Dan K. Ramsey

Do kinematic models reduce the effects of soft tissue artefacts in skin marker-based motion analysis? An in vivo study of knee kinematics

We investigated the effects of including kinematic constraints in the analysis of knee kinematics from skin markers and compared the result to simultaneously recorded trajectories of bone pin markers during gait of six healthy subjects. The constraint equations that were considered for the knee were spherical and revolute joints, which have been frequently used in musculoskeletal modelling. In the models, the joint centres and joint axes of rotations were optimised from the skin marker trajectories over the trial. It was found that the introduction of kinematic constraints did not reduce the error associated with soft tissue artefacts. The inclusion of a revolute joint constraint showed a statistically significant increase in the mean flexion/extension joint angle error and no statistically significant change for the two other mean joint angle errors. The inclusion of a spherical joint showed a statistically significant increase in the mean flexion/extension and abduction/adduction errors. In addition, when a spherical joint was included, a statistically significant increase in the sum of squared differences between measured marker trajectories and the trajectories of the pin markers in the models was seen. From this, it was concluded that both more advanced knee models as well as models of soft tissue artefacts should be developed before accurate knee kinematics can be calculated from skin markers.

A linear soft tissue artefact model for human movement analysis: Proof of concept using in vivo data

We investigated the accuracy of a linear soft tissue artefact (STA) model in human movement analysis. Simultaneously recorded bone-mounted pin and skin marker data for the thigh and shank during walking, cutting and hopping were used to measure and model the motion of the skin marker clusters within anatomical reference frames (ARFs). This linear model allows skin marker movements relative to the underlying bone contrary to a rigid-body assumption. The linear model parameters were computed through a principal component analysis, which revealed that 95% of the variance of the STA motion for the thigh was contained in the first four principal components for all three tasks and all subjects. For the shank, 95% of the variance was contained in the first four principal components during walking and cutting and first five during hopping. For the thigh, the maximum residual artefact was reduced from 27.0mm to 5.1mm (walking), 22.7 mm to 3.0mm (cutting) and 16.2mm to 3.5mm (hopping) compared to a rigid-body assumption. Similar reductions were observed for the shank: 24.2mm to 1.9 mm (walking), 20.3mm to 1.9 mm (cutting) and 14.7 mm to 1.8mm (hopping). A geometric analysis of the first four principal components revealed that, within the ARFs, marker cluster STA is governed by rigid-body translations and rotations rather than deformations. The challenge remains, however, in finding the linear model parameters without bone pin data, but this investigation shows that relatively few parameters in a linear model are required to model the vast majority of the STA movements.

Unloader braces for medial compartment knee osteoarthritis: Implications on mediating progression

Background: For persons with unicompartment knee osteoarthritis (OA), off-unloader braces are a mechanical intervention designed to reduce pain, improve physical function, and possibly slow disease progression. Pain relief is thought to be mediated by distracting the involved compartment via external varus or valgus forces applied to the knee. In so doing, tibiofemoral alignment is improved, and load is shifted off the degenerative compartment, where exposure to potentially damaging and provocative mechanical stresses are reduced. Objectives: To provide a synopsis of the evidence documented in the scientific literature concerning the efficacy of offloader knee braces for improving symptomatology associated with painful disabling medial compartment knee OA. Search Strategy: Relevant peer-reviewed publications were retrieved from a MEDLINE search using the terms with the reference terms osteoarthritis, knee, and braces (per Medical Subject Headings), plus a manual search of bibliographies from original and review articles and appropriate Internet resources. Results: For persons with combined unicompartment knee OA and mild to moderate instability, the strength of recommendation reported by the Osteoarthritis Research Society International in the ability of off-loader knee braces to reduce pain, improve stability, and diminish the risk of falling was 76% (95% confidence interval, 69%–83%). The more evidence the treatment is effective, the higher the percentage. Conclusions: Given the encouraging evidence that off-loader braces are effective in mediating pain relief in conjunction with knee OA and malalignment, bracing should be fully used before joint realignment or replacement surgery is considered. With the number of patients with varus deformities and knee pain predicted to increase as the population ages, a reduction of patient morbidity for this widespread chronic condition in combination with this treatment modality could have a positive impact on health care costs and the economic productivity and quality of life of the affected individuals.

Altered stride length in response to increasing exertion among baseball pitchers.

BACKGROUND Overexertion caused by increased pitch counts can evoke protective biomechanical responses signified by decreased ball velocity, such as reduced throwing arm kinematics and kinetics. Among skilled pitchers, overexertion may not always present ball velocity decrements, because compensatory throwing biomechanics aid in maintaining peak ball velocity although lowering physiologic stress. METHODS Nineteen pitchers (collegiate and elite high school), randomly crossed over to pitch two simulated games at ± 25% of their desired stride length, were recorded by an eight-camera motion capture system (240 Hz) integrated with two piezoelectric force plates (960 Hz) and a professional model radar gun. HR, self-reported exertion scores, blood glucose and lactate, salivary biomarkers, peak linear hand and fastball velocities were examined. Repeated-measures ANOVA as well as independent and pairwise t-tests examined significant differences (P ≤ 0.05). RESULTS Shortened strides reduced mean pitching HR by 11.1 bpm (P < 0.001), improved recovery capacity by 5.76% (P = 0.012), and lowered salivary cortisol from baseline (P = 0.001). Physiologic stress elevated with greater strides, because salivary alpha amylase was significantly elevated from baseline (P = 0.011) with no improvements evidenced in pitching HR or recovery capacity. Linear hand and ball velocities remained equivalent between stride conditions. CONCLUSION Stride length can affect physical exertion without disrupting ball velocity, where shortening strides can plausibly respond to competitive exertion in baseball pitchers. Current pitch count standards and radar velocity accounts have not been proven efficacious in predicting exertion in professional and collegiate baseball, where biomechanical compensations arise to maintain ball velocity. In some instances, compensatory adaptations may be pathomechanic where future research identifying injurious movement patterns can advance injury prevention in professional baseball.

Effect of stride length on overarm throwing delivery: A linear momentum response☆☆☆

Changing stride length during overhand throwing delivery is thought to alter total body and throwing arm linear momentums, thereby altering the proportion of throwing arm momentum relative to the total body. Using a randomized cross-over design, nineteen pitchers (15 collegiate and 4 high school) were assigned to pitch two simulated 80-pitch games at ±25% of their desired stride length. An 8-camera motion capture system (240Hz) integrated with two force plates (960Hz) and radar gun tracked each throw. Segmental linear momentums in each plane of motion were summed yielding throwing arm and total body momentums, from which compensation ratios (relative contribution between the two) were derived. Pairwise comparisons at hallmark events and phases identified significantly different linear momentum profiles, in particular, anteriorly directed total body, throwing arm, and momentum compensation ratios (P⩽.05) as a result of manipulating stride length. Pitchers with shorter strides generated lower forward (anterior) momentum before stride foot contact, whereas greater upward and lateral momentum (toward third base) were evident during the acceleration phase. The evidence suggests insufficient total body momentum in the intended throwing direction may potentially influence performance (velocity and accuracy) and perhaps precipitate throwing arm injuries.

Fastball Velocity Trends in Short-Season Minor League Baseball

Abstract Crotin, RL, Bhan, S, Karakolis, T, and Ramsey, DK. Fastball velocity trends in short-season Minor League Baseball. J Strength Cond Res 27(8): 2206–2212, 2013—Diminishing baseball velocities are objective measures to delineate pitching fatigue. Yet, velocity changes over the course of a competitive season vs. a single game remain unknown. This study examined fastball velocity (FBV) trends of minor league pitchers over an 8-game span. We assumed that accumulation of pitches would cause similar velocity decreases within games to produce velocity decreases between games pitched. Retrospective analysis of major league–affiliated pitching charts indicated mean FBVs, game pitches thrown, game innings pitched, rest days, and pitching work to rest ratios (PWRRs) for 12 pitchers over 8 games. Regression analyses (p < 0.05) were performed using the ordinary least squares method. The FBV was the dependent variable, where the explanatory variable was the game number (representing cumulative workload). Further analyses were performed on ball velocity differences predicted by days rest and PWRRs. The FBV increased linearly for the first 8 games of the season (R2 = 0.91, F(1,7) = 64.67, p < 0.001). Over the 8 - game period, mean FBVs increased 0.25 m/s (0.56 mph) with the greatest velocity increase occurring between the first and eighth game at 1.97 m/s (4.4 mph). Days rest and PWRRs did not impact FBV differences. When compared with previous research, minor league pitchers at the Class A Short Season level did not show similar exertion responses to cumulative workloads (pitches and innings pitched). Recovery factors (rest days, PWRRs, and training) also did not impact FBVs. Velocity increases may be attributable to biomechanical compensations, skill development, strength and conditioning regimens, multistarter rotations, and other performance-related factors. Strength and conditioning professionals should be aware of ball velocity trends, as apparent changes may infer neuromuscular fatigue and increased injury susceptibility, which require in-season training modifications.

Validation of knee joint models - an in vivo study

The effect of modeling the knee as a simple spherical or revolute joint during gait, cutting and hopping were evaluated. The results indicate that, even during gait, a revolute joint may be too restrictive in its representation of the knee, with flexion/extension errors as high as 9.4°. By imposing the spherical joint, joint angles showed consistent and strong correlations with the true joint angles for the functional tasks, although internal/external rotation angle were moderately affected (errors up to 4.2°). For both constraint types, the remaining Degrees of Freedom (DOF) were not consistent across subjects and must be considered unreliable, with translation errors of up to 11.0 mm with a spherical joint and 11.9 with a revolute joint.

Multi-plane, multi-joint lower extremity support moments during a rapid deceleration task: Implications for knee loading

The principle of lower limb support, and the contribution of hip, knee and ankle moments to an overall limb support strategy for an impact-like, rapid deceleration movement may help explain individual moment magnitude changes, thereby providing insight into how injury might occur or be avoided. Twenty subjects performed single limb, impact-like, deceleration landings at three different knee flexion angles in the range of 0-25, 25-50 and 50-75°. Kinematic and kinetic measures identified hip, knee and ankle moment contribution to limb support moments (LSMs) in three planes. Repeated measures ANOVA compared LSMs and the contribution of individual joint moments at initial contact (IC) and 50 ms after. There were no significant differences in the overall LSMs at IC in any plane when the deeper knee flexion landings (25-50° and 50-75°) were compared to the 0-25° landing position but there were significant changes in the 50 ms period after IC. There were greater overall extensor LSMs, less resistance to medial opening of the knee and decreased support against internal tibia rotation when landing in greater knee flexion. The role of individual joint moments changed rapidly in the 50 ms period after initial landing; and, the relative contribution of the hip and ankle moments depended on the degree of limb flexion at landing. Analyses of individual joint moments emphasized the critical role that the hip joint moments have in balancing potentially injurious knee moments in all three planes for all three landing conditions.