Active knee joint velocity replication measures are stable and accurate in healthy individuals

The purpose of this study was to determine the stability and accuracy of active knee joint velocity replication methods in healthy subjects. We used a repeated measures design with 14 healthy volunteers. Measures of velocity replication were performed in two ranges of knee joint flexion (0°–30° and 60°–90°), across four testing velocities (5, 10, 15, and 30°/s) in two movement directions (flexion and extension). Statistical analysis included intraclass correlation coefficients (ICCs; 2, k) and associated standard error of the measures calculated between day 1 and 2. We performed z-tests between all possible combinations of ICC pairs using Fisher’s Z transformations to determine if any significant differences existed between observed ICCs. We also calculated correlation ratios (η²) to explain the source of variability in the calculated ICCs. To assess measurement accuracy, we calculated constant error and absolute error between criterion and replication velocities. Results on ICCs and standard error of the measurements (SEMs) ranged from r = ?0.44 ± 7.00 to 0.88 ± 0.72°/s. Calculated z-tests indicated six paired ICCs were significantly different (?p < 0.1). In all six pairs, the faster test velocity had a lower ICC magnitude. The η² calculations demonstrated that inconsistent performance between day 1 and 2 caused the low ICC magnitudes observed with faster testing velocities. Significantly more absolute error occurred at 30 and 15°/s compared with 5°/s. Significantly less constant error was observed for 30°/s compared with 15°/s. A significant direction by range of motion interaction indicated less constant error for flexion movements in the 60°–90° range of motion (ROM) as compared with extension movements in either ROM. Healthy individuals could actively replicate slower criterion velocities in the mid and end ranges of knee joint motion in both movement directions with an acceptable amount of consistency and accuracy. The data support the use of velocity replication in future investigations on proprioceptive function.     

In vivo estimation of contraction velocity of human vastus lateralis muscle during "isokinetic" action.

To determine the shortening velocities of fascicles of the vastus lateralis muscle (VL) during isokinetic knee extension, six male subjects were requested to extend the knee with maximal effort at angular velocities of 30 and 150 degrees /s. By using an ultrasonic apparatus, longitudinal images of the VL were produced every 30 ms during knee extension, and the fascicle length and angle of pennation were obtained from these images. The shortening fascicle length with extension of the knee (from 98 to 13 degrees of knee angle; full extension = 0 degrees ) was greater (43 mm) at 30 degrees /s than at 150 degrees /s (35 mm). Even when the angular velocity remained constant during the isokinetic range of motion, the fascicle velocity was found to change from 39 to 77 mm/s at 150 degrees /s and from 6 to 19 mm/s at 30 degrees /s. The force exerted by a fascicle changed with the length of the fascicle at changing angular velocities. The peak values of fascicle force and velocity were observed at approximately 90 mm of fascicle length. In conclusion, even if the angular velocity of knee extension is kept constant, the shortening velocity of a fascicle is dependent on the force applied to the muscle-tendon complex, and the phenomenon is considered to be caused mainly by the elongation of the elastic element (tendinous tissue).     

Reliability of leg muscle electromyography in vertical jumping

In this study we aimed to determine the reliability of the surface electromyography (EMG) of leg muscles during vertical jumping between two test sessions, held 2 weeks apart. Fifteen females performed three maximal vertical jumps with countermovement. The displacement of the body centre of mass (BCM), duration of propulsion phase (time), range of motion (ROM) and angular velocity of the knee and surface EMG of four leg muscles (rectus femoris, vastus medialis. biceps femoris and gastrocnemius) were recorded during the jumps. All variables were analysed throughout the propulsion and mid-propulsion phases. Intraclass correlation coefficients (ICC) for the rectus femoris, vastus medialis, biceps femoris and gastrocnemius were calculated to be 0.88, 0.70, 0.24 and 0.01, respectively. BCM, ROM and time values all indicated ICC values greater than 0.90, and the mean knee angular velocity was slightly lower, at 0.75. ICCs between displacement of the BCM and integrated EMG (IEMG) of the muscles studied were less than 0.50. The angular velocity of the knee did not correlate well with muscle activity. Factors that may have affected reliability were variations in the position of electrode replacement, skin resistance, cross-talk between muscles and jump mechanics. The results of this study suggest that while kinematic variables are reproducible over successive vertical jumps, the degree of repeatability of an IEMG signal is dependent upon the muscle studied.     

Range of motion specificity resulting from closed and open kinetic chain resistance training after anterior cruciate ligament reconstruction

The purpose of this study was to examine whether joint angle specificity occurs in open and closed kinetic chain resistance training of the knee extensors after anterior cruciate ligament reconstruction (ACLR). Isokinetic knee extensor strength was measured at 60 and 210 degrees.s(-1) in 32 patients, 2 and 6 weeks after surgery. Between test sessions, patients participated in a 4-week program of injured leg resistance training of the knee extensors in either open kinetic chain (OKC) knee extension or leg press exercises. Isokinetic testing knee range of motion (ROM) was divided into 5 equal portions from flexion to extension, and the mean torque was calculated over those divisions: 0-20%, 20-40%, 40-60%, 60-80%, and 80-100% ROM. Analysis of variance indicated that there were no significant differences between patients in the knee extension or leg press exercise groups.     

Day-to-day reliability of gait characteristics in rats

The purpose of the present study was to determine the day-to-day reliability in stride characteristics in rats during treadmill walking obtained with two-dimensional (2D) motion capture. Kinematics were recorded from 26 adult rats during walking at 8 m/min, 12 m/min and 16 m/min on two separate days. Stride length, stride time, contact time, swing time and hip, knee and ankle joint range of motion were extracted from 15 strides. The relative reliability was assessed using intra-class correlation coefficients (ICC(1,1)) and (ICC(3,1)). The absolute reliability was determined using measurement error (ME). Across walking speeds, the relative reliability ranged from fair to good (ICCs between 0.4 and 0.75). The ME was below 91 mm for strides lengths, below 55 ms for the temporal stride variables and below 6.4° for the joint angle range of motion. In general, the results indicated an acceptable day-to-day reliability of the gait pattern parameters observed in rats during treadmill walking. The results of the present study may serve as a reference material that can help future intervention studies on rat gait characteristics both with respect to the selection of outcome measures and in the interpretation of the results.     

Reliability of rate of velocity development and phase measures on an isokinetic device

Isokinetic dynamometers have been measured for torque and force reliability in the past, but little research has been performed on rate of velocity development (RVD) measures. The purpose of this study was to determine the reliability of RVD measures on an isokinetic device at slow and fast speeds. Twenty volunteers performed 5 repetitions of concentric knee extension at 1.04 and 4.18 rad.s(-1) on a Kin-Com isokinetic dynamometer. Each subject was identically posttested 7 days later. Data were separated into 3 velocity range-of-motion (ROM) phases of RVD, load range (LR), and deceleration (DCCROM). Analyses of variance (ANOVAs) were performed to analyze the mean data between day 1 and day 2, while intraclass correlation coefficients (ICCs) were performed for reliability. Results at 1.04 rad.s(-1) demonstrated a low but significant (p < 0.05) ICC value (0.58) only for LR, while at 4.18 rad.s(-1) RVD (0.87), LR (0.83), and DCC (0.55) all exhibited significant ICC values. Percent error for high-speed testing ranged from 1.4-3.19%. No variable exhibited a significant mean difference between testing days. These results collectively point to moderate to high phase reliability for RVD measures at fast speeds of testing, while the slow speed showed very low reliability. Therefore, care should be exercised at slow speeds when comparing RVD measures from test to test.     

Between-session reliability of opto-electronic motion capture in measuring sagittal posture and 3-D ranges of motion of the thoracolumbar spine

This study evaluated between-session reliability of opto-electronic motion capture to measure trunk posture and three-dimensional ranges of motion (ROM). Nineteen healthy participants aged 24–74 years underwent spine curvature, pelvic tilt and trunk ROM measurements on two separate occasions. Rigid four-marker clusters were attached to the skin overlying seven spinous processes, plus single markers on pelvis landmarks. Rigid body rotations of spine marker clusters were calculated to determine neutral posture and ROM in flexion, extension, total lateral bending (left-right) and total axial rotation (left-right). Segmental spine ROM values were in line with previous reports using opto-electronic motion capture. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were calculated as measures of between-session reliability and measurement error, respectively. Retroreflective markers showed fair to excellent between-session reliability to measure thoracic kyphosis, lumbar lordosis, and pelvic tilt (ICC = 0.82, 0.63, and 0.54, respectively). Thoracic and lumbar segments showed highest reliabilities in total axial rotation (ICC = 0.78) and flexion-extension (ICC = 0.77–0.79) ROM, respectively. Pelvic segment showed highest ICC values in flexion (ICC = 0.78) and total axial rotation (ICC = 0.81) trials. Furthermore, it was estimated that four or fewer repeated trials would provide good reliability for key ROM outcomes, including lumbar flexion, thoracic and lumbar lateral bending, and thoracic axial rotation. This demonstration of reliability is a necessary precursor to quantifying spine kinematics in clinical studies, including assessing changes due to clinical treatment or disease progression.     

Modelling the maximum voluntary joint torque/angular velocity relationship in human movement

The force exerted by a muscle is a function of the activation level and the maximum (tetanic) muscle force. In "maximum" voluntary knee extensions muscle activation is lower for eccentric muscle velocities than for concentric velocities. The aim of this study was to model this "differential activation" in order to calculate the maximum voluntary knee extensor torque as a function of knee angular velocity. Torque data were collected on two subjects during maximal eccentric-concentric knee extensions using an isovelocity dynamometer with crank angular velocities ranging from 50 to 450 degrees s(-1). The theoretical tetanic torque/angular velocity relationship was modelled using a four parameter function comprising two rectangular hyperbolas while the activation/angular velocity relationship was modelled using a three parameter function that rose from submaximal activation for eccentric velocities to full activation for high concentric velocities. The product of these two functions gave a seven parameter function which was fitted to the joint torque/angular velocity data, giving unbiased root mean square differences of 1.9% and 3.3% of the maximum torques achieved. Differential activation accounts for the non-hyperbolic behaviour of the torque/angular velocity data for low concentric velocities. The maximum voluntary knee extensor torque that can be exerted may be modelled accurately as the product of functions defining the maximum torque and the maximum voluntary activation level. Failure to include differential activation considerations when modelling maximal movements will lead to errors in the estimation of joint torque in the eccentric phase and low velocity concentric phase.     

Evaluating the validity and reliability of inertial measurement units for determining knee and trunk kinematics during athletic landing and cutting movements

Inertial Measurement Units (IMUs) are promising alternatives to laboratory-based motion capture methods in biomechanical assessment of athletic movements. The aim of this study was to investigate the validity of an IMU system for determining knee and trunk kinematics during landing and cutting tasks for clinical and research applications in sporting populations. Twenty-seven participants performed five cutting and landing tasks while being recorded using a gold-standard optoelectronic motion capture system and an IMU system. Intra-class coefficients, Pearson’s r, root-mean-square error (RMSE), bias, and Bland-Altman limits of agreements between the motion capture and IMU systems were quantified for knee and trunk sagittal- and frontal-plane range-of-motion (ROM) and peak angles. Our results indicate that IMU validity was task-, joint-, and plane-dependent. Based on good-to-excellent (ICC) correlation, reasonable accuracy (RMSE < 5°), bias within 2°, and limits of agreements within 10°, we recommend the use of this IMU system for knee sagittal-plane ROM estimations during cutting, trunk sagittal-plane peak angle estimation during the double-leg landing task, trunk sagittal-plane ROM estimation for almost all tasks, and trunk frontal-plane peak angle estimation for the right single-leg landing task. Due to poor comparisons with the optoelectronic system, we do not recommend this IMU system for knee frontal-plane kinematic estimations.     

The effect of speed on leg stiffness and joint kinetics in human running

The goals of this study were to examine the following hypotheses: (a) there is a difference between the theoretically calculated (McMahon and Cheng, 1990. Journal of Biomechanics 23, 65-78) and the kinematically measured length changes of the spring-mass model and (b) the leg spring stiffness, the ankle spring stiffness and the knee spring stiffness are influenced by running speed. Thirteen athletes took part in this study. Force was measured using a "Kistler" force plate (1000 Hz). Kinematic data were recorded using two high-speed (120 Hz) video cameras. Each athlete completed trials running at five different velocities (approx. 2.5, 3.5, 4.5, 5.5 and 6.5 m/s). Running velocity influences the leg spring stiffness, the effective vertical spring stiffness and the spring stiffness at the knee joint. The spring stiffness at the ankle joint showed no statistical difference (p < 0.05) for the five velocities. The theoretically calculated length change of the spring-mass model significantly (p < 0.05) overestimated the actual length change. For running velocities up to 6.5 m/s the leg spring stiffness is influenced mostly by changes in stiffness at the knee joint.     

Quadriceps and hamstring isokinetic strength and electromyographic activity measured at different ranges of motion: a reproducibility study.

Isokinetic strength measurements of the quadriceps and hamstring that are commonly conducted using a 90 degrees range of motion (RoM) may involve some risk to specific knee patient groups. Testing these muscles at a much shorter RoM may reduce the risk but in order to render this method clinically acceptable the reproducibility of the derived test findings has to be established. Therefore the main objective of this study was to assess the reproducibility of isokinetic peak torque and normalized EMG scores of these muscles based on 90 degrees (0-90 degrees flexion, LR) and three successive short RoMs: 0-30 degrees (SR1), 30-60 degrees (SR2) and 60-90 degrees (SR3). Eight healthy subjects were tested three times with a 2 week between-session interval. All tests were performed on the dominant limb and consisted of maximal concentric and eccentric exertions. The velocities applied were 90 degrees /s for LR and 30 degrees /s for each of the SRs. Findings indicated no between-session improvement in strength. Based on the coefficient of variation the measurement error for all isokinetic strength scores remained stable throughout the testing sessions ranging 0.6-13.9% with the absolute majority of instances less than 10%. The reproducibility of the EMG scores was poorer ranging 1.5-25% and 0.5-19% for the quadriceps and hamstring, respectively. It is concluded that testing of knee muscles at short (30 degrees ) RoMs does not compromise the reproducibility of the strength or EMG scores derived from the commonly used RoM of 90 degrees . However, whereas strength was reproducible to within the accepted clinical standards, the corresponding EMG scores were characterized by a wider error band.     

Effects of knee joint angle on the fascicle behavior of the gastrocnemius muscle during eccentric plantar flexions

The present study aimed to clarify the effects of knee joint angle on the behavior of the medial gastrocnemius muscle (MG) fascicles during eccentric plantar flexions. Eight male subjects performed maximal eccentric plantar flexions at two knee positions [fully extended (K0) and 90° flexed (K90)]. The eccentric actions were preceded by static plantar flexion at a 30° plantar flexed position and then the ankle joint was forcibly dorsiflexed to 15° of dorsiflexion with an isokinetic dynamometer at 30°/s and 150°/s. Tendon force was calculated by dividing the plantar flexion torque by the estimated moment arm of the Achilles tendon. The MG fascicle length was determined with ultrasonography. The tendon forces during eccentric plantar flexions were influenced by the knee joint angle, but not by the angular velocity. The MG fascicle lengths were elongated as the ankle was dorsiflexed in K0, but in K90 they were almost constant despite the identical range of ankle joint motion. These results suggested that MG fascicle behavior during eccentric actions was markedly affected by the knee joint angle. The difference in the fascicle behavior between K0 and K90 could be attributed to the non-linear force–length relations and/or to the slackness of tendinous tissues.     

Reliability of impact forces, hip angles and velocities during simulated forward falls using a novel Propelled Upper Limb fall ARrest Impact System (PULARIS)

Previous forward fall simulation methods have provided good kinematic and kinetic data, but are limited in that they have started the falls from a stationary position and have primarily simulated uni-directional motion. Therefore, a novel Propelled Upper Limb fall ARest Impact System (PULARIS) was designed to address these issues during assessments of a variety of fall scenarios. The purpose of this study was to present PULARIS and evaluate its ability to impact the upper extremities of participants with repeatable velocities, hand forces and hip angles in postures and with vertical and horizontal motion consistent with forward fall arrest. PULARIS consists of four steel tubing crossbars in a scissor-like arrangement that ride on metal trolleys within c-channel tracks in the ceiling. Participants are suspended beneath PULARIS by the legs and torso in a prone position and propelled horizontally via a motor and chain drive until they are quick released, and then impact floor-mounted force platforms with both hands. PULARIS velocity, hip angles and velocities and impact hand forces of ten participants (five male, five female) were collected during three fall types (straight-arm, self-selected and bent-arm) and two fall heights (0.05 m and 0.10 m) to assess the reliability of the impact conditions provided by the system. PULARIS and participant hip velocities were found to be quite repeatable (mean ICC?=?0.81) with small between trial errors (mean?=?0.03 m/s). The ratio of horizontal to vertical hip velocity components (~0.75) agreed well with previously reported data (0.70-0.80). Peak vertical hand impact forces were also found to be relatively consistent between trials with a mean ICC of 0.73 and mean between trial error of 13.4 N. Up to 83% of the horizontal hand impact forces displayed good to excellent reliability (ICC?>?0.6) with small between trial differences. Finally, the ICCs for between trial hip angles were all classified as good to excellent. Overall, PULARIS is a reliable method and is appropriate for studying the response of the distal upper extremity to impact loading during non-stationary, multi-directional movements indicative of a forward fall. This system performed well at different fall heights, and allows for a variety of upper and lower extremity, and hip postures to be tested successfully in different landing scenarios consistent with elderly and sport-related falls.     

Static and dynamic assessment of the Biodex dynamometer

The validity and accuracy of the Biodex dynamometer was investigated under static and dynamic conditions. Static torque and angular position output correlated well with externally derived data (r = 0.998 and r greater than 0.999, respectively). Three subjects performed maximal voluntary knee extensions and flexions at angular velocities from 60 to 450 degrees.s-1. Using linear accelerometry, high speed filming and Biodex software, data were collected for lever arm angular velocity and linear accelerations, and subject generated torque. Analysis of synchronized angular position and velocity changes revealed the dynamometer controlled angular velocity of the lever arm to within 3.5% of the preset value. Small transient velocity overshoots were apparent on reaching the set velocity. High frequency torque artefacts were observed at all test velocities, but most noticeably at the faster speeds, and were associated with lever arm accelerations accompanying directional changes, application of resistive torques by the dynamometer, and limb instability. Isokinematic torques collected from ten subjects (240, 300 and 400 degrees.s-1) identified possible errors associated with reporting knee extension torques at 30 degrees of flexion. As a result of tissue and padding compliance, leg extension angular velocity exceeded lever arm angular velocity over most of the range of motion, while during flexion this compliance meant that knee and lever arm angles were not always identical, particularly at the start of motion. Nevertheless, the Biodex dynamometer was found to be both a valid and an accurate research tool; however, caution must be exercised when interpreting and ascribing torques and angular velocities to the limb producing motion.     

Torque-velocity characteristics and muscle fiber type in human vastus lateralis

The relationship between torque-velocity characteristics of the knee extensors during isokinetic contractions and muscle fiber type of the vastus lateralis, determined from two muscle biopsy samples, was investigated in 12 male and 18 female subjects. Peak torque, corrected for the effect of gravity and impact artifact, was classified as corrected peak torque. The torque measured 30 degrees from full extension and, corrected for gravity, was classified as corrected torque at 30 degrees. No significant correlations were found between the percentage of fast-twitch fibers (%FT) or the relative area of FT fibers (%FTA) and corrected peak torque values for any of the velocities tested or the knee angles where corrected peak torques were measured. However, significant inverse relationships were determined for corrected torque at 30 degrees at all but the fastest velocity (270 degrees/s) and both %FT and %FTA for the male subjects. These results reveal that muscle fiber type of the vastus lateralis, based on duplicate muscle samples, is not related to the peak torque actually generated by the knee extensors but may influence the shape of the torque output for maximal contractions sustained over the entire range of motion.     

Force-velocity relations and fiber composition in human knee extensor muscles.

Standardized measurements of dynamic strength of the kneee extensor muscles were performed in 25 healthy male subjects (17-37 yr) by means of isokinetic contractions, i.e., knee extensions with constant angular velocities. Overall variation between double determinations of maximal torque throughout the 90 degrees arc of motion (0 degrees = fully extended leg) averaged 10% for the different constant velocities chosen. At any given angle of the knee the torque produced was higher for isometric than for dynamic contractions. Dynamic torque decreased gradually with increased speed of shortening. Peak dynamic torque was reached at knee angles in the range: 55-66 degrees, with a displacement toward smaller knee angles with higher angular velocities. Correlations were demonstrated between peak torque produced at the highest speed of muscle shortening and percent as well as relative area of fast twitch fibers in the contracting muscle. In addition muscles with a high percentage of fast twitch fibers had the highest maximal contraction speeds. These observations on intact human skeletal muscle are consistent with earlier findings in animal skeletal muscle preparations.     

On the estimation of joint kinematics during gait.

In gait analysis, the concepts of Euler and helical (screw) angles are used to define the three-dimensional relative joint angular motion of lower extremities. Reliable estimation of joint angular motion depends on the accurate definition and construction of embedded axes within each body segment. In this paper, using sensitivity analysis, we quantify the effects of uncertainties in the definition and construction of embedded axes on the estimation of joint angular motion during gait. Using representative hip and knee motion data from normal subjects and cerebral palsy patients, the flexion-extension axis is analytically perturbed +/- 15 degrees in 5 degrees steps from a reference position, and the joint angles are recomputed for both Euler and helical angle definitions. For the Euler model, hip and knee flexion angles are relatively unaffected while the ab/adduction and rotation angles are significantly affected throughout the gait cycle. An error of 15 degrees in the definition of flexion-extension axis gives rise to maximum errors of 8 and 12 degrees for the ab/adduction angle, and 10-15 degrees for the rotation angles at the hip and knee, respectively. Furthermore, the magnitude of errors in ab/adduction and rotation angles are a function of the flexion angle. The errors for the ab/adduction angles increase with increasing flexion angle and for the rotation angle, decrease with increasing flexion angle. In cerebral palsy patients with flexed knee pattern of gait, this will result in distorted estimation of ab/adduction and rotation. For the helical model, similar results are obtained for the helical angle and associated direction cosines.(ABSTRACT TRUNCATED AT 250 WORDS)     

Reduction of knee range of motion during continuous passive motion due to misaligned hip joint centre

When using continuous passive motion (CPM) devices, appropriate setting of the device and positioning of the patient are necessary to obtain maximum range of motion (ROM). In this study, the ROMs in both the knee joint and CPM device during CPM treatment were measured using a motion analysis system for three different CPM devices. Additionally, the trajectories of the angles at the knee for hip joint misalignments were evaluated using kinematic models of the three CPM devices. The results showed that discrepancies in ROM between the knee joints and the CPM device settings during CPM treatment were revealed regardless of the CPM device and that the effect of misalignment is dependent on the design of the CPM device. The present technology could be applied for the development of a better design configuration for the CPM device to reduce the discrepancy in ROM at the knee joint.     

Reduction of knee range of motion during continuous passive motion due to misaligned hip joint centre

When using continuous passive motion (CPM) devices, appropriate setting of the device and positioning of the patient are necessary to obtain maximum range of motion (ROM). In this study, the ROMs in both the knee joint and CPM device during CPM treatment were measured using a motion analysis system for three different CPM devices. Additionally, the trajectories of the angles at the knee for hip joint misalignments were evaluated using kinematic models of the three CPM devices. The results showed that discrepancies in ROM between the knee joints and the CPM device settings during CPM treatment were revealed regardless of the CPM device and that the effect of misalignment is dependent on the design of the CPM device. The present technology could be applied for the development of a better design configuration for the CPM device to reduce the discrepancy in ROM at the knee joint.