Michael D. McDonald

Plantar pressure differences between obese and non-obese adults: a biomechanical analysis

OBJECTIVE: To investigate plantar pressure differences between obese and non-obese adults during standing and walking protocols using a pressure distribution platform.SUBJECTS: Thirty-five males (age 42.4±10.8 y; 67–179 kg) and 35 females (age 40.0±12.6 y; 46–150 kg) divided into obese (body mass index (BMI) 38.75±5.97 kg/m2) and non-obese (BMI 24.28±3.00 kg/m2) sub-groups, respectively.MEASUREMENTS: Data collection was performed with a capacitive pressure distribution platform with a resolution of 2 sensors/cm2 (Emed F01, Novel GmbH, München). The measurement protocol included half and full body weight standing on the left, right and both feet, respectively, and walking across the platform, striking with the right foot. Pressures were evaluated for eight anatomical sites under the feet.RESULTS: For both men and women, the mean pressure values of the obese were higher under all anatomical landmarks during half body weight standing. Significant increases in pressure were found under the heel, mid-foot and metatarsal heads II and IV for men and III and IV for women. Foot width during standing was also significantly increased in obese subjects. For walking, significantly higher peak pressures were also found in both obese males and females.CONCLUSION: Compared to a non-obese group, obese subjects showed increased forefoot width and higher plantar pressures during standing and walking. The greatest effect of body weight on higher peak pressures in the obese was found under the longitudinal arch of the foot and under the metatarsal heads. The higher pressures for obese women compared to obese men during static weight bearing (standing) may be the result of reduced strength of the ligaments of the foot.

The arch index: A measure of flat or fat feet?

Background: Studies using footprint-based estimates of arch height have indicated that obesity results in a lowered medial longitudinal arch in children. However, the potentially confounding effect of body composition on indirect measures of arch height, such as the arch index, has not been investigated. Methods: This study assessed the body composition of 12 male and 12 female adults (mean age: 39.9 ± 8.1 years, height: 1.724 ± 0.101 m; weight: 95.1 ± 13.7 kg, and BMI: 31.9 ± 3.0kg/m 2 ) using bioelectrical impedance analysis to produce a two-component model of fat mass (FM) and fat-free mass (FFM). The dynamic arch index also was determined from electronic footprints captured during gait using a capacitive pressure distribution platform with a resolution of 4 sensors/cm2. Results: While significant correlations were noted between FFM and the area of both the hindfoot (r = .75, p <.05) and forefoot (r = .72, p <.05), the midfoot area was correlated only with FM (r = .54, p <.05). Similarly, the arch index was significantly correlated with the FM percentage (r = .67, p <.05). Conclusions: The findings of this pilot study suggest that body composition influences arch index values in overweight and obese subjects. Consequently, body composition may be a confounding factor in interpreting footprint based estimates of arch height and, as such, these estimates would best be used with supplementary measures of body composition.

Single-subject analysis reveals variation in knee mechanics during step landing

PURPOSE Evidence concerning the alteration of knee function during landing suffers from a lack of consensus. This uncertainty can be attributed to methodological flaws, particularly in relation to the statistical analysis of variable human movement data. The aim of this study was to compare single-subject and group analyses in detecting changes in knee stiffness and coordination during step landing that occur independent of an experimental intervention. METHODS A group of healthy men (N=12) stepped-down from a knee-high platform for 60 consecutive trials, each trial separated by a 1-minute rest. The magnitude and within-participant variability of sagittal stiffness and coordination of the landing knee were evaluated with both group and single-subject analyses. RESULTS The group analysis detected significant changes in knee coordination. However, the single-subject analyses detected changes in all dependent variables, which included increases in variability with task repetition. Between-individual variation was also present in the timing, size and direction of alterations. CONCLUSION The results have important implications for the interpretation of existing information regarding the adaptation of knee mechanics to interventions such as fatigue, footwear or landing height. It is proposed that a participants natural variation in knee mechanics should be analysed prior to an intervention in future experiments.

Young men utilise limited neuromuscular preparation to regulate post-impact knee mechanics during step landing

PURPOSE The neuromuscular mechanisms determining the mechanical behaviour of the knee during landing impact remain poorly understood. It was hypothesised that neuromuscular preparation is subject-specific and ranges along a continuum from passive to active. METHODS A group of healthy men (N=12) stepped-down from a knee-high platform for 60 consecutive trials. Surface EMG of the quadriceps and hamstrings was used to determine pre-impact onset timing, activation amplitude and cocontraction for each trial. Partial least squares regression was used to associate pre-impact preparation with post-impact knee stiffness and coordination. RESULTS The group analysis revealed few significant changes in pre-impact preparation across trial blocks. Single-subject analyses revealed changes in muscle activity that varied in size and direction between individuals. Further, the association between pre-impact preparation and post-impact knee mechanics was subject-specific and ranged along a continuum of strategies. CONCLUSION The findings suggest that neuromuscular preparation during step landing is subject-specific and its association to post-impact knee mechanics occurs along a continuum, ranging from passive to active control strategies. Further work should examine the implications of these strategies on the distribution of knee forces in vivo.

Physical activity participation and nutrition and physical activity knowledge in university dance students

OBJECTIVE To assess participation in physical activity and knowledge of general nutrition and current public health messages about the health benefits of physical activity in university dance students, and to investigate differences between first-year and later-year students and between students in dance and dance performance course groups. METHODS This cross-sectional study recruited 67 participants from dance undergraduate degrees in a university in Australia. Nutrition knowledge was assessed using the General Nutrition Knowledge Questionnaire. Physical activity participation and awareness of its benefits were assessed using the Active Australia Survey. RESULTS Results indicate low nutrition knowledge among dance students, with 47% and 52% of responses correct in dance and dance performance students, respectively. Nutrition knowledge did not vary between students in first or later years. Self-reported participation in moderate and vigorous physical activity varied substantially and met or exceeded recommendations based upon duration and frequency for 98% of participants. However, awareness of physical activity messages varied, with dance students more likely to disagree about the level of activity needed for health benefits. CONCLUSIONS Dance students report varying levels of physical activity that usually met or exceeded recommendations; however, knowledge of general nutrition and physical activity benefits was low. Improved knowledge could contribute to changes in behavior that improve health status in this population.

Hip and knee kinematics display complex and time-varying sagittal kinematics during repetitive stepping: Implications for design of a functional fatigue model of the knee extensors and flexors

The validity of fatigue protocols involving multi-joint movements, such as stepping, has yet to be clearly defined. Although surface electromyography can monitor the fatigue state of individual muscles, the effects of joint angle and velocity variation on signal parameters are well established. Therefore, the aims of this study were to i) describe sagittal hip and knee kinematics during repetitive stepping ii) identify periods of high inter-trial variability and iii) determine within-test reliability of hip and knee kinematic profiles. A group of healthy men (N = 15) ascended and descended from a knee-high platform wearing a weighted vest (10%BW) for 50 consecutive trials. The hip and knee underwent rapid flexion and extension during step ascent and descent. Variability of hip and knee velocity peaked between 20-40% of the ascent phase and 80-100% of the descent. Significant (p<0.05) reductions in joint range of motion and peak velocity during step ascent were observed, while peak flexion velocity increased during descent. Healthy individuals use complex hip and knee motion to negotiate a knee-high step with kinematic patterns varying across multiple repetitions. These findings have important implications for future studies intending to use repetitive stepping as a fatigue model for the knee extensors and flexors.