The purpose of this study was to measure the effect of the implementation of a
Aims. This study is a prospective, non-randomized trial for the treatment of fractures of the medial malleolus using
Background and purpose: As hip fracture patients are common and constitute an increasing health problem it is important to use available resources effectively and provide high quality care. Correct treatment can start in the ambulance with administration of oxygen, pain relief and intravenous glucose liquid according to the
Weight-bearing is a known stimulus for bone remodelling and a reduction in weight-bearing is associated with reduced bone mineral density (BMD) in affected limbs post lower limb fracture. This study investigated short and long-term precision of a method for measuring relative left/right weight-bearing using two sets of identical calibrated scales. The effect of imbalance on BMD at the hip and on lower limb
Osteoarthritis (OA) and diabetis mellitus type 2 (DMT2) are pathogenetically linked. Complement dysregulation contributes to OA and could be involved in DMT2. The inflammatory anaphylatoxin C5a is released during complement activation. This study aims to understand the specific responses of chondrocytes isolated from diabetic and non-diabetic rats exposed to C5a and/or the proinflammatory cytokine TNFα in vitro dependent on the glucose supply. Articular chondrocytes of adult Zucker Diabetic Fatty (ZDF) rats (homozygous: fa/fa, diabetic, heterozygous: fa/+,
Osteoarthritis is one of the major causes of immobility. Most commonly, osteoarthritis manifests at the knee joint. Prevalence of knee osteoarthritis (KNOA) increases with age. Another important risk factor for KNOA is obesity. Research has shown that obese subjects have almost four times the risk of developing KNOA, which may be explained by both an increased knee loading. In medial compartment KNOA, the knee adduction moment (KAM) during gait is considered a marker for disease severity. KAM is dependent of the magnitude of the ground reaction force and its moment arm relative to the knee joint centre. In addition, obesity has been reported to augment KAM during gait. However, after removal of the direct contributions of body weight, KAM parameters may be different due to obesity-related gait adaptations to limit knee loading. While KAM has been thoroughly investigated during gait, little is known about KAM during stair negotiation, during which knee loads are higher compared to gait. The aim of the current study is therefore to compare normalized KAM during the stance phase of stair negotiation between
Medial knee OA effects approximately 4.1 million people in England. Non-surgical strategies to lower knee joint loading is commonly researched in the knee OA literature as a method to alleviate pain and discomfort. Medial knee OA is much more prevalent than lateral knee OA due to the weight bearing line passing medial to the knee causing an external knee adduction moment (KAM). Numerous potential gait retraining strategies have been proposed to reduce either the first and/or the second peak KAM, including: toe-in gait, toe-out gait, lateral trunk
Over 62,000 total hip arthroplasty (THA) cases are performed each year in Canada, with an estimated annual healthcare system cost of $1.4 billion and resulting in 4 billion tonnes of waste annually (6,600 tonnes per day). The aims of this study were 1) Assess satisfaction of current/standard set-up amongst different stakeholders. 2) Assess energy, economic and waste cost of current set up and apply
This study aims to assess the fracture mechanics of type-2 diabetic (T2D) femoral bone using innovative site-specific tests, whilst also examining the cortical and trabecular bone microarchitecture from various regions using micro-computed tomography (CT) of the femur as the disease progresses. Male [Zucker Diabetic Fatty (ZDF: fa/fa) (T2D) and Zucker
Introduction: Sock application is a daily task that can pose a dislocation risk to implanted hips. The aim of this study was to measure hip flexion and rotation using three seated techniques of sock application. Namely:- 1. The leg crossed in a “figure of four” technique, 2. The
For clinical movement analysis, optical marker-based motion capture is the gold standard. With the advancement of AI-driven computer vision, markerless motion capture (MMC) has emerged. Validity against the marker-based standard has only been examined for lightly-dressed subjects as required for marker placement. This pilot study investigates how different clothing affects the measurement of typical gait metrics. Gait tests at self-selected speed (4 km/h) were performed on a treadmill (Motek Grail), captured by 9 cameras (Qualisys Miqus, 720p, f=100Hz) and analyzed by a leading MMC application (Theia, Canada). A healthy subject (female, h=164cm, m=54kg) donned clothes between trials starting from lightly dressed (LD: bicycle tight, short-sleeved shirt), adding a short skirt (SS: hip occlusion) or a midi-skirt (MS: partial knee occlusion) or street wear (SW: jeans covering ankle, long-sleeved blouse), the lattern combined with a short jacket (SWJ) or a long coat (SWC). Gait parameters (mean±SD, t=10s) calculated (left leg, mid-stance) were ankle pronation (AP-M), knee flexion (KF-M), pelvic obliquity (PO-M) and trunk lateral
The increased incidence of type 2 Diabetes Mellitus is associated with an impaired skeletal structure and a higher prevalence of bone fractures. Sclerostin is a negative regulator of bone formation produced by osteocytes and there is recent evidence that its expression in serum is elevated in diabetic patients compared to control subjects. In this study, we test whether hyperglycemia affects serum and bone sclerostin levels in a rat model of type 2 Diabetes as well as sclerostin production by osteoblasts in culture. We used Zucker diabetic fatty (ZDF) male rats (n=6) that spontaneously develop obesity and frank diabetes around 8–9 weeks of age and Zucker
Background. Loss of muscle mass (sarcopenia) and function in ageing are associated with reduced functional ability, quality of life and reduced life expectancy. In cancer patients, age related muscle loss may be exacerbated by cachexia and poor nutritional intake. Individuals with widespread disseminated disease are most prone to increasing functional decline, increased morbidity and accelerated death. However subjective assessments of physical performance have been shown to be poor indicators of life expectancy in these patients. Aims. To develop an objective measure to aid calculation of life expectancy in cancer by investigating the association between objectively measured
Introduction and Objective. Individuals with type 2 diabetes (T2D) have a 3-fold increased risk of bone fracture compared to non-diabetics, with the majority of fractures occurring in the hip, vertebrae and wrists. However, unlike osteoporosis, in T2D, increased bone fragility is generally not accompanied by a reduction in bone mineral density (BMD). This implies that T2D is explained by poorer bone quality, whereby the intrinsic properties of the bone tissue itself are impaired, rather than bone mass. Yet, the mechanics remain unclear. The objective of this study is to (1) assess the fracture mechanics of bone at the structural and tissue level; and (2) investigate for changes in the composition of bone tissue along with measuring total fluorescent advanced glycation end products (fAGEs) from the skin, as T2D progresses with age in Zucker diabetic fatty (ZDF (fa/fa)) and
Purpose. Alpine skiing is associated with large skeletal loads with distinct patterns of loading rate and direction, and alpine skiers were previously found to have a robust bone structure compared to normally active controls. However, it is not known whether the mechanical stimuli experienced by skiers are also associated with enhanced bone microarchitecture and strength. Thus, the purpose of this study was to use high-resolution peripheral quantitative computed tomography (HR-pQCT) to compare bone macro- and microarchitecture and bone strength between elite alpine skiers and normally active controls. Method. Participants included 7 female and 12 male members of the Canadian Alpine Ski Team, and 10 female and 16 male normally active control subjects. A whole body dual energy X-ray absorptiometry (DXA) scan was performed to measure
Objectives. The most prevalent disorders of the shoulder are related to the
muscles of rotator cuff. In order to develop a mechanical method
for the evaluation of the rotator cuff muscles, we created a database
of isometric force generation by the rotator cuff muscles in normal
adult population. We hypothesised the existence of variations according
to age, gender and dominancy of limb. Methods. A total of 400 healthy adult volunteers were tested, classified
into groups of 50 men and women for each decade of life. Maximal
isometric force was measured at standardised positions for supraspinatus,
infraspinatus and subscapularis muscles in both shoulders in every
person. Torque of the force was calculated and normalised to
Purpose and Background. Both overall spine shape and the size and shape of individual vertebrae undergo rapid growth and development during early childhood. Motor development milestones such as age of walking influence spine development, with delayed ambulation linked with spinal conditions including spondylolysis. However, it is unclear whether associations between motor development and spine morphology persist into older age. Therefore, these associations were examined using data from the MRC National Survey of Health and Development, a large nationally-representative British cohort, followed up since birth in 1946. Methods and Results. Statistical shape modelling was used to characterise spinal shape (L5-T10) and identify modes of variation in shape (SM) from dual energy x-ray absorptiometry images of the spine taken at age 60–64 years (N=1327 individuals; 51.8% female). Associations between walking age in months (reported by mothers at 2 years) and SMs were examined with adjustment for sex, birthweight, socioeconomic position, height,
Introduction. Gluteus medius is disrupted during lateral approach total hip arthroplasty (THA) which may impact its function and ability to control the pelvis. The objective was to compare gluteus medius activation and joint mechanics associated with a Trendelenburg sign (pelvic drop, trunk lean) during gait and hip abductor strength between patients that underwent lateral or posterior THA approaches one year post-surgery and healthy adults. Methods. Participants that underwent primary THA for hip osteoarthritis using lateral (n=21) or posterior (n=21) approaches, and healthy adults (n=21) were recruited for this cross-sectional study. Participants completed five walking trials. Surface electromyography captured gluteus medius activation. A 3-dimensional optical motion capture system measured frontal plane pelvic obliquity and lateral trunk
Introduction. Total hip arthroplasty (THA) is the most effective treatment modality for severe arthritis of the hip. Patients report excellent clinical and functional outcomes following THA, including subjective improvement in gait mechanics. However, few studies in the literature have outlined the impact of THA, as well as surgical approach, on gait kinetics and kinematics. Purpose. The purpose of this study was to determine the impact of surgical approach for THA on quantitative gait analysis. Methods. Thirty patients undergoing THA for primary osteoarthritis of the hip were assigned to one of three surgical approaches (10 anterior, 10 posterior, and 10 lateral). A single surgeon performed each individual approach. Each patient received standardized implants at the time of surgery (cementless stem and acetabular component, cobalt chrome femoral head, highly cross-linked liner). Patients underwent 3D gait analysis pre-operatively, and at 6- and 12-weeks following the procedure. At each time point, temporal gait parameters, kinetics, and kinematics were compared. Statistical analysis was performed using one-way analysis of variance. Results. All three groups were similar with respect to age (p=0.27), body mass index (p=0.16), and the Charlson Comorbidity Index (p=0.66). Temporal parameters including step length, stride length, gait velocity, and percent stance and swing phase were similar between the groups at all time points. The lateral cohort had higher pelvic tilt during stance on the affected leg than the anterior cohort at 6-weeks (p=0.033). Affected leg ipsilateral trunk
Total hip arthroplasty (THA) is the most effective treatment modality for severe arthritis of the hip. Patients report excellent clinical and functional outcomes following THA, including subjective improvement in gait mechanics. However, few studies in the literature have outlined the impact of surgical approach on gait kinetics and kinematics. The purpose of this study was to determine the impact of surgical approach for THA on quantitative gait analysis. Thirty patients undergoing THA for primary osteoarthritis of the hip were assigned to one of three surgical approaches (10 anterior, 10 posterior, and 10 lateral). A single surgeon performed each individual approach. Each patient received standardised implants at the time of surgery (cementless stem and acetabular component, cobalt chrome femoral head, highly cross-linked liner). Patients underwent 3D gait analysis pre-operatively, and at 6- and 12-weeks following the procedure. At each time point, temporal gait parameters, kinetics, and kinematics were compared. Statistical analysis was performed using one-way analysis of variance. All three groups were similar with respect to age (p=0.27), body mass index (p=0.16), and the Charlson Comorbidity Index (p=0.66). Temporal parameters including step length, stride length, gait velocity, and percent stance and swing phase were similar between the groups at all time points. The lateral cohort had higher pelvic tilt during stance on the affected leg than the anterior cohort at 6-weeks (p=0.033). Affected leg ipsilateral trunk