Annals of Physical and Rehabilitation Medicine 61S (2018) e435–e557
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Posters (Third part)
C1.07 Physical and rehabilitation medicine
diagnostics as related to organ systems and body
functions–Diagnosis and assessment of
neurological, musculoskeletal and movement
related functions (including gait analysis,
posturography)
ISPR8-0078
Normative values of knee thrust
among healthy individuals across the
lifespan
Y. Palad 1,∗ , A. Leaver 2 , M. McKay 2 , J. Baldwin 3 , F.R. Lunar 1 ,
F. Caube 1 , J. Burns 2,4 , M. Simic 2
1 University of the Philippines Manila, College of Allied Medical
Professions, Manila, Philippines
2 The University of Sydney, Faculty of Health Sciences, Sydney,
Australia
3 Auckland University of Technology, Faculty of Health and
Environmental Sciences, Auckland, New Zealand
4 Sydney Children’s Hospitals Network Randwick and Westmead,
Paediatric Gait Analysis Service of New South Wales, Orthopedics
Department, Sydney, Australia
∗ Corresponding author.
E-mail address: yypalad@up.edu.ph (Y. Palad)
Introduction/Background Varus thrust is a gait deviation and a
known risk factor for knee osteoarthritis. Prevalence of varus thrust
and normative values of stance-phase knee deviation across the
lifespan are unknown. The aim of the study was to report preva-
lence of varus thrust and normative values for hip-knee-ankle
(HKA) angle deviation across the lifespan, and to explore associ-
ations between HKA angle deviation and selected clinical factors.
Material and method This is a cross-sectional study of 572 partic-
ipants from the 1000 Norms Project. People aged 3–101 years who
self-reported as being healthy were eligible to participate. Video
recordings (2D) of frontal plane gait were analysed for presence of
varus or valgus thrust and quantification of HKA angle deviation
(difference between HKA angles at initial contact and mid-stance).
Correlation and multiple regression analyses explored the rela-
tionship between HKA angle and age, sex, body mass index (BMI),
alignment, knee and hip strength, Knee Injury and Osteoarthritis
Outcomes Scores (KOOS), foot posture index, gait parameters, and
hypermobility.
1877-0657/
Results Thirty-one percent (31%) of the cohort had varus thrust.
This was most prevalent among adults > 60 years (42%) and chil-
dren < 10 years (41%), and was also common in adolescents (25%)
and adults aged 20–59 (23%). Mean HKA angle deviation for the
entire cohort was 1.2◦ (95% CI: 1.07–1.36), and 2.1◦ (95% CI:
1.84–2.36) among people with clinical varus thrust. BMI, stride
width, KOOS-Sports for adolescents, and height for adults were
independently associated with HKA angle deviation.
Conclusion Varus thrust is prevalent across the lifespan. Normat-
ive values established here can be readily used by clinicians and
researchers in monitoring this deviation.
Keywords Varus thrust; Normative values; Biomechanics
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
https://doi.org/10.1016/j.rehab.2018.05.1011
ISPR8-2626
Gender and laterality differences on
measurements of acromiohumeral
distance (AHD) at rest and at shoulder
abduction using musculoskeletal
ultrasound in asymptomatic Filipino
adults
M.N. Gelvosa ∗ , A. Azarcon
Veterans Memorial Medical Center, Department of Rehabilitation
Medicine, Quezon City, Philippines
∗ Corresponding author.
E-mail address: nicegelvosa@gmail.com (M.N. Gelvosa)
Introduction/Background Musculoskeletal ultrasound is increas-
ingly becoming a popular tool in the diagnosis of musculoskeletal
disorders with the shoulder as one of the most routinely scanned
joints. Common causes of shoulder pain, such as subacromial
impingement syndrome and rotator cuff tendinopathy, have been
shown to be associated with reduced acromiohumeral distance.
This study aimed to determine mean ultrasonographic acromio-
humeral distance and compare measurements between male and
female Filipino adults, dominant and non-dominant side, at neu-
tral shoulder position and at 60◦ abduction. Secondarily, it aimed to
determine interrater reliabiliy of ultrasonographic measurements.
Material and method This study employed a cross-sectional
observational study design. AHD was measured on both shoulders
of forty-one volunteers, 15 males and 26 females with mean age
22.1 and 22.3 respectively, at neutral shoulder position and at 60◦
of passive abduction by two different raters.
e436 Abstracts / Annals of Physical and Rehabilitation Medicine 61S (2018) e435–e557
Results For the dominant side, mean AHD at neutral was
11.40 mm (SD 1.16 mm) for males and 10.65 mm (SD 1.22 mm) for
females (P-value < 0.05). At 60◦ passive abduction, AHD decreased
to 9.96 mm (SD 1.10 mm) for males and 9.49 mm (SD 1.43 mm)
for females. For the non-dominant side, the mean AHD at neutral
was 11.15 mm (SD 1.13 mm) for males and 10.70 mm (1.20 mm)
for females. At 60◦ abduction, mean AHD was 9.86 mm (1.13 mm)
for males and 9.36 mm (1.54 mm) for females (P-value > 0.05).
Comparison of the dominant and non-dominant sides showed no
significant difference at both shoulder positions. ICC values for the
all the measurements ranged from 0.848 to 0.913.
Conclusion Results of this study suggest that measurement of
AHD may have gender differences, but is similar between the
dominant and non-dominant side. Musculoskeletal ultrasound was
found to have excellent interrater reliability to measure AHD at
both neutral position and at 60◦ of passive abduction.
Keywords Ultrasonography; Shoulder
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
https://doi.org/10.1016/j.rehab.2018.05.1012
ISPR8-0717
Dynamic motion and principal
component analysis of step-over in
patients with Musculoskeletal
ambulation disability symptom
complex (MADS)
M. Maeda 1,∗ , H. Maeda 2 , H. Iwase 3 , A. Kanda 3 , I. Morohashi 3 ,
O. Obayashi 3 , K. Kaneko 2 , T. Sato 4 , Y. Arai 5
1 Yamamoto and Maeda memorial Maeda Hospital, Japan
2 Department of Orthopaedic Surgery, School of Medicine, Juntendo
University, Japan
3 Department of Orthopaedic Surgery, Shizuoka Medical Research
Center for Disaster, Juntendo shizuoka Hospital, Japan
4 Department of Mechanical Engineering, Schoolof Engineering,
Tokyo Denki University, Japan
5 Tokyo metropolitan rehabilitation hospital, Japan
∗ Corresponding author.
E-mail address: hiroyuki.maeda78@gmail.com (M. Maeda)
Introduction/Background The functional evaluation criteria of
musculoskeletal ambulation disability symptom (MADS) complex
include the one-leg standing duration with eyes open and 3-m
timed up and go test, but actual measurement is physically dif-
ficult for many patients. Thus, it is necessary to investigate a new,
safe, and simple evaluation method. Considering that falls are likely
to occur when one is stepping over an obstacle, we investigated
the association between the musculoskeletal ambulation disabil-
ity symptom complex and dynamic motions by dynamic motion
analysis of “step-over” in healthy subjects and patients with the
complex.
Material and method This study examined the association
between the musculoskeletal ambulation disability symptom com-
plex (MADS) and dynamic motions by performing dynamic motion
analysis of “stepping over obstacles”, involving 11 MADS patients
(group-M) compared to 10 young (-Y) and 11 elderly (-E) individ-
uals with no health-related problems. All participants stepped over
an obstacle with a height of 9 cm by adopting 2 patterns: watching
or not watching the obstacle on measurement of each joint angle
and toe-obstacle clearance. The obtained values were examined
through principal component analysis.
Results The age, experience of falls, and hip and knee joint angles
showed higher absolute values representing factor loading on the
first principal component, and this was consistent with the subse-
quent result of dynamic motion analysis focusing on joint angles:
elderly group-E or M members showed greater hip and knee flex-
ion to improve their toe-obstacle clearance. Therefore, the first
principal component was considered to accurately represent the
characteristics of the elderly, while the second principle compo-
nent was likely to represent the characteristics of physical factors
and clearance level.
Conclusion It was clarified that items can be selected by dynamic
motion analysis and principle component analysis, which may
lead early evaluation of the musculoskeletal ambulation disability
symptom complex.
Keywords MADS; Step-over; Gait analysis
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
https://doi.org/10.1016/j.rehab.2018.05.1013
ISPR8-1108
Variability of motor performance and
symptoms of motor disregard in the
use of neurocomputer technologies in
the rehabilitation of patients after a
stroke
Y. Bushkova 1,∗ , I. Galina 2 , S. Andrey 1 , L. Stakhovskaya 1 ,
A. Frolov 3
1 Research Institute of cerebrovascular pathology and stroke, GBOU
VPO RNIMU him. N.I. Pirogov., Ministry of Health of the Russian
Federation, Moskow, Russia
2 Research Institute of cerebrovascular pathology and stroke, GBOU
VPO RNIMU him. N.I. Pirogov. Ministry of Health of the Russian
Federation, Institute of Higher Nervous Activity and Neurophysiology
RAS, Moscow, Russia
3 Institute of Higher Nervous Activity and Neurophysiology RAS,
Moscow, Russia
∗ Corresponding author.
E-mail address: bushkovay@yandex.ru (Y. Bushkova)
Introduction/Background Currently, neurobiological feedback
technologies based on neurocomputer interfaces are used in the
rehabilitation of patients after a stroke (Yekutiel M, 2000). The
ability to actively implement the capabilities of interface-brain-
computer technology (IMC) remains limited for most patients
(Cloutier S. et al., 2015).
Material and method The IMC was used, based on the analysis of
EEG patterns and recognition of the synchronization / desynchro-
nization reaction of the sensoro-motor (mu-rhythm) in imagining
the movements of the hands of patients. The data of 15 patients
(7 men, 8 women), at the age of 64 (62.0, 69.0) years, the dura-
tion of the stroke of 8 (5, 19) months, with right hemispheric
localization in 7 patients (46%), mild to plegia (MRCWS); with a
focus of stroke etiology (ischemic / hemorrhagic), supratentorial
localization (CT, MRI); received therapy IMK-an exoskeleton brush
with kinesthetic feedback, 9.5 (8; 10) procedures (ClinicalTrials.gov
(identifier: NCT02325947)).
Results Only 6 (40%) patients solved the mental motor problem
with accuracy of the EEG data (presence of the mu-rhythm) above
70%, 4 (26%) failed to solve the problem. The accuracy of their rep-
resentations according to EEG data was no more than 20%. The
accuracy of the representations of the remaining 5 (33%) patients
was in the range of 45–55%. What is consistent with the literature
(Ahn and Chan, 2015; Hammer EM et al., 2014).
Conclusion The absolute majority of patients with stroke have
motor disregard for the affected side. Even with a minimal motor
deficit, patients unconsciously prefer to use a healthy hand in
everyday life. Such patients need to restore the functional sys-
tem of formation of target motility by training the lost or altered
links of this functional system. The combination of neurocomputer
technologies (IMC) and physical training in a certain sequence will
facilitate their more successful interaction and will improve the
efficiency of rehabilitation.
Keywords Neurobiological technology of feedback;
Interface-brain-computer