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  • Author: Kristian M. O’Connor x
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Lauren C. Benson and Kristian M. O’Connor

About half of all runners sustain a running-related injury every year. Exertion may contribute to risk of injury by altering joint mechanics. The purpose of this study was to examine the effects of exertion on runners’ joint mechanics using principal component analysis (PCA). Three-dimensional motion analysis of the lower extremity was performed on 16 healthy female runners before and after their typical training run. PCA was used to determine exertion-related changes in joint mechanics at the ankle, knee, and hip. Statistical significance for repeated-measures MANOVA of the retained principal components at each joint and plane of motion was at P < .05. Exercise effects were identified at the ankle (greater rate of eversion [PC2: P = .027], and decreased plantar flexion moment [overall: P = .044] and external rotation moment [PC3: P = .003]), knee (increased adduction [overall: P = .044] and internal rotation [PC3: P = .034], and decreased abduction moment [overall: P = .045]), and hip (increased internal rotation [PC1: P = .013] and range of mid- to late-stance rotation [PC2: P = .009], and decreased internal rotation moment [PC1: P = .001]). The observed changes in running mechanics reflect a gait profile that is often linked to running injury. The effects of more strenuous activity may result in mechanics that present an even greater risk for injury.

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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.

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Joshua T. Weinhandl, Mukta Joshi and Kristian M. O’Connor

The increased number of women participating in sports has led to a higher knee injury rate in women compared with men. Among these injuries, those occurring to the ACL are commonly observed during landing maneuvers. The purpose of this study was to determine gender differences in landing strategies during unilateral and bilateral landings. Sixteen male and 17 female recreational athletes were recruited to perform unilateral and bilateral landings from a raised platform, scaled to match their individual jumping abilities. Three-dimensional kinematics and kinetics of the dominant leg were calculated during the landing phase and reported as initial ground contact angle, ranges of motion (ROM) and peak moments. Lower extremity energy absorption was also calculated for the duration of the landing phase. Results showed that gender differences were only observed in sagittal plane hip and knee ROM, potentially due to the use of a relative drop height versus the commonly used absolute drop height. Unilateral landings were characterized by significant differences in hip and knee kinematics that have been linked to increased injury risk and would best be classified as “stiff” landings. The ankle musculature was used more for impact absorption during unilateral landing, which required increased joint extension at touchdown and may increase injury risk during an unbalanced landing. In addition, there was only an 11% increase in total energy absorption during unilateral landings, suggesting that there was a substantial amount of passive energy transfer during unilateral landings.

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Thomas G. Almonroeder, Lauren C. Benson and Kristian M. O’Connor

The mechanism of action of a foot orthotic is poorly understood. The purpose of this study was to use principal components analysis (PCA) to analyze the effects of a prefabricated foot orthotic on frontal plane knee and ankle mechanics during running. Thirty-one healthy subjects performed running trials with and without a foot orthotic and PCA was performed on the knee and ankle joint angles and moments to identify the dominant modes of variation. MANOVAs were conducted on the retained principal components of each waveform and dependent t tests (P < .05) were performed in the case of significance. Mechanics of the ankle were not affected by the foot orthotic. However, mechanics of the knee were significantly altered as subjects demonstrated an increase in the magnitude of the knee abduction moment waveform in an orthotic condition. Subjects also demonstrated a significant shift in the timing of the knee abduction moment waveform toward later in the stance phase in the orthotic condition. These orthotic effects were not related to subject’s foot mobility, measured using the navicular drop test. The mechanism of action of a foot orthotic may be related to their effect on the timing of frontal plane knee loading.

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Kristian M. O’Connor, Carl Johnson and Lauren C. Benson

The function of the hamstrings in protecting the ACL is not fully understood. The purpose of this study was to determine how landing knee mechanics were affected by hamstrings fatigue, analyzed with principal components analysis (PCA). Knee joint mechanics were collected during single-leg stride landings that were followed by lateral and vertical jumps. An isokinetic fatigue protocol was employed to reduce hamstrings strength by 75% at the cessation of the exercise protocol. On the landing test day, participants performed the stride landing maneuvers before and after the fatigue protocol. PCA was performed on the landing knee joint angle, moment, and power waveforms, and MANOVAs were conducted on the retained PCs of each waveform (P < .05). On the strength test day, hamstrings strength recovery was assessed with an identical fatigue protocol followed by strength assessment ~75 s after the cessation of exercise. Pre- and postexercise hamstrings strength on this day was assessed with a dependent t test (P < .05). The hamstrings strength remained significantly reduced by ~8% postexercise (75 s). For stride landings followed by vertical jumps, there were significantly reduced knee flexion angles, extensor moments, and energy absorption. This was indicative of a stiffer landing strategy postfatigue, which has been associated with increased ACL loading.

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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.

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Kristian M. O’Connor, Sarika K. Monteiro and Ian A. Hoelker

The purpose of this study was to compare the knee joint dynamics for males and females performing constrained cutting tasks to an unanticipated running and cutting maneuver. Sixteen male and 17 female recreational athletes were recruited to perform four cutting tasks; unanticipated run and cut (CUT), stride land and cut (SLC), far box-land and cut (FLC), and close box-land and cut (CLC). Three-dimensional knee joint kinematics and kinetics were recorded. Data were compared across gender and task with a 2 × 4 ANOVA (p < .05), and a factor analysis was performed to examine task relationships. There were significant group mean differences between the tasks and across genders. The factor analysis revealed high correlations between the three constrained tasks, but for variables typically associated with ACL injury risk there was a poor relationship to the CUT task. This was particularly true for the frontal plane variables. The constrained tasks were only moderately useful in predicting cutting mechanics.

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Lauren C. Benson, Stephen C. Cobb, Allison S. Hyngstrom, Kevin G. Keenan, Jake Luo and Kristian M. O’Connor

Low foot clearance and high variability may be related to falls risk. Foot clearance is often defined as the local minimum in toe height during swing; however, not all strides have this local minimum. The primary purpose of this study was to identify a nondiscrete measure of foot clearance during all strides, and compare discrete and nondiscrete measures in ability to rank individuals on foot clearance and variability. Thirty-five participants (young adults [n = 10], older fallers [n = 10], older nonfallers [n = 10], and stroke survivors [n = 5]) walked overground while lower extremity 3D kinematics were recorded. Principal components analysis (PCA) of the toe height waveform yielded representation of toe height when it was closest to the ground. Spearman’s rank order correlation assessed the association of foot clearance and variability between PCA and discrete variables, including the local minimum. PCA had significant (P < .05) moderate or strong associations with discrete measures of foot clearance and variability. An approximation of the discrete local minimum had a weak association with PCA and other discrete measures of foot clearance. A PCA approach to quantifying foot clearance can be used to identify the behavioral components of toe height when it is closest to the ground, even for strides without a local minimum.