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.
Timothy A. Burkhart and David M. Andrews
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.
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.