Three-dimensional knee joint moments during performance of the bodyweight squat: effects of stance width and foot rotation

Females with knee osteoarthritis use a detrimental knee loading strategy when squatting

BACKGROUND

The purpose of this study was to identify sex differences in lower limb kinematics, kinetics, and muscle activation patterns between individuals with osteoarthritis and healthy controls during a two-legged squat.

METHOD

Thirty OA (15 females) and 30 healthy (15 females) participants performed three 2-legged squats. Sagittal and frontal plane hip, knee, and ankle kinematics and kinetics were calculated. Two-way ANOVAs (Sex X OA Status) were used to characterize differences in squatting strategies between sexes and between those with and without knee OA.

RESULTS

A greater decrease in sagittal hip, knee, and ankle range of motion and knee joint power was observed in the OA participants compared to the healthy controls. Females with OA had significantly reduced hip and knee adduction angles compared to the healthy females and males with OA. Females also had decreased hip power, hip flexion, and hip adduction moments and knee adduction moments compared to their male counterparts, with the greatest deficits observed in the females with OA. Females with OA also had the highest magnitude of muscle activation for the quadriceps, hamstrings, and gastrocnemius throughout the squat, while males with OA showed increased activation of the vastus lateralis and medial gastrocnemius compared to the healthy males.

CONCLUSIONS

OA significantly altered biomechanics and neuromuscular control during the squat, with males employing a hip-dominant strategy, allowing them to achieve a greater lower limb range of motion.

Biomechanical Process of Skeletal Muscle under Training Condition Based on 3D Visualization Technology

With the development and popularization of 3D technology, human behavior recognition has gradually developed from plane feature recognition to elevation feature recognition. In the process of collecting motion characteristics, the research on skeletal muscle will lead to a series of data in time series, which is the basis of sports biomechanics research and sports training. Some important semantic information such as centerline and joint center can be obtained by further data processing. The results of the study showed that the three-dimensional coordinate positions of the femur and pelvic attachment points of the muscles surrounding the hip joint from the pelvis were measured and positioned. A 3D model is built to simulate the human skeletal model subjected to speeds of 3 and 7 m/s, and different motion velocities can exhibit different motions. The research in this study shows that using 3D technology and comprehensively utilizing the expertise of biomechanical analysis and graphical modeling to study the mechanical properties of bone joints and soft tissues provide new ways and methods.

Relationships between physical characteristics and biomechanics of lower extremity during the squat

Background/objective

There is a lack of information about relationship between physical characteristics and biomechanics of the lower extremity during the squat. Additionally, studies did not examine sex-related differences. The purpose of this study was to investigate relationships between physical characteristics and biomechanics of the lower extremity during the squat, and to determine if any sex differences are present.

Methods

Fifty three participants recruited (21.82 ± 2.3 years; 75.56 ± 14.98 kg; 171.57 ± 8.38 cm) performed three squats with 75% of one repetition maximum. Femur to tibia length ratio, hip and ankle joints' flexibilities, and relative muscular strength were measured and used as physical characteristics. Net joint torques (NJT) and flexion angles of the lower extremity were extracted as dependent variables. Multiple regression (stepwise) analysis was conducted to examine the relationships with physical characteristics being factors. Pearson correlation coefficients were calculated to determine intercorrelations among the dependent variables.

Results

Relative muscular strength was related to hip NJT and knee flexion angle, and hip flexibility was related to ankle dorsiflexion. Hip and knee NJT showed moderate correlations with the corresponding flexion angles (r = 0.48-0.53; p < .01). Ankle dorsiflexion angle showed weak to moderate correlations with hip NJT and hip flexion angle (r = -0.36-0.50; p < .01) and a moderate correlation with knee NJT. No significant sex difference was observed (r = 0.52; p < .05).

Conclusion

Biomechanics of the lower extremity has been shown to correlate more with relative muscular strength and joint flexibility than with leg length ratio.

The impact of foot angle on lower limb muscles activity during the back squat and counter movement jump

BACKGROUND

Squatting is a core exercise for many purposes. However, there is still controversy surrounding the practice of targeting specific muscle groups when performing the back squat with different stance widths or foot positions. Therefore, this study aimed to assess lower limb muscle activation during different form of back squat when adopting three different foot angles.

METHODS

Eight male active participants (age 24.0±0.8 years, height 1.80±0.63m and mass 85.8±8.7kg) performed maximal isometric squat, back squat with an overalod of 80% of 1 repetition maximum, and countermovement jump (CMJ) when adopting three foot rotation angles: parallel (0°); +10° outward (external rotation); +20° outward (external rotation). We calculated the root mean square of the electromyographic signals recorded from eight participant's dominant leg muscles.

RESULTS

During the descending phase of the back squat, the 20° external foot rotation elicited greater activation of the biceps femoris (+35%; p = 0.027) and gastrocnemius medialis (+70%; p = 0.040) compared to parallel foot. There were no significant differences among the other muscles and exercise conditions.

CONCLUSIONS

The +20° foot position increased BF and GasM muscle activity only during the downward phase of the back squat. Strength coaches should consider the present findings when selecting specific resistance exercises aiming to improve athletes' strength and physical fitness.

Kinetics in lumbosacral and lower-limb joints of sprinters during barbell hip thrust compared to deadlift and back squat

Joint kinetic characteristics during the eccentric phase are important in resistance exercises because eccentric actions with elastic potential energy storage lead to the energy recoil with large joint moment and power generation during the subsequent concentric phase. Previous studies assessed the force production capacity in the barbell hip thrust; however, these were reported by the methodology using only surface electromyographic amplitudes recorded in the lower back and thigh muscles and did not focus on eccentric action. This study aimed to determine kinetic characteristics of lumbosacral, hip and knee joints of sprinters during the eccentric and concentric phases in a barbell hip thrust, compared to those of deadlift and back squat. Eleven well-trained male sprinters participated in this study. Each participant performed two full ranges of motion repetition using their previously determined six-repetition maximum loads. During strength exercises, reflective marker displacements attached to the body and a barbell were captured using 22 high-speed cameras, and ground reaction forces were captured using 4 force plates simultaneously. In the barbell hip thrust, as well as deadlift, the peak values of the lumbosacral and hip extension moments were generated almost immediately after the eccentric phase and were 24% and 42% larger than those in the back squat, respectively. In the knee joint, the largest was the peak extension moment in the back squat (155 ± 28 Nm), followed in order by that in the barbell hip thrust (66 ± 33 Nm) and that in the deadlift (24 ± 27 Nm). These demonstrated that a barbell hip thrust, as well as deadlift, can be a resistance exercise to strengthen the lower back and posterior thigh muscles. Thus, these resistance exercises may be able to be used separately according to their intended purposes, enabling transformations of strength training to specific dynamic motions such as sprint running.

Passive knee exoskeletons in functional tasks: Biomechanical effects of a SpringExo coil-spring on squats

Passive wearable exoskeletons are desirable as they can provide assistance during user movements while still maintaining a simple and low-profile design. These can be useful in industrial tasks where an ergonomic device could aid in load lifting without inconveniencing them and reducing fatigue and stress in the lower limbs. The SpringExo is a coil-spring design that aids in knee extension. In this paper, we describe the muscle activation of the knee flexors and extensors from seven healthy participants during repeated squats. The outcome measures are the timings of the key events during squat, flexion angle, muscle activation of rectus femoris and bicep femoris, and foot pressure characteristics of the participants. These outcome measures assess the possible effects of the device during lifting operations where reduced effort in the muscles is desired during ascent phase of the squat, without changing the knee and foot kinematics. The results show that the SpringExo significantly decreased rectus femoris activation during ascent (-2%) without significantly affecting either the bicep femoris or rectus femoris muscle activations in descent. This implies that the user could perform a descent without added effort and ascent with reduced effort. The exoskeleton showed other effects on the biomechanics of the user, increasing average squat time (+0.02 s) and maximum squat time (+0.1 s), and decreasing average knee flexion angle (-4°). The exoskeleton has no effect on foot loading or placement, that is, the user did not have to revise their stance while using the device.

Principal Component Analysis of the Running Ground Reaction Forces With Different Speeds

Ground reaction force (GRF) is a key metric in biomechanical research, including parameters of loading rate (LR), first impact peak, second impact peak, and transient between first and second impact peaks in heel strike runners. The GRFs vary over time during stance. This study was aimed to investigate the variances of GRFs in rearfoot striking runners across incremental speeds. Thirty female and male runners joined the running tests on the instrumented treadmill with speeds of 2.7, 3.0, 3.3, and 3.7 m/s. The discrete parameters of vertical average loading rate in the current study are consistent with the literature findings. The principal component analysis was modeled to investigate the main variances (95%) in the GRFs over stance. The females varied in the magnitude of braking and propulsive forces (PC1, 84.93%), whereas the male runners varied in the timing of propulsion (PC1, 53.38%). The female runners dominantly varied in the transient between the first and second peaks of vertical GRF (PC1, 36.52%) and LR (PC2, 33.76%), whereas the males variated in the LR and second peak of vertical GRF (PC1, 78.69%). Knowledge reported in the current study suggested the difference of the magnitude and patterns of GRF between male and female runners across different speeds. These findings may have implications for the prevention of sex-specific running-related injuries and could be integrated with wearable signals for the in-field prediction and estimation of impact loadings and GRFs.

Lower Limb Movement Pattern Differences Between Males and Females in Squatting and Kneeling

Movement pattern differences may contribute to differential injury or disease prevalence between individuals. The purpose of this study was to identify lower limb movement patterns in high knee flexion, a risk factor for knee osteoarthritis, and to investigate kinematic differences between males and females, as females typically develop knee osteoarthritis more commonly and severely than males. Lower extremity kinematic data were recorded from 110 participants completing 4 variations of squatting and kneeling. Principal component analysis was used to identify principal movements associated with the largest variability in the sample. Across the tasks, similar principal movements emerged at maximal flexion and during transitions. At maximal flexion, females achieved greater knee flexion, facilitated by a wider base of support, which may alter posterior and lateral tibiofemoral stress. Principal movements also detected differences in movement temporality between males and females. When these temporal differences occur due to alterations in movement velocity and/or acceleration, they may elicit changes in muscle activation and knee joint stress. Movement variability identified in the current study provides a framework for potential modifiable factors in high knee flexion, such as foot position, and suggests that kinematic differences between the sexes may contribute to differences in knee osteoarthritis progression.

Evaluating the effects of embedded self-massage practice on strength performance: A randomized crossover pilot trial

Background

Self-administered massage interventions with a roller massager are commonly used as part of warm-ups and post-workout recovery routines. There is yet no clear consensus regarding the practical guidelines for efficient embedded interventions.

Objectives

The present randomized crossover pilot trial aimed at examining the effects of a rolling intervention with a roller massager embedded within the rests periods of a resistance training protocol. The rolling intervention targeted quadriceps muscles.

Setting

Participants (n = 14) performed two resistance training protocols expected to elicit momentary muscle failure. The protocol consisted in 10 sets of 10 rest-pause repetitions of back squats, with a poundage set up at 50% of the maximal one-repetition. Two min were allocated to recovery between sets. During the recovery periods, participants completed a rolling routine with a roller massager for 60 s (Roller-massager), or underwent passive recovery (Control). The total workload, concentric power, thigh circumference rate of perceived exertion (RPE) and delayed onset of muscle soreness (DOMS) from 24 h to 120 h after completion of the protocol were the dependent variables.

Results

Roller-massager was associated with a reduction in total workload (-11.6%), concentric power (-5.1%) and an increase in perceived exertion compared to Control (p < 0.05). Roller-massager was also associated with reduced thigh circumference after the resistance training protocol, indicating reduced muscle swelling, and reduced DOMS 24 h to 120 h post-workout (p < 0.001).

Conclusion

These findings support that embedded rolling with a roller massager hinders performance and increases effort perception. Embedded interventions may not be suitable during conditioning periods designed to maximize training intensity.

A Comparative Study on Loadings of the Lower Extremity during Deep Squat in Asian and Caucasian Individuals via OpenSim Musculoskeletal Modelling

Populations of different ethnicities may present different movement capacities and muscular function adaptations. The purpose of this study was to investigate the differences of motion and loading in the lower extremity during dynamic deep squats between Asian and Caucasian individuals using OpenSim modelling technique with a customized squat-specific musculoskeletal model. Twenty-four participants joined the test performing the step-squat test, with right foot stepping side, squatting, and returning. The one-dimensional statistical parametric mapping package was used for statistical analysis. The main findings of the current study were as follows: (1) significant lower squat depth was observed in the Asian individuals, (2) the greater knee range of motion and contact forces were found in the Asian individuals, and (3) the greater ankle contact forces in the Caucasian individuals were notable while performing the deep squat compared to the Asian group. Knowledge found in the current study may provide implication for exercise practitioners and physiotherapists while designing schemes for the prevention of loading accumulation in the lower extremity.

The effects of a simulated occupational kneeling exposure on squat mechanics and knee joint load during gait

Occupational kneeling is associated with an increased risk for tibiofemoral knee osteoarthritis. Forces on the knee in the kneeling posture, as well as the greater incidence of meniscus tears among workers, likely contribute to the increased risk. We hypothesise that an additional mechanism may contribute - altered neuromuscular control due to prolonged high knee flexion. Forty participants (20 male, 20 female) completed an evaluation of gait and squatting before, immediately following, and 30 min following a 30 min simulated occupational kneeling exposure. An increase in the peak external knee adduction moment and a delay in vastus medialis activation onset during walking were observed post-kneeling, as well as increased frontal plane knee motion during squatting. This was the first investigation to find changes in high flexion transitions as a result of kneeling. Greater frontal plane knee motion may increase the risk for meniscal tears, and subsequently, knee osteoarthritis. Practitioner Summary: A 30 min simulated occupational kneeling exposure resulted in small but significant gait changes. The greatest effect was on frontal plane knee movement during squatting, which is especially relevant to occupations requiring frequent kneeling/squatting. This increased motion may indicate an increased risk of injury, which supports a link to knee osteoarthritis.

Hip and knee net joint moments that correlate with success in lateral load transfers over a low friction surface

We previously described two different preferred strategies used to perform a lateral load transfer. The wide stance strategy was not used successfully on a low-friction surface, while the narrow stance strategy was successful. Here, we retrospectively examined lower extremity net joint moments between successful and unsuccessful strategies to determine if there is a kinetic benefit consideration that may go into choosing the preferred strategy. Success vs. failure over a novel slippery surface was used to dichotomise 35 healthy working-age individuals into the two groups (successful and unsuccessful). Participants performed lateral load transfers over three sequential surface conditions: high friction, novel low friction and practised low friction. The unsuccessful strategy required larger start torques, but lower dynamic moments during transfer compared to the successful strategy. These results indicate that the periodically unsuccessful strategy may be preferred because it requires less muscle recruitment and lower stresses on lower extremity soft tissues. Practitioner Summary: The reason for this paper is to retrospectively examine the joint moment in two different load transfer strategies that are used in a lateral load transfer. We found that periodically unsuccessful strategies that we previously reported may be a beneficial toward reduced lower extremity joint stresses.

Uni-directional coupling between tibiofemoral frontal and axial plane rotation supports valgus collapse mechanism of ACL injury

Despite general agreement on the effects of knee valgus and internal tibial rotation on anterior cruciate ligament (ACL) loading, compelling debate persists on the interrelationship between these rotations and how they contribute to the multi-planar ACL injury mechanism. This study investigates coupling between knee valgus and internal tibial rotation and their effects on ACL strain as a quantifiable measure of injury risk. Nineteen instrumented cadaveric legs were imaged and tested under a range of knee valgus and internal tibial torques. Posterior tibial slope and the medial tibial depth, along with changes in tibiofemoral kinematics and ACL strain, were quantified. Valgus torque significantly increased knee valgus rotation and ACL strain (p<0.020), yet generated minimal coupled internal tibial rotation (p=0.537). Applied internal tibial torque significantly increased internal tibial rotation and ACL strain and generated significant coupled knee valgus rotation (p<0.001 for all comparisons). Similar knee valgus rotations (7.3° vs 7.4°) and ACL strain levels (4.4% vs 4.9%) were observed under 50 Nm of valgus and 20 Nm of internal tibial torques, respectively. Coupled knee valgus rotation under 20 Nm of internal tibial torque was significantly correlated with internal tibial rotation, lateral and medial tibial slopes, and medial tibial depth (R(2)>0.30; p<0.020). These findings demonstrate uni-directional coupling between knee valgus and internal tibial rotation in a cadaveric model. Although both knee valgus and internal tibial torques contribute to increased ACL strain, knee valgus rotation has the ultimate impact on ACL strain regardless of loading mode.

Lower extremity kinematics that correlate with success in lateral load transfers over a low friction surface

We previously studied balance during lateral load transfers, but were left without explanation of why some individuals were successful in novel low friction conditions and others were not. Here, we retrospectively examined lower extremity kinematics between successful (SL) and unsuccessful (UL) groups to determine what characteristics may improve low friction performance. Success versus failure over a novel slippery surface was used to dichotomise 35 healthy working-age individuals into the two groups (SL and UL). Participants performed lateral load transfers over three sequential surface conditions: high friction, novel low friction, and practiced low friction. The UL group used a wide stance with rotation mostly at the hips during the high and novel low friction conditions. To successfully complete the practiced low friction task, they narrowed their stance and pivoted both feet and torso towards the direction of the load, similar to the SL group in all conditions. This successful kinematic method potentially results in reduced muscle demand throughout the task. Practitioner Summary: The reason for this paper is to retrospectively examine the different load transfer strategies that are used in a low friction lateral load transfer. We found stance width to be the major source of success, while sagittal plane motion was altered to potentially maintain balance.

The effects of stance width and foot posture on lumbar muscle flexion-relaxation phenomenon

BACKGROUND

Characterizing the lumbar muscle flexion-relaxation phenomenon is a clinically relevant approach in understanding the neuromuscular alternations of low back pain patients. Previous studies have indicated that changes in stance posture could directly influence trunk kinematics and potentially change the lumbar tissue synergy. In this study, the effects of stance width and foot posture on the lumbar muscle relaxation responses during trunk flexion were investigated.

METHODS

Thirteen volunteers performed trunk flexion using three different stance widths and 'toe-forward' or 'toe-out' foot postures (six conditions in total). Lumbar muscle electromyography was collected from the L3 and L4 level paraspinals; meanwhile three magnetic motion sensors were placed over the S1, T12, and C7 vertebrae to track lumbar and trunk kinematics. The lumbar angle at which muscle activity diminished to a near resting level was recorded. At the systemic level, the boundary where the internal moment started to shift from active to passive tissues was identified.

FINDINGS

For the L3 paraspinals, the flexion relaxation lumbar angle reduced 1.3° with the increase of stance width. When changed from 'toe-forward' to 'toe-out' foot posture, the flexion relaxation lumbar angle reduced 1.4° and 1.1° for the L3 and L4 paraspinals respectively. However, the active and passive lumbar tissue load shifting boundary was not affected.

INTERPRETATION

Findings of this study suggest that changes in stance width and foot posture altered the lumbar tissue load sharing mechanism. Therefore, in a clinical setting, it is critical to maintain consistent stance postures when examining the characteristics of lumbar tissue synergy.

Principal component modeling of isokinetic moment curves for discriminating between the injured and healthy knees of unilateral ACL deficient patients

Bilateral knee strength evaluations of unilateral anterior cruciate ligament (ACL) deficient patients using isokinetic dynamometry are commonly performed in rehabilitation settings. The most frequently-used outcome measure is the peak moment value attained by the knee extensor and flexor muscle groups. However, other strength curve features may also be of clinical interest and utility. The purpose of this investigation was to identify, using Principal Component Analysis (PCA), strength curve features that explain the majority of variation between the injured and uninjured knee, and to assess the capabilities of these features to detect the presence of injury. A mixed gender cohort of 43 unilateral ACL deficient patients performed 6 continuous concentric knee extension and flexion repetitions bilaterally at 60°s(-1) and 180°s(-1) within a 90° range of motion. Moment waveforms were analyzed using PCA, and binary logistic regression was used to develop a discriminatory decision rule. For all directions and speeds, a statistically significant overall reduction in strength was noted for the involved knee in comparison to the uninvolved knee. The discriminatory decision rule yielded a specificity and sensitivity of 60.5% and 60.5%, respectively, corresponding to an accuracy of ∼62%. As such, the curve features extracted using PCA enabled only limited clinical usefulness in discerning between the ACL deficient and contra lateral, healthy knee. Improvement in discrimination capabilities may perhaps be achieved by consideration of different testing speeds and contraction modes, as well as utilization of other data analysis techniques.