Surface properties affect the interplay between fascicles and tendinous tissues during landing.

PURPOSE: Muscle-tendon units are forcefully stretched during rapid deceleration events such as landing. Consequently, tendons act as shock absorbers by buffering the negative work produced by muscle fascicles likely to prevent muscle damage. Landing surface properties can also modulate the amount of energy dissipated by the body, potentially effecting injury risk. This study aimed to evaluate the influence of three different surfaces on the muscle-tendon interactions of gastrocnemius medialis (GM), and vastus lateralis (VL) during single- and double-leg landings from 50 cm. METHODS: Ultrasound images, muscle activity and joint kinematics were collected for 12 participants. Surface testing was also performed, revealing large differences in mechanical behavior. RESULTS: During single-leg landing, stiffer surfaces increased VL fascicle lengthening and velocity, and muscle activity independent of joint kinematics while GM length changes showed no difference between surfaces. Double-leg landing resulted in similar fascicle and tendon behavior despite greater knee flexion angles on stiffer surfaces. CONCLUSION: This demonstrates that VL fascicle lengthening is greater when the surface stiffness increases, when performing single-leg landing. This is due to the combination of limited knee joint flexion and lower surface absorption ability which resulted in greater mechanical demand mainly withstood by fascicles. GM muscle-tendon interactions remain similar between landing surfaces and types. Together, this suggests that surface damping properties primarily affect the VL muscle-tendon unit with a potentially higher risk of injury as a result of increased surface stiffness when performing single-leg landing tasks.

Interactions between fascicles and tendinous tissues in gastrocnemius medialis and vastus lateralis during drop landing.

Animal tendons have been shown to act as shock absorbers to protect muscle fascicles from exercise-induced damage during landing tasks. Meanwhile, the contribution of tendinous tissues to damping activities such as landing has been less explored in humans. The aim of this study was to analyze in vivo fascicle-tendon interactions during drop landing to better understand their role in energy dissipation. Ultrafast ultrasound images of the gastrocnemius medialis (GM) and vastus lateralis (VL), lower limb electromyographic activity, 2-D kinematics, and ground reaction forces were collected from twelve participants during single- and double-leg drop landings from various heights. For both muscles, length changes were higher in tendinous tissues than in fascicles, demonstrating their key role in protecting fascicles from rapid active lengthening. Increasing landing height increased lengthening and peak lengthening velocity of VL fascicle and GM architectural gear ratio, whereas GM fascicle displayed similar length and velocity patterns. Single-leg landing lengthens the tendinous tissues of GM and, to a greater degree, VL muscles, without affecting the fascicles. These findings demonstrate the adjustment in fascicle-tendon interactions to withstand mechanical demand through the tendon buffer action and fascicle rotation. The higher VL fascicle contribution to negative work as the drop height increases would suggest muscle-specific damping responses during drop landing. This can originate from the distal-to-proximal sequence of joint kinetics, from differences in muscle and tendon functions (one- and two-joint muscles), architectural and morphological properties (eg, tendon stiffness), as well as from the muscle activity of the GM and VL muscles.

Modeling of muscular activation of the muscle-tendon complex using discrete element method.

The tearing of a muscle-tendon complex (MTC) is caused by an eccentric contraction; however, the structures involved and the mechanisms of rupture are not clearly identified. The passive mechanical behavior the MTC has already been modeled and validated with the discrete element method. The muscular activation is the next needed step. The aim of this study is to model the muscle fiber activation and the muscular activation of the MTC to validate their active mechanical behaviors. Each point of the force/length relationship of the MTC (using a parabolic law for the force/length relationship of muscle fibers) is obtained with two steps: 1) a passive tensile (or contractile) test until the desired elongation is reached and 2) fiber activation during a position holding that can be managed thanks to the Discrete Element model. The muscular activation is controlled by the activation of muscle fiber. The global force/length relationship of a single fiber and of the complete MTC during muscular activation is in agreement with literature. The influence of the external shape of the structure and the pennation angle are also investigated. Results show that the different constituents of the MTC (extracellular matrix, tendon), and the geometry, play an important role during the muscular activation and enable to decrease the maximal isometric force of the MTC. Moreover, the maximal isometric force decreases when the pennation angle increases. Further studies will combine muscular activation with a stretching of the MTC, until rupture, in order to numerically reproduce the tearing of the MTC.

Effects of Surface Properties on Gastrocnemius Medialis and Vastus Lateralis Fascicle Mechanics During Maximal Countermovement Jumping.

Interactions between human movement and surfaces have previously been studied to understand the influence of surface properties on the mechanics and energetics of jumping. However, little is known about the muscle-tendon unit (MTU) mechanics associated with muscle activity and leg adjustments induced by different surfaces during this movement. This study aimed to examine the effects of three surfaces with different properties (artificial turf, hybrid turf, and athletic track) on the muscle mechanics and muscle excitation of the gastrocnemius medialis (GM) and vastus lateralis (VL) during maximal countermovement jumping (CMJ). Twelve participants performed maximal CMJs on the three sport surfaces. GM and VL muscle fascicles were simultaneously imaged using two ultrafast ultrasound systems (500 Hz). MTUs lengths were determined based on anthropometric models and two-dimensional joint kinematics. Surface electromyography (EMG) was used to record GM and VL muscle activity. Surface mechanical testing revealed systematic differences in surface mechanical properties (P = 0.006, η2: 0.26-0.32, large). Specifically, the highest force reduction and vertical deformation values have been observed on artificial turf (65 ± 2% and 9.0 ± 0.3 mm, respectively), while athletic track exhibited the lowest force reduction and vertical deformation values (28 ± 1% and 2.1 ± 0.1 mm, respectively) and the highest energy restitution (65 ± 1%). We observed no significant difference in CMJ performance between the three surfaces (∼35-36 cm, P = 0.66). GM and VL fascicle shortening (P = 0.90 and P = 0.94, respectively) and shortening velocity (P = 0.13 and P = 0.65, respectively) were also unaffected by the type of surface. However, when jumping from greater deformable surface, both GM muscle activity (P = 0.022, η2 = 0.18, large) and peak shortening velocity of GM MTU (P = 0.042, η2 = 0.10, medium) increased during the push-off phase. This resulted in a greater peak plantar flexion velocity late in the jump (P = 0.027, η2 = 0.13, medium). Our findings suggest that maximal vertical jumping tasks in humans is not affected by common sport surfaces with different mechanical properties. However, internal regulatory mechanisms exist to compensate for differences in surface properties.

Corrigendum: An Initial Passive Phase That Limits the Time to Recover and Emphasizes the Role of Proprioceptive Information.

[This corrects the article DOI: 10.3389/fneur.2018.00986.].

Neck strength and EMG activity in fighter pilots with episodic neck pain.

INTRODUCTION: Neck pain is common in fighter pilots due to repeated exposure to high +Gz loads, but studies comparing neck function in symptomatic and healthy fighter pilots are lacking. This study compared neck strength and EMG activity during maximal isometric contractions in a sitting position in the sagittal and coronal planes in neck pain (SP), asymptomatic fighter pilots (AP), and healthy, male, non-pilot subjects (NPS). METHODS: There were 9 SP, 10 AP, and 8 NPS, all males, who performed maximal isometric neck contractions on a specific dynamometer. Surface EMG activity was recorded bilaterally over the sternocleidomastoid and paraspinal muscles. EMG amplitude during side bending was normalized to that measured in the sagittal plane. RESULTS: SP exhibited lower side-bending strength than AP (17-19%, P < 0.05). In addition, SP and NPS exhibited lower left side-bending-to-extension torque ratios (20% and 14%, respectively, P < 0.05) than AP. Similar activation level of neck flexors and extensors during side bending was found in SP and AP, whereas EMG activity of the extensors was higher than the flexors in NPS (+48%, P < 0.05). In addition, antagonistic EMG activity was higher in AP compared to NPS (26% vs. 41%, respectively, P < 0.05). CONCLUSION: Our results suggest altered muscle function in SP compared with AP in the coronal but not in the sagittal plane. Further, AP appeared to be more efficient in the coronal plane with reference to neck extension than NPS, suggesting that some adaptations occurred due to flight exposure. These findings may have clinical implications for the management and the follow-up of neck pain in fighter pilots.

An Initial Passive Phase That Limits the Time to Recover and Emphasizes the Role of Proprioceptive Information.

In the present experiments, multiple balance perturbations were provided by unpredictable support-surface translations in various directions and velocities. The aim of this study was to distinguish the passive and the active phases during the pre-impact period of a fall. It was hypothesized that it should be feasible if one uses a specific quantitative kinematic analysis to evaluate the dispersion of the body segments trajectories across trials. Moreover, a multi-joint kinematical model was created for each subject, based on a new 3-D minimally invasive stereoradiographic X-ray images to assess subject-specific geometry and inertial parameters. The simulations allowed discriminating between the contributions of the passive (inertia-induced properties) and the active (neuromuscular response) components during falls. Our data show that there is limited time to adjust the way one fall from a standing position. We showed that the pre-impact period is truncated of 200 ms. During the initial part of a fall, the observed trajectory results from the interaction between the destabilizing external force and the body: inertial properties intrinsic to joints, ligaments and musculotendinous system have then a major contribution, as suggested for the regulation of static upright stance. This passive phase is later followed by an active phase, which consists of a corrective response to the postural perturbation. We believe that during a fall from standing height, it takes about 300 ms for postural responses to start correcting the body trajectory, while the impact is expected to occur around 700 ms. It has been argued that this time is sufficient to change the way one falls and that this makes it possible to apply safer ways of falling, for example by using martial arts fall techniques. Also, our results imply visual and vestibular information are not congruent with the beginning of the on-going fall. This consequence is to be noted as subjects prepare to the impact on the basis of sensory information, which would be uniquely mainly of proprioceptive origin at the fall onset. One limitation of the present analysis is that no EMG was included so far but these data are the subject of a future study.

An Attempt of Early Detection of Poor Outcome after Whiplash.

The main concern with whiplash is that a large proportion of whiplash patients experience disabling symptoms or whiplash-associated disorders (WAD) for months if not years following the accident. Therefore, identifying early prognostic factors of WAD development is important as WAD have widespread clinical and economic consequences. In order to tackle that question, our study was specifically aimed at combining several methods of investigation in the same WAD patients at the acute stage and 6 months later. Our longitudinal, open, prospective, multi-center study included 38 whiplash patients, and 13 healthy volunteers matched for age, gender, and socio-economic status with the whiplash group. Whiplash patients were evaluated 15-21 days after road accident, and 6 months later. At each appointment, patients underwent a neuropsychological evaluation, a full clinical neurological examination, neurophysiological and postural tests, oto-neurological tests, cervical spine cord magnetic resonance imaging (MRI) with tractography (DTI). At 6 months, whiplash patients were categorized into two subgroups based on the results of the Diagnostic and Statistical Manual of Mental Disorders as having either favorable or unfavorable progression [an unfavorable classification corresponding to the presence of post-concussion symptom (PCS)] and we searched retrospectively for early prognostic factors of WAD predicting the passage to chronicity. We found that patients displaying high level of catastrophizing at the acute stage and/or post-traumatic stress disorder associated with either abnormalities in head or trunk kinematics, abnormal test of the otolithic function and at the Equitest or a combination of these syndromes, turned to chronicity. This study suggests that low-grade whiplash patients should be submitted as early as possible after the trauma to neuropsychological and motor control tests in a specialized consultation. In addition, they should be evaluated by a neuro-otologist for a detailed examination of vestibular functions, which should include cervical vestibular evoked myogenic potential. Then, if diagnosed at risk of WAD, these patients should be subjected to an intensive preventive rehabilitation program, including vestibular rehabilitation if required.