Biomechanics

Background: Cluster sets (CSs) maintain velocity and power in compound movements by employing similar propulsion strategies or maintaining impulse through different mechanisms. This study aimed to explore the effect of four CS conditions on back squat (BS) propulsion and provide models for estimating changes in propulsion based on repetition and set number. Methods: Twenty male participants (age = 28.3 ± 3.1 years, stature = 1.74 ± 8.21 m, body mass = 84.80 ± 7.80 kg, BS 1RM = 140.90 ± 24.20 kg) completed four data collection sessions. Each session consisted of three sets of five repetitions at 80% 1RM BS with three minutes of unloaded inter-set rest, using varying intra-set rest intervals. Experimental conditions included 0 s (TRAD), 10 s (CS10), 20 s (CS20), and 30 s (CS30) inter-repetition rest, randomly assigned to sessions in a counterbalanced order. Ground reaction force data were collected on dual force platforms sampling at 1000 Hz, from which net propulsive impulse (J_PROP), mean force (MF), and propulsion time (t_PROP) were calculated. Conditions and sets were analysed using a 4 × 3 (CONDITION*SET) repeated-measures ANOVA to assess differences between conditions and sets, and linear mixed models (LMMs) were used to provide regression equations for each dependent variable in each condition. Results: The ANOVA revealed no significant interactions for any dependent variable. No main effects of CONDITION or SET were observed for J_PROP. The main effects of CONDITION showed that MF was significantly lower in TRAD than CS20 (g = 0.757) and CS30 (g = 0.749). t_PROP was significantly higher in TRAD than CS20 (g = 0.437) and CS30 (g = 0.569). The main effects of SET showed that MF was significantly lower in S2 (g = 0.691) and S3 (g = 1.087) compared to S1. t_PROP was significantly higher in S2 (g = 0.866) and S3 (g = 1.179) compared to S1. LMMs for CS20 and CS30 revealed no significant effect (p > 0.05) between repetition or set number and dependent variables. Conclusions: The results suggest that CS20 and CS30 maintain J_PROP by limiting MF and t_PROP attenuation. This is less rest than that suggested by the previous literature, which may influence programming decisions during strength and power mesocycles to maximise training time and training density. LMMs provide accurate estimates of BS propulsive force attenuation when separating repetitions by up to 30 s, which may help practitioners optimise training load for long-term adaptations. Full article

Background/Objectives: this study describes the development of a novel three-dimensional electrogoniometer for the quantitative assessment of knee mobility and stability during gait. The primary objective is to determine whether real-time measurements obtained during dynamic activity provide more clinically relevant information than traditional static assessments. Methods: the device employs angular position encoders to capture knee joint kinematics—specifically flexion, extension, rotation, and tibial translation—during locomotion. Data are transmitted in real time to an Android-based application, enabling immediate graphical visualization. A descriptive observational study was conducted involving healthy participants and individuals with anterior cruciate ligament (ACL) injuries to evaluate the device’s performance. Results: results showed that the electrogoniometer captured knee flexion-extension with a range of up to 90°, compared to 45° typically recorded using conventional systems. The device also demonstrated enhanced sensitivity in detecting variations in tibial translation during gait cycles. Conclusions: this electrogoniometer provides a practical tool for clinical assessment of knee function, enabling real-time monitoring of joint behavior during gait. By capturing functional mobility and stability more accurately than static methods, it may enhance diagnostic precision and support more effective rehabilitation planning in orthopedic settings. Full article

Multiple-hops performed horizontally in series effectively assess return-to-play readiness, as they mimic the propulsive and decelerative demands of sports. Movement strategy variables (kinetic variables) offer more insight into injury recovery than outcome-based measures (kinematic variables) like hop distance alone. This study focused on kinematic and kinetic variables to assess asymmetries during triple-hop (3-Hop) and quintuple-hop (5-Hop) tests with 44 male athletes from university sports clubs and teams. The aim was to determine the magnitude and potential direction of asymmetry and compare the sensitivity of kinematic and kinetic variables. Results showed mean kinematic asymmetries below 7.1% (range: 0.00 to 28.9%), while average kinetic asymmetries were as high as 38.8% (range: 0.0% to 95.4%). These findings suggest that kinetic variables are more sensitive in assessing movement strategy, providing more detailed insight into rehabilitation and return-to-play decisions. The study emphasizes the importance of considering both outcome and movement strategy variables in injury recovery. These results have practical applications for clinicians and coaches supporting those in return-to-play scenarios, as well as those addressing performance deficits, therefore offering valuable information to refine exercise prescriptions and athletic program design. Full article

Background: Increased hip-flexion gait (HFgait) has been shown to promote increased aerobic demands by increasing peak swing-phase hip-flexion angles while walking at comfortable speeds. Biomechanically, HFgait produces a gait pattern similar to walking, while removing the flight phase from running and reducing tibial accelerations. We sought to identify knee joint contact forces between HFgait and common exercise modalities, including running, walking, and cycling, across intensity levels. Methods: Ten healthy participants completed two bouts (low and high intensity) of four different exercises: treadmill running, walking, HFgait, and cycling. Tibiofemoral joint compressive force (TCF) was estimated using a static optimization-based approach. Results: Peak TCF was greater in running compared to HFgait, walking, and cycling; greater in HFgait compared to cycling; and greater in walking compared to cycling. The integral of TCF (iTCF) was greater in running compared to cycling, greater in HFgait compared to running, walking, and cycling, and greater in walking compared to running and cycling. Conclusions: HFgait produced lower knee joint loading than running, comparable joint loading to walking, and greater joint loading than cycling. Thus, HFgait may serve as an exercise modality for populations where joint loading is of particular concern, while achieving aerobic demands similar to running or increased functional demands compared to stationary cycling. Full article

Background/Objectives: Multiple sclerosis (MS) often leads to gait impairments, even in early stages, and can affect autonomy and quality of life. Traditional assessment methods, while widely used, have been criticized because they lack sensitivity to subtle gait changes. This scoping review aims to map the landscape of advanced gait analysis technologies—both wearable and non-wearable—and evaluate their application in detecting, characterizing, and monitoring possible gait dysfunction in individuals with MS. Methods: A systematic search was conducted across PubMed and Scopus databases for peer-reviewed studies published in the last decade. Inclusion criteria focused on original human research using technological tools for gait assessment in individuals with MS. Data from 113 eligible studies were extracted and categorized based on gait parameters, technologies used, study design, and clinical relevance. Results: Findings highlight a growing integration of advanced technologies such as inertial measurement units, 3D motion capture, pressure insoles, and smartphone-based tools. Studies primarily focused on spatiotemporal parameters, joint kinematics, gait variability, and coordination, with many reporting strong correlations to MS subtype, disability level, fatigue, fall risk, and cognitive load. Real-world and dual-task assessments emerged as key methodologies for detecting subtle motor and cognitive-motor impairments. Digital gait biomarkers, such as stride regularity, asymmetry, and dynamic stability demonstrated high potential for early detection and monitoring. Conclusions: Advanced gait analysis technologies can provide a multidimensional, sensitive, and ecologically valid approach to evaluating and detecting motor function in MS. Their clinical integration supports personalized rehabilitation, early diagnosis, and long-term disease monitoring. Future research should focus on standardizing metrics, validating digital biomarkers, and leveraging AI-driven analytics for real-time, patient-centered care. Full article

Limb amputation causes significant challenges for patients in achieving effective mobility and functionality through prosthetic limbs. The prosthetic socket plays a pivotal role in the success of rehabilitation. This review explores the current advancements in prosthetic socket design and fabrication, focusing on traditional techniques like casting and lamination, and emerging technologies such as 3D printing and computer-aided design (CAD). By comparing these methods, this review highlights the advantages, limitations, and suitability for different clinical needs. This article discusses the importance of pressure distribution in socket design, emphasizing the need to relieve pressure in sensitive areas to prevent skin complications. It also examines the materials used in socket fabrication, from high-density polymers to advanced composites, assessing their impact on patient comfort and prosthetic performance. Additionally, we discuss the challenges practitioners face in prosthetic care, particularly in low-resource settings, and propose potential solutions through innovative techniques and materials. Advancements in computational modeling improved socket design and validation, enhancing patient comfort and improving the overall biomechanical interaction between the prosthesis and the user. The manuscript concludes by identifying future research opportunities, particularly in personalized prosthetic design and the integration of smart materials, to further enhance the comfort, functionality, and accessibility of prosthetic sockets. Full article

Background/Objectives: In recent years, 3D shape models of the human body have been used for various purposes. In principle, CT and MRI tomographic images are necessary to create such models. However, CT imaging and MRI generally impose heavy physical and financial burdens on the person being imaged, the model creator, and the hospital where the imaging facility is located. To reduce these burdens, the purpose of this study was to propose a method of creating individually adapted models by using simple X-ray images, which provide relatively little information and can therefore be easily acquired, and by transforming an existing base model. Methods: From medical images, anatomical feature values and scanning feature values that use the points that compose the contour line that can represent the shape of the femoral knee joint area were acquired, and deformed by free-form deformation. Free-form deformations were automatically performed to match the feature values using optimization calculations based on the confidence region method. The accuracy of the deformed model was evaluated by the distance between surfaces of the deformed model and the node points of the reference model. Results: Deformation and evaluation were performed for 13 cases, with a mean error of 1.54 mm and a maximum error of 12.88 mm. In addition, the deformation using scanning feature points was more accurate than the deformation using anatomical feature points. Conclusions: This method is useful because it requires only the acquisition of feature points from two medical images to create the model, and overall average accuracy is considered acceptable for applications in biomechanical modeling and motion analysis. Full article

Concurrent cognitive tasks, such as avoiding visual, auditory, chemical, and electrical hazards, and concurrent motor tasks, such as load carriage, are prevalent in ergonomic settings. Trips are extremely common in the workplace, leading to fatal and non-fatal fall-related injuries. Intrinsic factors, such as attention, fatigue, and anticipation, as well as extrinsic factors, including tasks at hand, affect trip recovery responses. Objective: The purpose of this study was to investigate the ankle joint kinematics in unexpected and expected trip responses during single-tasking (ST), dual-tasking (DT), and triple-tasking (TT), before and after a physically fatiguing protocol among young, healthy adults. Methods: Twenty volunteers’ (10 females, one left leg dominant, age 20.35 ± 1.04 years, height 174.83 ± 9.03 cm, mass 73.88 ± 15.55 kg) ankle joint kinematics were assessed using 3D motion capture system during unperturbed gait (NG), unexpected trip (UT), and expected trip (ET), during single-tasking (ST), cognitive dual-tasking (CDT), motor dual-tasking (MDT), and triple-tasking (TT), under both PRE and POST fatigue conditions. Results: Greater dorsiflexion angles were observed during UT compared to NG, MDT compared to ST, and TT compared to ST. Significantly greater plantar flexion angles were observed during ET compared to NG and during POST compared to PRE. Conclusions: Greater dorsiflexion angles during dual- and triple-tasking suggest that divided attention affects trip recovery. Greater plantar flexion angles following fatigue are likely an anticipatory mechanism due to altered muscle activity and increased postural control demands. Full article

Background/Objectives: In soccer, scanning before receiving the ball helps players better perceive and interpret their surroundings, enabling faster and more effective passes. Despite its importance, no standardized tests currently incorporate scanning actions into assessments of passing abilities. In this study, we test the reliability and validity of a battery of passing tests that assess a player’s ability to control and pass the ball while also scanning for the appropriate target. Methods: We designed three passing tests that reflect different scanning demands that are routinely placed upon players during matches. Using players from the first and reserve teams of two professional clubs in Ghana (Club A, first-team n = 11, reserve-team n = 10; Club B, first-team n = 16, reserve-team n = 17), we: (i) tested the repeatability of each passing test (intraclass correlations), (ii) assessed whether the tests could distinguish between first and reserve team players (linear mixed-effects model), and (iii) examined whether players who were better in the passing tests had higher performances in 3v1 Rondo possession games (linear models). Results: All passing tests were significantly repeatable (ICCs = 0.77–0.85). Performance was highest in the 120-degree test (30.11 ± 7.22 passes/min), where scanning was not required, and was lowest in the 360-degree test (25.55 ± 5.94 passes/min), where players needed to constantly scan behind them. When players were scanning through an arc of 180 degrees, their average performance was 27.41 ± 6.14 passes/min. Overall passing performance significantly distinguished first from reserve team players (β = −1.47, t (51) = −4.32, p < 0.001)) and was positively associated with 3v1 Rondo possession performance (R² = 0.51, p < 0.001). Conclusions: Our results show that these passing tests are reliable, distinguish players across competitive levels, and correlate with performance in possession games. These tests offer a simple, ecologically valid way to assess scanning and passing abilities for elite players. Full article

Background/Objectives: Sprinting is a fundamental locomotor skill and a key indicator of lower limb strength and anaerobic power in early childhood. The aim of the study was to examine possible differences in the step kinematic parameters and their contribution to sprint speed between children with different patterns of speed development. Methods: 65 prepubescent male and female track athletes (33 males and 32 females; 6.9 ± 0.8 years old) were examined in a maximal 15 m short sprint running test, where photocells measured time for each 5 m segment. At the last 5 m segment, step length, frequency, and velocity were evaluated via a video analysis method. The symmetry angle was calculated for the examined step kinematic parameters. Results: Based on the speed at the final 5 m segment of the test, two groups were identified, the maximum sprint phase (MAX) and the acceleration phase (ACC) group. Speed was significantly (p < 0.05) higher in ACC in the final 5 m segment, while there was a significant (p < 0.05) interrelationship between step length and frequency in ACC but not in MAX. No other differences were observed. Conclusions: The difference observed in the interrelationship between speed and step kinematic parameters between ACC and MAX highlights the importance of identifying the speed development pattern to apply individualized training stimuli for the optimization of training that can lead to better conditioning and wellbeing of children involved in sports with requirements for short-sprint actions. Full article

Current rehabilitation protocols for transitioning patients to late-stage recovery, evaluating return-to-play (RTP) clearance, and assessing tendon characteristics exhibit significant heterogeneity. Clinicians frequently interpret and apply research findings based on individual philosophies, resulting in varied RTP criteria and performance expectations. Despite medical clearance, patients recovering from Achilles tendon (AT) injuries often exhibit persistent impairments in muscle volume, tendon structure, and force-generating capacity. Inconsistencies in assessment frameworks, compounded by a lack of quantitative data and the utilization of specific metrics to quantify certain strength characteristics (endurance, maximal, explosive, etc.) and standardized protocols, hinder optimal functional recovery of the plantar flexors during the final stages of rehabilitation and RTP. With this in mind, the aim of this integrative review was to provide an overview of AT rehabilitation, with particular critique around mid-stage strengthening and the use of the heel-raise assessment in milestoning rehabilitation progress. From this critique, new perspectives in mid-stage strengthening are suggested and future research directions identified. Full article

Objectives: The aim of this study was to evaluate the impact of four working heights on lumbar biomechanics during wall construction tasks, focusing on work-related musculoskeletal disorders (WMSDs). Methods: Fifteen young male participants performed simulated mortar-spreading and bricklaying tasks while actual body movements were recorded using Inertial Measurement Unit (IMU) sensors. Muscle activities of the lumbar erector spinae (ES), quadratus lumborum (QL), multifidus (MF), gluteus maximus (GM), and iliopsoas (IL) were estimated using a 3D musculoskeletal (MSK) model and measured via surface electromyography (sEMG). The analysis of variance (ANOVA) test was conducted to identify the significant differences in muscle activities across four working heights (i.e., foot, knee, waist, and shoulder). Results: Findings showed that working at foot-level height resulted in the highest muscle activity (7.6% to 40.6% increase), particularly in the ES and QL muscles, indicating an increased risk of WMSDs. The activities of the ES, MF, and GM muscles were statistically significant across both tasks and all working heights (p < 0.01). Conclusions: Both MSK and sEMG analyses indicated significantly lower muscle activities at knee and waist heights, suggesting these as the best working positions (47 cm to 107 cm) for minimizing the risk of WMSDs. Conversely, working at foot and shoulder heights was identified as a significant risk factor for WMSDs. Additionally, the similar trends observed between MSK simulations and sEMG data suggest that MSK modeling can effectively substitute for sEMG in future studies. These findings provide valuable insights into ergonomic work positioning to reduce WMSD risks among wall construction workers. Full article

Background: The knee joint performs a vital function in human movement, supporting significant loads and ensuring stability during daily activities. Methods: The objective of this study was to develop and validate a subject-specific framework to model knee flexion–extension by integrating 3D gait data with individualized musculoskeletal (MS) and finite element (FE) models. In this proof of concept, gait data were collected from a 52-year-old woman using Xsens inertial sensors. The MS model was based on the same subject to define realistic loading, while the 3D knee FE model, built from another individual’s MRI, included all major anatomical structures, as subject-specific morphing was not possible due to unavailable scans. Results: The FE simulation showed principal stresses from –28.67 to +44.95 MPa, with compressive stresses between 2 and 8 MPa predominating in the tibial plateaus, consistent with normal gait. In the ACL, peak stress of 1.45 MPa occurred near the femoral insertion, decreasing non-uniformly with a compressive dip around –3.0 MPa. Displacement reached 0.99 mm in the distal tibia and decreased proximally. ACL displacement ranged from 0.45 to 0.80 mm, following a non-linear pattern likely due to ligament geometry and local constraints. Conclusions: These results support the model’s ability to replicate realistic, patient-specific joint mechanics. Full article

Background/Objectives: Vertical jump is considered a reliable and valid method of assessing the level of muscular power and coordination across one’s lifespan. The main aim of the present study was to establish sex- and age-normative data for vertical jump outcomes in pre-school children. Methods: We recruited 411 boys and girls aged 3−6 years from four major cities in Croatia and Slovenia. Vertical jump was assessed with two tests: countermovement jump (CMJ) without and with arm swing using a reliable and valid Optojump measuring platform. Data were presented for the 5th, 15th, 25th, 50th (median), 75th, 90th, and 95th percentile. Results: No significant differences were observed in multiple vertical jump outcomes between boys and girls. The mean values for CMJ without and with arm swing between boys and girls were as follows: contact time (1.4 vs. 1.4 s/1.8 vs. 1.7 s), flight time (0.32 vs. 0.31 s/0.33 vs. 0.32), height (12.3 vs. 12.2 cm/13.0 vs. 12.5 cm), power (9.4 vs. 9.5 W/kg/9.3 vs. 9.1 W/kg), pace (0.7 vs. 0.7 steps/s/0.6 vs. 0.6 steps/s), reactive strength index (RSI; 0.10 vs. 0.09 m/s/0.08 vs. 0.08 m/s), and verticality (2.5 vs. 2.3/1.9 vs. 1.9). A gradual increase in all measures according to ‘age’ was observed (p for trend < 0.05). No significant ‘sex*age’ interaction was observed (p > 0.05). Conclusions: This is one of the first studies to provide sex- and age-normative data for complete vertical jump outcomes in pre-school children. These data will serve as an avenue for monitoring and tracking motor development in this sensitive period. Full article

Background/Objectives: The simulation of human movement offers transformative potential for the design of medical devices, particularly in understanding the cause–effect dynamics in individuals with neurological or musculoskeletal impairments. This study presents a simulation-driven framework to determine the optimal ankle–foot orthosis (AFO) stiffness for mitigating the risk of ankle sprains due to excessive subtalar inversion during high-impact activities, such as landing from a free fall. Methods: We employed biomechanical simulations to assess the influence of translational stiffness on subtalar inversion control, given that inversion angles exceeding 25 degrees are strongly correlated with injury risk. Simulations were conducted using a musculoskeletal model with and without a passive AFO; the stiffness varied in three anatomical directions. A Design of Experiments (DoE) approach was utilized to capture nonlinear interactions among stiffness parameters. Results: The results indicated that increased translational stiffness significantly reduced inversion angles to safer levels, though direction–dependent effects were noted. Based on these insights, we developed a 4D visualization tool that integrates simulation data with an interactive color–coded interface to depict ”safe design” zones for various AFO stiffness configurations. This tool supports clinicians in selecting stiffness values that optimize both safety and functional performance. Conclusions: The proposed framework enhances clinical decision-making and engineering processes by enabling more accurate and individualized AFO designs. Full article

Background: This study was performed to validate the addition of capacitive-based pressure sensors to an existing smart sock developed by the research team. This study focused on evaluating the accuracy of soft robotic sensor (SRS) pressure data and its relationship with laboratory-grade Kistler force plates in collecting ground force reaction data. Methods: Nineteen participants performed walking trials while wearing the smart sock with and without shoes. Data was collected simultaneously with the sock and the force plates for each gait phase including foot-flat, heel-off, and midstance. The correlation between the smart sock and force plates was analyzed using Pearson’s correlation coefficient and R-squared values. Results: Overall, the strength of the relationship between the smart sock’s SRS data and the vertical ground reaction force (GRF) data from the force plates showed a strong correlation, with a Pearson’s correlation coefficient of 0.85 ± 0.1; 86% of the trials had a value higher than 0.75. The linear regression models also showed a strong correlation, with an R-squared value of 0.88 ± 0.12, which improved to 0.90 ± 0.07 when including a stretch-SRS for measuring ankle flexion. Conclusions: With these strong correlation results, there is potential for capacitive pressure sensors to be integrated into the proposed device and utilized in telehealth and sports performance applications. Full article

It is well established that combining exercise with medication may benefit functionality in individuals with PD (Parkinson’s disease). However, the long-term evolution of gait biomechanics under this combination remains poorly understood. Objectives: This study aims to analyze the evolution of spatiotemporal gait parameters, kinetics, and kinematics throughout a long-term exercise program conducted in water and on dry land. Methods: We have compared the trajectories of biomechanical variables across the treatment phases using statistical parametric mapping (SPM). A cohort of fourteen individuals with PD (mean age: 65.6 ± 12.1 years) participated in 24 sessions of aquatic exercises over three months, followed by a three-month retention phase, and then 24 additional sessions of land-based exercises. Three-dimensional gait data and spatiotemporal parameters were collected before and after each phase. Two-way ANOVA with repeated measures was used to compare spatiotemporal parameters. Results: The walking speed increased while the duration of the double support phase decreased. Additionally, the knee extensor moment consistently increased in the entire interval from midstance to midswing (20% to 70% of the stride period), approaching normal gait patterns. Regarding kinematics, significant increases were observed in both hip and knee flexion angles. Furthermore, the abnormal ankle dorsiflexion observed at the foot strike disappeared. Conclusions: These findings collectively suggest positive adaptations in gait biomechanics during the observation period. Full article

Background/Objectives: Australian terrestrial mammals that fall within the critical weight range (35 g–5.5 kg) have experienced large population declines due to a combination of habitat loss and modification, and the introduction of non-native cats, dogs, and foxes. Because running speed typically increases with body size, predators are usually faster but less agile than their prey due to the biomechanical trade-offs between speed and agility. Quantifying the maximum locomotor capacities of Australian mammals in the critical weight range, and the magnitude of the trade-off between speed and agility, can aid in estimating species’ vulnerability to predation. Methods: To do this, we quantified the trade-off between speed and agility in both males and females (n = 36) of a critical weight range species, the northern brown bandicoot (Isoodon macrourus), and determined if there was an influence of morphology on locomotor performance. Results: When turning, individuals who had higher turn approach speeds, and higher within-turn speeds, had greater turning radii and lower angular velocities, meaning a decrease in overall maneuverability. Females were more agile and exhibited greater turning speeds at similar turning radii than males. For both sexes, individuals with longer relative hind digits had relatively faster sprint speeds, while those with longer forearms had relatively smaller turning radii and higher agility. Conclusions: Due to the constrained limb morphology of the bandicoot species, these findings could translate across this group to provide a better understanding of their escape performance and risk of predation. Full article

Background/Objectives: This study focuses on the motion planning and control of an active ankle–foot orthosis (AFO) that leverages biomechanical insights to mitigate footdrop, a deficit that prevents safe toe clearance during walking. Methods: To adapt the motion of the device to the user’s walking speed, a geometric model was used, together with real-time measurement of the user’s gait cycle. A geometric speed-adaptive model also scales a trapezoidal ankle-velocity profile in real time using the detected gait cycle. The algorithm was tested at three different walking speeds, with a prototype of the AFO worn by a test subject. Results: At walking speeds of 0.44 and 0.61 m/s, reduced tibialis anterior (TA) muscle activity was confirmed by electromyography (EMG) signal measurement during the stance phase of assisted gait. When the AFO was in assistance mode after toe-off (initial and mid-swing phase), it provided an average of 48% of the estimated required power to make up for the deliberate inactivity of the TA muscle. Conclusions: Kinematic analysis of the motion capture data showed that sufficient foot clearance was achieved at all three speeds of the test. No adverse effects or discomfort were reported during the experiment. Future studies should examine the device in populations with footdrop and include a comprehensive evaluation of safety. Full article