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Thomas G. Almonroeder, Emily Watkins, and Tricia Widenhoefer

instructions, such as those utilized by exercise professionals, influence patellofemoral joint loading during bodyweight squatting. Verbal instructions regarding exercise technique can be slightly modified to promote either an internal focus of attention (FoAin) or an external focus of attention (FoAex). 17

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Abbigail Ristow, Matthew Besch, Drew Rutherford, and Thomas W. Kernozek

(PFJCA), 4 and abnormal joint loading. 3 PFJS is calculated from PFJRF and PFJCA. 6 Commonly, PFJS is higher in females due to less PFJCA when compared with males. 7 Many variables contribute to increased PFJS, including trauma, overuse, lower-extremity malalignment, muscle imbalance, muscle weakness

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Kyoungyoun Park-Braswell, Sandra J. Shultz, and Randy J. Schmitz

demonstrated to result in altered brain activation patterns during lower leg movement tasks. 6 This may indicate possible neuroplasticity in response to sensory alteration from the joint. It is understood that mechanoreceptors in the ACL respond to anterior knee joint loading. 4 Neuroimaging techniques such

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Joseph Hannon, J. Craig Garrison, Sharon Wang-Price, Shiho Goto, Angellyn Grondin, James Bothwell, and Curtis Bush

Joint loading following anterior cruciate ligament reconstruction (ACL-R) continues to be a topic of interest among researchers, because altered joint loading can contribute to compensatory movements, commonly seen in this patient population. Joint loading has been examined using a variety of

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Rebecca L. Lambach, Jay W. Young, David C. Flanigan, Robert A. Siston, and Ajit M.W. Chaudhari

Linemen are at high risk for knee cartilage injuries and osteoarthritis. High-intensity movements from squatting positions (eg, 3-point stance) may produce high joint loads, increasing the risk for cartilage damage. We hypothesized that knee moments and joint reaction forces during lineman-specific activities would be greater than during walking or jogging. Data were collected using standard motion analysis techniques. Fifteen NCAA linemen (mean ± SD: height = 1.86 ± 0.07 m, mass = 121.45 ± 12.78 kg) walked, jogged, and performed 3 unloaded lineman-specific blocking movements from a 3-point stance. External 3-dimensional knee moments and joint reaction forces were calculated using inverse dynamics equations. MANOVA with subsequent univariate ANOVA and post hoc Tukey comparisons were used to determine differences in peak kinetic variables and the flexion angles at which they occurred. All peak moments and joint reaction forces were significantly higher during jogging than during all blocking drills (all P < .001). Peak moments occurred at average knee flexion angles > 70° during blocking versus < 44° in walking or jogging. The magnitude of moments and joint reaction forces when initiating movement from a 3-point stance do not appear to increase risk for cartilage damage, but the high flexion angles at which they occur may increase risk on the posterior femoral condyles.

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Miriam Klous, Erich Müller, and Hermann Schwameder

Limited data exists on knee biomechanics in alpine ski turns despite the high rate of injuries associated with this maneuver. The purpose of the current study was to compare knee joint loading between a carved and a skidded ski turn and between the inner and outer leg. Kinetic data were collected using Kistler mobile force plates. Kinematic data were collected with five synchronized, panning, tilting, and zooming cameras. Inertial properties of the segments were calculated using an extended version of the Yeadon model. Knee joint forces and moments were calculated using inverse dynamics analysis. The obtained results indicate that knee joint loading in carving is not consistently greater than knee joint loading in skidding. In addition, knee joint loading at the outer leg is not always greater than at the inner leg. Differentiation is required between forces and moments, the direction of the forces and moments, and the phase of the turn that is considered. Even though the authors believe that the analyzed turns are representative, results have to be interpreted with caution due to the small sample size.

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Andrea Biscarini

We have developed a 2-D analytical biomechanical model for monoarticular open kinetic-chain exercises with lever selectorized equipment, and different relative placement between the joint center of rotation (J) and the center of rotation (C) of the resistance input lever (“off-center” exercises). All the relevant geometrical aspects of such exercises have been characterized: the change with the joint angle of the distance between the resistance pad (P) and J, and of the angle between CP and JP (i.e., the angle between the resistance input lever and the exercising limb). These changes may strongly affect the joint load and the muscle torque in inverse dynamic problems, given the joint kinematics and the mass of the selected weight stack. Therefore, the muscle torque, the shear and axial components of the joint load have been calculated analytically as a function of the relative positioning of C and J, and the length CP, in addition to the parameters that define the joint kinematics, the equipment mechanics, and the external load. From these results we have derived the optimal cam profiles for “off-center” exercises, as well as the geometrical “off-center” setting that minimizes the shear component of the tibiofemoral joint load in leg extension equipment.

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Stefan M. Gabriel, Anton G. Clifford, William J. Maloney, Mary K. O’Connell, and Paul Tornetta III

Medial knee osteoarthritis (OA) is a common disorder often associated with pathologic joint loading. Insoles, braces, and high tibial osteotomy are OA treatments aimed at reducing medial joint loads, but their use and effectiveness are limited. The KineSpring System implant also intends to reduce knee loads in OA patients while overcoming those limitations. The current study was undertaken to test the implant’s effect on loads at the knee. Six cadaver knees with Outerbridge Grade I-II medial OA were subjected to simulated gait using a kinematic test system. Knees were tested with and without the medial knee implant while thin film sensors measured medial and lateral femorotibial contact pressures. Significant medial compartment load reductions (134 ± 53 N [P = .002]) were found throughout the stance phase of gait in the treated knee. Significant total joint load decreases (91 ± 40 N [P = .002]) were also observed without substantial changes in lateral compartment loads. These significant reductions of medial and total intra-articular loads are also within clinically effective ranges of other unloading systems. This suggests that the KineSpring System could be a viable treatment for medial knee OA.

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Andrea Biscarini, Fabio M. Botti, and Vito E. Pettorossi

We developed a biomechanical model to determine the joint torques and loadings during squatting with a backward/forward-inclined Smith machine. The Smith squat allows a large variety of body positioning (trunk tilt, foot placement, combinations of joint angles) and easy control of weight distribution between forefoot and heel. These distinctive aspects of the exercise can be managed concurrently with the equipment inclination selected to unload specific joint structures while activating specific muscle groups. A backward (forward) equipment inclination decreases (increases) knee torque, and compressive tibiofemoral and patellofemoral forces, while enhances (depresses) hip and lumbosacral torques. For small knee flexion angles, the strain-force on the posterior cruciate ligament increases (decreases) with a backward (forward) equipment inclination, whereas for large knee flexion angles, this behavior is reversed. In the 0 to 60 degree range of knee flexion angles, loads on both cruciate ligaments may be simultaneously suppressed by a 30 degree backward equipment inclination and selecting, for each value of the knee angle, specific pairs of ankle and hip angles. The anterior cruciate ligament is safely maintained unloaded by squatting with backward equipment inclination and uniform/forward foot weight distribution. The conditions for the development of anterior cruciate ligament strain forces are clearly explained.

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Michael A. Hunt, Christopher K. Cochrane, Andrew M. Schmidt, Honglin Zhang, David J. Stockton, Alec H. Black, and David R. Wilson

within the tibiofemoral joint, there is a need for further assessment of the tibiofemoral joint loading in the presence of altered lower limb orientations. In addition to the magnitude of loading, the location of load transmission is also important to consider. Using a cadaveric model, Yazdi et al 23