Background:Despite the increasing incidence of Achilles tendon (AT) ruptures, there is a lack of information on the possible risks associated with regular running and walking for exercise after an injury. There are some known kinematic gait changes after an AT rupture, especially at the knee. However, it is not clear whether runners with AT ruptures may be at risk for secondary knee injuries during shod or barefoot running/walking.Purpose/Hypothesis:The purpose of this study was to compare the kinematics and kinetics of barefoot walking and barefoot and shod running between athletes with a history of AT ruptures and a healthy control group. We hypothesized that there would be increased knee joint loads in the affected limb of the AT rupture group, especially during shod running.Study Design:Controlled laboratory study.Methods:Ten patients who had undergone surgical treatment of a unilateral acute AT rupture (6.1 ± 3.7 years postoperatively ) and 10 control participants were matched according to age, sex, physical activity, weight, height, and footfall type. The kinematics and kinetics of barefoot walking and barefoot and shod running were recorded using a high-speed motion capture system synchronized with force platforms.Results:The main outcome measures were lower extremity joint angles and moments during the stance phase of walking and running. After AT repair, athletes had increased internal knee abduction moments during shod and barefoot running compared with the healthy control group (P < .05, η2 > 0.14). There were no significant differences in kinematics and kinetics during walking between the AT rupture and healthy control groups (P ≥ .05).Conclusion:After an AT rupture, athletes had increased internal knee abduction moments during running compared with the healthy control group.Clinical Relevance:The increased abduction loads on the knee in patients with an AT rupture could lead to further running-related injuries. However, barefoot walking may be used as a proprioceptive exercise without an increased risk of overuse injuries in these patients.
Although a number of different methods have been proposed to assess the time to stabilization (TTS), none is reliable in every axis and no tests of this type have been carried out on children. The purpose of this study was thus to develop a new computational method to obtain TTS using a time-scale (frequency) approach [i.e. continuous wavelet transformation (WAV)] in children. Thirty normally-developed children (mean age 10.16 years, SD = 1.52) participated in the study. Every participant performed 30 single-leg drop jump landings with the dominant lower limb (barefoot) on a force plate from three different heights (15cm, 20cm and 25cm). Five signals were used to compute the TTS: i) Raw, ii) Root mean squared, iii) Sequential average processing, iv) the fitting curve of the signal using an unbounded third order polynomial fit, and v) WAV. The reliability of the TTS was determined by computing both the Intraclass Correlation Coefficient (ICC) and the Standard Error of the Measurement (SEM).In the antero-posterior and vertical axes, the values obtained with the WAV signal from all heights were similar to those obtained by raw, root mean squared and sequential average processing. The values obtained for the medio-lateral axis were relatively small. This WAV provided substantial-to-good ICC values and low SEM for almost all the axes and heights. The results of the current study thus suggest the WAV method could be used to compute overall TTS when studying children’s dynamic postural stability.
Far too little attention has been paid to health effects of air pollution and physical (in)activity on musculoskeletal health. The purpose of the Healthy aging in industrial environment study (4HAIE) is to investigate the potential impact of physical activity in highly polluted air on musculoskeletal health. A total of 1500 active runners and inactive controls aged 18–65 will be recruited. The sample will be recruited using quota sampling based on location (the most air-polluted region in EU and a control region), age, sex, and activity status. Participants will complete online questionnaires and undergo a two-day baseline laboratory assessment, including biomechanical, physiological, psychological testing, and magnetic resonance imaging. Throughout one-year, physical activity data will be collected through Fitbit monitors, along with data regarding the incidence of injuries, air pollution, psychological factors, and behavior collected through a custom developed mobile application. Herein, we introduce a biomechanical and musculoskeletal protocol to investigate musculoskeletal and neuro-mechanical health in this 4HAIE cohort, including a design for controlling for physiological and psychological injury factors. In the current ongoing project, we hypothesize that there will be interactions of environmental, biomechanical, physiological, and psychosocial variables and that these interactions will cause musculoskeletal diseases/protection.
In large cohort studies, due to the time-consuming nature of the measurement of movement biomechanics, more than one evaluator needs to be involved. This may increase the potential occurrence of error due to inaccurate positioning of markers to the anatomical locations. The purpose of this study was to determine the reliability and objectivity of lower limb segments length by multiple evaluators in a large cohort study concerning healthy aging in an industrial environment. A total of eight evaluators performed marker placements on five participants on three different days. Evaluators placed markers bilaterally on specific anatomical locations of the pelvis, thigh, shank and foot. On the right foot, markers were placed in anatomical locations to define a multi-segmental foot model. The position of the marker at the anatomical locations was recorded by a motion capture system. The reliability and objectivity of lower limb segment lengths was determined by the intraclass correlation coefficient of a two-way random model and of the two-way mixed model, respectively. For all evaluators for all segments, the average reliability and objectivity was greater than 0.8, except for the metatarsus segment (0.683). Based on these results, we can conclude that multiple evaluators can be engaged in a large cohort study in the placement of anatomical markers.
The aim of the study was to determine if sex differences exist in the key elbow and wrist joint injury risk factors during different cartwheel (CW) and round-off (RO) techniques performed by young male and female artistic gymnasts. Sixteen active young gymnasts (8 males and 8 females) performed 30 successful trials of CW and RO with three different hand positions (parallel (10), T-shape (10) and reverse (10)). Synchronised kinematic and kinetic data were collected for each trial. Two-way repeated measures ANOVA (3 × 2, technique × sex) and effect-sizes (ES) were used for statistical analysis. In conclusion, female gymnasts exhibited greater normalised peak vertical ground reaction forces (VGRF), elbow and wrist compression forces and elbow internal adduction moments during CW and RO skills compared with male gymnasts. In both sexes, the parallel and reverse techniques increased peak VGRF, elbow and wrist compression forces and the elbow internal adduction moment. Increased elbow flexion resulted in decreased peak VGRF, elbow compression forces and elbow internal adduction moment. Injury risk factors including elbow extension and internal adduction moment with axial compression force suggest that a CW and RO in reverse and parallel techniques can be hazardous especially for young female gymnasts.
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