| 1. |
- Alm, M., et al.
(författare)
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Clinical evaluation of seating in persons with complete thoracic spinal cord injury
- 2003
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 41:10, s. 563-571
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: Consecutive male patients studied with photographic measurement of a combination of clinical methods. Objectives: To describe seating in individuals with complete thoracic spinal cord injury (SCI) by using a combination of clinical methods. Setting: Spinalis SCI unit, Stockholm, Sweden. Methods: Wheelchair specifications were documented. Measurements of posture from photographs in 30 male subjects with complete thoracic SCI, sitting in a relaxed and an upright position on a standardized surface and in a wheelchair were calculated. A comparison was made between positions and seating surfaces. An examiner's classification of lower trunk position in wheelchair was compared to subjects' evaluations. SCI subjects reported sitting support, satisfaction, and wishes for improvement. Results: Most SCI subjects used similar wheelchair specifications. None of the backrests were custom designed. Relatively small differences were found between the relaxed and upright position in the wheelchair regarding measurements of posture and according to the examiner's classification of the lower trunk position. Only 13/30 SCI subjects were sitting with the lower trunk centered relative to the backrest in the upright position. The examiner's classification and the subjects' evaluation of asymmetric sitting were not always in agreement. Only 12/30 SCI subjects were satisfied with their way of sitting. Conclusion: Current wheelchair specifications and adjustments seem to inhibit a postural correction towards upright sitting and fail to provide sufficient lateral support. Findings indicate an inability for SCI subjects to vary their sitting position in a wheelchair to a large extent. Both an examiner's classification and subjects' evaluation of asymmetric sitting are necessary to obtain a sufficient knowledge base for subsequent adjustment. By using methods regarding different aspects of seating, a more comprehensive view of seating was achieved. The combination of clinical methods seems to be useful in order to describe seating in individuals with complete thoracic SCI.
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| 2. |
- Gutierrez-Farewik, Elena M., et al.
(författare)
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Measuring seating pressure, area, and asymmetry in persons with spinal cord injury
- 2004
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Ingår i: European spine journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 13:4, s. 374-379
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Tidskriftsartikel (refereegranskat)abstract
- The goal of this study was to measure characteristics of seat loading in manual wheelchair users with complete spinal cord injury (SCI). Pressure distribution on the seating area of 25 adult males with SCI and eight non-injured adult males was measured in a relaxed and an upright posture on a standardized hard surface. Subjects with SCI were also tested in their wheelchairs. Maximum pressure, contact area, area of the highest pressure, and three asymmetry indices were compared. Subjects with SCI have higher pressure distributed over a smaller area, have a much smaller contact area, and distribute the loading more asymmetrically than non-injured subjects. Upright posture only corrects for some loading problems, while the wheelchair corrects for more loading parameters. Routine clinical seat loading evaluation may lead to improved chair and cushion selection for patients with SCI and may even alert clinicians to patients at high risk for complications due to high or unbalanced loads.
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| 3. |
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| 4. |
- Naili, J. E., et al.
(författare)
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The centre of mass trajectory is a sensitive and responsive measure of functional compensations in individuals with knee osteoarthritis performing the five times sit-to-stand test
- 2018
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Ingår i: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 62, s. 140-145
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to evaluate whether the trajectory of the body's Centre of Mass (CoM) is a sensitive and responsive measure of functional compensations in individuals with knee osteoarthritis (OA) performing the Five Times Sit-to-Stand test (5STS). This prospective study included 21 individuals with OA and 21 age- and gender-matched controls. Motion analysis data was collected while participants performed the 5STS, one month prior and one year after total knee arthroplasty (TKA). Pain was evaluated using a visual analogue scale. Repeated measures ANOVAs were used to evaluate (1) differences in the area under the curve (AUC) of CoM trajectories, and (2) the effect of number of sit-to-stand cycles on the AUC. Preoperatively, individuals with OA displayed a larger contralateral shift (p = 0.009) and forward displacement of the CoM (p < 0.004) than controls. Postoperatively, CoM trajectories of OA individuals were not statistically different from controls. However, upon comparison of specific cycles, OA individuals displayed a larger forward displacement during the final cycle. Pain was significantly reduced postoperatively (p = 0.001). The CoM trajectory appears to be a sensitive and responsive measure of functional compensations. The increased contralateral shift of the CoM represents a strategy to reduce pain by unloading the affected knee. Postoperatively, when pain was substantially reduced, OA individuals were comparable to controls. The increased forward CoM displacement characterises a strategy to reduce muscular effort by reducing the required knee extension moment. Postoperatively, OA individuals were comparable to controls in all cycles but the last, possibly suggesting residual muscle weakness.
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| 5. |
- Örtqvist, M., et al.
(författare)
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Knee muscle strength-A challenge to measure
- 2014
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 16:1, s. 33-40
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Tidskriftsartikel (refereegranskat)abstract
- The aims were to assess the reliability of knee extensor and flexor muscle strength measurements using the Strength Measuring Chair (SMC) in children and adults, and to assess agreement between the SMC and an isokinetic dynamometer (ID). 20 healthy children (10/10 boys/girls, 5-13 years) and 23 adults (10/13 men/women, 23-60 years) were included. Muscle strength tests were performed in the SMC and in the ID. The intra-subject reliability was shown to be excellent in both instruments (ICC 0.93-0.99) and an excellent test-retest reliability of measurements in the SMC was found (ICC 0.87-0.93). Agreement between instruments was evaluated with ICC, paired t-test and Bland-Altman 95% limits of agreement plots. In both adults' and children's groups, disagreements were found between the two instruments, with more in the children's group. The SMC, which has previously shown to be valid and reliable for measuring plantarflexor muscle strength, reliably measured knee muscle strength in healthy children and adults. However, the large disagreement found between the instruments, especially in the children's group, warrants care in standardizing measuring positions for different body size and warrants caution in comparing one's muscle strength measured using different assessment methods.
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| 6. |
- Örtqvist, Maria, et al.
(författare)
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Reliability of a new instrument for measuring plantarflexor muscle strength
- 2007
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993 .- 1532-821X. ; 88:9, s. 1164-1170
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To test the reliability of a new muscle strength testing instrument (the Strength Measuring Chair [SMC]) designed to quantify isometric strength in the lower extremities, and to determine the agreement between the SMC and an isokinetic dynamometer (Biodex). Design: Isometric strength tests were performed in plantar-flexors with 2 different knee positions (60 degrees, 30 degrees). Measurements were taken at 3 different sessions. Setting: Strength testing laboratory. Participants: Twenty-three able-bodied adults and 15 able-bodied children. Interventions: Not applicable. Main Outcome Measure: Isometric plantarflexor strength. Results: The reliability of isometric strength measurements of plantarflexors taken in the SMC was excellent for both the adult and children groups (intraclass correlation coefficient range,.84-.87). A Bland-Altman 95% limit of agreement test showed no systematic variation in 3 of the 4 SMC test observations; systematic variation was only observed in the adult group at a knee position of 30 degrees. There was no systematic difference in the adult group between the SMC and the isokinetic dynamometer, but there was a systematic variation in the children's group. Conclusions: The SMC reliably measured isometric plantarflexor strength in the tested populations.
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| 7. |
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| 8. |
- Bartonek, Asa, et al.
(författare)
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A new carbon fibre spring orthosis for children with plantarflexor weakness
- 2007
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 25:4, s. 652-656
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Tidskriftsartikel (refereegranskat)abstract
- We tested a new orthosis with a carbon fiber spring constructed to enable energy storing during increasing dorsiflexion in mid-stance, and to use the energy at the end of stance phase to aid push-off. The orthosis was tested on children with plantarflexor weakness due to motor disorders. All subjects were tested with 3D gait analysis with both the new orthosis and with their regularly used orthosis. In this technical note, the results of three individuals are reported. The preliminary findings show increased dorsiflexion, altered knee kinematics and improved kinetic and temporo-spatial parameters. Although the carbon spring orthosis influenced the subjects' gait in different ways, we conclude that the tested subjects with plantarflexion weakness benefit from the carbon fiber spring orthoses during walking. The parents' and children's subjective impressions as acquired from a questionnaire were also positive.
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| 9. |
- Bartonek, Asa, et al.
(författare)
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Effects of carbon fibre spring orthoses on gait in ambulatory children with motor disorders and plantarflexor weakness
- 2007
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Ingår i: Developmental Medicine & Child Neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 49:8, s. 615-620
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Tidskriftsartikel (refereegranskat)abstract
- A consecutive series of 17 children (six males, 11 females; mean age 11y 11mo [SD 4y 5mo]; range 3y 11mo-17y 4mo) with plantarflexor weakness was assessed to compare gait differences between a carbon fibre spring orthosis (CFSO) and participants' regular orthoses. Twelve children had myelomeningocele, four children had arthrogryposis, and one child had neuropathy with peripheral muscle pareses. All participants underwent clinical examination and 3D gait analysis. Parents answered a questionnaire to assess subjective perceptions of the orthoses. Results from 3D gait analysis provided evidence that CFSOs enhance gait function in most participants by improving ankle plantarflexion moment (p < 0.001), ankle positive work (p < 0.001), and stride length (p < 0.001). The CFSO did not suit all participants, which emphasizes the importance of analyzing each patient's needs.
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| 10. |
- Bartonek, A., et al.
(författare)
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Influence of external visual focus on gait in children with bilateral cerebral palsy
- 2016
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Ingår i: Pediatric Physical Therapy. - 0898-5669 .- 1538-005X. ; 28:4, s. 393-399
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore whether focusing a target influenced gait in children with cerebral palsy (CP) and typical development (TD). Methods: Thirty children with bilateral CP (Gross Motor Function Classification System [GMFCS] I-III) and 22 with TD looked at a light at walkway end (Gaze Target) while walking and returned (No Target). Results: During Gaze versus No Target, children with TD reduced temporal-spatial parameters and movements in the sagittal (SPM) and transverse planes. In comparison, during Gaze Target, children in CP1 (GMFCS I) had larger trunk SPM, children in CP2 (GMFCS II) larger neck (SPM), and children in CP3 (GMFCS III) greater head and neck frontal plane movements, and reduced cadence and single support. Conclusions: Focusing a target altered gait in children with CP. Children in CP1 reduced movements similar to children with TD, children in CP2 behaved nearly unchanged, whereas children in CP3 reduced movements and temporalspatial parameters, potentially as a consequence of lack of sensory information from lower limbs.
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