Biomedical subjects

M E Maitland

Publications and source records attributed to M E Maitland.

11 recordsLinked to original sources

PubMed2000

The effect of hamstring muscle compensation for anterior laxity in the ACL-deficient knee during gait.

The hamstring muscles have been recognized as an important element in compensating for the loss of stability in the ACL-deficient knee, but it is still not clear whether the hamstring muscle force can completely compensate for the loss of ACL, and the consequences of increased hamstring muscle force. A two-dimensional anatomical knee model in the sagittal plane was developed to examine the effect of various levels of hamstring muscle activation on restraining anterior tibial translation in the ACL-deficient knee during level walking. The model included the tibiofemoral and patellofemoral joints, four major ligaments, the medial capsule, and five muscle units surrounding the knee. Simulations were conducted to determine anterior tibial translation and internal joint loading at a single selected position when the knee was under a peak external flexion moment during early stance phase of gait. Incremental hamstring muscle forces were applied to the modeled normal and the ACL-deficient knees. Results of simulations showed that the ACL injury increased the anterior tibial translation by 11.8mm, while 56% of the maximal hamstring muscle force could reduce the anterior translation of the tibia to a normal level during the stance phase of gait. The consequences of increased hamstring muscle force included increased quadriceps muscle force and joint contact force.

Anterior Cruciate Ligament↗

PubMed2000

The effect of axial load on the in vivo anterior drawer test of the ankle joint complex.

The anterior drawer test is commonly used in the diagnosis of ankle joint mechanical instability. However, the effect of axial load on the anterior drawer test has not been examined in vivo. The purpose of the study was to assess the effect of axial load on passive anterior instability, and on the diagnostic measurement of the anterior drawer instability of the ankle joint complex. A total of 21 subjects with various degrees of ankle sprains were tested on a device that could continuously record applied anterior force and the resultant displacement of the rear-foot. Anterior drawer flexibility of the ankle joint complex in a neutral dorsi/plantar flexion position was quantified on both feet for all subjects without and with an axial load (385 N). Flexibility of the ankle joint complex in anterior drawer was defined as the slope of a linear load-displacement curve (which fitted test data with high correlation coefficients (r>0.991)). With axial load, anterior drawer flexibility was significantly reduced by 28.8% compared to that without axial load. The difference in anterior drawer flexibility between injured and intact ankles significantly decreased with axial load. An axial load increased the stability of ankle joint complex. However, axial load reduced the sensitivity of anterior drawer test to mechanical instability of the ankle joint complex.

Adult↗

PubMed1999

Test-retest reliabilty of isokinetic hip adductor and flexor muscle strength.

OBJECTIVE: To determine the test-retest reliability of eccentric hip flexor and adductor peak torque and endurance using a Cybex Norm isokinetic dynamometer and to evaluate muscle soreness after exercise as a result of the testing procedure. DESIGN: Prospective test-retest reliability study. PARTICIPANTS: A total of 19 male volunteers (21-43 years old). INTERVENTION: Tests included hip flexor and adductor peak torque strength measured at 60 degrees/s (concentric and eccentric) and endurance measurements (total work done over 20 continuous concentric/eccentric contractions at 150 degrees/s). Subjects were tested on three occasions at 1-week intervals. MAIN OUTCOME MEASURES: Repeated measures analysis of variance was performed for all dependent variables including the subject's dominant and nondominant side among the three test sessions. Intraclass correlation coefficients (ICCs) were calculated to compare the data between sessions. In addition, simple linear regression analysis was completed to determine the relationship between session measurements for all measures with ICC > 0.75. RESULTS: The main findings of this study are that eccentric peak hip adductor torque was reliably measured on a Cybex Norm isokinetic dynamometer using a continuous eccentric/ concentric cycle protocol at a speed of 60 degrees/s (ICC > 0.84). Peak concentric adductor torque and peak eccentric and concentric hip flexor torque were less reliable using the same protocol (ICC < 0.67). Endurance measurements, using total work done over 20 repetitions, were not reliable for hip flexor and adductor muscle groups using a continuous eccentric/concentric cycle protocol at a speed of 150 degrees/s (ICC < 0.55). Posttest muscle soreness was found to be of significant concern with such a protocol. CONCLUSION: The results from this test-retest reliability study confirm the reliability of eccentric peak hip adductor torque measurements for use clinically and in future research. In addition, the need to assess posttest muscle soreness after isokinetic muscle testing is confirmed.

Adult↗

PubMed1999

Quadriceps femoris and hamstring muscle function in a person with an unstable knee.

BACKGROUND AND PURPOSE: The purpose of this case report is to describe the evaluation, treatment, and short-term outcome for an individual with chronic, progressively worsening instability of the knee during gait associated with anterior cruciate ligament (ACL) insufficiency. CASE DESCRIPTION: The patient was a 34-year-old man who sustained bilateral ACL injuries. Subsequently, an autograft reconstruction of the left knee ACL was performed. Eight months post-reconstruction, the left knee was unstable despite bracing. Gait analysis and tests to determine the presence of muscle inhibition were performed prior to and after 12 weeks of training. Isometric torque of the knee extensors and flexors was measured with the knee in 90 degrees of flexion. A training program primarily consisted of electromyographic biofeedback during thigh muscle exercises, balance exercises, and gait. OUTCOMES: Muscle inhibition decreased and maximal isometric knee flexion and extension torques increased during the 12-week training period. Gait analysis demonstrated a 50% decrease in the maximum knee extensor moment and an increase in walking speed. DISCUSSION: Selected gait variables, torque production, and muscle inhibition may change in a person with an unstable knee. The measurement of variables that have previously been documented as mechanisms of knee instability during walking allows for the selection of a specific treatment approach.

Adult↗

PubMed1998

Method to assess in vivo knee stability longitudinally in an animal model of ligament injury.

The purpose of this study was to develop a method to prospectively quantify passive knee stability in an animal model of joint injury over time. Knee stability is defined here as the amount of translation or rotation of the tibia relative to the femur for a given application of force or moment, respectively. Five animals that had undergone transection of the anterior cruciate ligament and three control animals that had undergone a sham operation were anaesthetized and positioned in a stereotaxic frame. Motion of the tibia relative to the femur was quantified with use of reflective markers secured to modified bone pins and a three-dimensional motion analysis system. External forces and moments in the transverse plane of the tibia were measured with use of force transducers based on a strain-gauge design. Longitudinal measurements of knee stability were made before either sham surgery (control animals) or transection of the ligament (experimental animals), immediately after surgery, and at 2 and 4 months after transection. The results showed that the animals tolerated the procedures well and that systematic measurements could be obtained. The method described here has the practical advantage over cross-sectional experimental designs in that the number of subjects can be decreased while maintaining statistical power and has the further conceptual advantage that individual changes can be accounted for over time.

Animals↗

PubMed1998

Longitudinal measurement of tibial motion relative to the femur during passive displacements in the cat before and after anterior cruciate ligament transection.

Passive anterior-posterior displacement and medial-lateral rotation of the tibia on the femur in the feline knee were assessed before transection of the anterior cruciate ligament, immediately after transection, and 2 and 4 months after transection. Four anaesthetized experimental and three sham-operated control animals were positioned in a stereotaxic frame. Motions of the tibia relative to the femur were measured with use of 60-Hz video motion analysis, while a strain-gauged system allowed measurement of forces and moments applied to the tibia. Displacement at 15 N of anterior force and 30 degrees of knee flexion increased by an average of 6 mm following transection, and stiffness decreased by an average of 6 N/mm. At 2 and 4 months following transection, there were statistically significant reductions in this abnormal displacement. Stiffness during anterior displacement of the tibia at 30 degrees increased significantly from immediately after transection to 4 months. At 90 degrees, mean anterior displacement decreased from 5.1 mm immediately after transection to 2.9 mm at 4 months. Medial rotation at 30 degrees of knee flexion was significantly decreased from a mean of 16.5 degrees after transection to a mean of 10.7 degrees at 4 months. Changes in medial rotation at 90 degrees, lateral rotation at 90 degrees, and lateral rotation at 30 degrees were not statistically significant. These results indicate a significant change in secondary constraints to tibial motion in response to knee instability.

Animals↗

PubMed1994

A client-computer interface for questionnaire data.

Our purpose was to assess efficiency and patient acceptance of a simple, inexpensive method of direct client-computer interface. A computerized version of the Sickness Impact Profile (SIP) was developed with the standard keyboard replaced by a numeric keypad. Forty-eight volunteer clients of an occupational rehabilitation center completed both the paper format and the computer format in randomized order, then were asked to compare the two methods in four areas. The majority of subjects rated the computer as easier to use and as the preferred method. Most subjects rated the computer and paper formats as equivalent in comfort and understanding. A summary score established that significantly more individuals preferred the computer format over the paper format (p = .02). Efficiency was determined by the mean time to score the test and produce a report (computer 39s, paper 309s). The correlation coefficients for the physical, psychosocial, and overall scores were very acceptable being greater than 0.90. These data indicate that a simple client-computer interface for the SIP is preferred by clients and is more efficient compared to the paper and pencil format.

Adult↗

PubMed1991

A correlation between the distribution of biological apatite and amino acid sequence of type I collagen.

We have determined the localization of apatite within type I collagen fibrils of calcifying turkey leg tendons by both bright field and selected-area dark field (SADF) electron microscopy and have compared this to computer-modeled, chick type I collagen amino acid sequence data. Apatite crystals occur in both the gap and overlap zones at early stages of mineralization in an asymmetric pattern that corresponds to the polarity, N- to C- orientation, of the collagen molecule. Based on comparisons with computer-generated models of known amino acid sequence of collagen, it was determined for early stages of mineral deposition that apatite is restricted by areas of high hydrophobicity. The gap zone is less hydrophobic than the overlap zone on average but each of these zones had areas of high hydrophobicity that correlated with sites of low localization of mineral. Possible interactions between hydrophobic regions and the process of mineral deposition are discussed.

Amino Acid Sequence↗

PubMed1990

Histochemical classification based upon reaction types and its application to carbohydrate histochemistry.

A method of classification is presented, which divides histochemical visualization reactions into categories based on general reaction types. This scheme is dependent upon the reaction between two elements, the substrate and the probe. The substrate represents a tissue component(s) with one or more reactive groups that can combine directly with the probe. Alternatively, the substrate reactive groups are chemically modified (activation) with a suitable reagent before reaction with the probe. Probes are of three types: those that yield a coloured product, those that result in a colourless product, and those that produce a coloured product only after a further reaction. Methods used in carbohydrate histochemistry are divided into one, two and three probe reactions. Two probe reactions are further subdivided into sequences involving one or two coloured products (one and two dye sequences); three probe reactions into sequences involving one, two or three coloured products (one, two and three dye sequences). This classification permits the rationalization and organization of methods, and provides a framework for the examination of existing methods and the development of new ones.

Carbohydrates↗

PubMed1989

Freeze-substitution staining of rat growth plate cartilage with alcian blue for electron microscopic study of proteoglycans.

To selectively stain polyanionic macromolecules of growth plate cartilage and to prevent artifacts induced by aqueous fixation, proximal tibial growth plates were excised from rats, slam-frozen, and freeze-substituted in 100% methanol containing the cationic dye Alcian blue. Electron microscopic examination showed the tissue stained with Alcian blue to be comparable in ultrastructural preservation to tissues slam-frozen and freeze-substituted in the absence of Alcian blue. The extracellular matrix exhibited a characteristic staining pattern when stained by this method. The pericellular rim was identified as a band of varying width encircling the chondrocyte and its cell processes. Peripheral to the pericellular rim the heterogeneity of staining within the extracellular matrix increased, taking the form of polymorphic densities. X-ray microanalysis showed that the visual interpretation of electron density was related to the concentration of copper present, and that the concentration of sulfur was variable in the pericellular rim and in the interterritorial matrix. The difficulties associated with aqueous fixation and staining procedures are discussed in contrast to the improved preservation achieved by cryogenic methods.

Alcian Blue↗

PubMedDate not supplied

Does Cybex testing increase knee laxity after anterior cruciate ligament reconstructions?

Long-term stability of the knee after anterior cruciate ligament reconstruction is imperative. Testing protocols that use isokinetic systems are commonly performed despite controversies as to their safety. The purpose of this study was to test whether one episode of isokinetic testing would cause an increase in anterior tibial translation. Twenty-four subjects who had anterior cruciate ligament reconstructions 153 to 300 days earlier volunteered for the study. Initially, subjects walked on a treadmill at 5 km/hr for 10 minutes to test the effect of exercise on displacement measurements. One week later, subjects performed a maximal knee flexion-extension test on the Cybex dynamometer at 60, 150, and 240 deg/sec. Anterior tibial displacement at 133.5 N was obtained from force-displacement curves produced by KT-2000 arthrometer testing at nine intervals: before exercise on the treadmill, at four intervals after treadmill exercise, and at four intervals after Cybex testing. Repeated measures analysis of variance did not show a significant exercise effect, interaction between type of exercise and time interval, or change after Cybex testing for the reconstructed knee displacement, the contralateral knee displacement, or side-to-side difference. The average difference before and after Cybex testing was 0.1 mm for the reconstructed knee. In conclusion, a single Cybex test, performed at least 6 months after surgery, did not affect anterior tibial displacement in this study sample.

Adolescent↗