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Biomedical subjects

H Moffet

Publications and source records attributed to H Moffet.

10 recordsLinked to original sources

Influence of laptop computer design and working position on physical exposure variables.

OBJECTIVE: To evaluate the impact of two laptop designs (with or without palm rest) and two work situations (on desk or lap) on neck and upper limb posture, muscle activity and productivity. DESIGN AND METHODS: Eight healthy subjects performed a standardized typing task of 15 min duration. During the last 5 min of each test, the neck, upper arm and trunk postures were captured by a three-dimensional video system, wrist motion was measured by a biaxial electrogoniometer and muscle activity of four neck and upper limb muscles was recorded. RESULTS: Only minor differences in postures, wrist positions and productivity were observed when comparing the two laptop designs in the same situation. Larger differences were found when comparing the two situations (desk or lap). In the desk situation, the subjects bent their heads forward less, had less backward trunk inclination and wrist extension, but more elevation of the upper arm. Higher electromyographic (EMG) levels in the trapezius and deltoid muscles and lower EMG levels in the wrist extensors were also found in the desk situation. CONCLUSIONS: Our findings do not favor one particular laptop design because only small differences in physical exposure were found. However, the workstation set up influenced the physical exposure variables, and was pinpointed as the main determinant to be considered when doing laptop work even-though no ideal situation was found. Greater physical (muscular and articular) constraints seem to be imposed to the shoulder region in the desk situation whereas the head-neck and wrist segments appear to be more stressed in the lap situation. RELEVANCE: Laptop computers are often used although the physical exposure in laptop work and the impact of different laptop designs have not been systematically assessed. A better understanding of these factors may help formulate some recommendations for laptop users.

Adult↗

Feasibility of an eight-week dance-based exercise program and its effects on locomotor ability of persons with functional class III rheumatoid arthritis.

OBJECTIVES: The main objectives of this experimental case series were to evaluate the feasibility of a modified dance-based exercise program with low ground impacts in persons with rheumatoid arthritis (RA) functional class III and to describe its effects on locomotor ability. The relationship between 3 locomotor tests and their responsiveness also were addressed. METHODS: Ten female subjects participated in an 8-week exercise program. Locomotor ability was measured before and after the program using the 50-foot test of walking time, the 6-minute test of walking distance, and the locomotion biomechanical analysis. RESULTS: All subjects showed a high compliance (92.5% presence at sessions) over the 8 weeks of exercise without any aggravation in disease status. They were able to train efficiently at moderate intensity up to 25 minutes. Significant improvements were found in locomotor ability, with a higher responsiveness measured by the locomotion biomechanical analysis, followed by the 6-minute gait test and the 50-foot gait test. Inconsistent relationships between tests suggested that different locomotor abilities are required during tests. CONCLUSION: These results support the feasibility of a modified dance-based exercise program for persons with severe RA. With high levels of responsiveness, the detailed biomechanical analysis and the 6-minute gait test are recommended for the assessment of locomotor ability.

Aged↗

Three-dimensional gait analysis in women with a total hip arthroplasty.

OBJECTIVES: The purposes of this study were: (1) to identify the primary (hip) and secondary (neighboring joints) impairments during gait in subjects with a total hip arthroplasty total hip arthroplasty, (2) to determine which impairments persist when controlling for gait speed and (3) to study the relationships between primary and secondary impairments in order to describe the locomotor strategies used by these patients.DESIGN. This cross-sectional study compared the gait patterns of women with a total hip arthroplasty to those of healthy women.BACKGROUND. Several studies have reported residual hip impairments in the sagittal plane during gait after a total hip arthroplasty. There is, however, a substantial lack of knowledge in regard to the changes at the neighboring joints and in the other planes of movement.METHODS. Subjects have been examined during a gait laboratory testing session including the simultaneous recording of three-dimensional kinematics and ground reaction forces on one side, and bilateral activation of six lower limb muscles.RESULTS. A significant decrease of 20% in the hip extensor moment of force during the early stance phase was correlated (R(2)=43%) with a significant decrease of 14% in gait speed. Moreover, a significant decrease of 59% in the range of hip extension at the end of the stance phase was observed together with secondary impairments such as a significant increase in the anterior pelvic rotation, in knee flexion and in ankle dorsiflexion. Lastly, a significant increase in ipsilateral bending of the trunk during the single limb support on the operated limb was concomitant with a significant decrease in the hip abductor moment of force.CONCLUSIONS. The decrease in gait speed and the persistence of abnormal gait patterns one year after the total hip arthroplasty were associated respectively with a decrease in the hip extensor moment of force and with a decrease in the range of hip extension (sagittal plane) or in the hip abductor moment of force (frontal plane). RelevanceThe data provided in this paper may serve as guidelines to establish rehabilitation programs designed to restore optimal locomotor function.

Adaptation, Physiological↗

A method of measuring three-dimensional scapular attitudes using the optotrak probing system.

OBJECTIVE: To develop a method to obtain accurate three-dimensional scapular attitudes and to assess their concurrent validity and reliability. STUDY DESIGN: In this methodological study, the three-dimensional scapular attitudes were calculated in degrees, using a rotation matrix (cyclic Cardanic sequence), from spatial coordinates obtained with the probing of three non colinear landmarks first on an anatomical model and second on a healthy subject. BACKGROUND: Although abnormal movement of the scapula is related to shoulder impingement syndrome, it is not clearly understood whether or not scapular motion impairment is a predisposing factor. Characterization of three-dimensional scapular attitudes in planes and at joint angles for which sub-acromial impingement is more likely to occur is not known. METHODS: The Optotrak probing system was used. An anatomical model of the scapula was built and allowed us to impose scapular attitudes of known direction and magnitude. A local coordinate reference system was defined with three non colinear anatomical landmarks to assess accuracy and concurrent validity of the probing method with fixed markers. Axial rotation angles were calculated from a rotation matrix using a cyclic Cardanic sequence of rotations. The same three non colinear body landmarks were digitized on one healthy subject and the three dimensional scapular attitudes obtained were compared between sessions in order to assess the reliability. RESULTS AND CONCLUSIONS: The measure of three dimensional scapular attitudes calculated from data using the Optotrak probing system was accurate with means of the differences between imposed and calculated rotation angles ranging from 1.5 degrees to 4.2 degrees. Greatest variations were observed around the third axis of the Cardanic sequence associated with posterior-anterior transverse rotations. The mean difference between the Optotrak probing system method and fixed markers was 1.73 degrees showing a good concurrent validity. Differences between the two methods were generally very low for one and two direction displacements and the largest discrepancies were observed for imposed displacements combining movement about the three axes. The between sessions variation of three dimensional scapular attitudes was less than 10% for most of the arm positions adopted by a healthy subject suggesting a good reliability. The Optotrak probing system used with a standardized protocol lead to accurate, valid and reliable measures of scapular attitudes. RELEVANCE: Although abnormal range of motion of the scapula is often related to shoulder pathologies, reliable outcome measures to quantify three-dimensional scapular motion on subjects are not available. It is important to establish a standardized protocol to characterize three-dimensional scapular motion on subjects using a method for which the accuracy and validity are known. The method used in the present study has provided such a protocol and will now allow to verify to what extent, scapular motion impairment is linked to the development of specific shoulder pathologies.

Biomechanical Phenomena↗

Muscle strength changes as measured by dynamometry following functional rehabilitation in individuals with spinal cord injury.

OBJECTIVE: To objectively quantify muscle strength changes over the course of functional rehabilitation and up to 15 months postdischarge in individuals with spinal cord injury (SCI). METHOD: Hand-held dynamometry was used to evaluate the strength of six muscle groups in 31 individuals after acute SCI (tetraplegia, n = 13, paraplegia, n = 18). Assessment was performed by a single research therapist at admittance and discharge from functional rehabilitation and 3 months and 15 months after discharge. RESULTS: There were significant increases of mean strength values for all muscle groups between admittance and discharge in individuals with parapalegia (median value between 13% and 22%) and tetraplegia (median value between 33% and 83%). Three months after discharge, only individuals with tetraplegia continued to significantly improve their mean strength for four muscle groups (elbow flexors-extensors and shoulder flexors-extensors). One year later, elbow flexors were significantly improved in both paraplegic and tetraplegic persons, while shoulder extensors showed significant gains only in individuals with paraplegia. Study results showed a large variability in the individual profiles of upper limb strength recovery, particularly in tetraplegic individuals. Although some individuals showed strength gains exceeding 200%, some strength decreases were noted. CONCLUSION: Recovery of muscle strength in individuals with tetraplegia over individuals with parapalegia continues for a longer period since it depends initially on recovery of muscle innervation. This study quantified strength improvements during rehabilitation and clearly showed that these gains can be maintained or even increased when the person returns to community living.

Activities of Daily Living↗

Effects of the type of meniscal lesion on knee function.

The relationship between the type of meniscal lesion (bucket-handle, flap or degenerative tears) and preoperative knee function (5.1 +/- 6.2 days before arthroscopic meniscectomy) was studied in 35 patients. Patients with bucket-handle tears (group B, n = 12) had large knee extension work deficits during maximal voluntary contractions at 30 degrees and 180 degrees/s (Kin-Com dynamometer). These work deficits were accompanied by proportional decreases in the prime mover or agonist-EMG levels (VM: vastus medialis and/or VL: vastus lateralis). These patients had smaller deficits during flexion movements at 30 degrees/s. Moreover, a larger number of negative clinical signs and symptoms (pain at rest and during tests, locking, thigh atrophy, extension and flexion movement deficits larger than 10 degrees) were found with an equal or a higher prevalence in group B than in the other groups. Patients with flap tears (group F, n = 15) had deficits in work and agonist-EMG activity (VM and VL) only during the extension tests. In contrast, patients with degenerative tears (group D, n = 8) had a work deficit and a concomitant decrease in the EMG level of the medial gastrocnemius (MG), only during the flexion test at 30 degrees/s. Comparable mean knee function scores, as measured by the Lysholm and Gillquist questionnaire [35], were obtained for the three groups of patients, suggesting that this measure was not sensitive enough to discern functional differences related to types of meniscal tears. The results of this study have demonstrated a link between the type of meniscal lesion and the consequent preoperative knee joint disability profile as defined by comparison with the sound leg. These results emphasize the need to consider meniscal lesion type and an individual's preoperative strength deficit when group comparisons of patients are made or the effects of therapy (arthroscopic surgery and rehabilitation) are evaluated.

Adult↗

Early and intensive physiotherapy accelerates recovery postarthroscopic meniscectomy: results of a randomized controlled study.

The efficacy of an early, intensive, supervised rehabilitation program to accelerate knee strength recovery in the first 3 weeks postmeniscectomy by arthroscopy was evaluated using a randomized controlled trial design. The maximal voluntary isokinetic strength of 31 men, randomly allocated to either a treatment (EXP) or a control (CTL) group, was measured twice by a blind rater: preoperatively (pretest) and 3 weeks postsurgery (posttest), using a computer-controlled Kin-Com dynamometer (Chattecx Corporation, Chattanooga, TN). Strength deficits of the operated leg at the pretest and posttest were established in percent of the values obtained for the sound leg at the pretest. In the interval between the surgery and the posttest, the patients of the EXP group (n = 15) received nine supervised treatments combined to home exercises whereas patients of the control group (n = 16) had no specific physiotherapy treatment but were given instructions in postsurgical management and prescribed exercises by the orthopedic surgeons. Patients of the EXP group had better knee extensor strength recovery than patients of the CTL group (ANCOVA, p < 0.001). The size of the strength difference (3 weeks postsurgery) between EXP and CTL subgroups (n = 8) matched according to preoperative deficits was as large as 26% and the residual deficits of the untreated patients were two to three times larger than those of the treated patients. The results of this study highlight the importance of instituting an early intensive and supervised rehabilitation program, especially for workers returning to a strenuous job requiring good knee extensor muscle function.

Activities of Daily Living↗

Impact of knee extensor strength deficits on stair ascent performance in patients after medial meniscectomy.

After arthroscopic meniscectomy the relationship between the magnitude of knee extensor strength deficits and locomotor performance during stair ascent unloaded and when carrying a 22 kg load has been tested in 31 patients. The specific locomotor adaptations related to large strength deficits were also studied. The results indicate that large deficits were significantly associated to: 1) reduced activation of the knee extensor muscles (vastus medialis and lateralis) during the first double leg support and single leg support phases, and of the hip extensors (medial hamstrings) during the second double leg support of stair ascent, 2) overactivations of the hip extensors (gluteus maximus and medial hamstrings) during single leg support, and 3) longer cycle and step durations and lower cadences. Locomotor abnormalities in movements and muscle activations were generally found in patients with strength deficits greater than 25% while patients with smaller strength deficits (less than 25%) usually could climb stairs with normal performance. These results support the use of knee extensor strength measures to predict locomotor capacities, and also highlight the importance of postoperative knee strength rehabilitation.

Adaptation, Physiological↗

Acupuncture and AIDS.

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Acupuncture Therapy↗

Dance-based exercise program in rheumatoid arthritis. Feasibility in individuals with American College of Rheumatology functional class III disease.

Many studies have demonstrated that aerobic exercise training is beneficial to prevent physical deconditioning in persons with rheumatoid arthritis (RA) without inducing adverse effects on individual's joints and general health. After significant results in individuals with RA (Functional Class I and II), the present study was conducted to demonstrate the feasibility of a modified dance-based exercise program to improve the physical fitness and psychological state of persons with RA (Class III). Ten (10) female subjects (mean age, 54 +/- 10 years) participated in an eight-week exercise program (twice weekly). Health status, use of medication, joint pain and swelling, cardiorespiratory fitness, activity of daily living, and psychological state were assessed before and after the training program. A high level of participation has been maintained by the participants (mean = 14.8/16 sessions). Most of them were able to perform a maximal exercise test on treadmill and reached 90% of the predicted heart rate at maximal exercise. No significant gain in aerobic power was observed for the group as a whole, but four subjects showed improvements of between 10% and 20% of their cardiorespiratory fitness. Positive changes in depression, anxiety, fatigue, and tension were observed after the eight-week exercise program. No deleterious effect on the health status was observed. These findings provide some evidences as to the feasibility of submitting individuals with RA to a modified dance-exercise program. Further studies, however, are required to determine the long-term effect of weight-bearing exercise on the health status of individuals with RA.

Adult↗