Analysis of Movement Variability in Cycling: An Exploratory Study.

The purpose of this study was to determine the test-retest repeatability of Blue Trident inertial measurement units (IMUs) and VICON Nexus kinematic modelling in analysing the Lyapunov Exponent (LyE) during a maximal effort 4000 m cycling bout in different body segments/joints. An additional aim was to determine if changes in the LyE existed across a trial. Twelve novice cyclists completed four sessions of cycling; one was a familiarisation session to determine a bike fit and become better accustomed to the time trial position and pacing of a 4000 m effort. IMUs were attached to the head, thorax, pelvis and left and right shanks to analyse segment accelerations, respectively, and reflective markers were attached to the participant to analyse neck, thorax, pelvis, hip, knee and ankle segment/joint angular kinematics, respectively. Both the IMU and VICON Nexus test-retest repeatability ranged from poor to excellent at the different sites. In each session, the head and thorax IMU acceleration LyE increased across the bout, whilst pelvic and shank acceleration remained consistent. Differences across sessions were evident in VICON Nexus segment/joint angular kinematics, but no consistent trend existed. The improved reliability and the ability to identify a consistent trend in performance, combined with their improved portability and reduced cost, advocate for the use of IMUs in analysing movement variability in cycling. However, additional research is required to determine the applicability of analysing movement variability during cycling.

Reliability and Validity of the Polhemus Liberty System for Upper Body Segment and Joint Angular Kinematics of Elite Golfers.

Golf swing analysis is common in both recreational and professional levels where players are searching for improvements in shot accuracy and distance. The use of motion analysis systems such as the portable Polhemus Liberty system is gaining interest by coaches and players; however, to date, no research has examined the usefulness of the Polhemus Liberty system for golf swing analysis. Therefore, the purpose of this study was to determine the reliability of the Polhemus Liberty system and validity compared to the VICON Nexus motion analysis system when assessing segment (pelvis and thorax) and joint (shoulder, elbow and wrist) angular kinematics during a golf swing at key events (address, top of backswing and impact). Fifteen elite amateur/professional golfers performed ten golf swing trials within specified bounds using their 5-iron club. Reliability was assessed using interclass coefficient, effect size and t-test statistics by all participants completing two separate testing sessions on separate days following the same experimental protocol. Validity was assessed using effect size, Pearson correlation and t-test statistics by comparing swings captured using both Polhemus Liberty and VICON Nexus concurrently. Results demonstrated no difference in ball outcome results using the Trackman launch monitor (P > 0.05) and that the Polhemus Liberty system was reliable across the two sessions for all segment (pelvis and thorax) and joint (lead shoulder (gleno-humeral joint), elbow and wrist) angular kinematics (P > 0.05). Validity analysis showed that the Polhemus Liberty system for the segments (pelvis and thorax) and joints (lead shoulder and wrist) were different compared to the VICON Nexus data at key events during the golf swing. Although validity could not be confirmed against VICON Nexus modeling, the Polhemus Liberty system may still be useful for golf swing analysis across training sessions. However, caution should be applied when comparing data from the system to published research data using different motion analysis methods.

Validation of Plantar Pressure and Reaction Force Measured by Moticon Pressure Sensor Insoles on a Concept2 Rowing Ergometer.

The purpose of this study was to determine the reliability and validity of plantar pressure and reaction force measured using the Moticon and Pedar-x sensor insoles while rowing on a Concept2 ergometer. Nineteen participants performed four 500 m trials of ergometer rowing at 22-24 strokes/min; two trials wearing Moticon insoles and two wearing Pedar-x insoles in a randomised order. Moticon and Pedar-x insoles both showed moderate to strong test-retest reliability (ICC = 0.57-0.92) for mean and peak plantar pressure and reaction force. Paired t-test demonstrated a significant difference (p < 0.001) between Moticon and Pedar-x insoles, effect size showed a large bias (ES > 1.13), and Pearson's correlation (r < 0.37) showed poor agreement for all plantar pressure and reaction force variables. Compared to Pedar-x, the Moticon insoles demonstrated poor validity, however, the Moticon insoles had strong reliability. Due to poor validity, caution should be used when considering Moticon insoles to assess changes in pressure and force reliably over time, across multiple trials or sessions. Moticon's wireless and user-friendly application would be beneficial for assessing and monitoring biomechanical parameters in rowing if validity between measures of interest and Moticon's results can be established.

Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol.

BACKGROUND: Foot ulceration is the main precursor to lower limb amputation in patients with type 2 diabetes worldwide. Biomechanical factors have been implicated in the development of foot ulceration; however the association of these factors to ulcer healing remains less clear. It may be hypothesised that abnormalities in temporal spatial parameters (stride to stride measurements), kinematics (joint movements), kinetics (forces on the lower limb) and plantar pressures (pressure placed on the foot during walking) contribute to foot ulcer healing. The primary aim of this study is to establish the biomechanical characteristics (temporal spatial parameters, kinematics, kinetics and plantar pressures) of patients with plantar neuropathic foot ulcers compared to controls without a history of foot ulcers. The secondary aim is to assess the same biomechanical characteristics in patients with foot ulcers and controls over-time to assess whether these characteristics remain the same or change throughout ulcer healing. METHODS/DESIGN: The design is a case-control study nested in a six-month longitudinal study. Cases will be participants with active plantar neuropathic foot ulcers (DFU group). Controls will consist of patients with type 2 diabetes (DMC group) and healthy participants (HC group) with no history of foot ulceration. Standardised gait and plantar pressure protocols will be used to collect biomechanical data at baseline, three and six months. Descriptive variables and primary and secondary outcome variables will be compared between the three groups at baseline and follow-up. DISCUSSION: It is anticipated that the findings from this longitudinal study will provide important information regarding the biomechanical characteristic of type 2 diabetes patients with neuropathic foot ulcers. We hypothesise that people with foot ulcers will demonstrate a significantly compromised gait pattern (reduced temporal spatial parameters, kinematics and kinetics) at base line and then throughout the follow-up period compared to controls. The study may provide evidence for the design of gait-retraining, neuro-muscular conditioning and other approaches to off-load the limbs of those with foot ulcers in order to reduce the mechanical loading on the foot during gait and promote ulcer healing.

Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: a meta-analysis of observational studies.

AIMS: Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. METHODS: Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP) and pressure time integral (PTI) were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310). RESULTS: Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290-0.811, p<0.001; and 0.762, 95% CI 0.303-1.221, p = 0.001, respectively). Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181- 0.753, p = 0.001). Statistical heterogeneity between studies was moderate. CONCLUSIONS: Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings.