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The execution strategy of technical dance movements is constrained by aesthetic and qualitative artistic requirements. As such, there are limited leap-landing strategies that may be used by dancers when executing a grand jeté or saut de chat. The purpose of this study was to determine potential differences in lower extremity angular positioning and joint loading when performing a dance-style leap landing. Fifteen female dancers (age: 20 ± 1 years; height: 1.61 ± 0.13 m; weight: 58.00 ± 11.89 kg) completed six leap-landing trials during which three-dimensional kinematics and kinetics data were collected. Paired-samples t-tests (α = 0.05) and Cohen's d effect sizes (ES; large ≥ 0.8) were used to compare the following variables: jump height; peak vertical ground reaction force; loading time; loading rate; joint angular positioning of the ankle, knee, hip, and trunk in the frontal and sagittal planes; and joint angular impulse of the ankle, knee, and hip in the frontal and sagittal planes between the dominant and non-dominant limbs. Frontal plane hip angular impulse was significantly greater in the dominant limb (p = 0.023, ES = 1.53). While no other statistically significant differences were observed between dominant and non-dominant limbs, moderate effect sizes were observed for the hip and trunk angles in the frontal plane along with hip impulse in the sagittal plane. This study indicates that dancers might slightly alter their landing strategy at the hip joint when leap-landing onto the dominant limb. Frontal plane hip mechanics should be considered to minimize overuse injury potential in the dominant limb.

Research has identified an increased risk of lower extremity injury postconcussion, which may be due to aberrant biomechanics during dynamic tasks. The purpose of this study was to compare the drop landing biomechanics between individuals with and without a concussion history. Twenty-five individuals with and 25 without a concussion history were matched on age (±3 y), sex, and body mass index (±1 kg/m2). Three-dimensional landing biomechanics were recorded to obtain dependent variables (peak vertical ground reaction force, loading rate, knee flexion angle and external moment, knee abduction angle and external moment, and knee flexion and abduction angle at ground contact). A 1-way multivariate analysis of variance compared outcomes between groups. There was no difference in drop landing biomechanics between individuals with and without a concussion history (F10,39 = 0.460, P = .877, Wilk Λ = .918). There was an effect of time since concussion on knee flexion characteristics. Time since most recent concussion explained a significant amount of variation in both peak (ΔR2 = .177, β = −0.305, ΔP = .046) and initial ground contact (ΔR2 = .292, β = −0.204, ΔP = .008) knee flexion angle after covarying for sex and body mass index. Therefore, time since concussion should be considered when evaluating biomechanical patterns.

BACKGROUND Given that elevated vertical ground reaction forces (vGRF) have been reported to contribute to various lower-extremity injuries, there is a need for a practical method to characterize movement behavior that is representative of elevated impact forces. RESEARCH QUESTION Can images obtained from 2D video be used to predict vGRF parameters during athletic tasks? Specifically, we sought to determine whether the 2D thigh angle obtained at peak knee flexion could be used to predict the peak vGRF and vGRF impulse during single limb and double limb landings and movements that involve a change of direction. METHODS 2D sagittal plane video and vGRFs were obtained simultaneously from 39 participants (15 males and 24 females) during 5 athletic tasks (drop jump, lateral shuffle, deceleration, triple hop, side-step-cut). Linear regression analysis was performed to determine if the 2D thigh angle at peak knee flexion predicted the first peak of the vGRF and vGRF impulse during the deceleration phase of each task. RESULTS The 2D thigh angle predicted the peak vGRF for all tasks except cutting (R2 = 0.17 to 0.47, all p < 0.01). However, the 2D thigh angle predicted the vGRF impulse for all 5 tasks (R2 = 0.13 to 0.39, all p < 0.025). SIGNIFICANCE An increased 2D thigh angle (which is representative of increased hip and knee flexion) was able to predict lower peak vGRFs and vGRF impulse during athletic tasks. The 2D thigh angle is a potential clinical method to characterize movement behavior that may expose individuals to high impact forces.

To investigate the efficacy of two 'NetballSmart', netball specific warm-ups in improving landing technique measures in New Zealand secondary school netball players.Multi-site cluster experimental trial.77 youth participants, mean ± SD age = 15.8 ± 0.9 were recruited from secondary school netball teams.12 teams from 6 schools performed either the NetballSmart Dynamic Warm-up (NSDW) (n = 37); or Power warm-up (PWU) (n = 40), three times a week for 12 weeks. All players within a school (2 teams) were assigned the same warm-up, avoiding treatment contamination.A series of unilateral and bilateral drop vertical jumps on to a portable force plate were completed by all participants. Measures included peak vertical ground reaction force (GRF) for single-leg and bilateral landings; frontal plane projection angle (FPPA) for right and left single-leg landings and Landing error scoring system (LESS) for bilateral landings. Paired t-tests were used to assess mean differences pre and post the warm-up. Generalised linear mixed effects models were developed to evaluate the effects between the NSDW and PWU groups.Significant improvements were found in all the landing technique outcome measures for both warm-up groups (ES Range- GRF = -0.6 to -1.1; FPPA = 0.8 to 1.2; LESS = -1.6 to-3.2; p 0.05). Results of mixed effects models revealed that there was only a significantly greater improvement in LESS for the PWU group (β = -0.30, p = 0.001).Results show both warm-ups can improve landing technique measures in youth secondary school netball players. It is recommended that coaches should consider implementing one of the two warm-ups in their netball programmes. Their choice of warm-up will likely be dependent on their environment and time demands.

This study aimed to evaluate changes in the vertical and fore-aft force generation of the hindlimbs in dogs with stifle orthoses. Custom-made orthoses were used on the right stifle joint. Force plate and marker data from four beagle dogs in trials without orthoses, with fixed orthoses, and with unfixed orthoses were collected. The vertical ground reaction force of the right side was increased with fixed orthoses and decreased with unfixed orthoses compared to that of gait without orthoses. When compared to that of gait without orthoses, the fore-aft ground reaction force changed with fixed orthoses but not with unfixed orthoses. It is suggested that the level of constraint of the orthosis affected the ground reaction force pattern.

Purpose History of an anterior cruciate ligament reconstruction (ACLR) and high body mass index (BMI) are strong independent risk factors for knee osteoarthritis (KOA) onset. The combination of these risk factors may further negatively affect joint loading and KOA risk. We sought to determine the combined influence of BMI and ACLR on walking speed and gait biomechanics that are hypothesized to influence KOA onset. Methods Walking speed and gait biomechanics (peak vertical ground reaction force [vGRF], peak vGRF instantaneous loading rate [vGRF-LR], peak knee flexion angle, knee flexion excursion [KFE], peak internal knee extension moment [KEM], and peak internal knee abduction moment [KAM]) were collected in 196 individuals with unilateral ACLR and 106 uninjured controls. KFE was measured throughout stance phase, whereas all other gait biomechanics were analyzed during the first 50% of stance phase. A 2 × 2 ANOVA was performed to evaluate the interaction between BMI and ACLR and main effects for both BMI and ACLR on walking speed and gait biomechanics between four cohorts (high BMI ACLR, normal BMI ACLR, high BMI controls, and normal BMI controls). Results History of an ACLR and high BMI influenced slower walking speed (F1,298 = 7.34, P = 0.007), and history of an ACLR and normal BMI influenced greater peak vGRF-LR (F1,298 = 6.56, P = 0.011). When evaluating main effects, individuals with an ACLR demonstrated lesser KFE (F1,298 = 7.85, P = 0.005) and lesser peak KEM (F1,298 = 6.31, P = 0.013), and individuals with high BMI demonstrated lesser peak KAM (F1,297 = 5.83, P = 0.016). Conclusion BMI and history of ACLR together influence walking speed and peak vGRF-LR. History of an ACLR influences KFE and peak KEM, whereas BMI influences peak KAM. BMI may need to be considered when designing interventions aimed at restoring gait biomechanics post-ACLR.

Anterior cruciate ligament reconstruction (ACLR) incurs a high risk of posttraumatic knee osteoarthritis (PTOA). Aberrant gait biomechanics contribute to PTOA and are attributable in part to quadriceps dysfunction. Vibration improves quadriceps function following ACLR, but its effects on gait biomechanics are unknown. The purpose of this study was to evaluate the effects of whole-body vibration (WBV) and local muscle vibration (LMV) on gait biomechanics in individuals with ACLR. Seventy-five volunteers (time since ACLR 27 ± 16 months) were randomized to WBV, LMV, or Control interventions. Walking biomechanics were assessed prior to and following a single exposure to the interventions. Outcomes included pre-post change scores in the ACLR limb for the peak vertical ground reaction force (vGRF) and its loading rate, peak internal knee extension (KEM) and abduction moments, and peak knee flexion and varus angles. LMV produced a significant decrease in the vGRF loading rate (-3.6 BW/s) that was greater than the changes in the WBV (-0.3 BW/s) and Control (0.5 BW/s) groups. Additionally, WBV produced an increase in the peak KEM (0.27% BW × Ht) that was greater than the change in the Control group (-0.17% BW × Ht) but not the LMV group (0.01% BW × Ht). Lower KEM and greater loading rates have been linked to declines in joint health following ACLR. WBV acutely increased the peak KEM and LMV decreased loading rates. These data suggest that vibration has the potential to mitigate aberrant gait biomechanics, and may represent an effective approach for reducing PTOA risk following ACLR.

Purpose Peak vertical ground reaction force and linear loading rate can be valuable metrics for return-to-sport assessment because they represent limb loading dynamics; yet, there is no defined cutoff criterion to differentiate between healthy and altered limb loading. Studies have shown that healthy individuals exhibit strong first-order relationships between gait variables whereas individuals with pathological conditions did not. Thus, this study sought to explore and exploit this first-order relationship to define a region of healthy limb dynamics, which individuals with pathological conditions would reside outside of, to rapidly assess individuals with altered limb loading dynamics for return to sport. We hypothesized that there would be a strong first-order linear relationship between vertical ground reaction force peak force and linear loading rate in healthy controls' limbs, which could be exploited to identify abnormal limb loading dynamics in post-anterior cruciate ligament reconstruction (ACLR) individuals. Methods Thirty-one post-ACLR individuals and 31 healthy controls performed a running protocol. A first-order regression analysis modeled the relationship between peak vertical ground reaction forces and linear vertical ground reaction force loading rate in the healthy control limbs to define a region of healthy dynamics to evaluate post-ACLR reconstructed limb dynamics. Results A first-order regression model aided in the determination of cutoff criteria to define a region of healthy limb dynamics. Ninety percent of the post-ACLR reconstructed limbs exhibited abnormal limb dynamics based on their location outside of the region of healthy dynamics. Conclusion This approach successfully delineated between healthy and abnormal limb loadings dynamics in controls and post-ACLR individuals. The findings demonstrate how force and loading rate-dependent metrics can help develop criteria for individualized post-ACLR return-to-sport assessment.

Background Better midsole materials and comfort have been incorporated into more expensive shoes and are popular with runners. Consequently, knockoff running shoes are currently widely distributed in the Chinese market and and cost only 30%–50% of the total price of genuine branded products. Research question Uncertainty exists concerning the beneficial effects of advanced shoe material application in decreasing foot loading or impact force during running. Additionally, using comfort as a criterion to identify genuine branded running shoes may exclude brand factor. Methods Fifteen healthy male volunteers were asked to perform two different tests, including running and a comfort evaluation. Each participant was asked to identify which footwear was the Adidas brand shoe based on their perception of comfort. Results Time to the first peak of the vertical ground reaction force occurred significantly later when subjects wore the genuine branded shoe compared to knockoff shoe 1 (p = 0.003) and knockoff shoe 2 (p = 0.015) footwea. The genuine branded shoe (p = 0.005) and knockoff shoe 1 (p = 0.029) were significantly more comfortable compared to the knockoff shoe 2. Only four subjects selected the genuine branded shoe, whereas six subjects selected both the genuine branded shoe and knockoff shoe 1. Significance Knockoff running footwear significantly increases impact loading compared to the genuine branded product, thereby posing greater risk of running injury.

we determined the metabolic and biomechanical effects of adding mass to the running-specific prosthesis (RSP) and biological foot of individuals with a unilateral transtibial amputation (TTA) during running.10 individuals (8 males, 2 females) with a TTA ran on a force-measuring treadmill at 2.5 m/s with 100 g and 300 g added to their RSP alone or to their RSP and biological foot while we measured their metabolic rates and calculated peak vertical ground reaction force (vGRF), stance-average vGRF, and step time symmetry indices.for every 100 g added to the RSP alone, metabolic power increased by 0.86% (p = 0.007) and for every 100 g added to the RSP and biological foot, metabolic power increased by 1.74% ([Formula: see text] 0.001) during running. Adding mass had no effect on peak vGRF (p = 0.102), stance-average vGRF (p = 0.675), or step time (p = 0.413) symmetry indices. We also found that the swing time of the affected leg was shorter than the unaffected leg across conditions ([Formula: see text] 0.007).adding mass to the lower limbs of runners with a TTA increased metabolic power by more than what has been reported for those without an amputation. We found no effect of added mass on biomechanical asymmetry, but the affected leg had consistently shorter swing times than the unaffected leg. This suggests that individuals with a TTA maintain asymmetries despite changes in RSP mass and that lightweight prostheses could improve performance by minimizing metabolic power without affecting asymmetry.

The purpose of the present study was to analyse vertical ground reaction force (Fz) and oxygen uptake (VO2) responses in six different water-based exercises performed at different cadences by postm...

Objectives To explore the practicality of using functional principal components analysis (fPCA) and intra-athlete z-score changes for individual athlete monitoring post-ACL injury and surgery. Design A single athlete case study using within-athlete repeated measures in the context of applied athlete monitoring. Methods Using single leg (left) drop landing (3 landings per session) onto a force plate, the athlete completed 6 sessions prior (healthy) and 3 sessions post-ACL injury/surgery. Maximum vertical ground reaction force (vGRF), time to stabilisation (TTS) and outputs from fPCA (fPC scores) for the healthy sessions were used to develop intra-athlete means and standard deviations for each variable. Post-surgery measures were given z-scores relative to the healthy mean and standard deviation for each variable. The standard normal deviate (z = 1.96) was used as a threshold to flag landings that could be indicative of changes in movement behaviour. Results Maximum vGRF revealed no post-surgery trials that exceeded the standard normal deviate threshold based on the healthy data. TTS identified one landing post-surgery that exceeded the threshold. Scores for fPC2, fPC3 and fPC4 revealed landings that exceeded the threshold, with fPC4 demonstrating landings greater than the threshold for every trial (except two) post-surgery. Conclusions Including fPCA identified significant and stable changes to the landing strategy (particularly within fPC4). When used in conjunction with other measures such as maximum vGRF and TTS, fPCA has the potential to provide meaningful insights into athlete monitoring models regarding changes to movement characteristics after injury.

Background: An extraordinary long-term running performance may benefit from low dynamic loads and a high load-bearing tolerance. An extraordinary runner (age = 55 years, height = 1.81 m, mass = 92 kg) scheduled a marathon a day for 100 consecutive days. His running biomechanics and bone density were investigated to better understand successful long-term running in the master athlete. Methods: Overground running gait analysis and bone densitometry were conducted before the marathon-a-day challenge and near its completion. The case’s running biomechanics were compared pre-challenge to 31 runners who were matched by a similar foot strike pattern. Results: The case’s peak vertical loading rate (∆x̄ = -61.9 BW/s or -57%), peak vertical ground reaction force (Dx̄ = -0.38 BW or -15%), and peak braking force (∆x̄ = -0.118 BW or -31%) were remarkably lower (p < 0.05) than the control group at »3.3 m/s. The relatively low loading-related magnitudes were attributed to a remarkably high duty factor (0.41) at the evaluated speed. The foot strike angle of the marathoner (29.5°) was greater than that of the control group, affecting the peak vertical loading rate. Muscle powers in the lower extremity were also remarkably low in the case vs. controls: peak power of knee absorption (∆x̄ = -9.16 W/kg or -48%) and ankle generation (∆x̄ = -3.17 W/kg or -30%). The bone mineral density increased to 1.245 g/cm2 (+2.98%) near completion of the challenge, whereas the force characteristics showed no statistically significant change. Conclusion: The remarkable pattern of the high-mileage runner may be useful in developing or evaluating load-shifting strategies in distance running.

Purpose To compare gait biomechanics throughout stance phase 6 and 12 months after unilateral anterior cruciate ligament reconstruction (ACLR) between ACLR and contralateral limbs and compared with controls. Methods Vertical ground reaction force (vGRF), knee flexion angle (KFA), and internal knee extension moment (KEM) were collected bilaterally 6 and 12 months post-ACLR in 30 individuals (50% female, 22 ± 3 yr, body mass index = 23.8 ± 2.2 kg·m) and at a single time point in 30 matched uninjured controls (50% female, 22 ± 4 yr, body mass index = 23.6 ± 2.1 kg·m). Functional analyses of variance were used to evaluate the effects of limb (ACLR, contralateral, and control) and time (6 and 12 months) on biomechanical outcomes throughout stance. Results Compared with the uninjured controls, the ACLR group demonstrated bilaterally lesser vGRF (ACLR, 9% body weight [BW]; contralateral, 4%BW) during early stance and greater vGRF during midstance (ACLR, 5%BW; contralateral, 4%BW) 6 months post-ACLR. Compared to the uninjured controls, the ACLR group demonstrated bilaterally lesser vGRF (ACLR, 10%BW; contralateral, 8%BW) during early stance and greater vGRF during midstance (ACLR, 5%BW; contralateral, 5%BW) 12 months post-ACLR. Compared with controls, the ACLR limb demonstrated lesser KFA during early stance at 6 (2.3°) and 12 months post-ACLR (2.0°), and the contralateral limb demonstrated lesser KFA during early stance at 12 months post-ACLR (2.8°). Compared with controls, the ACLR limb demonstrated lesser KEM during early stance at both 6 months (0.011BW × height) and 12 months (0.007BW × height) post-ACLR, and the contralateral limb demonstrated lesser KEM during early stance only at 12 months (0.006BW × height). Conclusions Walking biomechanics are altered bilaterally after ACLR. During the first 12 months post-ACLR, both the ACLR and contralateral limbs demonstrate biomechanical differences compared with control limbs. Differences between the contralateral and control limbs increase from 6 to 12 months post-ACLR.

Context: High vertical ground reaction force (vGRF) when initiating ground contact during jump landing is one biomechanical factor that may increase risk of anterior cruciate ligament injury. Intervention programs have been developed to decrease vGRF to reduce injury risk, yet generating high forces is still critical for performing dynamic activities such as a vertical jump task. Objective: To evaluate if a jump-landing feedback intervention, cueing a decrease in vGRF, would impair vertical jump performance in a separate task (Vertmax). Design: Randomized controlled trial. Patients (or Other Participants): Forty-eight recreationally active females (feedback: n = 31; 19.63 [1.54] y, 1.6 [0.08] cm, 58.13 [7.84] kg and control: n = 15; 19.6 [1.68] y, 1.64 [0.05] cm, 60.11 [8.36] kg) participated in this study. Intervention: Peak vGRF during a jump landing and Vertmax were recorded at baseline and 4 weeks post. The feedback group participated in 12 sessions over the 4-week period consisting of feedback provided for 6 sets of 6 jumps off a 30-cm box. The control group was instructed to return to the lab 28 days following the baseline measurements. Main Outcome Measures: Change scores (postbaseline) were calculated for peak vGRF and Vertmax. Group differences were evaluated for peak vGRF and Vertmax using a Mann–Whitney U test (P Results: There were no significant differences between groups at baseline (P > .05). The feedback group (−0.5 [0.3] N/kg) demonstrated a greater decrease in vGRF compared with the control group (0.01 [0.3] N/kg) (t(46) = −5.52, P max between groups (feedback = 0.9 [2.2] cm, control = 0.06 [2.1] cm; t(46) = 0.46, P = .64). Conclusions: While the feedback intervention was effective in decreasing vGRF when landing from a jump, these participants did not demonstrate changes in vertical jump performance when assessed during a different task. Practitioners should consider implementing feedback intervention programs to reduce peak vGRF, without worry of diminished vertical jump performance.

Background The utilized coefficient of friction (uCOF) and the risk of slipping are known to increase as the heel height of shoes increases. The heel base area of shoes can also affect the uCOF. Objective The purpose of this study is to investigate the effect of the heel base area of high heels and walking speed on the uCOF during walking and their interaction effect. Methods The walking experiment was conducted at the speed of 1.0 m/s and 1.25 m/s using four 9-cm high heels having different heel areas (narrow, moderate, wide, and wedge heels). Results The peak uCOF was significantly lower when wearing the wide heels than when wearing the other heels. Wearing the narrow and moderate heels reduced the vertical ground reaction force (GRF) owing to the early timing of the peak anterior-posterior GRF and increased the peak uCOF. As the walking speed became faster, the peak uCOF became greater with more increases by the interaction effect when wearing the narrow and moderate heels than when wearing the wide and wedge heels. Conclusions These results imply that wearing narrow high heels should be considered carefully, as the potential for a slip could be high owing to the increase in the peak uCOF. If it is inevitable to wear narrow high heels, it is critical to walk at a slower speed than usual. It is better to wear high heels with a wide heel area, e.g., 3 cm*3 cm, rather than narrow high heels or even wedge heels to reduce the possibility of slipping.

Krajewski, K, LeFavi, R, and Riemann, B. A biomechanical analysis of the effects of bouncing the barbell in the conventional deadlift. J Strength Cond Res 33(7S): S70-S77, 2019-The purpose of this study is to analyze biomechanical differences between the bounce and pause styles of deadlifting. Twenty physically active males performed deadlifts at their 75% one-repetition maximum testing using both pause and bounce techniques in a within-subjects randomized study design. The average peak height the barbell attained from the 3 bounce style repetitions was used to compute a compatible phase for analysis of the pause style repetitions. Net joint moment impulse (NJMI), work, average vertical ground reaction force (vGRF), vGRF impulse, and phase time were computed for 2 phases, liftoff to peak barbell height and the entire ascent. Additionally, the ankle, knee, hip, and trunk angles at the location of peak barbell bounce height were computed. During the liftoff to peak barbell height phase, although each of the joints demonstrated significantly less NJMI and work during the bounce style, the hip joint was impacted the most. The average vGRF was greater for the bounce; however, the vGRF impulse was greater for the pause. The NJMI results for the ascent phase were similar to the liftoff to peak barbell height phase, whereas work was significantly less for the bounce condition compared with the pause condition across all 3 joints. Strength and conditioning specialists using the deadlift should be aware that the bounce technique does not allow the athlete to develop maximal force production in the early portion of the lift. Further analyses should focus on joint angles and potential vulnerability to injury when the barbell momentum generated from the bounce is lost.

Highlights • Forefoot strike gait retraining reduced load rates 3 times more than increased cadence. • Increased cadence gait retraining resulted in small load rate reductions. • Reduced load rates with forefoot strike gait persisted for 6 months. • Clinicians should incorporate a pre-gait retraining strengthening program. • Encourage patients to use a slow transition once gait retraining is completed., Background Excessive vertical impacts at landing are associated with common running injuries. Two primary gait-retraining interventions aimed at reducing impact forces are transition to forefoot strike and increasing cadence. The objective of this study was to compare the short- and long-term effects of 2 gait-retraining interventions aimed at reducing landing impacts. Methods A total of 39 healthy recreational runners using a rearfoot strike and a cadence of ≤170 steps/min were randomized into cadence (CAD) or forefoot strike (FFS) groups. All participants performed 4 weeks of strengthening followed by 8 sessions of gait-retraining using auditory feedback. Vertical average load rates (VALR) and vertical instantaneous load rates (VILR) were calculated from the vertical ground reaction force curve. Both cadence and foot strike angle were measured using 3D motion analysis and an instrumented treadmill at baseline and at 1 week, 1 month, and 6 months post retraining. Results ANOVA revealed that the FFS group had significant reductions in VALR (49.7%) and VILR (41.7%), and changes were maintained long term. Foot strike angle in the FFS group changed from 14.2° dorsiflexion at baseline to 3.4° plantarflexion, with changes maintained long term. The CAD group exhibited significant reduction only in VALR (16%) and only at 6 months. Both groups had significant and similar increases in cadence at all follow-ups (CAD, +7.2% to 173 steps/min; and FFS, +6.1% to 172 steps/min). Conclusion Forefoot strike gait-retraining resulted in significantly greater reductions in VALR and similar increases in cadence compared to cadence gait-retraining in the short and long term. Cadence gait-retraining resulted in small reductions in VALR at only the 6-month follow-up., Graphical abstract Image, graphical abstract

OBJECTIVE: To compare sagittal walking gait biomechanics between participants with knee osteoarthritis (KOA) who increased quadriceps strength following a lower-extremity strengthening intervention (responders) and those who did not increase strength following the same strengthening protocol (non-responders) both at baseline and following the lower extremity strengthening protocol. DESIGN: Fifty-three participants with radiographic KOA (47% female, 62.3±7.1 years, BMI = 28.5±3.9 kg/m(2)) were enrolled in 10 sessions of lower extremity strengthening over a 28-day period. Maximum isometric quadriceps strength and walking gait biomechanics were collected on the involved limb at baseline and 4-weeks following the strengthening intervention. Responders were classified as individuals who increased quadriceps strength greater than the upper limit of the 95% confidence interval for the minimal detectable change in quadriceps strength (29 Nm) determined in a previous study. 2 × 2 functional analyses of variance were used to evaluate the effects of group (responders and non-responders) and time (baseline and 4-weeks) on time-normalized waveforms for knee flexion angle, vertical ground reaction force (vGRF), and internal knee extension moment. RESULTS: A significant group x time interaction for knee flexion angle demonstrated greater knee flexion angle in the first half of stance at baseline and greater knee extension in the second half of stance at 4-weeks in responders compared to non-responders. There was no significant group x time interaction for vGRF or internal knee extension moment. CONCLUSIONS: Quadriceps strengthening may be used to stimulate small changes in knee flexion angle in individuals with KOA.

Although athletes with unilateral below-the-knee amputations (BKAs) generally use their affected leg, including their prosthesis, as their take-off leg for the long jump, little is known about the spring-like leg behavior and stiffness regulation of the affected leg. The purpose of this study was to investigate vertical stiffness during one-legged hopping in an elite-level long jump athlete with a unilateral BKA. We used the spring-mass model to calculate vertical stiffness, which equals the ratio of maximum vertical ground reaction force to maximum center of mass displacement, while the athlete with a BKA hopped on one leg at a range of frequencies. Then, we compared the vertical stiffness of this athlete to seven non-amputee elite-level long-jumpers. We found that from 1.8 to 3.4 Hz, the vertical stiffness of the unaffected leg for an athlete with a BKA increases with faster hopping frequencies, but the vertical stiffness of the affected leg remains nearly constant across frequencies. The athlete with a BKA attained the desired hopping frequencies at 2.2 and 2.6 Hz, but was unable to match the lowest (1.8 Hz) and two highest frequencies (3.0 and 3.4 Hz) using his affected leg. We also found that at 2.5 Hz, unaffected leg vertical stiffness was 15% greater than affected leg vertical stiffness, and the vertical stiffness of non-amputee long-jumpers was 32% greater than the affected leg vertical stiffness of an athlete with a BKA. The results of the present study suggest that the vertical stiffness regulation strategy of an athlete with a unilateral BKA is not the same in the unaffected versus affected legs, and compared to non-amputees.

PURPOSE Strategies that underload the surgical limb after anterior cruciate ligament reconstruction (ACLr) are observed in submaximal tasks. It is not known what underlies these strategies in early rehabilitation. The purpose of this study was to determine if underloading can be attributed to the inability to meet task demands with and without attention to limb loading or learned behavior. METHODS Twenty individuals (110.6 [18.1] days) post-ACLr and 20 healthy individuals (CTRL) participated in this study. Participants performed standing, sit-to-stand, and squat tasks under natural, instructed, and feedback conditions. Limb-loading symmetry was calculated as the between-limb ratio of vertical ground reaction force impulse during each task. General Linear Model repeated-measures analysis, 2 (group) × 3 (condition), determined the effects of group and condition on limb-loading symmetry for each task. RESULTS Significant interactions were observed for each task (all P < 0.001). Compared with CTRL, ACLr exhibited greater asymmetry during natural (deficits: standing, 10%, P = 0.001; sit-to-stand, 25%, P < 0.001; squat, 15%, P < 0.001) and instructed (deficits: sit-to-stand, 13%, P = 0.001; squat, 8%, P = 0.04), but not feedback conditions. The CTRL maintained symmetry across conditions and tasks. Anterior cruciate ligament reconstruction exhibited greater asymmetry in natural compared with instructed (deficits: standing, 11%, P < 0.001; sit-to-stand, 14%, P < 0.001; squat, 8%, P = 0.001) and feedback (deficits: standing, 10%, P = 0.001; sit-to-stand, 21%, P < 0.001; squat, 15%, P < 0.001) conditions. CONCLUSIONS The presence of loading asymmetries in natural but not feedback conditions indicates that individuals 3 months post-ACLr shift loading away from surgical limb despite the ability to meet task demands which may be suggestive of nonuse behavior. Even when instructed to load symmetrically, individuals continued to exhibit some degree of asymmetry.

One method to determine the forces produced during running is to conduct extensive kinematic and kinetic analysis. These analyses can be performed by having an individual perform repeated over-ground running trials or simply run continuously on an instrumented treadmill. The forces produced during over-ground running may not be the same as the forces during treadmill running and these differences could be attributed to a number of factors, including the design of the instrumented treadmill. The purpose of this paper was to determine whether there are differences in force measurements on different instrumented treadmill setups in comparison to over-ground running and to correct for any of these differences using a theoretical model. 11 participants ran on three different treadmills and performed over-ground running at 2.7, 3.6, and 4.5 m/s. Ground reaction forces were measured via force plates and an instrumented pressure insole. We found that the magnitude of the vertical ground reaction force differed between the three treadmills and over-ground running. The difference in ground reaction forces estimated by the pressure insole and the treadmill-force-plate system or instrumented treadmill can be explained by a three degree of freedom mechanical model of a person running on a treadmill and this model could potentially be used to correct for errors in force measurement from instrumented treadmills. The model included a force plate, a treadmill, and a wobbling mass with varying natural frequencies and damping characteristics, and constant masses. These findings provide researchers a method to correct forces from an instrumented treadmill set-up to determine a close approximation of the actual forces experienced by a participant during treadmill running.

Carbon fiber running-specific prostheses have allowed lower extremity amputees to participate in running activity by providing spring-like properties in their affected limb. It has been established that as running speed increases, stiffness of the leg spring (leg stiffness; kleg) remains constant in non-amputees. Although a better understanding of kleg regulation may be helpful for the development of spring-based prostheses, little is known about stiffness regulation in unilateral transfemoral amputees. The aim of this study was to investigate stiffness regulation at different running speeds in unilateral transfemoral amputees wearing a running-specific prosthesis. Nine unilateral transfemoral amputees performed running on an instrumented treadmill across a range of speeds (30, 40, 50, 60, and 70% of their maximum running speed). Using a spring-mass model, kleg was calculated as the ratio of maximal vertical ground reaction force to maximum leg compression during the stance phase in both affected and unaffected limbs. We found a decrease in kleg from the slower speed to 70% speed for the affected limb, whereas no change was present in the unaffected limb. Specifically, there was a significant differences in the kleg between 30% and 70%, 40% and 70%, and 50% and 70%, and the magnitude of the kleg difference between affected and unaffected limbs varied with variations in running speeds in unilateral TFAs with an RSP. These results suggest the kleg regulation strategy of unilateral transfemoral amputees is not the same in the affected and unaffected limbs across a range of running speeds.

Background While running, the human body absorbs repetitive shocks with every step. These shocks can be quantified by the peak vertical ground reaction force ( F v , m a x ). To measure so, using a force plate is the gold standard method (GSM), but not always at hand. In this case, a motion capture system might be an alternative if it accurately estimates F v , m a x . Research question The purpose of this study was to estimate F v , m a x based on motion capture data and validate the obtained estimates with force plate-based measures. Methods One hundred and fifteen runners participated at this study and ran at 9, 11, and 13 km/h. Force data (1000 Hz) and whole-body kinematics (200 Hz) were acquired with an instrumented treadmill and an optoelectronic system, respectively. The vertical ground reaction force was reconstructed from either the whole-body center of mass (COM-M) or sacral marker (SACR-M) accelerations, calculated as the second derivative of their respective positions, and further low-pass filtered using several cutoff frequencies (2−20 Hz) and a fourth-order Butterworth filter. Results The most accurate estimations of F v , m a x were obtained using 5 and 4 Hz cutoff frequencies for the filtering of COM and sacral marker accelerations, respectively. GSM, COM-M, and SACR-M were not significantly different at 11 km/h but were at 9 and 13 km/h. The comparison between GSM and COM-M or SACR-M for each speed depicted root mean square error (RMSE) smaller or equal to 0.17BW (≤6.5 %) and no systematic bias at 11 km/h but small systematic biases at 9 and 13 km/h (≤0.09 BW). COM-M gave systematic biases three times smaller than SACR-M and two times smaller RMSE. Significance The findings of this study support the use of either COM-M or SACR-M using data filtered at 5 and 4 Hz, respectively, to estimate F v , m a x during level treadmill runs at endurance speeds.

Summary Objective To compare gait biomechanics 6 months following anterior cruciate ligament (ACL) reconstruction (ACLR) between patients with the highest and lowest concentrations of synovial fluid (SF) interleukin-6 (IL-6) and matrix metalloproteinase-3 (MMP-3), as well as compared to uninjured controls. Design SF concentrations of IL-6 and MMP-3 were collected 7 ± 4 days post injury in 38 ACL injured patients (55% female, 21±4yrs, 25.3 ± 5.2BMI). ACL injured individuals were stratified into the lowest and highest quartiles based on IL-6 (IL-6Lowest and IL-6Highest) and MMP-3 (MMP-3Lowest and MMP-3Highest) concentrations. Gait biomechanics were collected on the injured limb 6 months post-ACLR and in 38 uninjured controls (50% female, 21±3yrs, 23.8 ± 2.8BMI). Functional analyses of variance were used to compare vertical ground reaction force (vGRF), knee flexion angle (KFA), and internal knee extension moment (KEM) waveforms throughout stance phase of gait to determine the proportions of stance differing between limbs and groups. Results Compared to uninjured controls, IL-6High and MMP-3High ACL subgroups demonstrated lesser vGRF (largest differences: IL-6, 7.88%BW; MMP-3, 11.05%BW) during early-stance and greater vGRF (largest differences: IL-6, 6.21%BW; MMP-3, 5.85%BW) in mid-stance, lesser KFA (largest differences: IL-6, 3.11°; MMP-3, 3.72°) and lesser KEM (largest differences: IL-6, 0.96%BW•m; MMP-3, 1.07%BW•m) in early-stance, as well as greater KFA in mid-stance (largest differences: IL-6, 1.5°; MMP-3, 2.95°). Conclusions High SF concentrations of a proinflammatory cytokine and a degradative enzyme early post-ACL injury are associated with aberrant gait biomechanics in the injured limb at 6 months post-ACLR (i.e., lesser vGRF, KFA and KEM) linked to posttraumatic osteoarthritis development.

The purpose of our study was to investigate peak torque (PT) of knee extensors (KE) and knee flexors (KF), bilateral and unilateral strength asymmetries in isokinetic testing and vertical jump height (JH), vertical ground reaction force (VGRF), and force differences (ΔVGRF) between legs during different jump tests in professional first-line firefighters (n = 15) competing in fire sports disciplines. There was a significant effect of jump type on JH (F2,44 = 7.23, p &lt, 0.05), VGRF (F2,44 = 16.03, p &lt, 0.05), and ΔVGRF (F2,44 = 3.45, p &lt, 0.05). Professional firefighters achieved a mean JH of 50.17 cm in the countermovement jump free arms and high PT of KEs (3.15 Nm/kg). No significant differences (p &gt, 0.05) and small effect sizes (d &lt, 0.3) were found between the legs when PTs were assessed. We found a slightly higher (d = 0.53) unilateral strength ratio in non-dominant legs (58.12 ± 10.26%) compared to dominant legs (55.31 ± 7.51%). No effect of laterality was found among limb comparisons, but a higher unilateral isokinetic strength ratio was found in non-dominant legs of firefighters. A high level of strength (PT of KEs &gt, 3 times body weight) and vertical jump performance is comparable to the performance of elite athletic populations.

Although weight transfer is an important component of gait rehabilitation, the biomechanical strategy underlying the vertical ground reaction force loading/unloading in individuals with unilateral transfemoral amputation between intact and prosthetic limbs remains unclear. We investigated weight transfer between limbs at different walking speeds in 15 individuals with unilateral transfemoral amputation and 15 individuals without amputation as controls, who walked on an instrumented treadmill. The normalized unloading and loading rates were calculated as the slope of decay and rise phase of the vertical ground reaction force, respectively. We performed linear regression analyses for trailing limb’s unloading rate and leading limb’s loading rate between the prosthetic, intact, and control limbs. While loading rate increased with walking speed in all three limbs, the greatest increase was observed in the intact limb. In contrast to the other limbs, the prosthetic limb unloading rate was relatively insensitive to speed changes. Consequently, the regression line between trailing prosthetic and leading intact limbs deviated from other relationships. These results suggest that weight transfer is varied whether the leading or trailing limb is the prosthetic or intact side, and the loading rate of the leading limb is partially affected by the unloading rate of the contralateral trailing limb.

Daugherty, HJ, Weiss, LW, Paquette, MR, Powell, DW, and Allison, LE. Potential predictors of vertical jump performance: Lower extremity dimensions and alignment, relative body fat, and kinetic variables. J Strength Cond Res 35(3): 616-625, 2021-The association of structural and kinetic variables with restricted vertical jump (RVJ) displacement without and with added mass was examined in 60 men and women. Added mass (weighted vest) simulated a 5% increase in body fat (BF%). Independent variables included BF%, thigh length, and static Q-angle (Q-angles), and while performing RVJ, different expressions of frontal-plane knee angle (FPKA), dynamic Q-angle (Q-angled), vertical ground reaction force (vGRF), concentric vertical impulse (Iz), concentric rate of force development (CRFD), and vertical power (Pz). Variables having significant (p ≤ 0.05) negative correlations with RVJ displacement included BF% (r = -0.76) and Q-angles (r = -0.55). Those having significant (p ≤ 0.05) positive correlations with RVJ displacement included peak and average concentric Pz (r range = 0.74-0.81), peak and average concentric vGRF (r range = 0.46-0.67), Iz (r range = 0.32-0.54), thigh length (r = 0.31), minimum Q-angled (r = 0.31), and maximum FPKA (r = 0.28). Variables not associated (p0.05) with RVJ displacement included minimum and excursion FPKA (r = 0.11 and 0.23), maximum, excursion, and average Q-angled (r = 0.24, 0.11, and 0.22), and CRFD (r range = 0.19-0.24). A simple regression model predicted RVJ displacement (p = 1.00) for the simulated 5% increase in body fat. To maximize jumping performance, (a) high levels of body fat should be avoided, (b) peak and average Pz, vGRF, and Iz should be maximized through training, and (c) having a lower Q-angles is associated with better jumping ability.

BACKGROUND: Quadriceps strength asymmetry at the time of return-to-sport (RTS) after anterior cruciate ligament reconstruction (ACLR) contributes to altered landing mechanics. However, the impact of RTS quadriceps strength on longitudinal alterations in landing mechanics, a risk factor for poor knee joint health over time, is not understood. The purpose of this study was to test the hypothesis that young athletes with quadriceps strength asymmetry at the time of RTS clearance after ACLR would demonstrate asymmetric landing mechanics 2 years later compared to those without quadriceps strength asymmetry. METHODS: We followed 57 young athletes (age at RTS=17.6±3.0 years; 77% females) with primary, unilateral ACLR for 2 years following RTS clearance. At RTS, we measured isometric quadriceps strength bilaterally and calculated limb-symmetry indices [LSI=(involved/uninvolved)x100%]. Using RTS quadriceps LSI, we divided participants into High-Quadriceps (HQ; LSI≥90%) and Low-Quadriceps (LQ; LSI0.093). CONCLUSION: Young athletes after ACLR with quadriceps strength asymmetry at the time of RTS favored the uninvolved limb during DVJ landing 2 years later. These landing asymmetries may relate to long-term knee joint health after ACLR.

Peak vertical tibial accelerations during running have shown strong correlations with vertical ground reaction force loading rates and some associations with injury. However, little attention has been given to tibial accelerations along the medial–lateral and anterior-posterior axes. Therefore, our purpose was to examine the correlation between peak tibial accelerations and ground reaction force loading rates in the medial–lateral and posterior directions. Eighteen recreational runners were recruited who ran with a rearfoot strike pattern (10 men/ 8 women, mean age (yrs) = 33 ± 11). Tibial accelerations and ground reaction forces were collected while participants ran on an instrumented treadmill at a self-selected speed. Correlations were developed for: a) peak medial and lateral accelerations with lateral and medial loading rates, respectively, b) peak anterior tibial accelerations and posterior loading rates. Significant correlations were found between tibial accelerations and loading rates in all planes. Peak medial tibial accelerations were correlated with lateral loading rates (Rs = 0.86, p

Objectives Impact forces are risk factors for injuries during jump-landing tasks. Rebound shoes could reduce impact forces and show potential applications in training and rehabilitation programs. Here, we determine the capacity of a rebound shoe in attenuating impact forces during different motor tasks involving foot landing. Design Crossover laboratory research design. Settings Women not trained for jump-landing tasks performed different exercises while the vertical ground reaction force impact peak, time to peak, and asymmetries were determined. They were wearing a commercial rebound shoe and a control running shoe. Paired t-tests were used to compare the shoes and asymmetries. Participants Fifteen physically active women (average age of 23 years old, height of 1.64 m, and body mass of 63 kg). Main outcome measures Ground reaction forces. Results The rebound shoe reduced the impact peak force and elicited slight asymmetries between the legs. The rebound shoe also showed a longer time to peak. Conclusions The rebound shoe tested reduced impact forces during jump-landing tasks, which is a potential application in training sessions and rehabilitation programs, requiring lower impact forces to the lower extremity. The effects of long-term use of these shoes still need to be investigated.

Peak tibial accelerations during running are of interest because of their correlation with vertical ground reaction force load rates and association with running injury. Previous work has demonstrated systematically lower accelerations measured with a bone- compared to skin-mounted accelerometer. However, no studies have assessed the effects of more or less secure attachment methods for skin mounted sensors. Our purpose was to compare two methods of attaching a skin mounted sensor on mean tibial accelerations, stride-to-stride variability, and correlations with vertical load rates. 18 injury-free runners were recruited as participants. An inertial measurement unit, containing a tri-axial accelerometer, was used to record tibial accelerations while participants ran at a self-selected speed on an instrumented treadmill to collect ground reaction forces. The two attachment methods for securing the sensor to the skin were a manufacturer-provided strap (strap condition) and a combination of tape and elastic wraps (wrap condition). Mean vertical accelerations were significantly lower in the wrap condition (p = 0.02, d = 0.57). No differences were detected in resultant accelerations, vertical loading rates, or stride-to-stride variability. Correlations between tibial accelerations and vertical loading rates were strong (r = 0.79–0.91) and similar between conditions. These results provide two key findings of evidence. Evidenced by systematically lower vertical accelerations, a more secure attachment method may be necessary for capturing the most representative measure of tibial accelerations during running. However, a less secure method (i.e. the strap) is sufficient for capturing tibial accelerations as a surrogate for impact loading forces.

Background Knee osteoarthritis (OA) is a degenerative joint disease that affects millions of individuals each year. Several biomechanical variables during walking have been identified as risk factors for developing knee OA, including the peak external knee adduction moment (KAM) and the knee flexion angle at initial contact. Many interventions have been studied to help mitigate these risk factors, including footwear. However, it is largely unknown how varying shoe cushioning may affect walking biomechanics related to knee OA risk. Research Question What is the effect of maximally and minimally cushioned shoes on walking biomechanics compared to a traditionally cushioned shoe in older females? Methods Walking biomechanics in three shoes (maximal, traditional, minimal) were collected on 16 healthy females ages 50–70 using an 8-camera 3D motion capture system and two embedded force plates. Key biomechanical variables related to knee OA disease risk were compared between shoes using repeated measures ANOVAs. Results The KAM was significantly larger in the maximal shoe (p = 0.005), while the knee flexion angle at initial contact was significantly larger in both the maximal and minimal shoe compared to the traditional shoe (p = .000). Additionally, the peak knee flexion angle (p = .000) and the loading rates of the vertical ground reaction force were (instantaneous: p = 0.001; average: p = .010) were significantly higher in the minimal shoe. Significance While these results are specific to the shoes used in this study, clinicians should exercise caution in prescribing maximal or minimal shoes to females in this age group who may be at risk of knee OA given these results. Research is needed on the effect of these shoes in patients with knee OA.

Running is a common exercise with numerous health benefits. Vertical ground reaction force (vGRF) influences running injury risk and running performance. Measurement of vGRF during running is now primarily constrained to a laboratory setting. The purpose of this study was to evaluate a new approach to measuring vGRF during running. This approach can be used outside of the laboratory and involves running shoes instrumented with novel piezoresponsive sensors and a standard accelerometer. Thirty-one individuals ran at three different speeds on a force-instrumented treadmill while wearing the instrumented running shoes. vGRF was predicted using data collected from the instrumented shoes, and predicted vGRF were compared to vGRF measured via the treadmill. Per cent error of the resulting predictions varied depending upon the predicted vGRF characteristic. Per cent error was relatively low for predicted vGRF impulse (2-7%), active peak vGRF (3-7%), and ground contact time (3-6%), but relatively high for predicted vGRF load rates (22-29%). These errors should decrease with future iterations of the instrumented shoes and collection of additional data from a more diverse sample. The novel technology described herein might become a feasible way to collect large amounts of vGRF data outside of the traditional biomechanics laboratory.

Perception of external loads may be a central topic to understand adjustments to the mechanical demands during movement. Nevertheless, the association between the perceived and the real load received is still controversial. This study aimed to correlate vertical ground reaction force (vGRF) to the perception of impact in different regimens of stimulus application. Ten physically active men performed drop jumps from four different heights (0.20, 0.40, 0.60 and 0.80 m). A force plate measured the vGRF, while perception of impact was evaluated through Borg's Ratings of Perceived Exertion. Higher values of maximum vGRF (Fy_max) and impulse of the first 50 ms (I_50), and reduced time to reach Fy_max indicate increased external forces as drop jump height raised. Perception of impact increased gradually with increasing jump height for I_50. Fy_max and I_50 showed moderate to strong correlations to perceived load for 70% and 90% of participants, respectively. Higher and different intensity of stimulus facilitated the perception of impact, presenting moderate to strong correlations to kinetic parameters related to external load during landing from drop jump. Perception of higher impacts could be used as a surrogate to monitor 'real' impacts and possibly also for managing impact-related injury risk.

Background The purpose of this study was to compare knee biomechanics of the replaced limb to the non-replaced limb of total knee replacement (TKR) patients and healthy controls during walking on level ground and on decline surfaces of 5°, 10°, and 15°. Methods Twenty-five TKR patients and 10 healthy controls performed 5 walking trials on different decline slopes on a force platform and an instrumented ramp system. Two analyses of variance, 2 × 2 (limb × group) and 2 × 4 (limb × decline slope), were used to examine selected biomechanics variables. Results The replaced limb of TKR patients had lower peak loading-response and push-off knee extension moment than the non-replaced and the matched limb of healthy controls. No differences were found in loading-response and push-off knee internal abduction moments among replaced, non-replaced, and matched limb of healthy controls. The knee flexion range of motion, peak loading-response vertical ground reaction force, and peak knee extension moment increased across all slope comparisons between 0° and 15° in both the replaced and non-replaced limb of TKR patients. Conclusion Downhill walking may not be appropriate to include in early stage rehabilitation exercise protocols for TKR patients.

The main objective was to investigate whether the cumulative load of the lower limbs, defined as the product of external load and step rate, could be predicted using spatiotemporal variables gathered with a commercially available wearable device in running. Therefore, thirty-nine runners performed two running tests at 10 and 12 km/h, respectively. Spatiotemporal variables (step rate, ground contact time, and vertical oscillation) were collected using a commercially available wearable device. Kinetic variables, measured with gold standard equipment (motion capture system and instrumented treadmill) and used for the calculation of a set of variables representing cumulative load, were peak vertical ground reaction force (peak vGRF), vertical instantaneous loading rate (VILR), vertical impulse, braking impulse, as well as peak extension moments and angular impulses of the ankle, knee and hip joints. Separate linear mixed-effects models were built to investigate the prediction performance of the spatiotemporal variables for each measure of cumulative load. BMI, speed, and sex were included as covariates. Predictive precision of the models ranged from .11 to .66 (R2m) and .22 to .98 (R2c), respectively. Greatest predictive performance was obtained for the cumulative peak vGRF (R2m = .66, R2c = .97), VILR (R2m = .43, R2c = .97), braking impulse (R2m = .52, R2c = .98), and peak hip extension moment (R2m = .54, R2c = .90). In conclusion, certain variables representing cumulative load of the lower limbs in running can be predicted using spatiotemporal variables gathered with a commercially available wearable device.

The main objective of this study was to investigate the effects of task execution variables on the value and point of application of the resultant vertical ground reaction force acting on the foot sole during squat lifting. This can be of particular importance since it may help to recognize the roles of the foot sole parts in bearing the support force during industrial and labor lifting activities. Twelve healthy men lifted a box with 4, 8 and 12 kg masses at fast and slow speeds. Ground reaction force and center of pressure were measured using two parallel Kistler force-plates. In addition, a Vicon system and a 3D linked segment model were used to define the movement pattern. Significant increases resulted for the peak vertical ground reaction force with the increases in the lift speed (P 0.05) and box weight (P 0.05). As well a significant increase resulted for the range of center of pressure location with the increase in the box weight (P 0.05). Moreover, significant interactions (P 0.05) between the lift speed and box weight were detected. The front and rear parts of the foot had the most important roles in bearing the support force during the beginning and final phases of movement, respectively. Finally, it was concluded that the value and point of application of vertical ground reaction force are seemingly dependent on the momentum of the subject plus box.

Given its apparent representation of cumulative (vs peak) loads, this feasibility study investigates vertical ground reaction impulse (vGRI) as a real-time biofeedback variable for gait training aimed at reducing lower limb loading. Fifteen uninjured participants (mean age = 27 y) completed 12 2-min trials, 1 at each combination of 4 walking speeds (1.0, 1.2, 1.4, and 1.6 m/s) and 3 targeted reductions in vGRI (5, 10, and 15%) of the assigned ("target") limb, with the latter specified relative to an initial baseline (no feedback) condition at each speed. The ability to achieve targeted reductions was assessed using step-by-step errors between measured and targeted vGRI. Mean (SD) errors were 5.2% (3.7%); these were larger with faster walking speeds but consistent across reduction targets. Secondarily, we evaluated the strategy used to modulate reductions (ie, stance time or peak vertical ground reaction force [vGRF]) and the resultant influences on knee joint loading (external knee adduction moment [EKAM]). On the targeted limb, stance times decreased (P .001) with increasing reduction target; first and second peaks in vGRF were similar (P .104) across all target conditions. While these alterations did not significantly reduce EKAM on the target limb, future work in patients with knee pathologies is warranted.

Background The plantar intrinsic foot muscles (PIFMs) contribute to support the medial longitudinal arch. But the functional role of the PIFMs during dynamic activities is not clear. The purpose of this study was to examine the change in the foot dynamics during gait accompanied with the change in the PIFMs activity to determine the functional role of the PIFMs during gait. Methods Twenty healthy male subjects were randomly assigned to the electrical stimulation group (ESG) or control group (CG). In the ESG, the electrical stimulation to the PIFMs was provided from mid-stance to pre-swing using surface electrodes to simulate reinforcement of the PIFMs. The foot dynamics during the stance phase of gait was measured using a 3D motion analysis, and the amount of change from baseline (electrical stimulation was not provided) was compared between groups using an independent sample t-test. Results In the ESG, the timing for the navicular height to reach the minimum value was significantly later, and the vertical ground reaction force (2nd peak) significantly decreased more. There were no group differences in the amount of change from baseline on gait velocity, stance phase duration, minimum navicular height and ground reaction force in other directions. Conclusion Results from this study showed that the functions of the PIFMs most likely include shock absorption and facilitation of efficient foot ground force transmission during the stance phase of gait.

Accurate and reliable vertical ground reaction force (VGRF) measurement is essential in various biomechanical and clinical studies. Recently, pressure–pad-embedded treadmills have been widely used for VGRF measurement as a relatively less expensive option than the force platform-mounted treadmills. Prior studies have shown that the popular Zebris treadmill is reliable when used to measure peak VGRF for short walking sessions. However, comprehensive evaluation of human walking requires information of gait parameters over sufficient gait cycles. In this study, we quantify the long-term temporal changes in VGRF values measured by the Zebris treadmill. Twenty participants walked on the treadmill for 10 min twice, with 10 min rest between trials. We found an evident decline in the measured VGRF and impulse over time for both trials. The Zebris system also consistently yielded the lower VGRF values during the second trials. These results indicate that the Zebris treadmill is unreliable in measuring VGRF during walking, and a 10 min break is not enough for the embedded sensors to recover their sensitivity. We provided a way to resolve these time-dependent errors, using the impulse-momentum theorem and collected kinematics of the participants, we formulated a curve-fitting model encapsulating the growing VGRF estimation error.

Introduction: Vertical ground reaction forces (VGRFs) are altered in patients after foot trauma. It is not known if this correlates with ankle kinematics. The aim of this study was to analyze VGRFs in patients after calcaneal trauma and correlate them to patient-reported outcome measures (PROMs), radiographic findings and kinematic analysis, using a multi-segment foot model. In addition, we determined the predictive value of VGRFs to identify patients with altered foot kinematics.Methods: Thirteen patients (13 feet) with displaced intra-articular calcaneal fractures, were included an average of two years after trauma surgery. PROMs, radiographic findings on postoperative computed tomography scans, gait analysis using the Oxford foot model and VGRFs were analysed during gait. Results were compared with those of 11 healthy subjects (20 feet). Speed was equal in both groups, with healthy subjects walking at self-selected slow speed (0.94 +/- 0.18m/s) and patients after surgery walking at self-selected normal speed (0.94 +/- 0.29 m/s). ROC curves were used to determine the predictive value.Results: Patients after calcaneal surgery showed a lower minimum force during midstance (p = 0.004) and a lower maximum force during toe-off (p = 0.011). This parameter correlated significantly with the range of motion in the sagittal plane during the push-off phase (r 0.523, p = 0.002), as well as with PROMs and with postoperative residual step-off (r 0.423, p = 0.016). Combining these two parameters yielded a cut-off value of 193% (p Conclusion: Patients after calcaneal fracture showed lower minimum force during midstance and lower maximum force during toe-off compared to healthy subjects. This lower maximum force during push-off correlated significantly with PROMs, range of motion in the sagittal plane during push-off and radiographic postoperative residual step-off in the posterior facet of the calcaneal bone. VGRFs are a valuable screening tool for identifying patients with altered gait patterns.

The aim of this study was to analyze the effect of teeth clenching on dynamic balance at jump landing. Twenty-five healthy subjects performed jump-landing tasks with or without teeth clenching. The first 3 trials were performed with no instruction; subsequently, subjects were ordered to clench at the time of landing in the following 3 trials. We collected the data of masseter muscle activity by electromyogram, the maximum vertical ground reaction force (vGRFmax) and center of pressure (CoP) parameters by force plate during jump-landing. According to the clenching status of control jump-landing, all participants were categorized into a spontaneous clenching group and no clenching group, and the CoP data were compared. The masseter muscle activity was correlated with vGRFmax during anterior jump-landing, while it was not correlated with CoP. In comparisons between the spontaneous clenching and the no clenching group during anterior jump-landing, the spontaneous clenching group showed harder landing and the CoP area became larger than the no clenching group. There were no significant differences between pre- and postintervention in both spontaneous clenching and no clenching groups. The effect of teeth clenching on dynamic balance during jump-landing was limited.

Patellofemoral pain (PFP) is often studied on subjects who are classified using only self-reported data. Neuromuscular activation influences movement mechanics for PFP subjects, but is not likely to be self-reported. We compared lower-extremity mechanics, during a common movement (walking), between two subdivisions of a group of PFP subjects that were similar, based on common self-report tools, but different, based on a common objective measure of quadriceps activation. Our intent was to highlight the importance of objectively considering neuromuscular activation when researching PFP movement mechanics. Thirty similar PFP research subjects (based on four common self-report tools) were divided into two subdivisions, based on different quadriceps central activation ratios (CAR): a quadriceps deficit (QD; CAR

Background Up to 79% of runners get injured every year, with higher rates of injuries occurring in females than males. A self-organizing map (SOM) is a type of artificial neural network that can be used to inspect large datasets and study coordination patterns. The purpose of this study was to use an SOM to study the effects of sex and speed on biomechanical coordination patterns. Method Thirty-two healthy runners ran on an instrumented treadmill at their long slow distance speed (LSD) and at speed 30% faster (LSD + 30%). Vertical ground reaction force (vGRF), vertical tibial acceleration, step parameters, electromyograms (EMG) of six lower limb muscles, and joint angles were collected across speeds. Rate of loading (ROL), tibial impact shock (TIS), coupling angle variability (CAV) and movement pattern proportions for hip/knee sagittal and hip frontal / knee sagittal plane couplings, peak EMG, step length, step rate, and knee and ankle joint angle at initial contact were used as an input for the SOM (37 variables). Results The analysis identified four clusters (i.e., running patterns). While males and females showed similar distribution across clusters at LSD (p = .36) and at LSD + 30% (p = .51), females did exhibit a significant (p = .03) shift between clusters as the speed increased from LSD to LSD + 30% whereas males did not (p = .17). The shift was associated with an increase in TIS, ROL, step length, step rate, vastus lateralis EMG, hip flexion/knee extension movement pattern proportion, and a decrease in ST EMG and CAVIC for hip sagittal/knee sagittal coupling. Conclusion As running speed increased there was a significant change in the coordination pattern in females, which was characterized by increases in several variables that are purported risk factors for running related injuries.

O Cathain, CP, Richter, C, and Moran, K. Can directed compliant running reduce the magnitude of variables associated with the development of running injuries? J Strength Cond Res XX(X): 000-000, 2020-Running is one of the most popular modes of activity worldwide and provides numerous health benefits. However, impact forces associated with the foot contacting the ground have been implicated in the development of running related injuries. As such, previous studies have used various methods to alter running to reduce the magnitude of these impact forces. However, it is unclear what kinematic changes facilitate this reduced loading or how loading further up the body changes. In this study, verbal direction was used to teach subjects to run with a more compliant running technique. Kinetic and kinematics characteristics of each subjects "normal" running technique and new "compliant technique" were measured in a fatigued and unfatigued state. Energy expenditure of each running style was also measured. Verbally directed compliant running significantly decreased (17%) vertical ground reaction force impact peaks, sacral (41%) and head (28%) impact accelerations, and increased energy expenditure (21%), in comparison with normal running. Findings suggest that verbally directed compliant running may reduce the magnitude of variables associated with the development of running injuries.

Background Increasing the ankle plantar-flexion angle at initial contact (IC) during landing reduces the impact features associated with landing, such as the vertical ground reaction force and loading rate, potentially affecting the risk of anterior cruciate ligament (ACL) injury. However, the relationships between the ankle plantar-flexion angle at IC and the previously identified biomechanical factors related to noncontact ACL injury have not been studied. Research question Thus, the purpose of this study was to determine whether significant relationships exist between the ankle plantar-flexion angle at IC and the biomechanical factors related to noncontact ACL injury. Methods The peak anterior tibial shear force, peak external knee valgus moment, peak knee valgus angle, and combined peak external knee valgus plus tibial internal rotation moments were measured in 26 individuals while performing self-selected, single-leg landing. Pearson correlation analyses were performed to assess the relationships between the ankle plantar-flexion angle at IC and the biomechanical factors mentioned above. Results The greater ankle plantar-flexion angle at IC was related to smaller the peak knee valgus moment (r = −0.5, p = 0.009) and the combined peak knee valgus plus internal rotation moments (r = −0.58, p = 0.001). Significance These results suggest that large ankle plantar-flexion angle at IC might be associated with lesser loading of the knee frontal plane and altering the self-selective ankle angle may result in biomechanical changes associated with ACL injury risk.

Purpose This study investigated the vertical ground reaction force (vGRF) variables and spatiotemporal parameters related to running speed across a range of speeds in sprinters with unilateral transfemoral amputation who used running-specific prostheses (RSPs). Methods Ten sprinters with unilateral transfemoral amputation ran on an instrumented treadmill at incremental speeds of 30%, 40%, 50%, 60%, and 70% of the average speed of their 100-m personal best (100%) while using their RSPs. The vGRF data were collected at 1000 Hz during each trial. We calculated the vGRF variables and spatiotemporal parameters, including the stance average vGRF (Favg), step frequency (Freqstep), and contact length (Lc; the length traveled by a runner's body during the stance phase). Results All three mechanical variables related to speed (Favg, Freqstep, and Lc) were similar for both the unaffected and affected limbs at relatively slower speeds, and these variables increased with speed for each limb. Although Freqstep remained similar between the limbs at relatively faster speeds, the affected limb exerted 11% smaller Favg and showed 12% longer Lc than the unaffected limb. Conclusion These results suggest that, in order to achieve a faster running speed, runners with unilateral transfemoral amputation using RSPs likely adopt limb-specific biomechanical strategies for the unaffected and affected limbs, where the smaller Favg of the affected limb would be compensated by the longer Lc of the affected limb, without achieving a higher Freqstep.

Background We aimed to determine the effect of cueing an increase or decrease in the vertical ground reaction force impact peak (peak in the first 50% of stance) on vertical ground reaction force, knee flexion angle, internal knee extension moment, and internal knee abduction moment waveforms throughout stance in individuals 6–12 months after an anterior cruciate ligament reconstruction. Methods Twelve individuals completed 3 conditions (High, Low, and Control) where High and Low Conditions cue a 5% body weight increase or decrease, respectively, in the vertical ground reaction force impact peak compared to usual walking. Biomechanics during High and Low Conditions were compared to the Control Condition throughout stance. Findings The High Condition resulted in: (a) increased vertical ground reaction forces at each peak and decreased during mid-stance, (b) greater knee excursion (i.e., greater knee flexion angle in early stance and a more extended knee in late stance), (c) greater internal extension moment for the majority of stance, and (d) lesser second internal knee abduction moment peak. The Low Condition resulted in: (a) vertical ground reaction forces decreased during early stance and increased during mid-stance, (b) decreased knee excursion, (c) increased internal extension moment throughout stance, and (d) decreased internal knee abduction moment peaks. Interpretation Cueing a 5% body weight increase in vertical ground reaction force impact peak resulted in a more dynamic vertical ground reaction force loading pattern, increased knee excursion, and a greater internal extension moment during stance which may be useful in restoring gait patterns following anterior cruciate ligament reconstruction.