Mechanical analysis of the landing phase in heel-toe running

The "impacts cause injury" hypothesis: Running in circles or making new strides?

Some of the earliest biomechanics research focused on running and the ground reaction forces generated with each step. Research in running gait accelerated in the 1970's as the growing popularity in running increased attention to the musculoskeletal injuries sustained by runners. Despite decades of high-quality research, running remains the most common cause of exercise-related musculoskeletal injuries and rates of overuse running-related injuries (RRI) have not appreciably declined since the research began. One leading area of running gait research focuses on discrete variables derived from the vertical ground reaction force, such as the vertical loading rate. Across sub-disciplines of running gait research, vertical loading rate is often discussed as the primary and undisputed variable associated with RRI despite only low to moderate evidence that retrospectively or prospectively injured runners generate greater vertical loading rates than uninjured counterparts. The central thesis of this review is that relying on vertical loading rate is insufficient to establish causal mechanisms for RRI etiology. To present this argument, this review examines the history of the 'impacts cause injury' hypothesis, including a historical look at ground reaction forces in human running and the research from which this hypothesis was generated. Additionally, a synthesis of studies that have tested the hypothesis is provided and recommendations for future research are discussed. Although it is premature to reject or support the 'impacts cause injury' hypothesis, new knowledge of biomechanical risk factors for RRI will remain concealed until research departs from the current path or adopts new approaches to previous paradigms.

Slack-based tunable damping leads to a trade-off between robustness and efficiency in legged locomotion

Animals run robustly in diverse terrain. This locomotion robustness is puzzling because axon conduction velocity is limited to a few tens of meters per second. If reflex loops deliver sensory information with significant delays, one would expect a destabilizing effect on sensorimotor control. Hence, an alternative explanation describes a hierarchical structure of low-level adaptive mechanics and high-level sensorimotor control to help mitigate the effects of transmission delays. Motivated by the concept of an adaptive mechanism triggering an immediate response, we developed a tunable physical damper system. Our mechanism combines a tendon with adjustable slackness connected to a physical damper. The slack damper allows adjustment of damping force, onset timing, effective stroke, and energy dissipation. We characterize the slack damper mechanism mounted to a legged robot controlled in open-loop mode. The robot hops vertically and planarly over varying terrains and perturbations. During forward hopping, slack-based damping improves faster perturbation recovery (up to 170%) at higher energetic cost (27%). The tunable slack mechanism auto-engages the damper during perturbations, leading to a perturbation-trigger damping, improving robustness at a minimum energetic cost. With the results from the slack damper mechanism, we propose a new functional interpretation of animals' redundant muscle tendons as tunable dampers.

Consistent inconsistencies in braking: a spatial analysis

The dynamic system that is the bipedal body in motion is of interest to engineers, clinicians and biological anthropologists alike. Spatial statistics is more familiar to public health researchers as a way of analysing disease clustering and spread; nonetheless, this is a practical approach to the two-dimensional topography of the foot. We quantified the clustering of the centre of pressure (CoP) on the foot for peak braking and propulsive vertical ground reaction forces (GRFs) over multiple, contiguous steps to assess the consistency of the location of peak forces on the foot during walking. The vertical GRFs of 11 participants were collected continuously via a wireless insole system (MoticonReGo AG) across various experimental conditions. We hypothesized that CoPs would cluster in the hindfoot for braking and forefoot for propulsion, and that braking would demonstrate more consistent clustering than propulsion. Contrary to our hypotheses, we found that CoPs during braking are inconsistent in their location, and CoPs during propulsion are more consistent and clustered across all participants and all trials. These results add to our understanding of the applied forces on the foot so that we can better predict fatigue failures and better understand the mechanisms that shaped the modern bipedal form.

Surface acceleration transmission during drop landings in humans

The purpose of this study was to quantify the magnitude and frequency content of surface-measured accelerations at each major human body segment from foot to head during impact landings. Twelve males performed two single leg drop landings from each of 0.15 m, 0.30 m, and 0.45 m. Triaxial accelerometers (2000 Hz) were positioned over the: first metatarsophalangeal joint; distal anteromedial tibia; superior to the medial femoral condyle; L5 vertebra; and C6 vertebra. Analysis of acceleration signal power spectral densities revealed two distinct components, 2-14 Hz and 14-58 Hz, which were assumed to correspond to time domain signal joint rotations and elastic wave tissue deformation, respectively. Between each accelerometer position from the metatarsophalangeal joint to the L5 vertebra, signals exhibited decreased peak acceleration, increased time to peak acceleration, and decreased power spectral density integral of both the 2-14 Hz and 14-58 Hz components, with no further attenuation beyond the L5 vertebra. This resulted in peak accelerations close to vital organs of less than 10% of those at the foot. Following landings from greater heights, peak accelerations measured distally were greater, as was attenuation prior to the L5 position. Active and passive mechanisms within the lower limb therefore contribute to progressive attenuation of accelerations, preventing excessive accelerations from reaching the torso and head, even when distal accelerations are large.

Relationships between tibial acceleration and ground reaction force measures in the medial-lateral and anterior-posterior planes

Peak vertical tibial accelerations during running have shown strong correlations with vertical ground reaction force loading rates and some associations with injury. However, little attention has been given to tibial accelerations along the medial-lateral and anterior-posterior axes. Therefore, our purpose was to examine the correlation between peak tibial accelerations and ground reaction force loading rates in the medial-lateral and posterior directions. Eighteen recreational runners were recruited who ran with a rearfoot strike pattern (10 men/ 8 women, mean age (yrs) = 33 ± 11). Tibial accelerations and ground reaction forces were collected while participants ran on an instrumented treadmill at a self-selected speed. Correlations were developed for: a) peak medial and lateral accelerations with lateral and medial loading rates, respectively, b) peak anterior tibial accelerations and posterior loading rates. Significant correlations were found between tibial accelerations and loading rates in all planes. Peak medial tibial accelerations were correlated with lateral loading rates (R_s = 0.86, p < 0.001) and peak lateral tibial accelerations were correlated with peak medial loading rates (R_s = 0.91, p < 0.001). A lower correlation was found between anterior accelerations and posterior loading rates (R_s = 0.51, p = 0.030). Tibial accelerations in the medial-lateral plane seem to be a valid surrogate for the respective ground reaction force measures during running on a treadmill, explaining 74-83% of the variance in loading rates. However, with only 26% of the variance explained, the same may not be true for anterior tibial accelerations and posterior loading rates.

The effect of running on foot muscles and bones: A systematic review

Despite the widespread evidence of running as a health-preserving exercise, little is known concerning its effect on the foot musculature and bones. While running may influence anatomical foot adaptation, it remains unclear to what extent these adaptations occur. The aim of this paper is to provide a systematic review of the studies that investigated the effects of running and the adaptations that occur in foot muscles and bones. The search was performed following the PRISMA guidelines. Relevant keywords were used for the search through PubMed/MEDLINE, Scopus and SPORTDiscus. The methodological quality of intervention studies was assessed using the Downs and Black checklist. For cross-sectional studies, the Newcastle-Ottawa scale was used. Sixteen studies were found meeting the inclusion criteria. In general, the included studies were deemed to be of moderate methodological quality. Although results of relevant literature are limited and somewhat contradictory, the outcome suggests that running may increase foot muscle volume, muscle cross-sectional area and bone density, but this seems to depend on training volume and experience. Future studies conducted in this area should aim for a standard way of reporting foot muscle/bone characteristics. Also, herein, suggestions for future research are provided.

Determinants of optimal leg use strategy: horizontal to vertical transition in the parkour wall climb

This study examined the mechanics of the horizontal to vertical transition used by parkour athletes in wall climbing. We used this task as an alternative to normal running - where the functional options differ substantially - exposing the movement control priorities required to successfully complete the task. Ground reaction forces were measured in several expert parkour athletes and centre of mass trajectory was calculated from force plates embedded in the ground and the wall. Empirical measures were compared with movements predicted by a work-based control optimization model. The model captured the fundamental dynamics of the transition and therefore allowed an exploration of parameter sensitivity for success at the manoeuvre (run-up speed, foot placement, etc.). The optimal transition of both the model and the parkour athletes used a common intermediate run-up speed and appears determined largely by a trade-off between positive and negative leg work that accomplishes the task with minimum overall work.

Grounded Running Reduces Musculoskeletal Loading

PURPOSE

Recent observations demonstrate that a sizeable proportion of the recreational running population runs at rather slow speeds and does not always show a clear flight phase. This study determined the key biomechanical and physiological characteristics of this running pattern, i.e., grounded running (GR), and compared these characteristics with slow aerial running (SAR) and reference data on walking at the same slow running speed.

METHODS

Thirty male subjects performed instructed GR and SAR at 2.10 m·s on a treadmill. Ground reaction forces, tibial accelerations, and metabolic rate were measured to estimate general musculoskeletal loading (external power and maximal vertical ground reaction force), impact intensity (vertical instantaneous loading rate and tibial acceleration), and energy expenditure. More explicit measures of muscular loading (muscle stresses and peak eccentric power) were calculated based on a representative subsample, in which detailed kinematics and kinetics were recorded. We hypothesized that all measures would be lower for the GR condition.

RESULTS

Subjects successfully altered their running pattern upon a simple instruction toward a GR pattern by increasing their duty factor from 41.5% to 51.2%. As hypothesized, impact intensity, general measures for musculoskeletal, and the more explicit measures for muscular loading decreased by up to 35.0%, 20.3%, and 34.0%, respectively, compared with SAR. Contrary to our hypothesis, metabolic rate showed an increase of 4.8%.

CONCLUSIONS

Changing running style from SAR to GR reduces musculoskeletal loading without lowering the metabolic energy requirements. As such, GR might be beneficial for most runners as it has the potential to reduce the risk of running-related injuries while remaining a moderate to vigorous form of physical activity, contributing to fulfillment of the recommendations concerning physical activity and public health.

A comparison of the ground reaction force frequency content during rearfoot and non-rearfoot running patterns

Running with a non-rearfoot pattern has been claimed to reduce injury risk because the impact peak in the vertical ground reaction force (GRF) is visually absent in the time-domain compared with a rearfoot pattern. However, running results in a rapid deceleration of the lower extremity segments immediately following initial contact with the ground, regardless of footfall pattern. Therefore, the frequency content of the GRF is expected to contain evidence of this collision. The purpose of the present study was to characterize the waveform components of the GRF generated during the impact phase by habitual rearfoot and habitual non-rearfoot pattern groups using the continuous wavelet transform. Twenty rearfoot and 20 non-rearfoot participants ran over-ground at a standardized speed with their habitual footfall pattern. The continuous wavelet transform was performed on the resultant GRF vector and the vertical GRF. GRF signals generated by the non-rearfoot pattern group during early stance had maximum signal power of 15.4±9.1Hz occurring at 23.1±6.3% of stance, which is within the 10-20Hz range previously associated with impact in rearfoot runners. Maximum signal power occurred earlier in the impact phase (11.5±1.5%) and with a higher frequency (27.2±3.9Hz) in the rearfoot pattern group verses the non-rearfoot pattern group (P<0.05). While the impact force transient may not appear as a prominent feature within the time-domain GRF with a non-rearfoot pattern, the results indicate that both footfall patterns generate frequencies associated with the impact peak in the resultant and vertical GRF.

Is changing footstrike pattern beneficial to runners?

Some researchers, running instructors, and coaches have suggested that the "optimal" footstrike pattern to improve performance and reduce running injuries is to land using a mid- or forefoot strike. Thus, it has been recommended that runners who use a rearfoot strike would benefit by changing their footstrike although there is little scientific evidence for suggesting such a change. The rearfoot strike is clearly more prevalent. The major reasons often given for changing to a mid- or forefoot strike are (1) it is more economical; (2) there is a reduction in the impact peak and loading rate of the vertical component of the ground reaction force; and (3) there is a reduction in the risk of a running-related injuries. In this paper, we critique these 3 suggestions and provide alternate explanations that may provide contradictory evidence for altering one's footstrike pattern. We have concluded, based on examining the research literature, that changing to a mid- or forefoot strike does not improve running economy, does not eliminate an impact at the foot-ground contact, and does not reduce the risk of running-related injuries.

Adjustments with running speed reveal neuromuscular adaptations during landing associated with high mileage running training

It remains to be determined whether running training influences the amplitude of lower limb muscle activations before and during the first half of stance and whether such changes are associated with joint stiffness regulation and usage of stored energy from tendons. Therefore, the aim of this study was to investigate neuromuscular and movement adaptations before and during landing in response to running training across a range of speeds. Two groups of high mileage (HM; >45 km/wk, n = 13) and low mileage (LM; <15 km/wk, n = 13) runners ran at four speeds (2.5-5.5 m/s) while lower limb mechanics and electromyography of the thigh muscles were collected. There were few differences in prelanding activation levels, but HM runners displayed lower activations of the rectus femoris, vastus medialis, and semitendinosus muscles postlanding, and these differences increased with running speed. HM runners also demonstrated higher initial knee stiffness during the impact phase compared with LM runners, which was associated with an earlier peak knee flexion velocity, and both were relatively unchanged by running speed. In contrast, LM runners had higher knee stiffness during the slightly later weight acceptance phase and the disparity was amplified with increases in speed. It was concluded that initial knee joint stiffness might predominantly be governed by tendon stiffness rather than muscular activations before landing. Estimated elastic work about the ankle was found to be higher in the HM runners, which might play a role in reducing weight acceptance phase muscle activation levels and improve muscle activation efficiency with running training.NEW & NOTEWORTHY Although neuromuscular factors play a key role during running, the influence of high mileage training on neuromuscular function has been poorly studied, especially in relation to running speed. This study is the first to demonstrate changes in neuromuscular conditioning with high mileage training, mainly characterized by lower thigh muscle activation after touch down, higher initial knee stiffness, and greater estimates of energy return, with adaptations being increasingly evident at faster running speeds.

Effects of structural components of artificial turf on the transmission of impacts in football players

The third generation of artificial turf systems (ATS) has matched the mechanical behaviour of natural grass, but today a high heterogeneity at structural level and mechanical behaviour in the new ATS also exists. The objective was to analyse the effect of the structural components of ATS football pitches and running speed on the capacity of impact attenuation. A total of 12 athletes were evaluated at three speed conditions (3.33 m/s, 4 m/s and maximum speed) on four different ATS, classifying them by their components (length of fibre, type of in-fill and sub-base). Impact attenuation was significantly higher in ATS3, characterised by longer fibre compared to other ATS with less fibre length. The ATS4 with a higher length fibre and built on compacted granular material proportioned significantly lower values in the maximum peaks of tibia acceleration. Finally, as speed increases, the peak tibia impacts were significantly higher. Longer fibre length and the capacity to accommodate a higher quantity of infill facilitate higher impact attenuation. Equally, a compacted granular sub-base is related to lower magnitude of maximum tibia peaks. Finally, the magnitude of the tibia acceleration peaks is dependent of running speed for all ATS analysed, being higher as speed increases.

Classifying the variability in impact and active peak vertical ground reaction forces during running using DFA and ARFIMA models

The vertical ground reaction force (VGRF) during rear-foot striking running typically exhibits peaks referred to as the impact peak and the active peak; their timings and magnitudes have been implicated in injury. Identifying the structure of time-series can provide insight into associated control processes. The purpose here was to detect long-range correlations associated with the time from first contact to impact peak (TIP) and active peak (TAP); and the magnitudes of impact (IPM) and active peaks (APM) using a Detrended Fluctuation Analysis, and Auto-Regressive Fractionally Integrated Moving Average models. Twelve subjects performed an 8min trial at their preferred running speed on an instrumented treadmill. TIP, TAP; IPM, and APM were identified from the VGRF profile for each footfall. TIP and TAP time-series did not demonstrate long-range correlations, conversely IPM and APM time-series did. Short range correlations appeared as well as or instead of long range correlations for IPM. Conversely pure powerlaw behaviour was demonstrated in 11 of the 24 time series for APM, and long range dependencies along with short range correlations were present in a further 9 time series. It has been hypothesised that control mechanisms for IPM and APM are different, these results support this hypothesis.

Stiffness Effects in Rocker-Soled Shoes: Biomechanical Implications

Rocker-soled shoes provide a way to reduce the possible concentration of stress, as well as change movement patterns, during gait. This study attempts to examine how plantar force and spatio-temporal variables are affected by two rocker designs, one with softer and one with denser sole materials, by comparing them with the barefoot condition and with flat-soled shoes. Eleven subjects' gait parameters during walking and jogging were recorded. Our results showed that compared with barefoot walking, plantar forces were higher for flat shoes while lower for both types of rocker shoes, the softer-material rocker being the lowest. The plantar force of flat shoes is greater than the vertical ground reaction force, while that of both rocker shoes is much less, 13.87-30.55% body weight. However, as locomotion speed increased to jogging, for all shoe types, except at the second peak plantar force of the denser sole material rocker shoes, plantar forces were greater than for bare feet. More interestingly, because the transmission of force was faster while jogging, greater plantar force was seen in the rocker-soled shoes with softer material than with denser material; results for higher-speed shock absorption in rocker-soled shoes with softer material were thus not as good. In general, the rolling phenomena along the bottom surface of the rocker shoes, as well as an increase in the duration of simultaneous curve rolling and ankle rotation, could contribute to the reduction of plantar force for both rocker designs. The possible mechanism is the conversion of vertical kinetic energy into rotational kinetic energy. To conclude, since plantar force is related to foot-ground interface and deceleration methods, rocker-design shoes could achieve desired plantar force reduction through certain rolling phenomena, shoe-sole stiffness levels, and locomotion speeds.

Impact testing of the residual limb: System response to changes in prosthetic stiffness

Currently, it is unknown whether changing prosthetic limb stiffness affects the total limb stiffness and influences the shock absorption of an individual with transtibial amputation. The hypotheses tested within this study are that a decrease in longitudinal prosthetic stiffness will produce (1) a reduced total limb stiffness, and (2) reduced magnitude of peak impact forces and increased time delay to peak force. Fourteen subjects with a transtibial amputation participated in this study. Prosthetic stiffness was modified by means of a shock-absorbing pylon that provides reduced longitudinal stiffness through compression of a helical spring within the pylon. A sudden loading evaluation device was built to examine changes in limb loading mechanics during a sudden impact event. No significant change was found in the peak force magnitude or timing of the peak force between prosthetic limb stiffness conditions. Total limb stiffness estimates ranged from 14.9 to 17.9 kN/m but were not significantly different between conditions. Thus, the prosthetic-side total limb stiffness was unaffected by changes in prosthetic limb stiffness. The insensitivity of the total limb stiffness to prosthetic stiffness may be explained by the mechanical characteristics (i.e., stiffness and damping) of the anatomical tissue within the residual limb.

Stochastic modelling of muscle recruitment during activity

Muscle forces can be selected from a space of muscle recruitment strategies that produce stable motion and variable muscle and joint forces. However, current optimization methods provide only a single muscle recruitment strategy. We modelled the spectrum of muscle recruitment strategies while walking. The equilibrium equations at the joints, muscle constraints, static optimization solutions and 15-channel electromyography (EMG) recordings for seven walking cycles were taken from earlier studies. The spectrum of muscle forces was calculated using Bayesian statistics and Markov chain Monte Carlo (MCMC) methods, whereas EMG-driven muscle forces were calculated using EMG-driven modelling. We calculated the differences between the spectrum and EMG-driven muscle force for 1-15 input EMGs, and we identified the muscle strategy that best matched the recorded EMG pattern. The best-fit strategy, static optimization solution and EMG-driven force data were compared using correlation analysis. Possible and plausible muscle forces were defined as within physiological boundaries and within EMG boundaries. Possible muscle and joint forces were calculated by constraining the muscle forces between zero and the peak muscle force. Plausible muscle forces were constrained within six selected EMG boundaries. The spectrum to EMG-driven force difference increased from 40 to 108 N for 1-15 EMG inputs. The best-fit muscle strategy better described the EMG-driven pattern (R (2) = 0.94; RMSE = 19 N) than the static optimization solution (R (2) = 0.38; RMSE = 61 N). Possible forces for 27 of 34 muscles varied between zero and the peak muscle force, inducing a peak hip force of 11.3 body-weights. Plausible muscle forces closely matched the selected EMG patterns; no effect of the EMG constraint was observed on the remaining muscle force ranges. The model can be used to study alternative muscle recruitment strategies in both physiological and pathophysiological neuromotor conditions.

Is there evidence to support a forefoot strike pattern in barefoot runners? A review

Context:

Barefoot running is a trend among running enthusiasts that is the subject of much controversy. At this time, benefits appear to be more speculative and anecdotal than evidence based. Additionally, the risk of injuries is not well established.

Evidence acquisition:

A PubMed search was undertaken for articles published in English from 1980 to 2011. Additional references were accrued from reference lists of research articles.

Results:

While minimal data exist that definitively support barefoot running, there are data lending support to the argument that runners should use a forefoot strike pattern in lieu of a heel strike pattern to reduce ground reaction forces, ground contact time, and step length.

Conclusions:

Whether there is a positive or negative effect on injury has yet to be determined. Unquestionably, more research is needed before definitive conclusions can be drawn.

Barefoot Running: The Effects of an 8-Week Barefoot Training Program

Background:

It has been proposed that running barefoot can lead to improved strength and proprioception. However, the duration that a runner must train barefoot to observe these changes is unknown.

Hypothesis:

Runners participating in a barefoot running program will have improved proprioception, increased lower extremity strength, and an increase in the volume or size of the intrinsic musculature of the feet.

Study Design:

Randomized controlled trial; Level of evidence, 2.

Methods:

In this 8-week study, 29 runners with a mean age of 36.34 years were randomized into either a control group (n = 10) who completed training in their regular running shoes or to an experimental barefoot group (n = 14). Pretraining tests consisted of a volumetric measurement of the foot followed by a strength and dynamic balance assessment. Five subjects completed the pretests but did not complete the study for reasons not related to study outcomes. Participants then completed 8 weeks of training runs. They repeated the strength and dynamic balance assessment after 8 weeks.

Results:

Significant changes from baseline to 8 weeks were observed within the barefoot group for single-leg hop (right, P = .0121; left, P = .0430) and reach and balance (right, P = .0029) and within the control group for single–left leg hop (P = .0286) and reach and balance (right, P = .0096; left, P = .0014). However, when comparing the differences in changes from baseline to 8 weeks between the barefoot and control groups, the improvements were not significant at the .05 level for all measures.

Conclusion:

Although statistically significant changes were not observed between the pre- and posttest evaluations in strength and proprioception with the 8-week low-intensity barefoot running regimen, this does not necessarily mean that these changes do not occur. It is possible that it may take months or years to observe these changes, and a short course such as this trial is insufficient.

Young men utilise limited neuromuscular preparation to regulate post-impact knee mechanics during step landing

PURPOSE

The neuromuscular mechanisms determining the mechanical behaviour of the knee during landing impact remain poorly understood. It was hypothesised that neuromuscular preparation is subject-specific and ranges along a continuum from passive to active.

METHODS

A group of healthy men (N=12) stepped-down from a knee-high platform for 60 consecutive trials. Surface EMG of the quadriceps and hamstrings was used to determine pre-impact onset timing, activation amplitude and cocontraction for each trial. Partial least squares regression was used to associate pre-impact preparation with post-impact knee stiffness and coordination.

RESULTS

The group analysis revealed few significant changes in pre-impact preparation across trial blocks. Single-subject analyses revealed changes in muscle activity that varied in size and direction between individuals. Further, the association between pre-impact preparation and post-impact knee mechanics was subject-specific and ranged along a continuum of strategies.

CONCLUSION

The findings suggest that neuromuscular preparation during step landing is subject-specific and its association to post-impact knee mechanics occurs along a continuum, ranging from passive to active control strategies. Further work should examine the implications of these strategies on the distribution of knee forces in vivo.

A comparison of negative joint work and vertical ground reaction force loading rates in Chi runners and rearfoot-striking runners

STUDY DESIGN

Observational.

OBJECTIVES

To compare lower extremity negative joint work and vertical ground reaction force loading rates in rearfoot-striking (RS) and Chi runners.

BACKGROUND

Alternative running styles such as Chi running have become a popular alternative to RS running. Proponents assert that this running style reduces knee joint loading and ground reaction force loading rates.

METHODS

Twenty-two RS and 12 Chi runners ran for 5 minutes at a self-selected speed on an instrumented treadmill. A 3-D motion analysis system was used to obtain kinematic data. Average vertical ground reaction force loading rate and negative work of the ankle dorsiflexors, ankle plantar flexors, and knee extensors were computed during the stance phase. Groups were compared using a 1-way analysis of covariance for each variable, with running speed and age as covariates.

RESULTS

On average, RS runners demonstrated greater knee extensor negative work (RS, -0.332 J/body height × body weight [BH·BW]; Chi, -0.144 J/BH·BW; P<.001), whereas Chi runners demonstrated more ankle plantar flexor negative work (Chi, -0.467 J/BH·BW; RS, -0.315 J/BH·BW; P<.001). RS runners demonstrated greater average vertical ground reaction force loading rates than Chi runners (RS, 68.6 BW/s; Chi, 43.1 BW/s; P<.001).

CONCLUSION

Chi running may reduce vertical loading rates and knee extensor work, but may increase work of the ankle plantar flexors.

Assessing locomotor skills development in childhood using wearable inertial sensor devices: the running paradigm

Objective quantitative evaluation of motor skill development is of increasing importance to carefully drive physical exercise programs in childhood. Running is a fundamental motor skill humans adopt to accomplish locomotion, which is linked to physical activity levels, although the assessment is traditionally carried out using qualitative evaluation tests. The present study aimed at investigating the feasibility of using inertial sensors to quantify developmental differences in the running pattern of young children. Qualitative and quantitative assessment tools were adopted to identify a skill-sensitive set of biomechanical parameters for running and to further our understanding of the factors that determine progression to skilled running performance. Running performances of 54 children between the ages of 2 and 12 years were submitted to both qualitative and quantitative analysis, the former using sequences of developmental level, the latter estimating temporal and kinematic parameters from inertial sensor measurements. Discriminant analysis with running developmental level as dependent variable allowed to identify a set of temporal and kinematic parameters, within those obtained with the sensor, that best classified children into the qualitative developmental levels (accuracy higher than 67%). Multivariate analysis of variance with the quantitative parameters as dependent variables allowed to identify whether and which specific parameters or parameter subsets were differentially sensitive to specific transitions between contiguous developmental levels. The findings showed that different sets of temporal and kinematic parameters are able to tap all steps of the transitional process in running skill described through qualitative observation and can be prospectively used for applied diagnostic and sport training purposes.

Towards a bio-inspired leg design for high-speed running

High-speed terrestrial locomotion inevitably involves high acceleration and extensive loadings on the legs. This imposes a challenging trade-off between weight and strength in leg design. This paper introduces a new design paradigm for a robotic leg inspired by musculoskeletal structures. The central hypothesis is that employing a tendon-bone co-location architecture not only provides compliance in the leg, but can also reduce bone stresses caused by bending on structures. This hypothesis is applied to a leg design, and verified by simulations and the experiments on a prototype. In addition, we also present an optimization scheme to maximize the strength to weight ratio. Using the tendon-bone co-location architecture, the stress on the bone during a stride is reduced by up to 59%. A new foam-core prototyping technique enables creating structural characteristics similar to mammalian bones in the robotic leg. This method allows us to use lighter polymeric structures that are cheaper and quicker to fabricate than conventional fabrication methods, and can eventually greatly shorten the design iteration cycle time.

Forefoot running improves pain and disability associated with chronic exertional compartment syndrome

BACKGROUND

Anterior compartment pressures of the leg as well as kinematic and kinetic measures are significantly influenced by running technique. It is unknown whether adopting a forefoot strike technique will decrease the pain and disability associated with chronic exertional compartment syndrome (CECS) in hindfoot strike runners.

HYPOTHESIS

For people who have CECS, adopting a forefoot strike running technique will lead to decreased pain and disability associated with this condition.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Ten patients with CECS indicated for surgical release were prospectively enrolled. Resting and postrunning compartment pressures, kinematic and kinetic measurements, and self-report questionnaires were taken for all patients at baseline and after 6 weeks of a forefoot strike running intervention. Run distance and reported pain levels were recorded. A 15-point global rating of change (GROC) scale was used to measure perceived change after the intervention.

RESULTS

After 6 weeks of forefoot run training, mean postrun anterior compartment pressures significantly decreased from 78.4 ± 32.0 mm Hg to 38.4 ± 11.5 mm Hg. Vertical ground-reaction force and impulse values were significantly reduced. Running distance significantly increased from 1.4 ± 0.6 km before intervention to 4.8 ± 0.5 km 6 weeks after intervention, while reported pain while running significantly decreased. The Single Assessment Numeric Evaluation (SANE) significantly increased from 49.9 ± 21.4 to 90.4 ± 10.3, and the Lower Leg Outcome Survey (LLOS) significantly increased from 67.3 ± 13.7 to 91.5 ± 8.5. The GROC scores at 6 weeks after intervention were between 5 and 7 for all patients. One year after the intervention, the SANE and LLOS scores were greater than reported during the 6-week follow-up. Two-mile run times were also significantly faster than preintervention values. No patient required surgery.

CONCLUSION

In 10 consecutive patients with CECS, a 6-week forefoot strike running intervention led to decreased postrunning lower leg intracompartmental pressures. Pain and disability typically associated with CECS were greatly reduced for up to 1 year after intervention. Surgical intervention was avoided for all patients.

THE EFFECT OF KNEE POSTURES AND CUSHIONS IN THE LOAD TRANSMISSION OF IMPACT LOADING - AN IN VITRO BIOMECHANICAL PORCINE MODEL

Degenerative osteoarthritis is the consequence of impact force applied to articular cartilage that results in surface fissuring. Soft cushions and flexed posture are two important factors to reduce the impact force; however, no quantitative information of how soft should the cushion be to prevent the injury and the mechanism of force attenuation of knee joint at neutral and flexed posture was not well documented yet. The objective of current study is hence to find the quantitative shock attenuation of knee joint using different stiffness of cushions when the knee is at neutral posture and flexed posture. A “drop-tower type” impact apparatus was used for testing. Nineteen fresh porcine knee joints were divided into two posture groups, i.e. neutral and flexed posture. All specimens were tested using stiff, medium, and soft cushions. The axial reaction force, anteroposterior shear force, and flexion bending moment were recorded for analysis. We found the flexed posture decreased the axial reaction force and anterior shear force but increased the flexion bending moment. The effect of stiffness of cushions on the mechanical response of knee joint during impact loading was significant for neutral posture but not for flexed posture.

DEALING WITH SKIN MOTION AND WOBBLING MASSES IN INVERSE DYNAMICS

Inverse dynamics is a standard analysis in biomechanics to reconstruct time histories of internal driving forces and torques from measured external forces and segmental kinematics. The main sources of inconsistency leading to analytical artefacts in this process are skin marker and soft tissue motion. These potentially artificial high frequency fluctuations in the joint torques may serve as an erroneous basis of (misleading) assumptions with respect to muscular activity. Here we suggest techniques to reduce these errors. In both parts of this study, high-speed video and force platform data were acquired. In one part, 69 sequences of human barefoot running were sampled followed by an inverse dynamic analysis of the stance leg. The time history of the hip joint torque in the sagittal plane served as a sensitive "detector" of dynamic analysis artefacts. We show that the most important error — the relative skin to bone motion especially of the knee marker — can be reduced significantly by processing kinematic data using bone rigidity (constant segment lengths) and bony contour (frontal knee edge) information. Further on, neglecting significantly initiated soft tissue dynamics in the inverse dynamic model introduces another inconsistency in the analytical process. Therefore, in a second part of this study, soft tissue kinematics from 14 jumping sequences were identified. These data provided a set of coupling parameters of wobbling masses to the bone that were ready to be implemented in the inverse dynamic model. Using realistic bone kinematics mainly avoids phase shifts in the acceleration scenario within the leg, and thus artifical hip torque fluctuations within the whole contact period. In human running, accounting for soft tissue dynamics mainly affects the calculated timing of the hip joint torque during the impact phase.

Human evolution and osteoporosis-related spinal fractures

The field of evolutionary medicine examines the possibility that some diseases are the result of trade-offs made in human evolution. Spinal fractures are the most common osteoporosis-related fracture in humans, but are not observed in apes, even in cases of severe osteopenia. In humans, the development of osteoporosis is influenced by peak bone mass and strength in early adulthood as well as age-related bone loss. Here, we examine the structural differences in the vertebral bodies (the portion of the vertebra most commonly involved in osteoporosis-related fractures) between humans and apes before age-related bone loss occurs. Vertebrae from young adult humans and chimpanzees, gorillas, orangutans, and gibbons (T8 vertebrae, n = 8–14 per species, male and female, humans: 20–40 years of age) were examined to determine bone strength (using finite element models), bone morphology (external shape), and trabecular microarchitecture (micro-computed tomography). The vertebrae of young adult humans are not as strong as those from apes after accounting for body mass (p<0.01). Human vertebrae are larger in size (volume, cross-sectional area, height) than in apes with a similar body mass. Young adult human vertebrae have significantly lower trabecular bone volume fraction (0.26±0.04 in humans and 0.37±0.07 in apes, mean ± SD, p<0.01) and thinner vertebral shells than apes (after accounting for body mass, p<0.01). Since human vertebrae are more porous and weaker than those in apes in young adulthood (after accounting for bone mass), even modest amounts of age-related bone loss may lead to vertebral fracture in humans, while in apes, larger amounts of bone loss would be required before a vertebral fracture becomes likely. We present arguments that differences in vertebral bone size and shape associated with reduced bone strength in humans is linked to evolutionary adaptations associated with bipedalism.

Biomechanical Response to Changes in Natural Turf During Running and Turning

Integrated biomechanical and engineering assessments were used to determine how humans responded to variations in turf during running and turning. Ground reaction force (AMTI, 960 Hz) and kinematic data (Vicon Peak Motus, 120 Hz) were collected from eight participants during running (3.83 m/s) and turning (10 trials per condition) on three natural turf surfaces in the laboratory. Surface hardness (Clegg hammer) and shear strength (cruciform shear vane) were measured before and after participant testing. Peak loading rate during running was significantly higher (p < .05) on the least hard surface (sandy; 101.48 BW/s ± 23.3) compared with clay (84.67 BW/s ± 22.9). There were no significant differences in running kinematics. Compared with the “medium” condition, fifth MTP impact velocities during turning were significantly (RM-ANOVA, p < .05) lower on clay (resultant: 2.30 m/s [± 0.68] compared with 2.64 m/s [± 0.70]), which was significantly (p < .05) harder “after” and had the greatest shear strength both “before” and “after” participant testing. This unique finding suggests that further study of foot impact velocities are important to increase understanding of overuse injury mechanisms.

The Influences of Impact Interface, Muscle Activity, and Knee Angle on Impact Forces and Tibial and Femoral Accelerations Occurring after External Impacts

The purpose of this study was to quantify relative contributions of impact interface, muscle activity, and knee angle to the magnitudes of tibial and femoral accelerations occurring after external impacts. Impacts were initiated with a pneumatically driven impacter under the heels of four volunteers. Impact forces were quantified with a force sensor. Segmental accelerations were measured with bone mounted accelerometers. Experimental interventions were hard and soft shock interfaces, different knee angles (0°, 20°, 40° knee flexion), and muscular preactivation (0%, 30%, 60% of maximal voluntary contraction) of gastrocnemii, hamstrings, and quadriceps. Greater knee flexion led to lower impact forces and higher tibial accelerations. Increased muscular activation led to higher forces and lower tibial accelerations. The softer of the two shock interfaces under study reduced both parameters. The effects on accelerations and forces through the activation and knee angle changes were greater than the effect of interface variations. The hardness of the two shock interfaces explained less than 10% of the variance of accelerations and impact forces, whereas knee angle changes explained 25–29%, and preactivation changes explained 35–48% of the variances. It can be concluded that muscle force and knee joint angle have greater effects in comparison with interface hardness on the severity of shocks on the lower leg.

Use of pressure insoles to compare in-shoe loading for modern running shoes

The primary objective of this paper was to compare in-shoe loading for different models of running shoe using measurements of force distribution. It was hypothesised that a shoe designed with minimal focus on cushioning would demonstrate significantly higher peak forces and rates of loading than running shoes designed with cushioning midsoles. Loading was compared using in-shoe peak forces for six footwear conditions. It was found that peak rate of loading at the heel provided clear distinctions between shoes. In support of the study hypothesis, the shoe with minimal focus on cushioning had a significantly higher rate of loading than all but one of the other test shoes. Data collected for midfoot and forefoot areas of the foot highlighted the importance of considering loading across the foot surface. The results of the present study demonstrate that pressure insoles provide a useful tool for the assessment of loading across the foot plantar surface for different footwear conditions. There are numerous models of running shoe for individuals to select from, with limited information available regarding the performance of the shoes during running. The current study demonstrates differences in loads across the foot plantar surface during running, indicating differences in performance for different footwear models.

Biomechanical response to systematic changes in impact interface cushioning properties while performing a tennis-specific movement

It is currently not known whether human responses across typical sports surfaces are dependent on cushioning or frictional properties of the interface. The present study assessed systematic changes in surface cushioning (baseline acrylic, rubber, thin foam, and thick foam) as participants performed tennis running forehand foot plants wearing a basic neutral shoe (plimsolls). It was hypothesized that systematic decreases in peak rates of loading, heel pressures, and perceived hardness would be yielded as surface cushioning increased (impact test device). A common acrylic top surface provided consistent frictional properties across surfaces. Kinetics (AMTI, 960 Hz and Footscan Pressure Insoles, 500 Hz), kinematics (Peak MOTUS, 120 Hz), and cushioning perception were assessed. Peak and mean loading rates of vertical ground reaction force, peak horizontal force, peak heel pressure, and rates of loading demonstrated significant correlations (P < 0.05) with the participants' perceived levels of cushioning and matched mechanical rankings of surface cushioning. In contrast, peak impact force was lowest on the least cushioned surface. Kinematic responses were not significantly different between surfaces. Present evidence supports ''peak rate of loading'' as a more suitable indicator of surface cushioning than peak impact force. Although cautionary, biomechanical support is also provided for mechanical methods of surface cushioning assessment.

Validation of vertical ground reaction forces on individual limbs calculated from kinematics of horse locomotion

The purpose of this study was to determine whether individual limb forces could be calculated accurately from kinematics of trotting and walking horses. We collected kinematic data and measured vertical ground reaction forces on the individual limbs of seven Warmblood dressage horses, trotting at 3.4 m s–1 and walking at 1.6 m s–1 on a treadmill. First, using a segmental model, we calculated from kinematics the total ground reaction force vector and its moment arm relative to each of the hoofs. Second, for phases in which the body was supported by only two limbs, we calculated the individual reaction forces on these limbs. Third, we assumed that the distal limbs operated as linear springs, and determined their force–length relationships using calculated individual limb forces at trot. Finally, we calculated individual limb force–time histories from distal limb lengths. A good correspondence was obtained between calculated and measured individual limb forces. At trot, the average peak vertical reaction force on the forelimb was calculated to be 11.5±0.9 N kg–1 and measured to be 11.7±0.9 N kg–1, and for the hindlimb these values were 9.8±0.7 N kg–1 and 10.0±0.6 N kg–1,respectively. At walk, the average peak vertical reaction force on the forelimb was calculated to be 6.9±0.5 N kg–1 and measured to be 7.1±0.3 N kg–1, and for the hindlimb these values were 4.8±0.5 N kg–1 and 4.7±0.3 N kg–1, respectively. It was concluded that the proposed method of calculating individual limb reaction forces is sufficiently accurate to detect changes in loading reported in the literature for mild to moderate lameness at trot.

Midsole Material-Related Force Control During Heel–Toe Running

The impact maximum and rearfoot eversion have been used as indicators of load on internal structures in running. The midsole hardness of a typical running shoe was varied systematically to determine the relationship between external ground reaction force (GRF), in-shoe force, and kinematic variables. Eight subjects were tested during overground running at 4 m/s. Rearfoot movement as well as in-shoe forces and external GRF varied nonsystematically with midsole hardness. Kinematic parameters such as knee flexion and foot velocity at touchdown (TD), also varied nonsystematically with altered midsole hardness. Results demonstrate that considerable variations of in-shoe loading occur that were not depicted by external GRF measurements alone. Individuals apparently use different strategies of mechanical and neuromuscular adaptation in response to footwear modifications. In conclusion, shoe design effects on impact forces or other factors relating to injuries depend on the individual and therefore cannot be generalized.

A model-based parametric study of impact force during running

This paper deals with the impact force during foot-ground impact activities such as the running. A previously developed model is used for this study. The model is a lumped-parameter one consisting of four masses connected to each other via linear springs and viscous dampers. A shoe-specific nonlinear function is used for representation of the ground reaction force. The authors have previously showed that the previous version of the model as well as its simulation is incorrect. This paper slightly modifies the previous model so as it is able to produce results in agreement with the experiments. Then, the modified model is simulated for two typical shoe types. A parametric study is also conducted. The parametric study concerns with the effects of masses, mass ratios, stiffness constants, and damping coefficients on the dynamics of the impact. It is shown that the impact forces increase as the rigid and wobbling masses increase. However, the increase in the impact forces is not the same for all the masses. It is found that the impact force increases as the touchdown velocities increase. Simulations imply that the variations of the damping coefficients result in larger variations of the impact force compared to the stiffness. The effect of the variation of gravity on the simulated impact force is also explored. It is concluded that both the first and the second peaks of the impact force are increased with gravity. An in-depth discussion is included to compare results of the current paper with results of other investigators.

Biomechanical analysis of anterior cruciate ligament injury mechanisms: three-dimensional motion reconstruction from video sequences

BACKGROUND

Methods for analyzing the mechanisms of injuries in sports from video sequences of injury situations are so far limited to a simple visual inspection, which has shown poor accuracy.

PURPOSE

To investigate whether a new model-based image-matching technique could successfully be applied to estimate kinematic characteristics of three typical anterior cruciate ligament (ACL) injury situations.

METHODS

A four-camera basketballvideo, a three-camera European team handball video and a single-camera downhill skiing video were imported into the program Poser 4, where a skeleton model and a model of the surroundings were matched to the background image frame by frame. When the match was considered satisfactory, joint angles as well as velocity and acceleration of the center of mass were calculated using Matlab.

RESULTS

In the basketball and handball matchings, the skeleton and surrounding models were successfully matched to the background through all frames in all camera angles. Detailed time courses for joint kinematics and ground reaction force were obtained, while less information could be acquired from the single-view skiing accident.

CONCLUSION

The model-based image matching technique can be used to extract kinematic characteristics from videotapes of actual ACL injuries, and may provide valuable information on the mechanisms for ACL injuries in sports.