Agreement between force and deceleration measures during backward somersault landings.

This study examined the agreement between force platform and inertial measurement unit (IMU) measures of backward somersault landings. Seven female gymnasts performed three trials, taking off from a 90 cm vaulting box and using competition landing technique. Two force platforms (1000 Hz) covered with a 6.4 cm thick carpeted landing surface measured the ground reaction forces. One inertial measurement unit (500 Hz) fixed on the second thoracic vertebra measured peak resultant deceleration of the gymnast. Measurement agreement between vertical and resultant peak force measures, and resultant peak force and peak deceleration was assessed using mean differences, Pearson's correlation, and Cohen's effect size (ES) statistics. There was perfect measurement agreement between vertical and resultant peak forces (R = 1.0, p < 0.001; ES = 0.005), but only moderate measurement agreement between resultant peak force and peak resultant deceleration (Mean Difference = -2.16%, R = 0.4, p = ns; ES = 0.121). Backward somersault landings can be assessed using either uni-axial or tri-axial force platforms to measure ground impact load/force, as the landing movements are almost purely vertical. However, force measures are not the same as peak resultant decelerations from IMUs which give an indication of impact shock. Landing load/shock measures are potentially important for injury prevention.

The use of inertial measurement units to quantify forearm loading and symmetry during gymnastics vault training sessions.

The upper limbs are important in gymnastics vaulting, as the success of the flight phase is dependent on a quick and forceful push-off from the vault. This places the upper limbs under stress, which has been associated with pain and injury. This study aimed to quantify forearm segmental loading and symmetry when performing foundation to advanced-level vaulting skills during training. Twelve advanced-level artistic gymnasts (female, n = 6; male, n = 6) wore bilaterally forearm-mounted inertial measurement units while completing their vaulting sessions. The peak resultant acceleration for the leading and non-leading forearms during contact were calculated. Female gymnasts performed variations of Yurchenko vaults, while male gymnasts performed Handspring and Tsukahara vaults. Descriptive statistics (median and inter-quartile range), symmetry index scores, and total session impact load (measure of cumulative loading) were calculated between the lead and non-lead forearms. High asymmetrical loading was identified for some Yurchenko, Handspring, and Tsukahara vaults, with large variations identified between gymnasts. Some gymnasts experienced greater loading at their lead forearm, while others experienced greater loading at their non-lead forearm. Results indicate that limb loading patterns in advanced gymnastics are highly individualised, indicating that individual analysis is needed to identify gymnasts (or limbs) at an increased risk for overuse injury.

The effect of hyper-pronated foot on postural control and ankle muscle activity during running and cutting movement / El efecto del pie hiperpronado sobre el control postural y la actividad de los músculos del tobillo durante el movimiento de carrera y cambio de dirección / O efeito do pé hiper-pronado no controlo postural e actividade muscular no tornozelo durante a corrida e movimentos cortantes

Objective: The aim of this study was to examine the effect of hyper pronated foot on postural control and ankle muscle activity during running and cutting movement (v-cut).Methods: In this Cross-Sectional study, 42 young physically active (exercising three times per week regularly) males participated in this study, including 21 with hyper-pronated feet and 21 with normal feet. Each participant completed a running and cutting task. Body postural control was measured using a force platform (1000Hz) which was synchronized with surface electromyography of selected ankle muscles. MATLAB software was used to process and analyze the data. One-away ANOVA was used to identify any differences between groups.Results: Differing muscle activation patterns in the surrounding ankle musculature (tibialis anterior, peroneus longus) through to reduced postural stability in the medial-lateral direction and increased vertical ground reaction forces were observed between groups.Conclusion: According to the obtained results it seems that subtalar hyper-pronation can be regarded as a factor affecting the biomechanics of cutting by changing activation patterns of the muscles surrounding the ankle, and reducing postural control of the body in medial-lateral direction, but not in anterior-posterior direction. (AU)

Objetivo: El objetivo de este estudio fue examinar el efecto del pie hiperpronado sobre el control postural y la actividad de los músculos del tobillo durante el movimiento de carrera y cambio de dirección.Métodos: En este estudio transversal, participaron 42 hombres jóvenes físicamente activos (ejercitándose tres veces por semana con regularidad), incluidos 21 con pies hiperpronados y 21 con pies normales. Cada participante completó una tarea de correr y cambiar de dirección. El control de la postura corporal se midió utilizando una plataforma de fuerza (1000 Hz) que se sincronizó con la electromiografía de superficie de los músculos seleccionados del tobillo. Se utilizó el software MATLAB para procesar y analizar los datos. Se utilizó un ANOVA de una distancia para identificar las diferencias entre los grupos.Resultados: Se observaron diferentes patrones de activación muscular en la musculatura del tobillo (tibial anterior, peroneo largo) con estabilidad postural reducida en la dirección medial-lateral y un aumento de las fuerzas de reacción vertical del suelo entre los grupos.Conclusión: De acuerdo con los resultados obtenidos, parece que la hiperpronación puede ser considerada como un factor que afecta la biomecánica del cambio de dirección al modificar los patrones de activación de los músculos que del tobillo y reducir el control postural del cuerpo en dirección medial-lateral, pero no en dirección anteroposterior. (AU)

Objetivo: O objetivo deste estudo é examinar o efeito do pé hiper-pronado no controlo postural e actividade muscular no tornozelo durante a corrida e movimentos cortantes.Métodos: Neste estudo seccionado, 42 rapazes fisicamente ativos (exercitam regularmente 3 vezes por semana) participaram neste estudo, incluindo 21 com pé hyper-pronated. Cada participante completou um desafio de corrida e corte. A postural corporal foi medida usando uma plataforma com potência de 1000Hz, cujo fora sincronizada com uma eletromiografia superficial do músculos do tornozelo seleccionados. O software MATLAB foi utilizado para processar e analisar os dados. ANOVA foi utilizado para identificar quaisquer diferenciações entre grupos.Resultados: Padrões divergentes de ativação por volta do músculo do tornozelo (tibialis anterior peroneus longus) pela redução de estabilidade postural na direção medial-lateral e foi observado um aumento de reacções verticais térreas entre grupos.Conclusão: De acordo com os resultados obtidos, parece que a hyper-pronation pode ser observada como um factor que afecta os biomecânica de corte através da mudança e ativação dos padrões dos músculos à volta do tornozelo, reduzindo assim o controlo do corpo na direção médio-lateral mas não na direção anterior-posterior. (AU)

Effects of digital filtering on peak acceleration and force measurements for artistic gymnastics skills.

Low-pass filters are ideal when filtering human movements, however the effectiveness of such filters relies on the correct selection of the cut-off frequency. The aim of this study was to determine the most appropriate filter cut-off for acceleration- and force-time data when measuring peak resultant acceleration (PRA) and ground reaction force (PRGRF) during gymnastics landings. Sixteen gymnasts executed backward handsprings and backward somersault landings onto a matted force plate while wearing four inertial measurement units (IMUs). Acceleration- and force-time data were filtered using a fourth-order Butterworth filter at different cut-off frequencies ranging from raw through to 250 Hz. Residual analysis plots were produced, and the PRGRF and PRA for all IMUs were calculated for each participant and skill at all cut-off frequencies. Descriptive statistics, model II linear regressions and Bland-Altman plots were conducted. Results indicated that a minimum 85 Hz cut-off is optimal. High cut-off frequencies (>80 Hz) showed good linear relationships and had minimal mean bias compared with raw values, indicating that either filtered (above ~85 Hz) or raw signals can be used. It is suggested that for applied sports settings no filtering is needed, however a minimum cut-off of 85 Hz should be implemented for research purposes.

Prevalence and factors associated with asymptomatic Achilles tendon pathology in male distance runners.

OBJECTIVES: This study investigated the prevalence of tendon pathology and associated factors in experienced, high mileage male endurance runners with no history of Achilles tendon pain. DESIGN: Cross-sectional study. SETTING: Achilles tendinopathy is a debilitating running injury affecting 50% of distance runners over their lifetime. It is diagnosed through a clinical examination and imaging, usually grey scale ultrasound (US) imaging. US imaging studies have shown that pathological changes can occur in asymptomatic individuals with no tendon pain. PARTICIPANTS: Thirty seven male runners who had never had Achilles tendon pain. MAIN OUTCOME MEASURES: Participants completed a running history survey, had their height, body mass, waist circumference, and ankle dorsiflexion range of movement (ROM) measured, and their tendons were assessed (normal, abnormal) using US imaging. RESULTS: Almost half (46%) of these asymptomatic distance runners had at least one abnormal tendon. The runners with tendon pathology had significantly (p = 0.024) more years of running training (abnormal: median 20 years, interquartile range 6-25.5) than runners with no pathology (normal: median 7 years, interquartile range 5-15). No other significant differences between the groups were identified. CONCLUSIONS: Asymptomatic male distance runners had a high incidence of tendon pathology. Increased running years was associated with pathology in the Achilles tendon...

Multi-segment spine range of motion in dancers with and without recent low back pain.

BACKGROUND: Altered spine kinematics are a common in people with LBP. This may be especially true for populations such as dancers, who are required to perform repetitive movements of the spine, although this remains unclear. RESEARCH QUESTION: Do dancers with recent LBP display altered spine kinematics compared to their asymptomatic counterparts? METHODS: A cross-sectional study of multi-segment spine kinematics was performed. Forty-seven pre-professional and professional female dancers either with LBP in the past two months (n = 26) or no LBP in the past 12 months (n = 21) participated. Range of motion (ROM) during standing side bending, seated rotation, and walking gait were compared. RESULTS: Female dancers with LBP displayed reduced upper lumbar transverse plane ROM in seated rotation (Effect Size (ES)= -0.61, 95% Confidence Interval (CI): -1.20, 0.02, p = 0.04), as well as reduced lower lumbar transverse plane ROM (ES=-0.65, 95% CI: -1.24, -0.06, p = 0.03) in gait. However, there was increased lower thoracic transverse plane ROM (ES = 0.62, 95% CI: 0.04, 1.21, p = 0.04) during gait. No differences in the frontal plane were observed. SIGNIFICANCE: Altered transverse plane spine kinematics were evident in dancers with recent LBP for select segments and tasks. This may reflect a protective movement strategy. However, as the effect sizes of observed differences were moderate, and the total number of differences between groups was small, collectively, it seems only subtle differences in spine kinematics differentiate dancers with LBP to dancers without.

The Epidemiology of Low Back Pain and Injury in Dance: A Systematic Review.

BACKGROUND: Dance is a physical pursuit that involves loading the spine through repetitive dynamic movements and lifting tasks. As such, low back pain (LBP) and low back injury (LBI) have been identified as common health problems in contemporary and classical ballet dancers. However, clarity regarding the experience of LBP and LBI in dance is lacking. OBJECTIVES: To systematically review and synthesize the epidemiology of LBP and LBI in dance populations. METHODS: A comprehensive search of 6 electronic databases, back catalogs of dance science-specific journals, and reference lists of relevant articles and a forward citation search were performed. RESULTS: Fifty full-text articles were included in the final systematic review. There was considerable methodological heterogeneity among the included studies. The median (range) point, yearly, and lifetime prevalence of LBP was 27% (17%-39%), 73% (41%-82%), and 50% (17%-88%), respectively. The lower back contributed to 11% (4%-22%) of time loss and 11% (5%-23%) of medical-attention injuries. CONCLUSION: Dancers are vulnerable to LBP and LBI. The use of definitions that are sensitive to the complexity of LBP and LBI would facilitate improved understanding of the problem within dance, inform health care strategies, and allow for monitoring LBP-specific intervention outcomes. J Orthop Sports Phys Ther 2019;49(4):239-252. Epub 18 Jan 2019. doi:10.2519/jospt.2019.8609.

Injury epidemiology and risk factors in competitive artistic gymnasts: a systematic review.

BACKGROUND: Artistic gymnastics is reported to have some of the highest injury rates in sports, which limits participation and often involves considerable medical expenses. PURPOSE: To critically appraise the epidemiological literature on injury patterns and risk factors in competitive artistic gymnastics. STUDY DESIGN: Systematic review. METHODS: Six databases were searched for articles that investigated injuries in competitive artistic gymnasts. Injury incidence, prevalence and risk factor data were extracted, alongside information on injury location, type, severity, nature and mechanism of injury. Quality and level of evidence were assessed using a modified Downs and Black quality index checklist and the Oxford Centre for Evidence-based Medicine guidelines. RESULTS: The search identified 894 articles, with 22 eligible for inclusion. Descriptive analysis showed that injury incidence and prevalence varied from 0.3 to 3.6 injuries per gymnast (female=0.3-3.6, male=0.7) and 2.0-2.3 (female=2.0-2.3, male=2.0), respectively. Male gymnasts sustained mostly upper limb injuries, while female gymnast reported lower limb injuries. Floor was associated with the greatest number of injuries for both male and female gymnasts. Higher competitive level and exposure to competition were risk factors for gymnastics injury: age, body mass, body size, training duration and life stress were significant associated factors. CONCLUSION: Injury incidence and prevalence results are substantial among artistic gymnasts of all competitive levels. Gymnasts who train at highly competitive levels and are exposed to competition environments are a greater risk of injury. Future researchers should implement consistent reporting methods.

Multi-segment spine kinematics: Relationship with dance training and low back pain.

BACKGROUND: Spine posture, range of motion (ROM) and movement asymmetry can contribute to low back pain (LBP). These variables may have greater impact in populations required to perform repetitive spine movements, such as dancers; however, there is limited evidence to support this. RESEARCH QUESTION: What is the influence of dance and LBP on spinal kinematics? METHODS: In this cross-sectional study, multi-segment spinal kinematics were examined in 60 female participants, including dancers (n = 21) and non-dancers (n = 39) with LBP (n = 33) and without LBP (n = 27). A nine-camera motion analysis system sampling at 100 Hz was used to assess standing posture, as well as ROM and movement asymmetry for side bend and trunk rotation tasks. A two-way ANOVA was performed for each of the outcome variables to detect any differences between dancers and non-dancers, or individuals with and without LBP. RESULTS: Compared to non-dancers, dancers displayed a flatter upper lumbar angle when standing (p < 0.01, ηp2 = 0.15), and achieved greater frontal plane ROM for the upper lumbar (p = 0.04, ηp2 = 0.08) and lower thoracic (p = 0.02, ηp2 = 0.09) segments. There were no differences between dancers and non-dancers for transverse plane ROM (p > 0.05) or movement asymmetry (p > 0.05). There was no main effect for LBP symptoms on any kinematic measures, and no interaction effect for dance group and LBP on spinal kinematics (p > 0.05). SIGNIFICANCE: Female dancers displayed a flatter spine posture and increased spine ROM compared to non-dancers for a select number of spine segments and movement tasks. However, the overall number of differences was small, and no relationship was observed between LBP and spinal kinematics. This suggests that these simple, static posture, ROM, and asymmetry measures often used in clinical practice can provide only limited generalisable information about the impact of dance or LBP on spinal kinematics.

The prevalence and impact of low back pain in pre-professional and professional dancers: A prospective study.

OBJECTIVES: To determine the prevalence of low back pain (LBP) in pre-professional and professional dancers and its impact on dance participation, care-seeking and medication use. DESIGN: Prospective cohort study. SETTING: One pre-professional ballet school, two pre-professional university dance programs, and a professional ballet company. PARTICIPANTS: Male and female classical ballet and contemporary dancers. MAIN OUTCOME MEASURES: An initial questionnaire collected demographic and LBP history data. The monthly prevalence of LBP (all episodes, activity limiting episodes and chronic LBP) and impact (activity limitation, care-seeking, and medication use) was collected over a nine-month period. RESULTS: 119 dancers participated, which represented 54% of those invited. Activity limiting LBP was reported by 52% of dancers, while chronic LBP was reported by 24%. Seventeen percent of all episodes of LBP resulted in some form of dance activity being completely missed. One-third of the sample reported care-seeking and one-fifth of the sample used medication. A history of LBP was associated with activity limiting LBP (p < 0.01; adjusted odds ratio: 3.98; 95% confidence interval: 1.44, 11.00). CONCLUSIONS: LBP in dancers was common and had multiple impacts. This study reinforces the need for dancer access to healthcare professionals with expertise in evidence-based LBP prevention and management.

Life history and point prevalence of low back pain in pre-professional and professional dancers.

OBJECTIVES: To investigate lifetime history and point prevalence of low back pain (LBP) in pre-professional and professional dancers and to identify any demographic or physical factors associated with LBP in dancers. DESIGN: Cross-sectional study. SETTING: One pre-professional ballet school, two pre-professional university dance programs, and a professional nationally touring ballet company. PARTICIPANTS: Male and female classical ballet and contemporary dancers aged 12 years old and above. MAIN OUTCOME MEASURES: Lifetime history and point prevalence of LBP. RESULTS: A total of 110 (n = 19 male) dancers (mean (SD) 17.8 (2.9) years old) participated in the study, which represented 50% of the population invited to participate. A 74% lifetime prevalence of LBP was reported by dancers. Point and 12 month prevalence were 24 and 64%, respectively. No significant association was observed between LBP and any demographic or physical variables. CONCLUSION: Pre-professional and professional dancers have an increased vulnerability to LBP. The development of LBP within this population is complex and may not be associated with individual factors measured in this study.

Do accelerometers mounted on the back provide a good estimate of impact loads in jumping and landing tasks?

Artistic gymnasts are frequently exposed to both low- and high-magnitude loads through impacts with the apparatus. These impact loads are thought to be associated with the high injury rates observed in gymnastics. Due to the variable apparatus and surfaces in gymnastics, impact loads during training are difficult to quantify. This study aimed to use triaxial accelerometers mounted on the back to assess impact loading during jumping and landing tasks. Twelve participants were fitted with an accelerometer on their upper and lower back, before performing a continuous hopping task, as well as drop landings and rebound jumps from various heights (37.5, 57.5, and 77.5 cm) onto a force platform. Peak resultant acceleration (PRA) was low-pass filtered with four cut-off frequencies (8, 15, 20, and 50 Hz). Filtering of PRA with the 20 Hz cut-off frequency showed the highest correlations between ground reaction force (GRF) and PRA. PRA recorded at the upper back, filtered with a 20 Hz cut-off frequency, appears to provide a good estimate of impact loading for continuous hopping and rebound jumps, but less so for drop landings since correlations between GRF and PRA were only significant when landing from 57.5 cm.

Reliability of accelerometry to assess impact loads of jumping and landing tasks.

Overuse injuries, resulting from repetitive subacute impact loading, are a problem in high-performance sports. Monitoring of impact loading may aid in the prevention of these injuries. The current study aimed to establish the intra-day and inter-day reliability of a tri-axial accelerometer to assess impact loading during jumping and landing tasks. Twelve participants wore an accelerometer on their upper and lower back. They performed a continuous hopping task as well as drop landings and rebound jumps from three drop heights (37.5, 57.5 and 77.5 cm), peak resultant acceleration (PRA) was calculated for all tasks. The tasks were performed twice, one week apart at the same time of day. The difference in the mean, intra-class correlation coefficient, coefficient of variation and Cohen's effect size were calculated as measures of reliability. PRA showed good intra-day reliability for the hopping task. Inter-day reliability of the PRA was moderate to good across all tasks. Reliability of PRA was slightly higher when accelerations were recorded on the lower back compared to the upper back. To assess impact loading, during continuous hopping, drop landings and rebound jumps, PRA recorded at both the upper and lower back appears to be a reliable measure.

The impact of data reduction on the intra-trial reliability of a typical measure of lower limb musculoskeletal stiffness.

Double-leg repeated jumping tasks are commonly used as measures of lower limb stiffness in exercise science research. Within similar stiffness calculations, variation in data-reduction criteria exists. The impact of these varied data-reduction methods on stiffness measures is unknown. Sixteen adolescent female participants from varied physical activity backgrounds performed 15 self-paced, bent-knee continuous jumps (CJb) on two force plates. Leg stiffness was calculated as the ratio of the peak force and the centre of mass displacement for each contact. Using combinations of criteria based on previous literature, 83 data-reduction methods were applied to the raw data. Data reduction suitability was assessed based on intra-trial reliability, the number of participants excluded and the average contacts excluded. Four data-reduction methods were deemed suitable for use with adolescent female populations, with three consecutive contacts within 1 SD of the average jump frequency considered optimal. The average individual stiffness values were not greatly influenced by the data-reduction method; however, for a single participant, a stiffness change of up to 6 kN · m(-1) (30%) was observed. The role and potential impact of data-reduction methods used to evaluate measures of lower limb stiffness during repeated jumping tasks warrants consideration.

Musculoskeletal stiffness during hopping and running does not change following downhill backwards walking.

Eccentric contractions that provide spring energy can also cause muscle damage. The aim of this study was to explore leg and vertical stiffness following muscle damage induced by an eccentric exercise protocol. Twenty active males completed 60 minutes of backward-walking on a treadmill at 0.67 m/s and a gradient of - 8.5° to induce muscle damage. Tests were performed immediately before; immediately post; and 24, 48, and 168 hours post eccentric exercise. Tests included running at 3.35 m/s and hopping at 2.2 Hz using single- and double-legged actions. Leg and vertical stiffness were measured from kinetic and kinematic data, and electromyography (EMG) of five muscles of the preferred limb were recorded during hopping. Increases in pain scores (over 37%) occurred post-exercise and 24 and 48 hours later (p < 0.001). A 7% decrease in maximal voluntary contraction occurred immediately post-exercise (p = 0.019). Changes in knee kinematics during single-legged hopping were observed 168 hours post (p < 0.05). No significant changes were observed in EMG, creatine kinase activity, leg, or vertical stiffness. Results indicate that knee mechanics may be altered to maintain consistent levels of leg and vertical stiffness when eccentric exercise-induced muscle damage is present in the lower legs.

Is starting with the feet out of the water faster in backstroke swimming?

This study aimed to determine if starting with the feet above the water (FAW) in male backstroke swimming resulted in faster start times (15-m time) than when the feet were underwater (FUW). It was hypothesised that setting higher on the wall would generate increased horizontal force and velocity, resulting in quicker starts. Twelve high-level male backstrokers performed three trials of the FAW and FUW techniques. A biomechanical swimming testing system comprising one force plate (1,000 Hz), four lateral-view (100Hz), and five overhead (50Hz) video cameras captured the swimmers' performance. Data for each participant's fastest trial for each technique were collated, grouped, and statistically analysed. Analysis included Wilcoxon, Spearman Rho correlation, and regression analysis. Wilcoxon results revealed a significantly faster start time for the FAW technique (p < 0.01). Peak horizontal force was significantly smaller for FAW (p = 0.02), while take-off horizontal velocity was significantly greater (p = 0.01). Regression analysis indicated take-off horizontal velocity to be a good predictor of start time for both techniques, and the horizontal displacement of the centre of mass for the FAW start.

The interday reliability of ankle, knee, leg, and vertical musculoskeletal stiffness during hopping and overground running.

A number of methods are used to measure lower extremity musculoskeletal stiffness, but there is a paucity of research examining the reliability of these techniques. Therefore, we investigated the reliability of vertical, leg, knee, and ankle stiffness during overground running and hopping in 20 active men. Participants were required to run on a 10 m overground runway at 3.83 m/s (actual; 3.35 ± 0.12 m/s) and to hop in place at 2.2 Hz (actual; 2.37 ± 0.03 Hz), and at a self-selected frequency (actual; 2.05 ± 0.12 Hz) and at 2.2 Hz (actual; 2.39 ± 0.04 Hz). Reliability was determined using the intraclass correlation coefficient, coefficient of variation, mean differences, and Cohen's effect sizes. There was good reliability for vertical stiffness, moderate reliability for leg stiffness, and poor reliability for knee and ankle stiffness during the running task. Similar results were observed during the 2.2 Hz hopping tasks, with good reliability displayed for vertical stiffness and poor reliability for ankle and knee stiffness. In conclusion, our results suggest that vertical stiffness is a reliable measure when running at 3.83 m/s and hopping at 2.2 Hz.