1
|
Johnson CD, Sara LK, Bradach MM, Zeppetelli DJ, Dæhlin TE, Mullineaux DR, Foulis SA, Hughes JM, Davis IS. Sex- and age-related differences in kinetics and tibial accelerations during military-relevant movement tasks in U.S. Army trainees. Eur J Sport Sci 2024; 24:740-749. [PMID: 38874992 PMCID: PMC11235782 DOI: 10.1002/ejsc.12091] [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: 10/16/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 06/15/2024]
Abstract
Lower extremity injuries are prevalent in military trainees, especially in female and older trainees. Modifiable factors that lead to higher injury risk in these subgroups are not clear. The purpose of this study was to identify whether external loading variables during military-relevant tasks differ by age and sex in U.S. Army trainees. Data was collected on 915 trainees in the first week of Basic Combat Training. Participants performed running and ruck marching (walking with 18.1 kg pack) on a treadmill, as well as double-/single-leg drop landings. Variables included: vertical force loading rates, vertical stiffness, first peak vertical forces, peak vertical and resultant tibial accelerations. Comparisons were made between sexes and age groups (young, ≤19 years; middle, 20-24 years; older, ≥25 years). Significant main effects of sex were found, with females showing higher vertical loading rates during ruck marching, and peak tibial accelerations during running and ruck marching (p ≤ 0.03). Males showed higher vertical stiffness during running and peak vertical tibial accelerations during drop landings (p < 0.01). A main effect of age was found for vertical loading rates during running (p = 0.03), however no significant pairwise differences were found between age groups. These findings suggest that higher external loading may contribute to higher overall injury rates in female trainees. Further, higher stiffness during running may contribute to specific injuries, such as Achilles Tendinopathy, that are more prevalent in males. The lack of differences between age groups suggests that other factors contribute more to higher injury rates in older trainees.
Collapse
Affiliation(s)
- Caleb D. Johnson
- Military Performance DivisionUnited States Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Lauren K. Sara
- Spaulding National Running CenterSpaulding Rehabilitation HospitalCambridgeMassachusettsUSA
- College of Health and Rehabilitation SciencesBoston UniversityBostonMassachusettsUSA
| | - Molly M. Bradach
- Spaulding National Running CenterSpaulding Rehabilitation HospitalCambridgeMassachusettsUSA
| | - David J. Zeppetelli
- Military Performance DivisionUnited States Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Torstein E. Dæhlin
- School of Physical Therapy and Rehabilitation SciencesUniversity of South FloridaTampaFloridaUSA
| | | | - Stephen A. Foulis
- Military Performance DivisionUnited States Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Julie M. Hughes
- Military Performance DivisionUnited States Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Irene S. Davis
- School of Physical Therapy and Rehabilitation SciencesUniversity of South FloridaTampaFloridaUSA
| |
Collapse
|
2
|
Brambilla C, Beltrame G, Marino G, Lanzani V, Gatti R, Portinaro N, Molinari Tosatti L, Scano A. Biomechanical Analysis of Human Gait When Changing Velocity and Carried Loads: Simulation Study with OpenSim. BIOLOGY 2024; 13:321. [PMID: 38785803 PMCID: PMC11118041 DOI: 10.3390/biology13050321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/22/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
Walking is one of the main activities of daily life and gait analysis can provide crucial data for the computation of biomechanics in many fields. In multiple applications, having reference data that include a variety of gait conditions could be useful for assessing walking performance. However, limited extensive reference data are available as many conditions cannot be easily tested experimentally. For this reason, a musculoskeletal model in OpenSim coupled with gait data (at seven different velocities) was used to simulate seven carried loads and all the combinations between the two parameters. The effects on lower limb biomechanics were measured with torque, power, and mechanical work. The results demonstrated that biomechanics was influenced by both speed and load. Our results expand the previous literature: in the majority of previous work, only a subset of the presented conditions was investigated. Moreover, our simulation approach provides comprehensive data that could be useful for applications in many areas, such as rehabilitation, orthopedics, medical care, and sports.
Collapse
Affiliation(s)
- Cristina Brambilla
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), 20133 Milan, Italy; (C.B.); (V.L.); (L.M.T.)
| | - Giulia Beltrame
- Residency Program in Orthopedics and Traumatology, Universitá degli Studi di Milano, 20122 Milan, Italy; (G.B.); (N.P.)
| | - Giorgia Marino
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Rozzano, 20098 Milan, Italy; (G.M.); (R.G.)
| | - Valentina Lanzani
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), 20133 Milan, Italy; (C.B.); (V.L.); (L.M.T.)
| | - Roberto Gatti
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Rozzano, 20098 Milan, Italy; (G.M.); (R.G.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Nicola Portinaro
- Residency Program in Orthopedics and Traumatology, Universitá degli Studi di Milano, 20122 Milan, Italy; (G.B.); (N.P.)
- Department of Pediatric Surgery, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Lorenzo Molinari Tosatti
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), 20133 Milan, Italy; (C.B.); (V.L.); (L.M.T.)
| | - Alessandro Scano
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), 20133 Milan, Italy; (C.B.); (V.L.); (L.M.T.)
| |
Collapse
|
3
|
Johnson CC, Dzewaltowski AC, Dever DE, Krajewski KT, Rai A, Ahamed NU, Allison KF, Flanagan SD, Graham SM, Lovalekar M, Anderst WJ, Connaboy C. Load carriage changes tibiofemoral arthrokinematics during ambulatory tasks in recruit-aged women. Sci Rep 2024; 14:9542. [PMID: 38664550 PMCID: PMC11045865 DOI: 10.1038/s41598-024-60187-3] [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: 01/31/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
The introduction of women into U.S. military ground close combat roles requires research into sex-specific effects of military training and operational activities. Knee osteoarthritis is prevalent among military service members; its progression has been linked to occupational tasks such as load carriage. Analyzing tibiofemoral arthrokinematics during load carriage is important to understand potentially injurious motion and osteoarthritis progression. The study purpose was to identify effects of load carriage on knee arthrokinematics during walking and running in recruit-aged women. Twelve healthy recruit-aged women walked and ran while unloaded (bodyweight [BW]) and carrying additional + 25%BW and + 45%BW. Using dynamic biplane radiography and subject-specific bone models, tibiofemoral arthrokinematics, subchondral joint space and center of closest contact location between subchondral bone surfaces were analyzed over 0-30% stance (separate one-way repeated measures analysis of variance, load by locomotion). While walking, medial compartment contact location was 5% (~ 1.6 mm) more medial for BW than + 45%BW at foot strike (p = 0.03). While running, medial compartment contact location was 4% (~ 1.3 mm) more lateral during BW than + 25%BW at 30% stance (p = 0.04). Internal rotation was greater at + 45%BW compared to + 25%BW (p < 0.01) at 30% stance. Carried load affects tibiofemoral arthrokinematics in recruit-aged women. Prolonged load carriage could increase the risk of degenerative joint injury in physically active women.
Collapse
Affiliation(s)
- Camille C Johnson
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
- Orthopaedic Biodynamics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alex C Dzewaltowski
- Center of Lower Extremity Ambulatory Research, Rosalind Franklin University of Medicine & Science, Chicago, IL, USA
| | - Dennis E Dever
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kellen T Krajewski
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ajinkya Rai
- Orthopaedic Biodynamics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nizam U Ahamed
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Katelyn F Allison
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shawn D Flanagan
- Center of Lower Extremity Ambulatory Research, Rosalind Franklin University of Medicine & Science, Chicago, IL, USA
| | - Scott M Graham
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, Scotland, UK
| | - Mita Lovalekar
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - William J Anderst
- Orthopaedic Biodynamics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chris Connaboy
- Center of Lower Extremity Ambulatory Research, Rosalind Franklin University of Medicine & Science, Chicago, IL, USA.
| |
Collapse
|
4
|
Hudson S, Ridland L, Blackburn J, Monchuk L, Ousey K. The comfort and functional performance of personal protective equipment for police officers: a systematic scoping review. ERGONOMICS 2024:1-21. [PMID: 38263946 DOI: 10.1080/00140139.2024.2302957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/03/2024] [Indexed: 01/25/2024]
Abstract
This scoping review aimed to identify and summarise evidence on the comfort and functional performance of police officer personal protective equipment (PPE). The Arksey and O'Malley (2005) five-stage framework for scoping reviews was followed. PubMed, CINAHL, Scopus, and Web of Science were searched, and 35 articles were included in the review. The findings show that increased police PPE mass increases heart rate, metabolic energy expenditure, and perceived exertion in response to exercise. Unisex armour designs cause increased discomfort for females with larger bra sizes. PPE reduces joint-specific range of motion, with the design and location impairing movement more than mass. Jumping and sprinting performance is decreased with heavy PPE but unaffected by lighter protection, while agility is compromised with most forms of protection. Future research is needed on the fit and function of PPE for specialist police units, such as mounted police, along with further investigations on how fit can affect functional performance.
Collapse
Affiliation(s)
- Sean Hudson
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Leanne Ridland
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Joanna Blackburn
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Leanne Monchuk
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Karen Ousey
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| |
Collapse
|
5
|
Hudson S, Barwood M, Low C, Wills J, Fish M. A systematic review of the physiological and biomechanical differences between males and females in response to load carriage during walking activities. APPLIED ERGONOMICS 2024; 114:104123. [PMID: 37625283 DOI: 10.1016/j.apergo.2023.104123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023]
Abstract
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.
Collapse
Affiliation(s)
- Sean Hudson
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom.
| | - Martin Barwood
- School of Health, Sport and Life Sciences, Leeds Trinity University, United Kingdom
| | - Chris Low
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Jodie Wills
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Michael Fish
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| |
Collapse
|
6
|
Hoolihan B, Wheat J, Dascombe B, Vickery-Howe D, Middleton K. The effect of external loads and biological sex on coupling variability during load carriage. Gait Posture 2023; 100:236-242. [PMID: 36640597 DOI: 10.1016/j.gaitpost.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/27/2022] [Accepted: 01/08/2023] [Indexed: 01/11/2023]
Abstract
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.
Collapse
Affiliation(s)
- Brooke Hoolihan
- Applied Sport Science and Exercise Testing Laboratory, School of Environmental and Life Sciences, University of Newcastle, Ourimbah, Australia; Applied Biomechanics Laboratory, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.
| | - Jonathan Wheat
- Sports Engineering Research Group, Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Ben Dascombe
- Applied Sport Science and Exercise Testing Laboratory, School of Environmental and Life Sciences, University of Newcastle, Ourimbah, Australia
| | - Danielle Vickery-Howe
- Applied Biomechanics Laboratory, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Kane Middleton
- Applied Biomechanics Laboratory, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| |
Collapse
|
7
|
Adopted walking condition for computational simulation approach on bearing of hip joint prosthesis: review over the past 30 years. Heliyon 2022; 8:e12050. [PMID: 36506403 PMCID: PMC9730145 DOI: 10.1016/j.heliyon.2022.e12050] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/23/2022] [Accepted: 11/24/2022] [Indexed: 12/11/2022] Open
Abstract
Bearing on artificial hip joint experiences friction, wear, and surface damage that impact on overall performance and leading to failure at a particular time due to continuous contact that endangers the user. Assessing bearing hip joint using clinical study, experimental testing, and mathematical formula approach is challenging because there are some obstacles from each approach. Computational simulation is an effective alternative approach that is affordable, relatively fast, and more accessible than other approaches in examining various complex conditions requiring extensive resources and several different parameters. In particular, different gait cycles affect the sliding distance and distribution of gait loading acting on the joints. Appropriate selection and addition of gait cycles in computation modelling are crucial for accurate and reliable prediction and analysis of bearing performance such as wear a failure of implants. However, a wide spread of gait cycles and loading data are being considered and studied by researchers as reported in literature. The current article describes a comprehensive literature review adopted walking condition that has been carried out to study bearing using computational simulation approach over the past 30 years. Many knowledge gaps related to adoption procedures, simplification, and future research have been identified to obtain bearing analysis results with more realistic computational simulation approach according to physiological human hip joints.
Collapse
|
8
|
Klaewkasikum K, Patathong T, Angsanuntsukh C, Woratanarat T, Sanguantrakul J, Woratanarat P. The ankle kinematic reference of normal gait pattern in Thai adults. Front Surg 2022; 9:915090. [PMID: 36034375 PMCID: PMC9403080 DOI: 10.3389/fsurg.2022.915090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThis study was aimed to establish the reference values of ankle kinematics and factors associated with ankle kinematics of healthy Thai adults.MethodsA prospective cohort was conducted among healthy volunteers aged between 18 and 40 years and evaluated gait analysis between 2016 and 2020. After applying the modified Halen Hayes marker set, participants were assigned to walk 8–10 rounds with their preferred speed. Demographic data i.e., age, gender and body mass index (BMI) and ankle kinematics (varus-valgus, dorsiflexion-plantar flexion, foot progression, and ankle rotation) using motion analysis software were recorded and analyzed.Results98 volunteers (60 females and 38 males) aged 28.6 ± 5.4 years with body mass index 21.2 ± 2.0 kg/m2 were included. The average ranges of ankle kinematics entire gait cycle were varus-valgus −1.62 to 3.17 degrees, dorsiflexion-plantar flexion 0.67 to 14.52 degrees, foot progression −21.73 to −8.47 degrees, and ankle rotation 5.22 to 9.74 degrees. The ankle kinematic data in this study population was significantly different from the normal values supplied by OrthoTrak software of the motion analysis program, especially more ankle internal rotation at mid-stance (5.22 vs. −12.10 degrees) and terminal stance (5.48 vs. −10.74 degrees) with P < 0.001. Foot progression significantly exhibited more external rotation for 1.5 degrees on the right compared to the left side, and for 5 degrees more in males than females. One increment in age was significantly correlated with ankle internal rotation at mid-swing (coefficient 0.21 degrees, P = 0.039). BMI had no statistical association with ankle kinematics. Statistical parametric mapping for full-time series of angle assessments showed significantly different foot progression at initial contact and terminal stance between sides, and our ankle kinematics significantly differed from the reference values of the motion analysis program in all planes (P < 0.05).ConclusionThe reference of ankle kinematics of Thai adults was established and differences between sides and the normal values of the motion analysis program were identified. Advanced age was associated with ankle internal rotation, and male gender was related to external foot progression. Further studies are needed to define all-age group reference values.
Collapse
Affiliation(s)
- Krongkaew Klaewkasikum
- Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tanyaporn Patathong
- Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chanika Angsanuntsukh
- Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thira Woratanarat
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, BangkokThailand
| | - Jongsook Sanguantrakul
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Patarawan Woratanarat
- Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Correspondence: Patarawan Woratanarat
| |
Collapse
|