Muscle activation patterns of selected lower extremity muscles during stepping and cutting tasks

Lower extremity muscle activations during crossover and side step cut tasks are hypothesized to play an important role in controlling knee motion, and therefore, impact the design of knee injury prevention and rehabilitation programs. However, the contribution of lower extremity muscles to frontal and transverse plane moments during cutting tasks is unclear. The purpose of this study was to compare the muscle activation patterns of selected lower extremity muscles (vastus lateralis, medial/lateral hamstrings and medial/lateral gastrocnemius) of subjects performing a stepping down and side step cut, a stepping down and crossover cut and an equivalent straight ahead task. Ground reaction force was used to determine the cut angle, stance time and compare the lower limb loading during each task. Electromyography data during all tasks were normalized to the average activation during the straight ahead tasks to determine relative changes in muscle activation between the straight ahead and different cut styles (crossover and side step). There were no differences in the pattern of muscle activation of the vastus lateralis, or lateral hamstring muscles when comparing the cutting tasks to the equivalent straight ahead task. However, the crossover cut task resulted in significantly higher muscle activation of the medial hamstrings and lateral gastrocnemius muscles relative to both the side step cut and straight ahead tasks. These results suggest the medial/lateral hamstrings and medial/lateral gastrocnemius play a role in transverse and frontal plane control during cut tasks.     

Three-dimensional dynamic simulation of total knee replacement motion during a step-up task.

A three-dimensional dynamic model of the tibiofemoral and patellofemoral articulations was developed to predict the motions of knee implants during a step-up activity. Patterns of muscle activity, initial joint angles and velocities, and kinematics of the hip and tinkle were measured experimentally and used as inputs to the simulation. Prosthetic knee kinematics were determined by integration of dynamic equations of motion subject to forces generated by muscles, ligaments, and contact at both the tibiofemoral and patellofemoral articulations. The modeling of contacts between implants did not rely upon explicit constraint equations; thus, changes in the number of contact points were allowed without modification to the model formulation. The simulation reproduced experimentally measured flexion-extension angle of the knee (within one standard deviation), but translations at the tibiofemoral articulations were larger during the simulated step-up task than those reported for patients with total knee replacements.     

A method for determining lower extremity muscle-tendon lengths during flexion/extension movements

A study was conducted to examine the relationship between muscle-tendon lengths of 16 lower extremity muscles and the flexion angle(s) of the joint(s) they cross. Anthropometric data from six subjects were obtained. Various lower extremity joint flexion angle combinations were simulated for each subject using computer software. For each simulated lower extremity position, muscle origin and insertion locations were determined based on averaged cadaveric origin/insertion information and individual anthropometric parameters. Corresponding muscle-tendon lengths were computed and normalized to segment lengths. Regression equations were derived which allow normalized muscle-tendon lengths to be estimated from known joint flexion angles. The regression equations obtained for biarticular muscles fit the data quite well giving correlation coefficients greater than 0.92. The correlation coefficients for the equations describing normalized single joint muscle-tendon lengths range from 0.77 to 0.97. The equations were then validated by comparing predicted lengths to those reported by previous investigations. Confirming the utility of the equations, the comparisons were excellent for both uniarticular and biarticular muscles. Used in conjunction with velocity data (obtained by differentiating the length data) and electromyogram recordings, these equations enable a detailed analysis of muscle function.     

Effects of gender and foot-landing techniques on lower extremity kinematics during drop-jump landings

The purpose of this study was to assess kinematic lower extremity motion patterns (hip flexion, knee flexion, knee valgus, and ankle dorsiflexion) during various foot-landing techniques (self-preferred, forefoot, and rear foot) between genders. 3-D kinematics were collected on 50 (25 male and 25 female) college-age recreational athletes selected from a sample of convenience. Separate repeated-measures ANOVAs were used to analyze each variable at three time instants (initial contact, peak vertical ground reaction force, and maximum knee flexion angle). There were no significant differences found between genders at the three instants for each variable. At initial contact, the forefoot technique (35.79 degrees +/- 11.78 degrees ) resulted in significantly (p = .001) less hip flexion than did the self-preferred (41.25 degrees +/- 12.89 degrees ) and rear foot (43.15 degrees +/- 11.77 degrees ) techniques. At peak vertical ground reaction force, the rear foot technique (26.77 degrees +/- 9.49 degrees ) presented significantly lower (p = .001) knee flexion angles as compared with forefoot (58.77 degrees +/- 20.00 degrees ) and self-preferred (54.21 degrees +/- 23.78 degrees ) techniques. A significant difference for knee valgus angles (p = .001) was also found between landing techniques at peak vertical ground reaction force. The self-preferred (4.12 degrees +/- 7.51 degrees ) and forefoot (4.97 degrees +/- 7.90 degrees ) techniques presented greater knee varus angles as compared with the rear foot technique (0.08 degrees +/- 6.52 degrees ). The rear foot technique created more ankle dorsiflexion and less knee flexion than did the other techniques. The lack of gender differences can mean that lower extremity injuries (e.g., ACL tears) may not be related solely to gender but may instead be associated with the landing technique used and, consequently, the way each individual absorbs jump-landing energy.     

Muscle activation patterns of the upper and lower extremity during the windmill softball pitch

Fast-pitch softball has become an increasingly popular sport for female athletes. There has been little research examining the windmill softball pitch in the literature. The purpose of this study was to describe the muscle activation patterns of 3 upper extremity muscles (biceps, triceps, and rhomboids [scapular stabilizers]) and 2 lower extremity muscles (gluteus maximus and medius) during the 5 phases of the windmill softball pitch. Data describing muscle activation were collected on 7 postpubescent softball pitchers (age 17.7 ± 2.6 years; height 169 ± 5.4 cm; mass 69.1 ± 5.4 kg). Surface electromyographic data were collected using a Myopac Jr 10-channel amplifier (RUN Technologies Scientific Systems, Laguna Hills, CA, USA) synchronized with The MotionMonitor? motion capture system (Innovative Sports Training Inc, Chicago IL, USA) and presented as a percent of maximum voluntary isometric contraction. Gluteus maximus activity reached (196.3% maximum voluntary isometric contraction [MVIC]), whereas gluteus medius activity was consistent during the single leg support of phase 3 (101.2% MVIC). Biceps brachii activity was greatest during phase 4 of the pitching motion. Triceps brachii activation was consistently >150% MVIC throughout the entire pitching motion, whereas the scapular stabilizers were most active during phase 2 (170.1% MVIC). The results of this study indicate the extent to which muscles are activated during the windmill softball pitch, and this knowledge can lead to the development of proper preventative and rehabilitative muscle strengthening programs. In addition, clinicians will be able to incorporate strengthening exercises that mimic the timing of maximal muscle activation most used during the windmill pitching phases.     

The impact of seatback angle on electromyographical activity of the lower back and quadriceps muscles during bilateral knee extension

This study investigated variations in electromyographic (EMG) responses of the erector spinae (ES), vastus medialis (VM), rectus femoris (RF), and vastus lateralis (VL) to different seatback angles during leg extension. Twenty men and women (10 men, 10 women; age 27.49 +/- 6.16 years) performed 8 repetitions at 70% of 8 repetition maximum at seatback angles of 1.57, 1.75, and 1.92 radius (rad). Analyses using repeated-measures analysis of variance indicated the greatest root square mean of the EMG (rmsEMG) and integrated EMG (intEMG) for the ES were at 1.92 rad, and the greatest for the VM (concentric) and VL (eccentric) were at 1.57 rad. No differences were observed among seat angles for the RF except for a higher normalized intEMG at 1.92 than 1.75 rad (concentric). Throughout all sets for all conditions and muscles, rmsEMG and intEMG significantly increased and median power frequency significantly decreased. These data indicate that a seatback angle of 1.57 rad is best for a leg extension machine, because this angle maximizes quadriceps activity while minimizing stress on the lower back muscles.     

Effects of turn angle and pivot foot on lower extremity kinetics during walk and turn actions

This study examined lower extremity joint moments during walk and turn with different turn angles and pivot feet. Seven young adults (age 21+/-1.3 yrs) were asked to walk at a self-selected speed (1.35+/-0.15 m/s) and to turn to the right using right (spin turn) and left (step turn) pivot feet at turn angles of 0 degrees (walking straight), 45 degrees, and 90 degrees. Video and forceplate systems were employed for kinematic and kinetic data collection. Inverse dynamics approach was used to compute joint moments using segmental kinematics, ground reaction forces, and moments. The participants decreased their forward speed by increasing the ankle plantar flexion moment as the turn angle increased. The peak ankle plantar flexion moment during the braking phase increased with increasing turn angle for both spin and step turns. Ankle invertor moments were observed only in spin turns, suggesting that more ankle muscles are involved in spin turns than in step turns. The turn angle had a significant effect on the transverse plane moment profiles at the different lower extremity joints. The results suggest that the loading patterns of different anatomical structures in the lower extremity are affected by both turn angle and pivot foot during walk and turn actions.     

Influence of a valgus knee brace on muscle activation and co-contraction in patients with medial knee osteoarthritis

The purpose of this study was to analyse the effect of a valgus knee orthosis designed for patients with knee osteoarthritis on the electromyographic activity (EMG) of seven muscles of the lower limb during gait. Twelve patients with medial knee osteoarthritis walked on a treadmill in three different conditions: without orthosis, with a knee orthosis in 4° valgus adjustment and with an orthosis in a neutral flexible adjustment. Root-mean-square (RMS) was analysed in each condition during a 150 ms pre-activation phase and during the stance phase of gait, which was divided in four sub-phases. In addition, co-contraction ratios (CCRs) were calculated between extensor/flexor, medial/lateral muscles and between agonist and antagonist muscle pairs. Significant decreases in muscle activity and CCRs were observed with the use of the knee orthosis in both adjustments compared to the condition without orthosis. Using the valgus brace, medial/lateral CCR decreased significantly during the late stance and the flexor/extensor CCR decreased significantly during the loading phase and late stance. Decreases of muscle pairs CCRs were observed with the neutral flexible adjustment. The results support the theory of a possible beneficial effect of knee braces in reducing knee loading by decreasing muscle activation and co-contraction levels, which could contribute to decelerate disease progression in patients with knee osteoarthritis.     

Effects of prior heavy-intensity exercise during single-leg knee extension on VO2 kinetics and limb blood flow.

The effects of prior heavy-intensity exercise on O(2) uptake (Vo(2)) kinetics of a second heavy exercise may be due to vasodilation (associated with metabolic acidosis) and improved muscle blood flow. This study examined the effect of prior heavy-intensity exercise on femoral artery blood flow (Qleg) and its relationship with Vo(2) kinetics. Five young subjects completed five to eight repeats of two 6-min bouts of heavy-intensity one-legged, knee-extension exercise separated by 6 min of loadless exercise. Vo(2) was measured breath by breath. Pulsed-wave Doppler ultrasound was used to measure Qleg. Vo(2) and blood flow velocity data were fit using a monoexponential model to identify phase II and phase III time periods and estimate the response amplitudes and time constants (tau). Phase II Vo(2) kinetics was speeded on the second heavy-intensity exercise [mean tau (SD), 29 (10) s to 24 (10) s, P < 0.05] with no change in the phase II (or phase III) amplitude. Qleg was elevated before the second exercise [1.55 (0.34) l/min to 1.90 (0.25) l/min, P < 0.05], but the amplitude and time course [tau, 25 (13) s to 35 (13) s] were not changed, such that throughout the transient the Qleg (and DeltaQleg/DeltaVo(2)) did not differ from the prior heavy exercise. Thus Vo(2) kinetics were accelerated on the second exercise, but the faster kinetics were not associated with changes in Qleg. Thus limb blood flow appears not to limit Vo(2) kinetics during single-leg heavy-intensity exercise nor to be the mechanism of the altered Vo(2) response after heavy-intensity prior exercise.     

An analysis of the effect of lower extremity strength on impact severity during a backward fall.

At least 280 000 hip fractures occur annually in the U.S. at an estimated cost of $9 billion. While over 90 percent of these are caused by falls, only about 2 percent of all falls result in hip fracture. Evidence suggests that the most important determinants of hip fracture risk during a fall are the body's impact velocity and configuration. Accordingly, protective responses for reducing impact velocity and the likelihood for direct impact to the hip, strongly influence fracture risk. One method for reducing the body's impact velocity and kinetic energy during a fall is to absorb energy in the lower extremity muscles during descent, as occurs during sitting and squatting. In the present study, we employed a series of in verted pendulum models to determine: (a) the theoretical effect of this mechanism on impact severity during a backward fall, and (b) the effect on impact severity of age-related declines (or exercise-induced enhancements) in lower extremity strength. Compared to the case of a fall with zero energy absorption in the lower extremity joints, best-case falls (which involved 81 percent activation of ankle and hip muscles, but only 23 percent activation of knees muscles) involved 79 percent attenuation (from 352 J to 74 J) in the body's vertical kinetic energy at impact (KEv), and 48 percent attenuation (from 3.22 to 1.68 m/s) in the downward velocity of the pelvis at impact (v(v)). Among the mechanisms responsible for this were: (1) eccentric contraction of lower extremity muscles during descent, which resulted in up to 150 J of energy absorption; (2) impact with the trunk in an upright configuration, which reduced the change in potential energy associated with the fall by 100 J; and (3) knee extension during the final stage of descent, which "transferred" up to 90 J of impact energy into horizontal (as opposed to vertical) kinetic energy. Declines in joint strength reduced the effectiveness of mechanisms (1) and (3), and thereby increased impact severity However, even with reductions of 80 percent in available torques, KEv was attenuated by 50 percent. This indicates the importance of both technique and strength in reducing impact severity. These results provide motivation for attempts to reduce elderly individuals' risk for fall-related injury through the combination of instruction in safe falling techniques and exercises that enhance lower extremity strength.     

Comparison of lower extremity kinematic curves during overground and treadmill running

Researchers conduct gait analyses utilizing both overground and treadmill modes of running. Previous studies comparing these modes analyzed discrete variables. Recently, techniques involving quantitative pattern analysis have assessed kinematic curve similarity in gait. Therefore, the purpose of this study was to compare hip, knee and rearfoot 3-D kinematics between overground and treadmill running using quantitative kinematic curve analysis. Twenty runners ran at 3.35 m/s ± 5% during treadmill and overground conditions while right lower extremity kinematics were recorded. Kinematics of the hip, knee and rearfoot at footstrike and peak were compared using intraclass correlation coefficients. Kinematic curves during stance phase were compared using the trend symmetry method within each subject. The overall average trend symmetry was high, 0.94 (1.0 is perfect symmetry) between running modes. The transverse plane and knee frontal plane exhibited lower similarity (0.86-0.90). Other than a 4.5 degree reduction in rearfoot dorsiflexion at footstrike during treadmill running, all differences were ≤1.5 degrees. 17/18 discrete variables exhibited modest correlations (>0.6) and 8/18 exhibited strong correlations (>0.8). In conclusion, overground and treadmill running kinematic curves were generally similar when averaged across subjects. Although some subjects exhibited differences in transverse plane curves, overall, treadmill running was representative of overground running for most subjects.     

Comparison of oxygen uptake kinetics during knee extension and cycle exercise

The knee extension exercise (KE) model engenders different muscle and fiber recruitment patterns, blood flow, and energetic responses compared with conventional cycle ergometry (CE). This investigation had two aims: 1) to test the hypothesis that upright two-leg KE and CE in the same subjects would yield fundamentally different pulmonary O(2) uptake (pVo(2)) kinetics and 2) to characterize the muscle blood flow, muscle Vo(2) (mVo(2)), and pVo(2) kinetics during KE to investigate the rate-limiting factor(s) of pVo(2) on kinetics and muscle energetics and their mechanistic bases after the onset of heavy exercise. Six subjects performed KE and CE transitions from unloaded to moderate [< ventilatory threshold (VT)] and heavy (>VT) exercise. In addition to pVo(2) during CE and KE, simultaneous pulsed and echo Doppler methods, combined with blood sampling from the femoral vein, were used to quantify the precise temporal profiles of femoral artery blood flow (LBF) and mVo(2) at the onset of KE. First, the gain (amplitude/work rate) of the primary component of pVo(2) for both moderate and heavy exercise was higher during KE ( approximately 12 ml.W(-1).min(-1)) compared with CE ( approximately 10), but the time constants for the primary component did not differ. Furthermore, the mean response time (MRT) and the contribution of the slow component to the overall response for heavy KE were significantly greater than for CE. Second, the time constant for the primary component of mVo(2) during heavy KE [25.8 +/- 9.0 s (SD)] was not significantly different from that of the phase II pVo(2). Moreover, the slow component of pVo(2) evident for the heavy KE reflected the gradual increase in mVo(2). The initial LBF kinetics after onset of KE were significantly faster than the phase II pVo(2) kinetics (moderate: time constant LBF = 8.0 +/- 3.5 s, pVo(2) = 32.7 +/- 5.6 s, P < 0.05; heavy: LBF = 9.7 +/- 2.0 s, pVo(2) = 29.9 +/- 7.9 s, P < 0.05). The MRT of LBF was also significantly faster than that of pVo(2). These data demonstrate that the energetics (as gain) for KE are greater than for CE, but the kinetics of adjustment (as time constant for the primary component) are similar. Furthermore, the kinetics of muscle blood flow during KE are faster than those of pVo(2), consistent with an intramuscular limitation to Vo(2) kinetics, i.e., a microvascular O(2) delivery-to-O(2) requirement mismatch or oxidative enzyme inertia.     

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.     

Effects of aging in postural strategies during a seated auto-stabilization task

Impaired sensory, motor and central processing systems combining with biomechanical changes are risk of fall factors in the elderly population. The aim of this study was to assess the auto-adaptation and the regulation of the dynamic control of equilibrium in age-related adaptive strategies, by using a seated position on a seesaw. 15 young adults and 12 healthy middle-aged adults were asked to actively maintain a sitting posture as stable as possible during 12.8 s, on a 1-degree of freedom seesaw (auto-stabilization paradigm), with and without vision. The seesaw was placed in order to allow roll or pitch oscillations. We determine length and surfaces CoP shifts, mean positions and variability, a Postural Performance Index (PI) and a Strategy Organization Ratio (SOR). Our results shows that adopted strategies are plane-dependant during auto-stabilization (parallel and perpendicular axes control is impacted) and age-dependant. PI_x during roll seated auto-stabilization tasks appears as the most relevant parameter of aged-related instability. The visual effect, during pitch auto-stabilization, characterizes the postural sensory-motor human behavior. The quantitative and qualitative postural assessment, thanks to seated auto-stabilization task, need to be promoted for long-term health care and probably for the rehabilitation of various disorders.     

The effects of knee brace hinge design and placement on joint mechanics

A computer model of 23 knees was obtained by embedding, slicing and digitizing the bone outlines and ligament co-ordinates. Using co-ordinate transformations, various three-dimensional motions were imposed on the knees, and calculations made of femoral-tibial contact error, contact point locations and ligament lengths. Significant deviations in these parameters were noted for abnormal motions including the elimination of internal-external rotation and a-p displacement and the misplacement of a hinge producing correct motion. The resulting mismatch could result in shear in soft tissues, cuff-to-skin slippage and inaccurate ligament length patterns.     

Shoe midsole hardness, sex and age effects on lower extremity kinematics during running

Previous studies investigating the effects of shoe midsole hardness on running kinematics have often used male subjects from within a narrow age range. It is unknown whether shoe midsole hardness has the same kinematic effect on male and female runners as well as runners from different age categories. As sex and age have an effect on running kinematics, it is important to understand if shoe midsole hardness affects the kinematics of these groups in a similar fashion. However, current literature on the effects of sex and age on running kinematics are also limited to a narrow age range distribution in their study population. Therefore, this study tested the influence of three different midsole hardness conditions, sex and age on the lower extremity kinematics during heel-toe running. A comprehensive analysis approach was used to analyze the lower-extremity kinematic gait variables for 93 runners (male and female) aged 16-75 years. Participants ran at 3.33±0.15 m/s on a 30 m-long runway with soft, medium and hard midsoles. A principal component analysis combined with a support vector machine showed that running kinematics based on shoe midsole hardness, sex, and age were separable and classifiable. Shoe midsole hardness demonstrated a subject-independent effect on the kinematics of running. Additionally, it was found that age differences affected the more dominant movement components of running compared to differences due to the sex of a runner.     

Reduction of knee range of motion during continuous passive motion due to misaligned hip joint centre

When using continuous passive motion (CPM) devices, appropriate setting of the device and positioning of the patient are necessary to obtain maximum range of motion (ROM). In this study, the ROMs in both the knee joint and CPM device during CPM treatment were measured using a motion analysis system for three different CPM devices. Additionally, the trajectories of the angles at the knee for hip joint misalignments were evaluated using kinematic models of the three CPM devices. The results showed that discrepancies in ROM between the knee joints and the CPM device settings during CPM treatment were revealed regardless of the CPM device and that the effect of misalignment is dependent on the design of the CPM device. The present technology could be applied for the development of a better design configuration for the CPM device to reduce the discrepancy in ROM at the knee joint.     

Muscular coordination of knee motion during the terminal-swing phase of normal gait

Children with cerebral palsy often walk with diminished knee extension during the terminal-swing phase, resulting in a troublesome "crouched" posture at initial contact and a shortened stride. Treatment of this gait abnormality is challenging because the factors that extend the knee during normal walking are not well understood, and because the potential of individual muscles to limit terminal-swing knee extension is unknown. This study analyzed a series of three-dimensional, muscle-driven dynamic simulations to quantify the angular accelerations of the knee induced by muscles and other factors during swing. Simulations were generated that reproduced the measured gait dynamics and muscle excitation patterns of six typically developing children walking at self-selected speeds. The knee was accelerated toward extension in the simulations by velocity-related forces (i.e., Coriolis and centrifugal forces) and by a number of muscles, notably the vasti in mid-swing (passive), the hip extensors in terminal swing, and the stance-limb hip abductors, which accelerated the pelvis upward. Knee extension was slowed in terminal swing by the stance-limb hip flexors, which accelerated the pelvis backward. The hamstrings decelerated the forward motion of the swing-limb shank, but did not contribute substantially to angular motions of the knee. Based on these data, we hypothesize that the diminished knee extension in terminal swing exhibited by children with cerebral palsy may, in part, be caused by weak hip extensors or by impaired hip muscles on the stance limb that result in abnormal accelerations of the pelvis.