The evaluation of the effect of stool height alteration on workload of squatting postures performed by Indonesians with different body mass index (BMI)

Indonesians commonly perform activities on the floor that require squatting postures. It has been identified that adopting squatting postures without any proper support would gradually cause postural stress. This study examines the influence of different squatting heights to the body kinematics and subjective discomfort rating. The subjects were divided into two different body types: overweight subjects with BMI > 24.9 and normal weight subjects with BMI 18-24.9. The subjects adopted a squatting posture at no-stool condition and at the stool height of 10, 15, and 20 cm. The task was to simulate the work close to the ground level with the hip joint deeply flexed. Body segmental angular flexion (SAF) and the visual analog scale (VAS) method were selected for parameter analyses. Significant differences were found in both parameters SAF (trunk, hip, knee, and ankle) and VAS. The interaction effect was found by squatting height and the body type for SAF of the trunk (p < 0.05). However, the increasing BMI index was also found significantly affected associated with the anthropometrical characteristics for buttock height and lower limbs depth. It is suggested that normal weight subjects sit comfortably at 15 cm stool height, whereas overweight subjects preferred 20 cm stool height as a better acceptability condition in terms of overall parameter analyses.     

The relation between the changes of postural achievement, lower limb muscle activities, and balance stability in three different deep-squatting postures

Deep squatting places a burden on the lower limb muscles and influences postural balance. We attempted to determine the effects of postural changes on the rectus femoris, tibialis anterior, gastrocnemius, soleus, and extensor digitorum brevis muscles during squatting in 8 healthy male subjects. Three squatting conditions were involved: full squatting (FS), tiptoe squatting (TT), and tiptoe squatting on a 15 degrees slope (TTS), performed randomly and recorded in a period of 4 min for each task. The influence of the squatting condition on electromyography and vertical ground reaction force parameters was examined in order to observe the effect of postural alteration on muscle activity and balance control. The results showed that the change of squatting posture from FS to TT decreased the activity of the rectus femoris and tibialis anterior muscles. FS has been suspected as a main cause of musculoskeletal complaint during prolonged squatting. In contrast, as the heel was lifted, the extensor digitorum brevis muscle increased to 39% of maximum activation. On the other hand, sway analysis at TT showed balance instability regarding the large area occupation of the center of pressure displacement. The presence of a 15 degrees slope significantly reduced the muscular load. This simple study suggests that the inclusion of a sloping surface in daily activities that requires a squatting posture would be an effective means to reduce muscular load.     

Comparison of office chairs with fixed forwards or backwards inclining, or tiltable seats

Three adjustments of an office chair seat: one inclining +10 degrees (forwards), one inclining -5 degrees (backwards), and one being freely tiltable from -8 degrees to +19.5 degrees were investigated using two groups of healthy female workers in a field (n = 12), and a laboratory study (n = 10), respectively. The seat adjustments were examined with regard to effects on foot swelling, lumbar muscular load, backrest pressure and subjective acceptability. Desk-work and typing were compared according to lumbar muscular activity, seat movements (tiltable seat), and backrest pressure. Foot swelling tended to increase with increasing seat height but was not influenced by the ability to tilt the seat or not. With the different seat adjustments lumbar muscular activity did not change systematically in spite of greater backrest pressure when the seat inclined backwards. The tiltable seat was preferred to the others. Typing was associated with a more constrained and tens posture than desk work, because movements, transferred to the tiltable seat, decreased and the muscular load increased. Backrest pressure was highest during typing. A tendency towards gradually increasing restlessness (i.e. seat movements) and increasing forward inclination of the tiltable seat with time was observed.     

Sitting on a Sloping Seat Does Not Reduce the Strain Sustained by the Postural Chain

The objective of this study was to explore the effect of a forward sloping seat on posture and muscular activity of the trunk and lower limbs. To this aim, twelve asymptomatic participants were tested in six conditions varying seat slope (0°, 15° forward) and height (high, medium, low). Angular position of head, trunk and pelvis was assessed with an inertial orientation system, and muscular activity of 11 superficial postural muscles located in the trunk and lower limbs was estimated using normalized EMG. Results showed that a forward sloping seat, compared to a flat seat, induced a greater activity of the soleus (p<0.01), vastus lateralis (p<0.05) and vastus medialis (p<0.05), as well a lower hip flexion (p<0.01). In contrast, no significant variation of head, trunk and pelvis angular position was observed according to seat slope. It was concluded that forward sloping seats increase the load sustained by the lower limbs, without a systematic improvement of body posture.     

Antagonist muscle co-contraction during a double-leg landing maneuver at two heights

Background: Knee injuries are common during landing activities. Greater landing height increases peak ground reaction forces (GRFs) and loading at the knee joint. As major muscles to stabilize the knee joint, Quadriceps and Hamstring muscles provide internal forces to attenuate the excessive GRF. Despite the number of investigations on the importance of muscle function during landing, the role of landing height on these muscles forces using modeling during landing is not fully investigated. Methods: Participant-specific musculoskeletal models were developed using experimental motion analysis data consisting of anatomic joint motions and GRF from eight male participants performing double-leg drop landing from 30 and 60 cm. Muscle forces were calculated in OpenSim and their differences were analyzed at the instances of high risk during landing i.e. peak GRF for both heights. Results: The maximum knee flexion angle and moments were found significantly higher from a double-leg landing at 60 cm compared to 30 cm. The results showed elevated GRF, and mean muscle forces during landing. At peak GRF, only quadriceps showed significantly greater forces at 60 cm. Hamstring muscle forces did not significantly change at 60 cm compared to 30 cm. Conclusions: Quadriceps and hamstring muscle forces changed at different heights. Since hamstring forces were similar in both landing heights, this could lead to an imbalance between the antagonist muscles, potentially placing the knee at risk of injury if combined with small flexion angles that was not observed at peak GRF in our study. Thus, enhanced neuromuscular training programs strengthening the hamstrings may be required to address this imbalance. These findings may contribute to enhance neuromuscular training programs to prevent knee injuries during landing.     

Kinetic analysis of several variations of push-ups

Push-ups are a common and practical exercise that is used to enhance fitness, including upper body strength or endurance. The kinetic characteristics of push-ups and its variations are yet to be quantified. Kinetic quantification is necessary to accurately evaluate the training load, and thus the nature of the training stimulus, for these exercise variations. This study assessed the peak vertical ground reaction forces (GRFs) of push-up variations including the regular push-up and those performed with flexed knee, feet elevated on a 30.48-cm box, and a 60.96-cm box, and hands elevated on a 30.48-cm box and a 60.96-cm box. Twenty-three recreationally fit individuals (14 men, 9 women) performed each of the 6 push-up variations in a randomized order. Peak GRF and peak GRF expressed as a coefficient of subject body mass were obtained with a force platform. Push-ups with the feet elevated produced a higher GRF than all other push-up variations (p ≤ 0.05). Push-ups with hands elevated and push-ups from the flexed knee position produced a lower GRF than all other push-up variations (p ≤ 0.05). No gender differences in response to these push-up variations were found (p > 0.05). Additionally, subject height was not related to the GRF for any of the push-up conditions (p > 0.05) other than the condition where hands were elevated on a 60.96-cm box (p ≤ 0.05; r = 0.63). These data can be used to progress the intensity of push-ups in a program and to quantify the training load as a percentage of body mass.     

Effect of unilateral load carriage on postures and gait symmetry in ground reaction force during walking

Unilateral load carriage is more hazardous to the musculoskeletal system than bilateral load. The purpose of this study was to examine the effect of such asymmetric carriage on postures and gait symmetry in ground reaction force (GRF) during walking. Kinematics and GRF of 19 adults were recorded while they walked under five load conditions: no load, dumbbell (10 and 20% body weight) held in right and left hand, respectively. After loading, the trunk bent towards the loaded or unloaded side in right- and left-hand trials and under different load weight conditions. The amplitude of trunk bend increased with load, accompanied by decreased stride width, progressively inclined legs towards unloaded side and higher level of asymmetry in medial/lateral GRF (GRFm/l) and free vertical moment GRF (GRFm). The findings indicate the postural adjustment is likely related to the characteristics of load and the task experience and handedness of subject and the unilateral load increases the gait asymmetry in GRFm/l and GRFm.     

Work stress of women in sewing machine operation.

The study examined the work stresses of 107 women who were engaged in sewing machine operation in small garment manufacturing units. Of the three types of sewing machines (motor-operated, full and half shuttle foot-operated), 74% of the machines were foot-operated, where throttle action of the lower limb is required to move the shuttle of the machine. The motor-operated machines were faster than the foot-operated machines. The short cycle sewing work involves repetitive action of hand and feet. The women had to maintain a constant seated position on a stool without backrest and the body inclined forward. Long-term sewing work had a cumulative load on the musculo-skeletal structures, including the vertebral column and reflected in the form of high prevalence of discomfort and pain in different body parts. About 68% of the women complained of back pain, among whom 35% reported a persistent low back pain. Common sewing work accident is piercing of the needle through the fingers, particularly the right forefingers. Unsatisfactory man-machine incompatibility, work posture and fatigue, improper coordination of eye, leg and hand are the major problems of the operators. The design mis-match of the work place may be significantly improved by taking women's anthropometric dimensions in modifying the workplace, i.e. the seat surface, seat height, work height, backrest, etc.     

Biomechanics of skateboarding: kinetics of the Ollie

Seven top amateur or professional skateboarders (BW=713 N+/-83 N) performed Ollie maneuvers onto and off an elevated wooden platform (45.7 cm high). We recorded ground reaction force (GRF) data for three Ollie Up (OU) and Ollie Down (OD) trials per participant. The vertical GRF (VGRF) during the OU has a characteristic propulsive peak (M=2.22 body weight [BW]+/-0.22) resulting from rapidly rotating the tail of the board into the ground to propel the skater and board up and forward. The anterior-posterior (A-P) GRF also shows a pronounced peak (M=0.05+/-0.01 BW) corresponding with this propulsive VGRF peak. The initial phase of landing in the OD shows an impact peak in VGRF rising during the first 30 to 80 ms to a mean of 4.74+/-0.46 BW. These impact peaks are higher than expected given the relatively short drop of 45.7 cm and crouched body position. But we observed that our participants intentionally affected a firm landing to stabilize the landing position; and the Ollie off the platform raised the center of mass, also contributing to higher forces.     

Influence of ground reaction force perturbations on anterior cruciate ligament loading during sidestep cutting

Anterior cruciate ligament (ACL) injury risk is likely increased under unexpected loading conditions. Such situations may arise from mid-air contact with another athlete, or misjudgments in landing height, stride length or surface compliance resulting in an unbalanced landing and unexpected changes in the ground reaction forces (GRFs). The purpose this study was to identify how GRF perturbations influence ACL loading during sidestep cutting. Muscle-actuated simulations of sidestep cutting were generated and analyzed for 20 subjects. Perturbations of 20, 40 and 60% of the nominal value were applied to the posterior, vertical, and medial GRF. Open-loop, forward dynamics simulations were run with no feedback or correction mechanism which allowed deviations from the experimentally measured kinematics as a result of the GRF perturbations. Posterior and vertical GRF perturbations significantly increased ACL loading, although the change was more pronounced with posterior perturbations. These changes were primarily due to the sagittal plane component of ACL loading regardless of perturbation direction. Peak ACL loading occurred almost immediately after initial ground contact, and was thus predicated on initial joint configuration. The results of this study give merit to including knee flexion angle at initial ground contact in the evolving neuromuscular training modalities aimed at preventing non-contact ACL injury.     

Influence of the relative difference in chair seat height according to different lower thigh length on floor reaction force and lower-limb strength during sit-to-stand movement

Chair-seat height affects the burden on the lower-limbs during sit-to-stand (STS) movement. Previous studies used the same height chair, attaching importance to practicability, but the difference in each subject's lower thigh length may relate to the burden on the lower-limbs. This study aimed to examine the influence of different lower thigh lengths on floor reaction force and lower-limb strength during an STS movement. Thirty young-adult male subjects participated in this study (age: 22.7+/-2.6 yr, height: 172.8+/-4.8 cm, body-mass: 66.3+/-5.2 kg). The subjects were divided into three groups (G1>42 cm, 42 cm > or =G2 > or =38 cm, 38 cm >G3) based on lower thigh length (G1: 44.1+/-2.5 cm, G2: 39.8+/-1.3 cm, G3: 34.3+/-2.1 cm). Namely, G1 was characterized by lower thigh length longer than 105% of 40 cm, G2 by 95-105% of lower thigh length and G3 by lower thigh length less than 95% of 40 cm, respectively. Subjects performed an STS movement twice from chairs at 40 cm-height and height adjusted by the lower thigh length of each subject. Vertical floor reaction force and electromyogram (EMG) on the rectus femoris and tibialis anterior muscles during an STS movement were measured to evaluate the force of knocking over and the burden on the lower-limbs. Fifteen parameters regarding floor reaction force (10) and EMG (5) were selected for analyses. Significant differences were found in floor reaction force at hip-syneresis (F1) and the impulse between hip-syneresis and appearance of the peak floor reaction force (F2). G1 was greater than G2 for the former, and G3 for the latter. Significant differences were found in active muscle mass of the tibialis anterior from the beginning of an STS movement to hip-syneresis (TE1) and peak active muscle level of the tibialis anterior (TE6). G1 was greater than G2 for the former, and G2 and G3 for the latter. It was suggested that when an STS movement is performed using a chair with the same height for each subject, the load imposed on the subject's leg at the time of an STS movement and the STS movement achievement strategy differed since chair seat height changes relatively by the difference in lower thigh length. Moreover, it is thought that the difference in these load conditions and movement strategies occurs when the chair seat height of a subject's lower thigh length is longer than 110%. When conducting the ability to achieve STS movement rating test, chair seat height considering each subject's lower thigh length may be needed.     

Comparative study of plantar pressure during step exercise in different floor conditions

Mechanical load has been estimated during step exercise based on ground reaction force (GRF) obtained by force platforms. It is not yet accurately known whether these measures reflect foot contact forces once the latter depend on footwear and are potentially modified by the compliant properties of the step bench. The aim of the study was to compare maximal and mean plantar pressure (PP), and maximal GRF obtained by pressure insoles after performing seven movements both over two metal force platforms and over the step bench. Fifteen step-experienced females performed the movements at the cadences of 130 and 140 beats per minute. PP and GRF (estimated from PP) obtained for each floor condition were compared. Maximal PP ranged from 29.27 +/- 9.94 to 47.07 +/- 12.88 N/cm2 as for metal platforms, and from 28.20 +/- 9.32 to 43.00 +/- 13.80 N/cm2 as for the step bench. Mean PP ranged from 11.09 +/- 1.62 to 14.32 +/- 2.06 N/cm2 (platforms) and from 10.71 +/- 1.54 to 14.22 +/- 1.77 N/cm2 (step bench). GRF (normalized body weight) ranged from 1.43 +/- 0.14 to 2.41 +/- 0.24 BW (platforms) and from 1.38 +/- 0.14 to 2.36 +/- 0.19 BW (step bench). No significant statistical differences were obtained for most of the comparisons between the two conditions tested. The results suggest that metal force platform surfaces are suitable to assess mechanical load during this physical activity. The forces applied to the foot are similar to the softer step bench and the hard force platform surface. This may reflect the ability of the performers to adapt their movement patterns to normalize the impact forces in different floor conditions.     

Similar changes of gene expression in human skeletal muscle after resistance exercise and multiple fine needle biopsies

Repeated biopsy sampling from one muscle is necessary to investigate muscular adaptation to different forms of exercise as adaptation is thought to be the result of cumulative effects of transient changes in gene expression in response to single exercise bouts. In a crossover study, we obtained four fine needle biopsies from one vastus lateralis muscle of 11 male subjects (25.9 ± 3.8 yr, 179.2 ± 4.8 cm, 76.5 ± 7.0 kg), taken before (baseline), 1, 4, and 24 h after one bout of squatting exercise performed as conventional squatting or as whole body vibration exercise. To investigate if the repeated biopsy sampling has a confounding effect on the observed changes in gene expression, four fine needle biopsies from one vastus lateralis muscle were also taken from 8 male nonexercising control subjects (24.5 ± 3.7 yr, 180.6 ± 1.2 cm, 81.2 ± 1.6 kg) at the equivalent time points. Using RT-PCR, we observed similar patterns of change in the squatting as well as in the control group for the mRNAs of interleukin 6 (IL-6), IL-6 receptor, insulin-like growth factor 1, p21, phosphofructokinase, and glucose transporter in relation to the baseline biopsy. In conclusion, multiple fine needle biopsies obtained from the same muscle region can per se influence the expression of marker genes induced by an acute bout of resistance exercise.     

Effects of various midsole densities of basketball shoes on impact attenuation during landing activities

The purpose of this study was to examine effects of shoe midsole densities and mechanical demands (landing heights) on impact shock attenuation and lower extremity biomechanics during a landing activity. Nine healthy male college athletes performed 5 trials of step-off landing in each of 9 test conditions, i.e., a combination of landings in shoes of 3 midsole densities (soft, normal, hard) from each of 3 landing potential energy (PE) levels (low, median, high). Ground reaction forces (GRF), accelerations (ACC) of the tibia and forehead, and sagittal kinematic data were sampled simultaneously. A 3 x 3 two-way (surface x height) repeated-measures analysis of variance (ANOVA) was performed on selected kinematic, ACC, and GRF variables; a 3 x 3 x 3 three-way (surface x height x joint) ANOVA was performed on variables related to eccentric muscular work. The GRF results showed that the forefoot peak GRF in the normal and hard midsoles was significantly greater than the soft midsole at the low and median PEs. Rearfoot peak GRF was significantly greater for the hard midsole than for the soft and normal midsoles at the median and high PEs, respectively. The peak head and tibia peak ACC were also attenuated in similar fashion. Kinematic variables did not vary significantly across different midsoles, nor did energy absorbed through lower extremity extensors in response to the increased shoe stiffness. Knee joint extensors were shown to be dominant in attenuating the forefoot impact force across the landing heights. The results showed limited evidence of impact-attenuating benefits of the soft midsole in the basketball shoes.     

Creatine supplementation and its effect on musculotendinous stiffness and performance

Anecdotal reports suggesting that creatine (Cr) supplementation may cause side effects, such as an increased incidence of muscle strains or tears, require scientific examination. In this study, it was hypothesized that the rapid fluid retention and "dry matter growth" evident after Cr supplementation may cause an increase in musculotendinous stiffness. Intuitively, an increase in musculotendinous stiffness would increase the chance of injury during exercise. Twenty men were randomly allocated to a control or an experimental group and were examined for musculotendinous stiffness of the triceps surae and for numerous performance indices before and after Cr ingestion. The Cr group achieved a significant increase in body mass (79.7 +/- 10.8 kg vs. 80.9 +/- 10.7 kg), counter movement jump height (40.2 +/- 4.8 cm vs. 42.7 +/- 5.9 cm), and 20-cm drop jump height (32.3 +/- 3.3 cm vs. 35.1 +/- 4.8 cm) after supplementation. No increase was found for musculotendinous stiffness at any assessment load. There were no significant changes in any variables within the control group. These findings have both performance- and injury-related implications. Primarily, anecdotal evidence suggesting that Cr supplementation causes muscular strain injuries is not supported by this study. In addition, the increase in jump performance is indicative of performance enhancement in activities requiring maximal power output.     

Quantifying plyometric intensity via rate of force development, knee joint, and ground reaction forces

Because the intensity of plyometric exercises usually is based simply upon anecdotal recommendations rather than empirical evidence, this study sought to quantify a variety of these exercises based on forces placed upon the knee. Six National Collegiate Athletic Association Division I athletes who routinely trained with plyometric exercises performed depth jumps from 46 and 61 cm, a pike jump, tuck jump, single-leg jump, countermovement jump, squat jump, and a squat jump holding dumbbells equal to 30% of 1 repetition maximum (RM). Ground reaction forces obtained via an AMTI force plate and video analysis of markers placed on the left hip, knee, lateral malleolus, and fifth metatarsal were used to estimate rate of eccentric force development (E-RFD), peak ground reaction forces (GRF), ground reaction forces relative to body weight (GRF/BW), knee joint reaction forces (K-JRF), and knee joint reaction forces relative to body weight (K-JRF/BW) for each plyometric exercise. One-way repeated measures analysis of variance indicated that E-RFD, K-JRF, and K-JRF/BW were different across the conditions (p < 0.05), but peak GRF and GRF/BW were not (p > 0.05). Results indicate that there are quantitative differences between plyometric exercises in the rate of force development during landing and the forces placed on the knee, though peak GRF forces associated with landing may not differ.     

Landing from different heights: Biomechanical and neuromuscular strategies in trained gymnasts and untrained prepubescent girls

The purpose of this study was to examine the biomechanics of the lower limb, during landing in female prepubertal gymnasts and prepubertal untrained girls, aged 9–12 years. Ten healthy participants were included in each group and performed five landings from 20, 40, and 60 cm. Kinematics, ground reaction forces (GRF) and electromyogram (EMG) from the lateral gastrocnemius, tibialis anterior, and vastus lateralis are presented. Gymnasts had higher vertical GRF and shorter braking phase during landing. Compared to untrained girls, gymnasts exhibited for all examined drop heights more knee flexion before and at ground contact, but less knee flexion at maximum knee flexion position. Especially when increasing drop heights the gymnasts activated their examined muscles earlier, and generally they had higher pre- and post landing EMG amplitudes normalized to the peak EMG at 60 cm drop height. Furthermore, gymnasts had lower antagonist EMG for the tibialis anterior compared to untrained girls, especially when landing from higher heights. It is concluded that the landing strategy preferred by gymnasts is influenced by long-term and specialized training and induces a stiffer landing pattern. This could have implications in injury prevention, which requires further investigation.     

The influence of foot position on body dynamics

During locomotion, the human body exhibits inherent dynamic properties such as mass (M), stiffness (K) and damping (B). During the gait cycle, foot contact with the ground progresses from the heel to the toe. Contact forces between the foot and ground are defined as ground reaction forces (GRF). It is unclear how body dynamics are affected by foot landing position. If the shape of GRF is indicative of body dynamics, our understanding of gait patterns in normal and pathologic conditions may improve. The aims of this study were to determine:(1) whether foot landing position affects the inherent dynamics of the human body and (2) the extent to which the GRF curve reflects the response of inherent body dynamics to sudden loading.Eight non-disabled control volunteers performed a series of small jumps and landed on one leg with a fully extended knee in three foot landing positions: heel, mid-foot, and toe. They then walked at self-paced velocity over force plates. For each foot landing position, values of K, B and the dimensionless damping coefficient, ξ, were calculated from the period of vertical body oscillations, T, and compared with an ANOVA test. In addition, the time between the two peaks of the vertical GRF, T_GRF, was compared with T. We found that that K and B decreased and ξ did not change (p<0.01) between heel to toe-landing positions. T_GRF was not different than T for the toe-landing position, which suggests that the dynamic body response has major impact on the shape of GRF.     

Subcutaneous treatment with growth hormone-releasing hormone for short stature

In the present study we report the effects of therapy with growth hormone-releasing factor (1-29)NH2 (GRF) on growth rate, plasma levels of insulin growth factor I (IGF-I) and growth hormone (GH) secretion in 11 children who were selected solely on the basis of their short stature and normal GH secretion on standard provocative tests. All children received GRF for 6 months (5 micrograms/kg body weight subcutaneously) each evening. The 24-hour GH secretory profile was studied before and after 6 months of treatment. Simultaneously, GH secretory responses to single intravenous bolus GRF (1.5 micrograms/kg body weight) were also studied before, during, and 6 months off therapy with GRF(1-29)NH2. Plasma levels of IGF-I were measured before, during (1, 2 and 6 months), and after 6 months off therapy with GRF. Statural growth was measured at 3-month intervals. The peak plasma GH level in response to GRF was 56.04 +/- (SD) 24.46 ng/ml before treatment, and similar results were found after therapy. The 24-hour GH secretory profile did not show differences before, during, and after treatment. Comparably, no differences were found in GH pulse frequency, pulse amplitude, pulse height, pulse increment, pulse area and total area before, and 6 months off therapy with GRF. The increments in serum IGF-I achieved were not significantly different at all intervals studied. All patients increased growth velocities (mean +/- SD, cm/year) in response to GRF therapy. Our results demonstrate that GRF administration was effective in accelerating growth velocity in 11 children without GH deficiency.