is known about their clinical and neurophysiological impacts when used repeatedly during the subacute phase post-stroke. This project aims to evaluate the effects of a 6-week LMV protocol on the paretic limb on spasticity development in a post-stroke subacute population.Methods and analysis This is an interventional, controlled, randomised, single-blind (patient) trial. 100 participants over 18 years old will be recruited, within 6 weeks following a first stroke with hemiparesis or hemiplegia. All participants will receive a conventional rehabilitation programme, plus 18 sessions of LMV (ie, continuously for 30 min) on relaxed wrist and elbow flexors: either (1) at 80 Hz for the interventional group or (2) at 40 Hz plus a foam band between the skin and the device for the control group.Participants will be evaluated at baseline, at 3 weeks and 6 weeks, and at 6 months after the end of the intervention. Spasticity will be measured by the modified Ashworth scale and with an isokinetic dynamometer. Sensorimotor function will be assessed with the Fugl-Meyer assessment of the upper extremity. Corticospinal and spinal excitabilities will be measured each time.Ethics and dissemination This study was recorded in a clinical trial and obtained approval from the institutional review board (Comité de protection des personnes Ile de France IV, 2021-A03219-32). All participants will be required to provide informed consent. The results of this trial will be published in peer-reviewed journals to disseminate information to clinicians and impact their practice for an improved patient’s care.Trial registration number Clinical Trial: NCT05315726Dataset EUDRAct

Used on clinical and sportive context, three-dimensional motion analysis is considered as the gold standard in the biomechanics field. The proposed dataset has been established on 30 asymptomatic young participants. Volunteers were asked to walk at slow, comfortable and fast speeds, and to run at comfortable and fast speeds on overground and treadmill using shoes. Three dimensional trajectories of 63 reflective markers, 3D ground reaction forces and moments were simultaneously recorded. A total of 4840 and 18159 gait cycles were measured for overground and treadmill walking, respectively. Additionally, 2931 and 18945 cycles were measured for overground and treadmill running, respectively. The dataset is presented in C3D and CSV files either in raw or pre-processed format. The aim of this dataset is to provide a complete set of data that will help for the gait characterization during clinical gait analysis and in a sportive context. This data could be used for the creation of a baseline database for clinical purposes to research activities exploring the gait and the run.

Running is the basis of many sports and has highly beneficial effects on health. To increase the understanding of running, DSPro® insoles were developed to collect running parameters during tasks. However, no validation has been carried out for running gait analysis. The aims of this study were to assess the test–retest reliability and criterion validity of running gait parameters from DSPro® insoles compared to a motion-capture system. Equipped with DSPro® insoles, a running gait analysis was performed on 30 healthy participants during overground and treadmill running using a motion-capture system. Using an intraclass correlation coefficient (ICC), the criterion validity and test–retest reliability of spatiotemporal parameters were calculated. The test–retest reliability shows moderate to excellent ICC values (ICC > 0.50) except for propulsion time during overground running at a fast speed with the motion-capture system. The criterion validity highlights a validation of running parameters regardless of speeds (ICC > 0.70). This present study validates the good criterion validity and test–retest reliability of DSPro® insoles for measuring spatiotemporal running gait parameters. Without the constraints of a 3D motion-capture system, such insoles seem to be helpful and relevant for improving the care management of active patients or following running performance in sports contexts.

BACKGROUND:This randomized controlled trial examined the feasibility of adding eccentric exercise to a conventional cardiac rehabilitation program (CCRP) for coronary heart disease patients. METHODS:Ninety-three patients were randomly assigned to either the MIX group (eccentric ergometer + CCRP) or the CON group (concentric ergometer + CCRP) for 7 weeks. Training effectiveness was assessed based on "good responders" showing improved functional capacities, such as 6-minute walk test (6MWT) distance and maximal voluntary contraction of the plantar flexors (ankle MVC). Safety was monitored with a visual analog scale for muscle soreness, perceived exertion, and heart rate during training. RESULTS:The proportion of good responders was similar between groups (26% in MIX, 29% in CON, P=0.744). Both groups improved in 6MWT (CON: 12.6%, MIX: 16.14%) and ankle MVC (CON: 15.5%, MIX: 11.30%), with no significant differences. Exercise tolerance did not differ significantly between the groups, but perceived effort was significantly lower in the MIX group (P<0.0001) compared to the CON group. CONCLUSIONS:Integrating eccentric exercise into cardiac rehabilitation is safe and well-tolerated. Nevertheless, this study did not find significant advantages over conventional programs for coronary heart disease patients. Further research should explore specific patient groups or conditions where eccentric exercise may be more beneficial, emphasizing personalized prescriptions and gradual workload progression for better cardiac rehabilitation outcomes.

BACKGROUND: We searched to quantify the influence of sagittal vertical axis (SVA) on the improvement of spatiotemporal gait parameters using a gait motion analysis (GMA) before and after decompression surgery in patients suffering from lumbar spinal stenosis (LSS). METHODS: Thirty-nine patients with severe LisSS planned for lumbar decompression underwent a full-body biplanar radiographs (EOS) to quantify the SVA and have benefited from a 3-dimensional GMA 1 month before surgery (M0) and 6 month (M6) after surgery. The first step of this study was to confirm the validation of 3-dimensional sagittal vertical axis (3D SVA) for posture analysis. An analysis of modification of the 3D SVA and spatiotemporal gait parameters was then carried out in order to identify any correlation. RESULTS: Decompression surgery did not significantly improve 3D SVA between M0 and M6 (respectively 49.1 [50.3] vs. 49.84 [19.02], P [ 0.42). Concerning spatiotemporal parameters, we found significant difference for all parameters between M0 and M6. A strong correlation (R 2 > 0.65) between static SVA (EOS) and 3D SVA was demonstrated using a statistical regression equation. There was also a statistically significant correlation between SVA (static and 3-dimension) and improvement in spatiotemporal gait parameters after decompression surgery. CONCLUSIONS: This study analyses the relationship between postural change (SVA) and improvement in gait parameters measured during GMA before and after decompression surgery for LSS. This specific analysis of gait parameters may represent a prognostic assessment tool for the recovery of patients undergoing surgery for a LSS.

The flexion relaxation phenomenon (FRP) is characterized by the reduction of paraspinal muscle activity at maximum trunk flexion. FRP is reported to be altered (persistence of spinal muscle activity) in more than half of nonspecific chronic low back pain (NSCLBP) patients. Little is known about how the multi-segmental spine affects FRP. The aim of this observational study was to investigate the relationship between FRP and kinematic parameters of the multi-segmental spine in NSCLBP patients. Forty NSCLBP patients and thirty-five asymptomatic participants performed a standing maximal trunk flexion task. Surface electromyography was recorded along the erector spinae longissimus. The kinematics of the spine were assessed using a 3D motion analysis system. The investigated spinal segments were upper thoracic, lower thoracic, thoracolumbar, upper lumbar, lower lumbar, and lumbopelvic. Upper lumbar ROM, anterior sagittal inclination of the upper lumbar relative to the lower lumbar in the upright position, and ROM of the upper lumbar relative to the lower lumbar during full trunk flexion were significantly correlated with the flexion relaxation ratio (Rho 0.42 to 0.58, p < 0.006). The relative position and movement of the upper lumbar segment seem to play an important role in the presence or absence of FRP in NSCLBP patients.

Wireless wearable insoles are interesting tools to collect gait parameters during daily life activities. However, studies have to be performed specifically for each type of insoles on a big data set to validate the measurement in ecological situations. This study aims to assess the criterion validity and test-retest reliability of gait parameters from wearable insoles compared to motion capture system. Gait of 30 healthy participants was recorded using DSPro® insoles and a motion capture system during overground and treadmill walking at three different speeds. Criterion validity and test-retest reliability of spatio-temporal parameters were estimated with an intraclass correlation coefficient (ICC). For both systems, reliability was found higher than 0.70 for all variables (p < 0.001) except for minimum toe clearance (ICC < 0.50) with motion capture system during overground walking. Regardless of speed and condition of walking, Speed, Cadence, Stride Length, Stride Time and Stance Time variables were validated (ICC > 0.90; p < 0.001). During walking on treadmill, loading time was not validated during slow speed (ICC < 0.70). This study highlights good criterion validity and test-retest reliability of spatiotemporal gait parameters measurement using wearable insoles and opens a new possibility to improve care management of patients using clinical gait analysis in daily life activities.

Background: Among the main methods used to identify an altered flexion relaxation phenomenon (FRP) in nonspecific chronic low back pain (NSCLBP), it has been previously demonstrated that flexion relaxation ratio (FRR) and extension relaxation ratio (ERR) are more objective than the visual reference method.Objective: To determine the sensitivity and specificity of the different methods used to calculate the ratios in terms of their ability to identify an altered FRP in NSCLBP.Methods: Forty-four NSCLBP patients performed a standing maximal trunk flexion task. Surface electromyog-raphy (sEMG) was recorded along the erector spinae longissimus (ESL) and multifidus (MF) muscles. Altered FRP based on sEMG was visually identified by three experts (current standard). Six FRR methods and five ERR methods were used both for the ESL and MF muscles. ROC curves (with areas under the curve (AUC) and sensitivity/specificity) were generated for each ratio.Results: All methods used to calculate these ratios had an AUC higher than 0.9, excellent sensitivity (>90 %), and good specificity (80-100 %) for both ESL and MF muscles.Conclusion: Both FRP ratios (FRR and ERR) for MF and ESL muscles, appear to be an objective, sensitive and specific method for identifying altered FRP in NSCLBP patients.

Although most research on spatial neglect (SN) has focused on spatial perception deficits with regard to the lateral (left-right) axis, deficits of spatial perception with regard to the vertical (up-down) axis, such as disturbances in the perception of verticality (e.g., judgement of vertical orientations), have also been suggested.We aimed to systematically analyse reported associations between SN and characteristics of verticality perception while considering the time post-stroke.PubMed, Web of Science, Scopus, PubPsych and PsycArticles databases were searched on May 24, 2022 for articles written in English that evaluated the association between SN and verticality perception (i.e., the subjective visual vertical [SVV], subjective postural vertical [SPV] and subjective haptic vertical [SHV]) in adults after stroke. Left and right SN were considered and had to be assessed using standardized methods. Data were manually extracted, and risk of bias was assessed with the Newcastle-Ottawa Scale. The tilt of the line/chair relative to the gravitational vector and its direction, together with uncertainty (i.e., variability across measurements), were evaluated.Thirteen studies were included (431 participants after stroke); at least 191 participants exhibited SN. Mainly the first 3 to 6 months post-stroke were evaluated. SN was associated with SVV misperception, which resulted in larger SVV tilts (mostly in the contralesional direction) and uncertainty in participants with than without SN. SVV tilt magnitudes ranged from a mean/median of -8.9° to -2.3° in SN participants and from -1.6° to 0.6° in non-SN participants, the latter falling within normative ranges. For SPV and SHV measurements, the magnitude of tilt and the uncertainty were insufficiently assessed or results were inconclusive.SN was associated with larger SVV tilts and uncertainty, which suggests that SVV misperception is a key feature of SN. This observation highlights the importance of regular SVV assessment in people with SN in clinical practice.CRD42019127616

Foot drop is a common disability in post-stroke patients and represents a challenge for the clinician. To date, ankle foot orthosis (AFO) combined with conventional rehabilitation is the gold standard of rehabilitation management. AFO has a palliative mechanical action without actively restoring the associated neural function. Functional electrical stimulation (FES), consisting of stimulation of the peroneal nerve pathway, represents an alternative approach. By providing an FES device (Bioness L-300, BIONESS, Valencia, CA, USA) for 6 months to a post-stroke 22-year-old woman with a foot drop, our goal was to quantify its potential benefit on walking capacity. The gait parameters and the temporal evolution of the speed were collected with a specific connected sole device (Feet Me®) during the 10-m walking, the time up and go, and the 6-minute walking tests with AFO, FES, or without any device (NO). As a result, the walking speed changes on 10-m were clinically significant with an increase from the baseline to 6 months in AFO (+0.14 m.s−1), FES (+0.36 m.s−1) and NO (+0.32 m.s−1) conditions. In addition, the speed decreased at about 4-min in the 6-minute walking test in NO and AFO conditions, while the speed increased in the FES conditions at baseline and after 1, 3, and 6 months. In addition to the walking performance improvement, monitoring the gait speed in an endurance test after an ecological rehabilitation training program helps to examine the walking performance in post-stroke patients and to propose a specific rehabilitation program.

Foot drop is a common disability in post-stroke patients and represents a challenge for the clinician. To date, Ankle Foot Orthosis (AFO) combined with conventional rehabilitation is the gold standard of rehabilitation management. AFO has a palliative mechanical action without actively restoring the associated neural function. Functional Electrical Stimulation (FES), consisting in stimulation of the peroneal nerve pathway, represents an alternative approach. By providing a FES device (Bioness L-300, BIONESS, USA) for 6 months to a post-stroke 22-year-old woman with a foot drop, our goal was to quantify its potential benefit on walking capacity. Gait parameters and the temporal evolution of the speed were collected with a specific connected sole device (Feet Me&reg;) during the 10-meter walking, the Time Up and Go, and the 6-minute walking tests with AFO, FES or without any device (NO). As a result, the walking speed changes on 10-meters were clinically significant with an increase from baseline to 6 months in AFO and FES conditions (+0.14m-1 and +0.36m-1), without any changes in NO condition. In addition, speed decreased at about 4-minutes of the 6-minute walking test in NO and AFO conditions, while speed increased in FES conditions at baseline and after 1, 3 and 6 months. Monitoring gait speed in an endurance test after an ecological rehabilitation training program helps to examine walking performance in post-stroke patients and to propose a specific rehabilitation program depending on a fatigue threshold.

This study aimed to compare neuromuscular alterations and perceptions of effort and muscle pain induced by concentric and eccentric cycling performed at the same power output or effort perception. Fifteen participants completed three 30‐min sessions: one in concentric at 60% peak power output (CON) and two in eccentric, at the same power output (ECCPOWER) or same perceived effort (ECCEFFORT). Muscle pain, perception of effort, oxygen uptake as well as rectus femoris and vastus lateralis electromyographic activities were collected when pedaling. The knee extensors maximal voluntary contraction (MVC) torque, the torque evoked by double stimulations at 100 Hz and 10 Hz (Dt100; Dt10), and the voluntary activation level (VAL) were evaluated before and after exercise. Power output was higher in ECCEFFORT than CON (89.1 ± 23.3% peak power). Muscle pain and effort perception were greater in CON than ECCPOWER (p < 0.03) while muscle pain was similar in CON and ECCEFFORT (p > 0.43). MVC torque, Dt100, and VAL dropped in all conditions (p < 0.04). MVC torque (p < 0.001) and the Dt10/ Dt100 ratio declined further in ECCEFFORT (p < 0.001). Eccentric cycling perceived as difficult as concentric cycling caused similar muscle pain but more MVC torque decrease. A given power output induced lower perceptions of pain and effort in eccentric than in concentric yet similar MVC torque decline. While neural impairments were similar in all conditions, eccentric cycling seemed to alter excitation‐contraction coupling. Clinicians should thus be cautious when setting eccentric cycling intensity based on effort perception.

Clinical gait analysis is a promising approach for quantifying gait deviations and assessing the impairments altering gait in patients with osteoarthritis. There is a lack of consensus on the identification of kinematic outcomes that could be used for the diagnosis and follow up in patients. The proposed dataset has been established on 80 asymptomatic participants and 106 patients with unilateral hip osteoarthritis before and 6 months after arthroplasty. All volunteers walked along a 6 meters straight line at their self-selected speed. Three dimensional trajectories of 35 reflective markers were simultaneously recorded and Plugin Gait Bones, angles, Center of Mass trajectories and ground reaction forces were computed. Gait video recordings, when available, anthropometric and demographic descriptions are also available. A minimum of 10 trials have been made available in the weka file format and C3D file to enhance the use of machine learning algorithms. We aim to share this dataset to facilitate the identification of new movement-related kinematic outcomes for improving the diagnosis and follow up in patients with hip OA.

Objective: To assess initial and mid-term efficacy of botulinum toxin A (BoNT-A) injections in patients with chronic exertional compartment syndrome (CECS) in the lower and upper limbs. Design: Retrospective monocentric study. Setting: A University Hospital Department of Physical Medicine and Rehabilitation. Patients: Sixteen patients with CECS of the lower and upper limbs treated with BoNT-A injections (first-line treatment) were included. Interventions, Main Outcome Measures: We collected data from a follow-up consultation (initial pain reduction [complete, partial, or ineffective] and specific activities triggering CECS) and a subsequent phone questionnaire (mid-term efficacy, pain recurrence, and adverse effects). Results: Sixteen patients were included (median age: 25.5 years), and 68.75% reported initial efficacy (4 partial and 7 complete); 8/16 patients were able to resume the activity that triggered CECS. All the patients with initial partial efficacy had pain recurrence (median time of 2.25 months). Among patients with initial complete efficacy, 57.14% had recurrence (median time of 5 months). Minor adverse effects were observed, but with no functional impact. Conclusion: In 16 individuals with CECS treated with BoNT-A injections, we observed moderate efficacy without major adverse effects, but an initial improvement was often followed by recurrence, especially among those with partial initial efficacy.

Level Walking is a frequent functional movement during daily life. However, sloped walking is also common. Exploring 6DOF knee kinematics during sloped walking is important. It provides a reference for the rehabilitation, safety, and knee health of patients with knee diseases walking on sloped surfaces.The study aimed to explore 6DOF knee kinematics characteristics during sloped walking compared to level walking. We hypothesized that tibial anteroposterior translation and flexion angle (the sagittal plane) were significantly different from those of level walking.One hundred young, healthy adults (50 males and 50 females) were recruited for this study. A three-dimensional gait analysis system was used to collect 6DOF knee kinematics during level and sloped walking. The slope was set to ± 15% when the sloped walking was performed.Sloped walking mainly increased knee flexion angle (upslope, 2.5–26.2°, 1–100% gait cycle (GC), p < 0.05; downslope, 1.7–11.9°, 15–95% GC, p < 0.05) and anterior tibial translation (upslope, 0.7–4.1 mm, 3–54% GC & 0.6–2.1 mm, 80–94% GC; downslope, 1.0–2.2 mm, 21–69% GC) in the participants' knees. However, participants' other 4DOF knee kinematics during sloped walking were significantly different from those during level walking (p < 0.05). Participants had 'drastically changeable' knee kinematic alterations in the transverse and coronal plane (the other 4DOF knee kinematics) during sloped walking compared to level walking.Our results confirmed the hypothesis. Sloped walking significantly increased anterior tibial translation (in most GC) and flexion angle. These kinematic changes in healthy subjects should be evaluated and further explored for patients with knee diseases, such as anterior cruciate ligament deficiency. Our findings are meaningful for their rehabilitation or safety or knee health while walking on sloped surfaces. Our study may provide a pilot reference for the 6DOF knee kinematic exploration of sloped walking.