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Hong-Wan Ng, Ee-Chon Teo and QingHang Zhang

Posterior decompressive techniques including one- and two-level laminotomies and laminectomies are often used in treating cervical stenosis. Previously, several in vitro studies were conducted to help us understand the biomechanical changes occurring in the cervical spine after these surgical techniques. However, changes in the intersegmental flexibility under combined flexion-extension remain unclear. In this study, a 3-D nonlinear intact model of the C2–C7 was developed to evaluate the influence of one- and two-level laminotomies and laminectomies on the intersegmental moment rotational responses and internal stresses. The intact model was validated by comparing the predicted responses against experimental data. The validated model was then modified to simulate various surgical techniques for finite element analysis. Results showed that one- and two-level laminectomies increase the C2–C7 rotation motions by about 15% and 20%, respectively. The predicted increase in rotational motions also correlated well with the published data. Furthermore, results indicated that laminectomies would influence the biomechanical responses on both the affected and adjacent motion segments. In contrast, laminotomies have no significant effects on cervical biomechanics. To conduct a one-level laminectomy study, current findings indicate that it takes at least five motion segments to capture the immediate postsurgical biomechanical changes accurately and realistically. Minimally invasive cervical spine surgeries with one- or two-level laminotomies are preferred over one- and two-level laminectomies. Also, there is no consideration as to the efficacy of the two techniques in decompressing the spinal cord or nerve roots, which is the goal of the surgery, but is not examined in this study.

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Klaus Schneider and Ronald F. Zernicke

With a validated mathematical model of the head-neck consisting of nine rigid bodies (skull, seven cervical vertebrae, and torso), we simulated head impacts to estimate the injury risk associated with soccer heading. Experimental data from head-linear accelerations during soccer heading were used to validate the nine-body head-neck model for short duration impact loading of the head. In the computer simulations, the mass ratios between head mass and impacting body mass, the velocity of the impacting body, and the impact elasticity were varied. Head-linear and angular accelerations were compared to standard head-injury tolerance levels, and the injury risk specifically related to soccer heading was estimated. Based on our choice of tolerance levels in general, our simulations showed that injury risk from angular head accelerations was greater than from linear head accelerations, and compared to frontal impacts, lateral impacts had greater angular and less linear head accelerations. During soccer heading, our simulations indicated an unacceptable injury risk caused by angular head accelerations for frontal and lateral impacts at relatively low impact velocities for children, and at medium range impact velocities for adults. For linear head accelerations, injury risk existed for frontal and lateral impacts at medium range to relatively larger impact velocities for children, while no injury risk was shown for adults throughout the entire velocity range. For injury prevention, we suggest that head-injury risk can be reduced most substantially by increasing the mass ratio between head and impacting body. In soccer with children, the mass of the impacting body has to be adjusted to the reduced head mass of a child, that is, it must be clearly communicated to parents, coaches, and youngsters to only use smaller soccer balls.

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Robin S. Vealey, Robin Cooley, Emma Nilsson, Carly Block and Nick Galli

effectiveness as a consultant     Coaches/administrators like to have quantitative data   Cross-validate observations/interviews Validation of my observations; cross-checking with interviews     Identify discrepancies between objective and subjective data   Selection Draft selection Build Relationships Rapport

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Christopher Joyce, Angus Burnett and Miccal Matthews

No method currently exists to determine the location of the kick point during the golf swing. This study consisted of two phases. In the first phase, the static kick point of 10 drivers (having identical grip and head but fitted with shafts of differing mass and stiffness) was determined by two methods: (1) a visual method used by professional club fitters and (2) an algorithm using 3D locations of markers positioned on the golf club. Using level of agreement statistics, we showed the latter technique was a valid method to determine the location of the static kick point. In phase two, the validated method was used to determine the dynamic kick point during the golf swing. Twelve elite male golfers had three shots analyzed for two drivers fitted with stiff shafts of differing mass (56 g and 78 g). Excellent between-trial reliability was found for dynamic kick point location. Differences were found for dynamic kick point location when compared with static kick point location, as well as between-shaft and within-shaft. These findings have implications for future investigations examining the bending behavior of golf clubs, as well as being useful to examine relationships between properties of the shaft and launch parameters.

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Sean P. Flanagan and George J. Salem

In the analysis of human movement, researchers often sum individual joint kinetics to obtain a single measure of lower extremity function. The extent to which these summed measures relate to the mechanical objectives of the task has not been formally validated. The criterion validity of these measures was established with comparisons to the mechanical objective of two multiple-joint tasks. For the Work task 18 participants performed a loaded barbell squat using 4 resistances while instrumented for biomechanical analysis. For the Power they performed 2 predetermined amounts of work at both self-selected and fast speeds. Using inverse dynamics techniques, the peak net joint moment (PM) was calculated bilaterally in the sagittal plane at the ankle, knee, and hip and was summed into a single measure. This measure was correlated with the task objectives using simple linear regression. Similar procedures were used for the average net joint moment (AM), peak (PP), and average (AP) net joint moment power, and the net joint moment impulse (IM) and work (IP). For the Work task all 6 measures were significantly correlated with the task objective, but only AM, PM, and IP had correlation coefficients above 0.90. For the Power task, IM was not significantly correlated with the task objective, and only AP had a correlation coefficient above 0.90. These findings indicate that the validity of summing individual kinetic measures depends on both the measure chosen and the mechanical objective of the task.

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Jeremy R. Dicus and Jeff G. Seegmiller

Few ankle inversion studies have taken anticipation bias into account or collected data with an experimental design that mimics actual injury mechanisms. Twenty-three participants performed randomized single-leg vertical drop landings from 20 cm. Subjects were blinded to the landing surface (a flat force plate or 30° inversion wedge on the force plate). After each trial, participants reported whether they anticipated the landing surface. Participant responses were validated with EMG data. The protocol was repeated until four anticipated and four unanticipated landings onto the inversion wedge were recorded. Results revealed a significant main effect for landing condition. Normalized vertical ground reaction force (% body weights), maximum ankle inversion (degrees), inversion velocity (degrees/second), and time from contact to peak muscle activation (seconds) were significantly greater in unanticipated landings, and the time from peak muscle activation to maximum VGRF (second) was shorter. Unanticipated landings presented different muscle activation patterns than landings onto anticipated surfaces, which calls into question the usefulness of clinical studies that have not controlled for anticipation bias.

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Benjamin W. Infantolino, Daniel J. Gales, Samantha L. Winter and John H. Challis

The purpose of this study was to validate ultrasound muscle volume estimation in vivo. To examine validity, vastus lateralis ultrasound images were collected from cadavers before muscle dissection; after dissection, the volumes were determined by hydrostatic weighing. Seven thighs from cadaver specimens were scanned using a 7.5-MHz ultrasound probe (SSD-1000, Aloka, Japan). The perimeter of the vastus lateralis was identified in the ultrasound images and manually digitized. Volumes were then estimated using the Cavalieri principle, by measuring the image areas of sets of parallel two-dimensional slices through the muscles. The muscles were then dissected from the cadavers, and muscle volume was determined via hydrostatic weighing. There was no statistically significant difference between the ultrasound estimation of muscle volume and that estimated using hydrostatic weighing (p > 0.05). The mean percentage error between the two volume estimates was 0.4% ± 6.9. Three operators all performed four digitizations of all images from one randomly selected muscle; there was no statistical difference between operators or trials and the intraclass correlation was high (>0.8). The results of this study indicate that ultrasound is an accurate method for estimating muscle volumes in vivo.

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Jaclyn B. Caccese, Thomas A. Buckley and Thomas W. Kaminski

The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r = .332) and tandem firm (r = .474), and double-leg foam (r = .660); and with sway velocity for single-leg (r = .406) and tandem firm (r = .601), and double-leg (r = .575) and single-leg foam (r = .434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass–center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures.

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Mark L. McMulkin, Jeffrey C. Woldstad and Richard E. Hughes

Biomechanical optimization models are often used to estimate muscular and intervertebral disc forces during physical exertions. The purpose of this study was to determine whether an optimization-based biomechanical model predicts torso muscular activity of males and females equally well. The Minimum Intensity Compression (MIC) model, which has been extensively applied in industrial ergonomic task analysis, was used to estimate muscle forces for 3D moments. Participants (6 M, 6 F) performed 18 isometric exertions resisting 3D L3/L4 moments while electromyographic (EMG) activity was recorded for 8 muscles. Overall, model force estimates correlated better with male EMG activity (R 2 = 0.43) than with female EMG activity (R 2 = 0.33). Model force estimates of 4 muscles (LRA, RRA, REO, and RES) correlated better with male EMG activity than with female EMG. We conclude that trunk muscle forces estimated by current biomechanical modeling do not correlate equally well to male and female EMG activity. Future research needs to address validation or improvement of biomechanical trunk models for females.

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Louis A. DiBerardino III, Chantal A. Ragetly, Sungjin Hong, Dominique J. Griffon and Elizabeth T. Hsiao-Wecksler

The regions of deviation method has been proposed as a technique for identifying regions of the gait cycle where joint motion deviates from normal (Shorter et al., 2008). The original statistical analysis distinguished only peak values during stance and swing. In the current article, we extend the approach by examining deviations from normal throughout the entire gait cycle using pointwise t tests. These methods were demonstrated on hind-limb joint angles of 21 Labrador Retrievers without and with cranial cruciate ligament disease. Results were compared with peak difference analysis previously performed on these subjects. All points in the gait cycle where symmetry deviations were significantly affected by cranial cruciate ligament disease (via pointwise t tests) were defined as regions of deviation from symmetry. Discriminant function analysis was used to consider single subjects and validate that these regions were truly areas of difference between groups. Regions of deviation encompassed previously determined significant peak differences, while extending analysis to additional areas of asymmetry. Discriminant function analysis suggested that the region of deviation method is a viable approach for distinguishing motion pattern differences. This enhanced method may help researchers better understand the mechanisms behind lameness and compensation.