LOAD CARRIAGE ALTERS TIBIOFEMORAL KINEMATICS DURING SLOW JOGGING IN ADULT MEN AND WOMEN

The purpose of this investigation was to determine the effects of load carriage on tibiofemoral kinematics during running. Nineteen healthy, recreationally active adults completed dynamic biplane radiography trials of the dominant limb knee with no load (BW), and an additional 55% of body weight (+55%BW) while running 10% above gait transition velocity. A volumetric model-based tracking technique was utilized to derive medial translation excursion, proximal (inferior-superior) translation excursion, anterior translation excursion, flexion, internal rotation and abduction. At heel strike, running with +55%BW exhibited a more flexed knee compared to BW. However, BW exhibited more proximal translation excursion compared to +55%BW. By contrast, +55%BW had greater anterior translation excursion compared to BW. There were no significant differences between BW and +55%BW for medial translation excursion, internal rotation angle/excursion or abduction angle/excursion The greater knee flexion angle at heel strike for +55%BW may serve as a mechanism to better attenuate the greater impact force via eccentric muscle action. However, reduced proximal translation excursion during +55%BW could suggest greater loading of the soft tissues

Assessment of the Sheffield Support Snood, an innovative cervical orthosis designed for people affected by neck weakness

The aim of this study was to quantify the biomechanical features of the Sheffield Support Snood (SSS), a cervical orthosis specifically designed for patients with neck weakness. The orthosis is designed to be adaptable to a patient’s level of functional limitation using adjustable removable supports, which contribute support and restrict movement only in desired anatomical planes. Methods: The SSS was evaluated along with two commercially available orthoses, the Vista and Headmaster. The orthoses were compared in a series of flexion, extension, axial-rotation and lateral bending movements. Characterisation was performed with twelve healthy subjects with and without the orthoses. Two Inertial-Magneto sensors, placed on forehead and sternum, were used to quantify the neck range of motion (ROM). Findings: In its less rigid configuration, the SSS was effective in limiting movements only in the desired planes, preserving free movement in other planes, whereas the headmaster was only effective in limiting the flexion. The percentage of ROM achieved with the SSS in its rigid configuration is equivalent (P > 0.05, effect size < 0.4) to that achieved with the Vista, both in trials performed reaching the maximum amplitude (ROM reduction: 25%-34% vs 24%-47%) and at maximum speed (ROM reduction: 24%-29% vs 25%-43%). Interpretation: The SSS is effectively adaptable to different tasks and in its rigid configuration offers a support comparable to the Vista, although it has a less bulky structure. The chosen method is suitable for the assessment of ROM movements while wearing neck orthoses and easily translatable in a clinical context

Load carriage changes tibiofemoral arthrokinematics during ambulatory tasks in recruit-aged women

The introduction of women into U.S. military ground close combat roles requires research into sex-specific effects of military training and operational activities. Knee osteoarthritis is prevalent among military service members; its progression has been linked to occupational tasks such as load carriage. Analyzing tibiofemoral arthrokinematics during load carriage is important to understand potentially injurious motion and osteoarthritis progression. The study purpose was to identify effects of load carriage on knee arthrokinematics during walking and running in recruit-aged women. Twelve healthy recruit-aged women walked and ran while unloaded (bodyweight [BW]) and carrying additional + 25%BW and + 45%BW. Using dynamic biplane radiography and subject-specific bone models, tibiofemoral arthrokinematics, subchondral joint space and center of closest contact location between subchondral bone surfaces were analyzed over 0–30% stance (separate one-way repeated measures analysis of variance, load by locomotion). While walking, medial compartment contact location was 5% (~ 1.6 mm) more medial for BW than + 45%BW at foot strike (p = 0.03). While running, medial compartment contact location was 4% (~ 1.3 mm) more lateral during BW than + 25%BW at 30% stance (p = 0.04). Internal rotation was greater at + 45%BW compared to + 25%BW (p < 0.01) at 30% stance. Carried load affects tibiofemoral arthrokinematics in recruit-aged women. Prolonged load carriage could increase the risk of degenerative joint injury in physically active women

Consensus statement on abusive head trauma in infants and young children

Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term is AHT. There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma. The workup must exclude medical diseases that can mimic AHT. However, the courtroom has become a forum for speculative theories that cannot be reconciled with generally accepted medical literature. There is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic-ischemic injury, lumbar puncture or dysphagic choking/vomiting. There is no substantiation, at a time remote from birth, that an asymptomatic birth-related subdural hemorrhage can result in rebleeding and sudden collapse. Further, a diagnosis of AHT is a medical conclusion, not a legal determination of the intent of the perpetrator or a diagnosis of murder. We hope that this consensus document reduces confusion by recommending to judges and jurors the tools necessary to distinguish genuine evidence-based opinions of the relevant medical community from legal arguments or etiological speculations that are unwarranted by the clinical findings, medical evidence and evidence-based literature

Forced Marching with Load Decreases Tibiofemoral Joint Space Compared to Running

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