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Chronic Adaptions in Quadriceps Fascicle Mechanics Are Related to Altered Knee Biomechanics After Anterior Cruciate Ligament Reconstruction

McKenzie S. White, Lucia M. Mancini, Luke Stoneback, Riann M. Palmieri-Smith, and Lindsey K. Lepley

Following anterior cruciate ligament reconstruction (ACLR), patients exhibit abnormal walking mechanics and quadriceps dysfunction. Quadriceps dysfunction has been largely attributed to muscle atrophy and weakness. While important, these factors do not capture intrinsic properties of muscle that govern its ability to generate force and withstand load. While fascicle abnormalities after ACLR have been documented in early stages of recovery (<12 mo), long-term effects of ACLR on fascicle mechanics remain unexplored. We evaluated quadriceps fascicle mechanics during walking 3 years post-ACLR and examined the relationship with knee mechanics. Participants included 24 individuals with ACLR and 24 Controls. Linear mixed models compared the ACLR, Contralateral, and Controls limbs for (1) quadriceps strength, (2) fascicle architecture and mechanics, and (3) knee mechanics. No difference in strength or overall fascicle length excursions was found between limbs. The ACLR limb exhibited longer fascicles at heel strike and peak knee extension moment (P < .001–.004), and smaller fascicle angles at heel strike, peak knee extension moment, and overall suppressed fascicle angle excursions (P < .001–.049) relative to the Contralateral and/or Control limb. This indicates an abnormality in fascicle architecture and mechanics following ACLR and suggests abnormalities in contractile function that cannot be explained by muscle weakness and may contribute to long-term gait irregularities.

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Measurement Position Influences Sex Comparisons of Distal Femoral Cartilage Thickness With Ultrasound Imaging

Harry S. Battersby, Ryan J. Evans, Iwi J. Eghobamien, and Derek N. Pamukoff

The purpose was to examine (1) the effect of measurement position and sex on femoral cartilage outcomes, and (2) the association between gait biomechanics and cartilage outcomes. Fifty individuals participated (25 males and 25 females; age = 20.62 [1.80] y). Ultrasound measured femoral cartilage thickness and echo-intensity at 90°, 115°, and 140° of knee flexion. Gait outcomes included the external knee adduction and knee flexion moments. Cartilage outcomes were compared using 2 (sex) × 3 (position) repeated-measures analysis of variance. Gait and cartilage associations were assessed using stepwise regression. Medial cartilage was thicker when measured at 90° compared with 115° (P = .02) and 140° (P < .01), and 115° compared with 140°, (P < .01) in males but not in females. Cartilage was thicker at 90° compared with 140° across both sexes within all regions (P < .01). Males had thicker cartilage than females in all positions (P < .01). Echo-intensity was lower at 90° than 115° (P < .01) and 140° (P = .01) in the central and lower at 90° than at 115° (P < .01) and 140° (P = .03) in lateral regions. No association was found between gait and cartilage outcomes. Ultrasound imaging position effects cartilage features more in males compared with females. Imaging position and sex influence cartilage outcomes and should be considered in study designs and clinical evaluation.

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Hierarchical Organization and Adjustment of Force Coordination in Response to Self-Triggered and External-Triggered Cues in Simulated Archery Performance

Kitae Kim, Junkyung Song, Dawon Park, and Jaebum Park

The purpose of this study was to investigate the hierarchical organization of digit force production and its effect on stability and performance during the simulated archery task. The simulated archery shooting task required the production of a prescribed level of force in virtual space with the left hand and an equivalent force with all 4 fingers of right hand. A single trial had 2 phases, including static force production as aiming in archery and quick force release to shoot the virtual arrow. The timing of the force release was determined by the participant’s choice or response to the external cue. The coordination indices, that is, the synergy index, of force stabilization were quantified in 2 hierarchies by decomposing the variance components. The accuracy and precision of the hit position of the virtual arrow were calculated as performance-related indices. The results confirmed that the precision, that is, reproducibility, of the performance was greater when the force release time was determined by the self-selected time, suggesting the beneficial effect of the anticipatory mechanism. There was a distinct synergistic organization of digit forces for the stabilization of net forces in both bimanual and multifinger levels, which was especially correlated with the precision of performance.

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Forearm Posture Affects the Corticospinal Excitability of Intrinsic and Extrinsic Hand Muscles in Dominant and Nondominant Sides

Marco Antonio Cavalcanti Garcia, Thiago Santos de Carvalho, Renan Hiroshi Matsuda, Oswaldo Baffa, Luis Aureliano Imbiriba, and Victor Hugo Souza

Different forearm postures can modulate corticospinal excitability. However, there is no consensus on whether handedness plays a role in such a mechanism. This study investigated the effects of 3 forearm postures (pronation, neutral, and supination) on the corticospinal excitability of muscles from the dominant and nondominant upper limbs. Surface electromyography was recorded from the abductor digiti minimi, flexor pollicis brevis, and flexor carpi radialis from both sides of 12 right-handed volunteers. Transcranial magnetic stimulation pulses were applied to each muscle’s hotspot in both cerebral hemispheres. Motor-evoked potential peak-to-peak amplitude and latency and resting motor threshold were measured. The data were evaluated by analysis of variance. The level of significance was set at 5%. The resting motor threshold was similar for the 3 muscles and both sides. Motor-evoked potential peak-to-peak amplitude from flexor pollicis brevis was lower during supination, and the dominant upper limb latency was longer. The flexor carpi radialis presented lower motor-evoked potential peak-to-peak amplitudes for neutral and shorter latencies during supination. Abductor digiti minimi seemed not to be affected by posture or side. Different muscles from dominant and nondominant sides may undergo corticospinal modulation, even distally localized from a particular joint and under rest.

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Muscle Coordination During Maximal Butterfly Stroke Swimming: Comparison Between Competitive and Recreational Swimmers

Keisuke K. Yamakawa, Rena Nishiwaki, and Yasuo Sengoku

This study aimed to clarify the differences in muscular coordination during butterfly swimming between high- and low-performance swimmers using muscle synergy analysis. Eight female competitive swimmers and 8 female recreational swimmers participated in this study. The participants swam a 25-m butterfly stroke with maximum effort. Surface electromyography was measured from 12 muscles and muscle synergy analysis was performed from the data using nonnegative matrix factorization algorithms. From the results of the muscle synergy analysis, 4 synergies were extracted from both groups. Synergies 1 and 2 were characterized by coactivation of the upper and lower limb muscles in the recreational swimmers, whereas only synergy 1 was characterized by this in the competitive swimmers. Synergy 3 was involved in arm recovery in both groups. Synergy 4 was only involved in the downward kick in the competitive swimmers. From these results, it can be concluded that muscle synergies with combined coordination of upper and lower limb muscles were extracted more in the recreational swimmers and that the competitive swimmers controlled the downward kick with an independent synergy and that the adjustment of the timing of the downward kick may be an important factor for the efficient performance of butterfly swimming.

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Marker-Based Versus IMU-Based Kinematics for Estimates of Lumbar Spine Loads Using a Full-Body Musculoskeletal Model

Maria Prado, Sakiko Oyama, and Hugo Giambini

Musculoskeletal modeling, typically implemented using marker-based systems in laboratory environments, is commonly used for noninvasive estimations of loads. Inertial measurement units (IMUs) have become an alternative for the evaluation of kinematics. However, estimates of spine joint contact forces using IMUs have yet to be thoroughly evaluated. Dynamics tasks and static postures from activities of daily living were captured on 11 healthy subjects using both systems simultaneously. Spine kinematics obtained from IMU- and marker-based systems and L4–L5 joint contact forces were compared. Lateral bending resulted in a weak agreement with significant differences between the 2 systems (P = .02, average root mean-squared error = 4.81), whereas flexion–extension and axial rotation exhibited the highest agreement with no significant differences (P < .05, average root mean-squared error = 5.51 and P < .31, average root mean-squared error = 5.08, respectively). All tasks showed excellent correlations (R 2 = .76–.99) in estimated loads between systems. Differences in predicted loads at the L4–L5 were only observed during flexion–extension (1041 N vs 947 N, P = .0004) and walking with weights (814 N vs 727 N, P = .004). Different joint reaction force outcomes were obtained in 2 of the 8 tasks between systems, suggesting that IMUs can be robust tools allowing for convenient and less expensive evaluations and for longitudinal assessments inside and outside the laboratory setting.

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Characterizing Longitudinal Alterations in Postural Control Following Lower Limb Injury in Professional Rugby Union Players

Molly F. McCarthy-Ryan, Stephen D. Mellalieu, Holly Jones, Adam Bruton, and Isabel S. Moore

Assessment of player’s postural control following a lower limb injury is of interest to sports medicine practitioners due to its fundamental role in daily tasks and sporting activities. The aim was to longitudinally monitor professional rugby union players’ postural control during each phase of the rehabilitation program (acute, middle, and late) following a lower limb injury. Seven male rugby union players (height 1.80 [0.02] m; mass 100.3 [11.4] kg; age 24 [4] y) sustained a time loss, noncontact lower limb injury. Static postural control was assessed via sway path (in meters), and dynamic postural control was assessed via vertical postural stability index. Group differences (P < .05) were reported across the acute, middle, and late phase. Smaller magnitudes of sway path were observed for eyes-open sway path, and for the middle and late phase smaller magnitudes of vertical postural stability index (P < .05) at the end session compared with first session. Whereas larger magnitudes of vertical postural stability index were found between baseline and the last session (P < .05). Large interindividual and intraindividual variation was apparent across the 3 phases of rehabilitation. Postural control improvements were identified during rehabilitation. However, postural control did not return to baseline, with altered kinetics throughout each rehabilitation phase.

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Effect of Data and Gap Characteristics on the Nonlinear Calculation of Motion During Locomotor Activities

Arash Mohammadzadeh Gonabadi, Thad W. Buster, Guilherme M. Cesar, and Judith M. Burnfield

This study investigated how data series length and gaps in human kinematic data impact the accuracy of Lyapunov exponents (LyE) calculations with and without cubic spline interpolation. Kinematic time series were manipulated to create various data series lengths (28% and 100% of original) and gap durations (0.05–0.20 s). Longer gaps generally resulted in significantly higher LyE% error values in each plane in noninterpolated data. During cubic spline interpolation, only the 0.20-second gap in frontal plane data resulted in a significantly higher LyE% error. Data series length did not significantly affect LyE% error in noninterpolated data. During cubic spline interpolation, sagittal plane LyE% errors were significantly higher at shorter versus longer data series lengths. These findings suggest that not interpolating gaps in data could lead to erroneously high LyE values and mischaracterization of movement variability. When applying cubic spline, a long gap length (0.20 s) in the frontal plane or a short sagittal plane data series length (1000 data points) could also lead to erroneously high LyE values and mischaracterization of movement variability. These insights emphasize the necessity of detailed reporting on gap durations, data series lengths, and interpolation techniques when characterizing human movement variability using LyE values.

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Osteoarthritic Tibiofemoral Joint Contact Characteristics During Weightbearing With Arch-Supported and Standalone Lateral Wedge Insoles

Calvin T.F. Tse, Michael B. Ryan, Natasha M. Krowchuk, Alexander Scott, and Michael A. Hunt

Imbalanced joint load distribution across the tibiofemoral surface is a risk factor for osteoarthritic changes to this joint. Lateral wedge insoles, with and without arch support, are a form of biomechanical intervention that can redistribute tibiofemoral joint load, as estimated by external measures of knee load. The objective of this study was to examine the effect of these insoles on the internal joint contact characteristics of osteoarthritic knees during weightbearing. Fifteen adults with tibiofemoral osteoarthritis underwent magnetic resonance imaging of the affected knee, while standing under 3 insole conditions: flat control, lateral wedge alone, and lateral wedge with arch support. Images were processed, and the surface area and centroid location of joint contact were quantified separately for the medial and lateral tibiofemoral compartments. Medial contact surface area was increased with the 2 lateral wedge conditions compared with the control (P ≤ .012). A more anterior contact centroid was observed in the medial compartment in the lateral wedge with arch support compared with the lateral wedge alone (P = .009). Significant changes in lateral compartment joint contact outcomes were not observed. These findings represent early insights into how loading at the tibiofemoral interface may be altered by lateral wedge insoles as a potential intervention for knee osteoarthritis.

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Volume 40 (2024): Issue 3 (Jun 2024)