Frontal Plane Joint Moments Research Articles

Age-associated changes in lower limb weight-bearing strategy during walking

BackgroundAs people age there is a proximal shift of joint moment generation from ankle plantarflexion and knee extension toward hip extension and flexion moments. This age-related redistribution has been documented in the context of propulsive force generation during the push-off phase with less evidence in the context of weight bearing. Additionally, these sagittal plane joint moments have been a primary focus of studies though the hip frontal plane moment also contributes to vertical support but has received less attention. Furthermore, how aging affects the relationships between changes in sagittal and frontal joint moments and changes in vertical support force as a function of walking speed remains unclear Research questionHow does aging affect the contributions of sagittal and frontal plane joint moments to weight-bearing across different walking speeds? MethodsGait analysis was performed on 24 young and 17 healthy older subjects walked on the treadmill at their preferred and 30 % faster speeds. Stepwise linear regression analysis was performed to determine the joint moments that predict the peak amplitudes of the vertical ground reaction force (VGRF) across different walking speeds. ResultsHip abduction and knee extension moments were the primary contributors to leading limb weight-bearing in young, whereas hip extension moment was the primary contributor in older adults. Ankle plantarflexion moment was the main contributor to trailing limb weight-bearing in young and hip flexion moment was the main contributor in older adults. From preferred to faster walking speed changes in knee extension moment were the primary contributor to changes in the trailing limb weight-bearing in young whereas changes in hip extension moment were the primary contributor in olderadults. SignificanceThese findings suggested that older and younger adults used different joint moment contributions to produce leading limb and trailing limb vertical support forces across different walking speeds.

A most painful knee does not induce interlimb differences in knee and hip moments during gait in patients with knee osteoarthritis

BackgroundPatients with knee osteoarthritis can adapt their gait to unload the most painful knee joint in order to try to reduce pain and improve physical function. However, these gait adaptations can cause higher loads on the contralateral joints. The aim of the study was to investigate the interlimb differences in knee and hip frontal plane moments during gait in patients with knee osteoarthritis and in healthy controls. MethodsForty patients with knee osteoarthritis and 19 healthy matched controls were measured during comfortable treadmill walking. Frontal plane joint moments were obtained of both hip and knee joints. Differences in interlimb moments within each group were assessed using statistical parametric mapping and discrete gait parameters. FindingsNo interlimb differences were observed in patients with knee osteoarthritis and control subjects at group level. Furthermore, the patients presented similar interlimb variability as the controls. In a small subgroup (n = 12) of patients, the moments in the most painful knee were lower than in the contralateral knee, while the other patients (n = 28) showed higher moments in the most painful knee compared to the contralateral knee. However, no interlimb differences in the hip moments were observed within the subgroups. InterpretationPatients with knee osteoarthritis do not have interlimb differences in knee and hip joint moments. Patients and healthy subjects demonstrate a similar interlimb variability in the moments of the lower extremities. In this context, differences in knee pain in patients with knee osteoarthritis did not induce any interlimb differences in the frontal plane knee and hip moments.

Sagittal And Frontal Plane Joint Moments Of The Sumo Deadlift During Shod And Barefoot Conditions

Sumo style deadlifting has recently become more prevalent. Barefoot-style lifting has also become increasingly popular with claims such as increased force production and improved “grounding” of the foot. However, the biomechanics of sumo deadlifting while barefoot have not been examined. PURPOSE: To examine the effects on the hip, knee, and ankle joint moments during a sumo deadlift when comparing shod and barefoot conditions. METHODS: Ten subjects (27.3±3.5 yrs, 1.74±0.13m, 77.97±17.34kg) with minimum six months of deadlift experience (7.6±4.6 yrs), who were free from lower extremity injury, performed 1 repetition maximum (1RM; 137.7±43.0 kg) testing on day 1. This testing was performed in self-selected footwear. On day 2, a minimum of 72 hours later, subjects lifted 70% of their 1RM during a 3-dimensional analysis. Subjects performed one set of five continuous repetitions of a sumo deadlift in shod and barefoot conditions in randomized order. Five minutes of rest was given between sets. Marker data were collected using Qualisys Track Manager, sampling at 240Hz. Force data were collected using Bertec force plates, sampling at 1200Hz. Raw marker and force data were imported into Visual3D. Marker and force data were filtered using a fourth-order lowpass Butterworth filter at 8Hz. Peak internal sagittal and frontal plane joint moments of the hip, knee, and ankle were calculated during the concentric phase of each repetition. Peak vertical ground reaction force was measured during the concentric phase. RESULTS: No significant differences were detected in peak hip extension moment (p=0.855), hip abduction (p=0.288), knee extension (p=0.607), knee abduction (p=0.926), ankle plantarflexion (p=0.376), ankle eversion (p=0.739), or peak vertical ground reaction force (p=0.558). CONCLUSIONS: There is no evidence to suggest that the barefoot lifting style increases performance capabilities when lifting the same weight as in the shod condition. Additionally, there is no evidence to suggest that there is any increased risk in excess frontal plane joint moments during barefoot lifting. Future research should examine the 1RM capabilities in both shod and barefoot conditions to determine if differences exist during maximal compared to submaximal efforts.

Kinematic And Kinetic Differences During A Conventional Deadlift With And Without Shoes

Despite the popularity of deadlifting without shoes, little research has examined the kinematic and kinetic differences during a conventional deadlift when performing the exercise barefoot. Excess joint torque in the frontal plane can be indicative of injury. PURPOSE: To examine the differences in frontal plane mechanics of the lower extremity and force development during a conventional deadlift with and without shoes. METHODS: Thirty participants with a mean height and weight of 1.75±0.10 meters and 81.12±16.05 kg. Participants recruited had consistently performed the conventional deadlift for six or more months and strength training at least two days per week. During the participant’s first visit, a one repetition maximum (1RM) using NSCA guidelines was determined. A second visit occurred at least 72 hours or more after the 1RM testing. Kinematic and kinetic data were collected using a 15-camera Qualisys Oqus system (240Hz) and two Bertec force plates (1200Hz). Participants performed five consecutive reps at 70% of their 1RM in random order (shoes and barefoot). Visual 3D was used to process raw marker and force data and to calculate frontal plane joint moments at the hip, knee, and ankle during the concentric phase. A one-way MANOVA (p<0.05) was used to investigate the different footwear conditions. RESULTS: There was a statistically significant difference between shoes (-0.28 ± 0.11 Nm/kg) and no shoes (-0.38 ± 0.14 Nm/kg) for internal ankle eversion moments (p=0.018). No significant differences were detected for knee and hip abduction moments. Peak vertical ground reaction force in the barefoot condition (1035.2±281.4 N) was not significantly different than the shoe condition (1044.9±286.5 N). CONCLUSION: The absence of shoes created an increase in frontal plane ankle moments, but there was no change in the vertical force characteristics. An increased internal eversion moment did not affect the joint moments further up the kinetic chain despite undergoing similar loading patterns.

Ankle Joint Kinetics in Runners with Medial Tibial Stress Syndrome

Medial tibial stress syndrome (MTSS) is a common overuse running injury. While numerous studies have reported abnormal ankle kinematics in runners with MTSS, to date, no studies have evaluated ankle kinetics in this population. PURPOSE: To compare ankle kinetics in runners with and without MTSS. METHODS: Participants included eight runners with MTSS (sex: 7M/1F; age: 35 ± 11.3 years) and eight matched controls (CON; sex: 7M/1F; age: 35 ± 8.7 years). Kinematics and ground reaction forces were recorded while participants ran overground. Sagittal plane kinetics were calculated about an axis connecting the malleoli while frontal plane kinetics were calculated about an axis approximating the 23° medially deviated and 42° inclined orientation of the subtalar joint. Joint work was calculated by integrating the joint power curves. Paired t-tests were used to compare peak moments, powers, and work between MTSS and CON groups. RESULTS: Neither peak plantar flexor (MTSS: 2.14 ± 0.53, CON: 2.24 ± 0.57 Nm/kg) nor peak invertor (MTSS: 1.04 ± 0.34, CON: 1.16 ± 0.32 Nm/kg) moments were different between groups (p = .720, p = .472, respectively). There were no differences in sagittal plane powers or work between groups. In the frontal plane, the MTSS group demonstrated lower peak positive power (MTSS: 1.97 ± 0.38, CON: 3.05 ± 1.12 W/kg, p = .021), and performed less negative (MTSS: -0.09 ± 0.02, CON: -0.16 ± 0.07 J/kg, p = .032), positive (MTSS: 0.14 ± 0.03, CON: 0.22 ± 0.07 J/kg, p = .039), and total (MTSS: 0.23 ± 0.06, CON: 0.37 ± 0.15 J/kg, p = .032) work. CONCLUSIONS: Compared to healthy individuals, runners with MTSS are not able to generate as much energy to invert their foot during late stance. This may explain why previous studies have observed runners with MTSS have prolonged rearfoot eversion during stance.Figure 1: Frontal plane joint moments (A) and powers (B). The solid line represents the CON group and the dotted line represents the MTSS group. Error bars show one standard deviation above and below the mean curve for the CON group.

Effects of infant transportation on lower extremity joint moments: Baby carrier versus carrying in-arms

BackgroundThe act of babywearing is recognizably a task of load carriage and has gained popularity among millennial caregivers. Research QuestionThe implications of babywearing on lower extremity joint moments of the caregiver are still unknown during prolonged transport and a direct comparison of babywearing to carrying an infant in-arms has not been previously conducted. MethodsEighteen females participated in this study by performing 3 conditions: a) 3 min walking unloaded (UL), b) 15 min walking while carrying a mannequin infant in-arms (IA), and c) 15 min walking while wearing a mannequin infant in an anteriorly positioned baby carrier (BC). Two separate data analyses were conducted using a repeated measures ANOVA. First, UL compared to the initial minute of walking for IA and BC. Second, UL compared to the final minute of walking for IA and BC. ResultsDuring initial minute comparisons, both IA and BC conditions increased joint moments in the frontal and sagittal plane at the knee with no change at the ankle and hip. During final minute comparisons, IA maintained the increases in the knee frontal plane joint moments observed during initial minute comparisons but also increased at the hip; however, BC generally showed no statistical difference from UL. Carrying an infant in a baby carrier more closely resembles unloaded walking, while carrying an infant in-arms appears to increase the mechanical load placed on the knee and hip joints in the frontal plane through an increase in joint moments. SignificanceDuring prolonged transportation, caregivers might choose to employ a baby carrier as opposed to carrying an infant in-arms, as in-arm carriage increases the loading knee abduction moment by 8.7% and the loading knee extension moment by 16.7%.

Body weight unloading modifications on frontal plane joint moments, impulses and Center of Pressure during overground gait

BackgroundBody weight unloading is a common method of gait rehabilitation. However, little is known about its effects on the overground gait biomechanical parameters which were often confounded by the walking modality (treadmill) or the speed variability when subjects walked overground while having to pull the body weight unloading system to which they were attached. By designing a mechanical device that pulled the system at a constant speed, we were able to assess the unique effects of body weight unloading on healthy subjects' kinetics during overground gait. MethodsFifteen healthy subjects walked overground under three (0%, 15%, and 30%) body weight unloading experimental conditions. Kinetic measures included hip and knee frontal plane moments and impulses and the foot center of pressure. FindingsA significant inverse relationship was shown between increased body weight unloading levels (0% to 30%) and a decrease in the hip and knee first adduction moments and impulses and an increase in the lateral shift of the foot center of pressure. Frontal plane hip and knee kinetic curvature patterns remained similar as evidenced by low normalized RMSE under paired comparisons of the experimental conditions. InterpretationOverground gait with up to 30% body weight unloading stands out as an efficient method of reducing loads on joints without distorting kinetic gait curvature patterns. The relationship between increased unloading with decreased hip and knee moments and impulses and increased lateral shift of the center of pressure also suggests that this shift may be an important diagnostic tool in gait assessment and correction.

Heel height affects lower extremity frontal plane joint moments during walking

Wearing high heels alters walking kinematics and kinetics and can create potentially adverse effects on the body. Our purpose was to determine how heel height affects frontal plane joint moments at the hip, knee, and ankle, with a specific focus on the knee moment due to its importance in joint loading and knee osteoarthritis. 15 women completed overground walking using three different heel heights (1, 5, and 9cm) for fixed speed (1.3ms−1) and preferred speed conditions while kinematic and force platform data were collected concurrently. For both fixed and preferred speeds, peak internal knee abduction moment increased systematically as heel height increased (fixed: 0.46, 0.48, 0.55Nmkg−1; preferred: 0.47, 0.49, 0.53Nmkg−1). Heel height effects on net frontal plane moments of the hip and ankle were similar to those for the knee; peak joint moments increased as heel height increased. The higher peak internal knee abduction moment with increasing heel height suggests greater medial loading at the knee. Kinetic changes at the ankle with increasing heel height may also contribute to larger medial loads at the knee. Overall, wearing high heels, particularly those with higher heel heights, may put individuals at greater risk for joint degeneration and developing medial compartment knee osteoarthritis.

Hip-Abductor Fatigue and Single-Leg Landing Mechanics in Women Athletes

Reduced hip-abductor strength and muscle activation may be associated with altered lower extremity mechanics, which are thought to increase the risk for anterior cruciate ligament injury. However, experimental evidence supporting this relationship is limited. To examine the changes in single-leg landing mechanics and gluteus medius recruitment that occur after a hip-abductor fatigue protocol. Descriptive laboratory study. Twenty physically active women (age = 21.0 ± 1.3 years). Participants were tested before (prefatigue) and after (postfatigue) a hip-abductor fatigue protocol consisting of repetitive side-lying hip abduction. Outcome measures included sagittal-plane and frontal-plane hip and knee kinematics at initial contact and at 60 milliseconds after initial contact during 5 single-leg landings from a height of 40 cm. Peak hip and knee sagittal-plane and frontal-plane joint moments during this time interval were also analyzed. Measures of gluteus medius activation, including latency, peak amplitude, and integrated signal, were recorded. A small (<1°) increase in hip-abduction angle at initial contact and a small (<1°) decrease in knee-abduction (valgus) angle at 60 milliseconds after contact were observed in the postfatigue landing condition. No other kinematic changes were noted for the knee or hip at initial contact or at 60 milliseconds after initial contact. Peak external knee-adduction moment decreased 27% and peak hip adduction moment decreased 24% during the postfatigue landing condition. Gluteus medius activation was delayed after the protocol, but no difference in peak or integrated signal was seen during the landing trials. Changes observed during single-leg landings after hip-abductor fatigue were not generally considered unfavorable to the integrity of the anterior cruciate ligament. Further work may be justified to study the role of hip-abductor activation in protecting the knee during landing.

Feasibility of a gait retraining strategy for reducing knee joint loading: Increased trunk lean guided by real-time biofeedback

The purpose of this feasibility study was to examine changes in frontal plane knee and hip walking biomechanics following a gait retraining strategy focused on increasing lateral trunk lean and to quantify reports of difficulty and joint discomfort when performing such a gait modification. After undergoing a baseline analysis of normal walking, 9 young, healthy participants were trained to modify their gait to exhibit small (4°), medium (8°), and large (12°) amounts of lateral trunk lean. Training was guided by the use of real-time biofeedback of the actual trunk lean angle. Peak frontal plane external knee and hip joint moments were compared across conditions. Participants were asked to report the degree of difficulty and the presence of any joint discomfort for each amount of trunk lean modification. Small (4°), medium (8°), and large (12°) amounts of lateral trunk lean reduced the peak external knee adduction moment (KAM) by 7%, 21%, and 25%, respectively, though the peak KAM was only significantly less in the medium and large conditions (p<0.001). Increased trunk lean also significantly reduced the peak external hip adduction moments (p<0.001). All participants reported at least some difficulty performing the exaggerated trunk lean pattern and three participants reported ipsilateral knee, hip, and/or lower spine discomfort. Results from this study indicate that a gait pattern with increased lateral trunk lean can effectively reduce frontal plane joint moments. Though these findings have implications for pathological populations, learning this gait pattern was associated with some difficulty and joint discomfort.

On the expression of joint moments during gait

The purpose of the current study was to examine the effect of different reference frames on lower limb joint moments during gait with a view to identifying a recommended convention for clinical purposes. Data were collected from 10 subjects (nine able-bodied adults and one child with diplegic cerebral palsy) whilst walking at a self-selected speed. Calculations utilised a three-dimensional inverse dynamics model. For each joint, moments were expressed in four different reference frames. Three of the frames were orthogonal: laboratory frame; anatomical frame of proximal segment; anatomical frame of distal segment. The fourth reference frame was a non-orthogonal joint coordinate system (JCS). Significant differences in the joint moment profiles during gait were found with alternative references frames. This was apparent primarily for the transverse plane joint moments for able-bodied adult gait. For the pathological gait pattern presented, there were also marked differences in the frontal plane joint moments and more subtle ones in the sagittal plane. Whilst it is recognised that all possible reference frames for the expression of the net moment vector are mathematically valid, a decision needs to be made as to which one is more clinically useful. It is proposed that the non-orthogonal JCS is most logical on the basis of what, biomechanically, the joint moment actually represents.

Effects of asymmetric load carrying on the biomechanics of walking

The purpose of the study was to investigate the effects of an asymmetric sidepack carrying system on frontal plane joint moments of force in both lower extremities and in the L5 S1 joint during level walking. Ground reaction force data and frontal plane film records were obtained from five males performing three walking conditions: 0, 10 and 20% bodyweight loads in a sidepack supported by the left shoulder. Inverse dynamics were used to calculate the lower extremity moments during stance and a static model of the pelvis was used to calculate the L5 S1 moments during single support for each limb. Normal walking was characterized by symmetric kinetics between left and right limbs and around the L5 S1 joint. The asymmetric loads produced unbalanced lateral trunk muscle dominance between left and right limb stance phases, increased right hip and knee moments and decreased left hip and knee moments. During normal walking, the L5 S1 moment was dominant on the contralateral trunk side for both limbs. The asymmetric loads applied to the left side caused a shift in L5 S1 moment dominance to the right side during left and right single support phases.