Journal of Biomechanics

Accurate estimation of body segment inertial properties is essential for biomechanical analyses, yet commonly used scaling methods rely on limited datasets and do not generalize well across diverse adult body morphologies. We developed a data-driven framework that estimates segment lengths, masses, centers of mass, and moments of inertia using regression models trained on large anthropometric datasets (ANSUR II and NHANES) combined with a geometric representation of 16 body segments. The framework uses height, weight, and sex as primary inputs and incorporates waist and hip circumferences or other length and cross-sectional measurements when available to refine body-shape predictions. For individuals with obesity, additional geometric rules redistribute excess mass based on segment-specific volume changes. The resulting models reproduced segment lengths, cross-sectional dimensions, and lumped segment masses within the ranges observed in the training datasets and outperformed published regression equations, particularly at higher body mass index (BMI) values. To promote broad adoption, we provide an open-source API in Python that performs the full parameter estimation using the trained models. This framework offers an accurate and accessible method for estimating adult body segment properties across a wide range of body sizes and shapes, supporting improved motion analysis, musculoskeletal simulation, and clinical biomechanics.

Objective: To identify brain injury metrics suitable for supporting sports head injury assessment by evaluating their association with brain tissue strain and consistency across sports. Methods: Head kinematics from 3,139 impacts in boxing, mixed martial arts, and rugby matches were recorded using instrumented mouthguards and used to calculate nine brain injury metrics. Impacts were simulated using an anatomically detailed finite element brain model to estimate peak 95th-percentile maximum principal strain (MPS) in the brain and brainstem, a measure of tissue deformation associated with long-term pathology. Sport-specific ordinary least squares models estimated xE, the metric value equivalent to a reference MPS of 0.21. Metric-MPS correlations and xE uncertainties were quantified using 5000 bootstrap resamples. Cross-sport consistency was assessed using the coefficient of variation (CV) of sport-specific median xE values, and uncertainty using the normalised confidence interval size (NCIS). Results: XGB, an extreme gradient boosting strain-prediction model, showed the strongest and most consistent correlations with whole-brain (r=0.924-0.974) and brainstem MPS (r=0.887-0.954) across all sports. PRV, BrIC and UBrIC also correlated strongly with whole-brain (r=0.724-0.930) and brainstem MPS (r=0.739-0.900), whereas HIC15 and HARM showed weaker correlation with MPS, particularly in rugby. XGB showed the lowest cross-sport variability (CV=0.034) and uncertainty (median NCIS=0.056). HARM, DAMAGE and HIC15 showed the greatest sport dependence (CV=0.575-0.588) and uncertainty (median NCIS=0.331-0.791). Conclusions: XGB, BrIC, and UBrIC demonstrated the strongest associations with brain tissue strain and the greatest consistency across sports. This study provides a biomechanically informed framework for selecting suitable metrics for sports HIA protocols.

Skeletal muscle is a living, perfused soft tissue whose viscoelastic behavior is shaped by both voluntary contraction and hemodynamic state. However, the independent and superimposed contributions of contractile loading and blood flow restriction (BFR) have not been quantified simultaneously in real time. Twenty-six healthy adults underwent multi-frequency ultrasound time-harmonic elastography (THE, 60-80 Hz) of the vastus lateralis under six conditions: rest, 15% and 30% maximal voluntary contraction (MVC) before BFR, passive BFR after 4 min of cuff inflation, and 15% and 30% MVC shortly after cuff release. Shear wave speed (SWS), reflecting elasticity, and penetration rate (PR), reflecting inverse viscous damping, were extracted using the k-MDEV inversion algorithm. BFR significantly elevated SWS at all three contraction levels relative to the corresponding pre-BFR measurements (Holm-corrected p [&le;] 0.011; dz = 0.54-2.13). PR decreased during resting BFR (dz = 1.34, p < 0.001) and at 15% MVC after cuff release (dz = 0.94, p < 0.001), but not at 30% MVC (dz = 0.21, p = 0.294). BFR-related changes reduced the SWS-force slope by 14.5% and the PR-force slope by 40.7%. Men exhibited a greater BFR-induced increase in resting SWS than women. These findings show that THE can distinguish contractile and hemodynamic contributions to skeletal-muscle viscoelasticity and provide complementary information on elastic and dissipative tissue behavior in vivo.

Objectives: Given the high injury burden in football and the documented limitations of strength-based screening, novel approaches are warranted. Adaptive Force (AF)being closer to injury-prone movements than pushing/pulling strength--offers an alternative. This study examined the association between AF-based muscle stability and musculoskeletal complaints in football players and compared AF-derived and conventional strength parameters in their discriminative capacity, complemented by a preliminary prospective follow-up. Methods: AF and maximal voluntary isometric contraction (MVIC) were measured in 23 male football players across five bilateral muscle groups (knee extensors/flexors; hip flexors/adductors/abductors). AF parameters (maximal isometric AF, maximal AF, AF-Ratio), MVIC and hamstrings-to-quadriceps (H:Q) ratio were compared between players with and without complaints assessed via questionnaire at baseline and six-month follow-up (n=13). Results: Stability deficits were strongly associated with complaints (OR=54.0, 82% side concordance). AF-Ratio discriminated clearly between players with and without complaints (d=-1.47), with hip abductors showing the strongest effect (d=-1.64). Players with subsequent complaints showed lower baseline AF-Ratio (d=-1.45) and more stability deficits (d=1.67). MVIC and H:Q ratio did not discriminate (p>0.430). Conclusion: The findings suggest that muscle stability assessment outperforms conventional strength parameters in discriminating players with and without complaints, with preliminary follow-up data providing tentative support for predictive value. The concept of functional instability syndrome (FIS) provides a mechanistic framework for non-contact injuries and musculoskeletal complaints. AF assessment offers potential for screening, including return-to-sport decisions. Further studies are needed to verify the results, investigate predictive value, and evaluate whether personalised stability-based interventions can reduce injury incidence.

Older adults sustain disproportionately severe injuries from trip-induced falls during obstacle crossing. Such falls depend partly on forward momentum when the foot crosses the obstacle. MOSAP, an index of passive dynamic gait stability, reflects this momentum. We quantified MOSAP and a synergy index from uncontrolled manifold analysis of step length and extrapolated center of mass in 25 young (21.6 {+/-} 3.5 yr) and 23 older adults (68 {+/-} 4.3 yr) during unobstructed and obstructed walking, to test whether MOSAP increases during obstacle crossing and whether it is actively stabilized at each step. Both groups increased MOSAP progressively over two approach steps by reducing forward momentum and shifting the center of mass posteriorly. Older adults showed greater increases at the crossing steps. The synergy index was positive for all steps, showing that deviations in step length and extrapolated center of mass covaried to stabilize MOSAP at step-specific values. The synergy index was not influenced by age. We conclude that adults actively recruit passive body mechanics while approaching and crossing obstacles to reduce the risk of a trip becoming a fall. Older adults amplify this strategy to compensate for diminished neuromuscular corrective capabilities.

Advanced footwear technology (AFT) has transformed competitive running, yet individual and sex-specific responses to different AFT models remain unclear, particularly near race pace. This study examined running economy (RE) and gait biomechanics in response to three top-tier AFT models (Shoe A: adidas Pro Evo 2; Shoe B: Nike Alphafly 3; Shoe C: On CloudBoom Strike 2) in 14 male and 12 female well-trained runners at sex-specific submaximal speeds (16 and 14 km{middle dot}h-{superscript 1}). RE, spatiotemporal, and joint kinematic/kinetic data were collected via indirect calorimetry, accelerometry, and three-dimensional motion capture with force platforms. RE was significantly lower in Shoe C than Shoe A (males: 2.1%; females: 1.4%) and Shoe B (males: 1.9%; females: 0.9%), with 73% of runners responding favourably to Shoe C, a more consistent response than previously reported. Despite being lightest, Shoe A produced the poorest RE, challenging conventional mass-economy assumptions. Biomechanically, Shoe C elicited greater impact magnitude, lower ankle quasi-stiffness, and greater ankle angular velocity during early stance. Female runners showed smaller RE improvements, potentially related to lower running velocity and body mass limiting midsole engagement. The most efficient AFT enabled these well-trained runners to be more spring-like through tolerating higher forces and faster angular velocities without greater demand on metabolic cost.

ABSTRACT Background: Athletes who return to soccer after anterior cruciate ligament reconstruction (ACLR) remain at elevated risk of secondary injury despite meeting conventional discharge criteria, and neuromuscular deficits in the reconstructed limb are known to be exposed by fatigue. Objective: To determine whether match-play fatigue differentially affects muscle stiffness, countermovement jump (CMJ) force symmetry, and rate of force development (RFD) asymmetry between soccer players with a history of ACLR and uninjured teammates. Methods: A prospective, cross-sectional, matched-control study enrolled 128 competitive soccer players (64 ACLR, 6-22 months post-surgery; 64 uninjured controls) across five recruitment waves (February-June 2026). Bilateral CMJ peak vertical force, jump height, RFD, and myotonometric stiffness of the rectus femoris (RF), vastus medialis (VM), and biceps femoris (BF) were recorded immediately before and after a standardized competitive match. Fatigue was quantified from second-half heart rate (percentage of age-predicted maximum) and end-match rating of perceived exertion (RPE). Within-group pre-to-post changes were evaluated with paired t-tests, between-group differences in the magnitude of change with independent-samples t-tests, and associations between fatigue indices and asymmetry changes with Pearson correlations. Results: Match play reduced CMJ limb symmetry index (LSI) in both groups, but the decline was more than three-fold greater in the ACLR group, 92.6% (SD 5.4%) to 85.1% (SD 7.1%), than in control group, 97.3% (SD 3.9%) to 95.0% (SD 4.2%), group-by-time difference, p < 0.001, (d = 0.64). RFD asymmetry approximately doubled in the ACLR group, 10.6% (SD 4.1%) to 17.6% (SD 6.5%), compared with a smaller rise in control group, 4.6% (SD 2.4%) to 6.3% (SD 3.7%); p < 0.001, d = 0.77). Involved-limb stiffness losses in the ACLR group exceeded those of controls for the RF (-21.2 vs. -9.2 N/m, p < 0.001), VM (-17.7 vs. -6.1 N/m, p < 0.001), and BF (-13.3 vs. -6.6 N/m, p < 0.001), whereas uninvolved-limb stiffness losses did not differ between groups (all p > 0.05). Fatigue markers (heart rate, RPE) were not significantly correlated with the magnitude of individual asymmetry change (|r| [&le;] 0.18, p > 0.15). Conclusions: In competitive soccer players 6-22 months after ACLR, match-play fatigue selectively compromises stiffness and explosive force output of the reconstructed limb, widening inter-limb asymmetries beyond what is seen in uninjured teammates, even though global cardiovascular and perceptual fatigue were comparable between groups. These findings suggest that return-to-sport testing performed only in a rested state may underestimate residual neuromuscular deficits, and support fatigue-inclusive assessment protocols before athletes are cleared for unrestricted competition. Abbreviations: ACL: anterior cruciate ligament, ACLR: anterior cruciate ligament reconstruction, BF: biceps femoris, CMJ: countermovement jump, HRmax: maximum heart rate, LSI: limb symmetry index, RF: rectus femoris, RFD: rate of force development, RPE: rating of perceived exertion, RTS: return to sport, VM: vastus medialis, SD: standard deviation. Keywords: Anterior cruciate ligament reconstruction, muscle fatigue, muscle stiffness, countermovement jump, limb symmetry index, rate of force development, soccer, return to sport.

Sleep deprivation is associated with impaired endurance performance and an increased risk of running-related injury. Previous research has identified alterations in running biomechanics following a single night of sleep deprivation under laboratory conditions. However, whether these biomechanical changes can be detected using wearable technology remains unknown. Twenty-one recreationally active runners completed submaximal treadmill running under both normal sleep and total sleep deprivation conditions in a randomized crossover design. Biomechanical features were extracted simultaneously using a full-body motion capture system and a trunk-mounted wearable sensor. Five machine learning classifiers were evaluated in two classification tasks: a within-subject task using paired recordings from the same individual, and a between-subject task performed without individual baseline data. Within-subject classification consistently exceeded chance level for both measurement systems, with best accuracies of 85% for the wearable sensor (Logistic Regression) and 83% for the motion capture system (Random Forest). These findings indicate that sleep deprivation produces a systematic and individually consistent biomechanical signature during running. In contrast, between-subject classification failed across nearly all models and systems, with accuracies remaining close to chance level ([~]50%), demonstrating that inter-individual variability obscures the sleep-deprivation signal in the absence of personalized baseline data. Both systems converged on temporal organization, loading-related variables, and stride-to-stride variability as the most discriminative feature domains. Contrary to expectations, the laboratory motion capture system did not outperform the wearable sensor. Together, these findings demonstrate that individualized, baseline-referenced monitoring is essential for detecting sleep-deprivation-related changes in running gait, and suggest that a single trunk-mounted wearable sensor may provide a practical solution for real-world monitoring when paired recordings are available.

Muscle force sharing during locomotion is influenced by the mechanical demands of movement and the contractile properties of synergistic muscles. In cats, plantarflexor muscles exhibit distinct functional specialization, with the slow-fibred soleus maintaining relatively constant force across conditions while faster muscles such as the plantaris and gastrocnemius increase force production with increasing locomotor demand. However, it remains unclear whether similar force-sharing patterns occur in larger animals with different musculoskeletal designs. Therefore, the purpose of this study was to examine force sharing between the superficial digital flexor (SDF) and medial gastrocnemius (MG) muscles during treadmill locomotion in sheep. Tendon buckle force transducers were surgically implanted on the SDF and MG tendons of seven sheep, and in vivo muscle forces were recorded during walking and trotting across different speeds and inclines. Both muscles increased force with increasing speed and incline; however, speed had a substantially greater effect than incline. The SDF consistently produced greater absolute force than the MG across all conditions, whereas the MG exhibited slightly larger relative increases in force with increasing speed. Time to peak force decreased with increasing speed in both muscles, although the SDF reached peak force later in stance than the MG across conditions. In contrast to the distinct specialization observed in cats, neither muscle displayed a relatively condition-independent, soleus-like force contribution. These findings suggest that force sharing in sheep is more distributed across synergistic muscles and may reflect the influence of musculoskeletal design, tendon compliance, and mixed fibre-type composition on muscle function in larger species.

Older adults face an increased risk of falls that may have severe consequences for their well-being. Routine, accessible clinical screening may help mitigate fall risk through early detection of balance impairments. Portable force plates offer a convenient and practical solution for balance assessment in clinical settings. A new force-plate-based balance measure, the intersection-point-height, has shown particularly promising results in its ability to distinguish between healthy and impaired balance behaviors. However, the intersection-point-height measure requires measurement of shear force during standing, which exhibits magnitudes of less than 0.2% of normal forces (body weight), taxing the dynamic range of most sensor technologies. The ability of existing force plates to measure such low-magnitude shear forces observed during quiet standing is currently unknown. This study presents a force-plate performance assessment method to evaluate shear-force measurement errors and quantify the uncertainty of the intersection-point-height measure. The method was applied to test a commonly used laboratory-grade portable force plate. While the device successfully captured sagittal-plane intersection-point-height at the lowest frequencies, low signal strength prevented precise readings in the frontal plane. Thus, the tested device only marginally met the precision required for quiet-standing analysis, underscoring the critical need for systematic performance validation of portable force plates prior to clinical use. Future efforts should focus on evaluating alternative portable force plates and exploring economical design improvements to enhance shear-force measurement precision.

Low-intensity vibration (LIV) is a non-invasive mechanical stimulus capable of regulating skeletal adaptation and cellular signaling pathways involved in bone remodeling. Despite growing interest in LIV, substantial methodological heterogeneity persists in the selection of experimental vibration parameters such as frequency, expressed in Hertz (Hz) and intensity, defined as earth's gravitational field (g) (9.81 m/s2). Focusing on micro-computed tomography (CT) derived trabecular bone volume fraction (BV/TV) as the main outcome measure, this study sought to synthesize the effects of different LIV frequency and intensity on BV/TV in small rodents (mice and rats) as they remain as the most studied pre-clinical model. To accomplish this, we performed a systematic review searching for publications in English on PubMed, Web of Science, CINAHL, and Embase databases. Two independent investigators followed inclusion criteria to select only peer-reviewed studies with mature mice, using whole-body vibration experiments without other co-variables. We further restricted to include studies that analyzed non-fractured bones and compared pre- and post-intervention or control values. In addition to these core criteria, a detailed hierarchical screening framework was applied during full-text review. The two independent investigators extracted data independently and considered the characteristics of the study, animals' characteristics, intervention characteristics, and results. For this study we considered load-bearing hindlimbs, femur and tibia, separately but did not include vertebrae in the analysis. A Bayesian network meta-analysis and a revised SYRCLE risk of bias (RoB) tool were used to evaluate the risk of bias across included studies. Seven studies met the inclusion criteria. Results showed that an LIV regime applied at 45Hz at 2g presented higher chances to increase trabecular BV/TV of the mouse tibia (estimated effect 3.22 [CrI 1.98, 4.45]), while LIV regimes applied to the femur at 90Hz and 1.4g (estimated effect 3.08 [CrI -1.99, 7.97]) present better chances to increase trabecular BV/TV results compared to other interventions but with no significant differences. Finally, we applied 45Hz at 0.2g LIV to 5 month old male C57BL/6 for 5 weeks (n=10/group) which showed significantly increased Trabecular Thickness (Tb.Th) for both the tibia (10%, p<0.01) and femur (17%, p<0.001), with the femur showing further increases in trabecular BV/TV (32%, p<0.05) compared to non-LIV controls. We conclude that changes in the microarchitectures of the tibia and femur respond differently to the same application of LIV (45Hz, 0.2g) in mice and rats.

ABSTRACT Background: Scapholunate instability (SLI) represents the most prevalent form of carpal instability and is increasingly recognized as a clinically significant occupational condition in manual-labor populations. Repetitive forceful gripping, sustained wrist loading, and awkward joint postures inherent to construction, manufacturing, and heavy industry may predispose workers to progressive scapholunate ligament compromise; however, the specific biomechanical mechanisms underlying dynamic grip force transmission in symptomatic laborers remain poorly characterized. Objective: This study aimed to quantify dynamic grip force profiles and wrist kinematics in manual laborers exhibiting clinical signs of scapholunate instability; compare these biomechanical parameters with asymptomatic worker controls; and identify occupation-specific loading patterns that may contribute to scapholunate ligament compromise. Methods: A cross-sectional observational design was employed. Forty-two male manual laborers, mean age 36.4 (SD 7.2 )years; mean occupational exposure 9.8 (SD 4.1) years, were recruited from construction and surgical instrument manufacturing sites in Sialkot District, Pakistan. Participants were stratified into a symptomatic group (n = 21) based on positive Watson scaphoid shift test, dorsal wrist pain, and functional limitation, and an asymptomatic control group (n = 21). Dynamic grip force was measured using a calibrated Jamar dynamometer across five standardized trials. Wrist kinematics were captured during a simulated gripping task using electrogoniometry. Surface electromyography (sEMG) recorded flexor digitorum superficialis, flexor carpi ulnaris, and extensor carpi radialis longus activity. Scapholunate gap was confirmed radiographically. Statistical analyses included independent samples t-tests, Pearson correlation, and logistic regression ( = 0.05). Results: Symptomatic workers demonstrated significantly reduced grip force (28.4 (SD 5.6) kg versus 41.7 (SD 6.3) kg; p < 0.001) and elevated wrist ulnar deviation during peak gripping (22.3 (SD 4.1) degrees versus 14.6 degrees (SD 3.8) degrees ; p = 0.002) compared with controls. sEMG amplitude of flexor digitorum superficialis was paradoxically elevated in the symptomatic group (mean difference 18.3 microvolts; 95% CI 11.4-25.2), suggesting compensatory hyperactivation. Scapholunate gap correlated positively with years of occupational exposure (r = 0.67; p < 0.001). Logistic regression identified wrist ulnar deviation angle (OR = 2.14; 95% CI 1.43-3.19) and grip force asymmetry (OR = 1.87; 95% CI 1.21-2.89) as independent predictors of instability signs. Conclusions: Manual laborers with work-related scapholunate instability signs exhibit distinct biomechanical signatures during dynamic gripping, including reduced force output, abnormal wrist posture, and compensatory neuromuscular recruitment. Occupational exposure duration is a significant predictor of radiographic scapholunate dissociation. These findings support the integration of ergonomic risk screening and early biomechanical assessment into occupational health protocols for manual labor populations in low- and middle-income settings. Abbreviations: CI: confidence interval, DRUJ: distal radioulnar joint, EMG/sEMG: (surface) electromyography, FCU: flexor carpi ulnaris, FDS: flexor digitorum superficialis, MSD: musculoskeletal disorder, OR: odds ratio, ROM: range of motion, SL/SLI: scapholunate/scapholunate instability, SLIL: scapholunate interosseous ligament, SLAC: scapholunate advanced collapse, WMSDs: work-related musculoskeletal disorders, SD: standard deviation. Keywords: scapholunate instability; dynamic gripping; manual labor; wrist biomechanics; carpal kinematics; occupational ergonomics; grip force; electromyography; Watson scaphoid shift test; work-related musculoskeletal disorders

Autonomic dysfunction is a common sequela of mild traumatic brain injury (mTBI). Physical activity progression is an integral component of mTBI rehabilitation, particularly in addressing autonomic dysfunction. However, clinicians often rely on point-in-time evaluation of orthostatic and exercise intolerance to guide activity recommendations. Commercially available wearable devices (e.g., Fitbits) provide an opportunity to evaluate heart rate response to activity in a real-world setting. Previous work has used physiologic (heart rate) and activity (step count) data to identify subgroups of adults with stroke that may be used to guide activity recommendations. This method may be useful to subgroup youth post-mTBI to identify those who have abnormal physiologic responses to activity. We aimed to identify subgroups using heart rate and step count data in adolescents presenting for specialty care after diagnosed mTBI. Eighty participants aged 13-18 within six months of mTBI diagnosis were recruited to wear a Fitbit Sense 2. Data from seven days and two nights collected within fourteen days of enrollment were included. A group-based steps per minute (SPM) threshold (25th percentile; 10 SPM) and individualized heart rate threshold (20% heart rate reserve (HRR)) were used to classify each minute of active daytime data into one of four quadrants: SPM>10 & HRR>20% (QI), SPM<10 & HRR>20% (QII), SPM<10 & HRR<20% (QIII), and SPM>10 & HRR<20% (QIV). We used percentage of minutes in each quadrant, mean steps per day, percentage of minutes with zero steps, mean SPM in QI, and resting heart rate in a k-means clustering algorithm to identify subgroups. We evaluated subgroup differences by clustering variables using Kruskal-Wallis tests. Sixty-one participants were included. Three subgroups emerged: Sedentary (n=12), Active (n=23), and Atypically Elevated Heart Rate (AEHR; n=26). Subgroups varied significantly on all clustering variables (p<0.01). The Active subgroup took a high number of steps per day, had lower sedentary time, and had the highest activity intensity (mean SPM in QI). The Sedentary subgroup took fewer steps per day compared to the Active subgroup, had high sedentary time, and showed the highest resting heart rate. The AEHR subgroup took fewer steps per day compared to the Active subgroup and had high sedentary time. The AEHR subgroup also spent a higher percentage of time with an atypically high heart rate response to low levels of activity compared to the other subgroups. Our findings suggest that data from wearable devices can identify subgroups of adolescents with mTBI with distinct physiologic/physical activity profiles, which may ultimately be used to inform personalized activity prescriptions. Future work should aim to understand how the identified subgroups relate to longitudinal outcomes.

Low cost inside out wearable trackers can be deployed at scale to measure body motion, but errors in estimated sensor position propagate through coordinate transformations into derived gait and dynamic-stability metrics. Healthy adults walked on a treadmill at 0.5 to 2.0 m/s while VIVE Ultimate Tracker (VUT) and Vicon data were recorded. Data-driven calibration models were developed to correct tracker coordinates and to estimate full body centre of mass (CoM) from a sacrum-only configuration. Agreement with Vicon was assessed using RMSE, mixed-effects Bland-Altman limits of agreement, MAE, and intraclass correlation coefficients. Calibration improved coordinate-level agreement. For gait parameters, model-corrected VUT showed small errors against Vicon (MAE: 0.24 to 0.71 mm step height, 1.73 to 4.63 mm step length, 0.15 to 0.95 mm step width, 0.26 to 0.88 mm foot clearance). Proxy CoM-derived margin of stability (MoS) agreed excellently with Vicon. For the sacrum-only pipeline, calibration reduced CoM RMSE from 103.65 to 104.04 mm to 7.55 to 8.95 mm, and markedly reduced systematic error in stability outcomes, with extrapolated CoM bias decreasing from 172.92 to 0.29 mm and MoS bias from -75.09 to -3.54 mm. Data-driven calibration improved the measurement utility of low-cost VUTs, enabling inexpensive, relatively simple gait and stability measurement from a sacrum-only setup in controlled settings.

This study examined how tempo, dynamics, and string influence upper-extremity physical exposure in professional violinists and how exposure variability is distributed among musical characteristics, between-subject differences, and residual variability. Twelve violinists performed seven standardized scales while bilateral upper-arm and wrist kinematics and shoulder and forearm muscle activity were recorded. Linear mixed-effects models showed that faster tempo increased right upper-arm velocity and bilateral forearm activity while reducing right upper-arm and wrist ranges of motion. Louder dynamics increased bilateral forearm and right trapezius activity and right-wrist ranges of motion. Higher-posture strings increased right upper-arm elevation and right shoulder muscle activity. Variance analysis identified exposures predominantly related to musical characteristics, jointly related to musical characteristics and between-subject differences, predominantly related to between-subject differences, or mainly unexplained. These findings support future exposure prediction from musical characteristics and targeted prevention through repertoire-based workload management, structured recovery, and individualized technique-focused strategies.

Abstract Introduction: Proximal humerus fractures account for approximately 5-6% of all adult fractures and are primarily managed nonoperatively. Healing is conventionally monitored with radiographs, with radiopaque callus formation indicating healing. Visible radiographic callus appears weeks after biological union begins. Ultrasound provides a dynamic, radiation-free, and cost-effective method that can detect early callus formation before x-ray visibility. Although ultrasound has demonstrated utility for fracture healing in the clavicle and humeral shaft, its role in proximal humerus fractures remains unclear. Methods: This single-centre prospective study will be conducted in two phases. The pilot phase will measure inter-rater reliability for ultrasound detection of early callus formation at 2 and 4 weeks post-injury. Ten patients with proximal humerus fractures treated nonoperatively will undergo standardized anterior and lateral scans. Each patient will generate four saved images (short- and long-axis views), producing forty anonymized images independently reviewed by two raters. The prospective cohort phase will recruit approximately thirty additional patients. Results: Reliability will be quantified using Cohens kappa. A power calculation will be performed after pilot analysis. Results from the prospective cohort phase will help determine the association and predictive value of early ultrasound-detected bridging callus for radiographic and clinical union at three and six months. Patient reported outcome measures will be assessed using the Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) questionnaire. Discussion: This study will develop and validate a standardized ultrasound protocol for assessing early fracture healing in proximal humerus fractures. By establishing both inter-rater reliability and predictive value, the findings may support ultrasound as a reproducible, radiation-free adjunct to conventional imaging and enable earlier identification of union status.

Energy expenditure (EE) during running depends on the interplay between active muscle work and elastic energy storage and return, yet the relative contribution of mechanical power to EE remains debated. Quantifying the relative contributions of segment-level mechanical power can provide a way to address this debate. In this study, we aimed to quantify how segment-level mechanical power contributes to EE during running and to demonstrate that these mechanistic insights support wearable-based EE estimation. Joint dynamics and respiratory gas-based EE were collected from healthy young adults running at multiple speeds. Scale factors were derived to quantitatively link efficiency-weighted segment power to measured EE. The stance leg consistently showed the strongest correlation with EE, and this dominance was preserved across speeds. Including swing-leg hip power further improved accuracy. Scale factors were approximately 0.45, suggesting that active muscle work and elastic energy return contribute comparably to the mechanical power associated with EE. Using a lightweight machine learning model, stance-leg and swing-leg hip joint power were reconstructed from a single sacral IMU, enabling accurate EE prediction. These findings demonstrate that lower-limb mechanical power is a robust predictor of running EE, supporting both the extensibility of biomechanically-informed frameworks and wearable-based EE monitoring.

Fascicle operating length during dynamic tasks is often compared to the isometric torque-length relationship, but there is a lack of evidence regarding the influence of joint velocity on optimal fascicle length. Moreover, there is no consensus in the literature regarding the influence of contraction initiation (pre-activation or passive start), although it could alter the interaction between fascicles and the tendon. This study aimed to investigate the effect of joint velocity and pre-activation on the torque-angle and torque-length relationships of the vastus lateralis during mono-articular isokinetic knee extensions. Twenty-one participants performed isometric, isokinetic (50{degrees}.s-1 to 450{degrees}.s-1), and isokinetic knee extensions with maximal isometric or eccentric pre-activation at 100{degrees}.s-1 and 300{degrees}.s-1. Torque, joint angle, fascicle length, and electromyographic activity of the quadriceps femoris muscles were recorded during contractions and then used to model the torque-angle and torque-length relationships. We were able to successfully fit the torque-angle and torque-length relationships (R{superscript 2}=0.93 and R{superscript 2}=0.92, respectively). A main effect of velocity was detected regarding the optimal angle (p<0.05), but no significant change was observed for the optimal fascicle length. Isometric pre-activation induced a reduction in maximal torque production compared with eccentric pre-activation and passive conditions at both isokinetic velocities (p<0.001), with no change in muscle activity. Our results suggest that muscle-tendon interactions may permit a dissimilar behavior between the torque-angle and the torque-fascicle length relationships. The reduction in torque following isometric pre-activation may be related to a contraction history-dependent phenomenon. NEW & NOTEWORTHYWe demonstrated that, at a given joint angle, increasing velocity altered fascicle operating length without shifting optimal fascicle length, likely because of muscle-tendon interactions. We also showed that maximal isometric pre-activation before a concentric contraction reduced mean and maximal torque during the isokinetic phase compared with eccentric pre-activation or no pre-activation. This effect may be linked to contraction history, since muscle activity did not differ between conditions.

The surface layer of articular cartilage provides for low-friction joint movement and protects the tissue from mechanical wear. The superficial zone chondrocytes (SZCs) of the surface layer produce proteoglycan-4 (PRG4), which is a lubricant that is necessary to reduce friction. Articular cartilage has limited capacity for self-repair and cell-based therapies, such as autologous chondrocyte implantation (ACI), is used to stimulate repair. However, in ACI, cells are expanded on tissue culture polystyrene where SZC poorly attach, proliferate slowly and dedifferentiate. Consequently, expanded SZC produce fibrocartilage tissue with insufficient PRG4. We previously demonstrated that culturing SZC on chondrocyte-derived decellularized extracellular matrix (CM) enhances SZC attachment and preserves phenotype. Since fibronectin (FN) was identified as the most abundant matrix protein within CM, here we tested the hypothesis that FN-coated culture surfaces would partially reproduce the beneficial effects of CM. We found that, similar to CM, SZC on FN-coated polystyrene increased SZC attachment and proliferation. However, unlike CM, SZCs expanded on FN-coated polystyrene remained more dedifferentiated as indicated by spread cells, elevated fibroblastic and contractile mRNA levels, and increased formation of SMA positive stress fibers. Consistent with the dedifferentiated phenotype, SZC on FN-coated polystyrene displayed extensive stress fibers, and higher nuclear myocardin-related-transcription-factor-a (MRTF-A). In contrast, CM reduced stress fiber formation and diminished nuclear MRTF-A in SZC. CM provides matrix cues beyond FN that suppress dedifferentiation and preserve the SZC phenotype. Identifying the matrix cues necessary to improve SZC expansion could lead to the generation of a superior surface in ACI repair tissue.

Introduction: Stair walking challenges balance and coordination in older people. Bench-stepping training improves stair climbing speed in healthy older women. This study assessed whether bench-stepping also improves dynamic balance and movement complexity during stair walking. Methods: Stair walking data were obtained from a previous study involving 45 healthy older women (69y+/-4) that assessed the effects of a 12-week bench-stepping intervention with non-training controls. Centre-of-mass acceleration was measured during stair ascent and descent. Linear dynamics included time, acceleration magnitude, and harmonic ratios (HR; indicating symmetry). Movement complexity was quantified using nonlinear dynamics including sample entropy (SE), recurrence quantification analysis (RQA), and fractal dimension (FD). Results: For stair ascent, increased speed (p =0.018, R2partial =0.093,) was accompanied by proportional increases in acceleration magnitudes (p=<0.039, R2partial =0.078-0.101). SE decreased more in the intervention group (p=<0.012, R2partial =0.049-0.101), indicating more predictable dynamics. In contrast, for stair descent, no changes in speed or acceleration magnitudes were observed. However, SE (p =0.001, R2partial =0.082) and maximum RQA line length (p= 0.008, R2partial =0.057) of vertical acceleration increased significantly compared to controls, indicating lower predictability and more persistent recurring patterns. No significant changes were found for other outcomes. Exploratory factor analysis revealed distinct differences in motor behaviour between stair ascent and descent. Conclusion: Bench-stepping training induced measurable changes in stair walking dynamics. Specifically, sample entropy shows potential as a sensitive marker of altered motor complexity, particularly of vertical accelerations. Interestingly, the direction of changes in unpredictability differed between stair ascent and descent, suggesting different underlying control strategies.