Using force sensing insoles to predict kinetic knee symmetry during a stop jump

Knee kinetic asymmetries are present during jump-landings in athletes returning to sport following anterior cruciate ligament (ACL) reconstruction, and are associated with an increased risk for sustaining a second ACL injury. The loadsol® is a wireless load sensing insole that can be used in non-laboratory settings. The purpose of this study was to determine if the loadsol® could be used to predict knee extension moment and power symmetry during a bilateral stop jump task in healthy recreational athletes. Forty-two uninjured recreational athletes completed seven bilateral stop jumps. During each landing, the loadsol® (100 Hz) measured plantar load while 3D ground reaction forces (1920 Hz) and lower extremity kinematics (240 Hz) were collected simultaneously. Peak impact force, loading rate, and impulse were quantified using the loadsol® and peak knee extension moment, average knee extension moment, and total knee work was quantified using the laboratory instrumentation. Limb symmetry indices were quantified for each outcome measure. Multivariate backwards regressions were used to determine if loadsol® symmetry could predict knee kinetic symmetry. Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to determine the agreement and error between predicted and actual knee kinetic symmetry. Loadsol® impulse and peak impact force symmetry significantly predicted kinetic knee symmetry and explained 42–61% of its variance. There was good agreement (ICCs = 0.742–0.862) between predicted and actual knee kinetic symmetry, and the error in the predicted outcomes range from ±18 to ±43. These results support using the loadsol® to screen for kinetic symmetries during landing in athletes following ACL reconstruction.     

Test-retest reliability of EMG and peak torque during repetitive maximum concentric knee extensions.

The aim of this study was to investigate the reliability of peak torque and surface electromyography (EMG) variable's root mean square (RMS) and mean frequency (MNF) during an endurance test consisting of repetitive maximum concentric knee extensions. Muscle fatigue has been quantified in several ways, and in isokinetic testing it is based on a set of repetitive contractions. To assess test-retest reliability, two sets of 100 dynamic maximum concentric knee extensions were performed using an isokinetic dynamometer. The two series were separated by 7-8 days. The subjects relaxed during the passive flexion phase. Twenty (10 men and 10 women) clinically healthy subjects volunteered.Peak torque and EMG from rectus femoris, vastus medialis, vastus lateralis and biceps femoris were recorded. RMS and MNF were calculated from the EMG signal. The reliability was calculated with intraclass correlation coefficient ICC (1.1) and standard error of measurements (SEM). The reliability of peak torque was good (ICC=0.93) and SEM showed low values. ICC was good for absolute RMS of rectus femoris (ICC>/=0.80), vastus medialis (ICC>/=0.88) and vastus lateralis (ICC>/=0.82) and MNF of rectus femoris (ICC>/=0.82) and vastus medialis (ICC>/=0.83). Peak torque, and MNF and RMS of rectus femoris and vastus medialis are reliable variables obtained from an isokinetic endurance test of the knee extensors.     

Test-retest reliability of barbell velocity during the free-weight bench-press exercise

The purpose of this study was to calculate test-retest reliability statistics for peak barbell velocity during the free-weight bench-press exercise for loads corresponding to 10-90% of the 1-repetition maximum (1RM). Twenty-one healthy, resistance-trained men (mean ± SD age = 23.5 ± 2.7 years; body mass = 90.5 ± 14.6 kg; 1RM bench press = 125.4 ± 18.4 kg) volunteered for this study. A minimum of 48 hours after a maximal strength testing and familiarization session, the subjects performed single repetitions of the free-weight bench-press exercise at each tenth percentile (10-90%) of the 1RM on 2 separate occasions. For each repetition, the subjects were instructed to press the barbell as rapidly as possible, and peak barbell velocity was measured with a Tendo Weightlifting Analyzer. The test-retest intraclass correlation coefficients (model 2,1) and corresponding standard errors of measurement (expressed as percentages of the mean barbell velocity values) were 0.717 (4.2%), 0.572 (5.0%), 0.805 (3.1%), 0.669 (4.7%), 0.790 (4.6%), 0.785 (4.8%), 0.811 (5.8%), 0.714 (10.3%), and 0.594 (12.6%) for the weights corresponding to 10-90% 1RM. There were no mean differences between the barbell velocity values from trials 1 and 2. These results indicated moderate to high test-retest reliability for barbell velocity from 10 to 70% 1RM but decreased consistency at 80 and 90% 1RM. When examining barbell velocity during the free-weight bench-press exercise, greater measurement error must be overcome at 80 and 90% 1RM to be confident that an observed change is meaningful.     

Test-retest reliability for hitting accuracy tennis test

Strecker, E, Foster, EB, and Pascoe, DD. Test-retest reliability for hitting accuracy tennis test. J Strength Cond Res 25(12): 3501-3505, 2011-The purpose of this investigation was to assess a test-retest reliability of the hitting accuracy tennis test (HATT). Twelve National Collegiate Athletic Association (NCAA) division I tennis players (4 men and 8 women) volunteered to participate in this investigation. Skill tests consisted of 15 consecutive ground strokes in all 4 directions (forehand [FH] and backhand [BH]; crosscourt and up the line) with not >1 minute between directions. The court was divided into 12 areas, and each area was assigned a value according to a grid system based on offensive, defensive, and neutral shots ranging from 1 point to 6 points. Total score, unforced errors, and shot index (total number of shots that landed on optimal performance areas 5 and 6 minus total number of unforced errors) were used for statistical analysis. The order of shot direction was randomized between participants and trials. The analysis of variance with repeated measures (p value ≤ 0.05) of this investigation showed no statistical difference between trials on any of the measurements. The results also suggest that division I level tennis players have the ability to hit accurately specific targets on a tennis court using either FH or BH with minimal daily variation. Therefore, we conclude that the HATT for trained tennis athletes is a simple, reliable, and accurate assessment tool to measure tennis skill performance based on accuracy. The HATT is also an easy, inexpensive training device that coaches can use to monitor players development.     

Test-retest reliability of 24-hour ambulatory blood pressures

The test-retest reliability of 24-hour ambulatory blood pressures (ABP) was examined using correlational analyses as well as idiographic and nomothetic time-series regression analyses. Thirty normotensives (equal males and females) underwent ABP monitoring on three occasions, each of which was separated by a week. When analyzing the data, various postural positions, activities, and locations were controlled for in order to differentially assess the effects of these variables independently. Correlational analyses found the overall test-retest reliability of the ABPs to be quite good (SBP r =.84–.88, DBP r =.83–.86, HR r =.91–.95). Correlations examined within specific postural positions, activities, and locations were also significant. The time-series regression analyses used confirmed the reproducibility of the ABPs, with no greater than 20% of the subjects showing significant changes in ABPs over the three monitoring periods. Gender effects were also examined. In general, males had significantly higher systolic ABPs overall, although there was no influence of gender in terms of the test-retest reliability of the ABPs.     

Test-retest reliability of 4 single-leg horizontal hop tests

The purpose of this study was to determine the test-retest reliability of 4 single-leg horizontal hop tests (i.e., single hop for distance, triple hop for distance, crossover hop for distance, and 6-m hop for time), with a time interval of approximately 4 weeks separating the 2 testing sessions. Eighteen healthy, young, adult men, all cadets enrolled at the U.S. Air Force Academy, Colorado, performed the single hop for distance, the triple hop for distance, the crossover hop for distance, and the 6-m hop for time during 2 testing sessions separated by 31.2 +/- 0.4 days. Reliability data for each of the single-leg hop tests were studied through a repeated measures analysis of variance, intraclass correlation coefficients (ICCs), and standard errors of measurement (SEMs). The ICCs ranged from 0.92 to 0.97 for the 4 single-leg hop tests. The SEMs for the single-leg hop tests that assessed the distance hopped ranged from 4.61 to 17.74 cm. The SEM for the 6-m hop for time test was 0.06 seconds. No significant differences were noted when the mean scores of the 2 test trials were compared by a repeated measures analysis of variance for any of the single-leg hop tests. These results indicate that the single-leg hop tests examined in this study offer strength and conditioning professionals a reliable method to assess the single-leg horizontal hopping capabilities of healthy, young, adult men, with intervals of approximately 4 weeks between testing sessions.     

Test-retest reliability of three different countermovement jumping tests

In studies of physical performance comprising muscle strength and power, a vertical jump is a test method that frequently is used. It is important to have access to accurate measuring tools providing data with high reproducibility. Studies have shown that body composition also may play an important part in physical performance. The purpose of this study was to determine test-retest reliability for 3 different kinds of vertical jumps and to correlate jump height with body composition. Thirty-four normally trained subjects (women n = 17) between 18 and 25 years participated. Test-retest, on 3 kinds of vertical jumps, was performed with a median of 7 days between jumps. Methods used were a countermovement jump (CMJ) on a contact mat, with and without arm swing, and an Abalakow jump (AJ) using measuring tape, with arm swing. Body composition was assessed with the use of bioelectric impedance analysis. The results showed that high intraclass correlation coefficients (ICCs) were observed between testing occasions for all 3 vertical jumps (ICC between 0.48 and 0.88). The AJ in women presented the lowest ICC. Also the correlation between CMJ and AJ was high (rs = 0.88). Moderate-to-high correlations could be shown between body composition and CMJ in women (rs = -0.57-0.76). In conclusion, very high test-retest reliability for CMJ on a contact mat was found. For the AJ using a measuring tape, ICC were overall high, but a moderate nonsignificant ICC were found in women, indicating poor reproducibility. The data from the CMJ and AJ may be compared if approximately 25% of the AJ value is subtracted. In practice, this means that vertical jump tests have high reproducibility and can be used as measures of power development.     

The effects of floor incline on lower extremity biomechanics during unilateral landing from a jump in dancers

Retrospective studies have suggested that dancers performing on inclined ("raked") stages have increased injury risk. One study suggests that biomechanical differences exist between flat and inclined surfaces during bilateral landings; however, no studies have examined whether such differences exist during unilateral landings. In addition, little is known regarding potential gender differences in landing mechanics of dancers. Professional dancers (N = 41; 14 male, 27 female) performed unilateral drop jumps from a 30 cm platform onto flat and inclined surfaces while extremity joint angles and moments were identified and analyzed. There were significant joint angle and moment effects due to the inclined flooring. Women had significantly decreased peak ankle dorsiflexion and hip adduction moment compared with men. Findings of the current study suggest that unilateral landings on inclined stages create measurable changes in lower extremity biomechanical variables. These findings provide a preliminary biomechanical rationale for differences in injury rates found in observational studies of raked stages.     

Use of an overhead goal alters vertical jump performance and biomechanics

This study examined whether an extrinsic motivator, such as an overhead goal, during a plyometric jump may alter movement biomechanics. Our purpose was to examine the effects of an overhead goal on vertical jump height and lower-extremity biomechanics during a drop vertical jump and to compare the effects on female (N = 18) versus male (N = 17) athletes. Drop vertical jump was performed both with and without the use of an overhead goal. Greater vertical jump height (p = 0.002) and maximum takeoff external knee flexion (quadriceps) moment (p = 0.04) were attained with the overhead goal condition versus no overhead goal. Men had significantly greater vertical jump height (p < 0.001), maximum takeoff vertical force (p = 0.009), and maximum takeoff hip extensor moment (p = 0.02) compared with women. A significant gender x overhead goal interaction was found for stance time (p = 0.02) and maximum ankle (p = 0.04) and knee flexion angles (p = 0.04), with shorter stance times and lower angles in men during overhead goal time. These results indicate that overhead goals may be incorporated during training and testing protocols to alter lower-extremity biomechanics and can increase performance.     

蹲跳、反向跳和下落跳的膝关节屈伸肌群肌电信号分析

目的：通过观察肌电图（EMG）的变化,了解运动员与普通中学生在纵跳过程中,膝关节屈伸肌群工作特点,为运动员科学选材提供依据。方法：30名男女青少年运动员和30名男女普通中学生进行各种形式纵跳（蹲跳、反向跳、下落跳）,测试膝关节屈伸肌群的EMG变化情况。结果：主动肌（股外肌）EMG的变化存在性别差异,随着下肢工作强度的增加,男运动员积分肌电图（iEMG)和平均功率频率（Fmean)均没有显著变化,女运动员iEMG增加,Fmean没有显著变化,对抗肌（股二头肌）,随着下肢工作强度的增加。青少年运动员EMG活动变化较小,而普通中学生的EMG活动明显增加。结论：在增加工作负荷的过程中,男运动员膝关节伸肌群以提高效率为主,女运动员以提高肌肉的募集数量为主;运动员的对抗肌协调水平高于普通中学生。     

A musculoskeletal finite element model of rat knee joint for evaluating cartilage biomechanics during gait

Abnormal loading of the knee due to injuries or obesity is thought to contribute to the development of osteoarthritis (OA). Small animal models have been used for studying OA progression mechanisms. However, numerical models to study cartilage responses under dynamic loading in preclinical animal models have not been developed. Here we present a musculoskeletal finite element model of a rat knee joint to evaluate cartilage biomechanical responses during a gait cycle. The rat knee joint geometries were obtained from a 3-D MRI dataset and the boundary conditions regarding loading in the joint were extracted from a musculoskeletal model of the rat hindlimb. The fibril-reinforced poroelastic (FRPE) properties of the rat cartilage were derived from data of mechanical indentation tests. Our numerical results showed the relevance of simulating anatomical and locomotion characteristics in the rat knee joint for estimating tissue responses such as contact pressures, stresses, strains, and fluid pressures. We found that the contact pressure and maximum principal strain were virtually constant in the medial compartment whereas they showed the highest values at the beginning of the gait cycle in the lateral compartment. Furthermore, we found that the maximum principal stress increased during the stance phase of gait, with the greatest values at midstance. We anticipate that our approach serves as a first step towards investigating the effects of gait abnormalities on the adaptation and degeneration of rat knee joint tissues and could be used to evaluate biomechanically-driven mechanisms of the progression of OA as a consequence of joint injury or obesity.     

A comparison of optimisation methods and knee joint degrees of freedom on muscle force predictions during single-leg hop landings

The aim of this paper was to compare the effect of different optimisation methods and different knee joint degrees of freedom (DOF) on muscle force predictions during a single legged hop. Nineteen subjects performed single-legged hopping manoeuvres and subject-specific musculoskeletal models were developed to predict muscle forces during the movement. Muscle forces were predicted using static optimisation (SO) and computed muscle control (CMC) methods using either 1 or 3 DOF knee joint models. All sagittal and transverse plane joint angles calculated using inverse kinematics or CMC in a 1 DOF or 3 DOF knee were well-matched (RMS error<3°). Biarticular muscles (hamstrings, rectus femoris and gastrocnemius) showed more differences in muscle force profiles when comparing between the different muscle prediction approaches where these muscles showed larger time delays for many of the comparisons. The muscle force magnitudes of vasti, gluteus maximus and gluteus medius were not greatly influenced by the choice of muscle force prediction method with low normalised root mean squared errors (<48%) observed in most comparisons. We conclude that SO and CMC can be used to predict lower-limb muscle co-contraction during hopping movements. However, care must be taken in interpreting the magnitude of force predicted in the biarticular muscles and the soleus, especially when using a 1 DOF knee. Despite this limitation, given that SO is a more robust and computationally efficient method for predicting muscle forces than CMC, we suggest that SO can be used in conjunction with musculoskeletal models that have a 1 or 3 DOF knee joint to study the relative differences and the role of muscles during hopping activities in future studies.     

Test-retest reliability of the olfactory detection threshold test of the Sniffin' sticks

The aim of the present study was to investigate the test-retest reliability of the olfactory detection threshold subtest of the Sniffin' Sticks test battery, if administered repeatedly on 4 time points. The detection threshold test was repeatedly conducted in 64 healthy subjects. On the first testing session, the threshold test was accomplished 3 times (T(1) = 0 min, T(2) = 35 min, and T(3) = 105 min), representing a short-term testing. A fourth threshold test was conducted on a second testing session (T(4) = 35.1 days after the first testing session), representing a long-term testing. The average scores for olfactory detection threshold for n-butanol did not differ significantly across the 4 points of time. The test-retest reliability (Pearson's r) between the 4 time points of threshold testing were in a range of 0.43-0.85 (P < 0.01). These results support the notion that the olfactory detection threshold test is a highly reliable method for repeated olfactory testing, even if the test is repeated more than once per day and over a long-term period. It is concluded that the olfactory detection threshold test of the Sniffin' Sticks is suitable for repeated testing during experimental or clinical studies.     

Lower extremity coupling parameters during locomotion and landings

During ballistic locomotion and landing activities, the lower extremity joints must function synchronously to dissipate the impact. The coupling of subtalar motion to tibial and knee rotation has been hypothesized to depend on the dynamic requirements of the task. This study was undertaken to look for differences in the coupling of 3-D foot and knee motions during walking, jogging, and landing from a jump. Twenty recreationally active young women with normal foot alignment (as assessed by a licensed physical therapist) were videotaped with high-speed cameras (250 Hz) during walking, jogging, hopping, and jumping trials. Coupling coefficients were compared among the four activities. The ratio of eversion to tibial rotation increased from the locomotion to the landing trials, indicating that with the increased loading demands of the activity, the requirements of foot motion increased. However, this increased motion was not proportionately translated into rotation of the tibia through the subtalar joint. Furthermore, the ratio of knee flexion to knee internal rotation increased significantly from the walking to landing trials. Together these findings suggest that femoral rotation may compensate for the increase in tibial rotation as the force-dissipating demands of the task increase. The relative unbalance among the magnitude of foot, tibial, and knee rotations observed with increasing task demands may have direct implications on clinical treatments aimed at reducing knee motion via controlling motion at the foot during landing tasks.     

Test-retest reliability of Patrick's hip range of motion test in healthy college-aged men

This study determined the test-retest reliability of Patrick's test as a hip range of motion assessment method. Fifty healthy college-aged men (mean age = 20.0 years) were studied during 2 testing sessions separated by 24 hours. A single inexperienced tester performed all the measurements in this study. Before data collection, the tester participated in a 15-minute instructional session on how to perform Patrick's test. To determine the range of motion associated with Patrick's test, the tester passively flexed, abducted, and externally rotated the hip of the lower extremity that was to be tested while subjects were in a supine position, so that the lateral malleolus of the tested lower extremity rested just superior to their opposite extended knee. The vertical distance between a mark on the lateral border of the patella of the tested lower extremity and the treatment table was then measured. The results revealed that Patrick's test demonstrated high test-retest reliability (intraclass correlation coefficient = 0.93). The results of this study support the use of Patrick's test as being a reliable measure of general hip motion when used by an inexperienced tester who participated in a 15-minute instructional session on how to perform Patrick's test.     

Test-retest reliability of isometric mid-thigh pull maximum strength assessment: a systematic review

The aim of this systematic review was to explore the test-retest reliability of isometric mid-thigh pull maximum strength assessment. We searched through five databases to find studies that examined the test-retest reliability of peak force in the isometric mid-thigh pull exercise. From each included study, we extracted intra-class correlation coefficients (ICC) and/or coefficient of variation (CV). The methodological quality of the included studies was evaluated using the COSMIN checklist. A total of 16 good-to-excellent quality studies were included in the review. When considering results from all included studies, ICCs ranged from 0.73 to 0.99 (median ICC = 0.96), where 78% of ICCs were ≥ 0.90, and 98% of ICCs were ≥ 0.75. The range of reported CVs was from 0.7% to 11.1% (median CV = 4.9%), where 58% of CVs were ≤ 5%. Reliability was also good-to-excellent for both relative and absolute peak force and for both bilateral and unilateral isometric mid-thigh pull tests. The majority of studies did not find significant differences between testing sessions. It can be concluded that the isometric mid-thigh pull maximum strength assessment has good-to-excellent test-retest reliability. The isometric mid-thigh pull maximum strength assessment can be used as a reliable test in sports practice and for research purposes.     

A normative database of hip and knee joint biomechanics during dynamic tasks using anatomical regression prediction methods

Many methodologies exist to predict the hip joint center (HJC), of which regression based on anatomical landmarks appear most common. Despite the fact that predicted HJC locations vary depending upon chosen method, inter-study comparisons and inferences about populations are commonly made. The purpose of this study was to create a normative database of hip and knee biomechanics during walking, running, and single leg landings based on five commonly utilized HJC methods to serve as a reference for inter-study comparisons. Secondarily, we devised to provide comparisons of peak knee angles and hip angles, moments, and powers from the five HJC methods. Thirty healthy young adults performed walking, running, and single leg landing tasks at self-selected speeds (walking/running) and at 90% of their maximum jump height (landing). Three-dimensional motion capture and ground reaction forces were collected during all tasks. Five different HJC prediction methods: Bell, Davis, Hara, Harrington, and Greater Trochanter were implemented separately in a 6 degree of freedom model. Predicted HJC locations, direct kinematics, and inverse dynamics were computed for all tasks. Predicted HJC mediolateral, anteroposterior, and superior-inferior locations differed between methods by an average of 1.3, 2.9, and 1.4 cm, respectively. A database was created using the mean of all subjects for all five methods. In addition, one-way ANOVAs were used to compare triplanar peak angles, moments, and powers between the methods. The database of hip and knee biomechanics illustrates (1) variability between methods increases with more dynamic tasks (running/landing vs. walking) and (2) frontal and transverse plane hip and knee biomechanics are more variable between methods. Comparisons between methods found 38 and 16 main effect differences in hip and knee biomechanics, respectively. The Greater Trochanter method provided the most differences compared with other methods, while the Davis method provided the least differences. The database constructed provides an important reference for inter-study comparisons and details the impact of anatomical regression methods for predicting the HJC.     

Intersession reliability of vertical jump height in women and men

The purpose of the present study was to investigate the intersession reliability of vertical jump height in women and men recorded from a contact mat. Thirty-five women and 35 men performed four testing sessions across a 4-week period, with each session separated by 1 week. Within each testing session, subjects completed three countermovement vertical jumps (CMJs) for maximum height. Reliability statistics were calculated using the highest jump (HIGH) and also from the mean of all three jumps (3 MEAN) during each session. Reliability was calculated as a change in the mean, coefficients of variation (CVs), and intraclass correlations coefficients (ICCs) between testing sessions. For women, jump heights were not substantially different between sessions for either the HIGH or 3 MEAN data. The CVs for women ranged from 4.4 to 6.6% for HIGH and 4.1 to 6.0% for 3 MEAN, with the corresponding ICCs ranging from 0.87 to 0.94 for HIGH and 0.90 to 0.95 for 3 MEAN. For men, jump heights were not substantially different between sessions for HIGH. However, jump heights during session 1 were substantially greater than those during session 2 when using the 3 MEAN data. CVs between sessions for HIGH ranged from 4.0 to 5.6%, and those for 3 MEAN ranged from 4.2 to 5.2%. The ICCs ranged from 0.87 to 0.93 for HIGH and from 0.89 to 0.93 for 3 MEAN. Given the maximal nature of vertical jump tests, it seems appropriate to use the highest jump from a number of trials for women and men when using a contact mat. Practitioners and researchers can use the data to identify the range in which the true value of an athlete's score lies and calculate sample sizes for studies assessing height during CMJs recorded from a contact mat.     

Hip and knee joint kinematics during a diagonal jump landing in anterior cruciate ligament reconstructed females

Anterior cruciate ligament (ACL) injury is a common injury encountered by sport medicine clinicians. Surgical reconstruction is the recommended treatment of choice for those athletes wishing to return to full-contact sports participation and for sports requiring multi-directional movement patterns. The aim of ACL reconstruction is to restore knee joint mechanical stability such that the athlete can return to sporting participation. However, knowledge regarding the extent to which lower limb kinematic profiles are restored following ACL reconstruction is limited. In the present study the hip and knee joint kinematic profiles of 13 ACL reconstructed (ACL-R) and 16 non-injured control subjects were investigated during the performance of a diagonal jump landing task. The ACL-R group exhibited significantly less peak knee joint flexion (P=0.01). Significant between group differences were noted for time averaged hip joint sagittal plane (P<0.05) and transverse plane (P<0.05) kinematic profiles, as well as knee joint frontal plane (P<0.05) and sagittal plane (P<0.05) kinematic profiles. These results suggest that aberrant hip and knee joint kinematic profiles are present following ACL reconstruction, which could influence future injury risk.