Joint-specific power production and fatigue during maximal cycling

Cycling power decreases substantially during a maximal cycling trial of just 30 s. It is not known whether movement patterns and joint powers produced at each joint decrease to a similar extent or if each joint exhibits an individual fatigue profile. Changes in movement patterns and/or joint powers associated with overall task fatigue could arise from several different mechanisms or from a complex interplay of these mechanisms. The purpose of this investigation was to determine the changes in movement and power at each joint during a fatiguing cycling trial. Thirteen trained cyclists performed a 30 s maximal cycling trial on an isokinetic cycle ergometer at 120 rpm. Pedal forces and limb kinematics were recorded. Joint powers were calculated using a sagittal plane inverse dynamics model and averaged for the initial, middle, and final three second intervals of the trial, and normalized to initial values. Relative ankle plantar flexion power was significantly less than all other joint actions at the middle interval (51±5% of initial power; p=0.013). Relative ankle plantar flexion power for the final interval (37±3%) was significantly less than the relative knee flexion and hip extension power (p=0.010). Relative knee extension power (41±5%) was significantly less than relative hip extension power (55±4%) during the final three second interval (p=0.045). Knee flexion power (47±5%) did not differ from relative hip extension power (p=0.06). These changes in power were accompanied by a decrease in time spent extending by each joint with fatigue (i.e., decreased duty cycle, p<0.03). While central mechanisms may have played a role across all joints, because the ankle fatigued more than the hip and knee joints, either peripheral muscle fatigue or changes in motor control strategies were identified as the potential mechanisms for joint-specific fatigue during a maximal 30 s cycling trial.     

Higher medially-directed joint reaction forces are a characteristic of dysplastic hips: A comparative study using subject-specific musculoskeletal models

Acetabular dysplasia is a known cause of hip osteoarthritis. In addition to abnormal anatomy, changes in kinematics, joint reaction forces (JRFs), and muscle forces could cause tissue damage to the cartilage and labrum, and may contribute to pain and fatigue. The objective of this study was to compare lower extremity joint angles, moments, hip JRFs and muscle forces during gait between patients with symptomatic acetabular dysplasia and healthy controls. Marker trajectories and ground reaction forces were measured in 10 dysplasia patients and 10 typically developing control subjects. A musculoskeletal model was scaled in OpenSim to each subject and subject-specific hip joint centers were determined using reconstructions from CT images. Joint kinematics and moments were calculated using inverse kinematics and inverse dynamics, respectively. Muscle forces and hip JRFs were estimated with static optimization. Inter-group differences were tested for statistical significance (p ≤ 0.05) and large effect sizes (d ≥ 0.8). Results demonstrated that dysplasia patients had higher medially directed JRFs. Joint angles and moments were mostly similar between the groups, but large inter-group effect sizes suggested some restriction in range of motion by patients at the hip and ankle. Higher medially-directed JRFs and inter-group differences in hip muscle forces likely stem from lateralization of the hip joint center in dysplastic patients. Joint force differences, combined with reductions in range of motion at the hip and ankle may also indicate compensatory strategies by patients with dysplasia to maintain joint stability.     

Knee joint kinematics and kinetics during the hop and cut after soft tissue artifact suppression: Time to reconsider ACL injury mechanisms?

The recent development of a soft tissue artifact (STA) suppression method allows us to re-evaluate the tibiofemoral kinematics currently linked to non-contact knee injuries. The purpose of this study was therefore to evaluate knee joint kinematics and kinetics in six degrees of freedom (DoF) during the loading phases of a jump lunge and side cut using this in silico method. Thirty-five healthy adults completed these movements and their surface marker trajectories were then scaled and processed with OpenSim’s inverse kinematics (IK) and inverse dynamics tools. Knee flexion angle-dependent kinematic constraints defined based on previous bone pin (BP) marker trajectories were then applied to the OpenSim model during IK and these constrained results were then processed with the standard inverse dynamics tool. Significant differences for all hip, knee, and ankle DoF were observed after STA suppression for both the jump lunge and side cut. Using clinically relevant effect size estimates, we conclude that STA contamination had led to misclassifications in hip transverse plane angles, knee frontal and transverse plane angles, medial/lateral and distractive/compressive knee translations, and knee frontal plane moments between the NoBP and the BP IK solutions. Our results have substantial clinical implications since past research has used joint kinematics and kinetics contaminated by STA to identify risk factors for musculoskeletal injuries.     

Leg stiffness adjustment for a range of hopping frequencies in humans

The purpose of the present study was to determine how humans adjust leg stiffness over a range of hopping frequencies. Ten male subjects performed in place hopping on two legs, at three frequencies (1.5, 2.2, and 3.0 Hz). Leg stiffness, joint stiffness and touchdown joint angles were calculated from kinetic and/or kinematics data. Electromyographic activity (EMG) was recorded from six leg muscles. Leg stiffness increased with an increase in hopping frequency. Hip and knee stiffnesses were significantly greater at 3.0 Hz than at 1.5 Hz. There was no significant difference in ankle stiffness among the three hopping frequencies. Although there were significant differences in EMG activity among the three hopping frequencies, the largest was the 1.5 Hz, followed by the 2.2 Hz and then 3.0 Hz. The subjects landed with a straighter leg (both hip and knee were extended more) with increased hopping frequency. These results suggest that over the range of hopping frequencies we evaluated, humans adjust leg stiffness by altering hip and knee stiffness. This is accomplished by extending the touchdown joint angles rather than by altering neural activity.     

The effects of walking speed on obstacle crossing in healthy young and healthy older adults

The effects of walking speed and age on the peak external moments generated about the joints of the trailing limb during stance just prior to stepping over an obstacle and on the kinematics of the trailing limb when crossing the obstacle were investigated in 10 healthy young adults (YA) and 10 healthy older adults (OA). The peak hip and knee adduction moments in OA were 21-43% greater than those in YA (p相似文献   

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.     

Comparative assessment of knee joint models used in multi-body kinematics optimisation for soft tissue artefact compensation

Estimating joint kinematics from skin-marker trajectories recorded using stereophotogrammetry is complicated by soft tissue artefact (STA), an inexorable source of error. One solution is to use a bone pose estimator based on multi-body kinematics optimisation (MKO) embedding joint constraints to compensate for STA. However, there is some debate over the effectiveness of this method. The present study aimed to quantitatively assess the degree of agreement between reference (i.e., artefact-free) knee joint kinematics and the same kinematics estimated using MKO embedding six different knee joint models. The following motor tasks were assessed: level walking, hopping, cutting, running, sit-to-stand, and step-up. Reference knee kinematics was taken from pin-marker or biplane fluoroscopic data acquired concurrently with skin-marker data, made available by the respective authors. For each motor task, Bland-Altman analysis revealed that the performance of MKO varied according to the joint model used, with a wide discrepancy in results across degrees of freedom (DoFs), models and motor tasks (with a bias between −10.2° and 13.2° and between −10.2 mm and 7.2 mm, and with a confidence interval up to ±14.8° and ±11.1 mm, for rotation and displacement, respectively). It can be concluded that, while MKO might occasionally improve kinematics estimation, as implemented to date it does not represent a reliable solution to the STA issue.     

Evaluation of plantar flexion contracture contribution during the gait of children with Duchenne muscular dystrophy

Because of extensor weakness, children with Duchenne muscular dystrophy (DMD) maintain internal flexion moments at the joints of the lower extremities when they walk. We believe that at the ankle, the plantar flexion moments caused by contractures may contribute significantly to the production of the net ankle flexion moment during the gait in these children. The goal of the present study is to quantify ankle plantar flexion passive moments that may be associated with the presence of flexion contractures and to estimate their contribution to the net moment during the gait of children with DMD. Kinematic and kinetic parameters were collected during gait of eleven subjects with DMD. Ankle plantar flexion passive moments were also measured experimentally during the same session. Fourteen control children participated in the study in order to have normal reference values. The presence of ankle plantar flexion contractures in children with DMD was reflected by a rigidity coefficient obtained at a common moment of ?7 Nm that was higher for these children (0.75 Nm/° vs. 0.48 Nm/°; p < 0.05). The relative passive moment contribution to the net plantar flexion moments was higher for the children with DMD at the end of the lengthening phase of the plantar flexors (25% vs. 18%; p < 0.05). We believe that the passive moments can compensate for the presence of progressive muscle weakness in the children with DMD and help these children with gait.     

Differences in neuromuscular control between impact and no impact roundhouse kick in athletes of different skill levels

This study aimed at investigating two aspects of neuromuscular control around the hip and knee joint while executing the roundhouse kick (RK) using two techniques: Impact RK (IRK) at trunk level and No-Impact RK at face level (NIRK). The influence of technical skill level was also investigated by comparing two groups: elite Karateka and Amateurs. Surface electromyographic (sEMG) signals have been recorded from the Vastus Lateralis (VL), Biceps Femoris (BF), Rectus Femoris (RF), Gluteus Maximum (GM) and Gastrocnemious (GA) muscles of the kicking leg in six Karateka and six Amateurs performing the RKs. Hip and knee kinematics were also assessed. EMG data were rectified, filtered and normalized to the maximal value obtained for each muscle over all trials; co-activation (CI) indexes of antagonist vs. overall (agonist and antagonist) activity were computed for hip and knee flexion and extension. Muscle Fiber Conduction Velocity (CV) obtained from VL and BF muscles was assessed as well. The effect of group and kick on angular velocity, CIs, and CVs was tested through a two-way ANOVA (p < 0.05). An effect of group was showed in both kicks. Karateka presented higher knee and hip angular velocity; higher BF-CV (IRK: 5.1 ± 1.0 vs. 3.5 ± 0.5 m/s; NIRK: 5.7 ± 1.3 vs. 4.1 ± 0.5 m/s), higher CIs for hip movements and knee flexion and lower CI for knee extension. The results obtained suggest the presence of a skill-dependent activation strategy in the execution of the two kicks. CV results are suggestive of an improved ability of elite Karateka to recruit fast MUs as a part of training induced neuromuscular adaptation.     

The relationship between external knee moments and muscle co-activation in subjects with medial knee osteoarthritis

PurposeExternal knee moments are reliable to measure knee load but it does not take into account muscle activity. Considering that muscle co-activation increases compressive forces at the knee joint, identifying relationships between muscle co-activations and knee joint load would complement the investigation of the knee loading in subjects with knee osteoarthritis. The purpose of this study was to identify relationships between muscle co-activation and external knee moments during walking in subjects with medial knee osteoarthritis.Methods19 controls (11 males, aged 56.6 ± 5, and BMI 25.2 ± 3.3) and 25 subjects with medial knee osteoarthritis (12 males, aged 57.3 ± 5.3, and BMI 28.2 ± 4) were included in this study. Knee adduction and flexion moments, and co-activation (ratios and sums of quadriceps, hamstring, and gastrocnemius) were assessed during walking and compared between groups. The relationship between knee moments and co-activation was investigated in both groups.FindingsSubjects with knee osteoarthritis presented a moderate and strong correlation between co-activation (ratios and sums) and knee moments.InterpretationMuscle co-activation should be used to measure the contribution of quadriceps, hamstring, and gastrocnemius on knee loading. This information would cooperate to develop a more comprehensive approach of knee loading in this population.     

In vivo moment generation and architecture of the human plantar flexors after different shortening–stretch cycles velocities

The purpose of this study was to examine the moment generation of the human plantar flexors and the architecture of the gastrocnemius medialis muscle during and after shortening–stretch cycles in vivo. Fourteen male subjects (30 ± 7 years, 177 ± 7 cm, 80 ± 9 kg) performed a series of electro-stimulated shortening–stretch plantar flexion contractions. The shortening–stretch cycles were performed at three constant angular velocities (25°/s, 50°/s, 100°/s), two amplitudes (15° and 25° ankle angle changes) and at two different stimulation frequencies (30 Hz and 85 Hz). The resultant ankle joint moments were calculated through inverse dynamics. Pennation angle and fascicle length of the m. gastrocnemius medialis at rest and during contractions were measured using ultrasonography. The corresponding ankle moments, kinematics and changes in muscle architecture were analysed at seven time intervals. A three-way analysis of variance (amplitude × velocity × stimulation frequency) and post-hoc test with Bonferroni correction were used to check the amplitude, velocity and stimulation level related effects on moment enhancement (α = 0.05). The results show an ankle joint moment enhancement after shortening–stretch cycles influenced by muscle architectural changes. We found 2–3% isometric ankle joint moment enhancement at steady state, 1.5–2.0 s after the shortening–stretch cycle. However, the observed alteration in muscle architecture after the imposed perturbation, could lead to an underestimation (1–3%) of joint moment enhancement due to the force–length relationship of the triceps surae. Furthermore, the enhancement observed was independent of the shortening–stretch amplitude, velocity and stimulation frequency.     

Lower limb joint work and joint work contribution during downhill and uphill walking at different inclinations

Work performance and individual joint contribution to total work are important information for creating training protocols, but were not assessed so far for sloped walking. Therefore, the purpose of this study was to analyze lower limb joint work and joint contribution of the hip, knee and ankle to total lower limb work during sloped walking in a healthy population. Eighteen male participants (27.0 ± 4.7 yrs, 1.80 ± 0.05 m, 74.5 ± 8.2 kg) walked on an instrumented ramp at inclination angles of 0°, ±6°, ±12° and ±18° at 1.1 m/s. Kinematic and kinetic data were captured using a motion-capture system (Vicon) and two force plates (AMTI). Joint power curves, joint work (positive, negative, absolute) and each joint’s contribution to total lower limb work were analyzed throughout the stance phase using an ANOVA with repeated measures. With increasing inclination positive joint work increased for the ankle and hip joint and in total during uphill walking. Negative joint work increased for each joint and in total work during downhill walking. Absolute work was increased during both uphill (all joints) and downhill (ankle & knee) walking. Knee joint contribution to total negative and absolute work increased during downhill walking while hip and ankle contributions decreased. This study identified, that, when switching from level to a 6° and from 6° to a 12° inclination the gain of individual joint work is more pronounced compared to switching from 12° to an 18° inclination. The results might be used for training recommendations and specific training intervention with respect to sloped walking.     

Lower limb joint stiffness and muscle co-contraction adaptations to instability footwear during locomotion

Unstable shoes (US) continually perturb gait which can train the lower limb musculature, but muscle co-contraction and potential joint stiffness strategies are not well understood. A shoe with a randomly perturbing midsole (IM) may enhance these adaptations. This study compares ankle and knee joint stiffness, and ankle muscle co-contraction during walking and running in US, IM and a control shoe in 18 healthy females. Ground reaction forces, three-dimensional kinematics and electromyography of the gastrocnemius medialis and tibialis anterior were recorded. Stiffness was calculated during loading and propulsion, derived from the sagittal joint angle-moment curves. Ankle co-contraction was analysed during pre-activation and stiffness phases. Ankle stiffness reduced and knee stiffness increased during loading in IM and US whilst walking (ankle, knee: p = 0.008, 0.005) and running (p < 0.001; p = 0.002). During propulsion, the opposite joint stiffness re-organisation was found in IM whilst walking (both joints p < 0.001). Ankle co-contraction increased in IM during pre-activation (walking: p = 0.001; running: p < 0.001), and loading whilst walking (p = 0.003), not relating to ankle stiffness. Results identified relative levels of joint stiffness change in unstable shoes, providing new evidence of how stability is maintained at the joint level.     

Joint kinematics estimation using a multi-body kinematics optimisation and an extended Kalman filter,and embedding a soft tissue artefact model

To reduce the impact of the soft tissue artefact (STA) on the estimate of skeletal movement using stereophotogrammetric and skin-marker data, multi-body kinematics optimisation (MKO) and extended Kalman filters (EKF) have been proposed. This paper assessed the feasibility and efficiency of these methods when they embed a mathematical model of the STA and simultaneously estimate the ankle, knee and hip joint kinematics and the model parameters. A STA model was used that provides an estimate of the STA affecting the marker-cluster located on a body segment as a function of the kinematics of the adjacent joints. The MKO and the EKF were implemented with and without the STA model. To assess these methods, intra-cortical pin and skin markers located on the thigh, shank, and foot of three subjects and tracked during the stance phase of running were used. Embedding the STA model in MKO and EKF reduced the average RMS of marker tracking from 12.6 to 1.6 mm and from 4.3 to 1.9 mm, respectively, showing that a STA model trial-specific calibration is feasible. Nevertheless, with the STA model embedded in MKO, the RMS difference between the estimated and the reference joint kinematics determined from the pin markers slightly increased (from 2.0 to 2.1 deg) On the contrary, when the STA model was embedded in the EKF, this RMS difference was slightly reduced (from 2.0 to 1.7 deg) thus showing a better potentiality of this method to attenuate STA effects and improve the accuracy of joint kinematics estimate.     

Influence of additional load on the moments of the agonist and antagonist muscle groups at the knee joint during closed chain exercise

The present study investigated the influence of additional loads on the knee net joint moment, flexor and extensor muscle group moments, and cocontraction index during a closed chain exercise. Loads of 8, 28, or 48 kg (i.e., respectively, 11.1 ± 1.5%, 38.8 ± 5.3%, and 66.4 ± 9.0% of body mass) were added to subjects during dynamic half squats. The flexor and extensor muscular moments and the amount of cocontraction were estimated at the knee joint using an EMG-and-optimization model that includes kinematics, ground reaction, and EMG measurements as inputs. In general, our results showed a significant influence of the Load factor on the net knee joint moment, the extensor muscular moment, and the flexor muscle group moment (all Anova p < .05). Hence we confirmed an increase in muscle moments with increasing load and moreover, we also showed an original “more than proportional” evolution of the flexor and extensor muscle group moments relative to the knee net joint moment. An influence of the Phase (i.e., descent vs. ascent) factor was also seen, revealing different activation strategies from the central nervous system depending on the mode of contraction of the agonist muscle group. The results of the present work could find applications in clinical fields, especially for rehabilitation protocols.     

Combined measurement and modeling of specimen-specific knee mechanics for healthy and ACL-deficient conditions

Quantifying the mechanical environment at the knee is crucial for developing successful rehabilitation and surgical protocols. Computational models have been developed to complement in vitro studies, but are typically created to represent healthy conditions, and may not be useful in modeling pathology and repair. Thus, the objective of this study was to create finite element (FE) models of the natural knee, including specimen-specific tibiofemoral (TF) and patellofemoral (PF) soft tissue structures, and to evaluate joint mechanics in intact and ACL-deficient conditions. Simulated gait in a whole joint knee simulator was performed on two cadaveric specimens in an intact state and subsequently repeated following ACL resection. Simulated gait was performed using motor-actuated quadriceps, and loads at the hip and ankle. Specimen-specific FE models of these experiments were developed in both intact and ACL-deficient states. Model simulations compared kinematics and loading of the experimental TF and PF joints, with average RMS differences [max] of 3.0° [8.2°] and 2.1° [8.4°] in rotations, and 1.7 [3.0] and 2.5 [5.1] mm in translations, for intact and ACL-deficient states, respectively. The timing of peak quadriceps force during stance and swing phase of gait was accurately replicated within 2° of knee flexion and with an average error of 16.7% across specimens and pathology. Ligament recruitment patterns were unique in each specimen; recruitment variability was likely influenced by variations in ligament attachment locations. ACL resections demonstrated contrasting joint mechanics in the two specimens with altered knee motion shown in one specimen (up to 5 mm anterior tibial translation) while increased TF joint loading was shown in the other (up to 400 N).     

Measuring three-dimensional knee kinematics under torsional loading

Excessive knee joint laxity is often used as an indicator of joint disease or injury. Clinical assessment devices are currently limited to anterior–posterior drawer measurements, while tools used to measure movement in the remaining degrees of freedom are either invasive or prone to soft tissue artefact. The objective of this work was, therefore, to develop a methodology whereby in vivo knee joint kinematics could be measured in three dimensions under torsional loading while still maintaining a non-invasive procedure. A device designed to administer a subject-normalized torque in the transverse plane of the knee was securely fastened to the outer frame of an open magnetic resonance imaging (MRI) magnet. Low resolution 3D T1-weighted images (6.25 mm slice thickness) were generated by the 0.2 Tesla MRI scanner in less than 3 min while the joint was under load. The 3D image volume was then shape-matched to a high resolution image volume (1.56 mm slice thickness) scanned in a no-load position. Three-dimensional rotations and translations of the tibia with respect to the femur were calculated by comparing the transformation matrices before and after torque was applied. Results from six subjects showed that this technique was repeatable over five trials with the knee in extended and flexed positions. Differences in range of rotation were shown between subjects and between knee positions, suggesting that this methodology has sufficient utility for further application in clinical studies.     

Sharper angle,higher risk? The effect of cutting angle on knee mechanics in invasion sport athletes

IntroductionCutting is an important skill in team-sports, but unfortunately is also related to non-contact ACL injuries. The purpose was to examine knee kinetics and kinematics at different cutting angles.Material and methods13 males and 16 females performed cuts at different angles (45°, 90°, 135° and 180°) at maximum speed. 3D kinematics and kinetics were collected. To determine differences across cutting angles (45°, 90°, 135° and 180°) and sex (female, male), a 4 × 2 repeated measures ANOVA was conducted followed by post hoc comparisons (Bonferroni) with alpha level set at α ≤ 0.05 a priori.ResultsAt all cutting angles, males showed greater knee flexion angles than females (p < 0.01). Also, where males performed all cutting angles with no differences in the amount of knee flexion −42.53° ± 8.95°, females decreased their knee flexion angle from −40.6° ± 7.2° when cutting at 45° to −36.81° ± 9.10° when cutting at 90°, 135° and 180° (p < 0.01). Knee flexion moment decreased for both sexes when cutting towards sharper angles (p < 0.05). At 90°, 135° and 180°, males showed greater knee valgus moments than females. For both sexes, knee valgus moment increased towards the sharper cutting angles and then stabilized compared to the 45° cutting angle (p < 0.01). Both females and males showed smaller vGRF when cutting to sharper angles (p < 0.01).ConclusionIt can be concluded that different cutting angles demand different knee kinematics and kinetics. Sharper cutting angles place the knee more at risk. However, females and males handle this differently, which has implications for injury prevention.     

Estimations of relative effort during sit-to-stand increase when accounting for variations in maximum voluntary torque with joint angle and angular velocity

The main purpose of this study was to compare three methods of determining relative effort during sit-to-stand (STS). Fourteen young (mean 19.6 ± SD 1.2 years old) and 17 older (61.7 ± 5.5 years old) adults completed six STS trials at three speeds: slow, normal, and fast. Sagittal plane joint torques at the hip, knee, and ankle were calculated through inverse dynamics. Isometric and isokinetic maximum voluntary contractions (MVC) for the hip, knee, and ankle were collected and used for model parameters to predict the participant-specific maximum voluntary joint torque. Three different measures of relative effort were determined by normalizing STS joint torques to three different estimates of maximum voluntary torque. Relative effort at the hip, knee, and ankle were higher when accounting for variations in maximum voluntary torque with joint angle and angular velocity (hip = 26.3 ± 13.5%, knee = 78.4 ± 32.2%, ankle = 27.9 ± 14.1%) compared to methods which do not account for these variations (hip = 23.5 ± 11.7%, knee = 51.7 ± 15.0%, ankle = 20.7 ± 10.4%). At higher velocities, the difference in calculating relative effort with respect to isometric MVC or incorporating joint angle and angular velocity became more evident. Estimates of relative effort that account for the variations in maximum voluntary torque with joint angle and angular velocity may provide higher levels of accuracy compared to methods based on measurements of maximal isometric torques.