The effects of 10 microM glibenclamide, an ATP-sensitive K(+) (K(ATP)) channel blocker, and 100 microM pinacidil, a channel opener, were studied to determine how the K(ATP) channel affects mouse extensor digitorum longus (EDL) and soleus muscle during fatigue. Fatigue was elicited with 200-ms-long tetanic contractions every second. Glibenclamide did not affect rate and extent of fatigue, force recovery, or (86)Rb(+) fractional loss. The only effects of glibenclamide during fatigue were: an increase in resting tension (EDL and soleus), a depolarization of the cell membrane, a prolongation of the repolarization phase of action potential, and a greater ATP depletion in soleus. Pinacidil, on the other hand, increased the rate but not the extent of fatigue, abolished the normal increase in resting tension during fatigue, enhanced force recovery, and increased (86)Rb(+) fractional loss in both the EDL and soleus. During fatigue, the decreases in ATP and phosphocreatine of soleus muscle were less in the presence of pinacidil. The glibenclamide effects suggest that fatigue, elicited with intermittent contractions, activates few K(ATP) channels that affect resting tension and membrane potentials but not tetanic force, whereas opening the channel with pinacidil causes a faster decrease in tetanic force, improves force recovery, and helps in preserving energy.

We investigated upper-body (ie, trunk) angular kinematics (motions) during gait, stair climbing and descending, and rising from a chair in two reference frames--relative to the pelvis and to room coordinates. Bilateral kinematic data were collected from 11 healthy subjects (6 female, 5 male), who were 27 to 88 years of age (mean = 58.9, SD = 17.9). During stair climbing, maximum trunk flexion relative to the room was at least double that during stair descending and gait. Arising from a chair required the most trunk flexion/extension range of motion (ROM) but the least abduction/adduction and medial/lateral (internal/external) rotation. Trunk ROM during gait was small (mean less than or equal to 12 degrees) and consistent with previous literature. Trunk range of motion relative to the room during stair climbing and descending was greater than trunk ROM during gait in all planes. The pelvis and trunk rotate in the transverse plane in greater synchrony during stair descending (mean = 8.1 degrees, SD = 5.6 degrees) than during gait (mean = 12.0 degrees, SD = 4.2 degrees). For all activities, trunk frontal and sagittal ROM relative to the pelvis was greater than that relative to the room coordinates. This finding suggests that trunk/pelvis coordination may be used to reduce potentially destabilizing anti-gravity trunk motions during daily activities. We conclude that upper-body kinematics relative to both pelvis and gravity during daily activities are important to locomotor control and should be considered in future studies of patients with locomotor disabilities.

Falls and fall-induced injuries are major global public health problems. Balance and gait disorders have been the second leading cause of falls. Inertial motion sensors and force sensors have been widely used to monitor both static and dynamic balance performance. Based on the detected performance, instant visual, auditory, electrotactile and vibrotactile biofeedback could be provided to augment the somatosensory input and enhance balance control. This review aims to synthesize the research examining the effect of biofeedback systems, with wearable inertial motion sensors and force sensors, on balance performance. Randomized and non-randomized clinical trials were included in this review. All studies were evaluated based on the methodological quality. Sample characteristics, device design and study characteristics were summarized. Most previous studies suggested that biofeedback devices were effective in enhancing static and dynamic balance in healthy young and older adults, and patients with balance and gait disorders. Attention should be paid to the choice of appropriate types of sensors and biofeedback for different intended purposes. Maximizing the computing capacity of the micro-processer, while minimizing the size of the electronic components, appears to be the future direction of optimizing the devices. Wearable balance-improving devices have their potential of serving as balance aids in daily life, which can be used indoors and outdoors.

This article examined factors influencing rehabilitation counseling students' attitudes toward people with disabilities in three social contexts, using a conjoint analysis design. A total of 98 graduate students participated in this study. A conjoint measurement of 38 cards (representing people with varying disability type, gender, ethnicity, age, education, and employment status) was used. The authors found that (a) disability-related factors were heavily involved in the preference-making process, (b) attitude or preference formation was also significantly affected by other client characteristics unrelated to disability, and (c) factors influencing attitude/preference formation were similar across the three social contexts. Conjoint analysis could increase our ability to understand factors contributing to the formation of attitudes/preferences in multiple social contexts.

Flatfoot is linked to secondary lower limb joint problems, such as patellofemoral pain. This study aimed to investigate the influence of medial posting insoles on the joint mechanics of the lower extremity in adults with flatfoot. Gait analysis was performed on fifteen young adults with flatfoot under two conditions: walking with shoes and foot orthoses (WSFO), and walking with shoes (WS) in random order. The data collected by a vicon system were used to drive the musculoskeletal model to estimate the hip, patellofemoral, ankle, medial and lateral tibiofemoral joint contact forces. The joint contact forces in WSFO and WS conditions were compared. Compared to the WS group, the second peak patellofemoral contact force (p < 0.05) and the peak ankle contact force (p < 0.05) were significantly lower in the WSFO group by 10.2% and 6.8%, respectively. The foot orthosis significantly reduced the peak ankle eversion angle (p < 0.05) and ankle eversion moment (p < 0.05); however, the peak knee adduction moment increased (p < 0.05). The reduction in the patellofemoral joint force and ankle contact force could potentially inhibit flatfoot-induced lower limb joint problems, despite a greater knee adduction moment.

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BackgroundTotal ankle arthroplasty is gaining popularity as an alternation to ankle arthrodesis for end-stage ankle arthritis. Owing to the complex anatomical characteristics of the ankle joint, total ankle arthroplasty has higher failure rates. Biomechanical exploration of the effects of total ankle arthroplasty on the foot and ankle is imperative for the precaution of postoperative complications. The objectives of this study are (1) to investigate the biomechanical differences of the foot and ankle between the foot with total ankle arthroplasty and the intact foot and (2) to investigate the performance of the three-component ankle prosthesis.MethodsTo understand the loading environment of the inner foot, comprehensive finite element models of an intact foot and a foot with total ankle arthroplasty were developed to simulate the stance phase of gait. Motion analysis on the model subject was conducted to obtain the boundary and loading conditions. The model was validated through comparison of plantar pressure and joint contact pressure between computational prediction and experimental measurement. A pressure mapping system was used to measure the plantar pressure during balanced standing and walking in the motion analysis experiment, and joint contact pressure at the talonavicular joint was measured in a cadaver foot.ResultsPlantar pressure, stress distribution in bones and implants and joint contact loading in the two models were compared, and motion of the prosthesis was analysed. Compared with the intact foot model, averaged contact pressure at the medial cuneonavicular joint increased by 67.4% at the second-peak instant. The maximum stress in the metatarsal bones increased by 19.8% and 31.3% at the mid-stance and second-peak instants, respectively. Force that was transmitted in three medial columns was 0.33, 0.53 and 1.15 times of body weight, respectively, at the first-peak, mid-stance and second-peak instants. The range of motion of the prosthetic ankle was constrained in the frontal plane. The lateral side of the prosthesis sustained higher loading than the medial side.ConclusionTotal ankle arthroplasty resulted in great increase of contact pressure at the medial cuneonavicular joint, making it sustain the highest contact pressure among all joints in the foot. The motion of the prosthesis was constrained in the frontal plane, and asymmetric loading was distributed in the bearing component of the ankle prosthesis in the mediolateral direction.The translational potential of this articleBiomechanical variations resulted from total ankle arthroplasty may contribute to negative postoperative outcomes. The exploration of the biomechanical performance in this study might benefit the surgeons in the determination of surgical protocols to avoid complications. The analysis of the performance of the ankle prosthesis could enhance the knowledge of prosthetic design.