A surgical technique for individual control of the muscles of the rabbit lower hindlimb.

Little is known regarding the precise muscle, bone and joint actions resulting from individual and simultaneous muscle activation(s) of the lower limb. An in situ experimental approach is described herein to control the muscles of the rabbit lower hindlimb, including the medial and lateral gastrocnemius, soleus, plantaris and tibialis anterior. The muscles were stimulated using nerve-cuff electrodes placed around the innervating nerves of each muscle. Animals were fixed in a stereotactic frame with the ankle angle set at 90 deg. To demonstrate the efficacy of the experimental technique, isometric plantarflexion torque was measured at the 90 deg ankle joint angle at a stimulation frequency of 100, 60 and 30 Hz. Individual muscle torque and the torque produced during simultaneous activation of all plantarflexor muscles are presented for four animals. These results demonstrate that the experimental approach was reliable, with insignificant variation in torque between repeated contractions. The experimental approach described herein provides the potential for measuring a diverse array of muscle properties, which is important to improve our understanding of musculoskeletal biomechanics.

Tibial strains are sensitive to speed perturbations, but not grade perturbations, during running.

A fatigue-failure process is hypothesized to govern the development of tibial stress fractures, where bone damage is highly dependent on the peak strain magnitude. To date, much of the work examining tibial strain during running has ignored uphill and downhill running despite the prevalence of this terrain. This study examined the sensitivity of tibial strain to changes in running grade and speed using a combined musculoskeletal-finite element modelling routine. Seventeen participants ran on a treadmill at ±10, ±5 and 0 deg; at each grade, participants ran at 3.33 m s-1 and at a grade-adjusted speed of 2.50 and 4.17 m s-1 for uphill and downhill grades, respectively. Force and motion data were recorded in each grade and speed combination. Muscle and joint contact forces were estimated using inverse-dynamics-based static optimization. These forces were applied to a participant-adjusted finite element model of the tibia. None of the strain variables (50th and 95th percentile strain and strained volume ≥4000 µÎµ) differed as a function of running grade; however, all strain variables were sensitive to running speed (F1≥9.59, P≤0.03). In particular, a 1 m s-1 increase in speed resulted in a 9% (∼260 µÎµ) and 155% (∼600 mm3) increase in peak strain and strained volume, respectively. Overall, these findings suggest that faster running speeds, but not changes in running grade, may be more deleterious to the tibia.

Sensitivity of Internal Tibial Forces and Moments to Static Optimization Moment Constraints at the Subtalar and Ankle Joints.

We examined the sensitivity of internal tibial forces and moments during running to different subtalar/ankle moment constraints in a static optimization routine. Seventeen participants ran at 2.20, 3.33, and 4.17 ms-1 while force and motion data were collected. Ankle joint contact force was estimated using inverse-dynamics-based static optimization. Three sets of joint moment constraints were tested. All sets included the flexion-extension and abduction-adduction moments at the hip and the flexion-extension moment at the knee but differed in the constraints used at the subtalar/ankle: (1) flexion-extension at the ankle (Sag), (2) flexion-extension and inversion-eversion at ankle (Sag + Front), and (3) flexion-extension at the ankle and supination-pronation at the subtalar (Sag + SubT). Internal tibial forces and moments were quantified at the distal one-third of the tibia, by ensuring static equilibrium with applied forces and moments. No interaction was observed between running speed and constraint for internal tibial forces or moments. Sag + SubT resulted in larger internal mediolateral force (+41%), frontal (+79%), and transverse (+29%) plane moments, compared to Sag and Sag + Front. Internal axial force was greatest in Sag + Front, compared to Sag and Sag + SubT (+37%). Faster running speeds resulted in greater internal tibial forces and moments in all directions (≥+6%). Internal tibial forces and moments at the distal one-third of the tibia were sensitive to the subtalar and ankle joint moment constraints used in the static optimization routine, independent of running speed.

Tibial Strains During Prolonged Downhill Running: A Finite Element Analysis.

Bone strains in the lower extremity may be influenced by neuromuscular fatigue. In this study, we examined potential changes in finite element (FE) predicted tibial strains over the course of a fatiguing downhill-running protocol. Twelve physically active males ran for 30 min on an instrumented treadmill at a speed of 2.8 m s-1 and a grade of -11.3 deg. Motion capture and inverse-dynamic-based static optimization were used to estimate lower-extremity joint contact and muscle forces at the beginning, middle, and end stages of the downhill run. Finite element models of the tibia-fibula complex, from database-matched computed tomography images, were then used to estimate resulting 90th percentile strain (peak strain) and strained volume (volume of elements above 3000 µÎµ). In the fatigued state, peak ankle joint contact forces decreased an average of 8.1% (p < 0.002) in the axial direction, but increased an average of 7.7% (p < 0.042) in the anterior-posterior direction; consequently, finite element estimations of peak strain and strained volume were unaffected (p > 0.190). Although neuromuscular fatigue may influence ankle joint contact forces, it may not necessarily influence tibial strains due to the complex, and sometimes nonintuitive, relationship between applied load and resulting bone strain.

Effect of stride length on the running biomechanics of healthy women of different statures.

BACKGROUND: Tibial stress fracture is a debilitating musculoskeletal injury that diminishes the physical performance of individuals who engage in high-volume running, including Service members during basic combat training (BCT) and recreational athletes. While several studies have shown that reducing stride length decreases musculoskeletal loads and the potential risk of tibial injury, we do not know whether stride-length reduction affects individuals of varying stature differently. METHODS: We investigated the effects of reducing the running stride length on the biomechanics of the lower extremity of young, healthy women of different statures. Using individualized musculoskeletal and finite-element models of women of short (N = 6), medium (N = 7), and tall (N = 7) statures, we computed the joint kinematics and kinetics at the lower extremity and tibial strain for each participant as they ran on a treadmill at 3.0 m/s with their preferred stride length and with a stride length reduced by 10%. Using a probabilistic model, we estimated the stress-fracture risk for running regimens representative of U.S. Army Soldiers during BCT and recreational athletes training for a marathon. RESULTS: When study participants reduced their stride length by 10%, the joint kinetics, kinematics, tibial strain, and stress-fracture risk were not significantly different among the three stature groups. Compared to the preferred stride length, a 10% reduction in stride length significantly decreased peak hip (p = 0.002) and knee (p < 0.001) flexion angles during the stance phase. In addition, it significantly decreased the peak hip adduction (p = 0.013), hip internal rotation (p = 0.004), knee extension (p = 0.012), and ankle plantar flexion (p = 0.026) moments, as well as the hip, knee, and ankle joint reaction forces (p < 0.001) and tibial strain (p < 0.001). Finally, for the simulated regimens, reducing the stride length decreased the relative risk of stress fracture by as much as 96%. CONCLUSIONS: Our results show that reducing stride length by 10% decreases musculoskeletal loads, tibial strain, and stress-fracture risk, regardless of stature. We also observed large between-subject variability, which supports the development of individualized training strategies to decrease the incidence of stress fracture.

Internal Tibial Forces and Moments During Graded Running.

The stress experienced by the tibia has contributions from the forces and moments acting on the tibia. We sought to quantify the influence of running grade on internal tibial forces and moments. Seventeen participants ran at 3.33 m/s on an instrumented treadmill at 0 deg, ±5 deg, and ±10 deg while motion data were captured. Ankle joint contact force was estimated from an anthropometrically-scaled musculoskeletal model using inverse dynamics-based static optimization. Internal tibial forces and moments were quantified at the distal 1/3rd of the tibia, by ensuring static equilibrium with all applied forces and moments. Downhill running conditions resulted in lower peak internal axial force (range of mean differences: -9% to -16%, p < 0.001), lower peak internal anteroposterior force (-14% to -21%, p < 0.001), and lower peak internal mediolateral force (-14% to -15%, p < 0.001), compared to 0 deg and +5 deg. Furthermore, downhill conditions resulted in lower peak internal mediolateral moment (-11%to -21%, p < 0.001), lower peak internal anteroposterior moment (-13% to -14%, p < 0.001), and lower peak internal torsional moment (-9% to -21%, p < 0.001), compared to 0 deg, +5 deg, and +10 deg. The +10 deg condition resulted in lower peak internal axial force (-7% to -9%, p < 0.001) and lower peak internal mediolateral force (-9%, p = 0.004), compared to 0 deg and +5 deg. These findings suggest that downhill running may be associated with lower tibial stresses than either level or uphill running.

Effects of body size and load carriage on lower-extremity biomechanical responses in healthy women.

BACKGROUND: Musculoskeletal injuries, such as stress fractures, are the single most important medical impediment to military readiness in the U.S. Army. While multiple studies have established race- and sex-based risks associated with a stress fracture, the role of certain physical characteristics, such as body size, on stress-fracture risk is less conclusive. METHODS: In this study, we investigated the effects of body size and load carriage on lower-extremity joint mechanics, tibial strain, and tibial stress-fracture risk in women. Using individualized musculoskeletal-finite-element-models of 21 women of short, medium, and tall statures (n = 7 in each group), we computed the joint mechanics and tibial strains while running on a treadmill at 3.0 m/s without and with a load of 11.3 or 22.7 kg. We also estimated the stress-fracture risk using a probabilistic model of bone damage, repair, and adaptation. RESULTS: Under all load conditions, the peak plantarflexion moment for tall women was higher than those in short women (p < 0.05). However, regardless of the load condition, we did not observe differences in the strains and the stress-fracture risk between the stature groups. When compared to the no-load condition, a 22.7-kg load increased the peak hip extension and flexion moments for all stature groups (p < 0.05). However, when compared to the no-load condition, the 22.7-kg load increased the strains and the stress-fracture risk in short and medium women (p < 0.05), but not in tall women. CONCLUSION: These results show that women of different statures adjust their gait mechanisms differently when running with external load. This study can educate the development of new strategies to help reduce the risk of musculoskeletal injuries in women while running with external load.

Biomechanics of graded running: Part I - Stride parameters, external forces, muscle activations.

Biomechanical alterations with graded running have only been partially quantified, and the potential interactions with running speed remain unclear. We measured spatiotemporal parameters, ground reaction forces, and leg muscle activations (EMG) in nineteen adults (10F/9M) running on an instrumented treadmills at 2.50, 3.33, and 4.17 m·s-1 and 0, ±5°, and ±10°. Step frequency illustrated a significant speed × grade interaction (P < .001) and was highest (+3%) at the steepest grade (+10°) and fastest speed (4.17 m·s-1 ) when compared to level running (LR) at the same speed. Significant interaction was also observed for ground reaction forces (all P ≤ .047). Peak ground reaction forces in the normal direction increased with running speed during downhill running (DR) only (+9% at -10° and 4.17 m·s-1 ). Impulse in the normal direction decreased at fastest speed and steepest DR (-9%) and uphill running (UR) (-17%) grades. Average normal loading rate increased and decreased at fastest speed and steepest DR (+52%) and UR (-28%) grades, respectively. Negative parallel impulse increased and decreased at fastest speed and steepest DR (+166%) and UR (-90%), respectively. Positive parallel impulse decreased and increased at fastest speed and steepest DR (-75%) and UR (+111%), respectively. EMG showed comparable u-shaped curves across the grades investigated, although only a change in vastus lateralis and tibilias anterior activity was detectable at the steepest grades and fastest speed. Overall, running grade and speed significantly influences spatiotemporal parameters, ground reaction forces, and muscle activations.

Biomechanics of graded running: Part II-Joint kinematics and kinetics.

Compared to level running (LR), different strategies might be implemented by runners to cope with specific challenges of graded running at different speeds. The changes in joint kinetics and kinematics associated with graded running have been investigated, but their interactions with speed are unknown. Nineteen participants ran on an instrumented treadmill at five grades (0°, ±5° and ± 10°) and three speeds (2.50, 3.33 and 4.17 m/s), while 3D motion and forces were recorded. Three speed × five-grade repeated-measures ANOVA was used to analyze kinetic and kinematic variables. A speed × grade interaction was observed for hip range of motion (ROM). Downhill running (DR) at fastest speed did not reduce ROM at the hip, compared to LR. Compared to LR, it was observed that the hip joint was responsible for a greater contribution of energy generation while running at the fastest speed at +10°. Speed × grade interactions were also observed for the energy absorption, peak moment, and peak power at the knee. Contrary to LR, running faster during UR did not require higher peak power at the knee. Finally, DR at the fastest speed did not increase peak negative power at the knee compared to LR. This study demonstrates that ankle, knee, and hip joint kinetics depend on speed and grade of running, while the effect of grade on joint kinematics was not substantially modulated by speed.

Subject-Specific Finite Element Models of the Tibia With Realistic Boundary Conditions Predict Bending Deformations Consistent With In Vivo Measurement.

Understanding the structural response of bone during locomotion may help understand the etiology of stress fracture. This can be done in a subject-specific manner using finite element (FE) modeling, but care is needed to ensure that modeling assumptions reflect the in vivo environment. Here, we explored the influence of loading and boundary conditions (BC), and compared predictions to previous in vivo measurements. Data were collected from a female participant who walked/ran on an instrumented treadmill while motion data were captured. Inverse dynamics of the leg (foot, shank, and thigh segments) was combined with a musculoskeletal (MSK) model to estimate muscle and joint contact forces. These forces were applied to an FE model of the tibia, generated from computed tomography (CT). Eight conditions varying loading/BCs were investigated. We found that modeling the fibula was necessary to predict realistic tibia bending. Applying joint moments from the MSK model to the FE model was also needed to predict torsional deformation. During walking, the most complex model predicted deformation of 0.5 deg posterior, 0.8 deg medial, and 1.4 deg internal rotation, comparable to in vivo measurements of 0.5-1 deg, 0.15-0.7 deg, and 0.75-2.2 deg, respectively. During running, predicted deformations of 0.3 deg posterior, 0.3 deg medial, and 0.5 deg internal rotation somewhat underestimated in vivo measures of 0.85-1.9 deg, 0.3-0.9 deg, 0.65-1.72 deg, respectively. Overall, these models may be sufficiently realistic to be used in future investigations of tibial stress fracture.

Water treadmill exercise reduces equine limb segmental accelerations and increases shock attenuation.

BACKGROUND: Equine water treadmills (WTs) are growing in popularity because they are believed to allow for high resistance, low impact exercise. However, little is known about the effect of water height on limb loading. The aim of this study was to evaluate the effect of water height and speed on segmental acceleration and impact attenuation during WT exercise in horses. Three uniaxial accelerometers (sampling rate: 2500 Hz) were secured on the left forelimb (hoof, mid-cannon, mid-radius). Horses walked at two speeds (S1: 0.83 m/s, S2: 1.39 m/s) and three water heights (mid-cannon, carpus, stifle), with a dry WT control. Peak acceleration of each segment was averaged over five strides, attenuation was calculated, and stride frequency was estimated by the time between successive hoof contacts. Linear mixed effects models were used to examine the effects of water height, speed, and accelerometer location on peak acceleration, attenuation and stride frequency (p < 0.05). RESULTS: Peak acceleration at all locations was lower with water of any height compared to the dry control (p < 0.0001). Acceleration was reduced with water at the height of the stifle compared to mid-cannon water height (p = 0.02). Water at the height of the stifle attenuated more impact than water at the height of the cannon (p = 0.0001). CONCLUSIONS: Water immersion during treadmill exercise reduced segmental accelerations and increased attenuation in horses. WT exercise may be beneficial in the rehabilitation of lower limb injuries in horses.

The repeated bout effect influences lower-extremity biomechanics during a 30-min downhill run.

The repeated bout effect in eccentric-biased exercises is a well-known phenomenon, wherein a second bout of exercise results in attenuated strength loss and soreness compared to the first bout. We sought to determine if the repeated bout effect influences changes in lower-extremity biomechanics over the course of a 30-min downhill run. Eleven male participants completed two bouts of 30-min downhill running (DR1 and DR2) at 2.8 m.s-1 and -11.3° on an instrumented treadmill. Three-dimensional kinematics and ground reaction forces were recorded and used to quantify changes in spatiotemporal parameters, external work, leg stiffness, and lower extremity joint-quasi-stiffness throughout the 30-min run. Maximum voluntary isometric contraction (MVIC) and perceived quadriceps pain were assessed before-after, and throughout the run, respectively. DR2 resulted in attenuated loss of MVIC (P = 0.004), and perceived quadriceps pain (P < 0.001) compared to DR1. In general, participants ran with an increased duty factor towards the end of each running bout; however, increases in duty factor during DR2 (+5.4%) were less than during DR1 (+8.8%, P < 0.035). Significant reductions in leg stiffness (-11.7%, P = 0.002) and joint quasi-stiffness (up to -25.4%, all P < 0.001) were observed during DR1 but not during DR2. Furthermore, DR2 was associated with less energy absorption and energy generation than DR1 (P < 0.004). To summarize, the repeated bout effect significantly influenced lower-extremity biomechanics over the course of a downhill run. Although the mechanism(s) underlying these observations remain(s) speculative, strength loss and/or perceived muscle pain are likely to play a key role.HighlightsA 30-min downhill running bout increased contact time and reduced flight time transitioning to an increased duty factor.Lower-extremity stiffness also decreased and mechanical energy absorption increased over the course of the first 30-min downhill running bout.When the same bout of 30-min downhill running was performed three weeks later, the observed changes to lower extremity biomechanics were significantly attenuated.The findings from this study demonstrated, for this first time, a repeated bout effect for lower extremity biomechanics associated with downhill running.

Effects of Stature and Load Carriage on the Running Biomechanics of Healthy Men.

OBJECTIVE: Overuse musculoskeletal injuries, often precipitated by walking or running with heavy loads, are the leading cause of lost-duty days or discharge during basic combat training (BCT) in the U.S. military. The present study investigates the impact of stature and load carriage on the running biomechanics of men during BCT. METHODS: We collected computed tomography images and motion-capture data for 21 young, healthy men of short, medium, and tall stature (n = 7 in each group) running with no load, an 11.3-kg load, and a 22.7-kg load. We then developed individualized musculoskeletal finite-element models to determine the running biomechanics for each participant under each condition, and used a probabilistic model to estimate the risk of tibial stress fracture during a 10-week BCT regimen. RESULTS: Under all load conditions, we found that the running biomechanics were not significantly different among the three stature groups. However, compared to no load, a 22.7-kg load significantly decreased the stride length, while significantly increasing the joint forces and moments at the lower extremities, as well as the tibial strain and stress-fracture risk. CONCLUSION: Load carriage but not stature significantly affected the running biomechanics of healthy men. SIGNIFICANCE: We expect that the quantitative analysis reported here may help guide training regimens and reduce the risk of stress fracture.

Differences in running biomechanics between young, healthy men and women carrying external loads.

During U.S. Army basic combat training (BCT), women are more prone to lower-extremity musculoskeletal injuries, including stress fracture (SF) of the tibia, with injury rates two to four times higher than those in men. There is evidence to suggest that the different injury rates are, in part, due to sex-specific differences in running biomechanics, including lower-extremity joint kinematics and kinetics, which are not fully understood, particularly when running with external load. To address this knowledge gap, we collected computed tomography images and motion-capture data from 41 young, healthy adults (20 women and 21 men) running on an instrumented treadmill at 3.0 m/s with loads of 0.0 kg, 11.3 kg, or 22.7 kg. Using individualized computational models, we quantified the running biomechanics and estimated tibial SF risk over 10 weeks of BCT, for each load condition. Across all load conditions, compared to men, women had a significantly smaller flexion angle at the trunk (16.9%-24.6%) but larger flexion angles at the ankle (14.0%-14.7%). Under load-carriage conditions, women had a larger flexion angle at the hip (17.7%-23.5%). In addition, women had a significantly smaller hip extension moment (11.8%-20.0%) and ankle plantarflexion moment (10.2%-14.3%), but larger joint reaction forces (JRFs) at the hip (16.1%-22.0%), knee (9.1%-14.2%), and ankle (8.2%-12.9%). Consequently, we found that women had a greater increase in tibial strain and SF risk than men as load increases, indicating higher susceptibility to injuries. When load carriage increased from 0.0 kg to 22.7 kg, SF risk increased by about 250% in women but only 133% in men. These results provide quantitative evidence to support the Army's new training and testing doctrine, as it shifts to a more personalized approach that shall account for sex and individual differences.

Tibial-fibular geometry and density variations associated with elevated bone strain and sex disparities in young active adults.

Tibial stress fracture is a common injury in runners and military personnel. Elevated bone strain is believed to be associated with the development of stress fractures and is influenced by bone geometry and density. The purpose of this study was to characterize tibial-fibular geometry and density variations in young active adults, and to quantify the influence of these variations on finite element-predicted bone strain. A statistical appearance model characterising tibial-fibular geometry and density was developed from computed tomography scans of 48 young physically active adults. The model was perturbed ±1 and 2 standard deviations along each of the first five principal components to create finite element models. Average male and female finite element models, controlled for scale, were also generated. Muscle and joint forces in running, calculated using inverse dynamics-based static optimization, were applied to the finite element models. The resulting 95th percentile pressure-modified von Mises strain (peak strain) and strained volume (volume of elements above 4000 µÎµ) were quantified. Geometry and density variations described by principal components resulted in up to 12.0% differences in peak strain and 95.4% differences in strained volume when compared to the average tibia-fibula model. The average female illustrated 5.5% and 41.3% larger peak strain and strained volume, respectively, when compared to the average male, suggesting that sexual dimorphism in bone geometry may indeed contribute to greater stress fracture risk in females. Our findings identified important features in subject-specific geometry and density associated with elevated bone strain that may have implications for stress fracture risk.

A statistical shape model of the tibia-fibula complex: sexual dimorphism and effects of age on reconstruction accuracy from anatomical landmarks.

A statistical shape model was created for a young adult population and used to predict tibia and fibula geometries from bony landmarks. Reconstruction errors with respect to CT data were quantified and compared to isometric scaling. Shape differences existed between sexes. The statistical shape model estimated tibia-fibula geometries from landmarks with high accuracy (RMSE = 1.51-1.62 mm), improving upon isometric scaling (RMSE = 1.78 mm). Reconstruction errors increased when the model was applied to older adults (RMSE = 2.11-2.17 mm). Improvements in geometric accuracy with shape model reconstruction changed hamstring moment arms 25-35% (1.0-1.3 mm) in young adults.

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.

Individual Differences in Women During Walking Affect Tibial Response to Load Carriage: The Importance of Individualized Musculoskeletal Finite-Element Models.

Subject-specific features can contribute to the susceptibility of an individual to stress fracture. Here, we incorporated tibial morphology and material properties into a standard musculoskeletal finite-element (M/FE) model and investigated how load carriage influences joint kinetics and tibial mechanics in women. We obtained the morphology and material properties of the tibia from computed tomography images for women of three distinctly different heights, 1.51 m (short), 1.63 m (medium), and 1.75 m (tall), and developed individualized M/FE models for each. Then, we calculated joint and muscle forces, and subsequently, tibial stress/strain for each woman walking at 1.3 m/s under various load conditions (0, 11.3, or 22.7 kg). Among the subjects investigated, using individualized and standard M/FE models, the joint reaction forces (JRFs) differed by up to 4 (hip), 22 (knee), and 26% (ankle), and the 90th percentile von Mises stress by up to 30% (tall woman). Load carriage evoked distinct biomechanical responses, with a 22.7-kg load decreasing the peak hip JRF during late stance by ∼18% in the short woman, while increasing it by ∼39% in the other two women. It also increased peak knee and ankle JRFs by up to ∼48 (tall woman) and ∼36% (short woman). The same load increased the 90th percentile von Mises stress (and corresponding cumulative stress) by 31 (28), 22 (30), and 27% (32%) in the short, medium, and tall woman, respectively. Our findings highlight the critical role of individualized M/FE models to assess mechanical loading in different individuals performing the same physical activity.

Effects of load carriage on biomechanical variables associated with tibial stress fractures in running.

BACKGROUND: Military personnel are required to run while carrying heavy body-borne loads, which is suggested to increase their risk of tibial stress fracture. Research has retrospectively identified biomechanical variables associated with a history of tibial stress fracture in runners, however, the effect that load carriage has on these variables remains unknown. RESEARCH QUESTION: What are the effects of load carriage on running biomechanical variables associated with a history of tibial stress fracture? METHODS: Twenty-one women ran at 3.0 m/s on an instrumented treadmill in four load carriage conditions: 0, 4.5, 11.3, and 22.7 kg. Motion capture and ground reaction force data were collected. Dependent variables included average loading rate, peak absolute free moment, peak hip adduction, peak rearfoot eversion, and stride frequency. Linear mixed models were used to asses the effect of load carriage and body mass on dependent variables. RESULTS: A load x body mass interaction was observed for stride frequency only (p = 0.017). Stride frequency increased with load carriage of 22.7-kg, but lighter participants illustrated a greater change than heavier participants. Average loading rate (p < 0.001) and peak free moment (p = 0.015) were greater in the 22.7-kg condition, while peak rearfoot eversion (p ≤ 0.023) was greater in the 11.3- and 22.7-kg conditions, compared to the unloaded condition. Load carriage did not affect peak hip adduction (p = 0.67). SIGNIFICANCE: Participants adapted to heavy load carriage by increasing stride frequency. This was especially evident in lighter participants who increased stride frequency to a greater extent than heavier participants. Despite this adaptation, running with load carriage of ≥11.3-kg increased variables associated with a history of tibial stress fracture, which may be indicative of elevated stress fracture risk. However, the lack of concomitant change amongst variables as a function of load carriage may highlight the difficulty in assessing injury risk from a single measure of running biomechanics.