Knee contact forces and lower extremity support moments during running in young individuals post-partial meniscectomy.

PURPOSE: While partial meniscectomy results in a compromised tibiofemoral joint, little is known regarding tibiofemoral joint loading during running in individuals who are post-partial meniscectomy. It was hypothesized that individuals post-partial meniscectomy would run with a greater hip support moment, yielding reduced peak knee extension moments and reduced tibiofemoral joint contact forces. METHODS: 3-D Treadmill running mechanics were evaluated in 23 athletic individuals post-partial meniscectomy (37.5 ± 19.0 months post-partial meniscectomy) and 23 matched controls. Bilateral hip, knee and ankle contributions to the total support moment and the peak knee extension moment were calculated. A musculoskeletal model estimated peak and impulse tibiofemoral joint contact forces. Knee function was quantified with the Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS: During running, the partial meniscectomy group had a greater hip support moment (p = 0.002) and a reduced knee support moment (p < 0.001) relative to the total support moment. This movement pattern was associated with a 14.5 % reduction (p = 0.019) in the peak knee extension moment. Despite these differences, there were no significant group differences in peak or impulse tibiofemoral joint contact forces. Lower KOOS Quality of Life scores were associated with greater hip support moment (p = 0.004, r = -0.58), reduced knee support moment (p = 0.006, r = 0.55) and reduced peak knee extension moment (p = 0.01, r = 0.52). CONCLUSIONS: Disordered running mechanics are present long term post-partial meniscectomy. A coordination strategy that shifts a proportion of the total support moment away from the knee to the hip reduces the peak knee extension moment, but does not equate to reduced tibiofemoral joint contact forces during running in individuals post-partial meniscectomy. LEVEL OF EVIDENCE: III.

In-field gait retraining and mobile monitoring to address running biomechanics associated with tibial stress fracture.

We sought to determine if an in-field gait retraining program can reduce excessive impact forces and peak hip adduction without adverse changes in knee joint work during running. Thirty healthy at-risk runners who exhibited high-impact forces were randomized to retraining [21.1 (± 1.9) years, 22.1 (± 10.8) km/week] or control groups [21.0 (± 1.3) years, 23.2 (± 8.7) km/week]. Retrainers were cued, via a wireless accelerometer, to increase preferred step rate by 7.5% during eight training sessions performed in-field. Adherence with the prescribed step rate was assessed via mobile monitoring. Three-dimensional gait analysis was performed at baseline, after retraining, and at 1-month post-retraining. Retrainers increased step rate by 8.6% (P < 0.0001), reducing instantaneous vertical load rate (-17.9%, P = 0.003), average vertical load rate (-18.9%, P < 0.0001), peak hip adduction (2.9° ± 4.2 reduction, P = 0.005), eccentric knee joint work per stance phase (-26.9%, P < 0.0001), and per kilometer of running (-21.1%, P < 0.0001). Alterations in gait were maintained at 30 days. In the absence of any feedback, controls maintained their baseline gait parameters. The majority of retrainers were adherent with the prescribed step rate during in-field runs. Thus, in-field gait retraining, cueing a modest increase in step rate, was effective at reducing impact forces, peak hip adduction and eccentric knee joint work.

Influence of step length and landing pattern on patellofemoral joint kinetics during running.

Elevated patellofemoral joint kinetics during running may contribute to patellofemoral joint symptoms. The purpose of this study was to test for independent effects of foot strike pattern and step length on patellofemoral joint kinetics while running. Effects were tested relative to individual steps and also taking into account the number of steps required to run a kilometer with each step length. Patellofemoral joint reaction force and stress were estimated in 20 participants running at their preferred speed. Participants ran using a forefoot strike and rearfoot strike pattern during three different step length conditions: preferred step length, long (+10%) step length, and short (-10%) step length. Patellofemoral kinetics was estimated using a biomechanical model of the patellofemoral joint that accounted for cocontraction of the knee flexors and extensors. We observed independent effects of foot strike pattern and step length. Patellofemoral joint kinetics per step was 10-13% less during forefoot strike conditions and 15-20% less with a shortened step length. Patellofemoral joint kinetics per kilometer decreased 12-13% using a forefoot strike pattern and 9-12% with a shortened step length. To the extent that patellofemoral joint kinetics contribute to symptoms among runners, these running modifications may be advisable for runners with patellofemoral pain.

Making leaps in amphibian ecotoxicology: translating individual-level effects of contaminants to population viability.

Concern that environmental contaminants contribute to global amphibian population declines has prompted extensive experimental investigation, but individual-level experimental results have seldom been translated to population-level processes. We used our research on the effects of mercury (Hg) on American toads (Bufo americanus) as a model for bridging the gap between individual-level contaminant effects and amphibian population viability. We synthesized the results of previous field and laboratory studies examining effects of Hg throughout the life cycle of B. americanus and constructed a comprehensive demographic population model to evaluate the consequences of Hg exposure on population dynamics. Our model explicitly considered density-dependent larval survival, which is known to be an important driver of amphibian population dynamics, and incorporated two important factors that have seldom been considered in previous amphibian modeling studies: environmental stochasticity and sublethal effects. We demonstrated that decreases in embryonic survival and sublethal effects (e.g., reduced body size) that delay maturation have minor effects on population dynamics, whereas contaminant effects that reduce late-larval or post-metamorphic survival have important population-level consequences. We found that excessive Hg exposure through maternal transfer or larval diet, alone, had minor effects on B. americanus populations. Simultaneous maternal and dietary exposure resulted in reduced population size and a dramatic increase in extinction probability, but explicit prediction of population-level effects was dependent on the strength of larval density dependence. Our results suggest that environmental contaminants can influence amphibian population viability, but that highly integrative approaches are needed to translate individual-level effects to populations.

Plantar loading and cadence alterations with fatigue.

PURPOSE: The purpose of this investigation was to identify changes in loading characteristics of the foot associated with fatigue during running. METHODS: Nineteen healthy subjects ranging from 20 to 30 yr (mean = 22.3, SD = 2.4) were equipped with the Pedar in-shoe measurement system (Novel GmbH) for the assessment of plantar loading. After acclimation to the treadmill, subjects were progressed through the Ohio State protocol for exercise testing until fatigue was reported using Borg's RPE scale. Six right footsteps were recorded at 150 Hz for each subject's comfortable running pace under normal and fatigued conditions. A series of repeated measures multiple analysis of variance was performed for all dependent variables analyzed in this study including peak force (PF), force-time integral (FTI), peak pressure (PP), and pressure-time integral (PTI) for all regions of the plantar surface. RESULTS: Decreased step time, significantly smaller values under the heel for PP, PF, FTI, CT, and PTI, and trends toward increased medial forefoot loading were identified while subjects were running under fatigued conditions (alpha < 0.05). CONCLUSION: These results suggest that subjects change running technique and plantar surface loading characteristics in response to fatigued conditions through increased cadence, decreased loading of the heel, and increased medial forefoot loading.