The skating acceleration to maximal speed transition (sprint) is an essential skill that involves substantial lower body strength and effective propulsion technique. Coaches and athletes strive to understand this optimal combination to improve performance and reduce injury risk. Hence, the purpose of this study was to compare body centre of mass and lower body kinematic profiles from static start to maximal speed of high calibre male and female ice hockey players on the ice surface. Overall, male and female skaters showed similar centre of mass trajectories, though magnitudes differed. The key performance difference was the male's greater peak forward skating speed (8.96 ± 0.44 m/s vs the females' 8.02 ± 0.36 m/s, p < 0.001), which was strongly correlated to peak leg strength (R = 0.81). Males generated greater forward acceleration during the initial accelerative steps, but thereafter, both sexes had similar stride-by-stride accelerations up to maximal speed. In terms of technique, males demonstrated greater hip abduction (p = 0.006) and knee flexion (p = 0.026) from ice contact to push off throughout the trials. For coaches and athletes, these findings underscore the importance of leg strength and widely planted running steps during the initial skating technique to achieve maximal skating speed over a 30 m distance.
Objective: To quantify differences in physical workload afforded by turn-assist surfaces relative to manual patient turns, and between nursing caregivers (turn-away vs. turn-toward) while performing partnered patient turning. Background: Nurse caregivers experience an increased risk of musculoskeletal injuries at the back or shoulders when performing patient-handling activities. Use of turn-assist surfaces can reduce the physical burden and risk on caregivers. Method: Whole-body motion capture and hand force measures were collected from 25 caregivers (17 female) while performing partnered manual and technology-facilitated turns. Shoulder and low back angles and L4/L5 joint contact forces were calculated at the instant of peak hand force application for both caregivers. Results: Hand force requirements for the turn-away caregiver were 93% of the estimated maximum acceptable force when performing a manual turn. Use of a turn-assist surface eliminated hand forces required to initiate the patient turn for the turn-away caregiver, where their role was reduced to inserting appropriate wedging behind the patient once the facilitated turn was complete. This reduced shoulder moments by 21.3 Nm for the turn-away caregiver, a reduction in exposure from 70% of maximum shoulder strength capacity to 15%. Spine compression exposures were reduced by 302.1 N for the turn-toward caregiver when using a turn-assist surface. Conclusion: Use of a turn-assist surface reduced peak hand force and shoulder-related exposures for turning away and reduced spine-related exposures for turning toward. Application: Turn-assist devices should be recommended to decrease the risk of musculoskeletal disorder hazards for both caregivers when performing a partnered patient turn.
Knee osteoarthritis (OA) is a significant problem in the aging population, causing pain, impaired mobility, and decreased quality of life. Conservative treatment methods are necessary to reduce rapidly increasing rates of knee joint surgery. Recommended strategies include weight loss and knee bracing to unload knee joint forces. Although weight loss can be beneficial for joint unloading, knee OA patients often find it difficult to lose weight or begin exercise due to knee pain, and not all patients are overweight. Unicompartment offloader knee braces can redistribute joint forces away from one tibiofemoral (TF) compartment; however, <5% of patients have unicompartmental tibiofemoral osteoarthritis (TFOA), while patients with isolated patellofemoral or multicompartmental OA are much more common. By absorbing body weight (BW) and assisting the knee extension moment using a spring-loaded hinge, sufficiently powerful knee-extension-assist (KEA) braces could be useful for unloading the whole knee. This paper (1) describes the design of a spring-loaded tricompartment unloader (TCU) knee brace intended to provide unloading in all three compartments of the knee while weight-bearing, (2) measures and compares the force output of the TCU against the only published and commercially available KEA brace, and (3) calculates the static unloading capacity of each device. The TCU and KEA braces delivered maximum assistive moments equivalent to reducing BW by approximately 45 and 6 lbs, respectively. The paper concludes that sufficiently powerful spring-loaded knee braces show promise in a new class of multicompartment unloader knee orthoses, capable of providing a clinically meaningful unloading effect across all three knee compartments.
Purpose. Traditional knee osteoarthritis (OA) braces are usually indicated for a minority of patients with knee OA, as they are only suitable for those with unicompartmental disease affecting the tibiofemoral joint. A new assistive brace design is intended for use in a wider range of knee OA patients with heterogeneous symptoms characteristic of patellofemoral, tibiofemoral, or multicompartmental knee OA. The purpose of this case series was to explore whether the use of this novel “tricompartment offloader” (TCO) brace was associated with clinically relevant improvements in pain and function. Materials and Methods. A retrospective analysis of individuals with knee OA ( n = 40 ) was conducted to assess pain, function, physical activity, and use of medication and other treatments before and after brace use. Validated outcome measures including the Visual Analog Scale (VAS) and Lower Extremity Functional Scale (LEFS) were used to assess pain and physical function (primary outcome measures). Exploratory measures were used to quantify physical activity levels and use of medication and other treatments (secondary outcome measures). Results. Average total pain (VAS) scores decreased by 36.6 mm and physical function (LEFS) scores increased by 16.0 points following the use of the TCO brace. Overall, 70% of the participants indicated increased weekly physical activity and 60% reported a decrease in their use of at least one other treatment. Conclusions. Results from this case series suggest that the TCO brace shows strong potential to fill a conservative treatment gap for patients with heterogeneous symptoms of knee OA that are characteristic of patellofemoral or multicompartment disease. Further investigation is warranted.
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