Contributions of muscle forces and toe-off kinematics to peak knee flexion during the swing phase of normal gait: an induced position analysis

A three-dimensional dynamic simulation of walking was used together with induced position analysis to determine how kinematic conditions at toe-off and muscle forces following toe-off affect peak knee flexion during the swing phase of normal gait. The flexion velocity of the swing-limb knee at toe-off contributed 30 degrees to the peak knee flexion angle; this was larger than any contribution from an individual muscle or joint moment. Swing-limb muscles individually made large contributions to knee angle (i.e., as large as 22 degrees), but their actions tended to balance one another, so that the combined contribution from all swing-limb muscles was small (i.e., less than 3 degrees of flexion). The uniarticular muscles of the swing limb made contributions to knee flexion that were an order of magnitude larger than the biarticular muscles of the swing limb. The results of the induced position analysis make clear the importance of knee flexion velocity at toe-off relative to the effects of muscle forces exerted after toe-off in generating peak knee flexion angle. In addition to improving our understanding of normal gait, this study provides a basis for analyzing stiff-knee gait, a movement abnormality in which knee flexion in swing is diminished.     

Hip extension, knee flexion paradox: a new mechanism for non-contact ACL injury

Considering that an athlete performs at-risk sports activities countless times throughout the course of his or her career prior to the instance of anterior cruciate ligament (ACL) injury, one may conclude that non-contact ACL injury is a rare event. Nevertheless, the overall number of non-contact ACL injuries, both in the US and worldwide, remains alarming due to the growing number of recreational and professional athletes participating in high-risk activities. To date, numerous non-contact ACL injury mechanisms have been proposed, but none provides a detailed picture of sequence of events leading to injury and the exact cause of this injury remains elusive. In this perspective article, we propose a new conception of non-contact ACL injury mechanism that comprehensively integrates risk factors inside and outside the knee joint. The proposed mechanism is robust in the sense that it is biomechanically justifiable and addresses a number of confounding issues related to ACL injury.     

Effects of support size and orientation on symmetric gaits in free-ranging tamarins of Amazonian Peru: implications for the functional significance of primate gait sequence patterns

The adoption of a specific gait sequence pattern during symmetrical locomotion has been proposed to have been a key advantage for the exploitation of the fine branch niche in early primates. Diverse aspects of primate locomotion have been extensively studied in technically equipped laboratory settings, but evolutionary conclusions derived from these investigations have rarely been verified in wild primates. Bridging the gap from the lab to the field, we conducted an actual performance determination of symmetrical gaits in two free-ranging tamarin species (Saguinus mystax and Saguinus fuscicollis) of Amazonian Peru by analyzing high-speed video recordings of naturally occurring locomotor bouts. Tamarins arguably represent viable models for aspects of early primate locomotion. We tested three specific hypotheses derived from laboratory studies to test for the influence of support size and orientation and to gain further insight into the functional significance of primate gait sequence patterns: (1) The tamarins utilize symmetrical gaits at a higher rate on small supports than on larger ones. (2) During symmetrical locomotion on small supports, diagonal sequences are utilized at a higher rate than on larger supports. (3) On inclines, diagonal sequences are predominantly used and on declines, lateral sequences are predominantly used. Our results corroborated hypotheses 1 and 3. We found no clear support for hypothesis 2. In conclusion, our results add to the notion that primate gait plasticity, rather than uniform adoption of diagonal sequence gaits, enabled early primates to accommodate different support types and effectively exploit the small branch niche.     

Experimental support for a right-handed vertical double helix

The experimentally observed geometry of a miniature double helix of high anti (χCN fixed ? 120°) nucleic acid structure indicates substantial interstrand base stacking with little intrastrand base stacking. This geometry is consistent with the right-handed vertical double helix in which the base planes are parallel to helical axis proposed by Olson [(1977) Proc. Natl. Acad. Sci. USA 74 , 1775] from theoretical calculations. The experimental data do not agree with the left-handed model in which the base planes are perpendicular to helical axis that has been proposed by Yathindra and Sundaralingam [(1976) Nucl. Acids Res. 3 , 729]. The theoretically computed chemical shift changes for the various double-helical configurations show that for the system examined, only the vertical model can explain the experimentally observed shift trends. The melting curve for the helix–coil transition for high anti dinucleoside monophosphate has been observed for the first time. Even though the experimental data support vertical double helices when χCN is fixed at 120°, data on naturally occurring nucleic acid structures indicate that they have no proclivity to enter into vertically stabilized double-helical arrays.     

Variability of gait is dependent on direction of progression: implications for active control

Typical healthy walking displays greater variability in the mediolateral direction compared to the anteroposterior direction. This greater variability is thought to represent increased uncertainty in movement. As a result, it has been postulated that the mediolateral direction of gait requires more active control by the central nervous system while the anteroposterior direction is controlled through passive actions. However, this theory has only been tested on gait where progression occurs in the anteroposterior direction. Therefore, the purpose of this study was to investigate how the amount of variability is affected if progression occurs in the mediolateral direction using a lateral stepping gait. Results showed the anteroposterior direction had a significantly greater amount of variability than the mediolateral direction (p<0.001). The results do not support current models of a partition of active control to different anatomical planes. Rather, it seems that other physical entities involved in motion, such as momentum and inertia, are able to decrease the dependence on active control from the central nervous system. In a lateral stepping gait, such physical entities were no longer assisting in the anteroposterior direction but had a larger impact in the mediolateral direction as it was the direction of progression. As a result variability in the anteroposterior direction increased. Thus, it is possible to infer increased reliance on active control from the central nervous system in the direction orthogonal to progression.     

Effects of antihypertensive agents on blood velocity: implications for atherogenesis.

Heart rate and blood velocity are major determinants of flow disturbances at arterial bifurcations. Since endothelial damage due to flow disturbances is thought to be significant in the pathogenesis of atherosclerosis, the effects of drugs on these parameters have to be considered in the selection of medications to prevent atherosclerosis. To determine the effects of antihypertensive drugs on heart rate and blood velocity 15 patients with hypertension were treated with placebo, hydrochlorothiazide, nadolol, propranolol and hydralazine in sequence. The doses given produced significant changes in heart rate and blood pressure, and Doppler ultrasonographic recording of aortic blood velocity showed that there were significant changes in peak blood velocity. Nadolol and propranolol produced significantly lower values of heart rate x blood velocity than placebo, hydralazine and hydrochlorothiazide.     

Symmetrical gaits of Cebus apella: implications for the functional significance of diagonal sequence gait in primates

Quadrupedal locomotion of primates is distinguished from the quadrupedalism of many other mammals by several features, including a diagonal sequence (DS) footfall used in symmetrical gaits. This presumably unique feature of primate locomotion has been attributed to an ancestral adaptation for cautious arboreal quadrupedalism on thin, flexible branches. However, the functional significance of DS gait remains largely hypothetical. The study presented here tests hypotheses about the functional significance of DS gait by analyzing the gait mechanics of a primate that alternates between DS and lateral sequence (LS) gaits, Cebus apella. Kinematic and kinetic data were gathered from two subjects as they moved across both terrestrial and simulated arboreal substrates. These data were used to test four hypotheses: (1) locomotion on arboreal supports is associated with increased use of DS gait, (2) DS gait is associated with lower peak vertical substrate reaction forces than LS gait, (3) DS gait is associated with greater forelimb/hind limb differentiation in force magnitudes, and (4) DS gait offers increased stability. Our results indicate that animals preferred DS gait on the arboreal substrate, and LS gait while on the ground. Peak vertical substrate reaction forces showed a tendency to be lower in DS gait, but not consistently so. Pole ("arboreal") forces were lower than ground forces in DS gait, but not in LS gait. The preferred symmetrical gait on both substrates was a grounded run or amble, with the body supported by only one limb throughout most of the stride. During periods of bilateral support, the DS gait had predominantly diagonal support couplets. This benefit for stability on an arboreal substrate is potentially outweighed by overstriding, its associated ipsilateral limb interference in DS gait and hind foot positioning in front of the hand on untested territory. DS gait also did not result in an optimal anchoring position of the hind foot under the center of mass of the body at forelimb touchdown. In sum, the results are mixed regarding the superiority of DS gait in an arboreal setting. Consequently, the notion that DS gait is an ancestral adaptation of primates, conditioned by the selection demands of an arboreal environment, remains largely hypothetical.     

Computational biodynamics of human knee joint in gait: from muscle forces to cartilage stresses

Using a validated finite element model of the intact knee joint we aim to compute muscle forces and joint response in the stance phase of gait. The model is driven by reported in vivo kinematics-kinetics data and ground reaction forces in asymptomatic subjects. Cartilage layers and menisci are simulated as depth-dependent tissues with collagen fibril networks. A simplified model with less refined mesh and isotropic depth-independent cartilage is also considered to investigate the effect of model accuracy on results. Muscle forces and joint detailed response are computed following an iterative procedure yielding results that satisfy kinematics/kinetics constraints while accounting at deformed configurations for muscle forces and passive properties. Predictions confirm that muscle forces and joint response alter substantially during the stance phase and that a simplified joint model may accurately be used to estimate muscle forces but not necessarily contact forces/areas, tissue stresses/strains, and ligament forces. Predictions are in general agreement with results of earlier studies. Performing the analyses at 6 periods from beginning to the end (0%, 5%, 25%, 50%, 75% and 100%), hamstrings forces peaked at 5%, quadriceps forces at 25% whereas gastrocnemius forces at 75%. ACL Force reached its maximum of 343 N at 25% and decreased thereafter. Contact forces reached maximum at 5%, 25% and 75% periods with the medial compartment carrying a major portion of load and experiencing larger relative movements and cartilage strains. Much smaller contact stresses were computed at the patellofemoral joint. This novel iterative kinematics-driven model is promising for the joint analysis in altered conditions.     

The effect of hamstring muscle compensation for anterior laxity in the ACL-deficient knee during gait

The hamstring muscles have been recognized as an important element in compensating for the loss of stability in the ACL-deficient knee, but it is still not clear whether the hamstring muscle force can completely compensate for the loss of ACL, and the consequences of increased hamstring muscle force. A two-dimensional anatomical knee model in the sagittal plane was developed to examine the effect of various levels of hamstring muscle activation on restraining anterior tibial translation in the ACL-deficient knee during level walking. The model included the tibiofemoral and patellofemoral joints, four major ligaments, the medial capsule, and five muscle units surrounding the knee. Simulations were conducted to determine anterior tibial translation and internal joint loading at a single selected position when the knee was under a peak external flexion moment during early stance phase of gait. Incremental hamstring muscle forces were applied to the modeled normal and the ACL-deficient knees. Results of simulations showed that the ACL injury increased the anterior tibial translation by 11.8mm, while 56% of the maximal hamstring muscle force could reduce the anterior translation of the tibia to a normal level during the stance phase of gait. The consequences of increased hamstring muscle force included increased quadriceps muscle force and joint contact force.     

A correction for axis misalignment in the joint angle curves representing knee movement in gait analysis

This paper derives a simple mathematical model relating changes in the orientations of the two Cartesian coordinate systems involved in recording knee movement and the varus-valgus and the internal-external rotation angles for describing the knee's motion. Rotation matrices are given for changing the orientations of the two Cartesian coordinate systems in such a way that the quadratic variations in the varus-valgus and in the external-internal angles are minimal. These estimated rotation matrices are used to correct for axis misalignment. The correction is calibrated by considering the impact of the new orientation of the thigh Cartesian coordinate system on the hip joint angles. The procedure is applied to kinematic data collected on normal subjects. The uncertainty about the specification of the thigh Cartesian coordinate system is shown to explain some of the between subject variability in the varus-valgus and in the internal-external rotation angles curves.     

Evaluation of a patient-specific cost function to predict the influence of foot path on the knee adduction torque during gait

A large external knee adduction torque during gait has been correlated with the progression of knee osteoarthritis (OA). Though foot path changes (e.g. toeing out) can reduce the adduction torque, no method currently exists to predict whether an optimal foot path exists for a specific patient. This study evaluates a patient-specific optimization cost function to predict how foot path changes influence both adduction torque peaks. Video motion and ground reaction data were collected from a patient with knee OA performing normal, toe out, and wide stance gait. Joint and inertial parameters in a dynamic, 27 degree-of-freedom, full-body gait model were calibrated to the patient's normal gait data. The model was then used in gait optimizations that predicted how the patient's adduction torque peaks would change due to changes in foot path. The cost function tracked the patient's normal gait data using weight factors calibrated to toe out gait and tested using wide stance gait. For both gait motions, the same cost function weights predicted the change in both adduction torque peaks to within 7% error. With further development, this approach may eventually permit the design of patient-specific rehabilitation procedures such as an optimal foot path for patients with knee OA.     

Muscular contributions to hip and knee extension during the single limb stance phase of normal gait: a framework for investigating the causes of crouch gait

Crouch gait, a troublesome movement abnormality among persons with cerebral palsy, is characterized by excessive flexion of the hips and knees during stance. Treatment of crouch gait is challenging, at present, because the factors that contribute to hip and knee extension during normal gait are not well understood, and because the potential of individual muscles to produce flexion or extension of the joints during stance is unknown. This study analyzed a three-dimensional, muscle-actuated dynamic simulation of walking to quantify the angular accelerations of the hip and knee induced by muscles during normal gait, and to rank the potential of the muscles to alter motions of these joints. Examination of the muscle actions during single limb stance showed that the gluteus maximus, vasti, and soleus make substantial contributions to hip and knee extension during normal gait. Per unit force, the gluteus maximus had greater potential than the vasti to accelerate the knee toward extension. These data suggest that weak hip extensors, knee extensors, or ankle plantar flexors may contribute to crouch gait, and strengthening these muscles--particularly gluteus maximus--may improve hip and knee extension. Abnormal forces generated by the iliopsoas or adductors may also contribute to crouch gait, as our analysis showed that these muscles have the potential to accelerate the hip and knee toward flexion. This work emphasizes the need to consider how muscular forces contribute to multijoint movements when attempting to identify the causes of abnormal gait.     

Bilateral deficit in plantar flexion: relation to knee joint position, muscle activation, and reflex excitability

Six male subjects made maximal isometric plantar flexions unilaterally (UL) and bilaterally (BL), with the knee joint angle positioned at 90° and 0° (full extension) and the ankle joint kept at 90°. Plantar flexion torque and electromyogram (EMG) of the lateral gastrocnemius (LG) and the soleus (Sol) muscles were recorded. There was a deficit in torque in BL compared to UL (P<0.05), and the deficit was greater when the knee was extended than when bent to 90° (13.9% vs 6.6%). The integrated EMG (iEMG) of UL and BL did not differ when the knee was at 90°. On the other hand, when the knee was extended iEMG of LG was smaller for BL than for UL, suggesting that the larger bilateral deficit when the knee was extended was due to a reduced activity of the LG motor units. In addition, the H-reflex recorded from Sol when the contralateral leg was performing a maximal unilateral plantarflexion was reduced. This would indicate that the force deficit was associated with a reduction of motoneuron excitability. Accepted: 18 August 1997     

Feasibility of a gait retraining strategy for reducing knee joint loading: increased trunk lean guided by real-time biofeedback

The purpose of this feasibility study was to examine changes in frontal plane knee and hip walking biomechanics following a gait retraining strategy focused on increasing lateral trunk lean and to quantify reports of difficulty and joint discomfort when performing such a gait modification. After undergoing a baseline analysis of normal walking, 9 young, healthy participants were trained to modify their gait to exhibit small (4°), medium (8°), and large (12°) amounts of lateral trunk lean. Training was guided by the use of real-time biofeedback of the actual trunk lean angle. Peak frontal plane external knee and hip joint moments were compared across conditions. Participants were asked to report the degree of difficulty and the presence of any joint discomfort for each amount of trunk lean modification. Small (4°), medium (8°), and large (12°) amounts of lateral trunk lean reduced the peak external knee adduction moment (KAM) by 7%, 21%, and 25%, respectively, though the peak KAM was only significantly less in the medium and large conditions (p<0.001). Increased trunk lean also significantly reduced the peak external hip adduction moments (p<0.001). All participants reported at least some difficulty performing the exaggerated trunk lean pattern and three participants reported ipsilateral knee, hip, and/or lower spine discomfort. Results from this study indicate that a gait pattern with increased lateral trunk lean can effectively reduce frontal plane joint moments. Though these findings have implications for pathological populations, learning this gait pattern was associated with some difficulty and joint discomfort.     

Ecomorphological pattern in Bermuda birds: The influence of competition and implications for nature preserves

Summary Previous ecomorphological studies of introduced land birds on oceanic islands have revealed several patterns consistent with the hypothesis that interspecific competition influenced the assembly process of that community. We extend one of these analyses to Bermuda, which differs from the previous islands in its size, latitude and isolation from the mainland. We tested for the presence of morphological overdispersion in surviving introduced passeriforms. Despite a possible predominance of random events in the assembly process due to Bermuda's small size and the presence of migrant species, the surviving passeriforms were morphologically overdispersed. The presence of this pattern supports the hypothesis that the assembly of the Bermuda passeriform community has been influenced by interspecific competition. This marks the third distinct community of island land birds in which this competitive pattern has been identified. This is particularly interesting because certain attributes of Bermuda and its avifauna make it more equivalent to communities in mainland refuges than avian assemblages on islands studied previously. This suggests that interspecific competition may have important effects on the structure of refuge communities.     

Optimizing whole-body kinematics to minimize valgus knee loading during sidestepping: implications for ACL injury risk

The kinematic mechanisms associated with elevated externally applied valgus knee moments during non-contact sidestepping and subsequent anterior cruciate ligament (ACL) injury risk are not well understood. To address this issue, the residual reduction algorithm (RRA) in OpenSim was used to create nine subject-specific, full-body (37 degrees of freedom) torque-driven simulations of athletic males performing unplanned sidestep (UnSS) sport tasks. The RRA was used again to produce an optimized kinematic solution with reduced peak valgus knee torques during the weight acceptance phase of stance. Pre-to-post kinematic optimization, mean peak valgus knee moments were significantly reduced by 44.2 Nm (p=0.045). Nine of a possible 37 upper and lower body kinematic changes in all three planes of motion were consistently used during the RRA to decrease peak valgus knee moments. The generalized kinematic strategy used by all nine simulations to reduce peak valgus knee moments and subsequent ACL injury risk during UnSS was to redirect the whole-body center of mass medially, towards the desired direction of travel.     

Kinematic and dynamic gait compensations resulting from knee instability in a rat model of osteoarthritis

Introduction

Osteoarthritis (OA) results in pain and disability; however, preclinical OA models often focus on joint-level changes. Gait analysis is one method used to evaluate both preclinical OA models and OA patients. The objective of this study is to describe spatiotemporal and ground reaction force changes in a rat medial meniscus transection (MMT) model of knee OA and to compare these gait measures with assays of weight bearing and tactile allodynia.

Methods

Sixteen rats were used in the study. The medial collateral ligament (MCL) was transected in twelve Lewis rats (male, 200 to 250 g); in six rats, the medial meniscus was transected, and the remaining six rats served as sham controls. The remaining four rats served as naïve controls. Gait, weight-bearing as measured by an incapacitance meter, and tactile allodynia were assessed on postoperative days 9 to 24. On day 28, knee joints were collected for histology. Cytokine concentrations in the serum were assessed with a 10-plex cytokine panel.

Results

Weight bearing was not affected by sham or MMT surgery; however, the MMT group had decreased mechanical paw-withdrawal thresholds in the operated limb relative to the contralateral limb (P = 0.017). The gait of the MMT group became increasingly asymmetric from postoperative days 9 to 24 (P = 0.020); moreover, MMT animals tended to spend more time on their contralateral limb than their operated limb while walking (P < 0.1). Ground reaction forces confirmed temporal shifts in symmetry and stance time, as the MMT group had lower vertical and propulsive ground reaction forces in their operated limb relative to the contralateral limb, naïve, and sham controls (P < 0.05). Levels of interleukin 6 in the MMT group tended to be higher than naïve controls (P = 0.072). Histology confirmed increased cartilage damage in the MMT group, consistent with OA initiation. Post hoc analysis revealed that gait symmetry, stance time imbalance, peak propulsive force, and serum interleukin 6 concentrations had significant correlations to the severity of cartilage lesion formation.

Conclusion

These data indicate significant gait compensations were present in the MMT group relative to medial collateral ligament (MCL) injury (sham) alone and naïve controls. Moreover, these data suggest that gait compensations are likely driven by meniscal instability and/or cartilage damage, and not by MCL injury alone.     

Coding of deflection velocity and amplitude by whisker primary afferent neurons: implications for higher level processing

Within the rat whisker-to-barrel pathway, local circuits in cortical layer IV are more sensitive to the initial timing of deflection-evoked thalamic responses than to the total number of spikes comprising them. Because thalamic response timing better reflects whisker deflection velocity than amplitude, cortical neurons are more responsive to the former than the latter. The aim of this study is to determine how deflection velocity and amplitude may be encoded by the primary afferent neurons innervating the vibrissae. Responses of 81 extracellularly recorded trigeminal ganglion neurons (60 slowly and 21 rapidly adapting) were studied using controlled whisker stimuli identical to those used previously to investigate the velocity and amplitude sensitivities of thalamic and cortical neurons. For either slowly (SA) or rapidly adapting (RA) neurons, velocity is reflected by both response magnitude, measured as the total number of evoked spikes/stimulus, and initial firing rate, measured as the number of spikes discharged during the first 2 ms of the response. Deflection amplitude, on the other hand, is represented only by the SA population in their response magnitudes. Thus, in both populations initial firing rates unambiguously reflect deflection velocity. Together with previous findings, results demonstrate that information about deflection velocity is preserved throughout the whisker-to-barrel pathway by central circuits sensitive to initial response timing.