Considerable variability in tibial acceleration slope (AS) values, and different interpretations of injury risk based on these values, have been reported. Acceleration slope variability may be due in part to variations in the quantification methods used. Therefore, the purpose of this study was to quantify differences in tibial AS values determined using end points at various percentage ranges between impact and peak tibial acceleration, as a function of either amplitude or time. Tibial accelerations were recorded from 20 participants (21.8 ± 2.9 years, 1.7 m ± 0.1 m, 75.1 kg ± 17.0 kg) during 24 unshod heel impacts using a human pendulum apparatus. Nine ranges were tested from 5–95% (widest range) to 45–55% (narrowest range) at 5% increments. ASAmplitude values increased consistently from the widest to narrowest ranges, whereas the ASTime values remained essentially the same. The magnitudes of ASAmplitude values were significantly higher and more sensitive to changes in percentage range than ASTime values derived from the same impact data. This study shows that tibial AS magnitudes are highly dependent on the method used to calculate them. Researchers are encouraged to carefully consider the method they use to calculate AS so that equivalent comparisons and assessments of injury risk across studies can be made.
Adriana M. Duquette and David M. Andrews
Adriana M. Holmes and David M. Andrews
The purpose of this research was to examine the effects of voluntarily manipulating muscle activation and localized muscle fatigue on tibial response parameters, including peak tibial acceleration, time to peak tibial acceleration, and the acceleration slope, measured at the knee during unshod heel impacts. A human pendulum delivered consistent impacts to 15 female and 15 male subjects. The tibialis anterior and lateral gastrocnemius were examined using electromyography, thus allowing voluntary contraction to various activation states (baseline, 15%, 30%, 45%, and 60% of the maximum activation state) and assessing localized muscle fatigue. A skin-mounted uniaxial accelerometer, preloaded medial to the tibial tuberosity, allowed tibial response parameter determination. There were significant decreases in peak acceleration during tibialis anterior fatigue, compared to baseline and all other activation states. In females, increased time to peak acceleration and decreased acceleration slope occurred during fatigue compared to 30% and 45%, and compared to 15% through 60% of the maximum activation state, respectively. Slight peak acceleration and acceleration slope increases, and decreased time to peak acceleration as activation state increased during tibialis anterior testing, were noted. When examining the lateral gastrocnemius, the time to peak acceleration was significantly higher across gender in the middle activation states than at the baseline and fatigue states. The acceleration slope decreased at all activation states above baseline in females, and decreased at 60% of the maximum activation state in males compared to the baseline and fatigue states. Findings agree with localized muscle fatigue literature, suggesting that with fatigue there is decreased impact transmission, which may protect the leg. The relative effects of leg stiffness and ankle angle on tibial response need to be verified.
Timothy A. Burkhart and David M. Andrews
The effectiveness of wrist guards and modifying elbow posture for reducing impact-induced accelerations at the wrist and elbow, for the purpose of decreasing upper extremity injury risk during forward fall arrest, has not yet been documented in living people. A seated human pendulum was used to simulate the impact conditions consistent with landing on outstretched arms during a forward fall. Accelerometers measured the wrist and elbow response characteristics of 28 subjects following impacts with and without a wrist guard, and with elbows straight or slightly bent. Overall, the wrist guard was very effective, with significant reductions in peak accelerations at the elbow in the axial and off-axis directions, and in the off-axis direction at the wrist by almost 50%. The effect of elbow posture as an intervention strategy was mixed; a change in magnitude and direction of the acceleration response was documented at the elbow, while there was little effect at the wrist. Unique evidence was presented in support of wrist guard use in activities like in-line skating where impacts to the hands are common. The elbow response clearly shows that more proximal anatomical structures also need to be monitored when assessing the effectiveness of injury prevention strategies.
David M. Andrews and James J. Dowling
A fourth order mass/spring/damper (MSD) mechanical model with linear coefficients was used to estimate axial tibial accelerations following impulsive heel impacts. A generic heel pad with constant stiffness was modeled to improve the temporal characteristics of the model. Subjects (n = 14) dropped (~5 cm) onto a force platform (3 trials), landing on the right heel pad with leg fully extended at the knee. A uni-axial accelerometer was mounted over the skin on the anterior aspect of the medial tibial condyle inferior to the tibial plateau using a Velcro™ strap (normal preload ~45 N). Model coefficients for stiffness (k1, k2) and damping (c1, c2) were varied systematically until the minimum difference in peak tibial acceleration (%PTAmin) plus maximum rate of tibial acceleration (%RTAmax) between the estimated and measured curves was achieved for each trial. Model responses to mean subject and mean group model coefficients were also determined. Subject PTA and RTA magnitudes were reproduced well by the model (%PTAmin = 1.4 ± 1.0 %, %RTAmin = 2.2 ± 2.7%). Model estimates of PTA were fairly repeatable for a given subject despite generally high variability in the model coefficients, for subjects and for the group (coefficients of variation: CVk1 = 57; CVk2 = 59; CVc1 = 48; CVc2 = 85). Differences in estimated parameters increased progressively when subject and group mean coefficients (%PTAsub = 8.4 ± 6.3%, %RTAsub = 18.9 ± 18.6%, and %PTAgrp = 19.9 ± 15.2 %, %RTAgrp = 30.2 ± 30.2%, respectively) were utilized, suggesting that trial specific calibration of coefficients for each subject is required. Additional model refinement seems warranted in order to account for the large intra-subject variability in coefficients.
Alison Schinkel-Ivy, Timothy A. Burkhart, and David M. Andrews
To date, there has not been a direct examination of the effect that tissue composition (lean mass/muscle, fat mass, bone mineral content) differences between males and females has on how the tibia responds to impacts similar to those seen during running. To evaluate this, controlled heel impacts were imparted to 36 participants (6 M and 6 F in each of low, medium and high percent body fat [BF] groups) using a human pendulum. A skin-mounted accelerometer medial to the tibial tuberosity was used to determine the tibial response parameters (peak acceleration, acceleration slope and time to peak acceleration). There were no consistent effects of BF or specific tissue masses on the un-normalized tibial response parameters. However, females experienced 25% greater peak acceleration than males. When normalized to lean mass, wobbling mass, and bone mineral content, females experienced 50%, 62% and 70% greater peak acceleration, respectively, per gram of tissue than males. Higher magnitudes of lean mass and bone mass significantly contributed to decreased acceleration responses in general.
Jeffrey D. Holmes, David M. Andrews, Jennifer L. Durkin, and James J. Dowling
The purpose of this study was to derive and validate regression equations for the prediction of fat mass (FM), lean mass (LM), wobbling mass (WM), and bone mineral content (BMC) of the thigh, leg, and leg + foot segments of living people from easily measured segmental anthropometric measures. The segment masses of 68 university-age participants (26 M, 42 F) were obtained from full-body dual photon x-ray absorptiometry (DXA) scans, and were used as the criterion values against which predicted masses were compared. Comprehensive anthropometric measures (6 lengths, 6 circumferences, 8 breadths, 4 skinfolds) were taken bilaterally for the thigh and leg for each person. Stepwise multiple linear regression was used to derive a prediction equation for each mass type and segment. Prediction equations exhibited high adjusted R 2 values in general (0.673 to 0.925), with higher correlations evident for the LM and WM equations than for FM and BMC. Predicted (equations) and measured (DXA) segment LM and WM were also found to be highly correlated (R 2 = 0.85 to 0.96), and FM and BMC to a lesser extent (R 2 = 0.49 to 0.78). Relative errors between predicted and measured masses ranged between 0.7% and –11.3% for all those in the validation sample (n = 16). These results on university-age men and women are encouraging and suggest that in vivo estimates of the soft tissue masses of the lower extremity can be made fairly accurately from simple segmental anthropometric measures.
Maureen M. Smith
Edited by David L. Andrews, Daniel S. Mason, and Michael L. Silk
Danielle L. Gyemi, Charles Kahelin, Nicole C. George, and David M. Andrews
Accurate prediction of wobbling mass (WM), fat mass (FM), lean mass (LM), and bone mineral content (BMC) of living people using regression equations developed from anthropometric measures (lengths, circumferences, breadths, skinfolds) has previously been reported, but only for the extremities. Multiple linear stepwise regression was used to generate comparable equations for the head, neck, trunk, and pelvis of young adults (38 males, 38 females). Equations were validated using actual tissue masses from an independent sample of 13 males and 13 females by manually segmenting full-body dual-energy x-ray absorptiometry scans. Prediction equations exhibited adjusted R2 values ranging from .249 to .940, with more explained variance for LM and WM than BMC and FM, especially for the head and neck. Mean relative errors between predicted and actual tissue masses ranged from −11.07% (trunk FM) to 7.61% (neck FM). Actual and predicted tissue masses from all equations were significantly correlated (R2 = .329 to .937), except head BMC (R2 = .046). These results show promise for obtaining in-vivo head, neck, trunk, and pelvis tissue mass estimates in young adults. Further research is needed to improve head and neck FM and BMC predictions and develop tissue mass prediction equations for older populations.
Nicole C. George, Charles Kahelin, Timothy A. Burkhart, and David M. Andrews
Soft and rigid tissue mass prediction equations have been previously developed and validated for the segments of the upper and lower extremities in living humans using simple anthropometric measurements. The reliability of these measurements has been found to be good to excellent for all measurement types (segment lengths, circumferences, breadths, skinfolds). However, the reliability of the measurements needed to develop corresponding equations for the head, neck, and trunk has yet to be determined. The purpose of this study was to quantify the inter- and intrameasurer reliability of 34 surface anthropometric measurements of the head, neck, and trunk segments. Measurements (11 lengths, 7 circumferences, 11 breadths, 5 skinfolds) were taken twice separately on 50 healthy, university-age individuals using standard anthropometric tools. The mean inter- and intrameasurer measurement differences were fairly small overall, with 64.7% and 67.6% of the relative differences less than 5%, respectively. All measurements, except for the right lateral trunk, had intraclass correlation coefficients (ICCs) greater than 0.75, and coefficients of variation (CVs) less than 10%, indicating good reliability overall. These results are consistent with previous work for the extremities and provide support for the use of the defined surface measurements for future tissue mass prediction equation development.