Flexibility in joint coordination remains unaffected by force and balance demands in young and old adults during simple sit-to-stand tasks

Biomechanics of the lower limb in patients with mild knee osteoarthritis during the sit-to-stand task

BACKGROUND

Knee osteoarthritis (KOA) is a prevalent and debilitating condition that markedly affects the sit-to-stand (STS) activity of patients, a prerequisite for daily activities. Biomechanical recognition of movements in patients with mild KOA is currently attracting attention. However, limited studies have been conducted solely on the observed differences in sagittal plane movement and muscle activation.

AIM

This study aimed to identify three-dimensional biomechanical and muscle activation characteristics of the STS activity in patients with mild KOA.

METHODS

A cross-sectional study was conducted to observe the differences between patients with mild KOA and a control group (CG). It was conducted to observe the differences in muscle activation, including root mean square (RMS%) and integrated electromyography (items), kinematic parameters like range of motion (ROM) and maximum angular velocity, as well as dynamic parameters such as joint moment and vertical ground reaction force (vGRF).

RESULTS

Patients with mild KOA had a higher body mass index and longer task duration. In the sagittal plane, patients with KOA showed an increased ROM of the pelvic region, reduced ROM of the hip-knee-ankle joint, and diminished maximum angular velocity of the knee-ankle joint. Furthermore, patients with KOA displayed increased knee-ankle joint ROM in the coronal plane and decreased ankle joint ROM in the horizontal plane. Integrated vGRF was higher in both lower limbs, whereas the vGRF of the affected side was lower. Furthermore, patients showed a decreased peak adduction moment (PADM) and increased peak external rotation moment in the knee joint and smaller PADM and peak internal rotation moment in the ankle joint. The affected side exhibited decreased RMS% and iEMG values of the gluteus medius, vastus medialis, and vastus lateralis muscles, as well as a decreased RMS% of the rectus femoris muscle. Conversely, RMS% and iEMG values of the biceps femoris, lateral gastrocnemius, and medial gastrocnemius muscles were higher.

CONCLUSION

The unbalanced activation characteristics of the anterior and posterior muscle groups, combined with changes in joint moment in the three-dimensional plane of the affected joint, may pose a potential risk of injury to the irritated articular cartilage.

Biomechanical and neuromuscular control characteristics of sit-to-stand transfer in young and older adults: A systematic review with implications for balance regulation mechanisms

BACKGROUND

Falls are major health concerns in older adults. Sit-to-stand transfer is an important functional movement that can predict falling risk in older adults. Aging-associated declines in neuromechanical control of movement may negatively impact sit-to-stand performance. This systematic review aims to summarize differences in neuromechanical characteristics of younger vs. older adults that likely affect balance regulation during sit-to-stand.

METHODS

Five databases (Academic search complete, MEDLINE, APA PsycInfo, Pubmed, and SPORTDiscus) were systematically searched from January 1985 through March 2023. Three reviewers assessed the quality of methodology, study design, results, and risk of bias using the Appraisal tool for Cross-Sectional Studies. Studies reported neuromuscular and biomechanical characteristics during sit-to-stand in young versus older adults were included.

FINDINGS

Seventeen studies (343 older and 225 younger adults) were included. Compared to younger adults, older adults showed slower sit-to-stand time, higher trunk flexion, postural sway, agonist-antagonist muscle co-activation of the ankle and knee muscles, and lower ankle dorsiflexion torque. Lower magnitude and rate of vertical ground reaction force development and lower vertical momentum during rising were observed with aging during fast-speed sit-to-stand. There was heterogeneity among studies on sit-to-stand speed, foot position, use of arms, and seat height adjustability.

INTERPRETATIONS

Higher trunk angular displacement and velocity accompanied by higher anterior momentum, likely to compensate for knee extensor muscle weaknesses, may lead to higher postural sway upon standing and therefore require higher knee and ankle muscle co-activation to maintain balance stability. Thus, additional attention to trunk control strategies is needed during clinical evaluations.

Effects of Age and Attentional Focus on the Performance and Coordination of the Sit-to-Stand Task

This study investigated whether age and attentional focus affect synergy organization of sit-to-stand (STS). Young and older adults performed STS while holding a cup under internal (IF) and external focus (EF) instructions. Uncontrolled manifold analysis was used to decompose trial-to-trial variability in joint kinematics into variability that preserves (V_UCM) and interferes (V_ORT) with the horizontal and vertical positions of the center of mass (CoM) and cup. V_UCM was significantly higher than V_ORT for all variables in both age groups and focus conditions. Older adults demonstrated higher V_UCM for all variables and higher V_ORT for all variables except the vertical position of the cup. IF instructions benefited older adults, leading to decreased V_ORT of the vertical position of CoM and horizontal and vertical positions of the cup.

Impact of different bilateral knee extension strengths on lower extremity performance

Despite the impact of leg muscle strength on lower extremity motor performance-including walking and sit-to-stand transfer-it remains difficult to predict the relationship between bilateral leg muscle strength and lower extremity performance. Therefore, this study was designed to predict lower extremity function through the differential modeling of logarithmic and linear regression, based on knee extension strength.The study included 121 individuals living in the same community. The bilateral strengths of the knee extensors were measured using a handheld dynamometer, and the Timed Up & Go test (TUG) performance time and 5-m minimum walking times were assessed to predict lower extremity motor functions. Bilateral normalized knee extension muscle strengths and lower extremity motor function scores, including walking or TUG performance times, were assessed on the logarithmic and linear models. The Akaike information criterion (AIC) was used to evaluate the coefficient compatibility between the logarithmic regression model and the linear regression model.The AIC value for the linear model was lower than that for the logarithmic model regarding the walking time. For walking time estimation in the linear model, the coefficient value of knee extension strength was larger on the strong than on the weak side; however, the AIC value for the logarithmic model was lower than that for the linear model regarding TUG performance time. In the logarithmic model's TUG performance time estimation, the coefficient value of knee extension strength was larger on the weak than on the strong side.In conclusion, our study demonstrated different models reflecting the relationship between both legs' strengths and lower extremity performance, including the walking and TUG performance times.

Effect of Instrument-Assisted Soft Tissue Mobilization on Ankle of Range of Motion and Balance in Older Women: A Preliminary Study

OBJECTIVES This study aims to investigate the effects of instrument-assisted soft tissue mobilization (IASTM) on ankle range of motion (ROM) and balance in older women.METHODS The 20 older women with a history of falls participated in the study, and the study subjects were randomly divided into the IASTM group (n=10) and control group (n=10).RESULTS There were no significant interactions between group and time for ankle ROM and functional reach after 8 weeks of IASTM on older women (P>0.05). Meanwhile, there were significant interactions between group and time for one-leg standing and star excursion balance (P<0.05), and in particular, the IASTM group had greater improvements compared to the control group.CONCLUSION In conclusion, the regular application of IASTM has been shown to improve the balance of older women with a history of falls.

Individuals with patellofemoral pain syndrome have altered inter-leg force coordination

BACKGROUND

Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders. Pain may be further exacerbated by atypical motor coordination strategies. It has been thought that low coordination variability may concentrate loads onto painful knee tissues.

RESEARCH QUESTION

To investigate if inter-limb force coordination is altered between individuals with and without PFPS.

METHODS

31 individuals (control = 17, PFPS = 14) performed bilateral vertical hopping, on two force plates at three frequencies (2.2, 2.6, 3.0 Hz). Uncontrolled manifold analysis (UCM) was used to provide an index of motor abundance (IMA) in the coordination of inter-limb forces to stabilize the two-limb's total force. UCM was applied to the study of forces in each plane (medial-lateral (ML), anterior-posterior (AP), vertical). Bayesian Functional Data Analysis was used for statistical inference. We calculated the mean (u) with 95 % credible interval (CrI) of the difference ΔIMA_con>PFPS between the two groups. We also calculated the probability PΔIMA_con>PFPS>0data).

RESULTS

Individuals with PFPS had the greatest significant decrement from controls at 6% of stance hopping at 2.6 Hz by a mean difference of -0.23 for ML GRF; at 19 % of stance hopping at 2.2 Hz by a mean difference of -0.14 for AP GRF; and 52 % of stance hopping at 2.6 Hz by a mean difference of -0.14 for vertical GRF. For vertical GRF, there was a > 0.95 probability that controls had greater IMA than individuals with PFPS hopping between 12-13% of stance at 2.2 Hz, and between 48-55% at 2.6 Hz.

SIGNIFICANCE

Individuals with PFPS have reduced inter-leg force coordination for impact force attenuation and body support, compared to asymptomatic controls. The present study provides insights into a plausible mechanism underpinning persistent knee pain which could be used in the development of novel rehabilitative approaches for individuals with PFPS.

Search Strategies in the Perceptual-Motor Workspace and the Acquisition of Coordination, Control, and Skill

In this paper we re-visit and elaborate-on the theoretical framework of learning as searching within the perceptual-motor workspace for a solution to the task. The central focus is the nature of search strategies to locate and create stable equilibrium regions in the perceptual-motor workspace and how these strategies relate to the emergent movement forms in the acquisition of coordination, control, and skill. In the ecological theory of perception and action, the enhanced stability of performance occurs through the attunement of the perceptual systems to the task dynamics together with modifications of action as task and intrinsic dynamics cooperate and/or compete. Thus, through practice in this search process, individuals adapt to the pick-up of task relevant perceptual variables and change their movement form according to the stability of the performed action and its outcome in relation to the task demands. Contemporary experimental findings have revealed features of the search process given the interaction of individual intrinsic dynamics in the context of task requirements and principles that drive the change – e.g., exploitation of more tolerant task-space solutions and emergence of compensatory mechanisms. Finally, we outline how the search strategy framework relates to traditional learning-related phenomena: including the dynamical pathways of learning, learning curves, factors of learning, individuality, motor development, and sport and rehabilitation interventions.