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David Werner, John Willson, Richard Willy and Joaquin Barrios

Frontal plane knee alignment can influence the development and management of various knee pathologies. Valid and reliable clinical methods for assessment are needed. The primary purposes of this study were to assess the validity and reliability of inclinometer-based frontal plane tibial orientation as a limb alignment measure, and secondarily to establish normal values in healthy individuals. Frontal tibial orientation was validated per moderately strong correlation to radiographic knee alignment. Intra- and interrater reliability were excellent. The normative mean was approximately 7°. In summary, inclinometer-based frontal tibial orientation is a valid and reliable clinical measure of frontal plane knee alignment.

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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.

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Gianluca Gatti

This article presents the validation of a technique to assess the appropriateness of a 2 degree-of-freedom model for the human knee, and, in which case, the dominant axes of flexion/extension and internal/external longitudinal rotation are estimated. The technique relies on the use of an instrumented spatial linkage for the accurate detection of passive knee kinematics, and it is based on the assumption that points on the longitudinal rotation axis describe nearly circular and planar trajectories, whereas the flexion/extension axis is perpendicular to those trajectories through their centers of rotation. By manually enforcing a tibia rotation while bending the knee in flexion, a standard optimization algorithm is used to estimate the approximate axis of longitudinal rotation, and the axis of flexion is estimated consequently. The proposed technique is validated through simulated data and experimentally applied on a 2 degree-of-freedom mechanical joint. A procedure is proposed to verify the fixed axes assumption for the knee model. The suggested methodology could be possibly valuable in understanding knee kinematics, and in particular for the design and implant of customized hinged external fixators, which have shown to be effective in knee dislocation treatment and rehabilitation.

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Ching-Chao Chan, Chou-Ching K. Lin and Ming-Shaung Ju

The steady-state passive joint moment was considered as a nonlinear elasticity in the past. However, we found that it was path dependent and the estimation error could be large if the commonly used path-independent functions were adopted. The aim of this study was to develop a model to describe the movement history-dependent passive moment in the steady state. The steady-state passive ankle moments of the rabbit were measured by a series of ramp-and-hold angle changes (stairway angle trajectory). A customized discrete Preisach model was constructed and a commonly adopted double-exponential function was also implemented. Two sets of data with different angle paths (major loop and inward loop trajectories) were acquired for model validation. The performance of the two models was compared. The results showed that the proposed model could accurately estimate the steady-state passive moment for both sets of validation data. The estimated error of the proposed model was approximately 50% smaller than that of the double-exponential function approach. It is expected that this new approach, by reducing the error of estimating passive joint moment, may contribute to the active control of joint moments.

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Damien Clement


The transtheoretical model has been widely used in the investigation of how people adapt to new behaviors; however, the literature appears to be lacking documentation of any assessment/s administered to injured athletes to determine their readiness for rehabilitation, which depending on the severity of the injury, could possibly represent a behavior change for that individual.


To validate the application of the transtheoretical model to injury rehabilitation and assess the impact of stages of change on athletes’ adherence and compliance rates.


Descriptive correlational.


Large Mid Atlantic Division I institution.


Seventy injured athletes.

Main Outcome Measures:

Readiness was assessed using the Transtheoretical Model. Adherence was assessed using the percentage of rehabilitation attendance and compliance was assessed using the Sport Injury Rehabilitation Scale.


Participants who were advanced in their stages of change generally reported an increase in self efficacy, utilization of pros versus cons, and the use of behavioral processes instead of experiential processes of change. No significant relationships were found between stages of change and athletes’ adherence and compliance.


Although no statistical significance was found between stages of change and adherence and compliance the results did validate the application of the transtheoretical model to injury rehabilitation.

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David B. Berry, Ana E. Rodríguez-Soto, Jana R. Tokunaga, Sara P. Gombatto and Samuel R. Ward

Vertebral level-dependent, angular, and linear translations of the spine have been measured in 2D and 3D using several imaging methods to quantify postural changes due to loading conditions and tasks. Here, we propose and validate a semiautomated method for measuring lumbar intervertebral angles and translations from upright MRI images using an endplate-based, joint coordinate system (JCS). This method was validated using 3D printed structures, representing intervertebral discs (IVD) at predetermined angles and heights, which were positioned between adjacent cadaveric vertebrae as a gold standard. Excellent agreement between our measurements and the gold standard was found for intervertebral angles in all anatomical planes (ICC > .997) and intervertebral distance measurements (ICC > .949). The proposed endplate-based JCS was compared with the vertebral body-based JCS proposed by the International Society of Biomechanics (ISB) using the 3D printed structures placed between 3 adjacent vertebrae from a cadaver with scoliosis. The endplate-based method was found to have better agreement with angles in the sagittal plane (ICC = 0.985) compared with the vertebral body-based method (ICC = .280). Thus, this method is accurate for measuring 3D intervertebral angles in the healthy and diseased lumbar spine.

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Rebecca J. Giorcelli, Richard E. Hughes, Richard S. Current and John R. Myers

This paper describes a procedure developed and validated to assess the accuracy of an infrared-based motion measurement system used to perform a kinematic analysis of the torso with respect to the pelvis during simulated lifting tasks. Two rigid reflective marker triads were designed and fabricated for attachment to the thorax over the 6th thoracic vertebra and the pelvis. System accuracy was assessed for planar rotation as well as rotations about multiple orthogonal axes. A test fixture was used to validate known triad orientations. The spatial coordinates of these triads were collected at 120 Hz using a ProReflex motion measurement system. Single value decomposition was used to estimate a rotation matrix describing the rigid body motion of the thorax triad relative to the sacral triad at each point in time. Euler angles corresponding to flexion, lateral bending, and twisting were computed from the rotation matrix. All measurement error residuals for flexion, lateral bending, and twisting were below 1.75°. The estimated mean measurement errors were less than 1° in all three planes. These results suggest that the motion measurement system is reliable and accurate to within approximately 1.5° for the angles examined.

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Neil E. Fowler and Adrian Lees

The aim of this study was to compare the kinetic and kinematic characteristics of plyometric drop-jump and pendulum exercises. Exercises were filmed (100 Hz) from the sagittal view and manually digitized; the data were smoothed and differentiated using cross-validated quintic splines. Ground reaction force data were sampled using a Kistler force platform sampling at 500 Hz. Differences between movement amplitudes and coordination strategies were assessed using t tests and conjugate cross-correlations. Pendulum exercises involved a greater range of motion at the ankle and knee but less motion at the hip joint than drop-jumps. Although different in absolute terms, the exercises used a similar coordination strategy. Drop-jumps resulted in greater peak vertical ground reaction forces than the pendulum exercises although the latter involved a greater net impulse. The similarity between the movement patterns for the two modes of exercise led to the conclusion that pendulum exercises offer a training stimulus similar to that of drop-jumps.

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Ahlem Arfaoui, Catalin Viorel Popa, Redha Taïar, Guillaume Polidori and Stéphane Fohanno

The objective of this article is to perform a numerical modeling on the flow dynamics around a competitive female swimmer during the underwater swimming phase for a velocity of 2.2 m/s corresponding to national swimming levels. Flow around the swimmer is assumed turbulent and simulated with a computational fluid dynamics method based on a volume control approach. The 3D numerical simulations have been carried out with the code ANSYS FLUENT and are presented using the standard k-ω turbulence model for a Reynolds number of 6.4 × 106. To validate the streamline patterns produced by the simulation, experiments were performed in the swimming pools of the National Institute of Sports and Physical Education in Paris (INSEP) by using the tufts method.

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Alexander Tsouknidas, Nikoalos Michailidis, Savvas Savvakis, Kleovoulos Anagnostidis, Konstantinos-Dionysios Bouzakis and Georgios Kapetanos

This study presents a CT-based finite element model of the lumbar spine taking into account all function-related boundary conditions, such as anisotropy of mechanical properties, ligaments, contact elements, mesh size, etc. Through advanced mesh generation and employment of compound elements, the developed model is capable of assessing the mechanical response of the examined spine segment for complex loading conditions, thus providing valuable insight on stress development within the model and allowing the prediction of critical loading scenarios. The model was validated through a comparison of the calculated force-induced inclination/deformation and a correlation of these data to experimental values. The mechanical response of the examined functional spine segment was evaluated, and the effect of the loading scenario determined for both vertebral bodies as well as the connecting intervertebral disc.