Objective: Bracing can reduce adult occupants' out-of-position postures, but it is unclear if this finding can be extended to child occupants. We investigated the effect of bracing, and age on the motion of vehicle occupants of different ages during sled-simulated pre-crash maneuvers.
Methods: Forty seatbelt restrained subjects (9-40 y.o.) experienced sled simulated evasive swerving maneuvers during a brace condition, where subjects actively brace before the maneuver onset, and an unbraced condition. A 3D motion capture system, electromyography (EMG), and seatbelt load cells captured head and trunk kinematics, muscle activation, and seat belt reaction forces, respectively. The effects of age and bracing on peak lateral head and trunk displacement were examined with Mixed Effects Model ( ≤ 0.05).
Results: In the braced condition, all subjects had reduced normalized peak head (0.09 ± 0.05) and trunk (0.11 ± 0.05) displacements compared to the unbraced condition (Head: 0.14 ± 0.06, Trunk: 0.17 ± 0.07) ( < 0.05). For the into-the-belt direction in the unbraced condition, children showed the smallest peak head and trunk displacement of all age groups ( < 0.01) while teens had the greatest peak head and trunk displacement compared to all other age groups ( < 0.02). Similar trends were found in the out-of-the-belt direction in the unbraced condition ( < 0.01). In the unbraced condition, all occupants showed greater shoulder seat belt reaction loads than the braced condition (unbraced 1.6-2.7 N/kg, braced 1.0-1.4 N/kg). Children also showed greater neck muscle activation (50-64% MVIC) compared to other muscles and older occupants regardless of the bracing condition or direction of motion.
Conclusion: Bracing reduced out-of-position postures across all ages. In the unbraced condition, children move less than teens and adults due to greater activation in the neck muscles. In the unbraced condition, teens showed the greatest motion, potentially due to their developing neuromotor control transitioning to a more mature stage. Across all age groups in the unbraced condition, occupants relied more heavily on the seat belt to maintain their position rather than their muscles to brace, suggesting the importance of good seatbelt-torso interaction in unbraced occupants.
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http://dx.doi.org/10.1080/15389588.2024.2370880 | DOI Listing |
JBJS Case Connect
October 2024
Department of Orthopaedics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Case: An 8-year-old girl with NF1 and congenital tibial dysplasia with significant bilateral tibial bowing underwent McFarland procedures. Now age 22 with 14-year follow-up indicating sustained correction and healing of her bilateral limb deformities.
Conclusion: This case illustrates the McFarland procedure provided adequate corrective treatment of this deformity and remains a success at long-term follow-up.
J Pediatr Orthop B
January 2025
Pediatric Orthopedics Department, Hospital San Ignacio, Bogotá, Colombia.
Clubfoot (CF) is one of the most common musculoskeletal congenital abnormalities. Despite having optimal methods for its treatment, factors associated with the recurrence of CF treatment continue to be a topic of interest. The aim of this study was to perform a scoping review of the existing literature on factors associated with the recurrence of CF following treatment with the Ponseti method in children under 5 years of age.
View Article and Find Full Text PDFJ Pediatr Orthop B
January 2025
Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, Texas, USA.
This study aimed to compare outcomes of idiopathic clubfeet (IC) treated with a percutaneous heel cord tenotomy (PHCT) at the conclusion of Ponseti casting with those that were not. A retrospective review of patients enrolled in a single institution prospective clubfoot registry over 19 years was performed. Patients under the age of 3 months with untreated IC managed via the Ponseti method that had a minimum of 2 years follow-up were included.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of General Pathology and Pathologic Anatomy, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
: In this paper, we investigate the association of glycoprotein 96 (GP96) and androgen receptor (AR) expression with clinicopathological factors, additional axillary lymph node burden, and their potential role in predicting 5-year overall survival (OS) and disease-free survival (DFS) in breast cancer (BC) patients with sentinel lymph node (SLN) involvement. We also explore the prognostic value of the presence of extranodal extension (ENE) in SLN. : We retrospectively enrolled 107 female patients with cT1-T2 invasive BC and positive SLN biopsy.
View Article and Find Full Text PDFChildren (Basel)
December 2024
Department of Surgery, Division of Neurosurgery, Queen's University, Kingston, ON K7L 3N6, Canada.
Background: Thoracolumbar (TL) fractures are uncommon injuries in the pediatric population. Surgery is recommended for TL fractures with significant deformity, posterior ligamentous complex disruption, or neurological compromise. The Thoracolumbar Injury Classification and Severity Scale (TLICS) has been validated in pediatric populations and serves as a valuable tool for guiding treatment decisions.
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