Tibiofemoral Load Magnitude and Distribution During Load Carriage.

Chronic exposure to high tibiofemoral joint (TFJ) contact forces can be detrimental to knee joint health. Load carriage increases TFJ contact forces, but it is unclear whether medial and lateral tibiofemoral compartments respond similarly to incremental load carriage. The purpose of our study was to compare TFJ contact forces when walking with 15% and 30% added body weight. Young healthy adults (n = 24) walked for 5 minutes with no load, 15% load, and 30% load on an instrumented treadmill. Total, medial, and lateral TFJ contact peak forces and impulses were calculated via an inverse dynamics informed musculoskeletal model. Results of 1-way repeated measures analyses of variance (α = .05) demonstrated total, medial, and lateral TFJ first peak contact forces and impulses increased significantly with increasing load. Orthogonal polynomial trends demonstrated that the 30% loading condition led to a curvilinear increase in total and lateral TFJ impulses, whereas medial first peak TFJ contact forces and impulses responded linearly to increasing load. The total and lateral compartment impulse increased disproportionally with load carriage, while the medial did not. The medial and lateral compartments responded differently to increasing load during walking, warranting further investigation because it may relate to risk of osteoarthritis.

Remote ischaemic conditioning combined with bimanual task training to enhance bimanual skill learning and corticospinal excitability in children with unilateral cerebral palsy: a study protocol of a single centre, phase II randomised controlled trial.

INTRODUCTION: Children with unilateral cerebral palsy (UCP) have difficulty in bimanual coordination that restricts the child's independence in daily activities. Although several efficacious interventions to improve bimanual coordination exist, these interventions often require higher training doses and have modest effect sizes. Thus, there is a critical need to find an effective priming agent that, when paired with task-specific training, will facilitate neurobiological processes to enhance the magnitude of training effects and subsequently improve functional capabilities of children with UCP. The aim of this study is to determine the effects of a novel priming agent, remote ischaemic conditioning (RIC), combined with bimanual training on bimanual skill learning and corticospinal excitability in children with UCP. METHODS AND ANALYSES: 46 children, aged 8-16 years, will be randomly assigned to receive RIC or sham conditioning combined with 5 days of bimanual skill (cup stacking) training (15 trials per session). RIC or sham conditioning will be performed with a standard conditioning protocol of five cycles of alternative inflation and deflation of a pressure cuff on the affected arm with the pressure of at least 20 mm Hg above systolic blood pressure for RIC and 25 mm Hg for sham conditioning. Primary outcomes will be movement time and corticospinal excitability measures determined with a single-pulse transcranial magnetic stimulation (TMS). Secondary outcomes include Assisting Hand Assessment, spatio-temporal kinematic variables and paired pulse TMS measures. All measures will be conducted before and immediately after the intervention. A mixed model analysis of variance will test the group×time interaction for all outcomes with group (RIC and sham) as between-subject and time (preintervention, postintervention) as within-subject factors. ETHICS AND DISSEMINATION: The study has been approved by the University Medical Centre Institutional Review Board (UMCIRB #21-001913). We will disseminate the study findings via peer-reviewed publications and presentations at professional conferences. TRIAL REGISTRATION NUMBER: NCT05777070.

Bimanual Movement Characteristics and Real-World Performance Following Hand-Arm Bimanual Intensive Therapy in Children with Unilateral Cerebral Palsy.

The purpose of this study was to quantify characteristics of bimanual movement intensity during 30 h of hand-arm bimanual intensive therapy (HABIT) and bimanual performance (activities and participation) in real-world settings using accelerometers in children with unilateral cerebral palsy (UCP). Twenty-five children with UCP participated in a 30 h HABIT program. Data were collected from bilateral wrist-worn accelerometers during 30 h of HABIT to quantify the movement intensity and three days pre- and post-HABIT to assess real-world performance gains. Movement intensity and performance gains were measured using six standard accelerometer-derived variables. Bimanual capacity (body function and activities) was assessed using standardized hand function tests. We found that accelerometer variables increased significantly during HABIT, indicating increased bimanual symmetry and intensity. Post-HABIT, children demonstrated significant improvements in all accelerometer metrics, reflecting real-world performance gains. Children also achieved significant and clinically relevant changes in hand capacity following HABIT. Therefore, our findings suggest that accelerometers can objectively quantify bimanual movement intensity during HABIT. Moreover, HABIT enhances hand function as well as activities and participation in real-world situations in children with UCP.

Differences in Muscle Demand and Joint Contact Forces Between Running and Skipping.

Skipping has been proposed as a viable cross-training exercise to running due to its lower knee contact forces and higher whole-body energy expenditure. However, how individual muscle forces, energy expenditure, and joint loading are affected by differences in running and skipping mechanics remains unclear. The purpose of this study was to compare individual muscle forces, energy expenditure, and lower extremity joint contact forces between running and skipping using musculoskeletal modeling and simulations of young adults (n = 5) performing running and skipping at 2.5 m·s-1 on an instrumented treadmill. In agreement with previous work, running had greater knee and patella contact forces than skipping which was accompanied by greater knee extensor energetic demand. Conversely, skipping had greater ankle contact forces and required greater energetic demand from the uniarticular ankle plantarflexors. There were no differences in hip contact forces between gaits. These findings further support skipping as a viable alternative to running if the primary goal is to reduce joint loading at the commonly injured patellofemoral joint. However, for those with ankle injuries, skipping may not be a viable alternative due to the increased ankle loads. These findings may help clinicians prescribe activities most appropriate for a patient's individual training or rehabilitation goals.

Peak and Per-Step Tibial Bone Stress During Walking and Running in Female and Male Recreational Runners.

BACKGROUND: Athletes, especially female athletes, experience high rates of tibial bone stress injuries (BSIs). Knowledge of tibial loads during walking and running is needed to understand injury mechanisms and design safe running progression programs. PURPOSE: To examine tibial loads as a function of gait speed in male and female runners. STUDY DESIGN: Controlled laboratory study. METHODS: Kinematic and kinetic data were collected on 40 recreational runners (20 female, 20 male) during 4 instrumented gait speed conditions on a treadmill (walk, preferred run, slow run, fast run). Musculoskeletal modeling, using participant-specific magnetic resonance imaging and motion data, was used to estimate tibial stress. Peak tibial stress and stress-time impulse were analyzed using 2-factor multivariate analyses of variance (speed*sex) and post hoc comparisons (α = .05). Bone geometry and tibial forces and moments were examined. RESULTS: Peak compression was influenced by speed (P < .001); increasing speed generally increased tibial compression in both sexes. Women displayed greater increases in peak tension (P = .001) and shear (P < .001) than men when transitioning from walking to running. Further, women displayed greater peak tibial stress overall (P < .001). Compressive and tensile stress-time impulse varied by speed (P < .001) and sex (P = .006); impulse was lower during running than walking and greater in women. A shear stress-time impulse interaction (P < .001) indicated that women displayed greater impulse relative to men when changing from a walk to a run. Compared with men, women displayed smaller tibiae (P < .001) and disproportionately lower tibial forces (P≤ .001-.035). CONCLUSION: Peak tibial stress increased with gait speed, with a 2-fold increase in running relative to walking. Women displayed greater tibial stress than men and greater increases in stress when shifting from walking to running. Sex differences appear to be the result of smaller bone geometry in women and tibial forces that were not proportionately lower, given the womens' smaller stature and lower mass relative to men. CLINICAL RELEVANCE: These results may inform interventions to regulate running-related training loads and highlight a need to increase bone strength in women. Lower relative bone strength in women may contribute to a sex bias in tibial BSIs, and female runners may benefit from a slower progression when initiating a running program.

Increased growth rates of stream salamanders following forest harvesting.

Timber harvesting can influence headwater streams by altering stream productivity, with cascading effects on the food web and predators within, including stream salamanders. Although studies have examined shifts in salamander occupancy or abundance following timber harvest, few examine sublethal effects such as changes in growth and demography. To examine the effect of upland harvesting on growth of the stream-associated Ouachita dusky salamander (Desmognathus brimleyorum), we used capture-mark-recapture over three years at three headwater streams embedded in intensely managed pine forests in west-central Arkansas. The pine stands surrounding two of the streams were harvested, with retention of a 14- and 21-m-wide forested stream buffer on each side of the stream, whereas the third stream was an unharvested control. At the two treatment sites, measurements of newly metamorphosed salamanders were on average 4.0 and 5.7 mm larger post-harvest compared with pre-harvest. We next assessed the influence of timber harvest on growth of post-metamorphic salamanders with a hierarchical von Bertalanffy growth model that included an effect of harvest on growth rate. Using measurements from 839 individual D. brimleyorum recaptured between 1 and 6 times (total captures, n = 1229), we found growth rates to be 40% higher post-harvest. Our study is among the first to examine responses of individual stream salamanders to timber harvesting, and we discuss mechanisms that may be responsible for observed shifts in growth. Our results suggest timber harvest that includes retention of a riparian buffer (i.e., streamside management zone) may have short-term positive effects on juvenile stream salamander growth, potentially offsetting negative sublethal effects associated with harvest.

Timing of oviposition influences the effects of a non-native grass on amphibian development.

Land-use change can alter the energy dynamics in aquatic systems by changing the subsidies that form the nutrient base within them. However, experimental evaluations of subsidy change often fail to consider how effects, such as differences in individual growth and survival, may differ under varying ecological contexts experienced in the field. We used a mesocosm approach to investigate how litter (Native Prairie or Non-Native Tall-Fescue Grass) surrounding wetlands and timing of oviposition affected larval amphibian development. We found that survival differed between litter types in the Early-Oviposition treatment, with nearly 100% mortality in Fescue treatments. Conversely, survival  was similar across litter types in the Late Oviposition treatment (~ 43%), and larvae in Late-Fescue treatments metamorphosed more quickly and were larger post-metamorphosis than larvae in Prairie treatments. Follow-up experiments confirmed that low dissolved oxygen (DO) was responsible for high mortality in Early-Fescue treatments; high quantities of Fescue resulted in a microbial bloom that reduced DO to < 2 mg/L for several days, resulting in low hatching success. This effect was eliminated in treatments with supplemental aeration. Finally, we confirmed that experimentally observed DO patterns also occurred in the field. Context (i.e., timing of inundation relative to amphibian breeding) is critical to understanding the effects of subsidies on amphibian populations; early and explosively breeding species may experience catastrophic mortality due to DO depletion; whereas, species that breed later may experience enhanced fitness of recruits. Considering the effects of non-native species across different ecological contexts is necessary for elucidating the extent of their impacts.

Relationships of hip abductor strength, neuromuscular control, and hip width to femoral length ratio with peak hip adduction angle in healthy female runners.

A large peak hip adduction angle during running is a risk factor for several overuse injuries in women. The purpose of this study was to determine if female runners with a large peak hip adduction angle have differences in eccentric hip abductor muscle strength, hip neuromuscular control, and/or hip width to femoral length ratio (HW:FL) compared to those with a small angle. Hip adduction during running, hip strength, hip control, and HW:FL were measured in sixty healthy female runners (1.66 ± 0.06 m; 63.2 ± 8.3 kg; 27 ± 6 years). Data from twenty runners with the largest and twenty with the smallest peak hip adduction angles were analysed. Between-group differences in hip strength, control, and HW:FL were determined using independent t-tests (p < 0.05). Variables that were significantly different between groups were entered into a regression model. Runners in both groups had similar hip strength (p = 0.90) and control (p = 0.65). HW:FL was greater in the large peak angle group (p = 0.04), but only explained a small amount of peak hip adduction angle variance for all sixty runners (R2 = 0.05). Alarge peak hip adduction angle in some healthy female runners may simply be instinctive as there were no deficiencies in the strength or neuromuscular control constructs assessed.

Differential responses of amphibian and reptile assemblages to size of riparian buffers within managed forests.

Streamside management zones (i.e., riparian buffers; SMZs) are commonly implemented within managed forests to protect water quality but may also provide habitat for riparian-associated wildlife. Yet, little research has rigorously addressed the value of SMZs for wildlife, particularly for cryptic species such as amphibians and reptiles. Previous studies of herpetofauna within SMZs have focused on one or a few stream-associated species, and questions remain regarding variation among species or guilds and what role SMZs serve toward conservation of herpetofaunal diversity in managed forests. However, recent statistical advances have improved our ability to analyze large multi-species presence-absence data sets, accounting for low detection rates typical for some herpetofaunal species. Our study represents an extensive landscape-scale examination of herpetofaunal communities within SMZs using a multi-species occupancy approach. We conducted four replicate surveys at 102 headwater streams, spanning a gradient of SMZ widths and adjacent forest stand ages, within the Ouachita Mountains, Arkansas, USA. We used a hierarchical Bayesian community occupancy model to estimate species richness and species-specific occupancy responses to SMZ and overstory characteristics, accounting for variation in occupancy and detection attributable to site and sampling covariates. We documented high richness (37 species) within SMZs. Across the herpetofaunal community, occupancy and species richness were consistently positively associated with SMZ width, with maximum predicted richness of 30 species occurring at sites with buffers extending 51 m on either side of the stream. However, we documented considerable variation among groups and species within groups, underscoring the potential for different responses to forest management among taxa. Reptile predicted richness increased more rapidly up to SMZs of ~35 m, whereas maximum salamander predicted richness was not seen until an SMZ width of 55 m. Estimated salamander richness was highest within SMZs embedded in mature managed pine stands and was higher in SMZs comprised of a deciduous or mixed overstory vs. a pine overstory. Compared to salamanders, more anuran species showed high mean estimated occupancy (>75%) at narrower SMZs (<30 m). Collectively, our results indicate that SMZs surrounding small first-order streams in intensively managed forests not only protect water quality, but also can support diverse amphibian and reptile communities.

Parental Effects and Climate Change: Will Avian Incubation Behavior Shield Embryos from Increasing Environmental Temperatures?

A major driver of wildlife responses to climate change will include non-genomic effects, like those mediated through parental behavior and physiology (i.e., parental effects). Parental effects can influence lifetime reproductive success and survival, and thus population-level processes. However, the extent to which parental effects will contribute to population persistence or declines in response to climate change is not well understood. These effects may be substantial for species that exhibit extensive parental care behaviors, like birds. Environmental temperature is important in shaping avian incubation behavior, and these factors interact to determine the thermal conditions embryos are exposed to during development, and subsequently avian phenotypes and secondary sex ratios. In this article, we argue that incubation behavior may be an important mediator of avian responses to climate change, we compare incubation strategies of two species adapted to different thermal environments nesting in extreme heat, and we present a simple model that estimates changes in egg temperature based on these incubation patterns and predicted increases in maximum daily air temperature. We demonstrate that the predicted increase in air temperature by 2100 in the central USA will increase temperatures that eggs experience during afternoon off-bouts and the proportion of nests exposed to lethal temperatures. To better understand how species and local adaptations and behavioral-plasticity of incubation behavior will contribute to population responses to climate change comparisons are needed across more avian populations, species, and thermal landscapes.

Effects of Load Carriage and Step Length Manipulation on Achilles Tendon and Knee Loads.

INTRODUCTION: Longer steps with load carriage is common in shorter Soldiers when matching pace with taller Soldiers whereas shorter steps are hypothesized to reduce risk of injury with load carriage. The effects of load carriage with and without step length manipulation on loading patterns of three commonly injured structures were determined: Achilles tendon, patellofemoral joint (PFJ) and medial tibiofemoral joint (mTFJ). MATERIALS AND METHODS: ROTC Cadets (n = 16; 20.1 years ± 2.5) walked with and without load carriage (20-kg). Cadets then altered preferred step lengths ±7.5% with load carriage. Achilles tendon, PFJ and mTFJ loads were estimated via musculoskeletal modeling. RESULTS: Large increases in peak Achilles tendon load (p < 0.001, d = 1.93), Achilles tendon impulse per 1-km (p < 0.001, d = 0.91), peak mTFJ load (p < 0.001, d = 1.33), and mTFJ impulse per 1-km (p < 0.001, d = 1.49) were noted with load carriage while moderate increases were observed for the PFJ (peak: p < 0.001, d = 0.69; impulse per 1-km: p < 0.001, d = 0.69). Shortened steps with load carriage only reduced peak Achilles tendon load (p < 0.001, d = -0.44) but did not reduce Achilles impulse per km due to the resulting extra steps and also did not reduce peak or cumulative PFJ and mTFJ loads (p > 0.05). Longer steps with load carriage increased PFJ loads the most (p < 0.001, d = 0.68-0.75) with moderate increases in mTFJ forces (p < 0.001, d = 0.48-0.63) with no changes in Achilles tendon loads (p = 0.11-0.20). CONCLUSION: A preferred step length is the safest strategy when walking with load carriage. Taking a shorter step is not an effective strategy to reduce loading on the Achilles tendon, PFJ, and mTFJ.

Tibiofemoral Joint Forces in Female Recreational Runners Vary with Step Frequency.

PURPOSE: Elevated tibiofemoral joint (TFJ) contact forces have been linked to the development and progression of knee osteoarthritis. The primary objective of this study was to determine the association between peak TFJ shear and compression forces during running at different self-selected step frequencies (SF) in female recreational runners. METHODS: Fifty-five healthy female recreational runners ran at 2.98 m·s on an instrumented treadmill. Peak TFJ anterior shear force, peak axial TFJ compression force, and peak medial compartment TFJ compression force were estimated using a musculoskeletal model with inputs from 3D joint kinematics and inverse dynamics calculations. Three SF groups were generated using tertiles, and differences between the groups were compared using one-way ANOVA (α = 0.05). RESULTS: Runners with an SF of ≥178 steps per minute demonstrated the lowest peak TFJ anterior shear force (P = 0.04), peak axial TFJ compression force (P = 0.01), and peak TFJ medial compartment compression forces (P = 0.01) compared with runners using lower SF. CONCLUSION: Female recreational runners with low SF of ≤166 steps per minute experience greater TFJ contact forces. This study provides evidence of an association between SF and both shear and axial peak TFJ contact forces during running.

Knee Frontal Plane Projection Angle: A Comparison Study Between Drop Vertical Jump and Step-Down Tests With Young Volleyball Athletes.

STUDY DESIGN: Observational study. CONTEXT: Altered frontal plane knee mechanics during dynamic tasks have been often associated with lower-extremity injuries. Strategies to decrease these risk factors and improve knee joint stability are often applied in rehabilitation and training environments. OBJECTIVE: The purpose of this study was to compare knee joint frontal plane projection angles (FPPA) via 2-dimensional video analysis during drop vertical jump (DVJ) and step-down test (SDT) tasks in the preferred and nonpreferred limbs of young male and female volleyball players. METHODS: A total of 60 young male (n = 29) and female (n = 31) volleyball players (13.6 [1.1] y, 62.2 [11.2] kg, and 170.8 [10] cm) participated in this study. Once the athletes were screened for inclusion and exclusion criteria, limb preference was operationally defined as the preferred kicking leg or the foot used for stair climbing. In a randomized study design, participants were asked to perform a bilateral DVJ and unilateral step-down landing tasks for both preferred and nonpreferred limb. Kinematic analysis was performed via a 2-dimensional video recording of knee joint FPPA alignment. RESULTS: No difference was noted in FFPA during DVJ and SDT tasks between preferred and nonpreferred limbs in both male and female groups (P > .05). The FFPA was significantly higher for both limbs during DVJ versus SDT in both groups (P ≤ .05), but it was not different between male and female athletes. CONCLUSIONS: Based on these findings, clinicians may expect young male and female volleyball athletes to demonstrate similar and symmetrical lower-extremity 2-dimensional knee joint FPPA values across screening tests intended to identify lower-extremity injury risk factors. However, greater FPPA values should be expected during the more dynamic DVJ task.

Phylogeny and Classification of Novel Diversity in Sainouroidea (Cercozoa, Rhizaria) Sheds Light on a Highly Diverse and Divergent Clade.

Sainouroidea is a molecularly diverse clade of cercozoan flagellates and amoebae in the eukaryotic supergroup Rhizaria. Previous 18S rDNA environmental sequencing of globally collected fecal and soil samples revealed great diversity and high sequence divergence in the Sainouroidea. However, a very limited amount of this diversity has been observed or described. The two described genera of amoebae in this clade are Guttulinopsis, which displays aggregative multicellularity, and Rosculus, which does not. Although the identity of Guttulinopsis is straightforward due to the multicellular fruiting bodies they form, the same is not true for Rosculus, and the actual identity of the original isolate is unclear. Here we isolated amoebae with morphologies like that of Guttulinopsis and Rosculus from many environments and analyzed them using 18S rDNA sequencing, light microscopy, and transmission electron microscopy. We define a molecular species concept for Sainouroidea that resulted in the description of 4 novel genera and 12 novel species of naked amoebae. Aggregative fruiting is restricted to the genus Guttulinopsis, but other than this there is little morphological variation amongst these taxa. Taken together, simple identification of these amoebae is problematic and potentially unresolvable without the 18S rDNA sequence.

Achilles tendon loading during weight bearing exercises.

OBJECTIVE: Compare the estimated Achilles tendon (AT) loading using a musculoskeletal model during commonly performed weight bearing therapeutic exercises. DESIGN: Controlled laboratory study. SETTING: University biomechanics laboratory. PARTICIPANTS: Eighteen healthy males (Age:22.1 ±â€¯1.8 years, height:177.7 ±â€¯8.4 cm, weight = 74.29 ±â€¯11.3 kg). MAIN OUTCOME MEASURE(S): AT loading was estimated during eleven exercises: tandem, Romberg, and unilateral standing, unilateral and bilateral heel raising, unilateral and bilateral jump landing, squat, lunge, walking, and running. Kinematic and kinetic data were recorded at 180 Hz and 1800 Hz respectively. These data were then used in a musculoskeletal model to estimate force in the triceps surae. AT cross-sectional images were measured by ultrasound to determine AT stress. A repeated measure multivariate analysis of variance (α = 0.05) was used on AT loading variables. RESULTS: Squat and unilateral jump landing were the most different in AT stress. Peak AT stress variables were generally greater during more dynamic, unilateral exercises compared to more static, bilateral exercises. CONCLUSIONS: Bilateral, more static exercises resulted in less AT loading and may serve as a progression during the rehabilitation compared to more dynamic, unilateral exercises.

Walking velocity and step length adjustments affect knee joint contact forces in healthy weight and obese adults.

Knee osteoarthritis is a major public health problem and adults with obesity are particularly at risk. One approach to alleviating this problem is to reduce the mechanical load at the joint during daily activity. Adjusting temporospatial parameters of walking could mitigate cumulative knee joint mechanical loads. The purpose of this study was to determine how adjustments to velocity and step length affects knee joint loading in healthy weight adults and adults with obesity. We collected three-dimensional gait analysis data on 10 adults with a normal body mass index and 10 adults with obesity during over ground walking in nine different conditions. In addition to preferred velocity and step length, we also conducted combinations of 15% increased and decreased velocity and step length. Peak tibiofemoral joint impulse and knee adduction angular impulse were reduced in the decreased step length conditions in both healthy weight adults (main effect) and those with obesity (interaction effect). Peak knee joint adduction moment was also reduced with decreased step length, and with decreased velocity in both groups. We conclude from these results that adopting shorter step lengths during daily activity and when walking for exercise can reduce mechanical stimuli associated with articular cartilage degenerative processes in adults with and without obesity. Thus, walking with reduced step length may benefit adults at risk for disability due to knee osteoarthritis. Clinical Significance: Adopting a shorter step length during daily walking activity may reduce knee joint loading and thus benefit those at risk for knee cartilage degeneration. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2679-2686, 2018.

Sex-specific kinetic and kinematic indicators of medial tibiofemoral force during walking and running.

BACKGROUND: Our aims were to (1) Evaluate sex-specific contributions of peak knee flexion moment (pKFM) and peak knee adduction moment (pKAM) in medial tibiofemoral joint (TFJ) force during walking and running; (2) identify kinematic variables to estimate peak medial TFJ force. METHODS: Eighty-seven runners participated (36 females, 51 males; age=23.0±3.8years (1 standard deviation)). Kinematics and kinetics data were collected during treadmill walking (1.3m/s) and running (3.0±0.4m/s). Peak medial TFJ contact force was estimated using a musculoskeletal model. Linear regression analyses were used to assess the contribution of pKFM, pKAM and kinematic indicators to estimated joint forces. RESULTS: During walking and running, pKAM and pKFM accounted for 74.9% and 64.5% of peak medial TFJ force variance (P<0.001), respectively. Similar pKAM contribution was found between males and females during walking (51.8% vs. 47.9%), as opposed to running (50.4% vs. 26.8%). Kinematic indicators during walking were peak knee flexion and adduction angles, regardless of sex. During running, indicators were ankle dorsiflexion at foot strike and center of mass (COM) vertical displacement in females (R2=0.364, P=0.012), and peak knee abduction angle and step length in males (R2=0.508, P=0.019). CONCLUSION: We conclude from these results that pKAM and pKFM make significant but potentially sex-specific contributions to peak medial TFJ force during walking and running. Clinically, peak medial TFJ force during walking can be estimated using peak knee flexion and adduction angles in both sexes. During running, ankle dorsiflexion at foot strike and COM oscillation are best indicators among females, while knee abduction and step length are best among males.

Gait biomechanics of skipping are substantially different than those of running.

The inherit injury risk associated with high-impact exercises calls for alternative ways to achieve the benefits of aerobic exercise while minimizing excessive stresses to body tissues. Skipping presents such an alternative, incorporating double support, flight, and single support phases. We used ground reaction forces (GRFs), lower extremity joint torques and powers to compare skipping and running in 20 healthy adults. The two consecutive skipping steps on each limb differed significantly from each other, and from running. Running had the longest step length, the highest peak vertical GRF, peak knee extensor torque, and peak knee negative and positive power and negative and positive work. Skipping had the greater cadence, peak horizontal GRF, peak hip and ankle extensor torques, peak ankle negative power and work, and peak ankle positive power. The second vs first skipping step had the shorter step length, higher cadence, peak horizontal GRF, peak ankle extensor torque, and peak ankle negative power, negative work, and positive power and positive work. The first skipping step utilized predominately net negative joint work (eccentric muscle action) while the second utilized predominately net positive joint work (concentric muscle action). The skipping data further highlight the persistence of net negative work performed at the knee and net positive work performed at the ankle across locomotion gaits. Evidence of step segregation was seen in distribution of the braking and propelling impulses and net work produced across the hip, knee, and ankle joints. CONCLUSIONS: Skipping was substantially different than running and was temporally and spatially asymmetrical with successive foot falls partitioned into a dominant function, either braking or propelling whereas running had a single, repeated step in which both braking and propelling actions were performed equally.

Reduced step length reduces knee joint contact forces during running following anterior cruciate ligament reconstruction but does not alter inter-limb asymmetry.

BACKGROUND: Anterior cruciate ligament reconstruction is associated with early onset knee osteoarthritis. Running is a typical activity following this surgery, but elevated knee joint contact forces are thought to contribute to osteoarthritis degenerative processes. It is therefore clinically relevant to identify interventions to reduce contact forces during running among individuals after anterior cruciate ligament reconstruction. The primary purpose of this study was to evaluate the effect of reducing step length during running on patellofemoral and tibiofemoral joint contact forces among people with a history of anterior cruciate ligament reconstruction. Inter limb knee joint contact force differences during running were also examined. METHODS: 18 individuals at an average of 54.8months after unilateral anterior cruciate ligament reconstruction ran in 3 step length conditions (preferred, -5%, -10%). Bilateral patellofemoral, tibiofemoral, and medial tibiofemoral compartment peak force, loading rate, impulse, and impulse per kilometer were evaluated between step length conditions and limbs using separate 2 factor analyses of variance. FINDINGS: Reducing step length 5% decreased patellofemoral, tibiofemoral, and medial tibiofemoral compartment peak force, impulse, and impulse per kilometer bilaterally. A 10% step length reduction further decreased peak forces and force impulses, but did not further reduce force impulses per kilometer. Tibiofemoral joint impulse, impulse per kilometer, and patellofemoral joint loading rate were lower in the previously injured limb compared to the contralateral limb. INTERPRETATION: Running with a shorter step length is a feasible clinical intervention to reduce knee joint contact forces during running among people with a history of anterior cruciate ligament reconstruction.

Elevated Knee Joint Kinetics and Reduced Ankle Kinetics Are Present During Jogging and Hopping After Achilles Tendon Ruptures.

BACKGROUND: Deficits in plantarflexor function are common after an Achilles tendon rupture. These deficits may result in an altered distribution of joint loads during lower extremity tasks. HYPOTHESIS: We hypothesized that, regardless of treatment, the Achilles tendon-ruptured limb would exhibit deficits in ankle kinematics and joint power while exhibiting elevated knee joint power and patellofemoral joint loads during walking, jogging, and hopping. We further hypothesized that this loading pattern would be most evident during jogging and hopping. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty-four participants (17 participants treated surgically, 17 treated nonsurgically) were tested at a mean 6.1 ± 2.0 years after an Achilles tendon rupture. Lower extremity kinematics and kinetics were assessed while participants completed walking, jogging, and single-legged hopping trials. Patellofemoral joint stress was calculated via a musculoskeletal model. Data were analyzed via mixed-model repeated analyses of variance (α = .05) and the limb symmetry index (LSI). RESULTS: No differences ( P ≥ .05) were found between the surgical and nonsurgical groups. In both groups, large side-to-side deficits in the plantarflexion angle at toeoff (LSI: 53.5%-73.9%) were noted during walking, jogging, and hopping in the involved limb. Side-to-side deficits in the angular velocity were only present during jogging (LSI: 93.5%) and hopping (LSI: 92.5%). This pattern was accompanied by large deficits in eccentric (LSI: 80.8%-94.7%) and concentric (LSI: 82.2%-84.7%) ankle joint powers in the involved limb during all tasks. Interestingly, only jogging and hopping demonstrated greater knee joint loads when compared with the uninvolved limb. Concentric knee power was greater during jogging (LSI: 117.2%) and hopping (LSI: 115.9%) compared with the uninvolved limb. Similarly, peak patellofemoral joint stress was greater in the involved limb during jogging (LSI: 107.5%) and hopping (LSI: 107.1%), while only hopping had a greater loading rate of patellofemoral joint stress (LSI: 110.9%). CONCLUSION: Considerable side-to-side deficits in plantarflexor function were observed during walking, jogging, and hopping in patients after an Achilles tendon rupture. As a possible compensation, increased knee joint loads were present but only during jogging and hopping. CLINICAL RELEVANCE: These data suggest that after an Achilles tendon rupture, patients may be susceptible to greater mechanical loading of the knee during sporting tasks, regardless of surgical or nonsurgical treatment.