Thesis (M.S.)--University of Kansas, 2004. / Includes bibliographical references (leaves 116-118). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.S.)--University of Kansas, 2004. / Includes bibliographical references (leaves 116-118).

Thesis (Ph. D.)--University of Queensland, 2001. / Includes bibliographical references.

Thesis (M. Phil.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 223-235).

Clinicians working on motor skill learning interventions often find that improvements observed during training are not sustained and do not transfer to very similar tasks. Research suggests that strategies such as real-time biofeedback and learner's focus of attention seem to facilitate motor skill learning. However, research on the implications of these strategies in rehabilitation is limited and has not been investigated in healthy individuals. The motor learning effects of these strategies need to be assessed as they offer the possibility of enhancing rehabilitation regimens. The purpose of this study was to investigate the generalizability of real-time biofeedback and learner's focus of attention to a treadmill gait retraining program aimed at correcting knee hyperextension insidious gait patterns in healthy young women. Assessing the acquisition, retention, and transfer of kinematic improvements was the focus of this study. 1.Knee sagittal plane kinematics could be influenced with dynamic gait training using real-time biofeedback. Gained proficiency in controlling knee hyperextension during treadmill training was evident during overground walking immediately and 1 month after training. 2.The effectiveness of real-time biofeedback in improving performance does not seem to be influenced by the focus of attention, internal or external, induced during treadmill training. Participants in both intervention groups improved in a similar way as a consequence of practice. However, there were trends in the data that pointed that the external focus of attention group had better long-term retention. It is not known if participants actively switched to an external focus of attention despite the instructions provided during training. Tests to ensure instructional compliance should be used. 3.A treadmill gait retraining program using learner's focus of attention indicated that that there were not differences in learning acquisition, short and long-term retention, and transfer to overground walking and obstacle crossing between intervention groups. It is not known if these changes persist beyond the 4-month follow-up included in this study. The results of this study will help to reduce knee hyperextension gait patterns in women. Future studies may also use the methodology used in this study to further investigate the implications of learner's focus of attention in rehabilitation. Similarly, the findings of this study could offer an additional strategy for rehabilitation regimens.

Biomechanics research investigating the knee kinematics of youth participants is very limited. The most accurate method of measuring knee kinematics utilizes invasive procedures such as bone pins. However, various experimental techniques have improved the accuracy of gait kinematic analyses using minimally invasive methods. In this study, gait trials were conducted with two participants between the ages of 11 and 13 to obtain the knee flexion-extension (FE), adduction-abduction (AA) and internal-external (IE) rotation angles of the right knee. The objectives of this study were to (1) conduct pilot experiments with youth participants to test whether any adjustments were necessary in the experimental methods used for adult gait experiments, (2) apply a Triangular Cosserat Point Element (TCPE) analysis for Soft-Tissue Artifact (STA) correction of knee kinematics with youth participants, and (3) develop a code to conduct a Principal Component Analysis (PCA) to find the PCA-defined flexion axis and calculate knee angles with both STA and PCA-correction for youth participants. The kinematic results were analyzed for six gait trials on a participant-specific basis. The TCPE knee angle results were compared between uncorrected angles and another method of STA correction, Procrustes Solution, with a repeated measures ANOVA of the root mean square errors between each group and a post-hoc Tukey test. The PCA-corrected results were analyzed with a repeated measures ANOVA of the FE-AA correlations from a linear regression analysis between TCPE, PS, PCA-TCPE and PCA-PS angles. The results indicated that (1) youth experiments can be conducted with minor changes to experimental methods used for adult gait experiments, (2) TCPE and PS analyses did not yield statistically different knee kinematic results, and (3) PCA-correction did not reduce FE-AA correlations as predicted.

No description available.

The purpose of this dissertation was to study the effects of graft pretension in anterior cruciate ligament (ACL) reconstruction through a series of experiments. First, an in vitro study of 5 human knees was conducted to determine if intact joint kinematics could be restored when using the ideal graft - the intrinsic ACL. The ACL tibial insertion site was freed, and pretensions of 0, 10, 20, 30, and 40 N were applied to the ligament using a custom designed load cell connection. Kinematics during a simulated active extension were compared to those of the intact knee. Intact knee kinematics were not restored. Pretensions that best restored tibial anterior/posterior translation and internal/external rotation ranged from 0-40 N. Furthermore, the pretensions that best restored these kinematic variables were widely disparate in two specimens. Second, the in vitro kinematics during a simulated active extension of human and porcine knees were compared and contrasted both prior to and following transection of the ACL. The ACL limited: (1) tibial anterior translation in both species, (2) tibial internal rotation in humans, and (3) tibial external rotation in pigs. Differences in kinematic patterns for tibial internal/external rotation and abduction/adduction between the species was explained by requirements for biped and quadruped stances. Third, the mechanical characteristics of porcine patellar tendon (PT) were investigated by uniaxial tensile testing at two strain rates. Patella-PT-tibia complexes from freshly sacrificed skeletally immature and mature animals were loaded to failure at elongation rates of 20 and 200 mm/min. Both strain rate and skeletal maturity significantly affected failure mode, tangent modulus, and ultimate stress of the tendons, and hence are important considerations in the mechanical evaluation of porcine PT. Fourth, ACL reconstructions were performed using pretensions of 10 or 20 N in an in vivo porcine model with a specially designed load cell/telemetry system to monitor graft load. Graft pretension was seen to increase during fixation with interference screws. Following sacrifice at 4 weeks, tissues were mechanically, histologically, and biochemically analyzed. A pretension of 20 N resulted in a tissue more similar to the intrinsic ACL. / Ph. D.

No description available.

De nombreuses études concluent que la charge mécanique supportée par le genou, qu’elle soit reliée à l’obésité, aux sports intenses, à une altération biomécanique des structures de l’articulation ou à une exposition à des charges lourdes durant les activités occupationnelles, est considérée comme un facteur de risque important au développement de la gonarthrose. La gonarthrose reliée au travail a été le sujet de nombreuses études et plusieurs d’entre elles ont rapporté une prévalence accrue de la gonarthrose chez les travailleurs de certains domaines en particulier, comme la construction, la pose de plancher, la peinture, l’exploitation minière, l’agriculture et le travail en atelier et en milieu de la santé. Les personnes qui travaillent dans ces métiers sont exposées à des positions ou des activités nuisibles, comme travailler à genoux ou accroupi, monter des escaliers ou des échelles, transporter des changes lourdes et marcher de façon prolongée. Ces gestes surchargent l’articulation du genou, ce qui cause des modifications aux structures de l’articulation du genou ou aux adaptations neuromusculaires de patron de mouvement du genou. Ces modifications structurelles et adaptations neuromusculaires peuvent apporter des changements cinématiques à la marche qui peuvent initier la gonarthrose ou contribuer à sa progression. L’objectif principal de la présente étude était d’analyser l’effet d’une surcharge mécanique sur l’articulation fémoro-tibiale (AF-T) subie au travail lors d’une tâche de marche et comparer le patron cinématique de l’articulation fémoro-tibiale des travailleurs exposés à une surcharge mécanique à celui des travailleurs non exposés. Vingt-quatre travailleurs exposés à une surcharge mécanique et neuf travailleurs non exposés ont participé à l’étude. Les données cinématiques de la marche ont été enregistrées au niveau du genou dans des conditions cliniques en utilisant un système de suivi du mouvement électromagnétique. Les paramètres suivant ont été extraits et utilisés pour la comparaison des groupes : l’angle maximum lors du contact initial, l’angle ii maximum de flexion durant la réponse à la charge, l’angle minimum au moment de l’appui unipodal et l’étendue max-min du cycle. La comparaison des groupes pour les variables cliniques et cinématiques a été effectué par l’utilisation de tests-t bilatéraux (« Student-t tests ») et de tests ANCOVA utilisant le poids et la vitesse comme covariables. Les travailleurs exposés à une surcharge mécanique présentaient un plus grand angle de flexion de l’articulation fémoro-tibiale au contact initial, durant la réponse au chargement et à la phase unipodale et ils ont démontré une étendue d’angle moindre que les travailleurs non exposés. Nous croyons que les données cinématiques de la marche peuvent donner des idées sur les facteurs biomécaniques qui pourraient prédisposer les travailleurs au développement ou à la progression de la gonarthrose. Une meilleure compréhension de ces facteurs pourrait être un premier pas vers le développement d’une intervention plus efficace pour cette population. / Many studies agree that mechanical knee loading, either related to obesity, intense sports, biomechanical alteration of the knee or exposition to heavy load occupational activities, is an important factor in knee OA development. Work related knee OA has been the focus of numerous studies, many of them reporting increased knee OA prevalence in workers involved in particular occupational fields such as construction, floor layer, painting, mining, agriculture, shop assistant and health care employees. Persons working in these occupations are exposed to noxious positions or activities such as kneeling, squatting, climbing stairs or ladders, carrying heavy load and prolonged walking. These gestures overload the knee joint, resulting in modifications of the knee joint structures or in neuromuscular adaptations of the knee movement pattern. These structural modifications and neuromuscular adaptations can bring about gait kinematic changes that can either initiate knee OA or contribute to its progression. The main objective of this study was to analyze the effect of mechanical overloading on the tibial-femoral joint suffered during walking tasks at work and compare the kinematics gait tibial femoral joint of workers exposed to knee overloading (KO workers) to that of non-knee overloaded workers (non-KO workers). Twenty four KO workers and 9 non-KO workers participated to the study. Gait kinematic data were recorded at the knee in a clinical setting using an electromagnetic motion tracking system. The following parameters were extracted and used for group comparison: knee angle at initial contact, peak knee flexion angle during loading response and angle range. Group comparison for clinical and kinematic variables of interest was performed with Student-t and ANCOVA tests. KO workers had greater knee flexion angle at initial contact, during loading response and single limb support, and they demonstrated a lower angle range than non-KO workers. iv We believe that gait kinematic data can suggest biomechanical factors that could predispose workers to the development or progression of knee OA. A better understanding of these factors could be a first step toward more efficient intervention within the population.