Monica Maly

McMaster University | McMaster · School of Rehabilitation Science

The potential of MRI to predict cartilage mechanical properties across an entire cartilage surface in an ex vivo model would enable novel perspectives in modeling cartilage tolerance and predicting disease progression. The purpose of this study was to integrate MR imaging with full-surface indentation mapping to determine the relationship between f...

Purpose: This cross-sectional study determines the sensitivity of muscle architecture and fat measurements of the rectus femoris (RF) and vastus lateralis (VL) muscles from ultrasound images acquired with varying transducer tilt, using a novel transducer attachment, in healthy adults. Secondary objectives were to estimate intrarater and interrater...

Background: Point of care ultrasonography (POCUS) is a non-ionizing imaging technique that is emerging in physiotherapy practice. Objective: To systematically map the research literature on physiotherapist performed POCUS. Data sources: Following PRISMA-ScR guidelines, OVID Medline, CINAHL, AMED, and EMBASE were searched. Eligibility criteria...

Objective Sarcopenic obesity is a key feature in osteoarthritis (OA). While ideal OA treatment involves physical activity and diet, how diet influences OA pathophysiology is unclear. We explored the associations between diet, nutrition risk and physical activity with body composition in older adults with OA. Methods Baseline data from the Canadian...

Purpose: This study collates and maps physiotherapy pre- and post-licensure curricula and pedagogical approaches for point of care ultrasonography (POCUS). Method: We used a standardized scoping review methodology and reporting framework. A total of 18,217 titles and abstracts, and 1,372 full text citations were screened, with 209 studies classifie...

Background Haemophilia treatment centres (HTCs) around the world are increasingly adopting point-of-care ultrasonography (POCUS) for the assessment of acute haemarthrosis and to monitor joint health. POCUS is in large part administered by physiotherapists in most comprehensive care teams. Appropriate implementation of haemophilia-specific POCUS req...

Objective: This proof-of-principle study integrates joint reaction forces (JRFs) and bone shape to assess acute cartilage changes from walking and cycling. Methods: Sixteen women with symptomatic knee osteoarthritis were recruited. Biomechanical assessment estimated JRFs during walking and cycling. Subsamples had magnetic resonance imaging (MRI)...

Background Muscle capacity utilization reflects the percentage of maximal knee extensor strength required to complete physical activities. Research Question Is pain associated with muscle capacity utilization during walking in older adults with knee osteoarthritis? Secondarily, is muscle capacity utilization in older adults with knee osteoarthriti...

Objectives Accurate and efficient knee cartilage and bone segmentation are necessary for basic science, clinical trial, and clinical applications. This work tested a multi-stage convolutional neural network framework for MRI image segmentation.Materials and methodsStage 1 of the framework coarsely segments images outputting probabilities of each vo...

Background It is unknown whether a greater accumulation of knee load over a typical day is related to how cartilage responds to an acute bout of loading. This information may clarify the role of habitual activity on cartilage function. Research Question Is there a relationship between change in tibial and femoral cartilage thickness, volume, and T...

Background Individuals with knee osteoarthritis have elevated circulating inflammatory markers and altered cartilage properties but it is unclear if these features adapt to exercise. We aimed to determine (1) whether inflammatory markers, cartilage transverse relaxation time and thickness mediate the effect of body mass index (BMI) on quadriceps st...

Objective The relationship between in vivo knee load predictions and longitudinal cartilage changes has not been investigated. This study aimed to develop an equation to predict the medial tibiofemoral contact force (MCF) peak during walking in persons with instrumented knee implants, and to apply this equation to determine the relationship between...

Overuse knee injuries are common in bicycling and are often attributed to poor bicycle-fit. Bicycle-fit for knee health focuses on setting saddle height to elicit a minimum knee flexion angle of 25-40°. Equations to predict saddle height include a single input, resulting in a likely suboptimal bicycle-fit. The purpose of this work was to develop an...

Objectives When measuring changes in knee cartilage thickness in vivo after loading, mean values may not reflect local changes. The objectives of this investigation were: (1) use statistical parametric mapping (SPM) to determine regional deformation patterns of tibiofemoral cartilage in response to running; (2) quantify regional differences in cart...

Background Infiltration of muscle with non-lean tissue, such as fat, reduces muscle quality. Ultrasound captures muscle quality through measurement of echogenicity. Given the potential implications of quadriceps muscle quality on physical function, particularly in knee osteoarthritis, the purpose of this study was to investigate the relationship be...

Introduction Adherence to treatment recommendations in patients with chronic disease is complex and is influenced by numerous factors. Haemophilia is a chronic disease with reported levels of adherence ranging from 17–82%. Aim Based on the theoretical foundation of the World Health Organization Multidimensional Adherence Model, the objective of th...

Objectives To assess the effect of ankle, knee, and hip kinematics on patellofemoral and tibiofemoral joint reaction forces (JRF) during bicycling. Secondarily, to assess if sex, horizontal saddle position, or crank arm length were related to JRFs, after accounting for kinematics. Design Experimental cross-sectional study. Methods Forty healthy a...

A dynamic and low-profile unloader tibiofemoral knee brace is designed and prototyped by synergizing concepts from the fields of microfluidics and soft robotics. Microfluidics provides strategies for miniaturization and multiplexing while soft robotics afford the tools to create soft fluidic actuators and allow compliant and inherently safe robotic...

There are factors that could affect both muscle architecture and muscle capacity, such as aging, chronic disease, and lifestyle. Few studies have investigated the relationship between muscle fat infiltration, muscle architecture, and muscle capacity. Therefore, a summary and evaluation of the measurements and findings in the existing literature can...

Cumulative load reflects the total accumulated load across a loading exposure. Estimated cumulative load can identify individuals with or at risk for pathology. However, there is no research into the accuracy of the estimated cumulative load. This study determined: (1) which impulses, from a 500 revolution bicycling activity, accurately estimate cu...

Objective: Inactivity and obesity are risk factors for osteoarthritis (OA) progression. The purpose of this review was to highlight intervention parameters of exercise and lifestyle diet interventions on clinical outcomes in OA that were published over 15 months, starting January 1, 2018. Design: Systematic literature searches were performed in...

Dynamic stability provided by muscles is integral for function and integrity of the glenohumeral joint. Although the high degree of inter-individual variation that exists in musculoskeletal geometry is associated with shoulder injuries, there is limited research associating the effects of muscle geometry on the potential stabilizing capacities of s...

Background This study examined whether aspects of diet and nutrition risk explain variance in physical capacity and general health, after controlling for covariates, in Canadian adults with osteoarthritis (OA). Methods This was a cross-sectional study of baseline data from the Canadian Longitudinal Study on Aging (CLSA). Data from 1404 participant...

Purpose: This article identifies how to assess multiple sources of measurement error and identify optimal measurement strategies for obtaining clinical outcomes. Method: Obtaining, interpreting, and using information gained from measurements is instrumental in physiotherapy. To be useful, measurements must have a sufficiently small measurement err...

Background: In patients with haemophilia, evidence suggests that the physical examination alone is not sensitive enough to detect small amounts of blood within a joint. Attention has shifted to methods of improving the sensitivity of the physical examination through adding diagnostic modalities such as point-of-care ultrasonography (POC-US). Profic...

Biomechanical investigations examining shoulder function commonly observe a high degree of inter-individual variability in muscle activity and kinematic patterns during static and dynamic upper extremity exertions. Substantial differences in musculoskeletal geometry between individuals can alter muscle moment arms and lines of action that, theoreti...

Purpose: Hand-held dynamometry (HHD) can be used to evaluate strength when gold-standard isokinetic dynamometry (IKD) is not feasible. HHD is useful for measuring lower limb strength in a healthy population; however, its reliability and validity in individuals with knee osteoarthritis (OA) has received little attention. In this research, we examine...

Introduction and objectives: Participation in meaningful activities has psychological, physical, social and cognitive benefits for older adults living in continuing care homes. The subjective experiences of the process of participation for cognitively competent older adults living in a continuing care home and how personal and environmental feature...

Objective Pain is a consistently reported barrier to physical activity by persons with knee osteoarthritis (KOA). Nonetheless, few KOA studies have investigated the association of pain with daily walking levels. This study assessed the relationship of two distinct measures of knee pain with objectively‐measured physical activity in adults with KOA....

Objective: Biomechanical factors are important treatment targets in knee osteoarthritis. The knee adduction (KAM) and flexion (KFM) moments, quadriceps strength and power, load frequency, and body mass index (BMI) all have the potential to affect knee articular cartilage integrity by modulating forces across the joint. To identify clinically meani...

Objective: To assess the effectiveness of a workplace leg-strengthening program on self-reported function, physical capacity, and work-related outcomes among desk-based workers. Methods: Forty-three desk-based workers were randomized to a 12-week exercise program or no exercise control. The primary outcome was change in self-reported physical fu...

Objective Certain exercises could overload the osteoarthritic knee. We developed an exercise program from yoga postures with a minimal knee adduction moment for knee osteoarthritis. The purpose was to compare the effectiveness of this biomechanically-based yoga exercise (YE), with traditional exercise (TE), and a no-exercise attention-equivalent co...

CONSORT 2010 checklist of information to include when reporting a randomised trial. (DOC)

Study Design Controlled laboratory study; cross-sectional. Background Despite the growing popularity of yoga, little is known about the muscle activity of the scapular stabilizers during isometric yoga postures and their potential utility in shoulder rehabilitation. Objectives To examine scapular stabilizer muscle activation during various yoga pos...

Objective: Monocytes contribute to synovitis and disease pathogenesis in OA. Low-grade inflammation occurs in OA and correlates with disease severity and progression. Since monocyte development and function is altered by systemic inflammation, we analyzed monocyte numbers and function between individuals with knee OA and healthy age- and sex-match...

This study examined the extent to which baseline measures of quadriceps strength, quadriceps power, knee pain and self-efficacy for functional tasks, and their interactions, predicted 2-year changes in mobility performance (walking, stair ascent, stair descent) in women with knee osteoarthritis. We hypothesized that lesser strength, power and self-...

Lower limb strengthening exercise is pivotal for the management of symptoms related to knee osteoarthritis (OA). Though improvement in clinical symptoms is well documented, concurrent changes in gait biomechanics are ill-defined. This may occur because discrete analyses miss changes following an intervention, analyses limited to the knee undermine...

Objective: The aim of this study was to evaluate the effectiveness of a 12-week workplace exercise program on work ability, performance, and patient-reported symptoms in older university employees with knee and/or hip osteoarthritis. Methods: Twenty-four participants with clinical hip and/or knee osteoarthritis were randomized to exercise or no...

Background In individuals with knee osteoarthritis (OA), fatty infiltration into thigh muscle is associated with poor physical performance and strength. However, it is not known whether this also occurs in the calf and if this impacts physical function. AimsWe investigated the relationships between volumes of intramuscular fat (intraMF), intermuscu...

This study aimed to determine the extent to which changes over 2.5 years in medial knee cartilage thickness and volume were predicted by: (1) peak values of the knee adduction (KAM) and flexion moments; and (2) KAM impulse and loading frequency, representing cumulative load, after controlling for age, sex and body mass index (BMI). Adults with clin...

Purpose: To compare the acute effect of running and bicycling of an equivalent cumulative load on knee cartilage composition and morphometry in healthy young men. A secondary analysis investigated the relationship between activity history and the change in cartilage composition after activity. Methods: In fifteen men (25.8±4.2 years), the vertic...

Muscle strengthening may be difficult to achieve in knee osteoarthritis (OA) due to pain. A large knee adduction moment (KAM), representing medial relative to lateral knee load, may also relate with pain during strengthening exercise. The objective of this study was to examine relationships between knee pain status and electromyography (EMG) amplit...

Background: Thigh lean muscle and intramuscular fat have been implicated in the impairment of physical function observed in people with knee osteoarthritis. We investigated the relationships of quadriceps and hamstrings intramuscular fat fraction and lean muscle volume with muscle power and strength, controlling for neuromuscular activation, and p...

Decreased muscle mass and increased fat mass are commonly seen in the thighs of individuals with knee osteoarthritis (OA). Despite the role of calf muscles in activities of daily living and knee mechanics, little work has investigated calf changes in knee OA. Unlike the thigh, muscle and fat in the lower leg can be imaged using a peripheral magneti...

While there are many comorbidities associated with obesity, one of the more poorly understood is knee osteoarthritis through obesity. The purpose of this study was to compare the kinematics and kinetics of gait and cumulative knee adductor load, which represents the sum of repetitive exposures to medial knee loading during daily activity, between y...

Purpose: Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL) injuries, we do not understand which options could potentially prevent knee osteoarthritis (OA). The aim of this systematic review was to examine the evidence pertaining to exercise treatment of ACL injuries in the context of knee OA. Methods:...

Objective: Determine the reliability of a magnetic resonance (MR) image segmentation protocol for quantifying intramuscular adipose tissue (IntraMAT), subcutaneous adipose tissue, total muscle and intermuscular adipose tissue (InterMAT) of the lower leg. Materials and methods: Ten axial lower leg MRI slices were obtained from 21 postmenopausal w...

Unlabelled: Accelerometers provide a measure of step-count. Reliability and validity of step-count and pedal-revolution count measurements by the GT3X+ accelerometer, placed at different anatomical locations, is absent in the literature. The purpose of this study was to investigate the reliability and validity of step and pedal-revolution counts p...

The Questionnaire to Identify Knee Symptoms (QuIKS) was recently developed to promote activity by screening for experiences related to early symptoms in people with emergent chronic knee pain problems, such as osteoarthritis (OA) – like knee pain. The main purpose of the current study was to evaluate measurement properties of the QuIKS using Rasch...

People with knee osteoarthritis may benefit from exercise prescriptions that minimize knee loads in the frontal plane. The primary objective of this study was to determine whether a novel 12-week strengthening program designed to minimize exposure to the knee adduction moment (KAM) could improve symptoms and knee strength in women with symptomatic...

Investigations of joint loading in knee osteoarthritis (OA) typically normalize the knee adduction moment (KAM) to global measures of body size (e.g., body mass, height) to allow comparison between individuals. However, such measurements may not reflect knee size. This study used a morphometric measurement of the cartilage surface area on the media...

This study aimed to compare muscle activations, co-contraction indices, and the knee adduction moment between static standing yoga postures to identify appropriate exercises for knee osteoarthritis. Healthy young women (24.4 (5.4) years, 23.1 (3.7) kg/m(2)) participated. Primary outcome variables were electromyographic activations of the vastus lat...

Introduction: Cumulative load during a cyclic activity is useful in discriminating between healthy individuals and those with pathology [1,2]. Cumulative load is represented as the product of the mean impulse of one loading event measured in the laboratory, and loading repetition. The purpose of this study was to determine (i) which impulses, and (...

Quadriceps strengthening is a common rehabilitation exercise for knee osteoarthritis (OA). More information is required to determine whether targeting muscle power is a useful adjunct to strengthening for people with knee OA. To identify the predictive ability of knee extensor strength and knee extensor power in the performance of physical tasks in...

To highlight research studies examining rehabilitation for hip and knee osteoarthritis (OA), as well as the outcome measures used to assess treatment efficacy, published in 2013. A systematic search was performed in Medline, CIHAHL and Embase databases from January to December 2013. The search was limited to 2013, human studies, and English. Rehabi...

Severe constant and intermittent knee pain are associated with "unacceptable" symptoms in older adults with osteoarthritis (OA) [22]. We hypothesized that constant and intermittent pain would be independently related to physical function, with intermittent knee pain being a better predictor of future declines in physical function in early symptomat...

Increased risk of medial tibiofemoral osteoarthritis (OA) is linked to occupations that require frequent transitions into and out of postures which require high knee flexion (>90°). Muscle forces are major contributors to joint loading, and an association between compressive forces due to muscle activations and the degeneration of joint cartilage h...

Muscle activations and knee joint loads were compared during squatting and lunging before and after lower extremity neuromuscular fatigue. Electromyographic activations of the rectus femoris, vastus lateralis and biceps femoris, and the external knee adduction and flexion moments were collected on 25 healthy women (mean age 23.5 years, BMI of 23.7...

Introduction: Obesity is thought to exacerbate osteoarthritis (OA) of the knee because greater body mass increases the forces across this load-bearing joint 1. Evidence has shown that medial tibial plateau bone area increases with increases in body mass index (BMI) 1. This adaptation is thought to reduce stress within the medial knee compartment. D...

Objective To determine the extent to which knee extensor strength and power explain variance in knee adduction moment (KAM) peak and impulse in clinical knee osteoarthritis (OA).Methods Fifty-three adults (mean ± SD age 61.6 ± 6.3 years, 11 men) with clinical knee OA participated. The KAM waveform was calculated from motion and force data and ensem...

Purpose: To determine whether activity-modifying behaviour mediates the relationship between the severity of knee pain and each of physical function and knee-related quality of life. Methods: A total of 105 participants with medial knee pain and no diagnosis of knee osteoarthritis (mean age 52.2 [SD 6.7] y) completed two self-report questionnair...

Co-activation of the knee extensors and flexors increases knee joint contact forces, which may lead to degradation of the articular surfaces. This study investigated the effect of neuromuscular fatigue induced by submaximal, repetitive, dynamic contractions on co-activation of knee musculature in young and middle-aged women. Data from 10 young wome...