High day-to-day repeatability of lower extremity muscle activation patterns and joint biomechanics of dual-belt treadmill gait: A reliability study in healthy young adults.

PURPOSE The reliability of lower extremity muscle activation patterns has not been clearly studied in a dual-belt instrumented treadmill environment. The primary study objective was to quantify the day-to-day reliability of quadriceps, hamstrings, gastrocnemius and gluteus medius activation patterns in healthy young adult gait. Secondarily, the reliability of spatiotemporal, and knee/hip motion and moment-based gait outcomes was assessed. SCOPE 20 young adults were recruited and tested on two separate days. Using standardized procedures, participants were prepared for surface electromyography and lower extremity motion capture. All individuals walked on a dual-belt instrumented treadmill while muscle activation, segment motions and ground reaction forces were recorded. Sagittal plane motion and net external sagittal and frontal plane moments were calculated. Discrete biomechanical and muscle activation measures were calculated, and non-negative matrix factorization extracted amplitude and temporal muscle activation features. Intraclass Correlation Coefficients, Standard Error of Measurement and Minimum Detectable Change were calculated. CONCLUSIONS High to excellent Intraclass correlation coefficients were found between visits for most primary and secondary outcomes. The absolute and relative reliability, including Minimum Detectable Change values, provided in this study support the use of dual-belt instrumented treadmill walking as an acceptable medium to collect biomechanical and lower extremity EMG outcomes for future studies.

[1]  Benno M Nigg,et al.  Reliability of the knee muscle co-contraction index during gait in young adults with and without knee injury history. , 2018, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[2]  D. Rutherford,et al.  Contralateral pelvic drop during gait increases knee adduction moments of asymptomatic individuals. , 2016, Human movement science.

[3]  B. Freriks,et al.  Development of recommendations for SEMG sensors and sensor placement procedures. , 2000, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[4]  D A Winter.  Knowledge base for diagnostic gait assessments. , 1993, Medical progress through technology.

[5]  C. Goldsmith,et al.  Use of the standard error as a reliability index of interest: an applied example using elbow flexor strength data. , 1997, Physical therapy.

[6]  Michael W. Berry,et al.  Algorithms and applications for approximate nonnegative matrix factorization , 2007, Comput. Stat. Data Anal..

[7]  Dara Meldrum,et al.  Test-retest reliability of three dimensional gait analysis: including a novel approach to visualising agreement of gait cycle waveforms with Bland and Altman plots. , 2014, Gait & posture.

[8]  D. Lloyd,et al.  Pre‐surgery knee joint loading patterns during walking predict the presence and severity of anterior knee pain after total knee arthroplasty , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[9]  Kohei Watanabe,et al.  Similarity of muscle synergies extracted from the lower limb including the deep muscles between level and uphill treadmill walking. , 2018, Gait & posture.

[10]  Andrea d'Avella,et al.  Matrix factorization algorithms for the identification of muscle synergies: evaluation on simulated and experimental data sets. , 2006, Journal of neurophysiology.

[11]  Hylton B Menz,et al.  Reliability of lower limb electromyography during overground walking: a comparison of maximal- and sub-maximal normalisation techniques. , 2010, Journal of biomechanics.

[12]  Stolze,et al.  Retest reliability of spatiotemporal gait parameters in children and adults. , 1998, Gait & posture.

[13]  K J Deluzio,et al.  Neuromuscular alterations during walking in persons with moderate knee osteoarthritis. , 2006, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[14]  H. K. Ramakrishnan,et al.  Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait , 1989, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[15]  Dual‐belt treadmill familiarization: Implications for knee function in moderate knee osteoarthritis compared to asymptomatic controls , 2017, Clinical biomechanics.

[16]  Alberto Rainoldi,et al.  Innervation zone locations in 43 superficial muscles: Toward a standardization of electrode positioning , 2014, Muscle & nerve.

[17]  K. An,et al.  Repeated measures of adult normal walking using a video tracking system 1 Presented in part at the 1 , 1997 .

[18]  M M van der Krogt,et al.  Effects of adding a virtual reality environment to different modes of treadmill walking. , 2014, Gait & posture.

[19]  P. Stratford,et al.  Relative and absolute test-retest reliabilities of biomechanical risk factors for knee osteoarthritis progression: benchmarks for meaningful change. , 2017, Osteoarthritis and cartilage.

[20]  Shawn M Robbins,et al.  Reliability of principal components and discrete parameters of knee angle and moment gait waveforms in individuals with moderate knee osteoarthritis. , 2013, Gait & posture.

[21]  A. Burden.  How should we normalize electromyograms obtained from healthy participants? What we have learned from over 25 years of research. , 2010, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[22]  M. Batavia,et al.  The validity and reliability of the GAITRite system's measurements: A preliminary evaluation. , 2001, Archives of physical medicine and rehabilitation.

[23]  N. Dominici,et al.  Muscle Synergies in Response to Biofeedback-Driven Gait Adaptations in Children With Cerebral Palsy , 2019, Front. Physiol..

[24]  M. Morris,et al.  The reliability of three-dimensional kinematic gait measurements: a systematic review. , 2009, Gait & posture.

[25]  Cheryl L. Hubley-Kozey,et al.  Maximal voluntary isometric contraction exercises: a methodological investigation in moderate knee osteoarthritis. , 2011, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[26]  Richard R Neptune,et al.  Merging of healthy motor modules predicts reduced locomotor performance and muscle coordination complexity post-stroke. , 2010, Journal of neurophysiology.

[27]  Tania Pizzari,et al.  Gluteus medius: an intramuscular EMG investigation of anterior, middle and posterior segments during gait. , 2013, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[28]  Shawn M Robbins,et al.  Reliability of surface electromyographic recordings during walking in individuals with knee osteoarthritis. , 2013, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[29]  Stephen T. Holgate,et al.  Reliability: What is it, and how is it measured? , 2000 .

[30]  M. Al-Amri,et al.  Intra-rater repeatability of gait parameters in healthy adults during self-paced treadmill-based virtual reality walking , 2017, Computer methods in biomechanics and biomedical engineering.

[31]  J. Weir.  Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. , 2005, Journal of strength and conditioning research.

[32]  S. Haley,et al.  Interpreting change scores of tests and measures used in physical therapy. , 2006, Physical therapy.

[33]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[34]  J. Moreside,et al.  Differences in Hip Joint Biomechanics and Muscle Activation in Individuals With Femoroacetabular Impingement Compared With Healthy, Asymptomatic Individuals: Is Level-Ground Gait Analysis Enough? , 2018, Orthopaedic journal of sports medicine.