Background: Increasing numbers of patients require permanent walking aids to maintain mobility. Current elbow crutches are not designed for long-term use, and overuse is often associated with hematoma formation and pain along the forearm. We therefore hypothesized that the highest pressures between the forearm and crutch cuff during walking and stance are located in the ulnar region and that the level of weight-bearing, forearm circumference and kinematic parameters influence peak pressure values and pressure distribution. Methods: Ten healthy adults participated in a cross-sectional study. A pressure sensor array was attached to the forearm of each participant separating the forearm into four quadrants (lateral, ulnar, intermediate and medial). Measurements were taken during crutch gait and during partial and full weight-bearing stance. A three-dimensional motion analysis system with reflective markers attached to the subject’s body and to the crutches was used to obtain kinematic data. Results: The mean pressure on the forearm during crutch gait was 37.5 kPa (SD 8.8 kPa). Highest mean pressure values were measured in the ulnar (41.0 kPa, SD 9.6 kPa) and intermediate (38.0 kPa, SD 9.0 kPa) quadrants. The center of pressure was mainly located in an oblique lamellar area in these two quadrants. With increasing weight-bearing on the crutches during stance, we observed a shift of the peak pressures towards the ulnar quadrant. The circumference of the forearm correlated with the peak pressure in the medial and intermediate quadrants during crutch gait (P < 0.05). Peak pressures on the forearm showed a trend towards correlation with crutch abduction, but no association with other kinematic parameters was detected. Conclusion: The pressure load on the forearm during crutch-assisted gait is located predominantly over the ulna and may be linked to a range of secondary conditions caused by crutch use including hematoma formation and pain.

In gymnastics, coaches are constantly searching for efficient training methods in order to improve the athletes’ performance. Therefore, in this study we aimed to investigate the effects of a novel, four-week, gymnastic-specific, eccentric–isokinetic (0.1 m/s) cluster training on a computer-controlled training device on the improvement of two static strength elements on rings (swallow and support scale). Nine elite male gymnasts participated in this study. Outcome parameters were maximum strength and strength endurance in maintaining the static position of both elements. After four weeks of training, specific maximum strength increased significantly (swallow: +4.1%; d = 0.85; p = 0.01; support scale: +3.6%; d = 2.47; p = 0.0002) and strength endurance tended to improve (swallow: +104.8%; d = 0.60; p = 0.07; support scale: +26.8%; d = 0.27; p = 0.19). Our results demonstrate that top athletes can considerably improve ring-specific strength and strength endurance in only four weeks. We assumed that the high specificity but also the unfamiliar stimulus of slow eccentric movements with very long times under maximal muscle tension led to these improvements. We suggest to use this type of training periodically and during phases in which the technical training load is low.

This article describes an easy to use test equipment for measuring the isometric force in the ankle joints in dorsiflexion and plantar flexion. The combination of the test equipment for measuring the voluntary maximal isometric muscle force in the ankle joint, the surface electromyograms and the motion analysis of the measured leg allow an objective comparison of the strength of the muscular force between the left and right leg. It might be also used as a control setup during rehabilitation after surgical treatment or injuries.

Dynamic three-dimensional (3D) deformation of the pelvic bones is a crucial factor in the successful design and longevity of complex orthopaedic oncological implants. The current solutions are often not very promising for the patient; thus it would be interesting to measure the dynamic 3D-deformation of the whole pelvic bone in order to get a more realistic dataset for a better implant design. Therefore we hypothesis if it would be possible to combine a material testing machine with a 3D video motion capturing system, used in clinical gait analysis, to measure the sub millimetre deformation of a whole pelvis specimen. A pelvis specimen was placed in a standing position on a material testing machine. Passive reflective markers, traceable by the 3D video motion capturing system, were fixed to the bony surface of the pelvis specimen. While applying a dynamic sinusoidal load the 3D-movement of the markers was recorded by the cameras and afterwards the 3D-deformation of the pelvis specimen was computed. The accuracy of the 3D-movement of the markers was verified with 3D-displacement curve with a step function using a manual driven 3D micro-motion-stage. The resulting accuracy of the measurement system depended on the number of cameras tracking a marker. The noise level for a marker seen by two cameras was during the stationary phase of the calibration procedure ± 0.036 mm, and ± 0.022 mm if tracked by 6 cameras. The detectable 3D-movement performed by the 3D-micro-motion-stage was smaller than the noise level of the 3D-video motion capturing system. Therefore the limiting factor of the setup was the noise level, which resulted in a measurement accuracy for the dynamic test setup of ± 0.036 mm. This 3D test setup opens new possibilities in dynamic testing of wide range materials, like anatomical specimens, biomaterials, and its combinations. The resulting 3D-deformation dataset can be used for a better estimation of material characteristics of the underlying structures. This is an important factor in a reliable biomechanical modelling and simulation as well as in a successful design of complex implants.

During ring performance in men’s gymnastics, static strength elements require a high level of maximal muscular strength. The aim of the study was to analyze the effect of a four-week eccentric–isokinetic training intervention in the frequency spectra of the wavelet-transformed electromyogram (EMG) during the two static strength elements, the swallow and support scale, in different time intervals during the performance. The gymnasts performed an instrumented movement analysis on the rings, once before the intervention and twice after. For both elements, the results showed a lower congruence in the correlation of the frequency spectra between the first and the last 0.5 s interval than between the first and second 0.5 s intervals, which was indicated by a shift toward the predominant frequency around the wavelet with a center frequency of 62 Hz (Wavelet W10). Furthermore, in both elements, there was a significant increase in the congruence of the frequency spectra after the intervention between the first and second 0.5 s intervals, but not between the first and last ones. In conclusion, the EMG wavelet spectra presented changes corresponding to the performance gain with the eccentric training intervention, and showed the frequency shift toward a predominant frequency due to acute muscular fatigue.

This article introduces a novel concept where advanced technologies have been leveraged to produce a modular walking orthosis (MOWA) within a completely digital process chain. All processes of this new supply chain are described step-by-step. The prescription and treatment of lower leg orthoses for individuals with paralysis or muscle weakness, particularly cerebral palsy (CP), are complex. A single case study indicates successful treatment with this new orthosis (MOWA). From the authors’ perspective, this innovative fitting concept is promising and will contribute to creating more efficient care within a multidisciplinary team.