Locomotor adaptations to prolonged step-by-step frontal plane trunk perturbations in young adults

AbstractBackgroundMovement alterations due to low back pain (LBP) could lead to long-term adverse consequences if they do not resolve after symptom subsides. This study aims to determine if altered trunk control associated with recurrent low back pain persists beyond symptom duration.MethodsTwenty young adults with recurrent low back pain were tested once during an LBP episode and once in symptom remission, and twenty matched back-healthy participants served as controls. Participants walked on a treadmill with five prescribed step widths. Motion capture and surface electromyography were used to record frontal plane trunk kinematics and muscle activation. Thorax-pelvis coordination was calculated using vector coding technique, and bilateral longissimus activation and co-activation were analyzed.FindingsYoung adults with recurrent LBP exhibited a “looser” trunk control strategy in the frontal plane during gait that was persistent regardless of pain status across multiple step widths compared to back-healthy controls. This was demonstrated by a greater pelvis-only, less thorax-only coordination pattern, and decreased bilateral longissimus co-activation in individuals with recurrent LBP than controls. The looser trunk control strategy was further amplified when individuals with recurrent LBP were in symptom remission and exhibited greater trunk excursion and reduced in-phase coordination.InterpretationThe amplification of aberrant movement during symptom remission may suggest that movement patterns or anatomical factors existing prior to the tested painful episode underlie the altered trunk control in individuals with recurrent LBP. The symptom remission period of recurrent LBP patients may be a critical window into clinical evaluation and treatment.

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Sensitivity of the Toe Height to Multijoint Angular Changes in the Lower Limbs During Unobstructed and Obstructed Gait

Journal of Applied Biomechanics ◽

10.1123/jab.2020-0217 ◽

2020 ◽

pp. 1-9

Author(s):

Chuyi Cui ◽

Brittney Muir ◽

Shirley Rietdyk ◽

Jeffrey Haddad ◽

Richard van Emmerik ◽

...

Keyword(s):

Young Adults ◽

Lower Limb ◽

Sagittal Plane ◽

Frontal Plane ◽

Singular Value ◽

Lower Limbs ◽

Joint Angles ◽

Adult Lifespan ◽

Main Contributor ◽

Bilateral Lower Limb

Tripping while walking is a main contributor to falls across the adult lifespan. Trip risk is proportional to variability in toe clearance. To determine the sources of this variability, the authors computed for 10 young adults the sensitivity of toe clearance to 10 bilateral lower limb joint angles during unobstructed and obstructed walking when the lead and the trail limb crossed the obstacle. The authors computed a novel measure—singular value of the appropriate Jacobian—as the combined toe clearance sensitivity to 4 groups of angles: all sagittal and all frontal plane angles and all swing and all stance limb angles. Toe clearance was most sensitive to the stance hip ab/adduction for unobstructed gait. For obstructed gait, sensitivity to other joints increased and matched the sensitivity to stance hip ab/adduction. Combined sensitivities revealed critical information that was not evident in the sensitivities to individual angles. The combined sensitivity to stance limb angles was 84% higher than swing limb angles. The combined sensitivity to the sagittal plane angles was lower than the sensitivity to the frontal plane angles during unobstructed gait, and this relation was reversed during obstacle crossing. The results highlight the importance of the stance limb joints and indicate that frontal plane angles should not be ignored.

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Medial Unloader Braces and Lateral Heel Wedges Do not Alter Gait Biomechanics in Healthy Young Adults

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0106 ◽

2019 ◽

Vol 28 (4) ◽

pp. 354-359 ◽

Cited By ~ 2

Author(s):

Jonathan S. Goodwin ◽

Robert A. Creighton ◽

Brian G. Pietrosimone ◽

Jeffery T. Spang ◽

J. Troy Blackburn

Keyword(s):

Older Adults ◽

Young Adults ◽

Lower Extremity ◽

Frontal Plane ◽

Heel Strike ◽

Orthotic Devices ◽

Healthy Individuals ◽

Gait Biomechanics ◽

Orthopedic Injury ◽

Unloader Brace

Context: Orthotic devices such as medial unloader knee braces and lateral heel wedges may limit cartilage loading following trauma or surgical repair. However, little is known regarding their effects on gait biomechanics in young, healthy individuals who are at risk of cartilage injury during physical activity due to greater athletic exposure compared with older adults. Objective: Determine the effect of medial unloader braces and lateral heel wedges on lower-extremity kinematics and kinetics in healthy, young adults. Design: Cross-sectional crossover design. Setting: Laboratory setting. Patients: Healthy, young adults who were recreationally active (30 min/d for 3 d/wk) between 18 and 35 years of age, who were free from orthopedic injury for at least 6 months, and with no history of lower-extremity orthopedic surgery. Interventions: All subjects completed normal over ground walking with a medial unloader brace at 2 different tension settings and a lateral heel wedge for a total of 4 separate walking conditions. Main Outcome Measures: Frontal plane knee angle at heel strike, peak varus angle, peak internal knee valgus moment, and frontal plane angular impulse were compared across conditions. Results: The medial unloader brace at 50% (−2.04° [3.53°]) and 100% (−1.80° [3.63°]) maximum load placed the knee in a significantly more valgus orientation at heel strike compared with the lateral heel wedge condition (−0.05° [2.85°]). However, this difference has minimal clinical relevance. Neither of the orthotic devices altered knee kinematics or kinetics relative to the control condition. Conclusions: Although effective in older adults and individuals with varus knee alignment, medial unloader braces and lateral heel wedges do not influence gait biomechanics in young, healthy individuals.

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Effects of age and surface instability on the control of the center of mass

10.1101/2021.09.08.459390 ◽

2021 ◽

Author(s):

Maud van den Bogaart ◽

Sjoerd M. Bruijn ◽

Joke Spildooren ◽

Jaap H. van Dieën ◽

Pieter Meyns

Keyword(s):

Older Adults ◽

Young Adults ◽

Postural Control ◽

Center Of Mass ◽

Frontal Plane ◽

Head Orientation ◽

Balance Performance ◽

Counter Rotation ◽

Balance Loss ◽

Balance Board

AbstractDuring standing, posture can be controlled by accelerating the Center of Mass (CoM) through shifting the center of pressure (CoP) within the base of support by applying ankle moments (“CoP mechanism”), or through the “counter-rotation mechanism”, i.e., changing the angular momentum of segments around the CoM to change the direction of the ground reaction force. Postural control develops over the lifespan; at both the beginning and the end of the lifespan adequate postural control appears more challenging. In this study, we aimed to assess mediolateral balance performance and the related use of the postural control mechanisms in children, older adults and young adults when standing on different (unstable) surfaces. Sixteen pre-pubertal children (6-9y), 17 young adults (18-24y) and eight older adults (65-80y) performed bipedal upright standing trials of 16 seconds on a rigid surface and on three balance boards that could freely move in the frontal plane, varying in height (15-19 cm) of the surface of the board above the point of contact with the floor. Full body kinematics (16 segments, 48 markers, using SIMI 3D-motion analysis system (GmbH) and DeepLabCut and Anipose) were retrieved. Performance related outcome measures, i.e., the number of trials with balance loss and the Root Mean Square (RMS) of the time series of the CoM acceleration, the contributions of the CoP mechanism and the counter-rotation mechanism to the CoM acceleration in the frontal plane and selected kinematic measures, i.e. the orientation of the board and the head and the Mean Power Frequency (MPF) of the balance board orientation and the CoM acceleration were determined. Balance loss only occurred when standing on the highest balance board, twice in one older adult once in one young adult. In children and older adults, the RMS of the CoM accelerations were larger, corresponding to poorer balance performance. Across age groups and conditions, the contribution of the CoP mechanism to the total CoM acceleration was much larger than that of the counter-rotation mechanisms, ranging from 94%-113% vs 23%-38% (with totals higher than 100% indicating opposite effects of both mechanisms). Deviations in head orientation were small compared to deviations in balance board orientation. We hypothesize that the CoP mechanism is dominant, since the counter-rotation mechanism would conflict with stabilizing the orientation of the head in space.

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Effect of Rear-Foot Orthotics on Postural Control in Healthy Subjects

Journal of Sport Rehabilitation ◽

10.1123/jsr.10.1.36 ◽

2001 ◽

Vol 10 (1) ◽

pp. 36-47 ◽

Cited By ~ 20

Author(s):

Jay Hertel ◽

Craig R. Denegar ◽

W.E. Buckley ◽

Neil A. Sharkey ◽

Wayne L. Stokes

Keyword(s):

Young Adults ◽

Postural Control ◽

Repeated Measures ◽

Healthy Subjects ◽

Sagittal Plane ◽

Center Of Pressure ◽

Frontal Plane ◽

Type Design ◽

Single Leg Stance ◽

Healthy Participants

Objective:To identify changes in sagittal- and frontal-plane center of pressure (COP) excursion length and velocity during single-leg stance under 6 orthotic conditions.Design:1 × 6 repeated-measures.Setting:University biomechanics laboratory.Participants:Fifteen healthy young adults without excessive forefoot, arch, or rear-foot malalignments.Measurements:Selected variables of COP length and velocity were calculated in both the frontal and sagittal planes during three 5-second trials of quiet unilateral stance.Methods:Postural control was assessed under 6 conditions: shoe only and 5 orthotics.Results:The medially posted orthotic caused the least frontal COP length and velocity, and the Cramer Sprained Ankle Orthotic® caused the greatest frontal-plane sway. No significant differences were found between the different orthotic conditions in sagittal-plane measures.Conclusions:Differently posted rear-foot orthotics had various effects on frontal-plane postural control in healthy participants. Further research is needed on pathological populations.

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Obstacle avoidance training in virtual environments leads to limb-specific locomotor adaptations but not to interlimb transfer in healthy young adults

Journal of Biomechanics ◽

10.1016/j.jbiomech.2021.110357 ◽

2021 ◽

pp. 110357

Author(s):

A. Weber ◽

D. Friemert ◽

U. Hartmann ◽

G. Epro ◽

J. Seeley ◽

...

Keyword(s):

Young Adults ◽

Virtual Environments ◽

Obstacle Avoidance ◽

Avoidance Training ◽

Locomotor Adaptations

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Continuum of Care Following Sports-Related Concussion

American Journal of Speech-Language Pathology ◽

10.1044/2020_ajslp-19-00131 ◽

2020 ◽

Vol 29 (3) ◽

pp. 1389-1403

Author(s):

Jessica Brown ◽

Kelly Knollman-Porter

Keyword(s):

Young Adults ◽

Life Span ◽

Sports Injuries ◽

Continuum Of Care ◽

Medical Professional ◽

Structured Interviews ◽

Youth Athletes ◽

Speech Language Pathologist ◽

History Of ◽

Injury Reporting

Purpose Although guidelines have changed regarding federally mandated concussion practices since their inception, little is known regarding the implementation of such guidelines and the resultant continuum of care for youth athletes participating in recreational or organized sports who incur concussions. Furthermore, data regarding the role of speech-language pathologists in the historic postconcussion care are lacking. Therefore, the purpose of this retrospective study was to investigate the experiences of young adults with history of sports-related concussion as it related to injury reporting and received follow-up care. Method Participants included 13 young adults with history of at least one sports-related concussion across their life span. We implemented a mixed-methods design to collect both quantitative and qualitative information through structured interviews. Participants reported experiencing 42 concussions across the life span—26 subsequent to sports injuries. Results Twenty-three concussions were reported to a parent or medical professional, 14 resulted in a formal diagnosis, and participants received initial medical care for only 10 of the incidents and treatment or services on only two occasions. Participants reported concussions to an athletic trainer least frequently and to parents most frequently. Participants commented that previous experience with concussion reduced the need for seeking treatment or that they were unaware treatments or supports existed postconcussion. Only one concussion incident resulted in the care from a speech-language pathologist. Conclusion The results of the study reported herein shed light on the fidelity of sports-related concussion care management across time. Subsequently, we suggest guidelines related to continuum of care from injury to individualized therapy.

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