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Are Age, Self-Selected Walking Speed, or Propulsion Force Predictors of Gait-Related Changes in Older Adults?

Dheyani Malde, Natalie Pizzimenti, John McCamley, and Bonnie Sumner

There is limited research that directly compares the effect of reduced speed with reduced propulsive force production (PFP) on age-related gait changes. We aimed to determine how changes in the gait of older adults correlate with age, speed, or peak PFP over a 6-year span. We collected kinematics and kinetics of 17 older subjects at 2 time points. We determined which biomechanical variables changed significantly between visits and used linear regressions to determine whether combinations of self-selected walking speed, peak PFP, and age correlated to changes in these variables. We found a suite of gait-related changes that occurred in the 6-year period, in line with previous aging studies. Of the 10 significant changes, we found 2 with significant regressions. Self-selected walking speed was a significant indicator of step length, not peak PFP or age. Peak PFP was a significant indicator for knee flexion. None of the biomechanical changes were correlated to the chronological age of the subjects. Few gait parameters had a correlation to the independent variables, suggesting that changes in gait mechanics were not solely correlated to peak PFP, speed, and/or age. This study improves understanding of changes in ambulation that lead to age-related gait modifications.

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Early Changes in Postural Balance Following Inverted V-Shaped High Tibial Osteotomy in Patients With Knee Osteoarthritis

Kento Sabashi, Takeshi Chiba, Koji Iwasaki, Tomohiro Onodera, Eiji Kondo, Norimasa Iwasaki, and Harukazu Tohyama

Patients with knee osteoarthritis and varus knee deformity have impaired postural balance, resulting in decreased walking performance and an increased risk of falls. This study aimed to investigate the early changes in the postural balance following inverted V-shaped high tibial osteotomy (HTO). Fifteen patients with medial knee osteoarthritis were recruited. Postural balance was assessed using the center-of-pressure (COP) data during single-leg standing before and 6 weeks after inverted V-shaped HTO. The maximum range, mean velocity, and area of COP movements in the anteroposterior and mediolateral directions were analyzed. Preoperative and postoperative visual analog scale for knee pain was assessed. The maximum range of COP in the mediolateral direction decreased (P = .017), whereas the mean velocity of COP in the anteroposterior direction increased 6 weeks postoperatively (P = .011). The visual analog scale score for knee pain significantly improved at 6 weeks postoperatively (P = .006). Valgus correction with inverted V-shaped HTO resulted in improved postural balance in the mediolateral direction and good short-term clinical outcomes early following surgery. Early rehabilitation after inverted V-shaped HTO should focus on postural balance in the anteroposterior direction.

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Effects of Gluteus Medius and Biceps Femoris Stimulation on Reduction of Knee Abduction Moment During a Landing Task

Dan Wang, Man Wang, Vikki Wing-Shan Chu, Patrick Shu-Hang Yung, and Daniel T.P. Fong

Anterior cruciate ligament injury prevention should focus primarily on reduction of the knee abduction moment (KAM) in landing tasks. Gluteus medius and hamstring forces are considered to decrease KAM during landing. The effects of different muscle stimulations on KAM reduction were compared using 2 electrode sizes (standard 38 cm2 and half size 19 cm2) during a landing task. Twelve young healthy female adults (22.3 [3.6] y, 1.62 [0.02] m, 50.2 [4.7] kg) were recruited. KAM was calculated under 3 conditions of muscle stimulation (gluteus medius, biceps femoris, and both gluteus medius, and biceps femoris) using 2 electrode sizes, respectively versus no stimulation during a landing task. A repeated-measures analysis of variance determined that KAM differed significantly among stimulation conditions and post hoc analysis revealed that KAM was significantly decreased in conditions of stimulating either the gluteus medius (P < .001) or the biceps femoris (P < .001) with the standard electrode size, and condition of stimulating both gluteus medius and biceps femoris with half-size electrode (P = .012) when compared with the control condition. Therefore, stimulation on the gluteus medius, the biceps femoris, or both muscles could be implemented for the examination of anterior cruciate ligament injury potential.

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Rapid Change in the Direction of Hand Movement to Increase Hand Propulsion During Front Crawl Swimming

Shigetada Kudo, Yuji Matsuda, Yoshihisa Sakurai, and Yasushi Ikuta

This study aims to investigate the difference in hand acceleration induced by rapid changes in hand movement directions and propulsion between fast and slow groups of swimmers during front crawl swimming. Twenty-two participants, consisting of 11 fast and 11 slow swimmers, performed front crawl swimming at their maximal effort. Hand acceleration and velocity and the angle of attack were measured using a motion capture system. The dynamic pressure approach was used to estimate hand propulsion. In the insweep phase, the fast group attained significantly higher hand acceleration than the slow group in the lateral and vertical directions (15.31 [3.44] m·s−2 vs 12.23 [2.60] m·s−2 and 14.37 [1.70] m·s−2 vs 12.15 [1.21] m·s−2), and the fast group exerted significantly larger hand propulsion than the slow group (53 [5] N vs 44 [7] N). Although the fast group attained large hand acceleration and propulsion during the insweep phase, the hand velocity and the angle of attack were not significantly different in the 2 groups. The rapid change in hand movement direction could be considered in the technique of underwater arm stroke, particularly in the vertical direction, to increase hand propulsion during front crawl swimming.

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Hip Joint Biomechanical Parameters and Their Relationship With the Esthetic Functional Performance of the Développé à la Seconde Movement in Classical Ballet Dancers

Fernanda Metzen, João Breno Ribeiro-Alvares, Klauber Dalcero Pompeo, Francesca Chaida Sonda, Rodrigo Silva Santos, and Marco Aurélio Vaz

Développé à la seconde is a classic ballet movement that requires the maintenance of a high hip joint range of motion (ROM) and muscle strength. However, the contribution of these hip joint biomechanical parameters to this movement’s esthetic performance is unclear. Therefore, this study evaluated hip joint biomechanical characteristics of 21 experienced ballet dancers (15–29 y old) and verified the relationship between these variables with the développé à la seconde static and dynamic performance. Correlations between age, ballet practice time, gluteus maximus and gluteus medius thicknesses, ROM, and muscle strength with absolute and relative static and dynamic performances were verified. Flexors, extensors, and internal rotators peak strength and external rotation ROM were highly correlated with absolute and relative static performances (0.5–0.7). Flexors and extensors strength and external and internal rotation ROM showed the highest correlations with the développé dynamic performance (0.49–0.67). Flexor strength and flexor and internal rotation ROM predicted 26% to 41% of this movement’s static and dynamic performances. Thus, from a biomechanical perspective, clinical assessment of hip strength and ROM may be used to predict the quality of the ballet dancers’ performance of the développé à la seconde and guide classical ballet training.

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Activity Distribution Among the Hamstring Muscles During the Nordic Hamstring Exercise: A Multichannel Surface Electromyography Study

Jozef J.M. Suskens, Gustaaf Reurink, Johannes L. Tol, Gino M.M.J. Kerkhoffs, Edwin A. Goedhart, Huub Maas, and Jaap H. van Dieën

This study assessed activity distribution among the hamstring muscles during the Nordic hamstring exercise (NHE). The objective was to compare muscle activity between and within muscles during the NHE to add insights in its underlying protective mechanism. Through multichannel electromyography, we measured muscle activity in male basketball players during the NHE. Electromyography was assessed at 15 locations: 5 for biceps femoris long head, 4 for semitendinosus, and 6 for semimembranosus. For each percent of the eccentric phase of the NHE, muscle activity was calculated for each electrode location within each hamstring muscle individually. To quantify whole muscle head activity, means and variances across electrodes within each muscle were calculated. Thirty-five noninjured participants were included (mean age, 18 [2] y; mass, 87 [12] kg; height, 192 [9] cm). Heterogeneous muscle activity was found between 38% and 62% and over the whole eccentric contraction phase within the semitendinosus and the semimembranosus, respectively. Muscle activity of the semitendinosus was significantly higher than that of the biceps femoris long head. During the NHE, the relative contribution of the semitendinosus is the highest among hamstring muscles. Its strong contribution may compensate for the biceps femoris long head, the most commonly injured hamstring muscle head.

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Volume 39 (2023): Issue 1 (Feb 2023)

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A Minimal Sensor Inertial Measurement Unit System Is Replicable and Capable of Estimating Bilateral Lower-Limb Kinematics in a Stationary Bodyweight Squat and a Countermovement Jump

AuraLea Fain, Benjamin Hindle, Jordan Andersen, Bradley C. Nindl, Matthew B. Bird, Joel T. Fuller, Jodie A. Wills, and Tim L.A. Doyle

This study aimed to validate a 7-sensor inertial measurement unit system against optical motion capture to estimate bilateral lower-limb kinematics. Hip, knee, and ankle sagittal plane peak angles and range of motion (ROM) were compared during bodyweight squats and countermovement jumps in 18 participants. In the bodyweight squats, left peak hip flexion (intraclass correlation coefficient [ICC] = .51), knee extension (ICC = .68) and ankle plantar flexion (ICC = .55), and hip (ICC = .63) and knee (ICC = .52) ROM had moderate agreement, and right knee ROM had good agreement (ICC = .77). Relatively higher agreement was observed in the countermovement jumps compared to the bodyweight squats, moderate to good agreement in right peak knee flexion (ICC = .73), and right (ICC = .75) and left (ICC = .83) knee ROM. Moderate agreement was observed for right ankle plantar flexion (ICC = .63) and ROM (ICC = .51). Moderate agreement (ICC > .50) was observed in all variables in the left limb except hip extension, knee flexion, and dorsiflexion. In general, there was poor agreement for peak flexion angles, and at least moderate agreement for joint ROM. Future work will aim to optimize methodologies to increase usability and confidence in data interpretation by minimizing variance in system-based differences and may also benefit from expanding planes of movement.

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Left–Right Differential Erector Spinae Muscles Activation in Prone and Quadruped Positions

Nader Farahpour, Mahboube Alemzadeh, Mehri Mohammadi, Mohammadreza Rezaie, and Paul Allard

Left–right differential erector spinae (ES) muscle strengthening is required to correct ES muscle imbalances. The objective was to test the effect of 6 body positions on the differential activation of the ES muscles. In 14 able-bodied young women, using a surface electromyography system, the bilateral ES muscles activity at the third lumbar (ESL3) and the 10th (EST10) and 6th (EST6) thoracic vertebral levels was measured with the contralateral arm and leg lifted in the prone and quadruped conditions and with a single arm lifted in the quadruped position. Results showed that the activity of the ESL3 was symmetrical (P > .05) and significantly smaller than that of the thoracic ES muscles in all body positions (P < .01). The EST10 and EST6 were differentially activated in all tests (P < .001). Besides, the differential activation was higher in the contralateral-arm and -leg lift in the quadruped position than in the other positions. In conclusion, contralateral-arm and -leg lift and single-arm lift in the quadruped and prone positions are capable of differentially activating the ES muscles on one side more than the other side. Further studies are recommended to examine the effectiveness of these exercises on the correction of ES muscle imbalances in clinical populations.

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Pelvic Rotation Is Associated With Asymmetry in the Knee Extensor Moment During Double-Leg Squatting After Anterior Cruciate Ligament Reconstruction

Tomoya Ishida, Mina Samukawa, Yuta Koshino, Takumi Ino, Satoshi Kasahara, and Harukazu Tohyama

Asymmetry in knee extensor moment during double-leg squatting was observed after anterior cruciate ligament reconstruction, even after the completion of the rehabilitation program for return to sports. The purpose of this study was to clarify the association between asymmetry in the knee extensor moment and pelvic rotation angle during double-leg squatting after anterior cruciate ligament reconstruction. Twenty-four participants performed double-leg squatting. Kinetics and kinematics during squatting were analyzed using a 3-dimensional motion analysis system with 2 force plates. The limb symmetry index of knee extensor moment was predicted by the pelvic rotation angle (R 2 = .376, P = .001). In addition, the pelvic rotation and the limb symmetry index of the vertical ground reaction force independently explained the limb symmetry index of the knee extensor moment (R 2 = .635, P < .001, β of pelvic rotation = −0.489, β of vertical ground reaction force = 0.524). Pelvic rotation toward the involved limb was associated with a smaller knee extensor moment in the involved limb than in the uninvolved limb. The assessment of pelvic rotation would be useful for partially predicting asymmetry in the knee extensor moment during double-leg squatting. Minimizing pelvic rotation may improve the asymmetry in the knee extensor moment during double-leg squatting after anterior cruciate ligament reconstruction.