Other e65

Poster 153

Validity and Reliability of a new Method for Evaluation of SerratusAnterior Muscle Strength

Jos Ijspeert (Radboud University Medical Center, Center For EvidenceBased Practice, Dept. of Rehabilitation), Hans Kerstens, Nens vanAlfen, Jan T. Groothuis

Objective: Scapular dyskinesia is described in patients with varying

shoulder disorders. For upper extremity use and function, adequate scap-

ular movement is deemed essential. The serratus anterior (SA) muscle is

recognized as a very important contributor to maintaining adequate scap-

ular movement. Testing muscle strength of the SA by use of current

standard protocols has shown to have low construct validity. Manual

muscle testing also shows low reliability. We adapted a manual testing

position which has shown better contruct validity for SA testing to make it

adequate for use in evaluating serratus anterior muscle strength with hand

held dynamometry. The objective of this study is to compare three pro-

prosed test procedures for SA muscle strength on construct validity and

reliability in healthy subjects.

Design: A mixed models validation and reliability study will be carried

out. EMG surface measurements will be used to measure serratus anterior

muscle activation in three different test positions. Reliability of hand held

dynamometry results will be explored.

Setting: University medical center and University of Applied Sciences,

school for physical therapy.

Participants: We aim to include 20 healthy adult subjects in this study

Interventions: none listed.

Main Outcome Measures: Maximum isometric voluntary contraction

values, of the serratus anterior muscle and possible compensating muscles,

measured with surface EMG will be used to evaluate validity of the

proposed test procedures. ICC2.1 and ICC3.1 will be used to evaluate

inter- and intra-rater reliability of measurements.

Results: We will collect data in June 2013. Results will be presented at

conference.

Conclusions: Not available yet.

Key Words: Reproducibility of Results, hand held dynamometry, serratus

anterior, Muscle Strength Dynamometer, serratus anterior.

Disclosure: Jos Ijspeert has nothing to disclose.

Poster 154

Local dynamic gait stability of pelvis movements in patients withtotal hip replacement vs. their healthy counterparts

Lutz Schega (Otto-von-Guericke University Magdeburg),Dennis Hamacher, Daniel Hamacher, Lutz Hamacher,Daniel Hamacher

Objective: To quantify possible sensorimotor deficits in the hip joint in

patients with total hip replacement (THR), we compared local

dynamic stability (LDS) of pelvis trajectories derived from walking

time series in THR patients and in elderly people without gait

disorders.

Kinematic data of 21 female THR patients (IG, 58�10 years) was

captured with 3-D motion analysis system (Moven, Xsens) during normal

level-grounded walking at the 2nd postoperative day (pre-test with

crutches) and after 3 weeks (last day, post-test without crutches) of the

inpatients treatment. Reference data was collected in 15 healthy elderly

women (65�4.2 years). The THR patients received a conventional

stationary inpatients treatment including gait retraining. To quantify LDS,

the largest Lyapunov Exponents of the 3 dimensional (3d) pelvis trajec-

tories (angular velocity) have been calculated.

Comparing IG vs. CG, a reduced LDS was found in pre- (pZ.024,

dZ0.91) and post-test (pZ.000, dZ1.37). There was no significant

difference in pre- vs. post-test in IG. Patients with THR showed decreased

LDS of the pelvis trajectories which indicates a sensorimotor deficit of the

hip joint. Whether THR patients develop more stable pelvis movement

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patterns after a longer time-span is not investigated, yet. Additionally, the

dose-response effect of specific proprioceptive training on LDS is not

sufficiently understood.

LDS might be a suitable parameter to complement the estimation of the

sensorimotor state after THR. Therefore, further research is recommended.

Design: Kinematic data of THR patients (IG) was captured during normal

level-grounded walking at the 2nd postoperative day (pre-test with crutches)

and after 3 weeks (last day, post-test without crutches) of the inpatients

treatment. Reference data was collected in healthy elderly participants.

Setting: Motion laboratory equipped with 3-D motion analysis system

(Moven, Xsens).

Participants: 21 female THR patients (IG, 58�10 years) and 15 healthy

elderly women (65�4.2 years) were recruited from a stationary inpatients

hospital and via a local health sport club, respectively.

Interventions: The THR patients received a conventional stationary

inpatients treatment including gait retraining.

Main Outcome Measure(s): To quantify LDS, the largest Lyapunov

Exponents of the 3 dimensional (3d) pelvis trajectories (angular velocity)

have been calculated.

Results: Comparing IG vs. CG, a reduced LDS was found in pre-

(pZ.024, dZ0.91) and post-test (pZ.000, dZ1.37). There was no

significant difference in pre- vs. post-test in IG.

Conclusions: Patients with THR showed decreased LDS of the pelvis

trajectories which indicates a sensorimotor deficit of the hip joint. Whether

THR patients develop more stable pelvis movement patterns after a longer

time-span is not investigated, yet. Additionally, the dose-response effect of

specific proprioceptive training on LDS is not sufficiently understood. LDS

might be a suitable parameter to complement the estimation of the

sensorimotor state after THR. Therefore, further research is recommended.

Key Words: Gait, Local Dynamic Stability, Rehabilitation

Disclosure: Lutz Schega has nothing to disclose.

Poster 155

Effects of Treadmill Inclination on Hemiparetic Gait: RandomizedControlled Clinical Trial

Gabriela Lopes Gama (Cruzeiro do Sul University),Camila Rocha Simao, Elida Galvao, Angelica Vieira, Cavalcanti Sousa,Raquel Rodrigues Lindquist

Objective: To assess the effects of gait training on inclined surfaces in

subjects with chronic hemiparesis.

Design: Blind, randomized, controlled clinical study.

Setting: Laboratory for Human Movement Analyses of Federal University

of Rio Grande do Norte (UFRN).

Participants: 24 subjects, aged between 40 and 70 years (54.91�8.3) and

lesion time between 6 and 144 months (37.95�33.46).

Interventions: Subjects were randomized to a Control Group (CG)

submitted to partial body weight support (PBWS) treadmill gait training

with no inclination and an Experimental Group (EG), which underwent

PBWS treadmill training at a 10% incline. Twelve training sessions were

held, each lasting 20 minutes.

Main Outcome Measure(s): All volunteers were assessed for neurological

status, functional independence, motor function and balance, in addition to

gait analysis. Spatiotemporal and angular gait variables were obtained by

kinematics using the Qualisys motion analysis system.

Results: Both groups showed post-training alterations in the following

variables: balance (p< 0.001), motor function (p<0.001) and functionality

(pZ 0.002). In regard to spatiotemporal variables, intergroup differences

were observed in velocity (pZ0.02) and stride length (pZ0.03). Angular

variables showed no significant differences.

Conclusions: Gait training on an inclined surface is a promising strategy

for recovering gait in subjects with chronic hemiparesis, since even indi-

viduals in this phase of the pathology were capable of producing spatial

and temporal changes, in addition to improving balance, motor function

and functionality after 12 training sessions.