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Variables Associated With Knee Valgus in Male Professional Soccer Players During a Single-Leg Vertical Landing Task

Matheus Vianna, Leonardo Metsavaht, Eliane Guadagnin, Carlos Eduardo Franciozi, Marcus Luzo, Marcio Tannure, and Gustavo Leporace

Prior studies have explored the relationship between knee valgus and musculoskeletal variables to formulate injury prevention programs, primarily for females. Nonetheless, there is insufficient evidence pertaining to professional male soccer players. Here, the aim was to test the correlation of lateral trunk inclination, hip adduction, hip internal rotation, ankle dorsiflexion range of motion, and hip isometric strength with knee valgus during the single-leg vertical jump test. Twenty-four professional male soccer players performed a single-leg vertical hop test, hip strength assessments, and an ankle dorsiflexion range of motion test. A motion analysis system was employed for kinematic analysis. Maximal isometric hip strength and ankle dorsiflexion range of motion were tested using a handheld dynamometer and a digital inclinometer, respectively. The correlation of peak knee valgus with peak lateral trunk inclination was .43 during the landing phase (P = .04) and with peak hip internal rotation was −.68 (P < .001). For knee valgus angular displacement, only peak lateral trunk inclination presented a moderate positive correlation (r = .40, P = .05). This study showed that trunk and hip kinematics are associated with knee valgus, which could consequently lead to increased knee overload in male professional soccer players following a unilateral vertical landing test.

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Reliability of Shoulder Helical Axes During Intransitive and Transitive Upper Limb Tasks

Paola Adamo, Federico Temporiti, Martina Maffeis, Francesco Bolzoni, and Roberto Gatti

Shoulder complex stability can be estimated in vivo through the analysis of helical axes (HAs) dispersion during upper limb movements. The study aimed at investigating test–retest reliability of shoulder HAs dispersion parameters during upper limb tasks. Twenty healthy volunteers performed 2 intransitive (shoulder flexion and rotation) and one transitive (combing) tasks with the dominant and nondominant upper limbs during 2 recording sessions at 1-week distance. Kinematics was detected through an optoelectronic system. Mean distance and mean angle (MA) were adopted as HAs dispersion indexes. Reliability was excellent for mean distance (intraclass correlation coefficient [ICC]: .91) and MA (ICC: .92) during dominant flexion, and good for MA (ICC: .90) during nondominant flexion. Moderate reliability was found for HAs parameters during rotation (ICCs from .70 to .59), except for MA during dominant rotation where reliability was poor. Reliability was good for mean distance (ICC: .83) and moderate for MA (ICC: .67) during the dominant combing task, whereas no reliability was found during the nondominant combing task. HAs dispersion parameters revealed high reliability during simple intransitive tasks with the dominant limb. Reliability decreased with the increase in task complexity due to the increase in movement variability. HAs dispersion technique could be used to assess shoulder complex stability in patients after rehabilitation or surgery.

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The History and Future of Neuromusculoskeletal Biomechanics

David G. Lloyd, Ilse Jonkers, Scott L. Delp, and Luca Modenese

The Executive Council of the International Society of Biomechanics has initiated and overseen the commemorations of the Society’s 50th Anniversary in 2023. This included multiple series of lectures at the ninth World Congress of Biomechanics in 2022 and XXIXth Congress of the International Society of Biomechanics in 2023, all linked to special issues of International Society of Biomechanics’ affiliated journals. This special issue of the Journal of Applied Biomechanics is dedicated to the biomechanics of the neuromusculoskeletal system. The reader is encouraged to explore this special issue which comprises 6 papers exploring the current state-of the-art, and future directions and roles for neuromusculoskeletal biomechanics. This editorial presents a very brief history of the science of the neuromusculoskeletal system’s 4 main components: the central nervous system, musculotendon units, the musculoskeletal system, and joints, and how they biomechanically integrate to enable an understanding of the generation and control of human movement. This also entails a quick exploration of contemporary neuromusculoskeletal biomechanics and its future with new fields of application.

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Tapping Into Skeletal Muscle Biomechanics for Design and Control of Lower Limb Exoskeletons: A Narrative Review

Zahra S. Mahdian, Huawei Wang, Mohamed Irfan Mohamed Refai, Guillaume Durandau, Massimo Sartori, and Mhairi K. MacLean

Lower limb exoskeletons and exosuits (“exos”) are traditionally designed with a strong focus on mechatronics and actuation, whereas the “human side” is often disregarded or minimally modeled. Muscle biomechanics principles and skeletal muscle response to robot-delivered loads should be incorporated in design/control of exos. In this narrative review, we summarize the advances in literature with respect to the fusion of muscle biomechanics and lower limb exoskeletons. We report methods to measure muscle biomechanics directly and indirectly and summarize the studies that have incorporated muscle measures for improved design and control of intuitive lower limb exos. Finally, we delve into articles that have studied how the human–exo interaction influences muscle biomechanics during locomotion. To support neurorehabilitation and facilitate everyday use of wearable assistive technologies, we believe that future studies should investigate and predict how exoskeleton assistance strategies would structurally remodel skeletal muscle over time. Real-time mapping of the neuromechanical origin and generation of muscle force resulting in joint torques should be combined with musculoskeletal models to address time-varying parameters such as adaptation to exos and fatigue. Development of smarter predictive controllers that steer rather than assist biological components could result in a synchronized human–machine system that optimizes the biological and electromechanical performance of the combined system.

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Tibiofemoral Load Magnitude and Distribution During Load Carriage

Blake W. Jones, John D. Willson, Paul DeVita, and Ryan D. Wedge

Chronic exposure to high tibiofemoral joint (TFJ) contact forces can be detrimental to knee joint health. Load carriage increases TFJ contact forces, but it is unclear whether medial and lateral tibiofemoral compartments respond similarly to incremental load carriage. The purpose of our study was to compare TFJ contact forces when walking with 15% and 30% added body weight. Young healthy adults (n = 24) walked for 5 minutes with no load, 15% load, and 30% load on an instrumented treadmill. Total, medial, and lateral TFJ contact peak forces and impulses were calculated via an inverse dynamics informed musculoskeletal model. Results of 1-way repeated measures analyses of variance (α = .05) demonstrated total, medial, and lateral TFJ first peak contact forces and impulses increased significantly with increasing load. Orthogonal polynomial trends demonstrated that the 30% loading condition led to a curvilinear increase in total and lateral TFJ impulses, whereas medial first peak TFJ contact forces and impulses responded linearly to increasing load. The total and lateral compartment impulse increased disproportionally with load carriage, while the medial did not. The medial and lateral compartments responded differently to increasing load during walking, warranting further investigation because it may relate to risk of osteoarthritis.

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The Influence of Multiple Pregnancies on Gait Asymmetry: A Case Study

Aude S. Lefranc, Glenn K. Klute, and Richard R. Neptune

Gait asymmetry is a predictor of fall risk and may contribute to increased falls during pregnancy. Previous work indicates that pregnant women experience asymmetric joint laxity and pelvic tilt during standing and asymmetric joint moments and angles during walking. How these changes translate to other measures of gait asymmetry remains unclear. Thus, the purpose of this case study was to determine the relationships between pregnancy progression, subsequent pregnancies, and gait asymmetry. Walking data were collected from an individual during 2 consecutive pregnancies during the second and third trimesters and 6 months postpartum of her first pregnancy and the first, second, and third trimesters and 6 months postpartum of her second pregnancy. Existing asymmetries in step length, anterior–posterior (AP) impulses, AP peak ground reaction forces, lateral impulses, and joint work systematically increased as her pregnancy progressed. These changes in asymmetry may be attributed to pelvic asymmetry, leading to asymmetric hip flexor and extensor length, or due to asymmetric plantar flexor strength, as suggested by her ankle work asymmetry. Relative to her first pregnancy, she had greater asymmetry in step length, step width, braking AP impulse, propulsive AP impulse, and peak braking AP ground reaction force during her second pregnancy, which may have resulted from increased joint laxity.

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Muscle Fiber Conduction Velocity During Electrically Stimulated Contraction at Various Joint Angles, During Joint Movements, and During Voluntary Contractions

Tetsuya Hirono and Kohei Watanabe

Muscle fiber conduction velocity (MFCV) can be affected by muscle fiber geometry at different joint angles and during joint movements. This study aimed to investigate MFCV during electrically evoked contraction at different joint angles, during joint movements, and during voluntary contractions. Sixteen healthy young men participated. A stimulation electrode was attached on the innervation zone of the vastus lateralis, and a linear electrode array was attached on the vastus lateralis. Under a static condition, electrically evoked electromyography signals were recorded at knee joint angles set every 15° between 0° and 105°. Under a passive movement condition, signals were recorded during knee extension and flexion passively. Under a voluntary contraction condition, signals were recorded while performing 30% or 60% of maximum voluntary contraction. MFCV was calculated using cross-correlation coefficients. Under the static condition, there were no differences in MFCV among various joint angles. Under the passive movement condition, MFCV was significantly greater during high velocity or shortening. Under the voluntary contraction condition, MFCV was significantly greater during high-intensity voluntary contraction and with a shortened muscle length. Joint angles do not influence MFCV markedly during relaxation, but it is possible to overestimate MFCV during movement or voluntary contraction.

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Walking Kinematic Coordination Becomes More In-Phase at Extreme Inclines

Alexis D. Gidley and Joshua P. Bailey

Previous research has shown that there are differences in mechanical energy, kinematics, and muscle activation when comparing walking on level and incline surfaces, especially on inclines above 15%. Muscle activations are significantly different while walking on extreme inclines, suggesting a different coordination pattern. We utilized continuous relative phase to assess walking kinematic coordination with respect to increased incline angles. Twelve healthy, college-aged individuals walked for 7 inclines of 1 minute each on a motorized treadmill at 3 mph at 0%, 5%, 10%, 15%, 20%, 25%, and 30% inclines. Kinematic data were collected during the last 20 seconds of each stage (120 Hz). Segmental and joint angles and angular velocities in the sagittal plane were calculated, from which continuous relative phase was determined for 3 joint couples: hip–knee, hip–ankle, and knee–ankle. There were significant differences in the coordination patterns during the first part of the contact phase in the hip–knee and hip–ankle couplings between the 0% and 30% inclines, with all 3 joint couplings becoming more in-phase at inclines above 15%. Importantly, the hip–knee coupling changed significantly from more out-of-phase to more in-phase between 10% and 15% incline. Shifting lower-extremity joint coordination in response to extreme inclines identifies potential coordinative strategies to achieve steep walking.

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Multifidus Denervation After Radiofrequency Ablation of the Medial Nerve Alters the Biomechanics of the Spine—A Computational Study

Faris A. Almalki and Daniel H. Cortes

Radiofrequency ablation of the medial branch is commonly used to treat chronic low back pain involving facet joints, which accounts for 12% to 37% of the total cases of chronic low back pain. An adverse effect of this procedure is the denervation of the multifidus muscle, which may lead to its atrophy which can affect the spine and possibly disc degeneration. This study aims to quantify changes in joint angles and loading caused by multifidus denervation after radiofrequency ablation. AnyBody model of the torso was used to evaluate intervertebral joints in flexion, lateral bending, and torsion. Force-dependent kinematics was used to calculate joint angles and forces. These dependent variables were investigated in intact multifidus, unilateral, and bilateral ablations of L3L4, L4L5, and L5S1 joints. The results showed pronounced angular joint changes, especially in bilateral ablations in flexion, when compared with other cases. The same changes’ trend from intact to unilaterally then bilaterally ablated multifidus occurred in joint angles of lateral bending. Meanwhile, joint forces were not adversely affected. These results suggest that multifidus denervation after radiofrequency ablation affects spinal mechanics. Such changes may be associated with abnormal tissue deformations and stresses that can potentially alter their mechanobiology and homeostasis, thereby possibly affecting the health of the spine.

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Prediction of Model Generated Patellofemoral Joint Contact Forces Using Principal Component Prediction and Reconstruction

Myles Ashall, Mitchell G.A. Wheatley, Chris Saliba, Kevin J. Deluzio, and Michael J. Rainbow

It is not currently possible to directly and noninvasively measure in vivo patellofemoral joint contact force during dynamic movement; therefore, indirect methods are required. Simple models may be inaccurate because patellofemoral contact forces vary for the same knee flexion angle, and the patellofemoral joint has substantial out-of-plane motion. More sophisticated models use 3-dimensional kinematics and kinetics coupled to a subject-specific anatomical model to predict contact forces; however, these models are time consuming and expensive. We applied a principal component analysis prediction and regression method to predict patellofemoral joint contact forces derived from a robust musculoskeletal model using exclusively optical motion capture kinematics (external approach), and with both patellofemoral and optical motion capture kinematics (internal approach). We tested this on a heterogeneous population of asymptomatic subjects (n = 8) during ground-level walking (n = 12). We developed equations that successfully capture subject-specific gait characteristics with the internal approach outperforming the external. These approaches were compared with a knee-flexion based model in literature (Brechter model). Both outperformed the Brechter model in interquartile range, limits of agreement, and the coefficient of determination. The equations generated by these approaches are less computationally demanding than a musculoskeletal model and may act as an effective tool in future rapid gait analysis and biofeedback applications.