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The Effects of Running Foot Strike Manipulation on Pelvic Floor Muscle Activity in Healthy Nulliparous Females

Michael Steimling, Melinda Steimling, Philip Malloy, and Kathleen Madara

Vertical loading rate (VLR) and pelvic floor muscle activity (PFA) increase with running velocity, which may indicate a relationship between VLR and PFA. Foot strike pattern has been shown to influence VLR while running, but little is known about its influence on PFA. Twenty healthy women ran on a treadmill for 2 conditions: with a rearfoot strike and with a forefoot strike. PFA was measured with electromyography. Running kinematics associated with VLR were collected using inertial measurement units and tibial accelerometers. Change scores between conditions were calculated for average PFA and running kinematics: peak vertical tibial acceleration, vertical excursion of the center of mass (VO), and cadence. Paired t tests assessed differences between running conditions for all variables. Pearson correlations assessed the relationships between changes in PFA and running kinematics. PFA was significantly higher during the forefoot compared with the rearfoot strike condition. Change in vertical tibial acceleration was positively correlated with change in PFA during the right stance. Change in cadence was negatively correlated, and change in vertical excursion of the center of mass was positively correlated with change in PFA during left stance. The average PFA increased during the forefoot strike pattern condition. Changes in PFA were correlated with changes in running kinematics associated with VLR.

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Fatigue-Related Changes in Running Technique and Mechanical Variables After a Maximal Incremental Test in Recreational Runners

Edilson Fernando de Borba, Edson Soares da Silva, Lucas de Liz Alves, Adão Ribeiro Da Silva Neto, Augusto Rossa Inda, Bilal Mohamad Ibrahim, Leonardo Rossato Ribas, Luca Correale, Leonardo Alexandre Peyré-Tartaruga, and Marcus Peikriszwili Tartaruga

Understanding the changes in running mechanics caused by fatigue is essential to assess its impact on athletic performance. Changes in running biomechanics after constant speed conditions are well documented, but the adaptive responses after a maximal incremental test are unknown. We compared the spatiotemporal, joint kinematics, elastic mechanism, and external work parameters before and after a maximal incremental treadmill test. Eighteen recreational runners performed 2-minute runs at 8 km·h−1 before and after a maximal incremental test on a treadmill. Kinematics, elastic parameters, and external work were determined using the OpenCap and OpenSim software. We did not find differences in spatiotemporal parameters and elastic parameters (mechanical work, ankle, and knee motion range) between premaximal and postmaximal test conditions. After the maximal test, the runners flexed their hips more at contact time (19.4°–20.6°, P = .013) and presented a larger range of pelvis rotation at the frontal plane (10.3°–11.4°, P = .002). The fatigue applied in the test directly affects pelvic movements; however, it does not change the lower limb motion or the spatiotemporal and mechanical work parameters in recreational runners. A larger frontal plane motion of the pelvis deserves attention due to biomechanical risk factors associated with injuries.

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Validation of Linear and Nonlinear Gait Variability Measures Derived From a Smartphone System Compared to a Gold-Standard Footswitch System During Overground Walking

Vincenzo E. Di Bacco and William H. Gage

Smartphones, with embedded accelerometers, may be a viable method to monitor gait variability in the free-living environment. However, measurements estimated using smartphones must first be compared to known quantities to ensure validity. This study assessed the validity and reliability of smartphone-derived gait measures compared to a gold-standard footswitch system during overground walking. Seventeen adults completed three 8-minute overground walking trials during 3 separate visits. The stride time series was calculated as the time difference between consecutive right heel contact events within the footswitch and smartphone-accelerometry signals. Linear (average stride time, stride time standard deviation, and stride time coefficient of variation) and nonlinear (fractal scaling index, approximate entropy, and sample entropy) measures were calculated for each stride time series. Bland–Altman plots with 95% limits of agreement assessed agreement between systems. Intraclass correlation coefficients assessed reliability across visits. Bland–Altman plots revealed acceptable limits of agreement for all measures. Intraclass correlation coefficients revealed good-to-excellent reliability for both systems, except for fractal scaling index, which was moderate. The smartphone system is a valid method and performs similarly to gold-standard research equipment. These findings suggest the development and implementation of an inexpensive, easy-to-use, and ubiquitous telehealth instrument that may replace traditional laboratory equipment for use in the free-living environment.

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Concussion History Moderates Trunk Motion and Lower Extremity Biomechanical Relationships During Jump Landing and Cutting

Kayla M. Kowalczyk, Eric J. Shumski, Julianne D. Schmidt, and Robert C. Lynall

Concussion history, trunk motion, and lower extremity biomechanics associate with musculoskeletal injury risk. We aimed to examine the interaction between concussion history and trunk motion as possible modifiable factors for injury risk biomechanics during jump landing and cutting. Division I female athletes (24 with, 20 without concussion history) performed jump landings and jump-to-cuts at 45° in the opposite direction of the landing limb. We used multiple linear regressions with interaction terms to examine ankle dorsiflexion angle, knee flexion and abduction angle, and external knee flexion and abduction moment. We observed a group by trunk flexion interaction for nondominant external knee flexion moment (P = .042) during jump landing. Concussion history associated with increased external knee flexion moment as trunk flexion increased. We observed a group by trunk flexion interaction for the dominant limb dorsiflexion angle (P = .044), and group by trunk lateral bending interactions for the dominant (P = .039) and nondominant limb (P = .016) external knee flexion moment during cutting. During cutting, concussion history associated with decreased dominant dorsiflexion angles as trunk flexion increased, and decreased dominant and nondominant external knee flexion moment as lateral bending toward the planted limb increased. Concussion history associated with atypical biomechanics as trunk flexion and lateral bending increased.

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The Role of the Lead Hip in Collegiate Baseball Pitching: Implications for Ball Velocity and Upper-Extremity Joint Moments

Matthew J. Solomito, Erin J. Garibay, Andrew Cohen, and Carl W. Nissen

Hip flexibility is an important biomechanical factor for a baseball pitcher. However, there have been limited investigations into the association between upper-extremity joint stresses and ball velocity and hip flexibility, as assessed via motion patterns during the pitch. The purpose of this study was to provide a detailed kinematic description of the lead hip during the pitch and determine the association between lead hip motion and both ball velocity and the elbow varus moment. This study was a secondary analysis of the kinematic and kinetic data previously collected on 99 collegiate-level baseball pitchers using standard optoelectronic motion capture. Significant associations were noted between lead hip internal rotation and both peak ball velocity and the elbow varus moment. The data indicated that for every 10° increase in internal lead hip rotation, ball velocity increased by 0.6 m/s (P < .001, r 2 = .26), and the elbow varus moment increased by 5 N·m (P < .001, r 2 = .33). The results of this study suggested that internal hip rotation may be an important means of identifying pitchers that may be at risk for future injury.

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Characterizing the Compressive Force at L5/S1 During Patient Transfer From Bed to Wheelchair

Seyoung Lee, Kitaek Lim, and Woochol Joseph Choi

The peak compressive forces at L5/S1 during patient transfers have been estimated. However, no study has considered the actual patient body weight that caregivers had to handle during transfers. We developed a simple kinematic model of lifting to address this limitation. Fifteen prospective health care providers transferred a 70-kg individual who mimicked a patient (“patient”) from bed to wheelchair. Trials were acquired with the patient donning (weighted) and doffing (unweighted) a 5-kg weight belt. Trials were also acquired with and without knee assistance and a mechanical lift. During trials, kinematics and kinetics of transfers were recorded to estimate the peak compressive force at L5/S1 using static equilibrium equations. The peak compressive force was associated with the transfer method (P < .0005), and the compressive force was 68% lower in lift-assisted than manual transfer (2230 [SD = 433] N vs 6875 [SD = 2307] N). However, the peak compressive force was not associated with knee assistance, nor with a change in the patient body weight. Our results inform that mechanical loading exceeding the National Institute for Occupational Safety and Health safety criterion occurs during patient transfers, confirming a high risk of lower back injuries in caregivers. However, the risk can be mitigated with the use of a mechanical lift.

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Directional-Specific Modulation of Postural Control and Stepping Kinematics in Multidirectional Gait Initiation

Kuanting Chen and Adam C. King

Daily living activities present a diverse array of task and environmental constraints, highlighting the critical role of adapting gait initiation (GI) for an individual’s quality of life. This study investigated the effects of GI directions, obstacle negotiation, and leg dominance on anticipatory postural adjustments and stepping kinematics. Fourteen active, young, healthy individuals participated in GI across 4 directions—forward, medial 45°, lateral 45°, and lateral 90°—with variations in obstacle presence and leg dominance. Results revealed a consistent decreasing trend in maximum center of pressure displacement, anticipatory postural adjustment duration, step distance, and swing leg velocity with lateral shifts in GI directions, yet the step duration and swing leg heel trajectory were not affected by GI directions except in lateral 90° GI. Center of pressure displacements were intricately scaled to directional propulsive forces generation, and the stepping kinematics were influenced by the directional modifications in movements. With obstacles, modifications in anticipatory postural adjustment metrics and stepping kinematics reflected the obstacle clearance movements. The dominant leg GI exhibited longer step durations and greater movement variability in medial 45° GI. The current investigation of GI factors expands our existing understanding of GI dynamics and offers valuable insights applicable to fall prevention and gait rehabilitation strategies.

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A Single Bout of On-Ice Training Leads to Increased Interlimb Asymmetry in Competitive Youth Hockey Athletes

Bryce D. Twible, Luca Ruggiero, Chris J. McNeil, and Brian H. Dalton

Interlimb asymmetry (ILA) refers to an anatomical or physiological imbalance between contralateral limbs, which can influence neuromuscular function. Investigating the influence of neuromuscular fatigue on ILA may be critical for optimizing training programs, injury rehabilitation, and sport-specific performance. The purpose of this study was to determine if a single bout of ice hockey-specific exercise creates or exacerbates lower-limb ILA. Before and after an on-ice training session, 33 youth ice-hockey athletes (14.9 [1.7] y; 11 females) performed 3 repetitions of a maximal vertical countermovement jump (CMJ), an eccentric hamstring contraction, and maximal isometric hip adduction and abduction contractions. Force- and power-related variables were analyzed to determine limb-specific neuromuscular function. The on-ice session reduced maximal isometric hip adduction (left: 7.3% [10.3%]; right: 9.5% [9.6%]) and abduction (left: 4.9% [6.9%]; right: 5.0% [8.1%]) force, but did not impair (P ≥ .10) CMJ performance (jump height, relative peak power, braking duration, and total duration). After the on-ice session, ILA was greater for CMJ propulsive impulse (6.3% [2.9%] vs 5.1% [2.6%]), CMJ braking rate of force development (19.3% [7.6%] vs 15.2% [6.4%]), and peak isometric hip adduction force (6.7% [5.5%] vs 6.1% [4.1%]). In conclusion, hockey-specific exercise leads to increased ILA for multiple force-related metrics, which may be a compensatory mechanism to maintain bilateral task performance when fatigued.

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Effect of External Work Magnitude on Mechanical Efficiency of Sledge Jumping

Keitaro Seki and Heikki Kyröläinen

The mechanical efficiency of human locomotion has been studied extensively. The mechanical efficiency of the whole body occasionally exceeds muscle efficiency during bouncing type gaits. It is thought to occur due to elasticity and stiffness of the tendinomuscular system and neuromuscular functions, especially stretch reflexes. In addition, the lower limb joint kinetics affect mechanical efficiency. We investigated the impact of varying external work on mechanical efficiency and lower limb kinetics during repeated sledge jumping. Fifteen male runners performed sledge jumping for 4 minutes at 3 different sledge inclinations. Lower limb kinematics, ground reaction forces, and expired gases were analyzed. Mechanical efficiency did not differ according to sledge inclination. Mechanical efficiency correlated positively with the positive mechanical work of the knee and hip joints and the negative contribution of the hip joints. Conversely, it correlated negatively with both the positive and negative contributions of the ankle joint. This may be attributable to the greater workload in this study versus previous studies. To achieve greater external work, producing more mechanical energy at the proximal joint and transferring it to the distal joint could be an effective strategy for improving mechanical efficiency because of the greater force-generating capability of distal joint muscles.

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Interlaboratory Study Toward Combining Gait Kinematics Data Sets of Long-Distance Runners

Reginaldo Kisho Fukuchi, Marcos Duarte, and Reed Ferber

The limited sample size in gait studies has hampered progress in the field. This challenge could be addressed through multicenter studies, thereby leveraging data sets from different laboratories. This study compared 3-dimensional lower-extremity running kinematics between the Biomechanics and Motor Control Laboratory, Federal University of ABC (Brazil), and the Running Injury Clinic, University of Calgary (Canada). Three-dimensional lower-extremity kinematics from 23 male runners were collected from each laboratory using comparable instrumentation and experimental procedures. The 3-dimensional hip, knee, and ankle angles were compared within and between centers using root-mean-square deviation. Two-sample t tests Statistical Parametric Mapping tested the hypothesis that the data from both laboratories were not different. The sagittal plane hip, knee, and ankle angles were similar between laboratories, while notable differences were observed for frontal (hip and ankle) and transverse (hip and knee) plane angles. The average interlaboratory root-mean-square deviation (2.6°) was lower than the intralaboratory root-mean-square deviation (Biomechanics and Motor Control = 4.8°, Running Injury Clinic = 5.6°), with the ankle transverse angle displaying the smallest, and the knee transverse angle displaying the largest variability. This study demonstrates the potential of combining gait kinematics data from different laboratories to increase sample size, but frontal and transverse plane data should be considered with caution.