Clinical Biomechanics最新文献

{"title":"Biomechanical effects of disc cement for lumbar locking interbody cementation: Finite-element mobility analysis and debris-removing reamer design","authors":"Kung-Chia Li ,&nbsp;Che-Wei Liu ,&nbsp;Yu-Kun Xu ,&nbsp;Chun-Ming Chen ,&nbsp;Shang-Chih Lin","doi":"10.1016/j.clinbiomech.2025.106708","DOIUrl":"10.1016/j.clinbiomech.2025.106708","url":null,"abstract":"<div><h3>Background</h3><div>Before locking interbody cementation, debris from the reamed disc should be thoroughly cleared to increase the cement volume and decrease its flow resistance to the vertebrae.</div></div><div><h3>Methods</h3><div>A finite element lumbosacral model was used to assess the biomechanical effects of five different disc cement sizes on disc mobility. A new reamer featuring staggered, barbed, and multilayered cutting edges, along with spiral and conical profiles, was designed and 3D-printed to enhance debris removal. Biomechanical and clinical tests were performed using synthetic and patient discs to compare the debris weights removed by the standard drill bit and the 3D-printed reamer.</div></div><div><h3>Findings</h3><div>Cement size significantly affected disc mobility beyond the impact of torsional factors alone. Larger cement volumes produced a more stable cage-cement foundation and reduced sagittal and coronal motions by approximately 23.8 % compared to the standard 5 mm-thick cement coverage. The average weight of synthetic disc debris removed was 926.28 ± 49.71 mg with the 3D-printed reamer versus only 63.04 ± 4.86 mg with the standard drill bit (p &lt; 0.01). When the drill bit was withdrawn, debris easily slipped from the spiral cutting edge. In contrast, drill bits failed to retain debris effectively, whereas the reamer’s staggered and barbed features consistently hooked and removed disc material.</div></div><div><h3>Interpretation</h3><div>Implanting a 5 mm cage requires removing approximately 6 ml of disc material. A larger cement fill provides a more stable cage-cement interface. The 3D-printed reamer’s staggered barbs removed debris more efficiently than traditional drill bits.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106708"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716672","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":"Importance of analyzing spasticity and co-activation as complementary biomarkers of gait in children with cerebral palsy","authors":"Gabriel Graffagnino ,&nbsp;Benoît Sijobert ,&nbsp;Karine Patte ,&nbsp;Christine Azevedo-Coste ,&nbsp;David Gasq","doi":"10.1016/j.clinbiomech.2025.106743","DOIUrl":"10.1016/j.clinbiomech.2025.106743","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral palsy (CP) is a neurological disorder characterized by motor impairments, including muscle spasticity, weakness, and abnormal co-activation leading to gait abnormalities. Understanding the relationship between these factors is essential for optimizing rehabilitation strategies but remains unclear, particularly in terms of phase-specific neuromuscular adaptations during gait. This study investigated the correlations between muscle spasticity, strength, co-activation, and gait variable scores (GVS) in children with CP during clinical gait analysis. Two muscle pairs were analyzed: Gastrocnemius Medialis-Tibialis Anterior (GM-TA) and Rectus Femoris-Semitendinosus (RF-ST).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 55 children with CP using surface electromyography and clinical scales (Modified Ashworth Scale for spasticity, Medical Research Council scale for strength). Co-activation was computed for stance and swing phases and compared to reference values from literature data about typically developing children. Correlations between variables were assessed using Spearman's coefficient and Chi-square tests evaluated categorical relationships between spasticity and abnormal co-activation.</div></div><div><h3>Findings</h3><div>No clear correlations between spasticity and co-activation were demonstrated, except for RF during swing (moderate correlation). GVS for ankle and hip flexion was moderately correlated with co-activation. Muscle strength negatively correlated with co-activation and deviations of joint angles relative to healthy gait.</div></div><div><h3>Interpretation</h3><div>These findings highlight partial correlations between clinical examination (i.e., spasticity and strength) and gait data (i.e., muscle co-activation and kinematic alterations), reinforcing the importance of assessing multiple biomarkers to better characterize gait abnormalities. Future rehabilitation protocols should comprehensively evaluate spasticity, muscle strength, co-activation, and GVS to better adapt interventions and optimize motor function in children with CP.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106743"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840883","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":"Ultrasound for the assessment of muscle architecture in Parkinson's disease: A scoping review","authors":"Mahyar Behraznia ,&nbsp;Massimiliano Ditroilo ,&nbsp;Tina Smith","doi":"10.1016/j.clinbiomech.2025.106733","DOIUrl":"10.1016/j.clinbiomech.2025.106733","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson's disease (PD) affects motor function and muscle performance, which are closely linked to muscle architecture (MA). Ultrasound (US) provides a non-invasive method to assess MA, yet its application in PD remains underexplored. This review aimed to map and synthesise existing research on US assessment of MA in individuals with PD to clarify how US imaging methodologies contribute to understanding muscle structure and function in this population.</div></div><div><h3>Methods</h3><div>This scoping review was conducted following established guidelines and searching these databases: Scopus, PubMed, Web of Science Core Collection, MEDLINE and CINAHL Ultimate.</div></div><div><h3>Findings</h3><div>Of the 913 records identified, 20 studies met the inclusion criteria. Research varied in design, US measurement methodology, and measurement and reporting approaches. The synthesis revealed that while MA at rest was largely preserved in PD with notable exceptions, muscle fascicle responsiveness during contraction was significantly impaired, potentially due to rigidity. MA differences were associated with PD clinical manifestations (i.e., bradykinesia and rigidity) and reduced functional performance. PD-related comorbidities including sarcopenia, camptocormia, and dysphagia were found to further affect MA, exacerbating muscle degradation and remodelling. Exercise was found to alter the structural characteristics of MA, suggesting beneficial adaptive potential.</div></div><div><h3>Significance and interpretation</h3><div>Despite consistent evidence of altered MA and muscle responsiveness in PD, methodological heterogeneity and small samples limit firm conclusions. Standardised US protocols and longitudinal studies are needed to clarify the relationship between MA, functional performance, and PD clinical features, and to evaluate the effects of exercise and rehabilitation on muscle structure and strength.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106733"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840907","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":"Patellofemoral pain is associated with complex gait deviations captured by an artificial intelligence-derived gait index","authors":"Gabriel Jacob Navarro ,&nbsp;Tadeu Aldrovando Bryhy de Albuquerque ,&nbsp;Cid André Fidelis-de-Paula-Gomes ,&nbsp;Cintia Lopes Ferreira ,&nbsp;João Carlos Ferreira Correa ,&nbsp;Gabor Jószef Barton ,&nbsp;Paulo Roberto Garcia Lucareli","doi":"10.1016/j.clinbiomech.2025.106735","DOIUrl":"10.1016/j.clinbiomech.2025.106735","url":null,"abstract":"<div><h3>Background</h3><div>Patellofemoral pain (PFP) in active women is associated with gait adaptations. The Movement Deviation Profile (MDP) summarises deviations in multi-segment kinematic deviation, but it is unclear how the magnitude of deviation relates to pain. We investigated the relationship between MDP and pain intensity during walking.</div></div><div><h3>Methods</h3><div>In a retrospective, laboratory-based study, we analysed three-dimensional gait data from women with PFP (<em>n</em> = 571) alongside matched asymptomatic controls for reference modelling. Pain intensity was rated on a 0–10 visual analogue scale (VAS). Typical gait was defined from controls; Euclidean distances across 13 kinematic curves yielded the mean MDP (MDP_mean). We used linear regression, and the results remained consistent after controlling for the year of data collection and addressing heteroskedasticity in the standard errors.</div></div><div><h3>Findings</h3><div>In women with PFP, the mean MDP was 13.17° (95 % CI: 12.93°–13.41°), and the mean VAS was 6.03 (95 % CI: 5.91–6.15). Each 1-point increase in VAS corresponded to an approximately 1.99° increase in MDP_mean (R² = 0.92). This relationship remained consistent even after adjusting for the year (β = 1.98°; 95 % CI: 1.93–2.04; <em>p</em> &lt; 0.001), suggesting that changes over time did not influence the observed association.</div></div><div><h3>Interpretation</h3><div>In women with PFP, higher pain intensity is closely linked to more significant gait deviations, underlining the clinical importance of MDP as a quick measure of movement change. Although the retrospective nature prevents causal conclusions, the strength and consistency of the link indicate that pain level can serve as a useful marker for kinematic deviations during gait analysis.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106735"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758298","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":"Limitations of standard gait models for the precise and accurate evaluation of prosthetic knee joints regarding their functional quality, reliability, reproducibility and safety","authors":"Eva Pröbsting ,&nbsp;Michael Ernst ,&nbsp;Harald Böhm ,&nbsp;Thomas Schmalz ,&nbsp;Veit Schopper ,&nbsp;Barbara Pobatschnig ,&nbsp;Malte Bellmann","doi":"10.1016/j.clinbiomech.2025.106715","DOIUrl":"10.1016/j.clinbiomech.2025.106715","url":null,"abstract":"<div><h3>Background</h3><div>Accurate motion analysis of prosthetic knee joints is essential for optimizing component design, improving gait restoration, and evaluating clinical performance. Sagittal knee angles and moments are key biomechanical parameters for assessing joint function. This study determined these parameters using various gait models and validated the results against sensor data from the prosthetic knee, supporting more reliable gait analysis and potential improvements in patient outcomes.</div></div><div><h3>Methods</h3><div>Nineteen above-knee amputees walked at three self-selected speeds while gait was analyzed using optoelectronic cameras and force plates. Sagittal prosthetic knee moment and angle were calculated with four different models: Plug-in Gait, adapted Clinical Cleveland, 2D-model and a new 3D-model developed for analysis of transfemoral amputees. Simultaneously, prosthetic knee sensor angle and moment data were recorded.</div></div><div><h3>Findings</h3><div>The mean sagittal knee angle and moment waveforms from all models closely match the sensor data, reflected by low root mean square errors, with the new developed model showing the smallest values. The most precise (most often lowest reproducibility coefficient) sagittal knee angle and moment is shown with the new model. For the sagittal knee angle the highest accuracy (most often lowest mean deviation) is also determined with this model. For the knee moment, the new model, the 2D-model and Plug-in Gait equally frequently show the smallest mean deviation.</div></div><div><h3>Interpretation</h3><div>Relevant parameters of prosthetic knee joints can be determined using gait analysis, but not all models have the level of accuracy and precision required for evaluating prosthetic knee joints. The new model shows the most reliable data.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106715"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665408","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":"Effect of gait pattern on patellofemoral joint stress during walking in individuals with patellar instability","authors":"Delaney M. McNeese ,&nbsp;Caitlin E. Conley ,&nbsp;Austin V. Stone ,&nbsp;Cale Jacobs ,&nbsp;Brian Noehren ,&nbsp;Meredith K. Owen","doi":"10.1016/j.clinbiomech.2025.106738","DOIUrl":"10.1016/j.clinbiomech.2025.106738","url":null,"abstract":"<div><h3>Background</h3><div>Patellar instability is a common injury among young, active individuals resulting in increased risk for future patellofemoral osteoarthritis. The purpose of this study is to quantify the effect of gait pattern on patellofemoral joint stress in those with patellar instability.</div></div><div><h3>Methods</h3><div>Individuals with patellar instability (<em>n</em> = 17) completed an instrumented gait analysis. A mathematical model, with sagittal plane knee angle and knee moment as inputs, was used to estimate patellofemoral joint stress during stance. Individuals were grouped by presenting with an extension dominant knee moment or a flexion dominant knee moment. Patellofemoral joint stress and knee and hip mechanics were compared between affected limbs. The injured limb of the extension dominant group was also compared to matched healthy control participants.</div></div><div><h3>Findings</h3><div>Extension dominant and flexion dominant groups had similar patellofemoral joint stress magnitudes (<em>p</em> = 0.37) throughout stance phase, but the flexion dominant group reached peak stress at a significantly later percentage of stance (<em>p</em> &lt; 0.05) and at a smaller knee flexion angle (p &lt; 0.05). There were no significant differences in peak or timing of patellofemoral joint stress or knee angle at peak stress between the extension dominant group and a matched set of healthy controls, but differences in other knee and hip mechanics were present.</div></div><div><h3>Interpretation</h3><div>The flexion dominant group's peak patellofemoral joint stress occurred later in stance placing it above the trochlear groove, perhaps loading cartilage unaccustomed to high magnitudes, and may contribute to the development of patellofemoral osteoarthritis through impaired adaptation to altered loading.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106738"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769966","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":"Knee adduction moment associates with pain irritability and frequency in people with severe radiographic knee osteoarthritis","authors":"L. Straatman,&nbsp;N.K. Ivanochko,&nbsp;J.M. Maciukiewicz,&nbsp;K.A. Marriott,&nbsp;E. Wiebenga,&nbsp;M.R. Maly","doi":"10.1016/j.clinbiomech.2026.106746","DOIUrl":"10.1016/j.clinbiomech.2026.106746","url":null,"abstract":"<div><h3>Background</h3><div>Pain irritability is the change in pain intensity after a task. The primary purpose was to determine the associations of knee adduction moment (KAM) with pain irritability and frequency in knee osteoarthritis, across varying radiographic severities. The secondary purpose was to compare pain measures between severities.</div></div><div><h3>Methods</h3><div>93 adults with clinical knee osteoarthritis (59 females, 34 males) participated. Kellgren-Lawrence grades (doubtful, mild, moderate, severe) were scored from x-rays acquired in a standardized weight-bearing position. The external KAM peak (Nm/kg) and impulse (Nm•s) were computed from kinematic and kinetic data from 10 barefoot walking trials at a self-selected speed. Pain measures included frequency and intensity from the Intermittent and Constant Osteoarthritis Pain (ICOAP) questionnaire. Pain irritability was the change in intensity on the Numeric Pain Rating Scale from before and after walking six minutes. Regression analyses evaluated the association of KAM with pain measures for each radiographic severity. Pain measures were compared between severities.</div></div><div><h3>Findings</h3><div>In severe, KAM impulse was positively associated with ICOAP constant pain (<em>p</em> = 0.035) and intermittent pain (<em>p</em> = 0.044). KAM impulse was not associated with any pain measure in other radiographic severity groups. Peak KAM was not associated with pain measures. Pain irritability was greater in severe compared to both mild (<em>p</em> = 0.004) and doubtful (<em>p</em> = 0.019) severities of knee osteoarthritis.</div></div><div><h3>Interpretation</h3><div>Greater loading of the medial knee during walking was associated with constant and intermittent pain in severe radiographic knee osteoarthritis. Pain irritability was higher in severe compared to mild disease.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106746"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926241","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":"Combining automated mechanical peripheral stimulation and treadmill exercise for gait rehabilitation in Parkinson's disease: A randomized controlled trial","authors":"Claudiane Arakaki Fukuchi ,&nbsp;Vinícius Christianini Moreno ,&nbsp;Carlos Augusto Kalva-Filho ,&nbsp;Antonio Roberto Zamunér ,&nbsp;Daniel Boari Coelho ,&nbsp;Fabio Augusto Barbieri","doi":"10.1016/j.clinbiomech.2025.106722","DOIUrl":"10.1016/j.clinbiomech.2025.106722","url":null,"abstract":"<div><h3>Background</h3><div>Treadmill exercise improves step length and velocity in Parkinson's disease (PD) but may not fully address all critical elements of gait, such as double support, which is closely associated with fall risk. Treadmill exercise combined with additional non-pharmacological strategies has the potential to yield a more comprehensive therapeutic approach. The application of automated mechanical peripheral stimulation (AMPS) has been identified as a potential intervention for gait rehabilitation, demonstrating efficacy in enhancing walking speed in PD. In principle, pre-activating sensory pathways via AMPS could prime the motor system for enhanced engagement during treadmill training. This study aimed to investigate the acute effects of AMPS combined with treadmill exercise in individuals with PD.</div></div><div><h3>Methods</h3><div>This randomized controlled trial involved fifteen individuals with PD (69.6 ± 5.1 years, MoCA: 27.3 ± 3.6 pts., UDPRS: 31.0 ± 6.9 pts., H&amp;Y: 1–3). Each participant visited the lab four times: once for clinical assessment and three times to undergo intervention conditions – AMPS, Exercise, and AMPS+Exercise - in a randomized order. A seven-day washout period was implemented between each intervention session. Gait assessment was conducted before and after each intervention.</div></div><div><h3>Findings</h3><div>Repeated measure ANOVA revealed a main effect of time for step length and step velocity (both <em>p</em> &lt; 0.05), with higher values post-intervention. After statistically controlling for baseline in step velocity, the Exercise showed greater adjusted post-intervention value than AMPS+Exercise condition (<em>p</em> = 0.031).</div></div><div><h3>Interpretation</h3><div>Although AMPS has emerged as a non-pharmacological technique to improve gait spatiotemporal parameters in individuals with PD, its combination with treadmill exercise did not yield superior effects in this acute protocol.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106722"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670863","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":"Pain, fear, and movement: Cognitive-behavioural connections in patellofemoral pain","authors":"Otávio Henrique Cardoso Leite ,&nbsp;Gabriel Jacob Navarro ,&nbsp;Nara Lourdes Moreno Rodrigues ,&nbsp;Cid André Fidelis de Paula Gomes ,&nbsp;Gábor József Barton ,&nbsp;Caio Sain Vallio ,&nbsp;Paulo Roberto Garcia Lucareli","doi":"10.1016/j.clinbiomech.2025.106716","DOIUrl":"10.1016/j.clinbiomech.2025.106716","url":null,"abstract":"<div><h3>Background</h3><div>Kinesiophobia, or fear of movement, is common in individuals with musculoskeletal pain, especially in those with patellofemoral pain, and it can lead to increased functional limitations. Although pain self-efficacy is known to affect kinesiophobia, the link between psychological factors and physical aspects such as movement patterns and pain intensity remains uncertain. This study aimed to assess the relationships between kinesiophobia and cognitive-behavioural factors, pain, and functional domains in participants with patellofemoral pain.</div></div><div><h3>Methods</h3><div>This was an observational, cross-sectional study involving 66 participants with patellofemoral pain who underwent assessments of cognitive-behavioural factors, self-reported pain, knee-related function, and movement function. Generalized linear models were used to examine the relationship between kinesiophobia and self-efficacy, pain catastrophizing, self-reported pain, knee-related function, and movement function measured by the Movement Deviation Profile.</div></div><div><h3>Findings</h3><div>The general linear model demonstrated that self-efficacy and the Movement Deviation Profile were predictors of kinesiophobia. The final model confirmed a notable inverse association between self-efficacy and kinesiophobia, with a 0.31-point decrease in kinesiophobia for each one-point increase in the Pain Self-Efficacy Questionnaire score. Regarding the Movement Deviation Profile, each one-degree increase in the movement deviation pattern was associated with a 0.24-point increase in kinesiophobia scores.</div></div><div><h3>Interpretation</h3><div>Kinesiophobia can decrease self-efficacy and lead to movement avoidance, negatively impacting perceived ability and physical function. Our findings emphasise the complex nature of kinesiophobia. Improving self-efficacy might help lessen fear-related avoidance, while movement patterns should be interpreted carefully by distinguishing between adaptive and maladaptive behaviours.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106716"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607164","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":"Exploring biomarkers of change in movement-evoked pain in Achilles tendinopathy: A secondary analysis of a randomized controlled trial","authors":"Adam J. Janowski ,&nbsp;Andrew A. Post ,&nbsp;Alberto Marcos Heredia-Rizo ,&nbsp;Laura A. Frey-Law ,&nbsp;Emine O. Bayman ,&nbsp;Kathleen A. Sluka ,&nbsp;Ruth L. Chimenti","doi":"10.1016/j.clinbiomech.2025.106706","DOIUrl":"10.1016/j.clinbiomech.2025.106706","url":null,"abstract":"<div><h3>Background</h3><div>Movement-evoked pain contributes to disability, yet factors that predict improvement in pain with rehabilitation remain largely unknown. We aimed to identify predictors and response biomarkers of the reduction in movement-evoked pain intensity with rehabilitation in individuals with Achilles tendinopathy (AT).</div></div><div><h3>Methods</h3><div>Individuals with AT (<em>n</em> = 65) were evaluated at baseline and after 8-weeks of rehabilitation. Pain (Numeric Rating Scale, 0 to 10) was collected during increasingly difficult tendon-loading (resting, walking, heel raises) and stretching (resting, standing, calf stretch) tasks. Psychological, ankle biomechanics, and clinical variables were collected. Linear mixed effects models were built around two paradigms of pain (tendon loading and stretching tasks) to determine variables predictive of change in pain (predictive biomarkers) and variables that changed along with change in pain (response biomarkers) with rehabilitation.</div></div><div><h3>Findings</h3><div>Lower ankle dorsiflexion during walking (β = 0.178, 95 %CI:0.06, 0.29), higher ankle dorsiflexion during stretching (β = −0.111, 95 %CI:-0.174, −0.05), a lower Victorian Institute of Sports Assessment- Achilles (VISA-A) score (β = 0.031, 95 % CI:0.010, 0.054), and younger age (β = 0.047, 95 %CI:0.022, 0.072) at baseline predicted a greater reduction in pain. For response biomarkers, reductions in duration of tendon stiffness (β = 0.018, 95 %CI: 0.001, 0.036), increases in ankle dorsiflexion during walking (β = −0.15, 95 %CI:-0.285, −0.016), reductions in depression (β = 0.109, 95 % CI:0.041, 0.178), and reductions in kinesiophobia (β = 0.151, 95 %CI:0.083, 0.219) were associated with greater reductions in pain. AT type was not associated with pain.</div></div><div><h3>Interpretation</h3><div>Regardless of AT type, kinesiophobia, ankle dorsiflexion, and clinical factors may be important factors to consider as predictors and/or response indicators for reductions in movement-evoked pain with rehabilitation.</div><div><strong>Study Registration:</strong></div><div><span><span>https://clinicaltrials.gov/study/NCT04059146</span><svg><path></path></svg></span></div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"131 ","pages":"Article 106706"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483901","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}