Lower extremity dexterity is associated with agility in adolescent soccer athletes.

Agility is important for sport performance and potentially injury risk; however, factors affecting this motor skill remain unclear. Here, we evaluated the extent to which lower extremity dexterity (LED) and muscle performance were associated with agility. Fourteen male and 14 female soccer athletes participated. Agility was evaluated using a hopping sequence separately with both limbs and with the dominant limb only. The LED test evaluated the athletes' ability to dynamically regulate foot-ground interactions by compressing a spring prone to buckling with the lower limb. Muscle performance included hip and knee isometric strength and vertical jump height. Correlation analyses were used to assess the associations between muscle performance, LED, and agility. Multiple regression models were used to determine whether linear associations differed between sexes. On average, the female athletes took longer to complete the agility tasks than the male athletes. This difference could not be explained by muscle performance. Conversely, LED was found to be the primary determinant of agility (double limb: R(2) = 0.61, P < 0.001; single limb: R(2) = 0.63, P < 0.001). Our findings suggest that the sensorimotor ability to dynamically regulate foot-ground interactions as assessed by the LED test is predictive of agility in soccer athletes. We propose that LED may have implications for sport performance, injury risk, and rehabilitation.

Swing- and support-related muscle actions differentially trigger human walk-run and run-walk transitions.

There has been no consistent explanation as to why humans prefer changing their gait from walking to running and from running to walking at increasing and decreasing speeds, respectively. This study examined muscle activation as a possible determinant of these gait transitions. Seven subjects walked and ran on a motor-driven treadmill for 40s at speeds of 55, 70, 85, 100, 115, 130 and 145% of the preferred transition speed. The movements of subjects were videotaped, and surface electromyographic activity was recorded from seven major leg muscles. Resultant moments at the leg joints during the swing phase were calculated. During the swing phase of locomotion at preferred running speeds (115, 130, 145%), swing-related activation of the ankle, knee and hip flexors and peaks of flexion moments were typically lower (P<0.05) during running than during walking. At preferred walking speeds (55, 70, 85%), support-related activation of the ankle and knee extensors was typically lower during stance of walking than during stance of running (P<0.05). These results support the hypothesis that the preferred walk-run transition might be triggered by the increased sense of effort due to the exaggerated swing-related activation of the tibialis anterior, rectus femoris and hamstrings; this increased activation is necessary to meet the higher joint moment demands to move the swing leg during fast walking. The preferred run-walk transition might be similarly triggered by the sense of effort due to the higher support-related activation of the soleus, gastrocnemius and vastii that must generate higher forces during slow running than during walking at the same speed.

Knee kinetics during functional electrical stimulation induced cycling in subjects with spinal cord injury: a preliminary study.

The purpose of this preliminary study was to describe pedal effectiveness parameters and knee-joint reaction forces generated by subjects with chronic spinal cord injury (SCI) during functional electrical stimulation (FES)-induced bicycling. Three male subjects (age 33-36 years old), who were post-traumatic SCI (ASIA-modified level A, level T4-C5) and enrolled in an FES rehabilitation program, signed informed consent forms and participated in this study. Kinematic data and pedal forces during bicycling were collected and effective force, knee-joint reaction forces, knee generalized muscle moments, and knee-joint power and work were calculated. There were three critical findings of this study: 1) pedaling effectiveness was severely compromised in this subject population as indicated by a lack of overall positive crank work; 2) knee-joint kinetics were similar in magnitude to data reported for unimpaired individuals pedaling at higher rates and workloads, suggesting excessive knee-joint loading for subjects with SCI; and 3) shear reaction forces and muscle moments were opposite in direction to data reported for unimpaired individuals, revealing an energetically unfavorable knee stabilizing mechanism. The critical findings of this study suggest that knee-joint kinetics may be large enough to produce a fracture in the compromised lower limbs of individuals with SCI.

Coordination of two-joint rectus femoris and hamstrings during the swing phase of human walking and running.

It has been hypothesized previously that because a strong correlation was found between the difference in electromyographic activity (EMG) of rectus femoris (RF) and hamstrings (HA; EMG(RF)-EMG(HA)) and the difference in the resultant moments at the knee and hip (Mk-Mh) during exertion of external forces on the ground by the leg, input from skin receptors of the foot may play an important role in the control of the distribution of the resultant moments between the knee and hip by modulating activation of the two-joint RF and HA. In the present study, we examined the coordination of RF and HA during the swing phase of walking and running at different speeds, where activity of foot mechanoreceptors is not modulated by an external force. Four subjects walked at speeds of 1.8 m/s and 2.7 m/s and ran at speeds of 2.7 m/s and 3.6 m/s on a motor-driven treadmill. Surface EMG of RF, semimembranosus (SM), and long head of biceps femoris (BF) and coordinates of the four leg joints were recorded. An inverse dynamics analysis was used to calculate the resultant moments at the ankle, knee, and hip during the swing phase. EMG signals were rectified and low-pass filtered to obtain linear envelopes and then shifted in time to account for electromechanical delay between EMG and joint moments. During walking and running at all studied speeds, mean EMG envelope values of RF were statistically (P<0.05) higher in the first half of the swing (or at hip flexion/knee extension combinations of joint moments) than in the second half (or at hip extension/knee flexion combinations of joint moments). Mean EMG values of BF and SM were higher (P<0.05) in the second half of the swing than in the first half. EMG and joint moment peaks were substantially higher (P<0.05) in the swing phase of walking at 2.7 m/s than during the swing phase of running at the same speed. Correlation coefficients calculated between the differences (EMG(RF)-EMG(HA)) and (Mk-Mh), taken every 1% of the swing phase, were higher than 0.90 for all speeds of walking and running. Since the close relationship between EMG and joint moments was obtained in the absence of an external force applied to the foot, it was suggested that the observed coordination of RF and HA can be regulated without a stance-specific modulation of cutaneous afferent input from the foot. The functional role of the observed coordination of RF and HA was suggested to reduce muscle fatigue.

Is coordination of two-joint leg muscles during load lifting consistent with the strategy of minimum fatigue?

The purpose of this study was to examine if strong correlations reported for a back lift task between activity (EMG) of two-joint rectus femoris (RF), hamstrings (HA), and gastrocnemius (GA) and the difference in the joint moments could be predicted by minimizing an objective function of minimum fatigue. Four subjects lifted barbell weights (9 and 18 kg) using a back lift technique at three speeds normal, slow, and fast. Recorded ground reaction forces and coordinates of the leg joints were used to calculate the resultant joint moments. Surface EMG of five muscles crossing the knee joint were also recorded. Forces of nine muscles were calculated using static optimization and a minimum fatigue criterion. Relationships (i) (RF EMG-HA EMG) vs (knee moment hip moment) and (ii) GA EMG vs. (ankle moment knee moment) were closely related (coefficients of determination were typically 0.9 and higher). Qualitatively similar relationships were predicted by minimizing fatigue. Gastrocnemius and hamstrings had the agonistic action at both joints they cross during load lifting, and their activation and predicted forces increased with increasing flexion knee moments and extension ankle and hip moments. The rectus femoris typically had the antagonistic action at the knee and hip, and its activation and predicted force were low. Patterns of predicted muscle forces were qualitatively similar to the corresponding EMG envelopes (except in phases of low joint moments where accuracy of determining joint moments was presumably poor). It was suggested that muscle coordination in load lifting is consistent with the strategy of minimum muscle fatigue.

Tendon force measurements and movement control: a review.

Knowledge of the mechanical and electrical output from skeletal muscle is of interest to investigators from several disciplines including physiology, biomechanics, neuroscience, orthopedics, and physical rehabilitation. Estimates of muscle output (i.e., force) have generally been made using indirect calculations. Forward solution (e.g., EMG) and optimization models have recently been developed using a wide variety of input parameters to estimate force output of individual muscles. These estimates, however, have lacked comparison values necessary for validation. In vivo measurements of muscle force have been made in both animals and humans using a "buckle" type tendon transducer surgically implanted on the tendons of the muscles under study. Investigations utilizing these transducers have addressed a wide range of questions regarding muscle function. This review examines the use of this technology and discusses the significance of the future use of "buckle" transducers in studies exploring load sharing among muscles and in the validation of existing models that estimate muscle force.

Biomechanical factors associated with shoe/pedal interfaces. Implications for injury.

The principal demand on the body during cycling is on the lower extremities as they are responsible for producing a majority of the energy imparted to the bike. As a result the legs, due to high reactive forces between the foot and pedal, experience high loads on the joints. These loads may adversely affect joint tissues and contribute to overuse injuries, e.g. knee pain. The mechanical link between the leg and the bike is the shoe/pedal interface. This transmission site, by design, can either create smooth transfer of energy or abnormally high repetitive loads which are potentially injurious to the body. Incidence of lower extremity injury in cycling is high, and historically biomechanical analyses of this activity have focused their attention on either the rider or the bike, but not the link between the two. Recently, pedal designs have changed in response to complaints of sore knees with the development of pedals allowing varying degrees of float. This form of transmission is intended to enhance power transfer from rider to bike as well as minimise trauma to the legs by permitting the foot to rotate during the pedalling cycle in a toe-in/heel-out or heel-in/toe-out movement pattern. Recent evidence suggests this type of pedal design does reduce trauma and maintains power output. This article reviews common lower extremity overuse injuries and biomechanical factors during the pedalling cycle with the primary focus on the shoe/pedal interface. We will summarise information available on lower extremity kinematics and kinetics as well as recent data specifically related to shoe/pedal interface kinetics, evaluation of different pedal types-specifically comparison between clipless 'fixed' and clipless 'float' systems-and discuss their resultant effect on lower extremity dynamics and their implications for injury.

Mechanical energy management in cycling: source relations and energy expenditure.

Conservation of energy suggests that during cycling the constrained lower extremity is capable of delivering energy to the bicycle without expending energy to move the limbs. The purpose of this study was to characterize the management of mechanical energy during cycling and, specifically, to evaluate the potential for system energetic conservatism. Mechanical energy contributions derived from lower extremity energy sources were computed for 12 experienced male cyclists riding at five combinations of cadence and power output. The knee joint dominated (> 50%) in contributing to system energy and a moderate amount of energy was derived from hip joint reaction forces (> 6%). Energy generations and dissipations at the sources were sensitive to power output and, within the range of conditions studied, insensitive to cadence. Two energy models estimated mechanical energy expenditure under hypothetical single-joint and multijoint muscle operating conditions. When multijoint muscles were incorporated into the energy management analysis, a significant reduction in mechanical work relative to the single-joint muscle operation occurred. Energy savings associated with multijoint muscle energy transfers were enhanced at higher bicycle power levels, suggesting that conservation of mechanical energy is plausible given appropriate actions of two-joint muscles.

Adaptive control for backward quadrupedal walking. IV. Hindlimb kinetics during stance and swing.

1. Hindlimb step-cycle kinetics of forward (FWD) and backward (BWD) walking in adult cats were assessed. The hindlimb was modeled as a linked system of rigid bodies and inverse-dynamics techniques were used to calculate hip, knee, and ankle joint kinetics. For swing, net torque at each joint was divided into three components: gravitational, motion dependent, and a generalized muscle torque. For stance, vertical and horizontal components of the ground-reaction force applied at a point on the paw (center of pressure) were added to the torque calculations. Muscle torque profiles were matched to electromyograms (EMGs) recorded from hindlimb muscles. 2. Torque profiles for BWD swing were the approximate time reversal of those for FWD swing. At each joint, the net torque during swing was small because the mean motion-dependent and muscle torque components counteracted each other. At the hip a flexor muscle torque persisted except for a brief extensor muscle torque late in FWD swing and at the onset of BWD swing. At the knee the muscle torque was relatively negligible except for a peak flexor muscle torque late in FWD swing and early in BWD swing. At the ankle there was a midswing transition from a flexor to an extensor muscle torque during FWD swing and the reverse was true for BWD swing. 3. The vertical ground-reaction force was greater for the forelimbs than the hindlimbs during FWD stance; the reverse was true for BWD stance. Thus the hindlimbs bore a greater percentage (66%) of body weight than the forelimbs during BWD stance, and the forelimbs bore a greater percentage (59%) during FWD stance. For most of FWD stance, the hindlimb exerted a small propulsive ground-reaction force, but for BWD stance the hindlimb first exerted a braking force and then a propulsive force, with the transition occurring after midstance (59% of stance). 4. At the hip the ground-reaction force vector was oriented anteriorly and then posteriorly to the estimated joint center with a midstance transition during FWD stance. The muscle torque and joint power patterns showed similar transitions, changing from extensor and power generation to flexor and power absorption, respectively. For most of BWD stance the ground-reaction force vector was oriented anteriorly to the joint center and was counter-balanced by a large extensor muscle torque; nonetheless, power was absorbed because the hip flexed.(ABSTRACT TRUNCATED AT 400 WORDS)

Relationship between ankle muscle and joint kinetics during the stance phase of locomotion in the cat.

The purpose of this study was to examine the relationship between internal force production in selected skeletal muscles and the externally calculated joint moment during overground locomotion in the adult cat. Hindlimb segments were modelled as a linked system of rigid bodies and a generalized muscle moment (GMM), the sum over all active and passive tissues acting about the joint, was calculated using principles of inverse dynamics. Moments produced by individual muscles were calculated using tendon transducers implanted in freely moving cats and muscle moment arm information. Results indicated that the externally measured variables of peak ground reaction force and joint position were equally important to the determination of peak ankle GMM. Examination of peak moments revealed that increases in peak ankle GMM were met by increases in medial (MG) and lateral (LG) gastrocnemius output. Peak soleus (SOL) moments did not change significantly as a function of peak ankle GMM. The role of the plantaris (PLT) was less clear, with peak moments increasing significantly as a function of peak ankle GMM in one cat. All four ankle extensors were important to the attainment of peak ankle GMM early in stance. Subsequently, SOL and PLT contributed substantially to the ankle GMM throughout stance, LG moments declined to near zero, soon after peak ankle GMM; and MG moments demonstrated a substantial but more gradual decline. The relative contributions of these individual muscles to the ankle GMM were supported by their respective architecture, uniarticular versus multiarticular function, and physiological profiles.

Biomechanics of sprint running. A review.

Understanding of biomechanical factors in sprint running is useful because of their critical value to performance. Some variables measured in distance running are also important in sprint running. Significant factors include: reaction time, technique, electromyographic (EMG) activity, force production, neural factors and muscle structure. Although various methodologies have been used, results are clear and conclusions can be made. The reaction time of good athletes is short, but it does not correlate with performance levels. Sprint technique has been well analysed during acceleration, constant velocity and deceleration of the velocity curve. At the beginning of the sprint run, it is important to produce great force/power and generate high velocity in the block and acceleration phases. During the constant-speed phase, the events immediately before and during the braking phase are important in increasing explosive force/power and efficiency of movement in the propulsion phase. There are no research results available regarding force production in the sprint-deceleration phase. The EMG activity pattern of the main sprint muscles is described in the literature, but there is a need for research with highly skilled sprinters to better understand the simultaneous operation of many muscles. Skeletal muscle fibre characteristics are related to the selection of talent and the training-induced effects in sprint running. Efficient sprint running requires an optimal combination between the examined biomechanical variables and external factors such as footwear, ground and air resistance. Further research work is needed especially in the area of nervous system, muscles and force and power production during sprint running. Combining these with the measurements of sprinting economy and efficiency more knowledge can be achieved in the near future.

EMG profiles of lower extremity muscles during cycling at constant workload and cadence.

Limited conclusions concerning the variability in EMG patterns during cycling can be made from available data in the literature because of methodological differences which include electrode placement and experimental design. The purpose of this study was to monitor EMG signals from ten lower extremity muscles over a large number of pedalling cycles in experienced cyclists at constant workload and cadence. Variability across subjects was evaluated by calculating the coefficient of variation (CV) at 10% intervals of the pedalling cycle. Within subject EMG patterns were very consistent within a single trial. The single-joint hip and knee extensors (gluteus maximus, vastus medialis, and vastus lateralis) had the lowest CV values (less than 30%). This low variability appears to support their role as power generators. Variability was generally higher in the hamstring muscles with two biceps femoris patterns emerging despite relatively similar experimental conditions. EMG signals from surface and fine wire electrodes for the hamstring muscles were compared for possible contribution to the discrepancies in the EMG profiles. Fine wire EMG data were quite similar to those obtained using surface electrodes, indicating that crosstalk had minimal effect, in general, on the hamstring signals. The tibialis anterior, gastrocnemius, and soleus muscles displayed fairly repeatable patterns, with variability highest in the first 20% of the pedalling cycle for all muscles studied.

A comparison of the triceps surae and residual muscle moments at the ankle during cycling.

The rigid linked system model and principles of inverse dynamics have been widely used to calculate residual muscle moments during various activities. EMG driven models and optimization algorithms have also been presented in the literature in efforts to estimate skeletal muscle forces and evaluate their possible contribution to the residual muscle moment. Additionally, skeletal muscle-tendon forces have been measured, directly, in both animals and humans. The purpose of this investigation was to calculate the moment produced by the triceps surae muscles and compare it to the residual muscle moment at the ankle during cycling at three power outputs (90, 180 and 270 W). Inferences were made regarding the potential contribution made by each triceps surae component to the tendon force using EMG and muscle-tendon length changes. A buckle-type transducer was surgically implanted on the right Achilles tendon of one male subject. Achilles tendon forces measured in vivo were multiplied by their corresponding moment arms to yield the triceps surae moment during the three working conditions. Moment arm lengths were obtained in a separate experiment using magnetic resonance imaging (MRI). Pedal reaction forces, body segment accelerations (determined from high speed film), and appropriate mass parameters served as input to the inverse solution. The triceps surae moment was temporally in phase with and consistently represented approximately 65% of the residual muscle moment at the ankle. These data demonstrate the feasibility of using implanted transducers in human subjects and provide a greater understanding of musculoskeletal mechanics during normal human movements.

Weight-bearing hindlimb stepping in treadmill-exercised adult spinal cats.

Hindlimb locomotion on a motor-driven treadmill was studied in 5 cats spinalized at a low thoracic level adults. Six months after surgery, the cats were anesthetized and implanted for electromyographic (EMG) and force recordings in hindlimb muscles. For the last 5 months of the spinalization period, the hindlimbs of each cat were exercised daily for 30 minutes on a treadmill. Data were collected during hindlimb locomotion on a treadmill across the entire range of speeds each cat could accommodate. All trials were filmed (100 frames/s) for kinematic analysis. EMG data were recorded from the soleus (Sol), medial gastrocnemius (MG), tibialis anterior (TA) and extensor digitorum longus (EDL). Forces were recorded in vivo from the Sol and MG tendons. All cats could sustain full weight-bearing stepping without the need for mechanical stimulation of the tail. Although the general stepping pattern of the spinal cats was remarkably similar to that of normal cats, several key differences were identified. Compared to normal cats, the adult spinal cats walked at a lower range of speeds and exhibited a longer swing phase duration. The Sol produced forces and displayed activation periods comparable to those observed in normal cats. The MG of adult spinal cats, however, produced lower forces and had a later onset of activation in comparison to normal cats. Each of the muscles in all spinal cats exhibited tremor during stepping. These results suggest that there were limitations in the activation levels of some hindlimb flexor and extensor muscles during treadmill locomotion. These data further suggest that, in normal cats, accommodation to treadmill speed is accomplished by modulating supraspinal input to the lumbar spinal cord while leaving many of the timing details to be regulated by lumbar spinal networks.

In vivo moment arm calculations at the ankle using magnetic resonance imaging (MRI).

In vivo moment arm lengths for the Achilles tendon and tibialis anterior (TA) were determined in 10 adult male subjects. Moment arms were measured as the perpendicular distance between the joint center of rotation (CR) and the center of the muscle's tendon on a series of sagittal plane magnetic resonance images. The first set of calculations used a fixed CR and the second a moving CR. The position of the CR was determined using a modification of the graphical method of Reuleaux. For both moving and fixed CR conditions, moment arms increased by approximately 20% for the Achilles tendon and decreased by approximately 30% for the TA when the ankle moved from maximum dorsiflexion to maximum plantarflexion. Moment arms averaged 3.1% greater for the Achilles tendon and 2.5% greater for the TA when calculated using a fixed CR. These data suggest that the averaged moment arm lengths for the Achilles tendon and the TA were relatively unaffected by the use of a fixed vs moving CR.

Electromyographic activity of cat hindlimb flexors and extensors during locomotion at varying speeds and inclines.

Electromyographic activity (EMG) was used to determine how hindlimb muscle activation patterns are modified as speed and incline of locomotion are varied in treadmill-trained cats. EMG was recorded using chronically implanted i.m. electrodes from the soleus, medial gastrocnemius, gluteus medius, and tibialis anterior muscles of adult cats during treadmill locomotion at a range of speeds and inclines. The patterns of changes in EMG activity at varying speeds and inclines were similar in all cats. Across speeds, the integrated EMG per step decreased for the soleus but remained constant for the other muscles. The integrated EMG per step was elevated in all muscles at higher inclines. Generally, with increased speed or incline the mean EMG per step was elevated in the medial gastrocnemius, gluteus medius, and tibialis anterior, the largest increase seen in the medial gastrocnemius. Soleus mean EMG per step remained unchanged with increased speed, but showed an absolute increase at the higher inclines. The integrated EMG per minute was always highest for the soleus followed by the medial gastrocnemius, and always lowest for the tibialis anterior. At the faster speeds, the 'on-time' increased in the tibialis anterior and decreased in the other muscles. These data suggest that the number of motor units activated and/or their firing frequencies increased in the medial gastrocnemius and the gluteus medius during locomotion at faster speeds or larger inclines, while relatively little change occurred in the soleus and tibialis anterior. These data also suggest that while there is considerable modulation of the level and duration of excitation of the extensor motor pools there is relatively little modulation of the flexor motor pools to adjust for both the speed and the incline of locomotion.

Endogenous Nocardia asteroides subretinal abscess diagnosed by transvitreal fine-needle aspiration biopsy.

The authors report a case of an endogenous Nocardia asteroides subretinal abscess in an immunosuppressed cardiac transplant recipient. On clinical grounds, the metastatic subretinal abscess was initially thought to be a fungal, atypical bacterial, or viral lesion. Transvitreal fine-needle aspiration biopsy of the lesion yielded a sufficient specimen for immediate preliminary identification of the microorganism and permitted prompt initiation of an appropriate antibiotic regimen. The definitive diagnosis was based on culture of the organism from the needle aspirate.

Spontaneous regression of choroidal melanoma over 8 years.

The authors observed clinical regression of an apparent primary choroidal melanoma in a 66-year old man over an eight-year interval. This regression was documented photographically and ultrasonographically. The authors discuss the possible mechanisms responsible for this clinical course.

Kinematic analysis of human upper extremity movements in boxing.

Using two synchronized cameras, four experienced boxers were filmed while they threw a series of punches at a practice bag. Three-dimensional (3D) coordinates of each boxer's shoulder, elbow, wrist, and glove were used to estimate linear and angular kinematics of the upper extremity. Average velocities at contact ranged from 5.9 to 8.2 m/s with peak velocities of 6.6 to 12.5 m/s reached 8 to 21 ms prior to hand/grove contact with the bag. Significant differences in shoulder and wrist velocitie, elbow angle excursions, and elbow angular velocities were seen when comparing hooks and jabs. Few differences were evident when comparing the kinematics of gloved versus bare-handed punches. Results are significant in providing kinematic data characteristic of experienced performers, which may be used in a kinetic model of punch impact and its relationship to potential injury mechanisms.