No physiological or biomechanical sex-by-load interactions during treadmill-based load carriage

A systematic review of the physiological and biomechanical differences between males and females in response to load carriage during walking activities

The purpose of this review was to systematically assess literature on differences between males and females in the physiological and biomechanical responses to load carriage during walking. PubMed, CINAHL, Scopus, Web of Science and the Cochrane library were searched. A total of 4637 records were identified and screened. Thirty-three papers were included in the review. Participant characteristics, load carriage conditions, study protocol, outcome measures and main findings were extracted and qualitatively synthesised. Absolute oxygen uptake and minute ventilation were consistently greater in males but there were limited sex-specific differences when these were expressed relative to physical characteristics. There is limited evidence of sex-specific differences in spatio-temporal variables, ground reaction forces (normalised to body mass) or sagittal plane joint angles with load. However, differences have been found in hip and pelvic motions in the frontal and horizontal planes, which might partly explain an economical advantage for females proposed by some authors.

The effect of external loads and biological sex on coupling variability during load carriage

BACKGROUND

Load carriage is a fundamental requirement for military personnel that commonly results in lower-limb injuries. Coupling variability represents a potential injury mechanism for such repetitive tasks and its unknown whether external loads and biological sex affect coupling variability during load carriage.

RESEARCH QUESTION

Is there a sex-by-load interaction during load carriage at self-selected walking speeds?

METHODS

Twenty-six participants (13 males, 13 females) completed three 10-minute treadmill-based trials wearing body-borne external load (0 %BM, 20 %BM, and 40 %BM) at load-specific self-selected walking speeds. A Vicon motion capture system tracked markers with a lower-body direct-kinematic model calculating sagittal-plane segment kinematics of the thigh, shank, and foot across 19 strides. Continuous relative phase standard deviation (CRPv) provided a measure of coupling variability for each coupling angle (Thigh-Shank and Shank-Foot). The CRPv for each load and sex was compared using statistical parametric mapping repeated measures ANOVA and paired t tests.

RESULTS

Significant sex-by-load interactions were reported for the Thigh-Shank coupling. Males demonstrated no significant load differences in CRPv, however, females displayed significantly higher CRPv in the 40 %BM than the 0 %BM condition. A significant main effect of load was observed in the Shank-Foot coupling, with the 40 %BM having significantly greater CRPv than the other load conditions.

SIGNIFICANCE

Both biological sex and external loads significantly affected CRPv during load carriage at self-selected walking speeds. Females demonstrated greater CRPv at the heavier loads, suggesting that the perturbation from the heavier mass increases coupling variability, which may also be amplified by a greater total passive load due to their relatively higher adipose tissue compared to males. The consistent CRPv in males suggests that higher relative loads may be required to change coupling variability. Collectively, these results suggest that external load affects the coupling variability of males and females differently, providing potential for injury screening and monitoring programs.

Biomechanical and physiological effects of female soldier load carriage: A scoping review

Loads carried by military populations can affect those of smaller stature, such as the average female, due to the higher percentage of body weight the loads represent. Despite this, most load carriage research is performed on males. Peer reviewed articles were collected from four databases to summarize available research on biomechanical and physiological effects of load carriage on females in the military. Extraction and thematic analysis were performed on 18 articles. 39% looked at biomechanical differences between loads in females, 61% looked at how the same load affected males and females, 44% looked at sex-by-load interaction effects, and 72% discussed impacts of load on females. The research revealed that military load carriage affects the biomechanics and physiology differently in females and to a greater extent than in males. Several gaps in available literature were found. Very few studies used military participants, military equipment, and/or employed occupationally relevant data collection methodologies.

Physiological impact of load carriage exercise: Current understanding and future research directions

Load carriage (LC) refers to the use of personal protective equipment (PPE) and/or load-bearing apparatus that is mostly worn over the thoracic cavity. A commonplace task across various physically demanding occupational groups, the mass being carried during LC duties can approach the wearer's body mass. When compared to unloaded exercise, LC imposes additional physiological stress that negatively impacts the respiratory system by restricting chest wall movement and altering ventilatory mechanics as well as circulatory responses. Consequently, LC activities accelerate the development of fatigue in the respiratory muscles and reduce exercise performance in occupational tasks. Therefore, understanding the implications of LC and the effects specific factors have on physiological capacities during LC activity are important to the implementation of effective mitigation strategies to ameliorate the detrimental effects of thoracic LC. Accordingly, this review highlights the current physiological understanding of LC activities and outlines the knowledge and efficacy of current interventions and research that have attempted to improve LC performance, whilst also highlighting pertinent knowledge gaps that must be explored via future research activities.

Mechanical Differences between Men and Women during Overground Load Carriage at Self-Selected Walking Speeds

Few studies have directly compared physical responses to relative loading strategies between men and women during overground walking. This study aimed to compare gait mechanics of men and women during overground load carriage. A total of 30 participants (15 male, 15 female) completed three 10-min walking trials while carrying external loads of 0%, 20% and 40% of body mass at a self-selected walking speed. Lower-body motion and ground reaction forces were collected using a three-dimensional motion capture system and force plates, respectively. Female participants walked with a higher cadence (p = 0.002) and spent less absolute time in stance (p = 0.010) but had similar self-selected walking speed (p = 0.750), which was likely due to the female participants being shorter than the male participants. Except for ankle plantarflexion moments, there were no sex differences in spatiotemporal, kinematic, or kinetic variables (p > 0.05). Increasing loads resulted in significantly lower self-selected walking speed, greater stance time, and changes in all joint kinematics and kinetics across the gait cycle (p < 0.05). In conclusion, there were few differences between sexes in walking mechanics during overground load carriage. The changes identified in this study may inform training programs to increase load carriage performance.

Modeling the Metabolic Costs of Heavy Military Backpacking

Introduction

Existing predictive equations underestimate the metabolic costs of heavy military load carriage. Metabolic costs are specific to each type of military equipment, and backpack loads often impose the most sustained burden on the dismounted warfighter.

Purpose

This study aimed to develop and validate an equation for estimating metabolic rates during heavy backpacking for the US Army Load Carriage Decision Aid (LCDA), an integrated software mission planning tool.

Methods

Thirty healthy, active military-age adults (3 women, 27 men; age, 25 ± 7 yr; height, 1.74 ± 0.07 m; body mass, 77 ± 15 kg) walked for 6–21 min while carrying backpacks loaded up to 66% body mass at speeds between 0.45 and 1.97 m·s⁻¹. A new predictive model, the LCDA backpacking equation, was developed on metabolic rate data calculated from indirect calorimetry. Model estimation performance was evaluated internally by k-fold cross-validation and externally against seven historical reference data sets. We tested if the 90% confidence interval of the mean paired difference was within equivalence limits equal to 10% of the measured metabolic rate. Estimation accuracy and level of agreement were also evaluated by the bias and concordance correlation coefficient (CCC), respectively.

Results

Estimates from the LCDA backpacking equation were statistically equivalent (P < 0.01) to metabolic rates measured in the current study (bias, −0.01 ± 0.62 W·kg⁻¹; CCC, 0.965) and from the seven independent data sets (bias, −0.08 ± 0.59 W·kg⁻¹; CCC, 0.926).

Conclusions

The newly derived LCDA backpacking equation provides close estimates of steady-state metabolic energy expenditure during heavy load carriage. These advances enable further optimization of thermal-work strain monitoring, sports nutrition, and hydration strategies.

Gait and neuromuscular dynamics during level and uphill walking carrying military loads

The neuromuscular system responds to perturbation and increasing locomotor task difficulty by altering the stability of neuromuscular output signals. The purpose of this study was to determine the effects of two different military load carriage systems on the dynamic stability of gait and muscle activation signals. 14 army office cadets (20 ± 1 years) performed 4-minute treadmill walking trials on level (0%) and uphill (10%) gradients while unloaded, and with 11 kg backpack and 11 kg webbing loads while the activity of 6 leg and trunk muscles and the motion of the centre of mass (COM) were recorded. Loaded and uphill walking decreased stability and increased magnitude of muscle activations compared to loaded and level gradient walking. Backpack loads increased the medio-lateral stability of COM and uphill walking decreased stability of vertical COM motion and increased stride time variability. However, there was no difference between the two load carriage systems for any variable. The reduced stability of muscle activations in loaded and uphill conditions indicates an impaired ability of the neuromuscular control systems to accommodate perturbations in these conditions which may have implications on the operational performance of military personnel. However, improved medio-lateral stability in backpack conditions may indicate that participants were able to compensate for the loads used in this study, despite the decreased vertical stability and increased stride time variability evident in uphill walking. This study did not find differences between load carriage systems however, specific load carriage system effects may be elicited by greater load carriage masses.Highlights Loaded and uphill walking decreased dynamic stability of muscle activationsLower activation stability indicates impaired neuromotor resistance to perturbationBackpack and webbing loads produced similar effects on muscle activations.

Treadmill load carriage overestimates energy expenditure of overground load carriage

This study compared physiological and biomechanical responses between treadmill and overground load carriage. Thirty adults completed six 10-minute walking trials across three loads (0, 20, and 40% body mass) and two surfaces (treadmill and overground). Relative oxygen consumption was significantly greater on the treadmill for 20% (1.54 ± 0.20 mL⋅kg^-1⋅min^-1) and 40% loads (1.08 ± 0.20 mL⋅kg^-1⋅min^-1). All other physiological and perceptual responses were significantly higher in the treadmill condition and with increases in load. Stance time was longer (0%: 0.05 s; 20%: 0.02 s, 40%: 0.05 s, p < 0.001) and cadence was lower (0%: 1 step·min^-1; 20%: 2 steps·min^-1; 40%: 3 steps·min^-1, p < 0.05) on the treadmill. Peak lower limb joint angles were similar between surfaces except for ankle plantar flexion, which was 8˚ greater on the treadmill. The physiological responses to treadmill-based load carriage are generally not transferable to overground load carriage and caution must be taken when conducting treadmill-based load carriage research to inform operational-based scenarios. Practitioner Summary: Literature is limited when comparing the physiological and biomechanical responses to treadmill and overground load carriage. Using a repeated measures design, it was shown that although walking kinematics are generally similar between surfaces, there was a greater physiological demand while carrying a load on a treadmill when compared with overground. Abbreviations: BM: body mass; e.g: for example; HR: heart rate; HR_max: heart rate maximum; Hz: hertz; kg: kilograms; km·h^-1: kilometres per hour; L⋅min^-1: litres per minute; m: metres; MD: mean difference; mL·kg^-1·min^-1: millilitres per kilogram per minute; mL⋅min^-1: millilitres per minute; η²p: partial-eta squared; OG: overground; RPE: rating of perceived exertion; s: seconds; SD: standard deviation; SE: standard error; steps·min^-1: steps per minute; TM: treadmill; V̇CO₂: volume of carbon dioxide; V̇E: ventilation; V̇O₂: volume of oxygen; V̇O_2max: maximum volume of oxygen; y: years.