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The Effects of Body Armor on Lower Back and Knee Biomechanics During Basic and Military Inspired Tasks

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University of Kentucky UKnowledge Theses and Dissertations--Biomedical Engineering Biomedical Engineering 2014 THE EFFECTS OF BODY ARMOR ON LOWER BACK AND KNEE BIOMECHANICS DURING BASIC AND MILITARY INSPIRED TASKS Megan P. Phillips University of Kentucky, [email protected] Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Recommended Citation Phillips, Megan P., "THE EFFECTS OF BODY ARMOR ON LOWER BACK AND KNEE BIOMECHANICS DURING BASIC AND MILITARY INSPIRED TASKS" (2014). Theses and Dissertations--Biomedical Engineering. 24. https://uknowledge.uky.edu/cbme_etds/24 This Doctoral Dissertation is brought to you for free and open access by the Biomedical Engineering at UKnowledge. It has been accepted for inclusion in Theses and Dissertations--Biomedical Engineering by an authorized administrator of UKnowledge. For more information, please contact [email protected]. STUDENT AGREEMENT: I represent that my thesis or dissertation and abstract are my original work. Proper attribution has been given to all outside sources. I understand that I am solely responsible for obtaining any needed copyright permissions. I have obtained needed written permission statement(s) from the owner(s) of each third-party copyrighted matter to be included in my work, allowing electronic distribution (if such use is not permitted by the fair use doctrine) which will be submitted to UKnowledge as Additional File. I hereby grant to The University of Kentucky and its agents the irrevocable, non-exclusive, and royalty-free license to archive and make accessible my work in whole or in part in all forms of media, now or hereafter known. I agree that the document mentioned above may be made available immediately for worldwide access unless an embargo applies. I retain all other ownership rights to the copyright of my work. I also retain the right to use in future works (such as articles or books) all or part of my work. I understand that I am free to register the copyright to my work. REVIEW, APPROVAL AND ACCEPTANCE The document mentioned above has been reviewed and accepted by the student’s advisor, on behalf of the advisory committee, and by the Director of Graduate Studies (DGS), on behalf of the program; we verify that this is the final, approved version of the student’s thesis including all changes required by the advisory committee. The undersigned agree to abide by the statements above. Megan P. Phillips, Student Dr. Robert Shapiro, Major Professor Dr. Abhijit Patwardhan, Director of Graduate Studies THE EFFECTS OF BODY ARMOR ON LOWER BACK AND KNEE BIOMECHANICS DURING BASIC AND MILITARY INSPIRED TASKS DISSERTATION A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the College of Engineering at the University of Kentucky By Megan Pagano Phillips Lexington, Kentucky Co- Directors: Dr. Robert Shapiro, Professor of Kinesiology and Health Promotion and Dr. Babak Bazrgari, Professor of Biomedical Engineering Lexington, Kentucky 2014 Copyright © Megan Pagano Phillips 2014 ABSTRACT OF DISSERTATION THE EFFECTS OF BODY ARMOR ON LOWER BACK AND KNEE BIOMECHANICS DURING BASIC AND MILITARY INSPIRED TASKS With increased military personal protection equipment, body armor, comes the addition of carried load. Such person protection in recent history has been instrumental in combating the imminent threats (e.g., improvised explosive devices) of hostile environments, preventing otherwise lethal injuries. However, body armor has been suggested to degrade warfighters’ performance and compound the risk of musculoskeletal injuries. Both performance and risk of injury are intensely related to joint biomechanics. Therefore the objective of this project was set to determine the immediate and prolonged effects of wearing body armor on biomechanics of the lower back and knee. A randomized cross-over study design, wherein 12 sex-balanced, physically fit, young participants completed a series of tests before and after 45 min of treadmill walking with and without body armor. Tests included two simple tests (i.e., toe-touch and two-legged squat), two military inspired tests (i.e., box drop and prone to standing) and four knee torque tests (i.e., maximum isometric contraction of knee flexors and extensors, and concentric and eccentric isokinetic contraction of knee flexors and extensors. During these tests, kinematic, kinetic and torque measurements were used to investigate the immediate and prolonged effects of exposure to body armor on several measures of knee and lower back mechanics related to performance and risk of injuries. For the simple tests, the immediate effects of body armor were an increase of > 40 ms (p ≤ 0.02) in flexion duration of the dominant joint and an ~1 s (p ≤ 0.02) increase in overall test duration as well as an ~18% (p = 0.03) increase in the lumbopelvic rhythm ratio near mid-range trunk flexion. For the military inspired tests, the immediate effects of body armor were an increase of ≥ 0.02 s (p ≤ 0.001) in temporal test durations and an increase of ~158 N (p = 0.01) box drop peak ground reaction force. Finally during the dynamometer testing, the BA condition was found to cause a greater reduction, ~10 N·m, in the maximum isometric strength of knee flexors (p = 0.04) and an increase (p ≤ 0.03) of strength ratios compared to the no armor condition. KEYWORD: Military Body Armor, Prolonged Walking, Performance, Risk of Injury, Military Ergonomics Megan P. Phillips Student’s Signature December 2, 2014 Date THE EFFECTS OF BODY ARMOR ON LOWER BACK AND KNEE BIOMECHANICS DURING BASIC AND MILITARY INSPIRED TASKS By Megan Pagano Phillips Dr. Robert Shapiro______ Co- Director of Dissertation Dr. Babak Bazrgari__ __ Co- Director of Dissertation Dr. Abhijit Patwardhan___ Director of Graduate Studies December 2, 2014 Acknowledgements I would like to thank everyone who has made this dissertation possible. First I would like to thank my advisors Dr. Shapiro and Dr. Bazrgari, who have supported and put up with me throughout my PhD studies. I would like to thank my committee members Dr. Puleo and Dr. Rouch for their advice and guidance. I would like to thank my lab mates, past and present, who helped me troubleshoot, bounce ideas off of, and be my pilot testing subjects. More importantly for the laughs we shared, friendships that were forged and nicknames given while we sat in a lab with no windows. Lastly, I would like to thank my husband, Lonnie. You are my biggest fan. Without your love, support, encouragement and sacrifice this would not have been possible. iii Table of Contents Acknowledgements........................................................................................................ iii List of Tables ................................................................................................................ vii List of Figures................................................................................................................ ix List of Acronyms and Abbreviations.............................................................................. x Chapter 1 Introduction and Specific Aims ..................................................................... 1 1.1 Introduction............................................................................................................... 1 1.1.1 Physical exertion and body armor ................................................................... 3 1.1.2 Performance and body armor .......................................................................... 3 1.1.3 Injury and body armor..................................................................................... 4 1.2 Conceptual model ..................................................................................................... 4 1.3 Objective and specific aims ...................................................................................... 5 Chapter 2 The Effects of Military Body Armor on the Lower Back and Knee Mechanics During Toe-touch and Two-legged Squat Tasks......................... 8 2.1 Introduction............................................................................................................... 8 2.2 Methods .................................................................................................................. 10 2.2.1 Study design .................................................................................................. 10 2.2.2 Particpants ..................................................................................................... 12 2.2.3 Testing procedures ........................................................................................ 12 2.2.4 Data analysis for TT and TLS Tests.............................................................. 13 2.3 Results..................................................................................................................... 14 2.3.1 The effects of body armor (pre-exposure model).......................................... 15 2.3.2 The effects of exposure (change model) ....................................................... 17 2.4 Discussion............................................................................................................... 19 Chapter 3 The Effects of Military Body Armor on the Lower Back and Knee Mechanics During Box Drop and Prone to Standing Tasks ........................ 25 3.1 Introduction............................................................................................................
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