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Peripheral Artery Disease Affects The Function Of The Legs Of Claudicating Patients In A Diffuse Manner Irrespective Of The Segment Of The Arterial Tree Primarily Involved, Todd Leutzinger, Panagiotis Koutakis, Matthew A. Fuglestad, Hafizur Rahman, Holly Despiegelaere, Mahdi Hassan, Molly Schieber, Jason Johanning, Nick Stergiou, G. Matthew Longo, George P. Casale, Sara A. Myers, Iraklis Pipinos

Journal Articles

Different levels of arterial occlusive disease (aortoiliac, femoropopliteal, multi-level disease) can produce claudication symptoms in different leg muscle groups (buttocks, thighs, calves) in patients with peripheral artery disease (PAD). We tested the hypothesis that different locations of occlusive disease uniquely affect the muscles of PAD legs and produce distinctive patterns in the way claudicating patients walk. Ninety-seven PAD patients and 35 healthy controls were recruited. PAD patients were categorized to aortoiliac, femoropopliteal and multi-level disease groups using computerized tomographic angiography. Subjects performed walking trials both pain-free and during claudication pain and joint kinematics, kinetics, and spatiotemporal parameters were calculated to …

Six Degree-Of-Freedom Analysis Of Hip, Knee, Ankle And Foot Provides Updated Understanding Of Biomechanical Work During Human Walking, Karl E. Zelik, Kota Z. Takahashi, Gregory S. Sawicki

Journal Articles

Measuring biomechanical work performed by humans and other animals is critical for understanding muscle–tendon function, jointspecific contributions and energy-saving mechanisms during locomotion. Inverse dynamics is often employed to estimate jointlevel contributions, and deformable body estimates can be used to study work performed by the foot. We recently discovered that these commonly used experimental estimates fail to explain whole-body energy changes observed during human walking. By re-analyzing previously published data, we found that about 25% (8 J) of total positive energy changes of/about the body’s center-of-mass and >30% of the energy changes during the Push-off phase of walking were not explained …

Persons With Multiple Sclerosis Show Altered Joint Kinetics During Walking After Participating In Elliptical Exercise, Jessie M. Huisinga, Kendra K. Schmid, Mary Filipi, Nikolaos Stergiou

Journal Articles

Patients with multiple sclerosis (MS) experience abnormal gait patterns and reduced physical activity. The purpose of this study was to determine if an elliptical exercise intervention for patients with MS would change joint kinetics during gait toward healthy control values. Gait analysis was performed on patients with MS (n = 24) before and after completion of 15 sessions of supervised exercise. Joint torques and powers were calculated, while also using walking velocity as a covariate, to determine the effects of elliptical exercise on lower extremity joint kinetics during gait. Results show that elliptical exercise significantly altered joint torques at the …

An Unstable Shoe With A Rocker Bottom Redistributes External Work, Shane R. Wurdeman, Jenna M. Yentes, Neil B. Huben, Nikolaos Stergiou

Journal Articles

The purpose of this study was to examine the external work performed by individuals wearing a rocker bottom shoe compared to a standard shoe. It was hypothesized that individuals wearing a rocker bottom shoe would have changes in the amount of work over the course of contact with the ground. External work on the body’s centre of mass (BCOM) was calculated for individuals in both conditions. Comparisons for external work were done for positive and negative work for the entire stance phase as well as the initial double support, single support and terminal double support periods. The results revealed that …

Stride-To-Stride Variability Is Altered During Backward Walking In Anterior Cruciate Ligament Deficient Patients, Franceska Zampeli, Constantina Moraiti Moraiti, Sofia Xergia, Vasilios Tsiaras, Nikolaos Stergiou, Anastasios D. Georgoulis

Journal Articles

Background: Recently backward walking is used by physical therapists to strengthen the hamstring muscles and thus improve the function of the knee joint of anterior cruciate ligament deficient patients. The aim of this study was to examine the stride-to-stride variability of anterior cruciate ligament deficient patients during backward walking. The variation of how a motor behavior emerges in time is best captured by tools derived from nonlinear dynamics, for which the temporal sequence in a series of values is the facet of interest.

Methods: Fifteen patients with unilateral anterior cruciate ligament deficiency and eleven healthy controls walked backwards …

A Remote Markerless Human Gait Tracking For E-Healthcare Based On Content-Aware Wireless Multimedia Communications, Haiyan Luo, Song Ci, Dalei Wu, Nikolaos Stergiou, Ka-Chun Siu

Journal Articles

Remote human motion tracking and gait analysis over wireless networks can be used for various e-healthcare systems for fast medical prognosis and diagnosis. However, most existing gait tracking systems rely on expensive equipment and take lengthy processes to collect gait data in a dedicated biomechanical environment, limiting their accessibility to small clinics located in remote areas. In this work we propose a new accurate and cost-effective e­ healthcare system for fast human gait tracking over wireless networks, where gait data can be collected by using advanced video content analysis techniques with low-cost cameras in a general clinic environment. Furthermore, based …

Acl Deficiency Affects Stride-To-Stride Variability As Measured Using Nonlinear Methodology, Constantina O. Moraiti, Nikolaos Stergiou, Stavros Ristanis, Anastasios D. Georgoulis

Journal Articles

Previous studies suggested that the small fluctuations present in movement patterns from one stride to the next during walking can be useful in the investigation of various pathological conditions. Previous studies using nonlinear measures have resulted in the development of the “loss of complexity hypothesis” which states that disease can affect the variability and decrease the complexity of a system, rendering it less able to adjust to the ever changing environmental demands. The nonlinear measure of the Lyapunov Exponent (LyE) has already been used for the assessment of stride-to-stride variability in the anterior cruciate ligament (ACL) deficient knee in comparison …

Tibial Rotation In Anterior Cruciate Ligament (Acl)-Deficient And Acl-Reconstructed Knees, Nikolaos Stergiou, Stavros Ristanis, Constantina O. Moraiti, Anastasios D. Georgoulis

Journal Articles

Excessive tibial rotation has been documented in ACL deficiency during walking. ACL reconstruction has been unable to correct this abnormality in activities that are more demanding than walking and involve both anterior and rotational loading of the knee. These findings persist regardless of graft selection for the ACL reconstruction [bone-patellar tendon-bone (BPTB) or semitendinosus-gracilis (ST/G)]. Based on this research work, we propose a theoretical perspective for the development of osteoarthritis in both the ACL deficient and the ACL reconstructed knee. We propose that excessive tibial rotation will lead to abnormal loading of the cartilage areas that are not commonly loaded …

Effectiveness Of Reconstruction Of The Anterior Cruciate Ligament With Quadrupled Hamstrings And Bone-Patellar Tendon-Bone Autografts: An In Vivo Study Comparing Tibial Internal-External Rotation, Vasileios Chouliaras, Stavros Ristanis, Constantina Moraiti Moraiti, Nikolaos Stergiou, Anastasios D. Georgoulis

Journal Articles

Background: The 2 most frequently used autografts for anterior cruciate ligament reconstruction are the bone-patellar tendon- bone and the quadrupled hamstrings tendon.

Hypothesis: Hamstring tendon graft is superior to patellar tendon graft in restoring tibial rotation during highly demanding activities because of its superiority in strength and linear stiffness and because it is closer morphologically to the anatomy of the natural anterior cruciate ligament.

Study Design: Case control study; Level of evidence, 3.

Methods: Eleven patients with patellar tendon graft anterior cruciate ligament reconstruction, 11 patients with hamstring tendon graft anterior cruciate ligament reconstruction, and 11 …

Follow-Up Evaluation 2 Years After Acl Reconstruction With Bone–Patellar Tendon–Bone Graft Shows That Excessive Tibial Rotation Persists, Stavros Ristanis, Nikolaos Stergiou, Kostas Patras, Elias Tsepis, Constantina O. Moraiti, Anastasios D. Georgoulis

Journal Articles

Objective: To investigate in vivo if the increased tibial rotation found in anterior cruciate ligament (ACL)-deficient patients before surgery is restored 2 years after the reconstruction, during 2 high-demanding activities.

Design: Prospective follow-up study.

Setting: A gait analysis laboratory.

Participants: Nine subjects with unilateral ACL rupture, reconstructed with a bone–patellar tendon–bone (BPTB) graft, and 10 healthy control subjects.

Interventions: All the ACL-deficient patients underwent a unilateral ACL reconstruction after prereconstruction data acquisition.

Main Outcome Measurements: Using a 6-camera motion analysis system, kinematics were collected as subjects (1) descended from a stair and, after foot …

Excessive Tibial Rotation During High-Demand Activities Is Not Restored By Anterior Cruciate Ligament Reconstruction, Stavros Ristanis, Nikolaos Stergiou, Kostas Patras, Haris S. Vasiliadis, Giannis Giakas, Anastasios D. Georgoulis

Journal Articles

Purpose: Recent in vitro research has suggested that anterior cruciate ligament (ACL) reconstruction does not restore control of tibial rotation. The purpose of this study was to explore these findings in vivo and investigate rotational knee stability during landing and subsequent pivoting. Such an activity places higher demands on the knee, almost similar to those found during high-level sports.

Type of Study: Case control series study.

Methods: We assessed 11 patients who had undergone ACL reconstruction with the same arthroscopic technique using a bone–patellar tendon–bone graft, 11 ACL-deficient subjects who had sustained the injury more than 1 year prior to …