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In Silico Biomarkers of Motor Function to Inform Musculoskeletal Rehabilitation and Orthopedic Treatment. Silico运动功能生物标志物为肌肉骨骼康复和骨科治疗提供信息。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-22 Print Date: 2023-10-01 DOI: 10.1123/jab.2023-0029
Ilse Jonkers, Erica Beaucage-Gauvreau, Bryce Adrian Killen, Dhruv Gupta, Lennart Scheys, Friedl De Groote

In this review, we elaborate on how musculoskeletal (MSK) modeling combined with dynamic movement simulation is gradually evolving from a research tool to a promising in silico tool to assist medical doctors and physical therapists in decision making by providing parameters relating to dynamic MSK function and loading. This review primarily focuses on our own and related work to illustrate the framework and the interpretation of MSK model-based parameters in patients with 3 different conditions, that is, degenerative joint disease, cerebral palsy, and adult spinal deformities. By selecting these 3 clinical applications, we also aim to demonstrate the differing levels of clinical readiness of the different simulation frameworks introducing in silico model-based biomarkers of motor function to inform MSK rehabilitation and treatment, with the application for adult spinal deformities being the most recent of the 3. Based on these applications, barriers to clinical integration and positioning of these in silico technologies within standard clinical practice are discussed in the light of specific challenges related to model assumptions, required level of complexity and personalization, and clinical implementation.

在这篇综述中,我们详细阐述了肌肉骨骼(MSK)建模与动态运动模拟相结合是如何从一种研究工具逐渐发展成为一种有前途的计算机工具的,通过提供与动态MSK功能和负荷相关的参数来帮助医生和理疗师进行决策。这篇综述主要集中在我们自己和相关的工作上,以说明MSK模型参数在3种不同疾病患者中的框架和解释,即退行性关节病、脑瘫和成人脊柱畸形。通过选择这3种临床应用,我们还旨在证明不同模拟框架的不同临床准备水平,引入基于计算机模型的运动功能生物标志物,为MSK的康复和治疗提供信息,其中成人脊柱畸形的应用是这3种应用中最新的。基于这些应用,根据与模型假设、所需的复杂性和个性化水平以及临床实施相关的具体挑战,讨论了这些计算机技术在标准临床实践中的临床集成和定位障碍。
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引用次数: 1
Joint Coordination With a Change in Task Constraint During Accurate Overhead Throwing. 精确顶投过程中任务约束变化下的关节协调。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-01 DOI: 10.1123/jab.2022-0130
Arata Kimura, Shinsuke Yoshioka, Senshi Fukashiro

In sports situations, players may be required to throw at different speeds. The question of how skilled players throw the ball accurately to the desired location under different speed conditions is of interest to biomechanics researchers. Previous research suggested that throwers use different types of joint coordination. However, joint coordination with a change in throwing speed has not been studied. Here, we show the effects of changes in throwing speed on joint coordination during accurate overhead throwing. Participants were seated on a low chair with their trunk fixed and threw a baseball aimed at a target under 2 different speed conditions (slow and fast). In the slow condition, the elbow flexion/extension angle coordinated with other joint angles and angular velocities to reduce the variability of the vertical hand velocity. In the fast condition, the shoulder internal/external rotation angle and the shoulder horizontal flexion/extension angular velocity coordinated with other joint angles and angular velocities to reduce the variability of the vertical hand velocity. These results showed that joint coordination differed with changes in throwing speed, indicating that joint coordination is not always fixed, but may differ depending on the task constraints, such as throwing speed.

在体育比赛中,运动员可能被要求以不同的速度投掷。技术娴熟的运动员如何在不同的速度条件下将球准确地扔到期望的位置,这是生物力学研究人员感兴趣的问题。先前的研究表明,投掷者使用不同类型的关节协调。然而,关节协调与投掷速度的变化还没有研究。在这里,我们展示了在准确的头顶投掷过程中,投掷速度的变化对关节协调的影响。参与者坐在一张低矮的椅子上,固定着鼻子,在两种不同的速度条件下(慢速和快速)向一个目标投掷棒球。在慢速状态下,肘关节屈伸角与其他关节角度和角速度协调,以减少垂直手速度的可变性。在快速状态下,肩关节内/外旋转角度和肩关节水平屈伸角速度与其他关节角度和角速度协调,以减少垂直手速度的可变性。这些结果表明,关节协调性随投掷速度的变化而变化,表明关节协调性并不总是固定不变的,而是可能根据任务约束(如投掷速度)而变化。
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引用次数: 1
The Effect of Sensor Placement on Measured Distal Tibial Accelerations During Running. 传感器放置对跑步时胫骨远端加速度测量的影响。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-01 DOI: 10.1123/jab.2022-0249
Lauren K Sara, Jereme Outerleys, Caleb D Johnson

Inertial measurement units (IMUs) attached to the distal tibia are a validated method of measuring lower-extremity impact accelerations, called tibial accelerations (TAs), in runners. However, no studies have investigated the effects of small errors in IMU placement, which would be expected in real-world, autonomous use of IMUs. The purpose of this study was to evaluate the effect of a small proximal shift in IMU location on mean TAs and relationships between TAs and ground reaction force loading rates. IMUs were strapped to 18 injury-free runners at a specified standard location (∼1 cm proximal to medial malleolus) and 2 cm proximal to the standard location. TAs and ground reaction forces were measured while participants ran at self-selected and 10% slower/faster speeds. Mean TA was lower at the standard versus proximal IMU location in the faster running condition (P = .026), but similar in the slower (P = .643) and self-selected conditions (P = .654). Mean TAs measured at the standard IMU explained more variation in ground reaction force loading rates (r2 = .79-.90; P < .001) compared with those measured at the proximal IMU (r2 = .65-.72; P < .001). These results suggest that careful attention should be given to IMU placement when measuring TAs during running.

附着在胫骨远端的惯性测量单元(imu)是一种经过验证的测量跑步者下肢冲击加速度的方法,称为胫骨加速度(TAs)。然而,没有研究调查IMU放置的小误差的影响,这在现实世界中是可以预期的,自主使用IMU。本研究的目的是评估IMU位置近端小位移对平均TAs的影响,以及TAs与地面反力加载率之间的关系。在指定的标准位置(内踝近1 cm)和标准位置近2 cm处,将imu绑在18名无损伤的跑步者身上。当参与者以自己选择的速度和慢/快10%的速度跑步时,测量ta和地面反作用力。在快速运行条件下,标准位置的平均TA低于IMU近端位置(P = 0.026),但在较慢运行条件下(P = 0.643)和自选条件下(P = 0.654)相似。在标准IMU上测量的平均TAs解释了地面反作用力加载率的更多变化(r2 = 0.79 - 0.90;P < 0.001)与近端IMU测量值相比(r2 = 0.65 - 0.72;P < 0.001)。这些结果表明,在跑步过程中测量ta时,应仔细注意IMU的放置。
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引用次数: 0
Mechanisms of Anterior Cruciate Ligament Tears in Professional National Basketball Association Players: A Video Analysis. 职业篮球运动员前十字韧带撕裂机制:视频分析。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-01 DOI: 10.1123/jab.2022-0266
Adam J Petway, Matthew J Jordan, Scott Epsley, Philip Anloague, Ernest Rimer

A systematic search was performed of online databases for any anterior cruciate ligament (ACL) injuries within the NBA. Video was obtained of injuries occurring during competition and downloaded for 2-dimensional video analysis. Thirty-five in-game videos were obtained for analysis. Of the reviewed cases, 19% were noncontact ACL injuries where there was no player-to-player contact from an opposing player. Three injury mechanism categories were found based on the events at the point of initial ground contact of the foot of the injured limb: single-leg casting (mean dorsiflexion angle 18.9° (14.4°); mean knee flexion angle 15.6° (7.8°); and mean trunk lateral flexion 18.2° (8.4°)); bilateral hop (mean dorsiflexion angle 18.2° (15.2°), mean knee flexion angle 21° (14.5°), mean trunk extension angle 6.9° (11.4°), and landing angle from the athlete's center of mass 47.9° (10.1°)); and single-leg landing after contact (mean abduction angle of the swing leg 105.4° (18.1°), mean knee flexion angle of the injured limb 34.2° (8.0°), and mean trunk ipsilateral flexion angle 22.2° (7.0°)).

一个系统的搜索进行了在线数据库的任何前交叉韧带(ACL)损伤在NBA。获取比赛中受伤的视频,下载进行二维视频分析。获得35个游戏内视频进行分析。在回顾的案例中,19%是非接触性前交叉韧带损伤,即球员与对手球员之间没有接触。根据受伤肢体足部最初接触地面的事件,发现了三种损伤机制:单腿铸造(平均背屈角度18.9°(14.4°));平均膝关节屈曲角度15.6°(7.8°);平均躯干外侧屈曲18.2°(8.4°);双侧跳(平均背屈角度18.2°(15.2°),平均膝关节屈曲角度21°(14.5°),平均躯干伸角6.9°(11.4°),离运动员质心的落点角度47.9°(10.1°));接触后单腿落地(摆腿外展角平均105.4°(18.1°),伤肢膝关节屈曲角平均34.2°(8.0°),躯干同侧屈曲角平均22.2°(7.0°))。
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引用次数: 2
The Effects of Posture and Dynamic Stretching on the Electromechanical Delay of the Paraspinal Muscles. 体位和动态拉伸对棘旁肌机电延迟的影响。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-01 DOI: 10.1123/jab.2022-0271
Richard O Fagbemigun, Melissa Cavallo, Stephen H M Brown

Electromechanical delay (EMD) of muscle is influenced in part by its in-series arrangement with connective tissue. Therefore, studying EMD might provide a better understanding of the muscle-connective tissue interaction. Here, EMD of the thoracic and lumbar erector spinae muscles were investigated under conditions that could influence muscle-connective tissue interaction. A total of 19 participants performed isometric back extension contractions in 3 different postures that influence lumbar spine angle: sitting, standing, and kneeling. They then performed a 15-minute dynamic stretching routine and repeated the standing contractions. Mean lumbar flexion angles of 0.5°, 9.9°, and 19.8° were adopted for standing, kneeling, and sitting, respectively. No statistically significant differences in the thoracic erector spinae EMD were found between the different postures. Lumbar erector spinae EMD was significantly longer in the sitting (94.1 ms) compared to the standing (69.9 ms) condition, with no differences compared to kneeling (79.7 ms). There were no statistically significant differences of the thoracic or lumbar erector spinae EMDs before and after dynamic stretching. These results suggest that dynamic stretching does not affect the mechanical behavior of the muscle-tendon-aponeurosis units in a way that alters force generation and transmission, but a sitting posture can alter how force is transmitted through the musculotendinous complex of the lumbar erector spinae.

肌肉的机电延迟(EMD)部分受其与结缔组织的串联排列的影响。因此,研究EMD可以更好地理解肌肉与结缔组织的相互作用。本文研究了在可能影响肌肉-结缔组织相互作用的条件下,胸和腰竖脊肌的EMD。共有19名参与者以3种影响腰椎角度的不同姿势(坐、站和跪)进行等距背部伸展收缩。然后,他们进行了15分钟的动态拉伸,并重复站立收缩。站立、跪、坐时腰屈平均角度分别为0.5°、9.9°、19.8°。不同体位的胸竖脊肌EMD差异无统计学意义。与站立(69.9 ms)相比,坐着(94.1 ms)时腰竖肌脊柱EMD明显更长,与跪着(79.7 ms)相比没有差异。动态拉伸前后胸、腰竖脊肌emd差异无统计学意义。这些结果表明,动态拉伸不会影响肌肉-肌腱-腱膜单元的机械行为,从而改变力的产生和传递,但坐姿可以改变力如何通过腰竖脊肌肌腱复合体传递。
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引用次数: 0
Lower Extremity Inverse Kinematics Results Differ Between Inertial Measurement Unit- and Marker-Derived Gait Data. 下肢逆运动学结果不同于惯性测量单元和标记派生的步态数据。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-01 DOI: 10.1123/jab.2022-0194
Jocelyn F Hafer, Julien A Mihy, Andrew Hunt, Ronald F Zernicke, Russell T Johnson

In-lab, marker-based gait analyses may not represent real-world gait. Real-world gait analyses may be feasible using inertial measurement units (IMUs) in combination with open-source data processing pipelines (OpenSense). Before using OpenSense to study real-world gait, we must determine whether these methods estimate joint kinematics similarly to traditional marker-based motion capture (MoCap) and differentiate groups with clinically different gait mechanics. Healthy young and older adults and older adults with knee osteoarthritis completed this study. We captured MoCap and IMU data during overground walking at 2 speeds. MoCap and IMU kinematics were computed with OpenSim workflows. We tested whether sagittal kinematics differed between MoCap and IMU, whether tools detected between-group differences similarly, and whether kinematics differed between tools by speed. MoCap showed more anterior pelvic tilt (0%-100% stride) and joint flexion than IMU (hip: 0%-38% and 61%-100% stride; knee: 0%-38%, 58%-89%, and 95%-99% stride; and ankle: 6%-99% stride). There were no significant tool-by-group interactions. We found significant tool-by-speed interactions for all angles. While MoCap- and IMU-derived kinematics differed, the lack of tool-by-group interactions suggests consistent tracking across clinical cohorts. Results of the current study suggest that IMU-derived kinematics with OpenSense may enable reliable evaluation of gait in real-world settings.

在实验室中,基于标记的步态分析可能不能代表现实世界的步态。使用惯性测量单元(imu)结合开源数据处理管道(OpenSense),现实世界的步态分析可能是可行的。在使用OpenSense研究真实世界的步态之前,我们必须确定这些方法对关节运动学的估计是否与传统的基于标记的运动捕捉(MoCap)相似,并区分临床不同步态力学的组。健康的年轻人和老年人以及患有膝骨关节炎的老年人完成了这项研究。我们以2种速度在地上行走时捕获动作捕捉和移动单元数据。使用OpenSim工作流计算动作捕捉和IMU运动学。我们测试了MoCap和IMU之间的矢状位运动学是否不同,工具是否同样检测到组间差异,以及工具之间的运动学是否因速度而不同。动作捕捉显示骨盆前倾(0%-100%步幅)和关节屈曲比IMU(髋关节:0%-38%和61%-100%步幅;膝关节:0%-38%,58%-89%,步幅95%-99%;脚踝:6%-99%步幅)。各组之间没有明显的相互作用。我们在各个角度都发现了显著的工具速度交互。虽然MoCap和imu衍生的运动学不同,但缺乏工具组间的相互作用表明在临床队列中有一致的跟踪。目前的研究结果表明,使用OpenSense的imu导出的运动学可以在现实环境中可靠地评估步态。
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引用次数: 2
Inertial Sensor-Based Estimation of Temporal Events in Skating Sub-Techniques While In-Field Roller Skiing. 基于惯性传感器的现场轮滑滑子技术时间事件估计。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-01 DOI: 10.1123/jab.2022-0073
Frédéric Meyer, Magne Lund-Hansen, Jan Kocbach, Trine M Seeberg, Øyvind B Sandbakk, Andreas Austeng

The aim of this study was to test and adapt a treadmill-developed method for determination of inner-cycle parameters and sub-technique in cross-country roller ski skating for a field application. The method is based on detecting initial and final ground contact of poles and skis during cyclic movements. Eleven athletes skied 4 laps of 2.5 km at low- and high-endurance intensities, using 2 types of skis with different rolling coefficients. Participants were equipped with inertial measurement units attached to their wrists and skis, and insoles with pressure sensors and poles with force measurements were used as reference systems. The method based on inertial measurement units was able to detect >97% of the temporal events detected with the reference system. The inner-cycle temporal parameters had a precision ranging from 49 to 59 milliseconds, corresponding to 3.9% to 13.7% of the corresponding inner-cycle duration. Overall, this study showed good reliability of using inertial measurement units on athletes' wrists and skis to determine temporal events, inner-cycle parameters, and the performed sub-techniques in cross-country roller ski skating in field conditions.

本研究的目的是测试和采用跑步机开发的方法来确定越野轮滑的内循环参数和子技术,并将其应用于现场应用。该方法是基于检测在循环运动中雪杖和滑雪板的初始和最终地面接触。11名运动员使用两种不同滚动系数的滑雪板,在低耐力和高耐力强度下滑了4圈2.5公里。参与者的手腕和滑雪板上都配备了惯性测量装置,鞋垫上装有压力传感器,鞋杆上装有力测量装置,作为参考系统。基于惯性测量单元的方法能够检测到参考系统检测到的>97%的时间事件。内周期时间参数的精度范围为49 ~ 59毫秒,对应于相应内周期时间的3.9% ~ 13.7%。总体而言,本研究表明,在野外条件下,使用运动员手腕和滑雪板上的惯性测量装置来确定越野轮滑的时间事件、内循环参数和执行的子技术具有良好的可靠性。
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引用次数: 1
Variability of Spatiotemporal Gait Kinematics During Treadmill Walking: Is There a Hawthorne Effect? 跑步机行走时时空步态运动学的变异性:是否存在霍桑效应?
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-01 DOI: 10.1123/jab.2022-0185
Saaniya Farhan, Marco A Avalos, Noah J Rosenblatt

Spatiotemporal gait kinematics and their variability are commonly assessed in clinical and laboratory settings to quantify fall risk. Although the Hawthorne effect, or modifications in participant behavior due to knowledge of being observed, has the potential to impact such assessments, it has received minimal attention in the study of gait-particularly gait variability. The purpose of this study was to quantify the Hawthorne effect on variability and central tendency measures of fall-related spatiotemporal gait parameters. Seventeen healthy young adults walked on a treadmill at a self-selected velocity for 2 minutes under covert evaluation (ie, without awareness of being evaluated) and 2 minutes under overt evaluation. The movement was recorded using motion capture technology, from which we calculated mean value and step-to-step variability (using standard deviation and mean absolute deviation) of step length, step width, percent double support, percent stance phase, and stride time. Although central tendencies were unaffected by evaluation type, four-of-five measures of variability were significantly lower during overt evaluation for at least one-of-two metrics. Our results suggest a Hawthorne effect on locomotor control. Researchers should be aware of this phenomenon when designing research studies and interpreting gait assessments.

时空步态运动学及其可变性通常在临床和实验室环境中评估,以量化跌倒风险。虽然霍桑效应,或由于被观察到的知识而改变参与者的行为,有可能影响这种评估,但在步态研究中,特别是步态变异性的研究中,它受到的关注很少。本研究的目的是量化霍桑效应对跌倒相关时空步态参数变异性和集中趋势测量的影响。17名健康的年轻人在跑步机上以自选的速度步行2分钟,隐蔽评估(即没有意识到被评估)和公开评估2分钟。使用动作捕捉技术记录运动,从中计算步长、步宽、双支撑百分比、站立相位百分比和步幅时间的平均值和步间变异性(使用标准差和平均绝对偏差)。尽管集中倾向不受评估类型的影响,但在公开评估中,至少两个指标中的一个的五分之四的变异性测量显着降低。我们的研究结果表明霍桑效应对运动控制有影响。研究人员在设计研究和解释步态评估时应该意识到这一现象。
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引用次数: 1
Effects of Visual Input Absence on Balance Recovery Responses to Lateral Standing Surface Perturbations in Older and Younger Adults. 视觉输入缺失对老年人和年轻人侧向站立面扰动下平衡恢复反应的影响。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-01 DOI: 10.1123/jab.2022-0029
Woohyoung Jeon, James Borrelli, Hao-Yuan Hsiao

Although the ability to recover balance in the lateral direction has important implications with regard to fall risk in older adults, the effect of visual input on balance recovery in response to lateral perturbation and the effect of age are not well studied. We investigated the effect of visual input on balance recovery response to unpredictable lateral surface perturbations and its age-related changes. Ten younger and 10 older healthy adults were compared during balance recovery trials performed with the eyes open and eyes closed (EC). Compared with younger adults, older adults showed increased electromyography (EMG) peak amplitude of the soleus and gluteus medius, reduced EMG burst duration of the gluteus maximus and medius, and increased body sway (SD of the body's center of mass acceleration) in EC. In addition, older adults exhibited a smaller % increase (EC-eyes open) of the ankle eversion angle, hip abduction torque, EMG burst duration of the fibularis longus, and a greater % increase of body sway. All kinematics, kinetics, and EMG variables were greater in EC compared with eyes open in both groups. In conclusion, the absence of visual input negatively affects the balance recovery mechanism more in older adults compared with younger adults.

虽然在侧面恢复平衡的能力对老年人跌倒风险具有重要意义,但视觉输入对侧向扰动下平衡恢复的影响以及年龄的影响尚未得到很好的研究。我们研究了视觉输入对平衡恢复反应的影响,以不可预测的侧向表面扰动及其与年龄相关的变化。10名年轻健康成人和10名年长健康成人在睁眼和闭眼(EC)的平衡恢复试验中进行比较。与年轻人相比,老年人在EC中表现为比目鱼肌和臀中肌肌电图(EMG)峰值幅度增加,臀大肌和中肌肌电图爆发持续时间缩短,身体摇摆(身体重心加速度SD)增加。此外,老年人踝关节外翻角、髋关节外展扭矩、腓骨长肌肌电图爆发持续时间的增加百分比较小(ec -睁眼),而身体摆动的增加百分比较大。所有运动学、动力学和肌电图变量都比两组睁眼时大。综上所述,视觉输入缺失对老年人平衡恢复机制的负面影响大于年轻人。
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引用次数: 1
Minimum Sampling Frequency for Accurate and Reliable Tibial Acceleration Measurements During Rearfoot Strike Running in the Field. 准确可靠的胫骨加速度测量的最小采样频率。
IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2023-06-01 DOI: 10.1123/jab.2022-0069
Kevin G Aubol, Clare E Milner

Field-based tibial acceleration measurements are increasingly common but sampling frequencies vary between accelerometers. The purpose of this study was to determine the minimum sampling frequency needed for reliable and accurate measurement of peak axial and resultant tibial acceleration during running in the field. Tibial acceleration was measured at 7161 Hz in 19 healthy runners on concrete and grass. Acceleration data were down sampled to approximate previously used sampling frequencies. Peak axial and resultant tibial acceleration were calculated for each sampling frequency. The within-session reliability and accuracy of peak axial and resultant tibial accelerations were evaluated using intraclass correlation coefficients, mean differences, and 95% limits of agreements. Intraclass correlation coefficients greater than .9 indicated excellent within-session reliability for both peak axial and resultant tibial acceleration measured while running on concrete and grass. Peak axial and resultant tibial accelerations were 0.5 to 1.4 g lower and minimal detectable differences were up to 0.6 g higher at 102 Hz compared with higher sampling frequencies. We recommend a minimum sampling frequency of 199 Hz for accurate and reliable measurements of peak axial and resultant tibial acceleration in the field.

基于场的胫骨加速度测量越来越普遍,但加速度计之间的采样频率不同。本研究的目的是确定在野外跑步时可靠和准确测量峰值轴向和由此产生的胫骨加速度所需的最小采样频率。在混凝土和草地上,19名健康跑步者的胫骨加速度为7161 Hz。加速度数据向下采样,以近似先前使用的采样频率。计算每个采样频率的峰值轴向加速度和由此产生的胫骨加速度。使用类内相关系数、平均差异和95%的一致性限来评估峰值轴向加速度和由此产生的胫骨加速度的组内可靠性和准确性。类内相关系数大于0.9表明,在混凝土和草地上跑步时测量的峰值轴向加速度和最终胫骨加速度的组内可靠性都很好。与较高的采样频率相比,102 Hz时的峰值轴向加速度和由此产生的胫骨加速度降低了0.5至1.4 g,最小可检测差异高达0.6 g。我们建议最小采样频率为199hz,以准确可靠地测量峰值轴向和由此产生的胫骨加速度。
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引用次数: 1
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Journal of Applied Biomechanics
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