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Effects of body size and load carriage on lower-extremity biomechanical responses in healthy women

  • Unnikrishnan, Ginu1, 2
  • Xu, Chun1, 2
  • Baggaley, Michael3, 4
  • Tong, Junfei1, 2
  • Kulkarni, Sahil1, 2
  • Edwards, W. Brent3, 4
  • Reifman, Jaques1
  • 1 Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, FCMR-TT, 504 Scott Street, Ft. Detrick, MD, 21702-5012, USA , Ft. Detrick (United States)
  • 2 The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720A Rockledge Drive, Bethesda, MD, 20817, USA , Bethesda (United States)
  • 3 University of Calgary, Calgary, AB, T2N 1N4, Canada , Calgary (Canada)
  • 4 The McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada , Calgary (Canada)
Published Article
BMC Musculoskeletal Disorders
Springer (Biomed Central Ltd.)
Publication Date
Feb 24, 2021
DOI: 10.1186/s12891-021-04076-0
Springer Nature


BackgroundMusculoskeletal injuries, such as stress fractures, are the single most important medical impediment to military readiness in the U.S. Army. While multiple studies have established race- and sex-based risks associated with a stress fracture, the role of certain physical characteristics, such as body size, on stress-fracture risk is less conclusive.MethodsIn this study, we investigated the effects of body size and load carriage on lower-extremity joint mechanics, tibial strain, and tibial stress-fracture risk in women. Using individualized musculoskeletal-finite-element-models of 21 women of short, medium, and tall statures (n = 7 in each group), we computed the joint mechanics and tibial strains while running on a treadmill at 3.0 m/s without and with a load of 11.3 or 22.7 kg. We also estimated the stress-fracture risk using a probabilistic model of bone damage, repair, and adaptation.ResultsUnder all load conditions, the peak plantarflexion moment for tall women was higher than those in short women (p < 0.05). However, regardless of the load condition, we did not observe differences in the strains and the stress-fracture risk between the stature groups. When compared to the no-load condition, a 22.7-kg load increased the peak hip extension and flexion moments for all stature groups (p < 0.05). However, when compared to the no-load condition, the 22.7-kg load increased the strains and the stress-fracture risk in short and medium women (p < 0.05), but not in tall women.ConclusionThese results show that women of different statures adjust their gait mechanisms differently when running with external load. This study can educate the development of new strategies to help reduce the risk of musculoskeletal injuries in women while running with external load.

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