Simultaneously assessing amplitude and temporal effects in biomechanical trajectories using nonlinear registration and statistical nonparametric mapping

How reliable are lower limb biomechanical evaluations during volleyball-specific jump-landing tasks?

BACKGROUND

Biomechanical evaluations of sport-specific jump-landing tasks may provide a more ecologically valid interpretation compared to generic jump-landing tasks. For accurate interpretation of longitudinal research, it is essential to understand the reliability of biomechanical parameters of sport-specific jump-landing tasks.

RESEARCH QUESTION

How reliable are hip, knee and ankle joint angles and moment curves during two volleyball-specific jump-landing tasks and is this comparable with the reliability of a generic jump-landing task?

METHODS

Three-dimensional (3D) biomechanical analyses of 27 male volleyball players were performed in two sessions separated by one week. Test-retest reliability was analyzed by calculating integrated as well as 1D intraclass correlation coefficient (ICC) and integrated standard error of measurement (SEM) for hip, knee and ankle angles and moments during a spike and block jump (volleyball-specific tasks), and during a drop vertical jump (generic task).

RESULTS

Reliability of joint angles of volleyball-specific and generic jump-landing tasks are similar with excellent-to-good integrated ICC for hip, knee and ankle flexion/extension (ICC= 0.61-0.89) and hip and knee abduction/adduction (ICC=0.61-0.78) but fair-to-poor ICC for ankle abduction/adduction (ICC=0.28-0.52) and hip, knee and ankle internal/external rotation (ICC=0.29-0.53). Reliability of hip, knee and ankle joint moments was good-to excellent (ICC= 0.62-0.86) except for hip flexion moment during spike jump and drop vertical jump (ICC=0.43-0.47) and knee flexion moment during both volleyball-specific tasks (ICC=0.56-0.57). For all tasks, curve analysis revealed poorer reliability at start and end of the landing phase than during the midpart.

SIGNIFICANCE

Our data suggests that kinematic evaluations of volleyball-specific jump-landing tasks are reliable to use in screening programs, especially in the sagittal plane. Notably, reliability is poorer at the beginning and end of the landing phase, requiring careful interpretation. In conclusion, the results of this study indicate the potential for integration of sport-specific jump-landing tasks in screening programs, which will be more ecologically valid.

Dependence on visual information in patients with ACL injury for multi-joint coordination during single-leg squats: a case control study

BACKGROUND

The influence of vision on multi-joint control during dynamic tasks in anterior cruciate ligament (ACL) deficient patients is unknown. Thus, the purpose of this study was to establish a new method for quantifying neuromuscular control by focusing on the variability of multi-joint movement under conditions with different visual information and to determine the cutoff for potential biomarkers of injury risk in ACL deficient individuals.

METHODS

Twenty-three ACL deficient patients and 23 healthy subjects participated in this study. They performed single-leg squats under two different conditions: open eyes (OE) and closed eyes (CE). Multi-joint coordination was calculated with the coupling angle of hip flexion, hip abduction and knee flexion. Non-linear analyses were performed on the coupling angle. Dependence on vision was compared between groups by calculating the CE/OE index for each variable. Cutoff values were calculated using ROC curves with ACL injury as the dependent variable and significant variables as independent variables.

RESULTS

The sample entropy of the coupling angle was increased in all groups under the CE condition (P < 0.001). The CE/OE index of coupling angle variability during the descending phase was higher in ACL deficient limbs than in the limbs of healthy participants (P = 0.036). The CE/OE index of sample entropy was higher in the uninjured limbs of ACL deficient patients than in the limbs of healthy participants (P = 0.027). The cutoff value of the CE/OE index of sample entropy was calculated to be 1.477 (Sensitivity 0.957, specificity 0.478).

CONCLUSION

ACL deficient patients depended on vision to control multiple joint movements not only on the ACL deficient side but also on the uninjured side during single leg squat task. These findings underscore the importance of considering visual dependence in the assessment and rehabilitation of neuromuscular control in ACL deficient individuals.

Altered upper limb kinematics in individuals with dyskinetic cerebral palsy in comparison with typically developing peers - A statistical parametric mapping study

BACKGROUND

Dyskinetic cerebral palsy (DCP) is clinically characterized by involuntary movements and abnormal postures, which can aggravate with activity. While upper limb movement variability is often detected in the clinical picture, it remains unknown how movement patterns of individuals with DCP differ from typically developing (TD) peers.

RESEARCH QUESTION

Do individuals with DCP show i) higher time-dependent standard deviations of upper limb joint angles and ii) altered upper limb kinematics in time and/or amplitude during functional upper limb tasks in comparison with TD individuals?

METHODS

Three-dimensional upper limb movement patterns were cross-sectionally compared in 50 individuals with and without DCP during three functional tasks: reach forward (RF), reach and grasp vertical (RGV) and reach sideways (RS). Mean and point-wise standard deviations of angular waveform of the upper limb joint angles were compared between groups to evaluate differences in time and/or amplitude using traditional and non-linear registration statistical parametric mapping.

RESULTS

Thirty-five extremities from 30 individuals (mean age 17y4m, range 5-25 y; MACS level I(n = 2); II(n = 15); III(n = 16); IV(n = 2)) with DCP and twenty TD individuals (mean age 16y8m, range 8-25 y) were evaluated. The DCP compared to TD group showed higher point-wise standard deviations at the level of all joints, which was time-dependent and varied between tasks. Mean wrist and elbow flexion was higher for the DCP group during RF (0-83 % wrist; 57-100 % elbow), RGV (0-82 % wrist; 12-100 % elbow) and RS (0-43 % wrist; 70-100 % elbow).

SIGNIFICANCE

This is the first study exploring the movement patterns of individuals with DCP during reaching using quantitative measures. Analyzing these individual movement patterns by statistical parametric mapping (SPM) allows us to focus on both specific joint or on specific timing during the movement cycle. The individual information that this method yields can guide individual therapy aiming to improve reaching function in different parts of the movement cycle or evaluate intervention effects on upper extremity treatment.

Acute effects of robot-assisted body weight unloading on biomechanical movement patterns during overground walking

Body weight unloading (BWU) is used in rehabilitation/training settings to reduce kinetic requirements, however different BWU methods may be unequally capable of preserving biomechanical movement patterns. Biomechanical analysis of both kinetic and kinematic movement trajectories rather than discrete variables has not previously been performed to describe the effect of BWU on gait patterns during horizontal walking. The aim of the present study was to investigate how robot-assisted BWU producing an dynamic unloading force on the body centre of mass, affects kinematic, kinetic, and spatiotemporal gait parameters in healthy young adults by use of time-continuous analysis. Twenty participants walked overground in a 3-D motion-capture lab at 0, 10, 20, 30, 40, and 50 % BWU at a self-selected speed. Vertical and anterior-posterior ground reaction forces (GRFs) and lower limb internal joint moments were obtained during the stance phase, while joint angles were obtained during entire strides. Time-continuous data were analysed using Statistical Parametric Mapping (SPM) and discrete data using conventional statistics to compare different BWU conditions by means of One-Way Repeated Measures Anova. With increasing BWU, corresponding reductions were observed for GRFs, internal joint moments, joint angles, walking speed, stride/step length and cadence. Observed effects were partially caused by decreased walking speed and increased BWU. While amplitude reductions were observed for kinetic and kinematic variables, trajectory shapes were largely preserved. In conclusion, dynamic robot-assisted BWU enables reduced kinetic requirements without distorting biomechanically normal gait patterns during overground walking in young healthy adults.

Beyond peak torque: Longitudinal analysis of angle-specific isokinetic knee torques in collegiate athletes post-ACLR

OBJECTIVES

To investigate changes in angle-specific knee extensor torque between limbs from 4 to 12 months post-anterior cruciate ligament reconstruction(ACLR) in Division I collegiate athletes at two different isokinetic velocities.

DESIGN

Case-series study.

SETTING

Laboratory-based.

PARTICIPANTS

Isokinetic knee flexion and extension assessments of 17 athletes (11 female) at 4, 8, and 12 months after ACLR with bone-patellar tendon-bone autograft were evaluated.

MAIN OUTCOME MEASURES

Angle-specific curve analyses were performed using statistical parametric mapping for torque data obtained between 14 and 101° at 60°/s and 240°/s velocities.

RESULTS

At 60°/s, knee extensor torque of the operated limb increased between 4 and 8 months (18-101°,p < 0.001), 4 and 12 months (28-101°,p < 0.001), and 8 and 12 months post-surgery (62-70°,p = 0.002, and 79-90°,p < 0.001). Knee extensor torque was lower in the operated limb compared to the non-operated limb at 4 (47-97°,p < 0.001) and 8 months (65-90°,p < 0.001) for 60°/s, at 4 (21-89°,p < 0.001) and 8 months (50-77°,p < 0.001) for 240°/s, with no between-limb differences at 12 months post-ACLR for both velocities.

CONCLUSIONS

Operated limb knee extensor torque increased throughout the majority of knee range of motion from 4 to 12 months post-ACLR at both isokinetic velocities, while non-operated limb torque only improved through a reduced arc of motion in greater knee flexion angles.

Application of statistical parametric mapping for comparison of scapular kinematics and EMG

Scapular kinematics and EMG are frequently measured as a functional assessment of the shoulder. Previous studies have compared interval averaging for these time series data, but it is not clear whether this method exactly captures the dynamics of scapular kinematics and muscle activity. Statistical parametric mapping (SPM) can be used to compare time series data. The purpose of this study was to investigate whether there is a difference between the results of SPM and interval averaging (every 10° or 30°) in comparing scapular kinematics, EMG, and EMG ratio. Scapular kinematics and EMG of the upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT) and serratus anterior (SA) were measured in 21 healthy males. Tasks included arm raising and lowering with or without load, and we compared scapular kinematics, EMG, and EMG ratio in the loaded and unloaded conditions. Results suggest disagreement between SPM and interval averaging. Characteristic results are that for scapular kinematics during lowering SPM showed a decrease in upward rotation in only the regions 113-65° and 42-30°, while interval averaging showed a decrease in all range. For EMG during lowering, SPM results were not significantly different in SA over 50-48 and 45-30°, while interval averaging suggested increased activity in all ranges. For EMG ratio during raising, SPM showed no significant difference, while interval averaging showed a decrease in UT/LT during the latter period. These results indicate that SPM provides better resolution regarding effect regions than interval averaging, and suggest that SPM may improve shoulder function assessment accuracy.

A continuous statistical-geometric framework for normative and impaired gaits

A quantitative analysis of human gait patterns in space-time provides an opportunity to observe variability within and across individuals of varying motor capabilities. Impaired gait significantly affects independence and quality of life, and thus a large part of clinical research is dedicated to improving gait through rehabilitative therapies. Evaluation of these paradigms relies on understanding the characteristic differences in the kinematics and underlying biomechanics of impaired and unimpaired locomotion, which has motivated quantitative measurement and analysis of the gait cycle. Previous analysis has largely been limited to a statistical comparison of manually selected pointwise metrics identified through expert knowledge. Here, we use a recent statistical-geometric framework, elastic functional data analysis (FDA), to decompose kinematic data into continuous 'amplitude' (spatial) and 'phase' (temporal) components, which can then be integrated with established dimensionality reduction techniques. We demonstrate the utility of elastic FDA through two unsupervised applications to post-stroke gait datasets. First, we distinguish between unimpaired, paretic and non-paretic gait presentations. Then, we use FDA to reveal robust, interpretable groups of differential response to exosuit assistance. The proposed methods aim to benefit clinical practice for post-stroke gait rehabilitation, and more broadly, to automate the quantitative analysis of motion.