Idiopathic congenital clubfoot can be treated either operatively (comprehensive surgical release (CSR)) or conservatively (ponseti technique (PCT)). This thesis compared the mid-term outcomes after CSR and PCT treatments to a typically developing sample. A Dynamical Systems Analysis (DSA) approach and a multi-segment foot model were used to examine group differences in multi-segment foot and lower extremity kinematics, kinetics, coordination and coordination variability during walking. Ten children with clubfoot treated with PCT and seven children with clubfoot treated with CSR were evaluated retrospectively and compared to ten typically developing children. Multi-segment foot and lower extremity kinematic (240 Hz) and kinetic (1080 Hz) data were collected while participants walked barefoot at a fixed walking velocity (1.0 m/s-1 ±5%). Sagittal plane metatarsophalangeal (MTP) and three-dimensional (3D) forefoot-rearfoot, ankle, knee and hip joint range of motion (ROM) during stance and 3D ankle, knee and hip peak joint moments during push-off were calculated. A modified vector coding technique was used to quantify the multi-segment foot and lower extremity coordination and coordination variability throughout stance for forefoot-rearfoot inversion/eversion (Ff-Rf), rearfoot inversion/eversion–tibial internal/external rotation (Rf-Tib) and femur-tibia internal/external rotation (Fem-Tib) couples. Reduced MTP and forefoot-rearfoot ROM was observed in the CSR group while the PCT group demonstrated values comparable to CTR. Sagittal plane ankle ROM was similar between groups however, the CSR group demonstrated reduced frontal plane ROM compared to PCT. Peak ankle plantar flexion moment was reduced in the last 50% of stance in the clubfoot groups. The CSR group demonstrated greater knee and hip moments compared to CTR and PCT. The PCT group demonstrated lessor peak ankle eversion, knee external rotation and knee valgus moments compared to CTR. No significant differences were observed in Ff-Rf, Rf-Tib and Fem-Tib coordination and coordination variability throughout stance between the groups. PCT and CSR gait was characterized by restricted multi-segment foot motion and abnormal lower extremity joint moments; suggesting mild residual deformity. Despite residual deformity, the coordination and coordination variability results indicate that the PCT and CSR groups are not functionally limited and demonstrate similar multi-segment foot and lower extremity movement patterns as CTR.

INTER-SEGMENT COORDINATION VARIABILITY POST ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION SEPTEMBER 2015 DEVIN K. KELLY, B.S., UNIVERSITY OF MASSACHUSETTS AMHERST M.S., UNIVERSITY OF MASSACHUSETTS AMHERST Directed by: Dr. Joseph Hamill There is an increased risk for ipsilateral graft rupture and contralateral ACL rupture following ACL reconstruction surgery (ACLR) despite return to sport clearance. The reason for this increased risk is not well understood. Previous literature has shown that decreased coordination variability is indicative of an injured system regardless of the absence of pain. PURPOSE: To quantify inter-segment coordination variability during three portions of the stance phase of gait in athletes at three progressive time points post-surgery compared to the contralateral limb (NI) and healthy controls. METHODS: Three-dimensional kinematic and kinetic data were collected for 10 ACLR and 10 healthy athletes matched for age, gender, and activity level. The ACLR group was measured at 4 weeks, 12 weeks, and when cleared to run post-surgery. Kinematic data were used in a modified vector coding technique to determine inter-segment coordination variability of lower extremity couples of interest. Statistical significance was determined using two factor multivariate ANOVAs (limb x visit) for early (1-33%), mid (34-66%), and late (67-100%) stance with alpha level set at .05. Tukey post-hoc tests were performed where appropriate. RESULTS: ACLR athletes have decreased inter-segment coordination variability of the involved lower extremity during the late stance phase of gait compared to both the contralateral limb and healthy controls at 4 weeks post-surgery. By 12 weeks post-surgery there were improvements in joint function as exemplified by inter-segment coordination variability of the ACLR involved limb becoming similar to the healthy control limb. CONCLUSION: Inter-segment coordination variability during late stance in the present study is not an indication for the increased risk for ipsilateral graft rupture and contralateral ACL rupture in ACLR athletes.

No description available.

O Tiro com Arco é uma modalidade olímpica na qual os atletas exibem diversas estratégias de coordenação muscular na preparação do disparo da flecha, principalmente no período da liberação do clicker, tornando dificultosa a interpretação da coordenação de arqueiros no que tange à sua pontuação. Deste modo, algumas técnicas, como a Análise de Vetor Codificado e co-ativação/inibição recíproca, provenientes de abordagens de Controle Motor, podem ajudar-nos a desvendar quais parâmetros em comum que estes arqueiros utilizam quando atiram e sua relação com seu desempenho obtido durante o disparo sequencial de flechas. O objetivo do trabalho foi o de avaliar a coordenação muscular utilizada por arqueiros da seleção brasileira durante uma simulação qualificatória olímpica, através da técnica eletromiográfica. Participaram 11 arqueiros da seleção brasileira; idade: 25,2±4,9 anos, altura: 1,72±0,12m, peso: 68,6±11,8 kg, FITA score: 1258±43 pontos, Qualificação: 632±20 pontos, Flecha média: 8,7±0,3 pontos. A análise EMG foi dividida em 0,5s antes e 0,15s após a liberação do clicker. Foi utilizado o valor RMS deste sinal de doze músculos: no lado que traciona a corda (dominante) - FSD (Flexor Superficial dos dedos); ED (Extensor dos dedos); BBL (Bíceps Braquial); TBL (Tríceps Braquial Cabeça longa); GD (Grande Dorsal) PMC (Peitoral Maior Clavicular); TS (Trapézio Superior); SAD (Serrátil Anterior); RA (Reto Abdominal) e ML (Multífido Lombar). Lado não dominante (nD) DPnD (Deltóide Posterior); SAnD (Serrátil Anterior), no qual foram criados em 14 pares de análise (agonista-antagonista: FSD-ED; BBL-TBL; GD-PMC; TS-SAD; RA-ML; distal-proximal: FSD-BBL; FSD-TBL; ED-BBL; ED-TBL; e mistos: PMC-SAD; GD-TS; SAD-SAnD; SAnD-DPnD; GD-DPnD), para a análise dentro das técnicas de Co-ativação/Inibição Reciproca e Análise de Vetor Codificado. Nos resultados; oito pares (FSD-ED; BBL-TBL; TS-SAD; FSD-BBL; FSD-TBL; ED-TBL; SAD-SAnD; SAnD-DPnD) co-ativaram diferentemente na transição de blocos (p<0.05); e 12 (FSD-ED; BBL-TBL; GD-PMC; TS-SAD; FSD-BBL; FSD-TBL; ED-BBL; ED-TBL; PMC-SAD; SAD-SAnD; SAnD-DPnD; GD-DPnD) co-ativaram diferentemente na comparação do escore obtido (p<0.05). Em nove pares, os arqueiros, evidenciaram diferentes estratégias de inibição recíproca na transição de blocos (FSD-ED; BBL-TBL; TS-SAD; FSD-BBL; FSD-TBL; ED-BBL; ED-TBL; SAD-SAnD; SAnD-DPnD) (p<0.05); um (TS-SAD) na análise de flechas (p<0.05); e nove (FSD-ED; BBL-TBL; FSD-BBL; FSD-TBL; ED-BBL; ED-TBL; SAD-SAnD; SAnD-DPnD; GD-DPnD) na análise do escore. A análise de Vetor Codificado apresentou que, no total de flechas disparadas nove pares (FSD-ED; GD-PMC; FSD-BBL; FSD-TBL; ED-BBL; ED-TBL; PMC-SAD; SAD-SAnD; SAnD-DPnD) mudaram a moda de fase de coordenação na transição de ajustes posturais, enquanto no desempenho 11 pares (FSD-ED; BBL-TBL; GD-PMC; TS-SAD; FSD-BBL; FSD-TBL; ED-BBL; ED-TBL; PMC-SAD; SAD-SAnD; SAnD-DPnD) evidenciaram tais mudanças. As técnicas apresentadas no presente estudo revelaram parâmetros em comum associados com as sequências temporais de disparo de flechas e com os escores obtidos por arqueiros de elite, isto corrobora com a complexidade da análise do desempenho em atletas de alto rendimento, contudo também colocam a disposição técnicas que ajudam na filtragem e verificação desses parâmetros outrora divergentes / Archery is an Olympic sport in which the athletes exhibit several muscular coordination patterns in the arrow shooting, mainly in the clicker falls tempo, making difficult the interpretation of the coordination of archers in what concerns to their score. Thus, some techniques, such as Vector Coding and co-activation/reciprocal inhibition, from Motor Control approaches, can help us to discover what common patterns these archers use when firing and their relation to their obtained performance during the sequential firing of arrows. Aim: evaluate the muscular coordination used by archers of the Brazilian team during an Olympic qualifying simulation, using the electromyographic technique. Eleven archers of the Brazilian team participated; age: 25.2 ± 4.9 years, height: 1.72 ± 0.12m, weight: 68.6 ± 11.8 kg, FITA score: 1258 ± 43 points, Qualification: 632 ± 20 points, Mean arrow: 8.7 ± 0.3 points. The EMG analysis was divided in 0.5s before and 0.15s after the release of the clicker. The RMS value of this twelve-muscle signal was used: drawning arm (dominant side) - FDS (Flexor Digitorum Superficilis); ED (Extensor Digitorum); BB (Biceps Brachii); TBL (Triceps Brachii - Long Head); LD (Latissimus Dorsi) PMC (Pectoralis Major Clavicular Head); UT (Upper Trapezius); ASD (Anterior Serratus); RA (Rectus Abdominis) and LM (Lumbar Multifidus). Non-dominant side (nD) DPnD (Posterior deltoid) and ASnD (Anterior Serratus non-dominant side); pairs created (Agonist-Antagonist: FDS-ED, BBL-TBL, LD-PMC, UT-ASD, RA-LM; Distal-Proximal: FDS-BBL, FDS-TBL, ED-BBL, ED-TBL and the pairs glenohumeral-scapular: PMC-SAD, GD-TS, SAD-SAnD, SAnD-DPnD, GD-DPnD) for analysis of co-activation/reciprocal inhibition and Vector Coding. Results; eight pairs (FDS-ED, BB-TBL, UT-ASD, FDS-BB, FDS-TBL, ED-TBL, ASD-ASnD, ASnD-DPnD) coactivated differently in blocks transition (p<0.05); and 12 (FDS-ED, BB-TBL, LD-PMC, UT-ASD, FDS-BB, FDS-TBL, ED-BB, ED-TBL, PMC-ASD, ASD-ASnD, ASnD-DPnD, LD-DPnD) co-activated differently in the score comparison (p<0.05). Also, the archers displayed different strategies of reciprocal inhibition in the blocks transition (FDS-ED, BB-TBL, UT-ASD, FDS-BB, FDS-TBL, ED-BBL, ED-TBL, ASD-ASnD; ASnD-DPnD) (p<0.05); one (UT-ASD) in the arrow analysis (p<0.05); and nine (FDS-ED, BB-TBL, FDS-BBL, FDS-TBL, ED-BBL, ED-TBL, ASD-ASnD, ASnD-DPnD, LD-DPnD) in the score analysis. Nine Vector Coding pairs (FDS-BB, FDS-TBL, ED-BB, ED-TBL, PMC-ASD, ASD-ASnD, ASnD- DPnD) changed the coordination phase mode in postural adjustments transition, while 11 pairs (FDS-ED; BB-TBL; LD-PMC; UT-ASD; FDS-BB; FDS-TBL; ED-BB; ED-TBL, PMC-ASD, ASD-ASnD, ASnD-DPnD) showed such changes in score analysis. The techniques presented in the present study revealed common parameters associated with temporal shoot-out and scores obtained by elite archers, dispite the complexity of performance analysis in high-performance athletes