Divergent expiratory braking activity of costal and crural diaphragm

BACKGROUND

There is increasing clinical interest in understanding the contribution of the diaphragm in early expiration, especially during mechanical ventilation. However, current experimental evidence is limited, so essential activity of the diaphragm during expiration and diaphragm segmental differences in expiratory activity, are unknown.

OBJECTIVES

To determine if: 1) the diaphragm is normally active into expiration during spontaneous breathing and hypercapnic ventilation, 2) expiratory diaphragmatic activity is distributed equally among the segments of the diaphragm, costal and crural.

METHODS

In 30 spontaneously breathing male and female canines, awake without confounding anesthetic, we measured directly both inspiratory and expiratory electrical activity (EMG), and corresponding mechanical shortening, of costal and crural diaphragm, during room air and hypercapnia.

RESULTS

During eupnea, costal and crural diaphragm are active into expiration, showing significant and distinct expiratory activity, with crural expiratory activity greater than costal, for both magnitude and duration. This diaphragm segmental difference diverged further during progressive hypercapnic ventilation: crural expiratory activity progressively increased, while costal expiratory activity disappeared.

CONCLUSION

The diaphragm is not passive during expiration. During spontaneous breathing, expiratory activity -"braking"- of the diaphragm is expressed routinely, but is not equally distributed. Crural muscle "braking" is greater than costal muscle in magnitude and duration. With increasing ventilation during hypercapnia, expiratory activity -"braking"- diverges notably. Crural expiratory activity greatly increases, while costal expiratory "braking" decreases in magnitude and duration, and disappears. Thus, diaphragm expiratory "braking" action represents an inherent, physiological function of the diaphragm, distinct for each segment, expressing differing neural activation.

Assessing the reliability of biomechanical variables during a horizontal deceleration task in healthy adults

Horizontal deceleration technique is an underpinning factor to musculoskeletal injury risk and performance in multidirectional sport. This study primarily assessed within- and between-session reliability of biomechanical and performance-based aspects of a horizontal deceleration technique and secondarily investigated the effects of limb dominance on reliability. Fifteen participants completed four horizontal decelerations on each leg during test and retest sessions. A three-dimensional motion analysis system was used to collect kinetic and kinematic data. Completion time, ground contact time, rate of horizontal deceleration, minimum centre of mass height, peak eccentric force, impulse ratio, touchdown distance, sagittal plane foot and knee angles at initial contact, maximum sagittal plane thorax angle, and maximum knee flexion moment were assessed. Coefficients of variation (COV) and intraclass correlation coefficients (ICC) were used to assess within- and between-session reliability, respectively. Seven variables showed "great" within-session reliability bilaterally (COV ≤9.13%). ICC scores were 'excellent' (≥0.91; n = 4), or 'good' (0.76-0.89; n = 7), bilaterally. Limb dominance affected five variables; three were more reliable for the dominant leg. This horizontal deceleration task was reliable for most variables, with little effect of limb dominance on reliability. This deceleration task may be reliably used to assess and track changes in deceleration technique in healthy adults.

Collision-free emergency planning and control methods for CAVs considering intentions of surrounding vehicles

Autonomous emergency braking (AEB) systems are able to control vehicles as needed to avoid vehicle rear-end collisions. However, these systems are ineffective in scenarios with laterally cut-in vehicles and rapidly-changing dangerous scenes. This paper proposes a novel collision-free emergency braking system (CFEBS) that can enable intelligent connected vehicles (CAVs) to plan and execute a more conservative safety trajectory for the braking process in dangerous scenes by considering the longitudinal and lateral motion intentions of the surrounding vehicles. An intention identification model for surrounding vehicles is proposed based on long-short term memory (LSTM) networks and conditional random fields (CRFs). By considering the surrounding vehicles as risk sources and quantifying the risk with the speed of the risk flow, a potential risk flow model is built to calculate the potential risk map (PRM) around the ego vehicle. The global safest trajectory is generated via the PRM using the discrete method. The output trajectory profile is regarded as the reference for a model predictive controller (MPC). Simulation results show that the proposed CFEBS can predict vehicle intention with 91.6% accuracy and control the ego vehicle to perform effective collision-free braking operations in emergency traffic environments.

Impact of vehicle type, tyre feature and driving behaviour on tyre wear under real-world driving conditions

Tyre wear generates not only large pieces of microplastics but also airborne particle emissions, which have attracted considerable attention due to their adverse impacts on the environment, human health, and the water system. However, the study on tyre wear is scarce in real-world driving conditions. In the present study, the left-front and left-rear tyre wear in terms of volume lost in mm³ of 76 taxi cars was measured about every three months. This study covered 22 months from September 2019 to June 2021 and included more than 500 measurements in total. Some of the data was used to evaluate the effects of vehicle type and tyre type on tyre wear. In addition, a machine learning method (i.e., Extreme gradient boosting (XGBoost)) was used to probe the effect of driving behaviour on tyre wear by monitoring real-time driving behaviour. The current statistical results showed that, on average, the tyre wear was 72 mg veh^-1 km^-1 for a hybrid car and 53 mg veh^-1 km^-1 for a conventional internal combustion engine car. The average tyre wear measured for a taxi vehicle configuration featuring winter tyres was 160 mg veh^-1 km^-1, which was 1.4 and 3.0 times as much as those with all-season tyres and summer tyres, respectively. The wear rate of left-front tyres was 1.7 times higher than that of left-rear tyres. The XGBoost results indicated that compared to driving behaviour, tyre type and tyre position had more important effects on tyre wear. Among driving behaviours, braking and accelerating events presented the most considerable impact on tyre wear, followed by cornering manoeuvres and driving speed. Thus, it seems that limiting harsh braking and acceleration has the potential to reduce tyre wear significantly.

Associations between lower limb eccentric muscle capability and change of direction speed in basketball and tennis players

Background

The ability to perform a quick and rapid change of direction (CoD) is an important determinant of success in a variety of sports. Previous studies have already highlighted that eccentric strength is a dominant predictor of CoD. However, these studies evaluated eccentric strength through a limited number of outcome measures and used small sample sizes.

Methods

A total of 196 athletes participated in the study. The aim of our study was to investigate: (1) the correlation between eccentric outcome measures derived from different tests (Nordic hamstring exercise (NHE), countermovement jump (CMJ) and flywheel (FW) squats), (2) the association between eccentric outcome measures and CoD 90°, CoD 180°; and (3) proportion of explained variance in CoD performance.

Results

Very large associations (r = 0.783, p < 0.001) were observed between peak torque during NHE (NHE_PT) and force impulse during the eccentric phase of CMJ (CMJ_FI). Small to moderate correlations were calculated between peak eccentric force in flywheel squats and peak eccentric force in CMJ (r = 0.220-035, p < 0002). All eccentric CMJ outcome measures and NHE_PT were reported as moderate negative associations with both CoD tests. Eccentric measures explained 25.1% of the variance in CoD 90° (CMJ_PF, NHE_PT, F_0.125 -peak eccentric force during FW squats with 0.125 kg m² load), while the same outcome measures explained 37.4% of the variance for CoD 180°.

Conclusion

Our results suggest that different measures of eccentric strength specifically contribute to CoD performance. Therefore, for successful CoD performance, different aspects of eccentric strength training should be considered in testing and training (maximal eccentric strength, eccentric-concentric actions with fast execution).

Time-integrated propulsive and braking impulses do not depend on walking speed

BACKGROUND

Enhancing propulsion during walking is often a focus in physical therapy for those with impaired gait. However, there is no consensus in the literature for assessing braking and propulsion. Both are typically measured from the anterior-posterior ground reaction force (AP-GRF). While normalization of AP-GRF force by bodyweight is commonly done in the analysis, different methods for AP-GRF time axis normalization are used.

RESEARCH QUESTION

Does walking speed affect propulsion and/or braking, and how do different methods for calculating propulsion and braking impact the conclusion, in both healthy adults and those with lower limb impairment?

METHODS

We investigated three different analysis methods for assessing propulsion. 1. BW-TimeIntegration: Bodyweight (BW) normalized time integration of AP-GRF (units of BWs). 2. BW-%StanceIntegration: BW normalized AP-GRF is resampled to percent stance phase prior to integration (units of BW%Stance). 3. BW-Peak: BW normalized peak force (units of BW). We applied these methods to two data sets. One data set included AP-GRFs from trials of slow, self-selected, and fast walking speeds for 203 healthy controls (HCs); a second data set included subjects with lower limb orthopedic injuries.

RESULTS

Using the BW-TimeIntegration method, we found no effect of walking speed on propulsion for HCs. Time integration over the longer stance phase of slower walking balanced the lower magnitude AP-GRFs of slower walking, resulting in a time-integrated impulse that was the same regardless of walking speed. In contrast, the other two methods that are not time integration methods found that propulsion increased with walking speed. Similarly, in the gait pathology data set, differences in results were found depending on the analysis method used.

SIGNIFICANCE

For many gait studies concerning propulsion and/or braking, the impulse measure used should be related to the body's change of momentum, necessitating an analysis method with a time integration of the AP-GRF.

Modelling brake transition time of young alcohol-impaired drivers using hazard-based duration models

Braking performance of drivers is a crucial factor in evaluating the collision patterns and implementing road safety measures. Further, alcohol is known to impair driving control. The present study aims to examine the influence of a comprehensive range of Blood Alcohol Concentration (BAC) levels (0%, 0.03 %, 0.05 % and 0.08 %) on brake transition times of drivers. As young drivers show significantly higher crash risks compared to the experienced drivers, fifty-four young Indian drivers in the age group of 21-25 years (forty males and fourteen females) participated in the driving simulator experiments. The study adopted the framework of a within-subjects design, where each driver encountered rural and urban driving scenarios in a counterbalanced order, during experimental driving at each of the four BAC levels. Their brake transition times were estimated with respect to sudden pedestrian crossing events. Weibull Accelerated Failure Time (AFT) models with shared frailty were developed for quantifying the effects of BAC levels along with driver attributes on brake transition time. Preliminary analysis showed significant main effects of BAC (p < 0.001) and driving environment (p = 0.002) on brake transition time; however, their interaction effect was not significant (p = 0.485). The models revealed that 0.03 %, 0.05 % and 0.08 % BACs significantly reduced the brake transition times by 16 %, 28 % and 52 % in rural driving environment, and by 23 %, 37 % and 53 % in urban driving environment, compared to 0% BAC. The study outcomes may find application in assisting collision warning systems which take into account the braking behaviour of drivers.

Drop jump neuromuscular performance qualities associated with maximal horizontal deceleration ability in team sport athletes

The purpose of this study was to investigate associations between, and within, drop jump (DJ) neuromuscular performance (NMP) qualities and maximal horizontal deceleration ability. We also compared DJ NMP qualities in "high" versus "low" horizontal deceleration ability athletes. Twenty-nine university athletes performed: (1) DJs on force plates from 20 (DJ20) and 40 cm (DJ40) heights and (2) maximal horizontal deceleration, measured using radar, following a 20 m acceleration. Maximal horizontal deceleration was evaluated using deceleration (HDEC; m·s^-2), across the entire deceleration phase and during early and late deceleration sub-phases. Of the DJ variables assessed, DJ20 and DJ40 reactive strength index (RSI) and concentric mean force had the largest correlations with HDEC (r = -0.54 to -0.61) and the largest differences between high and low HDEC groups (d = 1.20 to 1.40). These correlations were stronger with the early than late HDEC sub-phase (r = -0.54 to -0.66 vs. r = -0.24 to -0.40). Notably, eccentric mean force in DJ40 had large correlations with both DJ20 and DJ40 concentric mean force (r = 0.67 to 0.77), whereas at DJ20 these correlations were small (r = 0.22 to 0.40). Similarly, DJ40 eccentric mean force had a much larger difference between the high and low HDEC groups than DJ20 (d = 1.11 vs. 0.51). These findings suggest DJ RSI from either height may be used as a proxy for HDEC ability, while DJ kinetic analyses should use a higher height to distinguish those with a better capacity to generate eccentric braking forces under increased eccentric loading demands.HIGHLIGHTS Players with greater drop jump reactive strength index (RSI) demonstrated superior horizontal deceleration ability.Drop jump RSI had a greater association with the early compared to the late horizontal deceleration sub-phase.Of the drop jump kinetic variables examined, concentric mean force had the largest associations with horizontal deceleration ability.

Altered post-stroke propulsion is related to paretic swing phase kinematics

BACKGROUND

Gait propulsion is often altered following a stroke, with clear effects on anterior progression. Changes in the pattern of propulsion could potentially also influence swing phase mechanics. The purpose of the present study was to investigate whether post-stroke variability in paretic propulsion magnitude or timing influence paretic swing phase kinematics.

METHODS

29 chronic stroke survivors participated in this study, walking on an instrumented treadmill at their self-selected and fastest-comfortable speeds. For each participant, we calculated several propulsion-related metrics derived from anteroposterior ground reaction force or from center of mass power, as well as knee flexion angle and circumduction displacement during the swing phase. We performed a series of linear mixed model analyses to determine whether the propulsion metrics for the paretic leg were related to paretic swing phase mechanics.

FINDINGS

A subset of the stroke survivors exhibited unusual braking forces late in the paretic stance phase, when strong propulsion typically occurs among uninjured controls. Beyond the effects of walking speed or walking condition, these braking forces were significantly linked with altered paretic swing phase mechanics. Specifically, large braking impulses were associated with reduced paretic knee flexion (p = 0.039) and increased paretic circumduction (p = 0.023).

INTERPRETATION

The present results suggest that braking forces late in stance are particularly indicative of deficits in the production of typical swing phase kinematics. This relationship suggests that therapies designed to address altered swing kinematics should also consider altered force generation in late stance, as these behaviors appear to be coupled.

Potential benefits of controlled vehicle braking to reduce pedestrian ground contact injuries

Protecting struck pedestrians during the ground contact phase has been a challenge for decades. Recent studies have shown how ground related injury is influenced by pedestrian kinematics. In this paper we further developed this approach by assessing the potential of controlling vehicle braking to reduce pedestrian ground contact injuries. Applying a recently proposed Simulation Test Sample, a series of simulations were run using the MADYMO software environment. The approach considered 6 vehicle shapes, 4 pedestrian models, 3 impact velocities and 2 pedestrian gaits and each case was considered with two different vehicle braking approaches. The first was full braking, while the second applied controlled braking, for which a strategy based on pedestrian kinematics was applied. The effect of vehicle braking was evaluated using the Weighted Injury Cost (WIC) of overall pedestrian injuries and the pedestrian-ground impact velocity change. The proximity of the vehicle and pedestrian at the instant of ground contact was also evaluated to assess the potential of future vehicle based intervention methods to cushion the ground contact. Finally real-world videos of pedestrian collisions were analyzed to estimate the available free vehicle stopping distances. Results showed substantial median reductions in WIC and head impact velocity for all vehicle shapes except the Van. The proximity of the pedestrian to the vehicle front at the instant of ground contact under controlled braking is less than 1.5 m in most cases, and the required stopping distance for the vehicle under controlled braking was within the available stopping distance estimated from the video footage in about 74% of cases. It is concluded that controlled braking has significant potential to reduce the overall burden of pedestrian ground contact injuries, but future efforts are required to establish an optimized braking strategy as well as a means to handle those cases where controlled braking is not beneficial or even harmful.

Sprint running: from fundamental mechanics to practice-a review

In this review, we examine the literature in light of the mechanical principles that govern linear accelerated running. While the scientific literature concerning sprint mechanics is comprehensive, these principles of fundamental mechanics present some pitfalls which can (and does) lead to misinterpretations of findings. Various models of sprint mechanics, most of which build on the spring-mass paradigm, are discussed with reference to both the insight they provide and their limitations. Although much research confirms that sprinters to some extent behave like a spring-mass system with regard to gross kinematics (step length, step rate, ground contact time, and lower limb deformation), the laws of motion, supported by empirical evidence, show that applying the spring-mass model for accelerated running has flaws. It is essential to appreciate that models are pre-set interpretations of reality; finding that a model describes the motor behaviour well is not proof of the mechanism behind the model. Recent efforts to relate sprinting mechanics to metabolic demands are promising, but have the same limitation of being model based. Furthermore, a large proportion of recent literature focuses on the interaction between total and horizontal (end-goal) force. We argue that this approach has limitations concerning fundamental sprinting mechanics. Moreover, power analysis based on isolated end-goal force is flawed. In closing, some prominent practical concepts and didactics in sprint running are discussed in light of the mechanical principles presented. Ultimately, whereas the basic principles of sprinting are relatively simple, the way an athlete manages the mechanical constraints and opportunities is far more complex.

Patient Safety: Driving After Foot and Ankle Surgery

This article provides a review of the existing literature regarding driving limitations following lower extremity orthopedic surgery. Medicolegal requirements and insurance recommendations are often vague and subject to interpretation. Several studies have examined the impact of surgery and immobilization on brake reaction time. This study summarizes the findings of these studies. Additionally, the authors consider the impact of lower extremity amputations and peripheral vascular disease on driving. Literature regarding opioid use, obesity, sleep apnea, increasing age, and distraction is also reviewed. An improved understanding of these topics will enhance the orthopedic surgeon's ability to counsel patients and optimize their safety.

Driving ability after right-sided ankle arthroscopy--A prospective Study

INTRODUCTION

Due to the current lack of evidence the aim of this study was to investigate the driving ability after right-sided ankle arthroscopy.

MATERIALS AND METHODS

Nineteen patients underwent right-sided ankle arthroscopy. Brake response time (BRT) was assessed preoperatively, 2 days, 2 weeks, 6 weeks, and 12 weeks postoperative. We also determined patients' clinical outcome (AOFAS and AOS questionnaires) and their driving frequency.

RESULTS

BRT was 606ms preoperatively and changed to 821ms 2 days postoperative (p<0.001). The further postoperative BRT course was 606ms (2 weeks), 596ms (6 weeks) and 603ms (12 weeks) (p=n.s.). In addition, a significant influence of the AOS and AOFAS scores on BRT was found, namely poorer clinical outcome also leads to a prolonged BRT (p<0.01 for both). BRT was significantly prolonged in patients with little driving frequency (p=0.001). Furthermore, the 'time-by-driving interaction' was significant (p=0.018), which means the BRT-peak on the second day was much lower in low-frequency drivers.

CONCLUSIONS

From the findings made in the current study we conclude that a driving abstinence of two weeks is necessary following right-sided ankle arthroscopy. Greater driving frequency and good clinical outcome seem to be associated with better driving ability. However, for the time being no exceptions should be made from the above-mentioned recommendation on driving abstinence.

EMERGENCY BRAKING IN ADULTS VERSUS NOVICE TEEN DRIVERS: RESPONSE TO SIMULATED SUDDEN DRIVING EVENTS

Motor vehicle crashes remain the leading cause of death in teens in the United States. Newly licensed drivers are the group most at risk for crashes. Their driving skills are very new, still very often untested, so that their ability to properly react in an emergency situation remains a research question. Since it is impossible to expose human subjects to critical life threatening driving scenarios, researchers have been increasingly using driving simulators to assess driving skills. This paper summarizes the results of a driving scenario in a study comparing the driving performance of novice teen drivers (n=21) 16-17 year olds with 90 days of provisional licensure with that of experienced adult drivers (n=17) 25-50 year olds with at least 5 years of PA licensure, at least 100 miles driven per week and no self-reported collisions in the previous 3 years. As part of a 30 to 35 simulated drive that encompassed the most common scenarios that result in serious crashes, participants were exposed to a sudden car event. As the participant drove on a suburban road, a car surged from a driveway hidden by a fence on the right side of the road. To avoid the crash, participants must hard brake, exhibiting dynamic control over both attentional and motor resources. The results showed strong differences between the experienced adult and novice teen drivers in the brake pressure applied. When placed in the same situation, the novice teens decelerated on average 50% less than the experienced adults (p<0.01).

Inhibitory motor control based on complex stopping goals relies on the same brain network as simple stopping

Much research has modeled action-stopping using the stop-signal task (SST), in which an impending response has to be stopped when an explicit stop-signal occurs. A limitation of the SST is that real-world action-stopping rarely involves explicit stop-signals. Instead, the stopping-system engages when environmental features match more complex stopping goals. For example, when stepping into the street, one monitors path, velocity, size, and types of objects and only stops if there is a vehicle approaching. Here, we developed a task in which participants compared the visual features of a multidimensional go-stimulus to a complex stopping-template, and stopped their go-response if all features matched the template. We used independent component analysis of EEG data to show that the same motor inhibition brain network that explains action-stopping in the SST also implements motor inhibition in the complex-stopping task. Furthermore, we found that partial feature overlap between go-stimulus and stopping-template led to motor slowing, which also corresponded with greater stopping-network activity. This shows that the same brain system for action-stopping to explicit stop-signals is recruited to slow or stop behavior when stimuli match a complex stopping goal. The results imply a generalizability of the brain's network for simple action-stopping to more ecologically valid scenarios.

Muscle contributions to propulsion and braking during walking and running: insight from external force perturbations

There remains substantial debate as to the specific contributions of individual muscles to center of mass accelerations during walking and running. To gain insight, we altered the demand for muscular propulsion and braking by applying external horizontal impeding and aiding forces near the center of mass as subjects walked and ran on a treadmill. We recorded electromyographic activity of the gluteus maximus (superior and inferior portions), the gluteus medius, biceps femoris, semitendinosus/membrinosus, vastus medialis, lateral and medial gastrocnemius and soleus. We reasoned that activity in a propulsive muscle would increase with external impeding force and decrease with external aiding force whereas activity in a braking muscle would show the opposite. We found that during walking the gastrocnemius and gluteus maximus provide propulsion while the vasti are central in providing braking. During running, we found that the gluteus maximus, vastus medialis, gastrocnemius and soleus all contribute to propulsion.