Disparities Between Rural and Urban Communities: Response to 18 Months of Diet and Exercise Versus Control for Knee Osteoarthritis and Overweight or Obesity.

Objective: The study objective was to determine whether the clinical response of older adults with knee osteoarthritis and overweight or obesity to 18 months of diet and exercise (D + E) or attention control (C) interventions differed between participants from rural versus urban communities.

Methods: Participants were 823 older adults (mean age, 64.6 years; 77% women) with knee osteoarthritis and overweight or obesity who resided in rural (n = 410) and urban (n = 413) counties in North Carolina.

The association between obesity, knee pain, and gait during stair descent in older adults with knee osteoarthritis.

Background: Obesity and knee osteoarthritis adversely affect activities of daily living in older adults. Together, the complexities of their interaction on mobility, including stair negotiation, are unresolved. The purpose of this study was to determine the relationship between obesity, pain, and stair negotiation in older adults with knee osteoarthritis.

Cost-Effectiveness of Community-Based Diet and Exercise for Patients with Knee Osteoarthritis and Obesity or Overweight.

Objective: Obesity exacerbates pain and functional limitation in persons with knee osteoarthritis (OA). In the Weight Loss and Exercise for Communities with Arthritis in North Carolina (WE-CAN) study, a community-based diet and exercise (D + E) intervention led to an additional 6 kg weight loss and 20% greater pain relief in persons with knee OA and body mass index (BMI) >27 kg/m relative to a group-based health education (HE) intervention. We sought to determine the incremental cost-effectiveness of the usual care (UC), UC + HE, and UC + (D + E) programs, comparing each strategy with the "next-best" strategy ranked by increasing lifetime cost.

Gender differences on the age-related distal-to-proximal shift in joint kinetics during running.

The increased running participation in women and men over 40 years has contributed to scientific interest on the age-related and gender differences in running performance and biomechanics over the last decade. Gender differences in running biomechanics have been studied extensively in young runners, with inconsistent results. Understanding how gender influences the age-related differences in running mechanics could help develop population-specific training interventions or footwear to address any potential different mechanical demands.

Clinical, Health-Related Quality of Life, and Gait Differences Among Obesity Classes in Adults With Knee Osteoarthritis.

Objective: The purpose of this study was to determine whether clinical, health-related quality of life (HRQL), and gait characteristics in adults with knee osteoarthritis (OA) differed by obesity category.

Methods: This cross-sectional analysis of 823 older adults (mean age 64.6 years, SD 7.

Tibiofemoral Load Magnitude and Distribution During Load Carriage.

Chronic exposure to high tibiofemoral joint (TFJ) contact forces can be detrimental to knee joint health. Load carriage increases TFJ contact forces, but it is unclear whether medial and lateral tibiofemoral compartments respond similarly to incremental load carriage. The purpose of our study was to compare TFJ contact forces when walking with 15% and 30% added body weight.

Effect of Diet and Exercise on Knee Pain in Patients With Osteoarthritis and Overweight or Obesity: A Randomized Clinical Trial.

Importance: Some weight loss and exercise programs that have been successful in academic center-based trials have not been evaluated in community settings.

Objective: To determine whether adaptation of a diet and exercise intervention to community settings resulted in a statistically significant reduction in pain, compared with an attention control group, at 18-month follow-up.

Design, Setting, And Participants: Assessor-blinded randomized clinical trial conducted in community settings in urban and rural counties in North Carolina.

Differences in Muscle Demand and Joint Contact Forces Between Running and Skipping.

Skipping has been proposed as a viable cross-training exercise to running due to its lower knee contact forces and higher whole-body energy expenditure. However, how individual muscle forces, energy expenditure, and joint loading are affected by differences in running and skipping mechanics remains unclear. The purpose of this study was to compare individual muscle forces, energy expenditure, and lower extremity joint contact forces between running and skipping using musculoskeletal modeling and simulations of young adults (n = 5) performing running and skipping at 2.

The Feasibility of Using the Virtual Time-to-Contact Measure of Postural Stability to Examine Postural Recovery in People With Diabetes Mellitus.

This study aimed to examine the feasibility of using time-to-contact measures during the perturbation protocol in people with diabetes mellitus. Three-dimension motion capture and force data were collected during 0.5-s perturbations in four directions (forward, backward, right, and left) and at two accelerations (20 and 40 cm/s2) to compute the time-to-contact.

Quantifying national biomechanics day's impact on student perceptions toward biomechanics: A multisite pilot study.

National Biomechanics Day (NBD) is an international celebration of biomechanics that seeks to increase the awareness and appreciation of biomechanics among the high school community. Initial research supports the positive effects of NBD on students' attitudes toward the field of biomechanics; however, quantitative evidence remains scarce. The purpose of this study was to quantify changes in high school students' perceptions toward biomechanics after participating in NBD events to better understand the impact of NBD.

Changes in Body Weight and Knee Pain in Adults With Knee Osteoarthritis Three-and-a-Half Years After Completing Diet and Exercise Interventions: Follow-Up Study for a Single-Blind, Single-Center, Randomized Controlled Trial.

Objective: To determine whether long-term diet (D) and exercise (E) interventions, alone or in combination (D+E), have beneficial effects for older adults with knee osteoarthritis (OA) 3.5 years after the interventions end.

Methods: This is a secondary analysis of a subset (n = 94) of the first 184 participants who had successfully completed the Intensive Diet and Exercise in Arthritis (IDEA) trial (n = 399) and who consented to follow-up testing.

Age does not affect the relationship between muscle activation and joint work during incline and decline walking.

Older compared with younger adults walk with different configurations of mechanical joint work and greater muscle activation but it is unclear if age, walking speed, and slope would each affect the relationship between muscle activation and net joint work. We hypothesized that a unit increase in positive but not negative net joint work requires greater muscle activation in older compared with younger adults. Healthy younger (age: 22.

Severity of Overuse Injury Impacts Self-Efficacy and Quality of Life in Runners: A 2-Year Prospective Cohort Study.

Context: While 55 million Americans incorporate running into their exercise routines, up to 65% of runners sustain an overuse injury annually. It has been consistently shown that regular physical activity positively impacts quality of life (QOL), an essential public health indicator; however, the impact of running-related injuries on QOL is unknown. This study seeks to determine whether overuse injury severity impacts QOL in recreational runners, and if self-efficacy mediates this relationship.

Effect of High-Intensity Strength Training on Knee Pain and Knee Joint Compressive Forces Among Adults With Knee Osteoarthritis: The START Randomized Clinical Trial.

Importance: Thigh muscle weakness is associated with knee discomfort and osteoarthritis disease progression. Little is known about the efficacy of high-intensity strength training in patients with knee osteoarthritis or whether it may worsen knee symptoms.

Objective: To determine whether high-intensity strength training reduces knee pain and knee joint compressive forces more than low-intensity strength training and more than attention control in patients with knee osteoarthritis.

Age and training volume influence joint kinetics during running.

Recently, we proposed the hypothesis that weekly running volume and preferred running pace may play a role in preserving ankle joint kinetics in middle-age runners as ankle joint kinetics were generally similar in young and middle-aged runners with similar running volume and preferred pace. To further address this hypothesis, we compared lower extremity joint kinetics between high and low training volume runners in both young and middle-aged groups. Joint kinetics calculated from 3D kinematic and ground reaction force data during over-ground running at 2.

Lower Limb Joint Kinetics During Walking in Middle-Aged Runners With Low or High Lifetime Running Exposure.

Aging is associated with a distal-to-proximal shift in joint kinetics during walking. This plasticity of gait is amplified rather than attenuated in old adults with high physical capacity. Because running is associated with greater kinetic demands at the ankle, older individuals with more versus less lifetime running exposure may retain a larger proportion of their ankle kinetics.

The effects of intensive dietary weight loss and exercise on gait in overweight and obese adults with knee osteoarthritis. The Intensive Diet and Exercise for Arthritis (IDEA) trial.

The Intensive Diet and Exercise for Arthritis (IDEA) trial was an 18-month randomized controlled trial that enrolled 454 overweight and obese older adults with symptomatic and radiographic knee osteoarthritis (OA). Participants were randomized to either exercise (E), intensive diet-induced weight loss (D), or intensive diet-induced weight loss plus exercise (D + E) interventions. We previously reported that the clinical benefits of D + E were significantly greater than with either intervention alone (e.

How age and surface inclination affect joint moment strategies to accelerate and decelerate individual leg joints during walking.

A joint moment also causes motion at other joints of the body. This joint coupling-perspective allows more insight into two age-related phenomena during gait. First, whether increased hip kinetic output compensates for decreased ankle kinetic output during positive joint work.

Skipping has lower knee joint contact forces and higher metabolic cost compared to running.

Background: The health benefits of running based exercise programs are plentiful however the high rate of injury in these programs often reduces or eliminates exercise participation. Skipping has shorter steps, reduced vertical ground reaction forces (GRFs), and lower knee extensor torques, compared to running forming the basis of the present hypothesis that skipping would have lower tibio-femoral and patello-femoral joint contact forces.

Research Question: The purpose of this study was to compare knee contact forces between skipping and running at the same speed.

The Internationalization of National Biomechanics Day.

National Biomechanics Day (NBD) was initiated in 2016 as a nation-wide effort to introduce Biomechanics to high school students throughout the United States. After that initial year, many people around the world joined NBD to promote Biomechanics in their own countries. National Biomechanics Day became international.

Effects of Load Carriage and Step Length Manipulation on Achilles Tendon and Knee Loads.

Introduction: Longer steps with load carriage is common in shorter Soldiers when matching pace with taller Soldiers whereas shorter steps are hypothesized to reduce risk of injury with load carriage. The effects of load carriage with and without step length manipulation on loading patterns of three commonly injured structures were determined: Achilles tendon, patellofemoral joint (PFJ) and medial tibiofemoral joint (mTFJ).

Materials And Methods: ROTC Cadets (n = 16; 20.

Advanced Age Redistributes Positive but Not Negative Leg Joint Work during Walking.

Introduction: Advanced age brings a distal-to-proximal redistribution of positive joint work during walking that is relevant to walking performance and economy. It is unclear whether negative joint work is similarly redistributed in old age. Negative work can affect positive work through elastic energy return in gait.

Quadriceps-strengthening exercise and quadriceps and knee biomechanics during walking in knee osteoarthritis: A two-centre randomized controlled trial.

Objective: To assess the effect of quadriceps strengthening on quadriceps muscle force, power, and work and tibio-femoral compressive loads during walking in adults with knee osteoarthritis.

Methods: Study design: Two-center, randomized, controlled trial.

Intervention: Patients with knee osteoarthritis were randomly allocated to quadriceps strengthening program (3 times weekly) or no attention control group.