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Anand Nene


Dr Anand Nene obtained degrees of Bachelor of Medicine and Bachelor of Surgery from the University of Bombay. He further trained in orthopaedic surgery and obtained a post-graduate degree of Master of Surgery, also from the University of Bombay. On arrival in the United Kingdom he obtained a further Post-Graduate degree of Master of Orthopaedic Surgery from the University of Liverpool. After gaining further experience in the United Kingdom he returned to India. However, circumstances brought him back to the United Kingdom. He worked as a Medical Research Fellow in the Orthotic Research & Locomotor Assessment Unit (ORLAU) at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry. There he developed his interest in the subjects of Gait, Paraplegic locomotion, Functional Electrical Stimulation and use of Gait Analysis for clinical decision making in Cerebral Palsy. In January 1994 he arrived in the Netherlands. Here he retrained as a specialist in Physical Medicine and Rehabilitation (PMR). He was awarded PhD by the University of Twente for his work on hybrid paraplegic locomotion. Presently, he works as a specialist in PMR in Het Roessingh Rehabilitation Centre and also as a Research Fellow in Roessingh Research & Development. He was instrumental in establishing a clinical gait analysis service in Het Roessingh. He has published number of articles in the medical literature. His present research interests are: pathophysiology and management of spasticity, management of gait abnormalities and improvement of arm hand function in neurological disorders.

Abstract of this year's Bauman lecture:

Human body has 3 types of striated muscles, namely, mono-articular, bi-articular and poly-articular. Both human and animal studies suggest that mono- and bi-articular muscles have different roles in the complex movements such as walking. Mono articular muscles show simple unidirectional activation patterns, whereas bi-articular muscles exhibit complex patterns of movements. Sometimes these bi-articular muscles are considered to be bi-functional, i.e. they exert opposite actions at the joints they span, either individually or at the same time, e.g. flexion at one joint and the extension at the other. Bi-functional muscles control the direction of external forces by regulating the distribution of the net moments across theĀ  points. Rectus Femoris (RF) is one of such muscles. Quadriceps Femoris is one the dominant muscle groups at the knee. Anatomically it is described to consist of 4 heads, namely, Vastus Lateralis, Vastus Intermedius, Vastus Medialis and Rectus Femoris. The Vastii are mono-articular crossing only the knee joint, but RF is a bi-articular muscle. In the past, function of RF has been described as extension of the knee during loading response along with the Vastii and restricting the knee flexion during pre- and initial swing. Although these are 2 functions, however, in the real sense, this does correspond to a definition of being bi-functional. The electromyography (EMG) studies that formed the basis of above mentioned functions were carried out using surface electrodes. Studies carried out using both surface and fine wire electrodes in healthy subjects showed that RF is active only in the pre- and swing phases during walking at normal speeds. At faster walking speeds there is increasing activity of RF during terminal stance, probably to prevent excessive hip extension. Role played by abnormal activity of RF alone in cerebral palsied children is well established. A study carried out in subjects who walked with a stiff knee gait after stroke also showed, in majority of subjects, only RF activity was abnormal. Vastii did not show abnormal activity pattern. This shows that in healthy as well as in diseased RF is a completely different muscle and to include RF along with Vastii as part of Quadriceps does not make sense. Vastus Lateralis, Vastus Intermedius & Vastus Medialis should be renamed as Triceps Femoris & RF should have its own identity as a separate muscle with a different function thanTriceps Femoris.

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