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Kositsky A, Stenroth L, Barrett RS, Korhonen RK, Vertullo CJ, Diamond LE, Saxby DJ. Muscle Morphology Does Not Solely Determine Knee Flexion Weakness After Anterior Cruciate Ligament Reconstruction with a Semitendinosus Tendon Graft: A Combined Experimental and Computational Modeling Study. Ann Biomed Eng 2024; 52:1313-1325. [PMID: 38421479 PMCID: PMC10995045 DOI: 10.1007/s10439-024-03455-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024]
Abstract
The distal semitendinosus tendon is commonly harvested for anterior cruciate ligament reconstruction, inducing substantial morbidity at the knee. The aim of this study was to probe how morphological changes of the semitendinosus muscle after harvest of its distal tendon for anterior cruciate ligament reconstruction affects knee flexion strength and whether the knee flexor synergists can compensate for the knee flexion weakness. Ten participants 8-18 months after anterior cruciate ligament reconstruction with an ipsilateral distal semitendinosus tendon autograft performed isometric knee flexion strength testing (15°, 45°, 60°, and 90°; 0° = knee extension) positioned prone on an isokinetic dynamometer. Morphological parameters extracted from magnetic resonance images were used to inform a musculoskeletal model. Knee flexion moments estimated by the model were then compared with those measured experimentally at each knee angle position. A statistically significant between-leg difference in experimentally-measured maximal isometric strength was found at 60° and 90°, but not 15° or 45°, of knee flexion. The musculoskeletal model matched the between-leg differences observed in experimental knee flexion moments at 15° and 45° but did not well estimate between-leg differences with a more flexed knee, particularly at 90°. Further, the knee flexor synergists could not physiologically compensate for weakness in deep knee flexion. These results suggest additional factors other than knee flexor muscle morphology play a role in knee flexion weakness following anterior cruciate ligament reconstruction with a distal semitendinosus tendon graft and thus more work at neural and microscopic levels is required for informing treatment and rehabilitation in this demographic.
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Affiliation(s)
- Adam Kositsky
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
| | - Lauri Stenroth
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Rod S Barrett
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Christopher J Vertullo
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Knee Research Australia, Gold Coast, Queensland, Australia
| | - Laura E Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David J Saxby
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Gonçalves BAM, Saxby DJ, Meinders E, Barrett RS, Diamond LE. Hip Contact Forces During Sprinting in Femoroacetabular Impingement Syndrome. Med Sci Sports Exerc 2024; 56:402-410. [PMID: 37882088 DOI: 10.1249/mss.0000000000003320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
PURPOSE Sprinting often provokes hip pain in individuals with femoroacetabular impingement syndrome (FAIS). Asphericity of the femoral head-neck junction (cam morphology) characteristic of FAIS can increase the risk of anterior-superior acetabular cartilage damage. This study aimed to 1) compare hip contact forces (magnitude and direction) during sprinting between individuals with FAIS, asymptomatic cam morphology (CAM), and controls without cam morphology, and 2) identify the phases of sprinting with high levels of anteriorly directed hip contact forces. METHODS Forty-six recreationally active individuals with comparable levels of physical activity were divided into three groups (FAIS, 14; CAM, 15; control, 17) based on their history of hip/groin pain, results of clinical impingement tests, and presence of cam morphology (alpha angle >55°). Three-dimensional marker trajectories, ground reaction forces, and electromyograms from 12 lower-limb muscles were recorded during 10-m overground sprinting trials. A linearly scaled electromyogram-informed neuromusculoskeletal model was used to calculate hip contact force magnitude (resultant, anterior-posterior, inferior-superior, medio-lateral) and angle (sagittal and frontal planes). Between-group comparisons were made using two-sample t -tests via statistical parametric mapping ( P < 0.05). RESULTS No significant differences in magnitude or direction of hip contact forces were observed between FAIS and CAM or between FAIS and control groups during any phase of the sprint cycle. The highest anteriorly directed hip contact forces were observed during the initial swing phase of the sprint cycle. CONCLUSIONS Hip contact forces during sprinting do not differentiate recreationally active individuals with FAIS from asymptomatic individuals with and without cam morphology. Hip loading during early swing, where peak anterior loading occurs, may be a potential mechanism for cartilage damage during sprinting-related sports in individuals with FAIS and/or asymptomatic cam morphology.
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Gonçalves BA, Saxby DJ, Meinders E, Hams A, Lambert C, Jones T, Barrett RS, Diamond LE. Running Mechanics After Repeated Sprints in Femoroacetabular Impingement Syndrome, Cam Morphology, and Controls. Sports Health 2023; 15:638-644. [PMID: 36457193 PMCID: PMC10467473 DOI: 10.1177/19417381221131570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND People with femoroacetabular with femoroacetabular impingement syndrome (FAIS) often report pain during sports involving repeated sprinting. It remains unclear how sports participation influences running biomechanics in individuals with FAIS. HYPOTHESIS Changes in running biomechanics and/or isometric hip strength after repeated sprint exercise would be greatest in individuals with FAIS compared with asymptomatic individuals with (CAM) and without cam morphology (Control). STUDY DESIGN Controlled laboratory study. LEVEL OF EVIDENCE Level 3. METHODS Three-dimensional hip biomechanics during maximal running (10 m) and hip strength were measured in 49 recreationally active individuals (FAIS = 15; CAM = 16; Control = 18) before and after repeated sprint exercise performed on a nonmotorized treadmill (8-16 × 30 m). Effects of group and time were assessed for biomechanics and strength variables with repeated-measures analyses of variance. Relationships between hip pain (Copenhagen Hip and Groin Outcome Score) and changes in hip moments and strength after repeated sprint exercise were determined using Spearman's correlation coefficients (ρ). RESULTS Running speed, hip flexion angles, hip flexion and extension moments, and hip strength in all muscle groups were significantly reduced from pre to post. No significant between-group differences were observed before or after repeated sprint exercise. No significant relationships (ρ = 0.04-0.30) were observed between hip pain and changes in hip moments or strength in the FAIS group. CONCLUSION Changes in running biomechanics and strength after repeated sprint exercise did not differ between participants with FAIS and asymptomatic participants with and without cam morphology. Self-reported pain did not appear to influence biomechanics during running or strength after repeated sprint exercise in participants with FAIS. CLINICAL RELEVANCE A short bout of repeated sprinting may not elicit changes in running biomechanics in FAIS beyond what occurs in those without symptoms. Longer duration activities or activities requiring greater hip flexion angles may better provoke pathology-related changes in running biomechanics in people with FAIS.
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Affiliation(s)
- Basílio A.M. Gonçalves
- Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland; and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - David J. Saxby
- Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland; and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Evy Meinders
- Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland; and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Andrea Hams
- Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland; and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Conor Lambert
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Taryn Jones
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Rod S. Barrett
- Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland; and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Laura E. Diamond
- Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland; and School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
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Vial S, Cochrane Wilkie J, Turner M, Blazevich AJ. Fatigue does not increase limb asymmetry or induce proximal joint power shift in habitual, multi-speed runners. J Sports Sci 2023; 41:1250-1260. [PMID: 37837327 DOI: 10.1080/02640414.2023.2268374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 10/03/2023] [Indexed: 10/16/2023]
Abstract
During prolonged jogging, joint moment and work tend to decrease in the distal (ankle) joint but increase at proximal (hip/knee) joints as performance fatigue manifests, and such adaptations might be expected to occur in sprinting. Fatigue is also thought to increase inter-limb asymmetries, which is speculated to influence injury risk. However, the effects of fatigue on sprint running gait have been incompletely studied, so these hypotheses remain untested. Using statistical parametric mapping, we compared 3-D kinematics and ground reaction force production between the dominant (DL) and non-dominant (NDL) legs of 13 soccer players during both non-fatigued and fatigued sprint running. Contrary to the tested hypotheses, relative between-leg differences were greater in non-fatigued than fatigued sprinting. DL generated higher propulsive impulse due to increased ankle work, while NDL exhibited greater vertical impulse, potentially due to greater hip flexion prior to downward foot acceleration. Whilst few changes were detected in DL once fatigued, NDL shifted towards greater horizontal force production, largely resulting from an increase in plantar flexion (distal-joint) moments and power. After fatiguing running, inter-limb asymmetry was reduced and no distal-to-proximal shift in joint work was detected. These adaptations may attenuate decreases in running speed whilst minimising injury risk.
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Affiliation(s)
- Shayne Vial
- Centre for Human Performance, School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
- Centre for Precision Health, School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Jodie Cochrane Wilkie
- Centre for Human Performance, School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
- Physical Activity, Sport and Exercise Research Theme, Faculty of Health, Southern Cross University, QLD, Australia
| | - Mitchell Turner
- Centre for Precision Health, School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Anthony J Blazevich
- Centre for Human Performance, School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
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Pimenta R, Antunes H, Lopes T, Veloso A. Do Repeated Sprints Affect the Biceps Femoris Long Head Architecture in Football Players with and without an Injury History?-A Retrospective Study. BIOLOGY 2023; 12:biology12010096. [PMID: 36671788 PMCID: PMC9855802 DOI: 10.3390/biology12010096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
The aim of this study was to compare the biceps femoris long head (BFlh) architecture between football players with (twelve) and without (twenty) history of BFlh injury before and after a repeated sprint task. Fascicle length (FL), pennation angle (PA) and muscle thickness (MT) were assessed at rest and in the active condition before and after the repeated sprint protocol. Athletes with previous BFlh injury showed shorter FL at rest (p = 0.014; η2p = 0.196) and active state (p < 0.001; η2p = 0.413), and greater PA at rest (p = 0.002; η2p = 0.307) and active state (p < 0.001; η2p = 0.368) before and after the task. Intra-individual comparisons showed that injured limbs have shorter FL at rest (p = 0.012; η2p = 0.519) and in the active state (p = 0.039; η2p = 0.332), and greater PA in passive (p < 0.001; η2p = 0.732) and active conditions (p = 0.018; η2p = 0.412), when compared with contralateral limbs. Injured players, at rest and in the active condition, display shorter BFlh FL and greater PA than contralateral and healthy controls after repeated sprints. Moreover, the BFlh of injured players presented a different architectural response to the protocol compared with the healthy controls.
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Affiliation(s)
- Ricardo Pimenta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1649-004 Cruz Quebrada-Dafundo, Portugal
- Correspondence: ; Tel.: +35-19-1885-2877
| | - Hugo Antunes
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1649-004 Cruz Quebrada-Dafundo, Portugal
| | - Tomás Lopes
- Department of Biochemistry, King’s College London, London WC2R 2LS, UK
| | - António Veloso
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1649-004 Cruz Quebrada-Dafundo, Portugal
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Meinders E, Pizzolato C, Gonçalves BAM, Lloyd DG, Saxby DJ, Diamond LE. Electromyography measurements of the deep hip muscles do not improve estimates of hip contact force. J Biomech 2022; 141:111220. [PMID: 35841785 DOI: 10.1016/j.jbiomech.2022.111220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/16/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022]
Abstract
The deep hip muscles are often omitted in studies investigating hip contact forces using neuromusculoskeletal modelling methods. However, recent evidence indicates the deep hip muscles have potential to change the direction of hip contact force and could have relevance for hip contact loading estimates. Further, it is not known whether deep hip muscle excitation patterns can be accurately estimated using neuromusculoskeletal modelling or require measurement (through invasive and time-consuming methods) to inform models used to estimate hip contact forces. We calculated hip contact forces during walking, squatting, and squat-jumping for 17 participants using electromyography (EMG)-informed neuromusculoskeletal modelling with (informed) and without (synthesized) intramuscular EMG for the deep hip muscles (piriformis, obturator internus, quadratus femoris). Hip contact force magnitude and direction, calculated as the angle between hip contact force and vector from femoral head to acetabular center, were compared between configurations using a paired t-test deployed through statistical parametric mapping (P < 0.05). Additionally, root mean square error, correlation coefficients (R2), and timing accuracy between measured and modelled deep hip muscle excitation patterns were computed. No significant between-configuration differences in hip contact force magnitude or direction were found for any task. However, the synthesized method poorly predicted (R2-range 0.02-0.3) deep hip muscle excitation patterns for all tasks. Consequently, intramuscular EMG of the deep hip muscles may be unnecessary when estimating hip contact force magnitude or direction using EMG-informed neuromusculoskeletal modelling, though is likely essential for investigations of deep hip muscle function.
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Affiliation(s)
- Evy Meinders
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; Advanced Design and Prototyping Technologies Institute (ADaPT), Griffith University, Gold Coast, Queensland 4222, Australia; School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland 4222, Australia.
| | - Claudio Pizzolato
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; Advanced Design and Prototyping Technologies Institute (ADaPT), Griffith University, Gold Coast, Queensland 4222, Australia; School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland 4222, Australia
| | - Basílio A M Gonçalves
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; Advanced Design and Prototyping Technologies Institute (ADaPT), Griffith University, Gold Coast, Queensland 4222, Australia; School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland 4222, Australia
| | - David G Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; Advanced Design and Prototyping Technologies Institute (ADaPT), Griffith University, Gold Coast, Queensland 4222, Australia; School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland 4222, Australia
| | - David J Saxby
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; Advanced Design and Prototyping Technologies Institute (ADaPT), Griffith University, Gold Coast, Queensland 4222, Australia; School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland 4222, Australia
| | - Laura E Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland 4222, Australia; Advanced Design and Prototyping Technologies Institute (ADaPT), Griffith University, Gold Coast, Queensland 4222, Australia; School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland 4222, Australia; Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, The University of Queensland, Brisbane, Queensland 4072, Australia
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Meinders E, Pizzolato C, Gonçalves B, Lloyd DG, Saxby DJ, Diamond LE. Activation of the deep hip muscles can change the direction of loading at the hip. J Biomech 2022; 135:111019. [DOI: 10.1016/j.jbiomech.2022.111019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/27/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
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