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Purpose The classic periacetabular osteotomy (PAO) approach can result in hip flexor weakness in adolescents. The rectus-sparing approach (PAO-RS) preserves the origin of the rectus femoris tendon which may prevent hip flexor weakness and improve functional outcome. Methods This is a prospective analysis of adolescents treated with a PAO or PAO-RS. The PAO group included 24 hips/21 patients (18 female, meanage 16 years (sd 4)); the PAO-RS group included ten hips (eight female, mean age 16 years (sd 1)). Preoperatively, the PAO group had decreased hip flexion strength compared with the PAO-RS group (83 Nm/kg versus 102 Nm/kg). A subset of PAO patients (n = 13 hips/12 patients, nine female, mean age 15 years (sd 3)) were matched for preoperative flexion strength to the PAO-RS group. Radiographic parameters, modified Harris hip score (mHHS), isokinetic hip strength and instrumented motion analysis preoperatively, six months and one-year postoperatively were compared. Results There were no differences in preoperative deformity, postoperative correction or degree of correction between groups. Hip flexor strength decreased significantly at six months in the PAO group compared with the PAO-RS group (-35 Nm/kg versus -7 Nm/kg; p = 0.012), as did hip flexion pull-off power (1.33 W/kg PAO versus 1.76 W/kg PAO-RS; p = 0.010). Hip flexion strength improved from six months to one year in the PAO group, with no significant differences in strength at one year between groups (80 Nm/kg versus 90 Nm/kg). There were no differences between groups in mHHS any time point; both groups improved significantly postoperatively. Conclusion Preserving the rectus femoris may lead to improved short-term hip flexor strength and pull-off power. Further assessment at long-term follow-up is needed to determine if this strength leads to improved functional outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Accelerometer based devices have been widely used to assess the ambulatory activity of children with and without functional disabilities. Many researchers who utilize the StepWatch Activity Monitor (SAM) collect at a 60second (60sec) interval setting. The purpose of this study was to assess the effect of SAM interval settings on ambulatory activity outputs in children with cerebral palsy (CP) and typically developing youth.Methods: Participants wore a SAM which recorded the number of strides every 10seconds (10s) for one week. Raw 10s data was downsampled to combine strides into 60sec intervals. Strides were ensembled into walking bouts with the Intensity/Duration calculated as a percentage of Total Ambulatory Time (TAT).Results: Twenty-eight children with CP (14 boys; avg. 12 yrs. 4 mths.; GMFCS Level I n=4, Level II n=19, Level III n=5) completed testing and 28 age matched typically developing youth (14 boys; avg. 12 yrs. 6 mths.) were included. Using the 10sec interval, ∼80% of walking bouts in both groups were less than or equal to 60s. Data recorded at 60sec intervals had higher daily TAT but fewer walking bouts. In children with CP, daily steps were higher using the 60sec interval. At the Easy intensity, the 60sec interval reported an increased volume of Long duration walking, and it rarely identified any Moderate+ intensity activity.Conclusions: 60sec interval data overestimated low intensity and long duration ambulatory activity. It is imperative that investigators choose a finer interval setting (10sec) to maximize the detection of gait transitions and rest periods which are critical in describing community ambulation of patients with cerebral palsy. [ABSTRACT FROM AUTHOR]

Background: Discriminatory practices against minority populations are prominent, especially in the workplace. In particular, lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals experience several barriers and stressors more often than individuals who do not identify as LGBTQ+. Mistreatment is common among these individuals in their personal and professional lives. However, representation and perceptions of discrimination and bullying among attendings, residents, medical students, and other professionals who identify as LGBTQ+ and are "out" (openly acknowledging and expressing one's sexual orientation or gender identity) is seldom studied in orthopaedic surgery. Questions/purposes: (1) How often are orthopaedic trainees and professionals who identify as LGBTQ+ out in their workplaces? (2) What proportion of these individuals report experiencing discrimination, bullying, or differential treatment? (3) Is there regional variation in these reported experiences of bullying and discriminatory behaviors by orthopaedic trainees and professionals in the LGBTQ+ community?. Methods: Individuals registering for Pride Ortho, a community of LGBTQ+ individuals and their allies established in 2021 to provide mentorship, networking, and a sense of community among its members, completed an internetbased survey developed by organization leadership. A total of 156 individuals registering for the Pride Ortho community were eligible to participate in the internet-based survey. In all, 92% (144 of 156) fully completed the survey, 6% (10 of 156) partially completed it, and 1% (2 of 156) did not complete any part of the survey. Most respondents (64% [100 of 156]) identified as being LGBTQ+, with 77 members at the attending level of their careers. More than half of LGBTQ+ members (56% [56 of 100]) identified as cisgender women (individuals who identify as women and who were born female). Demographic information was privately collected and deidentified, and included sex assigned at birth, gender expression or identity (the social constructed role that an individual chooses to inhabit, regardless of that individual's assigned sex at birth), sexual orientation, self-identified race, location, level of training, and orthopaedic subspecialty. Results: Ninety-four percent (94 of 100) of LGBTQ+ respondents reported being out at their workplace, with nearly one-third of respondents indicating they were only partially out. Most (74% [74 of 100]) respondents reported either "yes" or "maybe" to perceived experiences of bullying, discrimination, or being treated differently. All individuals who partially completed the survey were straight or heterosexual and did not answer or answered "not applicable" to being out in their workplace. These individuals also all answered "no" to experiencing bullying, discrimination, or being treated differently. There was no geographic variation in reported experiences of bullying and discriminatory behaviors by orthopaedic trainees and professionals. Conclusion: Most LGBTQ+ orthopaedic trainees and professionals are out in their workplaces, although they report experiencing discrimination and bullying more than do non-LGBTQ+ individuals. Bullying and discrimination can deter individuals from beginning and completing their training in orthopaedic surgery. We recommend that orthopaedic institutions not only enforce existing antidiscrimination legal mandates but also increase the visibility of LGBTQ+ faculty and residents. This effort should include the implementation of diversity and sensitivity training programs, strengthened by a structured process of monitoring, reporting, and integrating feedback from all members in the workplace to continuously refine policy adherence and identify the root cause of the reported perceptions of bullying and discrimination. Clinical Relevance: To deepen our understanding of the experiences faced by sexual and gender minorities in orthopaedic surgery settings, it is crucial to quantify reports of perceived bullying and discrimination. Addressing these issues is key to creating a more diverse and empathetic workforce within orthopaedic institutions, which in turn can lead to improved patient care and a better work environment. Recognizing and understanding the specific contexts of these experiences is an essential starting point for developing a truly inclusive environment for both trainees and attending physicians. [ABSTRACT FROM AUTHOR]

SARS COVID-19 pandemic resulted in major changes to how daily life was conducted. Health officials instituted policies to decelerate the spread of the virus, resulting in changes in physical activity patterns of school-aged children. The aim of this study was to utilize a wearable activity monitor to assess ambulatory activity in elementary-school aged children in their home environment during a COVID-19 Stay-at-Home mandate. This institutional review board approved research study was performed between April 3rd – May 1st of 2020 during which health officials issued several stay-at-home (shelter-in-place) orders. Participant recruitment was conducted using a convenience sample of 38 typically developing children. Participants wore a StepWatch Activity Monitor for one week and data were downloaded and analyzed to assess global ambulatory activity measures along with ambulatory bout intensity/duration. For comparison purposes, SAM data collected before the pandemic, of a group of 27 age-matched children from the same region of the United States, was included. Statistical analyses were performed comparing SAM variables between children abiding by a stay-at-home mandate (Stay-at-Home) versus the Historical cohort (alpha=0.05). Stay-at-Home cohort took on average 3737 fewer daily total steps compared to the Historical cohort (p<0.001). Daily Total Ambulatory Time (TAT), across all days was significantly lower in the Stay-at-Home cohort compared to the Historical cohort (mean difference: 81.9 minutes, p=0.001). The Stay-at-Home cohort spent a significantly higher percentage of TAT in Easy intensity ambulatory activity (mean difference: 2%, p<0.001) and therefore a significantly lower percentage of TAT in Moderate+ intensity (mean difference: 2%, p<0.001). The stay-at-home mandates resulted in lower PA levels in elementary school-aged children, beyond global measures to also bout intensity/duration. It appears that in-person school is a major contributor to achieving higher levels of PA and our study provides additional data for policymakers to consider for future decisions. • Wearable sensor data during COVID-19 restrictions provided meaningful data. • Elementary school-aged children had lower global activity measures. • Stay-at-home mandates resulted in lower Moderate intensity ambulatory activity. • A higher percentage of time was spent at an Easy ambulatory intensity. • Ambulatory bout intensity/duration analysis techniques revealed greater insights. [ABSTRACT FROM AUTHOR]

Femoroacetabular impingement (FAI) is a condition where the femoral head-neck junction collides with the acetabulum. Open or arthroscopic treatment of FAI aims to increase hip motion while reducing impingement during passive or dynamic movements. What are the biomechanical characteristics of the hip and pelvis in adolescents and young adults diagnosed with FAI syndrome 1) pre-operatively compared to controls and 2) pre- to post-operatively? 43 patients with FAI and 43 controls were included in the study. All patients with FAI had cam deformities and underwent unilateral hip preservation surgery (either open or arthroscopic). Pre- and post-operative imaging, patient-reported outcomes, and gait analysis were performed. Joint angles and internal joint moments were evaluated with an emphasis on the pelvis and hip. A comparative analysis was conducted to evaluate the gait patterns before and after surgical treatment, as well as to compare pre-operative gait patterns to a control group. 43 patients with FAI (28 female, 16.5 ± 1.5 yrs) and 43 controls (28 female, 16.0 ± 1.5 yrs) were included. Pre-operative patients with FAI had decreased stride length and walking speed compared to controls, with no significant change following surgery. There were no differences in sagittal and coronal plane hip and pelvis kinematics comparing pre- to post-operative and pre-operative to controls. Pre-operatively, differences in internal hip rotation angle (pre: 3.3˚, post: 3.9˚, controls: 7.7˚) and hip extensor moment (pre: 0.121, post: 0.090, controls: 0.334 Nm/kg) were observed compared to controls with no significant changes observed following surgery. Compensatory movement strategies in pelvic and hip motion are evident during gait in patients with FAI, particularly in the sagittal and transverse planes. These strategies remained consistent two years post-surgery. While surgery improved radiographic measures and patient-reported outcomes, gait did not elicit biomechanical changes following surgical treatment. • Biomechanical outcomes following surgery for femoroacetabular impingement is varied • Pelvis and hip kinematics during gait did not change following surgical treatment • Joint kinetic differences evident pre-operatively did not improve post-operatively [ABSTRACT FROM AUTHOR]

Introduction: Simulations suggest that subjects with reduced hip range of motion (ROM) and/or weakness can achieve more normal walking mechanics through compensations at the ankle. The aims of this study were to assess whether subjects with reduced hip ROM (Stiff hip) or hip flexor weakness (Weak hip) exhibit ankle compensations during walking and investigate redistribution of power in the lower extremity joints.Methods: Retrospective gait data were reviewed (IRB-approved hip registry). Preoperative kinematic/kinetic walking data were collected in patients with: adolescent hip dysplasia (AHD), femoral acetabular impingement (FAI), and Legg-Calvé Perthes disease (Perthes). AHD patients with significantly weak hip flexors on their affected side were included (Weak hip group). The Gait Profile Score (GPS) was calculated on the affected side of the FAI and Perthes groups to identify patients who had a Stiff hip. Patients who had undergone a hip arthrodesis (Fusion) were also included (Stiff hip group). Ankle kinematics/kinetics were compared to healthy participants (Control). The total positive work of sagittal plane hip, knee and ankle power were compared along with the distribution of power.Results: Patients in the Weak/Stiff hip groups did not walk with greater ankle plantarflexion, peak push-off power or positive ankle work on their affected sides compared to Control. Ankle work contribution (percentage of total positive work) on the affected or unaffected sides was greater in the Perthes and Hip Fusion patients compared to Control. Significant gait abnormalities on the unaffected side were observed.Conclusions: Patients with a weak or stiff hip did exhibit altered ankle mechanics during walking. Greater percent ankle work contribution appeared to correspond with hip stiffness. In patients with hip pathology the redistribution of power among the lower extremity joints can highlight the importance of preserving ankle function. [ABSTRACT FROM AUTHOR]

The drop vertical jump (DVJ) is commonly used in return-to-play evaluations to assess movement quality and risk during a dynamic task. However, across biomechanics literature, a multitude of DVJ variations have been used, influencing the generalizability and potential interpretation of the reported findings. The purpose of this study was to identify differences in lower extremity kinematics and kinetics between DVJ variations that differ based on horizontal jump distance, verbal instructions, and the use of a jump target. A single-group repeated measures design was used in a laboratory setting. Twenty participants were tested, and three-dimensional angles and moments of the pelvis, hip, knee, and ankle were computed. Wilcoxon signed rank tests were performed to determine differences between DVJ variations. Reduced knee flexion at initial contact and greater knee extensor moments across the descent phase were observed with increased horizontal jump distance. Additionally, both verbal instructions and a jump target influenced movement strategies at the pelvis, hip, and knee. Ground reaction forces were found to be similar across conditions and jump height following the first landing increased with a target. Although subtle, the biomechanical differences observed between task variations emphasize the importance of standardizing motion analysis protocols for research and clinical decision-making. Given the findings of the current study, the authors recommend using the Half Height variation in patients treated for a knee injury as it will likely be the most indicative of movement quality. • Greater horizontal jump distance led to reduced knee flexion at initial contact. • Greater knee extensor moments across descent were found with further jump distance. • Verbal instructions and a jump target altered pelvis, hip, and knee mechanics. • Jump height following the first landing increased with the use of a jump target. • Motion analysis protocols for clinical / research assessments must be standardized. [ABSTRACT FROM AUTHOR]

Limb asymmetry is an important consideration when evaluating rehabilitation progress or re-injury risk. The drop vertical jump (DVJ) task is commonly used to assess landing mechanics; however, the extent to which task setup influences limb asymmetry is unknown. Our purpose was to examine limb asymmetries across DVJ variations. We hypothesized that more demanding variations involving greater jump distance and target use would elicit greater landing asymmetries. Participants performed six DVJ variations while lower extremity joint kinematics and kinetics were collected. Joint angles and internal moments of the hip, knee and ankle were computed at initial contact and over the decent phase of the initial landing. The horizontal jump distance and the verbal instructions provided on how to jump off the box influenced limb asymmetries. The DVJ variation without a horizontal jump distance resulted in significant differences at the hip and knee; specifically, greater hip and knee flexion asymmetry (7.0° and 15.2° differences, respectively) were observed between limbs at initial contact. Instructions restricting take-off and landing strategies reduced asymmetry; this indicates that verbal instructions are critical to avoid altering natural landing mechanics. To best utilize DVJ as a tool, study protocols should be standardized to allow for more generalizable research and clinical findings. [ABSTRACT FROM AUTHOR]

There appears a linear relationship between small increases in running speed and cardiovascular health benefits. Encouraging or coaching recreational runners to increase their running speed to derive these health benefits might be more effective if their joint level kinematic and kinetic strategy was understood. The aim of this investigation was to compare the peak sagittal plane motions, moments, and powers of the hip, knee and ankle at 85%, 100%, 115% and 130% of self-selected running speed. Overground running data were collected in 12 recreational runners (6 women, 6 men) with a full body marker set using a 12-camera Vicon MX system with an AMTI force plate. Kinematics and kinetics were analyzed with Vicon Nexus software. Participants chose to run at 2.6 ± 0.5 m/s (85%); 3.0 ± 0.5 m/s (100%); 3.3 ± 0.5 m/s (115%); and 3.7 ± 0.5 m/s (130%); these four speeds approximately correspond to 6:24-, 5:33-, 5:03-, and 4:30-min kilometer running paces. Running speed had a significant effect ( P  < 0.05) on peak kinematic and kinetic variables of the hips, knees and ankles, with peak sagittal hip moments invariant ( P  > 0.54) and the peak sagittal ankle power generation ( P  < 0.0001) the most highly responsive variable. The timing of the peak sagittal extensor moments and powers at the hip, knee and ankle were distributed across stance in a sequential manner. This study shows that running speed affects lower limb joint kinematics and kinetics and suggests that specific intersegmental kinetic strategies might exist across the narrow range of running speeds. [ABSTRACT FROM AUTHOR]

Background: The step-down tap (SDT) is a commonly used task to assess unilateral neuromuscular control and to identify deficient movement patterns of the trunk and lower extremities. However, instruction of the SDT varies greatly in recent reports, which may alter the clinical interpretation of potential movement deficiencies.Research Question: The purpose of this study was to identify differences in trunk and lower extremity kinematics between variations of a step-down tap that differ based on step direction, fixing the arms or stance foot, and trial collection methods.Methods: This study followed a single-group repeated measures design in a laboratory setting. Three-dimensional angles of the trunk, hip, and knee of 18 participants were evaluated at 60 degrees of knee flexion and at maximum squat depth during six SDT variations. Wilcoxon signed rank tests were performed to determine the effects of an anterior verse lateral step direction, a fixed arm or stance foot position, and an individual verse continuous trial collection method.Results: Knee flexion, external pelvic rotation, and external trunk rotation were greater in the anterior SDT, while the lateral SDT elicited greater pelvic tilt and hip flexion. Additionally, overall squat depth was greater across participants during the anterior SDT. Few clinically significant differences (≥3°) were observed due to fixing arm or stance foot position, and no differences were identified based on trial collection methods.Significance: The standardization of task instructions for motion analysis protocols utilized for research purposes and/or clinical decision-making is crucial. Specifically, for the SDT, the authors recommend using the anterior step direction. A fixed arm and stance foot position is not necessary, and trials may be collected individually or continuously based on convenience for a small number of repetitions. [ABSTRACT FROM AUTHOR]

The Gait Profile Score (GPS) requires a comparative dataset, to identify altered mechanics in persons with a gait abnormality. This gait index has been shown to be useful for identifying gait pathology prior to the assessment of treatment outcomes. Though studies have shown differences in kinematic normative datasets between different testing sites, there is limited information available on the changes in GPS score based on normative dataset selection. The aim of this study was to quantify the influence of normative reference data from two institutions, on the GPS and Gait Variable Scores (GVS), calculated on the same group of patients with Cerebral Palsy. Seventy patients (Avg. age: 12.1 ± 2.9) diagnosed with CP underwent gait analysis during walking at a self-selected speed at Scottish Rite for Children (SRC). GPS and GVS scores were determined using normative kinematic data at a self-selected speed from, 83 typically developing children ages 4–17 from Gillette, and the same age range of children from SRC's normative dataset. Average normalized speed was compared between institutions. Signed rank tests were performed on the GPS and GVS scores using each institution's dataset. Spearman's correlations between scores using SRC and Gillette were determined within GMFCS level. Normalized speed was comparable between each institution's datasets. Within each GMFCS level, significant differences when using SRC vs. Gillette were found in most scores (p < 0.05). Scores were moderately to strongly correlated within each GMFCS level (range ρ = 0.448–0.998). Significant statistical differences were found in GPS and GVS scores but were within the range of previously reported variation across multiple sites. Caution and consideration may need to be taken when reporting GPS and GVS scores that are calculated utilizing different normative datasets as these scores may not be equivalent. • Gait Profile scores are influenced by normative dataset selection. • Children with Cerebral Palsy will have different Gait Profile Scores. • Consistency across studies should be a consideration when reporting outcomes. [ABSTRACT FROM AUTHOR]

Accurate assessment of balance recovery throughout treatment of a sport-related concussion is imperative. This study examined differences in balance from diagnosis to return-to-play initiation in adolescent patients post-concussion. Second, this study investigated the extent to which the Balance Error Scoring System (BESS) correlated with center-of-pressure (COP) measures. Forty participants performed the BESS while standing on a force platform such that COP data were obtained simultaneously. Spatial and velocity COP-based measures were computed for the double-stance conditions. BESS scores and COP-based measures indicated improved balance performance between visits. Specifically, 62.5/65.0% of participants exhibited improved firm/foam BESS final scores, respectively, and 56.4–71.8% exhibited improved COP-based measures. However, once normative ranges were referenced to identify maintained performance, the percentage of participants who substantially improved differed from initial findings (BESS: 2.5/7.5%, COP: 48.7–69.2%). Additionally, positive correlations between balance measures were primarily found at diagnosis (r=0.33–0.53), while only three correlations were maintained at return-to-play initiation (r=0.34–0.39). BESS scores successfully identified poor balance performance at diagnosis when symptoms were most pronounced, but failed to accurately depict performance once balance impairment, indicated by COP-based measures, became less apparent. Further work is needed to implement more advanced balance assessments into clinical environments. [ABSTRACT FROM AUTHOR]

The Trendelenburg test has been used to assess hip abductor muscle function. A standardized evaluation of the test requires an assessment of both pelvis and trunk coronal plane alignment as the patient stands on one leg for 30 s. Coronal plane biomechanics using motion analysis allows for development of objective criteria to grade the test response. The aim of this study was to develop biomechanical criteria of the pelvis and trunk coronal plane kinematics. The video of 39 subjects with acetabular hip dysplasia performing the test while instrumented with a full-body modified Plug-In-Gait marker set for three-dimensional kinematic analysis, were evaluated by two orthopedic surgeons and one senior level biomechanist. Reviewers as a group assessed whether the subject had a positive test and noted the reason using guidelines outlined in the literature. Coronal plane trunk and pelvic angles of all subjects were analyzed and Receiver Operating Characteristic curves were used to determine optimal kinematic cutoff values for each positive Trendelenburg test reason. There were 26/39 patients who reviewers identified as having a positive test. Area under the curve of the receiver operating characteristic curve for trunk and pelvis mean/minimum were greater than 0.75. The curve was used to identify the optimal cut-offs of trunk lean and pelvic obliquity mean/minimum. The biomechanical criteria developed includes clinically derived coronal plane kinematic cut-offs of the pelvic and trunk angles. The criteria can be used within a motion capture setting for the standardization of the grading of the test response. • Reviewers identified Trendelenburg Test responses in hip dysplasia patients. • Kinematic data from trunk and pelvic angles can be used to grade responses. • Optimal kinematic cut-offs identified were to fair and good accuracy. • Biomechanical criteria allow for an objective assessment. [ABSTRACT FROM AUTHOR]

The vector coding technique has been used to quantify coordination of two joints, segments, and/or planes during cyclic activities, such as walking. Coordination patterns can be identified by categorizing the tangent lines of an angle-angle plot by their direction, termed "coupling angle binning" or "phase binning". In the literature the ranges of directions, or "bins", originally divided by Chang et al. and more recently by Needham et al. have different strengths. Chang's method identifies general patterns with large bins while Needham's method identifies a dominant joint or segment in the pattern. This study created a novel method that incorporates bin categories from both methods, and therefore recognizes both general patterns and a dominant contributor when appropriate. This new method, the SRC method, as well as the two existing methods, were used to quantify knee-ankle coordination in the sagittal plane for healthy individuals and an individual with clubfoot during gait. Similarities and differences in classification between methods were compared and further investigated by interpreting the uncoupled angular data. Each method was then used to evaluate sagittal-coronal coordination of the forefoot in an individual with clubfoot during gait. This was done to demonstrate across-plane coordination analysis, to confirm that the advantages of the combined method extend to coupling pairs with like ranges of motion, and to present a clinical application. It was found that the TSRH binning methods provides a more complete description of coordination by including coordination categories defined by both the Chang and Needham method. [ABSTRACT FROM AUTHOR]

Introduction: Squatting biomechanics assessed using motion analysis relies on the identification of specific events: start of descent, transition between descent/ascent and end of ascent. Automated identification reduces the time needed to process trials while allowing consistency across studies. The purpose of this study was to develop criteria for the identification of events and apply them to two squatting protocols in pathological patient and typically developing (TD) groups.Methods: Thirty-four subjects with hip dysplasia and 41 TD subjects were enrolled in this study. While instrumented with a full-body Plug-In-Gait marker set, participants performed two squatting protocols: a hold squat, where subjects paused for a count of three at their lowest squat depth, and a traditional squat, where the descent phase was immediately followed by the ascent phase. Reviewers analyzed the kinematic/kinetic waveforms of a subset of trials to develop criteria for events. Sagittal plane knee and vertical center of mass velocities were used to identify events and absolute vs. relative thresholds of the peak knee velocity were compared. These criteria were incorporated into an automatic event detection code.Results: Using a relative threshold algorithm, events were automatically identified in 244 of 259 total trials (94%). For the trials requiring manual placement of events (n=15 trials), there was perfect inter-rater reliability between research personnel.Conclusions: The criteria developed for the automatic detection of squatting events was highly successful for both protocols in each participant group and was also highly reliable for research personnel to follow in the few instances where manual placement was necessary. [ABSTRACT FROM AUTHOR]

Technological advancements have generated more opportunities to develop/distribute custom data analysis codes (e.g., automated events, biomechanical models, etc.). Industry standards for the code development process is regularly modeled to ensure product quality and usability. Procedural project management improves efficiency of the code development process by monitoring project planning, duration, analysis, success, and maintenance. The purpose of this study was to outline in the form of guidance to research labs, a framework that standardizes the development, management, testing, and documentation of various types of data analysis codes, utilized in the motion analysis laboratory setting. This brief report outlines the workflow, briefly highlights its success a year after implementation, and provides a framework that can be adopted across laboratories of different sizes and those involved in multi-center collaborative studies. Specifically, the workflow outlined is initiated when a requestor has identified the need for a custom data analysis code. The workflow is complete and the code is released once the results of testing performed by a non-affiliated user, verifies that the code project workflow was followed appropriately, confirms a standard operating procedure has been finalized, and ensures the requestor and additional end-users are satisfied with the final product. Guidance documents and optimization of workflows are imperative for motion analysis laboratories managing numerous coding projects. Implementation of the proposed framework is an effective approach to reduce workload, by minimizing redundancies, maximizing on the research team's expertise and promotes collaborative input which in turn allows for feedback along the process. • A structured development workflow improves efficiency and ensures quality. • The development process must consider all potential end-users to ensure usability. • Implementation of this framework facilitates movement science lab collaboration. [ABSTRACT FROM AUTHOR]

Sensorimotor cortex plasticity induced by constraint-induced movement therapy (CIMT) in six children (10.2 ± 2.1 years old) with hemiplegic cerebral palsy was assessed by functional near-infrared spectroscopy (fNIRS). The activation laterality index and time-to-peak/duration during a finger-tapping task and the resting-state functional connectivity were quantified before, immediately after, and 6 months after CIMT. These fNIRS-based metrics were used to help explain changes in clinical scores of manual performance obtained concurrently with imaging time points. Five age-matched healthy children (9.8 ± 1.3 years old) were also imaged to provide comparative activation metrics for normal controls. Interestingly, the activation time-to-peak/duration for all sensorimotor centers displayed significant normalization immediately after CIMT that persisted 6 months later. In contrast to this improved localized activation response, the laterality index and resting-state connectivity metrics that depended on communication between sensorimotor centers improved immediately after CIMT, but relapsed 6 months later. In addition, for the subjects measured in this work, there was either a trade-off between improving unimanual versus bimanual performance when sensorimotor activation patterns normalized after CIMT, or an improvement occurred in both unimanual and bimanual performance but at the cost of very abnormal plastic changes in sensorimotor activity. [ABSTRACT FROM AUTHOR]

Compensatory mechanisms for hip pain, pathology, and weakness include excessive trunk lean towards the stance limb, counteracting pelvic drop to maintain stability during single leg stance. Trunk lean shifts the center of mass towards the hip joint center to decrease the moment arm and reduce hip abductor demand. The purpose of this study was to evaluate whether adolescent patients with symptomatic hip pain demonstrate excessive trunk lean and the effect on the hip abductor moment impulse. Self-selected speed walking data collected through an approved study were reviewed on pre-operative patients clinically diagnosed with a hip deformity. Instrumented motion analysis was performed to analyze trunk kinematics and the hip abductor moment impulse. There was a weak, but significant correlation between hip abductor moment impulse and trunk lean. Patients diagnosed with Acetabular Dysplasia demonstrated an increased trunk lean and a decreased hip abductor moment impulse (r = − 0.311, p = 0.001). Of those who presented with excessive trunk lean, 62% of these patients had a normal hip abductor moment impulse. There was no correlation between hip abductor moment impulse and hip abductor strength. Excessive trunk lean was not seen uniformly across adolescent patients with symptomatic hip deformities, despite pain being reported in 80% of patients. Furthermore, a majority of those that presented with excessive trunk lean did not present with a reduced moment, suggesting that although the amount of lean was greater than normal, it was not enough to significantly reduce the demand on the hip musculature. • Excessive trunk lean alone may not significantly reduce hip abductor moment impulse. • Compensatory mechanisms may be related to the pathophysiology of the disorder. • Adolescent hip dysplasia patients utilize trunk lean to reduce impulse. • Peak hip abductor strength does not directly influence hip abductor moment impulse. [ABSTRACT FROM AUTHOR]