Biomedical subjects

S B Sepic

Publications and source records attributed to S B Sepic.

At least 19 recordsLinked to original sources

PubMed1987

Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient.

Fifteen male hemiplegic subjects were tested using the Fugl-Meyer Assessment and Barthel Index to evaluate their level of function. Walking performance using interrupted light photography and postural maneuvers while standing on a force platform were recorded for all subjects. Significant relationships were found among functional assessments, objective measures of walking, postural stability and between sections of the Fugl-Meyer Assessment. The hemiplegic subject's gait was characterized by a lack of symmetry and slow speed. Their area of stability during weight shifting was dramatically smaller than for normal men and was located closer to the non-paretic side. The results of this study lend support to the use of the Fugl-Meyer Assessment and Barthel Index as quantitative measures of hemiplegic patient's function.

Aged↗

PubMed1987

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↗

PubMed1986

Roentgenographic findings following anterior cervical fusion.

We reviewed the pre- and postoperative lateral cervical roentgenograms in 90 patients who had anterior fusions and compared their findings with age and sex-matched people without neck problems. The average interval from surgery to review was 5 years. Preoperatively, all patients had a higher incidence of degenerative spondylosis at the levels to be fused than their asymptomatic counterparts. Postoperatively, there was no difference in the incidence of degenerative change between the operated and the control group at the levels above and below the fusion with the exception of anterior osteophyte formation which was more frequent in those with fusions.

Cervical Vertebrae↗

PubMed1986

Correlations between objective measures of function and a clinical knee rating scale following total knee replacement.

Few objective measurements of function, other than range of motion, have been reported for patients with total condylar knee replacement. Moreover, to our knowledge, no studies have been reported which assess the degree of relationship between clinical ratings and measurements of function in these patients. Kinesiologic tests of function and the Hospital for Special Surgery (HSS) Knee Rating Form were used to evaluate 34 patients before and 2 years after 39 total condylar knee replacements. Prosthetic alignment was also evaluated postoperatively. The kinesiologic studies showed postoperative improvement in muscle strength, weight-bearing ability, and use of assistive devices, and in velocity, knee flexion-extension, and lateral head motion during walking. A moderate but significant degree of improvement was measured by the HSS score. Correlation coefficients showed that the postoperative knee rating score was significantly related to almost all of the postoperative objective measurements of function. Correlation coefficients between the prosthetic alignment scores and measurements of function were not statistically significant. The study strengthens the validity of use of the HSS Knee Rating Form as a tool for evaluating functional performance, particularly during the postoperative period.

Aged↗

PubMed1986

Shoulder-muscle strength and range of motion following surgical repair of full-thickness rotator-cuff tears.

Postoperative measurements of the range of motion and muscle strength of the shoulder and ratings of pain and the ability to perform daily activities were made in fifty-eight patients (sixty-three shoulders) who had a repair of a full-thickness rotator-cuff tear. Postoperatively, the patients had an average of 126 degrees of active flexion of the shoulder and an average of 130 degrees of active abduction. Passive motion averaged 21 degrees more than active motion. The strength of the abductor muscles of the shoulder averaged approximately 86 per cent of normal. Most patients reported marked relief of pain and rated themselves as having mild or no deficits in their ability to perform daily activities. The length of the cuff tear significantly affected the functional results. Short tears (less than 2.5 centimeters) were associated with greater strength and range of motion than were long tears. Fifteen of the nineteen patients who were unable to work preoperatively because of the shoulder returned to work after surgery, but not necessarily to the same type of work that they had done before the onset of the problem with the shoulder.

Acromion↗

PubMed1986

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↗

PubMed1985

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↗

PubMed1985

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↗

PubMed1985

Hip function after total vs. surface replacement.

Kinesiologic measurements were made in two groups of 20 men before and 6 and 24 months after resurfacing or conventional replacement. Before surgery the group to have resurfacing was younger, had less pain, slightly more hip motion, greater muscle strength, walked faster, and used fewer assistive devices during walking than the group to have the conventional replacement. After surgery, the group with resurfacing maintained its advantage in muscle strength and walking velocity.

Age Factors↗

PubMed1985

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↗

PubMed1984

Kinematic and EMG patterns during slow, free, and fast walking.

Kinematics and electromyographic (EMG) activity were recorded in seven normal women during walking at slow, free, and fast speeds. Speed-related differences were found in the stride dimensions, temporal components, and most of the simultaneous displacement patterns of body segments measured. For most of the muscles tested, the amplitude of normalized EMG activity decreased as walking speed decreased. The findings emphasize the importance of accounting for the effect of speed itself on measurements of gait.

Adult↗

PubMed1984

Anterior cervical fusion for degenerated or protruded discs. A review of one hundred forty-six patients.

The results of 146 patients with anterior cervical intervertebral disc removal and fusions are reviewed. The diagnosis was cervical spondylosis in 75%, disc protrusion in 16%, and spondylosis at one level with disc protrusions at another in 9%. There were 81 women and 65 men with an average age of 48 +/- 9 years. The average follow-up was 5 +/- 3.3 years. The rate of fusion was 97%. Complete pain relief occurred in 78%, partial in 18% and little or no pain relief in 4%. There were no serious complications, and none of the patients thought they were made worse by surgery.

Adult↗

PubMed1984

Function after revision of failed total hip arthroplasty.

Measurements of functional performance were made before and 6 months after 31 primary total hip replacements and 31 total hip revisions for prosthetic loosening. After revision, functional performance returned to levels substantially the same as after primary hip replacement except for greater reliance on canes for patients in the revised group. Ratings of hip status and hip pain were slightly less satisfactory after revision as compared to after the primary operation.

Adult↗

PubMed1983

Gait patterns in above-knee amputee patients: hydraulic swing control vs constant-friction knee components.

Multiple displacement patterns, stride dimensions, and temporal components during slow, free-speed, and fast walking were compared in the same seven above-knee amputees using prostheses with constant-friction knee components and using hydraulic swing-control knee components. During walking with the hydraulic-type prostheses, the amputees showed a wider range of walking speeds, improvement in the equality of the durations of successive swing and stance phases, and greater uniformity of forward progression. Improvements toward normal were also seen in several of the displacement patterns of the prosthetic limb during walking with the hydraulic knee. Several gait abnormalities persisted with both types of prostheses.

Adult↗

PubMed1982

Anterolateral compared to posterior approach in total hip arthroplasty: differences in component positioning, hip strength, and hip motion.

In order to identify the functional advantages or disadvantages between the anterolateral and the posterior approaches to total hip arthroplasty, measurements of prosthetic position, hip-muscle strength, and hip joint mobility were made after Müller total hip arthroplasty without osteotomy in 52 patents operated through a posterior approach and 41 patients operated through an anterolateral approach. Men and women who had the posterior approach had less prosthetic component anteversion and longer neck lengths, with resultant more lateral and distal placement of the greater trochanter than groups with the anterolateral approach. Groups with the posterior approach had more normal hip abductor-muscle strength and more inward rotation on the operated side than group with the anterolateral approach. Groups with the anterolateral approach had more outward rotation on the operated side than groups with the posterior approach. These differences in function were related to the surgical approach rather than to differences in component position. An understanding of these observations should be used for selection of the surgical approach for the patient on an individual basis.

Biomechanical Phenomena↗

PubMed1979

A comparison of the funtional performance of patients with Charnley and Müller total hip replacement. A two-year follow-up of eighty-nine cases.

Measurements of functional performance in 35 cases with Charnley total hip replacement were compared with those of 54 cases with Müller replacement before surgery and at 6- and 24-month follow-up intervals. The measurements included strength of the hip abductor and adductor muscles, hip motion, the amount of weight borne on the involved limb during standing posture, multiple components of free-speed and fast walking, and force applied to canes and crutches. Both replacement groups improved significantly in most components of function. In fact, both groups reached or nearly reached the lower limits of normal variability in weight-bearing ability, cadence, and some components which relate to smoothness of walking performance. The groups with Müller and Charnley replacement differed most in some components of range of hip motion, hip muscle strength, and lateral lurching during walking.

Adult↗

PubMed1978

Function of the triceps surae during gait. Compensatory mechanisms for unilateral loss.

We studied the gait of a woman who was normal except for surgical excision of the gastrocnemius and soleus muscles. She was able to compensate for nearly all of her abnormalites of gait by excessive lateral pelvic tilt and prolonged quadriceps activity. Her mild disability, as regards gait, consisted of inability to increase walking speeds beyond the normal pacing. However, despite uneven step lengths, she had uniform forward progression. She had excessive dorsiflexion of the ankle and diminished plantar flexion on the involved side even though the retained plantar flexors could provide 38 per cent of her normal plantar flexor strength.

Adult↗

PubMed1978

Walking patterns of men with parkinsonism.

Interrupted-light photography was used to record the simultaneous displacement patterns of multiple body segments of 44 patients with parkinsonism during free-speed and fast walking to quantitatively characterize their gait peculiarities. The patients were categorized into three disability groups according to their independence in activities of daily living. Their measurements of walking performance were compared to those of normal men. The gait components of the patients, which related systematically to the degree of disability, were: step lengths, vertical excursions of the head, extension of the hip and knee of the backward-directed limb at the onset of contralateral weight bearing, toe-floor distance at the onset of weight bearing, and rotation of the thorax.

Activities of Daily Living↗