Load carriage changes tibiofemoral arthrokinematics during ambulatory tasks in recruit-aged women.

The introduction of women into U.S. military ground close combat roles requires research into sex-specific effects of military training and operational activities. Knee osteoarthritis is prevalent among military service members; its progression has been linked to occupational tasks such as load carriage. Analyzing tibiofemoral arthrokinematics during load carriage is important to understand potentially injurious motion and osteoarthritis progression. The study purpose was to identify effects of load carriage on knee arthrokinematics during walking and running in recruit-aged women. Twelve healthy recruit-aged women walked and ran while unloaded (bodyweight [BW]) and carrying additional + 25%BW and + 45%BW. Using dynamic biplane radiography and subject-specific bone models, tibiofemoral arthrokinematics, subchondral joint space and center of closest contact location between subchondral bone surfaces were analyzed over 0-30% stance (separate one-way repeated measures analysis of variance, load by locomotion). While walking, medial compartment contact location was 5% (~ 1.6 mm) more medial for BW than + 45%BW at foot strike (p = 0.03). While running, medial compartment contact location was 4% (~ 1.3 mm) more lateral during BW than + 25%BW at 30% stance (p = 0.04). Internal rotation was greater at + 45%BW compared to + 25%BW (p < 0.01) at 30% stance. Carried load affects tibiofemoral arthrokinematics in recruit-aged women. Prolonged load carriage could increase the risk of degenerative joint injury in physically active women.

Hydrodynamic Flow Characteristics of a Recirculating Pool: Examining the Ecological Validity for Training and Testing.

ABSTRACT: Krajewski, KT, Beethe, AZ, Dever, DE, Johnson, CD, Nindl, BC, Lovalekar, MT, Flanagan, SD, and Connaboy, C. Hydrodynamic flow characteristics of a recirculating pool: examining the ecological validity for training and testing. J Strength Cond Res 37(10): 2023-2031, 2023-Recirculating swimming flumes (RSFs) with elliptical multifeature designs have grown in popularity due to their multifunctionality for rehabilitation and training. Because of their smaller footprint, laboratories have adopted their use to investigate swimming and underwater treadmill running. However, little is known about the hydrodynamic characteristics of these RSFs and how they might influence outcomes. The purpose was to determine hydrodynamic flow characteristics of an RSF at the manufacturers' set "speeds" around the centroid of flow projection. Hydrodynamic velocity profiles were collected through a 3D profiling velocimeter, sampling at 200 Hz in an RSF. Data were collected 0.5 and 1.5 m from the projection channel at designated flume "speeds" of 30-95 (+99) in 5-unit increments. Velocity data were collected for 1 minute per trial (location × speed) to determine mean flow velocity (MFV) for 10, 20, 30, and 40 cm2 cross-sectional areas (CSAs). A two-way ANOVA was conducted comparing CSAs from the surface by distance from the current channel (4 × 2). Separate ANOVAs were conducted to assess differences in MFV across each CSA. Significant differences between flow CSAs indicated that MFV is less for a larger area at the same speed, indicative of variable and turbulent flow characteristics across the respective CSAs. Mean flow velocity was further diminished by distance from the flow channel as supported by the main effect, thus exposing an individual to variant flow velocities simultaneously. Limited stability of the flow velocity centroid could affect swim mechanics making the movement pattern no longer analogous to traditional pool and open water swimming, rather resembling swimming upstream in a river with turbulent flow.

Increases in Load Carriage Magnitude and Forced Marching Change Lower-Extremity Coordination in Physically Active, Recruit-Aged Women.

The objective was to examine the interactive effects of load magnitude and locomotion pattern on lower-extremity joint angles and intralimb coordination in recruit-aged women. Twelve women walked, ran, and forced marched at body weight and with loads of +25%, and +45% of body weight on an instrumented treadmill with infrared cameras. Joint angles were assessed in the sagittal plane. Intralimb coordination of the thigh-shank and shank-foot couple was assessed with continuous relative phase. Mean absolute relative phase (entire stride) and deviation phase (stance phase) were calculated from continuous relative phase. At heel strike, forced marching exhibited greater (P < .001) hip flexion, knee extension, and ankle plantar flexion compared with running. At mid-stance, knee flexion (P = .007) and ankle dorsiflexion (P = .04) increased with increased load magnitude for all locomotion patterns. Forced marching (P = .009) demonstrated a "stiff-legged" locomotion pattern compared with running, evidenced by the more in-phase mean absolute relative phase values. Running (P = .03) and walking (P = .003) had greater deviation phase than forced marching. Deviation phase increased for running (P = .03) and walking (P < .001) with increased load magnitude but not for forced marching. With loads of >25% of body weight, forced marching may increase risk of injury due to inhibited energy attenuation up the kinetic chain and lack of variability to disperse force across different supportive structures.

Loaded forced-marching shifts mechanical contributions proximally and disrupts stride-to-stride joint work modulation in recruit aged women.

BACKGROUND: Military personnel in combat roles often perform gait tasks with additional load, which can affect the contributions of joint mechanical work (positive and negative). Furthermore, different locomotion patterns can also affect joint specific work contributions. While mean behavior of joint work is important to understanding gait, changes in joint kinetic modulation, or the regulation/control of stride-to-stride joint work variability is necessary to elucidate locomotor system function. Suboptimal modulation exhibited as a stochastic time-series (large fluctuation followed by an opposite smaller fluctuation) could potentially affect locomotion efficiency and portend injury risk. It remains unclear how the locomotor system responds to a combination of load perturbations and varying locomotion patterns. RESEARCH QUESTION: What are the interactive effects of load magnitude and locomotion pattern on joint positive/negative work and joint work modulation in healthy, active, recruit-aged women? METHODS: Eleven healthy, active, recruit-aged (18-33 years) women ran and forced-marched (walking at a velocity an individual would typically jog) in bodyweight (BW), an additional 25 % of BW (+25 %BW) and an additional 45 % of BW (+45 %BW) conditions at a velocity above their gait transition velocity. Joint work was calculated as the time integral of joint power. Joint work modulation was assessed with detrended fluctuation analysis (DFA) on consecutive joint work time-series. RESULTS: Joint work contributions shifted proximally for forced-marching demonstrated by lesser (p < .001) positive/negative ankle work but greater (p = .001) positive hip work contributions compared to running. Running exhibited optimal positive ankle work modulation compared to forced-marching (p = .040). Knee and ankle negative joint work modulation was adversely impacted compared to the hip during forced-marching (p < .001). SIGNIFICANCE: Employing forced-marching gait while under loads of 25 and 45 % of BW reduces the ability of the plantar-flexors and knee extensors to optimally contribute to energy absorption and propulsion in recruit-aged women, potentially reducing metabolic efficiency and increasing injury risk.

Load Magnitude and Locomotion Pattern Alter Locomotor System Function in Healthy Young Adult Women.

INTRODUCTION: During cyclical steady state ambulation, such as walking, variability in stride intervals can indicate the state of the system. In order to define locomotor system function, observed variability in motor patterns, stride regulation and gait complexity must be assessed in the presence of a perturbation. Common perturbations, especially for military populations, are load carriage and an imposed locomotion pattern known as forced marching (FM). We examined the interactive effects of load magnitude and locomotion pattern on motor variability, stride regulation and gait complexity during bipedal ambulation in recruit-aged females. METHODS: Eleven healthy physically active females (18-30 years) completed 1-min trials of running and FM at three load conditions: no additional weight/bodyweight (BW), an additional 25% of BW (BW + 25%), and an additional 45% of BW (BW + 45%). A goal equivalent manifold (GEM) approach was used to assess motor variability yielding relative variability (RV; ratio of "good" to "bad" variability) and detrended fluctuation analysis (DFA) to determine gait complexity on stride length (SL) and stride time (ST) parameters. DFA was also used on GEM outcomes to calculate stride regulation. RESULTS: There was a main effect of load (p = 0.01) on RV; as load increased, RV decreased. There was a main effect of locomotion (p = 0.01), with FM exhibiting greater RV than running. Strides were regulated more tightly and corrected quicker at BW + 45% compared (p < 0.05) to BW. Stride regulation was greater for FM compared to running. There was a main effect of load for gait complexity (p = 0.002); as load increased gait complexity decreased, likewise FM had less (p = 0.02) gait complexity than running. DISCUSSION: This study is the first to employ a GEM approach and a complexity analysis to gait tasks under load carriage. Reduction in "good" variability as load increases potentially exposes anatomical structures to repetitive site-specific loading. Furthermore, load carriage magnitudes of BW + 45% potentially destabilize the system making individuals less adaptable to additional perturbations. This is further evidenced by the decrease in gait complexity, which all participants demonstrated values similarly observed in neurologically impaired populations during the BW + 45% load condition.

Load carriage magnitude and locomotion strategy alter knee total joint moment during bipedal ambulatory tasks in recruit-aged women.

Knee osteoarthritis (OA) is prevalent among female soldiers, resulting in limited duty and long term adverse ambulatory effects. A proposed mechanism to the development of knee OA is the assiduous execution of load carriage tasks. Soldiers are often required to maintain a walking gait with load at velocities beyond their gait transition velocity (GTV) known as forced marching. The primary aim of this investigation is to determine the interactive effects of load magnitude and locomotion pattern on relative knee total joint moment (KTJM) in healthy recruit-aged women. The secondary aims are to determine knee total joint moment limb differences and to determine the interactive effect of load magnitude and locomotion pattern on the percent contributions of each plane of motion moment. Individuals were tasked with running and forced marching at 10% above their GTV at body weight (BW) and with an additional 25% and 45% of their BW. KTJM was analyzed at two specific gait events of heel-strike and mid-stance. At heel-strike, forced marching exhibited greater KTJM compared to run for all load conditions but running had greater KTJM than forced marching at mid-stance. The forced marching pattern exhibited larger KTJM for the dominant limb at both gait events compared to running. Lastly, at mid-stance the knee adduction moment percent (KAM%) contribution was greater for forced marching compared to running. The forced marching pattern demonstrates joint kinetics that may be more deleterious with prolonged exposure. Likewise, forced marching induced KAM% similar to those already suffering from knee OA.