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Rodrigo de M. Baldon, Daniel F.M. Lobato, Leonardo Furlan and Fábio Serrão

The purpose of this study was to compare lower limb kinematics between genders during stair descent. Fifteen females and fifteen males who were healthy and active were included in this study. The lower limb kinematics (pelvis, femur and knee) in the coronal and transversal planes were assessed during stair descent at 30°, 40°, 50° and 60° of knee flexion. The study found that females showed greater knee medial rotation for all the knee flexion angles (P = .02−.001), greater femoral adduction (P = .01 for all variables), with exception for 30° (P = .13), and greater femoral lateral rotation at 60° (P = .04). Females also showed a trend to have greater knee valgus at all the knee flexion angles (P = .06−.11) as well as less contralateral pelvis elevation at 50° and 60° (P = .10 and .12, respectively). This study showed that females carry out the stair descent with a lower limb alignment that might predispose them to develop overuse knee injuries, such as the iliotibial band syndrome and patellofemoral pain syndrome. Further prospective investigations should be carried out to verify whether these variables are factors that could predict these knee injuries.

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Cui Zhang, Qipeng Song, Wei Sun and Yu Liu

descent is more complicated than stair ascent ( Novak, Komisar, Maki, & Fernie, 2016 ). It requires more stability and lower-extremity strength due to the eccentric contraction of the lower-extremity muscle during stair descent ( Iris et al., 2012 ). The anterior–posterior dynamic margin stability of

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Susana Meireles, Neil D. Reeves, Richard K. Jones, Colin R. Smith, Darryl G. Thelen and Ilse Jonkers

compared with level walking. Thus, stair negotiation is particularly demanding for the older adults or subjects with knee osteoarthritis (OA), 6 who often face the first difficulties in daily task performance and pain complaints, 7 particularly during stair descent. 8 However, stair negotiation has not

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Chen Deng, Jason C. Gillette and Timothy R. Derrick

reaction moments. It was hypothesized that increased hip extensor muscle forces required to generate greater hip extensor moments during stair ascent 13 , 14 would cause femoral neck compression stresses to be greater than during stair descent. Methods Seven male (age, 60 [6] y; body mass, 75 [14] kg; and

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Yu-Jen Chen, Irving Scher and Christopher M. Powers

The purpose of this study was to describe an imaging based, subject specific model that was developed to quantify patellofemoral joint reaction forces (PFJRF’s). The secondary purpose was to test the model in a group of healthy individuals while performing various functional tasks. Twenty healthy subjects (10 males, 10 females) were recruited. All participants underwent two phases of data collection: 1) magnetic resonance imaging of the knee, patellofemoral joint, and thigh, and 2) kinematic, kinetic and EMG analysis during walking, running, stair ascent, and stair descent. Using data obtained from MRI, a subject specific representation of the extensor mechanism was created. Individual gait data were used to drive the model (via an optimization routine) and three-dimensional vasti muscle forces and subsequent three-dimensional PFJRF’s were computed. The average peak PFJRF was found to be highest during running (58.2 N/kg-bwt), followed by stair ascent (33.9 N/kg-bwt), stair descent (27.9 N/kg-bwt), and walking (10.1 N/kg-bwt). No differences were found between males and females. For all conditions, the direction of the PFJRF was always in the posterior, superior, and lateral directions. The posterior component of the PFJRF always had the greatest magnitude, followed by superior and lateral components. Our results indicate that estimates of the magnitude and direction of the PFJRF during functional tasks can be obtained using a 3D-imaging based model.

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Isaac Selva Raj, Stephen R. Bird, Ben A. Westfold and Anthony J. Shield

Reliable measures of muscle strength and functional capacity in older adults are essential. The aim of this study was to determine whether coefficients of variation (CVs) of individuals obtained at the first session can infer repeatability of performance in a subsequent session. Forty-eight healthy older adults (mean age 68.6 ± 6.1 years; age range 60–80 years) completed two assessment sessions, and on each occasion undertook: dynamometry for isometric and isokinetic quadriceps strength, 6 meter fast walk (6MFWT), timed up and go (TUG), stair climb and descent, and vertical jump. Significant linear relationships were observed between CVs in session 1 and the percentage difference between sessions 1 and 2 for torque at 60, 120, 240 and 360°/s, 6MFWT, TUG, stair climb, and stair descent. The results of this study could be used to establish criteria for determining an acceptably reliable performance in strength and functional tests.

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Yu-Jen Chen and Christopher M. Powers

The purpose of this study was to determine if persons with patellofemoral pain (PFP) exhibit differences in patellofemoral joint reaction forces (PFJRFs) during functional activities. Forty females (20 PFP, 20 controls) underwent two phases of data collection: (1) magnetic resonance imaging (MRI) and (2) biomechanical analysis during walking, running, stair ascent, and stair descent. A previously described three-dimensional model was used to estimate PFJRFs. Resultant PFJRFs and the orthogonal components were reported. The PFP group demonstrated lower peak resultant PFJRFs and posterior component and superior component of the PFJRFs compared with the control group across all conditions. However, the PFP group had a higher peak lateral component of the PFJRF in three out of the four conditions evaluated. The lower resultant PFJRFs suggested that individuals with PFP may employ strategies to minimize patellofemoral joint loading, but it did not result in diminished lateral forces acting on the patella.

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David Parsons and Wendy Gilleard

Patellofemoral taping is a technique used in the management of patellofemoral pain that has been shown to alter the pattern of muscle activation onset in symptomatic subjects. It is unknown, however, if this taping technique directly influences the patterns of muscle activity that controls patella position or if its benefits are more related to the effect of pain reduction. The purpose of this study was to investigate the effect of a taping technique on the muscle activation onset of selected quadriceps muscles where pain was not a confounding factor. Thirteen asymptomatic subjects completed a stair ascent and descent task with the right patella untaped and taped for a medial patella glide. Muscle activation onset was determined by computer algorithm from surface EMG of vastus lateralis (VL) and vastus medialis obliquus (VMO). Taping significantly delayed the muscle activation onset of VMO and VL during stair ascent. There was no significant change for stair descent. This effect may be an attempt by the motor control system to counter the mechanical effect of patella perturbation or may be due to cutaneous stimulation affecting threshold or recruitment of motor units.

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Vera Moniz-Pereira, Silvia Cabral, Filomena Carnide and António P. Veloso

The purpose of this research was to study the sensitivity of lower limb joint kinematics and kinetics, calculated during different functional tasks (walking, stair descent and stair ascent) in a sample of older adults, to different pose estimation algorithms and models’ joint constraints. Three models were developed and optimized differently: in one model, each segment had 6 degrees of freedom (segment optimization, SO), while in the other two, global optimization (GO) was used, with different joint constraints: (1) GO, allowing all joint rotations; (2) GOR, allowing three rotations at the hip, one at the knee (flexion/extension) and two at the ankle (dorsi/plantar flexion and eversion/inversion). The results showed that joint angles are more sensitive to the model’s constraints than joint moments and, the more restrictive the model, the higher the differences between models, especially for the frontal and transverse planes (max. RMS difference during gait: 11.7 degrees (64%) vs 0.12 N·m/kg (35.4%). In addition, except for knee abduction/adduction angle, differences between SO and GO models were relatively low. Since GO avoids the nonanatomical dislocations sometimes observed in SO, choosing this model seems to be reasonable for future studies with a similar sample and study design.

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Max R. Paquette, Gary Klipple and Songning Zhang

Increased step widths have been shown to reduce peak internal knee abduction moments in healthy individuals but not in knee osteoarthritis patients during stair descent. This study aimed to assess effects of increased step widths on peak knee abduction moments and associated variables in adults with medial knee osteoarthritis and healthy older adults during stair ascent. Thirteen healthy older adults and 13 medial knee osteoarthritis patients performed stair ascent using preferred, wide, and wider step widths. Three-dimensional kinematics and ground reaction forces (GRFs) using an instrumented staircase were collected. Increased step width reduced first and second peak knee abduction moments, and knee abduction moment impulse. In addition, frontal plane GRF at time of first and second peak knee abduction moment and lateral trunk lean at time of first peak knee abduction moment were reduced with increased step width during stair ascent in both groups. Knee abduction moment variables were not different between knee osteoarthritis patients and healthy controls. Our findings suggest that increasing step width may be an effective simple gait alteration to reduce knee abduction moment variables in both knee osteoarthritis and healthy adults during stair ascent. However, long term effects of increasing step width during stair ascent in knee osteoarthritis and healthy adults remain unknown.