Characterization of the shoulder net joint moment during manual wheelchair propulsion using four functional axes.

Understanding how individuals distribute mechanical demand imposed on their upper extremity during physically demanding activities provides meaningful insights to preserve function and mitigate detrimental mechanical loading of the shoulder. In this study, we hypothesized that parameterization of the shoulder net joint moment using four functional axes could characterize distribution tendencies about the shoulder during manual wheelchair propulsion and that regardless of demographics, a shoulder flexor dominant NJM distribution would be predominantly used by individuals with paraplegia (n = 130). Forces and kinematics of the upper extremity and trunk were quantified using motion capture and an instrumented wheel during steady state manual wheelchair propulsion at self-selected fast speeds on a stationary ergometer. The results indicate that parsing out the internal/external rotation component of the shoulder net joint moment about the upper arm and distributing the remainder across the three orthogonal axes of the torso was successful in identifying common shoulder net joint moment distribution techniques used across individuals with paraplegia during manual wheelchair propulsion. Distribution tendencies were predominantly flexor dominant across injury level, gender, time since injury, body mass index, and height demographics. The 4-axis parameterization of the shoulder NJM effectively differentiated moment distribution tendencies used by individuals during manual wheelchair propulsion using a functionally relevant representation of shoulder kinetics. Use of the four-axis parameterization of joint kinetics in future studies is expected to provide important insights that can advance knowledge, preserve function, and inform clinical decisions.

Regulation of reaction forces during the golf swing.

During the golf swing, the reaction forces applied at the feet control translation and rotation of the body-club system. In this study, we hypothesized that skilled players using a 6-iron would regulate shot distance by scaling the magnitude of the resultant horizontal reaction force applied to the each foot with minimal modifications in force direction. Skilled players (n = 12) hit golf balls using a 6-iron. Shot distance was varied by hitting the ball as they would normally and when reducing shot distance using the same club. During each swing, reaction forces were measured using dual force plates (1200 Hz) and three-dimensional kinematics were simultaneously captured (110 Hz). The results indicate that, on average, the peak resultant horizontal reaction forces of the target leg were significantly less than normal (5%, p < 0.05) when reducing shot distance. No significant differences in the orientation of the peak resultant horizontal reaction forces were observed. Resultant horizontal reaction force-angle relationships within leg and temporal relationships between target and rear legs during the swing were consistent within player across shot conditions. Regulation of force magnitude with minimal modification in force direction is expected to provide advantages from muscle activation, coordination, and performance points of view.

Multijoint control strategies transfer between tasks.

In this paper, the hypothesis that multijoint control strategies are transferred between similar tasks was tested. To test this hypothesis, we studied the take-off phase of two types of backward somersault dives: one while translating backwards (Back), the other while translating forward (Reverse). An experimentally based dynamic model of the musculoskeletal system was employed to simulate the measured kinematics and reaction force data and to study the sensitivity of take-off performance to initial kinematic conditions. It was found that the horizontal velocity of the total body center of mass (CM) was most sensitive to modifications in the initial shank conditions. Consequently, the initial shank kinematics of the Back dive was modified in the optimization procedure while maintaining the joint coordination of the Back in order to generate the CM trajectory and reaction forces of a Reverse. Similarly, the initial shank kinematics of the Reverse dive was modified to simulate the CM trajectory and reaction force of the Back. It was found that small modifications in the initial shank kinematics led to change in direction of horizontal CM velocity at take-off; resulting in a switch from Back to Reverse and vice versa. In both cases, the simulated momentum conditions at departure and the bimodal shape of the reaction force-time curve were consistent with those experimentally observed. The results of this study support the hypothesis that transfer of control strategies between similar tasks is a viable option in multijoint control. This transfer of control strategy is explained using a hierarchical model of the motion control system.

Lower extremity control and dynamics during backward angular impulse generation in forward translating tasks.

Observation of complex whole body movements suggests that the nervous system coordinates multiple operational subsystems using some type of hierarchical control. When comparing two forward translating tasks performed with and without backward angular impulse, we have learned that both trunk-leg coordination and reaction force-time characteristics are significantly different between tasks. This led us to hypothesize that differences in trunk-leg coordination and reaction force generation would induce between-task differences in the control of the lower extremity joints during impulse generation phase of the tasks. Eight highly skilled performers executed a series of forward jumps with and without backward rotation (reverse somersault and reverse timer, respectively). Sagittal plane kinematics, reaction forces, and electromyograms of lower extremity muscles were acquired during the take-off phase of both tasks. Lower extremity joint kinetics were calculated using inverse dynamics. The results demonstrated between-task differences in the relative angles between the lower extremity segments and the net joint forces/reaction force and the joint angular velocity profiles. Significantly less knee extensor net joint moments and net joint moment work and greater hip extensor net joint moments and net joint moment work were observed during the push interval of the reverse somersault as compared to the reverse timer. Between-task differences in lower extremity joint kinetics were regulated by selectively activating the bi-articular muscles crossing the knee and hip. These results indicate that between-task differences in the control of the center of mass relative to the reaction force alters control and dynamics of the multijoint lower extremity subsystem.

Lower extremity control and dynamics during backward angular impulse generation in backward translating tasks.

Observation of complex whole-body movements suggests that the nervous system coordinates multiple operational subsystems using some type of hierarchical control. When comparing two backward translating tasks performed with and without backward angular impulse, we have learned that task-specific modifications in trunk-leg coordination contribute to the regulation of total-body center of mass (CoM) position relative to the reaction force (RF). In this study, we hypothesized that task-specific differences in trunk-leg coordination would affect the control of the lower extremity joints during the impulse-generation phase of the tasks. Eight highly skilled performers executed a series of backward translating jumps with and without backward rotation (back somersault and back timer, respectively). Sagittal plane kinematics, RFs and electromyograms of lower extremity muscles were acquired during the take-off phase of both tasks. Lower extremity joint kinetics was calculated using inverse dynamics. The results indicate that between-task differences in the relative angles between the lower extremity segments and the net joint forces/RF contributed to significant reductions in knee-extensor net joint moments and increases in hip-extensor net joint moments during the push interval of the back somersault as compared to the back timer. Between-task differences in backward trunk angular velocity also contributed to the re-distribution of work done by the lower extremity net joint moments. Between-task differences in lower extremity joint kinetics were associated with synergistic activation of the bi-articular muscles crossing the knee and hip. These results indicated that task-specific control of CoM relative to the RF in order to regulate the backward angular-impulse-involved modification in the control and dynamics of the knee and hip joints. These results indicate that between-task differences in the control objectives at the total-body level (position of CoM relative to the RF) alters the control and dynamics of the multi-joint lower extremity subsystem.

Modifying center of mass trajectory during sit-to-stand tasks redistributes the mechanical demand across the lower extremity joints.

OBJECTIVE: Sit-to-stand tasks are commonly facilitated by modifying the initial position of the center of mass relative to the feet. It was hypothesized that modifications in the center of mass trajectory during sit-to-stand tasks altered the total body momentum at seat departure and redistributed the lower extremity net joint moments. DESIGN: Between-task within-subject comparison was employed using a robust statistical method to accommodate for small sample size. METHODS: Six individuals performed four sit-to-stand tasks with systematic modifications in the initial center of mass position by varying the orientation of the lower extremity segments. The momentum of the center of mass and lower extremity net joint moments were quantified and compared. RESULTS: Reducing the horizontal center of mass displacement significantly reduced horizontal total body momentum required at seat departure. Sit-to-stand tasks initiated with more horizontal shank and thigh positions required significantly greater knee and hip extensor net joint moments than those with more vertical shank and thigh positions. Sit-to-stand tasks initiated with vertical shank positions also required significantly greater hip extensor net joint moments as compared to those with more horizontal shank orientations. INTERPRETATION: When changes in initial center of mass position are made, alteration in center of mass horizontal momentum and the orientation of the lower extremity segments relative to the reaction force are observed. Consequently, mechanical demand imposed on the ankle, knee, and hip joint is redistributed. The magnitude of the net joint moments is dependent on the segment orientation, the reaction force, and the adjacent net joint moment.

Mechanical demand and multijoint control during landing depend on orientation of the body segments relative to the reaction force.

The purpose of this study was to determine how diverse momentum conditions and anatomical orientation at contact influences mechanical loading and multijoint control of the reaction force during landings. Male collegiate gymnasts (n=6) performed competition style landings (n=3) of drop jumps, front saltos, and back saltos from a platform (0.72 m) onto landing mats (0.12 m). Kinematics (200 fps), reaction forces (800 Hz) and muscle activation patterns (surface EMG, 1600 Hz) of seven lower extremity muscles were collected simultaneously. Between-task differences in segment orientation relative to the reaction force contributed to significant between-task differences in knee and hip net joint moments (NJM) during the impact phase. During the stabilization phase, ankle, knee, and hip NJMs acted to control joint flexion. Between-task differences in muscle activation patterns indicated that gymnasts scaled biarticular muscle activation to accommodate for between-task differences in NJM after contact. Activation of muscles on both sides of the joint suggests that impedance like control was used to stabilize the joints and satisfy the mechanical demand imposed on the lower extremity. Between-subject differences in the set of muscles used to control total body center of mass (TBCM) trajectory and achieve lower extremity NJMs suggests that control of multijoint movements involving impact needs to incorporate mechanical objectives at both the total body and local level. The functional consequences of such a control structure may prove to be an asset to gymnasts, particularly when required to perform a variety of landing tasks under a variety of environmental constraints.

Subject specific coordination of two- and one-joint muscles during landings suggests multiple control criteria.

The target article, thoughtfully constructed by Dr. Prilutsky, effectively synthesizes available data on multijoint movements regarding coordination patterns of major two- and one-joint muscles, provides evidence for an optimization criterion that predicts critical features of muscle activation patterns, and explores the functional consequences of muscle coordination. This work also provides a clear set of definitions and an organizational framework that is currently needed for a productive interdisciplinary discussion regarding the underlying control mechanisms used during realistic multijoint movements. Although identification of an optimization criterion that predicts muscle recruitment strategies would greatly simplify control logic required for rehabilitation and musculoskeletal modeling, our experimental data during landings indicate more than one criterion may exist. Preliminary review of our experimental landing data suggests the rules identified by Prilutsky apparently hold for some subjects during portions of the landing movements. The presence of more than one muscle activation pattern used to achieve the same NJMs demonstrates there may be more than one optimization criterion that predicts critical features of muscle activation patterns. The functional consequences of more than one control criterion may also prove to be an asset, particularly when adapting to different environmental constraints.

Quantitative gait assessment as a predictor of prospective and retrospective falls in community-dwelling older women.

The purpose of this investigation was to identify gait-related risk factors associated with both retrospective and prospective falls in 17 community-dwelling older women (mean age 73.4 years). The subjects were videotaped walking at their freely-chosen speed and 21 quantitative kinematic biomechanical variables describing the gait of each individual were computed. Faller status in the preceding year was determined by retrospective self reports and was monitored by an investigator for 10 months after the subjects were videotaped. None of the variables distinguished the retrospective fallers from nonfallers or were a significant predictor of prospective falls. The findings suggest that quantitative kinematic gait variables alone may not identify risk factors associated with falling in community-dwelling older women.

Kinetics of the lower extremities during drop landings from three heights.

In this study, the landing preferences of gymnasts (n = 6) and recreational athletes (n = 6) were determined by comparing the changes in lower extremity kinetics of drop landings performed from three heights (0.32-1.28 m). Net joint moments and work done on the extensor muscles of the ankle, knee, and hip were selected as variables representative of the demand placed on the muscles responsible for controlling flexion and dissipating the load. Kinematic and kinetic two-dimensional data were acquired simultaneously using high-speed film (202.4 fps) and a force plate (1000 Hz). Reaction forces and lower extremity joint motions were used to calculate net joint forces, net joint moments powers, and work done on the extensor muscles of the ankle, knee, and hip. Results indicated that the extensor joint moments tended to peak earlier after contact with increases in velocity, but the temporal sequence of events was maintained independently of velocity or group. As impact velocity increased, net peak extensor moments and work done on the extensor muscles significantly increased. Significantly larger ankle and hip peak extensor moments were observed for the gymnasts across velocities as compared to the recreational athletes. No significant differences in work done on the extensor muscles were noted between groups. Significant interaction effects indicate that gymnasts chose to dissipate the loads at contact by using larger ankle and hip extensor moments at higher impact velocities than the recreational athletes, whereas recreational athletes chose to adjust their strategy by using greater degrees of hip flexion (McNitt-Gray, Int. J. Sport Biomech, 7, 201-204, 1991) and longer landing phase durations than the gymnasts. The greater demands placed on the ankle and hip extensors by the gymnasts, as compared to the recreational athletes, may be explained by the need to maintain balance during competitive gymnastics landings or, perhaps, by the inability of recreational athletes to produce larger extensor moments at the ankle or hip during landings from great heights.

Orthopedic Problems in Pregnancy.

In brief Pregnant women undergo anatomic and physiologic changes that make certain problems, such as low-back pain and fluid retention, almost inevitable. After discussing the diagnosis and treatment of common orthopedic problems, several experts recommend the sports that are safe for the pregnant woman and her unborn child.