Multimodal Diagnostic Approaches to Advance Precision Medicine in Sarcopenia and Frailty.

Sarcopenia, defined as the loss of muscle mass, strength, and function with aging, is a geriatric syndrome with important implications for patients and healthcare systems. Sarcopenia increases the risk of clinical decompensation when faced with physiological stressors and increases vulnerability, termed frailty. Sarcopenia develops due to inflammatory, hormonal, and myocellular changes in response to physiological and pathological aging, which promote progressive gains in fat mass and loss of lean mass and muscle strength.

Sensor-Based Gait Retraining Lowers Knee Adduction Moment and Improves Symptoms in Patients with Knee Osteoarthritis: A Randomized Controlled Trial.

The present study compared the effect between walking exercise and a newly developed sensor-based gait retraining on the peaks of knee adduction moment (KAM), knee adduction angular impulse (KAAI), knee flexion moment (KFM) and symptoms and functions in patients with early medial knee osteoarthritis (OA). Eligible participants ( = 71) with early medial knee OA (Kellgren-Lawrence grade I or II) were randomized to either walking exercise or gait retraining group. Knee loading-related parameters including KAM, KAAI and KFM were measured before and after 6-week gait retraining.

How do training experience and geographical origin of a runner affect running biomechanics?

Background: Several studies compared African runners with runners from other places with difference ethnicities to identify biomechanical factors that may contribute to their extraordinary running performance. However, most studies only assessed runners at the elite level. Whether the performance difference was a result of nature or nurture remains unclear.

Right Temporal Oscillations of Infants in Relation to Contingent Learning.

Contingent learning is an agent for infants to explore the environment, which enhances the maturation of different developmental domains. This paper presents one of the first to investigate neural activities related to contingent learning of infants by analyzing their motor response that could elicit an audio-visual feedback. Three different kinds of motor response of infants were investigated, including unilateral kicks, synchronized kicks, and alternate kicks.

Plasticity of muscle synergies through fractionation and merging during development and training of human runners.

Complex motor commands for human locomotion are generated through the combination of motor modules representable as muscle synergies. Recent data have argued that muscle synergies are inborn or determined early in life, but development of the neuro-musculoskeletal system and acquisition of new skills may demand fine-tuning or reshaping of the early synergies. We seek to understand how locomotor synergies change during development and training by studying the synergies for running in preschoolers and diverse adults from sedentary subjects to elite marathoners, totaling 63 subjects assessed over 100 sessions.

Difference in the running biomechanics between preschoolers and adults.

Background: High vertical loading rate is associated with a variety of running-related musculoskeletal injuries. There is evidence supporting that non-rearfoot footstrike pattern, greater cadence, and shorter stride length may reduce the vertical loading rate. These features appear to be common among preschoolers, who seem to experience lower running injury incidence, leading to a debate whether adults should accordingly modify their running form.

Bilateral asymmetry of running gait in competitive, recreational and novice runners at different speeds.

The mechanisms and underlying causes of bilateral asymmetry among healthy runners of different levels remain unclear. This cross-sectional laboratory study aimed to investigate the effects of running speed and running experience or competitive level on bilateral symmetry during running. Eleven competitive runners, 9 recreational runners and 11 novice runners were recruited in this study.

Real-Time Estimation of Knee Adduction Moment for Gait Retraining in Patients With Knee Osteoarthritis.

Previous clinical studies have reported that gait retraining is an effective non-invasive intervention for patients with medial compartment knee osteoarthritis. These gait retraining programs often target a reduction in the knee adduction moment (KAM), which is a commonly used surrogate marker to estimate the loading in the medial compartment of the tibiofemoral joint. However, conventional evaluation of KAM requires complex and costly equipment for motion capture and force measurement.

The effects of midfoot strike gait retraining on impact loading and joint stiffness.

Objective: To assess the biomechanical changes following a systematic gait retraining to modify footstrike patterns from rearfoot strike (RFS) to midfoot strike (MFS).

Design: Pre-post interventional study. All participants underwent a gait retraining program designed to modify footstrike pattern to MFS.

Walking with head-mounted virtual and augmented reality devices: Effects on position control and gait biomechanics.

What was once a science fiction fantasy, virtual reality (VR) technology has evolved and come a long way. Together with augmented reality (AR) technology, these simulations of an alternative environment have been incorporated into rehabilitation treatments. The introduction of head-mounted displays has made VR/AR devices more intuitive and compact, and no longer limited to upper-limb rehabilitation.

Running biomechanics before and after Pose® method gait retraining in distance runners.

Pose® Method gait retraining has been claimed to modify running form and prevent injury. This study examined the running biomechanics before and after Pose® Method gait retraining. Fourteen runners underwent a 4-week Pose® Method gait retraining program delivered by a certified coach.

Neurophysiological Correlates of Gait Retraining With Real-Time Visual and Auditory Feedback.

Most people acquire motor skills through feedback-based training. How the human brain processes sensory feedbacks during training, especially in a gait training, remain largely unclear. The purpose of this paper is to explore how humans adopt a new gait pattern to reduce impacts during walking-with the aid of visual and audio feedbacks.

Transfer Learning Effects of Biofeedback Running Retraining in Untrained Conditions.

Purpose: Running gait retraining via peak tibial shock biofeedback has been previously shown to reduce impact loading and mitigate running-related symptoms. In previous research, peak tibial shock is typically measured and trained for one limb at a single constant training speed during all training sessions. The goal of this study was to determine how runners transfer learning in the trained limb to the untrained limb at different unconstrained speeds.

Shoe-mounted accelerometers should be used with caution in gait retraining.

Real-time biofeedback gait retraining has been reported to be an effective intervention to lower the impact loading during gait. While many of the previous gait retraining studies have utilized a laboratory-based setup, some studies used accelerometers affixed at the distal tibia to allow training outside the laboratory environment. However, many commercial sensors for gait modification are shoe-mounted.

Can runners maintain a newly learned gait pattern outside a laboratory environment following gait retraining?

Background: Previous peak tibial shock gait retraining programs, which were usually conducted on a treadmill, were reported to be effective on impact loading reduction in runners. However, whether the trained runners can translate the training effect at different running modes (treadmill/overground), or running slopes (uphill/downhill), remains unknown.

Research Question: Is the training effect from a treadmill-based gait retraining translatable to unconstrained running conditions, including overground and uphill/downhill running?

Methods: The peak tibial shock was measured during treadmill/overground running, as well as level/uphill/downhill running before and after a course of treadmill-based gait retraining.

Impact Loading During Distracted Running Before and After Auditory Gait Retraining.

Visual feedback gait retraining has been reported to successfully reduce impact loading in runners, even when the runners were distracted. However, auditory feedback is more feasible in real life application. Hence, this study compared the peak positive acceleration (PPA), vertical average (VALR) and instantaneous (VILR) loading rate during distracted running before and after a course of auditory feedback gait retraining in 16 runners.

Effects of footwear midsole thickness on running biomechanics.

Shoe manufacturers launch running shoes with increased (e.g., maximalists) or decreased (e.

Type effect of inhibitory KT tape on measured vs. perceived maximal grip strength.

This study examined the effects of KT tape (KT) applied in an inhibitory manner on muscle activity, measured maximal grip strength, and perceived maximal grip strength in regular KT-users and non-users. This study was a single-blinded crossover study with sixty participants including 27 kT-users and 33 non-users. Participants underwent maximal grip strength tests with and without inhibitory KT applied across the wrist extensors.

Biomechanical Outcomes Due to Impact Loading in Runners While Looking Sideways.

A stable gaze is necessary to optimize visual conditions during running. Head accelerations generally remain stable when looking in front; however, it is unclear if this response is similar when the head is turned sideways, and whether other adaptive strategies are present to maintain this stability. The purpose of this study, therefore, was to examine whether runners maintained stable head accelerations while gazing at fixed targets in front and to their sides.

Does maximalist footwear lower impact loading during level ground and downhill running?

A new model of running shoes which features an extreme cushioning and an oversized midsole, known as the maximalist (MAX) was launched. This design claims to provide excellent shock absorption, particularly during downhill running. This study sought to assess the effects of MAX on the external impact loading, footstrike pattern, and stride length during level ground and downhill running on an instrumented treadmill.

Placebo effect of facilitatory Kinesio tape on muscle activity and muscle strength.

Purpose: Kinesio tape (KT) is claimed to be able to facilitate muscle activation and promote muscle strength. Previous studies have proposed that placebo effect could be a major attributing factor. This study sought to compare the effects of facilitatory KT on muscle activity and performance between regular KT-users and non-users.

Control of impact loading during distracted running before and after gait retraining in runners.

Gait retraining using visual biofeedback has been reported to reduce impact loading in runners. However, most of the previous studies did not adequately examine the level of motor learning after training, as the modified gait pattern was not tested in a dual-task condition. Hence, this study sought to compare the landing peak positive acceleration (PPA) and vertical loading rates during distracted running before and after gait retraining.

Gait Retraining for the Reduction of Injury Occurrence in Novice Distance Runners: 1-Year Follow-up of a Randomized Controlled Trial.

Background: The increasing popularity of distance running has been accompanied by an increase in running-related injuries, such that up to 85% of novice runners incur an injury in a given year. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with many running ailments. However, softer footfalls may not necessarily prevent running injury.

Measurement agreement between a newly developed sensing insole and traditional laboratory-based method for footstrike pattern detection in runners.

This study introduced a novel but simple method to continuously measure footstrike patterns in runners using inexpensive force sensors. Two force sensing resistors were firmly affixed at the heel and second toe of both insoles to collect the time signal of foot contact. A total of 109 healthy young adults (42 males and 67 females) were recruited in this study.

Immediate and short-term biomechanical adaptation of habitual barefoot runners who start shod running.

This study investigated the immediate and short-term effects of minimalist shoes (MS) and traditional running shoes (TRS) on vertical loading rates, foot strike pattern and lower limb kinematics in a group of habitual barefoot runners. Twelve habitual barefoot runners were randomly given a pair of MS or TRS and were asked to run with the prescribed shoes for 1 month. Outcome variables were obtained before, immediate after and 1 month after shoe prescription.