Characterization of the shoulder net joint moment during manual wheelchair propulsion using four functional axes

Understanding how individuals distribute mechanical demand imposed on their upper extremity during physically demanding activities provides meaningful insights to preserve function and mitigate detrimental mechanical loading of the shoulder. In this study, we hypothesized that parameterization of the shoulder net joint moment using four functional axes could characterize distribution tendencies about the shoulder during manual wheelchair propulsion and that regardless of demographics, a shoulder flexor dominant NJM distribution would be predominantly used by individuals with paraplegia (n = 130). Forces and kinematics of the upper extremity and trunk were quantified using motion capture and an instrumented wheel during steady state manual wheelchair propulsion at self-selected fast speeds on a stationary ergometer. The results indicate that parsing out the internal/external rotation component of the shoulder net joint moment about the upper arm and distributing the remainder across the three orthogonal axes of the torso was successful in identifying common shoulder net joint moment distribution techniques used across individuals with paraplegia during manual wheelchair propulsion. Distribution tendencies were predominantly flexor dominant across injury level, gender, time since injury, body mass index, and height demographics. The 4-axis parameterization of the shoulder NJM effectively differentiated moment distribution tendencies used by individuals during manual wheelchair propulsion using a functionally relevant representation of shoulder kinetics. Use of the four-axis parameterization of joint kinetics in future studies is expected to provide important insights that can advance knowledge, preserve function, and inform clinical decisions.     

Frontal plane moments do not accurately reflect ankle dynamics during running

The ankle joint has typically been treated as a universal joint with moments calculated about orthogonal axes and the frontal plane moment generally used to represent the net muscle action about the subtalar joint. However, this joint acts about an oblique axis. The purpose of this study was to examine the differences between joint moments calculated about the orthogonal frontal plane axis and an estimated subtalar joint axis. Three-dimensional data were collected on 10 participants running at 3.6 m/s. Joint moments, power, and work were calculated about the orthogonal frontal plane axis of the foot and about an oblique axis representing the subtalar joint. Selected parameters were compared with a paired t-test (alpha = 0.05). The results indicated that the joint moments calculated about the two axes were characteristically different. A moment calculated about an orthogonal frontal plane axis of the foot resulted in a joint moment that was invertor in nature during the first half of stance, but evertor during the second half of stance. The subtalar joint axis moment, however, was invertor during most of the stance. These two patterns may result in qualitatively different interpretations of the muscular contributions at the ankle during the stance phase of running.     

A new non-orthogonal decomposition method to determine effective torques for three-dimensional joint rotation

This paper describes a new non-orthogonal decomposition method to determine effective torques for three-dimensional (3D) joint rotation. A rotation about a joint coordinate axis (e.g. shoulder internal/external rotation) cannot be explained only by the torque about the joint coordinate axis because the joint coordinate axes usually deviate from the principal axes of inertia of the entire kinematic chain distal to the joint. Instead of decomposing torques into three orthogonal joint coordinate axes, our new method decomposes torques into three "non-orthogonal effective axes" that are determined in such a way that a torque about each effective axis produces a joint rotation only about one of the joint coordinate axes. To demonstrate the validity of this new method, a simple internal/external rotation of the upper arm with the elbow flexed at 90 degrees was analyzed by both orthogonal and non-orthogonal decomposition methods. The results showed that only the non-orthogonal decomposition method could explain the cause-effect mechanism whereby three angular accelerations at the shoulder joint are produced by the gravity torque, resultant joint torque, and interaction torque. The proposed method would be helpful for biomechanics and motor control researchers to investigate the manner in which the central nervous system coordinates the gravity torque, resultant joint torque, and interaction torque to control 3D joint rotations.     

Three-dimensional knee joint loading during seated cycling.

The hypothesis which motivated the work reported in this article was that neglecting pure moments developed between the foot and pedal during cycling leads to a substantial error in computing axial and varus/valgus moments at the knee. To test this hypothesis, a mathematical procedure was developed for computing the three-dimensional knee loads using three-dimensional pedal forces and moments. In addition to data from a six-load-component pedal dynamometer, the model used pedal position and orientation and knee position in the frontal plane to determine the knee joint loads. Experimental data were collected from the right leg of 11 male subjects during steady-state cycling at 90 rpm and 225 W. The mean peak varus knee moment calculated was 15.3 N m and the mean peak valgus knee moment was 11.2 N m. Neglecting the pedal moment about the anterior/posterior axis resulted in an average absolute error of 2.6 N m and a maximum absolute error of 4.0 N m in the varus/valgus knee moment. The mean peak internal and external axial knee moments were 2.8 N m and 2.3 N m, respectively. The average and maximum absolute errors in the axial knee moment for not including the moment about an axis normal to the pedal were found to be 2.6 N m and 5.0 N m, respectively. The results strongly support the use of three-dimensional pedal loads in the computation of knee joint moments out of the sagittal plane.     

Shoulder joint kinetics and dynamics during underwater forward arm elevation

Aquatic exercises are widely implemented into rehabilitation programs. However, both evaluating their mechanical demands on the musculoskeletal system and designing protocols to provide progressive loading are difficult tasks. This study reports for the first time shoulder joint kinetics and dynamics during underwater forward arm elevation performed at speeds ranging from 22.5 to 90°/s. Net joint moments projected onto anatomical axes of rotation, joint power, and joint work were calculated in 18 participants through a novel approach coupling numerical fluid flow simulations and inverse dynamics. Joint dynamics was revealed from the 3D angle between the joint moment and angular velocity vectors, identifying three main functions—propulsion, stabilization, and resistance. Speeds <30°/s necessitated little to no power at all, whereas peaks about 0.20 W⋅kg⁻¹ were seen at 90°/s. As speed increased, peak moments were up to 61 × higher at 90 than at 22.5°/s, (1.82 ± 0.12%BW⋅AL vs 0.03 ± 0.01%BW⋅AL, P < 0.038). This was done at the expense of a substantial decrease in the joint moment contribution to joint stability though, which goes against the intuition that greater stabilization is required to protect the shoulder from increasing loads. Slow arm elevations (<30°/s) are advantageous for joint mobility gain at low mechanical solicitation, whereas the intensity at 90°/s is high enough to stimulate muscular endurance improvements. Simple predictive equations of shoulder mechanical loading are provided. They allow for easy design of progressive protocols, either for the postoperative shoulder or the conditioning of athlete targeting very specific intensity regions.     

ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion--part I: ankle, hip, and spine. International Society of Biomechanics

The Standardization and Terminology Committee (STC) of the International Society of Biomechanics (ISB) proposes a general reporting standard for joint kinematics based on the Joint Coordinate System (JCS), first proposed by Grood and Suntay for the knee joint in 1983 (J. Biomech. Eng. 105 (1983) 136). There is currently a lack of standard for reporting joint motion in the field of biomechanics for human movement, and the JCS as proposed by Grood and Suntay has the advantage of reporting joint motions in clinically relevant terms. In this communication, the STC proposes definitions of JCS for the ankle, hip, and spine. Definitions for other joints (such as shoulder, elbow, hand and wrist, temporomandibular joint (TMJ), and whole body) will be reported in later parts of the series. The STC is publishing these recommendations so as to encourage their use, to stimulate feedback and discussion, and to facilitate further revisions. For each joint, a standard for the local axis system in each articulating bone is generated. These axes then standardize the JCS. Adopting these standards will lead to better communication among researchers and clinicians.     

Biomechanical model and evaluation of a linear motion squat type exercise

A biomechanical model of a squat exercise performed on a device using a bar that is restricted to a linear motion was developed. Hip and knee moments were evaluated at varying foot positions. The range of motion of the exercise was limited by the knee joint angle beginning at an 80 degrees angle (flexed) to a 179 degrees joint angle (extended). Variations in foot placement were evaluated for differences in torque applied about the transverse axes of the user's knee and hip joints. Because the user's feet were positioned farther forward (anterior), the moment about the knee decreased whereas the moment about the hip increased. Positive moments were those that resulted in forces to flex the knee and hip joints. Positive knee moments were determined in all conditions when the knee was flexed and became negative when the knee was at or near full extension. The model always produced positive moments about the hip. Thus, foot position is a critical factor in hip and knee moments, and therefore in the muscle groups stressed, in a linear motion squat type exercise.     

Expressing the joint moments of drop jumps and sidestep cutting in different reference frames – does it matter?

Joint moments help us understand joint loading and muscle function during movement. However, the interpretation depends on the choice of reference frame, but the different reference frames have not been compared in dynamic, high-impact sporting movements. We have compared the magnitude and the resulting ranking of hip and knee joint moments expressed in the laboratory coordinate system, the local system of the distal segment and projected or decomposed to the Joint Coordinate System (JCS) axes. Hip and knee joint moments of drop jumps and sidestep cutting in 70 elite female handball players were calculated based on recordings from an eight-camera 240 Hz system and two force platforms and expressed with the four methods. The greatest variations in magnitude between conditions were seen for drop jump hip internal rotation (range: 0.31–0.71 Nm/kg) and sidestep cutting knee flexion (2.87–3.39 Nm/kg) and hip internal rotation (0.87–2.36 Nm/kg) and knee internal rotation (0.10–0.40 Nm/kg) moments. The rank correlations were highest between conditions for flexion moments (0.88–1.00) and sidestep cutting abduction moments (0.71–0.98). The rank correlations ranged from 0.64 to 0.73 for drop jump knee abduction moments and between −0.17 and 0.67 for hip and knee internal rotation moments. Expression of joint moments in different reference systems affects the magnitude and ranking of athletes. This lack of consistency may complicate the comparison and combination of results. Projection to the JCS is the only method where joint moments correspond to muscle and ligament loading. More widespread adoption of this convention could facilitate comparison of studies and ease the interpretation of results.     

Loading of the knee joint during activities of daily living measured in vivo in five subjects

Detailed knowledge about loading of the knee joint is essential for preclinical testing of implants, validation of musculoskeletal models and biomechanical understanding of the knee joint. The contact forces and moments acting on the tibial component were therefore measured in 5 subjects in vivo by an instrumented knee implant during various activities of daily living.Average peak resultant forces, in percent of body weight, were highest during stair descending (346% BW), followed by stair ascending (316% BW), level walking (261% BW), one legged stance (259% BW), knee bending (253% BW), standing up (246% BW), sitting down (225% BW) and two legged stance (107% BW). Peak shear forces were about 10–20 times smaller than the axial force. Resultant forces acted almost vertically on the tibial plateau even during high flexion. Highest moments acted in the frontal plane with a typical peak to peak range ?2.91% BWm (adduction moment) to 1.61% BWm (abduction moment) throughout all activities. Peak flexion/extension moments ranged between ?0.44% BWm (extension moment) and 3.16% BWm (flexion moment). Peak external/internal torques lay between ?1.1% BWm (internal torque) and 0.53% BWm (external torque).The knee joint is highly loaded during daily life. In general, resultant contact forces during dynamic activities were lower than the ones predicted by many mathematical models, but lay in a similar range as measured in vivo by others. Some of the observed load components were much higher than those currently applied when testing knee implants.     

Three-dimensional model of the feline hindlimb

This article describes a three-dimensional musculoskeletal model of the feline hindlimb based on digitized musculoskeletal anatomy. The model consists of seven degrees of freedom: three at the hip and two each at the knee and ankle. Lines of action and via points for 32 major muscles of the limb are described. Interspecimen variability of muscle paths was surprisingly low; most via points displayed a scatter of only a few millimeters. Joint axes identified by mechanical techniques as noncoincident and nonorthogonal were further honed to yield moment arms consistent with previous reports. Interspecimen variability in joint axes was greater than that of muscle paths and highlights the importance of joint axes in kinematic models. The contribution of specific muscles to the direction of endpoint force generation is discussed.     

Fatigue effects on the coordinative pattern during cycling: Kinetics and kinematics evaluation

The aim of the present study was to analyze the net joint moment distribution, joint forces and kinematics during cycling to exhaustion. Right pedal forces and lower limb kinematics of ten cyclists were measured throughout a fatigue cycling test at 100% of PO_MAX. The absolute net joint moments, resultant force and kinematics were calculated for the hip, knee and ankle joint through inverse dynamics. The contribution of each joint to the total net joint moments was computed. Decreased pedaling cadence was observed followed by a decreased ankle moment contribution to the total joint moments in the end of the test. The total absolute joint moment, and the hip and knee moments has also increased with fatigue. Resultant force was increased, while kinematics has changed in the end of the test for hip, knee and ankle joints. Reduced ankle contribution to the total absolute joint moment combined with higher ankle force and changes in kinematics has indicated a different mechanical function for this joint. Kinetics and kinematics changes observed at hip and knee joint was expected due to their function as power sources. Kinematics changes would be explained as an attempt to overcome decreased contractile properties of muscles during fatigue.     

Coordination of the leg muscles in backlift and leglift.

Net joint moments are often used to quantify the loading of structures (e.g. the intervertebral disc at L5S1) during lifting. This quantification method is also used to evaluate the loading of the knee, for instance, to determine the effect of backlifting as opposed to leglifting. However, the true loading of the joint as derived from net joint moments can be obscured by a possible co-contraction of antagonists. To unravel the mechanisms that determine the net joint moments in the knee, the leglift was compared to the backlift. Although a completely different net knee moment curve was found when comparing the two lifting techniques, it appeared to be closely related to the ground reaction force vector and its orientation with respect to the joint centre of rotation (R > 0.995). This close relation was established by co-contraction of both flexors and extensors of the knee. Furthermore, a close relation appeared to exist between the joint moment difference between hip and knee and the activity difference between rectus femoris muscle and hamstring (R = 0.72 and 0.83 in leglift and backlift, respectively). The knee-ankle joint moment difference and the activity of the gastrocnemius showed a close relation as well (R = -0.89 and 0.96 in leglift and backlift, respectively). These relations can be interpreted as a mechanism to distribute net moments across joints. It is concluded that during lifting tasks the intermuscular coordination is aimed at coupling of joint moments, such that the ground reaction force points in a direction that provides balance during the movement. The use of net joint moments as direct indicators for joint loading (e.g. knee) seems, therefore, questionable.     

ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion--Part II: shoulder, elbow, wrist and hand

In this communication, the Standardization and Terminology Committee (STC) of the International Society of Biomechanics proposes a definition of a joint coordinate system (JCS) for the shoulder, elbow, wrist, and hand. For each joint, a standard for the local axis system in each articulating segment or bone is generated. These axes then standardize the JCS. The STC is publishing these recommendations so as to encourage their use, to stimulate feedback and discussion, and to facilitate further revisions. Adopting these standards will lead to better communication among researchers and clinicians.     

Modeling the stance leg in two-dimensional analyses of sprinting: inclusion of the MTP joint affects joint kinetics

Two-dimensional analyses of sprint kinetics are commonly undertaken but often ignore the metatarsalphalangeal (MTP) joint and model the foot as a single segment. Due to the linked-segment nature of inverse dynamics analyses, the aim of this study was to investigate the effect of ignoring the MTP joint on the calculated joint kinetics at the other stance leg joints during sprinting. High-speed video and force platform data were collected from four to five trials for each of three international athletes. Resultant joint moments, powers, and net work at the stance leg joints during the first stance phase after block clearance were calculated using three different foot models. By ignoring the MTP joint, peak extensor moments at the ankle, knee, and hip were on average 35% higher (p < .05 for each athlete), 40% lower (p < .05), and 9% higher (p > .05), respectively, than those calculated with the MTP joint included. Peak ankle and knee joint powers and net work at all joints were also significantly (p < .05) different. By ignoring a genuine MTP joint plantar flexor moment, artificially high peak ankle joint moments are calculated, and these also affect the calculated joint kinetics at the knee.     

Resultant lower extremity joint moments in below-knee amputees during running stance

Resultant flexion/extension lower extremity joint moments of four below-knee amputees running between 2.5 and 5.7 m s-1 were computed during stance on their intact and prosthetic limbs. All subjects wore patellar tendon-bearing prostheses with either a SACH or Greissinger foot component. During stance on the prosthesis, the resultant hip extensor moment on the amputated side was greater in magnitude and duration than its counterpart on the intact limb during its corresponding stance period. Since the artificial foot was planted on the ground, such a moment may help control knee flexion and promote knee extension of the residual limb. For the three subjects whose knees continued to flex at the beginning of stance, there was a dominant extensor moment about the knee joint during stance on the prosthesis. By contrast, for the fourth subject whose knee remained straight or hyperextended throughout stance on the prosthesis, a flexor moment was dominant.     

Knee joint passive stiffness and moment in sagittal and frontal planes markedly increase with compression

Knee joints are subject to large compression forces in daily activities. Due to artefact moments and instability under large compression loads, biomechanical studies impose additional constraints to circumvent the compression position–dependency in response. To quantify the effect of compression on passive knee moment resistance and stiffness, two validated finite element models of the tibiofemoral (TF) joint, one refined with depth-dependent fibril-reinforced cartilage and the other less refined with homogeneous isotropic cartilage, are used. The unconstrained TF joint response in sagittal and frontal planes is investigated at different flexion angles (0°, 15°, 30° and 45°) up to 1800 N compression preloads. The compression is applied at a novel joint mechanical balance point (MBP) identified as a point at which the compression does not cause any coupled rotations in sagittal and frontal planes. The MBP of the unconstrained joint is located at the lateral plateau in small compressions and shifts medially towards the inter-compartmental area at larger compression forces. The compression force substantially increases the joint moment-bearing capacities and instantaneous angular rigidities in both frontal and sagittal planes. The varus–valgus laxities diminish with compression preloads despite concomitant substantial reductions in collateral ligament forces. While the angular rigidity would enhance the joint stability, the augmented passive moment resistance under compression preloads plays a role in supporting external moments and should as such be considered in the knee joint musculoskeletal models.     

Walking on high heels changes muscle activity and the dynamics of human walking significantly

The aim of the study was to investigate the distribution of net joint moments in the lower extremities during walking on high-heeled shoes compared with barefooted walking at identical speed. Fourteen female subjects walked at 4 km/h across three force platforms while they were filmed by five digital video cameras operating at 50 frames/second. Both barefooted walking and walking on high-heeled shoes (heel height: 9 cm) were recorded. Net joint moments were calculated by 3D inverse dynamics. EMG was recorded from eight leg muscles. The knee extensor moment peak in the first half of the stance phase was doubled when walking on high heels. The knee joint angle showed that high-heeled walking caused the subjects to flex the knee joint significantly more in the first half of the stance phase. In the frontal plane a significant increase was observed in the knee joint abductor moment and the hip joint abductor moment. Several EMG parameters increased significantly when walking on high-heels. The results indicate a large increase in bone-on-bone forces in the knee joint directly caused by the increased knee joint extensor moment during high-heeled walking, which may explain the observed higher incidence of osteoarthritis in the knee joint in women as compared with men.     

A joint coordinate system proposal for the study of the trapeziometacarpal joint kinematics

The International Society of Biomechanics (ISB) has recommended a standardisation for the motion reporting of almost all human joints. This study proposes an adaptation for the trapeziometacarpal joint. The definition of the segment coordinate system of both trapezium and first metacarpal is based on functional anatomy. The definition of the joint coordinate system (JCS) is guided by the two degrees of freedom of the joint, i.e. flexion-extension about a trapezium axis and abduction-adduction about a first metacarpal axis. The rotations obtained using three methods are compared on the same data: the fixed axes sequence proposed by Cooney et al., the mobile axes sequence proposed by the ISB and our alternative mobile axes sequence. The rotation amplitudes show a difference of 9 degrees in flexion-extension, 2 degrees in abduction-adduction and 13 degrees in internal-external rotation. This study emphasizes the importance of adapting the JCS to the functional anatomy of each particular joint.     

Altered control strategy between leading and trailing leg increases knee adduction moment in the elderly while descending stairs

The aim of the study was to examine the external knee adduction moments in a group of older and younger adults while descending stairs and thus the possibility of an increased risk of knee osteoarthritis due to altered knee joint loading in the elderly. Twenty-seven older and 16 younger adults descended a purpose-built staircase. A motion capture system and a force plate were used to determine the subjects' 3D kinematics and ground reaction forces (GRF) during locomotion. Calculation of the leg kinematics and kinetics was done by means of a rigid, three-segment, 3D leg model. In the initial portion of the support phase, older adults showed a more medio-posterior GRF vector relative to the ankle joint, leading to lower ankle joint moments (P<0.05). At the knee, the older adults demonstrated a more medio-posterior directed GRF vector, increasing in knee flexion and adduction in the second part of the single support phase (P<0.05). Further, GRF magnitude was lower in the initial and higher in the mid-portions of the support phase for the elderly (P<0.05). The results show that older adults descend stairs by using the trailing leg before the initiation of the double support phase more compared to the younger ones. The consequence of this altered control strategy while stepping down is a more medially directed GRF vector increasing the magnitude of external knee adduction moment in the elderly. The observed changes between leading and trailing leg in the elderly may cause a redistribution of the mechanical load at the tibiofemoral joint, affecting the initiation and progression of knee osteoarthritis in the elderly.