Are inter-limb differences in change of direction velocity and angle associated with inter-limb differences in kinematics and kinetics following anterior cruciate ligament reconstruction?

BACKGROUND: Quantifying inter-limb differences in kinematics and kinetics during change of direction is proposed as a means of monitoring rehabilitation following anterior cruciate ligament reconstruction (ACLR). Velocity and centre of mass (CoM) deflection angle are fundamental task descriptors that influence kinematics and kinetics during change of direction. Inter-limb differences in approach velocity and CoM deflection angle have been identified following ACLR and may contribute to the presence of inter-limb differences in kinematics and kinetics during change of direction. RESEARCH QUESTION: The aim of this study was to quantify the proportion of variance in kinematic and kinetic inter-limb differences attributable to inter-limb differences in approach velocity and centre of mass deflection angle during a change of direction task. METHODS: A cohort of 192 patients (male, 23.8 ± 3.6 years, 6.3 ± 0.4 months post primary ACLR) completed a pre-planned 90° change of direction task on both their operated and non-operated limb. Inter-limb differences in approach velocity and CoM deflection angle were calculated alongside lower-extremity kinematic and kinetic variables. The relationship between inter-limb differences in task-level variables and inter-limb differences in kinematic and kinetic variables was examined using linear regression models. Kinematic and kinetic inter-limb differences were adjusted for inter-limb differences in approach velocity and CoM deflection angle. Adjusted and unadjusted inter-limb differences were submitted to one sample t-tests. RESULTS: Inter-limb differences in approach velocity and centre of mass deflection angle explained 3 - 60% of the variance in kinematic and kinetic inter-limb differences. Statistical inferences remained consistent between adjusted and unadjusted conditions with the exception of hip flexion angle. SIGNIFICANCE: Inter-limb differences in task-level features explain a large proportion of the variance in inter-limb differences in several kinematic and kinetic variables. Accounting for this variation reduced the magnitude of kinematic and kinetic inter-limb differences comparable to those previously observed in normative cohorts.

Human locomotion over obstacles reveals real-time prediction of energy expenditure for optimized decision-making.

Despite decades of evidence revealing a multitude of ways in which animals are adapted to minimize the energy cost of locomotion, little is known about how energy expenditure shapes adaptive gait over complex terrain. Here, we show that the principle of energy optimality in human locomotion can be generalized to complex task-level locomotor behaviours requiring advance decision-making and anticipatory control. Participants completed a forced-choice locomotor task requiring them to choose between discrete multi-step obstacle negotiation strategies to cross a 'hole' in the ground. By modelling and analysing mechanical energy cost of transport for preferred and non-preferred manoeuvres over a wide range of obstacle dimensions, we showed that strategy selection was predicted by relative energy cost integrated across the complete multi-step task. Vision-based remote sensing was sufficient to select the strategy associated with the lowest prospective energy cost in advance of obstacle encounter, demonstrating the capacity for energetic optimization of locomotor behaviour in the absence of online proprioceptive or chemosensory feedback mechanisms. We highlight the integrative hierarchic optimizations that are required to facilitate energetically efficient locomotion over complex terrain and propose a new behavioural level linking mechanics, remote sensing and cognition that can be leveraged to explore locomotor control and decision-making.

International Women in Biomechanics: Promoting, supporting, and sustaining the careers of women in biomechanics.

Gender biases and inequities are prevalent across many scientific fields and biomechanics is likely no exception. While progress has been made to support women in the field, especially at biomechanics society conferences, the recent COVID-19 pandemic has exacerbated professional isolation. The International Women in Biomechanics (IWB) community started in July 2020 with the mission of fostering an environment for women and other under-represented genders in biomechanics to gain year-round support, visibility, and allyship. Nearly 700 biomechanists have joined the IWB community from over 300 universities/organizations and 33 countries. Our community ranges in career stages and professions and interacts through a forum-style platform, teleconference meetings, and social media. In 2021, we conducted a survey to identify the needs, concerns, and issues faced by individuals in the IWB community. We received 144 responses from members in 16 countries. Our survey revealed three primary needs for women in biomechanics: supportive working environments, career planning support, and addressing workplace gender bias. These results, in conjunction with scientific evidence on workforce gender bias, helped us identify three key areas to meet our mission: Member Support, Community Outreach, and Empowering Allyship. Several levels of support are required in these three areas to ensure a lasting, positive, and sustainable impact on gender equity in biomechanics. We conclude by providing our perspectives on an evidence-based call to action to continue addressing gender bias and inequity at the individual, institutional, and scientific society levels. These actions can collectively enhance our allyship for women in the field of biomechanics.

Effects of the menstrual cycle phase on anterior cruciate ligament neuromuscular and biomechanical injury risk surrogates in eumenorrheic and naturally menstruating women: A systematic review.

BACKGROUND: Eumenorrheic women experience cyclic variations in sex hormones attributed to the menstrual cycle (MC) which can impact anterior cruciate ligament (ACL) properties, knee laxity, and neuromuscular function. This systematic review aimed to examine the effects of the MC on ACL neuromuscular and biomechanical injury risk surrogates during dynamic tasks, to establish whether a particular MC phase predisposes women to greater ACL injury risk. METHODS: PubMed, Medline, SPORTDiscus, and Web of Science were searched (May-July 2021) for studies that investigated the effects of the MC on ACL neuromuscular and biomechanical injury risk surrogates. Inclusion criteria were: 1) injury-free women (18-40 years); 2) verified MC phases via biochemical analysis and/or ovulation kits; 3) examined neuromuscular and/or biomechanical injury risk surrogates during dynamic tasks; 4) compared ≥1 outcome measure across ≥2 defined MC phases. RESULTS: Seven of 418 articles were included. Four studies reported no significant differences in ACL injury risk surrogates between MC phases. Two studies showed evidence the mid-luteal phase may predispose women to greater risk of non-contact ACL injury. Three studies reported knee laxity fluctuated across the MC; two of which demonstrated MC attributed changes in knee laxity were associated with changes in knee joint loading (KJL). Study quality (Modified Downs and Black Checklist score: 7-9) and quality of evidence were low to very low (Grading of Recommendations Assessment Development and Evaluation: very low). CONCLUSION: It is inconclusive whether a particular MC phase predisposes women to greater non-contact ACL injury risk based on neuromuscular and biomechanical surrogates. Practitioners should be cautious manipulating their physical preparation, injury mitigation, and screening practises based on current evidence. Although variable (i.e., magnitude and direction), MC attributed changes in knee laxity were associated with changes in potentially hazardous KJLs. Monitoring knee laxity could therefore be a viable strategy to infer possible ACL injury risk.

Vertical jump impulse deficits persist from six to nine months after ACL reconstruction.

Later-stage rehabilitation following anterior cruciate ligament (ACL) reconstruction (ACLR) provides a valuable opportunity to target performance deficits before return to sport. This study aimed to: (1) evaluate bilateral counter-movement jump (CMJ) phase-specific impulse and isokinetic strength inter-limb asymmetry progression from 6 to 9 months post-ACLR; and (2) examine the extent to which individual changes in strength asymmetry could explain changes in impulse asymmetry. Male athletes (n = 44) with a hamstring tendon or bone-patellar tendon-bone autograft were tested 6 and 9 months post-ACLR. Two-way mixed-model ANOVAs were used to identify inter-session and inter-graft differences in CMJ phase-specific impulse asymmetries and knee isokinetic flexor and extensor strength asymmetries, as well as in absolute impulse and strength values of independent (ACLR/uninvolved) limbs. Linear regression models were used to assess the relationship between changes in impulse asymmetry and strength asymmetry. Reductions in strength asymmetry arose from improved ACLR-limb performance, whereas concentric impulse asymmetry reduced consequent to decreased uninvolved-limb performance and eccentric deceleration impulses decreased bilaterally. Graft type did not modulate findings. Changes in strength asymmetry had little or no ability to explain changes in impulse asymmetry. Consideration of approaches that may influence persisting deficits observed bi-laterally throughout vertical jumping performance post-ACLR may enhance rehabilitation practice.

Angle-specific analysis of knee strength deficits after ACL reconstruction with patellar and hamstring tendon autografts.

After anterior cruciate ligament reconstruction (ACLR), there are differences in the neuromuscular deficits observed in patients with bone-patellar tendon-bone (BPTB) and with hamstring tendon (HT) autografts. The differences in knee extensor and flexor strength are commonly reported, but analyses have largely focused on peak torque metrics despite the requirement to generate torque through range when returning to sport. The aim of this study was to investigate the angle-specific strength and strength asymmetry differences between BPTB and HT around the time of return to play after ACLR. A total of 357 male field sport athletes with either a BPTB (n = 297) or an HT (n = 60) autograft underwent concentric knee flexor and extensor isokinetic strength testing 9 months post-ACLR. Angle-specific torques were compared between grafts and limbs using 1D Statistical Parametric Mapping and discrete-point variables. Inter-limb extensor torque asymmetry was greater in BTPB than HT at knee angles of >30° (p = 0.001, peak d = 5.53), with flexor torque asymmetry lower in BPTB than HT at flexion angles of >25° (p = 0.001, peak d = 2.68). Angle of maximum asymmetry and angle of operated limb peak torque differed in knee extension for BPTB (p < 0.001, d = 0.32) but not HT, whereas knee flexion angle of maximum asymmetry and operated limb peak torque differed in both BTPB (p < 0.001, d = 0.75) and HT (p < 0.001, d = 0.43). Graft type affected extensor torque at knee angles of 67°-85° and flexor torque at knee angles of 27°-85°. Angle-specific strength analysis may inform the rehabilitation process and improve rehabilitation and return-to-play decision making strategies in comparison with the use of peak torque values alone.

Biomechanical asymmetries differ between autograft types during unplanned change of direction after ACL reconstruction.

Nine months after anterior cruciate ligament (ACL) reconstruction, athletes who undergo surgery using a bone-patellar-tendon-bone (BPTB) autograft demonstrate higher loading asymmetries during vertical jumping than those with a hamstring tendon (HT) autograft. These asymmetries may transfer into sporting movements with a greater ACL injury risk. The aim of this study was to compare between-limb asymmetries in knee mechanics and task performance during an unplanned 90° change-of-direction (CoD) task in male field sport athletes reconstructed with BPTB or HT autografts. Seventy-eight male multidirectional field sport athletes with either a BPTB (n = 39) or HT (n = 39) autograft completed maximal unplanned CoD trials in a three-dimensional motion capture laboratory at approximately 9 months post-surgery. A mixed-model 2x2 ANOVA (autograft type x limb) was used to compare variables related to ACL injury risk (e.g., internal knee moments) and performance (e.g., completion time) between autografts and limbs. Statistical parametric mapping was used for a waveform comparison throughout stance, supplemented with a discrete point analyses of peak knee moments and performance variables. Interaction effects were found at the knee joint, with BPTB demonstrating greater asymmetries than HT in knee extension moment (p < 0.001); resultant ground reaction force (p < 0.001); peak knee external rotation moment (p = 0.04); and knee adduction (p = 0.05), medial rotation (p < 0.001), and flexion (p < 0.001) angles. No differences were found between autografts for any performance variable. BPTB demonstrated greater lower-limb biomechanical asymmetries than HT during CoD, which may influence knee loading and longer-term outcomes and should thus be targeted during rehabilitation prior to return to play.

Relationship Between Isokinetic Knee Strength and Single-Leg Drop Jump Performance 9 Months After ACL Reconstruction.

BACKGROUND: Deficits in knee strength after anterior cruciate ligament reconstruction (ACLR) surgery are common. Deficits in the single-leg drop jump (SLDJ), a test of plyometric ability, are also found. PURPOSE: To examine the relationship between isokinetic knee strength, SLDJ performance, and self-reported knee function 9 months after ACLR. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Knee isokinetic peak torque, SLDJ jump height, contact time, and reactive strength index (RSI), as well as International Knee Documentation Committee (IKDC) scores were assessed in 116 male, field-sport athletes at 9.2 months after ACLR. SLDJ testing took place in a 3-dimensional biomechanics laboratory. Linear regression models were used to analyze the relationship between the variables. RESULTS: A significant relationship was found between ACLR-limb isokinetic knee extensor strength and SLDJ jump height (P < .001, r 2 = 0.29) and RSI (P < .001, r 2 = 0.33), and between ACLR-limb isokinetic knee flexor strength and SLDJ jump height (P < .001, r 2 = 0.12) and RSI (P < .001, r 2 = 0.15). A significant positive relationship was also found between knee extensor asymmetry and SLDJ jump height asymmetry (P < .001, r 2 = 0.27) and SLDJ reactive strength asymmetry (P < .001, r 2 = 0.18). Combined ACLR-limb jump height and contact time best predicted IKDC scores (P < .001, r 2 = 0.12). CONCLUSION: Isokinetic knee extension strength explained approximately 30% of SLDJ performance, with a much weaker relationship between knee flexion strength and SLDJ performance. Isokinetic strength and SLDJ performance were weak predictors of variation in IKDC scores.

Six methods for classifying lower-limb dominance are not associated with asymmetries during a change of direction task.

Quantifying asymmetries between dominant and non-dominant limbs is a common research objective aimed at identifying systematic differences between limbs and establishing normative ranges of asymmetry. Multiple methods for classifying limb dominance exist, and it is unclear how different methods relate to directional asymmetries during change of direction (CoD). This study aimed to determine whether different methods of classifying limb dominance, including a novel CoD task-specific method, identified significant inter-limb asymmetries during a 90° CoD task. Fifty participants completed a testing battery consisting of jumping, hopping, CoD, and isokinetic dynamometry. Limb dominance was classified for each participant according to preferred kicking limb, vertical jump height, horizontal hop distance, initial force plate contact during landing, max isokinetic knee extensor strength, and turning velocity. Asymmetries in whole-body and joint-level mechanics were defined using each method. No method for classifying limb dominance was associated with consistent inter-limb biomechanical asymmetries during CoD, and no method was related to any other method. The magnitude of asymmetry relative to the magnitude of absolute asymmetry present within the cohort suggests that using these tasks to classify the dominant limb in this CoD is akin to assigning dominance to a randomly selected limb. Previous observations of group symmetry during CoD may be statistical artifacts as opposed to a true indication of normative movement. Until an appropriate means of classifying limbs during CoD is established, quantifying normative asymmetry based on limb dominance should be done with caution.

Movement strategy correspondence across jumping and cutting tasks after anterior cruciate ligament reconstruction.

There are currently a multitude of tests used to assess readiness to return to sport (RTS) following anterior cruciate ligament reconstruction (ACLR). The aim of this study was to establish the extent to which movement strategies transfer between three common assessment tasks to help improve design of athlete testing batteries following ACLR. A cohort of 127 male patients 8-10 months post-ACLR and 45 non-injured controls took part in the study. Three movement tasks were completed (unilateral and bilateral drop jump, and 90° pre-planned cut), while ground reaction forces and three-dimensional kinematics (250 Hz) were recorded. Compared to the bilateral drop jump and cut, the unilateral drop jump had a higher proportion of work done at the ankle (d = 0.29, p < 0.001 and d = -1.87, p < 0.001, respectively), and a lower proportion of work done at the knee during the braking phase of the task (d = 0.447, p < 0.001 and d = 1.56, p < 0.001, respectively). The ACLR group had higher peak hip moments than the non-injured controls, although the proportion of work done at the ankle, knee and hip joints were similar. Movement strategies were moderately and positively related at the ankle (rs  = 0.728, p < 0.001), knee (rs  = 0.638, p < 0.001) and hip (rs  = 0.593, p < 0.001) between the unilateral and bilateral drop jump, but there was no relationship at the ankle (rs  = 0.10, p = 0.104), knee (rs  = 0.106, p = 0.166) and hip (rs  = -0.019, p = 0.808) between the unilateral drop jump and the cut. Clinicians could therefore consider omitting one of the drop jumps from assessment batteries but should include both jumping and cutting tasks.

Visuomotor control of leaping over a raised obstacle is sensitive to small baseline displacements.

The limb kinematics used for stepping or leaping over an obstacle are determined primarily by visual sensing of obstacle position and geometry. In this study, we demonstrate that changes are induced in limb kinematics even when obstacle geometry is manipulated in a way that does not introduce a mechanical requirement for a change of limb trajectory nor increase risk of collision. Human participants performed a running leap over a single raised obstacle bar. Kinematic changes were measured when an identical second bar was introduced at a ground level underneath the obstacle and displaced by a functionally insignificant distance along the axis of travel. The presence or absence of a baseline directly beneath the highest extremity had no significant effect on limb kinematics. However, displacing the baseline horizontally induced a horizontal translation of limb trajectory in the direction of the displacement. These results show that systematic changes to limb trajectories can occur in the absence of a change in sensed mechanical constraints or optimization. The nature of visuomotor control of human leaping may involve a continuous mapping of sensory input to kinematic output rather than one responsive only to information perceived to be mechanically relevant.

Biomechanical but Not Strength or Performance Measures Differentiate Male Athletes Who Experience ACL Reinjury on Return to Level 1 Sports.

BACKGROUND: Performance measures such as strength, jump height/length, and change of direction (CoD) time during anterior cruciate ligament (ACL) rehabilitation have been used to determine readiness to return to play and identify those who may be at risk of rerupture. However, athletes may reach these criteria despite ongoing biomechanical deficits when performing these tests. Combining return-to-play criteria with an assessment of movement through 3-dimensional (3D) biomechanics in male field sports athletes to identify risk factors for ACL rerupture has not been explored previously. PURPOSE: To prospectively examine differences in strength, jump, and CoD performance and movement using 3D biomechanics in a cohort of male athletes playing level 1 sports (ie, multidirectional field sports that involve landing, pivoting, or CoD) between those who reinjured the reconstructed ACL (RI group) and those with no reinjury (NRI group) after 2 years of follow-up and to examine the ability of these differences to predict reinjury. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: After primary ACL reconstruction (ACLR), 1045 male athletes were recruited and underwent testing 9 months after surgery including isokinetic strength, jump, and CoD performance measures as well as patient-reported outcomes and 3D biomechanical analyses. Participants were followed up after 2 years regarding ACL reinjury status. Differences were determined between the RI and NRI groups in patient-reported outcomes, performance measures, and 3D biomechanics on the ACLR side and symmetry between limbs. The ability of these measures to predict ACL reinjury was determined through logistic regression. RESULTS: No differences were identified in strength and performance measures on the ACLR side or in symmetry. Biomechanical analysis indicated differences on the ACLR side primarily in the sagittal plane for the double-leg drop jump (effect size, 0.59-0.64) and greater asymmetry primarily in the frontal plane during unplanned CoD (effect size, 0.61-0.69) in the RI group. While these biomechanical test results were different between groups, multivariate regression modeling demonstrated limited ability (area under the curve, 0.67 and 0.75, respectively) to prospectively predict ACL reinjury. CONCLUSION: Commonly reported return-to-play strength, jump, and timed CoD performance measures did not differ between the RI and NRI groups. Differences in movement based on biomechanical measures during double-leg drop jump and unplanned CoD were identified, although they had limited ability to predict reinjury. Targeting these variables during rehabilitation may reduce reinjury risk in male athletes returning to level 1 sports after ACLR. REGISTRATION: NCT02771548 (ClinicalTrials.gov identifier).

Can Biomechanical Testing After Anterior Cruciate Ligament Reconstruction Identify Athletes at Risk for Subsequent ACL Injury to the Contralateral Uninjured Limb?

BACKGROUND: Athletes are twice as likely to rupture the anterior cruciate ligament (ACL) on their healthy contralateral knee than the reconstructed graft after ACL reconstruction (ACLR). Although physical testing is commonly used after ACLR to assess injury risk to the operated knee, strength, jump, and change-of-direction performance and biomechanical measures have not been examined in those who go on to experience a contralateral ACL injury, to identify factors that may be associated with injury risk. PURPOSE: To prospectively examine differences in biomechanical and clinical performance measures in male athletes 9 months after ACLR between those who ruptured their previously uninjured contralateral ACL and those who did not at 2-year follow-up and to examine the ability of these differences to predict contralateral ACL injury. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A cohort of male athletes returning to level 1 sports after ACLR (N = 1045) underwent isokinetic strength testing and 3-dimensional biomechanical analysis of jump and change-of-direction tests 9 months after surgery. Participants were followed up at 2 years regarding return to play or at second ACL injury. Between-group differences were analyzed in patient-reported outcomes, performance measures, and 3-dimensional biomechanics for the contralateral limb and asymmetry. Logistic regression was applied to determine the ability of identified differences to predict contralateral ACL injury. RESULTS: Of the cohort, 993 had follow-up at 2 years (95%), with 67 experiencing a contralateral ACL injury and 38 an ipsilateral injury. Male athletes who had a contralateral ACL injury had lower quadriceps strength and biomechanical differences on the contralateral limb during double- and single-leg drop jump tests as compared with those who did not experience an injury. Differences were related primarily to deficits in sagittal plane mechanics and plyometric ability on the contralateral side. These variables could explain group membership with fair to good ability (area under the curve, 0.74-0.80). Patient-reported outcomes, limb symmetry of clinical performance measures, and biomechanical measures in change-of-direction tasks did not differentiate those at risk for contralateral injury. CONCLUSION: This study highlights the importance of sagittal plane control during drop jump tasks and the limited utility of limb symmetry in performance and biomechanical measures when assessing future contralateral ACL injury risk in male athletes. Targeting the identified differences in quadriceps strength and plyometric ability during late-stage rehabilitation and testing may reduce ACL injury risk in healthy limbs in male athletes playing level 1 sports. CLINICAL RELEVANCE: This study highlights the importance of assessing the contralateral limb after ACLR and identifies biomechanical differences, particularly in the sagittal plane in drop jump tasks, that may be associated with injury to this limb. These factors could be targeted during assessment and rehabilitation with additional quadriceps strengthening and plyometric exercises after ACLR to potentially reduce the high risk of injury to the previously healthy knee. REGISTRATION: NCT02771548 (ClinicalTrials.gov identifier).

Whole-Body Change-of-Direction Task Execution Asymmetries After Anterior Cruciate Ligament Reconstruction.

Cutting maneuvers can be executed at a range of angles and speeds, and these whole-body task descriptors are closely associated with lower-limb mechanical loading. Asymmetries in angle and speed when changing direction off the operated and nonoperated limbs after anterior cruciate ligament reconstruction may therefore influence the interpretation of interlimb differences in joint-level biomechanical parameters. The authors hypothesized that athletes would reduce center-of-mass heading angle deflection and body rotation during the change-of-direction stance phase when cutting from the operated limb, and would compensate for this by orienting their center-of-mass trajectory more toward the new intended direction of travel prior to touchdown. A total of 144 male athletes 8 to 10 months after anterior cruciate ligament reconstruction performed a maximum-effort sidestep cutting maneuver while kinematic, kinetic, and ground reaction force data were recorded. Peak ground reaction force and knee joint moments were lower when cutting from the operated limb. Center-of-mass heading angle deflection during stance phase was reduced for cuts performed from the operated limb and was negatively correlated with heading angle at touchdown. Between-limb differences in body orientation and horizontal velocity at touchdown were also observed. These systematic asymmetries in cut execution may require consideration when interpreting joint-level interlimb asymmetries after anterior cruciate ligament reconstruction and are suggestive of the use of anticipatory control to co-optimize task achievement and mechanical loading.

Changes in the kinetics and kinematics of a reactive cut maneuver after successful athletic groin pain rehabilitation.

Athletic groin pain (AGP) is a chronic, painful condition which is prevalent in players of field sports that require rapid changes of direction. Following successful rehabilitation, systematic changes have been observed in the kinetics and kinematics of pre-planned change of direction maneuvers, providing insight into potential foci for rehabilitation monitoring and for the assessment of interventions. However, changing direction in field sports is often reactive rather than pre-planned, and it is not known whether such post-rehabilitation changes are seen in reactive maneuvers. We analyzed the stance phase kinetics and kinematics of a 90° reactive cutting maneuver in 35 AGP patients before and after a successful exercise intervention program. Following the intervention, transverse plane rotation of the pelvis toward the intended direction of travel increased, and the body center of mass was positioned more anteriorly relative to the center of pressure. Ankle dorsiflexion also increased, and participants demonstrated greater ankle plantar flexor internal moment and power during the second half of stance. These findings provide insight into mechanical variables of potential importance in AGP, as identified during a maneuver based on a common sporting task.

Agreement between An Inertia and Optical Based Motion Capture during the VU-Return-to-Play- Field-Test.

The validity of an inertial sensor-based motion capture system (IMC) has not been examined within the demands of a sports-specific field movement test. This study examined the validity of an IMC during a field test (VU®) by comparing it to an optical marker-based motion capture system (MMC). Expected accuracy and precision benchmarks were computed by comparing the outcomes of a linear and functional joint fitting model within the MMC. The kinematics from the IMC in sagittal plane demonstrated correlations (r2) between 0.76 and 0.98 with root mean square differences (RMSD) < 5, only the knee bias was within the benchmark. In the frontal plane, r2 ranged between 0.13 and 0.80 with RMSD < 10, while the knee and hip bias was within the benchmark. For the transversal plane, r2 ranged 0.11 to 0.93 with RMSD < 7, while the ankle, knee and hip bias remained within the benchmark. The findings indicate that ankle kinematics are not interchangeable with MMC, that hip flexion and pelvis tilt higher in IMC than MMC, while other measures are comparable to MMC. Higher pelvis tilt/hip flexion in the IMC can be explained by a one sensor tilt estimation, while ankle kinematics demonstrated a considerable level of disagreement, which is likely due to four reasons: A one sensor estimation, sensor/marker attachment, movement artefacts of shoe sole and the ankle model used.

The use of continuous spectral analysis for the assessment of postural stability changes after sports-related concussion.

Impaired postural stability is associated with a variety of pathologies including sports-related concussion (SRC). Quantification of centre of pressure (COP) movement is the most common focus of instrumented assessment. Frequency-domain COP analyses have focused primarily on summary measures or pre-defined frequency bands but continuous analysis may provide novel and complementary insight into pathological control mechanisms. Our aims were (i) to compare post-SRC COP trajectory changes identified using clinician scores (Modified Balance Error Scoring System (M-BESS)), time-domain COP variables and continuous frequency spectral comparison; and (ii) to characterise frequency spectra changes. Male rugby players aged 15-19 years (n = 135) completed a pre-season baseline assessment comprising vision-obscured double-leg, single-leg and tandem stances on a force platform. Participants diagnosed with SRC during the season (n = 15) underwent repeat testing (median 4 days post-SRC; IQR 2.5-6.5). Baseline and post-SRC COP trajectories were compared using common time-domain COP variables, M-BESS scores and continuous frequency spectra. Post-SRC changes were identified using all three approaches. Spectral analysis revealed the largest effect size (Cliff's delta 0.39) and was the only method to identify differences in all three stances and in double-leg stance. All post-SRC increases in spectral content were in the anteroposterior direction; all decreases were in the mediolateral direction. Changes were localised to higher frequencies (1.7-8 Hz) except for double-leg stance anteroposterior direction, for which increases were observed throughout the analysed range. Our findings suggest that this method of spectral comparison may provide a more responsive and meaningful measure of postural stability changes after SRC than other commonly-used variables.

Patellar and hamstring autografts are associated with different jump task loading asymmetries after ACL reconstruction.

After anterior cruciate ligament reconstruction (ACLR), there is a higher re-injury rate to the contralateral limb in athletes who undergo surgery using a bone-patellar-tendon-bone (BPTB) autograft than using a semitendinosus and gracilis hamstring tendon (HT) autograft. This may be influenced by differing lower-limb loading asymmetries present when athletes of each graft type return to play (RTP). The aim of this study was to compare bilateral countermovement jump (CMJ) phase-specific impulse asymmetries between athletes with BPTB and HT autografts 9 months post-ACLR, and to identify the relationship between impulse and isokinetic strength asymmetries. Male field sport athletes with a BPTB (n = 22) or HT (n = 22) autograft were tested approximately 9 months post-ACLR. An uninjured control group (n = 22) was also tested on a single occasion. Phase-specific bilateral absolute impulse asymmetries were calculated during the CMJ and compared between groups using Kruskal-Wallis and post-hoc testing. A linear regression model was used to assess the relationship between impulse asymmetries and isokinetic concentric knee extensor strength asymmetries. BPTB athletes demonstrated greater impulse asymmetries than HT athletes during the eccentric (P = 0.01) and concentric (P = 0.008) phases of the jump. Isokinetic strength asymmetry was a significant predictor of CMJ concentric impulse asymmetry in both BPTB (r2  = 0.39) and HT athletes (r2  = 0.18) but not eccentric impulse asymmetry in any group. The greater loading asymmetries demonstrated by BPTB than HT athletes 9 months after ACLR may contribute to the differing incidence rates of contralateral ACL injury. The findings suggest that graft-specific loading asymmetries should be targeted during rehabilitation prior to RTP.

A simple model predicts energetically optimised jumping in dogs.

It is generally accepted that animals move in a way that minimises energy use during regular gait and there is evidence that the principle might extend more generally to locomotor behaviour and manoeuvres. Jumping during locomotion is a useful manoeuvre that contributes to the versatility of legged locomotion and is within the repertoire of many terrestrial animals. We describe a simple ballistic model that can be used to identify a single unique trajectory of the body's centre of mass that minimises the mechanical work to initiate a jump, regardless of the approach velocity or take-off position. The model was used to show that domestic dogs (Canis lupus familiaris) demonstrate complex anticipatory control of locomotor behaviour by systematically using jump trajectories close to those that minimised the mechanical energy of jumps over raised obstacles. It is unclear how the dogs acquired the complex perception and control necessary to exhibit the observed behaviour. The model may be used to investigate whether animals adopt energetically optimised behaviour in any similarly constrained ballistic task.

Fixation Prediction and Visual Priority Maps for Biped Locomotion.

This paper presents an analysis of the low-level features and key spatial points used by humans during locomotion over diverse types of terrain. Although, a number of methods for creating saliency maps and task-dependent approaches have been proposed to estimate the areas of an image that attract human attention, none of these can straightforwardly be applied to sequences captured during locomotion, which contain dynamic content derived from a moving viewpoint. We used a novel learning-based method for creating a visual priority map informed by human eye tracking data. Our proposed priority map is created based on two fixation types: first exploiting the observation that humans search for safe foot placement and second that they observe the edges of a path as a guide to safe traversal of the terrain. Texture features and the difference between them, observed at the region around an eye position, are employed within a support vector machine to create a visual priority map for biped locomotion. The results show that our proposed method outperforms the state-of-the-art, particularly for more complex terrains, where achieving smooth locomotion needs more attention on the traversing path.