Biomedical subjects
Publications and source records attributed to G M Gardner.
Torque generated about the ankle joints during maximum isometric contraction of the plantar flexor muscles was measured on a subject 4 months after unilateral excision of the entire triceps surae. Resulting torque output on the operated limb was 327 kg-cm, or 38 per cent of the 871 kg-cm total for the sound limb.
A new method for monitoring the durations of foot-floor contact during walking is described. The method uses a screen walkway and conducting paper on the soles of the shoes as parts of an electrical circuit. The materials used are identified and circuit diagrams are provided. Several clinical applications and advantages and disadvantages of the method are discussed.
The gait of men with unilateral hip fusion is somewhat slow, asymmetrical, and arrhythmic as compared with that of normal men. Compensation for absent hip motion is accomplished by increased transverse and sagittal rotation of the pelvis, increased motion in the sound hip, and increased flexion of the knee throughout the stance phase on the fused side. Relationships between the fusion position, certain physical traits, and walking performance suggest that the best gait can be expected in young patients who have free motion of the lumbar spine, the sound hip, and the knee on the side of fusion, and who have equal limb lengths and a hip fused in a position that does not include excessive adduction.
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The purpose of this study was to determine the incidence and severity of degenerative changes seen on lateral roentgenograms in 200 asymptomatic men and women in five age groups with an age range of 20-65 years and to determine the normal values of cervical lordosis and spinal canal sagittal diameters and their relationship to degenerative changes. It was found that by age 60-65, 95% of the men and 70% of the women had at least one degenerative change on their roentgenograms. A small sagittal diameter correlated with the presence of degenerative changes at the same disc level, and the strongest correlation was with the size of the posterior osteophytes at C5-6 (r = 0.52). Cervical lordosis measurements did not relate to degenerative changes except for subjects over age 50 with moderate or severe intervertebral narrowing. It is important to realize that although roentgenographic abnormalities represent structural changes in the spine, they do not necessarily cause symptoms.
Two hundred five patients with neck pain were evaluated clinically and roentgenographically for a minimum of 10 years after onset of symptoms. Seventy-nine percent had a decrease in pain, and 43% were free of pain; however, 32% had moderate or severe residual pain. Patients who had been injured and initially had severe pain were the most likely to have an unsatisfactory outcome; however, no other clinical features were of value in predicting the final result. The presence or severity of pain was not related to the presence of degenerative changes, the sagittal diameter of the spinal canal, the degree of cervical lordosis, or to any changes in these measurements over the evaluation period.
The performance of two Olympic race walkers was studied during free-speed, fast, and race walking. Measurements of the stride and temporal components of gait, as well as the simultaneous displacement patterns of the body segments, and the electromyographic activity of muscles of the trunk and upper and lower limbs were recorded during the three walking speeds. During the testing, the race walkers achieved an average speed of 12.5 km/hr as compared to the 8.7 km/hr average speed achieved by normal men of the same age during fast walking. Race walking was characterized by an increase in cadence and stride length beyond that of normal controls (in a prior study) during fast walking, with stride lengths averaging 125% of stature during race walking, and 115% during normal fast walking. In the two race walkers the amplitudes of most of the movement patterns of the trunk and upper and lower limbs were exaggerated during race walking as compared to normal controls' fast walking. Several mechanisms were used by the race walkers to minimize the vertical excursion of the center of gravity of the body during race walking. All of the muscles monitored in the race walkers showed an increase in the amplitude of electromyographic activity during race walking as compared to fast walking; duration of muscle activity was also usually increased during race walking. Several suggestions for prevention of injuries associated with race walking are made.
Normal age- and sex-related standards for shoulder range of motion (ROM) and muscle strength are unavailable in the literature. Active range of shoulder motion and maximum isometric strength (torque) of several shoulder muscle groups were measured in normal healthy men and women between 25 and 36 and between 55 and 66 years of age. Values for joint motion were similar for the two age and sex groups. The strength of the women was 45% to 66% of that in men, and strength of the older subjects was 66% to 93% of that in younger subjects. Strength of the second attempt at contraction was greater than that of the first attempt. Arm dominance did not significantly affect strength values.
Kinesiologic measurements were made in patients with severe arthritis before and after geometric total knee replacements to evaluate the nature, rate and extent of change in their functional ability. Preoperatively, patients with rheumatoid arthritis functioned at lower levels than patients with osteoarthritis. Most patients with rheumatoid arthritis improved steadily after surgery, while progress of those with osteoarthritis was often irregular. The group with rheumatoid arthritis improved more than those with osteoarthritis, but they did not generally reach the functional level attained by the patients with osteoarthritis, and neither group reached the lower limits of normal variability 1 year postoperatively. On the average, both groups gained knee extensions, lost knee flexion, and gained isometric knee flexor muscle strength postoperatively. Every patient with osteoarthritis lost extensor muscle strength 1 year after surgery, while most with rheumatoid arthritis gained. During quiet standing, most patients had straighter knees postoperatively and bore a greater percent of body weight on the operated limb. Patients with rheumatoid arthritis improved more than patients with osteoarthritis in the type and amount of force applied to canes and crutches. Most patients walked faster postoperatively, took longer and more rapid steps, improved the pattern of knee motion used, and had smoother forward, lateral and vertical head motion.
Measurements of functional performance were compared before and at 6 months after 58 McKee-Farrar, 50 Charnley, and 57 Muller total hip replacements in 143 patients. The measurment included: range of motion of the hip, hip abductor and adductor-muscle torque, weight-bearing activity during standing, forces applied to canes or crutches, and multiple components of walking performance. Each group of patients improved significantly after surgery in all of the components measured. Early postoperative differences among the 3 groups were found with respect to pain ratings, impressions of hip status, hip motions, muscle torque, the number of patients using assistive devices, and certain components of walking performance. There is nothing to suggest that the performance of any 1 group is distinctly better or worse than that of any other group 6 months after surgery. On the basis of average values, each group improved in every component of function and it is gratifying that, except for a few patients who developed postoperative infection, each patient could be considered to have successful reconstruction.