Directional Differences in the Biaxial Material Properties of Fascia Lata and the Implications for Fascia Function

Effect of prone trunk-extension on lumbar and lower limb muscle stiffness

This study investigated the effect of the prone trunk extension test (PTE) on lumbar and lower limb muscle stiffness to explore the optimal angle for lumbar muscle training, understand the peripheral muscle force transmission effect, and determine the modulation strategy and interaction mode of different muscles during PTE. Twenty healthy young females were recruited for this study, and the stiffness of the erector spinae (ES), semitendinosus (ST), biceps femoris (BF), medial head of the gastrocnemius (MG), and lateral head of the gastrocnemius (LG) was measured by MyotonPRO under four angular PTE conditions (0° horizontal position, 10°, 20°, and 30°). With the increasing angle, the stiffness of ES decreased gradually, while ST and BF increased first and then decreased. The stiffness of MG and LG increased first, then decreased, then increased. There was a moderate to strong negative correlation between ES stiffness variation and ST (r = -0.819 to -0.728, p < 0.001), BF (r = -0.620 to -0.527, p < 0.05), MG (r = -788 to -0.611, p < 0.01), and LG (r = -0.616 to -0.450, p < 0.05). Horizontal PTE maximizes the activation of ES. There is a tension transfer between the ES, hamstrings, and gastrocnemius, mainly between the ES, ST, and LG. The study provides data to explore the effect of peripheral muscle force transmission and the modulation strategies of different muscles during trunk extension.

Treatment of Gingival Recession and Root Coverage Outcomes Using Fascia Lata Allograft: A Case Report with Two Years of Follow-Up

Mucogingival surgery is a procedure for the treatment of gingival recession, which is a shift of marginal gingival tissue to the cementoenamel junction (CEJ), exposing the surface of the root teeth. One treatment for gingival recession is the Langer and Langer bilaminar technique, which involves the use of the fascia lata (FL) membrane. This membrane is harvested from the aponeurosis of the external muscles. The purpose of this case report was to present the clinical results of a 2-year follow-up using the Langer and Langer bilaminar technique modified with FL in a patient with gingival recession. Recessions are a shift of marginal gingival tissue to the CEJ, which exposes the surface of the root teeth. At the 2-year follow-up, the patient presented with a gingival recession in tooth 41, which resulted in complete root coverage, reaching 83.3%; the amount of keratinized tissue increased to 3 mm in each tooth, changing the gingival biotype from thin to thick and scalloped. This case report supports the use of FL as a successful alternative treatment.

First-in-human demonstration of floating EMG sensors and stimulators wirelessly powered and operated by volume conduction

BACKGROUND

Recently we reported the design and evaluation of floating semi-implantable devices that receive power from and bidirectionally communicate with an external system using coupling by volume conduction. The approach, of which the semi-implantable devices are proof-of-concept prototypes, may overcome some limitations presented by existing neuroprostheses, especially those related to implant size and deployment, as the implants avoid bulky components and can be developed as threadlike devices. Here, it is reported the first-in-human acute demonstration of these devices for electromyography (EMG) sensing and electrical stimulation.

METHODS

A proof-of-concept device, consisting of implantable thin-film electrodes and a nonimplantable miniature electronic circuit connected to them, was deployed in the upper or lower limb of six healthy participants. Two external electrodes were strapped around the limb and were connected to the external system which delivered high frequency current bursts. Within these bursts, 13 commands were modulated to communicate with the implant.

RESULTS

Four devices were deployed in the biceps brachii and the gastrocnemius medialis muscles, and the external system was able to power and communicate with them. Limitations regarding insertion and communication speed are reported. Sensing and stimulation parameters were configured from the external system. In one participant, electrical stimulation and EMG acquisition assays were performed, demonstrating the feasibility of the approach to power and communicate with the floating device.

CONCLUSIONS

This is the first-in-human demonstration of EMG sensors and electrical stimulators powered and operated by volume conduction. These proof-of-concept devices can be miniaturized using current microelectronic technologies, enabling fully implantable networked neuroprosthetics.

The Iliotibial Band: A Complex Structure with Versatile Functions

The development of a pronounced iliotibial band (ITB) is an anatomically distinct evolution of humans. The mechanical behaviour of this “new” structure is still poorly understood and hotly debated in current literature. Iliotibial band syndrome (ITBS) is one of the leading causes of lateral knee pain injuries in runners. We currently lack a comprehensive understanding of the healthy behaviour of the ITB, and this is necessary prior to further investigating the aetiology of pathologies like ITBS. Therefore, the purpose of this narrative review was to collate the anatomical, biomechanical and clinical literature to understand how the mechanical function of the ITB is influenced by anatomical variation, posture and muscle activation. The complexity of understanding the mechanical function of the ITB is due, in part, to the presence of its two in-series muscles: gluteus maximus (GMAX) and tensor fascia latae (TFL). At present, we lack a fundamental understanding of how GMAX and TFL transmit force through the ITB and what mechanical role the ITB plays for movements like walking or running. While there is a range of proposed ITBS treatment strategies, robust evidence for effective treatments is still lacking. Interventions that directly target the running biomechanics suspected to increase either ITB strain or compression of lateral knee structures may have promise, but clinical randomised controlled trials are still required.

Feasibility of extracting tissue material properties via cohesive elements: a finite element approach to probe insertion procedures in non-invasive spine surgeries

Modeling the mechanical behavior of soft tissue probe insertion remains a challenging endeavor due to involved interdependent phenomena comprising tissue nonlinear deformation, contact between the probe and the tissue, crack propagation, and viscoelastic effects. To that matter, cohesive elements allow simulating crack formation and propagation, which provides a promising path to modeling the mechanical behavior of probe insertion in soft tissues. As such, the aim of the present study was to investigate the feasibility of devising and integrating an algorithm in a finite element (FE) case study in efforts of reverse engineering the material properties of non-homogeneous soft tissues. A layered nonlinear tissue model with a cohesive zone was created in the commercial software ABAQUS. Material properties were iteratively modified via a hybrid gradient descent optimization algorithm: minimizing the resultant error to first find optimum Ogden's hyperelastic parameters, followed by obtaining the damage parameters. Perceived material properties were then compared to those obtained via experimental human cadaver testing. Under the investigated four-layered muscle model, numerical results overlapped, to a great extent, with six different force-insertion experimental profiles with an average error of [Formula: see text] 15%. The best profile fit was realized when the highest sudden force drop was less than 60% of the peak force. Lastly, the FE analysis revealed an increase in stiffness as the probe advanced inside the tissue. The optimization algorithm demonstrated its capability to reverse engineer the material parameters required for the FE analysis of real, non-homogeneous, soft tissues. The significance of this procedure lies within its ability to extract tissue material parameters, in real time, with little to no intervention or invasive experimental tests. This could potentially further serve as a database for different muscle layers and force-insertion profiles, used for surgeon and physician clinical training purposes.

Elastic Fibres in the subcutaneous tissue: Is there a difference between superficial and muscular fascia? A cadaver study

BACKGROUND

In last years the role of fascia in proprioception and pain has been confirmed in numerous papers, but the real structure of fasciae is not still entirely known. To date, many studies have evaluated the elastic fibres in arteries, ligaments, lungs, epidermis and dermis, but only two studies exist about the elastic fibres in the fasciae, and they did not distinguish between superficial (in the subcutaneous tissue) and deep/muscular fasciae. The aim of the study was to assess the percentage of elastic fibres between superficial and deep fascia.

MATERIALS AND METHODS

Three full thickness specimens (proximal, middle and distal respectively) were taken from each of four regions of the thigh of three non-embalmed cadavers: the anterior (Ant), the lateral (Lat), the posterior (Post) and the medial (Med) aspect. Thus, a total of 12 specimens were collected from each analysed thigh and histological Weigert Van Gieson stains was performed. Three sections per specimen were considered for the morphometric analysis.

RESULTS

In all the specimens the superficial and deep fasciae were clearly recognizable. The difference in percentage of elastic fibres between superficial and deep fasciae in same region for all four was highly significant (p < 0.001). They are abundant in the superficial fascia than deep fascia.

CONCLUSIONS

In the light of these findings is evident that the superficial (in the subcutaneous tissue) and deep fasciae have different elasticity. This difference may improve grading of fascial dysfunction in dermatological diseases as burns, scars and lymphedema to better plan treatments.

Proximal and mid-thigh fascia lata graft constructs used for arthroscopic superior capsule reconstruction show equivalent biomechanical properties: an in vitro human cadaver study

Background

The proximal fascia lata (FL) graft construct used for arthroscopic superior capsule reconstruction (ASCR) is openly harvested, whereas the mid-thigh FL graft construct is minimally invasively harvested. The purpose of the current study was to compare the biomechanical properties of proximal thigh and mid-thigh-harvested FL graft constructs used for ASCR. The hypothesis was that, despite the different morphological characteristics of the proximal thigh and mid-thigh FL graft constructs used for ASCR, their biomechanical properties would not significantly differ. This information may assist orthopedic surgeons in the choice of the harvest location, technique, and type of graft construct for ASCR.

Methods

Forty FL specimens, 20 proximal thigh and 20 mid-thigh, were harvested from the lateral thighs of 10 fresh human cadavers (6 male, 4 female; average age, 58.60 ± 17.20 years). The thickness of each 2-layered proximal thigh and 6-layered mid-thigh FL graft construct was measured. Each construct was mechanically tested in the longitudinal direction, and the stiffness and Young’s modulus were computed. Data were compared by Welch’s independent t-test and analysis of variance, and statistical significance was set at P < .05.

Results

The average thickness of the proximal thigh FL graft construct (7.17 ± 1.97 mm) was significantly higher than that of the mid-thigh (5.54 ± 1.37 mm) [F (1,32) = 7.333, P = .011]. The average Young’s modulus of the proximal thigh and mid-thigh graft constructs was 32.85 ± 19.54 MPa (range, 7.94 – 75.14 MPa; 95% confidence interval [CI], 23.71 – 42.99) and 44.02 ± 31.29 MPa (range, 12.53 –120.33 MPa; 95% CI, 29.38 – 58.66), respectively. The average stiffness of the proximal thigh and mid-thigh graft constructs was 488.96 ± 267.80 N/mm (range, 152.96 – 1086.49 N/mm; 95% CI, 363.63 – 614.30) and 562.39 ± 294.76 N/mm (range, 77.46 – 1229.68 N/mm; 95% CI, 424.44 – 700.34), respectively. There was no significant difference in the average Young’s modulus or stiffness between the proximal thigh and mid-thigh graft constructs (P = .185 and P = .415, respectively).

Conclusion

Despite the different morphological characteristics of the proximal thigh and mid-thigh FL graft constructs used for ASCR, their Young’s modulus and stiffness did not significantly differ.

Non-local acute stretching effects on strength performance in healthy young adults

BACKGROUND

Static stretching (SS) can impair performance and increase range of motion of a non-exercised or non-stretched muscle, respectively. An underdeveloped research area is the effect of unilateral stretching on non-local force output.

OBJECTIVE

The objective of this review was to describe the effects of unilateral SS on contralateral, non-stretched, muscle force and identify gaps in the literature.

METHODS

A systematic literature search following preferred reporting items for systematic review and meta-analyses Protocols guidelines was performed according to prescribed inclusion and exclusion criteria. Weighted means and ranges highlighted the non-local force output response to unilateral stretching. The physiotherapy evidence database scale was used to assess study risk of bias and methodological quality.

RESULTS

Unilateral stretching protocols from six studies involved 6.3 ± 2 repetitions of 36.3 ± 7.4 s with 19.3 ± 5.7 s recovery between stretches. The mean stretch-induced force deficits exhibited small magnitude effect sizes for both the stretched (-6.7 ± 7.1%, d = -0.35: 0.01 to -1.8) and contralateral, non-stretched, muscles (-4.0 ± 4.9%, d = , 0.22: 0.08 to 1.1). Control measures exhibited trivial deficits.

CONCLUSION

The limited literature examining non-local effects of prolonged SS revealed that both the stretched and contralateral, non-stretched, limbs of young adults demonstrate small magnitude force deficits. However, the frequency of studies with these effects were similar with three measures demonstrating deficits, and four measures showing trivial changes. These results highlight the possible global (non-local) effects of prolonged SS. Further research should investigate effects of lower intensity stretching, upper versus lower body stretching, different age groups, incorporate full warm-ups, and identify predominant mechanisms among others.

Non-local Acute Passive Stretching Effects on Range of Motion in Healthy Adults: A Systematic Review with Meta-analysis

BACKGROUND

Stretching a muscle not only increases the extensibility or range of motion (ROM) of the stretched muscle or joint but there is growing evidence of increased ROM of contralateral and other non-local muscles and joints.

OBJECTIVE

The objective of this meta-analysis was to quantify crossover or non-local changes in passive ROM following an acute bout of unilateral stretching and to examine potential dose-response relations.

METHODS

Eleven studies involving 14 independent measures met the inclusion criteria. The meta-analysis included moderating variables such as sex, trained state, stretching intensity and duration.

RESULTS

The analysis revealed that unilateral passive static stretching induced moderate magnitude (standard mean difference within studies: SMD: 0.86) increases in passive ROM with non-local, non-stretched joints. Moderating variables such as sex, trained state, stretching intensity, and duration did not moderate the results. Although stretching duration did not present statistically significant differences, greater than 240-s of stretching (SMD: 1.24) exhibited large magnitude increases in non-local ROM compared to moderate magnitude improvements with shorter (< 120-s: SMD: 0.72) durations of stretching.

CONCLUSION

Passive static stretching of one muscle group can induce moderate magnitude, global increases in ROM. Stretching durations greater than 240 s may have larger effects compared with shorter stretching durations.

Anisotropic and viscoelastic tensile mechanical properties of aponeurosis: Experimentation, modeling, and tissue microstructure

Aponeuroses are stiff sheath-like components of the muscle-tendon unit that play a vital role in force transmission and thus locomotion. There is clear importance of the aponeurosis in musculoskeletal function, but there have been relatively few studies of aponeurosis material properties to date. The goals of this work were to: 1) perform tensile stress-relaxation tests, 2) perform planar biaxial tests, 3) employ computational modeling to the data from 1 to 2, and 4) perform scanning electron microscopy to determine collagen fibril organization for aponeurosis tissue. Viscoelastic modeling and statistical analysis of stress-relaxation data showed that while relaxation rate differed statistically between strain levels (p = 0.044), functionally the relaxation behavior was nearly the same. Biaxial testing and associated modeling highlighted the nonlinear (toe region of ~2-3% strain) and anisotropic (longitudinal direction linear modulus ~50 MPa, transverse ~2.5 MPa) tensile mechanical behavior of aponeurosis tissue. Comparisons of various constitutive formulations showed that a transversely isotropic Ogden approach balanced strong fitting (goodness of fit 0.984) with a limited number of parameters (five), while damage modeling parameters were also provided. Scanning electron microscopy showed a composite structure of highly aligned, partially wavy collagen fibrils with more random collagen cables for aponeurosis microstructure. Future work to expand microstructural analysis and use these data to inform computational modeling would benefit this work and the field.

Overuse Injury: The Result of Pathologically Altered Myofascial Force Transmission?

Overuse injuries are suggested to result from repetitive microdamage eliciting pain in the affected tissue. Therapy commonly focuses on the area of symptom localization; however, such approach may oversimplify the true etiopathology. This review hypothesizes that the development of some sports-related soft tissue disorders, such as plantar fasciitis or lumbago, is promoted by pathologically altered force transmission from anatomically connected structures.

Myofascial chains of the upper limb: A systematic review of anatomical studies

The presence of structural in-series continuity between skeletal muscles has been confirmed in the trunk and lower extremity. However, it is not yet clear whether the same architecture can be found in the upper limb. Therefore, the aim of the present study was to review the available literature considering the existence of myofascial chains in the shoulder-arm region. Two independent investigators performed a systematic literature search using MEDLINE (PubMed) and Google Scholar (each 1900-2019). Peer-reviewed anatomical dissection studies reporting myofascial in-series continuity in the upper extremity were included. The methodological quality of the included studies was assessed by the QUACS scale. Thirteen studies were included in the review. Analysis of these papers led to the identification of three myofascial chains: the ventral arm chain (pectoralis major, brachial fascia/biceps brachii, flexor carpi ulnaris/brachioradialis/supinator, based on five studies); the lateral arm chain (trapezius, deltoideus, lateral intermuscular septum/brachialis, brachioradialis, four studies); and the dorsal arm chain (latissiumus dorsi/teres minor/infraspinatus, triceps brachii, anconeus, extensor carpi ulnaris, six studies). There is good evidence for direct serial tissue continuity extending from the neck and shoulder region to the forearm. Despite this intriguing finding, which could have implications for health professionals and the treatment of musculoskeletal disorders, further research is needed to establish the mechanical relevance of the identified myofascial chains. Clin. Anat. 32:934-940, 2019. © 2019 Wiley Periodicals, Inc.

Effect of high volume stretch-shortening cycle exercise on vertical leg stiffness and jump performance

The study aims were to investigate the effects of muscle damage induced by high-volume stretch-shortening cycle exercise on countermovement jump (CMJ) performance and vertical leg stiffness during squat and landing phases. Changes in the peak torque of knee extensor muscles, soreness, plasma CK activity, vertical leg stiffness, and CMJ characteristics were measured in recreationally active men after 50, 100, 150 and 200 drop jumps (DJs) and again 24 h later. The isometric voluntary peak torque after 50 DJs decreased by 22 ± 12% (p < 0.01). However, during the squat phase of CMJ eccentric peak power and rate of force development together with the concentric mean force during the push-off phase increased after 50 DJs (all p < 0.05). After 200 DJs, jump height and concentric peak power during push-off were decreased (p < 0.05). At 24 h after exercise, jump height, peak eccentric force, the rate of eccentric force development and the mean concentric force in CMJ and vertical leg stiffness in the squat all remained decreased (p < 0.05), while vertical leg stiffness in the landing phase was increased (p < 0.05). Muscle damaging exercise volume is associated with changes in vertical leg stiffness and CMJ performance.

Organization of the fascia and aponeurosis in the lumbar paraspinal compartment

PURPOSE

The thoracolumbar fascia (TLF) and the erector spinae aponeurosis (ESA) play significant roles in the biomechanics of the spine and could be a source of low back pain. Attachment, collagen fiber direction, size and biomechanical properties of the TLF have been well documented. However, questions remain about the attachment of the TLF and ESA in relation to adjoining tissues in the lumbosacral region. Moreover, quantitative data in relation to the ESA have rarely been examined. The aim of this study was to further investigate the anatomical features of the TLF and ESA and to determine the attachments and sliding areas of the paraspinal compartment through dissection.

MATERIALS AND METHODS

In 10 fresh cadavers (6 females, 4 males, mean age: 77 ± 10 years), we determined (1) the gross anatomy of the ESA and the TLF (attachments and sliding areas) and (2) the structure of the ESA and the TLF (thickness, width, orientation of collagen fibers). The pennation angle between the axis of the ES muscle fibers and the axis of the collagen fibers of the ESA were also measured.

RESULTS

The TLF is an irregular dense connective tissue with a mean thickness of 0.95 mm. The distance between the spinous processes line and the site where the neurovascular bundles pierced the TLF, depending on the vertebral level, ranged from 29 mm at L1 to 75 mm at L3. The ESA constituted a band of regular longitudinally oriented connective fibers (mean thickness: 1.85 mm). Muscles fibers of the ES were strongly diagonally attached to the ESA (mean pennation angle 8° for the iliocostalis and 14° for the longissimus). To a lesser extent, the superficial multifidi were attached to the ESA at the lumbar level close to the midline and at the sacral level.

CONCLUSION

The ESA, at twice the thickness of the pTLF, was the thickest dense connective tissue of the paraspinal compartment. The ESA and the TLF circumscribed subcompartments and sliding areas between the TFL and the lumbar paraspinal muscles, between the ES and the multifidus, and between the longissimus and the iliocostalis.

Not merely a protective packing organ? A review of fascia and its force transmission capacity

Recent research indicates that fascia is capable of changing its biomechanical properties. Moreover, as it links the skeletal muscles, forming a body-wide network of multidirectional myofascial continuity, the classical conception of muscles as independent actuators has been challenged. Hence, the present synthesis review aims to characterize the mechanical relevance of the connective tissue for the locomotor system. Results of cadaveric and animal studies suggest a clinically relevant myofascial force transmission to neighboring structures within one limb (e.g., between synergists) and in the course of muscle-fascia chains (e.g., between leg and trunk). Initial in vivo trials appear to underpin these findings, demonstrating the existence of nonlocal exercise effects. However, the factors influencing the amount of transmitted force (e.g., age and physical activity) remain controversial, as well as the role of the central nervous system within the context of the observed remote exercise effects.

Is remote stretching based on myofascial chains as effective as local exercise? A randomised-controlled trial

Lower limb stretching based on myofascial chains has been demonstrated to increase cervical range of motion (ROM) in the sagittal plane. It is, however, unknown whether such remote exercise is as effective as local stretching. To resolve this research deficit, 63 healthy participants (36 ± 13 years, ♂32) were randomly assigned to one of three groups: remote stretching of the lower limb (LLS), local stretching of the cervical spine (CSS) or inactive control (CON). Prior (M1), immediately post (M2) and 5 min following intervention (M3), maximal cervical ROM was assessed. Non-parametric data analysis (Kruskal-Wallis tests and adjusted post hoc Dunn tests) revealed significant differences between the disposed conditions. With one exception (cervical spine rotation after CSS at M2, P > .05), both LLS and CSS increased cervical ROM compared to the control group in all movement planes and at all measurements (P < .05). Between LLS and CSS, no statistical differences were found (P > .05). Lower limb stretching based on myofascial chains induces similar acute improvements in cervical ROM as local exercise. Therapists might consequently consider its use in programme design. However, as the attained effects do not seem to be direction-specific, further research is warranted in order to provide evidence-based recommendations.

Morphological features of fascia lata in relation to fascia diseases

Fascia lata is an important element of the fascial system, which forms the continuum of connective tissue throughout the body. This deep fascia envelops the entire thigh and hip area and its main function is to transmit mechanical forces generated by the musculoskeletal system of the lower extremities. Fascia lata is also known as a useful and easily harvested graft material. Despite its crucial role in lower extremity biomechanics and wide-ranging applications in plastic and reconstructive surgery, both the structure of fascia lata and particularly the cells populating this tissue are relatively unexplored and therefore poorly understood. The aim of this study was to characterize the main cell populations encountered within human fascia lata and to try to understand their role in health and diseases. Pathologically unchanged human fascia lata was obtained post mortem from adult males. The specimens were analyzed under light, electron, and confocal microscopy. On the basis of different visualization techniques, we were able to characterize in detail the cells populating human fascia lata. The main cells found were fibroblasts, fibrocytes, mast cells, cells showing myoid differentiation, nerve cells, and most interestingly, telocytes. Our results supplement the formerly inadequate information in the literature regarding the cellular components of deep fascial structure, may contribute to a better understanding of the pathogenesis of fascial disorders and improve fascia lata application as a graft material.

Determination and Finite Element Validation of the WYPIWYG Strain Energy of Superficial Fascia from Experimental Data

What-You-Prescribe-Is-What-You-Get (WYPIWYG) procedures are a novel and general phenomenological approach to modelling the behavior of soft materials, applicable to biological tissues in particular. For the hyperelastic case, these procedures solve numerically the nonlinear elastic material determination problem. In this paper we show that they can be applied to determine the stored energy density of superficial fascia. In contrast to the usual approach, in such determination no user-prescribed material parameters and no optimization algorithms are employed. The strain energy densities are computed solving the equilibrium equations of the set of experiments. For the case of superficial fascia it is shown that the mechanical behavior derived from such strain energies is capable of reproducing simultaneously the measured load-displacement curves of three experiments to a high accuracy.

Telocytes of Fascial Structures

Currently, the exact role of telocytes within fascial structures is unknown. The morphology, distribution and behaviour of fascial telocytes as well as the mutual relationship between telocytes and other cellular fascia constituents should be definitely a subject of further studies. It will contribute to better understanding of the role of the fascial system in health and diseases, may shed light on the regeneration potential of these tissues and may help to find targets for future treatments for locomotor disorders, including fascial diseases. Last but not least, confirmation of the presence of telocytes within fascia may contribute to optimise the use of fascia as a graft material.

Electron microscopy of human fascia lata: focus on telocytes

From the histological point of view, fascia lata is a dense connective tissue. Although extracellular matrix is certainly the most predominant fascia's feature, there are also several cell populations encountered within this structure. The aim of this study was to describe the existence and characteristics of fascia lata cell populations viewed through a transmission electron microscope. Special emphasis was placed on telocytes as a particular interstitial cell type, recently discovered in a wide variety of tissues and organs such as the heart, skeletal muscles, skin, gastrointestinal tract, uterus and urinary system. The conducted study confirmed the existence of a telocyte population in fascia lata samples. Those cells fulfil main morphological criteria of telocytes, namely, the presence of very long, thin cell processes (telopodes) extending from a relatively small cell body. Aside from telocytes, we have found fibroblasts, mast cells and cells with features of myofibroblastic differentiation. This is the first time it has been shown that telocytes exist in human fascia. Currently, the exact role of those cells within the fascia is unknown and definitely deserves further attention. One can speculate that fascia lata telocytes likewise telocytes in other organs may be involved in regeneration, homeostasis and intracellular signalling.

Kinematic, Cardiopulmonary, and Metabolic Responses of Overweight Runners While Running at Self-Selected and Standardized Speeds

OBJECTIVE

To determine the differences in kinematic, cardiopulmonary, and metabolic responses between overweight and healthy weight runners at a self-selected and standard running speed.

DESIGN

Comparative descriptive study.

SETTING

Tertiary care institution, university-affiliated research laboratory.

PARTICIPANTS

Overweight runners (n = 21) were matched with runners of healthy weight (n = 42).

METHODS

Participants ran at self-selected and standardized speeds (13.6 km/h). Sagittal plane joint kinematics were captured simultaneously with cardiopulmonary and metabolic measures using a motion capture system and portable gas analyzer, respectively.

MAIN OUTCOME MEASUREMENTS

Spatiotemporal parameters (cadence, step width and length, center of gravity displacement, stance time) joint kinematics, oxygen cost, heart rate, ventilation and energy expenditure.

RESULTS

At the self-selected speed, overweight individuals ran slower (8.5 ± 1.3 versus 10.0 ± 1.6 km/h) and had slower cadence (163 versus 169 steps/min; P < .05). The sagittal plane range of motion (ROM) for flexion-extension at the ankle, knee, hip, and anterior pelvic tilt were all less in overweight runners compared to healthy weight runners (all P < .05). At self-selected speed and 13.6 km/h, energy expenditure was higher in the overweight runners compared to their healthy weight counterparts (P < .05). At 13.6 km/h, only the frontal hip and pelvis ROM were higher in the overweight versus the healthy weight runners (P < .05), and energy expenditure, net energy cost, and minute ventilation were higher in the overweight runners compared to the healthy weight runners (P < .05).

CONCLUSION

At self-selected running speeds, the overweight runners demonstrated gait strategies (less joint ROM, less vertical displacement, and shorter step lengths) that resulted in cardiopulmonary and energetic responses similar to those of healthy weight individuals.