Publications
288 results found
Papi E, Bo YNJ, McGregor AH, 2016, KNEE FLEXION MEASURED WITH A FLEXIBLE WEARABLE SENSOR, European Society of Biomechanics Conference
Belsi A, Papi E, McGregor AH, 2016, The impact of wearable technology on psychosocial factors of osteoarthritis management: a qualitative study, BMJ Open, Vol: 6, ISSN: 2044-6055
Objectives To identify the impact the use of wearable technology could have in patients with osteoarthritis in terms of communication with healthcare providers and patients’ empowerment to manage their condition.Design Qualitative study using focus groups with patients with osteoarthritis; data from patients’ responses were analysed using Framework Methodology.Participants 21 patients with knee osteoarthritis from the London area (age range 45–65 years) participated in a total of four focus groups. Recruitment continued until data saturation.Setting The study was conducted in a university setting.Results Patients’ responses suggested a positive attitude on the impact wearable technology could have on the management of osteoarthritis. It was perceived that the use of wearable devices would benefit patients in terms of feeling in control of their condition, providing them with awareness of their progress, empowering in terms of self-management and improving communication with their clinician.Conclusions This paper suggests positive patient perspectives on the perceived benefits wearable technology could have on the management of osteoarthritis. The data that could be collected with the use of wearable technology could be beneficial both to patients and clinicians. The information obtained from this study suggests that introducing wearable technology into patient-centred care could enhance patient experience in the field of osteoarthritis and beyond.
Bates AV, McGregor AH, Alexander CM, 2016, Reliability and minimal detectable change of gait kinematics in people who are hypermobile, GAIT & POSTURE, Vol: 44, Pages: 37-42, ISSN: 0966-6362
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- Citations: 14
Papi E, Murtagh GM, McGregor AH, 2016, Wearable technologies in osteoarthritis: A qualitative study of clinicians’ preferences., BMJ Open, Vol: 6, ISSN: 2044-6055
Objective This study investigates clinicians’ views of health-related wearable technologies in the context of supporting osteoarthritis (OA) long-term management. Clinicians’ preferences are critical in identifying realistic implementation strategies for such technologies.Design Qualitative study incorporating an inductive thematic analysis applied to identify key themes from clinicians’ responses.Participants Clinicians, including 4 general practitioners, 4 physiotherapists and 5 orthopaedic surgeons were interviewed.Setting The study was conducted in a University setting.Results Participants all agreed wearable technologies could positively complement their role and enhance their relationship with patients. Perceived benefits of wearable technologies included monitoring patients’ progress, treatment evaluation, monitoring compliance and informing clinical decision-making. The device should be designed to provide objective data of patients’ locomotion capability in an easy and timely fashion via a simple interface. Data should be available to both clinicians and patients to provide them with the motivation to achieve clinical goals and allow them to take ownership of their treatment. The use of technology was also seen as a way to more effectively plan treatment and manage patients’ contact time saving time and cost.Conclusions Findings support the use of wearable technologies to enhance current OA management and suggest clinical uses. Adoption of technologies could have implications on the effectiveness of treatment provided overcoming current barriers, in particular compliance with treatment.
Greenwood J, McGregor A, Jones F, et al., 2016, Rehabilitation Following Lumbar Fusion Surgery: A Systematic Review and Meta-Analysis., Spine, Vol: 41, Pages: E28-E36, ISSN: 0362-2436
STUDY DESIGN: A systematic review with meta-analysis. OBJECTIVE: The aim of this study was to conduct a systematic review and meta-analysis of current evidence evaluating the effectiveness of rehabilitation following lumbar fusion surgery (LFS). SUMMARY OF BACKGROUND DATA: LFS for the management of lower back pain, with(out) neurogenic leg pain, is increasing as the population ages. Clinical outcomes commonly lag behind surgical outcomes and 40% of patients experience significant back-related disability 12 months after LFS. Identifying rehabilitation strategies to improve function and quality of life following LFS is important. METHODS: A systematic review of databases were searched, including MEDLINE, CINAHL, and grey literature. Studies identified were screened for inclusion by title and abstract. Full text of eligible/potentially eligible studies was evaluated against predetermined eligibility criteria. Included studies were subjected to critical appraisal and risk of bias evaluation. The GRADE approach to quality of evidence was utilized. A meta-analysis comparing usual care with "complex rehabilitation," comprising exercise and cognitive behavioral therapy, for outcomes relating to pain, disability, fear of movement, and mental health was conducted at short and longer term (<3 and >12 months postsurgery) time points. RESULTS: Three studies were identified for the systematic review and 2 included in the meta-analysis (n = 237, female = 62%, mean age = 55). Low-quality evidence suggests that "complex rehabilitation" provides short-term improvement in disability [effect size, -0.85, 95% confidence interval (95% CI), -1.41 to -0.29] and fear avoidance behavior (-1.07, 95% CI -1.33, -0.80), compared with usual care. Low-quality evidence exists favoring "complex rehabilitation" over usual care for longer term disability (-0.84, 95% CI -1.11 to -0.58) and fear avoidance behavior (-1.40, 95% CI -1.69 to -1.12). CONCLUSIONS: A small n
McGregor AH, Buckeridge E, Murphy AJ, et al., 2015, Communicating and using biomechanical measures through visual cues to optimise safe and effective rowing, Proceedings of the Institution of Mechanical Engineers Part P - Journal of Sports Engineering and Technology, Vol: 230, Pages: 246-252, ISSN: 1754-3371
The use of representations of physiological parameters to an athlete and coach during training is becoming increasingly common. Their utility is enhanced when the appropriate data are captured and communicated in real time for the athlete to make training adjustments immediately. The aim of this work was to develop a biofeedback tool for ergometer rowing by creating a data acquisition system, data analysis and interpretation that could be conducted in real time and a feedback system with appropriate cues to the athlete. This fourteen year study resulted in a set of measured parameters with inferred correlations between the directly measured parameters acquired during the activity and performance and injury outcome measures. These parameters were represented through a customisable visual display in real-time during ergometer training. An athlete and coach open survey was conducted to assess the utility of the biofeedback tool. This survey found that all parties valued the feedback system since it provided a common language to identify body motion and performance parameters in a way that was accessible and meaningful to all parties as well available during training and coaching. Athletes noted that it helped them to understand body segment motion and its relation to performance and both coaches and medical staff valued this in enhancing performance and monitoring injury and injury prediction. There was also speculation that the system help to underpin coaching practice and its translation to the team. The biofeedback tool has been adopted by the British elite rowing squad.
Pavlova A, Deane JA, Aspden R, et al., 2015, Lumbar spine curvature varies with modic changes and disc degeneration in asymptomatic individuals, Britspine
Chawla A, McGregor A, 2015, Highlights from day three of the EuroSciCon 2015 Sports Science Summit., Future Science OA, Vol: 1, ISSN: 2056-5623
This EuroSciCon Sports Science Summit represented a significant gathering of leading professionals in the field of sports science. The conference was held on 13-15 January 2015 at the O2 arena, London, UK. The chairman on the third day was Mr Greg Robertson, a specialist trainee Orthopedic surgeon from Edinburgh. The conference attracted over 80 attendants from all over the world, with 32 presentations from invited speakers and peer-reviewed submissions. This meeting report provides a summary of the best abstracts from the conference.
Weinert-Aplin RA, Bull AM, McGregor AH, 2015, Orthotic Heel Wedges Do Not Alter Hindfoot Kinematics and Achilles Tendon Force During Level and Inclined Walking in Healthy Individuals., Journal of Applied Biomechanics, Vol: 32, Pages: 160-170, ISSN: 1543-2688
Conservative treatments such as in-shoe orthotic heel wedges to treat musculoskeletal injuries are not new. However, weak evidence supporting their use in the management of Achilles tendonitis suggests the mechanism by which these heel wedges work remains poorly understood. It was the aim of this study to test the underlying hypothesis that heel wedges can reduce Achilles tendon load. A musculoskeletal modelling approach was used to quantify changes in lower limb mechanics when walking due to the introduction of 12mm orthotic heel wedges. 19 healthy volunteers walked on an inclinable walkway while optical motion, forceplate and plantar pressure data were recorded. Walking with heel wedges increased ankle dorsiflexion moments and reduced plantar flexion moments. This resulted in increased peak ankle dorsiflexor muscle forces during early stance and reduced Tibialis Posterior and toe flexor muscles forces during late stance. Heel wedges did not reduce overall Achilles tendon force during any walking condition, but did redistribute load from the medial to lateral triceps surae during inclined walking. These results add to the body of clinical evidence confirming that heel wedges do not reduce Achilles tendon load and our findings provide an explanation as to why this may be the case.
Bergmann JHM, Goodier H, Spulber I, et al., 2015, The "Wear and Measure" Approach: Linking Joint Stability Measurements from a Smart Clothing System to Optical Tracking, Journal of Sensors, Vol: 2015, ISSN: 1687-7268
Joint stability is essential for maintaining normal everyday function. However, assessment of stability often still relies on subjective or obtrusive methods. An unobtrusive approach would be to have our clothes assess our joint stability. Methods. A new application consisting of an attachable clothing sensing system (ACSS), constructed from a flexible carbon black and polyurethane composite film, was tested against an optical tracking system to assess if the ACSS placed across the knee could provide stability results that correlate with the optical tracking outcomes. Stability was challenged by reducing the base of support and by removing vision generating different experimental conditions. Results. Bland and Altman plots indicated a general proportional error between the measurement systems within each stability condition. However, across all conditions a Spearman correlation coefficient of 0.81 () was found between the displacement values and ACSS, showing a good association between stability measurements. Electromyography (EMG) also indicated that joint stability was challenged between the different conditions. The ACSS was experienced by users as comfortable and hardly noticeable. Conclusions. This study indicates that smart clothing can measure important physiological parameters in an unobtrusive manner. This “wear and measure” approach might change how we gather relevant clinical data in the future.
Deane JA, McGregor AM, 2015, Clinical Interpretations of Degenerative Lumbar Disc Disease, Society of Back Pain Research, Publisher: British Editorial Society of Bone and Joint Surgery, ISSN: 2049-4408
Papi E, Belsi A, McGregor AH, 2015, A knee monitoring device and the preferences of patients living with osteoarthritis: A qualitative study, BMJ Open, Vol: 5, ISSN: 2044-6055
Buckeridge EM, Bull AMJ, McGregor AH, 2015, Incremental training intensities increases loads on the lower back of elite female rowers, Journal of Sports Sciences, ISSN: 0264-0414
Lumbar-pelvic kinematics change in response to increasing rowing stroke rates, but little is known about the effect of incremental stroke rates on changes in joint kinetics and their implications for injury. The purpose of this study was to quantify the effects of incremental rowing intensities on lower limb and lumbar-pelvic kinetics. Twelve female rowers performed an incremental test on a rowing ergometer. Kinematic data of rowers’ ankle, knee, hip and lumbar-pelvic joints, as well as external forces at the handle, seat and foot-stretchers of the rowing machine were recorded. Inter-segmental moments and forces were calculated using inverse dynamics and were compared across stroke rates using repeated measures ANOVA. Rowers exhibited increases in peak ankle and L5/S1 extensor moments, reductions in peak knee moments and no change in peak hip moments, with respect to stroke rate. Large shear and compressive forces were seen at L5/S1 and increased with stroke rate (P < 0.05). This coincided with increased levels of lumbar-pelvic flexion. High levels of lumbar-pelvic loading at higher stroke rates have implications with respect to injury and indicated that technique was declining, leading to increased lumbar-pelvic flexion. Such changes are not advantageous to performance and can potentially increase the risk of developing injuries.
Pincus T, Anwar S, McCracken LM, et al., 2015, Delivering an Optimised Behavioural Intervention (OBI) to people with low back pain with high psychological risk; results and lessons learnt from a feasibility randomised controlled trial of Contextual Cognitive Behavioural Therapy (CCBT) vs. Physiotherapy, BMC Musculoskeletal Disorders, Vol: 16, ISSN: 1471-2474
BackgroundLow Back Pain (LBP) remains a common and costly problem. Psychological obstacles to recovery have been identified, but psychological and behavioural interventions have produced only moderate improvements. Reviews of trials have suggested that the interventions lack clear theoretical basis, are often compromised by low dose, lack of fidelity, and delivery by non-experts. In addition, interventions do not directly target known risk mechanisms. We identified a theory driven intervention (Contexual Cognitive Behavioural Therapy, CCBT) that directly targets an evidence-based risk mechanism (avoidance and ensured dose and delivery were optimised. This feasibility study was designed to test the credibility and acceptability of optimised CCBT against physiotherapy for avoidant LBP patients, and to test recruitment, delivery of the intervention and response rates prior to moving to a full definitive trial.MethodsA randomised controlled feasibility trial with patients randomised to receive CCBT or physiotherapy. CCBT was delivered by trained supervised psychologists on a one to one basis and comprised up to 8 one-hour sessions. Physiotherapy comprised back to fitness group exercises with at least 60 % of content exercise-based. Patients were eligible to take part if they had back pain for more than 3 months, and scored above a threshold indicating fear avoidance, catastrophic beliefs and distress.Results89 patients were recruited. Uptake rates were above those predicted. Scores for credibility and acceptability of the interventions met the set criteria. Response rates at three and six months fell short of the 75 % target. Problems associated with poor response rates were identified and successfully resolved, rates increased to 77 % at 3 months, and 68 % at 6 months. Independent ratings of treatment sessions indicated that CCBT was delivered to fidelity. Numbers were too small for formal analysis. Although average scores for acceptance were higher in the CCBT group t
Papi E, Spulber I, Kotti M, et al., 2015, Smart sensing system for combined activity classification and estimation of knee range of motion, IEEE Sensors Journal, Vol: 15, Pages: 5535-5544, ISSN: 1558-1748
Berwin JT, Burton TMW, Taylor J, et al., 2015, Plantar Loading Forces While Walking in a Below-Knee Cast With an Attached Loadbearing Frame, Foot & Ankle International, Vol: 36, Pages: 722-729, ISSN: 1944-7876
Background: We measured loading forces across different points of the plantar foot surface to examine how different types of casts affect load distribution through the foot and ankle. The patella tendon-bearing (PTB) or Sarmiento cast is the current “gold-standard” casting method for offloading force through the foot and ankle. We aimed to determine if a rocker bottom frame attached to a below-knee cast (Beagle Böhler Walker) would be as effective or better at reducing load distribution during full weightbearing.Method: We applied TekScan FlexiForce A201 force sensors to the first and fifth metatarsal heads and the plantar surface of the calcaneus of 14 healthy volunteers. All volunteers had force measurements taken without a cast applied and then with a traditional Sarmiento cast, a standard below-knee cast, and a below-knee cast with the Böhler Walker frame fitted.Results: Compared with a standard below-knee cast, the Böhler Walker frame reduced the mean peak force through the head of the first metatarsal by 58.9% (P < .0001), 73.1% through the head of the fifth metatarsal (P < .0001), and 32.2% (P < .0001) through the calcaneus. The Sarmiento cast demonstrated a mean percentage reduction in peak force of 8.6% (P = .39) and 4.4% (P = .87) through the first and fifth metatarsal heads, respectively, but increased the mean peak force by 5.9% (P = .54) through the calcaneus.Conclusion: Using a Böhler Walker frame applied to a below-knee cast significantly reduced weight transfer through the foot compared with a Sarmiento cast or standard below-knee cast.Clinical Relevance: This reduction in force through the foot could mean early weightbearing would be safer in patients with a wide variety of foot and ankle pathologies such as ankle fractures or operative fixations. This may reduce the incidence of immobility-dependent morbidity.
Greenwood J, McGregor A, Jones F, et al., 2015, Evaluating rehabilitation following lumbar fusion surgery (REFS): study protocol for a randomised controlled trial, Trials, Vol: 16, ISSN: 1745-6215
Weinert-Aplin RA, Bull AMJ, McGregor AH, 2015, Investigating the Effects of Knee Flexion during the Eccentric Heel-Drop Exercise, Journal of Sports Science and Medicine, Vol: 14, Pages: 459-465, ISSN: 1303-2968
This study aimed to characterise the biomechanics of the widelypracticed eccentric heel-drop exercises used in the managementof Achilles tendinosis. Specifically, the aim was to quantifychanges in lower limb kinematics, muscle lengths and Achillestendon force, when performing the exercise with a flexed kneeinstead of an extended knee. A musculoskeletal modelling approachwas used to quantify any differences between theseversions of the eccentric heel drop exercises used to treat Achillestendinosis. 19 healthy volunteers provided a group fromwhich optical motion, forceplate and plantar pressure data wererecorded while performing both the extended and flexed kneeeccentric heel-drop exercises over a wooden step when barefootor wearing running shoes. This data was used as inputs into ascaled musculoskeletal model of the lower limb. Range of anklemotion was unaffected by knee flexion. However, knee flexionwas found to significantly affect lower limb kinematics, intersegmentalloads and triceps muscle lengths. Peak Achilles loadwas not influenced despite significantly reduced peak ankleplantarflexion moments (p < 0.001). The combination of reducedtriceps lengths and greater ankle dorsiflexion, coupledwith reduced ankle plantarflexion moments were used to providea basis for previously unexplained observations regardingthe effect of knee flexion on the relative loading of the tricepsmuscles during the eccentric heel drop exercises. This findingquestions the role of the flexed knee heel drop exercise whenspecifically treating Achilles tendinosis
Papi E, Osei-Kuffour D, Chen Y-MA, et al., 2015, Use of wearable technology for performance assessment: A validation study, Medical Engineering & Physics, Vol: 37, Pages: 698-704, ISSN: 1873-4030
The prevalence of osteoarthritis is increasing globally but current compliance with rehabilitation remainspoor. This study explores whether wearable sensors can be used to provide objective measures of performancewith a view to using them as motivators to aid compliance to osteoarthritis rehabilitation. Morespecifically, the use of a novel attachable wearable sensor integrated into clothing and inertial measurementunits located in two different positions, at the waist and thigh pocket, was investigated. Fourteen healthy volunteerswere asked to complete exercises adapted from a knee osteoarthritis rehabilitation programme whilstwearing the three sensors including five times sit-to-stand test, treadmill walking at slow, preferred and fastspeeds. The performances of the three sensors were validated against a motion capture system and an instrumentedtreadmill. The systems showed a high correlation (r2 > 0.7) and agreement (mean difference range:−0.02–0.03 m, 0.005–0.68 s) with gold standards. The novel attachable wearable sensor was able to monitorexercise tasks as well as the inertial measurement units (ICC > 0.95). Results also suggested that a functionalplacement (e.g., situated in a pocket) is a valid position for performance monitoring. This study showsthe potential use of wearable technologies for assessing subject performance during exercise and suggestsfunctional solutions to enhance acceptance.
Spulber I, Chen Y-M, Papi E, et al., 2015, Live demonstration: Wearable electronics for a smart garment aiding rehabilitation, Pages: 1912-1912
Wilson F, McGregor A, 2014, Mythbusters in rowing medicine and physiotherapy: nine experts tackle five clinical conundrums, British Journal of Sports Medicine, Vol: 48, Pages: 1525-1528, ISSN: 0306-3674
Wilson F, Gissane C, McGregor A, 2014, Ergometer training volume and previous injury predict back pain in rowing; strategies for injury prevention and rehabilitation, BRITISH JOURNAL OF SPORTS MEDICINE, Vol: 48, Pages: 1534-U27, ISSN: 0306-3674
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- Citations: 35
Gopalakrishnan A, Phillips ATM, Higginson JS, et al., 2014, Predictive simulations of movement for informing rehabilitation programmes, 12th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering
Kotti M, Duffell LD, Faisal AA, et al., 2014, The Complexity of Human Walking: A Knee Osteoarthritis Study, PLOS ONE, Vol: 9, ISSN: 1932-6203
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- Citations: 18
Buckeridge EM, Bull AMJ, McGregor AH, 2014, Biomechanical determinants of elite rowing technique and performance, Scandinavian Journal of Medicine & Science in Sports, Vol: 25, Pages: e176-e183, ISSN: 0905-7188
Chiou SY, Shih YF, Chou LW, et al., 2014, Impaired neural drive in patients with low back pain, European Journal of Pain, Vol: 18, Pages: 794-802, ISSN: 1090-3801
BackgroundControl of trunk movement relies on the integration between central neuronal circuits and peripheral skeletomuscular activities and it can be altered by pain. There is increasing evidence that there are deficits within the central nervous system controlling the trunk muscles in people with low back pain (LBP). However, it is unclear how LBP impacts upon neural drive to back muscles at different levels of voluntary contraction. Therefore, the purpose of this study was to investigate if neural drive is impaired in these patients.MethodsSeventeen patients with LBP and 11 healthy controls were recruited. Bilateral electromyographic (EMG) recordings were obtained from the erector spinae (ES) muscles at two vertebral levels (T12 and L4). Participants performed a series of brief isometric back extensions (50–100% maximum voluntary contraction – MVC), during which transcranial magnetic stimulation was delivered. The size of the evoked (superimposed) twitch was measured using dynamometry.ResultsThe size of the superimposed twitch decreased linearly with increasing contraction strength in the controls; however, this linear relationship was not observed in the patients. Additionally, patients had larger superimposed twitches and longer time‐to‐peak amplitudes during MVCs than those observed in controls. Furthermore, patients had lower MVC and root‐mean‐square EMG activity of ES muscles during MVCs.ConclusionsA decline of central neural drive to the back muscles at high level of voluntary contraction was observed in patients with LBP. These results suggest that it might be pertinent to include neuromuscular facilitation programmes and therapeutic exercise utilizing high voluntary contractions for patients with LBP.
McGregor AH, Probyn K, Cro S, et al., 2014, Rehabilitation Following Surgery for Lumbar Spinal Stenosis <i>A Cochrane Review</i>, SPINE, Vol: 39, Pages: 1044-1054, ISSN: 0362-2436
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- Citations: 23
Duffell LD, Southgate DFL, Gulati V, et al., 2014, Balance and gait adaptations in patients with early knee osteoarthritis, GAIT & POSTURE, Vol: 39, Pages: 1057-1061, ISSN: 0966-6362
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- Citations: 58
McGregor AH, Probyn K, Cro S, et al., 2014, Rehabilitation following surgery for lumbar spinal stenosis., J Evid Based Med, Vol: 7, Pages: 62-63
Duffell LD, Hope N, McGregor AH, 2014, Comparison of kinematic and kinetic parameters calculated using a cluster-based model and Vicon's plug-in gait, PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE, Vol: 228, Pages: 206-210, ISSN: 0954-4119
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- Citations: 60
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