Altered joint kinematics and increased electromyographic muscle activity during walking in patients with intermittent claudication Lindy N.M. Gommans,

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Altered joint kinematics and increased electromyographic muscle activity during walking in patients with intermittent claudication Lindy N.M. Gommans, MD, MSc, Annemieke T. Smid, MD, Marc R.M. Scheltinga, MD, PhD, Frans A.M. Brooijmans, MSc, Emiel M.J. van Disseldorp, MSc, Fred T.P.M. van der Linden, MD, Kenneth Meijer, PhD, Joep A.W. Teijink, MD, PhD Journal of Vascular Surgery Volume 63, Issue 3, Pages 664-672 (March 2016) DOI: 10.1016/j.jvs.2015.09.045 Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 1 Measurement set up. Left, Light emitting diode (LED) lights are positioned on the bony landmarks of the lower limb, to determine the knee and ankle joint angles, respectively. A indicates knee joint angle; B indicates the electromyography (EMG) device on the tibialis anterior (TA) muscle; and C indicates the ankle joint angle. The current positions are set at zero degrees. Middle, D indicates the position of the EMG device on the TA muscle; the dashed circle indicates the muscle belly. Right, E indicates the position of the EMG device on the medial gastrocnemius (MG) muscle; the dashed circle indicates the muscle belly. Journal of Vascular Surgery 2016 63, 664-672DOI: (10.1016/j.jvs.2015.09.045) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 2 Knee joint angles in the sagittal plane during the complete gait cycle (ie, heel strike to heel strike) for intermittent claudication (IC) patients during pain-free walking (x), painful walking (-), and control subjects (*). The dashed vertical line separates the stance phase (approximately 60%) and swing phase (approximately 40%) of the gait cycle. Journal of Vascular Surgery 2016 63, 664-672DOI: (10.1016/j.jvs.2015.09.045) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 3 Ankle joint angles in the sagittal plane during the complete gait cycle (ie heel strike to heel strike) for intermittent claudication (IC) patients during pain-free walking (x), painful walking (-), and control subjects (*).The dashed vertical line separates the stance phase (approximately 60%) and swing phase (approximately 40%) of the gait cycle. Plantar flexion angles are expressed as negative values, and dorsal flexion angles as positive values. Journal of Vascular Surgery 2016 63, 664-672DOI: (10.1016/j.jvs.2015.09.045) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 4 Graphs showing the level of muscle activity of a typical intermittent claudication (IC) patient of the present study. Data of the medial gastrocnemius (MG; black solid and dashed line) and tibialis anterior (TA; gray solid and dashed line) muscles, during the complete gait cycle for respectively, pain-free and painful ambulation. The dashed vertical line separates the stance phase (approximately 60%) and the swing phase (approximately 40%) of the gait cycle. Journal of Vascular Surgery 2016 63, 664-672DOI: (10.1016/j.jvs.2015.09.045) Copyright © 2016 Society for Vascular Surgery Terms and Conditions