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Forty Years of the Journal of Applied Biomechanics: A Message From the Editor
Katherine A. Boyer
Early Surgical Treatment of Posttraumatic Myositis Ossificans of the Vastus Intermedius Muscle
Pave Kalebić, Silvije Šegulja, Bojan Miletić, Hrvoje Vlahović, and Gordana Starčević-Klasan
Context: This case study demonstrates the effectiveness of early surgical excision of the traumatic myositis ossificans of the vastus intermedius muscle in an elite football player and return to sports activity within 3 months from the initial injury. Case presentation: A 27-year-old male professional football player presented with progressive pain and loss of range of motion after sustaining a severe, right quadriceps contusion 4 weeks earlier. After unsuccessful conservative therapy, the differential diagnosis of myositis ossificans was suspected and confirmed on radiographic examination. MRI revealed significant edema encompassing a substantial portion of the vastus intermedius muscle. Management and outcomes: Surgical treatment was considered for the right thigh mass, being symptomatic 1 month after the onset and refractory to conservative treatment and rehabilitation program. At 2 months postsurgery, the patient was asymptomatic and had completed a rehabilitation program. Conclusion: Early surgical treatment followed-up with a rehabilitation program results with a complete recovery of muscle strength and range of motion. At 3 months postinitial injury, the patient was considered fully recovered and had returned to the match without reporting pain or other symptoms.
Electromyography-Informed Estimates of Joint Contact Forces Within the Lower Back and Knee Joints During a Diverse Set of Industry-Relevant Manual Lifting Tasks
Felicia R. Davenport, Jennifer K. Leestma, Adriana Staten, Krishan Bhakta, Joshua Fernandez, Anirban Mazumdar, Aaron J. Young, and Gregory S. Sawicki
Repetitive manual labor tasks involving twisting, bending, and lifting commonly lead to lower back and knee injuries in the workplace. To identify tasks with high injury risk, we recruited N = 9 participants to perform industry-relevant, 2-handed lifts with a 11-kg weight. These included symmetrical/asymmetrical, ascending/descending lifts that varied in start-to-end heights (knee-to-waist and waist-to-shoulder). We used a data-driven musculoskeletal model that combined force and motion data with a muscle activation-informed solver (OpenSim, CEINMS) to estimate 3-dimensional internal joint contact forces (JCFs) in the lower back (L5/S1) and knee. Symmetrical lifting resulted in larger peak JCFs than asymmetrical lifting in both the L5/S1 (+20.2% normal [P < .01], +20.3% shear [P = .001], +20.6% total [P < .01]) and the knee (+39.2% shear [P = .001]), and there were no differences in peak JCFs between ascending versus descending motions. Below-the-waist lifting generated significantly greater JCFs in the L5/S1 and knee than above-the-waist lifts (P < .01). We found a positive correlation between knee and L5/S1 peak total JCFs (R2 = .60, P < .01) across the task space, suggesting motor coordination that favors sharing of load distribution across the trunk and legs during lifting.
Outdoor Overground Gait Biomechanics and Energetics in Individuals With Transtibial Amputation Walking With a Prescribed Passive Prosthesis and a Bionic Myoelectric Prosthesis
Nicole Stafford, Eddie B. Gonzalez, and Daniel Ferris
The metabolic cost of walking for individuals with transtibial amputation is generally greater compared with able-bodied individuals. One aim of powered prostheses is to reduce metabolic deficits by replicating biological ankle function. Individuals with transtibial amputation can activate their residual limb muscles to volitionally control bionic ankle prostheses for walking; however, it is unknown how myoelectric control performs outside the laboratory. We recruited 6 individuals with transtibial amputation to walk an outdoor course with the Open Source Leg prosthesis under continuous proportional myoelectric control and compared it with their passive device. There were no significant differences (P = .142) in cost of transport between prostheses. Participants significantly increased residual limb vastus lateralis (P = .042) and rectus femoris (P = .029) muscle activity during early and midstance phase of walking with the powered prosthesis compared with their passive device. All but one participant preferred walking with myoelectric control compared with their passive prosthesis. The additional mass of the powered ankle prosthesis coupled with increased residual quadriceps activity could explain why the energy cost of walking was not lower compared with a passive prosthesis. This study demonstrates participants can volitionally control a bionic ankle prosthesis to navigate real-world environments.
Erratum. A Faster Walking Speed Is Important for Improving Biomechanical Function and Walking Performance in Stroke Survivors
Journal of Applied Biomechanics
Effects of Different Inertial Measurement Unit Sensor-to-Segment Calibrations on Clinical 3-Dimensional Humerothoracic Joint Angles Estimation
Alessandro Bonfiglio, Elisabetta Farella, David Tacconi, and Raoul M. Bongers
Calibrating inertial measurement units (IMUs) involves converting orientation data from a local reference frame into a clinically meaningful reference system. Several solutions exist but little work has been done to compare different calibration methods with each other and an optical motion capture system. Thirteen healthy subjects with no signs of upper limb injury were recruited for this study and instrumented with IMU sensors and optical markers. Three IMU calibration methods were compared: N-pose calibration, functional calibration, and manual alignment. Subjects executed simple single-plane single-joint tasks for each upper limb joint as well as more complex multijoint tasks. We performed a 3-way analysis of variance on range of motion error, root mean squared error, and offset to assess differences between calibrations, tasks, and anatomical axes. Differences in the 3 IMU calibrations are minor and not statistically significant for most tasks and anatomical axes, with the exception of the offset interaction calibration × axes (P < .001,
Erratum. Effects of Different Inertial Measurement Unit Sensor-to-Segment Calibrations on Clinical 3-Dimensional Humerothoracic Joint Angles Estimation
Journal of Applied Biomechanics
The Association Between Lower Limb Joint Position Sense and Different Aspects of Gait Pattern in Individuals With Bilateral Knee Osteoarthritis
Mohadeseh Sarvestani, Neda Orakifar, Razieh Mofateh, Maryam Seyedtabib, Mehrnoosh Karimi, and Mohammad Mehravar
Knee osteoarthritis (KOA) can have more pronounced effects on joint position sense (JPS) accuracy and gait characteristics. The aim of this study is to investigate the association between lower limb JPS and different aspects of gait pattern including gait asymmetry and variability and spatiotemporal coordination in individuals with bilateral KOA. In this cross-sectional study, lower limb JPS of 43 individuals with bilateral KOA (mild and moderate) were measured. Participants’ gait patterns during treadmill walking with self-selected comfortable speed were assessed. The correlations between JPS errors and gait parameters of limb with moderate KOA were analyzed. Positive relationships were found between stance time symmetry index and JPS errors of hip abduction (r = .46, P = .003), ankle plantar flexion (r = .33, P = .03), and ankle dorsiflexion (r = .33, P = .03). Positive relationship was found between single limb support time symmetry index and hip abduction JPS error (r = .41, P = .008). Significant negative associations were found between coefficient of variation of step length and JPS errors of knee extension (r = .47, P = .002) and ankle plantar flexion (r = .33, P = .003). Results did not show any significant relationship between lower limb JPS errors and walk ratio. It is likely that lower limb JPS deficits are partially responsible for some changes in gait patterns observed in individuals with bilateral KOA.
Sport and School Burnout in Norwegian Lower Secondary School Student-Athletes: A Person-Oriented Approach
Milla Saarinen, Daniel J. Phipps, Gro Jordalen, and Christian Thue Bjørndal
The study examined burnout profiles in adolescent student-athletes based on sport and school burnout symptoms. We explored whether psychological distress, self-esteem, athletic identity, and student identity were associated with these profiles, accounting for age, gender, and type of sport. Participants included 642 student-athletes from Grades 8–10 (age 12–14, 57% males and 43% females) in eight Norwegian sport schools. Using latent profile analysis, we identified five profiles: mild sport and school burnout (46%), high burnout (22.5%), well-functioning (17.9%), predominantly school burnout (8.6%), and predominantly sport burnout (5%). Female student-athletes and those in Grades 9–10 were more at risk. Low self-esteem and high psychological distress increased the likelihood of burnout in sport and school, while a strong student identity seemed to protect against school burnout. These findings suggest that combining competitive sport with education at an early age may put student-athletes at risk for burnout symptoms in sport and school.
Challenges and Research Opportunities for Integrating Quantitative Electroencephalography Into Sports Concussion Rehabilitation
Patrick S. Ledwidge, Lindsey C. Hartland, Kirstiana Brickman, Scott O. Burkhart, and John P. Abt
Although concussion management and return to play/learn decision making focuses on reducing symptoms, there is growing interest in objective physiological approaches to treatment. Clinical and technological advancements have aided concussion management; however, the scientific study of the neurophysiology of concussion has not translated into its standard of care. This expert commentary is motivated by novel clinical applications of electroencephalographic-based neurofeedback approaches (eg, quantitative electroencephalography [QEEG]) for treating traumatic brain injury and emerging research interest in its translation for treating concussion. QEEG’s low-cost relative to other brain recording/imaging techniques and precedent in clinical and medical care makes it a potential tool for concussion rehabilitation. Although uncommon, licensed and certified clinicians and medical professionals are implementing QEEG neurofeedback for concussion management within their score of practice. These approaches are not widely adopted nor recommended by professional medical societies, likely because of a limited evidence base of well-designed studies with available standard protocols. Thus, the potential efficacy of QEEG neurofeedback for treating persistent symptoms or cognitive dysfunction after sports-related concussion is unknown. This commentary will update the concussion clinician–scientist on the emerging research, techniques, and disagreements pertaining to the translation of QEEG neurofeedback for concussion management, particularly in the treatment of persistent cognitive difficulties. This commentary will also introduce to readers the fundamentals of how the electroencephalogram may be acquired, measured, and implemented during QEEG neurofeedback. An evidence base of supportive findings from well-designed studies, including those that are retrospective, outcomes-based, and, ultimately, placebo/sham-controlled is recommended prior to considering more widespread adoption of QEEG neurofeedback approaches for treating persistent symptoms or cognitive deficits after sports-related concussion. We review the considerable barriers to this research and clinical implementation, and conclude with opportunities for future research, which will be necessary for establishing the quality and efficacy of QEEG neurofeedback for concussion care.