Effect of Strength and Plyometric Training on Kinematics in Female Novice Runners.

ABSTRACT: Harrison, K, Williams, DSB III, Darter, BJ, Zernicke, RF, Shall, M, and Finucane, S. Effect of strength and plyometric training on kinematics in female novice runners. J Strength Cond Res 38(6): 1048-1055, 2024-Both running performance and injury have been associated with running kinematics. Plyometric training improves run performance and reduces injury risk in court-sport and field-sport athletes. The aim of this study was to assess longitudinal changes in kinematics in novice runners before and after a typical beginners' running program, compared with those who perform a plyometric intervention before running. Fifty-seven novice female runners were assigned to the control group (8 weeks walking +8 weeks running) or the intervention group (8 weeks strength or plyometric training +8 weeks running). Kinematics were assessed at baseline, 8 weeks, and 16 weeks. Joint angles throughout the stride of those who completed the training ( n = 21) were compared between groups and assessment time points using a statistical parametric mapping 2-way analysis of variance, with group and study time point as independent variables. There was no interaction effect of group and study time point ( p > 0.05), indicating that both training programs had similar effects on running kinematics. There was a main effect of time for sagittal plane knee and hip kinematics ( p < 0.001); after training, subjects ran with a more extended leg, particularly during swing. Programs of 8 weeks of preparatory training, followed by 8 weeks of running, resulted in altered sagittal plane biomechanics, which have previously been related to improved running economy. A greater volume of plyometric, run training or concurrent plyometric and run training may be required to elicit changes in running form associated with lower injury risk.

Identifying latent classes of Relative Energy Deficiency in Sport (RED-S) consequences in a sample of collegiate female cross country runners.

OBJECTIVE: The purpose of this study was to identify patterns of clustering of the 10 health consequences identified in the Relative Energy Deficiency in Sport (RED-S) framework among collegiate female Cross-Country runners. We also assessed risk characteristics associated with each cluster. METHODS: This randomly sampled population included 211 current National Collegiate Athletics Association (NCAA) Division I (DI) female cross country runners who completed a quantitative survey. We used latent class analysis (LCA) to group athletes into mutually exclusive classes based on shared response patterns of RED-S consequences. We computed descriptive statistics to identify demographics, personal characteristics, disordered eating and emotional health characteristics associated with each class. RESULTS: The average age of the sample was 21 years with mean body mass index 20.4 kg/m2. The LCA identified three unique classes of potential RED-S presentations: (1) low probability of RED-S consequences; (2) complex physical and psychological concerns with a higher burden of cardiovascular concern and (3) very high probability of anxiety with high burden of menstrual disturbance, bone injury and gastrointestinal concern. All classes were characterised by high levels of menstrual disturbance and distinguished by the number and burden of other potential RED-S consequences and in reported abuse history, emotional regulation and perfectionism. CONCLUSION: This study identified a high burden of menstrual disturbance in NCAA D1 cross country runners, and three unique presentations of RED-S consequences. Future research is warranted to better understand how early prevention and intervention strategies may mitigate RED-S consequences in distance runners.

Lower Extremity Inverse Kinematics Results Differ Between Inertial Measurement Unit- and Marker-Derived Gait Data.

In-lab, marker-based gait analyses may not represent real-world gait. Real-world gait analyses may be feasible using inertial measurement units (IMUs) in combination with open-source data processing pipelines (OpenSense). Before using OpenSense to study real-world gait, we must determine whether these methods estimate joint kinematics similarly to traditional marker-based motion capture (MoCap) and differentiate groups with clinically different gait mechanics. Healthy young and older adults and older adults with knee osteoarthritis completed this study. We captured MoCap and IMU data during overground walking at 2 speeds. MoCap and IMU kinematics were computed with OpenSim workflows. We tested whether sagittal kinematics differed between MoCap and IMU, whether tools detected between-group differences similarly, and whether kinematics differed between tools by speed. MoCap showed more anterior pelvic tilt (0%-100% stride) and joint flexion than IMU (hip: 0%-38% and 61%-100% stride; knee: 0%-38%, 58%-89%, and 95%-99% stride; and ankle: 6%-99% stride). There were no significant tool-by-group interactions. We found significant tool-by-speed interactions for all angles. While MoCap- and IMU-derived kinematics differed, the lack of tool-by-group interactions suggests consistent tracking across clinical cohorts. Results of the current study suggest that IMU-derived kinematics with OpenSense may enable reliable evaluation of gait in real-world settings.

Homo sapiens May Incorporate Daily Acute Cycles of "Conditioning-Deconditioning" to Maintain Musculoskeletal Integrity: Need to Integrate with Biological Clocks and Circadian Rhythm Mediators.

Human evolution required adaptation to the boundary conditions of Earth, including 1 g gravity. The bipedal mobility of Homo sapiens in that gravitational field causes ground reaction force (GRF) loading of their lower extremities, influencing the integrity of the tissues of those extremities. However, humans usually experience such loading during the day and then a period of relative unloading at night. Many studies have indicated that loading of tissues and cells of the musculoskeletal (MSK) system can inhibit their responses to biological mediators such as cytokines and growth factors. Such findings raise the possibility that humans use such cycles of acute conditioning and deconditioning of the cells and tissues of the MSK system to elaborate critical mediators and responsiveness in parallel with these cycles, particularly involving GRF loading. However, humans also experience circadian rhythms with the levels of a number of mediators influenced by day/night cycles, as well as various levels of biological clocks. Thus, if responsiveness to MSK-generated mediators also occurs during the unloaded part of the daily cycle, that response must be integrated with circadian variations as well. Furthermore, it is also possible that responsiveness to circadian rhythm mediators may be regulated by MSK tissue loading. This review will examine evidence for the above scenario and postulate how interactions could be both regulated and studied, and how extension of the acute cycles biased towards deconditioning could lead to loss of tissue integrity.

Position-Specific Physical Workload Intensities in American Collegiate Football Training.

ABSTRACT: MamonJr, MA, Olthof, SBH, Burns, GT, Lepley, AS, Kozloff, KM, and Zernicke, RF. Position-specific physical workload intensities in American collegiate football training. J Strength Cond Res 36(2): 420-426, 2022-Quantifying player training loads allows football coaching staff to make informed adjustments to the volume and intensity of training. Physical workload intensity in American football practices have not been extensively quantified. The current study examined physical workload intensities across positions in American collegiate football during training. Data from player tracking technology (Catapult Vector) were collected from 72 American football players (National Collegiate Athletic Association Division I) during in-season practices. Players were involved in individualized skill (indy), team playbook (team), and special team (ST) drills during practice and analyzed for their specialist offensive or defensive role (e.g., linebacker or wide receiver). Player running (i.e., high-speed running and sprint) and accelerations (i.e., high-intensity PlayerLoad and high-intensity inertial movement analysis) per minute were of interest. Drill type and practice day had significant effects on all workload intensity metrics (p < 0.01), but not position. Greater running intensities were seen in ST drills compared with other drill types. Tuesday practice sessions had greater overall intensities compared with other days. Interaction effect of position and drill type was significant (p < 0.001) for all intensity metrics, indicating that position groups exhibited unique workload responses to the drill types. Drill type and practice day interaction effect was significant for all intensity metrics (p < 0.01). The findings may be informative for coaches to tailor physical workloads of practice drills for positional roles in preparation for games and practices. Player tracking technology can add value for strength and conditioning coaches to adjust training programs based on position-specific on-field demands of players.

Improving spring-mass parameter estimation in running using nonlinear regression methods.

Runners are commonly modeled as spring-mass systems, but the traditional calculations of these models rely on discrete observations during the gait cycle (e.g. maximal vertical force) and simplifying assumptions (e.g. leg length), challenging the predicative capacity and generalizability of observations. We present a method to model runners as spring-mass systems using nonlinear regression (NLR) and the full vertical ground reaction force (vGRF) time series without additional inputs and fewer traditional parameter assumptions. We derived and validated a time-dependent vGRF function characterized by four spring-mass parameters - stiffness, touchdown angle, leg length and contact time - using a sinusoidal approximation. Next, we compared the NLR-estimated spring-mass parameters with traditional calculations in runners. The mixed-effect NLR method (ME NLR) modeled the observed vGRF best (RMSE:155 N) compared with a conventional sinusoid approximation (RMSE: 230 N). Against the conventional methods, its estimations provided similar stiffness approximations (-0.2±0.6 kN m-1) with moderately steeper angles (1.2±0.7 deg), longer legs (+4.2±2.3 cm) and shorter effective contact times (-12±4 ms). Together, these vGRF-driven system parameters more closely approximated the observed vertical impulses (observed: 214.8 N s; ME NLR: 209.0 N s; traditional: 223.6 N s). Finally, we generated spring-mass simulations from traditional and ME NLR parameter estimates to assess the predicative capacity of each method to model stable running systems. In 6/7 subjects, ME NLR parameters generated models that ran with equal or greater stability than traditional estimates. ME NLR modeling of the vGRF in running is therefore a useful tool to assess runners holistically as spring-mass systems with fewer measurement sources or anthropometric assumptions. Furthermore, its utility as statistical framework lends itself to more complex mixed-effects modeling to explore research questions in running.

A simple computational method to estimate stance velocity in running.

Running dynamical analyses typically approximate a runner's stance velocity as the average stride cycle velocity (the average running speed). That approximation necessarily overestimates stance velocity and biases subsequent results. Stance velocity is crucial in kinetic spring-mass analyses of running, where approximation of a runner's impact angle and calculation of leg stiffness require that input. Here, a new method is presented to approximate a runner's stance velocity via measurement of contact and flight times with the runner's average speed, leg length or height, and mass. This method accurately estimated the stance velocity of simulated spring-mass systems across typical running speeds of 3.5-5.5 m s-1 (r>0.99) and more accurately estimated the impact angle and leg stiffness. The method also accurately estimated the peak horizontal ground reaction force across speeds (r=0.82), but the bias magnitude increased with speed. Robustness of the new method was further tested for runners at 2.5, 3.5 and 4.5 m s-1, and the new method provided steeper impact angles than those from traditional estimates and correspondingly higher leg stiffnesses, analogous to the observations in the simulation models. Horizontal ground reaction force estimates were weakly correlated in braking and propulsion. They were improved by a corrective algorithm, but the intra- and inter-individual variation persisted. The directionality and magnitude of angle and stiffness estimates in the human runners were similar to simulations, suggesting the new method more accurately modeled runners' spring-mass characteristics by using an accurate approximation of stance velocity. The new method can improve traditional kinetic analyses of running where stance velocity recordings are not captured with kinematic recordings and extend opportunities for accurate field-based analyses with limited measurement sources.

Cultural and environmental associations with body image, diet and well-being in NCAA DI female distance runners: a qualitative analysis.

OBJECTIVE: We aimed to describe current and former National Collegiate Athletic Association (NCAA) Division One (DI) female distance runners' experiences of perceived norms of body image and disordered eating in their sport, as well as the emergence and influence of coach-athlete power dynamics.This manuscript reports a qualitative research study (consisting of interviews and thematic analysis) of women athletes' experiences of perceived norms of body image and disordered eating in their sport. We also report athletes' experiences of coach-athlete power dynamics. METHODS: The study sample included 29 current and former female NCAA DI female distance runners, defined as competing in 800-metre distance or greater. Interviews were conducted, audio-recorded and hand transcribed. A thematic analysis was performed and presented. RESULTS: Two major themes emerged: (1) sport body ideals and body image norms and myths that exist in the sport, and (2) the power dynamic between athletes and coaches. It is not clear whether sport body ideals and culture of running influences coaching culture, or whether the coaches-who maintain positions of power in the sport-perpetuate the culture. These themes likely feed into each other and reinforce the existing and dominant mentalities of the sport. CONCLUSION: Sport body image ideals and the power dynamic between coach and athlete may contribute to female athlete's risk of disordered eating and body image disturbance. We call for the NCAA and athletic departments to develop and implement prevention and intervention programmes to prevent eating and body image disorders in this high-risk population.

Validation of a wireless shoe insole for ground reaction force measurement.

Ground reaction force measurements are a fundamental element of kinetic analyses of locomotion, yet they are traditionally constrained to laboratory settings or stationary frames. This study assessed the validity and reliability of a new wireless in-shoe system (Novel Loadsol/Pedoped) for field-based ground reaction force measurement in hopping, walking, and running. Twenty participants bilaterally hopped on a force plate and walked (5 km/hr) and ran (10 km/hr) on an instrumented treadmill on two separate days while wearing the insoles. GRFs were recorded simultaneously on each respective system. Peak GRF in hopping and peak GRF, contact time (CT), and impulse (IMP) in walking and running were compared on a per-hop and step-by-step basis. In hopping, the insoles demonstrated excellent agreement with the force plate (ICC: 0.96). In walking and running, the insoles demonstrated good-to-excellent agreement with the treadmill across all measures (ICCs: 0.88-0.96) and were reliable across sessions (ICCs within 0.00-0.03). A separate verification study with ten participants was conducted to assess a correction algorithm for further agreement improvement but demonstrated little meaningful change in systemic agreements. These results indicated that the Novel Loadsol system is a valid and reliable tool for wireless ground reaction force measurement in hopping, walking, and running.

Ball Speed and Release Consistency Predict Pitching Success in Major League Baseball.

Whiteside, D, Martini, DN, Zernicke, RF, and Goulet, GC. Ball speed and release consistency predict pitching success in Major League Baseball. J Strength Cond Res XX(X): 000-000, 2015-This study aimed to quantify how ball flight kinematics (i.e., ball speed and movement), release location, and variations therein relate to pitching success in Major League Baseball (MLB). One hundred ninety starting MLB pitchers met the inclusion criteria for this study. Ball trajectory information was collected for 76,000 pitches and inserted into a forward stepwise multiple regression model, which examined how (a) pitch selection, (b) ball speed, (c) ball movement (horizontal and lateral), (d) release location (horizontal and lateral), (e) variation in pitch speed, (f) variation in ball movement, and (g) variation in release location related to pitching success (as measured by fielding independent pitching-FIP). Pitch speed, release location variability, variation in pitch speed, and horizontal release location were significant predictors of FIP and, collectively, accounted for 24% of the variance in FIP. These findings suggest that (a) maximizing ball speed, (b) refining a consistent spatial release location, and (c) using varied pitch speeds should be primary foci for the pitching coach. However, between-pitcher variations underline how training interventions should be administered at the individual level, with consideration given to the pitcher's injury history. Finally, despite offering significant predictors of success, these three factors explained only 22% of the variance in FIP and should not be considered the only, or preeminent, indicators of a pitcher's effectiveness. Evidently, traditional pitching metrics only partly account for a pitcher's effectiveness, and future research is necessary to uncover the remaining contributors to success.

Grading the Functional Movement Screen: A Comparison of Manual (Real-Time) and Objective Methods.

Although intertester and intratester reliability have been common themes in Functional Movement Screen (FMS) research, the criterion validity of manual grading is yet to be comprehensively examined. This study compared the FMS scores assigned by a certified FMS tester to those measured by an objective inertial-based (IMU) motion capture system. Eleven female division I collegiate athletes performed 6 FMS exercises and were manually graded by a certified tester. Explicit kinematic thresholds were formulated to correspond to each of the grading criteria for each FMS exercise and then used to grade athletes objectively using the IMU data. The levels of agreement between the 2 grading methods were poor in all 6 FMS exercises and implies that manual grading of the FMS may be confounded by vague grading criteria. Evidently, more explicit grading guidelines are needed to improve the uniformity and accuracy of manual FMS grading and also facilitate the use of objective measurement systems in the grading process. Contrary to the approach that has been adopted in several previous studies, the potential for subjective and/or inaccurate FMS grading intimates that it may be inappropriate to assume that manual FMS grading provides a valid measurement tool. Consequently, the development and criterion validation of uniform grading procedures must precede research attempting to link FMS performance and injury rates. With manual grading methods seemingly susceptible to error, the FMS should be used cautiously to direct strength and/or conditioning programs.

Ankle kinematics and muscle activity in functional ankle instability.

OBJECTIVE: Following an ankle injury, many patients have functional ankle instability (FAI) with an increased predisposition to reinjury. The purpose of this study was to assess the effects of FAI on ankle kinematics and muscle activity during a lateral hop movement. DESIGN: Cross-sectional and observational study; all data collection for each subject was performed on 1 day. SETTING: Clinical biomechanics laboratory. PATIENTS: Two groups were studied: (1) Control group-no ankle injury (n = 12), and (2) FAI group (n = 12). INTERVENTIONS: The lateral hop movement consisted of multiple lateral and medial 1-legged hops over an obstacle (width, 72.5 cm; depth, 25.5 cm; height, 14.3 cm) onto adjacent force platforms. Each subject was instructed to perform as many lateral hops as possible during the 6-second trial. Means, SDs, 95% confidence intervals of the differences, and P-values were calculated. MAIN OUTCOME MEASURES: Ankle kinematics and muscle activity throughout the lateral hop movement. RESULTS: Significant differences existed between groups for mean (SD) dorsiflexion ankle positions--FAI 82.4 degrees (6.4) versus normal 75.2 degrees (10.1) and tibialis anterior normalized muscle activity--FAI 0.27 (0.21) versus normal 0.16 (0.13) at ground contact. CONCLUSIONS: The FAI group revealed greater tibialis anterior muscle activity and dorsiflexion ankle position at contact moving in the lateral direction. These differences between groups may have been related to an inherent predisposition to ankle injuries, a preexisting difference in task performance, a consequence of injuries, or a compensatory adaptation to previous injuries.

Assessing spring-mass similarity in elite and recreational runners.

The dynamic complexity and individualization of running biomechanics has challenged the development of objective and comparative gait measures. Here, we present and explore several novel biomechanical metrics for running that are informed by a canonical inter-species gait template-the spring-mass model. The measures assess running mechanics systemically against the template via quantifying characteristics of a runner's kinetics relative to the energy-conserving elastic system-i.e., their "spring-mass similarity". Applying these metrics in a retrospective cohort investigation, we studied the overground kinetics of two heterogenous populations of runners in two footwear conditions: elite and recreational athletes in shod and barefoot conditions. Across all measures and within foot strike types, the elite runners exhibited mechanics that were more similar to those of the ideally elastic spring-mass template. The elite runners had more symmetric bounces, less discrepancy (i.e., greater coordination) between horizontal and vertical kinetic changes, and better fit to a spring-mass vertical ground reaction force time series. Barefoot running elicited greater kinetic coordination in the recreational runners. At a faster speed, the elites further improved their similarity to the template. Overall, the more economical elite group exhibited greater likeness to the linearly elastic, energy-conserving spring-mass system than their recreational counterparts. This study introduces novel biomechanical measures related to performance in distance running. More broadly, it provides new, approachable metrics for systemic quantification of gait biomechanics in runners across all demographics. These metrics may be applied to assess a runner's global biomechanical response to a variety of interventions, including training adaptations, rehabilitation programs, and footwear conditions.

A Novel Policy Alignment and Enhancement Process to Improve Sustainment of School-Based Physical Activity Programming.

The purpose of the current study was twofold: (1) to evaluate the strength and comprehensiveness of district wellness policies in one central Michigan intermediate school district (ISD; 16 districts), and (2) to pilot a novel policy alignment and enhancement process in one district within the ISD to improve sustainment of district-wide physical activity (PA) programming. Policy evaluation and alignment were determined using WellSAT 3.0. The Exploration, Preparation, Implementation, Sustainment (EPIS) framework was used to guide a seven-step policy alignment and enhancement process. Initial evaluation of the PA policy for the ISD revealed a strength score of 19/100 (i.e., included weak and non-specific language) and 31/100 for comprehensiveness (i.e., mentioned few components of the Comprehensive School Physical Activity Program). For the pilot school district, initial strength scores were 19/100 and 38/100 for comprehensiveness (exploration). An alignment of the tailored PA policy with current practices resulted in a 100% increase in strength (score of 38/100), and 132% increase in comprehensiveness (score of 88/100; preparation). However, district administrators encountered barriers to adopting the tailored policy and subsequently integrated the PA requirements into their curriculum guide and school improvement plan (implementation and sustainment). Future research should examine the effectiveness of our EPIS-informed policy evaluation, alignment, and enhancement process to promote widespread increases in student PA.

Lateral hop movement assesses ankle dynamics and muscle activity.

Ankle function is frequently measured using static or dynamic tasks in normal and injured patients. The purpose of this study was to develop a novel task to quantify ankle dynamics and muscle activity in normal subjects. Twelve subjects with no prior ankle injuries participated. Video motion analysis cameras, force platforms, and an EMG system were used to collect data during a lateral hop movement task that consisted of multiple lateral-medial hops over an obstacle. Mean (SD) inversion ankle position at contact was 4.4° (4.0) in the medial direction and -3.5° (4.4) in the lateral direction; mean (SD) tibialis anterior normalized muscle activity was 0.11 (0.08) in the medial direction and 0.16 (0.13) in the lateral direction. The lateral hop movement was shown to be an effective task for quantifying ankle kinematics, forces, moments, and muscle activities in normal subjects. Future applications will use the lateral hop movement to assess subjects with previous ankle injuries in laboratory and clinical settings.

Risk Factors for COVID-19 in College Students Identified by Physical, Mental, and Social Health Reported During the Fall 2020 Semester: Observational Study Using the Roadmap App and Fitbit Wearable Sensors.

BACKGROUND: The COVID-19 pandemic triggered a seismic shift in education to web-based learning. With nearly 20 million students enrolled in colleges across the United States, the long-simmering mental health crisis in college students was likely further exacerbated by the pandemic. OBJECTIVE: This study leveraged mobile health (mHealth) technology and sought to (1) characterize self-reported outcomes of physical, mental, and social health by COVID-19 status; (2) assess physical activity through consumer-grade wearable sensors (Fitbit); and (3) identify risk factors associated with COVID-19 positivity in a population of college students prior to release of the vaccine. METHODS: After completing a baseline assessment (ie, at Time 0 [T0]) of demographics, mental, and social health constructs through the Roadmap 2.0 app, participants were instructed to use the app freely, wear the Fitbit, and complete subsequent assessments at T1, T2, and T3, followed by a COVID-19 assessment of history and timing of COVID-19 testing and diagnosis (T4: ~14 days after T3). Continuous measures were described using mean (SD) values, while categorical measures were summarized as n (%) values. Formal comparisons were made on the basis of COVID-19 status. The multivariate model was determined by entering all statistically significant variables (P<.05) in univariable associations at once and then removing one variable at a time through backward selection until the optimal model was obtained. RESULTS: During the fall 2020 semester, 1997 participants consented, enrolled, and met criteria for data analyses. There was a high prevalence of anxiety, as assessed by the State Trait Anxiety Index, with moderate and severe levels in 465 (24%) and 970 (49%) students, respectively. Approximately one-third of students reported having a mental health disorder (n=656, 33%). The average daily steps recorded in this student population was approximately 6500 (mean 6474, SD 3371). Neither reported mental health nor step count were significant based on COVID-19 status (P=.52). Our analyses revealed significant associations of COVID-19 positivity with the use of marijuana and alcohol (P=.02 and P=.046, respectively) and with lower belief in public health measures (P=.003). In addition, graduate students were less likely and those with ≥20 roommates were more likely to report a COVID-19 diagnosis (P=.009). CONCLUSIONS: Mental health problems were common in this student population. Several factors, including substance use, were associated with the risk of COVID-19. These data highlight important areas for further attention, such as prioritizing innovative strategies that address health and well-being, considering the potential long-term effects of COVID-19 on college students. TRIAL REGISTRATION: ClinicalTrials.gov NCT04766788; https://clinicaltrials.gov/ct2/show/NCT04766788. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/29561.

In vivo microfocal computed tomography and micro-magnetic resonance imaging evaluation of antiresorptive and antiinflammatory drugs as preventive treatments of osteoarthritis in the rat.

OBJECTIVE: To determine whether treatment with an antiresorptive drug in combination with an antiinflammatory drug reduces periarticular bone and soft tissue adaptations associated with the progression of posttraumatic secondary osteoarthritis (OA). METHODS: We used in vivo microfocal computed tomography (micro-CT) to map bony adaptations and in vivo micro-magnetic resonance imaging (micro-MRI) to examine joint inflammation in a rat model of surgically induced OA secondary to knee triad injury. We examined the arthroprotective effects of the bisphosphonates alendronate and risedronate and the nonsteroidal antiinflammatory drug (NSAID) meloxicam. RESULTS: Micro-CT revealed reduced levels of periarticular trabecular bone loss in animals with knee triad injury treated with the bisphosphonate drugs alendronate or risedronate, or the NSAID meloxicam, compared with untreated animals. Alendronate treatment reduced bony osteophyte development. While risedronate as a monotherapy did not positively impact osteophytogenesis, combination therapy with risedronate and meloxicam reduced osteophyte severity somewhat. Micro-MRI revealed an increased, diffuse water signal in the epiphyses of untreated rats with knee triad injury 8 weeks after surgery, suggestive of a bone marrow lesion-like stimulus. In contrast, meloxicam-treated rats showed a significant reduction in fluid signal compared with both bisphosphonate-treated groups 8 weeks after surgery. Histologic analysis qualitatively confirmed the chondroprotective effect of both bisphosphonate treatments, showing fewer degradative changes compared with untreated rats with knee triad injury. CONCLUSION: Our findings indicate that select combinations of bisphosphonate and NSAID drug therapy in the early stages of secondary OA preserve trabecular bone mass and reduce the impact of osteophytic bony adaptations and bone marrow lesion-like stimulus. Bisphosphonate and NSAID therapy may be an effective disease-modifying drug regimen if administered early after the initial injury.

Time series spinal radiographs as prognostic factors for scoliosis and progression of spinal deformities.

The effectiveness of clinical measures to predict scoliotic progression is unclear. The objective of this study was to identify potential prognostic factors affecting scoliosis progression. Consecutive measurements (181) from 35 non-instrumented adolescent idiopathic scoliosis patients with at least two follow-up assessments were studied. Potential prognostic factors of gender, curve pattern, age, curve magnitude, apex location and lateral deviation and spinal growth were analyzed. Stable and progressed groups were compared (threshold: Cobb angle ≥5° or 10°) with sequential clinical data collected in 6-month intervals. Double curves progressed simultaneously or alternatively on curve regions. Age was not significantly different prior to and at maximal Cobb angle. Maximal Cobb angles were significantly correlated to initial Cobb angles (r = 0.81-0.98). Progressed males had larger initial Cobb angles than progressed females. Apex locations were higher in progressed than stable groups, and at least a half vertebra level higher in females than males. Maximal apex lateral deviations correlated significantly with the initial ones (r = 0.73-0.97) and moderately with maximal Cobb angles (r = 0.33-0.85). In the progressed groups, males had larger apex lateral deviations than females. Spinal growth did not relate to curve progression (r = -0.64 to +0.59) and was not significantly different between groups and genders. Scoliosis may dynamically progress between major and minor curves. Gender, curve magnitude, apex location and lateral deviation have stronger effects on scoliosis progression than age or spinal growth. Females with high apex locations may be expected to progress.

Adults with knee osteoarthritis use different coordinative strategies to transition from swing to stance compared to young asymptomatic adults.

BACKGROUND: Neuromuscular changes that occur with aging or joint pathology likely alter the coordinative strategies that adults use to walk and to recover from perturbations during gait. Differences in coordination patterns or in how coordination changes in response to a challenge may provide insight into neuromuscular targets for falls prevention interventions. RESEARCH QUESTION: Do young asymptomatic adults, older asymptomatic adults, and older adults with knee OA alter their lower extremity segment coordination differently in response to an increase in walking speed?. METHODS: We captured lower extremity kinematics using inertial measurement units as 29 participants (10 young, 10 older, 9 older with knee osteoarthritis) walked on a treadmill at self-selected preferred and faster speeds. We calculated lower extremity segment coordination and coordination variability using vector coding. We compared coordination and its variability among groups and speeds. RESULTS: There were no significant interactions between group and speed. Overall group or speed differences in coordination or variability occurred mostly during terminal swing or early stance. Coordination patterns differed between young adults and adults with knee osteoarthritis in all segment couples during terminal swing and at the foot vs. shank during early stance. During these same gait cycle phases for the foot vs. shank and shank vs. thigh segment couples, coordination patterns shifted towards those of young adults when participants walked faster. Where coordination variability differed by group or speed, it was lower in the young adults than in the older adults with or without knee osteoarthritis and at faster walking speed. SIGNIFICANCE: Our results identified that older adults with knee osteoarthritis have a different strategy for transitioning from swing to stance compared to young adults, especially at distal limb segments. These results may help target fall prevention interventions to specific gait cycle phases or strategies.