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The Effect of an Added Load on Postural Stability in Older Adults

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This study investigated the effect of a small added load on postural stability in older adults. Sixteen healthy older adults (6 male, 10 female, age=72 ± 3.2y, height=172± 9.3

This study investigated the effect of a small added load on postural stability in older adults. Sixteen healthy older adults (6 male, 10 female, age=72 ± 3.2y, height=172± 9.3 cm, weight=84± 7.6 kg) performed clinical measures of postural control with different loads placed on the shoulders (0%, 1% and 3% bodyweight). The functional reach test, comprising a forward, right and left lateral reach, along with COP data measured through the use of a force plate were the postural control measures utilized in this study. COP data used were COP sway velocity and COP mean sway area, in the form of a 95% confidence ellipse. During the COP trials, visual input (eyes open and eyes closed) and surface conditions (firm and foam) were varied to evaluate the effect of the loads under different conditions. Two trials of each measurement were performed for all tests, and participants were allowed rest intervals as needed. Anticipated results show a decreased reach distance of 8% in the forward direction, and a 7% decrease in the left and right lateral directions under a 1% bodyweight load. For expected results of COP velocity, there will be a 12% increase from baseline COP sway velocity in the 1% bodyweight condition. Anticipated results for COP sway area show a 39% increase in the eyes open firm surface, under a 1% bodyweight load, and a 40% increase under the 3% load. These expected results show a significant effect on postural control with a 1% and 3% bodyweight load placed on the shoulders of older adults. This information may be valuable in combatting the epidemic of falls seen among the elderly population, as part of an exercise program for improving balance and postural stability.

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  • 2016-05

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Assessment of upper limb function between symptomatic and asymptomatic rotator cuff tears in older adults: A grant proposal

Description

Rotator cuff tears (RCT) can affect up to 50% of the older population and this injury is typically associated with functional deficits and shoulder pain that prevent people from living

Rotator cuff tears (RCT) can affect up to 50% of the older population and this injury is typically associated with functional deficits and shoulder pain that prevent people from living a typical lifestyle. Particularly in an older population, this type of pain increases functional dependency on others and can hinder the possibility of independent living. An area of shoulder pathology that lacks research is the functional differences in symptomatic and asymptomatic tears on activities of daily living (ADL). In order to more fully understand the functional presentations associated with each of these types of tears, it is critical that we evaluate the various mechanisms that contribute to altered movement patterns. Understanding these different compensatory patterns between asymptomatic and symptomatic tears will allow for a better understanding of the presentation of this shoulder pathology and provide new insight for diagnostic and rehabilitation purposes. Therefore, the objective of this study is to quantify kinematic differences of daily upper limb movements between symptomatic and asymptomatic RCTs in an older population. To accomplish this goal, we will be using motion capture and electromyography to assess typical ADL movements and their associated muscle activation patterns during 2D and 3D tasks in older adults (≥55 years). Strength and shoulder range of motion measures will also be taken, as well as self-reported measures of function and pain. Through this project, we seek to understand the presentation of RCTs and what characteristics are associated with symptoms. Long term, outcomes from this work will be used to develop a more standardized approach to early detection and treatment of this common shoulder pathology in the older adult population.

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  • 2016-12

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The Relationship of Muscle Thickness and Pennation Angle to Muscle Function by Ultrasound Imaging

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This purpose of this study was to develop reliable methods for ultrasound measurements of skeletal muscle architecture, and to identify which specific quadriceps measurements most closely relate to peak isometric

This purpose of this study was to develop reliable methods for ultrasound measurements of skeletal muscle architecture, and to identify which specific quadriceps measurements most closely relate to peak isometric torque of the leg extensors. These data were obtained as part of a larger research study and consist of 9 total subjects (4 males, 5 females; age (30.6 ± 13.6yr). Ultrasound images for muscle thickness and pennation angle were obtained for each subject during two separate testing days (separated by 5-10 days). Images were acquired at various anatomical sites of the quadriceps and each image was analyzed using Image J software. Quadriceps muscles assessed for muscle thickness and pennation angle included the vastus lateralis (VL), and vastus intermedius (VI), while rectus femoris (RF) was assessed only for muscle thickness. Peak isometric torque measurements were obtained at 60 degrees of knee angle for knee extension using an isokinetic dynamometer. Results show that the methods chosen for ultrasound measurement produced reliable inter-day results for muscle thickness and pennation angle. VL muscle thickness and pennation angle obtained at the lateral site corresponding to 39% of leg length was highly related to peak isometric torque for knee extension. The results of this study identify specific measurement sites that are related to muscle function. In addition, these data further validate that ultrasound measurement is reliable to measure muscle thickness and pennation angle in skeletal muscle.

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  • 2016-05

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Development of joint control during drawing movements in childhood

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Research on joint control during arm movements in adults has led to the development of the Leading Joint Hypothesis (LJH), which states that the central nervous system takes advantage of

Research on joint control during arm movements in adults has led to the development of the Leading Joint Hypothesis (LJH), which states that the central nervous system takes advantage of interaction torque (IT) and muscle torque (MT) to produce movements with maximum efficiency in the multi-jointed limbs of the human body. A gap in knowledge exists in determining how this mature pattern of joint control develops in children. Prior research focused on the kinematics of joint control for children below the age of three; however, not much is known about interjoint coordination with respect to MT and IT in school-aged children. In the present study, joint control at the shoulder, elbow, and wrist during drawing of five shapes was investigated. A random sample of nine typically developing children ages 6 to 12 served as subjects. The task was to trace with the index finger a template placed on a horizontal table. The template consisted of a circle, horizontal, vertical, right-diagonal, and left-diagonal line. Analysis of muscle torque contribution (MTC) revealed the individual roles of MT and IT in the shoulder, elbow, and wrist joints. During drawing of the horizontal line, which requires the most difficult joint control pattern in adults because it does not allow the use of IT for joint rotation, joint control was found to change through development. For the youngest children, the function of elbow MT modified to suppress IT, thereby producing large elbow rotation. The oldest children simplified this by using the shoulder as the principal joint of movement production and with decreased assistance from the elbow. For the other four drawing movements, differences in the pattern of joint control used by all of the subjects was unaffected by an increase in age. Overall, the results suggest that in children above 6 years of age, minor changes in joint control occur during drawing of relatively simple movements. The limited effect of age that was observed could be related to the restriction of movements to the horizontal plane. For a future study, three-dimensional movements that provide more freedom in joint control due to redundancy of degrees of freedom could be more informative about developmental changes in joint coordination.

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  • 2016-12

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Assessment of Upper Limb Function and the Underlying Movement Strategies with Potential Application to Rotator Cuff Tears

Description

Introduction: Individuals with rotator cuff tears (RCT) have been found to compensate in their movement patterns by using lower thoracohumeral elevation angles during certain tasks, as well as increased internal

Introduction: Individuals with rotator cuff tears (RCT) have been found to compensate in their movement patterns by using lower thoracohumeral elevation angles during certain tasks, as well as increased internal rotation of the shoulder (Vidt et al., 2016). The leading joint hypothesis (LJH) suggests there is one leading joint that creates the foundation for the entire limb motion, and there are other subordinate joints that monitor the passive interaction torque (IT) and create a net torque (NT) aiding to limb motions required for the task. This experiment hopes to establish a better understanding of joint control strategies during a wide range of arm movements. Based off of the LJH, we hypothesize that when a subject has a rotator cuff tear, their performance of planar and three- dimensional motions should be altered not only at the shoulder, which is often the leading joint, but also at other joints on the arm such as the elbow and wrist.

Methods: There were 3 groups of participants: healthy younger adults (age 21.74 ± 1.97), healthy older adult controls (age 69.53 ± 6.85), and older adults with a RCT (age 64.33 ± 4.04). All three groups completed strength testing, horizontal drawing and pointing tasks, and three-dimensional (3D) activities of daily living (ADLs). Kinematic and kinetic variables of the arm were obtained during horizontal and 3D tasks using data from 13 reflective markers placed on the arm and trunk, 8 motion capture cameras, and Cortex motion capture software (Motion Analysis Corp., Santa Rosa, CA). During these tasks, electromyography (EMG) electrodes were placed on 12 muscles along the arm that affect shoulder, elbow, and wrist rotation. Strength testing tasks were measured using a dynamometer. All strength testing and 3D tasks were completed for three trials and horizontal tasks were completed for two trials.

Results: Results of the younger adult participants showed that during the forward portion of seven 3D tasks, there were four phases of different joint control mechanics seen in a majority of the movements. These phases included active rotation of both the shoulder and the elbow joint, active rotation of the shoulder with passive rotation of the elbow, passive rotation of the shoulder with active rotation of the elbow, and passive rotation of both the shoulder and the elbow. Passive rotation during movements was a result of gravitational torque (GT) on the different segments of the arm and IT caused as a result the multi-joint structure of human limbs. The number of tested participants for the healthy older adults and RCT older adults groups is not yet high enough to produce significant results and because of this their results are not reported in this article.

Discussion: Through the available results, multiple phases were found where one or both of the joints of the arm moved passively which further supports the LJH and extends it to include 3D movements. This article is a part of a bigger project which hopes to get a better understanding of how older adults adjust to large passive torques acting on the arm during 3D movements and how older adults with RCTs compensate for the decreased strength, the decreased range of motion (ROM), and the pain that accompany these types of tears. Hopefully the results of this experiment lead to more research toward better understanding how to treat patients with RCTs.

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  • 2018-05

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Coordination in the Arm after a Rotator Cuff Tear in the Elderly

Description

Introduction: Individuals with rotator cuff tears have been found to compensate in their movement patterns by using lower thoracohumeral elevation angles during certain tasks, as well as increased internal rotation

Introduction: Individuals with rotator cuff tears have been found to compensate in their movement patterns by using lower thoracohumeral elevation angles during certain tasks, as well as increased internal rotation of the shoulder (Vidt et al., 2016). Leading joint hypothesis suggests there is one leading joint that creates the foundation for the entire limb motion, and there are other subordinate joints which monitor the passive interaction torque and create a net torque aiding to limb motions required for the task. This experiment seeks to establish a better understanding of joint control strategies during a wide range of arm movements. Based on the leading joint hypothesis, we hypothesize that when a subject has a rotator cuff tear, their performance of planar and three-dimensional motions should be altered not only at the shoulder, which is often the leading joint, but also at other joints on the arm, such as the elbow and wrist. This paper will focus on the effect of normal aging on the control of the joints of the arm.
Methods: There were 4 groups of participants: healthy younger adults (n=14)(21.74 ± 1.97), healthy older adults (n=12)(55-75), older adults (n=4)(55-75) with a partial-thickness rotator cuff tear, and older adults (n=4)(55-75) with a full-thickness rotator cuff tear (RCT). All four groups completed strength testing, horizontal drawing and pointing tasks, and three dimensional (3D) activities of daily living. Kinematic and kinetic variables of the arm were obtained during horizontal and 3D tasks using data from 12 reflective markers placed on the arm, 8 motion capture cameras, and Cortex motion capture software (Motion Analysis Corp., Santa Rosa, CA). Strength testing tasks were measured using a dynamometer. All strength testing and 3D tasks were completed for three trials and horizontal tasks were completed for two trials.
Results: Results of the younger adult participants showed that during the forward portion of seven 3D tasks, there were four phases of different joint control mechanics seen in a majority of the movements. These phases included active rotation of both the shoulder and the elbow joint, active rotation of the shoulder with passive rotation of the elbow, passive rotation of the shoulder with active rotation of the elbow, and passive rotation of both the shoulder and the elbow. Passive rotation during movements was a result of gravitational torque on the different segments of the arm and interaction torque caused as a result of the multi-joint structure of human limbs. The number of tested participants for the minor RCT, and RCT older adults groups is not yet high enough to produce significant results and because of this their results are not reported in this article. Between the older adult control group and the young adult control group in the tasks upward reach to eye height and hair comb there were significant differences found between the groups. The differences were found in shorter overall time and distance between the two groups in the upward eye task.
Discussion: Through the available results, multiple phases were found where one or both of the joints of the arm moved passively which further supports the LJH and extends it to include 3D movements. With available data, it can be concluded that healthy older adults use movement control strategies, such as shortening distance covered, decreasing time percentage in active joint phases, and increasing time percentage in passive joint phases, to account for atrophy along with other age-related declines in performance, such as a decrease in range of motion. This article is a part of a bigger project which aims to better understand how older adults with RCTs compensate for the decreased strength, the decreased range of motion, and the pain that accompany this type of injury. It is anticipated that the results of this experiment will lead to more research toward better understanding how to treat patients with RCTs.

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Date Created
  • 2019-05

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Upper extremity biomechanics in native and non-native signers

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Individuals fluent in sign language who have at least one deaf parent are considered native signers while those with non-signing, hearing parents are non-native signers. Musculoskeletal pain from repetitive motion

Individuals fluent in sign language who have at least one deaf parent are considered native signers while those with non-signing, hearing parents are non-native signers. Musculoskeletal pain from repetitive motion is more common from non-natives than natives. The goal of this study was twofold: 1) to examine differences in upper extremity (UE) biomechanical measures between natives and non-natives and 2) upon creating a composite measure of injury-risk unique to signers, to compare differences in scores between natives and non-natives. Non-natives were hypothesized to have less favorable biomechanical measures and composite injury-risk scores compared to natives. Dynamometry was used for measurement of strength, electromyography for ‘micro’ rest breaks and muscle tension, optical motion capture for ballistic signing, non-neutral joint angle and work envelope, a numeric pain rating scale for pain, and the modified Strain Index (SI) as a composite measure of injury-risk. There were no differences in UE strength (all p≥0.22). Natives had more rest (natives 76.38%; non-natives 26.86%; p=0.002) and less muscle tension (natives 11.53%; non-natives 48.60%; p=0.008) for non-dominant upper trapezius across the first minute of the trial. For ballistic signing, no differences were found in resultant linear segment acceleration when producing the sign for ‘again’ (natives 27.59m/s2; non-natives 21.91m/s2; p=0.20). For non-neutral joint angle, natives had more wrist flexion-extension motion when producing the sign for ‘principal’ (natives 54.93°; non-natives 46.23°; p=0.04). Work envelope demonstrated the greatest significance when determining injury-risk. Natives had a marginally greater work envelope along the z-axis (inferior-superior) across the first minute of the trial (natives 35.80cm; non-natives 30.84cm; p=0.051). Natives (30%) presented with a lower pain prevalence than non-natives (40%); however, there was no significant difference in the modified SI scores (natives 4.70 points; non-natives 3.06 points; p=0.144) and no association between presence of pain with the modified SI score (r=0.087; p=0.680). This work offers a comprehensive analysis of all the previously identified UE biomechanics unique to signers and helped to inform a composite measure of injury-risk. Use of the modified SI demonstrates promise, although its lack of association with pain does confirm that injury-risk encompasses other variables in addition to a signer’s biomechanics.

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Date Created
  • 2018