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Daniel W. Sample, Tanner A. Thorsen, Joshua T. Weinhandl, Kelley A. Strohacker, and Songning Zhang

The purpose of this study was to investigate effects of preferred step width and increased step width modification on knee biomechanics of obese and healthy-weight participants during incline and decline walking. Seven healthy-weight participants and 6 participants who are obese (body mass index ≥ 30) performed 5 walking trials on level ground and a 10° inclined and declined instrumented ramp system at both preferred and wide step-widths. A 2 × 2 (step-width × group) mixed-model analysis of variance was used to examine selected variables. There were significant increases in step-width between the preferred and wide step-width conditions for all 3 walking conditions (all P < .001). An interaction was found for peak knee extension moment (P = .048) and internal knee abduction moment (KAM) (P = .025) in uphill walking. During downhill walking, there were no interaction effects. As step-width increased, KAM was reduced (P = .007). In level walking, there were no interaction effects for peak medial ground reaction force and KAM (P = .007). There was a step-width main effect for KAM (P = .007). As step-width increased, peak medial ground reaction force and peak knee extension moment increased, while KAM decreased for both healthy weight and individuals who are obese. The results suggest that increasing step-width may be a useful strategy for reducing KAM in healthy and young populations.

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Kevin G. Aubol, Jillian L. Hawkins, and Clare E. Milner

Measurements of tibial acceleration during running must be reliable to ensure valid results and reduce errors. The purpose of this study was to determine the reliability and minimal detectable difference (MDD) of peak axial and peak resultant tibial acceleration during overground and treadmill running. The authors also compared reliability and MDDs when peak tibial accelerations were determined by averaging 5 or 10 trials. Tibial acceleration was measured during overground and treadmill running of 19 participants using a lightweight accelerometer mounted to the tibia. Peak axial and peak resultant tibial accelerations were determined for each trial. Intraclass correlation coefficients determined within-session reliability, and MDDs were also calculated. Within-session reliability was excellent for all conditions (intraclass correlation coefficients  = .95–.99). The MDDs ranged from 0.6 to 1.4 g for peak axial acceleration and from 1.6 to 2.0 g for peak resultant acceleration and were lowest for peak axial tibial acceleration during overground running. Averaging 10 trials did not improve reliability compared to averaging 5 trials but did result in small reductions in MDDs. For peak axial tibial acceleration only, lower MDDs indicate that overground running may be the better option for detecting small differences.

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Nadège Tebbache and Alain Hamaoui

The sit-to-stand transfer can be separated into a postural phase (trunk flexion) and a focal phase (whole-body extension). The aim of this study was to analyze the as yet little known whole-body muscular activity characterizing each phase of this task and its variations with backrest inclination and execution speed. Fifteen muscles of the trunk and lower limbs of 10 participants were investigated using surface EMG. Results showed that backrest-induced modifications were mostly confined to the postural phase: reclining the backrest increased its duration and the activity level of the sternocleidomastoideus, the rectus and obliquus externus abdominis, and the semitendinosus. Speed-induced variations were also predominant during the postural phase, which was shortened with an increased activity of most muscles at maximal speed.

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Yumeng Li, Shuqi Zhang, and Christina Odeh

The purposes of the study were (1) to compare postural sway between participants with Parkinson’s disease (PD) and healthy controls and (2) to develop and validate an automated classification of PD postural control patterns using a machine learning approach. A total of 9 participants in the early stage of PD and 12 healthy controls were recruited. Participants were instructed to stand on a force plate and maintain stillness for 2 minutes with eyes open and eyes closed. The center of pressure data were collected at 50 Hz. Linear displacements, standard deviations, total distances, sway areas, and multiscale entropy of center of pressure were calculated and compared using mixed-model analysis of variance. Five supervised machine learning algorithms (ie, logistic regression, K-nearest neighbors, Naïve Bayes, decision trees, and random forest) were used to classify PD postural control patterns. Participants with PD exhibited greater center of pressure sway and variability compared with controls. The K-nearest neighbor method exhibited the best prediction performance with an accuracy rate of up to 0.86. In conclusion, participants with PD exhibited impaired postural stability and their postural sway features could be identified by machine learning algorithms.

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Seth T. Strayer, Seyed Reza M. Moghaddam, Beth Gusenoff, Jeffrey Gusenoff, and Kurt E. Beschorner

Pressure offloading is critical to diabetic foot ulcer healing and prevention. A novel product has been proposed to achieve this offloading with an insole that can be easily modified for each user. This insole consists of pressurized bubbles that can be selectively perforated and depressurized to redistribute weight to the nonulcer region of the foot. However, the effect of the insole design parameters, for example, bubble height and stiffness, on offloading effectiveness is unknown. To this end, a 3-dimensional finite element model was developed to simulate contact between the rearfoot and insole. The geometry of the calcaneus bone and soft tissue was based on the medical images of an average male patient, and material properties and loading conditions based on the values reported in the literature were used. The model predicts that increasing bubble height and stiffness leads to a more effectively offloaded region. However, the model also predicts that increasing stiffness leads to increasing contact pressures on the surrounding soft tissue. Thus, a combination of insole design parameters was determined, which completely offloads the desired region, while simultaneously reducing the contact pressure on the surrounding soft tissue. This design is expected to aid in diabetic foot ulcer healing and prevention.

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Jason M. Avedesian, Tracey Covassin, and Janet S. Dufek

Recent evidence suggests previously concussed athletes are at greater risk for lower-extremity (LE) injuries than are controls. However, little is known regarding the influence of sports-related concussion (SRC) on landing biomechanics that may provide a mechanistic rationale for LE injury risk. The purpose of this investigation was to examine LE drop-landing biomechanics in adolescent athletes with and without a previous SRC history. Participants included 10 adolescent athletes with an SRC history and 11 controls from multiple sports. Three-dimensional kinematic and kinetic data associated with LE injury risk were analyzed across 5 trials for 30- and 60-cm landing heights. Multivariate analyses indicated group differences in landing patterns from the 30- (P = .041) and 60-cm (P = .015) landing heights. Follow-up analyses indicated that concussed adolescent athletes demonstrated significantly less ankle dorsiflexion and knee flexion versus controls when performing drop landings. Our findings suggest that previously concussed adolescent athletes complete drop-landing maneuvers with ankle and knee joint kinematic patterns that suggest greater risk for LE injury. While limitations such as sport variety and explicit LE injury history are present, the results of this study provide a possible biomechanical rationale for the association between SRC and LE injury risk.

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Pedro Ángel Latorre-Román, Juan Francisco Fernández-Povedano, Jesús Salas-Sánchez, Felipe García-Pinillos, and Juan Antonio Párraga-Montilla

This study aimed to evaluate spatial and temporal perception in endurance runners as a mechanism of pacing control in comparison with other athletes (soccer players). A group of 38 endurance runners and 32 soccer players participated in this study. Runners displayed lower time differences and lower error than soccer players. Taking the athletic levels of endurance runners into consideration, significant differences (p = .011, Cohen’s d = 1.042) were found in the time differences (higher level group = 33.43 ± 29.43 vs. lower level group = 123.53 ±102.61). Significant correlations were found between time differences and performance in a Cooper test (r = −.546) and with the best time in a half marathon (r = .597). Temporal and spatial perception can be considered as a cognitive skill of endurance runners.

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Erika D. Van Dyke, Aaron Metzger, and Sam J. Zizzi

Little research has integrated mindfulness and perfectionism, particularly within sports wherein athletes are judged on performance to a standard of perfection. The current study had two primary aims: (a) to explore profiles of mindfulness and perfectionism among intercollegiate gymnasts through a person-centered approach and (b) to analyze differences in objective performance across the resulting profiles. The analytic sample consisted of 244 NCAA gymnasts who completed self-report measures of mindfulness and perfectionism. Competitive performance records (i.e., national qualifying scores) were then gathered for participating gymnasts. Cluster analyses revealed a three-cluster solution; however, significant performance differences were not observed across the three profiles due to lower than desired power. Small to moderate effect size estimates provided some evidence that perfectionism may be adaptive to gymnastics performance. Elite-level athletes were represented across three distinct profiles, suggesting that more than one profile of characteristics may be adaptive for reaching high levels of performance.

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Anderson Nascimento Guimarães, Herbert Ugrinowitsch, Juliana Bayeux Dascal, and Victor Hugo Alves Okazaki

To test Bernstein’s degrees of freedom (DF) hypothesis, the authors analyzed the effect of practice on the DF control and interjoint coordination of a Taekwondo kick. Thirteen inexperienced and 11 expert Taekwondo practitioners were evaluated. Contrary to Bernstein’s hypothesis, the inexperienced group froze the DF at the end of learning, reducing the joint range of motion of the knee. Moderate and strong cross-correlations between joints did not change, demonstrating that the interjoint coordination was maintained. The inexperienced group’s movement pattern was similar to that of the group of experts, from the beginning of the learning process. Thus, even after years of practice, experts continue to explore the strategy of freezing DF. The DF freeing/freezing sequence strategy was explored during the learning process, suggesting that DF-freezing/freeing strategies are task dependent.