The anterior cruciate ligament (ACL) provides resistance to tibial internal rotation torque and anterior shear at the knee. ACL deficiency results in knee instability. Optimisation of muscle contraction through functional electrical stimulation (FES) offers the prospect of mitigating the destabilising effects of ACL deficiency. The hypothesis of this study is that activation of the biceps femoris long head (BFLH) reduces the tibial internal rotation torque and the anterior shear force at the knee. Gait data of twelve healthy subjects were measured with and without the application of FES and taken as inputs to a computational musculoskeletal model. The model was used to investigate the optimum levels of BFLH activation during FES gait in reducing the anterior shear force to zero. This study found that FES significantly reduced the tibial internal rotation torque at the knee during the stance phase of gait (p = 0.0322) and the computational musculoskeletal modelling revealed that a mean BFLH activation of 20.8% (±8.4%) could reduce the anterior shear force to zero. At the time frame when the anterior shear force was zero, the internal rotation torque was reduced by 0.023 ± 0.0167 Nm/BW, with a mean 188% reduction across subjects (p = 0.0002). In conclusion, activation of the BFLH is able to reduce the tibial internal rotation torque and the anterior shear force at the knee in healthy control subjects. This should be tested on ACL deficient subject to consider its effect in mitigating instability due to ligament deficiency. In future clinical practice, activating the BFLH may be used to protect ACL reconstructions during post-operative rehabilitation, assist with residual instabilities post reconstruction, and reduce the need for ACL reconstruction surgery in some cases.
The validation approach using EMG and musculoskeletal modelling developed and tested can potentially be applied to the use of FES for other muscles and activities.
Students with special needs often associated with learning difficulties in subject of mathematics. Hence, this study aims to identify the challenges that arise in the implementation of teaching and facilitation of Mathematics for students with special educational needs in the Integrated Special Education Program. This concept paper is based on research in the library, which is through the collection of related information and materials to identify challenges that affect the implementation and facilitation in Mathematics as to increase the interest and performance of students with special needs towards Mathematics subjects. This concept paper is expected to help special education teachers in their efforts to diversify teaching methods that are capable of overcoming the challenges that arise in the implementation and facilitation in Mathematics subjects .The challenges which arise are regards to the special education teacher's delivery techniques, special need students factor itself which limits the learning of Mathematics to only take place in schools, the less attractive approaches and teaching method factor, and the limited use of teaching aids. Suggested implementation to increase special need students interest and performance in Mathematics subjects are the implementation of simulation, the implementation of pretend play, the implementation of student-centered teaching method, and the implementation of 21st Century Learning (PAK21).
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