The use of a mechanical model to describe the stiffness and damping characteristics of the knee joint in healthy adults

Sex differences in the modulation of the motor unit discharge rate leads to reduced force steadiness

The purpose of this study was to evaluate the relationship between the variability in the motor unit inter-pulse interval and force steadiness at submaximal and maximal force outputs between the sexes. Twenty-four male and 24 female participants were recruited to perform isometric dorsiflexion contractions at 20, 40, 60, 80, and 100% maximum voluntary contraction. Tibialis anterior myoelectric signal was recorded by an intramuscular electrode. Females had lower force steadiness (coefficient of variation of force (CoV-Force), 27.3%, p < 0.01) and a greater coefficient of variation of motor unit action potential inter-pulse interval (CoV-IPI), compared with males (9.6%, p < 0.01). There was no significant correlation between the normalized CoV-IPI and CoV-Force (r = 0.19, p > 0.01), but there was a significant repeated measures correlation between the raw scores for root-mean-square force error and the standard deviation of motor unit discharge rate (r = 0.65, p < 0.01). Females also had a greater incidence of doublet discharges on average across force levels (p < 0.01). The sex differences may result from motor unit behaviours (i.e., doublet and rapid discharges, synchronization, rate coding or recruitment), leading to lower force steadiness and greater CoV-IPI in females. Novelty: Sex differences in force steadiness may be due to neural strategies. Females have lower force steadiness compared with males. Greater incidence of doublet discharges in females may result in lesser force steadiness.

Modeling the resistance mechanism of passive knee joint flexion and extension for use in rehabilitation equipment

The purpose of this study was to model the resistance mechanism of Passive Knee Joint Flexion and Extension to create a similar torque mechanism in rehabilitation equipment. In order to better model the behavior of passive knee tissues, it is necessary to exactly calculate the two coefficients of elasticity of time-independent and time-dependent parts. Ten healthy male volunteers (mean height 176.4+/-4.59 cm) participated in this study. Passive knee joint flexion and extension occurred at velocities of 15, 45, and 120 (degree/s), and in five consecutive cycles and within the range of 0 to 100° of knee movement on the sagittal plane on Cybex isokinetic dynamometer. To ensure that the muscles were relaxed, the electrical activity of knee muscles was recorded. The elastic coefficient, (K_S) increased with elevating the passive velocity in flexion and extension. The elastic coefficient, (K_P) was observed to grow with the passive velocity increase. While, the viscous coefficient (C) diminished with passive velocity rise in extension and flexion. The heightened passive velocity of the motion resulted in increased hysteresis (at a rate of 42%). The desired of passive velocity is lower so that there is less energy lost and the viscoelastic resistance of the tissue in the movement decreases. The Coefficient of Determination, R² between the model-responses and experimental curves in the extension was 0.96 < R² < 0.99 and in flexion was 0.95 < R² < 0.99. This modeling is capable of predicting the true performance of the components of passive knee movement and we can create a resistance mechanism in the rehabilitation equipment to perform knee joint movement. Quantitative measurements of two elastic coefficients of Time-independent and Time-dependent parts passive knee joint coefficients should be used for better accurate simulation the behavior of passive tissues in the knee which is not seen in other studies.

Knee stiffness and viscosity: New implementation and perspectives in prosthesis development

The pendulum test is a method applied to measure passive resistance of the knee. A new and simple pendulum test with instrumentation based on infrared camera was used to evaluate knee stiffness and viscosity on a female human cadaver. The stiffness and viscosity were calculated based on the kinetic data. During the measurements, the periarticular and intraarticular soft tissue of the knee was gradually removed to determine the stiffness and viscosity as a function of the tissue removal rate. The measurements showed that the removal of tissue around the joint reduces the damping of leg oscillation, and therefore decreases the stiffness and viscosity. The contribution to knee joint damping was 10% for the skin, 20% for ligaments, and 40% for muscles and tendons. Tissue removal has a very large impact on the knee stiffness and viscosity.

Assessment of passive knee stiffness and viscosity in individuals with spinal cord injury using pendulum test

OBJECTIVE

Stiffness and viscosity represent passive resistances to joint motion related with the structural properties of the joint tissue and of the musculotendinous complex. Both parameters can be affected in patients with spinal cord injury (SCI). The purpose of this study was to measure passive knee stiffness and viscosity in patients with SCI with paraplegia and healthy subjects using Wartenberg pendulum test.

DESIGN

Non-experimental, cross-sectional, case-control design.

SETTING

An outpatient physical therapy clinic, University of social welfare and Rehabilitation Science, Iran.

PATIENTS

A sample of convenience sample of 30 subjects participated in the study. Subjects were categorized into two groups: individuals with paraplegic SCI (n = 15, age: 34.60 ± 9.18 years) and 15 able-bodied individuals as control group (n = 15, age: 30.66 ± 11.13 years).

INTERVENTIONS

Not applicable.

MAIN MEASURES

Passive pendulum test of Wartenberg was used to measure passive viscous-elastic parameters of the knee (stiffness, viscosity) in all subjects.

RESULTS

Statistical analysis (independent t-test) revealed significant difference in the joint stiffness between healthy subjects and those with paraplegic SCI (P = 0.01). However, no significant difference was found in the viscosity between two groups (P = 0.17). Except for first peak flexion angle, all other displacement kinematic parameters exhibited no statistically significant difference between normal subjects and subjects with SCI.

CONCLUSIONS

Patients with SCI have significantly greater joint stiffness compared to able-bodied subjects.

Mechanical Impedance and Its Relations to Motor Control, Limb Dynamics, and Motion Biomechanics

The concept of mechanical impedance represents the interactive relationship between deformation kinematics and the resulting dynamics in human joints or limbs. A major component of impedance, stiffness, is defined as the ratio between the force change to the displacement change and is strongly related to muscle activation. The set of impedance components, including effective mass, inertia, damping, and stiffness, is important in determining the performance of the many tasks assigned to the limbs and in counteracting undesired effects of applied loads and disturbances. Specifically for the upper limb, impedance enables controlling manual tasks and reaching motions. In the lower limb, impedance is responsible for the transmission and attenuation of impact forces in tasks of repulsive loadings. This review presents an updated account of the works on mechanical impedance and its relations with motor control, limb dynamics, and motion biomechanics. Basic questions related to the linearity and nonlinearity of impedance and to the factors that affect mechanical impedance are treated with relevance to upper and lower limb functions, joint performance, trunk stability, and seating under dynamic conditions. Methods for the derivation of mechanical impedance, both those for within the system and material-structural approaches, are reviewed. For system approaches, special attention is given to methods aimed at revealing the correct and sufficient degree of nonlinearity of impedance. This is particularly relevant in the design of spring-based artificial legs and robotic arms. Finally, due to the intricate relation between impedance and muscle activity, methods for the explicit expression of impedance of contractile tissue are reviewed.

Shear wave elastography of passive skeletal muscle stiffness: influences of sex and age throughout adulthood

BACKGROUND

Numerous structural and compositional changes - related not only to age, but also activity level and sex - may affect skeletal muscle stiffness across the adult age-span. Measurement techniques available thus far have largely limited passive stiffness evaluations to those of entire joints and muscle-tendon units. Shear wave elastography is an increasingly popular ultrasound technique for evaluating the mechanical properties of skeletal muscle tissue. The purpose of this study was to quantify the passive stiffness, or shear modulus, of the biceps brachii throughout adulthood in flexed and extended elbow positions. We hypothesized that shear modulus would be higher in males relative to females, and with advanced age in both sexes.

METHODS

Shear wave elastography quantified biceps brachii stiffness at 90° elbow flexion and full extension in a large sample of adults between 21 and 94 years old (n=133; 47 males).

FINDINGS

Regression analysis found sex and age were significant parameters for older adults (>60 years) in full extension. As expected, shear modulus values increased with advancing age; however, shear modulus values for females tended to be higher than those for males.

INTERPRETATION

This study begins to establish normative trends for skeletal muscle shear modulus throughout adulthood. Specifically, this work establishes for the first time that the higher passive joint torque often found in males relative to females likely relates to parameters other than muscle shear modulus. Indeed, perhaps increases in skeletal muscle passive stiffness, though potentially altering the length-tension curve, serve a protective role - maintaining the tendon-muscle-tendon length-tension curve within a functional range.

Correlations among measures of knee stiffness, gait performance and complaints in individuals with knee osteoarthritis

BACKGROUND

Stiffness is a common complaint in individuals with knee osteoarthritis and is a component of the osteoarthritis diagnosis. Yet the relationship between stiffness and function is poorly understood and methods to quantify stiffness are limited.

METHODS

Using a cross-sectional observational design with 66 subjects with knee osteoarthritis, stiffness and damping coefficients were calculated from a relaxed knee oscillation procedure. Gait parameters were measured using an electronic walkway. Self-reported pain, stiffness, and function were measured with the Western Ontario and McMaster Osteoarthritis Index. Correlation and Alexander's normalized-t approximation analyses were used to assess associations among the variables. Subset analysis was performed on subjects with and without tibiofemoral joint crepitus.

FINDINGS

Slight to moderate correlations existed between stiffness and damping coefficients and most gait parameters ((| r |=0.30-0.56; P<.05) and between Western Ontario and McMaster Osteoarthritis Index scores and all gait parameters (| r |=0.35-0.62; P<.05). The damping coefficient was only slightly associated with patient-rated Western Ontario and McMaster Osteoarthritis Index stiffness subscale scores. Subset analysis revealed significant correlations that differed between those with and without crepitus.

INTERPRETATION

These findings suggest that laboratory measured stiffness and damping coefficients, Western Ontario and McMaster Osteoarthritis Index scores and gait-related measurements assess different aspects related to movement in individuals with knee osteoarthritis. Stiffness and damping coefficients may offer the ability to explain gait changes in the knee that are independent of a person's perceptions particularly in the early stages of the disease.

Assessing musculo-articular stiffness using free oscillations: theory, measurement and analysis

Stiffness, the relationship between applied load and elastic deformation, is an important neuromechanical component related to muscular performance and injury risk. The free-oscillation technique is a popular method for stiffness assessment. There has been wide application of this technique assessing a variety of musculature, including the triceps surae, knee flexors, knee extensors and pectorals. The methodology involves the modelling of the system as a linear damped mass-spring system. The use of such a model has certain advantages and limitations that will be discussed within this review. Perhaps the major advantage of such a model is the specificity of the measure, whereby it is possible for the assessment conditions to simulate the type of loading witnessed during functional tasks and sporting situations. High levels of reliability and construct validity have typically been reported using such procedures. Despite these assurances of accuracy, a number of issues have also been identified. The literature reveals some concerns surrounding the use of a linear model for stiffness assessment. Further, procedural issues surrounding the administration of the perturbation, attention focus of the participant during the perturbation, signal collection, data processing and analysis, presentation of stiffness as a linear or torsional value, assessment load (single vs multiple vs maximal) and the stiffness-load relationship have been identified, and are all fundamentally related to the quality of the calculated output data. Finally, several important considerations for practitioners have been recommended to ensure the quality and consistency of stiffness data collection, processing and interpretation.

Gender differences in musculotendinous stiffness and range of motion after an acute bout of stretching

The purpose of the present study was to examine musculotendinous stiffness (MTS) and ankle joint range of motion (ROM) in men and women after an acute bout of passive stretching. Thirteen men (mean ± SD age = 21 ± 2 years; body mass = 79 ± 15 kg; and height = 177 ± 7 cm) and 19 women (21 ± 3 years; 61 ± 9 kg; 165 ± 8 cm) completed stretch tolerance tests to determine MTS and ROM before and after a stretching protocol that consisted of 9 repetitions of passive, constant-torque stretching. The women were all tested during menses. Each repetition was held for 135 seconds. The results indicated that ROM increased after the stretching for the women (means ± SD pre to post: 109.39° ± 10.16° to 116.63° ± 9.63°; p ≤ 0.05) but not for the men (111.79° ± 6.84° to 113.93° ± 8.15°; p > 0.05). There were no stretching-induced changes in MTS (women's pre to postchange in MTS: -0.35 ± 0.38; men's MTS: +0.17 ± 0.40; p > 0.05), but MTS was higher for the men than for the women (MTS: 1.34 ± 0.41 vs. 0.97 ± 0.38; p ≤ 0.05). electromyographic amplitude for the soleus and medial gastrocnemius during the stretching tests was unchanged from pre to poststretching (p > 0.05); however, it increased with joint angle during the passive movements (p ≤ 0.05). Passively stretching the calf muscles increased stretch tolerance in women but not in men. But the stretching may not have affected the viscoelastic properties of the muscles. Practitioners may want to consider the possible gender differences in passive stretching responses and that increases in ROM may not always reflect decreases in MTS.

Neuromuscular and psychological influences on range of motion recovery in anterior cruciate ligament reconstruction patients

To identify distinguishing characteristics for knee surgery patients who experience a protracted recovery process, we sought to determine if there is an association between the neuromuscular stretch reflex and psychological factors of pain perception and anxiety on the range of motion (ROM) recovery rate of post-operative anterior cruciate ligament reconstruction (ACLR) rehabilitation patients. The ACLR participants were categorized into a slow recovery group (SRG: >6 weeks to recover 0-125 degrees knee flexion [n=10]) and a normal recovery group (NRG: <6 weeks to recovery 0-125 degrees knee flexion [n=12]). Control participants (n=22) were age, gender and activity-level matched to the surgical participants. Neuromuscular testing consisted of sagittal plane video kinematics of the Wartenberg Pendulum Test for determining lower limb stiffness indices and electromyography-monitored patellar tendon tap reflex responses. Psychological and health status assessments consisted of the State-Trait Anxiety Inventory and SF-36 Health Survey. Data revealed that neuromuscular reflex profiles, lower limb stiffness indices, pain, anxiety and SF-36 indices of function were not significantly different between the two surgical groups (SRG and NRG). The surgical groups exhibited significantly greater pain (2.67+/-2.27 SRG, 1.49+/-1.15 NRG) than the control group (p.05). SF-36 indices were significantly lower for the surgical groups for total score (546.55+/-94.70 SRG, 577.57+/-125.58 NRG), function 69.00+/-20.24 SRG, 67.08+/-19.12 NRG), role physical (53.75+/-22.85 SRG, 53.12+/-23.15 NRG), social (76.24+/-25.31 SRG, 65.62+/-27.24 NRG), and emotional (82.49+/-19.81 SRG, 81.38+/-23.02 NRG) subscales (p.05). These results suggest that neuromuscular reflex responses, visual analogue scale (VAS) pain, and anxiety are not distinguishing factors for ROM recovery rate between the SRG and NRG. Decreased SF-36 indices, including pain as it influences function, though clinically relevant factors, were not statistically associated with post-operative ROM recovery rate.

Identification of Human Limb Viscoelasticity using Robotics Methods to Support the Diagnosis of Neuromuscular Diseases

In this paper we present an original method to estimate in vivo the joint dynamics of the human limbs. The method is based on a non-invasive and painless technology making use of an optical motion capture system and an associated skeletal model to record the human motion and compute its kinematics and its dynamics. The formalism that is used for the identification is commonly used in robotics. The passive limb joints properties are modeled by enhanced spring-damper systems. The inverse dynamics is sampled along a movement to give an over-determined system. The obtained system is solved by the linear least-squares method. To perform the estimation, we place emphasis on giving indicators and requirements to interpret the obtained results, and on using painless, passive constraint-free movements that are usually performed during the clinical diagnosis of neuromuscular diseases. Finally the method is experimentally applied to two healthy subjects and five patients of neuromuscular diseases in order to estimate the upper-limb viscoelastic properties. The obtained results are discussed.

A painless and constraint-free method to estimate viscoelastic passive dynamics of limbs' joints to support diagnosis of neuromuscular diseases

Though seldom identified, the human joints dynamics is important in the fields of medical robotics and medical research. We present a general solution to estimate in-vivo and simultaneously the passive dynamics of the human limbs' joints. It is based on the use of the multi-body description of the human body and its kinematics and dynamics computations. The linear passive joint dynamics of the shoulders and the elbows: stiffness, viscosity and friction, is estimated simultaneously using the linear least squares method. Acquisition of movements is achieved with an optical motion capture studio on one examinee during the clinical diagnosis of neuromuscular diseases. Experimental results are given and discussed.

Knee joint stiffness in individuals with and without knee osteoarthritis: a preliminary study

STUDY DESIGN

Descriptive, case-matched comparison.

OBJECTIVES

To compare the knee joint stiffness and damping coefficients of individuals with knee osteoarthritis (KOA) to those of age- and gender-matched individuals without KOA. A secondary purpose was to investigate relationships between these coefficients and complaints of stiffness in individuals with KOA.

BACKGROUND

KOA is a leading cause of disability, and stiffness is a common complaint in individuals with KOA. Yet the most common method of assessing knee joint stiffness is through a self-report questionnaire.

METHODS AND MEASURES

Stiffness and damping coefficients at the knee were calculated in 10 volunteers (mean age +/- SD, 64.1+/-15.5 years) with KOA and compared to coefficients from age-and gender-matched individuals without KOA, collected in a previous study (mean age +/- SD, 62.1+/-13.9 years). Stiffness and damping coefficients were calculated from the angular motion of the knee during a relaxed oscillation. Spearman correlation coefficients were calculated between stiffness and damping coefficients and WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scores for subjects with KOA.

RESULTS

Independent 2-tailed t tests revealed significantly larger damping coefficients (P = .035) among those with KOA (95% CI, 0.10-2.32 Nm s/rad). Spearman rank correlations revealed a significant positive relationship (r = .85, P = .003) between the damping coefficient and the stiffness subscore of the WOMAC.

CONCLUSION

This study offers preliminary data demonstrating the feasibility of measuring stiffness and damping coefficients in individuals with KOA. Additionally, the damping coefficient is increased in people with KOA when compared to age- and gender-matched individuals without KOA. The damping coefficient appears to be associated with the complaints of stiffness reported by the WOMAC.

Objective measurement of stiffness in knee osteoarthritis

PURPOSE

The purpose of this study was to evaluate an objective measure of knee joint stiffness in older adults with and without knee osteoarthritis.

DESIGN

Methodological study of the modified pendulum test.

SAMPLE

A convenience sample of community-dwelling older adults (n = 41).

METHODS

Knee angle oscillation data were collected with a VICON motion analysis system and were used to calculate stiffness and damping coefficients and measures of joint stiffness.

FINDINGS

Although some testing problems were encountered early in the study, useable data were obtained from 29 participants. Within-participant variability for calculated stiffness and damping coefficients was low (0.55% and 8.92%, respectively), whereas the between-participant variability was high for both the stiffness (99.45%) and damping (91.08%) coefficients.

DISCUSSION

The modified pendulum test is a reliable method for evaluation of knee joint stiffness. This method can be used in collection of outcome data for future intervention studies addressing joint stiffness.

Gender differences in head-neck segment dynamic stabilization during head acceleration

PURPOSE

Recent epidemiological research has revealed that gender differences exist in concussion incidence but no study has investigated why females may be at greater risk of concussion. Our purpose was to determine whether gender differences existed in head-neck segment kinematic and neuromuscular control variables responses to an external force application with and without neck muscle preactivation.

METHODS

Forty (20 females and 20 males) physically active volunteers participated in the study. The independent variables were gender, force application (known vs unknown), and force direction (forced flexion vs forced extension). The dependent variables were kinematic and EMG variables, head-neck segment stiffness, and head-neck segment flexor and extensor isometric strength. Statistical analyses consisted of multiple multivariate and univariate analyses of variance, follow-up univariate analyses of variance, and t-tests (P < or = 0.05).

RESULTS

Gender differences existed in head-neck segment dynamic stabilization during head angular acceleration. Females exhibited significantly greater head-neck segment peak angular acceleration (50%) and displacement (39%) than males despite initiating muscle activity significantly earlier (SCM only) and using a greater percentage of their maximum head-neck segment muscle activity (79% peak activity and 117% muscle activity area). The head-neck segment angular acceleration differences may be because females exhibited significantly less isometric strength (49%), neck girth (30%), and head mass (43%), resulting in lower levels of head-neck segment stiffness (29%).

CONCLUSION

For our subject demographic, the results revealed gender differences in head-neck segment dynamic stabilization during head acceleration in response to an external force application. Females exhibited significantly greater head-neck segment peak angular acceleration and displacement than males despite initiating muscle activity earlier (SCM only) and using a greater percentage of their maximum head-neck segment muscle activity.

Comparison of triceps surae structural stiffness and material modulus across sex

BACKGROUND

Dynamic joint stability is derived, in part, from active muscle stiffness. Previous research has identified greater structural musculotendinous stiffness in males than in females, suggesting potential sex differences in joint stability. However, structural stiffness is influenced by anthropometrics, and it is currently unclear if sex differences in musculotendinous stiffness are purely functions of anthropometrics or related to additional factors. The purpose of this investigation was to compare structural stiffness and material modulus of the triceps surae between sexes to determine the relative influence of anthropometrics. It was hypothesized that males would demonstrate greater structural stiffness and material modulus.

METHODS

Twenty male and 20 female individuals volunteered for participation. Active triceps surae structural stiffness was estimated from the damped frequency of oscillation of the shank about the ankle. Material modulus was calculated as the ratio of stress to strain, derived from estimates of triceps surae length and physiological cross-sectional area.

FINDINGS

Structural stiffness was significantly greater in males [mean (SD)] [137.41 (26.99) N/cm] than females [91.06 (20.10) N/cm]. Similarly, material modulus was significantly greater in males [2778.51 (549.95) Pa] than females [1968.58 (439.61) Pa].

INTERPRETATION

Greater structural stiffness in males identified in previous literature appears to be a true phenomenon. Identification of greater material modulus in males suggests that these differences are likely attributable to sex differences in tendon stiffness and muscle architecture. These results indicate that male musculature is more effective at resisting changes in its length, a finding which may have implications for joint stability.

Joint stiffness and pain in individuals with patellofemoral syndrome

STUDY DESIGN

Pretest-posttest matched control group design.

OBJECTIVES

To measure passive knee joint stiffness and pain in participants with and without patellofemoral pain syndrome (PFPS) and to determine the relationship between mechanical knee joint stiffness, self-reported stiffness, and pain.

BACKGROUND

Patients with PFPS complain of knee joint stiffness and pain, but no research has quantified both of these characteristics in this population.

METHODS AND MEASURES

Twenty-eight individuals (14 with PFPS [mean age +/- SD, 25.5 +/- 4.8 years] and 14 healthy controls [mean age +/- SD, 22.8 +/- 5.4 years]) volunteered for this study. Mechanical passive knee joint stiffness was calculated using the damped natural frequency of oscillation of the lower leg while sitting. Mechanical stiffness was compared to self-reports of knee stiffness and pain. All measurements were recorded presitting and after 20 minutes of sitting.

RESULTS

Sitting for 20 minutes did not induce significant changes in mechanical knee joint stiffness. However, participants with PFPS reported significantly greater (P<.01) knee stiffness after sitting for 20 minutes. A significant correlation (r = 0.70, P<.01) was found between self-reported stiffness and pain in participants with PFPS; however, no significant relationship was observed between mechanical and self-reported knee joint stiffness.

CONCLUSIONS

Despite frequent complaints of joint stiffness, the knees of individuals with PFPS do not appear physiologically stiffer than those of control subjects. Individuals with PFPS perceive increased knee stiffness after sitting, but may misinterpret the sensation of pain as joint stiffness.

Sex comparison of extensibility, passive, and active stiffness of the knee flexors

OBJECTIVE

To compare extensibility, and passive and active stiffness of the knee flexors between males and females.

DESIGN

An experimental design utilized 15 males and 15 females to identify sex differences in active extensibility, and active and passive stiffness of the knee flexors.

BACKGROUND

Muscle stiffness appears to contribute to joint stability from both mechanical and neuromuscular perspectives. Differences in knee flexor stiffness may partially explain higher female anterior cruciate ligament injury rates.

METHODS

Active knee flexor extensibility was assessed as subjects extend the knee from a fixed hip position, measuring the final knee position. Passive knee flexor stiffness was calculated as the slope of the moment-angle curve resulting from controlled passive knee extension. Active knee flexor stiffness was assessed by loading the lower extremity with 10% total body mass, and measuring the damping effect of the knee flexors on imposed vibratory motion about the knee joint.

RESULTS

Females displayed greater active extensibility (P<0.05), while males displayed greater active (P<0.05) and passive (P<0.05) knee flexor stiffness. Sex differences in active and passive knee flexor stiffness were not significant following normalization to anthropometric characteristics.

CONCLUSIONS

The knee flexor musculature in males is less extensible and displays greater active and passive stiffness compared to females. However, these differences may be functions of greater mass and height in males.

Spectral analysis of adult dancers' sways: sex and interaction vision-proprioception

In subjects of both sexes with or without dance training, dependence on vision and proprioception for postural control was studied by destabilizing these cues on a free seesaw. Fast Fourier transform processing allowed spectral frequency analysis of the platform sways recorded by an accelerometer. Two frequency bands of the total spectral energy were used: the lower (0 - 2 Hz) and the higher (2 - 20 Hz) frequency bands. Dancers were significantly less dependent on vision but use more proprioception than untrained subjects. Professional dance training appears to shift sensorimotor dominance from vision to proprioception, and this evolution seems more marked for males than females. Female and male dancers had similar dynamic performances, but for males, the better neuromuscular coordination may be associated with biomechanical factors.

Investigation into the relationship between the passive flexibility and active stiffness of the ankle plantar-flexor muscles

OBJECTIVE

The purpose of the study was to investigate the relationship between measurements of passive flexibility and active stiffness of the ankle plantar-flexor muscles.

DESIGN

The study was a correlation design.

BACKGROUND

Flexibility has passive and active components. Little information is available regarding the relationship of these measurements in terms of the information that they yield on the state of the muscle-tendon unit.

METHODS

Free oscillation data representing active stiffness was obtained using applied masses equivalent to 30%, 60% and 90% of the subject's maximal voluntary contraction. The angle of dorsiflexion, representing passive flexibility, was measured in standing using computer digitisation to obtain the angle.Results. Mean active stiffness values were 14280 N/m (30% maximal voluntary contraction), 22260 N/m (60% maximal voluntary contraction) and 28010 N/m (90% maximal voluntary contraction). Dorsiflexion measurement gave a mean of 34.3 degrees (S.D. 4.8). Correlation's obtained for the association between range of motion and active stiffness were r=0.01 (30% maximal voluntary contraction), r=0.09 (60% maximal voluntary contraction) and r=0.04 (90% maximal voluntary contraction). Moderate reliability coefficients of 0.71 (30% maximal voluntary contraction), 0.78 (60% maximal voluntary contraction) and 0.68 (90% maximal voluntary contraction) were obtained.

CONCLUSIONS

The results imply that measurements of passive flexibility and active stiffness of the lower leg musculature are independent measures of components of muscle-tendon unit flexibility.

RELEVANCE

Flexibility is a construct with different components of measurement. Etiological studies typically relate static flexibility measurements to injury with conflicting outcomes. This study suggests that static and active flexibility measures yield different information about the muscle tendon unit of the ankle plantar flexors, and that researchers should consider this point in the design of etiological studies.

Stiffness and muscle function with age and reduced muscle use

Changes in passive muscle stiffness with age and disuse were assessed in male Fischer-344 and Brown Norway rats. Three groups of rats were studied: young (approximately 7 months old), old (approximately 33 months old), and old that had undergone 2 weeks of hindlimb unweighting, a model of reduced muscle use. Four hindlimb muscles were examined: the soleus (postural), plantaris (locomotor), extensor digitorum longus (nonpostural), and peroneus longus (nonpostural). Supramaximal stimuli elicited peak tetanic tensions throughout the available range of motion (amount of muscle elongation before the maximal attainable contractile or tetanic tension is obtained) for each muscle, permitting the creation of length-tension curves. Passive tension (amount encountered at each millimeter of change in muscle length) was also recorded throughout the available range of motion and was unchanged with aging and unchanged or reduced with hindlimb unweighting; muscle stiffness remained unchanged under both conditions. Passive tension, however, accounted for a greater proportion of total tension with age and particularly with hindlimb unweighting. A significant loss in muscle range of motion, resulting in a leftward shift in the length-tension curve, occurred with aging in only the plantaris. Hindlimb unweighting resulted in a marked loss in muscle range for all four muscles studied, suggesting that the remaining muscle force was constrained to a very small arc. Significant declines in muscle mass and peak contractile tension, associated with age and hindlimb unweighting, were observed for all four muscles.

Viscoelastic behavior of plantar flexor muscle-tendon unit at rest

Muscle stretching as an exercise routine is widely used in orthopaedic and neurological rehabilitation. However, the muscle response to specific stretching parameters is still unclear. The aim of this study was to investigate the effect parameters, such as stretch velocity, stretch extent, and initial muscle-tendon resistance, on the plantar flexor response to passive movement. Eighteen healthy subjects (23-41 years) participated in this study. Five passive ankle dorsiflexions were randomly imposed at various velocities from 5 degrees/sec to 180 degrees/sec using a Kin-Com dynamometer, while unwanted activations of the soleus and tibialis anterior muscles were detected with surface electrodes. The resistive torque was averaged at -10 degrees and 0 degree of dorsiflexion. As shown by analyses of variance followed by Scheffé post hoc procedures, the resistive torque was significantly increased (p < 0.01) between 5 degrees/sec and higher velocities (60 degrees/sec or 120 degrees/sec and higher). A strong linear resistive torque-velocity relationship was also observed, as indicated by Pearson correlation coefficients of 0.92 (-10 degrees) and 0.91 (0 degree). The absolute resistive torque increment, calculated at 180 degrees/sec, was larger at 0 degree of dorsiflexion than at the -10 degrees of dorsiflexion position. Finally, subjects with larger initial plantar flexor resistance had a higher resistive torque increment (p < 0.05) at a high velocity of stretch (180 degrees/sec) than those with less initial muscle-tendon resistance. These results indicate that 1) the nonreflex resistive torque response to stretch is velocity-sensitive and 2) both a larger stretch extent and muscle initial resistance lead to greater resistive torque increments at high velocity. These observations suggest that slow and gradual stretching procedures, rather than rapid or ballistic movements, should be used, especially with stiff muscles to reduce the chance of injury from excessively high tension.

Impaired viscoelastic behaviour of spastic plantarflexors during passive stretch at different velocities

OBJECTIVE: The aim of this study was to evaluate the effect of velocity on non-reflexly induced resistive torque (RT) responses of the spastic plantarflexors (PFs) of subjects with spinal cord injuries. DESIGN: Descriptive study, transversal. BACKGROUND: In spastic muscles, non-reflex changes such as increased muscle stiffness, contractures and atrophy have been reported. These changes probably alter muscle tensile properties and viscoelastic behaviour. METHODS: Six subjects with chronic (1-3 yr) spinal cord injuries (SCI) and 12 normal controls (CTLs) participated in this study. Passive ankle dorsiflexions (DFs), ranging from -35 degrees to 5 degrees of DF, were randomly imposed at 5 degrees /s, 10 degrees /s, 20 degrees /s, 40 degrees /s, 60 degrees /s, 120 degrees /s and 180 degrees /s using an isokinetic dynamometer (Kin-Com(TM)). Unwanted muscle activity was detected using surface electrodes on the soleus and tibialis anterior muscles. RESULTS: The results show first that RT rose with increasing velocity; the RT increment reached statistical (analysis of variance (ANOVA); Scheffé post-hoc procedure) significance (P < 0.01) at a lower velocity for the CTLs (40 degrees /s) group than for the SCI group (60 degrees /s). Second, significantly (t-test; P < 0.001) larger net increments of RT (RT at each velocity minus RT at 5 degrees /s) were found for the CTLs at 180 degrees /s than for the SCI group whose RT plateaued at 60 degrees /s. Finally, whereas the RT-velocity relationship was linear (r = 0.94) in the CTLs, that of the SCI group followed a power regression model (r = 0.85). CONCLUSIONS: These results show that the spastic PFs of the subjects with SCIs have an impaired velocity-sensitive behaviour, especially at high velocities of stretch where greater resistance is expected.

The hybrid mass-spring pendulum model of human leg swinging: stiffness in the control of cycle period

Human leg swinging is modeled as the harmonic motion of a hybrid mass-spring pendulum. The cycle period is determined by a gravitational component and an elastic component, which is provided by the attachment of a soft-tissue/muscular spring of variable stiffness. To confirm that the stiffness of the spring changes with alterations in the inertial properties of the oscillator and that stiffness is relevant for the control of cycle period, we conducted this study in which the simple pendulum equivalent length was experimentally manipulated by adding mass to the ankle of a comfortably swinging leg. Twenty-four young, healthy adults were videotaped as they swung their right leg under four conditions: no added mass and with masses of 2.27, 4.55, and 6.82kg added to the ankle. Strong, linear relationships between the acceleration and displacement of the swinging leg within subjects and conditions were found, confirming the motion's harmonic nature. Cycle period significantly increased with the added mass. However, the observed increases were not as large as would be predicted by the induced changes in the gravitational component alone. These differences were interpreted as being due to increases in the active muscular stiffness. Significant linear increases in the elastic component (and hence stiffness) were demonstrated with increases in the simple pendulum equivalent length in 20 of the individual subjects, with r2 values ranging between 0.89 and 0.99. Significant linear relationships were also demonstrated between the elastic and gravitational components in 22 subjects, with individual r2 values between 0.90 and 0.99.(ABSTRACT TRUNCATED AT 250 WORDS)