Browsing by Author "Kobsar, Dylan"
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- ItemOpen AccessBiomechanical differences between young adults with and without a history of youth sport-related ankle injury(2022-10) Russell, Monica; Edwards, William Brent; Emery, Carolyn; Manocha, Ranita; Kuntze, Gregor; Kobsar, Dylan; Sparks, HollyAnkle sprain injuries are common in youth sport and often have residual symptoms that linger years after the initial injury. These symptoms could include impaired balance and altered lower extremity joint kinematics and kinetics. Ankle sprain injury is strongly associated with the development of post-traumatic ankle osteoarthritis, with potential pathomechanisms linked to altered ankle joint loading. Thus, the primary objective of this research was to quantify differences in balance and lower extremity joint kinematics and kinetics between individuals who have sustained an ankle injury during youth sport 3 to 15 years prior to study participation compared to those with no history of lower extremity injury. The secondary objective of this study was to assess the impact of limb asymmetry and age on balance and lower extremity joint kinematics in individuals with and without ankle injury history during their youth. Balance did not differ between females with and without ankle sprain history. During walking, females with ankle sprain history demonstrated larger peak knee external rotation angle, larger peak knee extension angle, and larger peak hip flexion than uninjured controls. During a single-leg squat task, previously injured females displayed smaller peak ankle plantarflexion angle, peak knee extension angle, and peak hip external rotation angle than uninjured controls. Differences in ground reaction forces were observed during the walking and single-leg squat task between injured and uninjured females. During walking, older females displayed smaller peak ankle inversion, plantarflexion, hip abduction, and hip extension angles than younger females. During the SLS task, older females demonstrated a larger peak eversion angle and peak plantarflexion angle, and smaller peak knee external rotation and extension angles. . Small numbers of male participants limited analytic possibilities, however descriptively they may have a longer centre of pressure (COP) pathlength during the single-leg balance task compared to females. Male participants also seem to demonstrate different peaks in lower extremity joint kinematics compared to female participants. These results indicate long-term biomechanical effects of ankle sprain injuries, or pre-existing differences in biomechanics that may predispose certain individuals to ankle sprain injuries.
- ItemOpen AccessGender differences in gait kinematics for patients with knee osteoarthritis(BMC Musculoskeletal Disorders, 2016-04-01) Phinyomark, Angkoon; Osis, Sean; Hettinga, Blayne; Kobsar, Dylan; Ferber, ReedBackground: Females have a two-fold risk of developing knee osteoarthritis (OA) as compared to their male counterparts and atypical walking gait biomechanics are also considered a factor in the aetiology of knee OA. However, few studies have investigated sex-related differences in walking mechanics for patients with knee OA and of those, conflicting results have been reported. Therefore, this study was designed to examine the differences in gait kinematics (1) between male and female subjects with and without knee OA and (2) between healthy gender-matched subjects as compared with their OA counterparts. Methods: One hundred subjects with knee OA (45 males and 55 females) and 43 healthy subjects (18 males and 25 females) participated in this study. Three-dimensional kinematic data were collected during treadmill-walking and analysed using (1) a traditional approach based on discrete variables and (2) a machine learning approach based on principal component analysis (PCA) and support vector machine (SVM) using waveform data. Results: OA and healthy females exhibited significantly greater knee abduction and hip adduction angles compared to their male counterparts. No significant differences were found in any discrete gait kinematic variable between OA and healthy subjects in either the male or female group. Using PCA and SVM approaches, classification accuracies of 98–100 % were found between gender groups as well as between OA groups. Conclusions: These results suggest that care should be taken to account for gender when investigating the biomechanical aetiology of knee OA and that gender-specific analysis and rehabilitation protocols should be developed.
- ItemOpen AccessTranslating technology to clinical practice: Predicting how knee osteoarthritis patients will respond to an exercise intervention(2017) Kobsar, Dylan; Ferber, Reed; Hettinga, Blayne; Boyd, JeffreyMuscle strengthening exercises consistently demonstrate improvements in the pain and function of adults with knee osteoarthritis, but individual response rates can vary greatly. Identifying individuals who are more likely to respond is important in developing more efficient rehabilitation programs for knee osteoarthritis. Therefore, the overall goal of this thesis was to identify responders to exercise with a conventional motion capture system and translate these findings into a clinically accessible wearable sensor system. It was found that a conventional motion capture system, in combination with patient-reported outcome measures (e.g., function) collected at the baseline of an exercise intervention can successfully predict responders to treatment with greater than 85% accuracy (chapter three). To translate these findings to the clinical setting, more accessible wearable sensors (e.g., accelerometers) were examined in the remaining chapters. Chapter four found that while a single sensor at the lower back could subgroup some gait patterns, it was not sensitive enough to separate other, more similar, gait patterns. Therefore, the reliability of using multiple wearable sensors was examined in chapter five. The lower back, thigh, shank, and foot were all found to be reliable sensor locations for gait analysis and therefore suitable in the final study as potential predictors of response. Finally, chapter six found that a unique combination of wearable sensor data and patient reported outcome measures could successfully identify responders to an exercise intervention with similar accuracy to the conventional motion capture system. Further, the best limited set of sensors included only the back and thigh. Therefore, these findings suggest the potential development of a simplified two sensor system that can provide clinicians with an efficient and relatively unobtrusive way to use to optimize treatment.
- ItemOpen AccessWearable sensors to predict improvement following an exercise intervention in patients with knee osteoarthritis(2017-09-12) Kobsar, Dylan; Osis, Sean T; Boyd, Jeffrey E; Hettinga, Blayne A; Ferber, ReedAbstract Background Muscle strengthening exercises consistently demonstrate improvements in the pain and function of adults with knee osteoarthritis, but individual response rates can vary greatly. Identifying individuals who are more likely to respond is important in developing more efficient rehabilitation programs for knee osteoarthritis. Therefore, the purpose of this study was to determine if pre-intervention multi-sensor accelerometer data (e.g., back, thigh, shank, foot accelerometers) and patient reported outcome measures (e.g., pain, symptoms, function, quality of life) can retrospectively predict post-intervention response to a 6-week hip strengthening exercise intervention in a knee OA cohort. Methods Thirty-nine adults with knee osteoarthritis completed a 6-week hip strengthening exercise intervention and were sub-grouped as Non-Responders, Low-Responders, or High-Responders following the intervention based on their change in patient reported outcome measures. Pre-intervention multi-sensor accelerometer data recorded at the back, thigh, shank, and foot and Knee Injury and Osteoarthritis Outcome Score subscale data were used as potential predictors of response in a discriminant analysis of principal components. Results The thigh was the single best placement for classifying responder sub-groups (74.4%). Overall, the best combination of sensors was the back, thigh, and shank (81.7%), but a simplified two sensor solution using the back and thigh was not significantly different (80.0%; p = 0.27). Conclusions While three sensors were best able to identify responders, a simplified two sensor array at the back and thigh may be the most ideal configuration to provide clinicians with an efficient and relatively unobtrusive way to use to optimize treatment.