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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.

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Clinical Biomechanics

Rafael Bahamonde

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The Intrinsic Properties of ActiGraph Counts and Alternatives

Jan Christian Brønd, Niels Christian Møller, and Anders Grøntved

.M. ( 1996 ). Relationship between vertical ground reaction force and speed during walking, slow jogging, and running . Clinical Biomechanics, 11 , 253 – 259 . LaMunion , S.R. , Bassett , D.R. , Toth , L.P. , & Crouter , S.E. ( 2017 ). The effect of body placement site on ActiGraph wGT3X

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Effectiveness of a Preschool Motor Skill Intervention on Body Mass Index and Movement Behavior: 6-, 18-, and 30-Month Findings From a Cluster Randomized Controlled Trial

Line Grønholt Olesen, Anders Grøntved, Jan Christian Brønd, Lise Hestbæk, and Peter Lund Kristensen

the preschool governing board approval by a statistician at the Department of Sport Science and Clinical Biomechanics otherwise not involved in the study. The randomization of preschools was stratified by an average preschool socioeconomic index based on family type, household income for the year 2015

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An Investigation of Structure, Flexibility, and Function Variables that Discriminate Asymptomatic Foot Types

Sarah P. Shultz, Jinsup Song, Andrew P. Kraszewski, Jocelyn F. Hafer, Smita Rao, Sherry Backus, Rajshree M. Hillstrom, and Howard J. Hillstrom

.1097/00124743-199512000-00001 19078008 23. Root ML . Normal and Abnormal Function of the Foot. 1st ed . Los Angeles, CA : Clinical Biomechanics Corp. ; 1977 . 24. Song J , Hillstrom HJ , Secord D , Leavitt J . Foot type biomechanics: comparison of planus and rectus foot types . J Am Podiatr Med Assoc. 1996 ; 86

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“Knowing That This Is My Place Is Very Positive”: The Case of a Swedish Table Tennis Club

Michaela Elisabeth Karlsson, Natalia B. Stambulova, and Kristoffer Henriksen

development in sport: A multiple case study of successful athletic talent development environments in Scandinavia [Doctoral thesis, Institute of Sport Science and Clinical Biomechanics, Faculty of Health Sciences]. University of Southern Denmark . Henriksen , K. ( 2015 ). Developing a high

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Effects of Volitional Spine Stabilization and Lower-Extremity Fatigue on the Knee and Ankle During Landing Performance in a Population With Recurrent Low Back Pain

Ram Haddas, Steven F. Sawyer, Phillip S. Sizer, Toby Brooks, Ming-Chien Chyu, and C. Roger James

Introduction:

Recurrent lower back pain (rLBP) and neuromuscular fatigue are independently thought to increase the risk of lower extremity (LE) injury. Volitional preemptive abdominal contraction (VPAC) is thought to improve lumbar spine and pelvis control in individuals with rLBP. The effects of VPAC on fatigued landing performance in individuals with rLBP are unknown.

Objectives:

To determine the effects of VPAC and LE fatigue on landing performance in a rLBP population.

Design:

Cross-sectional pretest-posttest cohort control design.

Setting:

A clinical biomechanics laboratory.

Subjects:

32 rLBP (age 21.2 ± 2.7 y) but without current symptoms and 33 healthy (age 20.9 ± 2.3 y) subjects.

Intervention(s):

(i) Volitional preemptive abdominal contraction using abdominal bracing and (ii) fatigue using submaximal free-weight squat protocol with 15% body weight until task failure was achieved.

Main Outcome Measure(s):

Knee and ankle angles, moments, electromyographic measurements from semitendinosus and vastus medialis muscles, and ground reaction force (GRF) were collected during 0.30 m drop-jump landings.

Results:

The VPAC resulted in significantly earlier muscle onsets across all muscles with and without fatigue in both groups (mean ± SD, 0.063 ± 0.016 s earlier; P ≤ .001). Fatigue significantly delayed semitendinosus muscle onsets (0.033 ± 0.024 s later; P ≤ .001), decreased GRF (P ≤ .001), and altered landing kinematics in a variety of ways. The rLBP group exhibited delayed semitendinosus and vastus medialis muscle onsets (0.031 ± 0.028 s later; P ≤ .001) and 1.8° less knee flexion at initial contact (P ≤ .008).

Conclusion:

The VPAC decreases some of the detrimental effects of fatigue on landing biomechanics and thus may reduce LE injury risk in a rLBP population.

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Intervening in a Messy Reality: A Case of Interorganizational Collaboration in Talent Development Within the Danish Sport System

Ole Winthereik Mathorne, Natalia Stambulova, and Kristoffer Henriksen

The overall aim of this paper is to share our experiences in development, implementation, and evaluation of an intervention designed for establishing interorganizational collaboration in talent development between a Danish sports club, a municipality, and a federation. Yet, despite a neat plan, we faced several challenges in what turned out to be a less successful intervention. The account is based on the first author’s field notes, informal interviews, and intervention debriefings. The professional philosophy of the research team was informed by the holistic ecological approach and an empowerment approach. We used the pyramid model for optimizing interorganizational collaboration in talent development as a framework to design and guide the 7-month intervention that included four workshops covering (a) initiation: building relationships; (b) exploration: foundation for the shared philosophy; (c) clarification: negotiating values and strategy; and (d) implementation: from talk to action. However, challenges (e.g., resignations of key stakeholders) led to program adjustments and, ultimately, termination. This paper shows the nuances of a less successful intervention, which can help practitioners plan and carry out better interventions in the future. Despite the challenges faced here, we still deem the pyramid model for optimizing interorganizational collaboration in talent development a valuable framework for practitioners working at an interorganizational level.

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A Maximal Rowing-Ergometer Protocol to Predict Maximal Oxygen Uptake in Female Rowers

Oscar B. Mazza, Søren Gam, Mikkel E.I. Kolind, Christian Kiær, Christina Donstrup, and Kurt Jensen

Background: Laboratory assessment of maximal oxygen uptake ( V ˙ O 2 max ) is physically and mentally draining for the athlete and requires expensive laboratory equipment. Indirect measurement of V ˙ O 2 max could provide a practical alternative to laboratory testing. Purpose: To examine the relationship between the maximal power output (MPO) in an individualized 7 × 2-minute incremental test (INCR-test) and V ˙ O 2 max and to develop a regression equation to predict V ˙ O 2 max from MPO in female rowers. Methods: Twenty female club and Olympic rowers (development group) performed the INCR-test on a Concept2 rowing ergometer to determine V ˙ O 2 max and MPO. A linear regression analysis was used to develop a prediction of V ˙ O 2 max from MPO. Cross-validation analysis of the prediction equation was performed using an independent sample of 10 female rowers (validation group). Results: A high correlation coefficient (r = .94) was found between MPO and V ˙ O 2 max . The following prediction equation was developed: V ˙ O 2 max (mL·min−1) = 9.58 × MPO (W) + 958. No difference was found between the mean predicted V ˙ O 2 max in the INCR-test (3480 mL·min−1) and the measured V ˙ O 2 max (3530 mL·min−1). The standard error of estimate was 162 mL·min−1, and the percentage standard error of estimate was 4.6%. The prediction model only including MPO, determined during the INCR-test, explained 89% of the variability in V ˙ O 2 max . Conclusion: The INCR-test is a practical and accessible alternative to laboratory testing of V ˙ O 2 max .

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Why No Support for an Association Between Active Commuting to School and Weight Status in the Literature?

Elling Bere and Lars Bo Andersen