Tibial accelerations estimate instantaneous vertical loading rate and peak patellofemoral joint stress during running

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Abstract

INTRODUCTION
Patellofemoral pain (PFP) is a commonly reported running-related injury. Runners with PFP demonstrate greater peak patellofemoral joint stress (PFJS) during running than pain-free individuals,1 which may be associated with injury development. Inertial measurement units (IMU) allow estimation of site-specific stress and vertical loading rates2 in field settings by directly measuring acceleration at anatomical landmarks. These estimations could provide a method for field-based load monitoring and running gait retraining that may assist with PFP prevention and management. However, the relationship between IMUs and knee specific kinetics, such as PFJS, is currently unknown. This study investigated the relationship between IMU acceleration measured at different lower limb locations and PFJS and instantaneous vertical loading rate (IVLR) in healthy runners.
METHODThirteen healthy runners (11M / 2F, mean age (years ± SD) = 35.8 ± 7.5) were fitted with three IMUs at the distal tibia, proximal tibia, and distal thigh on the right limb. Participants performed 3-minute running intervals on a force-instrumented treadmill at 9, 11, 13, 15 and 17 km/h. Simultaneous kinematic data were collected using an 8-camera 3D motion capture system. Peak vertical (relative to segment) and resultant accelerations were extracted from each IMU and compared to PFJS and IVLR. Relationships between dependent (PFJS and IVLR) and independent variables (IMU acceleration) were explored using linear mixed models that included speed and IMU acceleration as fixed effects and participant as a random effect. The magnitude of differences (effect sizes) was calculated using Cohen’s ƒ2 with values of 0.02, 0.15 and 0.35, representing a small, medium, and large effect size, respectively.
RESULTSThere was a significant relationship between PFJS and peak resultant (coefficient [b] = 0.021, p = 0.041, ƒ2 = 0.05) (Figure 1A) and peak vertical acceleration (b = 0.019, p = 0.43, ƒ2 = 0.04) at the proximal tibia regardless of speed. There were no significant relationships between PFJS and acceleration measured at other locations. There was a significant relationship between IVLR and peak vertical acceleration at the distal tibia (b = 0.644, p < 0.001, ƒ2 = 0.36), proximal tibia (b = 0.174, p < 0.001, ƒ2 = 0.22) and thigh (b = 0.584, p = 0.036, ƒ2 = 0.21) regardless of speed (Figure 1B).
CONCLUSIONSPeak resultant and vertical acceleration values from an IMU attached to the proximal tibia are positively related to PFJS, but the relationships are unlikely to be practically meaningful. Consistent with previous research, peak vertical acceleration values from IMUs attached to the lower limb are positively related to peak IVLR in runners. The strongest relationship to IVLR was observed with peak vertical acceleration measured at the distal tibia. This relationship could form the basis of running gait retraining and monitoring for injury prevention and management.
REFERENCES1 Liao, T. C. J Appl Biomech. 34(4):298-305, 2018.2 Tenforde, A.S. PM&R. 12(7):679-684, 2020.
Original languageEnglish
Title of host publication12th Australasian Biomechanics Conference (ABC12)
Subtitle of host publicationOnline Conference Program
Place of PublicationAustralia
PublisherAustralian and New Zealand Society of Biomechanics
Pages52
Number of pages1
Publication statusPublished - Dec 2021
Event12th Australasian Biomechanics Conference (ABC12) - Virtual, Australia
Duration: 6 Dec 20217 Dec 2021

Conference

Conference12th Australasian Biomechanics Conference (ABC12)
Country/TerritoryAustralia
Period6/12/217/12/21

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