Bilateral differences in the net joint torques during the squat exercise

Bilateral movements are common in human movement, both as exercises and as daily activities. Because the movement patterns are similar, it is often assumed that there are no bilateral differences (BDs; differences between the left and right sides) in the joint torques that are producing these movements. The aim of this investigation was to test the assumption that the joint torques are equal between the left and right lower extremities by quantifying BDs during the barbell squat. Eighteen recreationally trained men (n = 9) and women (n = 9) completed 3 sets of 3 repetitions of the squat exercise, under 4 loading conditions: 25, 50, 75, and 100% of their 3 repetition maximum, while instrumented for biomechanical analysis. The average net joint moment (ANJM) and maximum flexion angle (MFA) for the hip, knee, and ankle as well as the average vertical ground reaction force (AVGRF) and the average distance from the ankle joint center to the center of pressure (ADCOP) were calculated. Group mean and individual data were analyzed (alpha = 0.05). At each joint, there was a significant main effect for side and load, no main effect for gender, with few significant interactions. The hip ANJM was 12.4% larger on the left side, the knee ANJM was 13.2% larger on the right side, and the ankle ANJM was 16.8% larger on the left side. Differences in MFAs between sides were less than 2 degrees for all 3 joints (all p > 0.20 except for the knee at 75% [p = 0.024] and 100% [p = 0.025]), but the AVGRF and the ADCOP were 6% and 11% larger on the left side. Few subjects exhibited the pattern identified with the group mean data, and no subject exhibited nonsignificant BDs for all 3 joints. These findings suggest that joint torques should not be assumed to be equal during the squat and that few individual subjects follow the pattern exhibited by group mean data.     

Characterizing asymmetry across the whole sit to stand movement in healthy participants

Sit-to-stand transfer (STS) is a common yet critical prerequisite for many daily tasks. Literature conducted on healthy STS often assume the body to behave symmetrically across the left and right side; yet only a few studies have been conducted to investigate this supposition. These studies have focused on a single numerical indicator such as peak joint moment (JM) values to describe symmetricity; however, STS is a dynamic and time dependent movement. This study addresses the validity of peak value analyses through the introduction of a time based peak-offset measure and proposes two time-dependent techniques to further characterize asymmetry and assesses their feasibility in ten (10) healthy male participants. JM and joint power (JP) over the whole STS movement was determined using motion capture and inverse dynamics. Using a paired one-tailed t-test differences were found in the time at which the left and right side reached peak values in all lower extremity joints (p<0.05) with exception of the hip JM. Using a measure of JM and JP straight-difference it was determined that the ankle joint displayed the largest number of JM and JP development strategies of all the lower extremity joints. Finally, through numerical integration of the JM and JP data with respect to time, it was found that the longer one side spends dominating the movement, the larger the excess angular impulse and work that can be expected from that side. The results suggest that when analyzing STS movements, one must be aware of the potential asymmetry present even in healthy movements. Furthermore, a simple peak JM or JP analysis may not fully describe the extent of these asymmetries.     

Gait posture estimation using wearable acceleration and gyro sensors

A method for gait analysis using wearable acceleration sensors and gyro sensors is proposed in this work. The volunteers wore sensor units that included a tri-axis acceleration sensor and three single axis gyro sensors. The angular velocity data measured by the gyro sensors were used to estimate the translational acceleration in the gait analysis. The translational acceleration was then subtracted from the acceleration sensor measurements to obtain the gravitational acceleration, giving the orientation of the lower limb segments. Segment orientation along with body measurements were used to obtain the positions of hip, knee, and ankle joints to create stick figure models of the volunteers. This method can measure the three-dimensional positions of joint centers of the hip, knee, and ankle during movement. Experiments were carried out on the normal gait of three healthy volunteers. As a result, the flexion–extension (F–E) and the adduction–abduction (A–A) joint angles of the hips and the flexion–extension (F–E) joint angles of the knees were calculated and compared with a camera motion capture system. The correlation coefficients were above 0.88 for the hip F–E, higher than 0.72 for the hip A–A, better than 0.92 for the knee F–E. A moving stick figure model of each volunteer was created to visually confirm the walking posture. Further, the knee and ankle joint trajectories in the horizontal plane showed that the left and right legs were bilaterally symmetric.     

关节镜清理术治疗前踝撞击征的疗效

目的:探讨踝关节镜对前踝撞击征的诊疗价值。方法:采用关节镜清理术治疗前踝撞击综合征33例,其中男23例,女10例。年龄平均39岁(18～72岁)。左踝16例,右踝17例。病史6个月至20年,有运动损伤史13例,踝关节扭伤病史17例,踝关节骨折史3例。临床表现为踝关节肿胀、疼痛和下蹲活动受限。X线片显示胫骨前唇和距骨骨质增生,MRI显示距骨软骨损伤,踝关节腔内积液。采用局麻关节镜下骨赘磨削,滑膜切除,踝关节清理术。结果:随访33例,平均时间35个月(4个月-6年)。术后踝关节背伸活动功能正常,按照McGuire踝关节评分系统对术前、术后踝关节功能进行评估,术前平均55分,术后平均80分,术后提高了25分。优13例,良15例,可3例,差2例,优良率84.8%。结论:局麻下踝关节镜骨赘切除、滑膜刨削和软骨修整可有效解除踝关节撞击症状,手术创伤小、功能恢复快,效果满意。     

Inverse dynamic investigation of voluntary trunk movements in weightlessness: a new microgravity-specific strategy

Present investigation faces the question of quantitative assessment of exchanged forces and torques at the restraints during whole body posture exercises in long-term microgravity. Inverse dynamic modelling and total angular momentum at the ankle joint were used in order to reconstruct movement dynamics at the restraining point, represented by the ankle joint. The hypothesis is that the minimisation of the torques at the interface point assumes a key role in movement planning in 0 g. This hypothesis would respond to an optimisation of muscles activity, a minimisation of energy expenditure and therefore an accurate control of body movement. Results show that the 0 g movement strategy adopted ensures that the integral of the net ankle moment between the beginning and the end of the movement is zero. This expected mechanical constraint is not satisfied when 0 g movement dynamics is simulated using terrestrial kinematics. This accounts for a significant imposed change of movement strategy. Particularly, the efficient compensation of the inertial effects of the segments in terms of total angular momentum at the ankle joint was evidenced. These results explain the exaggerated axial synergies, observed on kinematics and which moved centre of mass (CM) backward from its already backward initial positioning, as a tool for enhancing the compensation and achieving the desired minimisation of the torques exchanges at the restraints.     

Trauma among the Shanidar Neandertals

Four of the adult Neandertals from Shanidar Cave, Iraq, Shanidar 1, 3, 4, and 5, show evidence of antemortem trauma. Shanidar 1 sustained injuries to the right frontal squama, the left lateral orbit, the right humerus and right fifth metatarsal. Associated with this trauma are hypoplasia or atrophy of the right clavicle, scapula, and humerus, osteomyelitis of the right clavicle, degenerative joint disease at the right knee, ankle, and first tarsometatarsal joint, and remodeling of the left tibia. Shanidar 3 experienced trauma-related degenerative joint disease at the right talocrural and talocalcaneal joints and sustained a penetrating wound across the left ninth rib. Shanidar 4 suffered a fracture of the right seventh or eighth rib, and Shanidar 5 had a scalp wound over the left frontal. A high frequency of antemortem trauma associated with the survival of the injured individuals appears to have been characteristic of the Neandertals.     

Adding weights to stretching exercise increases passive range of motion for healthy elderly

Stretching exercise is effective for increasing joint range of motion (ROM). However, the Surgeon General's Report and the American College of Sports Medicine cite a lack of studies identifying strategies capable of increasing the effectiveness of stretching exercise. This investigation evaluated adding modest weight (0.45-1.35 kg) to a stretching exercise routine (Body Recall [BR]) on joint ROM. Forty-three subjects ages 55-83 years participated in 1 of 2 training groups, BR, BR with weights (BR+W), or a control group (C). ROM was evaluated at the neck, shoulder, hip, knee, and ankle before and after 10 weeks of exercise. Using ANCOVA, significant differences (p < 0.01) were observed for right and left cervical rotation, hip extension, ankle dorsiflexion, ankle plantar flexion, and shoulder flexion. Post hoc analysis revealed that cervical rotation (left and right), hip extension, and ankle dorsiflexion for BR+W subjects differed significantly from BR and C (p < 0.01). Significant differences with shoulder flexion and ankle plantar flexion were found for both BR and BR+W in comparison to C (p < 0.01). Results indicate that addition of weights enhanced the effectiveness of stretching exercise for increasing joint ROM with 4 of the 6 selected measurements. Thus, a modest intensity exercise program that is within the reach of most elderly may significantly affect joint ROM and flexibility.     

Joint forces and torques when walking in shallow water

This study reports for the first time an estimation of the internal net joint forces and torques on adults' lower limbs and pelvis when walking in shallow water, taking into account the drag forces generated by the movement of their bodies in the water and the equivalent data when they walk on land. A force plate and a video camera were used to perform a two-dimensional gait analysis at the sagittal plane of 10 healthy young adults walking at comfortable speeds on land and in water at a chest-high level. We estimated the drag force on each body segment and the joint forces and torques at the ankle, knee, and hip of the right side of their bodies using inverse dynamics. The observed subjects' apparent weight in water was about 35% of their weight on land and they were about 2.7 times slower when walking in water. When the subjects walked in water compared with walking on land, there were no differences in the angular displacements but there was a significant reduction in the joint torques which was related to the water's depth. The greatest reduction was observed for the ankle and then the knee and no reduction was observed for the hip. All joint powers were significantly reduced in water. The compressive and shear joint forces were on average about three times lower during walking in water than on land. These quantitative results substantiate the use of water as a safe environment for practicing low-impact exercises, particularly walking.     

The Roles of Monoarticular and Biarticular Muscles of the Lower Limbs in Terrestrial Locomotion

Specific features of the functioning of mono- and biarticular muscles were studied using a multijoint movement (a high jump) as an example. The powers of the knee and ankle joint extensors are insufficient for a strong and quick movement such as a high jump. Biarticular muscles (m. rectus femoris) transfer forces/powers from one joint to another, thereby compensating for the physiological shortcoming of monoarticular muscles, that is, a decrease in the tractive force with increasing contraction rate. In a high jump, a power of 300 W may be transferred from the hip to the knee joint via the m. rectus femoris; 230 W, from the knee to the hip joint via the hamstring muscle; 210 W, from the knee joint to the ankle via the m. gastrocnemius; and 15 W, from the metatarsophalangeal joint to the ankle via the mm. flexors.     

Knee and ankle joint torque-angle relationships of multi-joint leg extension

The force-length-relation (F-l-r) is an important property of skeletal muscle to characterise its function, whereas for in vivo human muscles, torque-angle relationships (T-a-r) represent the maximum muscular capacity as a function of joint angle. However, since in vivo force/torque-length data is only available for rotational single-joint movements the purpose of the present study was to identify torque-angle-relationships for multi-joint leg extension. Therefore, inverse dynamics served for calculation of ankle and knee joint torques of 18 male subjects when performing maximum voluntary isometric contractions in a seated leg press. Measurements in increments of 10° knee angle from 30° to 100° knee flexion resulted in eight discrete angle configurations of hip, knee and ankle joints. For the knee joint we found an ascending-descending T-a-r with a maximum torque of 289.5° ± 43.3 Nm, which closely matches literature data from rotational knee extension. In comparison to literature we observed a shift of optimum knee angle towards knee extension. In contrast, the T-a-r of the ankle joint vastly differed from relationships obtained for isolated plantar flexion. For the ankle T-a-r derived from multi-joint leg extension subjects operated over different sections of the force-length curve, but the ankle T-a-r derived from isolated joint efforts was over the ascending limb for all subjects. Moreover, mean maximum torque of 234.7 ± 56.6 Nm exceeded maximal strength of isolated plantar flexion (185.7 ± 27.8 Nm). From these findings we conclude that muscle function between isolated and more physiological multi-joint tasks differs. This should be considered for ergonomic and sports optimisation as well as for modelling and simulation of human movement.     

Estimation of passive ankle joint moment during standing and walking

This study estimated the passive ankle joint moment during standing and walking initiation and its contribution to total ankle joint moment during that time. The decrement of passive joint moment due to muscle fascicle shortening upon contraction was taken into account. Muscle fascicle length in the medial gastrocnemius, which was assumed to represent muscle fascicle length in plantarflexors, was measured using ultrasonography during standing, walking initiation, and cyclical slow passive ankle joint motion. Total ankle joint moment during standing and walking initiation was calculated from ground reaction forces and joint kinematics. Passive ankle joint moment during the cyclical ankle joint motion was measured via a dynamometer. Passive ankle joint moment during standing and at the time (Tp) when the MG muscle-tendon complex length was longest in the stance phase during walking initiation were 2.3 and 5.4 Nm, respectively. The muscle fascicle shortened by 2.9 mm during standing compared with the length at rest, which decreased the contribution of passive joint moment from 19.9% to 17.4%. The muscle fascicle shortened by 4.3 mm at Tp compared with the length at rest, which decreased the contribution of passive joint moment from 8.0% to 5.8%. These findings suggest that (a) passive ankle joint moment plays an important role during standing and walking initiation even in view of the decrement of passive joint moment due to muscle fascicle shortening upon muscle contraction, and (b) muscle fascicle shortening upon muscle contraction must be taken into account when estimating passive joint moment during movements.     

Measurement of the isometric dorsiflexion and plantar flexion force in the ankle joint]

This article describes an easy to use test equipment for measuring the isometric force in the ankle joints in dorsiflexion and plantar flexion. The combination of the test equipment for measuring the voluntary maximal isometric muscle force in the ankle joint, the surface electromyograms and the motion analysis of the measured leg allow an objective comparison of the strength of the muscular force between the left and right leg. It might be also used as a control setup during rehabilitation after surgical treatment or injuries.     

A laboratory captured ‘giving way’ episode during a single-leg landing task in an individual with unilateral chronic ankle instability

An episode of ‘giving way’ at the ankle is described as excessive inversion of the rearfoot that does not result in an acute ankle sprain and is a unique feature associated with chronic ankle instability (CAI). Limited data currently exists describing the preparatory movement patterns and those that occur during an episode of ‘giving way. Therefore, this case report describes the movement patterns and the forces generated during an unintentional ‘giving way’ captured while an individual with unilateral CAI was performing a single-leg landing task in a research laboratory. The participant completed five single-leg landing trials for both limbs. 3D lower extremity kinematics and kinetics for the sagittal and frontal plane were extracted from 200 ms before and after initial contact (IC). Relative to the affected and un-affected single-leg landing trials, the ‘giving way’ episode was characterized by an increase in plantarflexion and hip extension moments before and after IC. The plantarflexion deviation dissipated (50 ms post-IC) and was followed by excessive ankle inversion. The ankle began to plantarflex again (150 ms post-IC) and the knee extended (50 ms post-IC) and adducted (100 ms post-IC). As a result, the ankle inversion angle plateaued at 150 ms post-IC. Furthermore, large sagittal plane internal joint moments were observed. In the frontal plane, the ‘giving way’ trial generated a large inversion joint moment which was counteracted by a large internal eversion joint moment. The observed plantarflexion and knee extension and adduction after initial contact likely contributed to preventing the ankle from continuing to invert and avoid an ankle sprain.     

Passive elastic properties of the rat ankle

Passive properties of muscles and tendons, including their elasticity, have been suggested to influence motor control. We examine here the potential role of passive elastic muscle properties at the rat ankle joint, focusing on their potential to specify an equilibrium position of the ankle. We measured the position-dependent passive torques at the rat ankle before and after sequential cuts of flexor (a.k.a. dorsiflexor) and extensor (a.k.a. plantarflexor) ankle muscles. We found that there was a passive equilibrium position of the ankle that shifted systematically with the cuts, demonstrating that the passive torques produced by ankle flexor and extensor muscles work in opposition in order to maintain a stable equilibrium. The mean equilibrium position of the intact rat ankle ranged from 9.3° to 15.7° in extension relative to the orthogonal position, depending on the torque metric. The mean shift in equilibrium position due to severing extensors ranged from 4.4° to 7.7°, and the mean shift due to severing flexors was smaller, ranging from 0.9° to 2.5°. The restoring torques generated by passive elasticity are large enough (approximately 1.5-5 mNm for displacements of 18° from equilibrium) to affect ankle movement during the swing phase of locomotion, and the asymmetry of larger extension vs. flexion torques is consistent with weight support, demonstrating the importance of accounting for passive muscle properties when considering the neural control of movement.     

The influence of foot positioning on ankle sprains

The goal of this study was to examine the influence of changes in foot positioning at touch-down on ankle sprain occurrence. Muscle model driven computer simulations of 10 subjects performing the landing phase of a side-shuffle movement were performed. The relative subtalar joint and talocural joint angles at touchdown were varied, and each subject-specific simulation was exposed to a set of perturbed floor conditions. The touchdown subtalar joint angle was not found to have a considerable influence on sprain occurrence, while increased touchdown plantar flexion caused increased ankle sprain occurrences. Increased touchdown plantar flexion may be the mechanism which causes ankles with a history of ankle sprains to have an increased susceptibility to subsequent sprains. This finding may also reveal a mechanism by which taping of a sprained ankle or the application of an ankle brace leads to decreased ankle sprain susceptibility.     

Triceps surae muscle-tendon unit length changes as a function of ankle joint angles and contraction levels: the effect of foot arch deformation

The purpose of this study was to clarify how foot deformation affects the relationship between triceps surae muscle-tendon unit (MTU) length and ankle joint angle. For six women and six men a series of sagittal magnetic resonance (MR) images of the right foot were taken, and changes in MTU length (the displacement of the calcaneal tuberosity), foot arch angle, and ankle joint angle were measured. In the passive session, each subject's ankle joint was secured at 10° dorsiflexed position, neutral position (NP), and 10° and 20° plantar flexed positions while MR images were acquired. In the active session, each subject was requested to perform submaximal isometric plantar flexions (30%, 60%, and 80% of voluntary maximum) at NP. The changes in MTU length in each trial were estimated by two different formulae reported previously. The changes of the measured MTU length as a function of ankle joint angles observed in all trials of the active session were significantly (p<0.05) larger than corresponding values in the passive session and by the estimation formulae. In the passive session, MTU length changes were significantly smaller than the estimated values when the ankle was plantar flexed. The foot arch angle increased as the contraction level increased from rest (117 ± 4°) to 80% (125 ± 3°), and decreased as the ankle was positioned further into plantar flexion in the passive session (115 ± 3°). These results indicate that foot deformation profoundly affects the triceps surae MTU length-ankle joint angle relationship during plantar flexion.     

Simulating mechanical consequences of voluntary movement upon whole-body equilibrium: the arm-raising paradigm revisited

Voluntary arm-raising movement performed during the upright human stance position imposes a perturbation to an already unstable bipedal posture characterised by a high body centre of mass (CoM). Inertial forces due to arm acceleration and displacement of the CoM of the arm which alters the CoM position of the whole body represent the two sources of disequilibrium. A current model of postural control explains equilibrium maintenance through the action of anticipatory postural adjustments (APAs) that would offset any destabilising effect of the voluntary movement. The purpose of this paper was to quantify, using computer simulation, the postural perturbation due to arm raising movement. The model incorporated four links, with shoulder, hip, knee and ankle joints constrained by linear viscoelastic elements. The input of the model was a torque applied at the shoulder joint. The simulation described mechanical consequences of the arm-raising movement for different initial conditions. The variables tested were arm inertia, the presence or not of gravity field, the initial standing position and arm movement direction. Simulations showed that the mechanical effect of arm-raising movement was mainly local, that is to say at the level of trunk and lower limbs and produced a slight forward displacement of the CoM (1.5 mm). Backward arm-raising movement had the same effect on the CoM displacement as the forward arm-raising movement. When the mass of the arm was increased, trunk rotation increased producing a CoM displacement in the opposite direction when compared to arm movement performed without load. Postural disturbance was minimised for an initial standing posture with the CoM vertical projection corresponding to the ankle joint axis of rotation. When the model was reduced to two degrees of freedom (ankle and shoulder joints only) the postural perturbation due to arm-raising movement increased compared to the four-joints model. On the basis of these results the classical assumption that APAs stabilise the CoM is challenged.     

The influence of knee alignment on lower extremity kinetics during squats

The squat is an assessment of lower extremity alignment during movement, however there is little information regarding altered joint kinetics during poorly performed squats. The purpose of this study was to examine changes in joint kinetics and power from altered knee alignment during a squat. Thirty participants completed squats while displacing the knee medially, anteriorly, and with neutral alignment (control). Sagittal and frontal plane torques at the ankle, knee, and hip were altered in the descending and ascending phase of the squat in both the medial and anterior malaligned squat compared to the control squat. Ankle and trunk power increased and hip power decreased in the medial malaligned squat compared to the control squat. Ankle, knee, and trunk power increased and hip power decreased in the anterior malaligned squat compared to the control squat. Changes in joint torques and power during malaligned squats suggest that altered knee alignment increases ankle and trunk involvement to execute the movement. Increased anterior knee excursion during squatting may also lead to persistent altered loading of the ankle and knee. Sports medicine professionals using the squat for quadriceps strengthening must consider knee alignment to reduce ankle and trunk involvement during the movement.     

Movement behavior of high-heeled walking: how does the nervous system control the ankle joint during an unstable walking condition?

The human locomotor system is flexible and enables humans to move without falling even under less than optimal conditions. Walking with high-heeled shoes constitutes an unstable condition and here we ask how the nervous system controls the ankle joint in this situation? We investigated the movement behavior of high-heeled and barefooted walking in eleven female subjects. The movement variability was quantified by calculation of approximate entropy (ApEn) in the ankle joint angle and the standard deviation (SD) of the stride time intervals. Electromyography (EMG) of the soleus (SO) and tibialis anterior (TA) muscles and the soleus Hoffmann (H-) reflex were measured at 4.0 km/h on a motor driven treadmill to reveal the underlying motor strategies in each walking condition. The ApEn of the ankle joint angle was significantly higher (p<0.01) during high-heeled (0.38±0.08) than during barefooted walking (0.28±0.07). During high-heeled walking, coactivation between the SO and TA muscles increased towards heel strike and the H-reflex was significantly increased in terminal swing by 40% (p<0.01). These observations show that high-heeled walking is characterized by a more complex and less predictable pattern than barefooted walking. Increased coactivation about the ankle joint together with increased excitability of the SO H-reflex in terminal swing phase indicates that the motor strategy was changed during high-heeled walking. Although, the participants were young, healthy and accustomed to high-heeled walking the results demonstrate that that walking on high-heels needs to be controlled differently from barefooted walking. We suggest that the higher variability reflects an adjusted neural strategy of the nervous system to control the ankle joint during high-heeled walking.