Biomechanics

Background/Objectives: Three-dimensional accelerometry data from the lower trunk during running is associated with intervertebral disc degeneration. The kinematic function known as the lumbo–pelvic–hip complex involves movements in the sagittal plane during running. If pelvic movement and acceleration in the anteroposterior direction are correlated, improving running mechanics may reduce the load on the intervertebral disc. This study investigated the relationship between the anteroposterior acceleration of the lower lumbar spine and pelvic tilt movements during running. Methods: Sixteen healthy male college students were enrolled and asked to run on a treadmill for 1 min at 16 km/h, and the acceleration data for their lower lumbar region and running motion in the sagittal plane were recorded. The pelvic tilt angle during running was calculated through two-dimensional motion analysis. Subsequently, a simple linear regression analysis was employed to clarify the relationship between the acceleration data of the lower lumbar region and the pelvic tilt angle during running. Results: The simple linear regression analysis indicated that the root mean squares of the anteroposterior acceleration of the lower lumbar spine were associated with the maximum pelvic tilt angle (r  =  0.32, p  =  0.003, adjusted R² = 0.09) and its range (r  =  0.42, p  =  0.0001, adjusted R² = 0.16). Conclusions: However, the adjusted R² value was low, indicating that although the pelvic tilt angle during running may be related to acceleration in the anteroposterior direction, the effect is small. Full article

Static and dynamic foot function can be evaluated using easy-to-implement, low-cost measurements like arch height index (AHI) and navicular drop (ND). Connections between AHI/ND and lower-extremity kinematics/kinetics have largely focused on gait. Some studies exist evaluating basketball players; however, these predominantly focus on men. To our knowledge, few studies evaluate female athletes, and none have investigated connections between AHI/ND and lower-extremity biomechanics in elite female basketball players. Thus, we conducted an IRB-approved observational investigation of 10 female, National Collegiate Athletic Association (NCAA) Division 1 basketball players, evaluating connections between AHI/ND and lower-extremity biomechanics during basketball activities. Participants completed one visit wherein bilateral AHI/ND measurements and kinematics/kinetics were captured via optical motion capture and force-instrumented treadmill during basketball activities (walking, running, vertical/horizontal jumping, side shuffles, 45° cuts). No connections existed between the AHI and any variable during any task. Contrastingly, ND was statistically significantly correlated with medial/lateral force maximum and range during left cutting. This implies that individuals with stiffer feet produced more side-to-side force than those with more foot mobility during cutting. This is the first report connecting ND to lower-extremity biomechanics in elite, female basketball players. This could inform novel interventions and technologies to improve frontal kinematics/kinetics. Full article

Background/Aims: Asymmetry of the internal (IR) and external (ER) shoulder rotators can increase the risk of injuries in judokas. Discrete analyses are usually performed in time series data, but they can have biases by removing trends, so other approaches have been proposed to avoid these biases such as statistical parametric mapping (SPM) and principal component analysis (PCA). This study analyzed the asymmetry in the shoulder rotators in female judokas, comparing dominant (D) vs. non-dominant (ND) upper limbs. Methods: For this, 11 elite athletes (age: 20.1 ± 2.9 yrs.; experience: 4.0 ± 0.5 yrs.; body mass: 66.0 ± 14.6 kg; height: 1.6 ± 0.1 m; BMI: 24.8 ± 4.3 kg/m²), were evaluated in an isokinetic dynamometer (Cybex^® Humac/Norm Dynamometer CSMI, 502140, Stoughton, MA, USA). All participants performed the concentric (CON/CON) isokinetic evaluations of internal and external rotation of the shoulder in 60°/s and 180°/s angular velocities. Results: There was no significative asymmetry between IR vs. ER at 60°/s; similar results were observed at 180°/s when analyzed by PCA or SPM methods (p > 0.05 for all comparison). There was no difference between peak torque at 60°/s or 180°/s (p > 0.05 for all comparison). Conclusions: no asymmetry was observed in IR and ER in elite female athletes, regardless of the analysis method. Full article

Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for patients with aortic stenosis (AS) at high surgical risk. However, TAVR is challenging in patients with a pre-existing mitral valve prosthesis, such as a transcatheter mitral valve replacement (TMVR), due to the likelihood of device interference. This study explores the feasibility and safety of performing TAVR in a patient with a pre-existing TMVR procedure using 3D printing, augmented reality (AR) and computational simulations to optimize preprocedural planning. Computational modeling allowed predictions of the spatial relationship between the TAVR and TMVR devices. The simulation output was therefore used as input for augmented visualization of the device interference. The 3D printing of an anatomical replica was used to physically simulate the procedure, ensuring that no significant interference would occur during heart function. The results demonstrated a safe distance of 6.4 mm between the TAVR and TMVR devices, and no functional interference was observed during simulated cardiac cycles. The use of AR in the operating room enhanced the understanding of device positioning, offering a new dimension of precision of the complex cardiovascular intervention. This study concludes that integrating AR, 3D printing, and computational simulations into preprocedural planning for high-risk structural intervention can significantly improve procedural outcomes by enhancing accuracy, safety, and operator confidence. Full article

Background/Purpose: Fractal gait patterns have been shown to be modifiable, but the extent to which they are retained and transferred to new contexts is relatively unknown. This study aimed to close those gaps by enrolling participants (N = 23) in a seven-day fractal gait training program. Methods: Building on related work, the fractal gait training occurred on a treadmill over a 10-min period. Before and after the treadmill training, each participant walked for 10 min overground without the fractal stimulus used during training. The daily post-test was used to examine immediate retention and transfer of the fractal gait patterns from the treadmill to overground. The pre-tests in days 2–7 were used to examine the extent to which the fractal gait patterns from the preceding day were retained 24 h later. Inertial measurement units were used to measure stride time so a consistent measurement method could be employed in the treadmill and overground phases of the study. Results: Our results showed that multiple days of treadmill training led to elevated fractal patterns, indicating a positive training effect. However, the positive training effect observed on the treadmill did not transfer to overground walking. Conclusions: Collectively, the data show that fractal patterns in gait are modifiable across multiple days of training, but the transferability of these patterns to new contexts needs to be further explored. Full article

Purpose: The purpose of this research was to investigate the relationship between horizontal jump distance, 10 m time, and 30–40 m time in multi-sport athletes separated by sex and sprint speed. Methods: A total of 1352 athletes (742 males and 610 females) performed 40 m sprints, standing broad jumps (SBJs), and standing triple jumps (STJs). Data were separated by sex and then grouped as fast, average, and slow using the K-Means algorithm in three conditions (acceleration, max speed, and combined). Results: Regression models explained 84.01% of the variance (F(7,757) = 574.5, p < 0.001) for the 10 m times with mass, speed group, and sex as significant predictors and 88.51% of the variance (F = (7,757 = 841.6, p < 0.001) for the 30–40 m times with SBJ, STJ, speed group, sex, and the interaction of sex and group as significant predictors. Conclusions: These results suggest that when examining general athlete physical performance, horizontal jump tests and max speed sprint times can be used equivalently to stratify athletes. However, it is important to group athletes by speed and sex before being able to predict sprint ability from horizontal jump tests. Further, athlete mass is a significant factor in the prediction of acceleration ability but not maximum speed, and horizontal jumps were significant factors in the prediction of max speed but not acceleration. Full article

Background/Objectives: For over 50 years, it has been suggested that the plantar flexors and hip extensors can compensate for weak knee extensors and prevent collapse of the leg during a single-limb stance. However, the effects of these compensations have not been studied thoroughly. The purpose of this computer simulation study was to determine, for a given posture, the hip and ankle net joint torque (NJT) required to prevent leg collapse due to systematic decreases in knee NJT and to determine the effect of these compensations on the horizontal ground reaction force. Methods: Single-limb stance was simulated using a static, multisegmented model in eight different postures. For each posture, the knee NJT was systematically decreased. The ankle and knee NJT necessary to prevent lower extremity collapse, along with any net horizontal ground reaction forces, were then calculated. Results: Decreases in knee NJT required linear increases in ankle and hip NJT to prevent the limb from collapsing. There were greater increases in ankle NJT compared to hip NJT, resulting in posteriorly-directed horizontal ground reaction forces. While the magnitudes were different, these findings applied to all postures simulated. Conclusions: For a given posture, ankle and hip NJTs can compensate for a decrease in knee NJT. However, this resulted in a horizontal ground reaction force, which was in the posterior direction for all the postures examined. This horizontal ground reaction force would induce an acceleration on the body’s center of mass that, if not accounted for, could have deleterious effects on achieving a task objective. Full article

Background/Objectives: Using advanced methodologies may enhance athlete profiling. This study profiled morphological and laboratory-derived performance biomechanics by position of American-style football players training for the draft. Methods: Fifty-five players were categorized into three groups: Big (e.g., lineman; n = 17), Big–skill (e.g., tight end; n = 11), and Skill (e.g., receiver; n = 27). Body fat (BF%), lean body mass (LBM), and total body mass were measured using a bioelectrical impedance device. Running ground reaction force (GRF) and ground contact time (GCT) were obtained using an instrumented treadmill synchronized with a motion capture system. Dual uniaxial force plates captured countermovement jump height (CMJ-JH), normalized peak power (CMJ-NPP), and reactive strength. Asymmetry was calculated for running force, GCT, and CMJ eccentric and concentric impulse (IMP). MANOVA determined between-group differences, and radar plots for morphological and performance characteristics were created using Z-scores. Results: There was a between-group difference (F(26,80) = 5.70, p < 0.001; Wilk’s Λ = 0.123, partial η² = 0.649). Fisher’s least squares difference post hoc analyses showed that participants in the Skill group had greater JH, CMJ-NPP, reactive strength, and running GRF values versus Big players but not Big–skill players (p < 0.05). Big athletes had greater BF%, LBM, total body mass, and GCT values than Skill and Big–skill athletes (p < 0.05). Big–skill players had greater GCT asymmetry than Skill and Big players (p < 0.05). Asymmetries in running forces, CMJ eccentric, and concentric IMP were not different (p > 0.05). Morphological and performance biomechanics differences are pronounced between Skill and Big players. Big–skill players possess characteristics from both groups. Laboratory-derived metrics offer precise values of running and jumping force strategies and body composition that can aid sports science researchers and practitioners in refining draft trainee profiles. Full article

Background/Objectives: The incorporation of biomechanics into stroke neurorehabilitation may serve to strengthen the effectiveness of rehabilitation strategies by increasing our understanding of human movement and recovery processes. The present bibliometric analysis of biomechanics research in stroke neurorehabilitation is conducted with the objectives of identifying influential studies, key trends, and emerging research areas that would inform future research and clinical practice. Methods: A comprehensive bibliometric analysis was performed using documents retrieved from the Scopus database on 6 August 2024. The analysis included performance metrics such as publication counts and citation analysis, as well as science mapping techniques, including co-authorship, bibliographic coupling, co-citation, and keyword co-occurrence analyses. Data visualization tools such as VOSviewer and Power BI were utilized to map the bibliometric networks and trends. Results: An overabundance of recent work has yielded substantial advancements in the application of brain–computer interfaces to electroencephalography and functional neuroimaging during stroke neurorehabilitation., which translate neural activity into control signals for external devices and provide critical insights into the biomechanics of motor recovery by enabling precise tracking and feedback of movement during rehabilitation. A sampling of the most impactful contributors and influential publications identified two leading countries of contribution: the United States and China. Three prominent research topic clusters were also noted: biomechanical evaluation and movement analysis, neurorehabilitation and robotics, and motor recovery and functional rehabilitation. Conclusions: The findings underscore the growing integration of advanced technologies such as robotics, neuroimaging, and virtual reality into neurorehabilitation practices. These innovations are poised to enhance the precision and effectiveness of therapeutic interventions. Future research should focus on the long-term impacts of these technologies and the development of accessible, cost-effective tools for clinical use. The integration of multidisciplinary approaches will be crucial in optimizing patient outcomes and improving the quality of life for stroke survivors. Full article

Introduction: Performance in a single step has been suggested to be a sensitive measure of movement quality in pediatric clinical populations. Although there is less information available in children with typical development, researchers have postulated the importance of analyzing the effect of body weight modulation on the initiation of stair ascent, especially during single-limb stance where upright stability is most critical. The purpose of this study was to investigate the effect of load modulation from −20% to +15% of body weight on typical pediatric lower limb joint moments during a step-up task. Methods: Fourteen participants between 5 and 21 years who did not have any neurological or musculoskeletal concerns were recruited to perform multiple step-up trials. Peak extensor support and hip abduction moments were identified during the push-off and pull-up stance phases. Linear regressions were used to determine the relationship between peak moments and load. Mixed-effects models were used to estimate the effect of load on hip, knee, and ankle percent contributions to peak support moments. Results: There was a positive linear relationship between peak support moments and load in both stance phases, where these moments scaled with load. There was no relationship between peak hip abduction moments and load. While the ankle and knee were the primary contributors to the support moments, the hip contributed more than expected in the pull-up phase. Discussion: Clinicians can use these results to contextualize movement differences in pediatric clinical populations, including in those with cerebral palsy, and highlight potential target areas for rehabilitation for populations such as adolescent athletes. Full article

Background: Shoulder pain is the third most common musculoskeletal issue in primary care, affecting up to 50% of patients six months post-consultation, leading to significant functional impairments and societal costs, especially due to sick leave. Shoulder injuries are particularly prevalent among ‘overhead athletes’ in sports like swimming, volleyball, and handball, with high injury rates reported annually. Screening tools like the Arm Care Screen (ACS) have been used to effectively identify athletes at risk of shoulder injuries. However, their applicability to the general population is less understood. This study aimed to assess the discriminant validity of a modified ACS (MACS) in detecting musculoskeletal risk factors among non-athletes. Methods: A prospective cross-sectional study was conducted with 30 asymptomatic subjects over 18, excluding those with a history of shoulder injuries or surgeries. The MACS, comprising four tests, was administered, and its diagnostic performance was evaluated through sensitivity, specificity, predictive values, and likelihood ratios. Results: The results indicated low sensitivity (0–47.62%) and variable specificity (55.56–100%), suggesting that the MACS may not effectively identify risk factors in the general population. Positive and negative predictive values were inconsistent (ranging from 0 to 100), as well as positive and negative likelihood ratios (ranging from 0 to 3.47), highlighting the need for non-athlete-specific screening tools. Conclusion: While the MACS shows promise in athletes, its application in the general population requires further refinement. This study underscores the necessity for tailored screening methods to enhance the early detection and prevention of musculoskeletal issues in diverse populations. Full article

This study investigated the collapse of the medial longitudinal arch (MLA) as a risk factor for medial tibial stress syndrome (MTSS), hypothesizing that overuse of extrinsic foot muscles to prevent MLA collapse can lead to disability. Twenty healthy adults (age: 20.8 ± 0.8, height: 162.2 ± 10.4, weight: 54.9 ± 9, BMI: 20.8 ± 1.7) (39 feet) with a foot posture index score below 6 and no recent lower extremity orthopedic history participated. Ultrasonography measured foot muscle cross-sectional areas, while three-dimensional motion analysis using VICON assessed foot kinematics during gait, focusing on navicular height at initial contact (ICNH) and dynamic navicular drop (DND) during the stance phase. Hierarchical cluster analysis based on ICNH and DND compared muscle cross-sectional areas between clusters using ANOVA or Kruskal–Wallis test. The analysis indicated that ICNH was lower in clusters 1 and 3 than in cluster 2, and DND was smaller in clusters 1 and 2 than in cluster 3. Although there was no significant difference in muscle cross-sectional area between the clusters, the flexor hallucis longus tended to be thicker in cluster 1 than in cluster 3 (p = 0.051). The findings suggest that flexor digitorum longus may help prevent MLA compression during loading, indicating that overuse of extrinsic foot muscles may contribute to MTSS development. Full article

Mobile motion capture is a promising technology for assessing physical movement; markerless motion capture systems (MLSs) offer great potential in rehabilitation settings, given their accessibility compared to marker-based motion capture systems (MBSs). This review explores the current literature on rehabilitation, for direct comparison of movement-related outcomes captured by MLSs to MBSs and for application of MLSs in movement measurements. Following a scoping review methodology, nine databases were searched (May to August 2023). Eligible articles had to present at least one estimate of the mean difference between a measure of a physical movement assessed by MLS and by MBS. Sixteen studies met the selection criteria and were included. For comparison of MLSs with MBSs, measures of mean joint range of motion (ROM) displacement were found to be similar, while peak joint angle outcomes were significantly different. Upper body movement outcomes were found to be comparable, while lower body movement outcomes were very different. Overall, nearly two-thirds of measurements identified statistical differences between MLS and MBS outcomes. Regarding application, no studies assessed the technology with patient populations. Further MLS-specific research with consideration of patient populations (e.g., intentional error testing, testing in less-than-ideal settings) would be beneficial for utilization of motion capture in rehabilitation contexts. Full article

Background/Objectives: The triple jump is included in the Paralympic Athletics competition. The aim of the research was to examine the relationship of the phase ratios and the inter-limb asymmetry in the spatiotemporal parameters of the approach run in Paralympic and international-level Class T46/T47 triple jumpers. Methods: Eleven Class T46/T47 male athletes were recorded during the examined competitions. Step length (SL), frequency (SF), and average velocity (ASV) for the late approach run as well as the length and the percentage distribution of each jumping phase (hop, step, jump) were measured using a panning video analysis method. The inter-limb asymmetry was estimated using the symmetry angle. Results: No significant inter-limb asymmetry was found (p > 0.05). In addition, SL, SF, and ASV were not different (p > 0.05) between the steps initiated from the ipsilateral and the contralateral leg regarding the impaired arm. However, the direction of asymmetry for SF was towards the ipsilateral leg to the impaired arm in the majority of the examined athletes. The maximum speed of the approach was correlated with the triple jump distance and the magnitude of asymmetry for AVS was correlated with the vertical take-off velocity and angle for the step. Conclusions: Since the distance of the triple jump related with the peak approach speed added the negative correlation of peak approach speed with the magnitude of the symmetry angle for SL, it is suggested to minimize the asymmetries in the step characteristics during the approach run to improve triple jump performance in Class T46/T47 jumpers. Full article

Background: Assessment of walking with shoes is important for understanding different types of walking in various environments. Methods: In this study, a shoe-type sensor was used to demonstrate the shoe–floor angle in fifteen participants who walked on a treadmill under varying gait speed and sole adjustments, lifting one side of the sole. The shoe–floor angle in the sagittal; the angle of toe-up (θTup) and toe-down (θTdown) and frontal planes; and the angle of pronation (θPro) and supination (θSup) were calculated, and angles at the initial contact and maximum angles were extracted. Results: The results showed that most angles significantly increased with an increase in the gait speed (θTup and θTdown; p < 0.01 both, θPro and θSup; p < 0.02 and 0.04). Conversely, only the supination angle at the initial contact changed significantly, owing to the tilt of the sole (p < 0.01). Conclusion: Shoe movements were more strongly affected by gait speed than by sole adjustment. Full article

Background/Objectives: The flexibility deficits of hip flexors have been identified as potential biomechanical risk factors for the lumbo–pelvic–hip complex, with postural repercussions on the trunk and lower limbs. The purpose of this study was to conduct a single gravity stretching experiment and to monitor its acute and prolonged effects. Methods: The sample comprised 14 healthy participants (8 females and 6 males). Data were collected during two-day measurement sessions. These analyzed via Kinovea software. The single intervention (i.e., gravity stretching) was performed on the first day. A modified Thomas test was used at the same time in two ways, both as a measurement and as an intervention tool. Stretching was achieved by relaxing in a position to perform the modified Thomas test where, each participant lies completely relaxed for 3 min, allowing gravity to stretch the hip flexors of the examined limb. Results: After intervention, a significant acute increase in hip extension range of motion and a decrease in knee extension range of motion were found. We did not find any significant prolonged effects; moreover, after 48 h, the hip range of motion almost returned to the initial value. Conclusions: A single 3 min stretch is very effective in terms of achieving immediate changes in the range of motion, but insufficient for long-term improvements in flexibility. Full article

This paper explores the adaptation of pseudo-rigid-body models (PRBMs) for simulating large geometric nonlinear deflections in passive exoskeletons, expanding upon their traditional application in small compliant systems. Utilizing the AnyBody modeling system, this study employs force-dependent kinematics to reverse the conventional simulation process, enabling the calculation of forces from the deformation of PRBMs. A novel approach, termed “Constraint Force”, is introduced to facilitate this computation. The approach is thoroughly validated through comparative analysis with laboratory trials involving a beam under bending loads. To demonstrate the functionality, the final segment of this study conducts a biomechanical simulation incorporating motion capture data from a lifting test, employing a novel passive exoskeleton equipped with flexible spring elements. The approach is meticulously described to enable easy adaptation, with an example code for practical application. The findings present a user-friendly and visually appealing simulation solution capable of effectively modeling complex mechanical load cases. However, the validation process highlights significant systematic errors in the direction and amplitude of the calculated forces (20% and 35%, respectively, in the worst loading case) compared to the laboratory results. These discrepancies emphasize the inherent accuracy challenges of the “Constraint Force” approach, pointing to areas for ongoing research and enhancement of PRBM methods. Full article

Background: Individuals may exhibit altered foot pronation during gait when fatigue sets in. Therefore, a more evidence-based understanding of these fatigue-induced changes may be helpful for future gait analysis and return-to-play tests since fatigue can provide new insights that might explain a person’s complaints. Methods: A total of 25 healthy individuals (12♂, 13♀; 24.3 ± 2.7 years; 174.9 ± 9.09 cm; 70 ± 14.2 kg; BMI: 22.7 ± 2.8) participated in this controlled non-randomized study of unilateral fatigue of the right foot’s stabilizing muscles with regard to the pronation of the foot, measured by navicular drop (ND) in static (statND; standing) and dynamic (dynND; walking) states. The left foot served as the control. Surface electromyography was used to verify fatigue. Results: While the statND did not change, the dynND increased significantly by 1.44 ± 2.1 mm (=22.3%) after the foot-stabilizing muscles experienced fatigue. No correlation was found between the statND and dynND. Conclusions: Muscular fatigue can affect foot pronation. The dynND appears to be more representative of the loads in everyday life, whereby most studies use the statND. Full article

The purpose of this study was to compare ankle stability and dynamic single-leg balance between jumping athletes and non-athletes, and to examine the correlation between ankle stability and dynamic single-leg balance. Thirty-eight jumping athletes and thirty-seven non-athletes participated in this study. The Cumberland Ankle Instability Tool (CAIT) was used to assess ankle stability. The Y-Balance Test (YBT) was used to examine single-leg balance in the anterior (AN), posteromedial (PM), and posterolateral (PL) directions. The results show that 42.11% of jumping athletes and 21.62% of non-athletes exhibited chronic ankle instability (CAI) in their examined leg. In addition, jumping athletes exhibited significantly worse ankle stability than non-athletes (p = 0.038). The two groups showed no significant difference in the YBT scores in all directions (p = 0.113 AN, 0.567 PM, 0.542 PL). Very low correlations were found between the CAIT and the YBT scores in all directions (r < 0.107). In conclusion, single-leg jumping athletes experienced a higher prevalence of CAI and significantly worse ankle stability than non-athletes. However, the results of the YBT did not correlate strongly with the CAIT scores, suggesting an inability to predict dynamic single-leg balance deficits based on perceived ankle stability alone in this population. Full article