Clinical Biomechanics最新文献

{"title":"Investigating the effect of distal screw and peg length on stability in volar plating of comminuted, intra-articular distal radius fractures in a cadaveric model","authors":"Francine Zeng ,&nbsp;Raghunandan Nayak ,&nbsp;Martinus Megalla ,&nbsp;Mehreen Pasha ,&nbsp;Shiza Bari ,&nbsp;Dashun Liu ,&nbsp;Joel V. Ferreira ,&nbsp;Anthony Parrino ,&nbsp;Craig M. Rodner","doi":"10.1016/j.clinbiomech.2025.106472","DOIUrl":"10.1016/j.clinbiomech.2025.106472","url":null,"abstract":"<div><h3>Background</h3><div>Volar plating is the preferred surgical treatment for distal radius fractures. Many have adopted unicortical distal fixation to prevent extensor tendon injury. This study aimed to determine the biomechanical effect of distal locking screws and pegs on stability in comminuted, intra-articular distal radius fracture cadavers.</div></div><div><h3>Methods</h3><div>We applied volar-locking distal radius plates to 24 cadaveric radiuses, which were divided into 4 groups based on distal fixation: 100 % length screws, 75 % length screws, 100 % length pegs, and 75 % length pegs. Osteotomies simulated dorsally comminuted, intra-articular fractures. We determined each construct's stiffness under physiologic loads (axial compression, dorsal bending, and volar bending) before and after 1000 cycles of axial conditioning, and before axial load to clinical failure (2 mm of displacement) and catastrophic failure.</div></div><div><h3>Findings</h3><div>Stiffness to volar and dorsal bending were equivalent between groups before and after cycling loading. Final stiffness under axial load was equivalent for all groups. Force to clinical failure was equivalent between 100 % (308 N) and 75 % screw length (351 N) constructs, and equivalent between 100 % (127 N) and 75 % peg length (150 N) constructs. Forces to clinical failure were greater for 100 % and 75 % screw lengths compared to their peg counterparts. Force to clinical failure was greater for 75 % screw lengths than 100 % smooth pegs. Force to catastrophic failure was equivalent between all groups.</div></div><div><h3>Interpretation</h3><div>We recommend the use of 75 % length screws or pegs over their bicortical counterparts to prevent dorsal penetration without compromising fixation. Surgeons may consider using locking screws over pegs in complex, intra-articular distal radius fractures.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106472"},"PeriodicalIF":1.4,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic femoral head coverage following periacetabular osteotomy for developmental dysplasia of the hip","authors":"Christina A. Bourantas ,&nbsp;Emma C. Behrman ,&nbsp;Molly C. Shepherd ,&nbsp;Keith R. Lohse ,&nbsp;John C. Clohisy ,&nbsp;Michael D. Harris","doi":"10.1016/j.clinbiomech.2025.106471","DOIUrl":"10.1016/j.clinbiomech.2025.106471","url":null,"abstract":"<div><h3>Background</h3><div>Developmental dysplasia of the hip reduces hip stability due to insufficient femoral head coverage. Periacetabular osteotomy surgery aims to increase this coverage. Typically measured using radiographs, most coverage assessments are limited to static hip positions and cannot capture 3D anatomy. This study quantified how dynamic 3D femoral coverage changes during gait and squat after periacetabular osteotomy surgery and compared dynamic coverage to static measures.</div></div><div><h3>Methods</h3><div>Pre- and post-surgery CT scans from 38 patients with hip dysplasia were used to reconstruct 3D femur and pelvis bones with which gait and squat were simulated. Models of 38 control subjects were also created. The femoral head was divided into anteromedial, anterolateral, posteromedial, and posterolateral regions. Regional coverage was compared pre- and post-surgery, and against controls, in a static neutral position, during the stance phase of gait, and throughout the squat cycle.</div></div><div><h3>Findings</h3><div>Lateral coverage increased post-surgery in the static neutral position (anterolateral: 4.9 ± 3.6 % to 13.8 ± 5.6 %; posterolateral: 22.9 ± 15.4 % to 39.8 ± 15.2 % (<em>p</em> ≤ 0.001)) and throughout gait and squat (p ≤ 0.001). Average changes in neutral anterolateral coverage (+8.9 ± 4.5 %) were similar to average changes during gait (+8.1 ± 3.0 %), but not squat (+12.0 ± 1.9 %). Static neutral coverage post-surgery differed significantly from dynamic coverage in every region of the femoral head during all of gait, and most of squat.</div></div><div><h3>Interpretation</h3><div>While static measures follow some patterns of dynamic coverage after surgery, they miss important variations that can impact joint loading. Understanding how periacetabular osteotomy changes dynamic femoral head coverage can aid with operative planning and assessment to optimize outcomes during daily activities.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106471"},"PeriodicalIF":1.4,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis on effects of trip-based perturbation training reducing fall risk","authors":"Sara Mahmoudzadeh Khalili,&nbsp;Feng Yang","doi":"10.1016/j.clinbiomech.2025.106470","DOIUrl":"10.1016/j.clinbiomech.2025.106470","url":null,"abstract":"<div><h3>Background</h3><div>Falls are a key cause of injury across all age groups. Perturbation-based training, particularly trip-induced perturbation, has shown promise in enhancing balance recovery in lab and real-world scenarios. This study aimed to synthesize the effects of trip-based perturbation training on fall risk, quantified by the fall rate, recovery step length, margin of stability, and maximum trunk flexion angle in healthy adults.</div></div><div><h3>Methods</h3><div>A literature search in major databases led to 11 qualified studies. Meta-analyses were conducted on the lab-induced fall rate, recovery step length, and maximum trunk flexion angle. Other outcome measures, such as fall rate in daily living conditions and margin of stability, were systematically reviewed to further assess the effects of trip-based perturbation training.</div></div><div><h3>Findings</h3><div>The pooled effect size was −0.30 (<em>p</em> &lt; 0.001) for the lab-induced fall rate, 0.27 (<em>p</em> = 0.38) for the recovery step length, and − 9.81 (<em>p</em> = 0.20) for the maximum trunk flexion angle. The review also revealed that the training reduced all-cause prospective falls and improved the margin of stability after a trip.</div></div><div><h3>Interpretation</h3><div>Trip-based perturbation training significantly reduces the fall rate and enhances postural stability, as evidenced by improvements in the recovery step length, margin of stability, and trunk kinematics.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106470"},"PeriodicalIF":1.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does joint hypermobility exacerbate altered landing and jumping strategies in adolescents with fibromyalgia syndrome compared to controls?","authors":"Tessa C. Hulburt ,&nbsp;William R. Black ,&nbsp;Scott Bonnette ,&nbsp;Staci Thomas ,&nbsp;Andrew Schille ,&nbsp;Chris DiCesare ,&nbsp;Matthew S. Briggs ,&nbsp;Sylvia Ounpuu ,&nbsp;Susmita Kashikar-Zuck ,&nbsp;Greg D. Myer","doi":"10.1016/j.clinbiomech.2025.106466","DOIUrl":"10.1016/j.clinbiomech.2025.106466","url":null,"abstract":"<div><h3>Background</h3><div>Joint hypermobility is common in children and persists in various genetic and connective tissue disorders, including conditions characterized by chronic musculoskeletal pain (i.e. Juvenile Fibromyalgia Syndrome), which involves movement dysfunction. It is unclear if joint hypermobility contributes to this dysfunction. This study investigated whether generalized joint hypermobility is associated with altered landing/jumping biomechanics in adolescents with juvenile fibromyalgia syndrome compared to controls.</div></div><div><h3>Methods</h3><div>Adolescents with juvenile fibromyalgia syndrome and hypermobility (<em>n</em> = 17), juvenile fibromyalgia syndrome without hypermobility (n = 17), and non-hypermobile controls (n = 17) performed a landing/jumping task while 3D-motion capture and ground reaction force data were collected. Timewise data were compared using statistical parametric mapping.</div></div><div><h3>Findings</h3><div>Both groups with juvenile fibromyalgia syndrome exhibited altered lower extremity biomechanics compared to controls, including increased sagittal hip and ankle kinematics (<em>P</em> &lt; 0.0001), ∼25 % reduced sagittal knee and ankle kinetics (<em>P</em> ≤ 0.038) and ∼ 2.5× greater knee internal rotation (<em>P</em> &lt; 0.0001) during landing/jumping, as well as ∼75 % and ∼ 20 % reduced ground reaction force during initial landing and jumping (<em>P</em> &lt; 0.0001), respectively. Both groups with juvenile fibromyalgia syndrome, demonstrated 17–26 % reduced landing depth (<em>P</em> &lt; 0.0001;d ≤ 1.79) and 26 % reduced jump height (<em>P</em> ≤ 0.01;d ≤ 0.86), indicating inefficient momentum absorption.</div></div><div><h3>Interpretation</h3><div>Altered biomechanics observed in both groups with juvenile fibromyalgia syndrome may reflect an attempt to avoid pain. While hypermobility did not significantly differentiate the groups with juvenile fibromyalgia syndrome overall, it was associated with more inefficiencies. This study highlights the need for hypermobility-specific movement assessments to understand movement-associated pain, strength, and kinesthetics to improve early identification and treatment of youth with hypermobility at risk for chronic pain and functional limitations.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106466"},"PeriodicalIF":1.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical and radiographic advantages of double-level osteotomy over single-level osteotomy for medial knee osteoarthritis with double-level deformity: A retrospective analysis","authors":"Hiroaki Tsukamoto ,&nbsp;Manabu Akagawa ,&nbsp;Hidetomo Saito ,&nbsp;Kimio Saito ,&nbsp;Akira Komatsu ,&nbsp;Takehiro Iwami ,&nbsp;Hiroaki Kijima ,&nbsp;Koji Nozaka ,&nbsp;Naohisa Miyakoshi","doi":"10.1016/j.clinbiomech.2025.106469","DOIUrl":"10.1016/j.clinbiomech.2025.106469","url":null,"abstract":"<div><h3>Background</h3><div>Double-level osteotomy is hypothesized to provide superior biomechanical outcomes compared to single-level osteotomy for medial knee osteoarthritis with double-level deformity. However, its advantages remain underexplored.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 20 knees treated with medial open wedge high tibial osteotomy alone or combined with lateral closed wedge distal femoral osteotomy. Patients were categorized into three groups: Single-level osteotomy for single deformity, single-level osteotomy for double deformity, and double-level osteotomy for double deformity. Radiographic parameters, including Hip-Knee-Ankle angle, mechanical lateral distal femoral angle, medial proximal tibial angle and joint line convergence angle, and gait biomechanics using nine-axis inertial measurement units were evaluated pre- and postoperatively.</div></div><div><h3>Findings</h3><div>The postoperative mechanical lateral distal femoral angle was better corrected in the double-level osteotomy for double deformity group compared to the single-level osteotomy for double deformity group (<em>P</em> = 0.012). Peak thigh varus acceleration was significantly reduced in both the double-level osteotomy for double deformity and single-level osteotomy for single deformity groups (<em>P</em> = 0.014), but not in the single-level osteotomy for double deformity group. No significant differences were observed in medial proximal tibial angle among groups.</div></div><div><h3>Interpretation</h3><div>Double-level osteotomy demonstrated superior biomechanical and radiographic outcomes in medial knee osteoarthritis with double-level deformity, emphasizing its role in mitigating joint line obliquity and in optimizing dynamic knee stability.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"123 ","pages":"Article 106469"},"PeriodicalIF":1.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel acoustic emission screwdriver reduces surgeons´ cancellous screw stripping rate - A biomechanical study","authors":"Bryan Joseph Wright ,&nbsp;Stephen Grigg ,&nbsp;John McCrory ,&nbsp;Rhys Pullin ,&nbsp;Jan Egil Brattgjerd","doi":"10.1016/j.clinbiomech.2025.106467","DOIUrl":"10.1016/j.clinbiomech.2025.106467","url":null,"abstract":"<div><h3>Background</h3><div>Orthopedic surgeons refine their torque sensitive skills from tightening cancellous screws. Still, experienced surgeons exhibit surprisingly high screw stripping rates in osteopenic cancellous bone. Whether Acoustic-Emission technology, detecting energy waves from microstructural damage during screw purchase, can reduce these rates is unclear. Our aim was to evaluate if surgeons, irrespective of their experience, reduced cancellous screw stripping rate by combining their skills with feedback from an innovative Acoustic-Emission screwdriver.</div></div><div><h3>Methods</h3><div>Thirteen orthopedic surgeons with 0–23 years´ experience inserted 468 large fragment cancellous screws through plates into synthetic osteoporotic bone. The 1st stage, surgeons tightened 9 screws each without Acoustic-Emission feedback. The 2nd stage, each tightened 18 screws using the Acoustic-Emission feedback modified screwdriver. The last stage, surgeons tightened 9 screws each, again without Acoustic-Emission feedback. A strain gauge on the screwdriver was used to verify screw stripping.</div></div><div><h3>Findings</h3><div>Surgeons stripped 36 out of 115 screws (31 %) in stage 1, 37 out of 227 screws (16 %) in stage 2, and 26 out of 114 screws (23 %) in stage 3. A significant reduced screw stripping rate was found in stage 2 compared to in stage 1 (<em>p</em> &lt; 0.001). Neither the individual surgeon nor experience of the surgeon contributed to screw stripping probability in a mixed effect logistical regression model.</div></div><div><h3>Interpretations</h3><div>Acoustic-Emission technology is superior to the torque sensitive skills of surgeons, demonstrating its potential to assist surgeons in real time, regardless of their experience, in reducing screw stripping rates in cancellous bone.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"123 ","pages":"Article 106467"},"PeriodicalIF":1.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similarity of shoulder kinematics between people with subacromial pain syndrome and asymptomatic individuals: A study using inertial measurement units","authors":"Adrien Beaud ,&nbsp;Quentin Lejeune ,&nbsp;Hélène Pillet ,&nbsp;Antoine Mazarguil ,&nbsp;Josette Bertheau ,&nbsp;Marie-Martine Lefèvre-Colau ,&nbsp;Alexandra Rören","doi":"10.1016/j.clinbiomech.2025.106462","DOIUrl":"10.1016/j.clinbiomech.2025.106462","url":null,"abstract":"<div><h3>Background</h3><div>Subacromial pain syndrome is the most common cause of shoulder pain and is associated with altered humeral and scapular kinematics. Symptoms can be improved by rehabilitation. Accurate tools to analyze shoulder kinematic curves are lacking.</div></div><div><h3>Methods</h3><div>A single-center prospective pilot study using inertial measurement units located on both arms and scapulae to assess bilateral arm elevation in the sagittal, scapular and frontal planes. Reparameterization and signal registration algorithms compared similarity of global shoulder and scapular kinematic curves from participants with subacromial pain syndrome before and after a short rehabilitation program, with a control template combining the curves of asymptomatic participants. A similarity score used curve comparisons; the more closely the curve shapes matched, the closer the score was to zero. We used a paired Wilcoxon test to compare the scores.</div></div><div><h3>Findings</h3><div>We included 9 right-handed symptomatic participants (10 shoulders): 2 males (22 %), mean (SD) age 53.8 (13.7) years, symptom duration 29 (23) months, pain (Numeric Rating Scale) 61.1 (22.4)/100, activity limitation (Quick-Dash): 48.3 (26.6)/100 points, and 10 asymptomatic age-matched right-handed participants (20 shoulders): 4 males (40 %), 54.2 (5.4) years old. Post-rehabilitation similarity scores decreased non-significantly for shoulder elevation (scapular and frontal planes), scapular lateral rotation (sagittal and scapular planes) and anterior-posterior tilt (scapular plane) and significantly for shoulder sagittal elevation (<em>P</em> = 0.004). Participant heterogeneity was high.</div></div><div><h3>Interpretation</h3><div>The similarity methodology, used for the first time in the context of subacromial pain syndrome, offers a new quantitative tool to assess kinematic changes, measure movement-related impairments and monitor patient progress.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"123 ","pages":"Article 106462"},"PeriodicalIF":1.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic subtalar joint space measurement analysis following tibiotalar arthrodesis and total ankle replacement","authors":"Rich J. Lisonbee ,&nbsp;Andrew C. Peterson ,&nbsp;Megan K. Mills ,&nbsp;Andrew E. Anderson ,&nbsp;Amy L. Lenz","doi":"10.1016/j.clinbiomech.2025.106464","DOIUrl":"10.1016/j.clinbiomech.2025.106464","url":null,"abstract":"<div><h3>Background</h3><div>Tibiotalar arthrodesis and total ankle replacement are current standards for treating end-stage ankle osteoarthritis. Our clinical understanding of biomechanical causes and risk factors for subtalar secondary osteoarthritis development following surgical treatment is limited. The objective of this retrospective study was to investigate subchondral bone morphometric differences of individuals treated with a tibiotalar arthrodesis or ankle arthroplasty that may influence subtalar joint measurements during overground walking; results were compared between surgical groups, their unaffected limb, and asymptomatic controls.</div></div><div><h3>Methods</h3><div>Previously collected kinematics were used to measure and compare subtalar joint space and congruence throughout the dynamic activity utilizing a correspondence-based joint measurement analysis. A morphometric analysis evaluated subchondral bone differences of the calcaneus subtalar joint between groups.</div></div><div><h3>Findings</h3><div>The affected subtalar joint of arthrodesis participants showed increased joint space distance in the medial facet during early stance that was related to kinematic differences compared to controls and their contralateral untreated limbs. Our morphometric analyses demonstrated subchondral bone asymmetries in both surgical groups compared to their contralateral untreated limbs.</div></div><div><h3>Interpretation</h3><div>Previously reported kinematic differences between treated and untreated limbs in arthrodesis participants may translate to the variations in joint space and morphology observed in this study. Our earlier findings within the arthroplasty group indicated no significant kinematic differences between treated and untreated limbs, and the current study showed minimal significant differences in joint space distances. Collectively, this suggests that arthroplasty joint space and subchondral bone shapes are not as strongly influenced by functional asymmetries as those in the arthrodesis group.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"123 ","pages":"Article 106464"},"PeriodicalIF":1.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing dynamic stability in children with idiopathic toe walking during overground walking","authors":"Michelle Gwerder ,&nbsp;Michèle Widmer ,&nbsp;Olivia Schären ,&nbsp;Navrag B Singh ,&nbsp;Morgan Sangeux ,&nbsp;Elke Viehweger","doi":"10.1016/j.clinbiomech.2025.106468","DOIUrl":"10.1016/j.clinbiomech.2025.106468","url":null,"abstract":"<div><h3>Background</h3><div>Children with idiopathic toe walking present with reduced ankle mobility, impaired balance, and difficulties in motor control. There is a need to diagnose idiopathic toe walking in a holistic manner and improve the monitoring of interventions. The aim is to assess dynamic stability with measures of margin of stability and whole-body angular momentum and evaluate their clinical relevance.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional study with 35 idiopathic toe walkers (23 male, mean age (SD) 10.0 (2.9) years) and 20 typically developing controls (10 male, 11.4 (2.8) years). All participants had a clinical gait analysis at the local hospital. Dynamic stability was assessed with margin of stability, whole-body angular momentum, GaitSD, and spatiotemporal gait parameters. Student <em>t</em>-tests with adjustments for multiple comparisons were performed.</div></div><div><h3>Findings</h3><div>Margin of stability in anterior direction was significantly shorter (ES = 1.29) and whole-body angular momentum in the coronal plane was significantly larger (ES = 0.90) in idiopathic toe walkers compared to typically developing children. No other results were below the set threshold for significance.</div></div><div><h3>Interpretation</h3><div>Children with idiopathic toe walking continue to use an immature, falling forward movement strategy to maintain forward momentum. It is probable that those children adopted toe walking behavior to support increased energy absorption during the initial fall. Furthermore, the addition of dynamic stability measures not only provides insight into their ability to balance, these measures also allow an understanding of the plausible strategies adopted during walking and could potentially improve diagnosis and quantification of therapeutic outcomes.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"123 ","pages":"Article 106468"},"PeriodicalIF":1.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower extremity energy absorption in individuals with lower extremity musculoskeletal injury history during functional tasks: A scoping review","authors":"Tsung-Yeh Chou ,&nbsp;Colin M.S. Mulligan ,&nbsp;Yu-Lun Huang","doi":"10.1016/j.clinbiomech.2025.106463","DOIUrl":"10.1016/j.clinbiomech.2025.106463","url":null,"abstract":"<div><h3>Background</h3><div>Recent evidence has utilized energetic absorption as an alternative method to evaluate biomechanical profiles associated with lower extremity injury risk. The aim of scoping review is to summarize the literatures that utilized energetic analysis in individuals with lower extremity injury history during functional tasks.</div></div><div><h3>Methods</h3><div>A literature search, conducted in August 2023, involved four databases—PubMed, SPORTDiscus, Scopus, and Web of Science. A manual search was performed to identify additional articles.</div></div><div><h3>Findings</h3><div>Among the 17 included studies, we identified 11 and 6 articles investigated lower extremity energetic absorption in individuals with anterior cruciate ligament reconstruction and chronic ankle instability history during jump-related tasks, receptively. Individuals with anterior cruciate ligament reconstruction displayed a reduction of energetic absorption in the involved knee, coupled with increased energetic absorption in the involved hip, as compared to the uninvolved limb or the reference group. The findings in those with chronic ankle instability were varied. Most studies suggested that individuals with chronic ankle instability displayed a compensatory movement pattern to off-load their ankle joint, while concurrently increasing energy absorbed at the knee joint compared to the reference group. Conversely, one study suggested that individuals with chronic ankle instability might rely more on their ankle joint for energy absorption.</div></div><div><h3>Interpretation</h3><div>Our findings indicated that both individuals with anterior cruciate ligament reconstruction and chronic ankle instability displayed a distinctive compensatory strategy during landing. This strategy is characterized by increasing energy dissipation on the proximal joints, compensating for a reduction on the distal joint to dissipate less energy.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"123 ","pages":"Article 106463"},"PeriodicalIF":1.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}