Effects of different step lengths at a preferred walking speed on forefoot, midfoot, and hindfoot motion in healthy young adults.

Hindfoot, midfoot, and forefoot motion during the stance phase of walking provide insights into the forward progression of the body over the feet via the rocker mechanisms. These segmental motions are affected by walking speed. Increases in walking speed are accomplished by increasing step length and cadence. It is unknown if taking short, medium, and long steps at the same speed would increase hindfoot, midfoot, and forefoot motion similarly to walking speed. We examined effects of different step lengths at the same preferred walking speed on peak forefoot, midfoot, and hindfoot motions related to the foot rockers. Twelve young healthy adults completed five walking trials under three step length conditions in a random order as feet and lower extremity motion were measured via marker positions for the combined Oxford foot and conventional gait models. Peak hindfoot, midfoot, and forefoot joint angles indicating heel, ankle, and forefoot rockers were identified. When walking at the same preferred speed with increase in step length, there were increases in peak hindfoot-tibia plantarflexion angle (p < 0.001; ηp2 = 0.76) in early stance associated with the heel rocker and peak hindfoot-tibia dorsiflexion angle (p = 0.016; ηp2 = 0.39) in midstance associated with ankle rocker. In late stance, the peak hindfoot-tibia plantarflexion angle, forefoot-hindfoot angle, and forefoot-hallux dorsiflexion angle indicating forefoot rocker motion also increased with step length (p < 0.01). When foot kinematics are compared across different individuals or the same individual across different sessions, researchers and clinicians should consider the influence of step length as a contributor to differences in foot kinematics observed.

Walking in high-heel shoes induces redistribution of joint power and work.

Walking in high-heel shoes (HHS) decreases the push-off power and little research has examined the specific muscle groups that compensate for it. The purpose was to examine the effects of walking in HHS compared to barefoot on lower extremity net joint work and power. Fourteen young women walked in HHS and barefoot at a fixed speed of 1.3 m·s-1. Marker position and ground reaction force data were synchronously measured at 100 and 1000 Hz, respectively. Peak power and joint work variables were computed over the power phases of the gait cycle using an inverse dynamic approach. When walking in HHS was compared to barefoot, participants exerted a diminished push-off characterized by lesser peak power and lesser work by the ankle plantar flexors in late stance (A2 phase; p < 0.001). To compensate for the reduced ankle plantar flexor power, greater peak power was generated and work was performed in early stance by hip extensors (H1 phase; p ≤ 0.001), in mid-stance by knee extensors (K2 phase; p < 0.001) and in late stance and early swing phase by hip flexor muscles (H3 phase; p ≤ 0.001). Walking in HHS induces biomechanical plasticity and causes distal-to-proximal redistribution of net joint power and work during walking.

The effect of EMG biofeedback training on muscle activation in an impingement population.

Subacromial impingement syndrome (SAIS) is one of the most diagnosed causes of pain in the upper extremity. The purpose of this study was to investigate muscle activity between asymptomatic and SAIS shoulders on the same subject while understanding the effectiveness of EMG biofeedback training (EBFB) on bilateral overhead movements. Ten participants (7 male), that tested positive for 2/3 SAIS clinical tests, volunteered for the study. Bilateral muscle activity was measured via electrodes on the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and lumbar paraspinals (LP). Participants performed bilateral scapular plane overhead movements before and after EBFB. EBFB consisted of 10 bilateral repetitions of I, W, T, and Y exercises focused on reducing UT and increasing LT and SA activity. Prior to EBFB, no significant difference in muscle activity was present between sides. A significant main effect of time indicated that after EBFB both sides exhibited reduced UT activity at 60° (p = 0.003) and 90° (p = 0.036), LT activity was increased at all measured humeral angles (p < 0.0005), and SA muscle activity was increased at 110° (p = 0.001). EBFB in conjunction with scapular based exercise effectively alters muscle activity of asymptomatic and symptomatic scapular musculature.

The effects of hallux valgus and walking speed on dynamic balance in older adults.

BACKGROUND: Hallux valgus (HV) contributes to deficits in static balance and increased fall risk in older adults. Very limited research has examined dynamic balance deficits in walking in this population. These individuals generally walk slowly, as balance challenge is lesser at slow speeds. RESEARCH QUESTION: How does the dynamic balance of older adults with HV differ from healthy controls at controlled slow and fast walking speeds? METHODS: Nineteen older adults with HV and 13 healthy controls completed 5 continuous walking trials at 1.0 and 1.3 m·s-1 as whole body marker position and ground reaction force data were captured. Dynamic balance was evaluated using whole body center of mass (COM) and center of pressure (COP) inclination angles (IA) and duration of double support. RESULTS: There were no differences in measures of dynamic balance between older adults with and without HV at slow and fast speeds. At the faster speed, the peak sagittal plane COM-COP IA increased and the double support duration decreased, while the peak frontal plane COM-COP IA were not affected. SIGNIFICANCE: Older adults with HV do not exhibit deficits in dynamic balance during continuous walking at comfortable speeds when compared to healthy older adults.

Effects of age, speed, and step length on lower extremity net joint moments and powers during walking.

During walking older adults' gait is slower, they take shorter steps, and rely less on ankle and more on knee and hip joint moments and powers compared to young adults. Previous studies have suggested that walking speed and step length are confounds that affect joint moments and powers. Our purpose was to examine the effects of walking speed and step length manipulation on net joint moments and powers in young and older adults. Sixteen young and 18 older adults completed walking trials at three speeds under three step length conditions as marker position and force platform data were captured synchronously. Net joint moments were quantified using inverse dynamics and were subsequently used to compute net joint powers. Average extensor moments at each joint during the stance phase were then computed. Older adults displayed greater knee extensor moment compared to young adults. Older adults showed trends (p < .10) of having lower ankle and higher hip moments, but these differences were not statistically significant. Average ankle, knee, and hip extensor moments increased with speed and step length. At the fast speed, older compared to young adults generated lower average ankle power (p = .003) and showed a trend (p = .056) of exerting less average moment at the ankle joint. Age-associated distal-to-proximal redistribution of net joint moments was diminished and not statistically significant when the confounding effects of walking speed and relative step length were controlled. These findings imply that age-related distal-to-proximal redistribution of joint moments may influence the different speeds and step lengths chosen by young and older adults.

Redistribution of joint moments and work in older women with and without hallux valgus at two walking speeds.

BACKGROUND: Hallux valgus (HV) is a highly prevalent foot deformity in older women. Differences in lower extremity joint function of older women with and without HV during walking at slower and faster speeds are unknown. RESEARCH QUESTION: Does walking speed affect lower extremity joint range of motion (ROM) and net extensor joint moment and associated work in older women with and without HV? METHODS: Thirteen older women with HV and 13 controls completed five walking trials at 1.1 and 1.3 m·s-1 as kinematic marker position and ground reaction force data were collected. Net ankle, knee, and hip joint moments were computed using inverse dynamics during the stance phase. Positive joint work was calculated by integrating hip power in early stance, knee power in mid stance, and ankle power in late stance. RESULTS: Average ankle ROM and plantarflexor moment did not increase with walking speed in the HV group, while in the control group these variables were greater for the faster compared to the slower speed (p < 0.05). The magnitude of increase in ankle joint work with speed was 12 % lesser in the HV compared to the control group (p = 0.008). The hip ROM, extensor moment, and associated work was greater in the HV compared to the control group (p < 0.05). Knee and hip joint ROM, extensor moments, and work increased with walking speed in both groups (p < 0.05). SIGNIFICANCE: Older women with HV compared to older women without HV demonstrate a distal-to-proximal redistribution by increasing hip motion and effort to compensate for reduced ankle contribution during walking.

Mechanical Demands at the Ankle Joint During Saut de Chat and Temps levé Jumps in Classically Trained Ballet Dancers.

BACKGROUND: During ballet, injuries to the Achilles tendon are associated with the take-off phase of various jumps. RESEARCH QUESTION: The purpose of the study was to assess differences in mechanical demand on the body, specifically at the ankle, in two single-leg jumps commonly trained in ballet: a saut de chat (SDC) and a temps levé (TL). METHODS: Fifteen classically trained female dancers had 16 reflective markers placed on the lower body and each dancer performed each jump three times on a force plate. The marker position data and ground reaction forces (GRF) were captured synchronously at 250 Hz and 1000 Hz, respectively. Peak vertical GRF, mean rate of force development (RFD), peak ankle moment, and peak ankle power were determined and averaged across trials. Paired t-tests were used to determine differences between the SDC and the TL. RESULTS: When compared to the TL, the SDC displayed significantly higher peak vertical GRF (p = 0.003), RFD (p = 0.002), and peak ankle moment and power (p < 0.001). The effect sizes for these differences were large for all variables (Cohen's d > 0.80). CONCLUSION: The mechanical demand at the ankle joint is significantly greater for the SDC than the TL.

Creatine electrolyte supplement improves anaerobic power and strength: a randomized double-blind control study.

BACKGROUND: Creatine supplementation aids the Phosphagen system by increasing the amount of free creatine and phosphocreatine available to replenish adenosine triphosphate. The purpose of this study was to investigate the effects of a creatine and electrolyte formulated multi-ingredient performance supplement (MIPS) on strength and power performance compared to a placebo. Maximal strength along with total concentric work, mean rate of force development (mRFD), mean power, peak power, and peak force for both bench press and back squat were determined at pre-test and post-test separated by 6 weeks of supplementation. METHODS: Twenty-two subjects (6 females, 21 ± 2 yrs., 72.46 ± 11.18 kg, 1.72 ± 0.09 m) performed a one-repetition maximum (1RM) for back squat and bench press. Eighty percent of the subject's pre-test 1RM was used for a maximal repetition test to assess performance variables. Testing was separated by 6 weeks of supplementation of a MIPS dose per day in a double-blind fashion for comparison. A two-way mixed analysis of covariance (ANCOVA) was applied with an alpha level of 0.05. RESULTS: For their back squat 1RM, the MIPS group displayed significant increase of 13.4% (95% CI: 2.77, 23.8%) while placebo displayed a decrease of - 0.2% (95% CI: - 1.46, 2.87%) (p = 0.047, ηp2 = 0.201). The MIPS displayed a significant increase of 5.9% (95% CI: 2.5, 10.1%) and placebo displayed a non-significant increase of 0.7% (95% CI: - 3.49, 3.9%) in bench press maximal strength (p = 0.033,0.217). The MIPS group displayed a significant increase as well in total concentric work (26.5, 95% CI: 6.07, 46.87%, p = 0.008, ηp2 = 0.330) and mean power (17.9, 95% CI: 3.42, 32.46%, p = 0.003, ηp2 = 0.402) for the maximal repetition bench press test at 80% of their 1RM. CONCLUSIONS: The MIPS was found to be beneficial to recreationally trained individuals compared to a placebo. The greatest benefits are seen in bench press and back squat maximal strength as well as multiple repetition tests to fatigue during the bench press exercise.

ACUTE EFFECTS OF TWO HIP FLEXOR STRETCHING TECHNIQUES ON KNEE JOINT POSITION SENSE AND BALANCE.

Background: Tightness of hip flexor muscles has been recognized as a risk factor for various musculoskeletal injuries in the lower extremities. Purpose: The purpose of this study was to examine the acute effects of two hip flexor stretching techniques (dynamic and hold-relax proprioceptive neuromuscular facilitation, HR-PNF) on hip extension (ROM), knee joint position sense (JPS) and balance in healthy college age students who exhibit tightness in hip flexor muscles. Study Design: Pretest-posttest randomized experimental groups. Methods: Thirty-six healthy college age students (mean = 22.37 years) with tight hip flexors participated in this study. Hip extension ROM, knee joint position sense and dynamic balance were tested pre- and post-stretching using a digital inclinometer, an iPod touch and the Y-Balance test, respectively. Subjects were randomly divided into dynamic and HR-PNF stretching groups. Three-way mixed analysis of variance was utilized to explore if an interaction existed between the groups in tested variables. Results: There was a significant effect of time on hip extension ROM in both groups (p < 0.001). There was also a significant effect of stretch type on hip extension ROM (p = 0.004) favoring hold-relax over dynamic stretching group. There was a non-significant effect of time on mean knee joint position replication error in both groups. There was a significant main effect of time on the Y-Balance test's mean distance of reach to posteromedial and posterolateral directions (p < 0.001). There was also a significant main effect of directions of reach on distances achieved (p < 0.001) favoring posterolateral over posteromedial, and the latter over anterior direction. Conclusions: The results of this study demonstrated the effectiveness of both HR-PNF and dynamic stretching techniques which resulted in a significant acute improvement in hip extension ROM and dynamic balance measures, with HR-PNF being more effective than dynamic stretch. However, there were no significant improvements in knee joint position replication over time in either stretching group. Level of Evidence: 2b.

Effects of Age, Power Output, and Cadence on Energy Expenditure and Lower Limb Antagonist Muscle Coactivation During Cycling.

It is unknown if higher antagonist muscle coactivation is a factor contributing to greater energy expenditure of cycling in older adults. We determined how age, power output, and cadence affect energy expenditure and lower limb antagonist muscle coactivation during submaximal cycling. Thirteen younger and 12 older male participants completed 6-min trials at four power output-cadence conditions (75 W-60 rpm, 75 W-90 rpm, 125 W-60 rpm, and 125 W-90 rpm) while electromyographic and metabolic energy consumption data were collected. Knee and ankle coactivation indices were calculated using vastus lateralis, biceps femoris, gastrocnemius, and tibialis anterior electromyography data. Energy expenditure of cycling was greater in older compared with younger participants at 125 W (p = .002) and at 90 rpm (p = .026). No age-related differences were observed in the magnitude or duration of coactivation about the knee or ankle (p > .05). Our results indicated that the knee and ankle coactivation is not a substantive factor contributing to greater energy expenditure of cycling in older adults.

Creatine-electrolyte supplementation improves repeated sprint cycling performance: A double blind randomized control study.

BACKGROUND: Creatine supplementation is recommended as an ergogenic aid to improve repeated sprint cycling performance. Furthermore, creatine uptake is increased in the presence of electrolytes. Prior research examining the effect of a creatine-electrolyte (CE) supplement on repeated sprint cycling performance, however, did not show post-supplementation improvement. The purpose of this double blind randomized control study was to investigate the effect of a six-week CE supplementation intervention on overall and repeated peak and mean power output during repeated cycling sprints with recovery periods of 2 min between sprints. METHODS: Peak and mean power generated by 23 male recreational cyclists (CE group: n = 12; 24.0 ± 4.2 years; placebo (P) group: n = 11; 23.3 ± 3.1 years) were measured on a Velotron ergometer as they completed five 15-s cycling sprints, with 2 min of recovery between sprints, pre- and post-supplementation. Mixed-model ANOVAs were used for statistical analyses. RESULTS: A supplement-time interaction showed a 4% increase in overall peak power (pre: 734 ± 75 W; post: 765 ± 71 W; p = 0.040; ηp2 = 0.187) and a 5% increase in overall mean power (pre: 586 ± 72 W; post: 615 ± 74 W; p = 0.019; ηp2 = 0.234) from pre- to post-supplementation for the CE group. For the P group, no differences were observed in overall peak (pre: 768 ± 95 W; post: 772 ± 108 W; p = 0.735) and overall mean power (pre: 638 ± 77 W; post: 643 ± 92 W; p = 0.435) from pre- to post-testing. For repeated sprint analysis, peak (pre: 737 ± 88 W; post: 767 ± 92 W; p = 0.002; ηp2 = 0.380) and mean (pre: 650 ± 92 W; post: 694 ± 87 W; p < 0.001; ηp2 = 0.578) power output were significantly increased only in the first sprint effort in CE group from pre- to post-supplementation testing. For the P group, no differences were observed for repeated sprint performance. CONCLUSION: A CE supplement improves overall and repeated short duration sprint cycling performance when sprints are interspersed with adequate recovery periods.

Individuals With Knee Osteoarthritis Demonstrate Interlimb Asymmetry in Pedaling Power During Stationary Cycling.

Cycling is commonly prescribed for physical rehabilitation of individuals with knee osteoarthritis (OA). Despite the known therapeutic benefits, no research has examined interlimb symmetry of power output during cycling in these individuals. We investigated the effects of external workload and cadence on interlimb symmetry of crank power output in individuals with knee OA versus healthy controls. A total of 12 older participants with knee OA and 12 healthy sex- and age-matched controls were recruited. Participants performed 2-minute bouts of stationary cycling at 4 workload-cadence conditions (75 W at 60 rpm, 75 W at 90 rpm, 100 W at 60 rpm, and 100 W at 90 rpm). Power output contribution of each limb toward total crank power output was computed over 60 crank cycles from the effective component of pedal force, which was perpendicular to the crank arm. Across the workload-cadence conditions, the knee OA group generated significantly higher power output with the severely affected leg compared with the less affected leg (10% difference; P = .02). Healthy controls did not show interlimb asymmetry in power output (0.1% difference; P > .99). For both groups, interlimb asymmetry was unaffected by external workload and cadence. Our results indicate that individuals with knee OA demonstrate interlimb asymmetry in crank power output during stationary cycling.

Effects of age and physical activity status on redistribution of joint work during walking.

During walking older adults rely less on ankle and more on hip work than young adults. Disproportionate declines in plantarflexor strength may be a mechanism underlying this proximal work redistribution. We tested the hypothesis that proximal redistribution is more apparent in older compared to young adults and in sedentary compared to active individuals over multiple walking speeds. We recruited 18 young (18-35 yrs) and 17 older (65-80 yrs) physically active and sedentary adults. Participants completed five trials at four walking speeds as marker positions and ground reaction forces were collected. Sagittal plane net joint moments were computed using inverse dynamics. Instantaneous joint powers for the ankle, knee, and hip were computed as products of net joint moments and joint angular velocities. Positive joint work was computed by integrating hip, knee, and ankle joint powers over time in early, mid, and late stance, respectively. Relative joint work was expressed as a percentage of total work. Isokinetic strength of lower limb flexor and extensor muscles was measured. Older adults had lower relative ankle (p=0.005) and higher relative hip (p=0.007) work than young adults for multiple speeds. Non-significant trends (p<0.10) indicating sedentary participants had lower relative ankle (p=0.068) and higher relative hip work (p=0.087) than active adults were observed. Age-related differences in plantarflexor strength were not disproportionate compared to strength differences in knee and hip musculature. Age influenced proximal work redistribution over multiple walking speeds. Physical activity status showed a similar trend for proximal work redistribution, but failed to reach statistical significance.

Mechanisms underlying the reduced performance measures from using equipment with a counterbalance weight system.

Bench press throws are commonly used in the assessment of upper-body power and are often performed on a Smith machine that uses a counterbalance weight to reduce the net load on the barbell. The use of a counterbalanced Smith machine was recently shown to reduce performance measures, but the mechanisms for this reduction have not been established. The purpose of this study was to determine the underlying physiological and biomechanical causes of the reduced performance measures found when using a counterbalanced Smith machine. Twenty-four men (mean ± SE: age, 23 ± 1 years; weight, 91.0 ± 3.5 kg; height, 178.9 ± 1.2 cm) performed Smith machine bench press throws at 30% of 1-repetition maximum under 4 conditions: (a) rebound movement and counterbalance, (b) rebound movement and no counterbalance, (c) concentric-only movement and counterbalance, and (d) concentric-only movement and no counterbalance. Peak power, peak force, and peak concentric and eccentric velocities were measured using a linear accelerometer, and peak ground reaction force was measured using a force plate. The counterbalance condition produced significantly (p < 0.05) lower peak accelerometer-based force (-21.2 and -17.0% for rebound and concentric-only bench press throws, respectively) but increased peak ground reaction force (5.3 and 3.2%). The discrepancy between changes in peak accelerometer-based force and peak ground reaction force suggests that an increase in net external load occurred during the movement. For performance testing of explosive movements, the use of a counterbalance system results in an underestimation of performance capability, likely because of an increase in the net external load during the concentric phase. Therefore, a counterbalance system should not be used for explosive movement performance testing.

Smith machine counterbalance system affects measures of maximal bench press throw performance.

Equipment with counterbalance weight systems is commonly used for the assessment of performance in explosive resistance exercise movements, but it is not known if such systems affect performance measures. The purpose of this study was to determine the effect of using a counterbalance weight system on measures of smith machine bench press throw performance. Ten men and 14 women (mean ± SD: age, 25 ± 4 years; height, 173 ± 10 cm; weight, 77.7 ± 18.3 kg) completed maximal smith machine bench press throws under 4 different conditions (2 × 2; counterbalance × load): with or without a counterbalance weight system and using 'light' or 'moderate' net barbell loads. Performance variables (peak force, peak velocity, and peak power) were measured using a linear accelerometer attached to the barbell. The counterbalance weight system resulted in significant (p < 0.001) reductions in measures of peak force (mean difference ± standard error: light: -112 ± 20 N; moderate: -140 ± 23 N), peak velocity (light: -0.49 ± 0.10 m·s; moderate: -0.33 ± 0.07 m·s), and peak power (light: -220 ± 43 W; moderate: -143 ± 28 W) compared with no counterbalance system for both load conditions. Load condition did not affect absolute or percentage reductions from the counterbalance weight system for any variable. In conclusion, the use of a counterbalance weight system reduces accelerometer-based performance measures for the bench press throw exercise at light and moderate loads. This reduction in measures is likely because of an increase in the external resistance during the movement, which results in a discrepancy between the manually input and the actual value for external load. A counterbalance weight system should not be used when measuring performance in explosive resistance exercises with an accelerometer.