Feasibility of Wearable Haptic Biofeedback Training for Reducing the Knee Abduction Moment During Overground Walking

2020 ◽  
Vol 143 (4) ◽  
Author(s):  
Bryndan W. Lindsey ◽  
Junkai Xu ◽  
David Chiasson ◽  
Peter Shull ◽  
Nelson Cortes
Keyword(s):  
Feedback System ◽  
Biofeedback Training ◽  
Overground Walking ◽  
Biofeedback System ◽  
Peak Knee ◽  
Knee Loading ◽  
Post Test ◽  
Knee Abduction ◽  
3D Motion Capture ◽  
Healthy Participants

Abstract Gait modifications are effective in reducing the first peak knee abduction moment (PKAM), a surrogate for knee loading. Reliance on 3D motion capture currently restricts these modifications to the laboratory. Therefore, our purpose was to test the feasibility of a novel wearable biofeedback system to train (1) toe-in and trunk lean modifications and (2) combined toe-in and trunk lean modifications to reduce PKAM during overground walking outside of the laboratory. Twelve healthy participants practiced modifications in a university hallway directly after performing five normal walking trials. The wearable feedback system provided real-time haptic biofeedback during training trials to inform participants if they were within the prescribed modification range (7–12 deg greater than baseline). Participants were instructed to move to the next modification only once they felt comfortable and could perform it with minimal errors. Following training, five trials of each modification were immediately performed in the gait laboratory without feedback. All participants successfully modified their foot progression and trunk angle using the wearable system. At post-test, PKAM decreased from baseline by 62%, 55%, and 28% during combined, trunk leanand toe-in gait, respectively. The wearable feedback system was effective to modify participants' foot and trunk angle by the prescribed amount, resulting in reduced PKAM during all modifications at post-test. Participants were also able to perform a combined modification, although it took longer to report feeling comfortable doing so. This study demonstrates that a wearable feedback system is feasible to modify kinematic parameters and train gait modifications outside the laboratory.

scholarly journals Development of a novel biofeedback system for the sprint start

2022 ◽  
pp. 174795412110727
Author(s):  
Jorge Cortes Gutierrez ◽  
Sean Peter Walton ◽  
Neil Edward Bezodis
Keyword(s):  
Control Group ◽  
The Novel ◽  
Knee Angle ◽  
Start Line ◽  
Acute Responses ◽  
Biofeedback System ◽  
Post Test ◽  
Measurement Units ◽  
Learning Principles ◽  
3D Motion Capture

This study developed and evaluated a novel concurrent biofeedback system for the sprint start. Previous studies have investigated sprint start biofeedback applications, but these have either not considered important kinematics, coaching implications or key motor learning principles. The biofeedback system was developed to convey rear knee angle information, obtained from 3D motion capture to novice participants as changes in the colour of an LED start line when they were in the “set” position. Based on initial user feedback, the system indicated whether the participants’ rear knee angles were within ± 2° of 130° (green) or not (red). A two-group experimental study was then employed to explore the acute responses of novices to the use of the biofeedback system during the sprint start. When exposed to biofeedback, the experimental group (EXP, n = 10) exhibited less deviation (4.0 ± 2.4°) from the target rear knee angle than they did in either a pre-test (11.9 ± 6.9°) or post-test (10.4 ± 4.4°) condition without biofeedback. The control group (CON, n = 10) with no biofeedback exhibited greater deviation from the target rear knee angle than the EXP group in all three condition blocks (pre-test = 21.8 ± 15.1°, no intervention = 15.6 ± 7.3°, post-test = 14.3 ± 6.5°) but the group × condition interaction effect was not significant (P = 0.210). The novel biofeedback system can be used to manipulate selected “set” position kinematics and has the potential to be incorporated with different input systems (e.g. inertial measurement units (IMUs)) or in longitudinal designs.

Relationship between kinematic gait parameters during three gait modifications designed to reduce peak knee abduction moment

The Knee ◽  
2021 ◽  
Vol 28 ◽  
pp. 229-239
Author(s):  
Bryndan Lindsey ◽  
Scott Bruce ◽  
Oladipo Eddo ◽  
Shane Caswell ◽  
Nelson Cortes
Keyword(s):  
Gait Parameters ◽  
Peak Knee ◽  
Knee Abduction

scholarly journals NEURAL ACTIVITY AND LANDING BIOMECHANICS: EXPLORING THE RELATIONSHIPS BETWEEN THE BRAIN, BODY, AND ACL INJURY-RISK

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0015
Author(s):  
Cody R. Criss ◽  
Dustin R. Grooms ◽  
Jed A. Diekfuss ◽  
Manish Anand ◽  
Alexis B. Slutsky-Ganesh ◽  
...  
Keyword(s):  
Neural Activity ◽  
Injury Risk ◽  
Neural Control ◽  
Motor Coordination ◽  
Cruciate Ligament ◽  
Vertical Jump ◽  
Frontal Plane ◽  
Peak Knee ◽  
Knee Abduction ◽  
Drop Vertical Jump

Background: Anterior cruciate ligament (ACL) injuries predominantly occur via non-contact mechanisms, secondary to motor coordination errors resulting in aberrant frontal plane knee loads that exceed the thresholds of ligament integrity. However, central nervous system processing underlying high injury-risk motor coordination errors remain unknown, limiting the optimization of current injury reduction strategies. Purpose: To evaluate the relationships between brain activity during motor tasks with injury-risk loading during a drop vertical jump. Methods: Thirty female high school soccer players (16.10 ± 0.87 years, 165.10 ± 4.64 cm, 63.43 ± 8.80 kg) were evaluated with 3D biomechanics during a standardized drop vertical jump from a 30 cm box and peak knee abduction moment was extracted as the injury-risk variable of interest. A neuroimaging session to capture neural activity (via blood-oxygen-level-dependent signal) was then completed which consisted of 4 blocks of 30 seconds of repeated bilateral leg press action paced to a metronome beat of 1.2 Hz with 30 seconds rest between blocks. Knee abduction moment was evaluated relative to neural activity to identify potential neural contributors to injury-risk. Results: There was a direct relationship between increased landing knee abduction moment and increased neural activation within regions corresponding to the lingual gyrus, intracalcarine cortex, posterior cingulate cortex, and precuneus (r2= 0.68, p corrected < .05, z max > 3.1; Table 1 & Figure 1). Conclusion: Elevated activity in regions that integrate sensory, spatial, and attentional information may contribute to elevated frontal plane knee loads during landing. Interestingly, a similar activation pattern related to high-risk landing mechanics has been found in those following injury, indicating that predisposing factors to injury may be accentuated by injury or that modern rehabilitation does not recover prospective neural control deficits. These data uncover a potentially novel brain marker that could guide the discovery of neural-therapeutic targets that reduce injury risk beyond current prevention methods. [Table: see text][Figure: see text]

Optimizing Whole-Body Kinematics During Single-Leg Jump Landing to Reduce Peak Abduction/Adduction and Internal Rotation Knee Moments: Implications for Anterior Cruciate Ligament Injury Risk

2021 ◽  
pp. 1-8
Author(s):  
Dhruv Gupta ◽  
Jeffrey A. Reinbolt ◽  
Cyril J. Donnelly
Keyword(s):  
Internal Rotation ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Whole Body ◽  
Jump Landing ◽  
Peak Knee ◽  
Knee Abduction ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Knee abduction/adduction moment and knee internal rotation moment are known surrogate measures of anterior cruciate ligament (ACL) load during tasks like sidestepping and single-leg landing. Previous experimental literature has shown that a variety of kinematic strategies are associated or correlated with ACL injury risk; however, the optimal kinematic strategies needed to reduce peak knee moments and ACL injury are not well understood. To understand the complex, multifaceted kinematic factors underpinning ACL injury risk and to optimize kinematics to prevent the ACL injury, a musculoskeletal modeling and simulation experimental design was used. A 14-segment, 37-degree-of-freedom, dynamically consistent skeletal model driven by force/torque actuators was used to simulate whole-body single-leg jump landing kinematics. Using the residual reduction algorithm in OpenSim, whole-body kinematics were optimized to reduce the peak knee abduction/adduction and internal/external rotation moments simultaneously. This optimization was repeated across 30 single-leg jump landing trials from 10 participants. The general optimal kinematic strategy was to bring the knee to a more neutral alignment in the transverse plane and frontal plane (featured by reduced hip adduction angle and increased knee adduction angle). This optimized whole-body kinematic strategy significantly reduced the peak knee abduction/adduction and internal rotation moments, transferring most of the knee load to the hip.

A WEARABLE BIOFEEDBACK SYSTEM SUPPORTING REAL-TIME PACED BREATHING TRAINING AND PHYSIOLOGICAL MONITORING

2013 ◽  
Vol 25 (02) ◽  
pp. 1350018 ◽  
Author(s):  
Zheng-Bo Zhang ◽  
Hao Wu ◽  
Jie-Wen Zheng ◽  
Wei-Dong Wang ◽  
Bu-Qing Wang ◽  
...  
Keyword(s):  
Real Time ◽  
Breathing Pattern ◽  
Detection Algorithm ◽  
Biofeedback Training ◽  
Physiological Data ◽  
Time Signal ◽  
Physiological Monitoring ◽  
Breathing Rate ◽  
Beneficial Effects ◽  
Biofeedback System

Slow and regular breathing can generate beneficial effects on cardiovascular system and reduce stress. Breathing pacer is usually helpful for a user to learn to control breathing and restore an optimal breathing pattern. In this paper, a wearable physiological monitoring system supporting real-time breathing biofeedback is presented. An elastic T-shirt with two inductive bands integrated in the positions of rib cage (RC) and abdomen (AB) is used as a motherboard both for physiological monitoring and respiratory biofeedback. Physiological signals such as RC and AB respiration, electrocardiography (ECG), photoplethysmograph (PPG) and artery pulse wave (APW) can be sampled, stored and transmitted wirelessly. When this system is used in biofeedback applications, respiratory signals are processed in real-time by a peak-detection algorithm to recognize the concurrent breathing pattern. By comparing the actual breathing rate with the guiding breathing rate, an audio biofeedback is generated by playing music audios stored in the Micro-SD card through an MP3 decoder chip VS1053. With this design, multiple functions of physiological monitoring, real-time signal processing and audio biofeedback were integrated in one wearable system. Experiment showed that through audio biofeedback this system can guide the user to practice a slow and regular breathing effectively. Physiological data recorded from a Yoga practitioner during meditation demonstrated the capability of the system to acquire cardiopulmonary physiological data during slow breathing. This system is a useful tool both for breathing biofeedback training and its related scientific researches.

scholarly journals Association of Quadriceps and Hamstrings Cocontraction Patterns With Knee Joint Loading

2009 ◽  
Vol 44 (3) ◽  
pp. 256-263 ◽  
Author(s):  
Riann M. Palmieri-Smith ◽  
Scott G. McLean ◽  
James A. Ashton-Miller ◽  
Edward M. Wojtys
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Female Athletes ◽  
Vastus Lateralis ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peak Knee ◽  
Knee Abduction

Abstract Context: Sex differences in neuromuscular control of the lower extremity have been identified as a potential cause for the greater incidence of anterior cruciate ligament (ACL) injuries in female athletes compared with male athletes. Women tend to land in greater knee valgus with higher abduction loads than men. Because knee abduction loads increase ACL strain, the inability to minimize these loads may lead to ACL failure. Objective: To investigate the activation patterns of the quadriceps and hamstrings muscles with respect to the peak knee abduction moment. Design: Cross-sectional study. Setting: Neuromuscular research laboratory. Patients or Other Participants: Twenty-one recreationally active adults (11 women, 10 men). Main Outcome Measure(s): Volunteers performed 3 trials of a 100-cm forward hop. During the hop task, we recorded surface electromyographic data from the medial and lateral hamstrings and quadriceps and recorded lower extremity kinematics and kinetics. Lateral and medial quadriceps-to-hamstrings (Q∶H) cocontraction indices, the ratio of medial-to-lateral Q∶H cocontraction, normalized root mean square electromyographic data for medial and lateral quadriceps and hamstrings, and peak knee abduction moment were calculated and used in data analyses. Results: Overall cocontraction was lower in women than in men, whereas activation was lower in the medial than in the lateral musculature in both sexes (P &lt; .05). The medial Q∶H cocontraction index (R2  =  0.792) accounted for a significant portion of the variance in the peak knee abduction moment in women (P  =  .001). Women demonstrated less activation in the vastus medialis than in the vastus lateralis (P  =  .49) and less activation in the medial hamstrings than in the lateral hamstrings (P  =  .01). Conclusions: Medial-to-lateral Q∶H cocontraction appears to be unbalanced in women, which may limit their ability to resist abduction loads. Because higher abduction loads increase strain on the ACL, restoring medial-to-lateral Q∶H cocontraction balance in women may help reduce ACL injury risk.

Three-Dimensional Knee Joint Kinetics During a Golf Swing

1998 ◽  
Vol 26 (2) ◽  
pp. 285-294 ◽  
Author(s):  
Charles J. Gatt ◽  
Michael J. Pavol ◽  
Richard D. Parker ◽  
Mark D. Grabiner
Keyword(s):  
Knee Joint ◽  
Three Dimensional ◽  
Skill Level ◽  
Golf Swing ◽  
Joint Kinetics ◽  
Peak Loads ◽  
Knee Rehabilitation ◽  
Peak Knee ◽  
Knee Loading ◽  
Joint Loads

This study characterized knee joint kinetics during a golf swing and determined the influence of shoe type and golfer skill on the peak knee joint loads. Thirteen golfers each hit a golf ball using a five iron under two footware conditions: spiked and spikeless golf shoes. Data from a video-based motion capture system and force plates were used to compute the knee joint kinetics. Mean peak forces and moments differed significantly between the lead and trail knees, but these peak loads were not significantly affected by shoe type. Only the lead knee flexion and internal rotation moments were significantly correlated to skill level. The magnitude of some of the peak loads at the knee during the golf swing approached those reached during activities prohibited until late-stage knee rehabilitation. We concluded the following: The type of shoe worn and the skill level of the golfer need not be considered in deciding time to return to golfing; however, the leg that is recovering from surgery or injury should be considered. The most stressful phase of the golf swing, relative to the knee, is the downswing. There is probably no “normal” swing; each golfer seems to possess consistent, characteristic, patterns of knee loading.

scholarly journals Differential Effects of Hip Rotation Range on Knee Abduction Biomechanics during Double-Legged Landing between Males and Females

2020 ◽  
Vol 22 (4) ◽  
pp. 34-47
Author(s):  
Tadashi Yasuda ◽  
Keiichi Oyanagi ◽  
Miyu Nakagaki ◽  
Hiromitsu Itoh
Keyword(s):  
Muscle Strength ◽  
External Rotation ◽  
Muscle Mechanics ◽  
Abduction Angle ◽  
Drop Landing ◽  
Peak Knee ◽  
Hip Abduction ◽  
Knee Abduction ◽  
Males And Females ◽  
Hip Rotation

OBJECTIVES Dynamic knee valgus is composed of hip-knee coupling. While females differ from males in passive hip motion, hip rotation range may alter muscle mechanics and neuromuscular activity. This study aimed to compare knee abduction biomechanics during double-legged drop-landing between males and females with different hip rotation ranges.METHODS This study included five females with the range of hip internal rotation (IR) > the range of hip external rotation (ER), five females with ER>IR, four males with IR>ER, and five males with ER>IR. There was no difference in other hip motions among them or no difference in hip muscle strength between the same sex groups. Three-dimensional motion analyses of the hip and knee joints were performed during double-legged drop-landing.RESULTS Multiple regression analysis of females with IR>ER showed that peak knee abduction moment (KAM) was associated with maximal hip abduction moment before detecting peak KAM whereas peak knee abduction angle (KAA) correlated with no variable. In females with ER>IR, peak KAM was associated with maximal hip ER moment before detecting peak KAM, hip ER muscle strength and hip adduction range while peak KAA correlated with peak hip abduction moment before detecting peak KAM. In males with IR>ER, peak KAM was associated with hip ER range and hip adductor strength whereas peak KAA correlated with maximal hip ER moment and maximal hip IR angle during landing. In males with ER>IR, peak KAM was associated with hip extensor strength, hip abduction range and hip flexion range whereas peak KAA correlated with hip ER moment before detecting peak KAM, hip ER muscle strength, and hip adduction range.CONCLUSIONS Hip rotation range may differentially affect hip-knee coupling strategy for knee abduction control during double-legged drop-landing between males and females.

Decision Making and Experience Level Influence Frontal Plane Knee Joint Biomechanics During a Cutting Maneuver

2013 ◽  
Vol 29 (6) ◽  
pp. 756-762 ◽  
Author(s):  
Kristof Kipp ◽  
Tyler N. Brown ◽  
Scott G. McLean ◽  
Riann M. Palmieri-Smith
Keyword(s):  
Decision Making ◽  
Knee Joint ◽  
Functional Data ◽  
Frontal Plane ◽  
Division I ◽  
Recreational Athletes ◽  
Data Analyses ◽  
Peak Knee ◽  
Joint Biomechanics ◽  
Knee Abduction

The purpose of this study was to examine the combined impact of experience and decision making on frontal plane knee joint biomechanics during a cutting maneuver. Kinematic and kinetic data were collected from 12 recreationally active and 18 NCAA Division I female athletes during execution of anticipated and unanticipated single-leg land-and-cut maneuvers. Knee joint abduction angles and external knee joint abduction torques were calculated and discrete peak stance-phase variables were extracted. Angle and torque time-series data were also submitted to separate functional data analyses. Variables derived from the functional data analyses indicated that decision making influenced knee abduction angle and torque time series in the recreational group only. Specifically, these variables pointed to greater knee abduction at the end of stance as well as a greater, albeit delayed peak in knee abduction torque at the beginning of landing in the recreational athletes during the unanticipated condition. In addition, the recreational athletes displayed greater discrete peak knee abduction angles than the Division I athletes regardless of condition. Discrete peak knee abduction torque did not differ between groups or conditions.

scholarly journals Difference in leg asymmetry between female collegiate athletes and recreational athletes during drop vertical jump

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yutaro Morishige ◽  
Kengo Harato ◽  
Shu Kobayashi ◽  
Yasuo Niki ◽  
Morio Matsumoto ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Collegiate Athletes ◽  
Acl Injury ◽  
Activity Level ◽  
Abduction Angle ◽  
Recreational Athletes ◽  
Increased Risk ◽  
Peak Knee ◽  
Knee Abduction ◽  
Leg Dominance

Abstract Background Neuromuscular imbalance will lead to loading asymmetry in sporting activities. This asymmetry is related to leg dominance, which has been associated with increased risk of anterior cruciate ligament (ACL) injury. Therefore, potential biomechanical differences between legs are important. However, little attention has been paid to the biomechanical details of leg dominance. The purpose of the present study was to clarify the relationship between leg dominance and knee biomechanics in females with different activity level during dynamic athletic tasks. Methods A total of 23 female collegiate (mean age = 19.6 ± 1.4 years, mean body mass index = 21.5 ± 0.9) and 19 recreational athletes (mean age = 20.7 ± 1.1 years, mean body mass index = 20.5 ± 1.7) were enrolled. Tegner activity scores of the collegiate and recreational athletes were 9 and 7, respectively. Knee kinematic and kinetic asymmetries between the dominant (DL) and non-dominant (NDL) legs during the landing phase of drop vertical jump (DVJ) were assessed using three-dimensional motion analysis in collegiate and recreational athletes separately. Statistical comparison was done using two-tailed paired t test between DL and NDL in each athlete. Results The peak knee abduction angle was significantly larger on the DL than on the NDL in collegiate athletes. Knee abduction angle at initial contact (IC), peak knee abduction angle, knee internal rotation angle at IC, and peak knee internal rotation angle were significantly larger on the NDL than on the DL in recreational athletes. Moreover, peak knee abduction moment within 40 ms from IC was larger on the NDL than on the DL in recreational athletes, while the moment was not significantly different in collegiate athletes. Conclusions From the present study, the relationship between leg dominance and knee biomechanics was totally different in females with different activity level. Specifically, asymmetry of the knee abduction angle between limbs was opposite between female recreational and collegiate athletes. According to previous literatures, abduction and internal rotation angles as well as abduction moment were key issues for mechanism of non-contact ACL injury. Therefore, the NDL in female recreational athletes was associated with increased risk of ACL injury.

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