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Krammer SM, Drew MD, Brown TN. Effects of prolonged load carriage on angular jerk of frontal and sagittal knee motion. Gait Posture 2021; 84:221-226. [PMID: 33373876 PMCID: PMC7902472 DOI: 10.1016/j.gaitpost.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND During training, service members routinely walk with heavy body borne loads for long periods of time. These loads alter knee biomechanics and may produce jerky knee motions that reportedly increase joint loading and risk of musculoskeletal injury. Yet, it is unknown if service members use jerky knee motions during prolong walking with body borne load. RESEARCH QUESTION To quantify the effects of body borne load and duration of walking on the jerkiness of sagittal and frontal plane knee motion. METHODS Eighteen participants had angular jerk of knee motion quantified while they walked (1.3 m/s) for 60-min with three body borne loads (0, 15, and 30 kg). Peak and cost of angular jerk for sagittal and frontal plane knee motion was quantified and submitted to a repeated measures linear model to test the main effects and interaction of load (0, 15, and 30 kg) and time (0, 15, 30, 45, and 60 min). RESULTS Body borne load increased peak and cost of angular jerk for sagittal plane knee motion up to 35 % and 110 %, respectively, and frontal plane knee motion up to 20 % and 51 %, respectively (all p<0.001), while jerk cost of frontal plane knee motion (p=0.001) increased 31 % after walking 45 min. SIGNIFICANCE Body borne load produced large (between 20 % and 110 %), incremental increases in angular jerk for both sagittal and frontal plane knee motion; whereas, duration of walking led to a 31 % increase in jerkiness of frontal plane knee motion. Service members who often walking for long periods of time with heavy body borne loads may have greater risk of developing musculoskeletal injury and disease due to large increases in jerky knee motions.
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Affiliation(s)
| | - Micah D. Drew
- Dept. of Kinesiology, Boise State University, Boise, ID, USA
| | - Tyler N. Brown
- Dept. of Kinesiology, Boise State University, Boise, ID, USA
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Costello KE, Eigenbrot S, Geronimo A, Guermazi A, Felson DT, Richards J, Kumar D. Quantifying varus thrust in knee osteoarthritis using wearable inertial sensors: A proof of concept. Clin Biomech (Bristol, Avon) 2020; 80:105232. [PMID: 33202314 PMCID: PMC7749075 DOI: 10.1016/j.clinbiomech.2020.105232] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/14/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Varus thrust during walking, visualized as excessive frontal plane knee motion during weight acceptance, is a modifiable risk factor for progression of knee osteoarthritis. However, visual assessment does not capture thrust severity and quantification with optical motion capture is often not feasible. Inertial sensors may provide a convenient alternative to optical motion capture. This proof-of-concept study sought to compare wearable inertial sensors to optical motion capture for the quantification of varus thrust. METHODS Twenty-six participants with medial knee osteoarthritis underwent gait analysis at self-selected and fast speeds. Linear regression with generalized estimating equations assessed associations between peak knee adduction velocity or knee adduction excursion from optical motion capture and peak thigh or shank adduction velocity from two inertial sensors on the lower limb. Relationships between inertial measures and peak external knee adduction moment were assessed as a secondary aim. FINDINGS Both thigh and shank inertial sensor measures were associated with the optical motion capture measures for both speeds (P < 0.001 to P = 0.020), with the thigh measures having less variability than the shank. After accounting for age, sex, body mass index, radiographic severity, and limb alignment, thigh adduction velocity was also associated with knee adduction moment at both speeds (both P < 0.001). INTERPRETATION An inertial sensor placed on the mid-thigh can quantify varus thrust in people with medial knee osteoarthritis without the need for optical motion capture. This single sensor may be useful for risk screening or evaluating the effects of interventions in large samples.
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Affiliation(s)
- Kerry E Costello
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, USA; Division of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Samantha Eigenbrot
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, USA
| | - Alex Geronimo
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, USA
| | - Ali Guermazi
- Division of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, VA Boston Healthcare System, Boston University School of Medicine, Boston, MA, USA
| | - David T Felson
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, USA; Division of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Jim Richards
- Allied Health Research Unit, School of Sport and Health Sciences, University of Central Lancashire, Preston, UK
| | - Deepak Kumar
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, USA; Division of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
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Fain AC, Lobb NJ, Seymore KD, Brown TN. Sex and limb differences during a single-leg cut with body borne load. Gait Posture 2019; 74:7-13. [PMID: 31437734 DOI: 10.1016/j.gaitpost.2019.07.198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/08/2019] [Accepted: 07/16/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Military personnel don body borne loads that produce maladaptive lower limb biomechanics, increasing risk of musculoskeletal injury during common training tasks. Female personnel have over twice the injury risk as males, but it is unknown if a sex dimorphism in lower limb biomechanics exists during common training-related tasks. RESEARCH QUESTION To determine whether lower limb biomechanics exhibited during a single-leg cut with military body borne loads differ between sexes. METHODS Sixteen females and 20 males had lower limb biomechanics quantified during five single-leg cuts off each limb with four loads (20, 25, 30 and 35 kg). Each cut required participants run 4 m/s, before planting their foot on a force platform and cut 45° towards the opposite limb. Lower limb biomechanics related to musculoskeletal injury were submitted to a repeated measures ANOVA to test for main and interaction effects of load, sex, and limb. RESULTS During the cut, load increased peak proximal anterior tibial shear force (p < 0.001) and peak hip flexion (p = 0.010) and knee abduction (p = 0.045) moments, but decreased peak knee flexion angle (p = 0.032). Females exhibited greater peak proximal anterior tibial shear (p = 0.014), and peak hip adduction (p < 0.001) and knee external rotation (p = 0.001) moment than males. Dominant limb exhibited larger peak hip adduction (p = 0.002); whereas, the non-dominant limb exhibited greater peak hip internal (p = 0.002) and knee external (p = 0.007) rotation moments. Only the non-dominant limb increased peak knee abduction moment (p = 0.001) with additional load. SIGNIFICANCE During the cut, adding body borne load produced maladaptive biomechanics that may increase knee musculoskeletal injury risk. Load increased peak proximal tibial shear and potential strain of knee's soft-tissues. Females exhibited a sex dimorphism in lower limb biomechanics that may further elevate their injury risk. Both limbs exhibited biomechanics that may increase injury risk, but only the non-dominant limb further increased injury risk with load.
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Affiliation(s)
- AuraLea C Fain
- Dept. of Kinesiology, Boise State University, 1910 University Drive, Boise, ID, 83702, USA.
| | - Nicholas J Lobb
- Dept. of Kinesiology, Boise State University, 1910 University Drive, Boise, ID, 83702, USA.
| | - Kayla D Seymore
- Dept. of Kinesiology, Boise State University, 1910 University Drive, Boise, ID, 83702, USA.
| | - Tyler N Brown
- Dept. of Kinesiology, Boise State University, 1910 University Drive, Boise, ID, 83702, USA.
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Lobb NJ, Fain AC, Seymore KD, Brown TN. Sex and stride length impact leg stiffness and ground reaction forces when running with body borne load. J Biomech 2019; 86:96-101. [DOI: 10.1016/j.jbiomech.2019.01.048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/10/2019] [Accepted: 01/26/2019] [Indexed: 11/26/2022]
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Lenton GK, Bishop PJ, Saxby DJ, Doyle TLA, Pizzolato C, Billing D, Lloyd DG. Tibiofemoral joint contact forces increase with load magnitude and walking speed but remain almost unchanged with different types of carried load. PLoS One 2018; 13:e0206859. [PMID: 30395591 PMCID: PMC6218072 DOI: 10.1371/journal.pone.0206859] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/19/2018] [Indexed: 11/25/2022] Open
Abstract
Musculoskeletal injuries (MSI) in the military reduce soldier capability and impose substantial costs. Characterizing biomechanical surrogates of MSI during commonly performed military tasks (e.g., load carriage) is necessary for evaluating the effectiveness of possible interventions to reduce MSI risk. This study determined the effects of body-borne load distribution, load magnitude, and walking speed on tibiofemoral contact forces. Twenty-one Australian Army Reserve soldiers completed a treadmill walking protocol in an unloaded condition and wearing four armor types (standard-issue and three prototypes) with two load configurations (15 and 30 kg) for a total of 8 armor x load ensembles. In each ensemble, participants completed a 5-minute warm-up, and then walked for 10 minutes at both moderate (1.53 m⋅s-1) and fast (1.81 m⋅s-1) speeds. During treadmill walking, three-dimensional kinematics, ground reaction forces, and muscle activity from nine lower-limb muscles were collected in the final minute of each speed. These data were used as inputs into a neuromusculoskeletal model, which estimated medial, lateral and total tibiofemoral contact forces. Repeated measures analyses of variance revealed no differences for any variables between armor types, but peak medial compartment contact forces increased when progressing from moderate to fast walking and with increased load (p<0.001). Acute exposure to load carriage increased estimated tibiofemoral contact forces 10.1 and 19.9% with 15 and 30kg of carried load, respectively, compared to unloaded walking. These results suggest that soldiers carrying loads in excess of 15 kg for prolonged periods could be at greater risk of knee MSI than those with less exposure.
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Affiliation(s)
- Gavin K. Lenton
- Gold Coast Orthopaedics Research, Engineering and Education Alliance, Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
- * E-mail:
| | - Peter J. Bishop
- Gold Coast Orthopaedics Research, Engineering and Education Alliance, Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
| | - David J. Saxby
- Gold Coast Orthopaedics Research, Engineering and Education Alliance, Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
| | - Tim L. A. Doyle
- Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia
| | - Claudio Pizzolato
- Gold Coast Orthopaedics Research, Engineering and Education Alliance, Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
| | - Daniel Billing
- Land Division, Defence Science and Technology Group, Fishermans Bend, VIC, Australia
| | - David G. Lloyd
- Gold Coast Orthopaedics Research, Engineering and Education Alliance, Menzies Health Institute Queensland, School of Allied Health Sciences, Griffith University, Southport, Queensland, Australia
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