Paul DeVita

East Carolina University | ECU · Department of Kinesiology

Importance Some weight loss and exercise programs that have been successful in academic center–based trials have not been evaluated in community settings. Objective To determine whether adaptation of a diet and exercise intervention to community settings resulted in a statistically significant reduction in pain, compared with an attention control...

Skipping has been proposed as a viable cross-training exercise to running due to its lower knee contact forces and higher whole-body energy expenditure. However, how individual muscle forces, energy expenditure, and joint loading are affected by differences in running and skipping mechanics remains unclear. The purpose of this study was to compare...

This study aimed to examine the feasibility of using time-to-contact measures during the perturbation protocol in people with diabetes mellitus. Three-dimension motion capture and force data were collected during 0.5-s perturbations in four directions (forward, backward, right, and left) and at two accelerations (20 and 40 cm/s ² ) to compute the t...

Resistance training (RT) improves the skeletal muscle’s ability to generate maximal voluntary force and is accompanied by changes in the activation of the antagonist muscle which is not targeted primarily by RT. However, the nature and role of neural adaptation to RT in the antagonist muscle is paradoxical and not well understood. We compared momen...

Objective To determine whether long-term diet (D) and exercise (E) interventions, alone or in combination (D+E), have beneficial effects for older adults with knee osteoarthritis 3.5-years after the interventions end. Methods This is a secondary analysis of a subset (N = 94) of the first 184 participants who had successfully completed the Intensiv...

Older compared with younger adults walk with different configurations of mechanical joint work and greater muscle activation but it is unclear if age, walking speed, and slope would each affect the relationship between muscle activation and net joint work. We hypothesized that a unit increase in positive but not negative net joint work requires gre...

Context: While 55 million Americans incorporate running into their exercise routines, up to 65% of runners sustain an overuse injury annually. It has been consistently shown that regular physical activity positively impacts quality of life (QOL), an essential public health indicator; however, the impact of running-related injuries on QOL is unknow...

Importance: Thigh muscle weakness is associated with knee discomfort and osteoarthritis disease progression. Little is known about the efficacy of high-intensity strength training in patients with knee osteoarthritis or whether it may worsen knee symptoms. Objective: To determine whether high-intensity strength training reduces knee pain and kne...

Recently, we proposed the hypothesis that weekly running volume and preferred running pace may play a role in preserving ankle joint kinetics in middle-age runners as ankle joint kinetics were generally similar in young and middle-aged runners with similar running volume and preferred pace. To further address this hypothesis, we compared lower extr...

The Intensive Diet and Exercise for Arthritis (IDEA) trial was an 18-month randomized controlled trial that enrolled 454 overweight and obese older adults with symptomatic and radiographic knee osteoarthritis (OA). Participants were randomized to either exercise (E), intensive diet-induced weight loss (D), or intensive diet-induced weight loss plus...

Introduction Longer steps with load carriage is common in shorter Soldiers when matching pace with taller Soldiers whereas shorter steps are hypothesized to reduce risk of injury with load carriage. The effects of load carriage with and without step length manipulation on loading patterns of three commonly injured structures were determined: Achill...

Objective: To assess the effect of quadriceps strengthening on quadriceps muscle force, power, and work and tibio-femoral compressive loads during walking in adults with knee osteoarthritis. Methods: Study design: Two-center, randomized, controlled trial. Intervention: Patients with knee osteoarthritis were randomly allocated to quadriceps str...

Introduction When walking at a similar habitual speed, older compared with younger adults perform less positive (i.e., concentric) ankle work and more positive hip work, a phenomenon known as the distal-to-proximal (DP) shift of concentric muscle function[1]. Because the magnitude and rate at which negative (i.e., eccentric) work is performed can a...

Objective To determine the dose response to weight loss on clinical and mechanistic outcomes in overweight and obese adults with knee osteoarthritis. Methods This is a secondary analysis of the diet‐only (D) and diet plus exercise (D+E) groups in the Intensive Diet and Exercise for Arthritis (IDEA) randomized controlled clinical trial. Participant...

Background: The National Center for Injury Prevention and Control, noting flaws in previous running injury research, called for more rigorous prospective designs and comprehensive analyses to define the origin of running injuries. Purpose: To determine the risk factors that differentiate recreational runners who remain uninjured from those diagn...

Physical activity decreases the risk of osteoarthritis (OA)-related disability; however, pain and lack of confidence represent barriers for older adults with knee OA. The purpose of this study was to examine (a) the baseline associations among self-efficacy and physical activity, function, and pain; (b) longitudinal changes in self-efficacy; and (c...

Purpose: To compare running biomechanics between young and middle-aged runners when controlling for the confounding effects of training volume and intensity. Methods: 15 middle-aged runners, 15 young runners with similar training volume as the middle-aged group and, 15 young runners with similar preferred training paces (i.e. intensity) as the m...

The inherit injury risk associated with high-impact exercises calls for alternative ways to achieve the benefits of aerobic exercise while minimizing excessive stresses to body tissues. Skipping presents such an alternative, incorporating double support, flight, and single support phases. We used ground reaction forces (GRFs), lower extremity joint...

Exploring relationships between physical capacity and magnitude of biomechanical plasticity in old adults during level and incline walking.

Introduction/purpose: Aging modifies neuromuscular activation of agonist and antagonist muscles during walking. Power training can evoke adaptations in neuromuscular activation that underlie gains in muscle strength and power but it is unknown if these adaptations transfer to dynamic tasks such as walking. We examined the effects of lower extremit...

Purpose: Hamstring strain injury is a frequent and serious injury in competitive and recreational sports. While Nordic hamstring (NH) eccentric strength training is an effective hamstring injury-prevention method, the protective mechanism of this exercise is not understood. Strength training increases muscle strength, but also alters muscle archit...

Background: Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trial...

Background: Aging is associated with slowed gait and old compared with young adults generally walk with greater positive hip work (H1) and reduced positive ankle work (A2). The role of exercise interventions on old adults' gait mechanics that underlie training-induced improvements in gait velocity is unclear. We examined the effects of lower extre...

Background: Anterior cruciate ligament reconstruction is associated with early onset knee osteoarthritis. Running is a typical activity following this surgery, but elevated knee joint contact forces are thought to contribute to osteoarthritis degenerative processes. It is therefore clinically relevant to identify interventions to reduce contact fo...

Introduction: Slow gait predicts many adverse clinical outcomes in old adults but the mechanisms of how power training can minimize the age-related loss of gait velocity is unclear. We examined the effects of 10 weeks of lower extremity power training and detraining on healthy old adults' lower extremity muscle power and gait kinematics. Methods:...

The purpose of this study was to examine the effects of step length and foot strike pattern along with their interaction on tibiofemoral joint (TFJ) and medial compartment TFJ kinetics during running. Nineteen participants ran with a rear foot strike pattern at their preferred speed using a short (-10%), preferred, and long (+10%) step length. Thes...

Purpose: Old compared with young adults walk with reduced ankle and increased hip mechanical output. We examined the idea that age, leg strength, or both are related to the age-related changes in mechanical output during gait. Methods: Healthy young (n = 32, age 21.5 years) and old adults (n = 32, age 76.8 years) participated in biomechanical ga...

Objective: To compare the gait of adults with unilateral and bilateral symptomatic and radiographic knee osteoarthritis (OA) to determine whether these subgroups can be treated similarly in the clinic and when recruiting for randomized clinical trials, and to use these data to generate future hypotheses regarding gait in these subsets of knee OA p...

Females in the military sustain a higher incidence of lower extremity injuries compared to males. Previous investigations of gender differences during load carriage used loads normalized to body mass; as a result of anthropometric and strength differences between genders, this may partially normalize to strength, masking gender or size differences...

Running has high injury rates, especially among older runners. Most aging literature compares young vs old runners without accounting for the progression of biomechanics throughout the lifespan. We used age as a continuous variable to investigate the continuum of age-related gait adaptations in running along with determining the chronology and rate...

Report the radiographic and MRI structural outcomes of an 18-month study of diet-induced weight loss, with or without exercise, compared to exercise alone in older, overweight and obese adults with symptomatic knee osteoarthritis. Prospective, single-blind, randomized controlled trial that enrolled 454 overweight and obese (BMI = 27-41 kg.m(-2)) ol...

The purpose of this study was to compare lower extremity joint angular position and muscle activity during elliptical exercise using different foot positions and, on a lateral elliptical trainer. Sixteen men exercised on a lateral elliptical and on a standard elliptical trainer using straight foot position, increased toe-out angle and, a wide step....

Magnetic resonance and ultrasound imaging have shown hamstring strain injuries occur most often in the biceps femoris long head (BFLH), and particularly in the proximal vs. distal region of this muscle. Animal research and musculoskeletal modeling (MSK) have detected heterogeneous fascicle behavior within muscle regions, and within fascicles. Under...

Purpose: Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee joint loads in older overweight and obese adults with knee osteoarthritis (OA). Methods: Fat depots were quantified using computed tomography, and total...

Since vision is used in studies of muscle force control, reduced muscle force control might be related to reduced visual ability. We investigated relationships between steadiness in eye movements and quadriceps muscle torque (a surrogate for force) during isometric contractions of constant and varying torques. 19 young adults (20.7yrs) and 18 old a...

Effects of Elliptical Training on Pain, Motor Function, Muscle Strength and Knee Joint Kinetics During Walking in People with Knee Osteoarthritis Max R. Paquette1, Audrey Zucker-Levin2, Paul DeVita3 and William Mihalko2 1 University of Memphis, Memphis, TN, USA 2 University of Tennessee Health Science Center, Memphis, TN, USA 3East Carolina Un...

Objective: To determine the influences of frontal plane knee alignment and obesity on knee joint loads in older, overweight and obese adults with knee osteoarthritis (OA). Methods: Cross-sectional investigation of alignment and obesity on knee joint loads using community dwelling older adults (age ≥ 55 years; 27 kg m(-2) ≥ body mass or body mass...

We examined the effects of whole-body mechanical vibration (WBV) on indices of motoneuronal excitability at rest and during muscle contraction in healthy humans. Real and sham WBV at 30 Hz had no effect on reflexes measured during muscle contraction. Real WBV at 30 and 50 Hz depressed the H-reflex ∼45%. These depressions diminished across the five...

Importance Knee osteoarthritis (OA), a common cause of chronic pain and disability, has biomechanical and inflammatory origins and is exacerbated by obesity.Objective To determine whether a ≥10% reduction in body weight induced by diet, with or without exercise, would improve mechanistic and clinical outcomes more than exercise alone.Design, Sett...

Muscle loss and fat gain contribute to the disability, pain, and morbidity associated with knee osteoarthritis (OA), and thigh muscle weakness is an independent and modifiable risk factor for it. However, while all published treatment guidelines recommend muscle strengthening exercise to combat loss of muscle mass and strength in knee OA patients,...

Objective: To assess differences in sagittal plane joint kinematics and ground reaction forces between lean and obese adult dogs of similar sizes at 2 trotting velocities. Animals: 16 adult dogs. Procedures: Dogs with body condition score (BCS) of 8 or 9 (obese dogs; n = 8) and dogs with BCS of 4 or 5 (lean dogs; 8) on a 9-point scale were eva...

We examined the hypothesis that metabolic surgery-induced massive weight loss causes mass-driven and behavioral adaptations in the kinematics and kinetics of obese gait. Gait analyses were performed at three time points over ∼1 yr in initially morbidly obese (mass: 125.7 kg; body mass index: 43.2 kg/m(2)) but otherwise healthy adults. Ten obese adu...

Although the squat exercise and its variations are commonly prescribed for anterior cruciate ligament rehabilitation, whether trunk position affects these ligament forces and strains during the squat is unclear. Our purpose was to evaluate the effects of trunk position on anterior cruciate ligament forces and strains during a single-leg squat. Whil...

Unilateral lengthening contractions provide a greater stimulus for neuromuscular adaptation than shortening contractions in the active and non-active contralateral homologous muscle, although little is known of the potential mechanism. Here we examined the possibility that corticospinal and spinal excitability vary in a contraction-specific manner...

The net metabolic cost of walking (C(w)) as well as the level of neural activation of agonist and antagonist leg muscles are higher in healthy old compared with young adults. This study examined the association between C(w) and agonist muscle activity and antagonist coactivity in young and old adults. Young and old adults walked at 0.98 m/s on a tr...

The aim of this study was to examine the effects of high weight loss on knee joint loads during walking in participants with knee osteoarthritis (OA). Data were obtained from a subset of participants enrolled in the Arthritis, Diet, and Activity Promotion Trial (ADAPT). Complete baseline and 18-month follow-up data were obtained on 76 sedentary, ov...

Accurate identification of the onset of muscle activity is an important element in the biomechanical analysis of human movement. The purpose of this study was to determine if inclusion of the Teager-Kaiser energy operator (TKEO) in signal conditioning would increase the accuracy of popular electromyography (EMG) onset detection methods. Three metho...