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.     

Age and gender differences in peak lower extremity joint torques and ranges of motion used during single-step balance recovery from a forward fall.

Previous studies have found substantial age and gender group differences in the ability of healthy adults to regain balance with a single step after a forward fall. It was hypothesized that differences in lower extremity joint strengths and ranges of motion (ROM) may have contributed to these observed differences. Kinematic and forceplate data were therefore used with a rigid-link biomechanical model simulating stepped leg dynamics to examine the joint torques and ROM used by subjects during successful single-step balance recoveries after release from a forward lean. The peak ROM and torques used by subjects in the study were compared to published estimates or measured values of the available maxima. No significant age or gender group differences were found in the mean ROM used by the subjects for any given initial lean angle. As initial lean angle increased, larger knee ROM and significantly larger hip ROM were used in the successful recoveries. There were substantial gender differences and some age group differences in peak lower extremity joint torques used in successful recoveries. Both young and older females often used nearly maximal joint torques to recover balance. Subjects' maximum joint strengths in plantarflexion and hip flexion were not good predictors of single-step balance recovery ability, particularly among the female subjects.     

The role of strength in rising from a chair in the functionally impaired elderly

Rising from a chair is a task essential for independent living. Many elderly persons have difficulty with this task. Previous studies have drawn conflicting conclusions as to the role of strength in limiting the ability to rise from a chair. The purpose of this study is to determine the role of knee extensor strength in rising from a chair in the functionally impaired elderly. It is hypothesized that knee extensor strength limits the minimum chair height from which a subject can rise in the functionally impaired elderly, but not in the young. Studying both young healthy adults and functionally impaired elderly showed that required joint moment increased monotonically with decreasing chair height. Further, the elderly used significantly more of their available strength to rise from any chair height, and their mean required knee moment was 97% of the available strength when rising from the lowest chair height from which they could successfully rise. These data suggest that strength is a limiting factor in determining the minimum chair height from which the functionally impaired elderly may rise     

Muscle pre- and coactivity during downward stepping are associated with leg stiffness in aging.

We have previously reported that elderly compared to young women executed downward stepping with substantially greater leg stiffness. Because antagonist muscle coactivity increases joint stiffness we hypothesized that increased leg stiffness in aging is associated with increased muscle coactivity. We also explored the possibility that the magnitude of the preparatory muscle activity preceding impact also differed between young and old subjects. Young (n=11, 20. 8 yr) and old (n=12, 69 yr) women performed downward stepping from a platform set at 20% body height. The leg was modeled as a simple mass-spring system. From video and ground reaction force data leg stiffness was computed as the ratio of force under the foot and the linear shortening of the limb. EMG activity of the vastus lateralis, biceps femoris, gastrocnemius lateralis, and tibialis anterior were recorded with a telemetric system. Elders compared to young subjects had 64% greater leg stiffness during downward stepping. Muscle activity over a 200-ms period preceding touch down was 136% greater in elderly than in young subjects. Biceps femoris and tibialis anterior coactivity during ground contact was 120% greater in the elders. Muscle pre- and coactivity, respectively, accounted for about 50% of the variance in leg stiffness. In conclusion, elderly people elevate muscle pre- and coactivity during downward stepping to stiffen the leg in compensation for impaired neuromotor functions.     

Estimating in vivo passive forces of the index finger muscles: Exploring model parameters

We compared predicted passive finger joint torques from a biomechanical model that includes the exponential passive muscle force–length relationship documented in the literature with finger joint torques estimated from measures in ten adult volunteers. The estimated finger joint torques were calculated from measured right index fingertip force, joint postures, and anthropometry across 18 finger and wrist postures with the forearm muscles relaxed. The biomechanical model predicting passive finger joint torques included three extrinsic and three intrinsic finger muscles. The values for the predicted passive joint torques were much larger than the values calculated from the fingertip force and posture measures with an average RMS error of 7.6 N cm. Sensitivity analysis indicated that the predicted joint torques were most sensitive to passive force–length model parameters compared to anthropometric and postural parameters. Using Monte Carlo simulation, we determined a new set of values for the passive force–length model parameters that reduced the differences between the joint torques calculated from the two methods to an average RMS value of 0.5 N cm, a 94% average improvement of error from the torques predicted using the existing data. These new parameter values did vary across individuals; however, using an average set for the parameter values across subjects still reduced the average RMS difference to 0.8 N cm. These new parameters may improve dynamic modeling of the finger during sub-maximal force activities and are based on in vivo data rather than traditional in vitro data.     

Age causes a redistribution of joint torques and powers during gait.

At self-selected walking speeds, elderly compared with young adults generate decreased joint torques and powers in the lower extremity. These differences may be actual gait-limiting factors and neuromuscular adaptations with age or simply a consciously selected motor pattern to produce a slower gait. The purpose of the study was to compare joint torques and powers of young and elderly adults walking at the same speed. Twelve elderly and fourteen young adults (ages 69 and 21 yr) walked at 1.48 m/s over a force platform while being videotaped. Hip, knee, and ankle torques and powers were calculated from the reaction force and kinematic data. A support torque was calculated as the sum of the three joint torques. Extensor angular impulse during stance and positive work at each joint were derived from the torques and powers. Step length was 4% shorter and cadence was 4% higher in elderly adults (both P < 0.05) compared with young adults. Support angular impulse was nearly identical between groups, but elderly adults had 58% greater angular impulse and 279% more work at the hip, 50% less angular impulse and 39% less work at the knee, and 23% less angular impulse and 29% less work at the ankle compared with young adults (t-test, all P < 0.05). Age caused a redistribution of joint torques and powers, with the elderly using their hip extensors more and their knee extensors and ankle plantar flexors less than young adults when walking at the same speed. Along with a reduction in motor and sensory functions, the natural history of aging causes a shift in the locus of function in motor performance.     

The effect of the partially restricted sit-to-stand task on biomechanical variables in subjects with and without Parkinson’s disease

The aim of this study was to explore the electromyographic, kinetic and kinematic patterns during a partially restricted sit-to-stand task in subjects with and without Parkinson’s disease (PD). If the trunk is partially restricted, different behavior of torques and muscle activities could be found and it can serve as a reference of the deterioration in the motor performance of subjects with PD. Fifteen subjects participated in this study and electromyography (EMG) activity of the tibialis anterior (TA), soleus (SO), vastus medialis oblique (VMO), biceps femoris (BF) and erector spinae (ES) were recorded and biomechanical variables were calculated during four phases of the movement. Subjects with PD showed more flexion at the ankle, knee and hip joints and increased knee and hip joint torques in comparison to healthy subjects in the final position. However, these joint torques can be explained by the differences in kinematic data. Also, the hip, knee and ankle joint torques were not different in the acceleration phase of movement. The use of a partially restricted sit-to-stand task in PD subjects with moderate involvement leads to the generation of joint torques similar to healthy subjects. This may have important implications for rehabilitation training in PD subjects.     

Not All Is Lost: Old Adults Retain Flexibility in Motor Behaviour during Sit-to-Stand

Sit-to-stand is a fundamental activity of daily living, which becomes increasingly difficult with advancing age. Due to severe loss of leg strength old adults are required to change the way they rise from a chair and maintain stability. Here we examine whether old compared to young adults differently prioritize task-important performance variables and whether there are age-related differences in the use of available motor flexibility. We applied the uncontrolled manifold analysis to decompose trial-to-trial variability in joint kinematics into variability that stabilizes and destabilizes task-important performance variables. Comparing the amount of variability stabilizing and destabilizing task-important variables enabled us to identify the variable of primary importance for the task. We measured maximal isometric voluntary force of three muscle groups in the right leg. Independent of age and muscle strength, old and young adults similarly prioritized stability of the ground reaction force vector during sit-to-stand. Old compared to young adults employed greater motor flexibility, stabilizing ground reaction forces during sit-to-sand. We concluded that freeing those degrees of freedom that stabilize task-important variables is a strategy used by the aging neuromuscular system to compensate for strength deficits.     

Do patients with diabetic neuropathy use a higher proportion of their maximum strength when walking?

Diabetic patients have an altered gait strategy during walking and are known to be at high risk of falling, especially when diabetic peripheral neuropathy is present. This study investigated alterations to lower limb joint torques during walking and related these torques to maximum strength in an attempt to elucidate why diabetic patients are more likely to fall. 20 diabetic patients with moderate/severe peripheral neuropathy (DPN), 33 diabetic patients without peripheral neuropathy (DM), and 27 non-diabetic controls (Ctrl) underwent gait analysis using a motion analysis system and force plates to measure kinetic parameters. Lower limb peak joint torques and joint work done (energy expenditure) were calculated during walking. The ratio of peak joint torques and individual maximum joint strengths (measured on a dynamometer) was then calculated for 59 of the 80 participants to yield the ‘operating strength’ for those participants. During walking DM and DPN patients showed significantly reduced peak torques at the ankle and knee. Maximum joint strengths at the knee were significantly less in both DM and DPN groups than Ctrls, and for the DPN group at the ankle. Operating strengths were significantly higher at the ankle in the DPN group compared to the Ctrls. These findings show that diabetic patients walk with reduced lower limb joint torques; however due to a decrement in their maximum ability at the ankle and knee, their operating strengths are higher. This allows less reserve strength if responding to a perturbation in balance, potentially increasing their risk of falling.     

The influence of sagittal center of pressure offset on gait kinematics and kinetics

ObjectivesKinetic patterns of the lower extremity joints have been shown to be influenced by modification of the location of the center of pressure (CoP) of the foot. The accepted theory is that a shifted location of the CoP alters the distance between the ground reaction force and the center of the joint, thereby modifying torques during gait. Various footwear designs have been reported to significantly alter the magnitude of sagittal joint torques during gait. However, the relationship between the CoP and the kinetic patterns in the sagittal plane has not been examined. The aim of this study was to evaluate the association between the sagittal location of the CoP and gait patterns during gait in healthy men.MethodsA foot-worn biomechanical device which allows controlled manipulation of the CoP location was utilized. Fourteen healthy men underwent successive gait analysis with the device set to convey three different sagittal locations of the CoP: neutral, anterior offset and posterior offset.ResultsCoP translation in the sagittal plane (i.e., from posterior to anterior) significantly related with an ankle dorsiflexion torque and a knee extension torque shift throughout the stance phase. Likewise, an anterior translation of the CoP significantly reduced the extension torque at the hip during pre-swing.ConclusionsThe study results confirm a direct correlation between sagittal offset of the CoP and the magnitude of joint torques throughout the lower extremity.     

Biomechanics of reactions to impending falls

Responses of 11 young adult males, initially standing, to support surface forward accelerations of 0.18 g were investigated. In response to the impending falls this stimulus initiated, body segment motions and myoelectric activities in six muscles were measured. These measurements were then input to 9 or 12 segment whole body biomechanical models and the reaction joint torques needed to produce the motions were calculated. Mean relative joint rotations were as large as 92.8 degrees and calculated relative joint angular accelerations as large as 29.7 rad s-2. Mean myoelectric signal latencies in the six muscles monitored ranged from 135 ms at the ankles to 176 ms at the shoulders with intermediate values at intermediate joints. Mean values of calculated maximum joint torques ranged to 70 Nm at the ankles, 82 Nm at the knees, 73 Nm at the hips, and 19 Nm at the shoulders.     

Power and work produced in different leg muscle groups when rising from a chair

The aim of this study was to determine the power output and work done by different muscle groups at the hip and knee joints during a rising movement, to be able to tell the degree of activation of the muscle groups and the relationship between concentric and eccentric work. Nine healthy male subjects rose from a chair with the seat at knee level. The moments of force about the hip and knee joints were calculated semidynamically. The power output (P) and work in the different muscle groups surrounding the joints was calculated as moment of force times joint angular velocity. Work was calculated as: work = f Pdt. The mean peak concentric power output was for the hip extensors 49.9 W, hip flexors 7.9 W and knee extensor 89.5 W. This power output corresponded to a net concentric work of 20.7 J, 1.0 J and 55.6 J, respectively. There was no concentric power output from the knee flexor muscles. Energy absorption through eccentric muscle action was produced by the hip extensors and hip flexors with a mean peak power output of 4.8 W and 7.4 W, respectively. It was concluded that during rising, the hip and knee muscles mainly worked concentrically and that the greatest power output and work were produced during concentric contraction of the knee and hip extensor muscles. There was however also a demand for eccentric work by the hip extensors as well as both concentric and eccentric work by the hip flexors. The knee flexor muscles were unloaded.     

Sitting movement in elderly subjects with and without Parkinson’s disease: A biomechanical study

The aim of the present study was to compare kinetic, kinematic, and electromyographic variables during the sitting movement between healthy elderly and in those with Parkinson’s disease (PD) with moderate involvement. We hypothesized that subjects with PD would show difficulty in selecting the muscles for the task and that this could be related to the co-activation pattern and would be reflected in the behavior of some biomechanical variables. Fifteen subjects participated in this study, seven healthy subjects (NN group) and eight with Parkinson’s disease. Electromyography (EMG) activity of the tibialis anterior (TA), soleus (SO), vastus medialis oblique (VMO), biceps femoris (BF), and erector spinae (ES) were recorded, and biomechanical variables were calculated, during four phases of the sitting movement. Compared to healthy subjects, the subjects with PD showed more flexion at the ankle, knee, and hip joints in the initial position and lower joint velocity. However, the EMG activity and hip, knee, and ankle joint torques were not different during all phases of movement. The sitting movement in PD subjects with moderate involvement generates EMG activity and joint torques similar to healthy elderly subjects. Only a reduced movement velocity was found in PD patients during the sitting task.     

Increased hip adductor activation during sit-to-stand improves muscle activation timing and rising-up mechanics in individuals with hemiparesis

Long sit-to-stand (STS) time has been identified as a feature of impaired functional mobility. The changes in biomechanics of STS performance with simultaneous hip adductor contraction have not been studied, which may limit indications for use of hip adductor activation during STS training.Ten individuals with hemiplegia (mean age 61.8 years, injury time 29.8 ± 15.2 months) performed the STS with and without squeezing a ball between two legs. The joint moments, ground reaction force (GRF), chair reaction force and movement durations and temporal index of electromyography were calculated from the control condition for comparison with those from the ball squeezing condition.Under the squeeze condition, reduced peak vertical GRF during the ascension phase with increased loading rate was observed in the nonparetic limb, and the peak knee extensor moment occurred earlier in the paretic. Earlier activation of tibialis anterior and gluteus maximus, and gluteus medius were found in squeeze STS.Squeezing a ball between limbs during STS increased the contraction timing of tibialis anterior, gluteus maximus, gluteus medius, and soleus as well as a more symmetric rising mechanics encourage the use of squeezing a ball between limbs during STS for individuals with hemiparesis.     

Age-related changes in the mechanical properties of the epimysium in skeletal muscles of rats

Skeletal muscle is composed of muscle fibers and an extracellular matrix (ECM). The collagen fiber network of the ECM is a major contributor to the passive force of skeletal muscles at high strain. We investigated the effect of aging on the biomechanical and structural properties of epimysium of the tibialis anterior muscles (TBA) of rats to understand the mechanisms responsible for the age-related changes. The biomechanical properties were tested directly in vitro by uniaxial extension of epimysium. The presence of age-related changes in the arrangement and size of the collagen fibrils in the epimysium was examined by scanning electron microscopy (SEM). A mathematical model was subsequently developed based on the structure-function relationships that predicted the compliance of the epimysium. Biomechanically, the epimysium from old rats was much stiffer than that of the young rats. No differences were found in the ultrastructure and thickness of the epimysium or size of the collagen fibrils between young and old rats. The changes in the arrangement and size of the collagen fibrils do not appear to be the principal cause of the increased stiffness of the epimysium from the old rats. Other changes in the structural composition of the epimysium from old rats likely has a strong effect on the increased stiffness. The age-related increase in the stiffness of the epimysium could play an important role in the impaired lateral force transmission in the muscles of the elderly.     

Effects of sagittal postural adjustments on seat reaction load

Wheelchair-dependent subjects often adopt a passive sitting posture and suffer from sitting acquired pressure ulcers (PU) that mainly occur when high buttock pressures sustain for a longer period of time. Body posture directly influences seating load and proper postural change is therefore essential. Many subjects cannot reposition themselves and seating systems that adjust sitting posture can regulate seating load and potentially diminish the risk to develop PU. We describe a mechanism for postural adjustments and investigated the influence of seat inclination (1), pelvis rotation (2) and chair recline (3) on buttock load. We developed an experimental simulator chair containing the concept to adjust body posture in the sagittal plane. Measurements involved quasi-static actuated chair movements in which chair configuration, buttock interface pressure and seating forces were simultaneously measured. Significant effects with high coefficients of determination (r(2)>0.8) were found for seating force, centre of pressure and sacral load. We conclude that a combination of independent pelvis rotation and seat inclination is effective to regulate the net buttock shear force and the sacral interface pressure in healthy subjects. Whether both techniques are also applicable in subjects without postural stability is still to be evaluated.     

A probabilistic method to estimate gait kinetics in the absence of ground reaction force measurements

Human joint torques during gait are usually computed using inverse dynamics. This method requires a skeletal model, kinematics and measured ground reaction forces and moments (GRFM). Measuring GRFM is however only possible in a controlled environment. This paper introduces a probabilistic method based on probabilistic principal component analysis to estimate the joint torques for healthy gait without measured GRFM. A gait dataset of 23 subjects was obtained containing kinematics, measured GRFM and joint torques from inverse dynamics in order to obtain a probabilistic model. This model was then used to estimate the joint torques of other subjects without measured GRFM. Only kinematics, a skeletal model and timing of gait events are needed. Estimation only takes 0.28 ms per time instant. Using cross-validation, the resulting root mean square estimation errors for the lower-limb joint torques are found to be approximately 0.1 Nm/kg, which is 6–18% of the range of the ground truth joint torques. Estimated joint torque and GRFM errors are up to two times smaller than model-based state-of-the-art methods. Model-free artificial neural networks can achieve lower errors than our method, but are less repeatable, do not contain uncertainty information on the estimates and are difficult to use in situations which are not in the learning set. In contrast, our method performs well in a new situation where the walking speed is higher than in the learning dataset. The method can for example be used to estimate the kinetics during overground walking without force plates, during treadmill walking without (separate) force plates and during ambulatory measurements.     

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.