The effect of military load carriage on 3-D lower limb kinematics and spatiotemporal parameters

The 3-D gait analysis of military load carriage is not well represented, if at all, within the available literature. This study collected 3-D lower limb kinematics and spatiotemporal parameters in order to assess the subsequent impact of carrying loads in a backpack of up to 32 kg. Results showed the addition of load significantly decreased the range of motion of flexion/extension of the knee and pelvic rotation. Also seen were increases in adduction/abduction and rotation of the hip and pelvis tilt. No changes to ankle kinematics were observed. Alterations to the spatiotemporal parameters of gait were also of considerable interest, namely, an increase in double support and a decrease in preferred stride length as carried load increased. Analysing kinematics during military or recreational load carriage broadens the knowledge regarding the development of exercise-related injuries, while helping to inform the human-centred design process for future load carrying systems. The importance of this study is that limited available research has investigated 3-D lower limb joint kinematics when carrying loads.     

Effects of prolonged load carriage on ground reaction forces, lower limb kinematics and spatio-temporal parameters in female recreational hikers

The effect of load carriage on female recreational hikers has received little attention. This study collected lower limb sagittal plane kinematic, spatio-temporal and ground reaction force (GRF) data from 15 female hikers carrying four loads (0%, 20%, 30% and 40% body weight (BW)) over 8 km. Increasing load resulted in a proportional increase in GRF up to 30% BW, increased stance time, and greater mediolateral impulse with 30% and 40% BW. Also seen were decreased velocity and cadence and increased double support and knee flexion when carrying load compared to no load. Increased distance resulted in increased knee flexion and ankle plantar flexion at initial foot-ground contact. It was concluded that, as load mass and distance increased, female hikers modified their gait to attenuate the lower limb impact forces. When carrying 30% and 40% BW loads, however, the changes aimed at attenuating the higher GRF may result in a less stable gait. PRACTITIONER SUMMARY: Limited research has investigated the biomechanical responses of female recreational hikers to prolonged load carriage. This study provides a better understanding of the effects of increasing load on lower limb kinematics, spatio-temporal parameters and the GRF generated by female hikers during prolonged load carriage. The results have implications for the development of load carriage guidelines to minimise the risk of injury to females who carry backpacks and to improve performance for this population.     

Effects of military load carriage on kinematics of gait

Manual load carriage is a universal activity and an inevitable part of the daily schedule of a soldier. Indian Infantry soldiers carry loads on the waist, back, shoulders and in the hands for a marching order. There is no reported study on the effects of load on gait in this population. It is important to evaluate their kinematic responses to existing load carriage operations and to provide guidelines towards the future design of heavy military backpacks (BPs) for optimising soldiers' performance. Kinematic changes of gait parameters in healthy male infantry soldiers whilst carrying no load (NL) and military loads of 4.2–17.5 kg (6.5–27.2% body weight) were investigated. All comparisons were conducted at a self-selected speed. Soldier characteristics were: mean (SD) age 23.3 (2.6) years; height 172.0 (3.8) cm; weight 64.3 (7.4) kg. Walk trials were collected using a 3-D Motion Analysis System. Results were subjected to one-way ANOVA followed by Dunnett post hoc test. There were increases in step length, stride length, cadence and midstance with the addition of a load compared to NL. These findings were resultant of an adaptive phenomenon within the individual to counterbalance load effect along with changes in speed. Ankle and hip ranges of motion (ROM) were significant. The ankle was more dorsiflexed, the knee and hip were more flexed during foot strike and helped in absorption of the load. The trunk showed more forward leaning with the addition of a load to adjust the centre of mass of the body and BP system back to the NL condition. Significant increases in ankle and hip ROM and trunk forward inclination (≥10°) with lighter loads, such as a BP (10.7 kg), BP with rifle (14.9 kg) and BP with a light machine gun (17.5 kg), may cause joint injuries. It is concluded that the existing BP needs design improvisation specifically for use in low intensity conflict environments.

Statement of Relevance:The present study evaluates spatial, temporal and angular changes at trunk and limb joints during military load carriage of relatively lighter magnitude. Studies on similar aspects on the specific population are limited. These data can be used for optimising load carriage and designing ensembles, especially a heavy BP, for military operations.     

Influence of carrying heavy loads on soldiers' posture,movements and gait

Military personnel are required to carry heavy loads whilst marching; this load carriage represents a substantial component of training and combat. Studies in the literature mainly concentrate on physiological effects, with few biomechanical studies of military load carriage systems (LCS). This study examines changes in gait and posture caused by increasing load carriage in military LCS. The four conditions used during this study were control (including rifle, boots and helmet carriage, totalling 8 kg), webbing (weighing 8 kg), backpack (24 kg) and a light antitank weapon (LAW; 10 kg), resulting in an incremental increase in load carried from 8, 16, 40 to 50 kg. A total of 20 male soldiers were evaluated in the sagittal plane using a 3-D motion analysis system. Measurements of ankle, knee, femur, trunk and craniovertebral angles and spatiotemporal parameters were made during self-paced walking. Results showed spatiotemporal changes were unrelated to angular changes, perhaps a consequence of military training. Knee and femur ranges of motion (control, 21.1° ± 3.0 and 33.9° ± 7.1 respectively) increased (p < 0.05) with load (LAW, 25.5° ± 2.3 and 37.8° ± 1.5 respectively). The trunk flexed significantly further forward, confirming results from previous studies. In addition, the craniovertebral angle decreased (p < 0.001) indicating a more forward position of the head with load. It is concluded that the head functions in concert with the trunk to counterbalance load. The higher muscular tensions necessary to sustain these changes have been associated with injury, muscle strain and joint problems.     

Does load position affect gait and subjective responses of females during load carriage?

Recreational hikers carry heavy loads while often walking long distances over uneven terrain. Previous studies have suggested that not only the load mass but also the position of the load may influence load carriage. The purpose of this study was to determine the effect of vertical load position on gait and subjective responses of female recreational hikers. Fifteen experienced female hikers walked for 2 km over a simulated hiking trail carrying 30% BW in three vertical load positions (high, medium and low). Lower limb and trunk kinematic, electromyography (EMG) and ground reaction force (GRF) data were collected together with heart rate (HR), ratings of perceived exertion (RPE) and discomfort measures. Although HR, RPE and discomfort measures were not able to discern statistical differences between load positions, the high load position was the most preferred by participants. The high load position also resulted in a more upright posture (p < 0.001), decreased gastrocnemius integrated EMG compared to the medium (p = 0.005) and low load positions (p = 0.02) and a higher first peak deceleration vertical GRF compared to the low load position (p = 0.011). However, the absolute differences were small and unlikely to be functionally relevant in load carriage studies. Based on the findings of this study, a high, medium or low load position cannot be preferentially recommended for healthy, experienced, female hikers carrying 30% BW.     

Kinetic changes in gait during low magnitude military load carriage

Indian infantry soldiers carry smaller magnitudes of loads for operational requirements. The ground reaction forces (GRFs) and impulse responses of 10 healthy male Indian infantry soldiers were collected while they walked carrying operational loads between 4.2 and 17.5 kg (6.5–27.2% of mean body weight (BW)) and a control condition of no external load (NL). The GRF and impulse components were normalised for BW, and data for each load condition were compared with NL in each side applying one-way analysis of variance followed by Dunnett's post hoc test. Right foot data were compared with corresponding left foot GRF data for all load conditions and NL. There were significant increases in vertical and anteroposterior GRFs with increase in load. Left and right feet GRF data in corresponding load conditions were significantly different in anteroposterior plane. No significant change was observed in the temporal components of support phase of gait. Changes in impulse parameter were observed in the anteroposterior and vertical planes while carrying load greater than 23 and 16.6% of BW for the right foot and left foot, respectively. Result indicates that smaller magnitudes of loads produced kinetic changes proportional to system weight, similar to heavier loads with the possibility of increased injury risk. Observed smaller asymmetric changes in gait may be considered as postural adjustment due to load. Unique physical characteristics of Indian soldiers and the probable design shortcomings of the existing backpack might have caused significant changes in GRF and peak impulse during smaller load carriage.     

The influence of rifle carriage on the kinetics of human gait

The influence that rifle carriage has on human gait has received little attention in the published literature. Rifle carriage has two main effects, to add load to the anterior of the body and to restrict natural arm swing patterns. Kinetic data were collected from 15 male participants, with 10 trials in each of four experimental conditions. The conditions were: walking without a load (used as a control condition); carrying a lightweight rifle simulator, which restricted arm movements but applied no additional load; wearing a 4.4 kg diving belt, which allowed arms to move freely; carrying a weighted (4.4 kg) replica SA80 rifle. Walking speed was fixed at 1.5 m/s (±5%) and data were sampled at 400 Hz. Results showed that rifle carriage significantly alters the ground reaction forces produced during walking, the most important effects being an increase in the impact peak and mediolateral forces. This study suggests that these effects are due to the increased range of motion of the body's centre of mass caused by the impeding of natural arm swing patterns. The subsequent effect on the potential development of injuries in rifle carriers is unknown.     

Effect of load mass on posture, heart rate and subjective responses of recreational female hikers to prolonged load carriage

Load carriage has been associated with a risk of upper and lower limb musculoskeletal disorders with women suffering significantly higher injury rates than their male counterparts. Despite this injury risk, there are limited evidence-based guidelines for recreational hikers, particularly female recreational hikers, regarding safe backpack loads. The purpose of the present study was to determine how variations in load mass affected the heart rate, posture and subjective responses of women during prolonged walking to provide evidence for a load mass limit for female recreational hikers. Heart rate (HR), posture and ratings of perceived exertion (RPE) and discomfort were collected for 15 female experienced recreational hikers (22.3 ± 3.9 years) while they hiked for 8 km at a self-selected pace under four different load conditions (0%, 20%, 30% and 40% of body weight (BW)). Although HR was not significantly affected by load mass or walking distance, increasing load mass and distance significantly affected posture, RPE and discomfort of the upper body. Carrying a 20% BW load induced significant changes in trunk posture, RPE and reported shoulder discomfort compared to the unloaded condition. The 20% BW load also resulted in a mean RPE rating of ‘fairly light’, which increased to ‘hard’ when carrying a 40% BW load. As load carriage distance increased participants reported significantly increased shoulder, neck and upper back discomfort. Based on the changes to posture, self-reported exertion and discomfort when carrying loads of 20%, 30% and 40% BW over 8 km, it was concluded that a backpack load limit of 30% BW should be recommended for female recreational hikers during prolonged walking.     

The effect of backpack load on the gait of normal adolescent girls

Concerns regarding the effects of load carriage have led to recommendations that backpacks be limited to 10?–?15% of body weight, based on significant changes in physical performance. However, gait responses to backpack loads are not entirely consistent and there is a particular lack of data regarding load-bearing gait in adolescent females. Gait patterns of 22 normal adolescent girls were recorded at backpack loads of 0, 7.5, 10.0, 12.5 and 15.0% body weight. Temporal-distance, ground reaction force and joint kinematic, moment and power parameters were analysed by repeated measures ANOVA with factors of backpack load and side (left or right).

Walking speed and cadence decreased significantly with increasing backpack load, while double support time increased. Kinematic changes were most marked at the proximal joints, with a decreased pelvic motion but a significant increase in the hip sagittal plane motion. Increased moments and power at the hip, knee and ankle showed increasing demand with backpack load. Parameters showed different responses to increasing load, and those that suggested a critical load indicated this to be approximately 10% body weight. While this may be due to a change in gait due to increased demand, further work is required to verify this and also to examine the cumulative effects of backpack load on the musculoskeletal system, which may be more appropriate in determining recommended load limits.     

Wearing body armour and backpack loads increase the likelihood of expiratory flow limitation and respiratory muscle fatigue during marching

Abstract

The effect of load carriage on pulmonary function was investigated during a treadmill march of increasing intensity. 24 male infantry soldiers marched on six occasions wearing either: no load, 15?kg, 30?kg, 40?kg or 50?kg. Each loaded configuration included body armour which was worn as battle-fit or loose-fit (40?kg only). FVC and FEV₁ were reduced by 6 to 15% with load. Maximal mouth pressures were reduced post load carriage by up to 11% (inspiratory) and 17% (expiratory). Increased ventilatory demands associated with carrying increased mass were met by increases in breathing frequency (from 3 to 26 breaths·min^?1) with minimal changes to tidal volume. 72% of participants experienced expiratory flow limitation whilst wearing the heaviest load. Loosening the armour had minimal effects on pulmonary function. It was concluded that as mass and exercise intensity are increased, the degree of expiratory flow limitation also increases.

Practitioner Summary: This study investigated the effect of soldier load carriage on pulmonary function, to inform the trade-off between protection and burden. Load carriage caused an inefficient breathing pattern, respiratory muscle fatigue and expiratory flow limitation during marching. These effects were exacerbated by increases in mass carried and march intensity.     

The effect of backpack load on the gait of normal adolescent girls

Concerns regarding the effects of load carriage have led to recommendations that backpacks be limited to 10?-?15% of body weight, based on significant changes in physical performance. However, gait responses to backpack loads are not entirely consistent and there is a particular lack of data regarding load-bearing gait in adolescent females. Gait patterns of 22 normal adolescent girls were recorded at backpack loads of 0, 7.5, 10.0, 12.5 and 15.0% body weight. Temporal-distance, ground reaction force and joint kinematic, moment and power parameters were analysed by repeated measures ANOVA with factors of backpack load and side (left or right). Walking speed and cadence decreased significantly with increasing backpack load, while double support time increased. Kinematic changes were most marked at the proximal joints, with a decreased pelvic motion but a significant increase in the hip sagittal plane motion. Increased moments and power at the hip, knee and ankle showed increasing demand with backpack load. Parameters showed different responses to increasing load, and those that suggested a critical load indicated this to be approximately 10% body weight. While this may be due to a change in gait due to increased demand, further work is required to verify this and also to examine the cumulative effects of backpack load on the musculoskeletal system, which may be more appropriate in determining recommended load limits.     

Neuromuscular and cardiovascular responses of Royal Marine recruits to load carriage in the field

Cardiovascular and neuromuscular responses of 12 male Royal Marine recruits (age 22 ± 3 years, body mass 80.7 ± 6.8 kg, VO(2)max 52.3 ± 2.7 ml kg(-1) min(-1)) were measured during 19.3 km of load carriage walking at 4.2 km h(-1) and carrying 31.0 kg. Heart rate during load carriage was 145 ± 10 beats·min(-1) (64 ± 5 %HRR) and showed a negative relationship with body mass (r = -0.72, P = 0.009) but no relationship with VO(2)max (ml kg(-1) min(-1); r = -0.40, P = 0.198). Load carriage caused a decrease in vertical jump height (8 ± 9%) and power (5 ± 5%) (P < 0.001). Change in vertical jump power showed a positive relationship with body mass (r(2) = 0.40, P = 0.029) but no relationship to VO(2)max (ml kg(-1) min(-1); r(2) = 0.13, P = 0.257). In conclusion, load carriage caused a reduction in vertical jump performance (i.e. decreased neuromuscular function). Lighter individuals were disadvantaged when carrying absolute loads, as they experienced higher cardiovascular strain and greater decreases in neuromuscular function.     

Effects of different loads and carrying systems on selected biomechanical parameters describing walking gait

The effects of two different systems on selected biomechanical parameters of walking gait, while carrying loads of varying magnitude, were investigated.

Ten healthy males who were not regularly engaged in carrying tasks walked a distance of 20 m for ten trials for each of the following five conditions: (i) normal walking without any external load; (ii) 20% and (iii) 40% body weight carried using a backpack system; and (iv) 20% and (v) 40% body weight carried using a doublepack system which distributed the load equally between the front and back of the subjects. The experimental set-up consisted of a Kistler force platform interfaced to a Tektronix 4051 Graphic Calculator, two super 8 mm movie cameras and a photoelectric timing system. Force data (417 Hz) were obtained for ten trials along with side- and rear-view film data (100 fps) for three of the trials for each of the subject conditions. In addition, selected aspects of foot-position data were acquired from a minimum of six footprints from one trial for each subject condition. Walking speed was controlled at 4·5 ± 0·3km/h. Parameters describing the temporal relationship of the gait pattern and values describing the spatial relationship of foot position were evaluated. Selected variables describing the components of the ground-reaction-force-time curves were also examined. Finally, selected kinematic and kinetic parameters were evaluated for four functional subphases of the support period.

Comparisons using a one-way ANOVA with repeated measures were conducted to examine differences between parameters describing the load-carrying conditions and normal gait. Results from the analysis revealed that both the light and heavy loads substantially modified the normal walking gait pattern. Interactions between the load conditions and carrying systems were tested using separate two-way ANOVA with repeated measures. Significant ordinal interactions as well as significant main effects were found between the two carrying systems for some parameters, suggesting that the doublepack system was more effective than the conventional backpack system, especially for carrying the heavy load.     

The influence of rifle carriage on the kinetics of human gait

The influence that rifle carriage has on human gait has received little attention in the published literature. Rifle carriage has two main effects, to add load to the anterior of the body and to restrict natural arm swing patterns. Kinetic data were collected from 15 male participants, with 10 trials in each of four experimental conditions. The conditions were: walking without a load (used as a control condition); carrying a lightweight rifle simulator, which restricted arm movements but applied no additional load; wearing a 4.4 kg diving belt, which allowed arms to move freely; carrying a weighted (4.4 kg) replica SA80 rifle. Walking speed was fixed at 1.5 m/s (+/-5%) and data were sampled at 400 Hz. Results showed that rifle carriage significantly alters the ground reaction forces produced during walking, the most important effects being an increase in the impact peak and mediolateral forces. This study suggests that these effects are due to the increased range of motion of the body's centre of mass caused by the impeding of natural arm swing patterns. The subsequent effect on the potential development of injuries in rifle carriers is unknown.     

The reliability of the Extra Load Index as a measure of relative load carriage economy

Abstract

The aim of this study was to measure the reliability of the extra load index (ELI) as a method for assessing relative load carriage economy. Seventeen volunteers (12 males, 5 females) performed walking trials at 3 km·h^?1, 6 km·h^?1 and a self-selected speed. Trial conditions were repeated 7 days later to assess test–retest reliability. Trials involved four 4-minute periods of walking, each separated by 5 min of rest. The initial stage was performed unloaded followed in a randomised order by a second unloaded period and walking with backpacks of 7 and 20 kg. Results show ELI values did not differ significantly between trials for any of the speeds (p = 0.46) with either of the additional loads (p = 0.297). The systematic bias, limits of agreement and coefficients of variation were small in all trial conditions. We conclude the ELI appears to be a reliable measure of relative load carriage economy.

Practitioner Summary: This paper demonstrates that the ELI is a reliable measure of load carriage economy at a range of walking speeds with both a light and heavy load. The ELI, therefore, represents a useful tool for comparing the relative economy associated with different load carriage systems.     

Effects of backpack load and positioning on nonlinear gait features in young adults

Overloaded backpacks can cause changes in posture and gait dynamic balance. Therefore, the aim of this study was to assess gait regularity and local dynamic stability in young adults as they carried a backpack in different positions, and with different loads. Twenty-one healthy young adults participated in the study, carrying a backpack that was loaded with 10 and 20% of their body weight (BW). The participants walked on a level treadmill at their preferred walking speeds for 4 min under different conditions of backpack load and position (i.e. with backpack positioned back bilaterally, back unilaterally, frontally or without a backpack). Results indicate that backpack load and positioning significantly influence gait stability and regularity, with the exception of the 10% BW bilateral back position. Therefore, the recommended safe load for school-age children and adolescents (10% of BW) should also be considered for young adults.

Practitioner summary: Increase in load results in changes in posture, muscle activity and gait parameters, so we investigated the gait adaptations related to regularity and stability. Conditions with high backpack loads significantly influenced gait stability and regularity in a position-dependent manner, except for 10% body weight bilateral back position.     

The Extra Load Index as a method for comparing the relative economy of load carriage systems

The Extra Load Index (ELI) has been proposed as a suitable method of assessing the relative economy of load carriage systems. The purpose of this study was to determine, based on empirical evidence, that the ELI can accommodate variations in both body composition and added load. In total, 30 women walked carrying loads of up to 70% body mass at self-selected walking speeds whilst expired air was collected. In addition, each of the women had body composition assessed via dual energy X-ray absorptiometry. Results show that the ELI is independent of body composition variables, the magnitude of additional loads and the speed of progression. Consequently, it is suggested that it represents an appropriate method of comparing load carriage systems in both scientific and commercial arenas.

Statement of Relevance:This paper demonstrates that ELI is independent of body composition, added load and speed and is therefore an appropriate method to generalise comparisons of load carriage systems. It has the advantage of being easily understood by manufacturers and consumers whilst retaining appropriate scientific precision.     

Influence of carrying heavy loads on soldiers' posture, movements and gait

Military personnel are required to carry heavy loads whilst marching; this load carriage represents a substantial component of training and combat. Studies in the literature mainly concentrate on physiological effects, with few biomechanical studies of military load carriage systems (LCS). This study examines changes in gait and posture caused by increasing load carriage in military LCS. The four conditions used during this study were control (including rifle, boots and helmet carriage, totalling 8 kg), webbing (weighing 8 kg), backpack (24 kg) and a light antitank weapon (LAW; 10 kg), resulting in an incremental increase in load carried from 8, 16, 40 to 50 kg. A total of 20 male soldiers were evaluated in the sagittal plane using a 3-D motion analysis system. Measurements of ankle, knee, femur, trunk and craniovertebral angles and spatiotemporal parameters were made during self-paced walking. Results showed spatiotemporal changes were unrelated to angular changes, perhaps a consequence of military training. Knee and femur ranges of motion (control, 21.1 degrees +/- 3.0 and 33.9 degrees +/- 7.1 respectively) increased (p < 0.05) with load (LAW, 25.5 degrees +/- 2.3 and 37.8 degrees +/- 1.5 respectively). The trunk flexed significantly further forward, confirming results from previous studies. In addition, the craniovertebral angle decreased (p < 0.001) indicating a more forward position of the head with load. It is concluded that the head functions in concert with the trunk to counterbalance load. The higher muscular tensions necessary to sustain these changes have been associated with injury, muscle strain and joint problems.     

The acceptable load while marching at a speed of 5km h-1 for young Chinese males

Ninety-three young Chinese men selected at random were involved in the load carrying experiments. They marched at 5 km h^?1 carrying loads of 0,15,20,25 and 31 kg for 7 h per day. At this speed the acceptable load to be carried was 20 kg. Under this load 95% of the men had heart rates below 120 btmin"’ while marching and energy metabolism was in balance. Nevertheless, 10-15% of the men were fatigued and felt tired.     

Changes in gait kinematics and posture with the use of a front pack

The objective of this study was to determine if posture during gait can be affected by position of the load. It was hypothesized that the front pack would result in postural changes in the gait cycle, compared to a similarly loaded backpack. Thirteen healthy adults, free of any injury, volunteered to participate in this study. Two dimensional video data were collected at 50 Hz using a MacReflex video system. A backpack and a front pack were compared using loads of 10 and 15% of body weight. Markers were placed on the ear, acromion, greater trochanter and lateral joint line of the knee, lateral malleolus and fifth metatarsophalangeal joint. Data were collected while the participants walked at 0.75 stride/s. The data were used to calculate joint angles and displacements during each gait cycle. There was a significant difference noted in angles of the hip flexion, with the backpack condition demonstrating a greater flexion in each stride than either the control or front pack. Both backpack and front pack conditions demonstrated a significant change in neck motion compared to the control condition. The results of the position analysis over time also revealed an increase in the forward head position when participants were wearing the backpack compared to either the control or the front pack condition. It was concluded that the use of a front pack results in a more upright posture in gait, when compared to a backpack carrying the same load.