Spinal joint moment prediction following simulated breast surgery using a female whole-body musculoskeletal model.

This study aimed to use a musculoskeletal model to predict changes in spinal moments following simulated breast surgery. A female full body musculoskeletal model with a fully articulated thoracolumbar spine and independent moveable breast segments was customised for this study. Key findings suggest that the simulated removal of breast tissue (750 g to 1501 g) can reduce the magnitude of lumbar spine extensor moments by >0.05 Nm/kg during walking and jogging. A customised female whole-body musculoskeletal model is capable of providing a first approximation of changes in spinal loading following simulated breast surgery.

Success to Clear the Bar in Elite Pole Vaulters is Affected by Step Frequency Perturbation.

The purpose of the study was to identify the interaction of step characteristics, along with the direction and magnitude of their asymmetry of elite male and female pole vaulters between successful and failed attempts. It was hypothesized that step characteristics and the magnitude of asymmetry between the two legs would interact with the outcome of the attempt. The approach runs of 12 pole vaulters (7 males, 5 females) were recorded during an indoor international competition. The leg used by the athlete for taking-off was defined as the non-pole-carrying leg, while the other was the pole-carrying leg. Using spatiotemporal information obtained from recordings with a panning camera (300 fps), the last steps of each athlete's approach run were analyzed for length, frequency, average velocity, and inter-limb asymmetry. There was no inter-limb difference (p > 0.05) in the absolute values of step length or step velocity between successful and failed attempts. However, the pole-carrying leg presented significantly (p < 0.05) higher step frequency values at the failed attempts. There was no significant difference (p > 0.05) in asymmetry values for step length, frequency, and average velocity between successful and failed attempts. Although step velocity remained unaffected, failed attempts were characterized by a perturbation in the interaction of step frequency and step length. The present findings suggest that although high velocity at the final phase of the approach is essential, it is not the sole determining factor for a successful attempt.

Does lateral banking and radius affect well-trained sprinters and team-sports players during bend sprinting?

This study investigated the short-term responses of step characteristics in sprinters and team-sports players under different bend conditions. Eight participants from each group completed 80 m sprints in four conditions: banked and flat, in lanes two and four (L2B, L4B, L2F, L4F). Groups showed similar changes in step velocity (SV) across conditions and limbs. However, sprinters produced significantly shorter ground contact times (GCT) than team sports players in L2B and L4B for both left (0.123 s vs 0.145 s and 0.123 s vs 0.140 s) and right steps (0.115 s vs 0.136 s and 0.120 s vs 0.141 s) (p > 0.001-0.029; ES = 1.15-1.37). Across both groups, SV was generally lower in flat conditions compared to banked (Left: 7.21 m/s vs 6.82 m/s and Right: 7.31 m/s vs 7.09 m/s in lane two), occurring due to reduced step length (SL) rather than step frequency (SF), suggesting that banking improves SV via increased SL. Sprinters produced significantly shorter GCT in banked conditions that led to non-significant increases in SF and SV, highlighting the importance of bend sprinting specific conditioning and training environments representative of indoor competition for sprint athletes.

An investigation of proprioception illusion using a stimulator with feedback control.

It is possible to create illusions of limb movements using vibrations over the skin. If a muscle is vibrated it can feel as if the limb is moving while it remains still. These illusions have been studied for decades but it is not yet entirely clear how to create them effectively and repeatedly. In this study, three parameters were varied; the frequency of the vibration, the stimulation site and the arm position. A closed loop control of the vibration frequency was used to ensure a fixed frequency over the stimulation time and across the participants. The experiment included twenty-five able-bodied participants (mean age 32±7 years, 9 females). A hanging arm position was introduced with the aim to increase the success rate of illusions compared to other studies. Twenty-four participants felt an illusion across all scenarios. The results highlight that tactile feedback affects the illusion.

Biomechanical responses to landing strategies of female artistic gymnasts.

Inconsistencies between sexes in the landing criteria provided by the international gymnastics governing body (FIG) may predispose female gymnasts to lower extremity injury. This study aimed to investigate lower extremity biomechanics when performing the male and female landing strategy. Seven collegiate, female gymnasts (age: 20.5 ± 1.2 years, height: 1.64 ± 0.06 m, mass: 60.4 ± 10.2 kg) performed drop landings using the prescribed women's and men's landing strategy. Kinematic and kinetic data from 10 trials of each landing strategy were collected. Differences between landing strategy at individual and group level for key injury risk variables of the lower limb were explored. Group differences (p ≤ .05) were reported in the sagittal range of motion (ROM) at the knees and hips, with the men's landing strategy eliciting a larger ROM decelerating the body upon impact. Large inter and intra-individual variation was apparent with different movement responses shown across individuals and demonstrating degeneracy as gymnasts satisfied the overall landing objective. These results indicate an individually favoured landing strategy to fulfil the informational constraints and hence supporting the use of a single-subject design. The current study emphasises the potential injury risk associated with the different informational constraints placed on females' landing strategy by the FIG, whilst recognising the individual gymnasts' task response.Highlights An increase in the range of motion at the knee and hip may support the recommendation of the men's landing style.Gymnasts appear to utilise individual landing strategies to complete the landing objective, supporting the use of a single-subject design.

There are two sides to every story: implications of asymmetry on breast support requirements for sports bra manufacturers.

This study aimed to investigate: (1) the prevalence and magnitude of breast movement asymmetry, (2) the interaction between static and dynamic breast asymmetry and (3) the influence of sports bras on breast asymmetry during running. Position data were collected from 167 females whilst treadmill running and then a sub-group of 12 participants in different bra conditions. Breast movement asymmetry existed in 89% of participants, with resultant static breast position asymmetry larger in participants displaying dynamic asymmetry. Asymmetry was most commonly caused (60% to 75%) by greater movement of the left breast. No significant relationships were found between asymmetry and bra size or breast pain. Sports bras reduced asymmetry prevalence from 75% to 33% of participants in the antero-posterior direction but only from 75% to 67% of participants in the infero-superior direction. The magnitude of range-of-motion asymmetry reduced from 67 mm with no bra to between 6 and 64 mm in-bra in the infero-superior direction, with the best performing bra incorporating encapsulating cups and adjustable straps and underband. It is recommended that sports bras allow underband and strap adjustment to facilitate individual breast support and that asymmetry is considered when designing and fitting bras, which could utilise resultant asymmetry measured statically.

Lower limb biomechanics before and after anterior cruciate ligament reconstruction: A systematic review.

This review aimed to synthesise the findings of literature that have assessed the changes in lower limb biomechanics following anterior cruciate ligament (ACL) reconstructive surgery. Systematic searches of CINHAL, MEDLINE, SCOPUS, and SPORTDiscus databases were run. All included studies had presented biomechanical variables pre- and post-surgery for the same participants. Articles were categorised by the analysed movement, and effect sizes were calculated. Fifty-four studies met the inclusion criteria, providing data on gait (n = 31), balance (n = 12), joint position sense (n = 5), stair ambulation (n = 4), pivoting (n = 6), and landing (n = 5). Measures of balance performance and joint position sense showed improvements from pre- to post-surgery. Changes in joint kinematics were inconsistent between studies, however increased knee flexion excursion, and reduced tibial anterior translation and internal rotation post reconstruction were identified. Joint kinetics reduced in magnitude in the early stages after surgery (≤5 weeks), then increased later in recovery (≥24 weeks). Risk of bias assessment identified most articles had a moderate or high risk (low = 5; moderate = 21; high = 11) resulting from participant retention and surgical intervention differences. The results of the review identified that although lower limb biomechanics did alter following reconstruction, few variables provided consistent results across studies and tasks. The low methodological quality of some articles may have contributed to these inconsistent findings. Alternatively, differences across studies may have resulted from individual coping strategies of participants that have previously been suggested to be present before reconstructive surgery, and future research should look to explore individual coping strategies to ACL reconstruction.

The effect of four weeks of plyometric training on reactive strength index and leg stiffness is sport dependent.

BACKGROUND: Plyometric exercises are often used to develop lower limb strength and performance-related biomechanics such as leg stiffness. However, the effectiveness of plyometric training may depend on participants' own training and performance demands. The purpose of this study was to examine the effect of plyometric training on Reactive Strength Index (RSI) and leg stiffness (Kleg) on young athletes of different sports. METHODS: Forty eight female athletes (25 Taekwondo (TKD) and 23 rhythmic gymnastics (RG), mean±SD: age: 8.94±2.50 years; mass: 29.73±7.69 kg; height: 138.84±11.90 cm; training experience: 4.62±2.37 years) participated in this study. Participants were randomly assigned to experimental (PT, N.=24) and control (CG, N.=24) groups. The PT group followed a twice-weekly plyometric training program for 4 weeks. Plyometric drills lasted approximately 5-10 s, and at least 90 s rest was allowed after each set. To examine RSI, participants performed trials of five maximal CMJs. Submaximal hopping (20 hops) was performed in order to examine leg stiffness. RESULTS: Significant interaction effect was found for RSI and the post hoc analysis showed that RSI significantly increased by 35% (P=0.017) in RG athletes, whereas a significantly reduction by 28% (P=0.004) was revealed in TKD athletes. The interaction effect between time and group was statistically significant for Kleg (P<0.05) with Kleg significantly increasing by 31% (P=0.008) in TKD athletes, but remaining unchanged (P>0.05) in RG athletes. CONCLUSIONS: The results showed that the effect of a 4-week plyometric training program on RSI and leg stiffness is sport dependent. Further, the applied plyometric program was effective in reducing ground contact time and therefore increasing leg stiffness.

A biomechanical comparison of initial sprint acceleration performance and technique in an elite athlete with cerebral palsy and able-bodied sprinters.

Cerebral palsy is known to generally limit range of motion and force producing capability during movement. It also limits sprint performance, but the exact mechanisms underpinning this are not well known. One elite male T36 multiple-Paralympic sprint medallist (T36) and 16 well-trained able-bodied (AB) sprinters each performed 5-6 maximal sprints from starting blocks. Whole-body kinematics (250 Hz) in the block phase and first two steps, and synchronised external forces (1,000 Hz) in the first stance phase after block exit were combined to quantify lower limb joint kinetics. Sprint performance (normalised average horizontal external power in the first stance after block exit) was lower in T36 compared to AB. T36 had lower extensor range of motion and peak extensor angular velocity at all lower limb joints in the first stance after block exit. Positive work produced at the knee and hip joints in the first stance was lower in T36 than AB, and the ratio of positive:negative ankle work produced was lower in T36 than AB. These novel results directly demonstrate the manner in which cerebral palsy limits performance in a competition-specific sprint acceleration movement, thereby improving understanding of the factors that may limit performance in elite sprinters with cerebral palsy.

Patterns of locomotor regulation during the pole vault approach phase.

A successful approach phase is key to achieving high performances in the pole vault. The aim of this study was to explore the nature of locomotor control patterns during the pole vault approach phase. Fourteen well-trained athletes performed ten jumps which were recorded using 2D video sampling at 200 Hz and analysed. Key kinematics were reconstructed from camera data using a modified 2D-DLT. Patterns of regulation were determined from the standard deviation of footfall locations during the approach phase. These patterns were found to be highly individual but structural differences between those who did and those who did not regulate were identified. Regulation of locomotion was associated with an ability to produce functionally adaptable movement patterns and the consistent achievement of desired performance outcomes. Coaches should include training exercises that require intentional use of regulation to aid athletes in achieving the flexibility to adapt to changing constraints during the approach phase. Athletes should be considered on an individual basis in order to effectively, efficiently and safely improve performance.

Upper limb and eye movement coordination during reaching tasks in people with stroke.

PURPOSE: To enhance understanding of the relationship between upper limb and eye movements during reaching tasks in people with stroke. METHODS: Eye movements were recorded from 10 control participants and 8 chronic stroke participants during a visual orienting task (Experiment 1) and a series of reaching tasks (Experiment 2). Stroke participants completed the reaching tasks using (i) their less impaired upper limb, (ii) their more impaired upper limb without support, and (iii) their more impaired upper limb, with support (SaeboMAS gravitational support and/or electrical stimulation). Participants were tested individually and completed both experiments in the same session. RESULTS: Oculomotor control and the coordination between the upper limb and the oculomotor system were found to be intact in stroke participants when no limb movements were required, or when the less impaired upper limb was used. However, when the more impaired upper limb was used, success and accuracy in reaching decreased and patterns of eye movements changed, with an observed increase in eye movements to the limb itself. With upper limb support, patterns of hand-eye coordination were found to more closely resemble those of the control group. CONCLUSION: Deficits in upper limb motor systems result in changes in patterns of eye movement behavior during reaching tasks. These changes in eye movement behavior can be modulated by providing upper limb support. Implications for Rehabilitation Deficits in upper limb motor systems can result in changes in patterns of eye movement behavior during reaching tasks. Upper limb support can reduce deficits in hand-eye coordination. Stroke rehabilitation outcomes should consider motor and oculomotor performance.

Acute Effects of Stretching on Leg and Vertical Stiffness During Treadmill Running.

Pappas, PT, Paradisis, GP, Exell, TA, Smirniotou, AS, Tsolakis, CK, and Arampatzis, A. Acute effects of stretching on leg and vertical stiffness during treadmill running. J Strength Cond Res 31(12): 3417-3424, 2017-The implementation of static (SS) and dynamic (DS) stretching during warm-up routines produces significant changes in biological and functional properties of the human musculoskeletal system. These properties could affect the leg and vertical stiffness characteristics that are considered important factors for the success of athletic activities. The aim of this study was to investigate the influence of SS and DS on selected kinematic variables, and leg and vertical stiffness during treadmill running. Fourteen men (age: 22.58 ± 1.05 years, height: 1.77 ± 0.05 m, body mass: 72.74 ± 10.04 kg) performed 30-second running bouts at 4.44 m·s, under 3 different stretching conditions (SS, DS, and no stretching). The total duration in each stretching condition was 6 minutes, and each of the 4 muscle groups was stretched for 40 seconds. Leg and vertical stiffness values were calculated using the "sine wave" method, with no significant differences in stiffness found between stretching conditions. After DS, vertical ground reaction force increased by 1.7% (p < 0.05), which resulted in significant (p < 0.05) increases in flight time (5.8%), step length (2.2%), and vertical displacement of the center of mass (4.5%) and a decrease in step rate (2.2%). Practical durations of SS and DS stretching did not influence leg or vertical stiffness during treadmill running. However, DS seems to result in a small increase in lower-limb force production which may influence running mechanics.

Step characteristic interaction and asymmetry during the approach phase in long jump.

The aim of this study was to investigate the relative influence of step length (SL) and step frequency (SF) on step velocity (SV) during the approach run of high-level long jumpers and to quantify the asymmetry of these step characteristics. Spatiotemporal data of the approach run were collected during national competition from 10 long jumpers (age 26.2 ± 4.1 years, height 1.84 ± 0.06 m, mass 72.77 ± 3.23 kg, personal best performance 7.96 ± 0.30 m). Analyses were conducted for total approach, early approach and late approach. For the total approach 4/10 athletes were SF reliant and 6/10 athletes favoured neither characteristic. At the early approach, 3/10 athletes were SF reliant and 7/10 athletes favoured neither. During late approach 2/10 athletes demonstrated SL reliance, 7/10 athletes were SF reliant and 1/10 athletes favoured neither. Four athletes displayed significant asymmetry for SL and three for SF. However, no athletes demonstrated significant asymmetry for SV indicating that the asymmetrical demands of take-off do not have a marked influence on step characteristic asymmetry, probably due to the constraints of the event. Consideration should be given to the potentially conflicting demands between limbs for individual athletes.

Functional phases and angular momentum characteristics of Tkatchev and Kovacs.

Understanding the technical requirements and underlying biomechanics of complex release and re-grasp skills on high bar allows coaches and scientists to develop safe and effective training programmes. The aim of this study was to examine the differences in the functional phases between the Tkatchev and Kovacs skills and to explain how the angular momentum demands are addressed. Images of 18 gymnasts performing 10 Tkatchevs and 8 Kovacs at the Olympic Games were recorded (50 Hz), digitised and reconstructed (3D Direct Linear Transformation). Orientation of the functional phase action, defined by the rapid flexion to extension of the shoulders and extension to flexion of the hips as the performer passed through the lower vertical, along with shoulder and hip angular kinematics, angular momentum and key release parameters (body angle, mass centre velocity and angular momentum about the mass centre and bar) were compared between skills. Expected differences in the release parameters of angle, angular momentum and velocity were observed and the specific mechanical requirement of each skill were highlighted. Whilst there were no differences in joint kinematics, hip and shoulder functional phase were significantly earlier in the circle for the Tkatchev. These findings highlight the importance of the orientation of the functional phase in the preceding giant swing and provide coaches with further understanding of the critical timing in this key phase.

Asymmetry analysis of the arm segments during forward handspring on floor.

Asymmetry in gymnastics underpins successful performance and may also have implications as an injury mechanism; therefore, understanding of this concept could be useful for coaches and clinicians. The aim of this study was to examine kinematic and external kinetic asymmetry of the arm segments during the contact phase of a fundamental skill, the forward handspring on floor. Using a repeated single subject design six female National elite gymnasts (age: 19 ± 1.5 years, mass: 58.64 ± 3.72 kg, height: 1.62 ± 0.41 m), each performed 15 forward handsprings, synchronised 3D kinematic and kinetic data were collected. Asymmetry between the lead and non-lead side arms was quantified during each trial. Significant kinetic asymmetry was observed for all gymnasts (p < 0.005) with the direction of the asymmetry being related to the lead leg. All gymnasts displayed kinetic asymmetry for ground reaction force. Kinematic asymmetry was present for more gymnasts at the shoulder than the distal joints. These findings provide useful information for coaching gymnastics skills, which may subjectively appear to be symmetrical. The observed asymmetry has both performance and injury implications.

The application of precisely controlled functional electrical stimulation to the shoulder, elbow and wrist for upper limb stroke rehabilitation: a feasibility study.

BACKGROUND: Functional electrical stimulation (FES) during repetitive practice of everyday tasks can facilitate recovery of upper limb function following stroke. Reduction in impairment is strongly associated with how closely FES assists performance, with advanced iterative learning control (ILC) technology providing precise upper-limb assistance. The aim of this study is to investigate the feasibility of extending ILC technology to control FES of three muscle groups in the upper limb to facilitate functional motor recovery post-stroke. METHODS: Five stroke participants with established hemiplegia undertook eighteen intervention sessions, each of one hour duration. During each session FES was applied to the anterior deltoid, triceps, and wrist/finger extensors to assist performance of functional tasks with real-objects, including closing a drawer and pressing a light switch. Advanced model-based ILC controllers used kinematic data from previous attempts at each task to update the FES applied to each muscle on the subsequent trial. This produced stimulation profiles that facilitated accurate completion of each task while encouraging voluntary effort by the participant. Kinematic data were collected using a Microsoft Kinect, and mechanical arm support was provided by a SaeboMAS. Participants completed Fugl-Meyer and Action Research Arm Test clinical assessments pre- and post-intervention, as well as FES-unassisted tasks during each intervention session. RESULTS: Fugl-Meyer and Action Research Arm Test scores both significantly improved from pre- to post-intervention by 4.4 points. Improvements were also found in FES-unassisted performance, and the amount of arm support required to successfully perform the tasks was reduced. CONCLUSIONS: This feasibility study indicates that technology comprising low-cost hardware fused with advanced FES controllers accurately assists upper limb movement and may reduce upper limb impairments following stroke.

Considerations of force plate transitions on centre of pressure calculation for maximal velocity sprint running.

The aims of this study were to evaluate the accuracy of centre of pressure (COP) data obtained during transition of load across the boundary between two force plates, and secondly to examine the effect of such COP data on joint kinetics during sprint running performances. COP data were collected from two piezoelectric force plates as a trolley wheel was rolled across the boundary between the plates. Position data for the trolley were collected using an opto-electronic motion analysis system for comparison with COP data. Mean COP errors during transition across the plate boundary were 0.003 +/- 0.002 m relative to a control point. Kinematic and kinetic data were also collected from eight athletes during sprint running trials to demonstrate the sensitivity of the inverse dynamics analysis to COP error for the ground contact phase of the dynamic movement trials. Kinetic sensitivity to the COP error was assessed during the entire stance phase for the ankle, knee, and hip joints and was less than 5% and 3% for joint moment and power data, respectively. Based on the small COP error during transition across plate boundaries, it is recommended that foot contacts overlapping two force plates may be included in inverse dynamics analyses.

Implications of intra-limb variability on asymmetry analyses.

The aim of this study was to investigate the effect of intra-limb variability on the calculation of asymmetry with the purpose of informing future analyses. Asymmetry has previously been quantified for discrete kinematic and kinetic variables; however, intra-limb variability has not been routinely included in these analyses. Synchronized lower-limb kinematic and kinetic data were collected from eight trained athletes (age 22 ± 5 years, mass 74.0 ± 8.7 kg, stature 1.79 ± 0.07 m) during maximal velocity sprint running. Asymmetry was quantified using a modified version of the symmetry angle for selected kinematic and kinetic variables. Significant differences (P < 0.05) between left and right values for each variable were calculated to indicate intra-limb variability relative to between-limb differences. Significant asymmetry was present in only 39% of kinematic variables and 23% of kinetic variables analysed. Large kinetic asymmetry values (>90%) were calculated for some athletes that were not significant, due to large intra-limb variability. Variables that displayed significant asymmetry were athlete-specific. Findings highlight the potential for misleading results if intra-limb variability is not included in asymmetry analyses. The exclusion of asymmetry scores for variables not displaying significant asymmetry will be useful when calculating overall asymmetry for different participants and could be applied to future running gait analyses.