Matthew K. Seeley

Alterations in evertor/invertor muscle activation and center of pressure trajectory in participants with functional ankle instability

Participants with ankle instability demonstrate more foot inversion during the stance phase of gait than able-bodied subjects. Invertor excitation, coupled with evertor inhibition may contribute to this potentially injurious position. The purpose of this experiment was to examine evertor/invertor muscle activation and foot COP trajectory during walking in participants with functional ankle instability (FI). Twelve subjects were identified with FI and matched to healthy controls. Tibialis anterior (TA) and peroneus longus (PL) electromyography (EMG), as well as COP, were recorded during walking. Functional analyses were used to detect differences between FI and control subjects with respect to normalized EMG and COP trajectory during walking. Relative to matched controls, COP trajectory was more laterally deviated in the FI group from 20% to 90% of the stance phase. TA activation was greater in the FI group from 15% to 30% and 45% to 70% of stance. PL activation was greater in the FI group at initial heel contact and toe off and trended lower from 20% to 40% of stance in the FI group. Altered motor strategies appear to contribute to COP deviations in FI participants and may increase the susceptibility to repeated ankle inversion injury.

Reliability of 16 Balance Tests in Individuals with down Syndrome

To assess test-retest reliability scores on 16 balance tests of 21 individuals with Down syndrome whose ages ranged from 5 to 31 yr., participants performed a standing test on firm and soft surfaces with the eyes open and closed, the balance subset of the Bruininks-Oseretsky test, full turn, timed-up-and-go test, forward reach, and sit-to-stand. Each participant completed all 16 tests twice in one day and then again on a subsequent day for a total of 4 sessions. The interclass reliability correlation coefficients (ICC) value for each measure of balance varied considerably by age and sex. Based on having an ICC > .50, only 3 tests were reliable in young males and young females, whereas 5 tests could reliably be used in adult females and 9 tests could reliably be used in adult males. The results of this study raise suspicions as to the reliability of tests commonly used to assess balance and differences in reliability due to age and sex. Results of balance tests should be interpreted with caution in males and females with Down syndrome across the age span.

A comparison of muscle activations during traditional and abbreviated tennis serves

The abbreviated tennis serve is a relatively novel modification of the traditional serve that has been reported to provide performance advantages over the traditional technique. However, there are limited objective data regarding the benefits and biomechanics of the abbreviated serve; no data exist that describe shoulder muscle activations during the abbreviated serve. The purpose of this study was to compare muscle activations between the traditional and abbreviated serves. Electromyographic data were collected for the anterior and posterior deltoid, infraspinatus, middle trapezius, latissimus dorsi, serratus anterior, and pectoralis major. When muscle activations were compared during each serve phase, no significant differences were observed between the traditional and abbreviated tennis serve techniques, indicating that the traditional and abbreviated serves are similar regarding shoulder muscle activations. These results could have implications for performance of and injury related to the abbreviated versus traditional serve technique. Although the abbreviated serve has anecdotally been described as advantageous, the present data do not indicate any significant advantages or disadvantages in performing the abbreviated serve technique versus the traditional serve.

EMG activity during positive-pressure treadmill running

Success has been demonstrated in rehabilitation from certain injuries while using positive-pressure treadmills. However, certain injuries progress even with the lighter vertical loads. Our purpose was to investigate changes in muscle activation for various lower limb muscles while running on a positive-pressure treadmill at different amounts of body weight support. We hypothesized that some muscles would show decreases in activation with greater body weight support while others would not. Eleven collegiate distance runners were recruited. EMG amplitude was measured over 12 lower limb muscles. After a short warm-up, subjects ran at 100%, 80%, 60%, and 40% of their body weight for two minutes each. EMG amplitudes were recorded during the final 30s of each stage. Most muscles demonstrated lower amplitudes as body weight was supported. For the hip adductors during the swing phase and the hamstrings during stance, no significant trend appeared. Positive-pressure treadmills may be useful interventions for certain injuries. However, some injuries, such as hip adductor and hamstring tendonitis or strains may require alternative cross-training to relieve stress on those areas. Runners should be careful in determining how much body weight should be supported for various injuries to return to normal activity in the shortest possible time.

A Novel Experimental Knee-Pain Model Affects Perceived Pain and Movement Biomechanics

CONTEXT Knee injuries are prevalent, and the associated knee pain is linked to disability. The influence of knee pain on movement biomechanics, independent of other factors related to knee injuries, is difficult to study and unclear. OBJECTIVE (1) To evaluate a novel experimental knee-pain model and (2) better understand the independent effects of knee pain on walking and running biomechanics. DESIGN Crossover study. SETTING Biomechanics laboratory. PATIENTS OR OTHER PARTICIPANTS Twelve able-bodied volunteers (age = 23 ± 3 years, height = 1.73 ± 0.09 m, mass = 75 ± 14 kg). INTERVENTION(S) Participants walked and ran at 3 time intervals (preinfusion, infusion, and postinfusion) for 3 experimental conditions (control, sham, and pain). During the infusion time interval for the pain and sham conditions, hypertonic or isotonic saline, respectively, was continuously infused into the right infrapatellar fat pad for 22 minutes. MAIN OUTCOME MEASURE(S) We used repeated-measures analyses of variance to evaluate the effects of time and condition on (1) perceived knee pain and (2) key biomechanical characteristics (ground reaction forces, and joint kinematics and kinetics) of walking and running (P < .05). RESULTS The hypertonic saline infusion (1) increased perceived knee pain throughout the infusion and (2) reduced discrete characteristics of each component of the walking ground reaction force, walking peak plantar-flexion angle (range = 62°-67°), walking peak plantar-flexion moment (range = 95-104 N·m), walking peak knee-extension moment (range = 36-49 N·m), walking peak hip-abduction moment (range = 62-73 N·m), walking peak support moment (range = 178-207 N·m), running peak plantar-flexion angle (range = 38°-77°), and running peak hip-adduction angle (range = 5-21°). CONCLUSIONS This novel experimental knee pain model consistently increased perceived pain during various human movements and produced altered running and walking biomechanics that may cause abnormal knee joint-loading patterns.

Tennis forehand kinematics change as post-impact ball speed is altered

Peak joint angles and joint angular velocities were evaluated for varying speed forehands in an attempt to better understand what kinematic variables are most closely related to increases in post-impact ball velocity above 50% of maximal effort. High-speed video was used to measure three-dimensional motion for 12 highly skilled tennis players who performed forehands at three different post-impact ball speeds: fast (42.7 ± 3.8 m/s), medium (32.1 ± 2.9 m/s), and slow (21.4 ± 2.0 m/s). Several dominant-side peak joint angles (prior to ball impact) increased as post-impact ball speed increased from slow to fast: wrist extension (16%), trunk rotation (28%), hip flexion (38%), knee flexion (27%), and dorsiflexion (5%). Between the aforementioned peak joint angles and ball impact, dominant-side peak angular velocities increased as ball speed increased from slow to fast: peak wrist flexion (118%), elbow flexion (176%), trunk rotation (99%), hip extension (143%), knee extension (56%), and plantarflexion (87%). Most kinematic variables changed as forehand ball speed changed; however, some variables changed more than others, indicating that range of motion and angular velocity for some joints may be more closely related to post-impact ball speed than for other joints.

Effects of transcutaneous electrical nerve stimulation on quadriceps function in individuals with experimental knee pain

Knee joint pain (KJP) is a cardinal symptom in knee pathologies, and quadriceps inhibition is commonly observed among KJP patients. Previously, KJP independently reduced quadriceps strength and activation. However, it remains unknown how disinhibitory transcutaneous electrical nerve stimulation (TENS) will affect inhibited quadriceps motor function. This study aimed at examining changes in quadriceps maximum voluntary contraction (MVC) and central activation ratio (CAR) before and after sensory TENS following experimental knee pain. Thirty healthy participants were assigned to either the TENS or placebo groups. All participants underwent three separate data collection sessions consisting of two saline infusions and one no infusion control in a crossover design. TENS or placebo treatment was administered to each group for 20 min. Quadriceps MVC and CAR were measured at baseline, infusion, treatment, and post‐treatment. Perceived knee pain intensity was measured on a 100‐mm visual analogue scale. Post‐hoc analysis revealed that hypertonic saline infusion significantly reduced the quadriceps MVC and CAR compared with control sessions (P < 0.05). Sensory TENS, however, significantly restored inhibited quadriceps motor function compared with placebo treatment (P < 0.05). There was a negative correlation between changes in MVC and knee pain (r = 0.33, P < 0.001), and CAR and knee pain (r = 0.62, P < 0.001), respectively.

Ambulation speed and corresponding mechanics are associated with changes in serum cartilage oligomeric matrix protein.

Because serum cartilage oligomeric matrix protein (COMP) has been used to reflect articular cartilage condition, we aimed to identify walking and running mechanics that are associated with changes in serum COMP. Eighteen subjects (9 male, 9 female; age=23 ± 2 yrs.; mass=68.3 ± 9.6 kg; height=1.70 ± 0.08 m) completed 4000 steps on an instrumented treadmill on three separate days. Each day corresponded to a different ambulation speed: slow (preferred walking speed), medium (+50% of slow), and fast (+100% of slow). Synchronized ground reaction force and video data were collected to evaluate walking mechanics. Blood samples were collected pre-, post-, 30-minute post-, and 60-minute post-ambulation to determine serum COMP concentration at these times. Serum COMP increased 29%, 18%, and 5% immediately post ambulation for the fast, medium, and slow sessions (p<0.01). When the speeds were pooled, peak ankle inversion, knee extension, knee abduction, hip flexion, hip extension, and hip abduction moment, and knee flexion angle at impact explained 61.4% of total variance in COMP concentration change (p<0.001). These results indicate that (1) certain joint mechanics are associated with acute change in serum COMP due to ambulation, and (2) increased ambulation speed increases serum COMP concentration.

Functional Fatigue Alters Lower-extremity Neuromechanics during a Forward-side Jump.

Neuromuscular fatigue impairs neuromuscular control of the lower extremity. The purpose of the study was to investigate the effect of functional fatiguing exercises on sagittal-plane lower-extremity neuromechanics during a forward-side jump. 21 participants performed 5 forward-side jump tasks before and after functional fatiguing exercises. A functional analysis of variance (FANOVA) evaluated differences between 2 different conditions (pre- vs. post-fatigue) for joint angle, moment, and EMG amplitude during stance of a forward-side jump. FANOVA compared variables as polynomial functions, and differences between functions with 95% confidence interval bands were plotted to determine significant differences. Plantar, knee, and hip flexion decreased during the initial stages of landing following fatigue. Plantarflexion moment decreased during 10-20% of stance in post-fatigue. Knee extension moment initially increased while decreased during 20-30% of stance following fatigue. Hip extension moment initially decreased while increased at 20% of stance. Tibialis anterior EMG decreased during 30-40% of stance, vastus lateralis EMG increased at 15% of stance, hamstring EMG decreased at foot contact and during 25-60% of stance, and gluteus maximus EMG decreased at foot contact and 35% of stance. The functional fatiguing exercises resulted in a more upright landing position, potentially indicating a greater reliance upon skeletal structures for support.

Efficacy of Sensory Transcutaneous Electrical Nerve Stimulation on Perceived Pain and Gait Patterns in Individuals With Experimental Knee Pain

OBJECTIVES To examine the effect of experimental knee pain on perceived knee pain and gait patterns and to examine the efficacy of transcutaneous electrical nerve stimulation (TENS) on perceived knee pain and pain-induced knee gait mechanics. DESIGN Crossover trial. SETTING Biomechanics laboratory. PARTICIPANTS Recreationally active, individuals without musculoskeletal pain aged 18 to 35 years (N=30). INTERVENTIONS Thirty able-bodied individuals were assigned to either a TENS (n=15) or a placebo (n=15) group. All participants completed 3 experimental sessions in a counterbalanced order separated by 2 days: (1) hypertonic saline infusion (5% NaCl); (2) isotonic saline infusion (0.9% NaCl); and (3) control. Each group received sensory electrical stimulation or placebo treatment for 20 minutes, respectively. MAIN OUTCOME MEASURES Perceived pain was collected every 2 minutes using a 10-cm visual analog scale (VAS) for 50 minutes and analyzed using a mixed model analysis of covariance with repeated measures. Gait analyses were performed at baseline, infusion, and treatment. Sagittal and frontal knee angles and internal net joint torque across the entire stance were analyzed using a functional data analysis approach. RESULTS Hypertonic saline infusion increased perceived pain (4/10cm on a VAS; P<.05) and altered right knee angle (more flexion and less abduction; P<.05) and internal net joint torque (less extension and greater abduction; P<.05) across various stance phases. TENS treatment reduced perceived pain and improved right sagittal gait abnormalities as compared with placebo treatment (P<.05). CONCLUSIONS This pain model increases perceived pain and induces compensatory gait patterns in a way that indicates potential quadriceps weakness. However, TENS treatment effectively reduces perceived pain and restores pain-induced gait abnormalities in sagittal knee mechanics.