Naghmeh Gheidi

Comparison of estimates of Achilles tendon loading from inverse dynamics and inverse dynamics-based static optimisation during running.

ABSTRACT Tendon stress may be one of the important risk factors for running-related tendon injury. Several methods have been used to estimate Achilles tendon (AT) loading during a human performance such as inverse dynamics (ID) and inverse dynamics-based static optimisation (IDSO). Our purpose was to examine differences between ID and IDSO estimates of AT loading during running. Kinematic data were captured simultaneously with kinetic data. Imaging of the AT cross-sectional area was performed with ultrasound for 17 healthy runners (height: 170.2 ± 6.2 cm, mass: 63.9 ± 11.0 kg, age: 21.8 ± 1.4 years). AT stress, strain, and force were estimated from both ID and IDSO approaches. The two methods resulted in minimal differences (3.6–4.7%) in estimated peak AT stress, strain, and force (P = 0.051–0.054); however, IDSO estimates were greater (32.7–36.8%) during early-stance phase of running (P = 0.000–0.008). This difference in AT load during early-stance may be due to the inability of the ID to account muscle coactivation. The similarity between the peak AT loading for ID and IDSO methods revealed that the advantage of IDSO used to estimate muscle forces had little effect on the ankle plantar flexor peak forces during running. Therefore, the use of IDSO with a higher computational cost compared with ID may not be necessary for estimating AT stress during running.

Plantar loading changes with alterations in foot strike patterns during a single session in habitual rear foot strike female runners.

OBJECTIVES Characterize plantar loading parameters when habitually rear foot strike (RFS) runners change their pattern to a non-rear foot strike (NRFS). DESIGN Experimental. SETTING University biomechanics laboratory. PARTICIPANTS Twenty three healthy female runners (Age: 22.17 ± 1.64 yrs; Height: 168.91 ± 5.46 cm; Mass: 64.29 ± 7.11 kg). MAIN OUTCOME MEASURES Plantar loading was measured using an in-sole pressure sensor while running down a 20-m runway restricted to a range of 3.52-3.89 m/s under two conditions, using the runners typical RFS, and an adapted NRFS pattern. Repeated measures multivariate analysis of variance was performed to detect differences in loading between these two conditions. RESULTS Force and pressure variables were greater in the forefoot and phalanx in NRFS and greater in the heel and mid foot in RFS pattern, but the total force imposed upon the whole foot and contact time remained similar between conditions. Total peak pressure was higher and contact area was lower during NRFS running. CONCLUSIONS The primary finding of this investigation is that there are distinctly different plantar loads when changing from a RFS to NRFS during running. So, during a transition from RFS to a NRFS pattern; a period of acclimation should be considered to allow for adaptations to these novel loads incurred on plantar regions of the foot.

Achilles Tendon Loading During Heel-Raising and -Lowering Exercises

CONTEXT Achilles tendinopathies are common injuries during sport participation, although men are more prone to Achilles tendon injuries than women. Heel-raising and -lowering exercises are typically suggested for Achilles tendon rehabilitation. OBJECTIVE To compare the estimated Achilles tendon loading variables and the ankle range of motion (ROM) using a musculoskeletal model during commonly performed heel-raising and -lowering exercises. DESIGN Controlled laboratory study. SETTING University biomechanics laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-one healthy men (age = 21.59 ± 1.92 years, height = 178.22 ± 8.02 cm, mass = 75.81 ± 11.24 kg). INTERVENTION(S) Each participant completed 4 exercises: seated heel raising and lowering, bilateral standing heel raising and lowering, bilateral heel raising and unilateral lowering, and unilateral heel raising and lowering. MAIN OUTCOME MEASURE(S) A repeated-measures multivariate analysis of variance (α = .05) was used to compare Achilles tendon stress, force, and strain and ankle ROM for each exercise. Kinematic data were recorded at 180 Hz with 15 motion-analysis cameras synchronized with kinetic data collected from a force platform sampled at 1800 Hz. These data were then entered in a musculoskeletal model to estimate force in the triceps surae. For each participant, we determined Achilles tendon stress by measuring cross-sectional images using ultrasound. RESULTS Peak Achilles tendon loading was lowest when performing the seated heel-raising and -lowering exercise and highest when performing the unilateral heel-raising and -lowering exercise. Loading was greater for the unilateral exercise or portions of the exercise that were performed unilaterally. CONCLUSIONS Bilateral and seated exercises with less weight-bearing force resulted in less Achilles tendon loading. These exercises may serve as progressions during the rehabilitation process before full-body weight-bearing, unilateral exercises are allowed. Ankle ROM did not follow the same order as loading and may need additional monitoring or instruction during rehabilitation.

Achilles tendon loading during weight bearing exercises

OBJECTIVE Compare the estimated Achilles tendon (AT) loading using a musculoskeletal model during commonly performed weight bearing therapeutic exercises. DESIGN Controlled laboratory study. SETTING University biomechanics laboratory. PARTICIPANTS Eighteen healthy males (Age:22.1 ± 1.8 years, height:177.7 ± 8.4 cm, weight = 74.29 ± 11.3 kg). MAIN OUTCOME MEASURE(S) AT loading was estimated during eleven exercises: tandem, Romberg, and unilateral standing, unilateral and bilateral heel raising, unilateral and bilateral jump landing, squat, lunge, walking, and running. Kinematic and kinetic data were recorded at 180 Hz and 1800 Hz respectively. These data were then used in a musculoskeletal model to estimate force in the triceps surae. AT cross-sectional images were measured by ultrasound to determine AT stress. A repeated measure multivariate analysis of variance (α = 0.05) was used on AT loading variables. RESULTS Squat and unilateral jump landing were the most different in AT stress. Peak AT stress variables were generally greater during more dynamic, unilateral exercises compared to more static, bilateral exercises. CONCLUSIONS Bilateral, more static exercises resulted in less AT loading and may serve as a progression during the rehabilitation compared to more dynamic, unilateral exercises.

Patellar tendon stress between two variations of the forward step lunge

Background Patellar tendinopathy (PT) or “jumpers knee” is generally found in active populations that perform jumping activities. Graded exposure of patellar tendon stress through functional exercise has been demonstrated to be effective for the treatment of PT. However, no studies have compared how anterior knee displacement variations during the commonly performed forward step lunge (FSL) affect patellar tendon stress. Methods Twenty-five subjects (age: 22.69 ± 0.74 years; height: 169.39 ± 6.44 cm; mass: 61.55 ± 9.74 kg) performed 2 variations of an FSL with the anterior knee motion going in front of the toes (FSL-FT) and the knee remaining behind the toes (FSL-BT). Kinematic and kinetic data were used with an inverse-dynamics based static optimization technique to estimate individual muscle forces to determine patellar tendon stress during both lunge techniques. A repeated measures multivariate analysis was used to analyze these data. Results The peak patellar tendon stress, stress impulse, quadriceps force, knee moment, knee flexion, and ankle dorsiflexion angle were significantly greater (p < 0.001) during the FSL-FT as compared to the FSL-BT. The peak patellar tendon stress rate did not differ between the FSL-FT and FSL-BT. Conclusion The use of an FSL-FT as compared to an FSL-BT increased the load and stress on the patellar tendon. Because a graded exposure of patellar tendon loading with other closed kinetic chain exercises has proven to be effective in treating PT, consideration for the prescription of variations of the FSL and further clinical evaluation of this exercise is warranted in individuals with PT.

Effect of Posttrial Visual Feedback and Fatigue During Drop Landings on Patellofemoral Joint Stress in Healthy Female Adults

Patellofemoral pain (PFP) is common in females. Patellofemoral joint stress (PFJS) may be important in the development of PFP. Ground reaction force (GRF) during landing activities may impact PFJS. Our purpose was to determine how healthy females alter their landing mechanics using visual posttrial feedback on their GRF and assess how PFJS changes. Seventeen participants performed a series of drop landings during 3 conditions: baseline, feedback, and postfatigue feedback. The fatigue protocol used repetitive jump squats. Quadriceps force was estimated through inverse-dynamics-based static optimization approach. Then, PFJS was calculated using a musculoskeletal model. Multivariate differences were shown across conditions (P = .01). Univariate tests revealed differences in PFJS (P = .014), knee range of motion (P = .001), and GRF (P = .005). There were no differences in quadriceps force (P = .125). PFJS and GRF decreased from baseline to feedback (P = .002, P = .007, respectively), while PFJS increased from feedback to postfatigue feedback (P = .03). Knee range of motion increased from baseline to feedback (P = .043), then decreased from feedback to postfatigue feedback (P < .001). Visual feedback of GRF may reduce PFJS, but may not effectively transfer to a fatigued state.

Changes in gluteal muscle forces with alteration of footstrike pattern during running

Gait retraining is a common form of treatment for running related injuries. Proximal factors at the hip have been postulated as having a role in the development of running related injuries. How altering footstrike affects hip muscles forces and kinematics has not been described. Thus, we aimed to quantify differences in hip muscle forces and hip kinematics that may occur when healthy runners are instructed to alter their foot strike pattern from their habitual rear-foot strike to a forefoot strike. This may gain insight on the potential etiology and treatment methods of running related lower extremity injury. Twenty-five healthy female runners completed a minimum of 10 running trials in a controlled laboratory setting under rear-foot strike and instructed forefoot strike conditions. Kinetic and kinematic data were used in an inverse dynamic based static optimization to estimate individual muscle forces during running. Within subject differences were investigated using a repeated measures multi-variate analysis of variance. Peak gluteus medius and minimus and hamstring forces were reduced while peak gluteus maximus force was increased when running with an instructed forefoot strike pattern. Peak hip adduction, hip internal rotation, and heel-COM distance were also reduced. Therefore, instructing habitual rearfoot strike runners to run with a forefoot strike pattern resulted in changes in peak gluteal and hamstring muscle forces and hip kinematics. These changes may be beneficial to the development and treatment of running related lower extremity injury.