Trunk and lower-extremity kinematics differ based on step-down tap variation: An assessment of methodology for a return-to-play protocol using motion analysis

Ulman, Sophia; Erdman, Ashley; Loewen, Alex; Õunpuu, Sylvia; Chafetz, Ross S.; Wren, Tishya A. L.; Tulchin-Francis, Kirsten

doi:10.1016/j.gaitpost.2022.09.079

Cited by 5 publications

(7 citation statements)

References 31 publications

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“…During overground walking, neither group demonstrated markers of a Trendelenburg gait such as trunk lean, pelvic obliquity, ipsilateral hip adduction, or increased hip abductor moment. Although the arthroscopic group demonstrated statistically significant changes following surgery in pelvic obliquity, hip adduction, and abduction moment, the mean difference in each category was <2 degrees, which was considered clinically insignificant 21–23 . During single-limb balance, a more focused test to assess abductor strength, the SHD cohort demonstrated no evidence of pelvic drop, trunk lean, or ipsilateral hip adduction, and had a similar tolerance to single-limb balance duration as a preoperative testing.…”

Section: Discussionmentioning

confidence: 89%

“…Although the arthroscopic group demonstrated statistically significant changes following surgery in pelvic obliquity, hip adduction, and abduction moment, the mean difference in each category was <2 degrees, which was considered clinically insignificant. [21][22][23] During singlelimb balance, a more focused test to assess abductor strength, the SHD cohort demonstrated no evidence of pelvic drop, trunk lean, or ipsilateral hip adduction, and had a similar tolerance to single-limb balance duration as a preoperative testing. Interestingly, the arthroscopic cohort demonstrated improved single-limb balance time from preoperative to postoperative testing (16.6 ± 7.2 to 19.7 ± 7.8 s, P = 0.022), while there were no statistically significant changes in kinematics.…”

Section: Discussionmentioning

confidence: 95%

“…For all statistical comparisons, alpha was set to 0.05. Due to inaccuracies with marker placement, camera error, and motion artifact, statistical differences in kinematics <3 degrees were deemed as clinically insignificant 21–23 …”

Section: Methodsmentioning

confidence: 99%

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Comparison of Gait and Functional Outcomes Between Open and Arthroscopic Treatment of Adolescent and Young Adult Femoroacetabular Impingement

Morris,

Loewen,

Ulman

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Management of femoroacetabular impingement (FAI) through an arthroscopic or surgical hip dislocation (SHD) approach has been shown to have similar clinical success and patient-reported outcomes. However, there are limited data comparing functional outcomes. The purpose of this study was to compare gait and functional outcomes of adolescent/young adult patients with FAI treated by either an arthroscopic or open SHD approach. Methods: We identified prospectively enrolled adolescent/young adult patients (≤20 years old) who underwent surgical treatment for FAI through an SHD or arthroscopic approach. Participants were evaluated in a movement science lab preoperatively and postoperatively (minimum 8 months postoperatively) with barefoot walking and a 30-second single-limb balance trial on the affected side. Participants also completed the Harris Hip Score at the same timepoints. Differences from preoperative to postoperative were determined using a paired-samples t test for each surgical technique, and differences between the SHD and arthroscopic groups were determined using an independent samples t test (α=0.05). Results: Fifty-five participants (42F, 16.2±1.4 y) were tested and grouped by surgical intervention. The SHD and arthroscopy groups consisted of 28 and 27 participants, respectively, with no significant difference between the SHD and arthroscopic cohorts in age (16.4±1.2 vs. 15.9±1.5 y, respectively, P=0.218) or sex distribution (78.6% vs. 74.1% females, respectively, P=0.75). Each group demonstrated significant postoperative improvement in Harris Hip Score (SHD: 64.8±16.4 to 81.8±17.8; arthroscopy: 57.0±16.7 to 84.7±19.7; preoperatively to postoperatively, respectively, both P<0.001). During gait, increased maximum hip flexion was observed following surgical intervention for the SHD group (32.3±5.7 vs. 36.1±5.2, P=0.003). No other clinically significant changes were detected in the SHD or arthroscopic groups preoperatively to postoperatively in trunk, pelvis, or hip kinematics in the coronal plane. During the balance task, neither cohort demonstrated markers of clinically significant abductor dysfunction. However, post operatively, the arthroscopy group was able to balance longer than the SHD group (18.8±7.8 vs. 14.2±2.7 s, respectively, P=0.008), although no differences were detected in trunk or pelvis position in the coronal plane during balance. Conclusions: Both open SHD and arthroscopic treatment of FAI resulted in improved clinical outcomes with no clinically significant abductor dysfunction 1 year post operatively. However, further study is needed to determine whether more dynamic tasks can potentially elicit subtle differences between the groups. Levels of Evidence: Level II—prospective study.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 95%

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Comparison of Gait and Functional Outcomes Between Open and Arthroscopic Treatment of Adolescent and Young Adult Femoroacetabular Impingement

Morris,

Loewen,

Ulman

et al. 2023

Journal of Pediatric Orthopaedics

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“…Retroreflective markers were placed on bony landmarks on the trunk, pelvis, and lower extremities according to a modified Cleveland Clinic marker set [ 23 ]. Marker placement was similar to Ulman et al [ 24 ] with the addition of bilateral patella markers, as well as posterior superior iliac spine markers instead of a sacral marker to allow for IMU placement. A 14-camera motion capture system (Vicon Motion Systems Ltd., Denver, CO, USA) was used to collect marker data sampling at 240 Hz.…”

Section: Methodsmentioning

confidence: 99%

“…The significance level (α) was set to 0.05 and was adjusted to 0.007 using a Bonferroni correction to account for comparing each of the seven calibration methods to motion capture independently. Differences exceeding 3° were considered clinically significant [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Inertial Measurement Unit Sensor-to-Segment Calibration Comparison for Sport-Specific Motion Analysis

Ekdahl,

Loewen,

Erdman

et al. 2023

Sensors

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Wearable inertial measurement units (IMUs) can be utilized as an alternative to optical motion capture as a method of measuring joint angles. These sensors require functional calibration prior to data collection, known as sensor-to-segment calibration. This study aims to evaluate previously described sensor-to-segment calibration methods to measure joint angle range of motion (ROM) during highly dynamic sports-related movements. Seven calibration methods were selected to compare lower extremity ROM measured using IMUs to an optical motion capture system. The accuracy of ROM measurements for each calibration method varied across joints and sport-specific tasks, with absolute mean differences between IMU measurement and motion capture measurement ranging from <0.1° to 24.1°. Fewer significant differences were observed at the pelvis than at the hip, knee, or ankle across all tasks. For each task, one or more calibration movements demonstrated non-significant differences in ROM for at least nine out of the twelve ROM variables. These results suggest that IMUs may be a viable alternative to optical motion capture for sport-specific lower-extremity ROM measurement, although the sensor-to-segment calibration methods used should be selected based on the specific tasks and variables of interest for a given application.

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Lower-extremity kinematics and kinetics differ based on drop vertical jump variation: An assessment of methodology for a return-to-play protocol using motion analysis

Ulman,

Loewen,

Erdman

et al. 2024

Gait & Posture

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Trunk and lower-extremity kinematics differ based on step-down tap variation: An assessment of methodology for a return-to-play protocol using motion analysis

Cited by 5 publications

References 31 publications

Comparison of Gait and Functional Outcomes Between Open and Arthroscopic Treatment of Adolescent and Young Adult Femoroacetabular Impingement

Comparison of Gait and Functional Outcomes Between Open and Arthroscopic Treatment of Adolescent and Young Adult Femoroacetabular Impingement

Inertial Measurement Unit Sensor-to-Segment Calibration Comparison for Sport-Specific Motion Analysis

Lower-extremity kinematics and kinetics differ based on drop vertical jump variation: An assessment of methodology for a return-to-play protocol using motion analysis

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