Special Issue: The Physically Challenged Child
Edited by Joseph Hamill
An Alternative Model of the Lower Extremity during Locomotion
Saunders N. Whittlesey and Joseph Hamill
An alternative to the Iterative Newton-Euler or linked segment model was developed to compute lower extremity joint moments using the mechanics of the double pendulum. The double pendulum model equations were applied to both the swing and stance phases of locomotion. Both the Iterative Newton-Euler and double pendulum models computed virtually identical joint moment data over the entire stride cycle. The double pendulum equations, however, also included terms for other mechanical factors acting on limb segments, namely hip acceleration and segment angular velocities and accelerations Thus, the exact manners in which the lower extremity segments interacted with each other could be quantified throughout the gait cycle. The linear acceleration of the hip and the angular acceleration of the thigh played comparable roles to muscular actions during both swing and stance.
Clinical Biomechanics: Contributions to the Medical Treatment of Physical Abnormalities
Joseph Hamill, George Gorton, and Peter Masso
Biomechanics is defined as the application of the laws of mechanics to the study or structure and function of movement. It is a relatively new subdiscipline to the domain of kinesiology. Biomechanics was initially closely associated with the study of sports technique. However, over the years, biomechanics has taken on a much more diverse field of study. In this paper, we will describe the contributions that biomechanics has made to the area of clinical biomechanics research in terms of clinical assessment and outcomes and the design of clinical apparatus. The first example examines a clinical assessment of a cerebral palsy child. The goals of such a clinical assessment are 1) to determine the primary problems with the locomotion capabilities of the individual, 2) to recommend treatment options, and 3) to evaluate treatment outcomes. In the second example, a procedure is described for designing braces for scoliosis patients. For this example, a three-dimensional digital twin is developed using a scanning technique. This example illustrates the research conducted on developing a technique to noninvasively and safely determine the torso deformities resulting from scoliosis. While these examples are but two of a wide variety of examples that could be used, they illustrate the contribution of biomechanics to the clinical world.
The Effects of Track Turns on Lower Extremity Function
Joseph Hamill, Michael Murphy, and Donald Sussman
The mechanics of moving along a curved path suggest that runners must change their body positions and thus adjust their lower extremity function as they accomplish a track turn. The purpose of the present study was to investigate the changes in the kinetics and kinematics of the lower extremity as runners proceed around the turn of a 400-m track (radius 31.5 m). Five skilled runners served as subjects in the study and were required to perform 10 trials in three conditions, running at 6.31 m/s plus or minus 5% (4:15 min/mile pace). The right and left limbs on a track turn and the right limb on the straightaway were evaluated using ground reaction force data and kinematic data from high-speed film. Statistical analysis of the 18 ground reaction force variables and 4 kinematic variables suggested that the right and left limbs at the midpoint of the track turn were asymmetrical and that most of the differences occurred in the first portion of the footfall Significant differences were found in the touchdown angle, maximum pronation angle, all mediolateral variables, and in the vertical variables describing the collision phase of the footfall (p < .05). The data suggest that the etiologies of injuries to the right and left lower extremity differ, with right foot injuries being of the impact type and left leg injuries being of the overpronation type.
Runners With Anterior Knee Pain Use a Greater Percentage of Their Available Pronation Range of Motion
Pedro Rodrigues, Trampas TenBroek, and Joseph Hamill
“Excessive” pronation is often implicated as a risk factor for anterior knee pain (AKP). The amount deemed excessive is typically calculated using the means and standard deviations reported in the literature. However, when using this method, few studies find an association between pronation and AKP. An alternative method of defining excessive pronation is to use the joints’ available range of motion (ROM). The purposes of this study were to (1) evaluate pronation in the context of the joints’ ROM and (2) compare this method to traditional pronation variables in healthy and injured runners. Thirty-six runners (19 healthy, 17 AKP) had their passive pronation ROM measured using a custom-built device and a motion capture system. Dynamic pronation angles during running were captured and compared with the available ROM. In addition, traditional pronation variables were evaluated. No significant differences in traditional pronation variables were noted between healthy and injured runners. In contrast, injured runners used significantly more of their available ROM, maintaining a 4.21° eversion buffer, whereas healthy runners maintained a 7.25° buffer (P = .03, ES = 0.77). Defining excessive pronation in the context of the joints’ available ROM may be a better method of defining excessive pronation and distinguishing those at risk for injury.
Does Running on a Cambered Road Predispose a Runner to Injury?
Kristian M. O'Connor and Joseph Hamill
Roads are generally designed with a camber to facilitate drainage. Running on a cambered road has been suggested as a potential cause of injury. Two possible mechanisms are mediolateral control and impact shock. The purpose of this study was to investigate the effect of a cambered surface on rearfoot motion and impact shock. Twelve runners ran at 3.83 m/s on both a flat and a cambered surface with the left side raised for all of them. Selected rearfoot kinematic and tibial acceleration measures were evaluated using a 2 × 2 repeated-measures ANOVA. The touchdown angle was less supinated on the left (high) side than on the right (low) side on the cambered surface. Maximum pronation was greater on the left (high) high side than on the right (low) side, as was total rearfoot motion. Maximum velocity of pronation was greater under the left (high) limb than under the right (low) limb while running on the cambered road. Time to maximum pronation did not differ, nor were there differences in peak acceleration or time to peak acceleration. The results of this study suggest that running on a cambered road caused changes in rearfoot motion kinematics that may predispose an individual to injury. Also, since the impact shock did not change with changes in rearfoot motion, perhaps the role of pronation on shock attenuation should be reexamined.
Frontal Plane Moments Do Not Accurately Reflect Ankle Dynamics during Running
Kristian M. O’Connor and Joseph Hamill
The ankle joint has typically been treated as a universal joint with moments calculated about orthogonal axes and the frontal plane moment generally used to represent the net muscle action about the subtalar joint. However, this joint acts about an oblique axis. The purpose of this study was to examine the differences between joint moments calculated about the orthogonal frontal plane axis and an estimated subtalar joint axis. Three-dimensional data were colected on 10 participants running at 3.6 m/s. Joint moments, power, and work were calculated about the orthogonal frontal plane axis of the foot and about an oblique axis representing the subtalar joint. Selected parameters were compared with a paired t-test (α = 0.05). The results indicated that the joint moments calculated about the two axes were characteristically different. A moment calculated about an orthogonal frontal plane axis of the foot resulted in a joint moment that was invertor in nature during the first half of stance, but evertor during the second half of stance. The subtalar joint axis moment, however, was invertor during most of the stance. These two patterns may result in qualitatively different interpretations of the muscular contributions at the ankle during the stance phase of running.
Influence of Custom Foot Orthotic Intervention on Lower Extremity Intralimb Coupling during a 30-Minute Run
Christopher L. MacLean, Richard van Emmerik, and Joseph Hamill
The purpose of this study was to analyze the influence of a custom foot orthotic (CFO) intervention on lower extremity intralimb coupling during a 30-min run in a group of injured runners and to compare the results to a control group of healthy runners. Three-dimensional kinematic data were collected during a 30-min run on healthy female runners (Shoe-only) and a group of female runners who had a recent history of overuse injury (Shoe-only and Shoe with custom foot orthoses). Results from the study revealed that the coordination variability and pattern for the some couplings were influenced by history of injury, foot orthotic intervention and the duration of the run. These data suggest that custom foot orthoses worn by injured runners may play a role in the maintenance of coordination variability of the tibia (transverse plane) and calcaneus (frontal plane) coupling during the Early Stance phase. In addition, it appears that the coupling angle between the knee (transverse plane) and rearfoot (frontal plane) joints becomes more symmetrical in the late stance phase as a run progresses.
Muscle Soreness during Running: Biomechanical and Physiological Considerations
Joseph Hamill, Patty S. Freedson, Priscilla M. Clarkson, and Barry Braun
This study involved an 8-day protocol to determine the effects of delayed-onset muscle soreness (DOMS) on the mechanics of the lower extremity and on oxygen consumption during level running. On Day 1 the subjects, 10 healthy female recreational runners, were administered a treadmill max V̇O2 test. They completed a 30-min downhill run on Day 3 to induce muscle soreness. On Days 2, 5, and 8 they completed a 15-min level run at a speed corresponding to 80% of V̇O2max. Subsequent to each run the subjects completed a muscle soreness questionnaire and a blood sample was taken for creatine kinase (CK) analysis. Data analysis revealed statistically significant between-day differences for perceived muscle soreness and CK activity. However, metabolic cost was not different between days. There were significant differences between days in maximum ankle support dorsiflexion and plantar flexion and maximum knee flexion during both support and swing. None of the global parameters describing the total stride produced significant differences between Days 2 and 5. Therefore DOMS appeared to have little effect on V̇O2 and a small effect on the kinematics of the lower extremity.