The effect of gait speed on minimum toe clearance (MTC) amount may vary across the lifespan due to changes in joint relationships, potentially affecting trip-related fall risk in older adults. We evaluated whether age influences the relationship between gait speed and MTC amount, as well as between joint movements and MTC amount. Optical motion capture data was collected on 62 participants between the ages of 20 and 83 years during 25 gait trials at self-selected normal, fast, and slow speeds. Multilevel models were used for data analysis. Gait speed was associated with a 0.13 cm increase in MTC amount for every meter per second increase in gait speed with other factors constant and was unaffected by age. Ankle dorsi–plantarflexion, knee and hip flexion–extension, and stance hip abduction–adduction changed the MTC amount by 0.05, 0.02, 0.04, and 0.04 cm, respectively, for each degree of joint movement, with other factors constant, and was unaffected by age. Age did not affect the relationship between gait speed and MTC amount, nor the relationship of joint moments with MTC, indicating that these factors may not be associated with trip-related fall risk with healthy aging.
An Exploration of the Effects of Gait Speed and Joint Movements on Minimum Toe Clearance Across the Lifespan: A Cross-Sectional Study
Sylvester Carter and Abolfazl Saghafi
Normative Values for Interlimb Symmetry in Single-Leg Vertical Jump Height Among Uninjured Adolescent Athletes
Adam W. VanZile, Daniel D. Jones, and Thomas G. Almonroeder
The lack of normative data for single-leg vertical jump testing makes it challenging to determine when an injured athlete has achieved a level of interlimb symmetry that is within normal limits. The purpose of this study was to establish normative values for single-leg vertical jump height interlimb symmetry based on data from uninjured adolescent athletes. One hundred seventy three uninjured adolescent athletes completed single-leg vertical jump testing with both limbs. Descriptive statistics were generated to summarize the percent differences in jump heights between the limbs (interlimb symmetry) for the male and female athletes. Having normative data available will help clinicians assess injured athletes’ recovery.
Injury Epidemiology and Preventative Strategies in Triathletes: A Study of the 2022 Season
Jeffrey J. Parr, Felix Twum, Susan R. Dobson, Helen M. Ziegler, and Traci Hayes
Context: Triathlons are a popular endurance sport with an elevated injury risk. Prevalence for injuries in triathletes varies greatly and is thought to be related to racing distance. The most common injuries in triathletes occur in the lower-extremities and are considered overuse in nature. The primary purpose of this study was to examine injury patterns and prevalence among triathletes during the 2022 season. Design: This study adopts an epidemiological approach using a retrospective survey to better understand the prevalence, nature, and patterns of injuries among triathletes. Methods: A live online questionnaire was developed that collected information about demographics, triathlon racing, and injury epidemiology. The survey was posted to social media and emailed to large triathlon clubs and international federations at the beginning of 2023 and was left open for 75 days. Results: Two hundred nineteen triathletes reported at least 1 injury, with 58.5% classified as overuse. Eighty-one percent were reported as triathlon related. The most frequent area of injury was to the lower-extremity (73.8%). Triathletes sought advice from a health care provider 64.6% of the time. Eighty-seven percent of triathletes had to miss or modify training because of their injury. Those triathletes not reporting injury indicated that strength training (72.2%) and stretching/foam rolling (64.9%) were believed to help prevent injury. Conclusion: The risk of injury while training for a triathlon is significant and can be severe enough to require modifications to the training program. The most vulnerable area for injury is the lower-extremities, and such injuries are usually caused by overuse. To reduce the risk of injury, there is a need to examine preventive strategies further and determine their effectiveness.
Movement Assessments as Predictors for Initial Anterior Cruciate Ligament Injury: A Critically Appraised Topic
Destinee Johnson, Rebecca Maldonado, and Erin Lally
Clinical Scenario: Anterior cruciate ligament (ACL) injury risk may increase when certain movements are noted during landings. Initial ACL injury produces poor long-term outcomes for patients. Movement assessments may help predict risk of initial ACL injuries. Clinical Question: Are movement assessments predictive of initial ACL injuries in college/high school athletes? Summary of Key Findings: Six articles met the inclusion criteria. Some movement assessments did not predict ACL injury. However, the functional movement screen composite score of 14 or less and landing error scoring system scores of 5 or greater were found to be associated with an increased risk of an ACL injury. Knee valgus angles of ≥6.5 cm were associated with future knee injury but only had fair predictive validity. Clinical Bottom Line: There are conflicting results on whether movement assessments can accurately predict primary ACL injuries. However, clinicians can consider the use of the functional movement screen composite score (14 or less) and the landing error scoring system score (5 or greater) as both may predict a future ACL injury. More research is needed to uncover movement assessments that better predict ACL injury. Strength of Recommendation: A grade B recommendation can be given that movement assessments may be used for screening for initial ACL injury.
Comparison of Ground Reaction Forces and Net Joint Moment Predictions: Skeletal Model Versus Artificial Neural Network-Based Approach
Juan Cordero-Sánchez, Bruno Bazuelo-Ruiz, Pedro Pérez-Soriano, and Gil Serrancolí
Artificial neural networks (ANNs) are becoming a regular tool to support biomechanical methods, while physics-based models are widespread to understand the mechanics of body in motion. Thus, this study aimed to demonstrate the accuracy of recurrent ANN models compared with a physics-based approach in the task of predicting ground reaction forces and net lower limb joint moments during running. An inertial motion capture system and a force plate were used to collect running biomechanics data for training the ANN. Kinematic data from optical motion capture systems, sourced from publicly available databases, were used to evaluate the prediction performance and accuracy of the ANN. The linear and angular momentum theorems were applied to compute ground reaction forces and joint moments in the physics-based approach. The main finding indicates that the recurrent ANN tends to outperform the physics-based approach significantly (P < .05) at similar and higher running velocities for which the ANN was trained, specifically in the anteroposterior, vertical, and mediolateral ground reaction forces, as well as for the knee and ankle flexion moments, and hip abduction and rotation moments. Furthermore, this study demonstrates that the trained recurrent ANN can be used to predict running kinetic data from kinematics obtained with different experimental techniques and sources.
Is There an Association Between Symptoms of Pelvic Floor Dysfunction, Running Kinetics, and Pelvic Acceleration in Postpartum Women?
Celeste E. Coltman, Gráinne M. Donnelly, Hans von Lieres Und Wilkau, and Isabel S. Moore
The aim of this study was to explore the association between pelvic floor dysfunction and running kinetics and pelvic acceleration in a cohort of postpartum women. The Australian Pelvic Floor Questionnaire was used to quantify symptom severity (mean [SD]: 6 [ 4] out of 40; range: 1–14) in 25 postpartum women. Participants completed a pelvic floor muscle assessment to measure pelvic muscle strength and endurance, then completed a 7-minute treadmill running protocol at a speed of 10 km·h−1 to evaluate their running kinetics and pelvic acceleration. After the run, participants responded to a modified version of the symptom’s component of the PFD-SENTINEL screening tool. Mean pelvic muscle strength and endurance were 3 (1) and 9 (2), respectively. We found no significant association between PFD symptom severity and running kinetic (P = .209–.410) or pelvic acceleration (P = .081–.947) outcome measures. Fifteen participants experienced at least one symptom during the treadmill protocol. Running kinetics and pelvic acceleration may not affect or be affected by symptoms of PFD. Given the relatively low symptom expression among study participants, further research in a cohort of women with higher levels of PFD is recommended.
NATA News & Notes
Wearing Compression Socks During Running Does Not Change Physiological, Running Performance, and Perceptual Outcomes: A Systematic Review With Meta-Analysis
Gustavo F. Telles, Larissa R. Souto, Marcella F. Pazzinatto, Fernanda Serighelli, Leandro A.C. Nogueira, and Danilo De Oliveira Silva
Background: Compression socks are a popular feature for runners and are widely advertised by the industry. Limited high-quality evidence has summarized the effects of compression socks during running. We aimed to investigate the effects of wearing compression socks compared with placebo or regular socks during running on physiological parameters, running performance, and perceptual outcomes. Methods: The protocol was registered at PROSPERO (CRD42022330437). Five databases (MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science) were searched. Clinical trials exploring the effect of compression socks during running on physiological parameters, performance, and perceptual outcomes were included. The Cochrane risk of bias 2 tool was used to assess the risk of bias. Results: We included 28 trials (600 runners), with 16 trials (284 runners) contributing to meta-analysis. For physiological outcomes (eg, heart rate mean difference [95% CI = 0.82 [−0.39 to 2.03] and blood lactate concentration mean difference [95% CI] = 0.30 [−0.39 to 0.98]), pooled analysis indicated low to moderate-certainty evidence that compression socks do not differ from regular socks. For running performance (eg, running speed mean difference [95% CI] = −0.24 [−0.79 to 0.31] and time to exhaustion standardized mean difference [95% CI] = −0.26 [−0.65 to 0.13]), pooled analysis indicated very low to low-certainty evidence that compression socks do not differ from regular socks. For perceptual outcomes (eg, perceived exertion standardized mean difference [95% CI] = 0.06 [−0.17 to 0.29] and lower limb muscle soreness standardized mean difference [95% CI] = 0.08 [−0.35 to 0.51]), pooled analysis indicated very low to moderate-certainty evidence that compression socks do not differ from regular socks. Conclusion: There is very low to moderate-certainty evidence that wearing compression socks during running does not benefit physiological, running performance, or perceptual outcomes compared with regular socks.
“We’re All Here to Be Dancers Together”: Perspectives on Facilitating Dance Classes for Individuals With Parkinson’s
Jenna Magrath, Sarah J. Kenny, Meghan S. Ingstrup, Lindsay Morrison, Vanessa Paglione, Meghan H. McDonough, and Cari Din
Parkinson’s is a progressive neurological disorder impacting physical, cognitive, emotional, and sensory functions. Dance is a form of physical activity that can offer social, psychological, and physical benefits and enhance quality of life for individuals with Parkinson’s. This study explored program facilitators’ perceptions and experiences facilitating a community dance class for individuals with Parkinson’s through the lens of physical literacy. Six program facilitators (four instructors, one volunteer, and one musical accompanist) of a weekly community dance class participated in semistructured interviews. Data were analyzed using reflexive thematic analysis, generating three themes: (a) Dance as tuning into one’s self: Enriching the body, mind, and spirit; (b) Everybody can dance: Feeling successful and fostering confidence; and (c) Looking forward to Tuesdays: Promoting connection, belonging, and community. This study provides insight into the teaching practices, as well as the design and facilitation of community dance classes for individuals with Parkinson’s.
Can Ground Reaction Force Variables Preidentify the Probability of a Musculoskeletal Injury in Collegiate Distance Runners?
Harper E. Stewart, Ryan S. Alcantara, Kathryn A. Farina, Michael E. Hahn, Alena M. Grabowski, Rodger Kram, Rand R. Wilcox, and Jill L. McNitt-Gray
The incidence of lower extremity injuries in collegiate distance runners is ∼20%. Identification of a runner sustaining a potential injury remains challenging. This exploratory, cross-institutional study sought to determine whether ground reaction force (GRF) characteristics during steady-state running could identify competitive collegiate distance runners who would later sustain lower extremity injuries. Normative boundaries for 10 GRF variables during braking and propulsion were established for noninjured runners using median ± scaled median absolute deviation. A subanalysis was conducted on runners with and without impact peaks in vertical GRF to mitigate the influence of impact peaks on GRF variables. We hypothesized that prior to injury, runners who later developed an injury would have more GRF variables outside of the normative boundaries than noninjured runners. Using Cliff’s method, a rank-based, nonparametric method for comparing 2 independent groups, we found no statistically significant difference between the number of variables outside the boundaries for injured and noninjured runners overall (P = .17). However, injured runners without impact peaks had more variables outside the normative boundaries than noninjured runners (P < .001). This novel analytical approach demonstrates the potential for preidentifying collegiate distance runners without impact peaks who may be at risk for injury.