Virtual Poster Session

Welcome to the Virtual Poster Session, a new and powerful tool for networking and information exchange. Here you can share your work, search though the poster library, and start a dialogue with others in your field. Each uploaded poster that pertains to force measurement and testing can currently be used to apply for an academic travel scholarship; please see the Scholarships page for application details and deadlines.

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Submitted by Seunguk Han

Context: Individuals with chronic ankle instability (CAI) have demonstrated altered lower-extremity joint kinematics during walking. The purpose of this study was to examine feedback control of gait kinematics following repeated sudden ankle inversion perturbation during walking in CAI patients relative to matched controls. Methods: Twenty-one CAI patients, 21 matched controls participated. Subjects performed five walking trials at a preferred speed both before and after 10 sudden ankle inversion perturbations during walking while 3D joint kinematic data were collected using high-speed video and in-ground force plate. Main outcome measures were ankle- (sagittal and frontal planes), knee- (sagittal plane), and hip-angles (sagittal and frontal planes) from heel-strike to toe-off. Spatial trajectories of 44 markers were smoothed using a digital filter. Functional analysis was used to detect mean differences. Results: CAI group demonstrated (i) less ankle dorsiflexion, (ii) more ankle eversion, (iii) less knee flexion, (iv) less hip flexion, and (v) more adduction during walking trails, compared to the control group. The 10 sudden ankle inversion perturbations resulted in more ankle dorsiflexion only in the CAI group. However, both the CAI and control groups demonstrated no differences in frontal ankle, sagittal knee and sagittal and frontal hip kinematics between pre- and post-intervention measurements. Conclusions: Sudden ankle inversion perturbations did not affect gait kinematics in both CAI and control groups except sagittal ankle kinematics in the CAI group. Increased ankle dorsiflexion after inversion perturbation in the CAI group may be the result of a change in motor control to avoid self-perceived vulnerable positions of the foot during walking.


Listed In: Biomechanics, Gait
Submitted by Adam Dyer

Background and Aim: Type 2 Diabetes (T2DM) in midlife represents a potent risk factor for the development of dementia in later life. Early indicators to highlight particular individuals with T2DM who are at risk of cognitive decline are lacking. Subtle abnormalities in gait (and particularly dual-task gait with a cognitive task) have emerged as a potential predictor of cognitive decline in older adults, but have not been investigated in patients with T2DM. The ENBIND Study (Exploring Novel Biomarkers of Brain health IN Diabetes) aims to assess patients with T2DM in midlife without cognitive impairment and follow participants over the course of several years to establish early predictors of cognitive decline in this poorly characterised yet high-risk group.

Methods: Patients with midlife T2DM (40-65 yrs) were recruited at the time of their diabetic clinic appointment. Patients were excluded if they had a diagnosis of peripheral neuropathy, peripheral vascular disease, musculoskeletal disease, previous stroke, any form of diagnosed cognitive impairment or diabetic retinopathy/nephropathy. Patients underwent medical/diabetes assessment and examination by a physician. Cognition was screened using the Montreal Cognitive Assessment (MoCA) and assessed using a computerised cognitive battery designed for prodromal Alzheimer's Disease (CANTAB®). Gait was then assessed using both a raw clinical measure (stopwatch) and Shimmer® Inertial Measurement Units (IMUs) across four tasks: (i) 30 metre walk at a normal pace (turn at 15m), (ii) 30 metre fast walk (turn at 15m) (iii) dual cognitive-gait task (reciting alternate letters of the alphabet) and (iv) a long walk at a self-selected pace. Between group differences were assessed using t-tests and appropriate non-parametric equivalents

Results: 20 participants with T2DM (52.05 yrs ± 2.13) and 10 matched healthy volunteers (mean age 52.2 yrs ± 2.74) were recruited. T2DM was associated with a significantly lower score on the MoCA (29.2 vs 27.6; p=0.0452). Participants with T2DM had slower but non-significant self-selected (0.87 ms-1 vs 0.8ms-1) and fast gait speed (0.66 ms-1 vs 0.59 ms-1). On the dual-cognitive task, participants with T2DM made more errors (1.1 vs 0.6), and had higher dual-task cost (9.17% vs 2.7%, p=0.014). Dual-task cost (the percentage decrement in walking speed due to introduction of the cognitive task) was significantly correlated with total MoCA score (R2 = 0.17, p =0.031).

Discussion: Otherwise healthy participants with midlife T2DM display significantly poorer scores on MoCA. Performance on the dual-cognitive gait task was significantly correlated with MoCA score. Our study adds evidence to the presence of cognitive decrements in midlife T2DM, in-keeping with its role as a potent risk factor for the later development of dementia. We provide early data to support the utility of simple clinical gait analysis, particularly where a dual-cognitive paradigm is employed. Expansion of the sample size of patients in this study as well as longitudinal follow up should afford more detailed insight into using gait as a potential marker for cognition in this high risk cohort


Submitted by Priyadharshini R

Gait is influenced by peripheral circulation and neuro musculoskeletal system which can be affected by diabetes. Gait variations play an important role in increasing the peak plantar pressure in persons with diabetes. Biomechanical alterations in diabetic neuropathy could facilitate foot injuries, thus contributing to foot ulceration [1]. Understanding the gait characteristics in different category of diabetic population during walking can reveal the biomechanical factors which may collectively lead to foot pathology.
3-Dimensional (3D) Gait analysis was performed on 28 subjects with similar age, height, weight and Body Mass Index (BMI) (p > 0.05) with diabetes and without neuropathy (D), persons with diabetic neuropathy (DN) and persons who had a history of foot ulcer (DHU). Spatial and Temporal gait parameters along with kinematics and kinetics were compared between the three groups.
The lower extremity gait data shows that DHU subjects show increased hip flexion throughout the gait cycle with delay in peak extension and DN subjects showing a slight delay in achieving peak hip extension. DHU show a significant deviation in hip, knee and ankle mechanics when compared to other two groups. There is a slight increase in dorsiflexion among diabetic subjects during the mid - stance phase. The ground reaction force (GRF) graphs shows that the breaking force and propelling force is less in magnitude for all the three groups when compared to normal. The vertical GRF data reveals there is no significant difference among the three groups but the graph shows delayed heel rocker during the gait.
The compensation gait observed in DHU group may be due to the muscle weakness acquired in the past when there was active foot ulcer. This altered compensatory gait observed in DHU participants need to be addressed using proper corrective footwear and gait training sessions for preventing recurrence of ulcer.
References
[1] Katoulis EC, Ebdon-Parry M, Lanshammar H, Vileikyte L, Kulkarni J, Boulton AJM. Gait Abnormalities in Diabetic Neuropathy. Diabetes Care. 1997 Dec; 20(12): 1904-1907.
Acknowledgements
1. M. V. Hospital for Diabetes, Royapuram, Chennai
2. CSIR – Central Leather Research Institute and Department of Science and Technology, India


Listed In: Gait
Submitted by Jamie Benson

It is well-accepted that cartilage maintains interstitial fluid load support under long-term joint loading because contact migration leaves insufficient time for fluid exudation. However, it’s also evident that the benefits of migration dissipate as range of motion first approaches the contact length, a situation typical of moving diarthrodial joints, and then zero—typical of static joints. This study aims to elucidate the transition from full fluid load support to zero fluid load support under restricted ranges of motion. Testing was performed on osteochondral plugs using varied probe sizes, loads and track-lengths at Pe >> 1; fluid load support, contact area, and contact stress were quantified in-situ. Fluid load support depended primarily on the migration length per unit contact length (S*) and maintained maximal magnitude (F*=100%) at S* > 10. At S* < 10, it varied as a sigmoidal function of S*, falling to F* = 50% by S* = 0.1 on average. This transition migration length was independent of probe radius and varied slightly, yet significantly with contact area, load, and contact stress over the ranges tested. When migration length approached the contact length, the fluid load support of cartilage fell below that predicted by the established mechanics of migrating contacts. Based on our results, we propose a simple analytical correction that should be used when S*<10. These results demonstrate that fluid retention and load support are impaired by reduced activity and reduced ranges of motion, especially given the relatively short tracks of most joints at full range of motion.


Submitted by Danilo Catelli

THA is a reliable method to improve the quality of life in osteoarthritis patients. However, it is still unclear whether it would lead to improved functional mobility. The purpose was to develop a biomechanical functional score to quantify the joint mechanics of THA patients compared to healthy participants (CTRL).
Twenty-four THA patients and 12 CTRL (age-, sex-, and BMI-matched) participants were recruited and underwent motion analysis for different ADLs tasks prior and nine months after THA. Three-dimensional joint kinematics and ground reaction forces were collected and five kinematic and six kinetic variables were included in the analysis. The normalized root-mean-square-deviation (nRMSD) was calculated between the THA and the CTRL groups for both pre- and post-op conditions: nRMSD= √((∑_(t=1)^n(x_(1,t)- y_(1,t))^2)/n)⁄(x_max-x_min). Kinematics and kinetics improvement scores (KMIS and KNIS) were calculated to estimate pre/post-op differences: KMIS=∑_(i=1)^n〖〖(KM〗_(pre/ctrl i)-〖KM〗_(post/ctrl i))〗; KNIS=∑_(i=1)^n〖〖(KN〗_(pre/ctrl i)- 〖KN〗_(post/ctrl i))〗.
THA patients experienced post-op improvements, with kinetics variables closely resembling the CTRLs, especially on hip and knee power production. Total improvement scores showed that THA experienced greater improvements during a squat task and this can be a practical approach to evaluate the change in biomechanical function and highlight small improvements that may go unnoticed with traditional statistical analysis.


Submitted by Youngwook Kim

Background: Several risk factors have been identified as contributors to the development of shoulder injuries, including glenohumeral internal rotation deficit, rotator cuff weakness, and shoulder instability. However, lasting deficits of the physical characteristics among overhead athletes with a history of a shoulder injury are unknown. Objective: To compare shoulder range of motion (ROM), strength, and upper-quarter dynamic balance between collegiate overhead athletes with and without a history of a shoulder injury. Methods: 58 overhead athletes were distributed into a shoulder injury history group (n=25) and healthy group (n=33). All participants were fully participating in NCAA Division I baseball, softball, volleyball, or tennis and free of any symptoms of shoulder injuries. An investigator measured active ROM for dominant shoulder internal rotation (IR), external rotation (ER), and horizontal adduction (HAD) using a digital inclinometer. Isometric strength for dominant shoulder IR and ER at 90° of abduction was measured using a hand-held dynamometer. The upper quarter dynamic balance was assessed via the Upper Quarter Y-Balance Test (UQYBT). Results: The injury group demonstrated a lower UQYBT mean score in the superolateral direction. However, there were no statistically significant intergroup differences in shoulder ROM, strength, ER/IR strength ratio, and UQYBT in the medial direction and inferolateral direction. Conclusions: Overhead athletes with a previous history of shoulder injury had poorer UQYBT in the superolateral direction despite a lack of ongoing symptoms or deficits in function. Well-planed dynamic balance training and related strengthening exercises may be warranted for overhead athletes to improve their upper quarter functions.


Submitted by Gregory Tierney

The tackle height law in rugby union has been an area of concern for many years. It is currently set at the line of the ball carrier’s shoulder. The goal of this study is to use Model-Based Image-Matching (MBIM) and human volunteer tackles in a marker-based 3D motion analysis laboratory to examine the severity of a legal tackle to the shoulder/chest of the ball carrier (with no head contact) and the effect of tackles above and below the chest on ball carrier inertial head kinematics, respectively.
From the real-world tackles, the estimated ball carrier peak resultant change in head angular velocity was 30.4 rad/s (23.1 rad/s, 14.0 rad/s and 21.8 rad/s in the coronal, sagittal and transverse direction, respectively). In the staged tackles, the median peak resultant head linear and angular acceleration and change in head angular velocity values for tackles above the chest were greater than for below the chest. The results support the proposition of lowering the current tackle height law. Due to the real-world tackle (MBIM), the ball carrier head kinematics indicated a greater than 75% chance of sustaining a concussion, based on the literature. This was the case even though no contact was made with the ball carrier’s head. Therefore, repeatedly engaging in this type of legal tackle may be detrimental for long-term brain health. However, by lowering the tackle height law to below the chest, ball carrier inertial head kinematics can be reduced significantly, thus reducing the repetitive loading placed on the brain.


Submitted by Nok-Yeung Law

Tai Chi (TC) has the rehabilitative potential to prevent falls in the elderly, however it is unclear how TC training improves postural control capacity. Fifteen male participants with more than 4 years of TC experience were asked to perform two TC movements, the “Repulse Monkey (RM)” and “Wave-hands in clouds (WHIC).” Three-dimensional (3-D) temporospatial, kinematic and kinetic data was collected using VICON motion analysis system with 10 infrared cameras and 4 force plates. Stride width, step length, step width, single- and double-support times, center of mass (COM) displacement, peak joint angles, range of motion, peak joint moments, time to peak moment, and ground reaction force (GRF) were analyzed. The differences in the measurements of the two TC movements were compared with walking using two-way ANOVA analysis. Compared with walking kinematics, both TC movements spent less time in single-support; RM and WHIC had larger mediolateral and vertical displacement of the COM. Compared with walking kinetics, both TC movements generated significantly smaller peak ground reaction forces in all directions, except the anterior; larger hip extension, adduction and internal rotational moments, knee adduction/abduction and internal rotation moments and eversion/inversion and external/internal moments of ankle–foot; and longer peak moment generation time for hip extension, adduction and internal rotation, knee extension and ankle dorsiflexion and inversion. The slow, gentle stepping-action and loading patterns that are consistent with the mechanical behavior of biological tissues. These two TC movements would be suitable training to help strengthen the lower extremities and prevent falls in the elderly.


Submitted by Nicholas Romanchuk

ACL injury mechanisms are commonly determined from evidence gathered during highly controlled lab-based activities. However, many non-contact ACL ruptures occur following a reaction to an external stimulus, when athletes are unable to pre-plan their movement strategy1. The purpose of this study was to determine if unanticipated drop-jump landing altered lower-limb biomechanics.

Ten participants performed two counter-balanced single-leg drop-jump landing conditions (anticipated and unanticipated). Unanticipated landings were conducted by randomly displaying either a left or right arrow immediately following jump takeoff. The visual cue was triggered by the participant making contact with a force platform, set at a threshold of 10N. Three-dimensional kinematic and kinetic data for the ankle, knee and hip were time-normalized over the jumping and landing phase and with-in participant averaged over the successful trials. Paired sample t-tests, using Statistical Parametric Mapping, evaluated between condition differences over the jumping and landing phases (α = 0.05).
Participants landed with significantly greater hip abduction (p=0.004) during the unanticipated condition over the entire landing phase (0-100%). Participants also landed with significantly less hip external rotation (p=0.048) over the final 17% of the landing phase.

Although no differences were identified at the knee joint, participants landed with greater hip abduction and less external rotation when the movement was unaticipated. Given that proximal factors play a contributing role towards controling knee mechanics, the altered hip position could be a compensatory strategy to limit knee abduction and reduce ACL injury risk during unanticipated tasks2.

1. Olsen et al. AJSM 2004;32(4):1002-1012
2. Powers JOSPT 2010;40(2):42-51


Listed In: Biomechanics
Submitted by Wai Yan Liu

Patients with chronic obstructive pulmonary disease (COPD) have an increased fall risk [1] and demonstrate gait deficits [2,3]. Gait variability has been associated with increased fall risk in the aging population [4]. However, studies reporting gait variability in COPD are scarce. Therefore, we aim to assess gait variability in patients with COPD during the 6-minute walk test (6MWT).
Eighty patients with COPD (62±7yrs; FEV1:56±19%pred.) and 39 healthy subjects (62±6yrs; FEV1:119±17%pred.) performed two self-paced 6MWTs while kinematic parameters were recorded (100Hz, Vicon). The amount (coefficient of variation; CoV) and structure (sample entropy; SE) of variability of stride time, stride length and step width, and local divergence exponent (LDE) of the centre of mass velocity (CoMv) in three directions were computed. The sub-analysis accounted for gait speed influences on gait variability between groups.
Stride time was longer (MD:0.13s, p<0.001) and stride length was smaller (MD:-0.30 m, p<0.001) in COPD. CoV for stride length was increased (MD:1.8%, p<0.001) and stride length SE was lower in COPD (MD:0.21, p<0.001). LDE for CoMv differed in vertical (MD: -0.12, p=0.001) and anteroposterior direction (MD: 0.10, p=0.017). The CoV for stride length remained higher in COPD (MD:1.0%, p=0.003) and stride length SE remained lower in COPD (MD:-0.12, p=0.011), after the sub-analysis of 14 patients with COPD and 14 healthy subjects with comparable walking speeds (MD:-0.02m/s, p=0.588).
Patients with COPD demonstrate alterations in the amount and structure of variability in stride length, indicating alterations in the control of stride length variability patterns.


Listed In: Biomechanics, Gait