Functional knee braces are frequently prescribed by physicians to ameliorate the function of individuals with anterior cruciate ligament (ACL) injuries. These braces have been shown in the literature to potentially enhance knee stability by augmenting muscle activation patterns and the timing of muscle response to perturbations. However, very few techniques are available in the literature to quantify how those modifications in lower-limb muscle activity influence stability of the knee. The aim of the present study was to quantify the effect of an off-the-shelf functional knee brace on muscle contributions to knee joint rotational stiffness in ACL-deficient and ACL-reconstructed patients. Kinematic, electromyography, and kinetic data were incorporated into an electromyography-driven model of the lower extremity to calculate individual and total muscle contributions to knee joint rotational stiffness about the flexion–extension axis, for 4 independent variables: leg condition (contralateral uninjured, unbraced ACL injured, and braced ACL injured); knee flexion (5°–10°, 20°–25°, and 30°–35°); squat stability condition (stable and unstable); and injury status (ACL deficient and ACL reconstructed). Participants had significantly higher (P < .05, η 2 = .018) total knee joint rotational stiffness values while wearing the brace compared with the control leg. A 2-way interaction effect between stability and knee flexion (P < .05, η 2 = .040) for total joint rotational stiffness was also found.
Iva Obrusnikova, Haley M. Novak and Albert R. Cavalier
Adults with intellectual disability have significantly lower musculoskeletal fitness than their peers without a disability. Appropriate instructional strategies are needed to facilitate their acquisition and maintenance of musculoskeletal fitness. In this multiple-baseline across-participants single-subject study, the authors evaluated the effects of a multicomponent package that included a video-enhanced system of least-to-most prompts on the acquisition of 5 muscle-strengthening exercises in 3 women with mild intellectual disability, age 24–37 yr. Results show substantive gains in correct and independent performance of steps in the 5 exercises during the treatment condition. The improved performance was maintained 2 wk after the last treatment session and in a large YMCA gym. The study suggests that use of the video-enhanced system of least-to-most prompts can lead to improved acquisition and maintenance of muscle-strengthening exercises by adults with mild intellectual disability.
Zachary M. Gillen, Lacey E. Jahn, Marni E. Shoemaker, Brianna D. McKay, Alegra I. Mendez, Nicholas A. Bohannon and Joel T. Cramer
This study measured peak force (PF), peak rate of force development (PRFD), peak power (PP), concentric impulse, and eccentric impulse during static jump (SJ), countermovement jump (CMJ), and drop jump (DJ) in youth athletes to examine changes in vertical jump power with progressively greater eccentric preloading in relation to age, maturity, and muscle mass. Twenty-one males ranging from 6 to 16 years old performed the following vertical jumps in a random order: SJ, CMJ, and DJ from drop heights of 20, 30, and 40 cm (DJ20, DJ30, and DJ40, respectively). Measurements included PF, PRFD, PP, eccentric impulse, and concentric impulse for each vertical jump condition. Maturity offset was calculated, while ultrasound images quantified thigh muscle cross-sectional area (CSA). PF and PRFD increased from CMJ to DJ20. PP increased from SJ to CMJ. Concentric impulse remained unchanged, but eccentric impulse increased systematically from across jumps. The change in PP from SJ to CMJ was correlated with age, height, weight, maturity offset, and CSA. The CMJ resulted in the greatest concentric PP with the least amount of eccentric preloading. The inability of young athletes to translate the energy absorbed during the eccentric phase of the stretch-shortening cycle of DJs may be influenced by growth and development.
Leah S. Goudy, Brandon Rhett Rigby, Lisa Silliman-French and Kevin A. Becker
The purpose of this study was to determine changes in balance, postural sway, and quality of life after 6 wk of simulated horseback riding in adults diagnosed with Parkinson’s disease. Eight older adults completed two 60-min riding sessions weekly for 6 wk. Variables of balance, postural sway, and quality of life were measured 6 wks before and within 1 wk before and after the intervention. Berg Balance Scale scores decreased from baseline to preintervention (48.36 ± 5.97 vs. 45.86 ± 6.42, p = .050) and increased from preintervention to postintervention (45.86 ± 6.42 vs. 50.00 ± 4.38, p = .002). Cognitive impairment, a dimension of quality of life, improved from baseline to postintervention (37.5 ± 20.5 vs. 21.5 ± 14.4, p = .007). Six weeks of simulated horseback riding may improve balance and cognitive impairment in older adults with Parkinson’s disease.
Mhairi K. MacLean and Daniel P. Ferris
The authors tested 4 young healthy subjects walking with a powered knee exoskeleton to determine if it could reduce the metabolic cost of locomotion. Subjects walked with a backpack loaded and unloaded, on a treadmill with inclinations of 0° and 15°, and outdoors with varied natural terrain. Participants walked at a self-selected speed (average 1.0 m/s) for all conditions, except incline treadmill walking (average 0.5 m/s). The authors hypothesized that the knee exoskeleton would reduce the metabolic cost of walking uphill and with a load compared with walking without the exoskeleton. The knee exoskeleton reduced metabolic cost by 4.2% in the 15° incline with the backpack load. All other conditions had an increase in metabolic cost when using the knee exoskeleton compared with not using the exoskeleton. There was more variation in metabolic cost over the outdoor walking course with the knee exoskeleton than without it. Our findings indicate that powered assistance at the knee is more likely to decrease the metabolic cost of walking in uphill conditions and during loaded walking rather than in level conditions without a backpack load. Differences in positive mechanical work demand at the knee for varying conditions may explain the differences in metabolic benefit from the exoskeleton.
Amy R. Lewis, William S.P. Robertson, Elissa J. Phillips, Paul N. Grimshaw and Marc Portus
For the wheelchair racing population, it is uncertain whether musculoskeletal models using the maximum isometric force-generating capacity of nonathletic, able-bodied individuals are appropriate, as few anthropometric parameters for wheelchair athletes are reported in the literature. In this study, a sensitivity analysis was performed in OpenSim, whereby the maximum isometric force-generating capacity of muscles was adjusted in 25% increments to literature-defined values between scaling factors of 0.25x and 4.0x for 2 elite athletes, at 3 speeds representative of race conditions. Convergence of the solution was used to assess the results. Artificially weakening a model presented unrealistic values, while artificially strengthening a model excessively (4.0x) demonstrated physiologically invalid muscle force values. The ideal scaling factors were 1.5x and 1.75x for each of the athletes, respectively, as was assessed through convergence of the solution. This was similar to the relative difference in limb masses between dual-energy X-Ray absorptiometry data and anthropometric data in the literature (1.49x and 1.70x), suggesting that dual-energy X-ray absorptiometry may be used to estimate the required scaling factors. The reliability of simulations for elite wheelchair racing athletes can be improved by appropriately increasing the maximum isometric force-generating capacity of muscles.
James W. Roberts
Investigations of visually guided target-directed movement frequently adopt measures of within-participant spatial variability to infer the contribution of planning and control. The present study aims to verify this current trend by exploring the distribution of displacements at kinematic landmarks with a view to understand the potential sources of variability. Separate sets of participants aiming under full visual feedback conditions revealed a comparatively normal distribution for the displacements at peak velocity and movement end. However, there was demonstrable positive skew in the displacement at peak acceleration and a significant negative skew at peak deceleration. The ranges of the distributions as defined by either ±1SD or ±34.13th percentile (equivalent to an estimated 68.26% of responses) also revealed differences at peak deceleration. These findings indicate that spatial variability in the acceleration domain features highly informative systematic, as well as merely inherent, sources of variability. Implications for the further quantification of trial-by-trial behavior are discussed.
Etem Curuk, Yunju Lee and Alexander S. Aruin
The authors investigated anticipatory postural adjustments in persons with unilateral stroke using external perturbations. Nine individuals with stroke and five control subjects participated. The electromyographic activity of 16 leg and trunk muscles was recorded. The onsets of muscle activity during the anticipatory phase of postural control were analyzed. The individuals with stroke did not show an anticipatory activation of leg and trunk muscles on the affected side; instead, the muscle onsets were seen after the perturbation, during the balance restoration phase. However, an anticipatory activation of muscles on the unaffected side was seen in individuals with stroke, and it was observed earlier compared with healthy controls (p < .05). The individuals with stroke showed a distal to proximal order of anticipatory activation of muscles on the unaffected side. The outcome of the study provides a basis for future investigations regarding ways of improving balance control in people with stroke.
Eric Foch and Clare E. Milner
It is unknown if female runners who have sustained multiple iliotibial band syndrome occurrences run differently compared with runners who developed the injury once or controls. Therefore, the purpose of this study was to determine if differences existed in coordination patterns and coordination variability among female runners with recurrent iliotibial band syndrome, 1 iliotibial band syndrome occurrence, and controls. Overground running trials were collected for 36 female runners (n = 18 controls). Lower extremity coordination patterns were examined during running via a vector coding analysis. Coordination variability was calculated via the ellipse area method. Separate 1-way (group) Kruskal–Wallis tests were performed to compare each coordination pattern and coordination variability. Lower extremity coordination between frontal plane hip–transverse plane hip, frontal plane pelvis–frontal plane thigh, and frontal plane thigh–transverse plane shank was similar among groups and so may not be related to the risk of iliotibial band syndrome. Runners with 1 iliotibial band syndrome occurrence demonstrated greater coordination variability for 2 of 3 couplings compared with both controls and runners with recurrent iliotibial band syndrome. Thus, the number of previous injury episodes may influence coordination variability in female runners with a history of iliotibial band syndrome.