1,721,035 research outputs found
Application of surface EMG in diabetic disease
Full text linkSummary: English
The World Health Organization warns that, in 2000, as many as 33 million Europeans suffered from diabetes, approximately 15% will likely develop foot ulcers, and approximately 15% to 20% of these patients will face lower-extremity amputation. In 2004, an estimated 3.4 million people died from consequences of high blood sugar. Diabetic neuropathy is the most common chronic complication associated with diabetes mellitus, affecting 20–50% of diabetic patients 10 years after their diagnosis. Peripheral neuropathy and peripheral arterial disease are the most common and invalidating diabetes’s complications, involved in the pathogenesis of diabetic foot. They account for the leading cause of non-traumatic lower limb amputations. It results from two factors. The first one is a reduced blow of blood in the inferior limbs, caused from the presence of obliterating peripheral arteriopathy disease. The second is the progressive laceration of nervous fibers (neuropathy) that cause a reduction of the sensitivity (also to the pain) and of the ability of movement, and that helps the appearance of lesions. Together with diabetes falls in older adults are a big public health concern and have provided much of the motivation for research into age-related changes in human gait. Tripping during walking is the predominant cause of falls not only in the elderly but also in the neuropathic subjects. Trips can occur during walking on a level ground, but also during crossing visible obstacle, stair ascending and descending. The social and economic weight of the diabetic foot and the tragic consequences that brings with it can be reduced through a prompt diagnosis and treatment from the very beginning. The aim of this thesis, was to evaluate differences in gait parameters, in performing stair ascending and descending task and evaluation of muscle fatigue during treadmill protocol in diabetes subjects with and without complications, in order to provide a further tool for early diagnosis which allows clinicians to change, if is necessary, or only to control, as soon as possible, the follow-up of patients according to their specific characteristics
A multi-scale framework for the prevention of plantar ulcers in diabetic subjects: a multidisciplinary approach combining gait analysis, musculkoskeletal and finite element foot modelling.
Full text linkThis study aims to evaluate the accuracy of a multiscale workflow applicable in clinical practice aiming to prevent ulceration by detecting excessive external and internal stresses preceding overloading and breakdown in diabetic subjects
On the effects of EMG normalization in muscle forces estimation when using a multi-DOF EMG-driven neuromusculoskeletal model
No full textEffects of a proprioceptive focal stimulation (Equistasi®) on reducing the biomechanical risk factors associated with ACL injury in female footballers
Full text linkIntroductionFootball presents a high rate of lower limb injuries and high incidence of Anterior Cruciate Ligament (ACL) rupture, especially in women. Due to this there is the need to optimize current prevention programs. This study aims to verify the possibility to reduce the biomechanical risk factors associated with ACL injury, through the application of proprioceptive stimulation by means of the Equistasi & REG; device. MethodsTen elite female footballers were enrolled and received the device for 4 weeks (5 days/week, 1h/day). Athletes were assessed directly on-field at four time points: T0 and T1 (evaluation without and with the device), T2 (after 2 weeks), T4 (after 4 weeks) while performing two different tasks: Romberg Test, and four sidestep cutting maneuvers bilaterally. Seven video cameras synchronized with a plantar pressure system were used, thirty double colored tapes were applied on anatomical landmarks, and three dimensional coordinates reconstructed. Vertical ground reaction forces and center of pressure data were extracted from the plantar pressure insoles. Hip, knee, and ankle flexion-extension angles and moments were computed as well as abd-adduction joint torques. From the Romberg Test both center of pressure descriptive variables and frequency analysis parameters were extracted. Each variable was compared among the different time frames, T1, T2 and T4, through Friedman Test for non-parametric repeated measures (p<0.05); Wilcoxon Signed Rank Test was used for comparing variables between T0 and T1 (p<0.05) and across the different time frames as follows: T1-T2, T2-T4 and T1-T4. ResultsStatistically significant differences in both posturographic and biomechanical variables between the assessment at T0 and T1 were detected. Reduced hip and knee abduction torques were revealed in association with reduced both ground reaction forces and ankle dorsiflexion torque from T1 up to T4. DiscussionThe proprioceptive stimuli showed to have the potential to improve cutting biomechanics mainly with respect to the ligament and quadriceps dominance theories. Results of the present study, even if preliminary and on a small sample size, could be considered promising towards the inclusion of proprioceptive training in injury prevention programs
The Effect of Custom Insoles on Muscle Activity in Diabetic Individuals with Neuropathy
Full text linkFoot ulcers are amongst the most serious complications of diabetes. Guidelines recommend that people with diabetes wear appropriate footwear or insoles to reduce repetitive stresses. Excessive plantar pressure has been recognized as the major risk factor for plantar ulcers in diabetic individuals; custom insoles are indicated as the gold standard treatment to unload the foot structure. The aim of this study was to investigate the effect of custom insoles on biomechanical and neuromuscular functions in diabetic neuropathic individuals. Ten diabetic subjects walked with and without custom insoles at their preferred speed; ten controls were assessed for comparison. Data were captured through seven video cameras, plantar pressure insoles, and surface electromyography. The electrical activity of Rectus Femoris, Tibialis Anterior, Medius Gluteus and Gastrocnemius Lateralis were acquired bilaterally. The plantar pressure and surface electromyographic variables were determined, while videos were used to detect the gait cycle. The following comparisons were made across the variables through the non-parametric SPM1D test (p < 0.05): condition with vs. without insoles vs. controls. Custom insoles provided a reduction in plantar pressure through contact surface redistribution in association with a reduced electromyographic activity. Our results suggest optimizing the prevention approach by including personalized foot and ankle exercises
Could Proprioceptive Stimuli Change Saddle Pressure on Male Cyclists during Different Hand Positions? An Exploratory Study of the Effect of the Equistasi(®) Device
Full text linkWhen pedaling, the excessive pressure on the seat has the potential to produce injuries and this can strongly affect sport performance. Recently, a large effort has been dedicated to the reduction of the pressure occurring at the saddle region. Our work aims to verify the possibility of modifying cyclists’ pedaling posture, and consequently the pressure on the saddle, by applying a proprioceptive stimulus. Equistasi(®) (Equistasi srl, Milano, Italy) is a wearable device that emits focal mechanical vibrations able to transform the body temperature into mechanical vibratory energy via the embedded nanotechnology. The data acquired through a pressure mapping system (GebioMized(®)) on 70 cyclists, with and without Equistasi(®), were analyzed. Pedaling in three positions was recorded on a spin trainer: with hands on the top, hands on the drop handlebar, and hands on the lever. Average force, contact surface, and average and maximum pressure each in different regions of the saddle were analyzed, as well as integral pressure time and center of pressure. In the comparisons between hands positions, overall pressure and force variables were significantly lower in the drop-handlebar position at the rear saddle (p < 0.03) and higher in hand-on-lever and drop-handlebar positions at the front saddle (p < 0.01). When applying the Equistasi device, the contact surface was significantly larger in all hand positions (p < 0.05), suggesting that focal stimulation of the lumbar proprioceptive system can change cyclists’ posture
Reliability and repeatability assessment of single camera 2D and 3D markerless approach for sport applications
No full textGait and posture abnormalities in children with maxillary transverse discrepancy and crossbite
No full textElectromyography-informed modeling for estimating muscle activation and force alterations in Parkinson’s disease
Full text linkElectromyography (EMG)-driven neuromusculoskeletal modeling (NMSM) enables simulating the mechanical function of multiple muscle-tendon units as controlled by nervous system in the generation of complex movements. In the context of clinical assessment this may enable understanding biomechanical factor contributing to gait disorders such as one induced by Parkinson’s disease (PD). In spite of the challenges in the development of patient-specific models, this preliminary study aimed at establishing a feasible and noninvasive experimental and modeling pipeline to be adopted in clinics to detect PD-induced gait alterations. Four different NMSM have been implemented for three healthy controls using CEINMS, an OpenSim-compatible toolbox. Models differed in the EMG-normalization methods used for calibration purposes (i.e. walking trial normalization and maximum voluntary contraction normalization) and in the set of experimental EMGs used for the musculotendon-unit mapping (i.e. 4 channels vs. 15 channels). Model accuracy assessment showed no statistically significant differences between the more complete model (non-clinically viable) and the proposed reduced one (clinically viable). The clinically viable reduced model was systematically applied on a dataset including ten PD’s and thirteen healthy controls. Results showed significant differences in the neuromuscular control strategy of the PD group in term of muscle forces and joint torques. Indeed, PD patients displayed a significantly lower magnitude on force production and revealed a higher amount of force variability with the respect of the healthy controls. The estimated variables could become a measurable biomechanical outcome to assess and track both disease progression and its impact on gait in PD subjects
LO ZEN DEL TIRO LIBERO: l’integrazione di costrutti psicologici e parametri elettromiografici per il successo nella prestazione agonistica giovanile.
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