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Asymmetry in knee extensor moment during double-leg squatting was observed after anterior cruciate ligament reconstruction, even after the completion of the rehabilitation program for return to sports. The purpose of this study was to clarify the association between asymmetry in the knee extensor moment and pelvic rotation angle during double-leg squatting after anterior cruciate ligament reconstruction. Twenty-four participants performed double-leg squatting. Kinetics and kinematics during squatting were analyzed using a 3-dimensional motion analysis system with 2 force plates. The limb symmetry index of knee extensor moment was predicted by the pelvic rotation angle (R2 = .376, P = .001). In addition, the pelvic rotation and the limb symmetry index of the vertical ground reaction force independently explained the limb symmetry index of the knee extensor moment (R2 = .635, P β of pelvic rotation = −0.489, β of vertical ground reaction force = 0.524). Pelvic rotation toward the involved limb was associated with a smaller knee extensor moment in the involved limb than in the uninvolved limb. The assessment of pelvic rotation would be useful for partially predicting asymmetry in the knee extensor moment during double-leg squatting. Minimizing pelvic rotation may improve the asymmetry in the knee extensor moment during double-leg squatting after anterior cruciate ligament reconstruction.

Single-leg landings with or without subsequent jumping are frequently used to evaluate landing biomechanics. The purpose of this study was to investigate the effects of subsequent jumping on the external knee abduction moment and trunk and hip biomechanics during single-leg landing. Thirty young adult female participants performed a single-leg drop vertical jumping (SDVJ; landing with subsequent jumping) and single-leg drop landing (SDL; landing without subsequent jumping). Trunk, hip, and knee biomechanics were evaluated using a 3-dimensional motion analysis system. The peak knee abduction moment was significantly larger during SDVJ than during SDL (SDVJ 0.08 [0.10] N·m·kg−1·m−1, SDL 0.05 [0.10] N·m·kg−1·m−1, P = .002). The trunk lateral tilt and rotation angles toward the support-leg side and external hip abduction moment were significantly larger during SDVJ than during SDL (P P = .003, R2 = .252). Landing tasks with subsequent jumping would have advantages for evaluating trunk and hip control as well as knee abduction moment. In particular, evaluating hip abduction moment may be important because of its association with the knee abduction moment.

It is well-known that multitasking impairs the performance of one or both of the concomitant ongoing tasks. Previous studies have mainly focused on how a secondary task can compromise visual or auditory information processing. However, despite dual tasking being critical to motor performance, the effects of dual-task performance on proprioceptive information processing have not been studied yet. The purpose of the present study was, therefore, to investigate whether sensorimotor task performance would be affected by the dual task and if so, in which phase of the sensorimotor task performance would this negative effect occur. The kinematic variables of passive and active knee movements elicited by the leg drop test were analyzed. Thirteen young adults participated in the study. The dual task consisted of performing serial subtractions. The results showed that the dual task increased both the reaction time to counteract passive knee–joint movements in the leg drop test and the threshold to detect those movements. The dual task did not affect the speed and time during the active knee movement and the absolute angle error between the final and the target knee angles. Furthermore, the results showed that the time to complete the sensorimotor task was prolonged in dual tasking. Our findings suggest that dual tasking reduces motor performance due to slowing down proprioceptive information processing without affecting movement execution.

In baseball pitching, suppressing trunk rotation while rotating the pelvis in the early phase of arm cocking is important for throwing a fast ball. However, quantitative evaluation of trunk rotation during pitching has not been established, and its associations with elbow and shoulder torques are unclear. The purpose of this study was to examine the correlation of a new measure of trunk rotation suppression with ball speed and elbow and shoulder torques during pitching. Eighteen adult male baseball pitchers (21.7 ± 1.2 years old) participated. Three qualified pitches were analysed using a three-dimensional motion capture system. Trunk rotation velocity, normalised to the peak velocity, was derived at the time of peak pelvic velocity. Pearson's correlation coefficient was used to determine correlations. The normalised trunk rotation velocity at the peak pelvic velocity was significantly correlated with elbow valgus torque (

To compare the lower limb kinematics of participants with chronic ankle instability (CAI) and healthy participants during forward, lateral, and medial landings.Cross-sectional study.Laboratory.Eighteen athletes with CAI and 18 control athletes.Hip, knee, and ankle joint kinematics during forward, lateral, and medial single-leg landings were compared between the groups using two-way ANOVA for discrete values and statistical parametric mapping two-sample t-tests for time-series data.The CAI group had significantly greater ankle dorsiflexion than the control group (P ≤ 0.013), which was observed from the pre-initial contact (IC) for lateral and medial landings and post-IC for forward landing. The CAI group showed greater knee flexion than the control group from the IC for lateral landing and post-IC for forward landing (P ≤ 0.014). No significant differences in ankle inversion kinematics were found between the CAI and control groups. Lateral landing had a greater peak inversion angle and velocity than forward and medial landings (P 0.001). Medial landing had a greater inversion velocity than forward landing (P 0.001).This study suggests that individuals with CAI show feedforward protective adaptations in the pre-landing phase for lateral and medial landings.

No consensus exists on rehabilitation programmes after medial patellofemoral ligament reconstruction (MPFLR) with or without tibial tuberosity osteotomy (TTO). This systematic review examined the content and timeline of rehabilitation (weightbearing, range of motion [ROM] and exercise therapy) and return to sport (RTS), as well as patient-reported outcomes after MPFLR with or without TTO.The PubMed, Cochrane Library, Web of Sciences, CINAHL and SPORTDiscus databases were searched from inception to December 2021. Studies that reported postoperative rehabilitation programmes and patient-reported outcomes for patients aged ≥ 18 years who underwent MPFLR with or without concomitant TTO were included.Eighty-five studies were included, 57 of which were case series and only one randomised controlled trial on rehabilitation programmes. Non-weightbearing was set within one week post-operatively in approximately 80% of weightbearing programmes for MPFLR without and with TTO. Joint immobilisation was set within one week post-operatively in 65.3% and 93.8% of programmes for MPFLR without and with TTO, respectively. Weightbearing and ROM (≤ 90°) restriction were within three weeks post-operatively for 50% of the programmes. Quadriceps strengthening was the most cited exercise therapy (33 programmes), most often initiated within two weeks post-operatively. However, few other exercise programmes were cited (only nine programmes). RTS was mostly noted at six months post-operatively (35 programmes). The weighted mean Kujala score was 87.4 points.Regardless of TTO addition to MPFLR, most studies restricted weightbearing and ROM only in the early post-operative period, with seemingly favourable clinical results. Limited information was available on post-operative exercise therapy.

BACKGROUND: Knee osteoarthritis (OA) impairs postural control and may affect how the lower limb joints are used for postural control. OBJECTIVE: To investigate how individuals with knee OA use lower limb joints for static postural control. METHODS: Ten patients with knee OA and thirteen healthy controls performed quiet standing for 30 s. The standard deviation of the center of mass (COM) and lower limb joint motions in the anterior-posterior (AP) and medial-lateral (ML) planes were calculated from three-dimensional marker trajectories. Pearson’s correlation analysis and independent t-tests were conducted to investigate the relationship between COM and lower limb joint motion and to compare group difference, respectively. RESULTS: The AP hip angular velocity alone in the knee OA group and the AP hip and knee angular velocity in the control group were significantly correlated with the AP COM velocity. The ML hip angular velocity was significantly correlated with the ML COM velocity in both groups. The knee OA group exhibited a significantly larger standard deviation of AP COM velocity than the control group. CONCLUSIONS: Individuals with knee OA depended solely on the contribution of the hip to the AP COM velocity, which could not be successfully controlled by the knee.

Objective: To provide consensus on how to plan, organize and implement exercise-based injury prevention program (IPP) in sports. Design: Delphi. Setting: LimeSurvey platform. Participants: Experienced sports physical therapists from the International Federation of Sports Physical Therapy member countries. Main outcome measures: Factors related to sports IPP planning, organization and implementation. Results: We included 305 participants from 32 countries. IPP planning should be based on an athlete's injury history, on pre-season screening results, and on injury rates (respectively, 98%, 92%, 89% agreement). In total 97% participants agreed that IPP organization should depend on the athlete's age, 93% on the competition level, and 93% on the availability of low-cost materials. It was agreed that IPP should mainly be implemented in warm-up sessions delivered by the head or strength/conditioning coach, with physical training sessions and individual physical therapy sessions (respectively, 94%, 92%, 90% agreement). Conclusion: Strong consensus was reached on (1) IPP based on the athlete's injury history, pre-season screening and evidence-based sports-specific injury rates; (2) IPP organization based on the athlete's age, competition level, and the availability of low-cost materials and (3) IPP implementation focussing on warm-up sessions implemented by the strength/conditioning coach, and/or individual prevention sessions by the physical therapist. (c) 2022 Elsevier Ltd. All rights reserved.

Background Lumbar degenerative disease has become more common, and surgery is performed in severe cases. However, some patients have residual disabilities. Although psychological factors are the most studied predictors of disability after lumbar spine surgery, it is unclear which factors strongly influence them. Thus, this study aimed to examine multidimensional factors that predict disability in patients postoperatively. Methods This was a retrospective longitudinal study. We collected data on pain intensity, disability, and psychosocial factors a day before surgery. In addition, pain intensity and disability were assessed for the same participants more than 1 year after surgery. Hierarchical multiple regression analysis was used to analyze the preoperative factors associated with the degree of disability in participants at postoperative lumbar surgery. The dependent variable was the Roland Morris disability questionnaire score postoperatively. The independent variables were the preoperative Roland Morris disability questionnaire scores in step 1; the participant's characteristics (age and sex) and numerical rating scale in step 2; Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Hospital Anxiety and Depression Scales as step 3; and the interaction of age with the other variables was added in step 4. Results There were 176 participants in this study. The preoperative Roland Morris disability questionnaire scores (B = 0.140; p

The purpose of this study was to determine how the application of static stretching to ankle plantar flexors affects postural control during maximum forward leaning. Twenty-six volunteer males (age 21.4 ± 1.2 years) were randomly assigned to stretching and control conditions. Participants conducted 5-min stretching on a stretch board for the stretching condition and were kept standing for 6-min for the control condition. Before and after intervention, the range of motion (ROM) at ankle dorsiflexion and the center of pressure (COP) excursion during maximal forward leaning were determined. Mean anteroposterior COP position, COP velocity and COP areas were calculated to compare the change in postural control. After stretching, ROM was significantly increased. During maximal forward leaning after stretching, both COP position and velocity showed significant increases compared to before stretching. Moreover, COP position and velocity in the stretching condition were significantly higher than in the control condition after stretching. No significant differences were found in COP area before and after stretching. Five-minute stretching increased not only ROM but also the anterior limit of stability while maintaining posture and led to faster COP shift than before stretching. These results indicate that static stretching would improve dynamic postural control as well.

Oba, K, Samukawa, M, Nakamura, K, Mikami, K, Suzumori, Y, Ishida, Y, Keeler, N, Saitoh, H, Yamanaka, M, and Tohyama, H. Influence of constant torque stretching at different stretching intensities on flexibility and mechanical properties of plantar flexors. J Strength Cond Res 35(3): 709-714, 2021-The purpose of this study was to examine the effects of constant torque stretching (CTS) at different stretching intensities on the maximal range of motion (ROM) and muscle-tendon unit (MTU) stiffness of plantar flexors. Fourteen healthy men performed 4 trials of differing stretch intensities: no stretching (control), 50, 75, and 100%. Stretch intensity was defined as maximum passive resistive torque predetermined at a familiarization trial. Each stretch trial consisted of 5 sets of 60-second CTS at the designated stretch intensity. Both maximal ROM and passive resistive torque were assessed during passive dorsiflexion, and MTU stiffness was calculated using the torque-angle curves measured before and after CTS. There were no significant differences in maximal ROM or MTU stiffness at the baseline condition. After the intervention, significantly greater maximal ROM and significantly lower MTU stiffness were observed in the 100% CTS condition than the control condition, whereas there were no significant differences between the submaximal intensity condition (i.e., 50 or 75% intensity) and the control condition. Therefore, our findings suggest that maximal intensity stretching is the most effective approach for improving both flexibility and MTU stiffness with CTS.

BackgroundHip osteoarthritis (OA) is a musculoskeletal condition that makes walking difficult due to pain induced by weight-bearing activities. Treadmills that support the body weight (BW) reduce the load on the lower limbs, and those equipped with a lower-body positive-pressure (LBPP) device, developed as a new method for unweighting, significantly reduce pain in patients with knee OA. However, the effects of unweighting on gait kinematics remain unclear in patients with hip OA. Therefore, we investigated the effects of unweighting on kinematics in patients with hip OA during walking on a treadmill equipped with an LBPP device.MethodsA total of 15 women with hip OA and 15 age-matched female controls wore a three-dimensional (3-D) motion analysis system and walked at a self-selected speed on the LBPP treadmill. Data regarding self-reported hip pain using a numeric rating scale (NRS) in which the scores 0 and 10 represented no pain and the worst pain, respectively, under three different BW conditions (100, 75, and 50%) were collected. Moreover, 3-D peak joint angles during gait under each condition were calculated and compared.ResultsIn the hip OA group, the NRS pain scores at 50 and 75% BW conditions significantly decreased compared with that at 100% BW condition (50%,P = 0.002; 75%,P = 0.026), and the peak hip extension angle decreased compared with that in the healthy controls (P = 0.044). In both groups, unweighting significantly decreased the peak hip (P P P ConclusionsUnweighting by the LBPP treadmill decreased pain in the hip OA group but did not drastically alter the gait kinematics compared with that in the control group. Therefore, regarding the use of the LBPP treadmill for patients with hip OA, clinicians should consider the benefits of pain reduction rather than the kinematic changes.

With this study, we aimed to investigate the effects of different warm-up intensities on counter-movement jump (CMJ) performance over time under cold conditions. Eleven male collegiate athletes volunteered. The participants performed high-intensity warm-up (HWU) at 80% VO2max and moderate-intensity warm-up (MWU) at 60% VO2max for 15 min on a bicycle ergometer in a laboratory room at 10 degrees C. CMJ height, vastus lateralis muscle temperature, heart rate, and perceived fatigue were measured before warm-up (Pre), immediately after (Post 0), 10 min after (Post 10), and 20 min after (Post 20). Significant main effects and interactions were found for CMJ height (time, p < 0.001 and eta(2)(p) = 0.859; interaction, p = 0.007 and eta(2)(p) = 0.327). HWU significantly increased CMJ height at Post 0 to Post 20 compared to that at Pre (p < 0.01), whereas MWU increased CMJ height at Post 0 only compared to that at Pre (p < 0.001). The results indicate that HWU achieved an increase in CMJ height for 20 min. MWU changed CMJ height instantly, but the change did not last compared to HWU in a cold environment.

The effects of changes in the anterior-posterior center of pressure (AP-COP) position on the lower limb joint moments during double-leg squatting remain unclear. The purpose of this study was to determine the effects of AP-COP positional changes on the hip, knee, and ankle extensor moments during double-leg squatting. Sixteen male participants (22.1 ± 1.5 years) performed double-leg squatting under two conditions (anterior and posterior COP conditions) with visual feedback on their COP positions. Kinematics and kinetics were analyzed using a three-dimensional motion analysis system and force plates. The hip, knee and ankle flexion angles and extensor moments at peak vertical ground reaction force were compared between the two conditions using paired t tests. The COP position was 53.5 ± 2.4% of the foot length, starting from the heel, under the anterior condition and 44.4 ± 2.1% under the posterior condition (P < 0.001). The knee extensor moment was significantly smaller under the anterior than the posterior COP condition (P = 0.003, 95% confidence interval (CI) -0.087 to -0.021 Nm/kg/m), while the ankle extensor moment significantly larger under the anterior COP condition than under the posterior COP condition (P < 0.001, 95% CI 0.113 to 0.147 Nm/kg/m). There was no significant difference in hip extensor moment (P = 0.431). The ankle dorsiflexion angle was significantly larger under the anterior than the posterior COP condition (P = 0.003, 95% CI 0.6 to 2.6°), while there was no difference in trunk, hip, or knee flexion angle. The present results indicate that changes in the AP-COP position mainly affect the ankle and knee extensor moments during double-leg squatting, while the effect on the lower limb joint and trunk flexion angles was limited. Visual feedback on the AP-COP position could be useful for modifying the ankle and knee extensor moments during double-leg squatting.

The effects of foot posture on postural stability and on muscular activation pattern for postural control remain unclear. This study aimed to investigate postural stability and muscular activation onset during the transition task from double- to single-leg stance in individuals with different foot postures. Twenty-seven healthy men (age: 21.5 ± 1.5 years) were divided into 3 groups using the Foot Posture Index: neutral foot (n = 10); flatfoot (n = 8); and high-arched foot (n = 9). Center of pressure (COP) data and muscle activation onset times of the tibialis anterior, peroneus longus, gastrocnemius medialis, and soleus during the transition task with eyes closed were compared among groups using one-way analysis of variance and a post-hoc Tukey honestly significant difference test (p < 0.05) when the data were normally distributed and the Kruskal-Wallis test and a post-hoc Mann-Whitney U-test with Bonferroni correction (p < 0.0167) when the data were not normally distributed. The COP displacements in the mediolateral and anteroposterior directions and the resultant COP displacement during the first 3 s after a stability time point, as determined by sequential estimation during the single-leg stance phase, differed significantly among the three groups (p < 0.05). Post-hoc tests showed that the displacements were significantly greater in the flatfoot group than in the neutral and high-arched foot groups (p < 0.05), and the effect sizes for these results were large. No muscular activation onset times showed significant intergroup differences. Postural stability was significantly decreased only in the flatfoot group, while muscle activation onsets did not differ significantly by foot posture during the transition task. Decreased postural stability may be one mechanism underlying the link between flatfoot and risk of lower limb injury, and foot posture represents a potential confounder for measuring postural stability during the transition task.

Jump performance is affected by warm-up intensity and body temperature, but the time course effects have not been thoroughly investigated. The purpose of this study was to investigate time course effects on jump performance after warm-up at different intensities. Nine male athletes (age: 20.9 ± 1.0 years; height: 1.75 ± 0.03 m; weight: 66.4 ± 6.3 kg; mean ± SD) volunteered for this study. The participants performed three warm-ups at different intensities: 15 min at 80% VO2 max, 15 min at 60% VO2 max, and no warm-up (control). After each warm-up, counter movement jump (CMJ) height, vastus lateralis temperature, heart rate and subjective fatigue level were measured at three intervals: immediately after warm-up, 10 min after, and 20 min after, respectively. Significant main effects and interactions were found for muscle temperature (intensity: p < 0.01, η2p = 0.909; time: p < 0.01, η2p = 0.898; interaction: p < 0.01, η2p = 0.917). There was a significant increase of muscle temperature from the baseline after warm-up, which lasted for 20 min after warm-up with 80% VO2 max and 60% VO2 max (p < 0.01). Muscle temperature was significantly higher with warm-up at 80% VO2 max than other conditions (P < 0.01). Significant main effects and interactions for CMJ height were found (intensity: p < 0.01, η2p = 0.762; time: p < 0.01, η2p = 0.810; interaction: p < 0.01, η2p = 0.696). Compared with the control conditions, CMJ height after 80% VO2 max and 60% VO2 max warm-ups were significantly higher (p < 0.01 and p < 0.05, respectively). CMJ height at 20 min after warm-up was significantly higher for 80% VO2 max warm-up than for 60% VO2 max warm-up (p < 0.01). However, CMJ height at 10 min after 60% VO2 max warm-up was not significantly different from the baseline (p < 0.05). These results showed that both high and moderate intensity warm-up can maintain an increase in muscle temperature for 20 min. Jump performance after high-intensity warm-up was increased for 20 min compared to a moderate intensity warm-up.

Objectives: To investigate the effects of pelvic and trunk lateral tilt-focused landing instructions on the knee abduction moment during the single-leg drop vertical jump task. Design: Descriptive laboratory study. Setting: Motion analysis laboratory. Participants: Fifteen young, healthy female participants. Main outcome measures: The participants performed 15 single-leg drop vertical jumps. Landing in-structions with self-video recordings were provided so that the participants' pelvis and trunk remained horizontal in the frontal plane. Pelvic, trunk and knee kinematics and kinetics were evaluated using a three-dimensional motion analysis system before and after the landing instructions. Results: The peak knee abduction moment significantly decreased postinstruction (preinstruction 22.6 +/- 15.3 Nm, postinstruction 17.9 +/- 15.4 Nm, P = 0.004), as did pelvic and trunk lateral tilt (P < 0.01). The knee abduction and internal rotation angles at initial contact significantly decreased postinstruction (P = 0.037, P = 0.007), with no significant change in the peak knee abduction and internal rotation angles from pre-to postinstruction. Conclusions: Landing instructions focused on pelvic and trunk lateral tilt are effective in decreasing the knee abduction moment during the single-leg drop vertical jump. Pelvic and trunk lateral tilt should be controlled to decrease the knee abduction moment during single-leg landing.

Background Abdominal draw-in maneuver (ADIM) has been recommended to achieve appropriate trunk muscle response for patients with non-specific chronic low back pain (CLBP). However, it has remained unclear whether the intervention with ADIM could change the trunk muscle response to sudden release from loading, which is considered to contribute mechanical circumstances to low back pain. The purpose of the present study was to investigate the effects of the intervention with ADIM on electromyography (EMG) activities of trunk muscles following sudden release from loading. Methods Seventeen subjects with non-specific CLBP participated. Subjects resisted trunk flexion or extension loading in semi-seated position, and then the loading was suddenly released. EMG recordings of 6 trunk muscles were acquired using a wireless surface EMG system. Onset and offset times were calculated from the EMG data. The intervention with ADIM was provided for 4 weeks. The onset and offset times were compared between pre- and post-intervention with ADIM. Results At the post-intervention, the onset of trunk flexors following release from trunk flexion loading became significantly earlier than pre-intervention (P = 0.028). The offset of flexors following release from trunk extension loading of post-intervention was significantly earlier than that of pre-intervention (P = 0.001). Conclusions We showed that the intervention with ADIM changed the EMG activity of trunk flexors in response to sudden release from loading. These results suggest a possibility that ADIM might be effective to improve the neuromuscular control of trunk flexors for the treatment of young patients with non-specific CLBP.

Objectives To investigate the prevalence and characteristics of chronic ankle instability (CAI) and copers among collegiate athletes as identified by criteria for research (CAI-R and copers-R) and for clinical practice (CAI-C and copers-C). Design Cross-sectional study. Setting University. Participants Collegiate athletes (n = 507). Main outcome measures Participants were assessed by questionnaires based on the International Ankle Consortium guidelines. The percentages of participants with CAI-R, CAI-C, copers-R and copers-C were calculated, respectively. Demographic and injury data were statistically compared between CAI-R and copers-R groups. Results The data of 470 participants was retained after exclusions. Of these, the prevalence of CAI-R (10.0%) was only half of that of CAI-C (19.8%), and that of copers-R and copers-C was about 5%. Seventy percent of unclassifiable participants had recurrent ankle sprains. CAI was most common in basketball, while copers were less prevalent in basketball, judo, rugby and gymnastics. The age at the initial injury was significantly younger in the CAI-R participants than in the copers-R. Conclusions The type of sport and the age at the initial injury may be associated with developing CAI. The standard criteria may not capture the entire clinical CAI population, therefore, care should be taken when applying the research to clinical practice.

BACKGROUND: The purpose of this study was to compare the acute effects of dynamic stretching and running on relative high-intensity endurance running performance in well-trained male runners. METHODS: The endurance running performances of 16 well-trained long-distance male runners were assessed on a treadmill at about 5 minutes after 2 types of intervention. The interventions were running intervention and dynamic stretching intervention. In the running intervention, each participant ran on the treadmill at a velocity equivalent to his 70% maximal oxygen uptake (V̇O2max) in each participant for 15 minutes. In the dynamic stretching intervention, dynamic stretching was performed for 10 repetitions as quickly as possible for the 5 muscle groups of the lower extremities for 3 minutes and 40±9 seconds. Endurance running performance was evaluated by time to exhaustion during running at a velocity equivalent to 90% V̇O2max in each participant. RESULTS: The time to exhaustion (870.7±237.6 seconds) after dynamic stretching intervention was significantly (d=0.75, P=0.01) prolonged compared with that (745.4±225.1 seconds) after running intervention. CONCLUSIONS: The results demonstrated that the dynamic stretching intervention improved the endurance performance of running at a velocity equivalent to 90% V̇O2max in well-trained male runners. Our findings suggested that performing dynamic stretching was effective for improving performance compared with performing only running during the warm-up.

This study was conducted to measured talar displacement using ultrasound during an anterior drawer test (ADT) with a Telos device. Five adults (3 men and 2 women; 8 ankles; mean age: 23.2 y) with a history of ankle sprain and eight adults (5 men and 3 women; 16 ankles; mean age: 22.1 y) without a history of ankle sprain were recruited into a history of ankle sprain (HAS) and a control group, respectively. Talar displacement was observed in response to load forces applied by a Telos device during the ultrasound stress imaging test. The ultrasound probe was placed 5 mm inside from the center of the Achilles tendon on the posterior ankle along the direction of the major axis. The inter-rater reliability for the present method was classified as good and excellent (ICC(2,2) = 0.858 and 0.957 at 120 N and 150 N, respectively) in the control group and excellent (ICC(2,2) = 0.940 and 0.905 at 120 N and 150 N, respectively) in the HAS group, according to specific intraclass correlation coefficient values. We found that talar displacement during the ADT was lower in the HAS group than in the control group. Analysis of the receiver operating characteristic curve revealed that the quantitative ultrasound-based ADT using a Telos device was superior to the X-ray-based test in detecting reduced ankle joint mobility during the ADT (area under the curve of 0.905 and 0.726 at a force of 150 N using ultrasound-based and X-ray-based tests, respectively). Further investigation is needed; nevertheless, this preliminary study suggests that the ultrasound-based quantitative ADT using a Telos device might detect talar displacement more sensitively than the conventional stress X-ray.

Background: Locomotive syndrome (LS) is a condition where a person requires nursing care services due to problems with locomotive abilities and musculoskeletal systems. Individuals with LS have a reduced walking speed compared to those without LS. However, differences in lower-limb kinematics and during walking between individuals with and without LS are not fully understood. The purpose of this study is to clarify the characteristics of gait kinematics using wearable sensors for individuals with LS.Methods: We assessed 125 people aged 65 years and older who utilized a public health promotion facility. The participants were grouped into Non-LS, LS-stage 1, LS-stage 2 (large number indicate worse locomotive ability) based on 25-question Geriatric Locomotive Function Scale (GLFS-25). Spatiotemporal parameters and lower-limb kinematics during 10-m walking test were analyzed by 7-inertia-sensors based motion analysis system. Peak joint angles during stance and swing phase as well as gait speed, cadence and step length were compared among all groups.Results: The number of each LS stage was 69, 33, 23 for Non-LS, LS-stage 1, LS-stage 2, respectively. LS-stage2 group showed significantly smaller peak hip extension angle, hip flexion angle and knee flexion angle than Non-LS group (hip extension: Non-LS: 9.5 ± 5.3°, LS-stage 2: 4.2 ± 8.2°, P = 0.002; hip flexion: No-LS: 34.2 ± 8.8°, LS-stage 2: 28.5 ± 9.5°, P = 0.026; knee flexion: Non-LS: 65.2 ± 18.7°, LS-stage 2: 50.6 ± 18.5°, P = 0.005). LS-stage 1 and LS-stage 2 groups showed significantly slower gait speed than Non-LS group (Non-LS 1.3 ± 0.2 m/s, LS-stage1 1.2 ± 0.2 m/s, LS-stage2 1.1 ± 0.2 m/s, P < 0.001).Conclusions: LS-stage2 group showed significantly different lower-limb kinematics compared with Non-LS group including smaller hip extension, hip flexion and knee flexion. The intervention based on these kinematic characteristics measured by wearable sensors would be useful to improve the locomotive ability for individuals classified LS-stage2.

Inadequate energy dissipation during landing may increase the risk of ankle sprain. Mechanical demands (landing height) in landing tasks may affect the biomechanical differences between individuals with and without chronic ankle instability (CAI). However, energy dissipation strategies during landing from various heights in individuals with CAI are unclear. The purpose of this study was to compare the effect of landing height on lower extremity biomechanics between individuals with and without CAI. Eleven participants in each of the CAI and Control group performed a single-leg landing from three heights (30, 40, and 50 cm). We calculated the contribution of each joint to total energy dissipation at 50-ms intervals during 0-200 ms post-initial contact (IC). Peak joint angles and moments and joint stiffnesses were calculated during 0-200 ms post-IC. Two-way mixed analysis of variance revealed significant group-by-height interactions for hip energy dissipation at 101-150 ms post-IC and peak ankle plantarflexion and hip extension moment. These significant interactions suggested that the effects of landing height on the ankle and hip joints differ between individuals with and without CAI. The effect of mechanical demands on altered landing biomechanics among CAI populations should be considered in biomechanical studies and clinical practice.