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Kim HK, Mirjalili SA. Differences in running biomechanics and tibiotalar cartilage T2 relaxation time between runners with and without asymptomatic tibial sesamoid bone marrow edema - clinical case series. Sports Biomech 2024:1-12. [PMID: 38803210 DOI: 10.1080/14763141.2024.2356859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 05/02/2024] [Indexed: 05/29/2024]
Abstract
The impact of asymptomatic bone marrow edema (BME) in sesamoids on running biomechanics remains largely unknown, but exploring this relationship could aid early detection of forefoot-related injuries with cost-effective modalities. This study aimed to compare the running biomechanics of runners with asymptomatic BME in the tibial sesamoids with that of healthy controls. Four runners with asymptomatic BME in tibial sesamoids and four healthy runners participated. Lower extremity joint kinetics and kinematics were assessed along with plantar pressure while running at a self-selected speed. The T2 relaxation time of the tibiotalar cartilage was measured using MRI-derived T2 maps. Compared to the non-injured group, the injured group exhibited significantly lower plantar pressure under the hallux (p = 0.001), increased peak ankle rotation angles (p = 0.025), reduced ankle power generation (p = 0.049), and increased knee extension torque (p = 0.015). No significant differences in T2 values of the tibiotalar cartilage were observed. It appears that runners with asymptomatic BME adapted their running strategies by modifying their ankle biomechanics and reducing plantar pressure, even in the absence of pain. While the precise implications of these biomechanical alterations warrant further investigation, this study provides valuable insights into the relationship between asymptomatic BME and running biomechanics.
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Affiliation(s)
- Hyun Kyung Kim
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, USA
| | - Seyed Ali Mirjalili
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Kyung Kim H, Qu H, Chou LS. Center of mass motion and plantar pressure distribution during walking in overweight individuals. Gait Posture 2024; 108:307-312. [PMID: 38199089 DOI: 10.1016/j.gaitpost.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/04/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Gait imbalance has been reported in overweight individuals and could further impair their mobility and quality of life. As the feet are the most distal part of the body and sensitively interface with external surroundings, evaluating the plantar pressure distribution can provide critical insights into their roles in regulating gait balance control. Therefore, the purpose of this study was to evaluate the effect of body weight and different gait speeds on the plantar pressure distribution and whole-body center of mass (COM) motion during walking. METHODS Eleven overweight individuals (OB) and 13 non-overweight individuals (NB) walked on a 10-meter walkway at three speed conditions (preferred, 80% and 120% of preferred speed). Gait balance was quantified by the mediolateral COM sway. Plantar pressure data were obtained using wireless pressure-sensing insoles that were inserted into a pair of running shoes. Analysis of variance models were used to examine the effect of body size, gait speeds, or their interactions on peak mediolateral COM and peak plantar pressure during walking. RESULTS Significant group effects of peak plantar pressure under the lateral forefoot (P = 0.03), lateral midfoot (P = 0.02), and medial heel (P = 0.02) were observed. However, the mediolateral COM motion and spatiotemporal gait parameters only revealed significant speed effects. SIGNIFICANCE Findings from this study indicated that overweight individuals exhibited increased plantar pressure under the lateral aspect of the foot, particularly during the late stance phase of walking, in an effort to maintain a comparable mediolateral COM motion to that of non-overweight individuals. Such elevated pressure in overweight individuals may potentially increase the risk of musculoskeletal pathology in the long term. The identified patterns are noteworthy as they have practical implications for designing targeted interventions and improving the overall health of individuals with a high BMI.
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Affiliation(s)
- Hyun Kyung Kim
- School of Kinesiology, Louisiana State University, USA; Department of Kinesiology, Iowa State University, USA
| | - Hang Qu
- Department of Kinesiology, Iowa State University, USA
| | - Li-Shan Chou
- Department of Kinesiology, Iowa State University, USA.
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Kim HK, Mirjalili SA, Zhang Y, Xiang L, Gu Y, Fernandez J. Effect of gender and running experience on lower limb biomechanics following 5 km barefoot running. Sports Biomech 2024; 23:95-108. [PMID: 33428537 DOI: 10.1080/14763141.2020.1829021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 09/21/2020] [Indexed: 10/22/2022]
Abstract
Barefoot running has been increasing in popularity, yet there is a gap in understanding concerning the biomechanics of mid-distance barefoot running, especially between genders and runners of different running-experience levels. This study examines the effects of running-experience, gender, and their interaction on running biomechanics following 5 km barefoot running. Before and after a 5 km run, three-dimensional kinematics and kinetics of the lower limb joints and plantar pressure during barefoot running were collected from 20 participants. Participants were stratified by their running-experience levels (novice and marathon-experienced) and gender. This study revealed significant gender effects on lower limb biomechanics following a 5 km barefoot run. Increased plantar pressure under the lateral aspect of the foot was observed in the female cohort, while the male cohort exhibited reduced plantar pressure under the lateral heel. This study suggests that modified lower limb running biomechanics and modified lateral foot loading after 5 km barefoot running may create a different foot loading environment for female and male runners that should be accommodated in barefoot runningand minimalist shoe design.
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Affiliation(s)
- Hyun Kyung Kim
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Seyed Ali Mirjalili
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Yanxin Zhang
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
| | - Liangliang Xiang
- Faculty of Sport Sciences, Ningbo University, Ningbo, China
- Research Academy of Grand Health Interdisciplinary, Ningbo University, Ningbo, China
| | - Yaodong Gu
- Faculty of Sport Sciences, Ningbo University, Ningbo, China
- Research Academy of Grand Health Interdisciplinary, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Justin Fernandez
- Research Academy of Grand Health Interdisciplinary, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Department of Engineering Science, University of Auckland, Auckland, New Zealand
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Watkins LE, Goyal A, Gatti AA, Kogan F. Imaging of joint response to exercise with MRI and PET. Skeletal Radiol 2023; 52:2159-2183. [PMID: 36646851 PMCID: PMC10350475 DOI: 10.1007/s00256-022-04271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 01/18/2023]
Abstract
Imaging of the joint in response to loading stress may provide additional measures of joint structure and function beyond conventional, static imaging studies. Exercise such as running, stair climbing, and squatting allows evaluation of the joint response to larger loading forces than during weight bearing. Quantitative MRI (qMRI) may assess properties of cartilage and meniscus hydration and organization in vivo that have been investigated to assess the functional response of these tissues to physiological stress. [18F]sodium fluoride ([18F]NaF) interrogates areas of newly mineralizing bone and provides an opportunity to study bone physiology, including perfusion and mineralization rate, as a measure of joint loading stress. In this review article, methods utilizing quantitative MRI, PET, and hybrid PET-MRI systems for assessment of the joint response to loading from exercise in vivo are examined. Both methodology and results of various studies performed are outlined and discussed. Lastly, the technical considerations, challenges, and future opportunities for these approaches are addressed.
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Affiliation(s)
| | - Ananya Goyal
- Department of Radiology, Stanford University, 1201 Welch Rd, Stanford, CA, 94305, USA
| | - Anthony A Gatti
- Department of Radiology, Stanford University, 1201 Welch Rd, Stanford, CA, 94305, USA
| | - Feliks Kogan
- Department of Radiology, Stanford University, 1201 Welch Rd, Stanford, CA, 94305, USA.
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Mei Q, Kim HK, Xiang L, Shim V, Wang A, Baker JS, Gu Y, Fernandez J. Toward improved understanding of foot shape, foot posture, and foot biomechanics during running: A narrative review. Front Physiol 2022; 13:1062598. [PMID: 36569759 PMCID: PMC9773215 DOI: 10.3389/fphys.2022.1062598] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
The current narrative review has explored known associations between foot shape, foot posture, and foot conditions during running. The artificial intelligence was found to be a useful metric of foot posture but was less useful in developing and obese individuals. Care should be taken when using the foot posture index to associate pronation with injury risk, and the Achilles tendon and longitudinal arch angles are required to elucidate the risk. The statistical shape modeling (SSM) may derive learnt information from population-based inference and fill in missing data from personalized information. Bone shapes and tissue morphology have been associated with pathology, gender, age, and height and may develop rapid population-specific foot classifiers. Based on this review, future studies are suggested for 1) tracking the internal multi-segmental foot motion and mapping the biplanar 2D motion to 3D shape motion using the SSM; 2) implementing multivariate machine learning or convolutional neural network to address nonlinear correlations in foot mechanics with shape or posture; 3) standardizing wearable data for rapid prediction of instant mechanics, load accumulation, injury risks and adaptation in foot tissue and bones, and correlation with shapes; 4) analyzing dynamic shape and posture via marker-less and real-time techniques under real-life scenarios for precise evaluation of clinical foot conditions and performance-fit footwear development.
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Affiliation(s)
- Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Hyun Kyung Kim
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,*Correspondence: Qichang Mei, , ; Yaodong Gu, ,
| | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, Ningbo, China,Research Academy of Grand Health, Ningbo University, Ningbo, China,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand,Department of Engineering Science, The University of Auckland, Auckland, New Zealand
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Dataset of lower extremity joint angles, moments and forces in distance running. Heliyon 2022; 8:e11517. [DOI: 10.1016/j.heliyon.2022.e11517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 10/17/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
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Kim HK, Dai X, Lu SH, Lu TW, Chou LS. Discriminating features of ground reaction forces in overweight old and young adults during walking using functional principal component analysis. Gait Posture 2022; 94:166-172. [PMID: 35339964 DOI: 10.1016/j.gaitpost.2022.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/10/2022] [Accepted: 03/17/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Limited attention has been paid to age- or body size-related changes in the ground reaction forces (GRF) during walking despite their strong associations with lower limb injuries and pathology. RESEARCH QUESTION Do the features of GRF during walking associate with age or body size? METHODS Fifty-four participants were subdivided into four groups according to their age and body size: overweight old (n = 12), non-overweight old (n = 13), overweight young (n = 13), and non-overweight young (n = 16). Participants were asked to walk at their self-selected speeds on level ground with force plates embedded in the center of walkway. Functional principal component analysis (FPCA) was performed to extract major modes of variation and functional principal component scores (FPCs) in three-dimensional GRFs. Analysis of variance models were employed to investigate the effect of age, body size, or their interactions on the FPCs of each component of the GRF, with the adjustment to gait speed. RESULTS Significant age and body size effects were observed in FPC1 across all three-dimensional GRF. Both overweight and older groups showed greater braking force after heel-strike and greater propulsive forces during pre-swing when compared to the non-overweight and younger groups, respectively. The overweight old group displayed greater medial forces during mid-stance and the overweight young group showed prominently larger medial forces during pre-swing, while non-overweight old showed a tendency of flatter medial-lateral GRF waveforms during the entire stance phase. FPC2 revealed that only body size had an effect on three-dimensional GRF with the highest FPC2 scores in the overweight old group. SIGNIFICANCE Three-dimensional GRF during walking could be altered by the body size and age, which were more pronounced in the overweight and older group. The more dynamic GRF pattern with greater and/or lower peaks could be contributing factors to the increased joint load and injury rates observed in overweight aged individuals.
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Affiliation(s)
- Hyun Kyung Kim
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Xiongtao Dai
- Department of Statistic, Iowa State University, Ames, IA, USA
| | - Shiuan-Huei Lu
- Department of Biomedical Engineering, National Taiwan University, Taiwan
| | - Tung-Wu Lu
- Department of Biomedical Engineering, National Taiwan University, Taiwan
| | - Li-Shan Chou
- Department of Kinesiology, Iowa State University, Ames, IA, USA.
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The Influence of Running on Lower Limb Cartilage: A Systematic Review and Meta-analysis. Sports Med 2021; 52:55-74. [PMID: 34478109 DOI: 10.1007/s40279-021-01533-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Running is a popular activity practiced worldwide. It is important to understand how running affects joint health to provide recommendations to sports medicine practitioners and runners. OBJECTIVE Our aim was to summarize the influence of running on lower limb cartilage morphology and composition using quantitative magnetic resonance imaging (MRI). METHODS Prospective repeated-measures studies evaluating cartilage using MRI before and after running were included. Data sources included Pubmed, Embase, CINAHL, SportDiscus, Web of Science, and Cochrane Central Registry of Controlled Trials. Qualitative analyses considered the number and methodological quality ratings of studies based on the QualSyst tool, and recommendations were based on the strength of evidence (strong, moderate, limited, or very limited). Quantitative analysis involved meta-analyses, for which effect sizes were calculated as Hedge's g standardized mean differences. RESULTS We included 43 articles, assessing seven outcomes (lesions, volume, thickness, glycosaminoglycan content, and T1ρ, T2, and T2* relaxation times). Nineteen articles were rated as high quality, 24 were rated as moderate quality, and none were rated as low quality. Qualitative analyses suggest that running may cause an immediate reduction in knee cartilage volume, thickness, as well as T1ρ and T2 relaxation times immediately; however, these changes did not persist. Meta-analyses revealed a small and moderate decrease immediately following a single running bout in T2 relaxation time in the medial femur and tibia, respectively. Qualitative analyses indicated that the influence of repeated exposure to running on cartilage morphology and composition was limited. Despite conflicting evidence regarding pre-existing knee cartilage lesions, moderate evidence suggests that running does not lead to the formation of new lesions. Repeated running exposure did not cause changes to foot and ankle cartilage thickness or composition. CONCLUSIONS Changes to lower limb cartilage following running are transient. Immediate changes to cartilage morphology and composition, which likely reflect natural fluid dynamics, do not persist and were generally not significant when pooled statistically. Results suggest that cartilage recovers well from a single running bout and adapts to repeated exposure. Given that moderate evidence indicates that running does not lead to new lesions, future trials should focus on clinical populations, such as those with osteoarthritis. TRIAL REGISTRATION Not applicable.
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Kim HK, Mei Q, Gu Y, Mirjalili A, Fernandez J. Reduced joint reaction and muscle forces with barefoot running. Comput Methods Biomech Biomed Engin 2021; 24:1263-1273. [PMID: 33522848 DOI: 10.1080/10255842.2021.1880572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Barefoot running has been associated with lowered joint loading, but it remains unclear whether the biomechanical benefits are evident after mid-distance running. A musculoskeletal model was adopted for estimating lower limb joint loading for barefoot (n = 10) versus shod (n = 10) 5 km running. The barefoot group reduced peak joint reaction force at the hip and knee, and presented muscle force reductions compared to shod controls with significant group effects and interaction effects (p < .05). These changes were primarily group effects as time point effects were not significant. These findings should be considered when designing barefoot running shoes, running programmes, and injury prevention programmes.
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Affiliation(s)
- Hyun Kyung Kim
- Kinesiology Department, Iowa State University, Ames, Iowa, USA.,Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Qichang Mei
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.,Faculty of Sport Sciences, Ningbo University, Ningbo, China.,Research Academy of Grand Health Interdisciplinary, Ningbo University, Ningbo, China
| | - Yaodong Gu
- Faculty of Sport Sciences, Ningbo University, Ningbo, China.,Research Academy of Grand Health Interdisciplinary, Ningbo University, Ningbo, China
| | - Ali Mirjalili
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Justin Fernandez
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.,Research Academy of Grand Health Interdisciplinary, Ningbo University, Ningbo, China.,Department of Engineering Science, Faculty of Engineering, University of Auckland, Auckland, New Zealand
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Kim HK, Mirjalili A, Doyle A, Fernandez J. Tibiotalar cartilage stress corresponds to T2 mapping: application to barefoot running in novice and marathon-experienced runners. Comput Methods Biomech Biomed Engin 2019; 22:1153-1161. [DOI: 10.1080/10255842.2019.1645133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Hyun Kyung Kim
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Ali Mirjalili
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Anthony Doyle
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Radiology Department, Auckland District Health Board, Auckland, New Zealand
| | - Justin Fernandez
- Department of Engineering Science, Faculty of Engineering, University of Auckland, Auckland, New Zealand
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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