Physiological and biomechanical effects on the human musculoskeletal system while carrying a suspended-load backpack

Altered trunk-pelvis kinematics during load carriage with a compliant versus a rigid system

Load carriage is a key component of hiking and military activity. The design of the load carriage system (LCS) could influence performance and injury risk. This study aimed to compare a traditional and a compliant LCS during walking and a step-up task to quantify differences in oxygen consumption and trunk-pelvis kinematics. Fourteen participants completed the tasks whilst carrying 16 kg in a rigid and a compliant LCS. There were no differences in oxygen consumption between conditions during either task (p > 0.05). There was significantly greater trunk-pelvis axial rotation (p = 0.041) and lateral flexion (p = 0.001) range of motion when carrying the compliant LCS during walking, and significantly greater trunk-pelvis lateral flexion range of motion during the step-up task (p = 0.003). Carrying 16 kg in a compliant load carriage system results in greater lateral flexion range of motion than a traditional, rigid system, without influencing oxygen uptake.

Biomechanical Consequences of Walking With the Suspended Backpacks

OBJECTIVE

This article aimed to investigate the biomechanical mechanisms underlying the energetic advantages of the suspended backpacks during load carriage.

METHODS

In this study, we examined eight adults walking with a 15 kg load at 5 km/h with a designed suspended backpack, in which the load could be switched to locked and suspended with four combinations of stiffness. Mechanical work and metabolic cost were measured during load carriage.

RESULTS

The results showed that the suspended backpacks led to an average reduction of 23.35% in positive work, 24.77% in negative work, and a 12.51% decrease in metabolic cost across all suspended load conditions. Notably, the decreased mechanical work predominantly occurred during single support (averaging 84.19% and 71.16% for positive and negative work, respectively), rather than during double support.

CONCLUSION

Walking with the suspended backpack induced a phase shift between body movement and load movement, altering the human-load interaction. This adjustment caused the body and load to move against each other, resulting in flatter trajectories of the human-load system center of mass (COM) velocities and corresponding profiles in ground reaction forces (GRFs), along with reduced vertical excursions of the trunk. Consequently, this interplay led to flatter trajectories in mechanical work rate and reduced mechanical work, ultimately contributing to the observed reduction in energetic expenditure.

SIGNIFICANCE

Understanding these mechanisms is essential for the development of more effective load-carrying devices and strategies in various applications, particularly for enhancing walking abilities during load carriage.

Load Carrying Walking Test for the Special Operation Forces of the Army of the Czech Republic

INTRODUCTION

The subject of this study was the creation of a new type of laboratory walking stress test for the Special Forces of the Army of the Czech Republic. This study developed a test model that has been validated in practice and that reflects the fact that the performance of endurance without and with a load varies considerably. Especially, if we focus on operators, as their activities are always performed with loads/full gear (equipment, weapons, equipment, etc.).

MATERIALS AND METHODS

24 men/operators from the Special Forces of the Army of the Czech Republic volunteered for this study. The maximal exercise test/spiroergometry was designed to include performance at a load of 55 kg/121 lb, a constant speed of 5.3 km/h, and an increase in incline angle of 1 degree after each elapsed minute. The test was performed on a treadmill under standard time, location, and temperature conditions. During the test, the following values were recorded: VO2 = oxygen consumption indicating the intensity of the exercise was monitored, VO2/kg = oxygen consumption converted to body weight, VO2/HR = pulse oxygen (the amount of oxygen converted in one heartbeat), HR = heart rate, VE = ventilation, volume of air exhaled in 1 min, breathe frequency (BF) = respiratory rate in 1 min.

RESULTS

Out of the total number of 24 respondents, the study found these mean values of variables. The variable mapping the oxygen consumption, which indicates the intensity of VO2 loading, was 3.8, with the lowest value being 3.2 and the highest being 4.5. After converting oxygen consumption to bodyweight, VO2/kg was 46, the lowest value of 38.8, and the highest 53.0 were measured for this variable. Pulse oxygen, i.e., the amount of oxygen calculated per heart contraction VO2/HR, was 20.5, the lowest value 16.0, and the highest 26.0. The average HR heart rate was 183.5, with the lowest value being recorded at 164 and the highest value is 205. Ventilation, i.e., the amount of exhaled air per minute in VE, was measured at 144.9, the lowest value was 114.7, and the highest was 176.6. The BF in 1 min was 58.5, the lowest value 35, and the highest 70. The mean time load was 10:20 min, the shortest test length was 7:25 min, and the longest was 13:23 min. These values correspond to the degree of inclination of the ascent, i.e., the mean value was 10 degrees, the smallest achieved slope was 7 degrees, and the largest 13 degrees.

CONCLUSION

The designed weighted walking test proved to be fully functional and effective in measurement. The further established protocol corresponds to the requirements of the current needs of the Special Forces of the Army of the Czech Republic. Last but not least, the walking stress test is applied for the external and internal selection and screening of operators. Data obtained from testing were used to develop deployment requirements for patrol/nuclear combat missions.

Exploring the physiological benefits of carrying a suspended backpack versus a traditional backpack

This study investigates the differences in metabolic energy cost and physiological adaptations between carrying a suspended backpack and a traditional backpack during exercise. For that, 30 males completed the Bruce test while carrying a loaded backpack. Researchers used a metabolic system to obtain variables, analysed muscle oxygen saturation, and used a 2-way RM ANOVA. As results, a significant fatigue interaction was found, but the interaction between fatigue and backpack was non-significant. Using a suspended backpack resulted in energetic advantages in oxygen consumption, muscle oxygen saturation, and performance compared to a traditional backpack. In conclusion, this study offers insights into the physiological implications of using a suspended backpack, suggesting it may reduce the risk of musculoskeletal issues and improve performance for those carrying heavy loads.Practitioner summary: The suspended-load backpacks have been proposed as an alternative to traditional backpacks. This study highlighted that the use of a suspended backpack provided some energetical advantages adaptation compared to the traditional backpack in terms of oxygen consumption, muscle oxygen saturation and performance during a multistage treadmill test walking-running test.

Influences of dynamic load phase shifts on the energetics and biomechanics of humans

Using load-suspended backpacks to reduce vertical peak dynamic load exerted on humans can reduce metabolic costs. However, is it possible to further reduce metabolic cost by modulating dynamic load phase shift? If so, is anti-phase better than the others? In this study, we investigated the biomechanics, energetics and trunk response under phase shifts. Nine subjects wearing an active backpack with 19.4 kg loads walked on a treadmill at 5 km h-1 with four phase shift trials (T1-T4) and a load-locked trial (LK). Our results show that anti-phase trial (T3) assists ankle more and reduces the moment and gastrocnemius medialis activity, while T4 assists knee more and reduces the moment and rectus femoris activity. Due to the load injecting more mechanical energy into human in T3 and T4, the positive centre-of-mass work is significantly reduced. However, the gross metabolic rate is lowest in T4 and 4.43% lower than in T2, which may be because the activations of erector spinae and gluteus maximus are reduced in T4. In addition, T3 increases trunk extensor effort, which may weaken the metabolic advantage. This study provides guidance for improving assistance strategies and human-load interfaces and deepens the understanding of the energetics and biomechanics of human loaded walking.

The effect of backpack load on intersegmental motions of the foot and plantar pressure in individuals with mild flatfoot

BACKGROUND

The feet play an essential role in shock absorption, and foot posture is closely related to gait. The compensatory mechanism under heavy-load conditions in individuals with mild flatfoot is poorly understood. In the authors' country, individuals with mild flatfoot are drafted as active-duty soldiers and participate in military rucking wearing heavy backpacks. This study investigated the effect of backpack load on gait and foot plantar pressure and possible differences in participants with mild flatfoot. The average weight of the backpack during military rucking (approximately 20 kg), was simulated in this study.

METHODS

This study prospectively enrolled 30 healthy young males, divided into a control group (CON, n = 15) and a mild low-arched group (MLA, n = 15), based on the presence of flatfoot. Segmental foot kinematics were evaluated using a three-dimensional multi-segment foot model, and gait data of the temporal and spatial parameters were obtained. The dynamic plantar pressure was simultaneously measured using a pedobarography platform with gait trials. The protocol was repeated with all participants wearing 20 kg backpacks. Comparisons between the baseline and loaded states, as well as comparison between groups, were conducted.

RESULTS

Although the cadence, gait speed, and stride length decreased in the loaded condition, step time and proportion of the stance phase increased in both groups. Although the MLA group showed more supinated and abducted positions of the forefoot and more pronated positions of the hindfoot than the CON group, the change in intersegmental foot and ankle motion in each group after backpack loading was minimal. However, the former showed a larger step width and a greater increase in contact area in the midfoot region, while the latter demonstrated a greater increase in peak pressure.

CONCLUSIONS

Individuals with mild flatfoot demonstrated significantly different gait curve patterns (waveforms) compared to the controls. In the loaded condition, the CON and MLA groups may have adopted different strategies to maintain balance during gait. We suggest that although individuals with asymptomatic mild flatfoot are drafted as active-duty soldiers, they should be thoroughly investigated under loaded conditions, and orthoses may be helpful.

Effects of different hydration supports on stride kinematics, comfort, and impact accelerations during running

BACKGROUND

Different supports for hydration can influence total body mass and affect running biomechanics.

RESEARCH QUESTION

Do different hydration supports affect the perceived exertion and comfort, stride kinematics, and impact accelerations during running?

METHODS

This was a crossover study design. Thirteen trail runners completed a treadmill running test divided into four different durations and randomized hydration supports conditions, lasting 8 min each at moderate intensity: A) waist bag (0.84 kg); B) medium load backpack (0.84 kg); C) full load backpack (3.40 kg); and D) a control condition without water support. Impact accelerations were measured for 30 s in 4, 6, and 8 min. The rate of perceived exertion and heart rate were registered on minutes 4 and 8. At the last minute of each condition, comfort perception was registered RESULTS AND SIGNIFICANCE: No condition affected the stride kinematics. Full load backpack condition reduced head acceleration peak (-0.21 g; p = 0.04; ES=0.4) and head acceleration magnitude (-0.23 g; p = 0.03; ES=0.4), and increased shock attenuation (3.08 g; p = 0.04; ES=0.3). It also elicited higher perceived exertion (p < 0.05; ES>0.8) being considered heavier (p < 0.01; ES > 1.1). The waist bag condition was more comfortable in terms of noise (p = 0.006; ES=1.3) and humidity/heat (p = 0.001; ES=0.8). The waist bag was the most comfortable support. On the other hand, the full backpack elicited lower comfort and was the only generating compensatory adjustments. These results may help to improve design of full load backpack aiming at comfort for runners.

Evaluation of the Load Reduction Performance Via a Suspended Backpack With Adjustable Stiffness

Backpacks are essential for travel but carrying a load during a long journey can easily cause muscle fatigue and joint injuries. Previous studies have suggested that suspended backpacks can effectively reduce the energy cost while carrying loads. Researchers have found that adjusting the stiffness of a suspended backpack can optimize its performance. Therefore, this paper proposes a stiffness-adjustable suspended backpack; the system stiffness can be adjusted to suitable values at different speeds. The stiffness of the suspended backpack with a 5-kg load was designed to be 690 N/m for a speed of 4.5 km/h, and it was adjusted to 870 and 1050 N/m at speeds of 5.5 and 6.5 km/h, respectively. The goal of this study was to determine how carrying a stiffness-adjustable suspended backpack affected performance while carrying a load. Six healthy participants participated in experiments where they wore two backpacks under three conditions: the adjustable-stiffness suspended backpack condition (S_A), the unadjustable-stiffness suspended backpack condition (S_UA), and the ordinary backpack condition (ORB). Our results showed that the peak accelerations, muscle activities, and peak ground reaction forces in the S_A condition were reduced effectively by adjusting the stiffness to adapt to different walking speeds; this adjustment decreased the metabolic cost by 4.21 ± 1.21% and 2.68 ± 0.88% at 5.5 km/h and 4.27 ± 1.35% and 3.38 ± 1.31% at 6.5 km/h compared to the ORB and S_UA, respectively.

A model for predicting ground reaction force and energetics of human locomotion with an elastically suspended backpack

This paper presents an actuated spring-loaded inverted pendulum model with a vertically constrained suspended load mass to predict the vertical GRF and energetics of walking and running. Experiments were performed to validate the model prediction accuracy of vertical GRF. The average correlation coefficient was greater than 0.97 during walking and 0.98 during running. The model's predictions of energy cost reduction were compared with experimental data from the literature, and the difference between the experimental and predicted results was less than 7%. The predicted results of characteristic forces and energy cost under different suspension stiffness and damping conditions showed a tradeoff when selecting the suspension parameters of elastically suspended backpacks.

Podiatric and Stabilographic Examinations of the Effects of School Bag Carrying in Children Aged 11 to 15 Years

Background: The issues raised in this study were inspired by the concern for the musculoskeletal status of school children. Carrying excess weight in the form of a school bag in this period of life affects the correct body posture of school children. The aim of the study was to analyze the influence of school bags on the feet force distribution on the ground and postural balance in children of both sexes between 11 and 15 years of age. Methods: The study investigated the distribution of pressure forces on the sole of the foot and its arch. The center of pressure for both feet and the whole body was also examined. The participants were 100 students from primary schools in Gdańsk, aged 11 to 15, including 54 girls and 46 boys. The research used a podobarographic platform that measures the distribution of foot pressure to the ground. The examinations included two measurements: in the first, the children stood on the platform in a natural position. Then, a 5 kg backpack was put on and they stood on the platform again. Results: Statistically significant differences were found in the distribution of the foot pressure on the ground in the left metatarsus (p = 0.000) and heel (p = 0.000) after putting on the backpack in both girls and boys. However, in the right foot, these differences concerned the metatarsal area (p = 0.001). The results of the balance tests were only statistically significant in the group of girls in the right foot sway area (p = 0.020). Conclusions: The school backpack load led to an increase in the values of the heel and metatarsal area measured in the students, causing its flattening.

Allowing the Load to Swing Reduces the Mechanical Energy of the Stance Leg and Improves the Lateral Stability of Human Walking

Loaded walking with typical rigid backpack results in a significant increase in the mechanical energy of the stance leg and a decrease in lateral stability. Allowing the load to swing, which has been applied in shoulder pole, a tool widely used in Asia for load carriage assistance, may attenuate these effects. This paper theoretically analyzes and experimentally validates the biomechanical and energetic effects of the swinging loads. When walking with a 30 kg load, allowing the load to swing reduces the fore-aft leg impulses by over 19% and further reduces the mechanical energy of the stance leg by 12.9% compared to the typical rigid backpack. The whole-body metabolic cost has no significant change, which may be attributed to the increase in the muscle work of the upper body and the leg swing. Moreover, the load movement out of phase to the human in the lateral direction reduces the lateral excursion of extrapolated center-of-mass by 27.2%, indicating an increase in the lateral margin of stability and implying an improvement in lateral stability. The results demonstrate that allowing the load to swing reduces the horizontal leg impulses and the mechanical energy of the stance leg, and improves the lateral stability of human walking.

Effects of Backpack Loads on Leg Muscle Activation during Slope Walking

Hikers and soldiers usually walk up and down slopes with a load carriage, causing injuries of the musculoskeletal system, especially during a prolonged load journey. The slope walking has been reported to lead to higher leg extensor muscle activities and joint moments. However, most of the studies investigated muscle activities or joint moments during slope walking without load carriage or only investigated the joint moment changes and muscle activities with load carriages during level walking. Whether the muscle activation such as the signal amplitude is influenced by the mixed factor of loads and grades and whether the influence of the degrees of loads and grades on different muscles are equal have not yet been investigated. To explore the effects of backpack loads on leg muscle activation during slope walking, ten young male participants walked at 1.11 m/s on a treadmill with different backpack loads (load masses: 0, 10, 20, and 30 kg) during slope walking (grade: 0, 3, 5, and 10°). Leg muscles, including the gluteus maximus (GM), rectus femoris (RF), hamstrings (HA), anterior tibialis (AT), and medial gastrocnemius (GA), were recorded during walking. The hip, knee, and ankle extensor muscle activations increased during the slope walking, and the hip muscles increased most among hip, knee, and ankle muscles (GM and HA increased by 46% to 207% and 110% to 226%, respectively, during walking steeper than 10° across all load masses (GM: p = 1.32 × 10−8 and HA: p = 2.33 × 10−16)). Muscle activation increased pronouncedly with loads, and the knee extensor muscles increased greater than the hip and ankle muscles (RF increased by 104% to 172% with a load mass greater than 30 kg across all grades (RF: p = 8.86 × 10−7)). The results in our study imply that the hip and knee muscles play an important role during slope walking with loads. The hip and knee extension movements during slope walking should be considerably assisted to lower the muscle activations, which will be useful for designing assistant devices, such as exoskeleton robots, to enhance hikers’ and soldiers’ walking abilities.