Search results for: lower limb muscle strength

Authors: Karima Abdel Aty Hassan Mohamed, Manal Mohamed Ismail, Mona Hassan Gamal Eldein, Ahmed Hassan Hussein, Abdel Aziz Mohamed Elsingerg

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Background: Patellofemoral pain (PFP) is a common musculoskeletal pain condition, especially in females. Decreased hip muscle strength has been implicated as a contributing factor, yet the relationships between pain, hip muscle strength and function are not known. Objective: The purpose of this study is to investigate the effects of strengthening hip abductors and lateral rotators on pain intensity, function and hip abductor and hip lateral rotator eccentric and concentric torques in patients with PFPS. Methods: Thirty patients had participated in this study; they were assigned into two experimental groups. With age ranged for eighty to thirty five years. Group A consisted of 15 patients (11females and 4 males) with mean age 20.8 (±2.73) years, received closed kinetic chain exercises program, stretching exercises for tight lower extremity soft tissues, and hip strengthening exercises .Group B consisted of 15 patients (12 females and 3 males) with mean age 21.2(±3.27) years, received closed kinetic chain exercises program and stretching exercises for tight lower extremity soft tissues. Treatment was given 2-3times/week, for 6 weeks. Patients were evaluated pre and post treatment for their pain severity, function of knee joint, hip abductors and external rotators concentric/eccentric peak torque. Result: the results revealed that there were significant differences in pain and function between both groups, while there was improvement for all values for both group. Conclusion: Six weeks rehabilitation program focusing on knee strengthening exercises either supplemented by hip strengthening exercises or not effective in improving function, reducing pain and improving hip muscles torque in patients with PFPS. However, adding hip abduction and lateral rotation strengthening exercises seem to reduce pain and improve function more efficiently.

Keywords: patellofemoral pain syndrome, hip muscles, rehabilitation, isokinetic

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Authors: Virginia Martin Torrejon, Binjie Wu

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Gelatine is a protein biopolymer obtained from the partial hydrolysis of animal tissues which contain collagen, the primary structural component in connective tissue. Gelatine hydrogels have attracted considerable research in recent years as an alternative to synthetic materials due to their outstanding gelling properties, biocompatibility and compostability. Surfactants, such as sodium dodecyl sulfate (SDS), are often used in hydrogels solutions as surface modifiers or solubility enhancers, and their incorporation can influence the hydrogel’s viscoelastic properties and, in turn, its processing and applications. Literature usually focuses on studying the impact of formulation parameters (e.g., gelatine content, gelatine strength, additives incorporation) on gelatine hydrogels properties, but processing parameters, such as curing temperature, are commonly overlooked. For example, some authors have reported a decrease in gel strength at lower curing temperatures, but there is a lack of research on systematic viscoelastic characterisation of high strength gelatine and gelatine-SDS systems at a wide range of curing temperatures. This knowledge is essential to meet and adjust the technological requirements for different applications (e.g., viscosity, setting time, gel strength or melting/gelling temperature). This work investigated the effect of curing temperature (10, 15, 20, 23 and 25 and 30°C) on the elastic modulus (G’) and melting temperature of high strength gelatine-SDS hydrogels, at 10 wt% and 20 wt% gelatine contents, by small-amplitude oscillatory shear rheology coupled with Fourier Transform Infrared Spectroscopy. It also correlates the gel strength obtained by rheological measurements with the gel strength measured by texture analysis. Gelatine and gelatine-SDS hydrogels’ rheological behaviour strongly depended on the curing temperature, and its gel strength and melting temperature can be slightly modified to adjust it to given processing and applications needs. Lower curing temperatures led to gelatine and gelatine-SDS hydrogels with considerably higher storage modulus. However, their melting temperature was lower than those gels cured at higher temperatures and lower gel strength. This effect was more considerable at longer timescales. This behaviour is attributed to the development of thermal-resistant structures in the lower strength gels cured at higher temperatures.

Keywords: gelatine gelation kinetics, gelatine-SDS interactions, gelatine-surfactant hydrogels, melting and gelling temperature of gelatine gels, rheology of gelatine hydrogels

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Authors: Muhammad Jahangeer Munir, Liaqat Ali Qureshi, Junaid Ahmed

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This paper presents the investigation regarding use of glass fibers in structural concrete members and determining the behavior of normal PCC, GFRC and retrofitted GFRC under different tests performed in the laboratory. Effect of retrofitting on the GFRC & PCC was investigated by using three patterns of CFRP wrapping. Properties like compressive, split tensile and flexural strength of normal GFRC and retrofitted GFRC were investigated and compared with their PCC counterparts. It was found that GFRC has more compressive strength as compared to PCC. At lower confinement pressures PCC behaves better than GFRC. Confinement efficiency was lower in GFRC as compared to PCC in terms of Split tensile strength. In case of GFRC all the patterns of wrapped CFRP strips showed more strength than their PCC counterparts.

Keywords: carbon fiber reinforced polymers, confinement, glass fibers, retrofitting

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Authors: Zeinab Rasouli Kahaki, Mohammad Ali Sanjari, Reza Khani Jazani, Mahnaz Saremi, Amir Kavousi

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Work which requires prolonged standing, especially in a fixed position can cause discomfort and fatigue. The purpose of this study was to compare the effects of height footrest in discomfort and fatigue lower extremities during long-standing activities. This cross-sectional study was carried out on 15 students with a mean (SD) age of 21.5 ± (2.3) and mean height of 163 ± (2.8). Participants attended 3 sessions each lasting one hour. They stood on three different surfaces: ceramic, footrest 10 and 25 cm. Surface electromyography was used to assess muscle fatigue. Body map and visual analog scale were employed to evaluate discomfort ratings of the lower extremities and the back. Data analyses were performed using ANOVA-R. Based on the results of electromyography there was no difference between soleus, anterior tibial and lateral gastrocnemius muscles fatigue and type of surfaces. There was a significant variation between the surfaces (p < 0.05) and different areas of the body discomfort level; so that the ceramic had the highest discomfort rating, while the lowest ratings were related to the footrest. Further investigations are recommended on the properties of the footrest.

Keywords: electromyography, fatigue, gastrocnemius, lower extremities, soleus, tibial

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Authors: Grange Sylvain, Plancher Ronan, Reurink Guustav, Croisille Pierre, Edouard Pascal

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The primary objective of this study was to analyze the potential correlation between the pain experienced at the time of a hamstring muscle injury and the volume of the lesion measured on MRI. The secondary objectives were to analyze a correlation between this pain and the lesion grade as well as the affected hamstring muscle. We performed a retrospective analysis of the data collected in a prospective, multicenter, non-interventional cohort study (HAMMER). Patients with suspected hamstring muscle injury had an MRI after the injury and at the same time were evaluated for their pain intensity experienced at the time of the injury with a Numerical Pain Rating Scale (NPRS) from 0 to 10. A total of 61 patients were included in the present analysis. MRIs were performed in an average of less than 8 days. There was a significant correlation between pain and the injury volume (r=0.287; p=0.025). There was no significant correlation between the pain and the lesion grade (p>0.05), nor between the pain and affected hamstring muscle (p>0.05). Pain at the time of injury appeared to be correlated with the volume of muscle affected. These results confirm the value of a clinical approach in the initial evaluation of hamstring injuries to better select patients eligible for further imaging.

Keywords: hamstring muscle injury, MRI, volume lesion, pain

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Authors: Bayan Almofty, Yuto Yamaki, Tadamasa Terai, Sadahito Uto

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Myopathy (muscles disease) treatment are expected in the field of regenerative medicine and applied research of cultured muscle to bio actuator is performed in Biomedical Engineering as applied research of cultured muscle. This study is about cultured myoblast C2C12 from mouse skeletal muscle and a mechanism of cultured muscle contraction by electric stimulation is investigated. Grayanotoxins (GTXs) belong to neurotoxins known to enhance the permeability of cell membrane for Na ions. Grayanotoxins are extracted from a famous Pieris japonica and Ericaceae as a phytotoxin. We investigated the functional role of GTXs on muscle cells (C2C12) contraction and membrane potential. A change in membrane potential is measured using a micro glass tube electrode contraction of myotubes is induced by applying an external electrical stimulation. The contraction and membrane potential change induced by injection of current using the micro glass electrode are also measured. From the result, contraction and membrane potential of muscle cells was affected by GTXs treatment, suggesting that the diverse chemical structures of GTXs are responsible for contraction and membrane potential of muscle cells.

Keywords: skeletal muscle, C2C12, myoblast, myotubes, contraction, Grayanotoxins, membrane potential, neurotoxins, phytotoxin

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Authors: Rachnavy Pornthep, Khaothin Thawichai

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The purpose of this paper was to investigate the effects of rowing ergometer exercise on older persons health. The subjects were divided into two groups. Group 1 was control group (10 male and 10 female) Group 2 was experimental group (10 male and 10 female). The time for study was 12 week. Group 1 engage in normal daily activities Group 2 Training with rowing machine for 20 minutes three days a week. The average age of the experimental group was 73.7 years old, mean weight 55.4 kg, height 154.8 cm in the control group, mean age was 74.95 years, mean weight 48.6 kg, mean height 153.85 cm. Physical fitness test composted of body size, flexibility, Strength, muscle endurance and cardiovascular endurance. The comparison between the experimental and control groups before training showed that body weight, body mass index and waist to hip ratio were significantly different. The flexibility, strength, cardiovascular endurance was not significantly different. The comparison between the control group and the experimental group after training showed that body weight, body mass index and cardiovascular endurance were significantly different. The ratio of waist to hips, flexibility and muscular strength were not significantly different. Comparison of physical fitness before training and after training of the control group showed that body weight, flexibility (Sit and reach) and muscular strength (30 – Second chair stand) were significantly different. Body mass index, waist to hip ratio, muscles flexible (Shoulder girdle flexibility), muscle strength (30 – Second arm curl) and the cardiovascular endurance were not significantly difference. Comparison of physical fitness before training and after training the experimental group showed that waist to hip ratio, flexibility (sit and reach) muscle strength (30 – Second chair stand), cardiovascular endurance (Standing leg raises - up to 2 minutes) were significantly different. The Body mass index and the flexibility (Shoulder girdle flexibility) no significantly difference. The study found that exercising with rowing machine can improve the physical fitness of the elderly, especially the cardiovascular endurance, corresponding with the past research on the effects of exercise in the elderly with different exercise such as cycling, treadmill, walking on the elliptical machine. Therefore, we can conclude that exercise by using rowing machine can improve cardiovascular system and flexibility in the elderly.

Keywords: effect, rowing, exercise, elderly

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Authors: M. Rezki, A. Belaidi

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This paper deals with a method of learning to solve a real problem in biomedical engineering from a technical study of muscle fatigue. Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles (viewpoint: anatomical and physiological). EMG is used as a diagnostics tool for identifying neuromuscular diseases, assessing low-back pain and muscle fatigue in general. In order to study the EMG signal for detecting fatigue in a muscle, we have taken a real problem which touches the tramway conductor the handle bar. For the study, we have used a typical autonomous platform in order to get signals at real time. In our case study, we were confronted with complex problem to do our experiments in a tram. This type of problem is recurring among students. To teach our students the method to solve this kind of problem, we built a similar system. Through this study, we realized a lot of objectives such as making the equipment for simulation, the study of detection of muscle fatigue and especially how to manage a study of biomedical looking.

Keywords: EMG, health platform, conductor’s tram, muscle fatigue

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Authors: Ricardo Chaves, Carlos Vasconcelos

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Candidates to join the Naval Academy have to take a set of physical tests, which is crucial for a high level of physical fitness. Thus, the planning of physical exercises for candidates to the Naval School must take into account the improvement of their physical fitness. The aim of this study was to investigate the impact of a 6-month exercise program to improve the physical fitness of an individual who will apply for the Naval Academy. This was a non-experimental pre-post-evaluation study. The patient was male, had 18 years old, and a body mass index of 21.1 kg.m². The patient participated in a 6-month aerobic and strength exercise program (3 sessions per week, 75 minutes duration each session). Physical fitness tests were performed according to the physical fitness requirements for entry into the Naval academy (muscle strength [maximum number of lifts and maximum number of sit-ups for 1 minute]; aerobic fitness [2.4 km run and 200 m swimming test]) before (baseline) and after the exercise intervention (6 months). Regarding muscle strength, in the abdominal test, the improvements between the pre-test (39 abdominals.) and post-test (61 abdominals) were 56.4%. For elevations, there was an increase in its number by 150% between the pre-test (4 elevations) and post-test (10 elevations). With regard to aerobic fitness, in the 2.4 km race, there was an evolution of 32.0% between the pre-test (16.46 min.) and the post-test (12.42 min.). For the 200-meter swimming test, there was a negative variation of 2% between the pre-test (2.25 min.) and post-test (2.28 min). A 6-month aerobic and strength exercise program leads to a positive evolution in the muscular strength of the patient. Regarding aerobic fitness, opposite results were found, with a positive evolution in the 2.4 km running test and a negative evolution in the swimming test. In future exercise programs for the improvement of the physical fitness of candidates for the Naval Academy, more emphasis has to be done on specific swimming training.

Keywords: case study, exercise program, Naval Academy, physical fitness

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Authors: Gopal Chandra Saha, Sumanta Daw

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Warm-up is an essential component for optimizing performance in various sports before a physical fitness training session. This study investigated the immediate comparative effect of Self-Myofascial Release through vibration rolling (VR), non-vibration rolling (NVR), and static stretching as a part of a warm-up treatment on the functional fitness of young adults. Functional fitness is a classification of training that prepares the body for real-life movements and activities. For the present study 20male physical education students were selected as subjects. The age of the subjects was ranged from 20-25 years. The functional fitness variables undertaken in the present study were flexibility, muscle strength, agility, static and dynamic balance of the lower extremity. Each of the three warm-up protocol was administered on consecutive days, i.e. 24 hr time gap and all tests were administered in the morning. The mean and SD were used as descriptive statistics. The significance of statistical differences among the groups was measured by applying ‘F’-test, and to find out the exact location of difference, Post Hoc Test (Least Significant Difference) was applied. It was found from the study that only flexibility showed significant difference among three types of warm-up exercise. The observed result depicted that VR has more impact on myofascial release in flexibility in comparison with NVR and stretching as a part of warm-up exercise as ‘p’ value was less than 0.05. In the present study, within the three means of warm-up exercises, vibration roller showed better mean difference in terms of NVR, and static stretching exercise on functional fitness of young physical education practitioners, although the results were found insignificant in case of muscle strength, agility, static and dynamic balance of the lower extremity. These findings suggest that sports professionals and coaches may take VR into account for designing more efficient and effective pre-performance routine for long term to improve exercise performances. VR has high potential to interpret into an on-field practical application means.

Keywords: self-myofascial release, functional fitness, foam roller, physical education

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Authors: Mirza Obaid Baig, MaimoonaYaqub

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A 51 year old lady; known case of diabetes mellitus, post wound debridement i.e. 4 open wounds of grade III presented to us with foot drop, with prominent sensory deficit over right lower leg/foot i.e. 0 on Nottingham scale for impaired sensation, marked pedal edema and 5/10 – 6/10 pain on VAS during day and night respectively, Wounds were poorly granulated and foul smelling. Physiotherapy sessions were planned including twice a day electrical muscle stimulation sessions, strategies to decrease edema and improve muscle action which resulted in noticeable improvement in motor and sensory ability, pain levels, edema and psychological status of patient. Thus, this study gives evidence of the effect of Electrical muscle stimulation in grade III open wounds associated with motor/sensory weakness post-surgery.

Keywords: EMS, foot drop, grade III wound, diabetes mellitus

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Authors: Bing-Wen Chen, Alvin W. Y. Su, Yu-Lin Wang

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Electromyography (EMG) is one of the important indicators during exercise, as it is closely related to the level of muscle activations. This work quantifies the muscle conditions of the lower limbs in a constant workload exercise. Surface EMG signals of the vastus laterals (VL), vastus medialis (VM), rectus femoris (RF), gastrocnemius medianus (GM), gastrocnemius lateral (GL) and Soleus (SOL) were recorded from fourteen healthy males. The EMG signals were segmented in two phases: activation segment (AS) and relaxation segment (RS). Period entropy (PE), peak count (PC), zero crossing (ZC), wave length (WL), mean power frequency (MPF), median frequency (MDF) and root mean square (RMS) are calculated to provide the quantitative information of the measured EMG segments. The outcomes reveal that the PE, PC, ZC and RMS have significantly changed (p<.001); WL presents moderately changed (p<.01); MPF and MDF show no changed (p>.05) during exercise. The results also suggest that the RS is also preferred for performance evaluation, while the results of the extracted features in AS are usually affected directly by the amplitudes. It is further found that the VL exhibits the most significant changes within six muscles during pedaling exercise. The proposed work could be applied to quantify the stamina analysis and to predict the instant muscle status in athletes.

Keywords: electromyographic feature extraction, muscle status, pedaling exercise, relaxation segment

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Authors: Eman Ahmed Ahmed, Ghada Abdelmoneim Mohamed, Hamada Ahmed Hamada, Nagui Sobhi Nassif

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Impaired skeletal muscle endurance may be an important causal factor in the development of patellofemoral pain syndrome (PFPS). However, there is lack of information regarding the effect of hip versus knee muscle fatigue on isokinetic parameters, and myoelectric activity of hip and knee muscles in these patients. Purpose: The study was conducted to investigate the effect of hip abductors versus knee extensors fatigue protocol on knee proprioception, hip and knee muscle strength and their myoelectric activity in patients with PFPS. Methods: Fifteen female patients with PFPS participated in the study. They were tested randomly under two fatiguing conditions; hip abductors and knee extensors fatigue protocols. Isolated muscle fatigue of two muscles was induced isokinetically on the affected side in a two separate sessions with a rest interval of at least three days. After determining peak torque, patients performed continuous maximal concentric-eccentric contraction of the selected muscle until the torque output dropped below 50% of peak torque value for 3 consecutive repetitions. Knee proprioception, eccentric hip abductors' peak torque, eccentric knee extensors' peak torque, EMG ratio of vastus medialis obliquus (VMO) / vastus lateralis (VL), and EMG activity of gluteus medius (GM) muscle, were recorded before and immediately after each fatigue protocol using the Biodex Isokinetic system and EMG Myosystem. Results: Two-way within subject MANOVA revealed that eccentric knee extensors’ peak torque decreased significantly after hip abductors fatigue protocol compared to pre fatigue condition (p<0.05). On the other hand, there was no statistically significant difference in the eccentric hip abductors’ peak torque after admitting knee extensors fatigue protocol (p > 0.05). Moreover, no significant difference was found in knee proprioception, EMG ratio of VMO/VL, and EMG activity of GM muscle, after either hip or knee fatigue protocol (p>0.05). Conclusion: A hip focused rehabilitation program may be beneficial in improving knee function through correcting faulty kinematics and hence decrease knee loading in patients with PFPS.

Keywords: electromyography, knee proprioception, mechanical responses, muscle fatigue, patellofemoral pain syndrome

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Authors: Cathy SW. Chow, Kristina Shin, Faming Wang, B. C. L. So

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During some dynamic giant puppet performances, an ergonomically designed load carrier system is necessary for the puppeteers to carry a giant puppet body’s heavy load with minimum muscle stress. A load carrier (i.e. prototype) was designed with two small wheels on the foot; and a hybrid spring device on the knee in order to assist the sliding and knee bending movements respectively. Thus, the purpose of this study was to evaluate the effect of three load carriers including two other commercially available load mounting systems, Tepex and SuitX, and the prototype. Ten male participants were recruited for the experiment. Surface electromyography (sEMG) was used to collect the participants’ muscle activities during forward moving and bouncing and with and without load of 11.1 kg that was 60 cm above the shoulder. Five bilateral muscles including the lumbar erector spinae (LES), rectus femoris (RF), bicep femoris (BF), tibialis anterior (TA), and gastrocnemius (GM) were selected for data collection. During forward moving task, the sEMG data showed smallest muscle activities by Tepex harness which exhibited consistently the lowest, compared with the prototype and SuitX which were significantly higher on left LES 68.99% and 64.99%, right LES 26.57% and 82.45%; left RF 87.71% and 47.61%, right RF 143.57% and 24.28%; left BF 80.21% and 22.23%, right BF 96.02% and 21.83%; right TA 6.32% and 4.47%; left GM 5.89% and 12.35% respectively. The result above reflected mobility was highly restricted by tested exoskeleton devices. On the other hand, the sEMG data from bouncing task showed the smallest muscle activities by prototype which exhibited consistently the lowest, compared with the Tepex harness and SuitX which were significantly lower on lLES 6.65% and 104.93, rLES 23.56% and 92.19%; lBF 33.21% and 93.26% and rBF 24.70% and 81.16%; lTA 46.51% and 191.02%; rTA 12.75% and 125.76%; IGM 31.54% and 68.36%; rGM 95.95% and 96.43% respectively.

Keywords: exoskeleton, giant puppet performers, load carriage system, surface electromyography

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Authors: O. Zarrin, M. Ramezan Shirazi

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The quality of concrete is usually defined by compressive strength, but flexural strength is the most important characteristic of concrete in a pavement which control the mix design of concrete instead of compressive strength. Therefore, the aggregates which are selected for the pavements are affected by higher flexural strength. Roller Compacting Concrete Pavement (RCCP) is not a new construction method. The other characteristic of this method is no bleeding and less shrinkage due to the lower amount of water. For this purpose, a roller is needed for placing and compacting. The surface of RCCP is not smooth; therefore, the most common use of this pavement is in an industrial zone with slower traffic speed which requires durable and tough pavement. For preparing a smoother surface, it can be achieved by asphalt paver. RCCP decrease the finishing cost because there are no bars, formwork, and the lesser labor need for placing the concrete. In this paper, different aspect of RCCP such as mix design, flexural, compressive strength and focus on the different part of RCCP on detail have been investigated.

Keywords: flexural strength, compressive strength, pavement, asphalt

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Authors: Wilawan Kanhachon, Yodchai Boonprakob, Uraiwon Chatchawan, Junichiro Yamauchi

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Introduction: Paslop is a traditional dance from Laos, which is popular in Laos and northeastern of Thailand. This unique type of Paslop dancing is to control body movement with the song. While dancing to the beat, dancers should contract their abdomen and back muscle all the time. Paslop may be a good alternative to improve strengthening, balance and flexibility. Objective: To investigate the effects of Paslop dance exercise on core strength, balance, and flexibility. Methods: Seven healthy participants (age, 20.57±1.13 yrs; height, 162.29±6.16 cm; body mass, 58.14±7.03 kg; mean± S.D.) were volunteered to perform the 45-minute Paslop dance exercise in three times a week for 8 weeks. Before, during and after the exercise period, core strength, balance and flexibility were measured with the pressure biofeedback unit (PBU), one-leg stance test (OLST), and sit and reach test (SAR), respectively. Result: PBU score for core strength increased from 2.12 mmHg in baseline to 6.34 mmHg at the 4th week and 10.10 mmHg at the 8th week after the Paslop dance training, while OLST and SAR did not change. Conclusion: The study demonstrates that 8-week Paslop dancing exercise can improve the core strength.

Keywords: balance, core strength, flexibility, Paslop

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Authors: Prem, Norhaya, Vwrene C., Mohammad Harris A., Amarjit, Fazir M.

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Upper limb surgery is a common orthopedic procedure. After surgery, it is necessary to raise the patient's arm to reduce limb swelling and promote recovery. After an injury or surgery, swelling (edema) in the limbs is common. This swelling can be painful, cause stiffness, and affect movement and ability to do daily activities. One of the easiest ways to manage swelling is to elevate the swollen limb. The goal is to elevate the swollen limb slightly above the level of the heart. This helps the extra fluid move back towards the heart for circulation to the rest of the body. Conventional arm sling or pillows are usually placed under the arm to raise it, but in this way the arm cannot be fixed well and easily slide down, without ideal raising effect. Conventional arm sling need experience to tie the sling and this delay in the application process. To reduce the waiting time and cost, modified Norhaya upper limb elevation sling was designed and made readily available. The sling is made from calico fabric, readily available in the ward. Measurements of patients’ arm lengths are obtained, and fabric sizes are cut into the average arm lengths, as well as 1 size above and below. The cut calico fabric is then sewn together with thick sewing threads. Its application is easy and junior most staff or doctor will be able to apply it on patient. The time taken to set up the sling is also reduced. Feedback gathered from ground staff regarding ease of setting up the sling was tremendous and patient also feel comfort in the modified Norhaya sling. The device can freely adjust the raising height of the affected limb and effectively fix the affected limb to reduce its swelling, thus promoting recovery. This device is worthy to be clinically popularized and applied. The Modified Norhaya upper limb elevation sling is the quickest to set up and the delay in elevating the patient’s hand is significantly reduced. Moreover, it is reproducible and there is also significant cost savings.

Keywords: elevate, effective, sling, timely

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Authors: Elham Azimzadeh, Saeedeh Sepehri, Hamidollah Hassanlouei

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Obesity is associated with postural instability, might influence the quality of daily life, and could be considered a potential factor for falling in obese people. The fat body mass especially in the abdominal area may increase body sway. Furthermore, loss of visual feedback may induce a larger postural sway in obese people. Moreover, Muscle fatigue may impair the work capacity of the skeletal muscle and may alter joint proprioception. So, the purpose of this study was to investigate the effect of physical fatigue and visual feedback on body sway and strength of lower extremities in obese people. 12 obese (4 female, 8 male; BMI >30 kg/m2), and 12 normal weight (4 female, 8 male; BMI: 20-25 kg/m2) subjects aged 37- 47 years participated in this study. The postural stability test on the Biodex balance system was used to characterize postural control along the anterior-posterior (AP) and mediolateral (ML) directions in eyes open and eyes closed conditions and maximal voluntary contraction (MVC) of knee extensors and flexors were measured before and after the high-intensity exhausting exercise protocol on the ergometer bike to confirm the presence of fatigue. Results indicated that the obese group demonstrated significantly greater body sway, in all indices (ML, AP, overall) compared with the normal weight group (eyes open). However, when visual feedback was eliminated, fatigue impaired the balance in the overall and AP indicators in both groups; ML sway was higher only in the obese group after exerting the fatigue in the eyes closed condition. Also, maximal voluntary contraction of knee extensors was impaired in the fatigued normal group but, there was no significant impairment in knee flexors MVC in both group. According to the findings, peripheral fatigue was associated with altered postural control in upright standing when eyes were closed, and that mechanoreceptors of the feet may be less able to estimate the position of the body COM over the base of support in the loss of visual feedback. This suggests that the overall capability of the postural control system during upright standing especially in the ML direction could be lower due to fatigue in obese individuals and could be a predictor of future falls.

Keywords: maximal voluntary contraction, obesity, peripheral fatigue, postural control, visual feedback

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Authors: P. T. Collett, M. Kershaw

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Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol.

Keywords: anaesthesia, orthopaedics, intensive care, patient centered decision making, treatment escalation

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Authors: Yoon- Ho Shin, Jin-Seung Choi, Dong-Won Kang, Jeong-Woo Seo, Joo-Hack Lee, Ju-Young Kim, Dae-Hyeok Kim, Seung-Tae Yang, Gye-Rae Tack

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It is difficult to study the effect of various variables on cycle fitting through actual experiment. To overcome such difficulty, the forward dynamics of a musculoskeletal model was applied to cycle fitting in this study. The measured EMG data were compared with the muscle activities of the musculoskeletal model through forward dynamics. EMG data were measured from five cyclists who do not have musculoskeletal diseases during three minutes pedaling with a constant load (150 W) and cadence (90 RPM). The muscles used for the analysis were the Vastus Lateralis (VL), Tibialis Anterior (TA), Bicep Femoris (BF), and Gastrocnemius Medial (GM). Person’s correlation coefficients of the muscle activity patterns, the peak timing of the maximum muscle activities, and the total muscle activities were calculated and compared. BIKE3D model of AnyBody (Anybodytech, Denmark) was used for the musculoskeletal model simulation. The comparisons of the actual experiments with the simulation results showed significant correlations in the muscle activity patterns (VL: 0.789, TA: 0.503, BF: 0.468, GM: 0.670). The peak timings of the maximum muscle activities were distributed at particular phases. The total muscle activities were compared with the normalized muscle activities, and the comparison showed about 10% difference in the VL (+10%), TA (+9.7%), and BF (+10%), excluding the GM (+29.4%). Thus, it can be concluded that muscle activities of model & experiment showed similar results. The results of this study indicated that it was possible to apply the simulation of further improved musculoskeletal model to cycle fitting.

Keywords: musculoskeletal modeling, EMG, cycle fitting, simulation

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Authors: Sanjana S. Mallya, Roshan Arvind Sivakumar

Abstract:

Orthotics is the branch of medicine that deals with the provision and use of artificial casts or braces to alter the biomechanical structure of the limb and provide support for the limb. Custom-made orthoses provide more comfort and can correct issues better than those available over-the-counter. However, they are expensive and require intricate modelling of the limb. Traditional methods of modelling involve creating a plaster of Paris mould of the limb. Lately, CAD/CAM and 3D printing processes have improved the accuracy and reduced the production time. Ordinarily, digital cameras are used to capture the features of the limb from different views to create a 3D model. We propose a system to model the limb using Microsoft Kinect2 sensor. The Kinect can capture RGB and depth frames simultaneously up to 30 fps with sufficient accuracy. The region of interest is captured from three views, each shifted by 90 degrees. The RGB and depth data are fused into a single RGB-D frame. The resolution of the RGB frame is 1920px x 1080px while the resolution of the Depth frame is 512px x 424px. As the resolution of the frames is not equal, RGB pixels are mapped onto the Depth pixels to make sure data is not lost even if the resolution is lower. The resulting RGB-D frames are collected and using the depth coordinates, a three dimensional point cloud is generated for each view of the Kinect sensor. A common reference system was developed to merge the individual point clouds from the Kinect sensors. The reference system consisted of 8 coloured cubes, connected by rods to form a skeleton-cube with the coloured cubes at the corners. For each Kinect, the region of interest is the square formed by the centres of the four cubes facing the Kinect. The point clouds are merged by considering one of the cubes as the origin of a reference system. Depending on the relative distance from each cube, the three dimensional coordinate points from each point cloud is aligned to the reference frame to give a complete point cloud. The RGB data is used to correct for any errors in depth data for the point cloud. A triangular mesh is generated from the point cloud by applying Delaunay triangulation which generates the rough surface of the limb. This technique forms an approximation of the surface of the limb. The mesh is smoothened to obtain a smooth outer layer to give an accurate model of the limb. The model of the limb is used as a base for designing the custom orthotic brace or cast. It is transferred to a CAD/CAM design file to design of the brace above the surface of the limb. The proposed system would be more cost effective than current systems that use MRI or CT scans for generating 3D models and would be quicker than using traditional plaster of Paris cast modelling and the overall setup time is also low. Preliminary results indicate that the accuracy of the Kinect2 is satisfactory to perform modelling.

Keywords: 3d scanning, mesh generation, Microsoft kinect, orthotics, registration

Procedia PDF Downloads 161

Authors: Harry Burton, Alexios Dimitrios Iliadis, Neil Jones, Aaron Saini, Nicola Bystrzonowski, Alexandros Vris, Georgios Pafitanis

Abstract:

This article portrays the authors’ experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of “spares parts” in reconstructive microsurgery. This case describes a successful use of the osteocutaneous distal tibia turn-over fillet flap that allowed ‘lowering the level of the amputation’ from a through knee to the conventional level of a below-knee amputation to preserve the knee joint function. This case demonstrates the value of ‘spare-parts’ surgery principles and how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-over fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

Keywords: osteocutaneous flap, fillet flap, spare-parts surgery, Below knee amputation

Procedia PDF Downloads 133

Authors: Bayan Almofty, Yuto Yamaki, Tadamasa Terai, Sadahito Uto

Abstract:

Culture techniques of skeletal muscle cells are advanced in the field of regenerative medicine and applied research of cultured muscle. As applied research of cultured muscle, myopathy (muscles disease) treatment is expected and development bio of actuator is also expected in biomedical engineering. Grayanotoxins (GTXs) is known as neurotoxins that enhance the permeability of cell membrane for Na ions. Grayanotoxins are extracted from a famous Pieris japonica and Ericaceae as well as a phytotoxin. In this study, we investigated the effect of GTXs on muscle cells (C2C12) contraction and membrane potential. Contraction of myotubes is induced by applied external electrical stimulation. Contraction and membrane potential change of skeletal muscle cells are induced by injection of current. We, therefore, concluded that effect of Grayanotoxins on contraction and membrane potential of C2C12 relate to acute toxicity of GTXs.

Keywords: skeletal muscle cells C2C12, grayanotoxins, contraction, membrane potential, acute toxicity, pytotoxin, motubes

Procedia PDF Downloads 484

Authors: Abeer Ahmed Abdelhamed

Abstract:

Introduction: Postoperative pulmonary complications (PPCs) are the most common complications observed and managed after abdominal or cardiothoracic surgery. Hypoxemia, atelectasis, pleural effusion, or diaphragmatic dysfunction, are often a source of morbidity in cardiac surgery patients, and are more common in patients receiving unilateral or bilateral internal mammary artery (IMT) grafts than patients receiving saphenous vein (SV) grafts alone. Purpose: The aim of this work was to investigate the effect of Threshold load inspiratory muscle training on pulmonary gas exchange and maximum inspiratory pressure (MIP) in patient undergoing coronary revascularization. Subject: Thirty three male patients eligible for coronary revascularization were selected to participate in the study. Method: They were divided into two groups(17 patients in the intervention group and 16 patients in the control group), the interventional group received inspiratory muscle training at 30% of their maximum inspiratory pressure throughout the hospitalization period in addition to routine post operative care. Result: The results of this study showed a significant improvement on maximum inspiratory pressure(MIP), Arterial-alveolar pressure gradient (A-a gradient) and oxygen saturation in the intervention group. Conclusion: Inspiratory muscle training using threshold mode significantly improves maximum inspiratory pressure, pulmonary gas exchange tested by alveolar-arterial gradient and oxygen saturation in Patients undergoing coronary revascularization.

Keywords: coronary revascularization, inspiratory muscle training, maximum inspiratory pressure, pulmonary gas exchange

Procedia PDF Downloads 274

Authors: Petr Sifta, Vaclav Bittner, Martin Kysela, Matej Kolar

Abstract:

The purpose of the research described in this work is to answer how to measure the rheologic (viscoelastic) properties tendo–deformational characteristics of soft tissue. The method would also resemble muscle palpation examination as it is known in clinical practice. For this purpose, an instrument with the working name “myotonometer” has been used. At present, there is lack of objective methods for assessing the muscle tone by viscous and elastic properties of soft tissue. That is why we decided to focus on creating or finding quantitative and qualitative methodology capable of specifying muscle tone.

Keywords: rheologic properties, tendo–deformational characteristics, viscosity, elasticity, hypertonus

Procedia PDF Downloads 591

Authors: S. F. Fakhouri, M.M. Shimano, D. Maranho, C. A. Araújo, M. V. Guimarães, A. C. Shimano, J. B. Volpon

Abstract:

Pathological deviations of the mechanical axis of the lower limbs deeply alter the stress distributions on the femur and tibia and the hip, knee, and ankle articulations. The purpose of this research was to assess the effects of pathological deviations in different levels of the lower limbs in the distribution of stress in the proximal femur region using photoelasticity of plane transmission. For most of the types of deviations studied, the results showed that the internal stress was generally higher in the calcar region than in the trochanteric region, followed by the third distal of the femur head. This study allowed for the development of better criteria for the correction of angular deviations and helped identify the deviations that are most harmful to the mechanical axis in terms of the effects on the bone and the articular effort of the lower limbs. These results will lead to future improvements in studies on prostheses.

Keywords: alignment, deviations, inferior limbs, mechanical axis, photoelasticity, stress

Procedia PDF Downloads 352

Authors: E. Ebru Demirci, Remzi Şahin

Abstract:

The purpose of this study is to compare Self Compacting Concrete (SCC) and Conventional Concrete (CC) in terms of their capillary water absorption. During the comparison of SCC and CC, the effects of two different factors were also investigated: concrete strength class and curing condition. In the study, both SCC and CC were produced in three different concrete classes (C25, C50 and C70) and the other parameter (i.e curing condition) was determined as two levels: moisture and air curing. It was observed that, for both curing environments and all strength classes of concrete, SCCs had lower capillary water absorption values than that of CCs. It was also detected that, for both SCC and CC, capillary water absorption values of samples kept in moisture curing were significantly lower than that of samples stored in air curing. Additionally, it was determined that capillary water absorption values for both SCC and CC decrease with increasing strength class of concrete for both curing environments.

Keywords: capillary water absorption, curing condition, reinforced concrete beam, self-compacting concrete

Procedia PDF Downloads 303

Authors: Akm Badrul Alam, Yoshiaki Fujii, Nahid Hasan Dipu, Shakil Ahmed Razo

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Shale rockmasses often include silt layers, impacting slope stability in construction and mining. Analyzing their interaction is crucial for long-term stability. A study used an elastoplastic model, incorporating the stress transfer method and Coulomb's criterion, to assess a shale rock mass with silt layers. It computed stress distribution, assessed failure potential, and identified vulnerable regions where nodal forces were calculated for a comprehensive analysis. A shale rock mass ranging from 14.75 to 16.75 meters thick, with silt layers varying from 0.36 to 0.5 meters, was considered in the model. It examined four silt layer conditions: horizontal (SiHL), vertical (SiVL), inclined against slope (SiIincAGS), and along slope (SilincALO). Mechanical parameters like uniaxial compressive strength (UCS), tensile strength (TS), Young’s modulus (E), Poisson’s ratio, and density were adjusted for varied scenarios: UCS (0.5 to 5 MPa), TS (0.1 to 1 MPa), and E (6 to 60 MPa). In elastic analysis of shale rock masses, stress distributions vary based on layer properties. When shale and silt layers have the same elasticity modulus (E), stress concentrates at corners. If the silt layer has a lower E than shale, marginal changes in maximum stress (σmax) occur for SilHL. A decrease in σmax is evident at SilVL. Slight variations in σmax are observed for SilincAGS and SilincALO. In the elastoplastic analysis, the overall decrease of 20%, 40%, 60%, 80%, and 90% was considered. For SilHL:(i) Same E, UCS, and TS for silt layer and shale, UCS/TS ratio 5: strength decrease led to shear (S), tension then shear (T then S) failure; noticeable failure at 60% decrease, significant at 80%, collapse at 90%. (ii) Lower E for silt layer, same strength as shale: No significant differences. (iii) Lower E and UCS, silt layer strength 1/10: No significant differences. For SilVL: (i) Same E, UCS, and TS for silt layer and shale, UCS/TS ratio 5: Similar effects as SilHL. (ii) Lower E for silt layer, same strength as shale: Slip occurred. (iii) Lower E and UCS, silt layer strength 1/10: Bitension failure also observed with larger slip. For SilincAGS: (i) Same E, UCS, and TS for silt layer and shale, UCS/TS ratio 5: Effects similar to SilHL. (ii) Lower E for silt layer, same strength as shale: Slip occurred. (iii) Lower E and UCS, silt layer strength 1/10: Tension failure also observed with larger slip. For SilincALO: (i) Same E, UCS, and TS for silt layer and shale, UCS/TS ratio 5: Similar to SilHL with tension failure. (ii) Lower E for silt layer, same strength as shale: No significant differences; failure diverged. (iii) Lower E and UCS, silt layer strength 1/10: Bitension failure also observed with larger slip; failure diverged. Toppling failure was observed for lower E cases of SilVL and SilincAGS. The presence of silt interlayers in shale greatly impacts slope stability. Designing slopes requires careful consideration of both the silt and shale's mechanical properties. The temporal degradation of strength in these layers is a major concern. Thus, slope design must comprehensively analyze the immediate and long-term mechanical behavior of interlayer silt and shale to effectively mitigate instability.

Keywords: shale rock masses, silt layers, slope stability, elasto-plastic model, temporal degradation

Procedia PDF Downloads 28

Authors: Noor Ayuni Che Zakaria, Takashi Komeda, Cheng Yee Low, Kaoru Inoue, Fazah Akhtar Hanapiah

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Previous studies have shown that there are arguments regarding the reliability and validity of the Ashworth and Modified Ashworth Scale towards evaluating patients diagnosed with upper limb disorders. These evaluations depended on the raters’ experiences. This initiated us to develop an upper limb disorder part-task trainer that is able to simulate consistent upper limb disorders, such as spasticity and rigidity signs, based on the Modified Ashworth Scale to improve the variability occurring between raters and intra-raters themselves. By providing consistent signs, novice therapists would be able to increase training frequency and exposure towards various levels of signs. A total of 22 physiotherapists and occupational therapists participated in the study. The majority of the therapists agreed that with current therapy education, they still face problems with inter-raters and intra-raters variability (strongly agree 54%; n = 12/22, agree 27%; n = 6/22) in evaluating patients’ conditions. The therapists strongly agreed (72%; n = 16/22) that therapy trainees needed to increase their frequency of training; therefore believe that our initiative to develop an upper limb disorder training tool will help in improving the clinical education field (strongly agree and agree 63%; n = 14/22).

Keywords: upper limb disorder, clinical education tool, inter/intra-raters variability, spasticity, modified Ashworth scale

Procedia PDF Downloads 280

Authors: Chengcao Sun, Cuili Yang, Shujun Li, Ruilin Xue, Yongyong Xi, Liang Wang, Dejia Li

Abstract:

Backgrounds: Inflammation is widely distributed in patients with Duchenne muscular dystrophy (DMD), and ultimately leads to progressive deterioration of muscle function with the co-effects of chronic muscle damage, oxidative stress, and reduced oxidative capacity. NF-E2-related factor 2 (Nrf2) plays a critical role in defending against inflammation in different tissues via activation of phase II enzymes, heme oxygenase-1 (HO-1). However, whether Nrf2/HO-1 pathway can attenuate muscle inflammation on DMD remains unknown. The purpose of this study was to determine the anti-inflammatory effects of Sulforaphane (SFN) on DMD. Methods: 4-week-old male mdx mice were treated with SFN by gavage (2 mg/kg body weight per day) for 4 weeks. Gastrocnemius, tibial anterior and triceps brachii muscles were collected for related analysis. Immune cell infiltration in skeletal muscles was analyzed by H&E staining and immuno-histochemistry. Moreover, the expressions of inflammatory cytokines,pro-inflammatory cytokines and Nrf2/HO-1 pathway were detected by western blot, qRT-PCR, immunohistochemistry and immunofluorescence assays. Results: Our results demonstrated that SFN treatment increased the expression of muscle phase II enzymes HO-1 in Nrf2 dependent manner. Inflammation in mdx skeletal muscles was reduced by SFN treatment as indicated by decreased immune cell infiltration and lower expressions of the inflammatory cytokines CD45, pro-inflammatory cytokines tumour necrosis factor-α and interleukin-6 in the skeletal muscles of mdx mice. Conclusions: Collectively, these results show that SFN can ameliorate muscle inflammation in mdx mice by Nrf2/HO-1 pathway, which indicates Nrf2/HO-1 pathway may represent a new therapeutic target for DMD.

Keywords: sulforaphane, Nrf2, HO-1, inflammation

Procedia PDF Downloads 305