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4. Biomechanische Aspekte in der Rehabilitation des Patellofemoralgelenks

Author

Bizzini, M., Biedert, R., Maffiuletti, N., and Impellizzeri, F.

Abstract

Zusammenfassung: Spezifische Kenntnisse über die Biomechanik des patellofemoralen Gelenks sind für eine erfolgreiche konservative oder postoperative Rehabilitation unentbehrlich. Die biomechanischen Aspekte in verschiedenen Situationen müssen in der Übungsauswahl berücksichtigt werden. Gelenkreaktionskräfte, Kontaktflächen, und der Gelenkdruck sind im patellofemoralen Gelenk je nach Winkelstellung und Übungssituation unterschiedlich. Belastende Aktivitäten in Flexion beeinflussen über die Muskelkraft des Quadrizeps die patellofemoralen Gelenkreaktionskräfte. Übungen in der offenen und geschlossenen Kette sollten in schonenden Bewegungsamplituden ausgeführt werden, indem sie eine Quadrizepsaktivierung mit möglichst geringen patellofemoralen Gelenkreaktionskräften gewährleisten. Die isolierte Extensionsbewegung in der offenen Kette (90–40°), die Kniebeuge (0–30–60°) und die Beinpresse (0–30–60°) stellen die 3 Hauptübungssituationen in der Frührehabilitation des patellofemoralen Gelenk dar, wobei stets auf eine kontrollierte Körperstellung zu achten ist. Schmerzen und Symptome sollten auf ein Minimum reduziert werden, um eine optimale funktionelle Progression in der neuromuskulären Kontrolle zu erlauben.

Published
2024
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9. Statistical shape modeling of the hip and the association with hip osteoarthritis: a systematic review

Author

ORT Research, Regenerative Medicine and Stem Cells, van Buuren, M. M.A., Arden, N. K., Bierma-Zeinstra, S. M.A., Bramer, W. M., Casartelli, N. C., Felson, D. T., Jones, G., Lane, N. E., Lindner, C., Maffiuletti, N. A., van Meurs, J. B.J., Nelson, A. E., Nevitt, M. C., Valenzuela, P. L., Verhaar, J. A.N., Weinans, H., Agricola, R., ORT Research, Regenerative Medicine and Stem Cells, van Buuren, M. M.A., Arden, N. K., Bierma-Zeinstra, S. M.A., Bramer, W. M., Casartelli, N. C., Felson, D. T., Jones, G., Lane, N. E., Lindner, C., Maffiuletti, N. A., van Meurs, J. B.J., Nelson, A. E., Nevitt, M. C., Valenzuela, P. L., Verhaar, J. A.N., Weinans, H., and Agricola, R.

Published
2021

10. Statistical shape modeling of the hip and the association with hip osteoarthritis:a systematic review

Author

van Buuren, M. M.A., Arden, N. K., Bierma-Zeinstra, S. M.A., Bramer, W. M., Casartelli, N. C., Felson, D. T., Jones, G., Lane, N. E., Lindner, C., Maffiuletti, N. A., van Meurs, J. B.J., Nelson, A. E., Nevitt, M. C., Valenzuela, P. L., Verhaar, J. A.N., Weinans, H., Agricola, R., van Buuren, M. M.A., Arden, N. K., Bierma-Zeinstra, S. M.A., Bramer, W. M., Casartelli, N. C., Felson, D. T., Jones, G., Lane, N. E., Lindner, C., Maffiuletti, N. A., van Meurs, J. B.J., Nelson, A. E., Nevitt, M. C., Valenzuela, P. L., Verhaar, J. A.N., Weinans, H., and Agricola, R.

Abstract

Objective: To summarize available evidence on the association between hip shape as quantified by statistical shape modeling (SSM) and the incidence or progression of hip osteoarthritis. Design: We conducted a systematic search of five electronic databases, based on a registered protocol (available: PROSPERO CRD42020145411). Articles presenting original data on the longitudinal relationship between radiographic hip shape (quantified by SSM) and hip OA were eligible. Quantitative meta-analysis was precluded because of the use of different SSM models across studies. We used the Newcastle–Ottawa Scale (NOS) for risk of bias assessment. Results: Nine studies (6,483 hips analyzed with SSM) were included in this review. The SSM models used to describe hip shape ranged from 16 points on the femoral head to 85 points on the proximal femur and hemipelvis. Multiple hip shape features and combinations thereof were associated with incident or progressive hip OA. Shape variants that seemed to be consistently associated with hip OA across studies were acetabular dysplasia, cam morphology, and deviations in acetabular version (either excessive anteversion or retroversion). Conclusions: Various radiographic, SSM-defined hip shape features are associated with hip OA. Some hip shape features only seem to increase the risk for hip OA when combined together. The heterogeneity of the used SSM models across studies precludes the estimation of pooled effect sizes. Further studies using the same SSM model and definition of hip OA are needed to allow for the comparison of outcomes across studies, and to validate the found associations.

Published
2021

28. Assessment of quadriceps muscle weakness in patients after total knee arthroplasty and total hip arthroplasty: Methodological issues

Author

Lauermann , S. P., Lienhard , K., Item-Glatthorn , J. F., Casartelli , N. C., Maffiuletti , N. A., Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), and Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )

Subjects
ACTIVATION, OSTEOARTHRITIS, ORTHOPEDIC PRACTICE, STRENGTH, WOMEN, EXERCISE, [ SCCO ] Cognitive science, RANDOMIZED CONTROLLED-TRIAL, IMPAIRMENTS, RECOVERY, FUNCTIONAL LIMITATIONS
Abstract

International audience; The aim of this exploratory study was to verify whether the evaluation of quadriceps muscle weakness is influenced by the testing modality (isometric vs. isokinetic vs. isoinertial) and by the calculation method (within-subject vs. between-subject comparisons) in patients 4-8 months after total knee arthroplasty (TKA, n = 29) and total hip arthroplasty (THA, n = 30), and in healthy controls (n = 19). Maximal quadriceps strength was evaluated as (1) the maximal voluntary contraction (MVC) torque during an isometric contraction, (2) the peak torque during an isokinetic contraction, and (3) the one repetition maximum (1-RM) load during an isoinertial contraction. Muscle weakness was calculated as the difference between the involved and the uninvolved side (within-subject comparison) and as the difference between the involved side of patients and controls (between-subject comparison). Muscle weakness estimates were not significantly affected by the calculation method (within-subject vs. between-subject; P > 0.05), whereas a significant main effect of testing modality (P < 0.05) was observed. Isometric MVC torque provided smaller weakness estimates than isokinetic peak torque (P = 0.06) and isoinertial 1-RM load (P = 0.008), and the clinical occurrence of weakness (proportion of patients with large strength deficits) was also lower for MVC torque. These results have important implications for the evaluation of quadriceps muscle weakness in TKA and THA patients 4-8 months after surgery. (C) 2013 Elsevier Ltd. All rights reserved.

Published
2014
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30. Increased H-reflex excitability is not accompanied by changes in neural drive following 24 days of unilateral lower limb suspension

Author

Seynnes, O. R., Maffiuletti, N. A., Horstman, A. M., and Narici, M.

Subjects
Adult, Male, electromyography, plantaris muscle, Unloading, Physiological, Neuromuscular Junction, Activation capacity, torque, Pilot Projects, human experiment, H-Reflex, V-wave, muscle contraction, Young Adult, Humans, Biomechanics, human, normal human, Muscle Strength, neuromuscular function, Adaptation, ULLS, flexor muscle, Motor Neurons, Neurons, adult, article, Hoffmann reflex, immobilization, male, muscle action potential, muscle strength, muscle twitch, priority journal, soleus muscle, torque, Adaptation, Physiological, Electric Stimulation, Electromyography, Lower Extremity, Muscle Contraction, Muscle, Skeletal, Neurons, Efferent, Spinal Cord, Tibial Nerve, H-reflex, Skeletal, Efferent, Muscle
Published
2010

47. Random Motor Unit Activation by Electrostimulation.

Author

M. Jubeau, Gondin, J., Martin, A., Sartorio, A., and Maffiuletti, N. A.

Subjects
MUSCLE strength, MUSCLES, ROTATIONAL motion (Rigid dynamics), RIGID dynamics, TORQUE, MECHANICS (Physics), MOTOR unit, MOTOR ability, NEUROMUSCULAR system, FIBERS
Abstract

Whether the involvement of motor units is different between surface neuromuscular electrostimulation and voluntary activation remains an unresolved issue. The aim of this pilot study was to verify if motor unit activation during electrostimulation is nonselective/random (i.e., without obvious sequencing related to fibre type), as recently suggested by Gregory and Bickel [6]. Sixteen healthy men randomly performed submaximal isometric contractions (10-s duration) of the quadriceps femoris muscle at 20, 40 and 60% of maximal voluntary torque under both stimulated and voluntary conditions. During the contractions, paired stimuli were delivered to the femorat nerve (twitch interpolation technique) and the characteristics of the superimposed doublet were compared between the two conditions. For each torque level, time-to-peak torque was significantly longer (p range=0.05-0.0002) during electrostimulation compared to voluntary con- tractions. Moreover, time-to-peak torque during voluntary trials decreased significantly when in- creasing the torque level from 20 to 60% of maximal voluntary torque (p range=0.03-0.0001), whereas it was unchanged during electrostimulation. In conclusion, over-the-muscle electro-stimulation would neither result in motor unit recruitment according to Henneman's size principle nor would it result in a reversal in voluntary recruitment order. During electrostimulation, muscle fibres are activated without obvious sequencing related to fibre type. [ABSTRACT FROM AUTHOR]

Published
2007
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