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Bewegungsanalysesysteme in der Forschung und für niedergelassene Orthopädinnen und Orthopäden
(2023)
Hintergrund
Komplexe biomechanische Bewegungsanalysen können für eine Vielzahl orthopädischer Fragestellungen wichtige Informationen liefern. Bei der Beschaffung von Bewegungsanalysesystemen sind neben den klassischen Messgütekriterien (Validität, Reliabilität, Objektivität) auch räumliche und zeitliche Rahmenbedingungen sowie Anforderungen an die Qualifikation des Messpersonals zu berücksichtigen.
Anwendung
In der komplexen Bewegungsanalyse werden Systeme zur Bestimmung der Kinematik, der Kinetik und der Muskelaktivität (Elektromyographie) eingesetzt. Der vorliegende Artikel gibt einen Überblick über Methoden der komplexen biomechanischen Bewegungsanalyse für den Einsatz in der orthopädischen Forschung oder in der individuellen Patientenversorgung. Neben dem Einsatz zur reinen Bewegungsanalyse wird auch der Einsatz von Bewegungsanalyseverfahren im Bereich des Biofeedbacktrainings diskutiert.
Beschaffung
Für die konkrete Anschaffung von Bewegungsanalysesystemen empfiehlt sich die Kontaktaufnahme mit Fachgesellschaften (z. B. Deutsche Gesellschaft für Biomechanik), Hochschulen und Universitäten mit vorhandenen Bewegungsanalyseeinrichtungen oder Vertriebsfirmen im Bereich der Biomechanik.
Treadmills are essential to the study of human and animal locomotion as well as for applied diagnostics in both sports and medicine. The quantification of relevant biomechanical and physiological variables requires a precise regulation of treadmill belt velocity (TBV). Here, we present a novel method for time-efficient tracking of TBV using standard 3D motion capture technology. Further, we analyzed TBV fluctuations of four different treadmills as seven participants walked and ran at target speeds ranging from 1.0 to 4.5 m/s. Using the novel method, we show that TBV regulation differs between treadmill types, and that certain features of TBV regulation are affected by the subjects’ body mass and their locomotion speed. With higher body mass, the TBV reductions in the braking phase of stance became higher, even though this relationship differed between locomotion speeds and treadmill type (significant body mass × speed × treadmill type interaction). Average belt speeds varied between about 98 and 103% of the target speed. For three of the four treadmills, TBV reduction during the stance phase of running was more intense (> 5% target speed) and occurred earlier (before 50% of stance phase) unlike the typical overground center of mass velocity patterns reported in the literature. Overall, the results of this study emphasize the importance of monitoring TBV during locomotor research and applied diagnostics. We provide a novel method that is freely accessible on Matlab’s file exchange server (“getBeltVelocity.m”) allowing TBV tracking to become standard practice in locomotion research.
High-tech running shoes and spikes ("super-footwear") are currently being debated in sports. There is direct evidence that distance running super shoes improve running economy; however, it is not well established to which extent world-class performances are affected over the range of track and road running events.
This study examined publicly available performance datasets of annual best track and road performances for evidence of potential systematic performance effects following the introduction of super footwear. The analysis was based on the 100 best performances per year for men and women in outdoor events from 2010 to 2022, provided by the world governing body of athletics (World Athletics).
We found evidence of progressing improvements in track and road running performances after the introduction of super distance running shoes in 2016 and super spike technology in 2019. This evidence is more pronounced for distances longer than 1500 m in women and longer than 5000 m in men. Women seem to benefit more from super footwear in distance running events than men.
While the observational study design limits causal inference, this study provides a database on potential systematic performance effects following the introduction of super shoes/spikes in track and road running events in world-class athletes. Further research is needed to examine the underlying mechanisms and, in particular, potential sex differences in the performance effects of super footwear.
Background: Running overuse injuries (ROIs) occur within a complex, partly injury-specific interplay between training loads and extrinsic and intrinsic risk factors. Biomechanical risk factors (BRFs) are related to the individual running style. While BRFs have been reviewed regarding general ROI risk, no systematic review has addressed BRFs for specific ROIs using a standardized methodology.
Objective: To identify and evaluate the evidence for the most relevant BRFs for ROIs determined during running and to
suggest future research directions.
Design: Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236,832).
Data Sources: PubMed. Connected Papers. The search was performed in February 2021.
Eligibility Criteria: English language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic BRF. A BRF needed to be identified in at least one prospective or two independent retrospective studies. BRFs needed to be determined during running.
Results: Sixty-six articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some BRFs appeared for several ROIs, most BRFs were specific for a particular ROI. Most BRFs derived from lower-extremity joint kinematics and kinetics were located in the frontal and transverse planes of motion. Further, plantar pressure, vertical ground reaction force loading rate and free moment-related parameters were identified as kinetic BRFs.
Conclusion: This study offers a comprehensive overview of BRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. We identified limited evidence for most ROI-specific risk factors, highlighting the need for performing further high-quality studies in the future. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted.
Objective: To identify and evaluate the evidence of the most relevant running-related risk factors (RRRFs) for running-related overuse injuries (ROIs) and to suggest future research directions.
Design: Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236832)
Data sources: Pubmed. Connected Papers. The search was performed in February 2021.
Eligibility criteria: English language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic RRRF. An RRRF needed to be identified in at least one prospective or two retrospective studies.
Results: Sixty-two articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some RRRFs appeared for several ROIs, most RRRFs were specific for a particular ROI. The biomechanical measurements performed in many studies would have allowed for consideration of many more RRRFs than have been reported, highlighting a potential for more effective data usage in the future.
Conclusion: This study offers a comprehensive overview of RRRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. Future work should use macroscopic (big data) approaches involving long-term data collections in the real world and microscopic approaches involving precise stress calculations using recent developments in biomechanical modelling. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted.
Background:
Ankle braces aim to reduce lateral ankle sprains. Next to protection, factors influencing user compliance, such as sports performance, motion restriction, and users’ perceptions, are relevant for user compliance and thus injury prevention. Novel adaptive protection systems claim to change their mechanical behavior based on the intensity of motion (eg, the inversion velocity), unlike traditional passive concepts of ankle bracing.
Purpose:
To compare the performance of a novel adaptive brace with 2 passive ankle braces while considering protection, sports performance, freedom of motion, and subjective perception.
Study Design:
Controlled laboratory study.
Methods:
The authors analyzed 1 adaptive and 2 passive (one lace-up and one rigid brace) ankle braces, worn in a low-cut, indoor sports shoe, which was also the no-brace reference condition. We performed material testing using an artificial ankle joint system at high and low inversion velocities. Further, 20 male, young, healthy team sports athletes were analyzed using 3-dimensional motion analysis in sports-related movements to address protection, sports performance, and active range of motion dimensions. Participants rated subjective comfort, stability, and restriction experienced when using the products.
Results:
Subjective stability rating was not different between the adaptive and passive systems. The rigid brace was superior in restricting peak inversion during the biomechanical testing compared with the passive braces. However, in the material test, the adaptive brace increased its stiffness by approximately 400% during the fast compared with the slow inversion velocities, demonstrating its adaptive behavior and similar stiffness values to passive braces. We identified minor differences in sports performance tasks. The adaptive brace improved active ankle range of motion and subjective comfort and restriction ratings.
Conclusion:
The adaptive brace offered similar protective effects in high-velocity inversion situations to those of the passive braces while improving range of motion, comfort, and restriction rating during noninjurious motions.
Clinical Relevance:
Protection systems are only effective when used. Compared with traditional passive ankle brace technologies, the novel adaptive brace might increase user compliance by improving comfort and freedom of movement while offering similar protection in injurious situations.
The purpose of this study was to describe the effects of running speed and slope on metatarsophalangeal (MTP) joint kinematics. 22 male and female runners underwent 3D motion analysis on an instrumented treadmill at three different speeds (2.5 m/s, 3.0 m/s, 3.5 m/s). At each speed, participants ran at seven slope conditions (downhill: -15%, -10%, -5%, level, and uphill: +5%, +10%, +15%). We found a significant main effect (p < 0.001) of running speed and slope on peak MTP dorsiflexion and a running speed by slope interaction effect (p < 0.001) for peak MTP dorsiflexion velocity. These findings highlight the need to consider running intensity and environmental factors like running surface inclination when considering MTP joint mechanics and technological aids to support runners.
Background: Many countries have restricted public life in order to contain the spread of the novel coronavirus (SARS-CoV2). As a side effect of related measures, physical activity (PA) levels may have decreased.
Objective: We aimed (1) to quantify changes in PA and (2) to identify variables potentially predicting PA reductions.
Methods: A systematic review with random-effects multilevel meta-analysis was performed, pooling the standardized mean differences in PA measures before and during public life restrictions.
Results: A total of 173 trials with moderate methodological quality (modified Downs and Black checklist) were identified. Compared to pre-pandemic, total PA (SMD − 0.65, 95% CI − 1.10 to − 0.21) and walking (SMD − 0.52, 95% CI − 0.29 to − 0.76) decreased while sedentary behavior increased (SMD 0.91, 95% CI: 0.17 to 1.65). Reductions in PA affected all intensities (light: SMD − 0.35, 95% CI − 0.09 to − 0.61, p = .013; moderate: SMD − 0.33, 95% CI − 0.02 to − 0.6; vigorous: SMD − 0.33, − 0.08 to − 0.58, 95% CI − 0.08 to − 0.58) to a similar degree. Moderator analyses revealed no influence of variables such as sex, age, body mass index, or health status. However, the only continent without a PA reduction was Australia and cross-sectional trials yielded higher effect sizes (p < .05).
Conclusion: Public life restrictions associated with the COVID-19 pandemic resulted in moderate reductions in PA levels and large increases in sedentary behavior. Health professionals and policy makers should therefore join forces to develop strategies counteracting the adverse effects of inactivity.