Tai Ji is one of the recommended non-pharmacologic treatments for knee osteoarthritis (OA), but it is not clear if all Tai Ji movements would be suitable and beneficial for knee OA patients. PURPOSE: To examine knee biomechanical characteristics of the selected knee unfriendly Tai Ji movement elements performed in high-pose position compared to slow walking. METHODS: Seventeen healthy participants (age: 23.9 ± 2.7 years, height: 1.73 ± 0.08 m, body mass: 69.0 ± 13.0 kg) performed three trials in each of the following five test conditions: level walking at 0.8 m/s and four identified knee unfriendly Tai Ji movement elements: lunge, pushdown and kick performed in high-pose position (35 ± 5°) and pseudo-step. Simultaneous collection of 3D kinematics (120 Hz) and ground reaction forces (1200 Hz) was conducted. A one-way ANOVA was performed with post hoc paired samples t-tests to determine differences of the high-pose lunge, pushdown, and kick, and pseudo-step and walking. RESULTS: Knee flexion range of motion for high-pose lunge (29.5°), pushdown (24.3°) and kick (11.1°) was lower than pseudo-step (45.0°, p<0.001 for all comparisons) and walking (47.8°, p<0.001 for all comparisons). Peak knee extensor moment was lower in high-pose lunge (1.04 Nm/kg), pushdown (1.01 Nm/kg) and kick (0.48 Nm/kg) than pseudo-step (1.46 Nm/kg, p<0.001 for all comparisons), but higher than walking (0.38 Nm/kg, p<0.001 for all comparisons) except for kick. Peak knee abduction moment was higher in pseudo-step (-0.61 Nm/kg) than high-pose pushdown (-0.43 Nm/kg), kick (-0.44 Nm/kg), and walking (-0.45 Nm/kg, for all comparisons p<0.001). CONCLUSION: These findings demonstrate higher peak knee extensor moment in most of the Tai Ji knee unfriendly movement elements compared to slow walking. It is recommended that Tai Ji participants with knee OA and other knee pathological conditions modify knee unfriendly movement elements (e.g. lunge) and reduce the size of their movements to minimize knee joint loading. The Tai Ji movement elements including pushdown and pseudo-step should be avoided in the Tai Ji exercises designed for knee OA patients.
Introduction and Objectives: Traditional motion analysis provides limited insight into muscle and tendon forces during movement. This study used B-mode ultrasound, in combination with measured joint angles and scaled musculoskeletal models, to provide subject-specific estimates of in vivo Achilles tendon (AT) force. Previous studies have used ultrasound images, tracked in 3D space, to estimate AT strains during walking, running, and jumping [1,2]. Our approach extends this work in one novel way. Specifically, we characterized AT stiffness on a subject-specific basis by recording subjects’ ankle moments and AT strains during a series of isometric tests. We then used these data to estimate AT force during movement from in vivo measurements of tendon strain.
To demonstrate this approach, we report AT forces measured during cycling. Cycling offers a unique paradigm for studying AT mechanics. First, because the crank trajectory is constrained, joint angles and muscle-tendon unit (MTU) lengths of the gastrocnemius (MG, LG) and soleus (SOL) are also constrained. By varying crank load, subjects’ ankle moments can be altered without imposing changes in MTU lengths. For this study, 10 competitive cyclists were tested at 4 different crank loads while pedaling at 80 rpm. Based on published EMG recordings (e.g., ) and on in vivo tendon force buckle data from one subject , we hypothesized that the cyclists’ AT forces would increase systematically with crank load.
Methods: We coupled B-mode ultrasound with motion capture, EMG, and pedal forces to estimate in vivo AT forces non-invasively during cycling and during a series of isometric ankle plantarflexion tests. Marker trajectories were tracked using an optical motion capture system. Joint angles and MTU lengths were calculated based on scaled musculoskeletal models  using OpenSim . A 50 mm linear-array B-mode ultrasound probe was secured over the distal muscle-tendon junction (MTJ) of the MG and was tracked using rigid-body clusters of LEDs. AT lengths were calculated as the distance from a calcaneus marker to the 3D coordinates of the MG MTJ. Subject-specific AT force-strain curves were obtained from isometric tests using ultrasound to track the MTJ, markers to track both the ultrasound probe and the AT insertion, and a strain gauge to measure the net ankle torques generated by each of the subjects at ankle angles of -10° dorsiflexion, 0°, +10° plantarflexion, and +20° plantarflexion. AT strain during cycling was converted to AT force using each subject’s force-strain relation. Subject-specific tendon slack lengths were calculated as the mean tendon length at 310° over all pedal cycles, based on examination of the AT length changes and on published data showing that this position in the pedal cycle precedes tendon loading across multiple pedalling conditions .
Results: Peak AT forces during cycling ranged from 1320 to 2160 N ± 400 N (mean± SD) and increased systematically with load (p<0.001; Fig. 1A/B). At the highest load, the peak AT forces represented, on average, 50 to 70 % of the combined MG, LG, and SOL muscles’ maximum isometric force-generating capacity, as estimated from the muscles’ scaled volumes , the muscles’ scaled optimal fiber lengths , and a specific tension of 20-30 N/cm2. Peak AT forces occurred midway through the pedaling downstroke, at about 80°, which is consistent with the AT forces directly measured from one subject  and with patterns of EMG during cycling . Peak AT strains during cycling were uncoupled from the MG MTU strains and ranged from 3 to 5 % across the different loads examined, measured at the MG MTJ.
Conclusion: Our results are consistent with published data from a single subject in which AT force was measured using an implanted tendon buckle ; however, our results were obtained non-invasively using ultrasound and motion capture. These methods substantially augment the experimental tools available to study muscle-tendon dynamics during movement.
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Introduction and Objectives: It has previously been reported that deterioration in contractile strength and tendon
stiffness in the elderly is associated with altered motor task execution and reduced performance while walking [1,2], and
that resistance training improves muscle function, resulting in more effective and safer gait characteristics in the older
population . In particular, triceps surae (TS) muscle-tendon unit (MTU) properties seem to be an important determinant
for walk-to-run transition speed , emphasizing the relevant role intrinsic MTU properties play in gait performance. The
objective of this empirical study was to examine the hypothesis that maximal walking velocity is related to TS MTU
mechanical and morphological properties and their enhanced capacities would improve gait velocity in the elderly.
Methods: Thirty four older female adults (66±7 yrs.) took part in the study. Nineteen of them were recruited for the
experimental group, who underwent a 14-week TS MTU physical exercise intervention which has been previously
established to increase muscle strength and tendon stiffness . The remaining 15 subjects formed the control group (no
physical exercise intervention). The experimental group performed three times per week five sets of four repetitive (3·s
loading, 3·s relaxation) isometric plantar flexion contractions in order to induce high cyclic strain magnitudes on the TS
tendon and aponeurosis. Maximal walking velocity, defined as walking with a double support phase, was determined by
using two force plates (60 x 40 cm, 1080 Hz; Kistler, Winterthur, CH) and a motion capture system (Vicon Motion
Systems, Oxford, UK) with 12 infrared cameras operating at a frequency of 120 Hz. TS MTU properties were assessed
using simultaneous dynamometry and ultrasonography (Esaote MyLab Five; Esaote Biomedica, Genoa, IT).
Results: A significant correlation was found between the TS MTU mechanical and morphological properties and maximal
gait velocity (0.40 < r < 0.64; P < 0.05; n = 34). The experimental group showed higher TS contractile strength, tendon
stiffness, and higher gastrocnemius medialis muscle thickness post- compared to pre-intervention (P < 0.05). However,
calculated maximal gait velocity did not differ between pre and post-intervention measurements (2.39 ± 0.41 vs. 2.44 ±
0.45 m·s-1). Control subjects showed no statistically significant differences in maximal gait velocity or TS MTU mechanical
and morphological properties.
Conclusion: This empirical study confirms previous forward simulation models  proposing that intrinsic TS MTU
properties are significant determinants of gait performance. However, older adults may not be capable of fully utilizing
improvements of the MTU capacities while walking at maximal velocities following a 14 week physical exercise
intervention. Therefore, the benefits of a long term physical exercise intervention (1.5 years) will be discussed.
2015-2016 $10,000 Academic Scholarship Recipients Are....
The Force and Motion Foundation recipients of the 2015-2016 $10,000 Academic Scholarship have been determined. Our Congratulations go out to: Sijia Zhang from the University of Pennsylvania, Erin Futrell from MGH Institute of Health Professionals and Alison McDonald from McMaster University. Thanks to everyone who participated.