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  • Author: Ingrid G. van de Port x
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Hans H.C.M. Savelberg, Ingrid G.L. Van de Port and Paul J.B. Willems

By manipulating trunk angle in ergometer cycling, we studied the effect of body configuration on muscle recruitment and joint kinematics. Changing trunk angle affects the length of muscles that span the hip joint. It is hypothesized that this affects the recruitment of the muscles directly involved, and as a consequence of affected joint torque distributions, also influences the recruitment of more distal muscles and the kinematics of distal joints. It was found that changing the trunk from an upright position to approximately 20 deg forward or backward affected muscle activation patterns and kinematics in the entire lower limb. The knee joint was the only joint not affected by manipulation of the lengths of hip joint muscles. Changes in trunk angle affected ankle and hip joint kinematics and the orientation of the thigh. A similar pattern has been demonstrated for muscle activity: Both the muscles that span the hip joint and those acting on the ankle joint were affected with respect to timing and amplitude of EMG. Moreover, it was found that the association between muscle activity and muscle length was adapted to manipulation of trunk angle. In all three conditions, most of the muscles that were considered displayed some eccentric activity. The ratio of eccentric to concentric activity changed with trunk angle. The present study showed that trunk angle influences muscle recruitment and (inter)muscular dynamics in the entire limb. As this will have consequences for the efficiency of cycling, body configuration should be a factor in bicycle design.

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Michiel Punt, Sjoerd M. Bruijn, Ingrid G. van de Port, Ilona J.M. de Rooij, Harriet Wittink and Jaap H. van Dieën

A recent review indicated that perturbation-based training (PBT) interventions are effective in reducing falls in older adults and patients with Parkinson’s disease. It is unknown whether this type of intervention is effective in stroke survivors. We determined whether PBT can enhance gait stability in stroke survivors. A total of 10 chronic stroke survivors who experienced falls in the past 6 months participated in the PBT. Participants performed 10 training sessions over a 6-week period. The gait training protocol was progressive, and each training contained unexpected gait perturbations and expected gait perturbations. Evaluation of gait stability was performed by determining steady-state gait characteristics and daily-life gait characteristics. We previously developed fall prediction models for both gait assessment methods. We evaluated whether predicted fall risk was reduced after PBT according to both models. Steady-state gait characteristics significantly improved, and consequently, predicted fall risk was reduced after the PBT. However, daily-life gait characteristics did not change, and thus, predicted fall risk based on daily-life gait remained unchanged after the PBT. A PBT resulted in more stable gait on a treadmill and thus lower predicted fall risk. However, the more stable gait on the treadmill did not transfer to a more stable gait in daily life.