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Purpose: To document experiences with one year of clinical implementation of the first Cherenkov imaging system and share the methods that we developed to utilize Cherenkov imaging to improve treatment delivery accuracy in real-time., Methods: A Cherenkov imaging system was installed commissioned and calibrated for clinical use. The optimal room lighting conditions and imaging setup protocols were developed to optimize both image quality and patient experience. The Cherenkov images were analyzed for treatment setup and beam delivery verification., Results: We have successfully implemented a clinical Cherenkov imaging system in a community-based hospital. Several radiation therapy patient setup anomalies were found in 1) exit dose to the contralateral breast, 2) dose to the chin due to head rotation for a supraclavicular field, 3) intrafractional patient motion during beam delivery, and 4) large variability (0.5 cm to 5 cm) in arm position between fractions. The system was used to deliver deep inspiration breath hold (DIBH) treatment delivery of an electron treatment beam. Clinical process and procedures were improved to mitigate the identified issues to ensure treatment delivery safety and to improve treatment accuracy., Conclusion: The Cherenkov imaging system has proven to be a valuable clinical tool for the improvement of treatment delivery safety and accuracy at our hospital. With only minimal training the therapists were able to adjust or correct treatment positions during treatment delivery as needed. With future Cherenkov software developments Cherenkov imaging systems could provide daily surface guided radiotherapy (SGRT) and real time treatment delivery quality control for all 3D and clinical setup patients without adding additional radiation image dose as in standard kV, MV and CBCT image verifications. Cherenkov imaging can greatly improve clinical efficiency and accuracy, making real time dose delivery consistency verification and SGRT a reality., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Published by Elsevier B.V. on behalf of European Society for Radiotherapy & Oncology.)

We investigated whether 20 candidate single nucleotide polymorphisms (SNPs) were associated with in vivo exercise-induced muscle damage (EIMD), and with an in vitro skeletal muscle stem cell wound healing assay. Sixty-five young, untrained Caucasian adults performed 120 maximal eccentric knee-extensions on an isokinetic dynamometer to induce EIMD. Maximal voluntary isometric/isokinetic knee-extensor torque, knee joint range of motion (ROM), muscle soreness, serum creatine kinase activity and interleukin-6 concentration were assessed before, directly after and 48 h after EIMD. Muscle stem cells were cultured from vastus lateralis biopsies from a separate cohort (n = 12), and markers of repair were measured in vitro. Participants were genotyped for all 20 SNPs using real-time PCR. Seven SNPs were associated with the response to EIMD, and these were used to calculate a total genotype score, which enabled participants to be segregated into three polygenic groups: 'preferential' (more 'protective' alleles), 'moderate', and 'non-preferential'. The non-preferential group was consistently weaker than the preferential group (1.93 ± 0.81 vs. 2.73 ± 0.59 N ∙ m/kg; P = 9.51 × 10 -4 ) and demonstrated more muscle soreness (p = 0.011) and a larger decrease in knee joint ROM (p = 0.006) following EIMD. Two TTN-AS1 SNPs in linkage disequilibrium were associated with in vivo EIMD (rs3731749, p ≤ 0.005) and accelerated muscle stem cell migration into the artificial wound in vitro (rs1001238, p ≤ 0.006). Thus, we have identified a polygenic profile, linked with both muscle weakness and poorer recovery following EIMD. Moreover, we provide evidence for a novel TTN gene-cell-skeletal muscle mechanism that may help explain some of the interindividual variability in the response to EIMD., (© 2022 The Authors. Journal of Cellular Physiology published by Wiley Periodicals LLC.)

The objective of this study was to investigate how the inclusion of a cushioning underlay in a third-generation artificial turf (3G) affects player biomechanics during soccer-specific tasks. Twelve soccer players (9 males/3 females; 22.6 ± 2.3 y) participated in this study. Mechanical impact testing of each 3G surface; without (3G-NCU) and with cushioning underlay (3G-CU) were conducted. Impact force characteristics, joint kinematics and joint kinetics variables were calculated on each surface condition during a sprint 90° cut (90CUT), a sprint 180° cut (180CUT), a drop jump (DROP) and a sprint with quick deceleration (STOP). For all tasks, greater peak resultant force, peak knee extensor moment and peak ankle dorsi-flexion moment were found in 3G-NCU than 3G-CU (p < 0.05). During 90CUT and STOP, loading rates were higher in 3G-NCU than 3G-CU (p < 0.05). During 180CUT, higher hip, knee and ankle ranges of motion were found in 3G-NCU (p < 0.05). These findings showed that the inclusion of cushioning underlay in 3G reduces impact loading forces and lower limb joint loading in soccer players across game-specific tasks. Overall, players were not attempting to reduce higher lower limb impact loading associated with a lack of surface cushioning underlay.

Hamstring muscle injury is highly prevalent in sports involving repeated maximal sprinting. Although neuromuscular fatigue is thought to be a risk factor, the mechanisms underlying the fatigue response to repeated maximal sprints are unclear. Here, we show that repeated maximal sprints induce neuromuscular fatigue accompanied with a prolonged strength loss in hamstring muscles. The immediate hamstring strength loss was linked to both central and peripheral fatigue, while prolonged strength loss was associated with indicators of muscle damage. The kinematic changes immediately after sprinting likely protected fatigued hamstrings from excess elongation stress, while larger hamstring muscle physiological cross-sectional area and lower myoblast:fibroblast ratio appeared to protect against fatigue/damage and improve muscle recovery within the first 48 h after sprinting. We have therefore identified novel mechanisms that likely regulate the fatigue/damage response and initial recovery following repeated maximal sprinting in humans.

We investigated whether single nucleotide polymorphisms (SNPs) within genes encoding the alpha-1 chain of type I ( COL1A1, rs2249492 ; rs1800012 ), type II ( COL2A1, rs2070739 ), and type V (COL5A1, rs12722 ) collagen were associated with the variable response to exercise-induced muscle damage (EIMD). Knee extensor muscle strength and soreness were assessed pre-, post-, and 48 h post-EIMD (120 maximal eccentric knee extensor contractions) in 65 young healthy participants, who were genotyped for the aforementioned SNPs. We found that COL1A1 (minor) T-allele carriers ( rs1800012 ) and (major) T-allele homozygotes ( rs2249492 ) were generally weaker ( P ≤ 0.019); and (minor) A-allele carriers of COL2A1 ( P = 0.002) and (major) T-allele carriers of COL5A1 ( P = 0.004) SNPs reported greater muscle soreness, all compared with their respective major ( rs1800012 ; rs2070739 ) and minor ( rs2249492 ; rs12722 ) allele homozygote counterparts. To conclude, the risk alleles of these four SNPs appear to negatively influence muscle strength and post-EIMD recovery, possibly via a dysregulated collagen network affecting the muscle's mechanical properties.

Different modes of perturbations have been used to understand how individuals negotiate irregular surfaces, with a general notion that increased locomotion variability induces a positive training stimulus. Individuals tend to walk slower when initially exposed to such locomotion tasks, potentially influencing the magnitude and variability of biomechanical parameters. This study investigated theeffects of gait speed on lower extremity biomechanics when walking on an irregular (IS) and regular surface (RS). Twenty physically active males walked on a RS and IS at three different speeds (4 km/h, 5 km/h, 6 km/h). Lower extremity kinematics (300 Hz) and surface electromyography (3000 Hz) were recorded during the first 90 s of gait. Two-factor repeated measures ANOVA was used to determine surface and speed effects (p < 0.05). Gait speed influences walking biomechanics (kinematic and muscle activity parameters) the same irrespective of surface condition. As walking speed increased, sagittal shoe-surface angle, maximum ankle inversion, ankle abduction, knee and hip flexion increased during stance phase when walking on the IS and RS (p < 0.05). Increasing walking speed caused increased muscle activity of the tibialis anterior, peroneus longus, gastrocnemius medialis, vastus medialis and biceps femoris (p < 0.05) on the IS and RS during the gait cycle. Increased gait, kinematic and muscle activity variability was reported at lower walking speed on both the IS and RS. Further, irrespective of gait speed, walking on an IS triggers postural adjustments, higher muscle activity and increased gait variability compared to RS walking. Our findings suggest the benefits of training on the irregular surface may be further enhanced at slower gait speeds., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Unaccustomed strenuous exercise can lead to muscle strength loss, inflammation and delayed-onset muscle soreness, which may be influenced by genetic variation. We investigated if a missense single nucleotide polymorphism (A>G, rs2275950 ) within the TRIM63 gene (encoding MuRF-1 and potentially affecting titin mechanical properties) was associated with the variable response to unaccustomed eccentric exercise. Sixty-five untrained, healthy participants (genotyped for rs2275950 : AA, AG, and GG) performed 120 maximal eccentric knee extensions (ECC) to induce muscle damage. Isometric and isokinetic maximal voluntary knee extension contractions (MVCs) and muscle soreness were assessed before, immediately after, and 48 h after ECC. AA homozygotes were consistently stronger [baseline isometric MVC: 3.23 ± 0.92 Nm/kg (AA) vs. 2.09 ± 0.67 Nm/kg (GG); P = 0.006] and demonstrated less muscle soreness over time ( P = 0.022) compared with GG homozygotes. This may be explained by greater titin stiffness in AA homozygotes, leading to intrinsically stronger muscle fibers that are more resistant to eccentric damaging contractions.

We derive upper and lower limits for the mass-radius ratio of spin-fluid spheres in Einstein-Cartan theory, with matter satisfying a linear barotropic equation of state, and in the presence of a cosmological constant. Adopting a spherically symmetric interior geometry, we obtain the generalized continuity and Tolman-Oppenheimer-Volkoff equations for a Weyssenhoff spin fluid in hydrostatic equilibrium, expressed in terms of the effective mass, density and pressure, all of which contain additional contributions from the spin. The generalized Buchdahl inequality, which remains valid at any point in the interior, is obtained, and general theoretical limits for the maximum and minimum mass-radius ratios are derived. As an application of our results we obtain gravitational red shift bounds for compact spin-fluid objects, which may (in principle) be used for observational tests of Einstein-Cartan theory in an astrophysical context. We also briefly consider applications of the torsion-induced minimum mass to the spin-generalized strong gravity model for baryons/mesons, and show that the existence of quantum spin imposes a lower bound for spinning particles, which almost exactly reproduces the electron mass.

It remains to be determined whether running training influences the amplitude of lower limb muscle activations before and during the first half of stance and whether such changes are associated with joint stiffness regulation and usage of stored energy from tendons. Therefore, the aim of this study was to investigate neuromuscular and movement adaptations before and during landing in response to running training across a range of speeds. Two groups of high mileage (HM; >45 km/wk, n = 13) and low mileage (LM; <15 km/wk, n = 13) runners ran at four speeds (2.5-5.5 m/s) while lower limb mechanics and electromyography of the thigh muscles were collected. There were few differences in prelanding activation levels, but HM runners displayed lower activations of the rectus femoris, vastus medialis, and semitendinosus muscles postlanding, and these differences increased with running speed. HM runners also demonstrated higher initial knee stiffness during the impact phase compared with LM runners, which was associated with an earlier peak knee flexion velocity, and both were relatively unchanged by running speed. In contrast, LM runners had higher knee stiffness during the slightly later weight acceptance phase and the disparity was amplified with increases in speed. It was concluded that initial knee joint stiffness might predominantly be governed by tendon stiffness rather than muscular activations before landing. Estimated elastic work about the ankle was found to be higher in the HM runners, which might play a role in reducing weight acceptance phase muscle activation levels and improve muscle activation efficiency with running training. NEW & NOTEWORTHY Although neuromuscular factors play a key role during running, the influence of high mileage training on neuromuscular function has been poorly studied, especially in relation to running speed. This study is the first to demonstrate changes in neuromuscular conditioning with high mileage training, mainly characterized by lower thigh muscle activation after touch down, higher initial knee stiffness, and greater estimates of energy return, with adaptations being increasingly evident at faster running speeds., (Copyright © 2017 the American Physiological Society.)

Prolonged unaccustomed exercise involving muscle lengthening (eccentric) actions can result in ultrastructural muscle disruption, impaired excitation-contraction coupling, inflammation and muscle protein degradation. This process is associated with delayed onset muscle soreness and is referred to as exercise-induced muscle damage. Although a certain amount of muscle damage may be necessary for adaptation to occur, excessive damage or inadequate recovery from exercise-induced muscle damage can increase injury risk, particularly in older individuals, who experience more damage and require longer to recover from muscle damaging exercise than younger adults. Furthermore, it is apparent that inter-individual variation exists in the response to exercise-induced muscle damage, and there is evidence that genetic variability may play a key role. Although this area of research is in its infancy, certain gene variations, or polymorphisms have been associated with exercise-induced muscle damage (i.e. individuals with certain genotypes experience greater muscle damage, and require longer recovery, following strenuous exercise). These polymorphisms include ACTN3 (R577X, rs1815739), TNF (-308 G>A, rs1800629), IL6 (-174 G>C, rs1800795), and IGF2 (ApaI, 17200 G>A, rs680). Knowing how someone is likely to respond to a particular type of exercise could help coaches/practitioners individualise the exercise training of their athletes/patients, thus maximising recovery and adaptation, while reducing overload-associated injury risk. The purpose of this review is to provide a critical analysis of the literature concerning gene polymorphisms associated with exercise-induced muscle damage, both in young and older individuals, and to highlight the potential mechanisms underpinning these associations, thus providing a better understanding of exercise-induced muscle damage.

The purpose of this study was to investigate the effects of prolonged high-intensity running on impact accelerations in trained runners. Thirteen male distance runners completed two 20-minute treadmill runs at speeds corresponding to 95% of onset of blood lactate accumulation. Leg and head accelerations were collected for 20 s every fourth minute. Rating of perceived exertion (RPE) scores were recorded during the third and last minute of each run. RPE responses increased (P < .001) from the start (11.8 ± 0.9, moderate intensity) of the first run to the end (17.7 ± 1.5, very hard) of the second run. Runners maintained their leg impact acceleration, impact attenuation, stride length, and stride frequency characteristics with prolonged run duration. However, a small (0.11-0.14g) but significant increase (P < .001) in head impact accelerations were observed at the end of both first and second runs. It was concluded that trained runners are able to control leg impact accelerations during sustained high-intensity running. Alongside the substantial increases in perceived exertion levels, running mechanics and frequency domain impact attenuation levels remained constant. This suggests that the present trained runners are able to cope from a mechanical perspective despite an increased physiological demand.

Purpose: The purpose of this study was to determine whether real-time feedback (RTF) training would reduce impact loading variables previously linked with tibial stress fracture risk and whether these adaptations would influence running economy., Methods: Twenty-two male runners were randomly assigned to RTF (n = 12) and control (n = 10) groups. The RTF group received feedback based on their peak tibial axial accelerations (PTA) during six 20-min treadmill runs for 3 wk, whereas the control group adhered to the same training but without feedback. Unilateral three-dimensional kinematic and kinetic analysis and running economy measurements were conducted before, after, and at 1 month posttraining., Results: The RTF group had significant reductions (P < 0.01) in PTA and average and instantaneous vertical force loading rates after training as compared with no changes in the control group. These modifications in impact loads were only maintained in PTA 1 month after the training. A significant increase (P = 0.0033) in ankle plantarflexion at initial contact and a significant change (P = 0.030) in foot strike pattern from a rearfoot to midfoot strike pattern and a significant decrease (P = 0.008) in heel vertical velocity at initial contact appeared to be the primary mechanical strategies adopted by runners to reduce impact loading after RTF training. Despite these gait adaptations, running economy was unaffected., Conclusions: The results of this study suggest that gait retraining using RTF is an effective means of eliciting reductions in impact loading without negatively affecting running economy. However, with loading rate reductions not being maintained 1 month posttraining, further research is required to determine how these reductions in impact severity can be retained long term.

Purpose: The purpose of this study was to investigate the acute effects of progressive fatigue on the parameters of running mechanics previously associated with tibial stress fracture risk., Methods: Twenty-one trained male distance runners performed three sets (Pre, Mid, and Post) of six overground running trials at 4.5 m.s(-1) (± 5%). Kinematic and kinetic data were collected during each trial using a 12-camera motion capture system, force platform, and head and leg accelerometers. Between tests, each runner ran on a treadmill for 20 min at their corresponding lactate threshold (LT) speed. Perceived exertion levels (RPE) were recorded at the third and last minute of each treadmill run., Results: RPE scores increased from 11.8 ± 1.3 to 14.4 ± 1.5 at the end of the first LT run and then further to 17.4 ± 1.6 by the end of the second LT run. Peak rearfoot eversion, peak axial head acceleration, peak free moment and vertical force loading rates were shown to increase (P < 0.05) with moderate-large effect sizes during the progression from Pre to Post tests, although vertical impact peak and peak axial tibial acceleration were not significantly affected by the high-intensity running bouts., Conclusion: Previously identified risk factors for impact-related injuries (such as tibial stress fracture) are modified with fatigue. Because fatigue is associated with a reduced tolerance for impact, these findings lend support to the importance of those measures to identify individuals at risk of injury from lower limb impact loading during running.

The primary objective of this paper is to study the use of medical image-based finite element (FE) modelling in subject-specific midsole design and optimisation for heel pressure reduction using a midsole plug under the calcaneus area (UCA). Plugs with different relative dimensions to the size of the calcaneus of the subject have been incorporated in the heel region of the midsole. The FE foot model was validated by comparing the numerically predicted plantar pressure with biomechanical tests conducted on the same subject. For each UCA midsole plug design, the effect of material properties and plug thicknesses on the plantar pressure distribution and peak pressure level during the heel strike phase of normal walking was systematically studied. The results showed that the UCA midsole insert could effectively modify the pressure distribution, and its effect is directly associated with the ratio of the plug dimension to the size of the calcaneus bone of the subject. A medium hardness plug with a size of 95% of the calcaneus has achieved the best performance for relieving the peak pressure in comparison with the pressure level for a solid midsole without a plug, whereas a smaller plug with a size of 65% of the calcaneus insert with a very soft material showed minimum beneficial effect for the pressure relief.

Background: The human heel pad is a complex biological structure consisting of the fat pad and the skin. The mechanical properties of the skin layer are of significant importance to the load-bearing function of the heel pad and human locomotion. The condition of the heel skin is also directly associated with some medical conditions such as heel ulcers that may become a site for the skin breakdown, which is the most common precursor to lower extremity amputation among persons with diabetes. It is essential to develop a detailed understanding of the properties of the heel skin layer and its effect on hind foot biomechanics during heel strike., Objectives: This work aims to gain a better insight into the biomechanical behaviour of the heel skin layer through a combined experimental and numerical study. The main objective is to characterise the biomechanical responses of the hind foot system during heel strike with potential variation of the skin stiffness based on a subject-specific finite element (FE) model and biomechanical testing., Methods: A three-dimensional (3D) FE model of the human hind foot incorporating a separate heel skin layer was developed based on subject-specific medical images. An inverse FE analysis of the in vivo indentation test was carried out to study the nonlinear material property of the heel skin. The FE model was then used to study the deformation of the hind foot during heel strike in comparison with the plantar pressure measurement results and to establish the effects of stiffness of the heel skin on the stress and pressure distributions., Results: The FE foot model with subject-specific heel skin properties was successfully used to predict the deformation of the hind foot during heel strike, and the results showed good agreements with biomechanical pressure measurements. The results showed that the high pressure and stress in the heel skin appeared in the centre region during a heel strike. Heel skin stiffness sensitivity studies showed that an increase in the skin stiffness had a limited effect on the stress and contact pressure of the hind foot bones, but caused a slight increase in the skin stresses, while skin softening caused a decrease in the peak plantar pressure and its distribution pattern changed. In addition, the results also suggest that skin softening may cause a higher stress level in the bones and ligaments., Conclusion: The nonlinear parameter of the heel skin has been successfully predicted from in vivo indentation tests based on a subject-specific FE model. Skin properties' sensitivity tests clearly showed that the stiffness of the heel skin could have a direct effect on the biomechanics of the hind foot. The results suggest that individuals with a pathologically stiffened heel skin could exert an increase in the heel pressure, which may potentially lead to skin breakdown or ulcer.

Metatarsal fracture is one of the most common foot injuries, particularly in athletes and soldiers, and is often associated with landing in inversion. An improved understanding of deformation of the metatarsals under inversion landing conditions is essential in the diagnosis and prevention of metatarsal injuries. In this work, a detailed three-dimensional (3D) finite element foot model was developed to investigate the effect of inversion positions on stress distribution and concentration within the metatarsals. The predicted plantar pressure distribution showed good agreement with data from controlled biomechanical tests. The deformation and stresses of the metatarsals during landing at different inversion angles (normal landing, 10 degree inversion and 20 degree inversion angles) were comparatively studied. The results showed that in the lateral metatarsals stress increased while in the medial metatarsals stress decreased with the angle of inversion. The peak stress point was found to be near the proximal part of the fifth metatarsal, which corresponds with reported clinical observations of metatarsal injuries.

There are evidences to suggest that wearing footwear constrains the natural barefoot motion during locomotion. Unlike prior studies that deduced foot motions from shoe sole displacement parameters, the aim of this study was to examine the effect of footwear motion on forefoot to rearfoot relative motion during walking and running. The use of a multi-segment foot model allowed accurate both shoe sole and foot motions (barefoot and shod) to be quantified. Two pairs of identical sandals with different midsole hardness were used. Ten healthy male subjects walked and ran in each of the shod condition. The results showed that for barefoot locomotion there was more eversion of the forefoot and it occurred faster than for shod locomotion. In this later condition, the range of eversion was reduced by 20% and the rate of eversion in late stance by 60% in comparison to the barefoot condition. The sole constrained both the torsional (eversion/inversion) and adduction range of motion of the foot. Interestingly, during the push-off phase of barefoot locomotion the rate and direction of forefoot torsion varied between individuals. However, most subjects displayed a forefoot inversion direction of motion while shod. Therefore, this experiment showed that the shoes not only restricted the natural motion of the barefoot but also appeared to impose a specific foot motion pattern on individuals during the push-off phase. These findings have implications for the matching of footwear design characteristics to individual natural foot function.

Several injuries to the lower extremity in runners have been linked to excessive rates of internal rotation of the tibia just after ground impact. This study presents an improved method of capturing internal/external tibial rotation, and investigates whether estimates of rates of internal tibial rotation during the first 50 ms of contact during running are influenced by the sampling rate and processing of tibial displacement data. A lightweight plate was moulded to the shape of each subject's right anterior-medial tibia. Nine male subjects ran barefoot (3.35 m.s(-1)) and the landing kinematics of the right leg were recorded at 1000 Hz. The group mean value for the total range of internal rotation of the tibia for the whole stance phase was consistent with the literature (15.4 degrees ), but peak angular velocities (8.3 rad.s(-1)) were substantially higher than previously reported. The cut-off frequency of the low-pass filter influenced the peak angular velocity values obtained with the largest changes occurring between 15 and 40 Hz. Typically, researchers using lower sample rates have to filter around 10 Hz and consequently are likely to underestimate peak angular velocities. These findings have implications for obtaining a sound quantitative foundation for transient tibial motion before furthering our understanding of injury mechanisms.

To reduce the risk of injury associated with foot-ground interaction during sporting activities, there is a need for adequate assessment of the protective function of sports footwear. The present objectives are to review the typical biomechanical approaches used to identify protection offered by sports footwear during dynamic activities and to outline some of the recent methodological approaches aimed at improving this characterization. Attention is focused on biomechanical techniques that have been shown to best differentiate safety features of footwear. It was determined that subject tests would be used in combination with standard mechanical techniques to evaluate footwear protection. Impact attenuation characteristics of footwear during sporting activities were most distinguished by analysis of tibial shock signals in the frequency and joint time-frequency domains. It has been argued that lateral stability and traction properties of footwear are better assessed using game-like manoeuvres of subjects on the actual sporting surface. Furthermore, the ability of such tests to discriminate between shoes has been improved through methods aimed at reducing or accounting for variability in individual execution of dynamic manoeuvres. Advances in tools allowing measurement of dynamic foot function inside the shoe also aid our assessment of shoe protective performance. In combination, these newer approaches should provide more information for the design of safer sports footwear.

For in vivo impact loadings administered under controlled initial conditions, it was hypothesized that larger initial knee angles (IKA) and softer impacting interfaces would reduce impact loading and initial leg stiffness. A human pendulum was used to deliver controlled impacts to the right foot of 21 subjects for three IKA (0, 20 and 40 degrees) and three interfaces (barefoot, soft and hard EVA foams). The external impact force and the shock experienced by the subjects' shank were measured simultaneously with a wall mounted force platform and a skin mounted accelerometer, respectively. Stiffness of the leg was derived using impact velocity and wall reaction force data. The results disproved the role of the knee joint in regulating initial leg stiffness and provided only partial support for the hypothesized improved cushioning. Larger knee flexion at contact reduced impact force but increased the shock travelling throughout the shank. Conversely, softer interfaces produced sizable reductions in both initial leg stiffness and severity of the impact experienced by the lower limb. Force rate of loading was found to be highly correlated (r = 0.95) to limb stiffness that was defined by the heel fat pad and interface deformations. These results would suggest that interface interventions are more likely to protect the locomotor system against impact loading than knee angle strategies.

The shocks imparted to the foot during locomotion may lead to joint-degenerative diseases and jeopardize the visual-vestibular functions. The body relies upon several mechanisms and structures that have unique viscoelastic properties for shock attenuation. The purpose of the present study was to determine whether impact severity and initial knee angle (IKA) could alter the shock transmission characteristics of the body. Impacts were administered to the right foot of 38 subjects with a human pendulum device. Combinations of velocities (0.9, 1.05 and 1.2 m s-1) and surfaces (soft and hard foams) served to manipulate impact severity in the first experiment. Three IKA (0, 20 and 40 degrees) were examined in the second experiment. Transmission between shank and head was characterized by measuring the shock at these sites with miniature accelerometers. Velocity and surface had no effect on the frequency profile of shock transmission suggesting a consistent response of the body to impact severity. Shank shock power spectrum features accounted for the lower shock ratio (head/shank) measured under the hard surface condition. IKA flexion caused considerable reduction in effective axial stiffness of the body (EASB), 28.7-7.9 kNm-1, which improved shock attenuation. The high correlation (r = 0.97) between EASB and shock ratio underscored the importance of EASB to shock attenuation. The present findings provide valuable information for the development of strategies aimed at protecting the joints, articular cartilage, spine and head against locomotor shock.

The understanding of impact mechanics during locomotion is important for research within the fields of injury prevention and footwear design. Instrumented missiles offer a worthy solution to the lack of control inherent in in vivo activities and to the isolated nature of tissue studies. However, missiles cannot mimic the magnitude and temporal characteristics of locomotion impacts. A human pendulum approach employed the subject's own body as the missile to impart controlled impacts to the lower extremity. The subject is swung toward a force platform instrumented wall while lying supine on a suspended lightweight bed. The ability of the pendulum to reproduce locomotor impact loading was assessed for heel-toe running. Axial reaction force and shank acceleration patterns recorded during pendulum tests in ten subjects were found to closely resemble running patterns and they were obtained without discomfort to the subjects. This new approach relies upon one's own body to impart impacts representative of locomotion. It should prove useful to study human impact loading in a controlled manner.

The purpose of the present study was to capture the relationship between ground reaction force (GRF) and tibial axial acceleration. Tibia acceleration and GRF were simultaneously recorded from five subjects during running. The acceleration of the bone was measured with a transducer mounted onto an intracortical pin. The signals were analyzed in the frequency domain to characterize the relationship between GRF and tibial acceleration. The results confirmed that for each subject this relationship could be represented by a frequency transfer function. The existence of a more general relationship for all five subjects was also confirmed by the results. The transfer functions provided information about transient shock transmissibility for the entire impact phase of running.