Siobhan Strike

The temporal–spatial and ground reaction impulses of turning gait: Is turning symmetrical?

This study had two aims. Firstly, to characterise the temporal-spatial and ground reaction impulse adjustments, compared to straight gait, required to complete step turns to the left and to the right and secondly, to assess if the turns were asymmetrical. Seven participants were instructed to perform 90 degrees step turns to the left and right. The actual angle turned was less for both turns (right 80.2+/-5.5 degrees , left 82.8+/-5.3 degrees ). Data were collected using a 7 camera VICON infra-red motion analysis system (120 Hz) and a Kistler force plate (600 Hz). Adjustments were made in the approach, turn and depart strides compared to straight gait. The mean velocity was significantly lower and the stride was significantly shorter in the approach stride before the turn (p<0.0125) compared to straight gait, indicating a possible feed-forward mechanism prior to turning. Velocity was significantly lower and the stride length significantly shorter during the depart stride (p<0.0125) compared to straight gait. Participants did not return to a normal pattern within one stride. For the turn step, the velocity, step length and step width were all significantly different (p<0.0125) compared to straight gait. The turning ground reaction impulses were significantly greater (p<0.0125) compared to straight gait, indicating a need for increased support, medial shift, braking and propulsion. The turns to the left and right were statistically asymmetrical (p<0.0125) in 11 of the 18 variables. However, impulses were generally symmetrical, which does not generally support the functional asymmetry theory, though the contributions to propulsion were significantly greater when turning from the dominant limb.

Postural Responses to Dynamic Perturbations in Amputee Fallers Versus Nonfallers: A Comparative Study With Able-Bodied Subjects

OBJECTIVES To quantify postural responses in amputee fallers versus nonfallers by using computerized dynamic posturography. DESIGN All participants completed standard protocols on the Sensory Organization Test (SOT) and Motor Control Test (MCT) of the NeuroCom Equitest. SETTING Human performance laboratory in a university in the United Kingdom. PARTICIPANTS Transtibial amputees (n=9) and able-bodied subjects (n=9) (all categorized into fallers and nonfallers according to their falls history in the previous 9 mo). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Equilibrium and strategy scores on the SOT. Postural response latency and weight distribution on the MCT. RESULTS Equilibrium scores were highest when somatosensory information was accurate, but there were no differences between the groups. Strategy scores were lower when visual cues and somatosensory information were inaccurate, and the fallers and nonfallers used a combination of ankle and hip strategies to prevent a loss of balance. The amputee nonfallers indicated they had a greater reliance on visual input even when it was inaccurate compared with the amputee fallers, whereas the control fallers used the hip strategy significantly more compared with the control nonfallers (SOT condition 6: 56+/-22 vs 72+/-10, P=.01). Weight distribution symmetry showed that the amputee nonfallers bore significantly more weight through their intact limb compared with the amputee fallers during backward and forward translations (P<.05). CONCLUSIONS The SOT and MCT appeared to be population specific and therefore did not reliably identify fallers among transtibial amputees or distinguish between community-dwelling control fallers and nonfallers. Amputee and control fallers can prevent a fall during challenging static and dynamic conditions by adapting their neuromuscular responses. The results from this study have important implications for amputee gait rehabilitation, falls prevention, and treatment programs.

Biomechanical factors associated with time to complete a change of direction cutting maneuver

Abstract Marshall, BM, Franklyn-Miller, AD, King, EA, Moran, KA, Strike, SC, and Falvey, ÉC. Biomechanical factors associated with time to complete a change of direction cutting maneuver. J Strength Cond Res 28(10): 2845–2851, 2014—Cutting ability is an important aspect of many team sports, however, the biomechanical determinants of cutting performance are not well understood. This study aimed to address this issue by identifying the kinetic and kinematic factors correlated with the time to complete a cutting maneuver. In addition, an analysis of the test-retest reliability of all biomechanical measures was performed. Fifteen (n = 15) elite multidirectional sports players (Gaelic hurling) were recruited, and a 3-dimensional motion capture analysis of a 75° cut was undertaken. The factors associated with cutting time were determined using bivariate Pearsons correlations. Intraclass correlation coefficients (ICCs) were used to examine the test-retest reliability of biomechanical measures. Five biomechanical factors were associated with cutting time (2.28 ± 0.11 seconds): peak ankle power (r = 0.77), peak ankle plantar flexor moment (r = 0.65), range of pelvis lateral tilt (r = −0.54), maximum thorax lateral rotation angle (r = 0.51), and total ground contact time (r = −0.48). Intraclass correlation coefficient scores for these 5 factors, and indeed for the majority of the other biomechanical measures, ranged from good to excellent (ICC >0.60). Explosive force production about the ankle, pelvic control during single-limb support, and torso rotation toward the desired direction of travel were all key factors associated with cutting time. These findings should assist in the development of more effective training programs aimed at improving similar cutting performances. In addition, test-retest reliability scores were generally strong, therefore, motion capture techniques seem well placed to further investigate the determinants of cutting ability.

Isokinetic muscle strength and readiness to return to sport following anterior cruciate ligament reconstruction: is there an association? A systematic review and a protocol recommendation

Introduction Following anterior cruciate ligament reconstruction (ACLR), strength is a key variable in regaining full function of the knee. Isokinetic strength is commonly used as part of the return to sport (RTS) criteria. Aim We systematically reviewed the isokinetic strength evaluation protocols that are currently being used following ACLR. A secondary aim was to suggest an isokinetic protocol that could meet RTS criteria. Method Articles were searched using ScienceDirect, PubMed and Sage Journals Online, combined with cross-checked reference lists of the publications. Protocol data and outcome measurements and RTS criteria were extracted from each article included in the review. Results 39 studies met the inclusion criteria and reported their isokinetic strength evaluation protocol following ACLR. The variables that were most commonly used were concentric/concentric mode of contraction (31 studies), angular velocity of 60°/s (29 studies), 3–5 repetitions (24 studies), range of motion of 0–90° (6 studies), and using gravity correction (9 studies). 8 studies reported strength limb symmetry index scores as part of their RTS criteria. Conclusions There was no standardised isokinetic protocol following ACLR; isokinetic strength measures have not been validated as useful predictors of successful RTS. We propose a standard protocol to allow consistency of testing and accurate comparison of future research.

A High Omega-3 Fatty Acid Multinutrient Supplement Benefits Cognition and Mobility in Older Women: A Randomized, Double-blind, Placebo-controlled Pilot Study

Background. Mobility is a key determinant of frailty in older persons, and a variety of dietary factors, such as the omega-3 fatty acid docosahexaenoic acid (DHA), are positively associated with decreased frailty and improved mobility and cognition in older persons. Methods. The effects of a multinutrient supplement on mobility and cognition were assessed in postmenopausal women (60–84 years). Participants received either Efalex Active 50+ (1g DHA, 160mg eicosapentaenoic acid, 240mg Ginkgo biloba, 60mg phosphatidylserine, 20mg d-α tocopherol, 1mg folic acid, and 20 µg vitamin B12 per day; N = 15) or placebo (N = 12) for 6 months. Mobility was assessed by VICON 9 motion capture camera system synchronized with Kistler force plates, cognitive performance by computerized cognitive function tests, and blood fatty acid levels by pin-prick analysis. Results. Significant effects of treatment were seen in two of the four cognitive tests, with shorter mean latencies in a motor screening task (p < .05) and more words remembered (p < .03), and one of the three primary mobility measures with improved habitual walking speed (p < .05). Compared with the placebo group, supplementation also resulted in significantly higher blood DHA levels (p < .02). Conclusions. In this pilot study, multinutrient supplementation improved cognition and mobility in able older females at clinically relevant levels, suggesting a potential role in reducing the decline to frailty.

Turning bias and lateral dominance in a sample of able-bodied and amputee participants

Turning bias is the tendency to turn towards a given direction. Conflicting results from previous studies suggest that a number of factors may influence turning direction. The aim of this study was to determine if biomechanical asymmetries influence turning bias. A total of 100 able-bodied participants, and 30 trans-tibial amputees who, by definition, possess a functional asymmetry, volunteered to participate in the study. The right hand and right foot were significantly dominant for the able-bodied sample. Able-bodied participants showed a significant turning preference towards the left, which was opposite to the dominant hand and foot. The amputees were significantly right-hand dominant and the side of the amputation influenced foot dominance. The amputee sample showed no preferred turning direction. Turning bias indices in the amputee sample were not significantly associated with handedness, footedness, side of amputation, or dominance prior to amputation. The lack of a preferred direction of turn in the amputee sample suggests that biomechanical asymmetries can influence turning bias.

Lower limb kinematic and kinetic differences between transtibial amputee fallers and non-fallers.

Stair walking relies on concentric contraction of the ankle plantarflexor and knee extensor muscles, which are either absent or weakened in transtibial amputees. As a result the risk of falling is increased in this population. The aim of this study was to compare the gait patterns of transtibial amputee fallers and non-fallers during stair ascent. Eleven participants (fallers = 6; non-fallers = 5) walked along a 3-m walkway and ascended a three-step staircase with handrails, at their self-selected pace, while three-dimensional kinematic data were collected from the lower limbs. A force plate was embedded into the first step and kinetic data were measured for the intact lead limb only. The fallers walked significantly faster (p = 0.00) and exhibited less hip flexion (p = 0.05) and less anterior pelvic tilt (p = 0.04) compared to the non-fallers. The fallers had significantly greater first and second peak vertical ground reaction force (GRF) on the intact limb than the non-fallers (p = 0.05 and p = 0.01, respectively) contributing to the significantly larger ankle (p = 0.02) and hip moments (p = 0.04). These findings suggested the amputee non-fallers performed mechanically demanding tasks more cautiously. Two of the participants self-selected a ‘step to’ gait pattem, ascending one step at a time. This may be considered a compensatory mechanism for the lack of ankle mobility and functional muscle performance in these two transtibial amputees.

The biomechanics of one-footed vertical jump performance in unilateral trans-tibial amputees.

This study investigated vertical jumps from single support for two trans-tibial amputees from a standing position. The mechanisms used to achieve flight and the compensatory mechanisms used in the production of force in the absence of plantarflexors are detailed. Two participants completed countermovement maximum vertical jumps from the prosthetic and the sound limbs. The jumps were recorded by a 7-camera 512 VICON motion analysis system integrated with a Kistler forceplate. Flight height was 5 cm jumping from the prosthetic side and 18–19 cm from the sound side. The countermovement was shallower and its duration was less on the prosthetic side compared to the sound side. The reduced and passive range of motion at the prosthesis resulted in an asymmetrical countermovement for both participants with the knee and ankle joints most affected. The duration of the push-off phase was not consistently affected. At take-off the joints on the sound side reached close to full extension while on the prosthetic side they remained more flexed. Joint extension velocity in the push-off phase was similar for both participants on the sound side, though the timing for participant 2 illustrated earlier peaks. The pattern of joint extension velocity was not a smooth proximal to distal sequence on the prosthetic side. The magnitude and timing of the inter-segment extensor moments were asymmetrical for both subjects. The power pattern was asymmetrical in both the countermovement and push-off phases; the lack of power generation at the ankle affected that produced at the remaining joints.

Stiffness properties of the trunk in people with low back pain

The purpose of this study was to examine the dynamic properties of the trunk during unstable sitting and to determine differences between healthy and low back pain (LBP) participants. Participants sat on a custom-made chair that was able to swing freely in the sagittal plane. The chair was mounted on a force platform to measure loads acting at the trunk. Each participant was asked to find a balanced position after the chair was tilted backward and released. Movements of the trunk and chair were recorded. Effective moment of inertia, stiffness and damping coefficients were derived using a second order linear model. 10 participants were re-tested to assess reliability. Trunk stiffness was found increased for LBP subjects (p<.05) while no difference was found for damping coefficient. Gender and initial tilt angle did not affect viscoelastic properties of the spine. A second order linear model adequately described the biomechanical response of the trunk. It was shown that the trunk response was mainly elastic for all participants. The increase in trunk stiffness in LBP subjects could be a compensatory strategy to decrease pain and the risk of further injuries, but further investigations are needed to understand the nature of the viscoelastic alterations.

The role of trunk muscles in sitting balance control in people with low back pain

The purpose of this study was to examine the muscular activities and kinetics of the trunk during unstable sitting in healthy and LBP subjects. Thirty-one healthy subjects and twenty-three LBP subjects were recruited. They were sat on a custom-made chair mounted on a force plate. Each subject was asked to regain balance after the chair was tilted backward at 20°, and then released. The motions of the trunk and trunk muscle activity were examined. The internal muscle moment and power at the hip and lumbar spine joints were calculated using the force plate and motion data. No significant differences were found in muscle moment and power between healthy and LBP subjects (p>0.05). The duration of contraction of various trunk muscles and co-contraction were significantly longer in the LBP subjects (p<0.05) when compared to healthy subjects, and the reaction times of the muscles were also significantly reduced in LBP subjects (p<0.05). LBP subjects altered their muscle strategies to maintain balance during unstable sitting, but these active mechanisms appear to be effective as trunk balance was not compromised and the internal moment pattern remained similar. The changes in muscle strategies may be the causes of LBP or the result of LBP with an attempt to protect the spine.