Rotation sequence and marker tracking method affects the humerothoracic kinematics of manual wheelchair propulsion.

The literature on shoulder (humerothoracic) kinematics in manual wheelchair propulsion is growing. Inconsistencies in the reporting of which rotation sequence is used to compute three-dimensional (3D) angles complicates the interpretation and comparison between studies. The purpose of this study was to compare the effects of three often used and recommended rotation sequences (ZXY, XZY, and YXY) and two tracking methods (anatomical and cluster only) on the humerothoracic kinematics of manual wheelchair propulsion. Fourteen able-bodied participants performed manual wheelchair propulsion on a treadmill, while a motion capture system recorded the movements at 120 Hz. Humeral and thoracic segment coordinate systems were constructed according to ISB recommendations. Humerothoracic angles were calculated using each of the three rotation sequences. The ZXY and XZY sequences yielded similar angles in terms of both shape and amplitude, but, perhaps unsurprisingly, these differed substantially from the YXY sequence. Anatomical tracking showed neither gimbal locks nor phase angle discontinuities for any rotation sequence, while cluster tracking yielded phase angle discontinuities for the ZXY and YXY rotation sequences. The two tracking methods yielded similar joint angles for all sequences except for internal/external rotation, and the cluster-only method had larger variability than the anatomical method. These results highlight the importance of reporting which rotation sequence and tracking method are used when calculating humerothoracic angles in order to allow for straightforward interpretation of results and comparison across studies.

Three-dimensional kinematics in healthy older adult males during golf swings.

The biomechanics of the golf swing have received considerable attention in previous research. However, existing studies have focused on young athletes, while the kinematics of older golfers remain poorly documented. This study presents kinematic data for healthy senior golfers during swings performed with a driver and six-iron. Seventeen male golfers (62.2 ± 8.8 years) volunteered for participation and a 10-camera Vicon system (Oxford, UK) recorded kinematic data (500 Hz). A launch monitor (TrackMan, Vedbæk, Denmark) recorded club head speed and initial ball speed. Joint angles and peak velocities of the trunk and lower body were extracted at the top of the backswing, ball contact, and end of the swing. Intraclass correlations and standard error of measurement determined reliability, and pairwise statistics determined between-club differences. Swings with the driver had 7.3° less trunk extension and 4.3° less X-factor at backswing, and 10.5° less trunk flexion and 3.2° less X-factor at ball impact. Older adults portray several differences in lower body kinematics between a six-iron and driver but maintain good to excellent reliability (0.728-0.997) during the swings. Comparisons with previous research also showed senior athletes produce slower club head and ball speeds than younger golfers, and that kinematic differences exist between the populations.

Changes in Mediolateral Postural Control Mechanisms During Gait After Total Knee Arthroplasty.

BACKGROUND: Patients who have total knee arthroplasty (TKA) likely suffer from decreased postural stability because of postoperative changes in musculoskeletal structure and loss of proprioception. The purpose of this experimental biomechanical study was to determine if patients who have TKA improve their dynamic postural control during walking after TKA as compared with before TKA. The secondary purpose was to assess changes in postural control between post-TKA patients and healthy controls. METHODS: Twenty-three patients who had primary knee osteoarthritis scheduled to undergo unilateral or bilateral TKA were prospectively enrolled. Each patient was tested at 3 months, 6 months, and 12 months after TKA. Ten healthy controls matched for age, sex, and body mass index were selected from a database of previous healthy volunteers without knee osteoarthritis. Ten Vicon cameras and four AMTI force platforms were used to collect the marker and center of pressure (COP) data while participants performed gait. RESULTS: Initial improvement in the double stance ratio was found by 6 months after TKA compared with before TKA. Patients showed improved postural control as evidenced by a faster mediolateral COP velocity and decreased double stance ratio at 12-month post-TKA compared with pre-TKA (P < .05). However, patients who underwent TKA exhibited limited ability to maintain consistent COP movement during walking with increased variability in COP parameters as compared with controls (P < .05). CONCLUSION: Patients exhibited improvement in dynamic postural control after TKA with time, but had higher variability in COP parameters during gait than controls. It is possible that therapy aimed to improve proprioceptive balance after TKA may improve dynamic postural control.

Effect of movement speed on lower and upper body biomechanics during sit-to-stand-to-sit transfers: Self-selected speed vs. fast imposed speed.

Preferred and fast speed sit-to-stand and stand-to-sit (STS) tests are prevalent in literature, but biomechanical changes between the different speeds of STS have never been studied. Understanding differences between these STS techniques will better inform experimental design for research assessing functional ability in clinical populations. The purpose of this study was to investigate the effect of different speeds of STS transfers on lower body and trunk kinematics and kinetics in healthy adults. Nineteen healthy middle-aged and older adults participated in this study. Two different speeds of STS were tested: self-selected speed and fast speed (as quickly as possible). Ten Vicon cameras and two AMTI force platforms were used to collect three-dimensional kinematic and kinetic data. During sit-to-stand transfer, peak knee extension velocity and knee extension moment were significantly increased for the fast speed STS as compared to the preferred speed STS. During stand-to-sit transfer, peak knee extension moment and lower back moment were significantly increased while STS time was decreased for the fast speed STS as compared to the preferred speed STS. Our results indicate that the fast speed STS could be more challenging for participants compared to the preferred speed STS evidenced by greater knee and lower back joint movements. Therefore, fast STS tests should be reconsidered when testing middle-aged and older adults with chronic low back pain and knee joint problems.

Management of Periprosthetic Joint Infection and Extensor Mechanism Disruption With Modular Knee Fusion: Clinical and Biomechanical Outcomes.

BACKGROUND: Extensor mechanism disruption (EMD) combined with periprosthetic joint infection (PJI) after total knee arthroplasty are life-changing complications. The literature suggests many eventually receive above-knee amputation and lose ambulatory function. An alternative is modular knee fusion (KF), but little is known about its outcomes and biomechanical function. We report early term results on a case series of patients. METHODS: A retrospective review was conducted of patients who underwent 2-stage reconstruction with modular KF for combined EMD and PJI. Patient-reported outcomes at 1 year after arthrodesis and complications of surgery were recorded. Biomechanical analysis was conducted on 6 patients >1 year after surgery to measure gait speed and balance. RESULTS: Fifteen patients received a modular KF. At the most recent follow-up visit (average 25.7 months), 12 patients had their modular KFs in place and were ambulatory while 2 had died. Six patients used a walker; 4, a cane; and 2, unassisted. Gait analysis of 6 of these patients showed variation in patterns and speed. Balance was better than historical controls treated with above-knee amputation. Average Knee Injury and Osteoarthritis Outcome Score Junior was 76 ± 11. CONCLUSION: Modular KF for EMD and PJI can result in successful outcomes in terms of preventing additional operations and maintaining ambulation. While speed is variable, physical testing shows this method for limb salvage may allow patients to ambulate with a gait aid although further studies are needed to evaluate midterm and long-term results.

The required number of trials for biomechanical analysis of a golf swing.

The increasing interest in the biomechanical analysis of the golf swing warrants establishing the minimum number of trials required to obtain reliable data. Several such methods have been suggested previously for other movement tasks, and it has been shown that the number of required trials depends on the method used and on the task examined. This study aimed to compare three methods of reliability: a sequential average, intraclass correlations, and a modified version of the standard error of measurement (SEMind). Kinematic and kinetic data of 10 recreational golfers performing 15 shots with both a six-iron and a driver was collected using a ten-camera motion capture system and force platforms. Range-of-motion, velocity, joint moments, and ground reaction forces were extracted and analysed using the three methods. The sequential average method yielded the highest number of required trials (12), while the intraclass correlations and SEMind both resulted in lower numbers of required trials (4). Considering the variability between participants and strengths and limitations of the various methods, we conclude that 8 trials is sufficient for biomechanical analyses of a golf swing and recommend the SEMind method for determining how many swings should be collected.

Infant carrying method impacts caregiver posture and loading during gait and item retrieval.

BACKGROUND: Human babies are carried by their caregivers during infancy, and the use of ergonomic aids to wear the baby on the body has recently grown in popularity. However, the effects of wearing or holding a baby in-arms on an individual's mechanics during gait and a common object retrieval task are not fully understood. RESEARCH QUESTION: What are the differences in: 1) spatiotemporal, lower extremity kinematics, and ground reaction force variables during gait, and 2) technique, center of mass motion, and kinematics during an object retrieval task between holding and wearing an infant mannequin? METHODS: In this prospective biomechanics study, 10 healthy females performed over-ground walking and an object retrieval task in three conditions, holding: (1) nothing (unloaded), (2) an infant mannequin in-arms, and (3) an infant mannequin in a baby carrier. Mechanics were compared using repeated measures ANOVA. RESULTS: During gait, greater vertical ground reaction force and impulse and braking force was found during the in-arms and carrier conditions compared to unloaded. Significant but small (<5°) differences were found between conditions in lower extremity kinematics. Increased back extension was found during carrier and in-arms compared to unloaded. Step length was the only spatiotemporal parameter that differed between conditions. During object retrieval, most participants used a squatting technique to retrieve the object from the floor. They maintained a more upright posture, with less trunk flexion and anteroposterior movement of their center of mass, and also did not try to fold forward over their hips during the two loaded conditions. Lower extremity kinematics did not differ between unloaded and carrier, suggesting that babywearing may promote more similar lower extremity mechanics to not carrying anything. SIGNIFICANCE: Holding or wearing an infant provides a mechanical constraint that impacts the forces and kinematics, which has implications for caregivers' pain and dysfunction.

Ankle motion in common yoga poses.

BACKGROUND: Motion of the ankle is essential for many yoga poses. An understanding of range of ankle motion during typical yoga poses may help the clinician to understand expected outcomes of patients when returning from ankle surgery or injury to yoga. METHODS: The biomechanics of twenty healthy active yogis were collected during seven yoga poses that are common within their practices. Motion capture and force plates were used to assess the range of motion and joint moments of the ankle for each pose. RESULTS: All poses resulted in plantarflexion and external rotation moments at the ankle joints. Joint loading was highest in single leg poses. The arc of motion used by the study participants in the poses was 29° of sagittal motion, 20° of frontal motion and 35° of transverse motion. DISCUSSION: Ankle motion was evaluated when healthy yogis perform standard poses. These results may help in discussion with patients regarding expected outcomes after ankle injury or surgery.

Effects of Water Immersion on Squat and Split Squat Kinematics in Older Adults.

This study examined the effect of water immersion on trunk and lower limb kinematics during squat exercises in older participants. A total of 24 active older adults (71.4 ± 5.4 years) performed squats and split squats on land and while partially submerged in water. Inertial sensors (100 Hz) were used to record trunk and lower body kinematics. Water immersion increased the squat depth (squat: p = .028, d = 0.63 and split squat: p = .005, d = 0.83) and reduced the trunk flexion range (squat: p = .006, d = 0.76 and split squat: p < .001, d = 1.35) during both exercises. In addition, water immersion increased the hip range of motion during the split squat (p = .002, d = 0.94). Waveform analyses also indicated differences in the timing of the movements. These results showed that water-based exercise generates a different exercise outcome and appears to provide an alternative option for older adults, enabling exercisers to perform these tasks in a manner not possible on land.

Limb symmetry during double-leg squats and single-leg squats on land and in water in adults with long-standing unilateral anterior knee pain; a cross sectional study.

BACKGROUND: The presence of pain during movement typically results in changes in technique. However, the physical properties of water, such as flotation, means that water-based exercise may not only reduce compensatory movement patterns but also allow pain sufferers to complete exercises that they are unable to perform on land. The purpose of this study was to assess bilateral kinematics during double-leg squats and single-leg squats on land and in water in individuals with unilateral anterior knee pain. A secondary aim was to quantify bilateral asymmetry in both environments in affected and unaffected individuals using a symmetry index. METHODS: Twenty individuals with unilateral knee pain and twenty healthy, matched controls performed body weight double- and single-leg squats in both environments while inertial sensors (100 Hz) recorded trunk and lower body kinematics. Repeated-measures statistics tested for environmental effects on movement depths and peak angles within the anterior knee pain group. Differences in their inter-limb symmetry in each environments was compared to the control group using analysis of variance tests. RESULTS: Water immersion allowed for greater movement depths during both exercises (double-leg squat: +7 cm, p = 0.032, single-leg squat: +9 cm, p = 0.002) for the knee pain group. The double-leg squat was symmetrical on land but water immersion revealed asymmetries in the lower body frontal plane movements. The single-leg squat revealed decreased hip flexion and frontal plane shank motions on the affected limb in both environments. Water immersion also affected the degree of lower limb asymmetry in both groups, with differences also showing between groups. CONCLUSIONS: Individuals with anterior knee pain achieved increased squat depth during both exercises whilst in water. Kinematic differences between the affected and unaffected limbs were often increased in water. Individuals with unilateral anterior knee pain appear to utilise different kinematics in the affected and unaffected limb in both environments.

Quantifying kinematic differences between land and water during squats, split squats, and single-leg squats in a healthy population.

Aquatic exercises can be used in clinical and sporting disciplines for both rehabilitation and sports training. However, there is limited knowledge on the influence of water immersion on the kinematics of exercises commonly used in rehabilitation and fitness programs. The aim of this study was to use inertial sensors to quantify differences in kinematics and movement variability of bodyweight squats, split squats, and single-leg squats performed on dry land and whilst immersed to the level of the greater trochanter. During two separate testing sessions, 25 active healthy university students (22.3±2.9 yr.) performed ten repetitions of each exercise, whilst tri-axial inertial sensors (100 Hz) recorded their trunk and lower body kinematics. Repeated-measures statistics tested for differences in segment orientation and speed, movement variability, and waveform patterns between environments, while coefficient of variance was used to assess differences in movement variability. Between-environment differences in segment orientation and speed were portrayed by plotting the mean difference ±95% confidence intervals (CI) throughout the tasks. The results showed that the depth of the squat and split squat were unaffected by the changed environment while water immersion allowed for a deeper single leg squat. The different environments had significant effects on the sagittal plane orientations and speeds for all segments. Water immersion increased the degree of movement variability of the segments in all exercises, except for the shank in the frontal plane, which showed more variability on land. Without compromising movement depth, the aquatic environment induces more upright trunk and shank postures during squats and split squats. The aquatic environment allows for increased squat depth during the single-leg squat, and increased shank motions in the frontal plane. Our observations therefore support the use of water-based squat tasks for rehabilitation as they appear to improve the technique without compromising movement depth.