A pilot study testing an Achilles tendinopathy human cadaver model using intratendinous injection of collagenase.

Background: Achilles tendinopathy is one of the most frequently occurring soft-tissue injuries. Despite decades of research, there is still much that is unknown about the progression of tendinopathy. Animal models, such as collagenase injection, allow researchers to gain insight into disease progression and investigate clinical interventions, yet are limited in their direct application to humans.

Using Inertial Measurement Unit Sensor Single Axis Rotation Angles for Knee and Hip Flexion Angle Calculations During Gait.

Background: Hip and knee flexion joint motions are frequently examined in clinical practice using camera based motion capture (CBMC) systems; however, these systems require elaborate setups and dedicated space. Inertial measurement unit (IMU) based systems avoid these disadvantages but require validation before widespread adoption. Moreover, it is important for clinical practice to determine the stability of these systems for prolonged evaluation periods.

Differences between adults and adolescents in responding to hip and knee pattern feedback during gait.

Visual feedback techniques have shown potential in interventions aiming to retrain deviated gait patterns. Understanding the abilities of different age groups to modify their gait is needed to optimize interventions. Twelve adults (6F, 6 M; 26.

Feasibility of a real-time pattern-based kinematic feedback system for gait retraining in pediatric cerebral palsy.

Introduction: Visual biofeedback of lower extremity kinematics has the potential to enhance retraining of pathological gait patterns. We describe a system that uses wearable inertial measurement units to provide kinematic feedback on error measures generated during periods of gait in which the knee is predominantly extended ('extension period') and flexed ('flexion period').

Methods: We describe the principles of operation of the system, a validation study on the inertial measurement unit derived knee flexion angle on which the system is based, and a feasibility study to assess the ability of a child with cerebral palsy to modify a gait deviation (decreased swing phase knee flexion) in response to the feedback.

Dynamic Margins of Stability During Robot-Assisted Walking in Able-Bodied Individuals: A Preliminary Study.

Gait analysis studies during robot-assisted walking have been predominantly focused on lower limb biomechanics. During robot-assisted walking, the users' interaction with the robot and their adaptations translate into altered gait mechanics. Hence, robust and objective metrics for quantifying walking performance during robot-assisted gait are especially relevant as it relates to dynamic stability.

Visual kinematic feedback enhances the execution of a novel knee flexion gait pattern in children and adolescents.

Background: Altered knee motion is one of the most common gait deviations in pediatric populations with gait disorders. The potential for pediatric gait retraining using visual feedback based on knee kinematic patterns is under-explored.

Research Question: This study investigated whether pediatric participants could successfully modify knee flexion patterns in response to a visual kinematic feedback system (VKFS).

Mechanisms for improving walking speed after longitudinal powered robotic exoskeleton training for individuals with spinal cord injury.

The goal of this study was to establish strideparameter gait models correlated to speed on individuals with chronic SCI and able-bodied controls walking with a powered robotic exoskeleton (EksoGT $^{\mathrm{ TM}}$). Longitudinal exoskeleton training $( >100$ hours) across eight individuals with SCI resulted in a 30% increase in walking speed. A simple linear regression between step length, stride length for given speed were very tightly correlated along a line of best fit $( \mathrm {p}<$.

Kinematics and pushrim kinetics in adolescents propelling high-strength lightweight and ultra-lightweight manual wheelchairs.

Purpose: The purpose of this study is to describe and compare pushrim forces, propulsive work cost, and upper body kinematics in adolescents propelling (1) a standard high strength lightweight wheelchair, and (2) an ultra-lightweight wheelchair with adjustable main axle positioning, on a level tiled floor ("Tile"), ascending a ramp ("Ramp"), and across a foam mat ("Mat").

Methods: A within-subjects repeated measures study design was used. Eight adolescent manual wheelchair users propelled the standard and ultra-lightweight wheelchairs across the three conditions.

Upright Magnetic Resonance Imaging Tasks in the Knee Osteoarthritis Population: Relationships Between Knee Flexion Angle, Self-Reported Pain, and Performance.

Objective: To characterize the ability of patients with symptomatic knee osteoarthritis (OA) to perform a weight-bearing activity compatible with upright magnetic resonance imaging (MRI) scanning and how this ability is affected by knee pain symptoms and flexion angles.

Design: Cross-sectional observational study assessing effects of knee flexion angle, pain level, and study sequence on accuracy and duration of performing a task used in weight-bearing MRI evaluation. Visual feedback of knee position from an MRI compatible sensor was provided.

American Society of Biomechanics Clinical Biomechanics Award 2013: tibiofemoral contact location changes associated with lateral heel wedging--a weight bearing MRI study.

Background: Vertically open magnetic resonance imaging permits study of knee joint contact during weight bearing. Lateral wedging is a low cost intervention for knee osteoarthritis that may influence load distribution and contact. This study assessed the ability of feedback-assisted weight bearing magnetic resonance imaging to detect changes in tibiofemoral contact associated with lateral wedging.

Paretic muscle atrophy and non-contractile tissue content in individual muscles of the post-stroke lower extremity.

Muscle atrophy is one of many factors contributing to post-stroke hemiparetic weakness. Since muscle force is a function of muscle size, the amount of muscle atrophy an individual muscle undergoes has implications for its overall force-generating capability post-stroke. In this study, post-stroke atrophy was determined bilaterally in fifteen leg muscles with volumes quantified using magnetic resonance imaging (MRI).

Cross-correlations of center of mass and center of pressure displacements reveal multiple balance strategies in response to sinusoidal platform perturbations.

Compared to static balance, dynamic balance requires a more complex strategy that goes beyond keeping the center of mass (COM) within the base of support, as established by the range of foot center of pressure (COP) displacement. Instead, neuromechanics must accommodate changing support conditions and inertial effects. Therefore, because they represent body's position and changes in applied moments, relative COM and COP displacements may also reveal dynamic postural strategies.

Comparison of MRI-based estimates of articular cartilage contact area in the tibiofemoral joint.

Knee osteoarthritis (OA) detrimentally impacts the lives of millions of older Americans through pain and decreased functional ability. Unfortunately, the pathomechanics and associated deviations from joint homeostasis that OA patients experience are not well understood. Alterations in mechanical stress in the knee joint may play an essential role in OA; however, existing literature in this area is limited.

Time course of quad strength, area, and activation after knee arthroplasty and strength training.

Introduction: changes in strength, activation, and morphology of the quadriceps femoris muscle group were assessed in 61 individuals that underwent unilateral total knee arthroplasty, with progressive postoperative strength training, for primary knee osteoarthritis.

Methods: assessments of these three parameters were made at four time points (preoperatively and 4, 12, and 52 wk postoperatively). Maximal voluntary knee extension strength was recorded using an electromechanical dynamometer, and voluntary muscle activation was measured using a burst superimposition technique.

Mechanisms underlying quadriceps weakness in knee osteoarthritis.

Purpose: To identify determinants of quadriceps weakness among persons with end-stage knee osteoarthritis (OA).

Methods: One-hundred twenty-three individuals (mean age 64.9 +/- 8.

Do ACL-injured copers exhibit differences in knee kinematics?: An MRI study.

Kinematic changes after anterior cruciate ligament (ACL) injury may play a role in the long-term development of osteoarthritis (OA). Some ACL-injured patients (copers) successfully return to demanding activities without the reconstructive surgery usually recommended for functionally unstable patients (noncopers). We determined whether copers exhibit less disruption to kinematics than noncopers, perhaps because of lower impairment of muscular control as observed in earlier studies.

Altered knee kinematics in ACL-deficient non-copers: a comparison using dynamic MRI.

Kinematics measured during a short arc quadriceps knee extension exercise were compared in the knees of functionally unstable ACL-deficient patients, these patients' uninjured knees, and uninjured control subjects' knees. Cine phase contrast dynamic magnetic resonance imaging, in combination with a model-based tracking algorithm developed by the authors, was used to measure tibiofemoral kinematics as the subjects performed the active, supine posture knee extension exercise in the terminal 30 degrees of motion. Two determinants of tibiofemoral motion were measured: anterior/posterior location of the tibia relative to the femur, and axial rotation of the tibia relative to the femur.

Lower extremity muscle morphology in young athletes: an MRI-based analysis.

Purpose: This study was conducted to describe lower extremity muscle morphology (volume and peak cross-sectional area (CSA)) in young athletes and compare these with previously reported values. A second aim was to determine if muscle morphological values differ significantly between sides, implying that unilateral measurements cannot represent both limbs accurately.

Methods: Axial spin-echo T1-weighted magnetic resonance (MR) images were obtained between the ankle mortise and iliac crest in 10 athletes (age 18.

A method for measurement of joint kinematics in vivo by registration of 3-D geometric models with cine phase contrast magnetic resonance imaging data.

A new method is presented for measuring joint kinematics by optimally matching modeled trajectories of geometric surface models of bones with cine phase contrast (cine-PC) magnetic resonance imaging data. The incorporation of the geometric bone models (GBMs) allows computation of kinematics based on coordinate systems placed relative to full 3-D anatomy, as well as quantification of changes in articular contact locations and relative velocities during dynamic motion. These capabilities are additional to those of cine-PC based techniques that have been used previously to measure joint kinematics during activity.

Neuromuscular function after anterior cruciate ligament reconstruction with autologous semitendinosus-gracilis graft.

Background: The quadrupled autologous semitendinosus-gracilis graft is the first choice of many orthopaedic surgeons when reconstructing the anterior cruciate ligament. The effect that this procedure has on voluntary muscle control remains unclear. The purpose of this study was to evaluate the effect that anterior cruciate ligament reconstruction with autologous semitendinosus-gracilis graft has on voluntary muscle control by assessing subjects' specificity of muscle action.

Quadriceps weakness, atrophy, and activation failure in predicted noncopers after anterior cruciate ligament injury.

Background: Quadriceps weakness is common after anterior cruciate ligament injury, especially in those who do not compensate well for the injury ("noncopers"). Both atrophy and activation failure have been demonstrated in this population but have not been directly related to quadriceps weakness.

Hypotheses: (1) Quadriceps strength, volumes, and cross-sectional areas of the noncopers would be smaller than those of the contralateral muscles, whereas other muscles would not demonstrate atrophy.

Quadriceps femoris muscle morphology and function after ACL injury: a differential response in copers versus non-copers.

The morphology (volume and peak cross-sectional area) and voluntary muscle control of 27 athletic people were evaluated with magnetic resonance imaging (MRI) and an established method of testing neuromuscular control in order to explain why some people are able to cope with anterior cruciate ligament (ACL) injury (copers), whereas most cannot (non-copers). Axial spin-echo T1 weighted MRI images were acquired from the level of the ankle mortise to the iliac crest. The subjects' quadriceps, hamstrings, and gastrocnemius muscles were digitally reconstructed from the MRI images.

Muscle and tendon morphology after reconstruction of the anterior cruciate ligament with autologous semitendinosus-gracilis graft.

Background: The autologous semitendinosus-gracilis graft is the first choice of many orthopaedic surgeons when reconstructing the anterior cruciate ligament. The effect that graft harvest has on muscle and tendon morphology remains unclear. The purpose of this study was to describe these effects more completely.

Altered quadriceps control in people with anterior cruciate ligament deficiency.

Purpose: The purpose of this study was to determine whether similar patterns of quadriceps dysfunction are observed when people with anterior cruciate ligament (ACL) deficiency perform static and dynamic tasks.

Methods: EMG data were collected from 15 subjects with an ACL deficient knee and 15 uninjured subjects as they performed static and dynamic tasks that were isolated to the knee and presented no threat to joint stability. The dynamic task was cyclic flexion and extension in the terminal 30 degrees of knee extension; the static task was an established isometric target-matching protocol.

Specificity of muscle action after anterior cruciate ligament injury.

Neuromuscular control is believed to be a critical factor in dynamic knee stability. The purpose of this study was to evaluate voluntary muscle control in anterior cruciate ligament deficient (ACL-D) and uninjured people. Twenty athletes of similar age participated in this study.