In wheelchair rugby (WR) athletes with tetraplegia, wheelchair performance may be impaired due to (partial) loss of innervation of upper extremity and trunk muscles, and low blood pressure (BP). The objective was to assess the effects of electrical stimulation (ES)-induced co-contraction of trunk muscles on trunk stability, arm force/power, BP, and WR performance.
Knee joint instability is frequently reported by patients with knee osteoarthritis (KOA). Objective metrics to assess knee joint instability are lacking, making it difficult to target therapies aiming to improve stability. Therefore, the aim of this study was to compare responses in neuromechanics to perturbations during gait in patients with self-reported knee joint instability (KOA-I) versus patients reporting stable knees (KOA-S) and healthy control subjects.Forty patients (20 KOA-I and 20 KOA-S) and 20 healthy controls were measured during perturbed treadmill walking. Knee joint angles and muscle activation patterns were compared using statistical parametric mapping and discrete gait parameters. Furthermore, subgroups (moderate versus severe KOA) based on Kellgren and Lawrence classification were evaluated.Patients with KOA-I generally had greater knee flexion angles compared to controls during terminal stance and during swing of perturbed gait. In response to deceleration perturbations the patients with moderate KOA-I increased their knee flexion angles during terminal stance and pre-swing. Knee muscle activation patterns were overall similar between the groups. In response to sway medial perturbations the patients with severe KOA-I increased the co-contraction of the quadriceps versus hamstrings muscles during terminal stance.Patients with KOA-I respond to different gait perturbations by increasing knee flexion angles, co-contraction of muscles or both during terminal stance. These alterations in neuromechanics could assist in the assessment of knee joint instability in patients, to provide treatment options accordingly. Furthermore, longitudinal studies are needed to investigate the consequences of altered neuromechanics due to knee joint instability on the development of KOA.
OBJECTIVE: To evaluate if using surface neuromuscular electrical stimulation (NMES) for paralyzed lower-limb muscles results in an increase in energy expenditure and if the number of activated muscles and duty cycle affect the potential increase.DESIGN: Cross-sectional study.RESULTS: Energy expenditure during all NMES protocols was significantly higher than the condition without NMES (1.2 ± 0.2 kcal/min), with the highest increase (+ 51%; +0.7 kcal/min, 95% CI: 0.3 - 1.2) for the protocol with more muscles activated and the duty cycle with a shorter rest period. A significant decrease in muscle contraction size during NMES was found with a longer stimulation time, more muscles activated or the duty cycle with a shorter rest period.CONCLUSION: Using NMES for paralyzed lower-limb muscles can significantly increase the energy expenditure compared to sitting without NMES with the highest increase for the protocol with more muscles activated and the duty cycle with a shorter rest period. Muscle fatigue occurred significantly with the more intense NMES protocols which might cause a lower energy expenditure in a longer protocol. Future studies should further optimize the NMES parameters and investigate the long-term effects of NMES on weight management in people with SCI.
The main aim of KiNESIS is to create a Knowledge Alliance among academia, NGOs, communities, local authorities, businesses to develop a program of multidisciplinary activities in shrinking areas with the aim of promoting and fostering ideas, projects, workforce, productivity and attractiveness. The problems affecting peripheral territories in rural or mountain areas of the interior regions, compared to small, medium or large population centres and large European capitals, are related to complex but clear phenomena: the emigration of young generations, abandonment and loneliness of elderly people, the loss of jobs, the deterioration of buildings and land, the closing of schools and related services, the disappearance of traditions and customs, the contraction of local governments, which in absence of adequate solutions can only generate worse conditions, leading to the abandonment of areas rich in history, culture and traditions. It is important that these communities - spread all over Europe - are not abandoned since they are rich in cultural traditions, which need to be preserved with a view to new developments, intended as "intelligent" rebirth and recovery.The focus of KiNESIS is to converge the interest of different stakeholders by recalling various skills around abandoned villages to make them "smart" and "attractive".Keeping in mind the triangular objectives of cooperation and innovation of research, higher education and business of the Knowledge Alliance action, the project aims are: i) revitalising depopulated areas by stimulating entrepreneurship and entrepreneurial skills; ii) creating local living laboratories, shared at European level, in which the exchange of knowledge, best practices, experiences can help promote social inclusion and entrepreneurial development;iii) experimenting new, innovative and multidisciplinary approaches in teaching and learning; iv) facilitating the exchange, flow and co-creation of knowledge at a local and global level.
