Prolonged Load Carriage Impacts Magnitude and Velocity of Knee Adduction Biomechanics

Background: This study determined whether prolonged load carriage increased the magnitude and velocity of knee adduction biomechanics and whether increases were related to knee varus thrust or alignment. Methods: Seventeen participants (eight varus thrust and nine control) had knee adduction quantified during 60-min of walking (1.3 m/s) with three body-borne loads (0 kg, 15 kg, and 30 kg). Magnitude, average and maximum velocity, and time to peak of knee adduction biomechanics were submitted to a mixed model ANOVA. Results: With the 0 and 15 kg loads, varus thrust participants exhibited greater magnitude (p ≤ 0.037, 1.9–2.3°), and average (p ≤ 0.027, up to 60%) and maximum velocity (p ≤ 0.030, up to 44%) of varus thrust than control, but differences were not observed with the 30 kg load. The 15 and 30 kg loads led to significant increases in magnitude (p ≤ 0.017, 15–25%) and maximum velocity (p ≤ 0.017, 11–20%) of knee adduction moment, while participants increased magnitude (p ≤ 0.043, up to 0.3°) and maximum velocity (p ≤ 0.022, up to 5.9°/s and 6.7°/s) for knee adduction angle and varus thrust at minutes 30 and 60. Static alignment did not differ between groups (p = 0.412). Conclusion: During prolonged load carriage, all participants increased the magnitude and velocity of knee adduction biomechanics and the potential risk of knee OA.

Sex-Specific Physical Performance Adaptive Responses Are Elicited After 10 Weeks of Load Carriage Conditioning

ABSTRACT Introduction The purpose of this study was to identify and characterize sex-specific physical and psychophysical performance adaptations in response to a novel 10-week training program. Materials and Methods Fifteen males and thirteen females completed a standardized load carriage task (5 km at 5.5 km.h−1, wearing a 23 kg torso-borne vest) before and after 10 weeks of resistance and load carriage training. Psychophysical responses (i.e., heart rate and ratings of perceived exertion) were measured throughout the load carriage task. Physical performance (i.e., countermovement and squat jumps, push-ups, sit-ups, and beep test) was measured at before, mid-way, and after the training program (weeks 0, 6, and 11, respectively). Results Training elicited significant improvements in squat jump maximal force, push-ups, and beep test performance (P < .05). Males outperformed females in all performance measures, with interactions (time, sex) for push-ups, sit-ups, and beep test performance. After training, aerobic capacity improved by 5.4% (42.9 mL· kg−1· min−1 to 45.2 mL· kg−1· min−1) in males but did not improve in females. Psychophysical responses decreased for both sexes (P < .05) during the load carriage task post-training. Conclusion While 10 weeks of standardized training elicited positive adaptations in both physical and psychophysical performance, sex-specific differences were still evident. To lessen these differences, sex-specific training should be considered to optimize load carriage performance.

Optimized hip-knee-ankle exoskeleton assistance reduces the metabolic cost of walking with worn loads

Background Load carriage is common in a wide range of professions, but prolonged load carriage is associated with increased fatigue and overuse injuries. Exoskeletons could improve the quality of life of these professionals by reducing metabolic cost to combat fatigue and reducing muscle activity to prevent injuries. Current exoskeletons have reduced the metabolic cost of loaded walking by up to 22% relative to walking in the device with no assistance when assisting one or two joints. Greater metabolic reductions may be possible with optimized assistance of the entire leg. Methods We used human-in the-loop optimization to optimize hip-knee-ankle exoskeleton assistance with no additional load, a light load (15% of body weight), and a heavy load (30% of body weight) for three participants. All loads were applied through a weight vest with an attached waist belt. We measured metabolic cost, exoskeleton assistance, kinematics, and muscle activity. We performed Friedman’s tests to analyze trends across worn loads and paired t-tests to determine whether changes from the unassisted conditions to the assisted conditions were significant. Results Exoskeleton assistance reduced the metabolic cost of walking relative to walking in the device without assistance for all tested conditions. Exoskeleton assistance reduced the metabolic cost of walking by 48% with no load (p = 0.05), 41% with the light load (p = 0.01), and 43% with the heavy load (p = 0.04). The smaller metabolic reduction with the light load may be due to insufficient participant training or lack of optimizer convergence. The total applied positive power was similar for all tested conditions, and the positive knee power decreased slightly as load increased. Optimized torque timing parameters were consistent across participants and load conditions while optimized magnitude parameters varied. Conclusions Whole-leg exoskeleton assistance can reduce the metabolic cost of walking while carrying a range of loads. The consistent optimized timing parameters across participants and conditions suggest that metabolic cost reductions are sensitive to torque timing. The variable torque magnitude parameters could imply that torque magnitude should be customized to the individual, or that there is a range of useful torque magnitudes. Future work should test whether applying the load to the exoskeleton rather than the person’s torso results in larger benefits.