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Biomedical subjects

L A Mollinger

Publications and source records attributed to L A Mollinger.

9 recordsLinked to original sources

Function following partial fibulectomy.

The fibula is a valuable source of a bone graft, but because the fibula has a role in lower extremity function, it is important to determine whether partial removal results in dysfunction or other problems. Forty-one patients (48 +/- 10 years of age) had a portion of their fibula removed for a bone graft. At evaluation 27 +/- 8 months later, 24 had no pain, 11 mild pain, and six moderate or severe pain. Sixteen had no complaints of any kind, but four without pain had minor difficulties with vigorous activities, and three complained of ankle swelling. There were no differences in range of motion between the operated and nonoperated side. Average muscle torque was lower on the operated than on the nonoperated side, but this difference was statistically significant only for ankle evertors in men. This study demonstrates that most patients will have subjective complaints and mild muscular weakness after removal of a portion of the fibula.

Adult

Comparison of function two years after revision of failed total hip arthroplasty and primary hip arthroplasty.

Because of the known high complication rate, it is important for both the patient and physician to know as much as possible about the outcome of revision operations for loosened total hip arthroplasties. This study evaluates the changes in subjective ratings and objective kinesiologic measurements from before revision operations through two years after revision operations. The object is to compare these measurements with the measurements of a group of patients with primary replacements. Both groups of patients showed significant improvement in most parameters from before to after surgery. These parameters included walking performance, hip muscle strength, range of motion, forces applied to canes, and the amount of weight borne on the operated limb during quiet standing. Compared to the control group with primary replacements, the group with revision used more assistive devices, had less pain relief, walked slower, had less hip motion, and had more lateral lurch. While results after revision surgery were not as gratifying as those after primary hip replacement, patients requiring revision can still anticipate substantial improvement.

Adult

Strength and range of motion in the ankle in two age groups of men and women.

Strength and range of motion of the ankle were measured in 20 normal men and 20 normal women divided equally into two age groups (25-35 and 50-60 years). Total range of dorsiflexion/plantar flexion averaged 75 degrees and the total range of inversion/eversion averaged 28 degrees. Few significant differences in range of motion were found between age groups, between men and women, or between dominant and nondominant limbs. Mean torque values for the men were greater than those for the women for all four muscle groups tested (plantar flexors, dorsiflexors, invertors and evertors). Strength of the women ranged from 62 to 70 percent of that of the men, depending upon muscle group. A multiple regression analysis showed that after the variability in muscle strength due to height and lean body weight had been taken into account, the additional variance accounted for by gender was very small. Differences in torque between age groups were not statistically significant. Differences in strength between dominant and nondominant limbs were significant only for the plantar flexors and dorsiflexors of the men.

Adult

Age-related differences in knee muscle strength in normal women.

This study provides normal baselines of knee muscle strength for women up to 86 years of age. Knee muscle strength (torque) was measured during maximum isometric and dynamic (isokinetic) contractions in 72 normal healthy women in three age groups between 20 and 86 years. Strength of the oldest group ranged from 56 to 78% of that in the youngest group, depending on knee joint position. Strength values were greater for isometric contractions than for isokinetic contractions (performed at 36 degrees per second) and were approximately twice as great for the extensor as for the flexor muscles. For both muscle groups, the torque generated with the knee in 30 degrees of flexion was usually lower than that generated with the knee at the 45- or 60-degree position. Despite the significant deficit found in the strength of the oldest group, it is likely that this relative weakness would not be detected on routine clinical examination using manual muscle testing.

Adult

Treadmill vs. floor walking: kinematics, electromyogram, and heart rate.

To identify the degree of difference between treadmill and floor walking, kinematic, electromyographic (EMG), and heart rate measurements were recorded in seven normal female subjects during walking at three speeds on the treadmill and on the floor. During treadmill walking, subjects tended to use a faster cadence and shorter stride length than during floor walking. In addition the displacements of the head, hip, and ankle in the sagittal plane showed statistically significant differences between floor and treadmill walking. Average EMG activity was usually greater on the treadmill than on the floor; however, this difference was only significant for the quadriceps. Heart rate was significantly higher during fast treadmill walking than floor walking. In general, treadmill walking was not found to differ markedly from floor walking in kinematic measurements or EMG patterns.

Adult

Functional performance after tibial rotationplasty.

We measured muscle strength, joint motion, and gait parameters and determined the electromyographic activities of the ankle and knee during walking, running, and stair-climbing in two children who had had a tibial rotationplasty for osteosarcoma of the distal end of the femur. Both had marked loss of strength in the plantar flexors on the side of the prosthesis compared with the sound side, although electromyographic recordings showed that the rotated calf muscles, to a substantial degree, had assumed the function of extensors of the prosthetic knee. Despite some abnormalities in gait, both children walked at speeds that were comparable to those of normal children. They could also run, climb stairs by stepping up with both limbs, and participate in many recreational activities. The functional abilities of these children suggested that rotationplasty, in patients with a similar lesion, is a worth-while alternative to above-the-knee amputation.

Artificial Limbs

Daily energy expenditure and basal metabolic rates of patients with spinal cord injury.

Basal metabolic rate (BMR) and daily energy expenditure were measured in 48 men with complete traumatic transections of the spinal cord. Subjects were classified according to their residual motor function as high or low quadriplegic (HQ, LQ) or as high or low paraplegic (HP, LP). Measured BMR was lower than predicted BMR in almost all of the subjects and was significantly lower in the HQ group than in the other groups. High quadriplegics also expended significantly less energy while awake and over a 24-hour period than did the other groups. Measurements of BMR and total energy expenditure were significantly correlated with the level of lesion. The data provide a basis for establishing guidelines on the average energy needs of patients with spinal cord injury.

Adult

Antalgic maneuvers during walking in men with unilateral knee disability.

The gait of men with unilateral knee disability has not been quantified previously. Interrupted-light photography was used to quantify the gait abnormalities of 35 men whose major disability was unilateral knee pain. The following antalgic maneuvers were found to be common to the gait of these patients: slow and uneven forward progression with lateral lurching toward the painful side, asymmetry in stride and temporal components, and abnormalities in the displacement patterns of most body segments. Subnormal knee motion was found during the stance and swing phases. Because treatment of patients with knee problems is usually directed toward pain relief, an understanding of how pain affects walking performance is important to the clinician when assessing a patient's problem.

Adult

Shoulder motion and muscle strength of normal men and women in two age groups.

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.

Adult