Although humans are well-adapted to negotiating sloped terrain, balance recovery after a disturbance on slopes is poorly understood. This study investigated how slope affects recovery from ...unanticipated simulated trips and slips. Eighteen healthy young adults walked on a split-belt treadmill at 1.25 m/s and three slope angles (downhill: - 8°; level: 0°; uphill: + 8°), with slip- and trip-like perturbations applied randomly at heel-strike. We evaluated balance recovery using whole-body angular momentum (WBAM) and perturbation response (PR), for which larger PR values indicate greater deviation of the margin of stability from baseline, therefore, greater destabilisation after perturbation. Overall, trips were more destabilising than slips, producing larger PR and greater range and integral of WBAM across all tested slopes, most significantly in the sagittal plane. Contrary to expectation, sagittal-plane PR post-trip was greatest for level walking and smallest for downhill walking. Heightened vigilance during downhill walking may explain this finding. Recovery strategy in both frontal and sagittal planes was consistent across all slopes and perturbation types, characterized by a wider and shorter first recovery step, with trips requiring the greatest step adjustment. Our findings advance understanding of the robustness of human locomotion and may offer insights into fall prevention interventions.
Reactive lower limb muscle function during walking plays a key role in balance recovery following tripping, and ultimately fall prevention. The objective of this study was to evaluate muscle and ...joint function in the recovery limb during balance recovery after trip-based perturbations during walking. Twenty-four healthy participants underwent gait analysis while walking at slow, moderate and fast speeds over level, uphill and downhill inclines. Trip perturbations were performed randomly during stance, and lower limb kinematics, kinetics, and muscle contribution to the acceleration of the whole-body centre of mass (COM) were computed pre- and post-perturbation in the recovery limb. Ground slope and walking speed had a significant effect on lower limb joint angles, net joint moments and muscle contributions to support and propulsion during trip recovery (p < 0.05). Specifically, increasing walking speed during trip recovery significantly reduced hip extension in the recovery limb and increased knee flexion, particularly when walking uphill and at higher walking speeds (p < 0.05). Gluteus maximus played a critical role in providing support and forward propulsion of the body during trip recovery across all gait speeds and ground inclinations. This study provides a mechanistic link between muscle action, joint motion and COM acceleration during trip recovery, and underscores the potential of increased walking speed and ground inclination to increase fall risk, particularly in individuals prone to falling. The findings of this study may provide guidelines for targeted exercise therapy such as muscle strengthening for fall prevention.
Successful recovery following a perturbation during walking depends on a quick well-coordinated response from the body. As such, lower limb joint power and work provide critical information ...characterizing the success of the recovery after a perturbation. Therefore, this study aimed to investigate lower-limb joint power and the relative contribution of each joint to the total leg work during the recovery following a trip-induced perturbation.
Twenty-four young male volunteers walked at 1.1 m/s for 2 min, followed by two unexpected perturbations induced by rapidly decelerating the right belt of the split-belt treadmill. Joint moments and powers were calculated using an inverse dynamic approach. Joint work was found as the integral of joint power with respect to time. Statistical parametric mapping (SPM) and paired-sample t-tests were used to compare joint power and work between recovery and unperturbed steps.
Compared to normal walking, recovery from the trip required a significant increase in both positive (+27 %, p < 0.05) and negative(+28 %,p < 0.05) leg work. During unperturbed walking, the ankle was the key contributor to both positive (ankle=50 %, hip=34 %, and knee=15 %) and negative (ankle=62 %, knee=32 %, and hip=6 %) leg work. During recovery, the knee eccentric work significantly increased (+83 %,p < 0.05) making it the main contributor to the negative leg work (knee=46 %, ankle=45 %, and hip=9 %). The hip positive work also increased during recovery (+62.7 %, p < 0.05), while ankle and the knee positive work remained unchanged.
These findings highlight the importance of eccentric work of the knee, and concentric work of the hip joint during recovery from trip-induced perturbations. The additional mechanical demand of producing and absorbing more power during recovery is primarily imposed on the knee and hip, rather than the ankle. This new insight into the specific functions of lower-limb joints during recovery from trip-induced perturbations has important implications for the design of targeted fall prevention interventions.
•Trip perturbations altered lower-limb joints contribution to leg work.•Knee joint played the most crucial role in absorbing energy during recovery.•The excessive demand of producing more power was mainly imposed on the hip joint.
Anterior cruciate ligament (ACL) injuries most commonly occur following a perturbation. Perturbations make the athlete unbalanced or at loss of control, which ultimately can lead to injury. The ...purpose of this study was to identify differences in ACL agonist and antagonist muscle forces, between sexes, during unexpected perturbations. Twenty recreational athletes were perturbed during walking at a speed of 1.1 m/s. Motion analysis data were used to create subject-specific musculoskeletal models and static optimization was performed to calculate muscle forces in OpenSim. Statistical parametric mapping (SPM) was used to compare muscle forces between males and females during the stance phase of the perturbed cycle. Females illustrated higher ACL antagonist muscle forces (p < 0.05) and lower ACL agonist muscle forces, compared to their male counterparts. The quadriceps (QUADs) muscle group peak was about 1.4 times higher in females (35.50 ± 8.71 N/kg) than males (22.81 ± 5.83 N/kg during 57%-62% of the stance phase (p < 0.05). Females presented a larger peak of gastrocnemius (GAS) at two instances: 12.42 ± 4.5 N/kg vs. 8.10 ± 2.83 N/kg between 70% and 75% at p < 0.05 and 2.26 ± 0.55 N/kg vs. 0.52 ± 0.09 N/kg between 95% and 100% at p < 0.05. Conversely, males illustrated higher initial hamstrings (HAMS) peak of 10.67 ± 4.15 N/kg vs. 5.38 ± 1.1 N/kg between 8% and 11%. Finally, males showed almost double the soleus (SOL) peak at 30.63 ± 8.64 N/kg vs. 17.52 ± 3.62 N/kg between 83% and 92% of the stance phase at p < 0.001. These findings suggest that females may exhibit riskier neuromuscular control in unanticipated situations, like sports.
Subchondral bone (SCB) microdamage is prevalent in the joints of human athletes and animals subjected to high rate and magnitude cyclic loading of the articular surface. Quantifying the effect of ...such focal in vivo fatigue-induced microdamage on the mechanical response of the tissue is critical for the understanding of joint surface injury and the development of osteoarthritis. Thus, we aimed to quantify the mechanical properties of cartilage-bone from equine third metacarpal (MC3) condyles, which is a common area of accumulated microdamage due to repetitive impact loading. We chose a non-destructive technique, i.e. high-resolution microcomputed tomography (µCT) imaging, to identify various degrees of in vivo microdamage in SCB prior to mechanical testing; because µCT imaging can only identify a proportion of accumulated microdamage, we aimed to identify racing and training history variables that provide additional information on the prior loading history of the samples. We then performed unconfined high-rate compression of approximately 2% strain at 45%/s strain rate to simulate a cycle of gallop and used real-time strain measurements using digital image correlation (DIC) techniques to find the stiffness and shock absorbing ability (relative energy loss) of the cartilage-bone unit, and those associated with cartilage and SCB. Results indicated that stiffness of cartilage-bone and those associated with the SCB decreased with increasing grade of damage. Whole specimen stiffness also increased, and relative energy loss decreased with higher TMD, whereas bone volume fraction of the SCB was only associated negatively with the stiffness of the bone. Overall, the degree of subchondral bone damage observed with µCT was the main predictor of stiffness and relative energy loss of the articular surface of the third metacarpal bone of Thoroughbred racehorses under impact loading.
Abstract Subchondral bone (SCB) microdamage is commonly observed in traumatic joint injuries and has been strongly associated with post-traumatic osteoarthritis (PTOA). Knowledge of the ...three-dimensional stress and strain distribution within the SCB tissue helps to understand the mechanism of SCB failure, and may lead to an improved understanding of mechanisms of PTOA initiation, prevention and treatment. In this study, we used high-resolution micro-computed tomography (µCT)-based finite element (FE) modelling of cartilage-bone to evaluate the failure mechanism and the locations of SCB tissue at high-risk of initial failure under compression. The µCT images of five cartilage-bone specimens with an average SCB thickness of 1.23±0.20 mm were used to develop five µCT-based FE models. The FE models were analysed under axial compressions of approximately 30 MPa applied to the cartilage surface while the bone edges were constrained. Strain and stress-based failure criteria were then applied to evaluate the failure mechanism of the SCB tissue under excessive compression through articular cartilage. µCT-based FE models predicted two locations in the SCB at high-risk of initial failure: (1) the interface of the calcified-uncalcified cartilage due to excessive tension, and (2) the trabecular bone beneath the subchondral plate due to excessive compression. µCT-based FE models of cartilage-bone enabled us to quantify the distribution of the applied compression which was transferred through the articular cartilage to its underlying SCB, and to investigate the mechanism and the mode of SCB tissue failure. Ultimately, the results will help to understand the mechanism of injury formation in relation to PTOA.
Abstract The aim of this study was to identify the contribution of the Soleus and Gastrocnemius (Gastroc) muscles' forces to anterior cruciate ligament (ACL) loading during single-leg landing. ...Although Quadriceps (Quads) and Hamstrings (Hams) muscles were recognized as the main contributors to the ACL loading, less is known regarding the role of ankle joint plantarflexors during landing. Eight healthy subjects performed single-landing tasks from 30 and 60 cm heights. Scaled generic musculoskeletal models were developed in OpenSim to calculate lower limb muscle forces. The model consisted of 10 segments with 23 degrees of freedom and 92 lower body muscle-tendon units. Knee joint reaction forces were calculated based on the estimated muscle forces and used to predict ACL forces. We hypothesized that Soleus and Gastrocs muscle forces have opposite effects on tibial loading in the anterior/posterior directions. In situations where greater landing height would lead to an increase in GRF and risk of ACL injury, we further hypothesized that posterior forces of the Soleus and Hams would increase correspondingly to help protect the ACL during a safe landing maneuver. Our results demonstrated the antagonistic and agonistic roles of Gastrocs and Soleus respectively in ACL loading. The posterior force of Soleus reached 28–32% of Ham's posterior force for both landing heights at peak GRF while the posterior force of Gastrocs on femur was negligible. ACL injury risk during single-leg landing is not only dependent on knee musculature but also influenced by muscles that do not span the knee joint, such as the Soleus. In conclusion, the role of the ankle plantarflexors should be considered when developing training strategies for ACL injury prevention.
Abstract Subchondral bone microdamage due to high-impact loading is a key factor leading to post-traumatic knee osteoarthritis. A quantified assessment of the mechanical characteristics of ...subchondral bone at the tissue-level is essential to study the mechanism of impact-induced microdamage. We combined mechanical impact testing of equine cartilage-bone with µCT image-based finite element models (μFEM) of each specimen to determine subchondral bone (including calcified cartilage: CCSB) elastic tissue modulus and local stresses and strains associated with micro-fractures within the CCSB tissue. The material properties of each specimen-specific μFEM were iteratively adjusted to match the FE-predicted stress-strain curves with experimental results. Isotropic homogeneous material properties for both uncalcified cartilage (UC) and CCSB were assumed. UC large-deformation was simulated using hyperelastic material properties. Final UC shear and CCSB tissue elastic modulus of G =38±20 MPa and E t =3.3±0.7 GPa were achieved after fit procedure. The results suggested that initial failure in CCSB occurred at local tensile and compressive stresses of 29.47±5.34 MPa and 64.3±21.3 MPa, and tensile and compressive strains of 1.12±0.06% and 1.99±0.41%, respectively. Tissue-level material properties can be used in finite element modeling of diarthrodial joints under impact loading, and also in designing artificial cartilage-bone to replace the damaged tissue in the joint. Results can provide an estimate for the threshold of initial failure in subchondral bone tissue due to an impact compression transmitted through the overlying articular cartilage.
Female athletes are more prone to anterior cruciate ligament (ACL) injury. A neuromuscular imbalance called leg dominance may provide a biomechanical explanation. Therefore, the purpose of this study ...was to compare the side-to-side lower limb differences in movement patterns, muscle forces and ACL forces during a single-leg drop-landing task from two different heights. We hypothesized that there will be significant differences in lower limb movement patterns (kinematics), muscle forces and ACL loading between the dominant and non-dominant limbs. Further, we hypothesized that significant differences between limbs will be present when participants land from a greater drop-landing height. Eight recreational female participants performed dominant and non-dominant single-leg drop landings from 30 to 60cm. OpenSim software was used to develop participant-specific musculoskeletal models and to calculate muscle forces. We also predicted ACL loading using our previously established method. There were no significant differences between dominant and non-dominant leg landing except in ankle dorsiflexion and GMED muscle forces at peak GRF. Landing from a greater height resulted in significant differences among most kinetics and kinematics variables and ACL forces. Minimal differences in lower-limb muscle forces and ACL loading between the dominant and non-dominant legs during single-leg landing may suggest similar risk of injury across limbs in this cohort. Further research is required to confirm whether limb dominance may play an important role in the higher incidence of ACL injury in female athletes with larger and sport-specific cohorts.
Abstract It has been hypothesized that diabetic foot ulceration might be internally initiated. This study established a three-dimensional and nonlinear finite element model of a human foot complex ...with comprehensive skeletal and soft-tissue components. The model was validated by experimental data of subject-specific barefoot plantar pressure measurements. The feasibility of the model to predict the 3D, internal, plantar soft-tissue deformation and stress was evaluated. The preliminary results indicate that large von Mises stress occurs where plantar soft-tissue contacts with geometrically irregular bony structures, thus internal stress distribution within the plantar soft-tissue was dramatically influenced by bony prominences due to stress concentration. At the forefoot part, an average stress magnification factor of 3.01 was quantified. The lateral sesamoid bone associated to the 1st MTH showed the largest effect of stress concentration. The modeling approach presented provides a possible way to explore the complexity of the mechanical environment inside the plantar soft-tissue.
