The force output of handle and pedal in different bicycle-riding postures.

The purpose of this study was to analyse the force output of handle and pedal as well as the electromyography (EMG) of lower extremity in different cycling postures. Bilateral pedalling asymmetry indices of force and EMG were also determined in this study. Twelve healthy cyclists were recruited for this study and tested for force output and EMG during steady state cycling adopting different pedalling and handle bar postures. The standing posture increased the maximal stepping torque (posture 1: 204.2 ± 47.0 Nm; posture 2: 212.5 ± 46.1 Nm; posture 3: 561.5 ± 143.0 Nm; posture 4: 585.5 ± 139.1 Nm), stepping work (posture 1: 655.2 ± 134.6 Nm; posture 2: 673.2 ± 116.3 Nm; posture 3: 1852.3 ± 394.4 Nm; posture 4: 1911.3 ± 432.9 Nm), and handle force (posture 1: 16.6 ± 3.6 N; posture 2: 16.4 ± 3.6 N; posture 3: 26.5 ± 8.2 N; posture 4: 41.4 ± 11.1 N), as well as muscle activation (posture 1: 13.6-25.1%; posture 2: 13.0-23.9%; posture 3: 23.6-61.8%; posture 4: 22.5-65.8%) in the erector spine, rectus femoris, tibialis anterior, and soleus. However, neither a sitting nor a standing riding posture affected the hamstring. The riding asymmetry was detected between the right and left legs only in sitting conditions. When a cyclist changes posture from sitting to standing, the upper and lower extremities are forced to produce more force output because of the shift in body weight. These findings suggest that cyclists can switch between sitting and standing postures during competition to increase cycling efficiency in different situations. Furthermore, coaches and trainers can modify sitting and standing durations to moderate cycling intensity, without concerning unbalanced muscle development.

Shear cushions reduce the impact loading rate during walking and running.

In addition to vertical ground reaction force (GRF), anterior-posterior GRF with a greater external moment arm may be another repetitive impact force that contributes to overuse running injuries. In this study, a shear cushion device was placed between the sole of a shoe and the ground to reduce not only the vertical loading, but also the anterior-posterior loading while walking and running. For this study, 15 healthy male runners classified as heel strikers (height: 173.2 +/- 4.7 cm, mass: 68.5 +/- 5.6 kg) were recruited. Participants were required to walk (2.5 m/s), jog (3.5 m/s), and run (4.2 m/s) while wearing shoes with three different sole groove designs (conventional, straight groove, and 45 degrees groove). Both the straight and 45 degrees groove soles provided significant shear shift during walking, jogging, and running, as well as delayed the time to first peak anterior-posterior GRF during walking. The straight groove sole reduced the vertical loading rate during jogging (p = 0.010) and running (p = 0.010), and delayed the time to first peak vertical GRF in all gait conditions. These findings suggest that the vertical loading rate and the time to the first peak anterior-posterior GRF can be changed by the sole groove design under various gait conditions.

Prioritizing limb loading improves symmetry during dual-tasking in individuals following anterior cruciate ligament reconstruction.

Understanding the extent to which attention prioritization interfere with limb loading in daily activities following anterior cruciate ligament reconstruction (ACLr) is important for reshaping loading behaviors. A dual-task paradigm, prioritizing limb loading symmetry (LLS) during standing or response time during an upper extremity task response time task was used to probe the effects of attention prioritization of loading. Individuals 115.6 ± 17.8 days post-ACLr (ACLr; n = 13) and matched healthy individuals (n = 13; CTRL) performed a simple response time (RT) task and 2 dual tasks prioritizing limb loading (LS-RT) and response time (RT-LS). 2 × 3 General Linear Model repeated measures analyses determined effects of group and focus condition on LLS error and response time. Significant interaction (P = 0.010) was noted in LLS error. ACLr group, exhibited greater LLS error in RT (P = 0.001) and RT-LS (P = 0.001) than LS-RT condition. ACLr group exhibited greater LLS error in the RT (P = 0.001) and RT-LS (P = 0.040) than CTRL, but not in LS-RT. A main effect of condition (P < 0.001) for response time indicated that times were slower in LS-RT compared to RT (P < 0.001) and to RT-LS (P < 0.001) for both groups. These data suggest that limb loading symmetry during standing is more automatic for controls than individuals following ACLr. Unlike controls, improving loading symmetry during standing requires additional attention in individuals in early recovery following ACLr.

Individuals following anterior cruciate ligament reconstruction practice underloading strategies during daily activity.

Underloading the surgical limb has been described in biomechanical studies across recovery time points following anterior cruciate ligament reconstruction (ACLr). This study aimed to examine the extent to which laboratory findings translate to daily activities. Limb loading was quantified during a sit-to-stand task in laboratory testing and throughout 2 days of daily activity in 15 individuals 114.8 (17.2) days post-ACLr and 15 controls. Vertical force impulse calculated from force platform (laboratory) and pressure insoles (daily) was used to quantify limb loading. Between-limb symmetry was calculated for limb loading and knee strength measures, 2 × 2 GLM repeated measures determined a significant group-by-limb interaction on daily limb loading. Surgical limb daily loading was lower compared to nonsurgical (p < .001; effect sizes [ES] = 0.63), and control matched limbs (surgical: p = .037, ES = 0.80 and nonsurgical: p = .02, ES = 0.89). No group differences were found in total daily loading (summed loading between limbs; p = .18; ES = 0.50) and time performing weight-bearing activities (p = .32; ES = 0.36). Pearson's correlation determined that between-limb symmetry in daily loading was related to sit-to-stand loading (r = .62; p = .01) and knee extensor strength symmetry (r = .6; p = .02) in the ACLr group. These data support the presence of underloading behaviors in individuals 10-14 weeks following ACLr that are consistent with previous biomechanical studies and current biomechanical data. Knee extensor weakness was related to greater underloading. Asymmetrical loading quantified in the laboratory is practiced throughout the day in individuals post-ACLr. Practice afforded by daily activities represents powerful contributors to learning of a pattern that contrasts the goal of rehabilitation exercises.

Center of pressure predicts Intra-limb compensatory patterns that shift demands away from knee extensors during squatting.

The persistence of knee extensor moments deficits following anterior cruciate ligament reconstruction (ACLr) may be attributed to difficulty quantifying inter- and intra-limb compensations clinically. Force plate derived center of pressure (CoPpos) and vertical force (vGRF) may provide valuable information regarding limb and joint loading impairments in this group. This study aimed to determine the: 1) relationship between measures CoPpos and intra-limb extensor moment distribution during a squat, and 2) utility of using CoPpos and vGRF to estimate knee extensor moment deficits post-ACLr. Twenty-four individuals, 142 ± 22.5 days post-ACLr, performed bilateral squats. Ankle (aEXT), knee (kEXT) and hip (hEXT) extensor moments were calculated using three-dimensional kinematics and GRF. Moments, CoPpos and vGRF were identified at peak kEXT. Intra-limb moment distribution was characterized using hEXT/kEXT and aEXT/kEXT ratios. Linear regressions analyzed relationships between CoPpos and hEXT/kEXT and aEXT/kEXT. Stepwise regressions determined if between-limb CoPpos ratio predicted between-limb ratios of hEXT/kEXT and aEXT/kEXT. Stepwise regression determined if between-limb CoPpos and vGRF ratios predicted between-limb kEXT ratio. Results found that CoPpos predicts intra-limb moment distribution (hEXT/kEXT and aEXT/kEXT); more anterior CoPpos related to higher moments at the hip and ankle relative to the knee. In addition, between-limb CoPpos ratio predicts between-limb ratio of hEXT/kEXT and aEXT/kEXT ratios. Together between-limb CoPpos (52%) and vGRF (18%) ratios explained 70% of the variance in between-limb kEXT ratios (R2 = 0.70, p < 0.001). These data suggest that force plate derived CoPpos and vGRF may be important for detection of knee extensor moment deficits in individuals post-ACLr.

Loading Behaviors Do Not Match Loading Abilities Postanterior Cruciate Ligament Reconstruction.

PURPOSE: Strategies that underload the surgical limb after anterior cruciate ligament reconstruction (ACLr) are observed in submaximal tasks. It is not known what underlies these strategies in early rehabilitation. The purpose of this study was to determine if underloading can be attributed to the inability to meet task demands with and without attention to limb loading or learned behavior. METHODS: Twenty individuals (110.6 [18.1] days) post-ACLr and 20 healthy individuals (CTRL) participated in this study. Participants performed standing, sit-to-stand, and squat tasks under natural, instructed, and feedback conditions. Limb-loading symmetry was calculated as the between-limb ratio of vertical ground reaction force impulse during each task. General Linear Model repeated-measures analysis, 2 (group) × 3 (condition), determined the effects of group and condition on limb-loading symmetry for each task. RESULTS: Significant interactions were observed for each task (all P < 0.001). Compared with CTRL, ACLr exhibited greater asymmetry during natural (deficits: standing, 10%, P = 0.001; sit-to-stand, 25%, P < 0.001; squat, 15%, P < 0.001) and instructed (deficits: sit-to-stand, 13%, P = 0.001; squat, 8%, P = 0.04), but not feedback conditions. The CTRL maintained symmetry across conditions and tasks. Anterior cruciate ligament reconstruction exhibited greater asymmetry in natural compared with instructed (deficits: standing, 11%, P < 0.001; sit-to-stand, 14%, P < 0.001; squat, 8%, P = 0.001) and feedback (deficits: standing, 10%, P = 0.001; sit-to-stand, 21%, P < 0.001; squat, 15%, P < 0.001) conditions. CONCLUSIONS: The presence of loading asymmetries in natural but not feedback conditions indicates that individuals 3 months post-ACLr shift loading away from surgical limb despite the ability to meet task demands which may be suggestive of nonuse behavior. Even when instructed to load symmetrically, individuals continued to exhibit some degree of asymmetry.

Optimal shear cushion stiffness at different gait speeds.

The present study quantified the effects of different shear cushion stiffness on the time to peak posterior shear force (TPPSF), peak posterior shear force (PPSF), average posterior loading rate (APLR), and maximum posterior loading rate (MPLR) at different locomotion speeds using a custom-made sliding platform, as well as to identify the optimal stiffness of shear cushion. Twelve male collegiate students (heel-strikers) performed walking at 1.5 m/s, jogging at 2.5 m/s, and running at 3.5 m/s. A custom-made sliding platform was used to provide the different shear cushion conditions. The shear cushion conditions were fixed (a fixed platform; control group), stiff (K = 2746 N/m), medium stiff (K = 2256 N/m), medium soft (K = 1667 N/m), and soft (K = 1079 N/m). The results showed that all cushion conditions produced sliding displacement and delayed the TPPSF during walking, jogging, and running compared with fixed condition. The APLR and MPLR were lowest under medium soft condition during walking, while the PPSF was similar between medium soft and soft conditions. For jogging and running, the PPSF as well as APLR and MPLR were the lowest under medium stiff condition except the maximum PLR was similar among stiff, medium stiff, and medium soft conditions during running. In conclusion, shear cushion produces appropriate sliding displacement and effectively delays the TPPSF to provide the musculoskeletal system additional time to absorb the impact and reduce loading. The present study demonstrates optimal stiffness of shear cushion at different traveling speeds and suggests that a shear cushion system can be applied in future designs of cushion structures.

Compensatory Strategies That Reduce Knee Extensor Demand During a Bilateral Squat Change From 3 to 5 Months Following Anterior Cruciate Ligament Reconstruction.

Background Decreased extensor moments in the surgical knee during bilateral squats can persist beyond 1 year following anterior cruciate ligament reconstruction (ACLR). This is accomplished using interlimb and intralimb compensations. Objectives This study sought to assess loading during squatting longitudinally, 3 and 5 months post ACLR, and to determine the extent to which interlimb and intralimb compensations contribute to reduced knee extensor moments. Methods In this controlled, longitudinal laboratory study, 11 individuals (4 male) underwent 3-D motion analysis of a squat at 3 and 5 months post ACLR. A repeated-measures multivariate analysis of variance (limb by time) assessed differences in peak knee and hip flexion angles, knee extensor moment, vertical ground reaction force, and hip-to-knee extensor moment ratio. Stepwise linear regression analysis was used to determine the contribution of interlimb (between-limb vertical ground reaction force ratio) and intralimb (within-surgical-limb hip-to-knee moment ratio) compensations to the between-limb knee extensor moment ratio. Results A significant effect of limb was observed for knee flexion angle, knee extensor moment, vertical ground reaction force, and hip-to-knee extensor moment ratio, while a significant effect of time was observed for knee extensor moment and hip-to-knee extensor moment ratio. At 3 months, the vertical ground reaction force ratio and hip-to-knee extensor moment ratio predicted the knee extensor moment ratio (R2 = 0.854, P<.001). At 5 months, the hip-to-knee extensor moment ratio predicted the knee extensor moment ratio (R2 = 0.584, P = .006). Conclusion Individuals used interlimb and intralimb compensations to reduce the knee extensor moment of the surgical limb at 3 months post ACLR. Similar reductions in the knee extensor moment at 5 months were accomplished with only intralimb compensations. J Orthop Sports Phys Ther 2018;48(9):713-718. Epub 12 Jun 2018. https://doi.org/10.2519/jospt.2018.7977.

Characterizing knee loading asymmetry in individuals following anterior cruciate ligament reconstruction using inertial sensors.

Limitations in the ability to identify knee extensor loading deficits during gait in individuals following anterior cruciate ligament reconstruction (ACLr) may underlie their persistence. A recent study suggested that shank angular velocity, directly output from inertial sensors, differed during gait between individuals post-ACLr and controls. However, it is not clear if this kinematic variable relates to knee moments calculated using joint kinematics and ground reaction forces. Heel rocker mechanics during loading response of gait, characterized by rapid shank rotation, require knee extensor control. Measures of shank angular velocity may be reflective of knee moments. This study investigated the relationship between shank angular velocity and knee extensor moment during gait in individuals (n=19) 96.7±16.8days post-ACLr. Gait was assessed concurrently using inertial sensors and a marker-based motion system with force platforms. Peak shank angular velocity and knee extensor moment were strongly correlated (r=0.75, p<0.001) and between limb ratios of angular velocity predicted between limb ratios of extensor moment (r(2)=0.57, p<0.001) in the absence of between limb differences in spatiotemporal gait parameters. The strength of these relationships indicate that shank kinematic data offer meaningful information regarding knee loading and provide a potential alternative to full motion analysis systems for identification of altered knee loading following ACLr.

Walking beyond preferred transition speed increases muscle activations with a shift from inverted pendulum to spring mass model in lower extremity.

BACKGROUND: The triggers for the transition of gait from walking to running during increasing speed locomotion have been attributed to an energy conservation strategy or a relief of excessive muscle activation. Walking beyond the preferred transition speed (PTS) has been proposed as an exercise protocol for boosting energy consumption. However, the biomechanical factors involved while this protocol is used have not been investigated. Thus, this study investigated the difference between walking and running below, during, and beyond the PTS from a biomechanical perspective. METHODS: Sixteen healthy male participants were recruited. After determination of their PTS, five speeds of walking and running were defined. Kinematic data, including center-of-mass (COM) displacement, COM acceleration, and electromyography (EMG) data of rectus femoris (RF), biceps femoris, gastrocnemius (GAS), and tibialis anterior were collected at the five speeds for both walking and running. RESULT: The vertical COM displacement and acceleration in running were significantly larger than those in walking at all five speeds (p<0.05). EMG signals of the two antigravity muscles, RF and GAS, demonstrated a significant higher activation in walking than that in running at the speed beyond PTS (p<0.05). CONCLUSION: The larger energy consumption in walking than that in running beyond the PTS may be attributed to the high activation of lower-extremity muscles. The smaller vertical COM displacements and accelerations exhibited when participants walked beyond the PTS rather than ran did not indicate adverse effects of using walking beyond the PTS as an exercise prescription for boosting energy consumption.