Treadmill versus overground and barefoot versus shod comparisons of triceps surae fascicle behaviour in human walking and running

Physiological, perceptual, and biomechanical differences between treadmill and overground walking in healthy adults: A systematic review and meta-analysis

This systematic review and meta-analysis aims to compare physiological, perceptual and biomechanical outcomes between walking on a treadmill and overground surfaces. Five databases (CINAHL, EMBASE, MEDLINE, SPORTDiscus, Web of Science) were searched until September 2022. Included studies needed to be a crossover design comparing biomechanical, physiological, or perceptual measures between motorised-treadmill and overground walking in healthy adults (18-65 years) walking at the same speed (<5% difference). The quality of studies were assessed using a modified Downs and Black Quality Index. Meta-analyses were performed to determine standardised mean difference ± 95% confidence intervals for all main outcome measures. Fifty-five studies were included with 1,005 participants. Relative oxygen consumption (standardised mean difference [95% confidence interval] 0.38 [0.14,0.63]) and cadence (0.22 [0.06,0.38]) are higher during treadmill walking. Whereas stride length (-0.36 [-0.62,-0.11]) and step length (-0.52 [-0.98,-0.06]) are lower during treadmill walking. Most kinetic variables are different between surfaces. The oxygen consumption, spatiotemporal and kinetic differences on the treadmill may be an attempt to increase stability due to the lack of control, discomfort and familiarity on the treadmill. Treadmill construction including surface stiffness and motor power are likely additional constraints that need to be considered and require investigation. This research was supported by an Australian Government Research Training Program (RTP) scholarship. Protocol registration is CRD42020208002 (PROSPERO International Prospective Register of Systematic Reviews) in October 2020.

Running gait produces long range correlations: A systematic review

BACKGROUND

Walking and running are common forms of locomotion, both of which exhibit variability over many gait cycles. Many studies have investigated the patterns generated from that ebb and flow, and a large proportion suggests human gait exhibits Long Range Correlations (LRCs). LRCs refer to the observation that healthy gait characteristic, like stride times, are positively correlated to themselves over time. Literature on LRCs in walking gait is well known but less attention has been given to LRCs in running gait.

RESEARCH QUESTION

What is the state of the art concerning LRCs in running gait?

METHODS

We conducted a systematic review to identify the typical LRC patterns present in human running gait, in addition to disease, injury, and running surface effects on LRCs. Inclusion criteria were human subjects, running related experiments, computed LRCs, and experimental design. Exclusion criteria were studies on animals, non-humans, walking only, non-running, non-LRC analysis, and non-experiments.

RESULTS

The initial search returned 536 articles. After review and deliberation, our review included 26 articles. Almost every article produced strong evidence for LRCs apparent in running gait and in all running surfaces. Additionally, LRCs tended to decrease due to fatigue, past injury, increased load carriage and seem to be lowest at preferred running speed on a treadmill. No studies investigated disease effects on LRCs in running gait.

SIGNIFICANCE

LRCs seem to increase with deviations away from preferred running speed. Previously injured runners produced decreased LRCs compared to non-injured runners. LRCs also tended to decrease due to an increase in fatigue rate, which has been associated with increased injury rate. Lastly, there is a need for research on the typical LRCs in an overground environment, for which the typical LRCs found in a treadmill environment may or may not transfer.

How velocity impacts eccentric force generation of fully activated skinned skeletal muscle fibers in long stretches

Eccentric muscle contractions are fundamental to everyday life. They occur markedly in jumping, running, and accidents. Following an initial force rise, stretching of a fully activated muscle can result in a phase of decreasing force ('Give') followed by force redevelopment. However, how the stretch velocity affects 'Give' and force redevelopment remains largely unknown. We investigated the force produced by fully activated single skinned fibers of rat extensor digitorum longus muscles during long stretches. Fibers were pulled from length .85 to 1.3 optimal fiber length at a rate of 1, 10 and 100% of the estimated maximum shortening velocity. 'Give' was absent in slow stretches. Medium and fast stretches yielded a clear 'Give'. After the initial force peak, forces decreased by 11.2% and 27.8% relative to the initial peak force before rising again. During the last half of the stretch (from 1.07 to 1.3 optimal fiber length, which is within the range of the expected descending limb of the force-length relationship), the linear force slope tripled from slow to medium stretch and increased further by 60% from medium to fast stretch. These results are compatible with forcible cross-bridge detachment and re-development of a cross-bridge distribution, and a viscoelastic titin contribution to fiber force. Accounting for these results can improve muscle models and predictions of multi-body simulations.

Fusion of Wearable Kinetic and Kinematic Sensors to Estimate Triceps Surae Work during Outdoor Locomotion on Slopes

Muscle–tendon power output is commonly assessed in the laboratory through the work loop, a paired analysis of muscle force and length during a cyclic task. Work-loop analysis of muscle–tendon function in out-of-lab conditions has been elusive due to methodological limitations. In this work, we combined kinetic and kinematic measures from shear wave tensiometry and inertial measurement units, respectively, to establish a wearable system for estimating work and power output from the soleus and gastrocnemius muscles during outdoor locomotion. Across 11 healthy young adults, we amassed 4777 strides of walking on slopes from −10° to +10°. Results showed that soleus work scales with incline, while gastrocnemius work is relatively insensitive to incline. These findings agree with previous results from laboratory-based studies while expanding technological capabilities by enabling wearable analysis of muscle–tendon kinetics. Applying this system in additional settings and activities could improve biomechanical knowledge and evaluation of protocols in scenarios such as rehabilitation, device design, athletics, and military training.

6MWT on a new self-paced treadmill system compared with overground

The 6-min walk test (6MWT) is a useful tool for clinicians and researchers to estimate gait performance and fatigue affecting functional mobility. A modified 6MWT administered on a treadmill (TM) can be an efficient, space-saving alternative to perform the 6MWT. The aim of this study was to investigate if a 6MWT on a self-paced (SP) TM produced similar results compared to an overground (OG) 6MWT among healthy participants with the hypothesis that users would demonstrate similar gait parameters. The second aim was to assess the reliability of SP TM sessions with the hypothesis that gait parameters would be reliable. Twelve healthy young adults performed one OG 6MWT and two SP TM 6MWTs, with the TM tests performed on two different testing days. The OG 6MWTs were conducted along a 20 m corridor with a portable optometric system. The SP TM 6MWTs were performed using a dual-belt instrumented TM with speed controlled by feedback from a LIDAR sensor. In the OG condition, participants walked 664.8 m ± 48.9 m when the standard method was used to calculate distance and 721.3 m ± 56.2 m with an average-speed-based estimation of distance, which corrects for U-turns. For the SP TM 6MWT, they covered 729.4 m ± 45.8 m in the first session and 727.4 m ± 56.0 m in the second session. Gait parameters showed good to excellent within- and between-day reliability on the adaptive TM. Gait parameters were similar between modalities. A significant difference in the 6MWT distance was found between modalities. This is attributable to the U-turns, because a comparison between TM 6MWT distance and the average-speed-based estimation of the distance for the OG modality showed no significant difference. However, this system produced similar spatiotemporal gait parameters among participants compared to OG.

Is treadmill walking biomechanically comparable to overground walking? A systematic review

BACKGROUND

The equivalency of treadmill and overground walking has been investigated in a large number of studies. However, no systematic review has been performed on this topic.

RESEARCH QUESTION

The aim of this study was to compare the biomechanical, electromyographical and energy consumption outcomes of motorized treadmill and overground walking.

METHODS

Five databases, ScienceDirect, SpringerLink, Web of Science, PubMed, and Scopus, were searched until January 13, 2021. Studies written in English comparing lower limb biomechanics, electromyography and energy consumption during treadmill and overground walking in healthy young adults (20-40 years) were included.

RESULTS

Twenty-two studies (n = 409 participants) were included and evaluated via the Cochrane Collaboration's tool. These 22 studies showed that some kinematic (reduced pelvic ROM, maximum hip flexion angle for females, maximum knee flexion angle for males and cautious gait pattern), kinetic (sagittal plane joint moments: dorsiflexor moments, knee extensor moments and hip extensor moments and sagittal plane joint powers at the knee and hip joints, peak backwards, lateral and medial COP velocities and propulsive forces during late stance) and electromyographic (lower limbs muscles activities) outcome measures were significantly different for motorized treadmill and overground walking.

SIGNIFICANCE

Spatiotemporal, kinematic, kinetic, electromyographic and energy consumption outcome measures were largely comparable for motorized treadmill and overground walking. However, the differences in kinematic, kinetic and electromyographic parameters should be taken into consideration by clinicians, trainers, and researchers when working on new protocols related to patient rehabilitation, fitness rooms or research as to be as close as possible to the outcome measures of overground walking. The protocol registration number is CRD42021236335 (PROSPERO International Prospective Register of Systematic Reviews).

Biopsychosocial Functions of Human Walking and Adherence to Behaviourally Demanding Belief Systems: A Narrative Review

Human walking is a socially embedded and shaped biological adaptation: it frees our hands, makes our minds mobile, and is deeply health promoting. Yet, today, physical inactivity is an unsolved, major public health problem. However, globally, tens of millions of people annually undertake ancient, significant and enduring traditions of physiologically and psychologically arduous walks (pilgrimages) of days-to-weeks extent. Pilgrim walking is a significant human activity requiring weighty commitments of time, action and belief, as well as community support. Paradoxically, human walking is most studied on treadmills, not ‘in the wild’, while mechanistically vital, treadmill studies of walking cannot, in principle, address why humans walk extraordinary distances together to demonstrate their adherence to a behaviourally demanding belief system.

Pilgrim walkers provide a rich ‘living laboratory’ bridging humanistic inquiries, to progressive theoretical and empirical investigations of human walking arising from a behaviourally demanding belief system. Pilgrims vary demographically and undertake arduous journeys on precisely mapped routes of tracked, titrated doses and durations on terrain of varying difficulty, allowing investigations from molecular to cultural levels of analysis. Using the reciprocal perspectives of ‘inside→out’ (where processes within brain and body initiate, support and entrain movement) and ‘outside→in’ (where processes in the world beyond brain and body drive activity within brain and body), we examine how pilgrim walking might shape personal, social and transcendental processes, revealing potential mechanisms supporting the body and brain in motion, to how pilgrim walking might offer policy solutions for physical inactivity.

Rules of nature's Formula Run: Muscle mechanics during late stance is the key to explaining maximum running speed

The maximum running speed of legged animals is one evident factor for evolutionary selection-for predators and prey. Therefore, it has been studied across the entire size range of animals, from the smallest mites to the largest elephants, and even beyond to extinct dinosaurs. A recent analysis of the relation between animal mass (size) and maximum running speed showed that there seems to be an optimal range of body masses in which the highest terrestrial running speeds occur. However, the conclusion drawn from that analysis-namely, that maximum speed is limited by the fatigue of white muscle fibres in the acceleration of the body mass to some theoretically possible maximum speed-was based on coarse reasoning on metabolic grounds, which neglected important biomechanical factors and basic muscle-metabolic parameters. Here, we propose a generic biomechanical model to investigate the allometry of the maximum speed of legged running. The model incorporates biomechanically important concepts: the ground reaction force being counteracted by air drag, the leg with its gearing of both a muscle into a leg length change and the muscle into the ground reaction force, as well as the maximum muscle contraction velocity, which includes muscle-tendon dynamics, and the muscle inertia-with all of them scaling with body mass. Put together, these concepts' characteristics and their interactions provide a mechanistic explanation for the allometry of maximum legged running speed. This accompanies the offering of an explanation for the empirically found, overall maximum in speed: In animals bigger than a cheetah or pronghorn, the time that any leg-extending muscle needs to settle, starting from being isometric at about midstance, at the concentric contraction speed required for running at highest speeds becomes too long to be attainable within the time period of a leg moving from midstance to lift-off. Based on our biomechanical model, we, thus, suggest considering the overall speed maximum to indicate muscle inertia being functionally significant in animal locomotion. Furthermore, the model renders possible insights into biological design principles such as differences in the leg concept between cats and spiders, and the relevance of multi-leg (mammals: four, insects: six, spiders: eight) body designs and emerging gaits. Moreover, we expose a completely new consideration regarding the muscles' metabolic energy consumption, both during acceleration to maximum speed and in steady-state locomotion.

Is Motorized Treadmill Running Biomechanically Comparable to Overground Running? A Systematic Review and Meta-Analysis of Cross-Over Studies

BACKGROUND

Treadmills are often used in research, clinical practice, and training. Biomechanical investigations comparing treadmill and overground running report inconsistent findings.

OBJECTIVE

This study aimed at comparing biomechanical outcomes between motorized treadmill and overground running.

METHODS

Four databases were searched until June 2019. Crossover design studies comparing lower limb biomechanics during non-inclined, non-cushioned, quasi-constant-velocity motorized treadmill running with overground running in healthy humans (18-65 years) and written in English were included. Meta-analyses and meta-regressions were performed where possible.

RESULTS

33 studies (n = 494 participants) were included. Most outcomes did not differ between running conditions. However, during treadmill running, sagittal foot-ground angle at footstrike (mean difference (MD) - 9.8° [95% confidence interval: - 13.1 to - 6.6]; low GRADE evidence), knee flexion range of motion from footstrike to peak during stance (MD 6.3° [4.5 to 8.2]; low), vertical displacement center of mass/pelvis (MD - 1.5 cm [- 2.7 to - 0.8]; low), and peak propulsive force (MD - 0.04 body weights [- 0.06 to - 0.02]; very low) were lower, while contact time (MD 5.0 ms [0.5 to 9.5]; low), knee flexion at footstrike (MD - 2.3° [- 3.6 to - 1.1]; low), and ankle sagittal plane internal joint moment (MD - 0.4 Nm/kg [- 0.7 to - 0.2]; low) were longer/higher, when pooled across overground surfaces. Conflicting findings were reported for amplitude of muscle activity.

CONCLUSIONS

Spatiotemporal, kinematic, kinetic, muscle activity, and muscle-tendon outcome measures are largely comparable between motorized treadmill and overground running. Considerations should, however, particularly be given to sagittal plane kinematic differences at footstrike when extrapolating treadmill running biomechanics to overground running. Protocol registration CRD42018083906 (PROSPERO International Prospective Register of Systematic Reviews).

Power Amplification Increases With Contraction Velocity During Stretch-Shortening Cycles of Skinned Muscle Fibers

Muscle force, work, and power output during concentric contractions (active muscle shortening) are increased immediately following an eccentric contraction (active muscle lengthening). This increase in performance is known as the stretch-shortening cycle (SSC)-effect. Recent findings demonstrate that the SSC-effect is present in the sarcomere itself. More recently, it has been suggested that cross-bridge (XB) kinetics and non-cross-bridge (non-XB) structures (e.g., titin and nebulin) contribute to the SSC-effect. As XBs and non-XB structures are characterized by a velocity dependence, we investigated the impact of stretch-shortening velocity on the SSC-effect. Accordingly, we performed in vitro isovelocity ramp experiments with varying ramp velocities (30, 60, and 85% of maximum contraction velocity for both stretch and shortening) and constant stretch-shortening magnitudes (17% of the optimum sarcomere length) using single skinned fibers of rat soleus muscles. The different contributions of XB and non-XB structures to force production were identified using the XB-inhibitor Blebbistatin. We show that (i) the SSC-effect is velocity-dependent-since the power output increases with increasing SSC-velocity. (ii) The energy recovery (ratio of elastic energy storage and release in the SSC) is higher in the Blebbistatin condition compared with the control condition. The stored and released energy in the Blebbistatin condition can be explained by the viscoelastic properties of the non-XB structure titin. Consequently, our experimental findings suggest that the energy stored in titin during the eccentric phase contributes to the SSC-effect in a velocity-dependent manner.

Muscle Activation Patterns Are More Constrained and Regular in Treadmill Than in Overground Human Locomotion

The use of motorized treadmills as convenient tools for the study of locomotion has been in vogue for many decades. However, despite the widespread presence of these devices in many scientific and clinical environments, a full consensus on their validity to faithfully substitute free overground locomotion is still missing. Specifically, little information is available on whether and how the neural control of movement is affected when humans walk and run on a treadmill as compared to overground. Here, we made use of linear and non-linear analysis tools to extract information from electromyographic recordings during walking and running overground, and on an instrumented treadmill. We extracted synergistic activation patterns from the muscles of the lower limb via non-negative matrix factorization. We then investigated how the motor modules (or time-invariant muscle weightings) were used in the two locomotion environments. Subsequently, we examined the timing of motor primitives (or time-dependent coefficients of muscle synergies) by calculating their duration, the time of main activation, and their Hurst exponent, a non-linear metric derived from fractal analysis. We found that motor modules were not influenced by the locomotion environment, while motor primitives were overall more regular in treadmill than in overground locomotion, with the main activity of the primitive for propulsion shifted earlier in time. Our results suggest that the spatial and sensory constraints imposed by the treadmill environment might have forced the central nervous system to adopt a different neural control strategy than that used for free overground locomotion, a data-driven indication that treadmills could induce perturbations to the neural control of locomotion.

Impact of Altered Gastrocnemius Morphometrics and Fascicle Behavior on Walking Patterns in Children With Spastic Cerebral Palsy

Spastic cerebral palsy (SCP) affects neural control, deteriorates muscle morphometrics, and may progressively impair functional walking ability. Upon passive testing, gastrocnemius medialis (GM) muscle bellies or fascicles are typically shorter, thinner, and less extensible. Relationships between muscle and gait parameters might help to understand gait pathology and pathogenesis of spastic muscles. The current aim was to link resting and dynamic GM morphometrics and contractile fascicle behavior (both excursion and velocity) during walking to determinants of gait. We explored the associations between gait variables and ultrasonography of the GM muscle belly captured during rest and during gait in children with SCP [n = 15, gross motor function classification system (GMFCS) levels I and II, age: 7–16 years] and age-matched healthy peers (n = 17). The SCP children’s plantar flexors were 27% weaker. They walked 12% slower with more knee flexion produced 42% less peak ankle push-off power (all p < 0.05) and 7/15 landed on their forefoot. During the stance phase, fascicles in SCP on average operated on 9% shorter length (normalized to rest length) and displayed less and slower fascicle shortening (37 and 30.6%, respectively) during push-off (all p ≤ 0.024). Correlation analyses in SCP patients revealed that (1) longer-resting fascicles and thicker muscle bellies are positively correlated with walking speed and negatively to knee flexion (r = 0.60–0.69, p < 0.0127) but not to better ankle kinematics; (2) reduced muscle strength was associated with the extent of eccentric fascicle excursion (r = −0.57, p = 0.015); and (3) a shorter operating length of the fascicles was correlated with push-off power (r = −0.58, p = 0.013). Only in controls, a correlation (r = 0.61, p = 0.0054) between slower fascicle shortening velocity and push-off power was found. Our results indicate that a thicker gastrocnemius muscle belly and longer gastrocnemius muscle fascicles may be reasonable morphometric properties that should be targeted in interventions for individuals with SCP, since GM muscle atrophy may be related to decreases in walking speed and undesired knee flexion during gait. Furthermore, children with SCP and weaker gastrocnemius muscle may be more susceptible to chronic eccentric muscle overloading. The relationship between shorter operating length of the fascicles and push-off power may further support the idea of a compensation mechanism for the longer sarcomeres found in children with SCP. Nevertheless, more studies are needed to support our explorative findings.

Techniques for In Vivo Measurement of Ligament and Tendon Strain: A Review

The critical clinical and scientific insights achieved through knowledge of in vivo musculoskeletal soft tissue strains has motivated the development of relevant measurement techniques. This review provides a comprehensive summary of the key findings, limitations, and clinical impacts of these techniques to quantify musculoskeletal soft tissue strains during dynamic movements. Current technologies generally leverage three techniques to quantify in vivo strain patterns, including implantable strain sensors, virtual fibre elongation, and ultrasound. (1) Implantable strain sensors enable direct measurements of tissue strains with high accuracy and minimal artefact, but are highly invasive and current designs are not clinically viable. (2) The virtual fibre elongation method tracks the relative displacement of tissue attachments to measure strains in both deep and superficial tissues. However, the associated imaging techniques often require exposure to radiation, limit the activities that can be performed, and only quantify bone-to-bone tissue strains. (3) Ultrasound methods enable safe and non-invasive imaging of soft tissue deformation. However, ultrasound can only image superficial tissues, and measurements are confounded by out-of-plane tissue motion. Finally, all in vivo strain measurement methods are limited in their ability to establish the slack length of musculoskeletal soft tissue structures. Despite the many challenges and limitations of these measurement techniques, knowledge of in vivo soft tissue strain has led to improved clinical treatments for many musculoskeletal pathologies including anterior cruciate ligament reconstruction, Achilles tendon repair, and total knee replacement. This review provides a comprehensive understanding of these measurement techniques and identifies the key features of in vivo strain measurement that can facilitate innovative personalized sports medicine treatment.

Imaging and Simulation of Inter-muscular Differences in Triceps Surae Contributions to Forward Propulsion During Walking

Forward propulsion during the push-off phase of walking is largely governed at the ankle by differential neuromechanical contributions from the biarticular medial (MG) and lateral gastrocnemii (LG) and the uniarticular soleus (SOL). However, the relative contribution of these individual muscles to forward propulsion is equivocal, with important implications for the design and control of wearable assistive devices and for targeted therapeutics. The aim of this study was to evaluate the agreement between empirical and model-predicted triceps surae (i.e., MG, LG, and SOL) contributions to forward propulsion during walking using conditions that systematically manipulated both walking speed and the mechanical demand for forward propulsion at a fixed speed-through the use of aiding and impeding forces. Ten young adults (age: 24.1 ± 3.6 years, 6M/4F) participated. We found that muscle-specific responses derived from experimental measurements (i.e., activation and fascicle behavior) were consistent with those derived from musculoskeletal simulations (i.e., muscle force and positive mechanical work) within the same subjects. In vivo, compared to walking normally, only LG muscle activation was affected by both aiding and impeding forces. Similarly, increased propulsive demand elicited greater relative fascicle shortening in the MG but not the SOL. In silico, only MG and LG force and positive mechanical work increased significantly to meet the increased demands for forward propulsion. By combining electromyography, ultrasound imaging, and musculoskeletal modeling in the same subjects, our cumulative findings suggest that the biarticular gastrocnemius muscles play a more significant role than the uniarticular soleus in governing changes in forward propulsion during the mid to late stance phase of walking.

The influence of Achilles tendon mechanical behaviour on "apparent" efficiency during running at different speeds

Purpose

We investigated the role of elastic strain energy on the “apparent” efficiency of locomotion (AE), a parameter that is known to increase as a function of running speed (up to 0.5–0.7) well above the values of “pure” muscle efficiency (about 0.25–0.30).

Methods

In vivo ultrasound measurements of the gastrocnemius medialis (GM) muscle–tendon unit (MTU) were combined with kinematic, kinetic and metabolic measurements to investigate the possible influence of the Achilles tendon mechanical behaviour on the mechanics (total mechanical work, W_TOT) and energetics (net energy cost, C_net) of running at different speeds (10, 13 and 16 km h⁻¹); AE was calculated as W_TOT/C_net.

Results

GM fascicles shortened during the entire stance phase, the more so the higher the speed, but the majority of the MTU displacement was accommodated by the Achilles tendon. Tendon strain and recoil increased as a function of running speed (P < 0.01 and P < 0.001, respectively). The contribution of elastic energy to the positive work generated by the MTU also increased with speed (from 0.09 to 0.16 J kg⁻¹ m⁻¹). Significant negative correlations (P < 0.01) were observed between tendon work and metabolic energy at each running speed (the higher the tendon work the lower the metabolic demand) and significant positive correlations were observed between tendon work and AE (P < 0.001) at each running speed (the higher the tendon work the higher the efficiency).

Conclusion

These results support the notion that the dynamic function of tendons is integral in reducing energy expenditure and increasing the “apparent” efficiency of running.

Muscle-tendon morphology and function following long-term exposure to repeated and strenuous mechanical loading

We mapped structural and functional characteristics of muscle-tendon units in a population exposed to very long-term routine overloading. Twenty-eight military academy cadets (age = 21.00 ± 1.1 years; height = 176.1 ± 4.8 cm; mass = 73.8 ± 7.0 kg) exposed for over 24 months to repetitive overloading were profiled via ultrasonography with a senior subgroup of them (n = 11; age = 21.4 ± 1.0 years; height = 176.5 ± 4.8 cm; mass = 71.4 ± 6.6 kg) also tested while walking and marching on a treadmill. A group of eleven ethnicity- and age-matched civilians (age = 21.6 ± 0.7 years; height = 176.8 ± 4.3 cm; mass = 74.6 ± 5.6 kg) was also profiled and tested. Cadets and civilians exhibited similar morphology (muscle and tendon thickness and cross-sectional area, pennation angle, fascicle length) in 26 out of 29 sites including the Achilles tendon. However, patellar tendon thickness along the entire tendon was greater (P < .05) by a mean of 16% for the senior cadets compared with civilians. Dynamically, cadets showed significantly smaller ranges of fascicle length change and lower shortening velocity in medial gastrocnemius during walking (44.0% and 47.6%, P < .05-.01) and marching (27.5% and 34.3%, P < .05-.01) than civilians. Furthermore, cadets showed lower normalized soleus electrical activity during walking (22.7%, P < .05) and marching (27.0%, P < .05). Therefore, 24-36 months of continuous overloading, primarily occurring under aerobic conditions, leads to more efficient neural and mechanical behavior in the triceps surae complex, without any major macroscopic alterations in key anatomical structures.

Foot strike pattern during running alters muscle-tendon dynamics of the gastrocnemius and the soleus

Running is thought to be an efficient gait due, in part, to the behavior of the plantar flexor muscles and elastic energy storage in the Achilles tendon. Although plantar flexor muscle mechanics and Achilles tendon energy storage have been explored during rearfoot striking, they have not been fully characterized during forefoot striking. This study examined how plantar flexor muscle-tendon mechanics during running differs between rearfoot and forefoot striking. We used musculoskeletal simulations, driven by joint angles and electromyography recorded from runners using both rearfoot and forefoot striking running patterns, to characterize plantar flexor muscle-tendon mechanics. The simulations revealed that foot strike pattern affected the soleus and gastrocnemius differently. For the soleus, forefoot striking decreased tendon energy storage and fiber work done while the muscle fibers were shortening compared to rearfoot striking. For the gastrocnemius, forefoot striking increased muscle activation and fiber work done while the muscle fibers were lengthening compared to rearfoot striking. These changes in gastrocnemius mechanics suggest that runners planning to convert to forefoot striking might benefit from a progressive eccentric gastrocnemius strengthening program to avoid injury.

Ultrasound imaging to assess skeletal muscle architecture during movements: a systematic review of methods, reliability, and challenges

B-mode ultrasound is often used to quantify muscle architecture during movements. Our objectives were to 1) systematically review the reliability of fascicle length (FL) and pennation angles (PA) measured using ultrasound during movements involving voluntary contractions; 2) systematically review the methods used in studies reporting reliability, discuss associated challenges, and provide recommendations to improve the reliability and validity of dynamic ultrasound measurements; and 3) provide an overview of computational approaches for quantifying fascicle architecture, their validity, agreement with manual quantification of fascicle architecture, and advantages and drawbacks. Three databases were searched until June 2019. Studies among healthy human individuals aged 17-85 yr that investigated the reliability of FL or PA in lower-extremity muscles during isoinertial movements and that were written in English were included. Thirty studies (n = 340 participants) were included for reliability analyses. Between-session reliability as measured by coefficient of multiple correlations (CMC), and coefficient of variation (CV) was FL CMC: 0.89-0.96; CV: 8.3% and PA CMC: 0.87-0.90; CV: 4.5-9.6%. Within-session reliability was FL CMC: 0.82-0.99; CV: 0.0-6.7% and PA CMC: 0.91; CV: 0.0-15.0%. Manual analysis reliability was FL CMC: 0.89-0.96; CV: 0.0-15.9%; PA CMC: 0.84-0.90; and CV: 2.0-9.8%. Computational analysis FL CMC was 0.82-0.99, and PA CV was 14.0-15.0%. Eighteen computational approaches were identified, and these generally showed high agreement with manual analysis and high validity compared with phantoms or synthetic images. B-mode ultrasound is a reliable method to quantify fascicle architecture during movement. Additionally, computational approaches can provide a reliable and valid estimation of fascicle architecture.

Do Stretch-Shortening Cycles Really Occur in the Medial Gastrocnemius? A Detailed Bilateral Analysis of the Muscle-Tendon Interaction During Jumping

The effect of stretch-shortening cycles (SSCs) is often studied in laboratory settings, yet it remains unclear whether highly active muscle SSCs actually occur during in vivo movement. Nine highly trained jumping athletes performed single-leg pre-hop forward jumps at maximal effort. We hypothesized that these jumps would induce a SSC at the level of the muscle in the medial gastrocnemius. Kinematic and kinetic data were collected together with electromyography signals (EMG) and muscle fascicle length and pennation angle changes of the medial gastrocnemius of both legs and combined with a musculoskeletal model to calculate the stretch-shortening behavior of the muscle (fascicles) and tendon (series-elastic element). The length changes of the fascicles, longitudinal muscle displacement, series-elastic element, and whole muscle-tendon unit further allowed for a detailed analysis of the architectural gearing ratio between different phases of the SSC within a single movement. We found a SSC at the level of the joint, muscle-tendon unit and tendon but not at the muscle. We further found that the average architectural gearing ratio was higher during the stretching of the series-elastic element as compared to when the series-elastic element was shortening, yet this was not statistically tested because of low sample size for this parameter. However, we found no correlation when plotting the architectural gearing ratio as a function of the fascicle velocities at each instance in time. Despite the athletes having a clear preferred leg for jumping, we found no differences in any kinematic or kinetic parameter between the preferred and non-preferred leg or any parameter from the muscle-tendon interaction analysis other than a reduced longitudinal muscle shortening in the non-preferred leg (p = 0.008). We conclude that, although common at the level of the joints, MTUs, and tendon (series-elastic element), highly active SSCs very rarely occur in the medial gastrocnemius, even in movements that induce high loading. This has important implications for the translation of ex vivo findings on SSC effects, such as residual force enhancement, in this muscle. We further conclude that there is no precise tuning of the architectural gearing ratio in the medial gastrocnemius throughout the whole movement.

Ultrasound as a Tool to Study Muscle-Tendon Functions during Locomotion: A Systematic Review of Applications

Movement science investigating muscle and tendon functions during locomotion utilizes commercial ultrasound imagers built for medical applications. These limit biomechanics research due to their form factor, range of view, and spatio-temporal resolution. This review systematically investigates the technical aspects of applying ultrasound as a research tool to investigate human and animal locomotion. It provides an overview on the ultrasound systems used and of their operating parameters. We present measured fascicle velocities and discuss the results with respect to operating frame rates during recording. Furthermore, we derive why muscle and tendon functions should be recorded with a frame rate of at least 150 Hz and a range of view of 250 mm. Moreover, we analyze why and how the development of better ultrasound observation devices at the hierarchical level of muscles and tendons can support biomechanics research. Additionally, we present recent technological advances and their possible application. We provide a list of recommendations for the development of a more advanced ultrasound sensor system class targeting biomechanical applications. Looking to the future, mobile, ultrafast ultrasound hardware technologies create immense opportunities to expand the existing knowledge of human and animal movement.

Ankle Joint Dynamic Stiffness in Long-Distance Runners: Effect of Foot Strike and Shoes Features

Foot strike mode and footwear features are known to affect ankle joint kinematics and loading patterns, but how those factors are related to the ankle dynamic properties is less clear. In our study, two distinct samples of experienced long-distance runners: habitual rearfoot strikers (n = 10) and habitual forefoot strikers (n = 10), were analysed while running at constant speed on an instrumented treadmill in three footwear conditions. The joint dynamic stiffness was analysed for three subphases of the moment–angle plot: early rising, late rising and descending. Habitual rearfoot strikers displayed a statistically (p < 0.05) higher ankle dynamic stiffness in all combinations of shoes and subphases, except in early stance in supportive shoes. In minimal-supportive shoes, both groups had the lowest dynamic stiffness values for early and late rising (initial contact through mid-stance), whilst the highest stiffness values were at late rising in minimal shoes for both rearfoot and forefoot strikers (0.21 ± 0.04, 0.24 ± 0.06 (Nm/kg/°∙100), respectively). In conclusion, habitual forefoot strikers may have access to a wider physiological range of the muscle torque and joint angle. This increased potential may allow forefoot strikers to adapt to different footwear by regulating ankle dynamic stiffness depending upon the motor task.

Do habitual foot-strike patterns in running influence functional Achilles tendon properties during gait?

The capacity of foot-strike running patterns to influence the functional properties of the Achilles tendon is controversial. This study used transmission-mode ultrasound to investigate the influence of habitual running foot-strike pattern on Achilles tendon properties during barefoot walking and running. Fifteen runners with rearfoot (RFS) and 10 with a forefoot (FFS) foot-strike running pattern had ultrasound transmission velocity measured in the right Achilles tendon during barefoot walking (≈1.1 ms^-1) and running (≈2.0 ms^-1). Temporospatial gait parameters, ankle kinematics and vertical ground reaction force were simultaneously recorded. Statistical comparisons between foot-strike patterns were made using repeated measure ANOVAs. FFS was characterised by a significantly shorter stance duration (-4%), greater ankle dorsiflexion (+2°), and higher peak vertical ground reaction force (+20% bodyweight) than RFS running (P < .05). Both groups adopted a RFS pattern during walking, with only the relative timing of peak dorsiflexion (3%), ground reaction force (1-2%) and peak vertical force loading rates (22-23%) differing between groups (P < .05). Peak ultrasound transmission velocity in the Achilles tendon was significantly higher in FFS during walking (≈100 ms^-1) and running (≈130 ms^-1) than RFS (P < .05). Functional Achilles tendon properties differ with habitual footfall patterns in recreational runners.

Forefoot running requires shorter gastrocnemius fascicle length than rearfoot running

This study aimed to investigate the influence of foot strike patterns on the behaviour of the triceps surae muscle-tendon unit, including the Achilles tendon whose length nearly corresponds to force of the triceps surae, and the medial gastrocnemius muscle (MG) during running. Seven male volunteers ran with forefoot and rearfoot strikes at 10, 14 and 18 km h^-1 on a treadmill. The MG fascicle length was measured using ultrasonography. The in vivo length of the curved Achilles tendon was quantified by combining ultrasonography with optical motion capture of reflective markers on the right lower limb and an ultrasound probe. The forefoot strike resulted in a significantly shorter MG fascicle length at the initial contact, at Achilles tendon peak elongation, and at toe-off, than the rearfoot strike. The Achilles tendon length at initial contact was greater during the forefoot strike than during the rearfoot strike at 18 km h^-1, while its peak elongation was not significantly different during forefoot and rearfoot running. These results indicate that the MG, with a shorter length during forefoot running, manages to address demands for a similar peak force of the triceps surae than during rearfoot running.

Effect of habitual foot-strike pattern on the gastrocnemius medialis muscle-tendon interaction and muscle force production during running

The interaction between gastrocnemius medialis (GM) muscle and Achilles tendon, i.e., muscle-tendon unit (MTU) interaction, plays an important role in minimizing the metabolic cost of running. Foot-strike pattern (FSP) has been suggested to alter MTU interaction and subsequently the metabolic cost of running. However, metabolic data from experimental studies on FSP are inconsistent, and a comparison of MTU interaction between FSP is still lacking. We, therefore, investigated the effect of habitual rearfoot and mid-/forefoot striking on MTU interaction, ankle joint work, and plantar flexor muscle force production while running at 10 and 14 km/h. GM muscle fascicles of 9 rearfoot and 10 mid-/forefoot strikers were tracked using dynamic ultrasonography during treadmill running. We collected kinetic and kinematic data and used musculoskeletal models to determine joint angles and calculate MTU lengths. In addition, we used dynamic optimization to assess plantar flexor muscle forces. During ground contact, GM fascicle shortening ( P = 0.02) and average contraction velocity ( P = 0.01) were 40-45% greater in rearfoot strikers than mid-/forefoot strikers. Differences in contraction velocity were especially prominent during early ground contact. Moreover, GM ( P = 0.02) muscle force was greater during early ground contact in mid-/forefoot strikers than rearfoot strikers. Interestingly, we did not find differences in stretch or recoil of the series elastic element between FSP. Our results suggest that, for the GM, the reduced muscle energy cost associated with lower fascicle contraction velocity in mid-/forefoot strikers may be counteracted by greater muscle forces during early ground contact. NEW & NOTEWORTHY Kinetic and kinematic differences between foot-strike patterns during running imply (not previously reported) altered muscle-tendon interaction. Here, we studied muscle-tendon interaction using ultrasonography. We found greater fascicle contraction velocities and lower muscle forces in rearfoot compared with mid-/forefoot strikers. Our results suggest that the higher metabolic energy demand due to greater fascicle contraction velocities might offset the lower metabolic energy demand due to lower muscle forces in rearfoot compared with mid-/forefoot strikers.

Lower material stiffness in rupture-repaired Achilles tendon during walking: transmission-mode ultrasound for post-surgical tendon evaluation

PURPOSE

This cross-sectional study used transmission-mode ultrasound to evaluate dynamic tendon properties during walking in surgically repaired and contralateral Achilles tendon (AT), with a median (range) post-operative period of 22 (4-58) months. It was hypothesised that the axial transmission speed of ultrasound (TSOU) during walking would be slower, indicating lower material stiffness in repaired compared with contralateral AT.

METHODS

Ten patients [median (range) age 47 (37-69) years; height 180 (170-189) cm; weight 93 (62-119) kg], who had undergone open surgical repair of the AT and were clinically recovered according to their treating clinicians, walked barefoot on a treadmill at self-selected speed (1.0 ± 0.2 m/s). Synchronous measures of TSOU, sagittal ankle motion, vertical ground reaction force (GRF), and spatiotemporal gait parameters were recorded during 20 s of steady-state walking. Paired t tests were used to evaluate potential between-limb differences in TSOU, GRF, ankle motion, and spatiotemporal gait parameters.

RESULTS

TSOU was significantly lower (≈175 m/s) in the repaired than in the contralateral AT over the entire gait cycle (P < 0.05). Sagittal ankle motion was significantly greater (≈3°) in the repaired than in the contralateral limb (P = 0.036). There were no significant differences in GRF or spatiotemporal parameters between limbs.

CONCLUSIONS

Repaired AT was characterised by a lower TSOU, reflecting a lower material stiffness in the repaired tendon than in the contralateral tendon. A lower material stiffness may underpin greater ankle joint motion of the repaired limb during walking and long-term deficits in the muscle-tendon unit reported with AT repair. Treatment and rehabilitation approaches that focus on increasing the material stiffness of the repaired AT may be clinically beneficial. Transmission-mode ultrasound would seem useful for quantifying tendon properties post AT rupture repair and may have the potential to individually guide rehabilitation programmes, thereby aiding safer return to physical activity.

LEVEL OF EVIDENCE

II.

Effect of a prehop on the muscle-tendon interaction during vertical jumps

Many movements use stretch-shortening cycles of a muscle-tendon unit (MTU) for storing and releasing elastic energy. The required stretching of medial gastrocnemius (MG) tendinous tissue during jumps, however, requires large length changes of the muscle fascicles because of the lack of MTU length changes. This has a negative impact on the force-generating capacity of the muscle fascicles. The purpose of this study was to induce a MG MTU stretch before shortening by adding a prehop to the squat jump. Eleven well-trained athletes specialized in jumping performed a prehop squat jump (PHSJ) and a standard squat jump (SSJ). Kinematic data were collected using a 3D motion capture system and were used in a musculoskeletal model to calculate MTU lengths. B-mode ultrasonography of the MG was used to measure fascicle length and pennation angle during the jumps. By combining the muscle-tendon unit lengths, fascicle lengths, and pennation angles, the stretch and recoil of the series elastic element of MG were calculated using a simple geometric muscle-tendon model. Our results show less length changes of the muscle fascicles during the upward motion and lower maximal shortening velocities, increasing the moment-generating capacity of the plantar flexors, reflected in the higher ankle joint moment in the PHSJ compared with the SSJ. Although muscle-tendon interaction during the PHSJ was more optimal, athletes were not able to increase their jump height compared with the SSJ. NEW & NOTEWORTHY This is the first study that aimed to improve the muscle-tendon interaction in squat jumping. We effectively introduced a stretch to the medial gastrocnemius muscle-tendon unit resulting in lower maximal shortening velocities and thus an increase in the plantar flexor force-generating capacity, reflected in the higher ankle joint moment in the prehop squat jump compared with the standard squat jump. Here, we demonstrate an effective method for mechanical optimization of the muscle-tendon interaction in the medial gastrocnemius during squat jumping.

Achilles Tendon Load is Progressively Increased with Reductions in Walking Speed

INTRODUCTION

Achilles tendon rehabilitation protocols commonly recommend a gradual increase in walking speed to progressively intensify tendon loading. This study used transmission-mode ultrasound to evaluate the influence of walking speed on loading of the human Achilles tendon in vivo.

METHODS

Axial transmission speed of ultrasound was measured in the right Achilles tendon of 33 adults (mean ± SD: age, 29 ± 3 yr; height, 1.725 ± 0.069 m; weight, 71.4 ± 19.9 kg) during unshod, steady-state treadmill walking at three speeds (slow, 0.85 ± 0.12 ms; preferred, 1.10 ± 0.13 m·s; fast, 1.35 ± 0.20 m·s). Ankle kinematics, spatiotemporal gait parameters and vertical ground reaction force were simultaneously recorded. Statistical comparisons were made using repeated-measures ANOVA models.

RESULTS

Increasing walking speed was associated with higher cadence, longer step length, shorter stance duration, greater ankle plantarflexion, higher vertical ground reaction force peaks, and a greater loading rate (P < 0.05). Maximum (F1,38 = 7.38, P < 0.05) and minimum (F1,46 = 8.95, P < 0.05) ultrasound transmission velocities in the Achilles tendon were significantly lower (16-23 m·s) during the stance but not swing phase of gait, with each increase in walking speed.

CONCLUSIONS

Despite higher vertical ground reaction forces and greater ankle plantarflexion, increasing walking speed resulted in a reduction in the axial transmission velocity of ultrasound in the Achilles tendon; indicating a speed-dependent reduction in tensile load within the triceps surae muscle-tendon unit during walking. These findings question the rationale for current progressive loading protocols involving the Achilles tendon, in which reduced walking speeds are advocated early in the course of treatment to lower Achilles tendon loads.

Associations Between Individual Lower-Limb Muscle Volumes and 100-m Sprint Time in Male Sprinters

PURPOSE

To elucidate the relationship between the muscularity of individual lower-limb muscles and 100-m-race time (t₁₀₀) in young-adult male sprinters.

METHODS

Thirty-one young-adult male sprinters took part in this study (age 19.9 ± 1.4 y, height 173.5 ± 4.6 cm, body mass 67.0 ± 4.9 kg, t₁₀₀ 10.23-11.71 s). Cross-sectional images from the origin to insertion of 12 lower-limb muscles were obtained with via magnetic resonance imaging (MRI). The absolute volume of each muscle, the ratio of total volume of measured muscles to body mass, the ratio of individual muscle volume to body mass, and the ratio between 2 individual muscle volumes were calculated as indices of muscularity using the images. A stepwise multiple-regression analysis was performed to examine the association between the indices and t₁₀₀.

RESULTS

A stepwise multiple-regression analysis produced an equation (adjusted R² = .234) with the gluteus maximus-to-quadriceps femoris muscle-volume ratio (β = -0.509, P = .003) as the explanatory variable.

CONCLUSIONS

Individual differences in 100-m-race performance cannot be explained by the muscularity of specific muscles, and 23% of the variability in the performance can be explained by the relative difference between the muscularity of gluteus maximus and quadriceps femoris; faster runners have a greater gluteus maximus relative to quadriceps femoris.

Medial gastrocnemius and soleus muscle-tendon unit, fascicle, and tendon interaction during walking in children with cerebral palsy

AIM

This study investigates the in vivo function of the medial gastrocnemius and soleus muscle-tendon units (MTU), fascicles, and tendons during walking in children with cerebral palsy (CP) and an equinus gait pattern.

METHOD

Fourteen children with CP (9 males, 5 females; mean age 10y 6mo, standard deviation [SD] 2y 11mo; GMFCS level I=8, II=6), and 10 typically developing (6 males, 4 females; mean age 10y, SD 2y 1mo) undertook full body 3D gait analysis and simultaneous B-mode ultrasound images of the medial gastrocnemius and soleus fascicles during level walking. Fascicle lengths were analysed using a semi-automated tracking algorithm and MTUs using OpenSim. Statistical parametric mapping (two-sample t-test) was used to compare differences between groups (p<0.05).

RESULTS

In the CP group medial gastrocnemius fascicles lengthened during mid-stance gait and remained longer into late-stance compared to the typically developing group (p<0.001). CP medial gastrocnemius fascicles shortened less during stance (1.16mm [SD 1.47mm]) compared to the typically developing group (4.48mm [SD 1.94mm], p<0.001). In the CP group the medial gastrocnemius and soleus MTU and tendon were longer during early- and mid-stance (p<0.001). Ankle power during push-off (p=0.015) and positive work (p<0.002) and net work (p<0.001) were significantly lower in the CP group.

INTERPRETATION

Eccentric action of the CP medial gastrocnemius muscle fascicles during mid-stance walking is consistent with reduced volume and neuromuscular control of impaired muscle. Reduced ankle push-off power and positive work in the children with CP may be attributed to reduced active medial gastrocnemius fascicle shortening. These findings suggest a reliance on passive force generation for forward propulsion during equinus gait.

In vivo fascicle behavior of the flexor hallucis longus muscle at different walking speeds

Ankle plantar flexor muscles support and propel the body in the stance phase of locomotion. Besides the triceps surae, flexor hallucis longus muscle (FHL) may also contribute to this role, but very few in vivo studies have examined FHL function during walking. Here, we investigated FHL fascicle behavior at different walking speeds. Ten healthy males walked overground at three different speeds while FHL fascicle length changes were recorded with ultrasound and muscle activity was recorded with surface electromyography (EMG). Fascicle length at heel strike at toe off and at peak EMG activity did not change with speed. Range of FHL fascicle length change (3.5-4.5 and 1.9-2.9 mm on average in stance and push-off phase, respectively), as well as minimum (53.5-54.9 and 53.8-55.7 mm) and maximum (58-58.4 and 56.8-57.7 mm) fascicle length did not change with speed in the stance or push-off phase. Mean fascicle velocity did not change in the stance phase, but increased significantly in the push-off phase between slow and fast walking speeds (P=.021). EMG activity increased significantly in both phases from slow to preferred and preferred to fast speed (P<.02 in all cases). FHL muscle fascicles worked near-isometrically during the whole stance phase (at least during slow walking) and operated at approximately the same length at different walking speeds. FHL and medial gastrocnemius (MG) have similar fiber length to muscle belly length ratios and, according to our results, also exhibit similar fascicle behavior at different walking speeds.

Contractile behavior of the medial gastrocnemius in children with bilateral spastic cerebral palsy during forward, uphill and backward-downhill gait

BACKGROUND

Plantarflexor tightness due to muscle degenerations has been frequently documented in children with spastic cerebral palsy but the contractile behavior of muscles during ambulation is largely unclear. Especially the adaptability of gastrocnemius muscle contraction on sloped surface could be relevant during therapy.

METHODS

Medial gastrocnemius contractions were measured during flat-forward, uphill (+12% incline) and backward-downhill (-12% decline) treadmill gait in 15 children with bilateral cerebral palsy, walking in crouch, and 17 typically developing controls (age: 7-16years) by means of ultrasound and motion analysis. Tracked fascicle and calculated series elastic element length during gait were normalized on seated rest length. Additionally electromyography of the medial gastrocnemius, soleus and tibialis anterior was collected.

FINDINGS

During forward gait spastic gastrocnemii reached 10% shorter relative fascicle length, 5% shorter series elastic element length and showed 37% less concentric fascicle excursion than controls. No difference in eccentric fascicle excursion existed. Uphill gait increased concentric fascicle excursion in children with cerebral palsy and controls (by 23% and 41%) and tibialis anterior activity during swing (by 33% and 48%). Backward downhill gait more than doubled (+112%) eccentric fascicle excursion in cerebral palsy patients.

INTERPRETATION

Apart from having innately shorter fascicles at rest, flat-forward walking showed that spastic gastrocnemius fascicles work at shorter relative length than those of controls. Uphill gait may be useful to concentrically train push-off skills and foot lift. During backward-downhill gait the gastrocnemius functions as a brake and displays more eccentric excursion which could potentially stimulate sarcomere-genesis in series with repeated training.

Stretching Your Energetic Budget: How Tendon Compliance Affects the Metabolic Cost of Running

Muscles attach to bones via tendons that stretch and recoil, affecting muscle force generation and metabolic energy consumption. In this study, we investigated the effect of tendon compliance on the metabolic cost of running using a full-body musculoskeletal model with a detailed model of muscle energetics. We performed muscle-driven simulations of running at 2–5 m/s with tendon force–strain curves that produced between 1 and 10% strain when the muscles were developing maximum isometric force. We computed the average metabolic power consumed by each muscle when running at each speed and with each tendon compliance. Average whole-body metabolic power consumption increased as running speed increased, regardless of tendon compliance, and was lowest at each speed when tendon strain reached 2–3% as muscles were developing maximum isometric force. When running at 2 m/s, the soleus muscle consumed less metabolic power at high tendon compliance because the strain of the tendon allowed the muscle fibers to operate nearly isometrically during stance. In contrast, the medial and lateral gastrocnemii consumed less metabolic power at low tendon compliance because less compliant tendons allowed the muscle fibers to operate closer to their optimal lengths during stance. The software and simulations used in this study are freely available at simtk.org and enable examination of muscle energetics with unprecedented detail.

Barefoot vs common footwear: A systematic review of the kinematic, kinetic and muscle activity differences during walking

Habitual footwear use has been reported to influence foot structure with an acute exposure being shown to alter foot position and mechanics. The foot is highly specialised thus these changes in structure/position could influence functionality. This review aims to investigate the effect of footwear on gait, specifically focussing on studies that have assessed kinematics, kinetics and muscle activity between walking barefoot and in common footwear. In line with PRISMA and published guidelines, a literature search was completed across six databases comprising Medline, EMBASE, Scopus, AMED, Cochrane Library and Web of Science. Fifteen of 466 articles met the predetermined inclusion criteria and were included in the review. All articles were assessed for methodological quality using a modified assessment tool based on the STROBE statement for reporting observational studies and the CASP appraisal tool. Walking barefoot enables increased forefoot spreading under load and habitual barefoot walkers have anatomically wider feet. Spatial-temporal differences including, reduced step/stride length and increased cadence, are observed when barefoot. Flatter foot placement, increased knee flexion and a reduced peak vertical ground reaction force at initial contact are also reported. Habitual barefoot walkers exhibit lower peak plantar pressures and pressure impulses, whereas peak plantar pressures are increased in the habitually shod wearer walking barefoot. Footwear particularly affects the kinematics and kinetics of gait acutely and chronically. Little research has been completed in older age populations (50+ years) and thus further research is required to better understand the effect of footwear on walking across the lifespan.

Foot Morphological Difference between Habitually Shod and Unshod Runners

Foot morphology and function has received increasing attention from both biomechanics researchers and footwear manufacturers. In this study, 168 habitually unshod runners (90 males whose age, weight & height were 23±2.4 years, 66±7.1 kg & 1.68±0.13 m and 78 females whose age, weight & height were 22±1.8 years, 55±4.7 kg & 1.6±0.11 m) (Indians) and 196 shod runners (130 males whose age, weight & height were 24±2.6 years, 66±8.2 kg & 1.72±0.18 m and 66 females whose age, weight & height were 23±1.5 years, 54±5.6 kg & 1.62±0.15 m) (Chinese) participated in a foot scanning test using the easy-foot-scan (a three-dimensional foot scanning system) to obtain 3D foot surface data and 2D footprint imaging. Foot length, foot width, hallux angle and minimal distance from hallux to second toe were calculated to analyze foot morphological differences. This study found that significant differences exist between groups (shod Chinese and unshod Indians) for foot length (female p = 0.001), width (female p = 0.001), hallux angle (male and female p = 0.001) and the minimal distance (male and female p = 0.001) from hallux to second toe. This study suggests that significant differences in morphology between different ethnicities could be considered for future investigation of locomotion biomechanics characteristics between ethnicities and inform last shape and design so as to reduce injury risks and poor performance from mal-fit shoes.

In vivo behavior of the human soleus muscle with increasing walking and running speeds

The interaction between the muscle fascicle and tendon components of the human soleus (SO) muscle influences the capacity of the muscle to generate force and mechanical work during walking and running. In the present study, ultrasound-based measurements of in vivo SO muscle fascicle behavior were combined with an inverse dynamics analysis to investigate the interaction between the muscle fascicle and tendon components over a broad range of steady-state walking and running speeds: slow-paced walking (0.7 m/s) through to moderate-paced running (5.0 m/s). Irrespective of a change in locomotion mode (i.e., walking vs. running) or an increase in steady-state speed, SO muscle fascicles were found to exhibit minimal shortening compared with the muscle-tendon unit (MTU) throughout stance. During walking and running, the muscle fascicles contributed only 35 and 20% of the overall MTU length change and shortening velocity, respectively. Greater levels of muscle activity resulted in increasingly shorter SO muscle fascicles as locomotion speed increased, both of which facilitated greater tendon stretch and recoil. Thus the elastic tendon contributed the majority of the MTU length change during walking and running. When transitioning from walking to running near the preferred transition speed (2.0 m/s), greater, more economical ankle torque development is likely explained by the SO muscle fascicles shortening more slowly and operating on a more favorable portion (i.e., closer to the plateau) of the force-length curve.

Spatial variability of muscle activity during human walking: the effects of different EMG normalization approaches

Human leg muscles are often activated inhomogeneously, e.g. in standing. This may also occur in complex tasks like walking. Thus, bipolar surface electromyography (sEMG) may not accurately represent whole muscle activity. This study used 64-electrode high-density sEMG (HD-sEMG) to examine spatial variability of lateral gastrocnemius (LG) muscle activity during the stance phase of walking, maximal voluntary contractions (MVCs) and maximal M-waves, and determined the effects of different normalization approaches on spatial and inter-participant variability. Plantar flexion MVC, maximal electrically elicited M-waves and walking at self-selected speed were recorded in eight healthy males aged 24-34. sEMG signals were assessed in four ways: unnormalized, and normalized to MVC, M-wave or peak sEMG during the stance phase of walking. During walking, LG activity varied spatially, and was largest in the distal and lateral regions. Spatial variability fluctuated throughout the stance phase. Normalizing walking EMG signals to the peak value during stance reduced spatial variability within LG on average by 70%, and inter-participant variability by 67%. Normalizing to MVC reduced spatial variability by 17% but increased inter-participant variability by 230%. Normalizing to M-wave produced the greatest spatial variability (45% greater than unnormalized EMG) and increased inter-participant variability by 70%. Unnormalized bipolar LG sEMG may provide misleading results about representative muscle activity in walking due to spatial variability. For the peak value and MVC approaches, different electrode locations likely have minor effects on normalized results, whereas electrode location should be carefully considered when normalizing walking sEMG data to maximal M-waves.

Achilles tendon loading patterns during barefoot walking and slow running on a treadmill: An ultrasonic propagation study

Measurement of tendon loading patterns during gait is important for understanding the pathogenesis of tendon "overuse" injury. Given that the speed of propagation of ultrasound in tendon is proportional to the applied load, this study used a noninvasive ultrasonic transmission technique to measure axial ultrasonic velocity in the right Achilles tendon of 27 healthy adults (11 females and 16 males; age, 26 ± 9 years; height, 1.73 ± 0.07 m; weight, 70.6 ± 21.2 kg), walking at self-selected speed (1.1 ± 0.1 m/s), and running at fixed slow speed (2 m/s) on a treadmill. Synchronous measures of ankle kinematics, spatiotemporal gait parameters, and vertical ground reaction forces were simultaneously measured. Slow running was associated with significantly higher cadence, shorter step length, but greater range of ankle movement, higher magnitude and rate of vertical ground reaction force, and higher ultrasonic velocity in the tendon than walking (P < 0.05). Ultrasonic velocity in the Achilles tendon was highly reproducible during walking and slow running (mean within-subject coefficient of variation < 2%). Ultrasonic maxima (P1, P2) and minima (M1, M2) were significantly higher and occurred earlier in the gait cycle (P1, M1, and M2) during running than walking (P < 0.05). Slow running was associated with higher and earlier peaks in loading of the Achilles tendon than walking.

Running shoes increase achilles tendon load in walking: an acoustic propagation study

BACKGROUND

Footwear remains a prime candidate for the prevention and rehabilitation of Achilles tendinopathy because it is thought to decrease tension in the tendon through elevation of the heel. However, evidence for this effect is equivocal.

PURPOSE

This study used an acoustic transmission technique to investigate the effect of running shoes on Achilles tendon loading during barefoot and shod walking.

METHODS

Acoustic velocity was measured in the Achilles tendon of 12 recreationally active males (age, 31 ± 9 yr; height, 1.78 ± 0.06 m; weight, 81.0 ± 16.9 kg) during barefoot and shod walking at matched self-selected speed (3.4 ± 0.7 km·h). Standard running shoes incorporating a 10-mm heel offset were used. Vertical ground reaction force and spatiotemporal parameters were determined with an instrumented treadmill. Axial acoustic velocity in the Achilles tendon was measured using a custom-built ultrasonic device. All data were acquired at a rate of 100 Hz during 10 s of steady-state walking. Statistical comparisons between barefoot and shod conditions were made using paired t-tests and repeated-measure ANOVA.

RESULTS

Acoustic velocity in the Achilles tendon was highly reproducible and was typified by two maxima (P1, P2) and minima (M1, M2) during walking. Footwear resulted in a significant increase in step length, stance duration, and peak vertical ground reaction force compared with barefoot walking. Peak acoustic velocity in the Achilles tendon (P1, P2) was significantly higher with running shoes.

CONCLUSIONS

Peak acoustic velocity in the Achilles tendon was higher with footwear, suggesting that standard running shoes with a 10-mm heel offset increase tensile load in the Achilles tendon. Although further research is required, these findings question the therapeutic role of standard running shoes in Achilles tendinopathy.

Does wearing shoes affect your biomechanical efficiency?

Studies involving minimalist shoes have dramatically increased this past 10 years. While a deeper knowledge of the related modifications has ensued regarding the kinematics, electromyographic, and dynamic patterns, little is known regarding the modifications at the muscle forces and muscle fiber levels. The aim of the present study was to assess at a muscular level the modifications brought up when running barefoot, using 0mm midsole height running shoe, or using classical midsole height running shoes. An EMG-Driven model that combines the kinematics, dynamics, and electromyographic data was used to estimate the Triceps Surae (TS) muscle forces and fiber behavior during running using different footwear conditions. Despite differences at the joint level between barefoot and shod running when looking at ankle joint range of motion, or foot-ground angle at touchdown, the results showed no effect of footwear neither on the maximal muscle forces nor on the relative amount of force produced by each muscle within the TS muscle group when wearing different footwear. On the contrary, different behaviors of muscle fibers were shown with lower amplitudes of fiber lengths for the Gastrocnemii biarticular muscles when running barefoot. This particular results reveal that wearing a shoe, even with a very thin sole, could deeply modify the intricate muscle-tendon mechanics of running.

Triceps surae fascicle stretch is poorly correlated with short latency stretch reflex size

INTRODUCTION

The short latency stretch reflex (SLR) is well described, but the stimulus that evokes the SLR remains elusive. One hypothesis states that reflex size is proportional to muscle fiber stretch, so in this study we examined the relationship between these 2 parameters in human triceps surae muscles.

METHODS

Achilles tendon taps and dorsiflexion stretches with different amplitudes and preactivation torques were applied to 6 participants while electromyography and muscle fascicle length changes were recorded in soleus and medial gastrocnemius (MG).

RESULTS

In response to tendon taps, neither fascicle length nor velocity changes were correlated with SLR size in either muscle, but accelerometer peaks were observed immediately after hammer-tendon contact. Similar results were obtained after dorsiflexion stretches.

CONCLUSION

Muscle fascicle stretch is poorly correlated with SLR size, regardless of perturbation parameters. We attribute the SLR trigger to the transmission of vibration through the lower limb, rather than muscle fiber stretch.

Tendon elastic strain energy in the human ankle plantar-flexors and its role with increased running speed

The human ankle plantar-flexors, soleus (SOL) and gastrocnemius (GAS), utilize tendon elastic strain energy to reduce muscle fiber work and optimize contractile conditions during running. However, studies to date have considered only slow to moderate running speeds up to 5 m/s. Little is known about how the human ankle plantar-flexors utilize tendon elastic strain energy as running speed is advanced towards maximum sprinting. We used data obtained from gait experiments in conjunction with musculoskeletal modeling and optimization techniques to calculate muscle-tendon unit (MTU) work, tendon elastic strain energy and muscle fiber work for the ankle plantar-flexors as participants ran at five discrete steady-state speeds ranging from jogging (~2 m/s) to sprinting (≥8 m/s). As running speed progressed from jogging to sprinting, the contribution of tendon elastic strain energy to the positive work generated by the MTU increased from 53% to 74% for SOL and from 62% to 75% for GAS. This increase was facilitated by greater muscle activation and the relatively isometric behavior of the SOL and GAS muscle fibers. Both of these characteristics enhanced tendon stretch and recoil, which contributed to the bulk of the change in MTU length. Our results suggest that as steady-state running speed is advanced towards maximum sprinting, the human ankle plantar-flexors continue to prioritize the storage and recovery of tendon elastic strain energy over muscle fiber work.

Gender differences in fascicular lengthening during eccentric contractions: the role of the patella tendon stiffness

AIM

Elastic tendons have been suggested to attenuate fascicle lengthening during eccentric contractions; however, there is no in vivo evidence to support this hypothesis. Therefore, the aim of this study was to determine whether patella tendon stiffness modulates vastus lateralis (VL) fascicle lengthening during eccentric contractions in males and females.

METHOD

Vastus lateralis and patella tendon properties were measured in males and females owing to previously reported intrinsic gender differences in tendon properties. During maximal voluntary eccentric knee extensions, VL fascicle lengthening and torque were recorded at every 10° (range of motion 20-90°).

RESULTS

A significant correlation between maximal patella tendon stiffness and change in fascicle length (r=0.476, P=0.023) was observed. Similarly, there was a significant correlation between maximal Young's modulus and change in fascicle length (r=0.470, P=0.049). As expected, patella tendon stiffness and Young's modulus were significantly higher in males compared with females (P<0.05). Interestingly, change in VL fascicle length during the eccentric contractions was significantly greater in males compared with females (P<0.05). Based on patella tendon moment arm measurements, VL muscle-tendon unit elongation was estimated to be significantly greater in males compared with females (5.24 and 4.84 cm respectively).

CONCLUSION

The significant difference in fascicle lengthening during eccentric contractions may be partly explained by the significantly higher patella tendon moment arm, patella tendon stiffness and Young's modulus found in males compared with females. The current study provides in vivo evidence to support the hypothesis that the tendon acts as a 'mechanical buffer' during eccentric contractions.