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Context: Analyzing flick movement kinematics biomechanically is important to prevent sport-related injuries in underwater hockey players since the aquatic-based flick movement is completely different from land-based flick movements. The study aimed to describe the flick movement kinematic biomechanically in underwater hockey players. Moreover, this study further aimed to investigate the effect of the Thrower's Ten exercises on flick movement kinematics in underwater hockey players. Design: Descriptive laboratory study. Methods: Seventeen underwater hockey players (age: 26.2 [4.3] y; sports age: 6.2 [4.5] y) were included. First, 2 underwater cameras using motion capture video analysis MATLAB were used to biomechanically analyze the angular changes on the shoulder, elbow, wrist, and body while players were performing the flick movements. Players were then recruited to the Thrower's Ten exercise program for 6 weeks. Flick movement kinematics and flick-throwing distance were recorded at baseline and 6 weeks. Results: The flick movement kinematic patterns demonstrated increased shoulder flexion (from 102.5° to 144.9°), wrist extension (from 9.5° to 10.8°), and upper-extremity rotation (from 5.7° to 56.8°) while decreased elbow extension (from 107.7° to 159.2°) from the stick met the puck until the competition of the movement. The Thrower's Ten exercises improved the elbow extension (P =.04), wrist extension (P =.01), body rotation (P <.001), and flick-throwing distance (P <.001) from baseline to 6 weeks. Conclusion: This study describes the underwater flick kinematic technique biomechanically and interprets preliminary findings for the first time. Thus, 6 weeks of Thrower's Ten exercise program provides more body muscle movements than the smaller ones during the flick movements and higher flick-throwing distance in underwater hockey players. [ABSTRACT FROM AUTHOR]

Purpose: Performing back squats with elastic bands has been widely used in resistance training. Although research demonstrated greater training effects obtained from adding elastic bands to the back squat, little is known regarding the optimal elastic resistance and how it affects neuromuscular performance. This study aimed to compare the force, velocity, power, and muscle activity during back squats with different contributions of elastic resistance. Methods: Thirteen basketball players performed 3 repetitions of the back squat at 85% of 1-repetition maximum across 4 conditions: (1) total load from free weight and (2) 20%, (3) 30%, and (4) 40% of the total load from elastic band and the remaining load from free weight. The eccentric and concentric phases of the back squat were divided into upper, middle, and bottom phases. Results: In the eccentric phase, mean velocity progressively increased with increasing elastic resistance, and muscle activity of the vastus medialis and rectus femoris significantly increased with the largest elastic resistance in the upper phase (P ≤.036). In the concentric phase, mean power (P ≤.021) and rate of force development (P ≤.002) significantly increased with increasing elastic resistance. Furthermore, muscle activity of the vastus lateralis and vastus medialis significantly improved with the largest elastic resistance in the upper phases (P ≤.021). Conclusion: Velocity, power, rate of force development, and selective muscle activity increased as the elastic resistance increased in different phases during the back-squat exercise. [ABSTRACT FROM AUTHOR]

Purpose: To compare the kinematic profile of 2 underwater pullout breaststroke techniques. Methods: Sixteen swimmers (9 men, 20.67 [2.71] y old; 7 women, 18.86 [0.83] y old) performed 3 × 25-m breaststroke using 2 pullout breaststroke techniques: Fly-Kick first and Combined. A speedometer was used to assess the peak and the mean velocity during the glide, propulsion, and recovery phases of both techniques, as well as for the total underwater sequence. The underwater distance was retrieved from video footage and was considered for each pullout technique. The range of motion of the knee during the fly-kick was also retrieved, and the time to complete the 25 m was considered the performance outcome, accompanied by the mean velocity, stroke rate, stroke length, and stroke index. Results: Velocity–time series showed different profiles between pullout techniques (P ≤.05) mostly in the glide and propulsion phases for males and females, respectively. The mean velocity of 25 m was shown to be greater in females when using the Fly-Kick first technique (P =.05, d = 0.36). Greater values in total underwater distance and knee range of motion were also observed for this technique in both cohorts. Conclusions: Female swimmers presented a higher performance when using the Fly-Kick first technique. Different kinematic profiles arise when swimmers use different underwater pullout techniques where the Fly-Kick first may allow them to reach higher kinematical standard. [ABSTRACT FROM AUTHOR]

Musculoskeletal modeling, typically implemented using marker-based systems in laboratory environments, is commonly used for noninvasive estimations of loads. Inertial measurement units (IMUs) have become an alternative for the evaluation of kinematics. However, estimates of spine joint contact forces using IMUs have yet to be thoroughly evaluated. Dynamics tasks and static postures from activities of daily living were captured on 11 healthy subjects using both systems simultaneously. Spine kinematics obtained from IMU- and marker-based systems and L4–L5 joint contact forces were compared. Lateral bending resulted in a weak agreement with significant differences between the 2 systems (P =.02, average root mean-squared error = 4.81), whereas flexion–extension and axial rotation exhibited the highest agreement with no significant differences (P <.05, average root mean-squared error = 5.51 and P <.31, average root mean-squared error = 5.08, respectively). All tasks showed excellent correlations (R2 =.76–.99) in estimated loads between systems. Differences in predicted loads at the L4–L5 were only observed during flexion–extension (1041 N vs 947 N, P =.0004) and walking with weights (814 N vs 727 N, P =.004). Different joint reaction force outcomes were obtained in 2 of the 8 tasks between systems, suggesting that IMUs can be robust tools allowing for convenient and less expensive evaluations and for longitudinal assessments inside and outside the laboratory setting. [ABSTRACT FROM AUTHOR]

This study investigated how data series length and gaps in human kinematic data impact the accuracy of Lyapunov exponents (LyE) calculations with and without cubic spline interpolation. Kinematic time series were manipulated to create various data series lengths (28% and 100% of original) and gap durations (0.05–0.20 s). Longer gaps generally resulted in significantly higher LyE% error values in each plane in noninterpolated data. During cubic spline interpolation, only the 0.20-second gap in frontal plane data resulted in a significantly higher LyE% error. Data series length did not significantly affect LyE% error in noninterpolated data. During cubic spline interpolation, sagittal plane LyE% errors were significantly higher at shorter versus longer data series lengths. These findings suggest that not interpolating gaps in data could lead to erroneously high LyE values and mischaracterization of movement variability. When applying cubic spline, a long gap length (0.20 s) in the frontal plane or a short sagittal plane data series length (1000 data points) could also lead to erroneously high LyE values and mischaracterization of movement variability. These insights emphasize the necessity of detailed reporting on gap durations, data series lengths, and interpolation techniques when characterizing human movement variability using LyE values. [ABSTRACT FROM AUTHOR]

Postural assessments of the lumbar spine lack valuable information about its properties. The purpose of this study was to assess neutral zone (NZ) characteristics via in vivo lumbar spine passive stiffness and relate NZ characteristics to standing lumbar lordosis. A comparison was made between those that develop low back pain during prolonged standing (pain developers) and those that do not (nonpain developers). Twenty-two participants with known pain status stood on level ground, and median lumbar lordosis angle was calculated. Participants were then placed in a near-frictionless jig to characterize their passive stiffness curve and location of their NZ. Overall, both pain developers and nonpain developers stood with a lumbar lordosis angle that was more extended than their NZ boundary. Pain developers stood slightly more extended (in comparison to nonpain developers) and had a lower moment corresponding to the location of their extension NZ boundary. Overall, in comparison to nonpain developers, pain developers displayed a lower moment corresponding to the location of their extension NZ boundary which could correspond to greater laxity in the lumbar spine. This may indicate why pain developers have a tendency to stand further beyond their NZ with greater muscle co-contraction. [ABSTRACT FROM AUTHOR]

This study estimated the contribution of the midfoot joint complex (MJC) kinematics to the pelvis anterior–posterior positions during the stance phase of walking and investigated whether the MJC is functionally coordinated with the lower limb joints to maintain similar pelvic positions across steps. Hip, knee, ankle, and MJC sagittal angles were measured in 11 nondisabled participants during walking. The joints' contributions to pelvic positions were computed through equations derived from a link-segment model. Functional coordination across steps was identified when the MJC contribution to pelvic position varied and the summed contributions of other joints varied in the opposite direction (strong negative covariations [r ≤ −.7] in stance phase instants). We observed that the MJC plantarflexion (arch raising) during the midstance and late stance leads the pelvis backward, avoiding excessive forward displacement. The MJC was the second joint that contributed most to the pelvis positions (around 18% of all joints' contributions), after the ankle joint. The MJC and ankle were the joints that were most frequently coordinated with the other joints (≅70% of the stance phase duration). The findings suggest that the MJC is part of the kinematic chain that determines pelvis positions during walking and is functionally coordinated with the lower limb joints. [ABSTRACT FROM AUTHOR]

Purpose: To explore the association of the load–velocity (L-V) relationship variables and ability to maintain maximal mechanical performance during the prone bench-pull exercise with sprint swimming performance and in-water forces. Methods: Eleven competitive adult male swimmers (50-m front crawl World Aquatics points: 488 [66], performance level 4) performed 1 experimental session. The L-V relationship variables (L0 [ie, maximal theoretical load at 0 velocity]; v0 [ie, maximal theoretical velocity at 0 load], and Aline [ie, area under the L-V relationship]) and maximal mechanical maintenance capacity were assessed at the beginning of the session. Afterward, sprint swimming performance and in-water force production were tested through a 50-m front-crawl all-out trial and 15-s fully-tethered swimming, respectively. Results: Only v0 presented high positive associations with 50-m time and swimming kinematics (r >.532; P <.046). The L0, v0, and Aline showed very high positive associations with the in-water forces during tethered swimming (r >.523; P <.049). However, the ability to maintain maximal mechanical performance, assessed by the mean velocity decline during the prone bench pull, was only significantly correlated with stroke rate (r = −.647; P =.016) and stroke index (r =.614; P =.022). Conclusions: These findings indicate that maximal neuromuscular capacities, especially v0, have a stronger correlation with swimming performance and in-water force production than the ability to maintain maximal mechanical performance in level 4 swimmers. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the preliminary effects of movement pattern training (MoveTrain) versus strengthening/flexibility (standard) treatment on hip and pelvic biomechanics in patients with chronic hip-related groin pain. This is a secondary analysis of data collected during a pilot randomized clinical trial. Thirty patients with hip pain, between the ages of 15 and 40 years, were randomized to MoveTrain or standard. Both groups completed 10 treatment sessions over 12 weeks along with a daily home exercise program. Three-dimensional motion analysis was used to collect kinematic and kinetic data of the pelvis and hip during a single-leg squat task at pretreatment and immediately posttreatment. Compared with the standard group, the MoveTrain group demonstrated smaller hip adduction angles (P =.006) and smaller hip external adduction moments (P =.008) at posttreatment. The desired changes to hip joint biomechanics, as found in this study, may require specificity in training that could allow health care professionals to better customize the rehabilitation of patients with hip pain. These findings can also be applied to the design and implementation of future clinical trials to strengthen our understanding of the long-term implications of different rehabilitation techniques for patients with hip pain. [ABSTRACT FROM AUTHOR]

More than 80% of adult manual wheelchair users with spinal cord injuries will experience shoulder pain. Females and those with decreased shoulder dynamics variability are more likely to experience pain in adulthood. Sex-related differences in shoulder dynamics variability during pediatric manual wheelchair propulsion may influence the lifetime risk of pain. We evaluated the influence of sex on 3-dimensional shoulder complex joint dynamics variability in 25 (12 females and 13 males) pediatric manual wheelchair users with spinal cord injury. Within-subject variability was quantified using the coefficient of variation. Permutation tests evaluated sex-related differences in variability using an adjusted critical alpha of P =.001. No sex-related differences in sternoclavicular or acromioclavicular joint kinematics or glenohumeral joint dynamics variability were observed (all P ≥.042). Variability in motion, forces, and moments are considered important components of healthy joint function, as reduced variability may increase the likelihood of repetitive strain injury and pain. While further work is needed to generalize our results to other manual wheelchair user populations across the life span, our findings suggest that sex does not influence joint dynamics variability in pediatric manual wheelchair users with spinal cord injury. [ABSTRACT FROM AUTHOR]

Purpose: Power output is dependent on the load used during exercise such as bench-press throw (BPT). Attentional focus (external [EXT] vs internal [INT]) during exercise significantly modulates power performance. The purpose of the present study was to examine the effects of load and attentional focus on mechanical parameters during BPT. Methods: In a crossover study, 31 resistance-trained men (mean age 23.5 [3.0] y) performed BPT at 30% (light), 50% (moderate), and 70% (heavy) of 1-repetition maximum (1-RM) using an INT or EXT focus of attention in randomized order. A linear encoder was used to identify barbell vertical displacement, throw time, peak/average velocity, force, and power during the concentric lifting phase. Results: Statistical analysis revealed significant load × focus interaction effects for velocity and vertical displacement (P ≤.045; 0.66 ≤ d ≤ 0.89). Post hoc analyses indicated significantly larger velocities and displacements at 30% and 70% of 1-RM in favor of EXT (P ≤.038; 0.79 ≤ d ≤ 1.13) but similar values at 50% of 1-RM (P >.05). Furthermore, significant main effects of load were found for throw time, force, and power (P <.001; 4.20 ≤ d ≤ 14.0). While time and force gradually increased with higher loads (P <.001; 1.45 ≤ d ≤ 14.0), power output was larger at 50% compared with 30% and 70% 1-RM (P <.001; 3.09 ≤ d ≤ 7.07), irrespective of attentional focus. Conclusions: The present findings indicated that practitioners may use EXT over INT attentional focus to enhance velocity and vertical displacement during BPT at light and heavy loads (ie, 30% and 70% 1-RM). At moderate loads (ie, 50% 1-RM), mechanical bench-press parameters appear to be less affected by attentional focus. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to analyze the effect of different eccentric tempos on eccentric kinetics and kinematics and the subsequent concentric performance when performing countermovement jumps against different loads. Methods: After 1-repetition-maximum assessment and 2 familiarization sessions, 13 well-trained participants performed, in randomized order, 12 sets (4 tempos × 3 loads) of 4 repetitions of the loaded countermovement-jump exercise. The eccentric tempos analyzed were 5 and 2 seconds, as fast as possible, and accelerated (ie, without pause between repetitions), while the loads used were 30%, 50%, and 70% of 1-repetition maximum. Several kinetic and kinematic variables during both phases were recorded by linking a linear position transducer to the barbell. Results: The eccentric work was greater in the accelerated condition despite no changes in the eccentric depth. The peak and mean propulsive velocities were greater in the as-fast-as-possible and accelerated conditions. Correlation analysis showed that, compared with the 5-second condition, the increased concentric performance in the accelerated condition was related to the difference in eccentric work performed in the last 100 milliseconds of the eccentric phase (r >.770). Conclusions: Contrary to current practices, the current study highlights the need for performing the eccentric phase of loaded countermovement jumps, a common exercise performed by athletes for both training and evaluation purposes, as fast as possible. This allows not only a greater eccentric work but also improved concentric performance. [ABSTRACT FROM AUTHOR]

Context: Anterior cruciate ligament injuries are directly related to the control of dynamic knee valgus in the landing of a jump, and this is mainly due to the correct activation and neuromuscular function of the lower-extremity muscles. The aim of the study is to assess the relationship between lower limb muscle activity during a single-legged drop jump and knee frontal plane projection angle (FPPA). Design: A correlation study. Methods: Thirty healthy collegiate female athletes were included in the study. Main outcomes measures were peak knee FPPA and muscle activity (% of maximal voluntary isometric contraction). Peak knee FPPA during a single-legged drop jump test was identified using a 2-dimensional motion analysis system. Muscle activity was assessed using a surface electromyograph for gluteus maximus, gluteus medius, biceps femoris, semitendinosus, vastus medialis quadriceps, vastus lateralis quadriceps, medial gastrocnemius, and lateral gastrocnemius. All variables were assessed for both dominant and nondominant limbs. A correlation analysis between peak knee FPPA and muscle activity was performed. Statistical significance was set at P <.05. Results: A mean peak knee FPPA of 14.52° and 13.38° was identified for dominant and nondominant limb single-legged drop jump test, respectively. Muscle activity (% of maximal voluntary isometric contraction) for muscles assessed ranged from 43.97% to 195.71% during the single-legged drop jump test. The correlation analysis found no significant correlation between any of the muscles assessed and peak knee FPPA during the single-legged drop jump test (Pearson coefficient between −.3 and.1). Conclusions: There is no association between muscle activity from the lower limb muscles and the knee FPPA during a single-legged drop jump in female athletes. Thus, different muscle properties should be assessed in order to understand such an important movement as the knee FPPA during a jump. [ABSTRACT FROM AUTHOR]

Prior studies have explored the relationship between knee valgus and musculoskeletal variables to formulate injury prevention programs, primarily for females. Nonetheless, there is insufficient evidence pertaining to professional male soccer players. Here, the aim was to test the correlation of lateral trunk inclination, hip adduction, hip internal rotation, ankle dorsiflexion range of motion, and hip isometric strength with knee valgus during the single-leg vertical jump test. Twenty-four professional male soccer players performed a single-leg vertical hop test, hip strength assessments, and an ankle dorsiflexion range of motion test. A motion analysis system was employed for kinematic analysis. Maximal isometric hip strength and ankle dorsiflexion range of motion were tested using a handheld dynamometer and a digital inclinometer, respectively. The correlation of peak knee valgus with peak lateral trunk inclination was.43 during the landing phase (P =.04) and with peak hip internal rotation was −.68 (P <.001). For knee valgus angular displacement, only peak lateral trunk inclination presented a moderate positive correlation (r =.40, P =.05). This study showed that trunk and hip kinematics are associated with knee valgus, which could consequently lead to increased knee overload in male professional soccer players following a unilateral vertical landing test. [ABSTRACT FROM AUTHOR]

There is mixed evidence on the role that biological sex plays in shoulder biomechanics despite known differences in musculoskeletal disorder prevalence between males and females. Additionally, advancing age may contribute to shoulder kinematic changes. The purpose of this study was to determine if sex and age influenced scapular and thoracohumeral kinematics during a range of functional tasks. Sixty healthy participants aged 19–63 years (30 males; 30 females) completed a functional task protocol while their upper limb motion was recorded. Scapular and humeral angles were calculated and compared with multiple linear regressions to assess the interaction effects of sex and age. Shoulder kinematics were not different between sex and age groups for many of the functional tasks. However, females had lower humeral external rotation in the overhead lift task (15°, P <.001), and less scapular anterior tilt angles in the forward transfer task (6°, P <.001) than males. Age was positively associated with humeral elevation (R2 =.330, P <.001) and scapular rotation (R2 =.299, P <.001) in the Wash Axilla task. There exist some kinematic differences between sex and with advancing age for select functional tasks, which should be considered for musculoskeletal disorder development. [ABSTRACT FROM AUTHOR]

The present randomized study investigated the effect of acute supplementation of 800 mg/kg of ketone monoester ingestion (KE) or placebo (PL) and 210 mg/kg of NaHCO3 co-ingestion on cycling performance of WorldTour cyclists during a road cycling stage simulation. Twenty-eight cyclists participated in the study (27.46 ± 4.32 years; 1.80 ± 0.06 m; 69.74 ± 6.36 kg). Performance, physiological, biochemical, and metabolism outcomes, gut discomfort, and effort perceived were assessed during a road cycling simulation composed of an 8-min time-trial (TT) performance + 30-s TT + 4.5 hr of outdoor cycling + a second 8-min TT + a second 30-s TT. Greater absolute and relative mean power during the first 8-min TT (F = 5.067, p =.033, η p 2 =.163 , F = 5.339, p =.029, η p 2 =.170 , respectively) was observed after KE than after PL (KE: 389 ± 34, PL: 378 ± 44 W, p =.002, d = 0.294 and KE: 5.60 ± 0.42, PL: 5.41 ± 0.44 W/kg, p =.001, d = 0.442). Additionally, greater concentration of β-hydroxybutyrate blood concentration (F = 42.195, p <.001, η p 2 =.619) was observed after KE than after PL during the first steps of the stage (e.g., after warm-up KE: 1.223 ± 0.642, PL: 0.044 ± 0.058 mM, p <.001, d = 2.589), although the concentrations returned to near baseline after 4.5 hr of outdoor cycling. Moreover, higher values of anion gap were observed (F = 2.333, p =.026, η p 2 =.080) after KE than after PL ingestion, after the warm-up and after the first 8-min and 30-s TT. Additionally, lower concentrations of HCO 3 − were reported in the KE condition after warm-up and after the first 8-min and 30-s TT. During the initial phase of the stage simulation, acute supplementation with KE + NaHCO3 co-ingestion enhanced 8-min TT cycling performance (3.1%) in WorldTour cyclists with a concomitant hyperketonaemia. [ABSTRACT FROM AUTHOR]

Radiofrequency ablation of the medial branch is commonly used to treat chronic low back pain involving facet joints, which accounts for 12% to 37% of the total cases of chronic low back pain. An adverse effect of this procedure is the denervation of the multifidus muscle, which may lead to its atrophy which can affect the spine and possibly disc degeneration. This study aims to quantify changes in joint angles and loading caused by multifidus denervation after radiofrequency ablation. AnyBody model of the torso was used to evaluate intervertebral joints in flexion, lateral bending, and torsion. Force-dependent kinematics was used to calculate joint angles and forces. These dependent variables were investigated in intact multifidus, unilateral, and bilateral ablations of L3L4, L4L5, and L5S1 joints. The results showed pronounced angular joint changes, especially in bilateral ablations in flexion, when compared with other cases. The same changes' trend from intact to unilaterally then bilaterally ablated multifidus occurred in joint angles of lateral bending. Meanwhile, joint forces were not adversely affected. These results suggest that multifidus denervation after radiofrequency ablation affects spinal mechanics. Such changes may be associated with abnormal tissue deformations and stresses that can potentially alter their mechanobiology and homeostasis, thereby possibly affecting the health of the spine. [ABSTRACT FROM AUTHOR]

Shoulder complex stability can be estimated in vivo through the analysis of helical axes (HAs) dispersion during upper limb movements. The study aimed at investigating test–retest reliability of shoulder HAs dispersion parameters during upper limb tasks. Twenty healthy volunteers performed 2 intransitive (shoulder flexion and rotation) and one transitive (combing) tasks with the dominant and nondominant upper limbs during 2 recording sessions at 1-week distance. Kinematics was detected through an optoelectronic system. Mean distance and mean angle (MA) were adopted as HAs dispersion indexes. Reliability was excellent for mean distance (intraclass correlation coefficient [ICC]:.91) and MA (ICC:.92) during dominant flexion, and good for MA (ICC:.90) during nondominant flexion. Moderate reliability was found for HAs parameters during rotation (ICCs from.70 to.59), except for MA during dominant rotation where reliability was poor. Reliability was good for mean distance (ICC:.83) and moderate for MA (ICC:.67) during the dominant combing task, whereas no reliability was found during the nondominant combing task. HAs dispersion parameters revealed high reliability during simple intransitive tasks with the dominant limb. Reliability decreased with the increase in task complexity due to the increase in movement variability. HAs dispersion technique could be used to assess shoulder complex stability in patients after rehabilitation or surgery. [ABSTRACT FROM AUTHOR]

Previous research has shown that there are differences in mechanical energy, kinematics, and muscle activation when comparing walking on level and incline surfaces, especially on inclines above 15%. Muscle activations are significantly different while walking on extreme inclines, suggesting a different coordination pattern. We utilized continuous relative phase to assess walking kinematic coordination with respect to increased incline angles. Twelve healthy, college-aged individuals walked for 7 inclines of 1 minute each on a motorized treadmill at 3 mph at 0%, 5%, 10%, 15%, 20%, 25%, and 30% inclines. Kinematic data were collected during the last 20 seconds of each stage (120 Hz). Segmental and joint angles and angular velocities in the sagittal plane were calculated, from which continuous relative phase was determined for 3 joint couples: hip–knee, hip–ankle, and knee–ankle. There were significant differences in the coordination patterns during the first part of the contact phase in the hip–knee and hip–ankle couplings between the 0% and 30% inclines, with all 3 joint couplings becoming more in-phase at inclines above 15%. Importantly, the hip–knee coupling changed significantly from more out-of-phase to more in-phase between 10% and 15% incline. Shifting lower-extremity joint coordination in response to extreme inclines identifies potential coordinative strategies to achieve steep walking. [ABSTRACT FROM AUTHOR]

Purpose: Advanced footwear technology is prevalent in distance running, with research focusing on these "super shoes" in competitive athletes, with less understanding of their value for slower runners. The aim of this study was to compare physiological and biomechanical variables between a model of super shoes (Saucony Endorphin Speed 2) and regular running shoes (Saucony Cohesion 13) in recreational athletes. Methods: We measured peak oxygen uptake (VO2peak) in 10 runners before testing each subject 4 times in a randomly ordered crossover design (ie, Endorphin shoe or Cohesion shoe, running at 65% or 80% of velocity at VO2peak [vVO2peak]). We recorded video data using a high-speed camera (300 Hz) to calculate vertical and leg stiffnesses. Results: 65% vVO2peak was equivalent to a speed of 9.4 km·h−1 (0.4), whereas 80% vVO2peak was equivalent to 11.5 km·h−1 (0.5). Two-way mixed-design analysis of variance showed that oxygen consumption in the Endorphin shoe was 3.9% lower than in the Cohesion shoe at 65% vVO2peak, with an interaction between shoes and speed (P =.020) meaning an increased difference of 5.0% at 80% vVO2peak. There were small increases in vertical and leg stiffnesses in the Endorphin shoes (P <.001); the Endorphin shoe condition also showed trivial to moderate differences in step length, step rate, contact time, and flight time (P <.001). Conclusions: There was a physiological benefit to running in the super shoes even at the slower speed. There were also spatiotemporal and global stiffness improvements indicating that recreational runners benefit from wearing super shoes. [ABSTRACT FROM AUTHOR]

Context: Single- and dual-task walking gait assessments have been used to identify persistent movement and cognitive dysfunction among athletes with concussions. However, it is unclear whether previous ankle sprain injuries confound these outcomes during baseline testing. The purpose of this study was to determine the effects of (1) ankle sprain history and (2) time since prior ankle sprain injury on single- and dual-task spatiotemporal gait outcomes and cognitive measures. Design: Cross- sectional study. Methods: We assessed 60 college Division-I athletes (31 with ankle sprain history; 13 females and 18 males, 19.3 [0.8] y; 29 with no ankle sprain history, 14 females and 15 males, 19.7 [0.9] y) who completed injury history forms and underwent concussion baseline testing. Athletes completed single- and dual-task gait assessments by walking back and forth along an 8-m walkway for 40 seconds. Athletes wore a smartphone with an associated mobile application on their lumbar spine to record spatiotemporal gait parameters and dual-task cognitive performance. Separate multivariate analyses of variance were used to assess the effects of ankle sprain injury history on spatiotemporal measures, gait variability, and cognitive performance. We performed a multivariate regression subanalysis on athletes who reported time since injury (n = 23) to assess temporal effects on gait and cognitive performance. Results: Athletes with and without a histoiy of ankle sprains had comparable spatiotemporal and gait variability outcomes during single- (P = .42; P = .13) and dual-task (P = .75; P = .55) conditions. Additionally, ankle sprain injury history did not significantly influence cognitive performance (P = .35). Finally, time since ankle sprain did not significantly affect single- (P = .75) and dual-task gait (P = .69), nor cognitive performance (P = 19). Conclusions: Ankle sprain injury history did not significantly alter spatiotemporal gait outcomes nor cognitive performance during this common clinical assessment. Future studies may consider including athletes with ankle sprain injury history during concussion assessments. [ABSTRACT FROM AUTHOR]

Context: To assess the reliability of a remote 2D markerless motion tracking method (Kinovea) to quantify knee and hip angles during dynamic tasks. Methods: Fourteen healthy adults performed body weight squats and lateral lunges while video recording themselves at home. Knee and hip angles were quantified in the sagittal plane for the squats and in the frontal plane for the lateral lunges. Two students each performed the video analysis procedure twice, 2 weeks apart. Intraclass correlation coefficients were used to calculate the intrarater and interrater reliability for angles at maximum depth. The intrarater and interrater agreement over the joint angle-time signals were quantified using a validation metric; an acceptable agreement threshold was set at a validation metric of 0.803 or higher. Standard error of measurement (SEM) was also calculated. Results: Reliability was good to excellent (intraclass correlation coefficients = .80-.98) for all angle comparisons at maximum depth. The agreement over the entire joint angle-time signal was acceptable for all squat variables except for the interrater hip angle comparison (validation metric = 0.797). None of the lateral lunge variables met the threshold of acceptable agreement. The mean SEM across participants for all joint angle-time signal and for maximum depth was acceptable (<5°) for all measurements (SEM = 1.2°-4.9°). Conclusions: Overall, the reliability, agreement, and SEM quantified in this study support the integration of remote methods to quantify lower-extremity kinematics into research and clinical practice. [ABSTRACT FROM AUTHOR]

Context: Different resistance exercise determinants modulate the musculotendinous adaptations following eccentric hamstring training. The Nordic Hamstring Exercise (NHE) can be performed 2-fold: the movement velocity irreversibly increases toward the end of the range of motion or it is kept constant. Design: This cross-sectional study aimed to investigate if the downward acceleration angle (DWAangle) can be used as a classification parameter to distinguish between increasing and constant velocity NHE execution. Furthermore, the kinetic and kinematic differences of these 2 NHE execution conditions were examined by analyzing the DWAangle in relation to the angle of peak moment. Methods: A total of 613 unassisted NHE repetitions of 12 trained male sprinters (22 y, 181 cm, 76 kg) were analyzed. Results: The majority of analyzed parameters demonstrated large effects. NHEs with constant velocity (n = 285) revealed significantly higher impulses (P <.001; d = 2.34; + 61%) and fractional time under tension (P <.001; d = 1.29; +143%). Although the generated peak moments were significantly higher for constant velocity (P =.003; d = 0.29; +4%), they emerged at similar knee flexion angles (P =.167; d = 0.28) and revealed on average just low relationships to the DWAangle ( R mean 2 = 22.4 %). DWAangle highly correlated with the impulse ( R mean 2 = 60.8 %) and δ (DWAangle–angle of peak moment; R mean 2 = 83.6 %). Conclusions: Relating DWAangle to angle of peak moment assists to distinguish between significantly different NHE execution, which will potentially elicit different musculotendinous adaptations. These insights are essential for coaches and athletes to understand how to manipulate eccentric hamstring training to change its purpose. [ABSTRACT FROM AUTHOR]

Context: Early identification of incoming military personnel at elevated odds for bone stress injury (BSI) is important for the health and readiness of the US military. Design: Prospective cohort study. Methods: Knee kinematic data of the incoming US Military Academy cadets were collected while performing a jump-landing task (The Landing Error Scoring System) using a markerless motion capture system and depth camera. Data on incidence of lower-extremity injury, including BSI, were collected throughout the study period. Results: A total of 1905 participants (452 females, 23.7%) were examined for knee valgus and BSI status. A total of 50 BSI occurred during the study period (incidence proportion = 2.6%). The unadjusted odds ratio for BSI at initial contact was 1.03 (95% confidence interval [CI], 0.94–1.14; P =.49). Adjusted for sex, the odds ratio for BSI at initial contact was 0.97 (95% CI, 0.87–1.06; P =.47). At the instant of maximum knee-flexion angle, the unadjusted odds ratio was 1.06 (95% CI, 1.02–1.10; P =.01), and the odds ratio was 1.02 (95% CI, 0.98–1.07; P =.29) after adjusting for sex. This suggests that there was not a significant enough association for an increase in the odds of BSI based on either degree of knee valgus. Conclusions: Our results did not demonstrate an association between knee valgus angle data during a jump-landing task and future increased odds of BSI in a military training population. Further analysis is warranted, but the results suggests the association between kinematics and BSI cannot be effectively screened by knee valgus angle data in isolation. [ABSTRACT FROM AUTHOR]

Purpose: This study sought to quantify the within-individual relationships between spatiotemporal variables and initial acceleration sprint performance in elite rugby backs and to establish a normative data set of relevant strength-based measures. Methods: First, the spatiotemporal variables, ratios of step length to step rate and of contact time to flight time, and initial acceleration performance were obtained from 35 elite male rugby backs (mean [SD] age 25 [3] y) over the first 4 steps of 3 sprints. Angular and linear kinematic aspects of technique and strength-based qualities were collected from 25 of these participants. Second, the same spatiotemporal variables were collected from 19 of the participants on 3 further occasions (12 trials in total) to determine the within-individual associations of these variables and initial acceleration performance. Results: Moderate to very large meaningful within-individual relationships (|r| =.43–.88) were found between spatiotemporal variables and initial acceleration performance in 17 of the 19 participants. From these relationships, a theoretically "desirable" change in whole-body kinematic strategy was individually determined for each participant, and normative strength-based measures to contextualize these were established. Conclusions: Meaningful within-individual relationships are evident between sprint spatiotemporal variables and initial acceleration performance in elite rugby backs. Individualized approaches are therefore necessary to understand how aspects of technique relate to initial acceleration performance. This study provides an objective, evidence-based approach for applied practitioners to identify the initial acceleration technical needs of individual rugby backs. [ABSTRACT FROM AUTHOR]

Context: Laboratorial 3-dimensional kinematic analyses have shown changes in the single-leg squat's (SLS) pattern of patients with femoroacetabular impingement syndrome (FAIS). However, it is unknown whether clinicians are able to detect these changes using 2-dimensional kinematics. Objective: To compare the frontal plane 2-dimensional kinematics of patients with FAIS and asymptomatic individuals in the SLS test performed in a clinical setting. Design: Case-control study. Setting: Physical therapy clinic. Participants: Twenty men with bilateral FAIS and 20 asymptomatic men. Main Outcome Measures: Two-dimensional kinematic analysis was collected in the frontal plane during the execution of the SLS test. The outcomes were squat depth, pelvic drop (pelvis angle relative to the horizontal plane), hip adduction (femur angle relative to the pelvis), and knee valgus (femur angle relative to the tibia). Results: Most and least painful limbs of patients with FAIS had squat depth (9.8% [2.9%] and 9.5% [3.1%] of height), pelvic drop (4.2° [3.9°] and 3.7° [4.2°]), hip adduction (74.9° [5.8°] and 75.9° [5.7°]), and knee valgus (4.0° [11.0°] and 5.0° [9.9°]) similar to asymptomatic individuals (9.0% [2.3%], 4.8° [2.6°], 73.7° [4.9°], and −1.7° [8.5°]; P >.05 for all). Conclusion: The frontal plane 2-dimensional kinematic analysis of the SLS test in the clinical setting is not able to distinguish patients with FAIS from asymptomatic individuals. [ABSTRACT FROM AUTHOR]

The upper body and trunk muscles are crucial to perform soccer kicks. Resistance training targeting these muscles may modify the pattern adopted during kicking. This study aimed to investigate the effect of resistance training of the arm and anterior trunk muscles on instep kicking kinematics. Twenty-six male participants were randomly allocated into a training group or control group. The training group underwent resistance training of arm and trunk muscles and practiced the instep kick for 8 weeks. The control group only practiced kicking during the same period. The trunk, hip, and knee kinematics were assessed during the instep kick before and after the intervention. Kinematics were analyzed according to their data distribution with statistical parametric or nonparametric mapping. The effect of the training on the 1-repetition maximum test was analyzed using a repeated-measures multivariate analysis of variance. The training group showed greater hip extension after the training during the backswing phase (Hedge g effect size of 0.316–0.321) and increased 1-repetition maximum for all exercises. There were no other differences. The present study documented the nonlocal effect of strengthening training in which arm and trunk muscle training resulted in changes in hip kinematics during the backswing phase of the instep kick. [ABSTRACT FROM AUTHOR]

Single-leg landings with or without subsequent jumping are frequently used to evaluate landing biomechanics. The purpose of this study was to investigate the effects of subsequent jumping on the external knee abduction moment and trunk and hip biomechanics during single-leg landing. Thirty young adult female participants performed a single-leg drop vertical jumping (SDVJ; landing with subsequent jumping) and single-leg drop landing (SDL; landing without subsequent jumping). Trunk, hip, and knee biomechanics were evaluated using a 3-dimensional motion analysis system. The peak knee abduction moment was significantly larger during SDVJ than during SDL (SDVJ 0.08 [0.10] N·m·kg−1·m−1, SDL 0.05 [0.10] N·m·kg−1·m−1, P =.002). The trunk lateral tilt and rotation angles toward the support-leg side and external hip abduction moment were significantly larger during SDVJ than during SDL (P <.05). The difference in the peak hip abduction moment between SDVJ and SDL predicted the difference in the peak knee abduction moment (P =.003, R2 =.252). Landing tasks with subsequent jumping would have advantages for evaluating trunk and hip control as well as knee abduction moment. In particular, evaluating hip abduction moment may be important because of its association with the knee abduction moment. [ABSTRACT FROM AUTHOR]

Breast cancer affects one in 8 females with a 5-year survival rate of 89%. Up to 72% of breast cancer survivors have trouble with activities of daily living (ADL) following treatment. Increased time-from-treatment improves some measures of function, yet ADL limitations persist. Therefore, this study assessed the effect of time-from-treatment on upper extremity kinematics during ADLs in breast cancer survivors. Twenty-nine female breast cancer survivors were divided into 2 groups: <1 year (n = 12) and 1–2 years (n = 17) from treatment. Kinematics were collected during 6 ADL tasks, and humerothoracic joint angles were quantified. A 2-way mixed analysis of variance assessed the effects of time-from-treatment and arm on maximum angles for each ADL. Decreased maximum angle existed for breast cancer survivors with increased time-from-treatment during all ADLs. Breast cancer survivors in the 1–2 years group used ∼28° to 32° lower elevation, ∼14° to 28° lower axial rotation, and ∼10° to 14° lower plane of elevation range across tasks. Decreased ranges of arm movement during ADLs with increased time-from-treatment may reflect compensatory movement strategies. Recognizing this shift in strategies and accompanying underlying disease progression can help inform responses to functional performance limitations in breast cancer survivors as delayed effects are present posttreatment. [ABSTRACT FROM AUTHOR]

Soccer, one of the most popular sports in the world, has one of the highest rates of sports-related concussions. Additionally, soccer players are frequently exposed to nonconcussive impacts from intentionally heading the ball, a fundamental component of the sport. There have been many studies on head impact exposure in soccer, but few focus on soccer practices or practice activities. This study aimed to characterize the frequency and magnitude of head impacts in National Collegiate Athletic Association Division I female soccer practice activities using a custom-fit instrumented mouthpiece. Sixteen players were instrumented over the course of 54 practice sessions. Video analysis was performed to verify all mouthpiece-recorded events and classify practice activities. Category groupings of practice activities include technical training, team interaction, set pieces, position-specific, and other. Differences in head impact rates and peak resultant kinematics were observed across activity types and category groupings. Technical training had the highest impact rate compared to other category groupings. Impacts occurring during set piece activities had the highest mean kinematic values. Understanding drill exposure can help inform coaches on training plans aimed to reduce head impact exposure for their athletes. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the interaction of kinematic, kinetic, and energetic variables as speed predictors in adolescent swimmers in the front-crawl stroke. Design: Ten boys (mean age [SD] = 16.4 [0.7] y) and 13 girls (mean age [SD] = 14.9 [0.9] y) were assessed. Methods: The swimming performance indicator was a 25-m sprint. A set of kinematic, kinetic (hydrodynamic and propulsion), and energetic variables was established as a key predictor of swimming performance. Multilevel software was used to model the maximum swimming speed. Results: The final model identified time (estimate = −0.008, P =.044), stroke frequency (estimate = 0.718, P <.001), active drag coefficient (estimate = −0.330, P =.004), lactate concentration (estimate = 0.019, P <.001), and critical speed (estimate = −0.150, P =.035) as significant predictors. Therefore, the interaction of kinematic, hydrodynamic, and energetic variables seems to be the main predictor of speed in adolescent swimmers. Conclusions: Coaches and practitioners should be aware that improvements in isolated variables may not translate into faster swimming speed. A multilevel evaluation may be required for a more effective assessment of the prediction of swimming speed based on several key variables rather than a single analysis. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effect of neuromuscular electrical stimulation on the frontal ankle motor control in individuals with chronic ankle instability during drop landing. Design: This was a randomized, controlled, double-blind trial. Thirtysix individuals with chronic ankle instability were randomly assigned to each group. Participants received 6-wk neuromuscular electrical stimulation intervention and sham stimulation in the neuromuscular electrical stimulation and control groups, respectively. Data were collected at week0 and week6. A mixed-effects model and analysis of covariance were employed to investigate the between-group differences in continuous and discrete outcome variables at week6, with the outcome variables at week0 as covariates. Results: Compared to control group, neuromuscular electrical stimulation group exhibited a 2.66° (2.45, 2.86) reduction in frontal ankle inversion angle, a 47.41°/sec (−16.05, −78.77) decrease in peak ankle inversion angular velocity, and a 0.43 Nm/kg (0.18, 0.68) increase in peak ankle eversion moment during drop landing at week6. Conclusions: Applying 6-wk neuromuscular electrical stimulation to the fibularis longus resulted in decreased ankle inversion angle and ankle inversion angular velocity and increased peak ankle eversion moment during drop landing. Consequently, neuromuscular electrical stimulation could be considered an effective modality for individuals with chronic ankle instability to enhance the frontal ankle movement patterns and overall ankle motor control. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the impact of combining transcranial direct current stimulation with end-effector robot-assisted treatment on upper limb function, spasticity, and hand dexterity in chronic stroke patients. Design: This was a prospective, double-blind randomized trial with 20 equally allocated stroke patients. The experimental group received dual transcranial direct current stimulation (anode over affected M1, cathode over contralateral M1) alongside robot-assisted treatment, while the control group received sham transcranial direct current stimulation with the same electrode placement + robot-assisted treatment. Each patient underwent 20 combined transcranial direct current stimulation and robot-assisted treatment sessions. The primary outcome measure was the Fugl-Meyer Upper Limb motor score, with secondary outcomes including AMADEO kinematic measures, Action Research Arm Test, and Functional Independence Measure. Assessments were conducted at baseline, after rehabilitation, and 3 mos later. Results: Combining bilateral transcranial direct current stimulation with robot-assisted treatment did not yield additional improvements in Fugl Meyer Upper Limb motor score, Functional Independence Measure, or Action Research Arm Test scores among stroke patients. However, the real transcranial direct current stimulation group showed enhanced finger flexion in the affected hand based on AMADEO kinematic measures. Conclusions: The addition of transcranial direct current stimulation to robot-assisted treatment did not result in significant overall functional improvements in chronic stroke patients. However, a benefit was observed in finger flexion of the affected hand. [ABSTRACT FROM AUTHOR]

This study compared lower extremity, trunk, and upper extremity kinematics between tee and front toss hitting in youth baseball athletes. Twenty youth baseball athletes (14.3±2.9 yrs) performed three maximal effort swings off front toss and tee. Kinematic data were collected during the preparatory and acceleration phases. Lower extremity, trunk, and upper extremity kinematics were compared between tee and front toss hitting using 1-dimensional statistical parametric mapping (SPM). There was a significant difference in trunk kinematics between tee and front toss during the preparatory phase (p=.001); the trunk rotated more toward the back side when hitting off a tee compared to front toss (p<0.001). There was also a significant difference in trunk kinematics between tee and front toss for 67% of the acceleration phase; the trunk rotated more towards the back side from 0 to 67% when hitting off the tee (p<0.001). Significant differences were found in trunk kinematics between tee and front toss hitting in youth baseball players, where the trunk is less rotated toward the pitcher in the tee than in the front toss. Coaches utilize various training modalities to enhance hitting performance; however, differences in trunk kinematics should be considered between modalities when developing fundamental hitting techiques in youth baseball athletes. [ABSTRACT FROM AUTHOR]

The purpose of this quasiexperimental study was to test the effects of wearing the NewGait rehabilitative device on walking abilities in individuals with foot drop. The study involved 16 participants with foot drops caused by stroke (11 participants), multiple sclerosis (one participant), and peripheral neuropathies (four individuals). During a single testing session, participants walked 12 m at their self‐selected speed in four experimental conditions: walking without any orthotic device; walking while wearing a regular plastic posterior leaf ankle foot orthosis (AFO); walking with the NewGait device assisting ankle dorsiflexion only; and walking with the NewGait device assisting the hip, knee, and ankle joint motions. Body motions during walking were recorded using a 3D system for motion analysis and analyzed with a set of spatiotemporal and kinematic parameters and a gait decomposition index. The gait decomposition index indicated sagittal interjoint coordination in the three joint pairs (hip–knee, knee–ankle, and hip–ankle) of the paretic (foot drop) leg during walking and was validated in a previous study. Overall, wearing all three orthotic devices improved the gait velocity, ankle dorsiflexion, and foot clearance compared to gait trials in which no assistive devices were used. However, wearing the AFO significantly restricted the plantarflexion range of motion and decreased interjoint coordination as measured by joint decomposition. In contrast, the NewGait device altered the ankle plantarflexion motions but also increased coordinated movement (reduced the decomposition) in most lower‐extremity joint pairs and conditions. Therefore, the NewGait rehabilitative device can be considered superior to a regular AFO in correcting gait deviations caused by foot drop. [ABSTRACT FROM AUTHOR]

Objective: To investigate in vivo 6-degree-of-freedom (DOF) vertebral motion in patients with isthmic spondylolisthesis (IS) during various functional weight-bearing activities. Methods: Fifteen asymptomatic volunteers (mean age 54.8 years) and fourteen patients with IS at L4-5 (mean age 53.4 years) were recruited. The positions of the vertebrae (L4-L5) in the supine, standing, flexion–extension, left–right twisting and left–right bending positions were determined using previously described CT-based models and dual fluoroscopic imaging techniques. Local coordinate systems were established at the center of the anterior vertebra of L4 isthmic spondylolisthesis (AIS), the posterior lamina of L4 isthmic spondylolisthesis (PIS) and the center of the L5 vertebra to obtain the 6DOF range of motion (ROM) at L4-L5 and the range of motion (ROM) between the AIS and the PIS. Results: The translation along the anteroposterior axis at L4-L5 during flexion–extension, left–right bending and left–right twisting was significantly greater than that of the healthy participants. However, the translation along the mediolateral axis at L4-L5 presented paradoxical motion under different positions: the ROM increased in the supine-standing and flexion–extension positions but decreased in the left–right bending and left–right twisting positions. The separation along the anteroposterior axis during flexion was significantly greater than that during standing, on average, reaching more than 1 mm. The separation along the mediolateral axis during standing, flexion and extension was significantly greater than that in the supine position. Conclusions: This study revealed the occurrence of displacement between the AIS and PIS, primarily in the form of separation during flexion. Symptomatic patients with isthmic spondylolisthesis exhibit intervertebral instability, which might be underestimated by flexion–extension radiographs. [ABSTRACT FROM AUTHOR]

This study examined the relationship between motor competence (MC) and Landing Error Scoring System (LESS) performance in a sample of male junior grassroots footballers aged 10-13 years. Ninety-eight boys aged 10-13 years (mean ± SD = 11.7 ± 1 years) undertook assessment of MC, using the Test of Gross Motor Development (third edition) and anterior cruciate ligament (ACL) injury risk using the LESS. Height and mass were assessed from which maturity status was predicted. Multiple backward linear regressions indicated a significant model (p = 0.001), which explained 49% of the variance in LESS scores. Locomotor MC (β = -0.538, p = 0.001), object control MC (β = -0.261, p = 0.004), and age (β = 1.17, p = 0.03) significantly contributed to the model. Maturity offset (p = 0.100) was not significant. Analysis of covariance (controlling for age and maturity offset) indicated a significant difference in locomotor MC between those classified as poor for LESS. A similar result was observed for object control MC (p = 0.003, ηp² = 0.09), where those classed as poor for LESS had significantly poorer object control MC compared with those classed as excellent, good, and moderate. The results of this study indicate that there is a relationship between both locomotor and object control MC and errors in drop jump landing mechanics in boys aged 10-13 years, with MC explaining nearly 50% of the variance in LESS scores. Practically, this study indicates that MC, particularly locomotor MC, has potential to identify performance in jump landing tests that are associated with increased risk of ACL injury in boys who play grassroots soccer. [ABSTRACT FROM AUTHOR]

High-quality cutting technique is essential for agility development and safer cuttings in adolescent athletes. Certain sidestep techniques and kinematics are characteristic of high movement quality and are associated with both, faster performance and lower knee joint loading (i.e., reduced anterior cruciate ligament injury risk). The aim of this study was to determine the effects of a 6-week, side step, technique modification training intervention targeting specific kinematics on agility performance and movement quality. Twenty-two adolescent American football players were recruited for a nonrandomized, controlled, intervention study. For 6 weeks, an intervention group (IG) of 11 players participated in 25-minute cutting technique training sessions integrated into team training twice a week, whereas a control group (CG) of 11 players continued their usual training routine. Agility performance was assessed based on percentage-based change of direction deficit (CODDp) obtained during reactive agility tests at 45° and 90° angles. The Cutting Movement Assessment Score (CMAS) qualitative screening tool was used to assess 2D high-speed videos of the cuts for movement quality. The significance level was set at α = 0.01. The intervention effectively altered players' sidestep technique irrespective of cutting angle with large time x group interaction effects observed for CMAS (ηp² = 0.82). Statistical and practical significant improvements in CMAS pre-to-post intervention were evident in the IG (-2.30 ≤ g ≤ -1.75; 313.87 ≤ BF10 ≤ 2,342.00), whereas deteriorations were found in the CG for 90° (g = 1.38; BF10 = 64.21). However, in both groups, no statistically significant differences in CODDp were observed pre-to-post intervention (0.019 ≤ p ≤ 0.586; 0.34 ≤ BF10 ≤ 3.59). The cutting technique modification training meaningfully improved movement quality, without negatively affecting agility performance, and can be used by practitioners to foster a safe technical foundation for subsequent agility development in adolescent athletes. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of our report was to use a Random Forest classification approach to predict the association between transcutaneous electrical nerve stimulation (TENS) and walking kinematics at the stride level when middle-aged and older adults performed the 6-min test of walking endurance. Methods: Data from 41 participants (aged 64.6 ± 9.7 yr) acquired in two previously published studies were analyzed with a Random Forest algorithm that focused on upper and lower limb, lumbar, and trunk kinematics. The four most predictive kinematic features were identified and utilized in separate models to distinguish between three walking conditions: burst TENS, continuous TENS, and control. SHAP analysis and linear mixed models were used to characterize the differences among these conditions. Results: Modulation of four key kinematic features--toe-out angle, toe-off angle, and lumbar range of motion (ROM) in coronal and sagittal planes--accurately predicted walking conditions for the burst (82%accuracy) and continuous (77% accuracy) TENS conditions compared with control. Linear mixed models detected a significant difference in lumbar sagittal ROM between the TENS conditions. SHAP analysis revealed that burst TENS was positively associated with greater lumbar coronal ROM, smaller toe-off angle, and less lumbar sagittal ROM. Conversely, continuous TENS was associated with less lumbar coronal ROM and greater lumbar sagittal ROM. Conclusions: Our approach identified four kinematic features at the stride level that could distinguish between the three walking conditions. These distinctions were not evident in average values across strides. [ABSTRACT FROM AUTHOR]

Introduction: Maximal acceleration and deceleration tasks are frequently required in team sports, often occurring rapidly in response to external stimuli. Accelerating and decelerating can be associated with lower limb injuries; thus, knowledge of joint mechanics during these tasks can improve the understanding of both human high performance and injury mechanisms. The current study investigated the fundamental differences in lower limb joint mechanics when accelerating and decelerating by directly comparing the hip, knee, and ankle joint moments and work done between the two tasks. Methods: Twenty participants performed maximal effort acceleration and deceleration trials, with three-dimensional marker trajectories and ground reaction forces collected simultaneously. Experimental data were combined with inverse dynamics analysis to compute joint moments and work. Results: Net joint work for all lower limb joints was positive during acceleration and negative during deceleration. This occurred because of significantly greater positive work production from the ankle and hip during acceleration and significantly greater negative work production from all joints during deceleration. The largest contributions to positive work during acceleration came from the ankle, followed by the hip and knee joints, whereas the largest contributions to negative work during deceleration came from the knee and hip joints, followed by the ankle. Peak joint moments were significantly greater when decelerating compared with accelerating, except for the peak ankle plantar flexion and hip flexion moments, which were significantly greater when accelerating. Conclusions: Our findings may help to guide training interventions, which aim to enhance the performance of acceleration and deceleration tasks, while also mitigating the associated injury risk. [ABSTRACT FROM AUTHOR]

Limited research exists on the relationship between aesthetic saut de chat performance and muscle-tendon unit (MTU) characteristics of dancers. We developed a weighted parameter ranking (WPR) tool to incorporate aesthetic leaping aspects (i.e., height, peak split angle, average trunk angle and trunk angle range) for correlation with MTU properties. The purpose was to identify the relationship of saut de chat WPR and leap height with maximal plantarflexion strength, medial gastrocnemius (MG) stiffness, Achilles tendon (AT) stiffness and relative peak power (PP). Dancers (n = 18) performed maximal plantarflexion, short-range stretches and isometric ramping contractions on a dynamometer equipped with ultrasound to determine strength, MG stiffness and AT stiffness, respectively. Subjects then performed saut de chat leaps atop force platforms surrounded by motion capture cameras. A principal component analysis (PCA) was performed to compare WPR variable weightings with PCA results and rankings. Moderate–strong relationships were identified among WPR, maximal plantarflexion strength, MG stiffness and PP. Strong–very strong relationships were also identified between leap height and maximal plantarflexion strength, MG stiffness, AT stiffness, peak split angle and PP. A very strong correlation existed between PCA rankings and WPRs. Practitioners may consider developing strength and power capabilities in dancers to improve leaping. [ABSTRACT FROM AUTHOR]

Performance during the baseball pitch is dependent on the flow of mechanical energy through the kinetic chain. Little is known about energy flow during the pitching motion and it is not known whether patterns of energy flow are related to pitching performance and injury risk. Therefore, the purpose of this study was to quantify energy generation, absorption, and transfer across the shoulder and elbow during the baseball pitch and explore the associations between these energetic measures, pitch speed, and traditional measures of upper extremity joint loading. The kinematics of 40 youth baseball pitchers were measured in a controlled laboratory setting. Energy flow between the thorax, humerus, and forearm was calculated using a segmental power analysis. Regression analyses revealed that pitch speed was best predicted by arm cocking phase shoulder energy transfer to the humerus and peak elbow valgus torque was best predicted by arm acceleration-phase elbow energy transfer to the forearm. Additionally, energy transfer across the shoulder and elbow generally exhibited the strongest correlations to pitch speed and upper extremity joint loads. These data reinforce the importance of energy transfer through the kinetic chain for producing high pitch speeds and provide descriptive data for energy flow during baseball pitching not previously found in the literature. [ABSTRACT FROM AUTHOR]

This study was aimed to compare the knee kinematic parameters between dominant and non-dominant legs of adolescent female athletes during change of direction (CoD) in fatigued and unpredictable settings. Knee kinematic parameters on 49 athletes (mean± SD; age = 14.69 ± 0.14 years; mass = 49.05 ± 1.22 kg; height = 1.61 ± 0.08 m) during CoD before and after performing the Bruce protocol and also in predictable and unpredictable setting situations were collected. Kinematic data were recorded at a sampling rate of 200 Hz. The results showed that the dominant leg had significantly 18.7% more flexion (p = 0.001, η = 0.95), 7.1% less valgus (p = 0.001, η = 0.95) and 0.32% lower tibia rotation (p = 0.003, η = 0.16) compared to the non-dominant leg in predictable and pre-fatigue (p < 0.05) conditions. With unpredictable and post-fatigue conditions the dominant limb again demonstrated 17.4% (p = 0.001, η = 0.67), greater knee flexion, 6.8% (0.003,η = 0.97) lower knee valgus and 1.4% (p = 0.001, η = 0.71) less tibiarotation. In conclusion, there may be an increased risk of injury withthe non-dominant leg due to changes in kinematic parameters caused by fatigue and unpredictable CoD manoeuvres. [ABSTRACT FROM AUTHOR]

The study objective is to test general- and sport-specific adaption during a single training on the Flexibility Trainer. The device is designed to trigger residual muscle tone decreases of the hip-joint muscles by providing (nearly) isokinetic resistance during a full range of motion strength training in adduction/abduction and flexion/extension direction. Static hip flexion and abduction as well as kinematics of double side kicks were analysed on 15 participants before and after training (or rest for controls) to assess general flexibility and sport-specific movement range. Tests were recorded by a Vicon® motion capturing system. Static hip flexion and abduction as well as leg vector spreading angles (VSA) at different nodes of the kick were selected to determine adaptions of active and passive flexibility. Normalised hip joint moments, movement velocities and VSA were calculated to evaluate the training with the device. ANOVAs with 4-repeated measures and Friedman tests were performed to identify time differences and Bonferroni post-hoc test to identify between-subject effects. Significant differences were found for both static flexibility tests (Flexion = 13.65%; Abduction = 9.94%) and the VSA at specific action phases (≤15.15%). Results indicate that short-term adaptions when training with the Flexibility Trainer are exceeding comparable literature showing improved flexibility and sport-specific performance. [ABSTRACT FROM AUTHOR]

Background During sprinting, the biceps femoris long head predominantly gets injured, while hamstring strengthening exercises predominantly activate the semitendinosus more effectively. Understanding how joint dominance influences hamstring activity may offer clarity on appropriate exercise selection in strengthening programs. Purpose This study compared three hip-dominant hamstring exercises: the rocker, perpetuum mobile fast and slow (PMfast and PMslow) and the Nordic Hamstring exercise (NHE) on their potential to simulate sprint-like activity and kinematics. Methods Muscle activity of the posterior kinetic chain (biceps femoris, semitendinosus, gluteus maximus, and medial gastrocnemius) was measured with surface electromyography (sEMG) during the exercises and treadmill running at 75% of the individual maximal sprint velocity in male athletes. sEMG data were normalized to maximal sprinting. 3D-motion capture was employed to assess hip and knee angles. Results Eight male athletes were included (age: 24.0 years ± SD 2.9; body mass: 76.8 kg ± 7.7; height: 1.79 m ± 0.08). Greater activity of the hamstrings occurred during the explosive exercises ranging from 63.9% [95%CI: 56.3-71.5%] (rocker) to 49.0% [95%CI: 40.4-57.6%] (PMfast) vs. 34.0% [95%CI: 29.1-38.9%] (NHE) to 32.1% [95%CI: 26.9-37.3%] (PMslow). The rocker showed greatest hamstring and gluteus maximus activity. Biceps femoris consistently showed greater activity than the semitendinosus across all exercises in peak (mean difference: 0.16, [95%CI: 0.07-0.26]) and average (mean difference: 0.06, [95%CI: 0.01-0.11]) activity. PMfast, PMslow and NHE demonstrated less hip flexion angle at peak hamstring activity than the rocker and high-speed running and every exercise showed less hamstring elongation stress than during high-speed running. Discussion Hamstring activity is comparable to high-intensity treadmill running for NHE and PMslow, and greater for the rocker and PMfast. Gluteus maximus activity varied, with the rocker and PMfast showing greater activity than in sprinting. All examined exercises demonstrated their peak activity at short hamstring muscle length. Level of evidence 3b [ABSTRACT FROM AUTHOR]

Background Sidestep cutting technique is highly individual and has been shown to influence knee joint loading. However, studies assessing whether individualized technique feedback improves technique and ACL injury-relevant knee joint loads instantly in a sport-specific task are lacking. Purpose To determine the instant effects of individualized augmented technique feedback and instructions on technique and the peak external knee abduction moment (pKAM) in a handball-specific sidestep cut. Additionally, to determine the effects of technique modifications on the resultant ground reaction force and its frontal plane moment arm to the knee joint center. Study Design Controlled laboratory cohort study Methods Three-dimensional biomechanics of 48 adolescent female handball players were recorded during a handball-specific sidestep cut. Following baseline cuts to each side, leg-specific visual and verbal technique feedback on foot strike angle, knee valgus motion, or vertical impact velocity using a hierarchically organized structure accounting for the variables' association with performance was provided. Subsequently, sidestep cuts were performed again while verbal instructions were provided to guide technique modifications. Combined effects of feedback and instructions on technique and pKAM as well as on the resultant ground reaction force and its frontal plane moment arm to the knee joint center were assessed. Results On average, each targeted technique variable improved following feedback and instructions, leading to instant reductions in pKAM of 13.4% to 17.1%. High inter-individual differences in response to feedback-instruction combinations were observed. These differences were evident in both the adherence to instructions and the impact on pKAM and its components. Conclusion Most players were able to instantly adapt their technique and decrease ACL injury-relevant knee joint loads through individualized augmented technique feedback, thereby potentially reducing the risk of injury. More research is needed to assess the retention of these adaptations and move towards on-field technique assessments using low-cost equipment. Level of Evidence: Level 3 [ABSTRACT FROM AUTHOR]

BACKGROUND: There is a lack of information about the optimal setup of multiple screen configurations in virtual reality (VR) office work. OBJECTIVE: The objective of this study was to evaluate the effects of different screen configurations on neck flexion, rotation, neck muscle activity, and simulator sickness symptoms during Virtual Reality (VR) office work. METHODS: Twelve participants (7 males; 21 to 27 years old) performed copy-paste and drag-drop tasks in three different screen configurations (single screen, primary-secondary screen, and double screen) in a randomized order. Optical motion capture system, electromyography (EMG) device, and simulator sickness questionnaire (SSQ) were used to measure the users' responses. RESULTS: Neck rotation angles, muscle activities, and VR sickness were significantly affected by the screen configurations (p < 0.021). The primary-secondary screen showed the highest right rotation angle (median: -33.47°) and left sternocleidomastoid (SCM) muscle activities (median: 12.57% MVC). Both single (median: 22.42) and primary-secondary (median: 22.40) screen showed the highest value of SSQ. CONCLUSIONS: The screen configurations in VR could be an important design factor affecting the users' physical demands of the neck and VR sickness symptoms. Asymmetric neck rotations caused by the primary-secondary screen conditions should be avoided. [ABSTRACT FROM AUTHOR]

Background: Characterizing the condition of patients suffering from knee osteoarthritis is complex due to multiple associations between clinical, functional, and structural parameters. While significant variability exists within this population, especially in candidates for total knee arthroplasty, there is increasing interest in knee kinematics among orthopedic surgeons aiming for more personalized approaches to achieve better outcomes and satisfaction. The primary objective of this study was to identify distinct kinematic phenotypes in total knee arthroplasty candidates and to compare different methods for the identification of these phenotypes. Methods: Three-dimensional kinematic data obtained from a Knee Kinesiography exam during treadmill walking in the clinic were used. Various aspects of the clustering process were evaluated and compared to achieve optimal clustering, including data preparation, transformation, and representation methods. Results: A K-Means clustering algorithm, performed using Euclidean distance, combined with principal component analysis applied on data transformed by standardization, was the optimal approach. Two unique kinematic phenotypes were identified among 80 total knee arthroplasty candidates. The two distinct phenotypes divided patients who significantly differed both in terms of knee kinematic representation and clinical outcomes, including a notable variation in 63.3% of frontal plane features and 81.8% of transverse plane features across 77.33% of the gait cycle, as well as differences in the Pain Catastrophizing Scale, highlighting the impact of these kinematic variations on patient pain and function. Conclusion: Results from this study provide valuable insights for clinicians to develop personalized treatment approaches based on patients' phenotype affiliation, ultimately helping to improve total knee arthroplasty outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The upper body Wingate Anaerobic Test (WAnT) is a 30-smaximal effort sprint against a set load (percentage of body mass). However, there is no consensus on the optimal load and no differential values for males and females, even when there are well-studied anatomical and physiological differences in muscle mass for the upper body. Our goal was to describe the effects of load, sex, and crank position on the kinetics, kinematics, and performance of the upper body WAnT. Methods: Eighteen participants (9 females) performed threeWAnTs at 3%, 4%, and 5%of body mass. Arm crank forces, 2D kinematics, and performance variables were recorded during eachWAnT. Results: Our results showed an increase of ~49% effective force, ~36%peak power, ~5° neck flexion, and ~30° shoulder flexion from 3% to 5% load (P < 0.05). Mean power and anaerobic capacity decreased by 15%, with no changes in fatigue index (P < 0.05). The positions of higher force efficiency were at 12 and 6 o'clock. The least force efficiency occurred at 3 o'clock (P < 0.05). Sex differences showed that males produced 97% more effective force and 109% greater mean power than females, with 11.7%more force efficiency (P < 0.001). Males had 16° more head/neck flexion than females, and females had greater elbow joint variability with 17°morewrist extension at higher loads. Males cycled ~32%faster at 3%versus 5%WAnT load with a 65%higher angular velocity than females. Grip strength, maximal voluntary isometric contraction, mass, and height positively correlated with peak and mean power (P < 0.001). Conclusions: In conclusion, load, sex, and crank position have a significant impact on performance of theWAnT. These factors should be considered when developing and implementing an upper body WAnT. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine associations between running economy (RE) and running sagittal plane kinematic and kinetic parameters. Method: A total of 30 male recreational runners (age: 21.21 ± 1.22 yr, VO2max: 54.61 ± 5.42 mL·kg-1·min-1) participated in two separate test sessions. In the first session, the participant's body composition and RE at 10 and 12 km·h-1 were measured. In the second session, measurements were taken for the sagittal plane of hip, knee, and ankle angles and range of motion (ROM), as well as ground reaction force. Results:Moderate correlations were found between lower energy costs at 12 km·h-1 and smaller hip flexion at toe-off (r = 0.373) as well as smaller peak hip flexion during stance (r = 0.397). During the swing phase, lower energy costs at 10 km·h-1 were moderately correlated with smaller peak knee flexion and smaller knee flexion and extension ROM (r = 0.366-0.443). Lower energy costs at 12 km·h-1 were moderately correlated with smaller peak hip and knee flexion as well as knee extension ROM(r = 0.369-0.427). In terms of kinetics, there was a moderate correlation between higher energy costs at 10 km·h-1 and larger peak active force, as well as larger peak braking and propulsion force (r = -0.470-0.488). Lower energy costs at 12 km·h-1 were moderately to largely correlated with smaller peak impact and braking force (r = 0.486 and -0.500, respectively). Regarding the statistical parametric mapping analysis, most outcomes showed associations with RE at 10 km·h-1, including knee flexion (42.5%-65.5%of the gait cycle), ankle plantarflexion (32.5%-36%of the gait cycle), active force (30.5%-35%of the stance phase), and propulsion force (68%-72.5% of the stance phase). Lower energy costs at 12 km·h-1 were correlated with smaller hip flexion (5.5%-12% and 66.5%-74%) and smaller knee flexion (57%-57.5%) during the running gait cycle. Conclusions: This study indicates that biomechanical factors are associated with RE in recreational runners. To design effective training methods to improve RE, coaches and runners should focus on the sagittal plane kinematics of the hip, knee, and ankle, as well as lower vertical and horizontal kinetic parameters. [ABSTRACT FROM AUTHOR]