Spatiotemporal variables comparison between drop jump and horizontal drop jump in elite jumpers and sprinters.

Background: General expectations speculated that there are differences between drop jump (DJ) and horizontal drop jump (HDJ) exercises. While these criteria may be valid, we have yet to find a report that explores these differences in competitive level athletes. Objective: The study aimed to compare spatiotemporal variables in the drop jump (DJ) vs. the horizontal drop jump (HDJ) in elite jumpers and sprinters. Methods: Sixteen international-level male athletes performed two DJ attempts at different fall heights 0.3, 0.4, and 0.5 m (DJ30, DJ40, and DJ50), and after 2 h, they performed two HDJ attempts (HDJ30, HDJ40, HDJ50). All jumps were performed on a Kistler force plate. The variables analyzed were ground contact time (GCT), flight time (FT), eccentric phase time, concentric phase time, and time to peak concentric force. Results: The GCT was found to be significantly shorter in DJ vs. HDJ (Z = 4.980; p = 0.0001; ES = 3.11). FT was significantly lower in DJ30 versus HDJ30 (Z = 4.845; p = 0.0001, d = 3.79), but significantly higher in DJ40 vs. HDJ40 (Z = 4.437; p ≤ 0.0001, d = 3.70) and in DJ50 vs. HDJ50 (Z = 4.549; p ≤ 0.0001, d = 4.72). Conclusions: It is concluded that the HDJ requires more time for force production, that the eccentric component requires more time than the concentric and that it is not recommended to use the HDJ over the DJ for reactive purposes. This is the first study that comprehensively compare the differences between DJ and HDJ, which will assist coaches and researchers in the design of future training strategies.

Gait Analysis in Children with Cerebral Palsy: Are Plantar Pressure Insoles a Reliable Tool?

Cerebral palsy (CP) is a common cause of motor disability, and pedobarography is a useful, non-invasive, portable, and accessible tool; is easy to use in a clinical setting; and can provide plenty of information about foot-soil interaction and gait deviations. The reliability of this method in children with CP is lacking. The aim of this study is to investigate test-retest reliability and minimal detectable change (MDC) of plantar pressure insole variables in children with CP. Eight children performed two trials 8 ± 2.5 days apart, using foot insoles to collect plantar pressure data. Whole and segmented foot measurements were analyzed using intraclass correlation coefficients (ICC). The variability of the data was measured by calculating the standard error of measurement (SEM) and the MDC/ICC values demonstrated high test-retest reliability for most variables, ranging from good to excellent (ICC ≥ 0.60). The SEM and the MDC values were considered low for the different variables. The variability observed between sessions may be attributed to the heterogeneous sub-diagnosis of CP.

Evaluation of Upper Limb Joint Contribution to Racket Head Speed in Elite Tennis Players Using IMU Sensors: Comparison between the Cross-Court and Inside-Out Attacking Forehand Drive.

This study aimed to quantify and compare the upper limb angular kinematics and its contributions to the racket head speed between the cross-court (CC) and inside-out (IO) attacking tennis forehand of elite tennis players in a competitive environment. A new approach was used to study the forehand drive with mini-inertial sensors of motion capture to record the kinematic data. Six strokes in each direction per participant (72 shots in total) were chosen for analysis. Upper limb kinematics were calculated in the Visual 3D platform (Visual 3D Professional V5.01.21, C-motion, Germantown, MD, USA). The method used to calculate the upper limb's contributions was performed with MATLAB software and used the segment's (upper arm, forearm and hand) angular velocities and their respective displacement vectors obtained through the inertial sensors. Upper limb kinematics demonstrated a higher shoulder rotation in the IO direction with significant differences at the end of the backswing, which could be a key factor in distinguishing the two directions of the shot. Results also demonstrated that the horizontal flexion of the upper arm (around the shoulder joint) was primarily responsible for the racket velocity in the anteroposterior direction (48.1% CC and 45.2% IO), followed by the extension of the forearm (around the elbow joint) (17.3% CC and 20.9% IO) and the internal rotation of the upper arm (around the shoulder joint) (15.6% CC and 14.2% IO). No significant differences were shown in the contributions of upper limbs to the racket head velocity between the two directions of the shot. Tennis coaches and players should develop a specific training programme to perform higher angular velocities in these specific joint rotations.

Effects of Ankle Foot Orthoses on the Gait Patterns in Children with Spastic Bilateral Cerebral Palsy: A Scoping Review.

BACKGROUND: Cerebral palsy (CP) is the most common cause of motor disability in children and can cause severe gait deviations. The sagittal gait patterns classification for children with bilateral CP is an important guideline for the planning of the rehabilitation process. Ankle foot orthoses should improve the biomechanical parameters of pathological gait in the sagittal plane. METHODS: A systematic search of the literature was conducted to identify randomized controlled trials (RCT) and controlled clinical trials (CCT) which measured the effect of ankle foot orthoses (AFO) on the gait of children with spastic bilateral CP, with kinetic, kinematic, and functional outcomes. Five databases (Pubmed, Scopus, ISI Web of SCIENCE, SciELO, and Cochrane Library) were searched before February 2020. The PEDro Score was used to assess the methodological quality of the selected studies and alignment with the Cochrane approach was also reviewed. Prospero registration number: CRD42018102670. RESULTS: We included 10 studies considering a total of 285 children with spastic bilateral CP. None of the studies had a PEDro score below 4/10, including five RCTs. We identified five different types of AFO (solid; dynamic; hinged; ground reaction; posterior leaf spring) used across all studies. Only two studies referred to a classification for gait patterns. Across the different outcomes, significant differences were found in walking speed, stride length and cadence, range of motion, ground force reaction and joint moments, as well as functional scores, while wearing AFO. CONCLUSIONS: Overall, the use of AFO in children with spastic bilateral CP minimizes the impact of pathological gait, consistently improving some kinematic, kinetic, and spatial-temporal parameters, and making their gait closer to that of typically developing children. Creating a standardized protocol for future studies involving AFO would facilitate the reporting of new scientific data and help clinicians use their clinical reasoning skills to recommend the best AFO for their patients.

Modeling the musculoskeletal loading in bone remodeling at the hip of a child.

BACKGROUND AND OBJECTIVES: The mechanical load associated with physical activity affects the bone adaptation process. The bone adaptationeffect varies with age, being more effective during childhood and adolescence, particularly during pre-pubertal years. Bone-strengthening physical activity is recommended for children and adolescents. The number of time periods (bouts) per day of vigorous physical activity seems to be more important than the total cumulative time for optimal bone strength. So, the aim of this study was to evaluate the effects of weight-bearing physical activity on bone mineral density (BMD) of the proximal femur through computational simulation considering the intensity, exposure time (bouts) and regionalization of the results. METHODS: For this purpose, a finite element model of a 7 year-old child femur was developed based on computed tomography images. Musculoskeletal loads were obtained from experimental kinematic data of weight-bearing physical activity performed by children of the same age (standing, walking, running, jumping). The effects of physical activity on BMD of several regions of interest of the femur were analyzed using a bone remodeling model. A daily accumulation of 400 min of physical activity (200 min walking and 200 min standing) was considered as reference, against with which the effects of additional 10 min loading bouts were compared: 10 min bouts of vigorous intensity physical activity vs. 10 min bouts of light to moderate intensity physical activity. RESULTS: The simulations revealed greater increases in BMD associated with higher intensity and longer duration of physical activity. The largest BMD increases occurs during the first 10 min bout compared to longer durations and in less mineralized central regions compared to regions far from the neutral axis of the bone. CONCLUSION: Weight bearing physical activity is more effective in bone remodeling when the musculoskeletal loading is more intense and of short duration and, under these conditions, less mineralized regions are more positively impacted.

Combined Use of Chitosan and Olfactory Mucosa Mesenchymal Stem/Stromal Cells to Promote Peripheral Nerve Regeneration In Vivo.

Peripheral nerve injury remains a clinical challenge with severe physiological and functional consequences. Despite the existence of multiple possible therapeutic approaches, until now, there is no consensus regarding the advantages of each option or the best methodology in promoting nerve regeneration. Regenerative medicine is a promise to overcome this medical limitation, and in this work, chitosan nerve guide conduits and olfactory mucosa mesenchymal stem/stromal cells were applied in different therapeutic combinations to promote regeneration in sciatic nerves after neurotmesis injury. Over 20 weeks, the intervened animals were subjected to a regular functional assessment (determination of motor performance, nociception, and sciatic indexes), and after this period, they were evaluated kinematically and the sciatic nerves and cranial tibial muscles were evaluated stereologically and histomorphometrically, respectively. The results obtained allowed confirming the beneficial effects of using these therapeutic approaches. The use of chitosan NGCs and cells resulted in better motor performance, better sciatic indexes, and lower gait dysfunction after 20 weeks. The use of only NGGs demonstrated better nociceptive recoveries. The stereological evaluation of the sciatic nerve revealed identical values in the different parameters for all therapeutic groups. In the muscle histomorphometric evaluation, the groups treated with NGCs and cells showed results close to those of the group that received traditional sutures, the one with the best final values. The therapeutic combinations studied show promising outcomes and should be the target of new future works to overcome some irregularities found in the results and establish the combination of nerve guidance conduits and olfactory mucosa mesenchymal stem/stromal cells as viable options in the treatment of peripheral nerves after injury.

Muscle contributions to maximal single-leg forward braking and backward acceleration in elite athletes.

Abrupt deceleration is a common practice in several sports, where sudden changes of direction are needed to reach the highest performance level. When inappropriately performed, these actions can impose excessive mechanical loads at the lower limb joints, specifically at the knee and ankle joints, usually associated with increased risk of injury. This work aims to estimate muscle forces and muscle contributions to the acceleration of the center of mass during a rapid maximal single-leg forward braking and backward acceleration task. Fourteen elite male injury-free indoor-sports athletes participated in this work. Scaled generic musculoskeletal models, consisting of 12 segments, 23 degrees of freedom, and 92 muscle-tendon actuators were used in OpenSim software. Due to the nature of the musculoskeletal system, all muscles are considered when joint and segment positions, velocities, and accelerations are calculated, resulting in muscles acting to accelerate joints it does not span. The knowledge of muscle interaction during this multijoint task is important and was achieved through an induced acceleration analysis. The vasti (-9.18 ± 2.09 and -7.63 ± 1.33 N/Kg) were the main contributors to the centre of mass deceleration profile along the anterior/posterior direction, aided by the soleus muscle (9.72 ± 2.35 and 9.62 ± 2.07 N/Kg), which counteracted most of the effects applied by gravity along the vertical direction, during both phases. This study provides a computational approach to quantify the dynamical interactions between muscles and joints during an abrupt anterior/posterior deceleration task, thus giving robust and insightful indicators that can be implemented in injury prevention protocols.

Preliminary Feasibility Study to Measure the Immediate Changes of Bilateral Asymmetry After Lumbar Spinal Manipulative Therapy in Asymptomatic Athletes.

OBJECTIVE: The purpose of this preliminary study was to assess the feasibility of a study to measure the immediate changes in bilateral asymmetry on physical performance tests before and after lumbar spinal manipulative therapy (SMT). METHODS: Thirteen asymptomatic athletes participated in this study. Each participant underwent a clinical and physical evaluation for inclusion according to eligibility criteria. Assessments were performed in all participants and included a physical test symmetry sequence (static standing position, squat, and countermovement jump) before and after lumbar SMT intervention. The immediate changes were quantitatively measured from before to after intervention by statistical calculations. RESULTS: All recruited participants completed the study, and none of them reported complaints during participation. Statistically significant differences between before and after lumbar SMT were found only for static symmetry (respectively, mean = 14.4% and 3.7%), not for squatting or the countermovement jump. CONCLUSION: According our sample characteristics, asymptomatic athlete participants, presented initially bilateral asymmetry values, such as described in the literature, and after lumbar SMT, these values decreased significantly in static posture. This preliminary study demonstrates the feasibility to measure the pre-to-post changes in symmetry after lumbar SMT intervention. The results showed a great decrease in bilateral symmetry on static symmetry percentage, but none in dynamic tests, which deserves further investigation. Nevertheless, this preliminary study demonstrated the feasibility of measuring the immediate changes in symmetry produced by lumbar SMT, and of a larger study to measure whether lumbar SMT changes symmetry.

The effects of a single session of lumbar spinal manipulative therapy in terms of physical performance test symmetry in asymptomatic athletes: a single-blinded, randomised controlled study.

BACKGROUND AND AIM: Musculoskeletal disorders in athletes, including spinal biomechanical dysfunctions, are believed to negatively influence symmetry. Spinal manipulative therapy (SMT) is recognised as a safe and effective treatment for musculoskeletal disorders, but there is little evidence about whether it can be beneficial in symmetry. Therefore, this study aimed to measure the effects of lumbar SMT in symmetry. METHODS: Forty asymptomatic athletes participated in the study. The randomisation procedure was performed according to the following group allocation: group 1 (SMT) and group 2 (SHAM). Each participant completed a physical activity questionnaire, and also underwent clinical and physical evaluation for inclusion according to eligibility criteria. Statistical significance (P<0.05) between groups and types of therapy were calculated by physical performance tests symmetry (static position, squat and counter movement jump (CMJ), pre- and post-SMT and SHAM. There were 14 trials of three symmetry tests for each participant, for a total of 560 trials. RESULTS: Lumbar SMT produced immediate effects in symmetry in the static position; however, the same effects were not found in squat and CMJ on symmetry 1. Therefore, our results showed a significant difference in pre- (mean 16.3%) and post-lumbar SMT (mean 3.7%) in static symmetry. However, symmetry 2 showed no statistical significant differences for any of the tests and intervention groups. No statistically significant effects in symmetry pre- to post-SHAM were found in any of the tests. CONCLUSIONS: Statistically significant differences were found in lumbar SMT, but only for static symmetry. These findings suggest that SMT was effective in producing immediate effects in symmetry in the static position, but none in dynamic tests. Future studies could address our study's limitations. CLINICAL TRIALS REGISTER NUMBER: NCT03361592.

Joint moments' contributions to vertically accelerate the center of mass during stair ambulation in the elderly: An induced acceleration approach.

Falls are a serious problem faced by the elderly. Older adults report mostly to fall while performing locomotor activities, especially the ones requiring stair negotiation. During these tasks, older adults, when compared with young adults, seem to redistribute their lower limb joint moments. This may indicate that older adults use a different strategy to accelerate the body upward during these tasks. The purposes of this study were to quantify the contributions of each lower limb joint moment to vertically accelerate the center of mass during stair ascent and descent, in a sample of community-dwelling older adults, and to verify if those contributions were correlated with age and functional fitness level. A joint moment induced acceleration analysis was performed in 29 older adults while ascending and descending stairs at their preferred speed. Agreeing with previous studies, during both tasks, the ankle plantarflexor and the knee extensor joint moments were the main contributors to support the body. Although having a smaller contribution to vertically accelerate the body, during stair descent, the hip joint moment contribution was related with the balance score. Further, older adults, when compared with the results reported previously for young adults, seem to use more their knee extensor moment than the ankle plantarflexor moment to support the body when the COM downward velocity is increasing. By contributing for a better understanding of stair negotiation in community dwelling older adults, this study may help to support the design of interventions aiming at fall prevention and/or mobility enhancement within this population.

An informational framework to predict reaction of constraints using a reciprocally connected knee model.

Researchers have used screw theory to describe the motion of the knee in terms of instantaneous axes of the knee (IAK). However, how geometric change to the dynamic alignment of IAK may affect stance phase of foot loading has not yet been fully explained. We have tested our informational framework through readily accessible benchmark data (Fregly et al. 2012): muscle contraction and ground reaction force are compounded into a wrench that is reciprocal to the IAK and resolved into component wrenches belonging to the reciprocal screw system. This revealed the special screw system that defines the freedom available to the knee and more precisely revealed how to measure this first order of freedom. After this step, we determined the reciprocal screw system, which involves the theory of equilibrium. Hence, a screw system of the first order will have a screw system of the fifth order as its reciprocal. We established a framework the estimation of reaction of constraints about the knee using a process that is simplified by the judicious generation of IAK for the first order of freedom in equilibrium.

Synergistic interaction between ankle and knee during hopping revealed through induced acceleration analysis.

The forces produced by the muscles can deliver energy to a target segment they are not attached to, by transferring this energy throughout the other segments in the chain. This is a synergistic way of functioning, which allows muscles to accelerate or decelerate segments in order to reach the target one. The purpose of this study was to characterize the contribution of each lower extremity joint to the vertical acceleration of the body's center of mass during a hopping exercise. To accomplish this, an induced acceleration analysis was performed using a model with eight segments. The results indicate that the strategies produced during a hopping exercise rely on the synergy between the knee and ankle joints, with most of the vertical acceleration being produced by the knee extensors, while the ankle plantar flexors act as stabilizers of the foot. This synergy between the ankle and the knee is perhaps a mechanism that allows the transfer of power from the knee muscles to the ground, and we believe that in this particular task the net action of the foot and ankle moments is to produce a stable foot with little overall acceleration.

Efferent Copy and Corollary Discharge Motor Control Behavior Associated with a Hopping Activity.

Hoppers respond not only to stimuli from the ground surfaces but also to cues generated by their own behaviors. This leads to desensitization because although the afferent and reafferent signals have distinct causes, they are carried by the same sensory channels. From a behavioral viewpoint, it may be necessary to distinguish between signals from the two causes especially when monitoring changes in the external environment separate from those due to self-movement. We were able to separate afferent sensory stimuli from self-generated, reafferent signals using an action-oriented perception system and dynamic programming approach. This effort addressed the question of how the nerve system selects which particular degree of freedom (DOF) to cancel reafferent input. We have proposed an internal one-DOF model characterizing the motor control system during hopping, allowing the generation of an estimated ground reaction signal to drive natural shock absorption of the leg.

An Informational Algorithm as the Basis for Perception-Action Control of the Instantaneous Axes of the Knee.

Traditional locomotion studies emphasize an optimization of the desired movement trajectories while ignoring sensory feedback. We propose an information based theory that locomotion is neither triggered nor commanded but controlled. The basis for this control is the information derived from perceiving oneself in the world. Control therefore lies in the human-environment system. In order to test this hypothesis, we derived a mathematical foundation characterizing the energy that is required to perform a rotational twist, with small amplitude, of the instantaneous axes of the knee (IAK). We have found that the joint's perception of the ground reaction force may be replaced by the co-perception of muscle activation with appropriate intensities. This approach generated an accurate comparison with known joint forces and appears appropriate in so far as predicting the effect on the knee when it is free to twist about the IAK.

The natural shock absorption of the leg spring.

When a human being runs, muscles, tendons, and ligaments together behave like a single linear spring. This "leg spring" can be described remarkably well by spring/mass models. Although leg-stiffness during running (and logically, therefore, in hopping) has been shown to be adjusted in line with the individual characteristics of the external contact surface, the relative contribution of each of the sub-components of the leg spring to the mechanics of running is unclear. We proposed the three-degree-of-freedom leg spring chain in a position of stable equilibrium under the action of the leg stiffness. If the leg spring receives a displacement in hopping, the forces will no longer equilibrate, but the system will be exposed to the action of a force on a leg spring chain. We thus have two corresponding sets of modes, one set being the mode about which the chain is displaced, the other set for the forces which are evoked in consequence of the displacement. We found that if the leg has been displaced from a position of equilibrium about one of harmonic modes, then a vibration about this harmonic mode evokes a system of forces in the leg spring which in its turn tends to produce a motion on the original harmonic mode, and thus produce oscillation about the same harmonic mode. Our results suggest that the desired harmonic mode can be explained in terms of the natural shock absorption ability of the leg.

The sensitivity of two-dimensional hindlimb joint kinematics analysis in assessing functional recovery in rats after sciatic nerve crush.

Walking analysis in the rat is increasingly used to assess functional recovery after peripheral nerve injury. Here we assess the sensitivity and specificity of hindlimb joint kinematics measures during the rat gait early after sciatic nerve crush injury (DEN), after twelve weeks of recovery (REINN) and in sham-operated controls (Sham) using discriminant analysis. The analysis addressed gait spatiotemporal variables and hip, knee and ankle angle and angular velocity measures during the entire walking cycle. In DEN animals, changes affected all studied joints plus spatiotemporal parameters of gait. Both the spatiotemporal and ankle kinematics parameters recovered to normality within twelve weeks. At this time point, some hip and knee kinematics values were still abnormal when compared to sham controls. Discriminant models based on hip, knee and ankle kinematics displayed maximal sensitivity to identify DEN animals. However, the discriminant models based on spatiotemporal and ankle kinematics data showed a poor performance when assigning animals to the REINN and Sham groups. Models using hip and knee kinematics during walking showed the best sensitivity to recognize the reinnervated animals. The model construed on the basis of hip joint kinematics was the one combining highest sensitivity with robustness and high specificity. It is concluded that ankle joint kinematics fails in detecting minor functional deficits after long term recovery from sciatic nerve crush and extending the kinematic analysis during walking to the hip and knee joints improves the sensitivity of this functional test.

Comparative evaluation of the tridimensional spine position measured with a new instrument (Vertebral Metrics) and an optoelectronic system of stereophotogrammetry.

We designed and built a non-invasive instrument, called Vertebral Metrics, to measure the x, y, and z positions of each spinous process of the spine on a standing position. In the present study, we perform a comparative evaluation of Vertebral Metrics, by comparing the results obtained from this instrument with those from a validated optoelectronic system of stereophotogrammetry, with 10 infrared cameras. The sample was composed of 11 women aged between 14 and 39 years. After marking the various points on the spinal column, from the first cervical vertebra to the first sacral vertebra, they were measured first with the new instrument (Vertebral Metrics) and then by means of the optoelectronics system. Afterwards, the results were subjected to a thorough comparison. The statistical comparison of the results was performed using an ANOVA model with three factors (Instrument, Subject, and Vertebra) for the intervertebral distance.

Anatomical reference frame versus planar analysis: implications for the kinematics of the rat hindlimb during locomotion.

Functional recovery is the primary goal of therapeutic intervention in neuromuscular rehabilitation. The purpose of this study was to perform a segmental kinematic analysis using both planar angles computation and a tridimensional (3D) reconstruction of the rat hindlimb, regarding the morphology and the movement of each segment. Seven rats were evaluated for natural overground walking, and motion capture of the right hindlimb was collected with an optoeletronic system while the animals walked in the track. 3D biomechanical analyses were carried out and hip, knee, ankle, and metatarsophalangeal joint angular displacements were calculated. For flexion/extension, the knee joint and toe segment were statistically different between planar and 3D analysis, with the toe segment performing less extension at initial contact (IC) and the amplitude during swing phase for the knee being larger. During abduction/adduction, all hip joint parameters were statistically different except at IC and toe-off (TO) instants, the planar angles being higher than the 3D angles. In the horizontal plane, significant differences were found for ankle peaks of rotation, with increased results for the planar angles. In conclusion, a comparison between planar and 3D segmental kinematic analysis using a tridimensional reconstruction of the rat hindlimb demonstrated that different joints have different motion patterns within motion planes, probably related with physiological constraints and muscle actions. A major indication of the need for an anatomical reference frame kinematic analysis is supported by the knowledge that neuromuscular diseases are related to important clinical signs or motor deficits that should be observed, qualified, and quantified.