Darren C. James

Triaxial modulation of the acceleration induced in the lower extremity during whole-body vibration training: a pilot study.

Cook, DP, Mileva, KN, James, DC, Zaidell, LN, Goss, VG, and Bowtell, JL. Triaxial modulation of the acceleration induced in the lower extremity during whole-body vibration training: a pilot study. J Strength Cond Res 25(2): 298-308, 2011-The purpose of the present study was to quantify vibration transmissibility through the lower extremity during exercise on a whole-body vibration (WBV) platform. Six healthy adults completed 20 trials of 30-second static squat exercise at 30 or 40 degrees of knee flexion angle on a WBV platform working at combinations of 5 frequencies (VF: 20, 25, 30, 35, 40 Hz) and 2 amplitudes (VA: low, 1.5 mm or high, 3 mm). Accelerations induced by the platform were recorded simultaneously at the shank and the thigh using triaxial accelerometers positioned at the segmental center of mass. Root-mean-square (RMS) acceleration amplitude and transmission ratios between the platform and the leg segments were calculated and compared between the experimental conditions. An alpha level of 0.05 was set to establish significance. Shank vertical acceleration was greatest at the lower VF (p = 0.028), higher VA (p = 0.028), and deeper squat (p = 0.048). Thigh vertical acceleration was not affected by depth of squat (p = 0.25), but it was greatest at higher VA (p = 0.046) and lower VF (p = 0.028). Medial-lateral shank acceleration was greatest at higher VF and deeper squat (both p = 0.046) and at higher VA (p = 0.028). Medial-lateral thigh acceleration was positively related to both VF (p = 0.046) and VA (p = 0.028) but was not affected by knee angle (p = 0.46). Anterior-posterior shank acceleration was higher at deeper squat (p = 0.046) and at lower VF and higher VA (both p = 0.028). Anterior-posterior thigh acceleration was related positively to the VA (p = 0.028), inversely to the VF (p = 0.028), and not dependent on knee angle (p = 0.75). Identification of specific vibration parameters and posture, which underpin WBV training efficacy, will enable coaches and athletes to design WBV training programs to specifically target shank or thigh muscles for enhanced performance.

Low-frequency accelerations over-estimate impact-related shock during walking

During gait, a failure to acknowledge the low-frequency component of a segmental acceleration signal will result in an overestimation of impact-related shock and may lead to inappropriately drawn conclusions. The present study was undertaken to investigate the significance of this low-frequency component in two distinctly different modalities of gait: barefoot (BF) and shod (SHOD) walking. Twenty-seven participants performed five walking trials at self-selected speed in each condition. Peak positive accelerations (PPA) at the shank and spine were first derived from the time-domain signal. The raw acceleration signals were then resolved in the frequency-domain and the active (low-frequency) and impact-related components of the power spectrum density (PSD) were quantified. PPA was significantly higher at the shank (P<0.0001) and spine (P=0.0007) in the BF condition. In contrast, no significant differences were apparent between conditions for shank (P=0.979) or spine (P=0.178) impact-related PSD when the low-frequency component was considered. This disparity between approaches was due to a significantly higher active PSD in both signals in the BF condition (P<0.0001; P=0.008, respectively), due to kinematic differences between conditions (P<0.05). These results indicate that the amplitude of the low-frequency component of an acceleration signal during gait is dependent on knee and ankle joint coordination behaviour, and highlight that impact-related shock is more accurately quantified in the frequency-domain following subtraction of this component.

Wide-Pulse Electrical Stimulation to an Intrinsic Foot Muscle Induces Acute Functional Changes in Forefoot–Rearfoot Coupling Behaviour during Walking

Interventions for strengthening intrinsic foot muscles may be beneficial for rehabilitation from overuse injuries. In this study the acute effects of high-frequency, low-intensity wide-pulse electrical stimulation (WPS) over an intrinsic muscle on subsequent foot function during walking was assessed in healthy participants. WPS was delivered to the m. abductor hallucis (m.AH) of the non-dominant foot during relaxed standing. 3-dimensional forefoot (FF)--rearfoot (RF) coordination was quantified with a vector coding technique within separate periods of the stance phase to study WPS functional effects on foot motion. 4 types of coordinative strategies between the FF and RF were interpreted and compared PRE-to-POST-WPS for both the experimental and control feet. Bilateral electromyography (EMG) from m.AH was analysed during the intervention period for evidence of acute neuromuscular adaptation. The results showed that WPS significantly modulated FF-RF coordination during mid-stance, indicative of a more stable foot. Specifically, a statistically significant increase in FF eversion with concomitant RF inversion in the frontal plane and RF-dominated adduction in the transverse plane was observed. Subject-specific increases in post-stimulus m.AH EMG activation were observed but this was not reflected in an overall group effect. It is concluded that the structural integrity of the foot during walking is enhanced following an acute session of WPS and that this mechanical effect is most likely due to stimulation induced post-tetanic potentiation of synaptic transmission.

Sit-to-walk and sit-to-stand-and-walk task dynamics are maintained during rising at an elevated seat-height independent of lead-limb in healthy individuals

INTRODUCTION Sit-to-walk (STW) is a common transitional motor task not usually included in rehabilitation. Typically, sit-to-stand (STS), pause, then gait initiation (GI) before walking is used, which we term sit-to-stand-and-walk (STSW). Separation between centre-of-pressure (COP) and whole-body centre-of-mass (BCOM) during GI is associated with dynamic postural stability. Rising from seats higher than knee-height (KH) is more achievable for patients, but whether this and/or lead-limb significantly affects task dynamics is unclear. This study tested whether rising from seat-heights and lead-limb affects STW and STSW task dynamics in young healthy individuals. METHODS Ten (5F) young (29±7.7 years) participants performed STW and STSW from a standardised position. Five trials of each task were completed at 100 and 120%KH leading with dominant and non-dominant legs. Four force-plates and optical motion capture delineated key movement events and phases with effect of seat-height and lead-limb determined by 2-way ANOVA within tasks. RESULTS At 120%KH, lower peak vertical ground-reaction-forces (vGRFs) and vertical BCOM velocities were observed during rising irrespective of lead-limb. No other parameters differed between seat-heights or lead-limbs. During GI in STSW there was more lateral, and less posterior, COP excursion than expected. CONCLUSION Reduction in vGRFs and velocity during rising at 120%KH is consistent with reduced effort in young healthy individuals and is likely therefore to be an appropriate seat-height for patients. Lead-limb had no effect upon STSW or STW parameters suggesting that normative data independent of lead-limb can be utilised to monitor motor rehabilitation should differences be observed in patients. STSW should be considered an independent movement transition.

The biomechanical characteristics of wearing FitFlop™ sandals highlight significant alterations in gait pattern: A comparative study

BACKGROUND The net contribution of all muscles that act about a joint can be represented as an internal joint moment profile. This approach may be advantageous when studying footwear-induced perturbations during walking since the contribution of the smaller deeper muscles that cross the ankle joint cannot be evaluated with surface electromyography. Therefore, the present study aimed to advance the understanding of FitFlop™ footwear interaction by investigating lower extremity joint moment, and kinematic and centre of pressure profiles during gait. METHODS 28 healthy participants performed 5 walking trials in 3 conditions: a FitFlop™ sandal, a conventional sandal and an athletic trainer. Three-dimensional ankle joint, and sagittal plane knee and hip joint moments, as well as corresponding kinematics and centre of pressure trajectories were evaluated. FINDINGS FitFlop™ differed significantly to both the conventional sandal and athletic trainer in: average anterior position of centre of pressure trajectory (P<0.0001) and peak hip extensor moment (P=0.001) during early stance; average medial position of centre of pressure trajectory during late stance; peak ankle dorsiflexion and corresponding range of motion; peak plantarflexor moment and total negative work performed at the ankle (all P<0.0001). INTERPRETATION The present findings demonstrate that FitFlop™ footwear significantly alters the gait pattern of wearers. An anterior displacement of the centre of pressure trajectory during early stance is the primary response to the destabilising effect of the mid-sole technology, and this leads to reductions in sagittal plane ankle joint range of motion and corresponding kinetics. Future investigations should consider the clinical implications of these findings.

Loading rate and contraction duration effects on in vivo human Achilles tendon mechanical properties.

Tendons are viscoelastic, which implies loading rate dependency, but loading rates of contractions are often not controlled during assessment of human tendon mechanical properties in vivo. We investigated the effects of sustained submaximal isometric plantarflexion contractions, which potentially negate loading rate dependency, on the stiffness of the human Achilles tendon in vivo using dynamometry and ultrasonography. Maximum voluntary contractions (high loading rate), ramp maximum force contractions with 3 s loading (lower loading rate) and sustained contractions (held for 3 s) at 25%, 50% and 80% of maximal tendon force were conducted. No loading rate effect on stiffness (25–80% max. tendon force) was found. However, loading rate effects were seen up to 25% of maximum tendon force, which were reduced by the sustained method. Sustained plantarflexion contractions may negate loading rate effects on tendon mechanical properties and appear suitable for assessing human Achilles tendon stiffness in vivo.

Coefficient of cross correlation analysis of kinematics during walking barefoot and in Vibram FiveFingers

The current phenomenon of barefoot running appears to have facilitated a near market saturation of conceptual barefoot-related footwear. It is no wonder since the related literature has demonstrated favourable impact-moderating adaptations (De Clercq et al. 1994, Squadrone and Gallozzi 2009, Lieberman et al. 2010) and provided evolutionary (Lieberman et al. 2010) and philosophical perspectives (Oschman 2008). The Vibram FiveFingers is one such concept and its efficacy has been demonstrated in the literature where external reaction forces, oxygen uptake kinetics and lower extremity kinematics have been shown to demonstrate no significant differences compared to a barefoot running (Squadrone and Gallozzi 2009). The kinematic variables however, were constrained to discrete sagittal plane timing events; therefore, a more robust method of discriminating between temporal kinematic changes is warranted. Such a method can be derived from the coefficient of cross correlation (CCC) (Li and Caldwell 1999).

Parameters that remain consistent independent of pausing before gait-initiation during normal rise-to-walk behaviour delineated by sit-to-walk and sit-to-stand-and-walk

Background Rising-to-walk is an everyday transitional movement task rarely employed in gait rehabilitation. Sit-to-walk (STW) and sit-to-stand-and-walk (STSW), where a pause separates sit-to-stand and gait-initiation (GI) represent extremes of rising-to-walk behaviour. Delayed GI can indicate pathological impairment but is also observed in healthy individuals. We hypothesise that healthy subjects express consistent biomechanical parameters, among others that differ, during successful rising-to-walk task performance regardless of behaviour. This study therefore sought to identify if any parameters are consistent between STW and STSW in health because they represent normal rise-to-walk performance independent of pause, and also because they represent candidate parameters sensitive enough to monitor change in pathology. Methods Ten healthy volunteers performed 5 trials of STW and STSW. Event timing, ground-reaction-forces (GRFs), whole-body-centre-of-mass (BCoM) displacement, and centre-of-pressure (CoP) to extrapolated BCoM (xCoM) distance (indicator of positional stability) up to the 3rd step were compared between-tasks with paired t-tests. For consistent parameters; agreement between-tasks was assessed using Bland-Altman analyses and minimal-detectable-change (MDC) calculations. Results Mean vertical GRFs, peak forward momentum and fluidity during rising; CoP-xCoM separation at seat-off, upright, GI-onset, and steps1-2; and forward BCoM velocity were all significantly greater in STW. In contrast, peak BCoM vertical momentum, flexion-momentum time, and 3rd step stability were consistent between tasks and yielded acceptable reliability. Conclusion STW is a more challenging task due to the merging of rising with GI reflected by greater CoP-xCoM separation compared to STSW indicative of more positional instability. However, BCoM vertical momentum, flexion-momentum time, and step3 stability remained consistent in healthy individuals and are therefore candidates with which to monitor change in gait rehabilitation following pathology. Future studies should impose typical pause-durations observed in pathology upon healthy subjects to determine if the parameters we have identified remain consistent.

47 An acute session of high-frequency, low-intensity, wide-pulse electrical stimulation evokes fatigue adaptations in an intrinsic foot muscle

Background Compromised intrinsic foot muscle strength and tonic control underlie a variety of common over-use injuries associated with the foot and ankle complex. The abductor hallucis (AH) muscle plays an important role in the support of the longitudinal arch. Due to its superficial location, neuromuscular electrical stimulation represents a viable option as a strengthening modality. Objective To investigate the effects of an acute session of high-frequency, low-intensity wide-pulse electrical stimulation (WPS) applied to AH on peripheral muscle excitability and contractility. Design Within-day-repeated-measures design comprising a WPS intervention session. Setting Laboratory. Participants Nine healthy male volunteers free from any orthopaedic, neurological or vascular pathology identified as exclusion criteria. Intervention Participants received 24 × 15-sec of 2-sec alternating WPS (20Hz-100Hz-20Hz), interspersed with 45-ses rest, to the motor point area of their right AH. Square wave (1 msec) pulses (400 V) were delivered (constant current) at a stimulation intensity of 150% motor threshold. Main outcome measurements Medial plantar nerve stimulation at 130% maximal Mwave (Mmax130) was performed at PRE, POST and 30 min after (RET) WPS. Dependent variables were: latency (ms), peak amplitude (mV), area (mV•s-1) and duration (a.u; Mmax130 area/P-P Mmax130) of Mmax130; and electromechanical delay (EMD; ms), peak (pTw; N) and half relaxation time (HRT; ms) of the evoked twitch force. Results At POST, an increased latency (p < 0.01), area (p < 0.05) and duration (p < 0.0001) were observed in Mmax130. Latency and duration were still significantly elevated at RET (p < 0.01 and p < 0.0001, respectively). Also, HRT was significantly increased at POST (p < 0.01) and RET (p < 0.05). Conclusions In healthy persons, an acute intervention of WPS induces lasting peripheral fatigue in AH muscle, which is required for gains in muscle strength in response to training. The clinical implication of our findings is that WPS appears to be a worthwhile rehabilitation modality for persons with suboptimal neuromuscular foot function.