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Chijimatsu M, Henmi R, Yokoyama H, Kimura Y, Ishibashi Y, Tsuda E. Anterior-Posterior Center of Pressure Is Associated With Knee Extensor Moment During Landing After Anterior Cruciate Ligament Reconstruction. J Sport Rehabil 2024; 33:259-266. [PMID: 38531345 DOI: 10.1123/jsr.2023-0296] [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: 09/08/2023] [Revised: 01/13/2024] [Accepted: 02/10/2024] [Indexed: 03/28/2024]
Abstract
CONTEXT A reduced knee extensor moment (KEM) in the involved limb and asymmetry in the KEM during landing tasks are observed after anterior cruciate ligament reconstruction (ACLR). There is limited information about the association of kinetic and kinematic parameters with the KEM during landing after ACLR. This study investigated the association of the anterior-posterior center of pressure (AP-COP) position, vertical ground reaction force (VGRF), and lower limb joint angles with the KEM during landing in female athletes following ACLR. DESIGN Cross-sectional study. METHODS Twenty-two female athletes who underwent ACLR performed a drop vertical jump at 7.9 (1.7) months after surgery. We evaluated the KEM, AP-COP position, VGRF, and sagittal plane hip, knee, and ankle angles using a 3-dimensional motion analysis system with force plates. RESULTS The peak KEM in the involved limb was significantly smaller than that in the uninvolved limb during landing (1.43 [0.33] N·m/kg/m vs 1.84 [0.41] Nm/kg/m, P = .001). The VGRF in the involved limb was significantly smaller than that in the uninvolved limb (11.9 [2.3] N/kg vs 14.6 [3.5] N/kg, P = .005). The limb symmetry index of the KEM was predicted by that of the VGRF (P < .001, R2 = .621, β = 0.800). The KEM was predicted by the AP-COP position in the involved limb (P = .015, R2 = .227, β = 0.513) and by the VGRF in the uninvolved limb (P = .018, R2 = .213, β = 0.500). No significant correlation was noted between the KEM and the lower limb joint angles. CONCLUSIONS The AP-COP position and VGRF were associated with the KEM during landing. Evaluating the VGRF and AP-COP position, not the lower limb joint angles, may contribute to understanding the KEM during double-leg landing after ACLR in the clinical setting.
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Affiliation(s)
- Masato Chijimatsu
- Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
- Department of Rehabilitation, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Rui Henmi
- Department of Rehabilitation, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Hiroko Yokoyama
- Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
- Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Miyagi, Japan
| | - Yuka Kimura
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Eiichi Tsuda
- Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
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Ishida T, Samukawa M. The Difference in the Assessment of Knee Extension/Flexion Angles during Gait between Two Calibration Methods for Wearable Goniometer Sensors. SENSORS (BASEL, SWITZERLAND) 2024; 24:2092. [PMID: 38610306 PMCID: PMC11014198 DOI: 10.3390/s24072092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
Frontal and axial knee motion can affect the accuracy of the knee extension/flexion motion measurement using a wearable goniometer. The purpose of this study was to test the hypothesis that calibrating the goniometer on an individual's body would reduce errors in knee flexion angle during gait, compared to bench calibration. Ten young adults (23.2 ± 1.3 years) were enrolled. Knee flexion angles during gait were simultaneously assessed using a wearable goniometer sensor and an optical three-dimensional motion analysis system, and the absolute error (AE) between the two methods was calculated. The mean AE across a gait cycle was 2.4° (0.5°) for the on-body calibration, and the AE was acceptable (<5°) throughout a gait cycle (range: 1.5-3.8°). The mean AE for the on-bench calibration was 4.9° (3.4°) (range: 1.9-13.6°). Statistical parametric mapping (SPM) analysis revealed that the AE of the on-body calibration was significantly smaller than that of the on-bench calibration during 67-82% of the gait cycle. The results indicated that the on-body calibration of a goniometer sensor had acceptable and better validity compared to the on-bench calibration, especially for the swing phase of gait.
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Affiliation(s)
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, North 12, West 5, Kita-ku, Sapporo 060-0812, Japan;
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Ishida T, Ino T, Yamakawa Y, Wada N, Koshino Y, Samukawa M, Kasahara S, Tohyama H. Estimation of Vertical Ground Reaction Force during Single-leg Landing Using Two-dimensional Video Images and Pose Estimation Artificial Intelligence. Phys Ther Res 2024; 27:35-41. [PMID: 38690532 PMCID: PMC11057390 DOI: 10.1298/ptr.e10276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/09/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Assessment of the vertical ground reaction force (VGRF) during landing tasks is crucial for physical therapy in sports. The purpose of this study was to determine whether the VGRF during a single-leg landing can be estimated from a two-dimensional (2D) video image and pose estimation artificial intelligence (AI). METHODS Eighteen healthy male participants (age: 23.0 ± 1.6 years) performed a single-leg landing task from a 30-cm height. The VGRF was measured using a force plate and estimated using center of mass (COM) position data from a 2D video image with pose estimation AI (2D-AI) and three-dimensional optical motion capture (3D-Mocap). The measured and estimated peak VGRFs were compared using a paired t-test and Pearson's correlation coefficient. The absolute errors of the peak VGRF were also compared between the two estimations. RESULTS No significant difference in the peak VGRF was found between the force plate measured VGRF and the 2D-AI or 3D-Mocap estimated VGRF (force plate: 3.37 ± 0.42 body weight [BW], 2D-AI: 3.32 ± 0.42 BW, 3D-Mocap: 3.50 ± 0.42 BW). There was no significant difference in the absolute error of the peak VGRF between the 2D-AI and 3D-Mocap estimations (2D-AI: 0.20 ± 0.16 BW, 3D-Mocap: 0.13 ± 0.09 BW, P = 0.163). The measured peak VGRF was significantly correlated with the estimated peak by 2D-AI (R = 0.835, P <0.001). CONCLUSION The results of this study indicate that peak VGRF estimation using 2D video images and pose estimation AI is useful for the clinical assessment of single-leg landing.
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Affiliation(s)
- Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Japan
| | - Takumi Ino
- Faculty of Health Sciences, Hokkaido University of Science, Japan
| | | | - Naofumi Wada
- Faculty of Engineering, Hokkaido University of Science, Japan
| | - Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Japan
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Koshino Y, Ishida T, Taniguchi S, Samukawa M, Kasahara S, Tohyama H. Hip and knee kinematics, center of pressure position, and ground reaction force are associated with Achilles tendon force during jump landing. Scand J Med Sci Sports 2024; 34:e14510. [PMID: 37787026 DOI: 10.1111/sms.14510] [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: 04/11/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE Jump-landing exercises are often performed during the rehabilitation of Achilles tendon (AT) injuries. However, the factors that affect the AT force (ATF) during landing are unclear. This study aimed to determine the kinematics and ground reaction force (GRF) variables associated with the peak ATF during a drop vertical jump (DVJ). METHODS The landing phase of DVJ was evaluated in 101 healthy participants (46 males, age: 21.2 ± 1.4 years old) using a three-dimensional motion analysis system with two force plates. ATF was estimated from the ankle flexion angle and moment. Univariate and multivariate regression analyses were performed with the peak ATF as the dependent variable. The vertical GRF (VGRF), center of pressure (COP), forward trunk leaning, hip/knee/ankle joint angles at peak ATF, and sex were used as independent variables. RESULTS In the univariate regression analysis, larger VGRF (β = 0.813), more anterior COP position (β = 0.214), smaller knee flexion (β = -0.251) and adduction (β = -0.252), smaller hip flexion (β = -0.407), smaller forward trunk lean (β = -0.492), and male sex (β = -0.282) were significantly associated with a larger peak ATF. Multivariate analysis revealed that larger VGRF (β = 1.018), more anterior COP position (β = 0.320), a larger knee (β = 0.442), and smaller hip flexion (β = -0.205) were associated with the larger peak ATF. CONCLUSIONS The VGRF, COP position, and knee and hip flexion were independently associated with ATF. Modifying these factors may be useful in managing tendon loading during jump-landing exercises.
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Affiliation(s)
- Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | | | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Ishida T, Samukawa M. Validity and Reliability of a Wearable Goniometer Sensor Controlled by a Mobile Application for Measuring Knee Flexion/Extension Angle during the Gait Cycle. SENSORS (BASEL, SWITZERLAND) 2023; 23:3266. [PMID: 36991977 PMCID: PMC10059898 DOI: 10.3390/s23063266] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/10/2023] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
Knee kinematics during gait is an important assessment tool in health-promotion and clinical fields. This study aimed to determine the validity and reliability of a wearable goniometer sensor for measuring knee flexion angles throughout the gait cycle. Twenty-two and seventeen participants were enrolled in the validation and reliability study, respectively. The knee flexion angle during gait was assessed using a wearable goniometer sensor and a standard optical motion analysis system. The coefficient of multiple correlation (CMC) between the two measurement systems was 0.992 ± 0.008. Absolute error (AE) was 3.3 ± 1.5° (range: 1.3-6.2°) for the entire gait cycle. An acceptable AE (<5°) was observed during 0-65% and 87-100% of the gait cycle. Discrete analysis revealed a significant correlation between the two systems (R = 0.608-0.904, p ≤ 0.001). The CMC between the two measurement days with a 1-week interval was 0.988 ± 0.024, and the AE was 2.5 ± 1.2° (range: 1.1-4.5°). A good-to-acceptable AE (<5°) was observed throughout the gait cycle. These results indicate that the wearable goniometer sensor is useful for assessing knee flexion angle during the stance phase of the gait cycle.
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Affiliation(s)
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, North 12, West 5, Kita-ku, Sapporo 060-0812, Japan
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Pelvic Rotation Is Associated With Asymmetry in the Knee Extensor Moment During Double-Leg Squatting After Anterior Cruciate Ligament Reconstruction. J Appl Biomech 2023; 39:62-68. [PMID: 36649718 DOI: 10.1123/jab.2022-0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/29/2022] [Accepted: 12/09/2022] [Indexed: 01/19/2023]
Abstract
Asymmetry in knee extensor moment during double-leg squatting was observed after anterior cruciate ligament reconstruction, even after the completion of the rehabilitation program for return to sports. The purpose of this study was to clarify the association between asymmetry in the knee extensor moment and pelvic rotation angle during double-leg squatting after anterior cruciate ligament reconstruction. Twenty-four participants performed double-leg squatting. Kinetics and kinematics during squatting were analyzed using a 3-dimensional motion analysis system with 2 force plates. The limb symmetry index of knee extensor moment was predicted by the pelvic rotation angle (R2 = .376, P = .001). In addition, the pelvic rotation and the limb symmetry index of the vertical ground reaction force independently explained the limb symmetry index of the knee extensor moment (R2 = .635, P < .001, β of pelvic rotation = -0.489, β of vertical ground reaction force = 0.524). Pelvic rotation toward the involved limb was associated with a smaller knee extensor moment in the involved limb than in the uninvolved limb. The assessment of pelvic rotation would be useful for partially predicting asymmetry in the knee extensor moment during double-leg squatting. Minimizing pelvic rotation may improve the asymmetry in the knee extensor moment during double-leg squatting after anterior cruciate ligament reconstruction.
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Ramadurai S, Jeong H, Kim M. Predicting the metabolic cost of exoskeleton-assisted squatting using foot pressure features and machine learning. Front Robot AI 2023; 10:1166248. [PMID: 37151375 PMCID: PMC10154631 DOI: 10.3389/frobt.2023.1166248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/05/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction: Recent studies found that wearable exoskeletons can reduce physical effort and fatigue during squatting. In particular, subject-specific assistance helped to significantly reduce physical effort, shown by reduced metabolic cost, using human-in-the-loop optimization of the exoskeleton parameters. However, measuring metabolic cost using respiratory data has limitations, such as long estimation times, presence of noise, and user discomfort. A recent study suggests that foot contact forces can address those challenges and be used as an alternative metric to the metabolic cost to personalize wearable robot assistance during walking. Methods: In this study, we propose that foot center of pressure (CoP) features can be used to estimate the metabolic cost of squatting using a machine learning method. Five subjects' foot pressure and metabolic cost data were collected as they performed squats with an ankle exoskeleton at different assistance conditions in our prior study. In this study, we extracted statistical features from the CoP squat trajectories and fed them as input to a random forest model, with the metabolic cost as the output. Results: The model predicted the metabolic cost with a mean error of 0.55 W/kg on unseen test data, with a high correlation (r = 0.89, p < 0.01) between the true and predicted cost. The features of the CoP trajectory in the medial-lateral direction of the foot (xCoP), which relate to ankle eversion-inversion, were found to be important and highly correlated with metabolic cost. Conclusion: Our findings indicate that increased ankle eversion (outward roll of the ankle), which reflects a suboptimal squatting strategy, results in higher metabolic cost. Higher ankle eversion has been linked with the etiology of chronic lower limb injuries. Hence, a CoP-based cost function in human-in-the-loop optimization could offer several advantages, such as reduced estimation time, injury risk mitigation, and better user comfort.
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Affiliation(s)
- Sruthi Ramadurai
- Rehabilitation Robotics Laboratory, Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, IL, United States
| | - Heejin Jeong
- The Polytechnic School, Ira A. Fulton Schools of Engineering, Arizona State University, Mesa, AZ, United States
- *Correspondence: Myunghee Kim, ; Heejin Jeong,
| | - Myunghee Kim
- Rehabilitation Robotics Laboratory, Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Myunghee Kim, ; Heejin Jeong,
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Ishida T, Samukawa M, Kasahara S, Tohyama H. The center of pressure position in combination with ankle dorsiflexion and trunk flexion is useful in predicting the contribution of the knee extensor moment during double-leg squatting. BMC Sports Sci Med Rehabil 2022; 14:127. [PMID: 35836275 PMCID: PMC9281074 DOI: 10.1186/s13102-022-00523-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022]
Abstract
Background Squatting exercises are commonly used in rehabilitation for knee joint disorders; in these exercises, control of knee extensor moment is important to enhance training effects and to avoid adverse effects. Ankle dorsiflexion and trunk flexion are widely used to reduce knee extensor moments during squatting, but the increased load on the low back is a concern. The purpose of this study was to determine whether the anterior–posterior (AP) center-of-pressure (COP) position and the AP-COP position in combination with ankle dorsiflexion and trunk flexion angles can predict the contribution of the knee extensor moment during double-leg squatting. Methods Twenty-eight healthy individuals (14 female and 14 male participants, age 22.8 ± 1.3 years) performed three sets of five consecutive double-leg squats. Kinematics and kinetics were analyzed using a three-dimensional motion analysis system with force plates. Univariate and multivariate regression analyses were performed to predict the contribution of the knee extensor moment (% total support moment) from AP-COP position, ankle dorsiflexion, and trunk flexion. Results The AP-COP position was a significant predictor of the knee extensor moment contribution (R2 = 0.168, P = 0.030). Multivariate analysis showed that the ankle dorsiflexion angle (ΔR2 = 0.561, β = 0.842) and AP-COP position (ΔR2 = 0.296, β = − 0.499) predicted the knee extensor moment contribution (model R2 = 0.857, P < 0.001). Additionally, the combination of trunk flexion (ΔR2 = 0.429, β = − 0.613) and AP-COP position (ΔR2 = 0.109, β = − 0.332) predicted the knee extensor moment contribution (model R2 = 0.538, P < 0.001). The limb symmetry index of the knee extensor moment was significantly associated with that of the AP-COP position (R2 = 0.493, P < 0.001) but not with that of the ankle dorsiflexion angle (P = 0.057). Conclusions The AP-COP position can predict the contribution of the knee extensor moment and improve the prediction when combined with ankle dorsiflexion and trunk flexion. The present findings suggest that intervention focusing on the AP-COP position in combination with ankle dorsiflexion or trunk flexion would be useful to coordinate the contribution of the knee extensor moment during double-leg squatting.
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Affiliation(s)
- Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, North 12, West 5, Kitaku, Sapporo, 060-0812, Japan.
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, North 12, West 5, Kitaku, Sapporo, 060-0812, Japan
| | - Satoshi Kasahara
- Faculty of Health Sciences, Hokkaido University, North 12, West 5, Kitaku, Sapporo, 060-0812, Japan
| | - Harukazu Tohyama
- Faculty of Health Sciences, Hokkaido University, North 12, West 5, Kitaku, Sapporo, 060-0812, Japan
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