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Prelanding Knee Kinematics and Landing Kinetics During Single-Leg and Double-Leg Landings in Male and Female Recreational Athletes

Ling Li, Yu Song, Maddy Jenkins, and Boyi Dai

Biomechanical behavior prior to landing likely contributes to anterior cruciate ligament (ACL) injuries during jump-landing tasks. This study examined prelanding knee kinematics and landing ground reaction forces (GRFs) during single-leg and double-leg landings in males and females. Participants performed landings with the dominant leg or both legs while kinematic and GRF data were collected. Single-leg landings demonstrated less time between prelanding minimal knee flexion and initial ground contact, decreased prelanding and early-landing knee flexion angles and velocities, and increased peak vertical and posterior GRFs compared with double-leg landings. Increased prelanding knee flexion velocities and knee flexion excursion correlated with decreased peak posterior GRFs during both double-leg and single-leg landings. No significant differences were observed between males and females. Prelanding knee kinematics may contribute to the increased risk of ACL injuries in single-leg landings compared with double-leg landings. Future studies are encouraged to incorporate prelanding knee mechanics to understand ACL injury mechanisms and predict future ACL injury risks. Studies of the feasibility of increasing prelanding knee flexion are needed to understand the potential role of prelanding kinematics in decreasing ACL injury risk.

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A Statistical Parametric Mapping Analysis Approach for the Evaluation of a Passive Back Support Exoskeleton on Mechanical Loading During a Simulated Patient Transfer Task

Unai Latorre Erezuma, Maialen Zelaia Amilibia, Ander Espin Elorza, Camilo Cortés, Jon Irazusta, and Ana Rodriguez-Larrad

This study assessed the effectiveness of a passive back support exoskeleton during a mechanical loading task. Fifteen healthy participants performed a simulated patient transfer task while wearing the Laevo (version 2.5) passive back support exoskeleton. Collected metrics encompassed L5-S1 joint moments, back and abdominal muscle activity, lower body and back kinematics, center of mass displacement, and movement smoothness. A statistical parametric mapping analysis approach was used to overcome limitations from discretization of continuous data. The exoskeleton reduced L5-S1 joint moments during trunk flexion, but wearing the device restricted L5-S1 joint flexion when flexing the trunk as well as hip and knee extension, preventing participants from standing fully upright. Moreover, wearing the device limited center of mass motion in the caudal direction and increased its motion in the anterior direction. Therefore, wearing the exoskeleton partly reduced lower back moments during the lowering phase of the patient transfer task, but there were some undesired effects such as altered joint kinematics and center of mass displacement. Statistical parametric mapping analysis was useful in determining the benefits and hindrances produced by wearing the exoskeleton while performing the simulated patient transfer task and should be utilized in further studies to inform design and appropriate usage.

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The Effects of Increasing Trunk Flexion During Stair Ascent on the Rate and Magnitude of Achilles Tendon Force in Asymptomatic Females

Lee T. Atkins, Michael Lowrey, Sarah Reagor, Kirsten Walker, and Dhalston Cage

Research indicates that increasing trunk flexion may optimize patellofemoral joint loading. However, this postural change could cause an excessive Achilles tendon force (ATF) and injury risk during movement. This study aimed to examine the effects of increasing trunk flexion during stair ascent on ATF, ankle biomechanics, and vertical ground reaction force in females. Twenty asymptomatic females (age: 23.4 [2.5] y; height: 1.6 [0.8] m; mass: 63.0 [12.2] kg) ascended stairs using their self-selected and flexed trunk postures. Compared with the self-selected trunk condition, decreases were observed for peak ATF (mean differences [MD] = 0.14 N/kg; 95% confidence interval [CI], 0.06 to 0.23; Cohen d = −1.2; P = .003), average rate of ATF development (MD = 0.25 N/kg/s; 95% CI, 0.07 to 0.43; Cohen d = −0.9; P = .010), ankle plantar flexion moment (MD = 0.08 N·m/kg; 95% CI, 0.03 to 0.13; Cohen d = −1.1; P = .005), and vertical ground reaction force (MD = 38.6 N/kg; 95% CI, 20.3 to 56.90; Cohen d = −1.8; P < .001). Increasing trunk flexion did not increase ATF. Instead, this postural change was associated with a decreased ATF rate and magnitude and may benefit individuals with painful Achilles tendinopathy.

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The Effect of Foot Position and Lean Mass on Jumping and Landing Mechanics in Collegiate Dancers

Chris J. Alfiero, Ann F. Brown, Youngmin Chun, Alexandra Holmes, and Joshua P. Bailey

The purpose of this study was to investigate the effects of foot positioning and lean mass on jumping and landing mechanics in collegiate dancers. Thirteen dancers performed 3 unilateral and bilateral vertical jumps with feet in neutral and turnout positions. Dual-energy x-ray absorptiometry scans, jump height, vertical stiffness, and joint stiffness were assessed for relationships between foot positions. Jump heights were greater in right compared with left limb (P = .029) and neutral compared with turnout (P = .020) during unilateral jumping. In unilateral landing, knee stiffness was greater in turnout compared with neutral (P = .004) during the loading phase. Jump height (P < .001) was significantly increased, and vertical stiffness (P = .003) was significantly decreased during bilateral jumping in neutral compared with turnout. Significantly increased hip stiffness during the attenuation phase was observed in neutral compared with turnout (P = .006). Left-limb lean mass was significantly less than the right limb (P < .05). Adjustments for bilateral jumping were focused on hip stiffness, whereas there was a slight shift to knee strategy for unilateral jump.

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Volume 38 (2022): Issue 6 (Dec 2022)

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Alterations in the Functional Knee Alignment Are Not an Effective Strategy to Modify the Mediolateral Distribution of Knee Forces During Closed Kinetic Chain Exercises

Will Bosch, Amir Esrafilian, Paavo Vartiainen, Jari Arokoski, Rami K. Korhonen, and Lauri Stenroth

Pain felt while performing rehabilitation exercises could be a reason for the low adherence of knee osteoarthritis patients to physical rehabilitation. Reducing compressive forces on the most affected knee regions may help to mitigate the pain. Knee frontal plane positioning with respect to pelvis and foot (functional knee alignment) has been shown to modify the mediolateral distribution of the tibiofemoral joint contact force in walking. Hence, different functional knee alignments could be potentially used to modify joint loading during rehabilitation exercises. The aim was to understand whether utilizing different alignments is an effective strategy to unload specific knee areas while performing rehabilitation exercises. Eight healthy volunteers performed 5 exercises with neutral, medial, and lateral knee alignment. A musculoskeletal model was modified for improved prediction of tibiofemoral contact forces and used to evaluate knee joint kinematics, moments, and contact forces. Functional knee alignment had only a small and inconsistent effect on the mediolateral distribution joint contact force. Moreover, the magnitude of tibiofemoral and patellofemoral contact forces, knee moments, and measured muscle activities was not significantly affected by the alignment. Our results suggest that altering the functional knee alignment is not an effective strategy to unload specific knee regions in physical rehabilitation.

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Differences in Knee Extensors’ Muscle–Tendon Unit Passive Stiffness, Architecture, and Force Production in Competitive Cyclists Versus Runners

Leonardo Cesanelli, Sigitas Kamandulis, Nerijus Eimantas, and Danguole Satkunskiene

To describe the possible effects of chronic specific exercise training, the present study compared the anthropometric variables, muscle–tendon unit (MTU) architecture, passive stiffness, and force production capacity between a group of competitive cyclists and runners. Twenty-seven competitive male cyclists (n = 16) and runners (n = 11) participated. B-mode ultrasound evaluation of the vastus lateralis muscle and patellar tendon as well as passive stiffness of the knee extensors MTU were assessed. The athletes then performed a test of knee extensor maximal voluntary isometric contractions. Cyclists displayed greater thigh girths, vastus lateralis pennation angle and muscle thickness, patellar tendon cross-sectional area, and MTU passive stiffness than runners (P < .05). Knee extensor force production capacity also differed significantly, with cyclists showing greater values compared with runners (P < .05). Overall, the direct comparison of these 2 populations revealed specific differences in the MTU, conceivably related to the chronic requirements imposed through the training for the different disciplines.

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Sex Differences in Spatiotemporal Gait Parameters of Transtibial Amputees

Tess M.R. Carswell, Brenton G. Hordacre, Marc D. Klimstra, and Joshua W. Giles

Research addressing lower limb amputee gait and prosthetic design often focuses on men, despite female lower limb amputees having different risk factors and lower success with their prosthetics overall. It is widely agreed that sex differences exist in able-bodied gait, but research analyzing sex differences in amputee gait is rare. This study compared male and female transtibial amputee gait to ascertain potential sex differences. Forty-five transtibial amputees were asked to walk at their self-selected speed, and spatiotemporal gait data were obtained. Both the mean and variability metric of parameters were analyzed for 10 male and 10 female participants. For all participants, amputated limbs had a shorter stance time, longer swing time, and larger step length. Females had a 10% shorter stance time and 26% larger normalized step and stride length than males. Female participants also walked over 20% faster than male participants. Finally, significant interactions were found in the mean and variability metric of stride velocity, indicating greater variability in women. These findings suggest that sex differences exist in transtibial amputee gait, offering possible explanations for the different comorbidities experienced by female lower limb amputees. These results have major implications for female amputees and for sex-specific research, rehabilitation, and prosthetic design.

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Relationship Between Shoulder Pain and Joint Reaction Forces and Muscle Moments During 2 Speeds of Wheelchair Propulsion

Li-Shan Chang, Xiong-Wen Ke, Weerawat Limroongreungrat, and Yong Tai Wang

The purpose of this study was to determine shoulder joint reaction forces and muscle moments during 2 speeds (1.3 and 2.2 m/s) of wheelchair propulsion and to investigate the relationship between joints reaction forces, muscle moments, and shoulder pain. The measurements were obtained from 20 manual wheelchair users. A JR3 6-channel load sensor (±1% error) and a Qualisys system were used to record 3-dimensional pushrim kinetics and kinematics. A 3-dimensional inverse dynamic model was generated to compute joint kinetics. The results demonstrated significant differences in shoulder joint forces and moments (P < .01) between the 2 speeds of wheelchair propulsion. The greatest peak shoulder joint forces during the drive phase were anterior directed (Fy, 184.69 N), and the greatest joint moment was the shoulder flexion direction (flexion moment, 35.79 N·m) at 2.2 m/s. All the shoulder joint reaction forces and flexion moment were significantly (P < .05) related to shoulder pain index. The forces combined in superior and anterior direction found at the shoulder joint may contribute to the compression of subacromial structure and predispose manual wheelchair users to potential rotator cuff impingement syndrome.

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Weighted Vest Loads Do Not Elicit Changes in Spatial-Temporal Gait Parameters in Children and Adolescents With Autism

Alyssa N. Olivas, Emily A. Chavez, and Jeffrey D. Eggleston

Weighted vests have been used primarily as behavioral interventions for children and adolescents with autism. Contemporary research has begun to examine weighted vest effects on movement. Previous research in children with neurotypical development revealed 15% body mass loads modified spatial-temporal gait characteristics; however, a value applicable to children and adolescents with autism has not been established. The purpose of this study was to establish an appropriate mass value by examining spatial-temporal gait parameters in children and adolescents with autism with various loads in a weighted vest. Nine children and adolescents with autism, aged 8–17, walked without a weighted vest, with 5%, 10%, 15%, and 20% body mass while spatial-temporal data were captured. Repeated-measures analysis of variance (α = .05) were conducted among conditions for each variable, with a Holm–Bonferroni method correction. Analysis revealed significant decreases in right step length, but no differences in stride width, left step length, double-limb support time, or stride velocity were observed. Due to insignificant findings, an appropriate mass value could not be determined for weighted vests for children with autism. However, unchanged spatial-temporal gait parameters with increasing loads could be clinically relevant as weighted vest loads of 10% are typically used for behavioral interventions.