Association of navicular drop and selected lower-limb biomechanical measures during the stance phase of running.

There is evidence to suggest that navicular drop measures are associated with specific lower-extremity gait biomechanical parameters. The aim of this study was to examine the relationship between navicular drop and a) rearfoot eversion excursion, b) tibial internal rotation excursion, c) peak ankle inversion moment, and d) peak knee adduction moment during the stance phase of running. Sixteen able-bodied men having an average age of 28.1 (SD=5.30) years, weight of 81.5 (SD=10.40) kg, height of 179.1 (SD=5.42) cm volunteered and ran barefoot at 170 steps/minute over a force plate. Navicular drop measures were negatively correlated with tibial internal rotation excursion (r=-0.53, P=.01) but not with rearfoot eversion excursion (r=-0.19; P=.23). Significant positive correlations were found between navicular drop and peak knee adduction moment (r=.62, P<.01) and peak ankle inversion moment (r=.60, P<.01). These findings suggest that a low navicular drop measure could be associated with increasing tibial rotation excursion while high navicular drop measure could be associated with increased peak ankle and knee joint moments. These findings indicate that measures of navicular drop explained between 28% and 38% of the variability for measures of tibial internal rotation excursion, peak knee adduction moment and peak ankle inversion moments.

Knee joint kinematics and neuromuscular responses in female athletes during and after multi-directional perturbations.

The purpose of this study was to investigate weight-bearing knee joint kinematic and neuromuscular responses during lateral, posterior, rotational, and combination (simultaneous lateral, posterior, and rotational motions) perturbations and post-perturbations phases in 30° flexed-knee and straight-knee conditions. Thirteen healthy female athletes participated. Knee joint angles and muscle activity of vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (ST), lateral gastrocnemius (LG), and medial gastrocnemius (MD) muscles were computed. Knee abducted during lateral perturbations, whereas it adducted during the other perturbations. It was internally rotated during flexed-knee and externally rotated during straight-knee perturbations and post-perturbations. VL and VM's mean and maximum activities during flexed-knee perturbations were greater than those of straight-knee condition. BF's mean activities were greater during flexed-knee perturbations compared with straight-knee condition, while its maximum activities observed during combination perturbations. ST's maximum activities during combination perturbations were greatest compared with the other perturbations. LG and MG's activities were greater during straight-knee conditions. Compared with the perturbation phase, the mean and maximum muscles' activities were significantly greater during post-perturbations. The time of onset of maximum muscle activity showed a distinctive pattern among the perturbations and phases. The perturbation direction is an important variable which induces individualized knee kinematic and neuromuscular response.

Side-sloped surfaces substantially affect lower limb running kinematics.

Running on side-sloped surfaces is a common obstacle in the environment; however, how and to what extent the lower extremity kinematics adapt is not well known. The purpose of this study was to determine the effects of side-sloped surfaces on three-dimensional kinematics of hip, knee, and ankle during stance phase of running. Ten healthy adult males ran barefoot along an inclinable runway in level (0°) and side-sloped (10° up-slope and down-slope inclinations, respectively) configurations. Right hip, knee, and ankle angles along with their time of occurrence were analysed using repeated measures MANOVA. Up-slope hip was more adducted (p = 0.015) and internally rotated (p = 0.030). Knee had greater external rotations during side-sloped running at heel-strike (p = 0.005), while at toe-off, it rotated externally and internally during up-slope and down-slope running, respectively (p = 0.001). Down-slope ankle had greatest plantar flexion (p = 0.001). Up-slope ankle had greatest eversion compared with down-slope (p = 0.043), while it was more externally rotated (p = 0.030). These motion patterns are necessary to adjust the lower extremity length during side-sloped running. Timing differences in the kinematic events of hip adduction and external rotation, and ankle eversion were observed (p = 0.006). Knowledge on these alterations is a valuable tool in adopting strategies to enhance performance while preventing injury.

Gait ground reaction force characteristics of low back pain patients with pronated foot and able-bodied individuals with and without foot pronation.

UNLABELLED: The link between gait parameters and foot abnormalities in association with low back pain is not well understood. The objective of this study was to investigate the effects of excessive foot pronation as well as the association of LBP with excessive foot pronation on the GRF components during shod walking. METHODS: Forty-five subjects were equally divided into a control group, a group of subjects with pronated feet only, and another group with pronated feet and LBP. Ground reaction forces were analyzed during shod walking. RESULTS: Foot pronation without low back pain was associated with increased lateral-medial ground reaction force, impulse, and time to peak of all reaction forces in heel contact phase (p<0.03). In low back pain patients with pronated foot, greater vertical reaction forces (p=0.001) and loading rate, and time to peak on propulsion force were observed compared to pronated foot without low back pain group. Impulse in posterior-anterior reaction force was smaller in the able-bodied group with normal foot than in the other groups (p<0.05). Positive peak of free moments of the LBP group was significantly greater than that in other groups (p<0.05). In conclusion, foot pronation alone was not associated with elevated vertical ground reaction forces. While, low back pain patients with foot pronation displayed higher vertical ground reaction force as well as higher loading rate. Present results reveal that gait ground reaction force components in low back pain patients with pronated foot may have clinical values on the prognosis and rehabilitation of mechanical LBP patients.

Head and trunk moments of inertia of able-bodied and unbraced scoliotic girls.

OBJECTIVE: The purposes of this study were to estimate head and trunk's (HT) radii of gyration (K) and moments of inertia (I) in able-bodied and unbraced scoliotic girls using an angular momentum method, to test if the use of mean ratios calculated in this study and given by de Leva present similar values compared to the experimental data, and to determine how these methods behave in estimation of scoliotic HT's K and I with variable Cobb angles. BACKGROUND: Scoliotic HT's I estimated from anthropometric tables can lead to error in joint muscle moment calculations. METHOD: Twenty-one unbraced scoliotic and 20 able-bodied girls participated. HT's I values were calculated using an angular momentum method. RESULTS: Angular momentum method provided greater HT's I for the scoliotic group compared with the able-bodied girls. HT's I obtained by the mean ratios calculated from this study were close to the measured values. Compared with the experimental I, de Leva method provided significantly lower I in the scoliotic group. Scoliotic HT's K and I obtained from angular momentum method showed greater correlations with the Cobb angles. CONCLUSION: The use of mean ratios obtained in this study to estimate HT's K values in unbraced scoliotic girls could overcome the drawbacks of current anthropometric methods. APPLICATION: These results can be used to calculate more precise moments of force during daily activities in scoliotic girls with mild scoliosis and to improve the design of corrective flexible body braces prescribed in cases of rapid interventions in young patients of moderate spinal deformities.

Head and trunk mass and center of mass position estimations in able-bodied and scoliotic girls.

Anthropometric tables are not applicable to calculate the scoliotic trunk mass and center of mass (COM). The purposes of this study were: (1) to estimate the head and trunk mass and COM in able-bodied and scoliotic girls using a force plate method, (2) to estimate head and trunk COM offset compared to those of the body, and (3) the use of mean ratios to estimate the head and trunk COM calculated in this study and that calculated according to a conventional three-dimensional (3D) method compared to the measured values. Twenty-one scoliotic and twenty able-bodied girls participated. The subjects stood upright with arms beside the trunk on a force plate that collected data at 60 Hz for a period of 5s. The anteroposterior and mediolateral positions of the body COM were obtained from the mean center of pressure values. The height of the body COM was estimated by the reaction board method. Afterwards a body segment was displaced and changes in force plate readings were recorded and applied to estimate the head and trunk mass and COM. Trunk offset was defined as the difference between the COM of the body and head and trunk. The measured head and trunk COM was compared to values obtained by the mean ratios calculated from this study and given by the conventional 3D method. The relative head and trunk mass and the anteroposterior trunk offset were larger in scoliotic girls. The force plate method gave similar results to measured COM values for both groups underlying its capability to provide a more accurate estimation of COM related values. Thus, the use of mean ratios of 0.5538 and 0.6438 obtained in this study to estimate the head and trunk mass and COM position in scoliotic girls can overcome the main drawbacks of current anthropometric methods, if direct measurements cannot be taken.

Ground reaction force adaptations during cross-slope walking and running.

Though transversely inclined (cross-sloped) surfaces are prevalent, our understanding of the biomechanical adaptations required for cross-slope locomotion is limited. The purpose of this study was to examine ground reaction forces (GRF) in cross-sloped and level walking and running. Nine young adult males walked and ran barefoot along an inclinable walkway in both level (0°) and cross-slope (10°) configurations. The magnitude and time of occurrence of selected features of the GRF were extracted from the force plate data. GRF data were collected in level walking and running (LW and LR), inclined walking and running up-slope (IWU and IRU), and down-slope (IWD and IRD), respectively. The GRF data were then analyzed using repeated measures MANOVA. In the anteroposterior direction, the timing of the peak force values differed across conditions during walking (p=.041), while the magnitude of forces were modified across conditions for running (p=.047). Most significant differences were observed in the mediolateral direction, where generally force values were up to 390% and 530% (p<.001) larger during the cross-slope conditions compared to level for walking and running, respectively. The maximum force peak during running occurred earlier at IRU compared to the other conditions (p≤.031). For the normal axis a significant difference was observed in the first maximum force peak during walking (p=.049). The findings of this study showed that compared to level surfaces, functional adaptations are required to maintain forward progression and dynamic stability in stance during cross-slope walking and running.

Head and trunk segment moments of inertia estimation using angular momentum technique: validity and sensitivity analysis.

Classical models to estimate the head and trunk (HT) moments of inertia (I) are limited to populations from which the anthropometric measures were obtained. The purposes of this study were to determine if the angular momentum technique can be used to estimate subject-specific HT's I values and test its validity and sensitivity. Twenty-three adults who participated in this study were divided into three morphological groups according to their body mass index (BMI). Using the proposed technique, the HT's I values were estimated for the whole sample and compared to three well-known methods to test its validity. The sensitivity of the proposed method was verified while applied to individuals with different BMI (i.e., lean, normal, and obese). The angular momentum technique gave I values within the range of those of the three methods for the entire sample. Statistical differences were identified between the lean and obese groups in relative radii of gyration for the anteroposterior and mediolateral axes ( P<0.05). Since the proposed technique makes no assumption on the mass distribution and segments' geometry, it appeared to be more sensitive to body morphology changes in estimating the HT's I values in lean and obese subjects compared to the classical methods.

Inter-segment foot kinematics during cross-slope running.

Cross-slopes are a common terrain characteristic, however there is no biomechanical knowledge of the intra-foot adaptations required for running on these surface inclinations. The purpose of this study was to evaluate the kinematic changes induced within the foot while running on a transversely inclined surface. A three-segment foot model distinguishing between the hindfoot, forefoot, and hallux was used for this purpose. Nine healthy experienced male runners volunteered to perform level (0°) and cross-slope (10°) running trials barefoot at a moderate speed. Multivariate analysis of variance (MANOVA) for repeated measures was used to analyze the kinematics of the hindfoot with respect to tibia (HF/TB), forefoot with respect to hindfoot (FF/HF), and hallux with respect to forefoot (HX/FF) during level running (LR), incline running up-slope (IRU), and incline running down-slope (IRD) conditions. In the sagittal plane, the FF/HF angle showed greater dorsiflexion at peak vertical force production (MaxFz) in IRD compared to LR (p=0.042). The HX/FF was significantly more extended during IRU than LR at foot strike (p=0.027). More importantly, frontal plane asymmetries were also found. HF/TB angles revealed greater inversion at foot strike followed by greater eversion at MaxFz for IRU compared to IRD (p=0.042 and p=0.018, respectively). For the FF/HF angle, maximum eversion was greater during IRD than LR (p=0.035). Data suggests that running on cross-slopes can induce substantial intra-foot kinematic adaptations, whether this represents a risk of injury to both recreational and professional runners remains to be determined.

Kinematic adaptations of the hindfoot, forefoot, and hallux during cross-slope walking.

Despite cross-slope surfaces being a regular feature of our environment, little is known about segmental adaptations required to maintain both balance and forward locomotion. The purpose of this study was to determine kinematic adaptations of the foot segments in relation to transverse (cross-sloped) walking surfaces. Ten young adult males walked barefoot along an inclinable walkway (level, 0° and cross-slope, 10°). Kinematic adaptations of hindfoot with respect to tibia (HF/TB), forefoot with respect to hindfoot (FF/HF), and hallux with respect to forefoot (HX/FF) in level walking (LW), inclined walking up-slope (IWU), i.e., the foot at the higher elevation, and inclined walking down-slope (IWD), i.e., the foot at the lower elevation, were measured. Multivariate analysis of variance (MANOVA) for repeated measures was used to analyze the data. In the sagittal plane, the relative FF/HF and HX/FF plantar/dorsiflexion angles differed across conditions (p=0.024 and p=0.026, respectively). More importantly, numerous frontal plane alterations occurred. For the HF/TB angle, inversion of IWU and eversion of IWD was seen at heel-strike (p<0.001). This pattern reversed with IWU showing eversion and IWD inversion in early stance (p=0.024). For the FF/HF angle, significant differences were observed in mid-stance with IWD revealing inversion while IWU was everted (p<0.004). At toe-off, the pattern switched to eversion of IWD and inversion of IWU (p=0.032). The information obtained from this study enhances our understanding of the kinematics of the human foot in stance during level and cross-slope walking.

Determination of body segment masses and centers of mass using a force plate method in individuals of different morphology.

Body segment masses and center of mass (COM) locations are required to calculate intersegmental forces and net joint moments using inverse or forward dynamics equations. These inertial properties are estimated from methods involving cadavers or living individuals. The present clinical methods are limited to similar populations from which the anthropometric measures were obtained. This study presented a simple force plate method that can be used to determine subject-specific segment masses and COM locations and compared it to other well-known methods. The proposed method was tested in individuals with different body mass index (i.e., lean, normal, and obese) to verify its sensitivity. All the segmental mass and COM values obtained from the force plate method were within the range of those of the other methods for the entire sample. Significant differences were identified between the morphological groups in relative segmental masses at the upper arm and leg and foot, and COM locations at the leg and foot and head and trunk as obtained from the force plate method (p<0.05). The proposed method involves direct procedures to determine subject-specific segmental masses and COM locations. It is sensitive to detect differences between various morphological populations.

Effect of the calculation methods on body moment of inertia estimations in individuals of different morphology.

Body segment moments of inertia (MOI) are estimated from data obtained from cadavers or living individuals. Though these methods can be valid for the general population, they usually are limited when applied to special populations (e.g., obese). The effect of two geometric methods, photogrammetry and two new methods, namely, inverse dynamics and angular momentum on the estimations of MOI in individuals of different body mass index (BMI) were compared to gain insight into their relative accuracy. The de Leva (1996) method was chosen as a criterion to determine how these methods behaved. MOI methods were not different in individuals with a normal BMI. On the average, MOI values obtained with inverse dynamics and angular momentum were respectively 13.2% lower for lean participants and 17.9% higher for obese subjects than those obtained from the de Leva method. The average Pearson coefficients of correlation between the MOI values, estimated by the de Leva method, and the other methods was 0.76 (+/-0.31). Since the proposed methods made no assumption on the mass distribution and segments' geometry, they appeared to be more sensitive to body morphology changes to estimate whole body MOI values in lean and obese subjects.