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Landing from a jump is a challenging task as the energy accumulated during the aerial phase of the jump must be fully dissipated by the lower limbs during landing; the higher the jump height, the greater the amount of energy to be dissipated. In the present study, we aim to understand (1) how the biomechanical behavior is tuned as a function of the mechanical demand, and (2) the relationship between the self-selected landing strategy and the behavior of the joints. Fourteen subjects were asked to drop off a box of 10 to 60 cm height and land on the ground. The ground reaction forces and the kinematics were recorded using force plates and a motion capture system. A model was used to estimate the properties, i.e. stiffness and damping, of the lower limbs and of the joints. Our results show that, whatever the amount of energy to be dissipated (i.e. height of the jump), the lower limbs and the anke and knee joints behave first as a spring, then as a spring-damper system. However each joint plays a specific role: during the spring phase, the behaviour of the lower limb is associated with the stiffness of the ankle and with the landing constraints (i.e. force peak and loading rate), while during the spring-damper phase, it is associated with the stiffness of the knee and with the amount of energy to be dissipated. Our findings suggest that constraints and performance result from a distinct control of biomechanical parameters at the joints.

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The development and acquisition of mature walking in children is multifactorial, depending among others on foot interaction with the ground, body dynamics and the knowledge of the 'rules' stemming from the gravity field. Indeed, each step the velocity of the centre of mass must be redirected upwards. This redirection may be initiated by the trailing leg, propulsing forward and upward the body before foot contact, or later by the loading limb after the contact with the ground. While it has been suggested that mature walking develops slowly from first independent steps to about 7 years of age, it is still unknown how children acquire the appropriate loading and propulsion forces during the step-to-step transition. To answer that question, twenty-four children (from 3 to 12 years old) and twelve young adults (from 20 to 27 years old) walked on force platforms at different walking speed. The ground reaction forces under each foot were recorded and the vertical velocity of the centre of mass of the body was computed. With decreasing age and increasing velocity (or Froude number), the occurrence of unanticipated transition is higher, related to a different ratio between the vertical support of the front and back leg. The different transition strategy observed in children indicates that body weight transfer from one limb to the other is not fully mature at 12 years old.

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Background: Work-related musculoskeletal disorders (WRMSDs) are a major health issue for low-income countries because of their high prevalence among workers and on account of the scarcity of ergonomic preventative measures in the workplace. Objectives: To determine the prevalence of WRMSDs among weavers, assess their consequences, and analyse the associated occupational risk factors. Method: A cross-sectional survey was carried out among 257 handloom weavers using the Nordic questionnaireand the working conditions were assessed through a descriptive analysis using the key indicator method. Results: The WRMSDs annual prevalence was 85% in all parts of the body, 71% for the low back region, 41% for the shoulders, and 37% for the knees. One quarter of the weavers indicated having stopped work for 1-30 days because of their low back pain (LBP). The prevalence of WRMSDs was associated with the number of hours worked per day, the years of experience, and age. Long working hours, load carrying (> 20 kg - 25 kg), awkward postures, repetitive limb movements, and unfavourable environmental conditions were identified as occupational risk factors. Conclusion: Work-related musculoskeletal disorders are common among weavers and LBP is the most frequently cited disorder and the primary reason for work interruptions and a decrease of activities. The prevalence of WRMSDs is associated with professional and personal factors. Actions based on ergonomic rules are necessary to prevent WRMSDs. Clinical implications: Our study highlights the issue of WRMSDs and the need for prevention in the informal sector, which constitutes the major part of economic activity in low-income countries.

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Background: The management of nonspecific chronic low back pain (NCLBP) is complex because of its multifactorial origin. Objectives: To investigate NCLBP care by evaluating patients' condition and therapeutic management of health practitioners. Method: A cross-sectional survey was carried out among 92 patients with NCLBP, 30 medical practitioners (MP) and 20 physiotherapists (PT) from four public health institutions in Burkina Faso. Patients completed the Visual Analogue Scale, Roland Morris Disability Questionnaire and Fear-Avoidance Beliefs Questionnaire. Practitioners were asked about therapy and continuing professional training. Results: Pain was moderate to intense for 80% of participants with NCLBP. They were functionally affected and showed fear-avoidance beliefs related to physical and work activities. The majority (97%) of medical practitioners prescribed analgesics and 53% prescribed nonsteroidal anti-inflammatory drugs (NSAIDs). Physiotherapy was the most frequently recommended nonpharmacological treatment. Forty-three per cent of medical practitioners referred to physiotherapy; 20% never did. Physiotherapists practised both passive treatments, such as massage (50%), electrotherapy (55%) and thermotherapy (50%), as well as active treatments, such as general exercises (55%), specific exercises (70%), functional revalidation (50%) and back school (40%). Having had recent continuing professional training and assessing risk factors for chronicity were associated with MPs' and PTs' therapeutic choices. Conclusion: Participants with NCLBP showed fear-avoidance beliefs, correlated with their algo-functional status. Prescribing habits of MPs were drug-based. Treatments by PTs were passive and active. Continuing professional training of healthcare practitioners and assessment of risk factors had a positive impact on therapeutic choices. Clinical implications: Our study is an invitation to the health care system to improve the relationship between a patient's NCLBP and therapeutic choices.

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PURPOSE: Landing involves a tuned anticipatory control to allow for soft and safe contact with the ground. Fearful situations are known to affect postural control strategies during standing, but it is still unclear how fear interferes with the control of a voluntary dynamic task requiring coordination between posture and movement. METHODS: Ground reaction forces, limb movements, physiological arousal, and perceived levels of confidence and fear of falling were recorded when hopping off a box to a platform situated 0.8 m above ground and 3.2 m above ground. RESULTS: Height induced a perceived threat as arousal was augmented by the elevated surface for all subjects. Threat induced by height modifies the way participants land, leading to a stiffer landing, as evidenced by an increased loading rate at touchdown during high threat conditions. Greater psychological and physiological changes are associated with greater changes in the control of landing: individuals that are less confident/more fearful appear to compensate for this stiffer landing, by slowing down their landing. CONCLUSION: Threatening conditions induces a harder contact to the ground, but the strategy is dependent of the level of confidence/fear. Less confident/more fearful participants are more focused on coping strategy and adopt a more cautious behaviour.

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Gait is a powerful measurement tool to evaluate the functional decline throughout ageing. Falls in elderly adults happen mainly during the redirection of the center of mass of the body (CoM) in the transition between steps. In young adults, this step-to-step transition begins before the double contact phase (DC) with a simultaneous forward and upward acceleration of the CoM. We hypothesize that, compared to young adults, elderly adults would exhibit unbalanced contribution of the back leg and the front leg during the transition. We calculated the mean vertical push-off done by the back leg (FBACK) and the mean impact force on the front leg (FFRONT) during the transition. Eight young (mean ±â€¯SD; age: 24 ±â€¯2 y) and 19 elderly (age: 74 ±â€¯6 y) healthy adults walked on a force-measuring treadmill at five selected speeds ranging from 0.56 to 1.67 m·s-1. Results show that, at mid and high speeds, elderly adults exhibit a smaller FBACK compared to young adults, possibly linked to the decreased plantar flexion of the back foot. As a consequence, FFRONT is significantly increased and the transition begins lately in the step, at the beginning of DC. Also, elderly adults show an inability to accelerate the CoM upward and forward simultaneously. Our findings show a different adaptation of the step-to-step transition with speed in elderly adults and identify two potential indicators of gait impairment with age: the FFRONT/FBACK contribution and the synchronization between the upward and forward acceleration of the CoM during the transition.

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PURPOSE: Results on reliability and normative data for the Timed Up and Go test (TUG) in children who are developing typically are systematically reviewed. SUMMARY OF KEY POINTS: Six different TUG protocols are presented for which normative data are available for ages 3 to 18 years. TUG time is consistent within and between raters and sessions and is influenced by age. The choice of protocol, self-selected versus fastest walking speed, and use of a motivational aspect and of the outcome calculation affect TUG time as well as its consistency within and between sessions. CONCLUSIONS: A standard protocol for the TUG is lacking and should be developed with attention to reliability. RECOMMENDATIONS FOR CLINICAL PRACTICE: If the TUG is to be used as a screening tool for dynamic balance control, clinicians need to apply protocols that include fastest walking speed motivation.

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In gait lab, the quantification of the ground reaction forces (GRFs) acting upon individual limbs is required for dynamic analysis. However, using a single force plate, only the resultant GRF acting on both limbs is available. The aims of this study are (a) to develop an algorithm allowing a reliable detection of the front foot contact (FC) and the back foot off (FO) time events when walking on a single plate, (b) to reconstruct the vertical GRFs acting upon each limb during the double contact phase (DC) and (c) to evaluate this reconstruction on healthy and clinical gait trials. For the purpose of the study, 811 force measurements during DC were analyzed based on walking trials from 27 healthy subjects and 88 patients. FC and FO are reliably detected using a novel method based on the distance covered by the centre of pressure. The algorithm for the force reconstruction is a revised version of the approach of Davis and Cavanagh [24]. In order to assess the robustness of the algorithm, we compare the resulting GRFs with the real forces measured with individual force plates. The median of the relative error on force reconstruction is 1.8% for the healthy gait and 2.5% for the clinical gait. The reconstructed and the real GRFs during DC are strongly correlated for both healthy and clinical gait data (R(2)=0.998 and 0.991, respectively).

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On Earth, when landing from a counter-movement jump, muscles contract before touchdown to anticipate imminent collision with the ground and place the limbs in a proper position. This study assesses how the control of landing is modified when gravity is increased above 1 g. Hypergravity was simulated in two different ways: (1) by generating centrifugal forces during turns of an aircraft (A300) and (2) by pulling the subject downwards in the laboratory with a Subject Loading System (SLS). Eight subjects were asked to perform counter-movement jumps at 1 g on Earth and at 3 hypergravity levels (1.2, 1.4 and 1.6 g) both in A300 and with SLS. External forces applied to the body, movements of the lower limb segments and muscular activity of 6 lower limb muscles were recorded. Our results show that both in A300 and with SLS, as in 1 g: (1) the anticipation phase is present; (2) during the loading phase (from touchdown until the peak of vertical ground reaction force), lower limb muscles act like a stiff spring, whereas during the second part (from the peak of vertical ground reaction force until the return to the standing position), they act like a compliant spring associated with a damper. (3) With increasing gravity, the preparatory adjustments and the loading phase are modified whereas the second part does not change drastically. (4) The modifications are similar in A300 and with SLS, however the effect of hypergravity is accentuated in A300, probably due to altered sensory inputs. This observation suggests that otolithic information plays an important role in the control of the landing from a jump.

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The purpose of this study was to mechanically evoke a triceps surae stretch reflex during the swing phase of running, to study its within-the-step phase dependency. Seven participants ran on a treadmill at 2.8 m·s-1 wearing an exoskeleton capable of evoking a sudden ankle dorsiflexion. We measured the electromyographic activity of the soleus, medial and lateral gastrocnemii just after the perturbation to evaluate the triceps surae stretch reflex. Similar perturbations were also delivered at rest. Our results showed that the stretch reflex was suppressed during the swing phase of running, except in late swing where a late reflex response was observed. At rest, all triceps surae muscles showed an early reflex response to stretch. Our findings suggest that the triceps surae short/medium-latency stretch reflex cannot be evoked during swing phase and thus cannot contribute to the control of the locomotor pattern after aperturbation during this phase.

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In an ideal elastic bounce of the body, the time during which mechanical energy is released during the push equals the time during which mechanical energy is absorbed during the brake, and the maximal upward velocity attained by the center of mass equals the maximal downward velocity. Deviations from this ideal model, prolonged push duration and lower upward velocity, have found to be greater in older than in younger adult humans. However it is not known how similarity to the elastic bounce changes during growth and whether an optimal elastic bounce is attained at some age. Here we show that similarity with the elastic bounce is minimal at 2 years and increases with age attaining a maximum at 13-16 years, concomitant with a mirror sixfold decrease of the impact deceleration peak following collision of the foot with the ground. These trends slowly reverse during the course of the lifespan.

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During walking, muscles must perform positive work to replace the energy lost from the body at each step, even if the average speed is constant and the terrain level. Young children have immature and irregular walk, but little is known about the effect of this walking pattern on the muscular external work done. Our objective was to measure using force platforms and the method of Cavagna (J Appl Physiol 39:174-179, 1975) the amount of muscular external work done by 1-year-old-, 4-year-old children and adults during walking. We were interested to quantify the approximation made by measuring only the positive external work done and assuming it reflects the external work done. After having confirmed that young children were not able to walk at a constant average speed over a complete number of steps, we showed the effect of the selection of trials by measuring the external work done assuming the amount of positive work done is equal to the negative work done (supposing there is no acceleration or deceleration over a complete number of steps). We observed that even if young subjects were not able to walk at a constant lateral speed over a complete number of steps, the amount of work done to maintain the center of mass movements in the transversal plane is not more than 10% of the external positive work done. This observational study points out that the measurement of external work, a good summary indicator for the gait mechanics, may be interpreted precociously when the population studied walked irregularly.

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We have previously suggested that the discharge characteristics of some neurons in the pontomedullary reticular formation (PMRF) are contingent on the simultaneous requirement for activity in both ipsilateral flexor muscles and contralateral extensors. To test this hypothesis we trained cats to stand on four force platforms and to perform a task in which they were required to reach forward with one forelimb or the other and depress a lever. As such the task required the cat to make a flexion movement followed by an extension in the reaching limb while maintaining postural support by increasing extensor muscle tonus in the supporting limbs. We recorded the activity of 131 neurons from the PMRF of three cats during left, ipsilateral reach. Of these, 86/131 (66%) showed a change in discharge frequency prior to the onset of activity in one of the prime flexor muscles and 43/86 (50%) showed a bimodal pattern of discharge in which activity decreased during the lever press. Among the remaining cells, 28/86 (33%) showed maintained activity throughout the reach and the lever press. Most cells showed a broadly similar pattern of discharge during reaches with the right, contralateral limb. We suggest these results support the view that a population of neurons within the PMRF contributes to the control of movement in one forelimb and the control of posture in the other forelimb as a coordinated unit. Another population of neurons contributes to the control of postural support independently of the nature of the activity in the reaching limb.

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We examined the contribution of neurons within the pontomedullary reticular formation (PMRF) to the control of reaching movements in the cat. We recorded the activity of 127 reticular neurons, including 56 reticulospinal neurons, during movements of each forelimb; 67/127 of these neurons discharged prior to the onset of activity in the prime flexor muscles during the reach of the ipsilateral limb and form the focus of this report. Most neurons (63/67) showed similar patterns and levels of discharge activity during reaches of either limb, although activity was slightly greater during reach of the ipsilateral limb. In 26/67 cells, the initial change in discharge activity was time-locked to the go signal during reaches of either limb; we have argued that this early discharge contributes to the anticipatory postural adjustments that precede movement. In 11/26 cells, the initial change in activity was reciprocal for reaches with the left and right limbs, although activity during the movement was nonreciprocal. Spike-triggered averaging produced postspike facilitation or depression (PSD) in 12/50 cells during reaches of the limb ipsilateral to the recording site and in 17/49 cells during reach of the contralateral limb. Some cells produced PSD in ipsilateral extensor muscles before the start of the reach and during reaches made with the contralateral, but not the ipsilateral limb; this suggests the signal must be differentially gated. Overall, the results suggest a strong bilateral, albeit asymmetric, contribution from the PMRF to the control of posture and movement during voluntary movement.

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Nepalese porters routinely carry head-supported loads equal to 100 to 200% of their body weight (Mb) for many days up and down steep mountain footpaths at high altitudes. Previous studies have shown that African women carry head-supported loads of up to 60% of their Mb far more economically than army recruits carrying equivalent loads in backpacks. Here we show that Nepalese porters carry heavier loads even more economically than African women. Female Nepalese porters, for example, carry on average loads that are 10% of their Mb heavier than the maximum loads carried by the African women, yet do so at a 25% smaller metabolic cost.

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We have addressed the nature of the postural control signals contained within the discharge activity of neurons in the pontomedullary reticular formation, including reticulospinal neurons, during a reaching task in the cat. We recorded the activity of 142 neurons during ipsilateral reaching movements that required anticipatory postural adjustments (APAs) in the supporting limbs to maintain equilibrium. Discharge activity in 82/142 (58%) neurons was significantly increased before the onset of the reach. Most of these neurons discharged either in a phasic (22/82), tonic (10/82), or phasic/tonic (41/82) pattern. In each of these 3 groups, the onset of the discharge activity in some neurons was temporally related either to the go signal or to the onset of the movement. In many neurons, one component of the discharge sequence was better related to the go signal and another to the onset of the movement. Based on our previous behavioral study during the same task, we suggest that reticular neurons in which the discharge activity is better related to the go signal contribute to the initiation of the APAs that precede the movement. Neurons in which the discharge activity is better related to the movement signal might contribute to the initiation of the movement and to the production of the postural responses that accompany that movement. Together our results suggest the existence of neurons that signal posture and movement independently and others that encode a convergent signal that contributes to the control of both posture and movement.

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While a basic locomotor rhythm is centrally generated by spinal circuits, descending pathways are critical for ensuring appropriate anticipatory modifications of gait to accommodate uneven terrain. Neurons in the motor cortex command the changes in muscle activity required to modify limb trajectory when stepping over obstacles. Simultaneously, neurons in the brainstem reticular formation ensure that these modifications are superimposed on an appropriate base of postural support. Recent experiments suggest that the same neurons in the same structures also provide similar information during reaching movements. It is suggested that, during both locomotion and reaching movements, the final expression of descending signals is influenced by the state and excitability of the spinal circuits upon which they impinge.

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We have examined the relationship between the movement and the anticipatory postural adjustments (APAs) that precede that movement during a reaching task in the cat. We recorded ground reaction forces in all 3 planes from all 4 limbs as well as electromyographic (EMG) activity from limb and axial muscles. The reaching movement was always preceded by an APA that was characterized by a loading of the reaching forelimb and an unloading of the support forelimb. This loading of the reaching forelimb was preceded, and accompanied, by increased activity in shoulder and limb extensor muscles of the reaching limb; extensor muscle activity in the supporting limb was simultaneously decreased. An important finding from this study was that the onset of the APA and of the movement was temporally decoupled. Analyses of the onset of EMG activity showed that most of the muscles that we recorded could be classified as either related to the APA or related to the movement. These results support the idea of distributed, and perhaps independent, systems for the execution of the APA and of the prime movement. There was also postural activity in the supporting limb during the movement. Analysis of this activity, which is also anticipatory in nature, suggests that it was tightly linked to the movement. We suggest that this postural response is signaled as part of the command for movement. Some muscles, particularly the extensors of the reaching limb, received convergent input from the command signals for the APA and for the movement.

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