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3Background
Gait analysis has been used for decades to quantify knee function in patients with knee osteoarthritis; however, it is unknown whether and to what extent inter-laboratory differences affect the comparison of gait data between studies. Therefore, the aim of this study was to perform an inter-laboratory comparison of knee biomechanics and muscle activation patterns during gait of patients with knee osteoarthritis.
Methods
Knee biomechanics and muscle activation patterns from patients with knee osteoarthritis were analyzed, previously collected at Dalhousie University (DAL: n = 55) and Amsterdam UMC, VU medical center (VUmc: n = 39), using their in-house protocols. Additionally, one healthy male was measured at both locations. Both direct comparisons and after harmonization of components of the protocols were made. Inter-laboratory comparisons were quantified using statistical parametric mapping analysis and discrete gait parameters.
Results
The inter-laboratory comparison showed offsets in the sagittal plane angles, moments and frontal plane angles, and phase shifts in the muscle activation patterns. Filter characteristics, initial contact identification and thigh anatomical frame definitions were harmonized between the laboratories. After this first step in protocol harmonization, the offsets in knee angles and sagittal plane moments remained, but the inter-laboratory comparison of the muscle activation patterns improved.
Conclusions
Inter-laboratory differences obstruct valid comparisons of gait datasets from patients with knee osteoarthritis between gait laboratories. A first step in harmonization of gait analysis protocols improved the inter-laboratory comparison. Further protocol harmonization is recommended to enable valid comparisons between labs, data-sharing and multicenter trials to investigate knee function in patients with knee osteoarthritis.
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The pervasiveness of wearable technology has opened the market for products that analyse running biomechanics and provide feedback to the user. To improve running technique feedback should target specific running biomechanical key points and promote an external focus. Aim for this study was to define and empirically test tailored feedback requirements for optimal motor learning in four consumer available running wearables. First, based on desk research and observations of coaches, a screening protocol was developed. Second, four wearables were tested according to the protocol. Third, results were reviewed, and four experts identified future requirements. Testing and reviewing the selected wearables with the protocol revealed that only two less relevant running biomechanical key points were measured. Provided feedback promotes an external focus of the user. Tailoring was absent in all wearables. These findings indicate that consumer available running wearables have a potential for optimal motor learning but need improvements as well.
DOCUMENT
Mechanical power output is a key performance-determining variable in many cyclic sports. In rowing, instantaneous power output is commonly determined as the dot product of handle force moment and oar angular velocity. The aim of this study was to show that this commonly used proxy is theoretically flawed and to provide an indication of the magnitude of the error. To obtain a consistent dataset, simulations were performed using a previously proposed forward dynamical model. Inputs were previously recorded rower kinematics and horizontal oar angle, at 20 and 32 strokes∙min−1. From simulation outputs, true power output and power output according to the common proxy were calculated. The error when using the common proxy was quantified as the difference between the average power output according to the proxy and the true average power output (P̅residual), and as the ratio of this difference to the true average power output (ratiores./rower). At stroke rate 20, P̅residual was 27.4 W and ratiores./rower was 0.143; at stroke rate 32, P̅residual was 44.3 W and ratiores./rower was 0.142. Power output in rowing appears to be underestimated when calculated according to the common proxy. Simulations suggest this error to be at least 10% of the true power output.
DOCUMENT
In this study, the effect of strapping rowers to their sliding seat on performance during 75 m on-water starting trials was investigated. Well-trained rowers performed 75 m maximum-effort starts using an instrumented single scull equipped with a redesigned sliding seat system, both under normal conditions and while strapped to the sliding seat. Strapping rowers to their sliding seat resulted in a 0.45 s lead after 75 m, corresponding to an increase in average boat velocity of about 2.5%. Corresponding effect sizes were large. No significant changes were observed in general stroke cycle characteristics. No indications of additional boat heaving and pitching under strapped conditions were found. The increase in boat velocity is estimated to correspond to an increase in average mechanical power output during the start of on-water rowing between 5% and 10%, which is substantial but smaller than the 12% increase found in a previous study on ergometer starting. We conclude that, after a very short period of adaptation to the strapped condition, single-scull starting performance is substantially improved when the rower is strapped to the sliding seat.
DOCUMENT
Knee joint instability is frequently reported by patients with knee osteoarthritis (KOA). Objective metrics to assess knee joint instability are lacking, making it difficult to target therapies aiming to improve stability. Therefore, the aim of this study was to compare responses in neuromechanics to perturbations during gait in patients with self-reported knee joint instability (KOA-I) versus patients reporting stable knees (KOA-S) and healthy control subjects.
Forty patients (20 KOA-I and 20 KOA-S) and 20 healthy controls were measured during perturbed treadmill walking. Knee joint angles and muscle activation patterns were compared using statistical parametric mapping and discrete gait parameters. Furthermore, subgroups (moderate versus severe KOA) based on Kellgren and Lawrence classification were evaluated.
Patients with KOA-I generally had greater knee flexion angles compared to controls during terminal stance and during swing of perturbed gait. In response to deceleration perturbations the patients with moderate KOA-I increased their knee flexion angles during terminal stance and pre-swing. Knee muscle activation patterns were overall similar between the groups. In response to sway medial perturbations the patients with severe KOA-I increased the co-contraction of the quadriceps versus hamstrings muscles during terminal stance.
Patients with KOA-I respond to different gait perturbations by increasing knee flexion angles, co-contraction of muscles or both during terminal stance. These alterations in neuromechanics could assist in the assessment of knee joint instability in patients, to provide treatment options accordingly. Furthermore, longitudinal studies are needed to investigate the consequences of altered neuromechanics due to knee joint instability on the development of KOA.
DOCUMENT
Within this study the aim is to measure running workload and relevant running technique key points on varying cadence in recreational runners using a custom build sensor system ‘Nodes’. Seven participants ran on a treadmill at a self-chosen comfortable speed. Cadence was randomly guided by a metronome using 92%, 96%, 100%, 104%, and 108% of the preferred cadence in 2-min trials. Workload was measured by collecting the heart rate and the rating of perceived exertion (RPE 1 to 10) scores. Heart rate data shows that the 100% cadence trial was most economical with a relative heart rate of 99.2%. The 108% cadence trial had the lowest relative RPE score with 96.2%. The sample rate of the Nodes system during this experiment was too low to analyze the key points. Three requirements are proposed for the further engineering of a wearable running system, (i) sampling frequency of minimal 50 Hz, (ii) step-by-step analysis, and (iii) collecting workload in the heart rate and RPE.
DOCUMENT
Disability in children diagnosed with hypermobility syndrome (HMS) and Ehlers-Danlos (hypermobility type: EDS-HT) can vary from mild to very severe. This disability can be of temporary nature but for some may persist and become chronic, eventually leading to disablement. Historically it is believed that the origin of disability in HMS/EDS-HT arises from dysfunctions in joint biomechanics. Generalized connective tissue laxity (expressed in generalized joint hypermobility (GJH)) causes joint instability, musculoskeletal injury due to biomechanical overloading. In turn, these biomechanical dysfunctions render a child more vulnerable for musculoskeletal injury. This view is widely accepted as a potential mechanism for chronic pain and disability, still the evidence is limited. This rationality is the bases for most non-pharmacological interventions however the effectiveness is variable. In this thesis, it was observed in professional dancers that the presence of GJH was associated with decreased physical fitness, pain, fatigue and increased anxiety. Although joint laxity/instability was shown as an important determinant for the severity of pain, it was not the largest contributor to disability in children with HMS/EDS-HT. On the bases of observations on the natural course of disability, it was shown that a hyper-sensitized central nervous system and multi-systemic complaints were the largest contributors to disability. In addition, the natural course can follow different trajectories, in which children with a more progressive course of disability are characterized by the presence of dysautonomia, skin issues and gastro-intestinal complaints. These findings were integrated in a new theoretical framework on which new treatment modalities may be developed.
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Disability sport science is a dynamic and rapidly evolving field, with advancements occurring across a wide range of research areas. However, the unique needs of athletes with disabilities – and the theoretical and practical knowledge required to support them – are still underrepresented in the literature.
The book covers current research in a wide range of sport, exercise, training and health-related topic areas related to disability sport science and identifies future research directions. Key knowledge is gleaned from research within sport, exercise, rehabilitation and medicine and is brought together in one single resource, covering both current and future relevance for researchers, students and practitioners alike.
The Routledge Handbook of Disability Sport Science is the first book to offer a comprehensive and in-depth review of current and emerging topics within disability sport science and provides a complete overview of academic and professional knowledge, divided into six sections covering the following topics:
Physiology
Biomechanics
Technology
Nutrition
Physical Preparation, Health and Classification
Psychology
Written by an international team of leading experts from academia and professional practice, the book is an essential reference for researchers, academics and students of disability sport science and related disciplines alike, as well as anyone working, or wanting to work, in disability sport.
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BACKGROUND: Implicit (IF) and explicit (EF) feedback are two motor learning strategies demonstrated to alter movement patterns. There is conflicting evidence on which strategy produces better outcomes. The purpose of this study was to examine the effects of reduced IF and EF video feedback on lower extremity landing mechanics. METHODS: Thirty participants (24 ± 2 years, 1.7 ± 0.1 m, 70 ± 11 kg) were randomly assigned to three groups: IF (n = 10), EF (n = 10), and control (CG) (n = 10). They performed twelve box-drop jumps three times a week on the training sessions for six weeks. Only IF and EF groups received video feedback on the training sessions. IF was cued to focus their attention on the overall jump, while EF was cued to focus on position of their knees. 3D lower extremity biomechanics were tested on testing sessions with no feedback. All sessions were at least 24 h apart from another. Testing sessions included baseline testing (pretest), testing after 3 training sessions with 100% feedback (pst1), testing after 6 training sessions with 33.3% feedback (pst2), testing after 6 training sessions with 16.6% feedback (Pst3), and testing 1 month after with no feedback (retention - ret). ANOVA compared differences between groups and time at initial contact and peak for hip flexion (HF, °) and abduction angle (HA, °), hip abduction moment (HAM, Nm/kgm), knee flexion (KF, °) and abduction angle (KA, °), knee abduction moment (KAM, Nm/kgm) and VGRF (N) (p < 0.05). RESULTS: A significant main effect for group was found between IF and EF groups for HA (IF = - 6.7 ± 4; EF = - 9.4 ± 4.1) and KAM (IF = 0.05 ± 0.2; EF = - 0.07 ± 0.2) at initial contact, and peaks HA (IF = - 3.5 ± 4.5; EF = - 7.9 ± 4.7) and HAM (IF = 1.1 ± 0.6; EF = 0.9 ± 0.4). A significant main effect for time at initial contact for HF (pre = 32.4 ± 3.2; pst2 = 36.9 ± 3.2; pst3 = 37.9 ± 3.7; ret. = 34.1 ± 3.7), HAM (pre = 0.1 ± 0.1; pst1 = 0.04 ± 0.1; pst3 = 0.1 ± 0.01), KA (pre = 0.7 ± 1.1; pst1 = 0.2 ± 1.2; pst3 = 1.7 ± 1), and KAM (pre = 0.003 ± 0.1; pst3 = 0.01 ± 0.1) was found. DISCUSSION/CONCLUSION: We found that implicit feedback produced positive changes in landing mechanics while explicit feedback degraded motor learning. Our results indicate that implicit feedback should be used in programs to lower the ACL injury risk. We suggest that implicit feedback should be frequent in the beginning and not be reduced as much following the acquisition phase.
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Literature highlights the need for research on changes in lumbar movement patterns, as potential mechanisms underlying the persistence of low-back pain. Variability and local dynamic stability are frequently used to characterize movement patterns. In view of a lack of information on reliability of these measures, we determined their within- and between-session reliability in repeated seated reaching. Thirty-six participants (21 healthy, 15 LBP) executed three trials of repeated seated reaching on two days. An optical motion capture system recorded positions of cluster markers, located on the spinous processes of S1 and T8. Movement patterns were characterized by the spatial variability (meanSD) of the lumbar Euler angles: flexion–extension, lateral bending, axial rotation, temporal variability (CyclSD) and local dynamic stability (LDE). Reliability was evaluated using intraclass correlation coefficients (ICC), coefficients of variation (CV) and Bland-Altman plots. Sufficient reliability was defined as an ICC ≥ 0.5 and a CV < 20%. To determine the effect of number of repetitions on reliability, analyses were performed for the first 10, 20, 30, and 40 repetitions of each time series. MeanSD, CyclSD, and the LDE had moderate within-session reliability; meanSD: ICC = 0.60–0.73 (CV = 14–17%); CyclSD: ICC = 0.68 (CV = 17%); LDE: ICC = 0.62 (CV = 5%). Between-session reliability was somewhat lower; meanSD: ICC = 0.44–0.73 (CV = 17–19%); CyclSD: ICC = 0.45–0.56 (CV = 19–22%); LDE: ICC = 0.25–0.54 (CV = 5–6%). MeanSD, CyclSD and the LDE are sufficiently reliable to assess lumbar movement patterns in single-session experiments, and at best sufficiently reliable in multi-session experiments. Within-session, a plateau in reliability appears to be reached at 40 repetitions for meanSD (flexion–extension), meanSD (axial-rotation) and CyclSD.
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