Gait variability and symmetry remain consistent during high-intensity 10,000 m treadmill running

Constant low-to-moderate mechanical asymmetries during 800-m track running

Introduction

Modifications in asymmetry in response to self-paced efforts have not been thoroughly documented, particularly regarding horizontally-derived ground reaction force variables. We determined the magnitude and range of gait asymmetries during 800 m track running.

Methods

Eighteen physical education students completed an 800 m self-paced run on a 200 m indoor track. During the run, vertical and horizontal ground reaction forces were measured at a sampling frequency of 500 Hz using a 5 m-long force platform system, with data collected once per lap. The following mechanical variables were determined for two consecutive steps: contact time and duration of braking/push-off phases along with vertical/braking/push-off peak forces and impulses. The group mean asymmetry scores were evaluated using the "symmetry angle" (SA) formula, where scores of 0% and 100% correspond to perfect symmetry and perfect asymmetry, respectively.

Results

There was no influence of distance interval on SA scores for any of the nine biomechanical variables (P ≥ 0.095). The SA scores were ∼1%-2% for contact time (1.3 ± 0.5%), peak vertical forces (1.8 ± 0.9%), and vertical impulse (1.7 ± 1.0%). The SA scores were ∼3%-8% for duration of braking (3.6 ± 1.1%) and push-off (3.2 ± 1.4%) phases, peak braking (5.0 ± 2.1%) and push-off (6.9 ± 3.1%) forces as well as braking (7.6 ± 2.3%) and push-off (7.7 ± 3.3%) impulses. The running velocity progressively decreased at 300 m and 500 m compared to that at 100 m but levelled off at 700 m (P < 0.001).

Discussion

There were no modifications in gait asymmetries, as measured at 200-m distance intervals during 800-m track running in physical education students. The 800 m self-paced run did not impose greater mechanical constraints on one side of the body. Experimental procedures for characterizing the gait pattern during 800 m track running could be simplified by collecting leg mechanical data from only one side.

Mechanical asymmetries remain low-to-moderate during 30 min of self-paced treadmill running

Introduction: We characterized the magnitude and range of gait asymmetry during self-paced treadmill running. Methods: On an instrumented treadmill, twelve trained runners (11 males, 1 female) completed a 30-min self-paced run, during which participants were instructed to cover the most distance possible. Ground reaction force recordings at a constant velocity corresponding to 70% of their maximal aerobic velocity (13.3 ± 0.8 km.h-1) allowed for the measurement of running kinetics and kinematics, as well as the calculation of spring-mass characteristics at the beginning, middle, and end of the run (minutes 1, 14, and 29, respectively). Group mean asymmetry scores were assessed using the "symmetry angle" (SA) formulae, where scores of 0% and 100% represent perfect symmetry and perfect asymmetry, respectively. Results: There was no time effect on SA scores for any of the 13 biomechanical variables (p ≥ 0.128). Mean SA scores were <2.5% for contact time (0.8% ± 0.7%), flight time (1.4% ± 0.6%), step frequency (0.7% ± 0.3%), duty factor (0.7% ± 0.3%), duration of braking (1.3% ± 0.7%) and push-off phases (0.9% ± 0.8%), as well as peak braking (2.3% ± 1.3%) and push-off forces (1.4% ± 0.9%). Mean SA scores were ≥2.5% for peak vertical loading rate (3.1% ± 1.7%), mean vertical loading rate (3.4% ± 2.1%), peak vertical forces (2.9% ± 2.2%), as well as vertical stiffness (5.2% ± 3.5%) and leg stiffness (2.5% ± 1.5%). Conclusion: Throughout a 30-min running time trial, there were consistently low-to-moderate mechanical asymmetries for spatiotemporal variables, kinetics, and spring-mass model characteristics. This suggests that trained runners maintained relatively even strides during the self-paced treadmill run, with lower extremities behaving similarly when controlling for velocity.

The one-week and three-month reliability of acceleration outcomes from an insole-embedded inertial measurement unit during treadmill running

Inertial measurement units (IMUs) represent an exciting opportunity for researchers to broaden our understanding of running-related injuries, and for clinicians to expand their application of running gait analysis. The primary aim of our study was to investigate the 1-week (short-term) and 3-month (long-term) reliability of peak resultant, vertical, and anteroposterior accelerations derived from insole-embedded IMUs. The secondary aim was to assess the reliability of peak acceleration variability and left-right limb symmetry in all directions over the short and long term. A sample of healthy adult rearfoot runners (n = 23; age 41.7 ± 11.2 years) ran at a variety of speeds (2.5 m/s, 3.0 m/s, and 3.5 m/s) on a treadmill in standardised footwear with insole-embedded IMUs in each shoe. Peak accelerations exhibited good to excellent short-term reliability and moderate to excellent long-term reliability in all directions. Peak acceleration variability showed poor to good short- and long-term reliability, whereas the symmetry of peak accelerations demonstrated moderate to excellent and moderate to good short- and long-term reliability, respectively. Our results demonstrate how insole-embedded IMUs represent a viable option for clinicians to measure peak accelerations within the clinic.

Monitoring lower limb biomechanical asymmetry and psychological measures in athletic populations-A scoping review

BACKGROUND

Lower limb biomechanics, including asymmetry, are frequently monitored to determine sport performance level and injury risk. However, contributing factors extend beyond biomechanical and asymmetry measures to include psychological, sociological, and environmental factors. Unfortunately, inadequate research has been conducted using holistic biopsychosocial models to characterize sport performance and injury risk. Therefore, this scoping review summarized the research landscape of studies concurrently assessing measures of lower limb biomechanics, asymmetry, and introspective psychological state (e.g., pain, fatigue, perceived exertion, stress, etc.) in healthy, competitive athletes.

METHODS

A systematic search of MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science Core Collections was designed and conducted in accordance with PRISMA guidelines. Fifty-one articles were included in this review.

RESULTS

Significant relationships between biomechanics (k = 22 studies) or asymmetry (k = 20 studies) and introspective state were found. Increased self-reported pain was associated with decreased range of motion, strength, and increased lower limb asymmetry. Higher ratings of perceived exertion were related to increased lower limb asymmetry, self-reported muscle soreness, and worse jump performance. Few studies (k = 4) monitored athletes longitudinally throughout one or more competitive season(s).

CONCLUSION

This review highlights the need for concurrent analysis of introspective, psychological state, and biomechanical asymmetry measures along with longitudinal research to understand the contributing factors to sport performance and injury risk from biopsychosocial modeling. In doing so, this framework of biopsychosocial preventive and prognostic patient-centered practices may provide an actionable means of optimizing health, well-being, and sport performance in competitive athletes.

Asymmetries of foot strike patterns during running in high-level female and male soccer players

BACKROUND

Foot strike pattern (FSP) is defined by the way the foot makes initial ground contact and is influenced by intrinsic and extrinsic factors. This study investigated the effect of running speed on asymmetries of FSP.

METHODS

Seventeen female and nineteen male soccer players performed an incremental running test on an instrumented treadmill starting at 2.0 m/s until complete exhaustion. Force plate data were used to categorize foot strikes into rearfoot (RFS) and non-rearfoot strikes. Additionally, peak vertical ground reaction force (peakGRF) and stride time were calculated. The symmetry index (SI) was used to quantify lateral asymmetries between legs.

RESULTS

The SI indicated asymmetries of the rate of RFS (%RFS) of approximately 30% at slow running speed which decreased to 4.4% during faster running speed (p = 0.001). There were minor asymmetries in peakGRF and stride time at each running stage. Running speed influenced %RFS (p < 0.001), peakGRF (p < 0.001) and stride time (p < 0.001). Significant interaction effects between running speed and sex were shown for %RFS (p = 0.033), peakGRF (p < 0.001) and stride time (p = 0.041).

CONCLUSION

FSP of soccer players are asymmetric at slower running speed, but symmetry increases with increasing speed. Future studies should consider that FSP are non-stationary and influenced by running speed but also differ between legs.

Stride-to-stride variability and fluctuations at intensities around lactate threshold in distance runners

Stride-to-stride variability and fluctuations in running have been widely investigated in relation to fatigue, injury, and other factors. However, no studies have examined the relationship of stride-to-stride variability and fluctuations with lactate threshold (LT), a well-known performance indicator for distance runners that represents the threshold at which fast-twitch muscle fibers are activated and the glycolytic system is hyperactivated. In this study, we examined a relationship between LT and stride-to-stride variability and fluctuations in trained middle- and long-distance runners (n = 33). All runners were asked to perform multistage graded exercise tests while wearing accelerometers on the upper surface of their shoes. The LT was determined by measuring blood lactate concentrations after each stage. Three gait parameters for each step were calculated based on the acceleration data: stride time (ST), ground contact time (CT), and peak acceleration (PA). The coefficient of variation (CV) and the long-range correlations (α) for each parameter were also calculated. The effects of the runner's group and the relative intensity for CV and α on gait parameters were evaluated using a two-way repeated measures analysis of variance. Although no significant effect was observed in the CV and α of ST, significant intensity main effects were observed for the CV and α of CT and PA. The lack of significant changes in ST might be the result of runners' adequate control of ST to minimize energy cost. All the parameters showing significant changes with increasing intensity decreased dramatically when they were close to LT. This might have been caused by an increase in physiological load near LT and be interpreted as a variation in motor control because of alternations in the mobilized muscle fibers and physiological changes around the LT. The α should be useful for non-invasive LT detection.

Kinematic and muscle force asymmetry in healthy runners: How do different methods measure up?

BACKGROUND

Comparing the performance of one leg to another is a common means of assessing running gait to help inform clinical management strategies. Various methods are employed to quantify asymmetries between limbs. However, limited data is available describing the amount of asymmetry that may be expected during running and no index has been identified as preferable for making a clinical determination of asymmetry. Therefore, this study aimed to describe amounts of asymmetry in collegiate cross-country runners and compare different methods of calculating asymmetry.

RESEARCH QUESTION

What can be expected as a normal amount of asymmetry in biomechanical variables in healthy runners when using different indices to quantify limb symmetry?

METHODS

Sixty-three (29 male and 34 female) runners participated. Running mechanics were assessed during overground running using 3D motion capture and a musculoskeletal model using static optimization to estimate muscle forces. Independent t-tests were utilized to determine statistical differences in variables between legs. Different methods of quantifying asymmetry were then compared to statistical differences between limbs to determine cut-off values and the sensitivity and specificity of each method.

RESULTS

A large portion of runners demonstrated asymmetry during running. Kinematic variables can be expected to have small differences (2-3 degrees) between limbs while muscle forces may show greater amounts of asymmetry. The sensitivities and specificities for each method of calculating asymmetry were similar, however, different methods led to different cut-off values for each variable investigated.

SIGNIFICANCE

Asymmetry can be expected between limbs during running. However, when assessing asymmetry, practitioners should consider the joint, variable, and method of calculating asymmetry when determining differences between limbs.

Acute effects of a 60-min time trial on power-related parameters in trained endurance runners

Background

The advent of power meters for running has raised the interest of athletes and coaches in new ways of assessing changes in running performance. The aim of this study is to determine the changes in power-related variables during and after a strenuous endurance running time trial.

Methods

Twenty-one healthy male endurance runners, with a personal record of 37.2 ± 1.2 min in a 10-km race, completed a 1-h run on a motorized treadmill trying to cover as much distance as they could. Before and after the time trial the athletes were asked to perform a 3-min run at 12 km h⁻¹. Normalized mean power output, step frequency, form power and running effectiveness were calculated using the Stryd™ power meter. Heart rate (HR) and rating of perceived exertion (RPE) were monitored, and data averaged every 5 min.

Results

Despite high levels of exhaustion were reached during the time trial (HRpeak = 176.5 ± 9.8 bpm; RPE = 19.2 ± 0.8), the repeated measures ANOVA resulted in no significant differences (p ≥ 0.05), between each pair of periods for any of the power-related variables. The pairwise comparison (T test) between the non-fatigued and fatigued constant 3-min runs showed an increase in step frequency (p = 0.012) and a decrease in form power (p < 0.001) under fatigue conditions, with no meaningful changes in normalized mean power output and running effectiveness.

Conclusions

Trained athletes are able to maintain power output and running effectiveness during a high demanding extended run. However, they preferred to reduce the intensity of vertical impacts under fatigue conditions by increasing their step frequency.

Identification of Secondary Biomechanical Abnormalities in the Lower Limb Joints after Chronic Transtibial Amputation: A Proof-of-Concept Study Using SPM1D Analysis

SPM is a statistical method of analysis of time-varying human movement gait signal, depending on the random field theory (RFT). MovementRx is our inhouse-developed decision-support system that depends on SPM1D Python implementation of the SPM (spm1d.org). We present the potential application of MovementRx in the prediction of increased joint forces with the possibility to predispose to osteoarthritis in a sample of post-surgical Transtibial Amputation (TTA) patients who were ambulant in the community. We captured the three-dimensional movement profile of 12 males with TTA and studied them using MovementRx, employing the SPM1D Python library to quantify the deviation(s) they have from our corresponding reference data, using "Hotelling 2" and "T test 2" statistics for the 3D movement vectors of the 3 main lower limb joints (hip, knee, and ankle) and their nine respective components (3 joints × 3 dimensions), respectively. MovementRx results visually demonstrated a clear distinction in the biomechanical recordings between TTA patients and a reference set of normal people (ABILITY data project), and variability within the TTA patients' group enabled identification of those with an increased risk of developing osteoarthritis in the future. We conclude that MovementRx is a potential tool to detect increased specific joint forces with the ability to identify TTA survivors who may be at risk for osteoarthritis.

Running-induced fatigue and impact loading in runners: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to synthesise and clarify the effect of running-induced fatigue on impact loading during running. Eight electronic databases were systematically searched until April 2021. Studies that analysed impact loading over the course of a run, in adult runners free of medical conditions were included. Changes in leg stiffness, vertical stiffness, shock attenuation, peak tibial accelerations, peak ground reaction forces (GRF) and loading rates were extracted. Subgroup analyses were conducted depending on whether participants were required to run to exhaustion. Thirty-six studies were included in the review, 25 were included in the meta-analysis. Leg stiffness decreased with running-induced fatigue (SMD -0.31, 95% CI -0.52, -0.08, moderate evidence). Exhaustive and non-exhaustive subgroups were different for peak tibial acceleration (Chi² = 3.79, p = 0.05), with limited evidence from exhaustive subgroups showing an increase in peak tibial acceleration with fatigue. Findings for vertical GRF impact peak and peak braking force were conflicting based on exhaustive and non-exhaustive protocols (Chi² = 3.83, p = 0.05 and Chi² = 5.10, p = 0.02, respectively). Moderate evidence suggests leg stiffness during running decreases with fatigue. Given the non-linear relationship between leg stiffness and running economy, this may have implications for performance.

Comparisons of Gait Variability and Symmetry in Healthy Runners, Runners with a History of Lower Limb Injuries, and Runners with a Current Lower Limb Injury

Background: Running is a cyclic movement requiring bilateral symmetry between the lower limbs to reduce injury risk. The assessment of side-to-side differences is often performed to detect functional deficits. Objectives: The purpose was to study side-to-side differences using clinical and running performance assessments in healthy runners (HR), runners with a history of lower limb injuries (RHI), and runners with a current lower limb injury (RLI). Methods: Forty-three runners were recruited, with 14 participants being allocated to the HR group, 13 to the RHI group, and 16 to the RLI group. Peak vertical ground reaction force (GRF), midfoot pressure, foot rotation, and gait variability were recorded using a Zebris FDM-T treadmill analysis system. Participants were also assessed using the navicular drop test. Dependent t-tests were used to determine if any differences existed between the lower limbs within each group. One-way ANOVAs were then used to investigate the side-to-side differences between the three groups. Results: Significant differences were seen in navicular drop height between lower limbs within both the HR (P = 0.02) and RHI (P = 0.009) groups, and side-to-side differences in foot rotation were greatest in the RLI group (~34%) compared to both the RHI (~30.5%) and HR (~24%) groups. The lateral variability of the center of pressure was greatest in the RLI group (37.1 mm) compared to the RHI (28.9 mm) and HR (22.2 mm) groups. Conclusions: Variability of butterfly center of pressure diagram may help identify runners at a greater risk of lower limb injury. Side-to-side differences should be expected to progressively decrease from the injured stage, through the recovery and return to sport phases. Target goals of less than 34% side-to-side difference for foot rotation and 37.1 mm for the lateral center of pressure variability may be used to help the decision-making process when considering a return to running practice.

Asymmetry in sprinting: An insight into sub-10 and sub-11 s men and women sprinters

We assessed sprint mechanical asymmetry in world-class competitors and evaluated whether inter-limb sex-based differences in sprinting mechanics exist. The eight finalists in the men's and women's 100 m events at the 2017 IAAF World Championships were studied. Five high-speed cameras (150 Hz) were used to capture two consecutive steps of the whole body between 47.0 m and 55.5 m from the start, while four additional cameras (250 Hz) focussed on the lower extremities. A total of 33 spatio-temporal, touchdown and toe-off joint angles, and horizontal and vertical foot velocity parameters were extracted through three-dimensional analysis. Group mean asymmetry scores were assessed using the symmetry angle (SA) where scores of 0% and 100% represent perfect symmetry and perfect asymmetry, respectively. Although considered generally low (SA <3% for 22 out of 33 parameters), the magnitude of mechanical asymmetry varied widely between sprinters of the same sex. However, there was no mean SA scores difference between men and women for any stride mechanical parameters (all p ≥ 0.064). Asymmetry scores were inconsistent between parameters and phases (touchdown vs toe-off instants), and sprinting mechanics were generally not related to asymmetry magnitudes. In summary, low to moderate asymmetry is a natural phenomenon in elite sprinting. Asymmetry was inconsistent between parameters and competitors during near maximum velocity running, yet mean values for a given parameter generally did not differ between sexes. Sprinters' performances were not related to their SA scores.

Strides to Achieve a Stable Symmetry Index During Running

CONTEXT

The quality of running mechanics is often characterized by limb pattern symmetry and used to support clinical decisions throughout the rehabilitation of lower-extremity injuries. It is valuable to ensure that gait analyses provide stable measures while not asking an individual to complete an excessive number of running strides. The present study aimed to determine the minimum number of strides required to establish a stable mean symmetry index (SMSI) of discrete-level measures of spatiotemporal parameters, joint kinematics, and joint kinetics. Further, the study aimed to determine if differences occurred between random and consecutive strides for directional and absolute symmetry indices.

DESIGN

Descriptive laboratory study.

METHODS

A sequential average was used to determine how many strides were required to achieve a SMSI within a 60-second trial. Multiple 2-factor repeated-measure analysis of variances were used to determine if differences between bins of strides and symmetry calculations were significantly different.

RESULTS

A median SMSI was achieved in 15 strides for all biomechanical variables. There were no significant differences (P > .05) found between consecutive and random bins of 15 strides within a 60-second trial. Although there were significant differences between symmetry calculation values for most variables (P < .05), there appeared to be no systematic difference between the numbers of strides required for stable symmetry for either index.

CONCLUSIONS

As 15 strides were sufficient to achieve a SMSI during running, a continued emphasis should be placed on the number of strides collected when examining interlimb symmetry.

Lower Extremity Kinematic and Kinetic Asymmetries during Running

PURPOSE

The primary aims of this investigation were to describe the magnitude of asymmetries of common variables during running among healthy athletes and to determine if sex and speed influence magnitudes of asymmetry.

METHODS

This study analyzed routinely collected running gait data on healthy Division I collegiate athletes. All athletes had no history of lower extremity surgery, no lower extremity injuries for 3 months before testing, and running data available at 2.68, 2.95, 3.35, 3.80, and 4.47 m·s-1. Asymmetries were calculated for ground reaction forces, spatiotemporal metrics, joint kinematics, and joint kinetics. Separate linear mixed-effects models assessed the influence of sex, speed, and the interaction on asymmetries of interest. z Scores were calculated for significant effects to further assess the magnitude of differences.

RESULTS

Results from 204 athletes were included. The magnitude of asymmetry varied depending on the variable of interest, with asymmetries ≤3° observed for joint kinematics and greater asymmetries observed among joint work asymmetries ranging from 10% to 40%. No significant interactions between sex and speed were observed. Differences in sex and speed were noted; however, the effect sizes were very small based on z score comparison (-0.17 ≤ z ≤ 0.36) and were unlikely to be meaningful.

CONCLUSIONS

The magnitude of asymmetry varies considerably depending on the running gait variable. Interpretation of between-limb asymmetry in running mechanics needs to be specific to the variable of interest, whereas sex or running speed seem to be minor factors.

Fatigue-Related Changes in Spatiotemporal Parameters, Joint Kinematics and Leg Stiffness in Expert Runners During a Middle-Distance Run

Fatigue with its underlying mechanisms and effects is a broadly discussed topic and an important phenomenon, particularly in endurance sports. Although several studies have already shown a variety of changes in running kinematics with fatigue, few of them have analyzed competitive runners and even fewer have focused on middle-distance running. Furthermore, the studies investigating fatigue-related changes have mostly reported the results in terms of discrete parameters [e.g., range of motion (RoM)] in the frontal or sagittal plane, and therefore potentially overlooked effects occurring in subphases of the gait cycle or in the transverse plane. On this basis, the goal of the present study was to analyze the effects of exhaustive middle-distance running on expert runners by means of both discrete parameters and time series analysis in 3D. In this study, 13 runners ran on a treadmill to voluntary exhaustion at their individually determined fatigue speeds which was held constant during the measurements. Kinematic data were collected by means of a 3D motion capture system. Spatiotemporal and stiffness parameters as well as the RoM of joints and of center of mass (CoM) within the stance and flight phases were calculated. Independent t-tests were performed to investigate any changes in means and coefficients of variation (CV) of these parameters between the rested (PRE) and fatigued (POST) state. Statistical parametric mapping method was applied on the time series data of the joints and the CoM. Results from this exploratory study revealed that during a middle-distance run, expert runners change their stance time, rather than their step frequency or step length in order to maintain the constant running speed as long as possible. Increased upper body movements occurred to counteract the increased angular moment of the lower body possibly due to longer stance times. These findings provide insights into adaptation strategies of expert runners during a fatiguing middle-distance run and may serve a valuable information particularly for comparisons with other group of runners (e.g., females or non-athletes) as well with other conditions (e.g., non-constant speed or interval training), and might be useful for the definition of training goals (e.g., functional core training).

Validity and Reliability of an Instrumented Treadmill with an Accelerometry System for Assessment of Spatio-Temporal Parameters and Impact Transmission

Running retraining programs focused on concurrent feedback of acceleration impacts have been demonstrated to be a good strategy to reduce running-related injuries (RRI), as well as to improve running economy and reduce acceleration impacts and injury running incidence. Traditionally, impacts have been registered by mean of accelerometers attached directly to the athletes, which is inaccessible to the entire population, because it requires laboratory conditions. This study investigated the validity and reliability of a new device integrated directly into the treadmill, compared to a traditional acceleration impact system. Thirty healthy athletes with no history of RRI were tested on two separate days over the instrumented treadmill (AccTrea) and simultaneously with an acceleration impact system attached to the participant (AccAthl). AccTrea was demonstrated to be a valid and reliable tool for measuring spatio-temporal parameters like step length (validity intraclass correlation coefficient (ICC) = 0.94; reliability ICC = 0.92), step time (validity ICC = 0.95; reliability ICC = 0.96), and step frequency (validity ICC = 0.95; reliability ICC = 0.96) during running. Peak acceleration impact variables showed a high reliability for the left (reliability ICC = 0.88) and right leg (reliability ICC = 0.85), and peak impact asymmetry showed a modest validity (ICC = 0.55). These results indicated that the AccTrea system is a valid and reliable way to assess spatio-temporal variables, and a reliable tool for measuring acceleration impacts during running.

Development of Machine Learning Algorithms for the Determination of the Centre of Mass

The study of the human body and its movements is still a matter of great interest today. Most of these issues have as their fulcrum the study of the balance characteristics of the human body and the determination of its Centre of Mass. In sports, a lot of attention is paid to improving and analysing the athlete’s performance. Almost all the techniques for determining the Centre of Mass make use of special sensors, which allow determining the physical magnitudes related to the different movements made by athletes. In this paper, a markerless method for determining the Centre of Mass of a subject has been studied, comparing it with a direct widely validated equipment such as the Wii Balance Board, which allows determining the coordinates of the Centre of Pressure. The Motion Capture technique was applied with the OpenPose software, a Computer Vision method boosted with the use of Convolution Neural Networks. Ten quasi-static analyses have been carried out. The results have shown an error of the Centre of Mass position, compared to that obtained from the Wii Balance Board, which has been considered acceptable given the complexity of the analysis. Furthermore, this method, despite the traditional methods based on the use of balances, can be used also for prediction of the vertical position of the Centre of Mass.

Fatigue-Induced Inter-Limb Asymmetries in Strength of the Hip Stabilizers, Postural Control and Gait Following a Unilateral Countermovement Vertical Jump Protocol

It is generally accepted that neuromuscular overload and fatigue of one lower limb can affect the functional ability of the ipsilateral limb, and possibly the contralateral limb, increasing the likelihood of injury. The purpose of the current study was to examine the effect of a unilateral countermovement vertical jump (UCVJ) fatigue protocol on the neuromuscular function of the ipsilateral as well as the contralateral lower limb. The isometric strength of the hip stabilizers, postural control via posturographic analysis during the Y-Balance-Test (YBT), and the stance-phase-of-gait were assessed in 24 healthy physical active males and females before and after execution of a UCVJ fatigue protocol. The fatigue protocol included 5 sets of 20 maximum UCVJs performed on the supportive leg, with a 30-s break between sets. Following a 16.8% decline in vertical jump performance and an associated 2.3-fold increase in perceived exertion, our findings revealed significant post-fatigue inter-limb differences regarding postural control. The post-fatigue inter-limb differences regarding the isometric strength of the hip stabilizers and the stance-phase-of-gait parameters were not significant. Our findings showed that a 100 UCVJs session is likely to induce significant inter-limb differences in postural control, possibly increasing the risk of lower limb injury.

The Influence of Exercise-Induced Fatigue on Inter-Limb Asymmetries: a Systematic Review

BACKGROUND

Non-contact injuries such as anterior cruciate ligament ruptures often occur during physical load toward the end of a match. This is ascribed to emerging processes due to exercise-induced fatigue. Moreover, non-contact injuries often occur during dynamic actions such as landing or cutting movements. Inter-limb asymmetries are suggested as one possible cause for those injuries based on findings indicating that asymmetries between limbs are associated with a higher injury risk. Hence, assessing inter-limb asymmetry during physical load in the condition of exercise-induced fatigue is warranted to identify potentially relevant precursors for non-contact injuries.

OBJECTIVE

The objective of this study was to overview the current state of evidence concerning the influence of exercise-induced fatigue on inter-limb asymmetries through a systematic review.

METHODS

A systematic literature search was conducted using the databases Web of Science, Scopus, PubMed, SURF, and SPONET to identify studies that assessed inter-limb asymmetries of healthy people, calculated with an asymmetry equation, before and after, or during a loading protocol.

RESULTS

Thirteen studies were included in the systematic review. The loading protocols involved running, race walking, jumping, squatting, soccer, rowing, and combinations of different exercises. Moreover, different tasks/procedures were used to assess inter-limb asymmetries, e.g., squats, single-leg countermovement jumps, gait analysis, or isokinetic strength testing. The results seem to depend on the implemented loading protocol, the tasks/procedures, and the measured parameters.

CONCLUSIONS

Future research needs more systematization and consistency, assessing the effect of exercise-induced fatigue on inter-limb asymmetries. Moreover, the emergence of inter-limb asymmetries should be regarded in the context of sport-specific movements/tasks. Testing before, after, and during a physical loading protocol is advisable to consider the influence of exercise-induced fatigue on sport-specific tasks and to identify the possible mechanisms underlying load-dependent inter-limb asymmetries with regard to risk of non-contact injury.

Increases in speed do not change gait symmetry or variability in world-class race walkers

The aim of this study was to analyse changes in gait variability and symmetry with increasing speed in race walkers. Eighteen international athletes race walked on an instrumented treadmill at speeds of 11, 12, 13 and 14 km·h^-1 in a randomised order for 3 min each. Spatiotemporal and ground reaction force data were recorded for 30 s at each speed. Gait variability was measured using median absolute deviation and inter-leg symmetry was measured using the symmetry angle. There was an overall effect of speed on all absolute values except push-off force, but symmetry and variability (except flight time) did not change with increased speed, step length and step frequency. Most athletes were asymmetrical for at least one variable, but none was asymmetrical for more than half of the variables measured. Therefore, being asymmetrical or having higher variability (<5%) in a few variables is normal. Taking all findings together, practitioners should exercise caution when deciding on the need for corrective interventions and should not be concerned that increasing gait speed could increase injury risk through changes to athletes' asymmetry. Race walking coaches should test at competition speeds to ensure that flight times, and any variability or asymmetry, are measured appropriately.

The Effect of Prolonged Running on the Symmetry of Biomechanical Variables of the Lower Limb Joints

The aim of this study was to examine whether there are kinematic and kinetic differences in the lower limb and whether the symmetry of the lower extremities is different after prolonged-running. Fifteen healthy male amateur runners (age: 22 ± 1 years, height: 173 ± 8 cm, mass: 65 ± 7 kg, BMI: 21.62 ± 2 kg/m2) were recruited as participants for this study. A Vicon eight-camera motion capture system and Kistler force plate were used to collect kinematic and kinetic parameters. A motorized treadmill, 15-point Borg scale and heart rate bands were used to monitor fatigue during a running-induced fatigue protocol. Paired sample T tests were used to check statistical difference (p = 0.05) between the lower limbs and the symmetry changes in pre-fatigue and post-fatigue running sessions. The symmetry angle (SA) of the knee flexion angle, hip flexion angle and hip extension angle in post-fatigue was significantly greater than in pre-fatigue, increasing by 4.32%, 10.71%, and 23.12%, respectively. Moreover, the SA of hip flexion moment increased by 2.61%. However, the knee extension velocity and hip flexion velocity became more symmetrical than in pre-fatigue (p < 0.05), the SA decreased by 5.91% and 5.45%, respectively. Differences in limb function during post-fatigue may lead to changes of symmetry in the lower limbs. The variables of asymmetry may be used as a compensation mechanism to maintain gait stability. Physical therapy assessment of fatigue injuries and long-distance running training programs may want to consider the changes in symmetry due to limb dominance.

Distance running stride-to-stride variability for sagittal plane joint angles

Recent research indicates that distance running stride-to-stride variability (SSV) is related to performance and injury. Previous studies have primarily focused on stride characteristics (stride length and time). We assessed SSV for sagittal plane joint angles with the primary purpose of testing for significant differences among the lower body joints. The secondary purpose was to determine if strong correlations exist among joint SSV measures. Thirty recreational adult runners participated in the study (8 females, 22 males, 39 ± 10 years; 53.1 ± 25.7 km/week). A 6-camera motion capture system (200 Hz) collected kinematic data during treadmill running at a preferred pace. A 2 by 3 repeated measures factorial ANOVA (phase-stance, swing; joint-hip, knee, ankle) was run (p = 0.05). There was a significant interaction effect (p < 0.001) and post hoc analysis revealed knee swing to be the most variable condition by far. For all three joints, there were strong correlations between stance and swing SSV (r = 0.80 to r = 0.88) and correlations among the joints were moderate to strong (r = 0.55 to 0.86). This study helps to better understand the joints/phases that contribute most to variability in the overall stride. Also, the strong correlations suggest that runners appear to have an overall SSV pattern that is similar across joints/phases.

Metabolic testing does not alter distance running lower body sagittal kinematics

BACKGROUND

Distance running fitness is commonly assessed using metabolic testing (MT). During MT, the runner must wear a mask that covers the nose and mouth. It is unclear if this increased challenge alters running kinematics and/or stride-to-stride variability (SSV). In this study we thoroughly assess the sagittal plane lower body joint angles.

RESEARCH QUESTION

Are there significant differences between standard treadmill running kinematics and those collected during MT?

METHODS

Twenty recreational runners participated (34.8 ± 10.0 years; 20+ miles per week). Six Vicon Bonita cameras were used to collect kinematic data (200 Hz). A metabolic cart (Parvo Medics TrueOne 2400) was used for heart rate (HR) collection and testing. Participants ran 4 × 4 min at preferred pace: 2 control runs (CON) and 2 MT runs. Ten strides were used to generate average stance and swing joint angle plots. The phase plots were compared for CON and MT and mean difference scores were calculated (to determine the kinematic change). SSV was determined by assessing the standard deviations among the 10 strides. Repeated measures ANOVA was used to test for significant differences among CON and MT trials. Reliability was assessed for 8 discrete joint angles using ICC analysis.

RESULTS

There were no significant differences between CON and MT for both the joint angle plot comparisons and SSV. For the discrete kinematic measures, ICC scores were strong (0.89-0.99) between CON and MT. During MT, there were slight increases (p < 0.01) in HR (145 ± 14 vs. 147 ± 14) and RPE (10.4 ± 1.5 vs. 11.4 ± 1.5).

SIGNIFICANCE

Results from this study support the validity of simultaneously conducting a kinematic and MT analysis. However, clinicians and performance coaches should be aware that 1) MT is slightly more physiologically demanding than CON and 2) approaches from this study can be used during individual assessments to confirm that kinematics are similar (between CON and MT).

Does fatigue alter step characteristics and stiffness during running?

BACKGROUND

Describing the response of spatiotemporal gait characteristics, and related variables such as variability and stiffness, to different stressors is important to better understand spring-mass model.

RESEARCH QUESTION

This study aimed to examine the effect of fatigue induced by a running protocol on spatiotemporal gait parameters, step variability and vertical (Kvert) and leg stiffness (Kleg) during running on a treadmill.

METHODS

Twenty-two trained male endurance runners performed a 60-min time trial run. An analysis of spatiotemporal parameters (contact time [CT], flight time [FT], step frequency [SF] and step length [SL]), step variability (in terms of coefficient of variation [CV]) and stiffness was conducted in two different conditions: non-fatigued (before the protocol) and fatigued (after the protocol).

RESULTS

The pairwise comparisons (i.e., non-fatigued vs. fatigued condition) indicated that temporal parameters (i.e., CT and FT) experienced significant changes (p = 0.001 and <0.001, respectively). Step variability increased in presence of fatigue, with higher CV in CT (p = 0.039), FT (p = 0.005), SF (p = 0.046) and SL (p = 0.027) after the running protocol. The Kleg experienced a reduction in the fatigued condition (p < 0.001) whereas the Kvert remained unchanged (p = 0.602).

SIGNIFICANCE

The results indicate that fatigue induced by a 60-min time trial run causes some adaptations in spatiotemporal gait characteristics and stiffness in trained endurance runners. Specifically, in the presence of fatigue, the athletes showed greater CT and shorter FT, higher step variability and lower leg stiffness.

Effects of experimentally induced fatigue on healthy older adults' gait: A systematic review

Introduction

While fatigue is ubiquitous in old age and visibly interferes with mobility, studies have not yet examined the effects of self-reported fatigue on healthy older adults’ gait. As a model that simulates this daily phenomenon, we systematically reviewed eleven studies that compared the effects of experimentally induced muscle and mental performance fatigability on gait kinematics, variability, kinetics, and muscle activity in healthy older adults.

Methods

We searched for studies in databases (PubMed and Web of Science) using Fatigue, Gait, and Clinical conditions as the main terms and extracted the data only from studies that experimentally induced fatigue by sustained muscle or mental activities in healthy older adults.

Results

Eleven studies were included. After muscle performance fatigability, six of nine studies observed increases in stride length, width, gait velocity (Effect Size [ES] range: 0.30 to 1.22), inter-stride trunk acceleration variability (ES: 2.06), and ankle muscle coactivation during gait (ES: 0.59, n = 1 study). After sustained mental activity, the coefficient of variation of stride outcomes increased (ES: 0.59 to 0.67, n = 1 study) during dual-task but not single-task walking.

Conclusion

Muscle performance fatigability affects spatial and temporal features of gait and, mainly, inter-stride trunk acceleration variability. In contrast, sustained mental activity tends only to affect step variability during dual tasking. A critical and immediate step for future studies is to determine the effects of self-reported fatigue on gait biomechanics and variability in healthy older adults to verify the viability of experimentally induced fatigue as a model for the study of gait adaptability in old age.

Minimal effects of age and prolonged physical and mental exercise on healthy adults' gait

BACKGROUND

Gait adaptability in old age can be examined by responses to various perturbations. Fatigability due to mental or muscle exercises can perturb internal cognitive and muscle resources, necessitating adaptations in gait.

RESEARCH QUESTION

What are the effects of age and mental and muscle fatigability on stride outcomes and gait variability?

METHODS

Twelve older (66-75yrs) and twelve young (20-25 yrs) adults walked at 1.2 m/s before and after two fatigue conditions in two separate sessions. Fatigue conditions were induced by repetitive sit-to-stand task (RSTS) and by 30-min of mental tasks and randomized between days (about a week apart). We calculated the average and coefficient of variation of stride length, width, single support, swing time and cadence, and the detrended fluctuations analysis (DFA) based on 120 strides time intervals. We also calculated multi-scale sample entropy (MSE) and the maximal Lyapunov exponent (λmax) of mediolateral (ML) and anteroposterior (AP) of the Center of Pressure (CoP) trajectories.

RESULTS

In both age groups, RSTS modestly affected stride length, single support time, cadence, and CV of stride length (p ≤ 0.05), while the mental task did not affect gait. After fatigability, λmax - ML increased (p ≤ 0.05), independent of fatigue condition. All observed effects were small (η²: 0.001 to 0.02).

SIGNIFICANCE

Muscle and mental fatigability had minimal effects on gait in young and healthy older adults possibly because treadmill walking makes gait uniform. It is still possible that age-dependent muscle activation underlies the uniform gait on the treadmill. Age- and fatigability effects might be more overt during real life compared with treadmill walking, creating a more effective model for examining gait and age adaptability to fatigability perturbations.

Foot Pronation Contributes to Altered Lower Extremity Loading After Long Distance Running

This study presents an investigation of the changes in foot posture, joint kinematics, joint moments and joint contact forces in the lower extremity following a 5 k treadmill run. A relationship between knee and ankle joint loading and foot posture index (FPI) is developed. Twenty recreational male heel-strike runners participated in this study. All participants had a history of running exercise and were free from lower extremity injuries and foot deformities. Foot posture was assessed from a six-item FPI to quantitatively classify high supination to high pronation foot poses. The FPI is scored using a combination of observations and foot palpations. The three-dimensional marker trajectories, ground reaction force and surface electromyography (EMG) were recorded at pre and post-gait sessions conducted over-ground and 5 k running was conducted on a treadmill. Joint kinematics, joint moments and joint contact forces were computed in OpenSim. Simulated EMG activations were compared against experimental EMG to validate the model. A paired sample t-test was conducted using a 1D statistical parametric mapping method computed temporally. Hip joint moments and contact forces increased during initial foot contact following 5 k running. Knee abduction moment and superior-inferior knee contact force increased, whereas the knee extension moment decreased. Ankle plantarflexion moment and ankle contact forces increased during stance. FPI was found to be moderately correlated with peak knee and ankle moments. Recreational male runners presented increased static foot pronation after 5 k treadmill running. These findings suggest that following mid distance running foot pronation may be an early indicator of increased lower limb joint loading. Furthermore, the FPI may be used to quantify the changes in knee and ankle joint moments.