A musculoskeletal model of the right lower limb was developed to estimate 3D tibial contact forces in high knee flexion postures. This model determined the effect of intersegmental contact between thigh–calf and heel–gluteal structures on tibial contact forces. This model includes direct tracking and 3D orientation of intersegmental contact force, femoral translations from in vivo studies, wrapping of knee extensor musculature, and a novel optimization constraint for multielement muscle groups. Model verification consisted of calculating the error between estimated tibial compressive forces and direct measurements from the Grand Knee Challenge during movements to ∼120° of knee flexion as no high knee flexion data are available. Tibial compression estimates strongly fit implant data during walking (R 2 = .83) and squatting (R 2 = .93) with a root mean squared difference of .47 and .16 body weight, respectively. Incorporating intersegmental contact significantly reduced model estimates of peak tibial anterior–posterior shear and increased peak medial–lateral shear during the static phase of high knee flexion movements by an average of .33 and .07 body weight, respectively. This model supports prior work in that intersegmental contact is a critical parameter when estimating tibial contact forces in high knee flexion movements across a range of culturally and occupationally relevant postures.
David C. Kingston and Stacey M. Acker
Anna Lee, Tanvi Bhatt, Xuan Liu, Yiru Wang, Shuaijie Wang and Yi-Chung (Clive) Pai
The purpose was to examine and compare the longer-term generalization between 2 different practice dosages for a single-session treadmill slip-perturbation training when reexposed to an overground slip 6 months later. A total of 45 older adults were conveniently assigned to either 24 or 40 slip-like treadmill perturbation trials or a third control group. Overground slips were given immediately after initial training, and at 6 months after initial training in order to examine immediate and longer-term effects. The performance (center of mass stability and vertical limb support) and fall percentage from the laboratory-induced overground slips (at initial posttraining and at 6 mo) were measured and compared between groups. Both treadmill slip-perturbation groups showed immediate generalization at the initial posttraining test and longer-term generalization at the 6-month retest. The higher-practice-dosage group performed significantly better than the control group (P < .05), with no difference between the lower-practice-dosage and the control groups at the 6-month retest (P > .05). A single session of treadmill slip-perturbation training showed a positive effect for reducing older adults’ fall risk for laboratory-induced overground slips. A higher-practice dosage of treadmill slip perturbations could be more beneficial for further reducing fall risk.
Seong-won Han, Andrew Sawatsky, Azim Jinha and Walter Herzog
Vastus medialis (VM) weakness is thought to alter patellar tracking, thereby changing the loading of the patellofemoral joint (PFJ), resulting in patellofemoral pain. However, it is challenging to measure VM force and weakness in human studies, nor is it possible to measure the associated mechanical changes in the PFJ. To obtain fundamental insight into VM weakness and its effects on PFJ mechanics, the authors determined PFJ loading in the presence of experimentally simulated VM weakness. Skeletally mature New Zealand White rabbits were used (n = 6), and the vastus lateralis, VM, and rectus femoris were stimulated individually through 3 custom-built nerve cuff electrodes. Muscle torque and PFJ pressure distribution were measured while activating all muscles simultaneously, or when the vastus lateralis and rectus femoris were activated, while VM was not, to simulate a quadriceps muscle strength imbalance. For a given muscular joint torque, peak pressures were greater and joint contact areas were smaller when simulating VM weakness compared with the condition where all muscles were activated simultaneously. The results in the rabbit model support that VM weakness results in altered PFJ loading, which may cause patellofemoral pain, often associated with a strength imbalance of the knee extensor muscle group.
Masahiro Yamada and Louisa D. Raisbeck
Contexts: Directing an individual’s attention to the effect of the movements (external focus) has been shown to improve performance than directing attention to body movements (internal focus). However, the effect of attentional focus instructions specific to movement quality has not been investigated thoroughly. Objective: To compare the effects of internal and external focus instructions specific to body movements. Design: Mixed design, 2 (sex) × 2 (instructions). Settings: Laboratory setting. Participants: A total of 40 participants (males, n = 20; mean [SD]; age = 22.0 [2.19] y; height = 179.33 [5.90] cm; mass = 77.7 [13.04] kg; females, n = 20; age = 22.0 [3.87] y; height = 164.84 [5.80] cm; mass = 71.48 [20.66] kg) were recruited. Intervention: Participants completed 2 consecutive jumps (ie, a forward jump from a height and then a maximal vertical jump) with internal focus and external focus instructions. External focus was elicited by placing pieces of tape on the participants’ legs. Main Outcome measures: Landing quality was measured by the Landing Error Scoring System to assess movement quality, and the vertical jump height was measured by Vertec. Results: The performance results showed that the external focus condition resulted in superior vertical jump height compared with the internal focus condition (P < .05). Although landing quality did not show significant differences between 2 conditions, the effect size (η 2 = .09) indicated that landing quality was better when participants adopted an external, rather than an internal focus of attention (P = .07). Conclusions: The body-oriented instructions can be provided externally by adding artificial external cues and directing attention to them. Importantly, the findings were evident in a qualitative assessment that can be adopted by practitioners. The results suggest that practitioners should adopt an external focus cue for performance and also consider using an external focus for movement quality.
Michael Dressing, Jillian Wise, Jennifer Katzenstein and P. Patrick Mularoni
Does academic-related anxiety contribute to an adolescent’s recovery process and return to activity after experiencing a concussion? The authors created a novel measure of academic-related anxiety (Mularoni Measure of Academic Anxiety following Concussion [MMAAC]) and administered it to adolescents following concussion in outpatient pediatric sports medicine clinics. Two previously validated measures of anxiety were also administered, and results were compared with the MMAAC scores as well as the lengths of time for return to school and sports. Results show that higher MMAAC scores positively correlate with the length of time an adolescent needs to return to school. Study results indicate that the MMAAC reliably measures academic-related anxiety in adolescents suffering from concussions and can be helpful in predicting a basic timetable for return to school. The authors believe that this brief survey can be used by physicians in clinic to evaluate anxiety and assist with return to school expectations to provide comprehensive recovery support.
Marzie Balali, Shahab Parvinpour and Mohsen Shafizadeh
The ability to coordinate different body parts under different constraints that are imposed by organism, environment, and tasks during motor development might be different in children. The aim of this study was to examine whether children with different motor development levels are different with regard to multijoint coordination during two-hand catching. Eighty-four children (age: 6.05 ±0.67 years) who were assessed on object control skills were recruited voluntarily. The biomechanical model was defined from 20 movements of seven segments (shoulders, elbows, wrists, and torso), and the principal component analysis was used to quantify the multijoint coordination and kinematic synergies during catching. The results showed that the redundancy of joints in two-hand catching is controlled by three kinematic synergies that defined the majority of the variance. The participants who were grouped based on their development levels did not show differences in the number and strength of synergies; however, they were different in the utilization of the kinematic synergies for successful catching. In conclusion, the number and the strength of the kinematic synergies during two-hand catching are not affected by the developmental levels and are related to the nature of the task.
Desiree Camara Miraldo, Renato Naville Watanabe and Marcos Duarte
This study describes an open data set of inertial, magnetic, foot–ground contact, and electromyographic signals from wearable sensors during walking at different speeds. These data were acquired from 22 healthy adults using wearable sensors and walking at self-selected comfortable, fast and slow speeds, and standing still. All data are publicly available in the Internet (https://doi.org/10.6084/m9.figshare.7778255). In total, there are data of 9,661 gait strides. This data set also contains files with the instants of the gait events identified using the foot–ground contact sensors and notebooks exemplifying how to access and visualize the data. This data set gives the opportunity to all interested researchers to work with such data, for example, making tests of algorithms for gait event estimation against a common reference, possible.
James Scales, Jamie M. O’Driscoll, Damian Coleman, Dimitrios Giannoglou, Ioannis Gkougkoulis, Ilias Ntontis, Chrisoula Zisopoulou and Mathew Brown
The primary purpose of this study was to examine lateral deviations in center of pressure as a result of an extreme-duration load carriage task, with particular focus on heel contact. A total of 20 (n = 17 males and n = 3 females) soldiers from a special operation forces unit (body mass 80.72 [21.49] kg, stature 178.25 [8.75] cm, age 26  y) underwent gait plantar pressure assessment and vertical jump testing before and after a 43-km load carriage event (duration 817.02 [32.66] min) carrying a total external load of 29.80 (1.05) kg. Vertical jump height decreased by 18.62% (16.85%) from 0.30 (0.08) to 0.24 (0.07) m, P < .001. Loading peak and midstance force minimum were significantly increased after load carriage (2.59 [0.51] vs 2.81 [0.61] body weight, P = .035, Glass delta = 0.44 and 1.28 [0.40] vs 1.46 [0.41] body weight, P = .015, Glass delta = 0.45, respectively) and increases in lateral center of pressure displacement were observed as a result of the load carriage task 14.64 (3.62) to 16.97 (3.94) mm, P < .029. In conclusion, load carriage instigated a decrease in neuromuscular function alongside increases in ground reaction forces associated with injury risk and center of pressure changes associated with ankle sprain risk. Practitioners should consider that possible reductions in ankle stability remain once load carriage has been completed, suggesting soldiers are still at increased risk of injury even once the load has been removed.
Walaa M. Elsais, Stephen J. Preece, Richard K. Jones and Lee Herrington
The superficial hip adductor muscles are situated in close proximity to each other. Therefore, relative movement between the overlying skin and the muscle belly could lead to a shift in the position of surface electromyography (EMG) electrodes and contamination of EMG signals with activity from neighboring muscles. The aim of this study was to explore whether hip movements or isometric contraction could lead to relative movement between the overlying skin and 3 adductor muscles: adductor magnus, adductor longus, and adductor gracilis. The authors also sought to investigate isometric torque–EMG relationships for the 3 adductor muscles. Ultrasound measurement showed that EMG electrodes maintained a position which was at least 5 mm within the muscle boundary across a range of hip flexion–extension angles and across different contraction levels. The authors also observed a linear relationship between torque and EMG amplitude. This is the first study to use ultrasound to track the relative motion between skin and muscle and provides new insight into electrode positioning. The findings provide confidence that ultrasound-based positioning of EMG electrodes can be used to derive meaningful information on output from the adductor muscles and constitute a step toward recognized guidelines for surface EMG measurement of the adductors.