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Specific participant characteristics may be leveraged to dictate marker placements which reduce soft tissue artifact; however, a better understanding of the relationships between participant characteristics and soft tissue artifact are first required. The purpose of this study was to assess the accuracy in which measures of whole-body and thigh anthropometry could predict mislocation error of the hip joint center, tracked using skin-mounted marker clusters. Fifty participants completed squatting and kneeling, while pelvis and lower limb motion were recorded. The effect of soft tissue artifact was estimated from 6 rigid thigh marker clusters by evaluating their ability to track the position of the hip joint center most like the pelvis cluster. Eighteen backward stepwise linear regressions were performed using 10 anthropometric measures as independent variables and the mean of the peak difference between the thigh and pelvis cluster-tracked hip joint centers. Fourteen models significantly predicted error with low to moderate fit (R = .38–.67), explaining 14% to 45% of variation. Partial correlations indicated that soft tissue artifact may increase with soft tissue volume and be altered by local soft tissue composition. However, it is not recommended that marker placement be adjusted based on anthropometry alone.

Hockey is a fast-paced sport known for body checking, or intentional collisions used to separate opponents from the puck. Exposure to these impacts is concerning, as evidence suggests head impact exposure (HIE), even if noninjurious, can cause long-term brain changes. Currently, there is limited understanding of the effect of impact direction and collision speed on HIE. Video analysis was used to determine speed and direction for 162 collisions from 13 youth athletes. These data were paired with head kinematic data collected with an instrumented mouthpiece. Relationships between peak resultant head kinematics and speeds were evaluated with linear regression. Mean athlete speeds and relative velocity between athletes ranged from 2.05 to 2.76 m/s. Mean peak resultant linear acceleration, rotational velocity, and rotational acceleration were 13.1 g, 10.5 rad/s, and 1112 rad/s², respectively. Significant relationships between speeds and head kinematics emerged when stratified by contact characteristics. HIE also varied by direction of collision; most collisions occurred in the forward-oblique (ie, offset from center) direction; frontal collisions had the greatest magnitude peak kinematics. These findings indicate that HIE in youth hockey is influenced by speed and direction of impact. This study may inform future strategies to reduce the severity of HIE in hockey.

Studies of human movement usually collect data from multiple repetitions of a task and use the average of all movement trials to approximate the typical kinematics or kinetics pattern for each individual. Few studies report the expected accuracy of these estimated mean kinematics or kinetics waveforms for each individual. The purpose of this study is to demonstrate how simultaneous confidence bands, which is an approach to quantify uncertainty across an entire waveform based on limited data, can be used to calculate margin of error (MOE) for waveforms. Bilateral plantar pressure data were collected from 70 participants as they walked over 4 surfaces for an average of at least 300 steps per surface. The relationship between MOE and the number of steps included in the analysis was calculated using simultaneous confidence bands, and 3 methods commonly used for pointwise estimates: intraclass correlation, sequential averaging, and T-based MOE. The conventional pointwise approaches underestimated the number of trials required to estimate biomechanical waveforms within a desired MOE. Simultaneous confidence bands are an objective approach to more accurately estimate the relationship between the number of trials collected and the MOE in estimating typical biomechanical waveforms.

The diverse and grueling nature of activities undertaken during Special Forces selection makes it difficult to develop physical training to improve performance and reduce injury risk. It is generally accepted that increased strength is protective against injury, but it is unclear if this is evident in a Special Forces selection environment. This study investigated the effect of the rigors of a Special Forces selection course has on performance of the isometric mid-thigh pull, countermovement jump, squat jump, drop landing, elastic utilization ratio (EUR), and injury occurrence. Throughout the course, 26% of participants sustained a preventable lower limb injury, with 65% of these occurring at the knee. The uninjured had higher values of absolute strength as measured by isometric mid-thigh pull peak absolute force (3399 [371] N, 3146 [307] N; P = .022) and lower EUR (0.94 [0.08], 1.01 [0.09]; P = .025) compared to the injured. Preventable knee injury was significantly correlated with isometric mid-thigh pull (r = −.245, P = .031) and EUR (r = .227, P = .044). The selection course altered EUR for uninjured individuals only (P = .004). Findings indicate that individuals with higher strength levels may be at a lower risk of injury than their weaker counterparts.

The purpose of this study was to quantify the contribution of the individual quadriceps muscles to patellar tracking. The individual and/or combined quadriceps muscles were activated in rabbits (n = 6) during computer-controlled flexion/extension of the knee. Three-dimensional patellar tracking was measured for the vastus lateralis, vastus medialis, and rectus femoris when activated alone and when activated simultaneously at different frequencies, producing a range of knee extensor torques. Patellar tracking changed substantially as a function of knee extensor torque and differed between muscles. Specifically, when all quadriceps muscles were activated simultaneously, the patella shifted more medially and proximally and rotated and tilted more medially compared with when vastus lateralis and rectus femoris were activated alone (P < .05), whereas vastus medialis activation alone produced a similar tracking pattern to that observed when all quadriceps muscles were activated simultaneously. Furthermore, patellar tracking for a given muscle condition shifted more medially and proximally and rotated and tilted more medially with increasing knee extensor torques across the entire range of knee joint angles. The authors conclude that patellar tracking depends crucially on knee extensor force/torque and that vastus medialis affects patellar tracking in a distinctly different way than vastus lateralis and rectus femoris, which produce similar tracking patterns.

The objective was to assess how patellofemoral loads (joint force and stress) change while lunging with step length and step height variations. Sixteen participants performed a forward lunge using short and long steps at ground level and up to a 10-cm platform. Electromyography, ground reaction force, and 3D motion were captured, and patellofemoral loads were calculated as a function of knee angle. Repeated-measures 2-way analysis of variance (P < .05) was employed. Patellofemoral loads in the lead knee were greater with long step at the beginning of landing (10°–30° knee angle) and the end of pushoff (10°–40°) and greater with short step during the deep knee flexion portion of the lunge (50°–100°). Patellofemoral loads were greater at ground level than 10-cm platform during lunge descent (50°–100°) and lunge ascent (40°–70°). Patellofemoral loads generally increased as knee flexion increased and decreased as knee flexion decreased. To gradually increase patellofemoral loads, perform forward lunge in the following sequence: (1) minimal knee flexion (0°–30°), (2) moderate knee flexion (0°–60°), (3) long step and deep knee flexion (0°–100°) up to a 10-cm platform, and (4) long step and deep knee flexion (0°–100°) at ground level.

The purpose of this study was to investigate normative and age-related differences in trunk and pelvis kinematics and intersegmental coordination during sagittal plane flexion–extension. Trunk and pelvis kinematics were recorded while 76 participants performed a maximal range of motion task in the sagittal plane. Cross-correlation was calculated to determine the phase lag between adjacent segment motion, and coupling angles were calculated using vector coding and classified into one of 4 coordination patterns: in-phase, antiphase, superior, and inferior phase. A 2-way mixed-model multivariate analysis of variance was used to compare lumbar spine and pelvis angular kinematics, phase lags, and cross-correlation coefficients between groups. Young participants exhibited greater trunk range of motion compared with middle-aged participants. The lumbar spine and pelvis were predominantly rotating with minimum phase lag during flexion and extension movement for both age groups, and differences in coordination between the groups were seen during hyperextension and return to upright position. In conclusion, middle-aged adults displayed lower range of motion but maintained similar movement patterns to young adults, which could be attributed to protective mechanisms. Healthy lumbar and pelvis movement patterns are important to understand and need to be quantified as a baseline, which can be used to develop rehabilitation protocols for individuals with spinal ailments.

Patients following unilateral total knee arthroplasty (TKA) display interlimb differences in knee joint kinetics during gait and more recently, stationary cycling. The purpose of this study was to use musculoskeletal modeling to estimate total, medial, and lateral tibiofemoral compressive forces for patients following TKA during stationary cycling. Fifteen patients of unilateral TKA, from the same surgeon, participated in cycling at 2 workrates (80 and 100 W). A knee model (OpenSim 3.2) was used to estimate total, medial, and lateral tibiofemoral compressive forces for replaced and nonreplaced limbs. A 2 × 2 (limb × workrate) and a 2 × 2 × 2 (compartment × limb × workrate) analysis of variance were run on the selected variables. Peak medial tibiofemoral compressive force was 23.5% lower for replaced compared to nonreplaced limbs (P = .004, G = 0.80). Peak medial tibiofemoral compressive force was 48.0% greater than peak lateral tibiofemoral compressive force in nonreplaced limbs (MD = 344.5 N, P < .001, G = 1.6) with no difference in replaced limbs (P = .274). Following TKA, patients have greater medial compartment loading on their nonreplaced compared to their replaced limbs and ipsilateral lateral compartment loading. This disproportionate loading may be cause for concern regarding exacerbating contralateral knee osteoarthritis.

This study aimed to determine the relationship between lower limb muscle strength and explosive force with force plate–derived timing measures of reactive stepping. Nineteen young, healthy adults responded to 6 perturbations using an anterior lean-and-release system. Foot-off, swing, and restabilization times were estimated from force plates. Peak isokinetic torque, isometric torque, and explosive force of the knee extensors/flexors and plantar/dorsiflexors were measured using isokinetic dynamometry. Correlations were run based on a priori hypotheses and corrected for the number of comparisons (Bonferroni) for each variable. Knee extensor explosive force was negatively correlated with swing time (r = −.582, P = .009). Knee flexor peak isometric torque also showed a negative association with restabilization time (r = −.459, P = .048); however, this was not statistically significant after correcting for multiple comparisons. There was no significant relationship between foot-off time and knee or plantar flexor explosive force (P > .025). These findings suggest that there may be utility to identifying specific aspects of reactive step timing when studying the relationship between muscle strength and reactive balance control. Exercise training aimed at improving falls risk should consider targeting specific aspects of muscle strength depending on specific deficits in reactive stepping.