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Introduction
Varus knee alignment has been identified as a risk factor for the progression of medial knee osteoarthritis. However, the underlying mechanisms have not been elucidated yet in children. Thus, the aims of the present study were to examine differences in ground reaction forces, loading rate, impulses, and free moment values during running in children with and without genu varus.
Methods
Thirty-six boys aged 9–14 volunteered to participate in this study. They were divided in two age-matched groups (genu varus versus healthy controls). Body weight adjusted three dimensional kinetic data (Fx, Fy, Fz) were collected during running at preferred speed using two Kistler force plates for the dominant and non-dominant limb.
Results
Individuals with knee genu varus produced significantly higher (p = .01; d = 1.09; 95%) body weight adjusted ground reaction forces in the lateral direction (Fx) of the dominant limb compared to controls. On the non-dominant limb, genu varus patients showed significantly higher body weight adjusted ground reaction forces values in the lateral (p = .01; d = 1.08; 86%) and medial (p < .001; d = 1.55; 102%) directions (Fx). Further, genu varus patients demonstrated 55% and 36% greater body weight adjusted loading rates in the dominant (p < .001; d = 2.09) and non-dominant (p < .001; d = 1.02) leg, respectively. No significant between-group differences were observed for adjusted free moment values (p>.05).
Discussion
Higher mediolateral ground reaction forces and vertical loading rate amplitudes in boys with genu varus during running at preferred running speed may accelerate the development of progressive joint degeneration in terms of the age at knee osteoarthritis onset. Therefore, practitioners and therapists are advised to conduct balance and strength training programs to improve lower limb alignment and mediolateral control during dynamic movements.
A comparison of running kinetics in children with and without genu varus: A cross sectional study
(2017)
Introduction Varus knee alignment has been identified as a risk factor for the progression of medial knee osteoarthritis. However, the underlying mechanisms have not been elucidated yet in children. Thus, the aims of the present study were to examine differences in ground reaction forces, loading rate, impulses, and free moment values during running in children with and without genu varus. Methods Thirty-six boys aged 9-14 volunteered to participate in this study. They were divided in two age-matched groups (genu varus versus healthy controls). Body weight adjusted three dimensional kinetic data (Fx, Fy, Fz) were collected during running at preferred speed using two Kistler force plates for the dominant and non-dominant limb. Results Individuals with knee genu varus produced significantly higher (p = .01; d = 1.09; 95%) body weight adjusted ground reaction forces in the lateral direction (Fx) of the dominant limb compared to controls. On the non-dominant limb, genu varus patients showed significantly higher body weight adjusted ground reaction forces values in the lateral (p = .01; d = 1.08; 86%) and medial (p < .001; d = 1.55; 102%) directions (Fx). Further, genu varus patients demonstrated 55% and 36% greater body weight adjusted loading rates in the dominant (p < .001; d = 2.09) and non-dominant (p < .001; d = 1.02) leg, respectively. No significant between-group differences were observed for adjusted free moment values (p>.05). Discussion Higher mediolateral ground reaction forces and vertical loading rate amplitudes in boys with genu varus during running at preferred running speed may accelerate the development of progressive joint degeneration in terms of the age at knee osteoarthritis onset. Therefore, practitioners and therapists are advised to conduct balance and strength training programs to improve lower limb alignment and mediolateral control during dynamic movements.
Age-related decline in executive functions and postural control due to degenerative processes in the central nervous system have been related to increased fall-risk in old age. Many studies have shown cognitive-postural dual-task interference in old adults, but research on the role of specific executive functions in this context has just begun. In this study, we addressed the question whether postural control is impaired depending on the coordination of concurrent response-selection processes related to the compatibility of input and output modality mappings as compared to impairments related to working-memory load in the comparison of cognitive dual and single tasks. Specifically, we measured total center of pressure (CoP) displacements in healthy female participants aged 19–30 and 66–84 years while they performed different versions of a spatial one-back working memory task during semi-tandem stance on an unstable surface (i.e., balance pad) while standing on a force plate. The specific working-memory tasks comprised: (i) modality compatible single tasks (i.e., visual-manual or auditory-vocal tasks), (ii) modality compatible dual tasks (i.e., visual-manual and auditory-vocal tasks), (iii) modality incompatible single tasks (i.e., visual-vocal or auditory-manual tasks), and (iv) modality incompatible dual tasks (i.e., visual-vocal and auditory-manual tasks). In addition, participants performed the same tasks while sitting. As expected from previous research, old adults showed generally impaired performance under high working-memory load (i.e., dual vs. single one-back task). In addition, modality compatibility affected one-back performance in dual-task but not in single-task conditions with strikingly pronounced impairments in old adults. Notably, the modality incompatible dual task also resulted in a selective increase in total CoP displacements compared to the modality compatible dual task in the old but not in the young participants. These results suggest that in addition to effects of working-memory load, processes related to simultaneously overcoming special linkages between input- and output modalities interfere with postural control in old but not in young female adults. Our preliminary data provide further evidence for the involvement of cognitive control processes in postural tasks.
Age-related decline in executive functions and postural control due to degenerative processes in the central nervous system have been related to increased fall-risk in old age. Many studies have shown cognitive-postural dual-task interference in old adults, but research on the role of specific executive functions in this context has just begun. In this study, we addressed the question whether postural control is impaired depending on the coordination of concurrent response-selection processes related to the compatibility of input and output modality mappings as compared to impairments related to working-memory load in the comparison of cognitive dual and single tasks. Specifically, we measured total center of pressure (CoP) displacements in healthy female participants aged 19-30 and 66-84 years while they performed different versions of a spatial one-back working memory task during semi-tandem stance on an unstable surface (i.e., balance pad) while standing on a force plate. The specific working-memory tasks comprised: (i) modality compatible single tasks (i.e., visual-manual or auditory-vocal tasks), (ii) modality compatible dual tasks (i.e., visual-manual and auditory-vocal tasks), (iii) modality incompatible single tasks (i.e., visual-vocal or auditory-manual tasks), and (iv) modality incompatible dual tasks (i.e., visual-vocal and auditory-manual tasks). In addition, participants performed the same tasks while sitting. As expected from previous research, old adults showed generally impaired performance under high working-memory load (i.e., dual vs. single one-back task). In addition, modality compatibility affected one-back performance in dual-task but not in single-task conditions with strikingly pronounced impairments in old adults. Notably, the modality incompatible dual task also resulted in a selective increase in total CoP displacements compared to the modality compatible dual task in the old but not in the young participants. These results suggest that in addition to effects of working-memory load, processes related to simultaneously overcoming special linkages between input-and output modalities interfere with postural control in old but not in young female adults. Our preliminary data provide further evidence for the involvement of cognitive control processes in postural tasks.
Objectives: Postural control in elderly people is impaired by degradations of sensory, motor, and higher-level adaptive mechanisms. Here, we characterize the effects of a progressive balance training programon these postural control impairments using a brain network model based on system identification techniques. Methods and Material: We analyzed postural control of 35 healthy elderly subjects and compared findings to data from 35 healthy young volunteers. Eighteen elderly subjects performed a 10 week balance training conducted twice per week. Balance training was carried out in static and dynamic movement states, on support surfaces with different elastic compliances, under different visual conditions and motor tasks. Postural control was characterized by spontaneous sway and postural reactions to pseudorandom anterior-posterior tilts of the support surface. Data were interpreted using a parameter identification procedure based on a brain network model. Conclusion: Balance training reduced overactive proprioceptive feedback and restored vestibular orientation in elderly. Based on the assumption of a linear deterioration of postural control across the life span, the training effect can be extrapolated as a juvenescence of 10 years. This study points to a considerable benefit of a continuous balance training in elderly, even without any sensorimotor deficits.
The present study aimed to examine the effects of fatigue and surface instability on kinetic and kinematic jump performance measures. Ten female and 10 male elite volleyball players (18 +/- 2 years) performed repetitive vertical double-leg box jumps until failure. Pre and post fatigue, jump height/performance index, ground reaction force and knee flexion/valgus angles were assessed during drop and countermovement jumps on stable and unstable surfaces. Fatigue, surface condition, and sex resulted in significantly lower drop jump performance and ground reaction force (p0.031, 1.1d3.5). Additionally, drop jump knee flexion angles were significantly lower following fatigue (p=0.006, d=1.5). A significant fatiguexsurfacexsex interaction (p=0.020, d=1.2) revealed fatigue-related decrements in drop jump peak knee flexion angles under unstable conditions and in men only. Knee valgus angles were higher on unstable compared to stable surfaces during drop jumps and in females compared to males during drop and countermovement jumps (p0.054, 1.0d1.1). Significant surfacexsex interactions during countermovement jumps (p=0.002, d=1.9) indicated that knee valgus angles at onset of ground contact were significantly lower on unstable compared to stable surfaces in males but higher in females. Our findings revealed that fatigue and surface instability resulted in sex-specific knee motion strategies during jumping in elite volleyball players.
The purpose of this study was to examine whether drop height-induced changes in leg muscle activity during drop jumps (DJ) are additionally modulated by surface condition. Twenty-four healthy participants (23.7 +/- 1.8years) performed DJs on a force plate on stable, unstable, and highly unstable surfaces using different drop heights (i.e., 20cm, 40cm, 60cm). Electromyographic (EMG) activity of soleus (SOL), gastrocnemius (GM), tibialis anterior (TA) muscles and coactivation of TA/SOL and TA/GM were analyzed for time intervals 100ms prior to ground contact (preactivation) and 30-60ms after ground contact [short latency response (SLR)]. Increasing drop heights resulted in progressively increased SOL and GM activity during preactivation and SLR (P<0.01; 1.01 d 5.34) while TA/SOL coactivation decreased (P<0.05; 0.51 d 3.01). Increasing surface instability produced decreased activities during preactivation (GM) and SLR (GM, SOL) (P<0.05; 1.36 d 4.30). Coactivation increased during SLR (P<0.05; 1.50 d 2.58). A significant drop heightxsurface interaction was observed for SOL during SLR. Lower SOL activity was found on unstable compared to stable surfaces for drop heights 40cm (P<0.05; 1.25 d 2.12). Findings revealed that instability-related changes in activity of selected leg muscles are minimally affected by drop height.
The purpose of this study was to examine the combined effects of drop-height and surface condition on drop jump (DJ) performance and knee joint kinematics. DJ performance, sagittal and frontal plane knee joint kinematics were measured in jump experienced young male and female adults during DJs on stable, unstable and highly unstable surfaces using different drop-heights (20, 40, 60 cm). Findings revealed impaired DJ performance (Δ5–16%; p<0.05; 1.43≤d≤2.82), reduced knee valgus motion (Δ33–52%; p<0.001; 2.70≤d≤3.59), and larger maximum knee flexion angles (Δ13–19%; p<0.01; 1.74≤d≤1.75) when using higher (60 cm) compared to lower drop-heights (≤40 cm). Further, lower knee flexion angles and velocity were found (Δ8-16%; p<0.01; 1.49≤d≤2.38) with increasing surface instability. When performing DJs from high (60 cm) compared to moderate drop-heights (40 cm) on highly unstable surfaces, higher knee flexion velocity and maximum knee valgus angles were found (Δ15–19%; p<0.01; 1.50≤d≤1.53). No significant main and/or interaction effects were observed for the factor sex. In conclusion, knee motion strategies were modified by the factors ‘drop-height’ and/or ‘surface instability’. The combination of high drop-heights (>40 cm) together with highly unstable surfaces should be used cautiously during plyometrics because this may increase the risk of injury due to higher knee valgus stress.
Previous studies contrasted the effects of plyometric training (PT) conducted on stable vs. unstable surfaces on components of physical fitness in child and adolescent soccer players. Depending on the training modality (stable vs. unstable), specific performance improvements were found for jump (stable PT) and balance performances (unstable PT). In an attempt to combine the effects of both training modalities, this study examined the effects of PT on stable surfaces compared with combined PT on stable and unstable surfaces on components of physical fitness in prepuberal male soccer athletes. Thirty-three boys were randomly assigned to either a PT on stable surfaces (PTS; n = 17; age = 12.1 +/- 0.5 years; height = 151.6 +/- 5.7 cm; body mass = 39.2 +/- 6.5 kg; and maturity offset = 22.3 +/- 0.5 years) or a combined PT on stable and unstable surfaces (PTC; n = 16; age = 12.2 +/- 0.6 years; height = 154.6 +/- 8.1 cm; body mass = 38.7 +/- 5.0 kg; and maturity offset = 22.2 +/- 0.6 years). Both intervention groups conducted 4 soccer-specific training sessions per week combined with either 2 PTS or PTC sessions. Before and after 8 weeks of training, proxies of muscle power (e.g., countermovement jump [CMJ], standing long jump [SLJ]), muscle strength (e.g., reactive strength index [RSI]), speed (e.g., 20-m sprint test), agility (e.g., modified Illinois change of direction test [MICODT]), static balance (e.g., stable stork bal-ance test [SSBT]), and dynamic balance (unstable stork balance test [USBT]) were tested. An analysis of covariance model was used to test between-group differences (PTS vs. PTC) at posttest using baseline outcomes as covariates. No significant between-group differences at posttest were observed for CMJ (p > 0.05, d = 0.41), SLJ (p > 0.05, d = 0.36), RSI (p > 0.05, d = 0.57), 20-m sprint test (p > 0.05, d = 0.06), MICODT (p > 0.05, d = 0.23), and SSBT (p > 0.05, d = 0.20). However, statistically significant between-group differences at posttest were noted for the USBT (p < 0.01, d = 1.49) in favor of the PTC group. For most physical fitness tests (except RSI), significant pre-to-post improvements were observed for both groups (p < 0.01, d = 0.55-3.96). Eight weeks of PTS or PTC resulted in similar performance improvements in components of physical fitness except for dynamic balance. From a performance-enhancing perspective, PTC is recommended for pediatric strength and conditioning coaches because it produced comparable training effects as PTS on proxies of muscle power, muscle strength, speed, agility, static balance, and additional effects on dynamic balance.
This study aimed at examining the effects of plyometric training on stable (SPT) vs. unstable (UPT) surfaces on physical fitness in prepuberal soccer players. Male athletes were randomly assigned to SPT (n = 18; age = 12.7 +/- 0.2 years) or UPT (n = 16; age = 12.2 +/- 0.5 years). Both groups conducted 3 regular soccer training sessions per week combined with either 2 SPT or UPT sessions. Assessment of jumping ability (countermovement jump [CMJ], and standing long jump [SLJ]), speed (10-m, 20-m, 30-m sprint), agility (Illinois agility test [IAT]), and balance (stable [SSBT], unstable [USBT] stork balance test; stable [SYBT], unstable [UYBT] Y balance test) was conducted pre-and post-training. An ANCO-VA model was used to test for between-group differences (SPT vs. UPT) at post-test using baseline values as covariates. No significant differences were found for CMJ height (p > 0.05, d = 0.54), SLJ (p > 0.05; d = 0.81), 10-m, 20-m, and 30-m sprint performances (p > 0.05, d = 0.00-0.24), IAT (p > 0.05, d = 0.48), and dynamic balance (SYBT and UYBT, both p > 0.05, d = 0.39, 0.08, respectively). Statistically significant between-group differences were detected for the USBT (p < 0.01, d = 1.86) and the SSBT (p < 0.01, d = 1.75) in favor of UPT. Following 8 weeks of SPT or UPT in prepuberal athletes, similar performance levels were observed in both groups for measures of jumping ability, speed, dynamic balance, and agility. However, if the goal is to additionally enhance static balance, UPT has an advantage over SPT.