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Dan M, Parr W, Broe D, Cross M, Walsh WR. Biomechanics of the knee extensor mechanism and its relationship to patella tendinopathy: A review. J Orthop Res 2018; 36:3105-3112. [PMID: 30074265 DOI: 10.1002/jor.24120] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/26/2018] [Indexed: 02/04/2023]
Abstract
The term jumpers knee for patella tendinitis, as coined by Dr. Martin Blazina, is now commonly referred to as tendinopathy. He believed it was associated with patella alta. Since then multiple studies have failed to reliably show an association between patella tendinopathy and associated intrinsic risk factors. There is, unfortunately, a well-established doctrine that the extensor mechanism is simply a pulley. The goal of the review is to examine the biomechanics of the extensor mechanism and apply this to studies investigating intrinsic risk factors for patella tendinopathy. A better understanding of the biomechanics of the extensor mechanism may stimulate the discovery of intrinsic risk factors for developing patella tendinopathy, and subsequent surgical options to address them. Clinical significance: The aim of this review is to direct future research into biomechanical risk factors for developing patella tendinopathy and subsequently, possible treatments. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:3105-3112, 2018.
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Affiliation(s)
- Michael Dan
- Surgical and Orthopaedic Research Laboratory, Prince of Wales Clinical School University of New South Wales, Sydney 2052, Australia.,Prince of Wales Hospital, Barker St, Randwick, New South Wales 2031, Australia
| | - William Parr
- Surgical and Orthopaedic Research Laboratory, Prince of Wales Clinical School University of New South Wales, Sydney 2052, Australia
| | - David Broe
- Surgical and Orthopaedic Research Laboratory, Prince of Wales Clinical School University of New South Wales, Sydney 2052, Australia.,Prince of Wales Hospital, Barker St, Randwick, New South Wales 2031, Australia
| | - Mervyn Cross
- The Stadium Sports Medicine Clinic, Sydney 2012, Australia
| | - William R Walsh
- Surgical and Orthopaedic Research Laboratory, Prince of Wales Clinical School University of New South Wales, Sydney 2052, Australia.,Prince of Wales Hospital, Barker St, Randwick, New South Wales 2031, Australia
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Ishida T, Koshino Y, Yamanaka M, Ueno R, Taniguchi S, Samukawa M, Saito H, Matsumoto H, Aoki Y, Tohyama H. The effects of a subsequent jump on the knee abduction angle during the early landing phase. BMC Musculoskelet Disord 2018; 19:379. [PMID: 30342498 PMCID: PMC6195693 DOI: 10.1186/s12891-018-2291-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 10/03/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND A double-leg landing with or without a subsequent jump is commonly used to evaluate the neuromuscular control of knee abduction. However, the differences in frontal plane knee biomechanics between landings with and without a subsequent jump are not well known. The purpose of the present study was to investigate the effects of a subsequent jump on knee abduction, including during the early landing phase, in female and male subjects. METHODS Twenty-one female subjects and 21 male subjects participated. All subjects performed drop landing task (a landing without a subsequent jump) and drop vertical jump task (a landing with a subsequent jump). The subjects landed from a 30-cm height. In drop vertical jump, the subjects also performed a maximum vertical jump immediately after landing. The knee abduction angle and moment were analyzed using a 3D motion analysis system. A two-way analysis of variance (task × time) was performed to examine the effects of a subsequent jump on the knee abduction angle during the early landing phase in female and male subjects. Another two-way analysis of variance (task × sex) was performed to compare peak knee abduction angles and moments. RESULTS In female subjects, the knee abduction angle was significantly greater during drop vertical jump than during drop landing, as measured 45 to 80 ms after initial contact (P < 0.05). Significant task-dependent effects in the peak knee abduction angle (P = 0.001) and the abduction moment (P = 0.029) were detected. The peak knee abduction angle and the abduction moment were greater during drop vertical jump than during drop landing. CONCLUSIONS Subsequent jumps cause greater knee abduction during the early landing phase only in female subjects. This finding may relate to the sex discrepancy in non-contact anterior cruciate ligament injuries. Additionally, the presence of a subsequent jump significantly increases the peak knee abduction angle and the peak knee abduction moment during landings. Therefore, compared with a landing task without a subsequent jump (drop landing), a landing task with a subsequent jump (drop vertical jump) may be advantageous for screening for knee abduction control, especially in female athletes.
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Affiliation(s)
- Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nshi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nshi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Masanori Yamanaka
- Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Satomi 2-10, Chitose, 066-0055, Japan.
| | - Ryo Ueno
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nshi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Shohei Taniguchi
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nshi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nshi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Hiroshi Saito
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nshi 5, Kita-ku, Sapporo, 060-0812, Japan
| | - Hisashi Matsumoto
- Department of Rehabilitation, Hokushin Orthopaedic Hospital, Kikusui-motomachi 3-jo 3-chome 1-18, Sapporo, 003-0823, Japan
| | - Yoshimitsu Aoki
- Department of Orthopaedic Surgery, Hokushin Orthopaedic Hospital, Kikusui-motomachi 3-jo 3-chome 1-18, Sapporo, 003-0823, Japan
| | - Harukazu Tohyama
- Faculty of Health Sciences, Hokkaido University, Kita 12, Nshi 5, Kita-ku, Sapporo, 060-0812, Japan
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Avedesian JM, Judge LW, Wang H, Dickin DC. The biomechanical effect of warm-up stretching strategies on landing mechanics in female volleyball athletes. Sports Biomech 2018; 19:587-600. [PMID: 30118391 DOI: 10.1080/14763141.2018.1503322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Female volleyball athletes incorporate dynamic and static stretching into a warm-up, with evidence generally supporting dynamic stretching to improve performance. However, the effects of these stretching practices on injury risk during subsequent volleyball manoeuvres have yet to be fully elucidated in the warm-up literature. Three-dimensional kinematic data associated with non-contact, lower extremity injury were recorded on 12 female collegiate club volleyball athletes during unilateral landing tasks on the dominant and non-dominant limb. Participants performed landings as part of a volleyball-simulated manoeuvre prior to and post-dynamic (DWU) and combined dynamic-static (CDS) warm-ups. A significant reduction in non-dominant hip adduction angle was found at 15 min post CDS warm-up (p = 0.016; d = 0.38), however, no other warm-up differences were detected. The non-dominant limb demonstrated greater knee abduction (p = 0.006; d = 0.69) and internal rotation angle (p = 0.004; d = 0.88), suggesting that this limb demonstrates more risky landing patterns that are potentially due to altered trunk positioning upon landing. The results show that the majority of selected landing kinematics are unaffected by additional static stretching to a dynamic warm-up and that the non-dominant limb may be at a higher injury risk in female volleyball athletes.
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Affiliation(s)
- Jason M Avedesian
- College of Health, Biomechanics Laboratory, Ball State University , Muncie, IN, USA
| | | | - Henry Wang
- College of Health, Biomechanics Laboratory, Ball State University , Muncie, IN, USA
| | - D Clark Dickin
- College of Health, Biomechanics Laboratory, Ball State University , Muncie, IN, USA
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54
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Avedesian JM, Judge LW, Wang H, Dickin DC. Kinetic Analysis of Unilateral Landings in Female Volleyball Players After a Dynamic and Combined Dynamic-Static Warm-up. J Strength Cond Res 2018; 33:1524-1533. [PMID: 30074969 DOI: 10.1519/jsc.0000000000002736] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Avedesian, JM, Judge, LW, Wang, H, and Dickin, DC. Kinetic analysis of unilateral landings in female volleyball players after a dynamic and combined dynamic-static warm-up. J Strength Cond Res 33(6): 1524-1533, 2019-A warm-up is an important period before training or competition to prepare an athlete for the physical demands of subsequent activity. Previous research has extensively focused on the effects of warm-up in relation to various jumping performance attributes; however, limited research has examined the biomechanical nature of landings after common warm-up practices. Twelve female, collegiate-level volleyball players performed unilateral landings on the dominant and nondominant limb before and after dynamic warm-ups and combined dynamic-static (CDS) warm-ups. Kinetic variables of interest were measured at the hip and knee during the landing phase of a volleyball-simulated jump-landing maneuver. A significant 3-way interaction (warm-up × limb × time) for peak internal knee adduction moment was observed, as this kinetic parameter significantly increased (p = 0.01; d = 0.79) in the nondominant limb at 1-minute post-CDS warm-up. No other warm-up differences were detected; however, significant main effects of limb were determined for dominant-limb internal hip abduction moment (p < 0.01; d = 1.32), dominant-knee internal rotation moment (p < 0.01; d = 1.88), and nondominant-knee external rotation moment (p < 0.01; d = 1.86), which may be due to altered hip and trunk mechanics during the jump landings. This information provides strength and conditioning professionals with biomechanical information to determine warm-up protocols that reduce the risk of injury in female volleyball athletes.
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Affiliation(s)
| | | | - Henry Wang
- Biomechanics Laboratory, Ball State University, Muncie, Indiana
| | - D Clark Dickin
- Biomechanics Laboratory, Ball State University, Muncie, Indiana
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Read PJ, Oliver JL, Myer GD, De Ste Croix MBA, Belshaw A, Lloyd RS. Altered landing mechanics are shown by male youth soccer players at different stages of maturation. Phys Ther Sport 2018; 33:48-53. [PMID: 30014967 DOI: 10.1016/j.ptsp.2018.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/04/2018] [Accepted: 07/06/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Examine the effects of maturation on single leg jumping performance in elite male youth soccer players. DESIGN Cross sectional. SETTING Academy soccer clubs. PARTICIPANTS 347 male youth players classified as either pre, circa or post-peak height velocity (PHV). MAIN OUTCOME MEASURES Single leg countermovement jump (SLCMJ) height, peak vertical landing forces (pVGRF), knee valgus and trunk side flexion. RESULTS Vertical jump height and absolute pVGRF increased with each stage of maturation (p < 0.001; d = 0.85-2.35). Relative to body weight, significantly higher landing forces were recorded on the left leg in circa versus post-PHV players (p < 0.05; d = -0.40). Knee valgus reduced with maturation but the only notable between-group differences were shown in post-PHV players (p < 0.05; d = 0.67); however, greater ipsilateral lateral trunk flexion angles was also present and these differences were significantly increased relative to circa-PHV players (p < 0.05; d = 0.85). CONCLUSION Periods of rapid growth are associated with landing kinetics which may heighten injury risk. While reductions in knee valgus were displayed with maturation; a compensatory strategy of greater trunk lateral flexion was evident in post-PHV players and this may increase the risk of injury.
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Affiliation(s)
- Paul J Read
- Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, Cardiff, UK.
| | - Jon L Oliver
- Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, Cardiff, UK; Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand
| | - Gregory D Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA; Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA; The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
| | | | - Angus Belshaw
- School of Sports Health and Applied Sciences, St Marys University, London, UK
| | - Rhodri S Lloyd
- School of Sport and Health Sciences and Youth Physical Development Centre, Wales, UK
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Lopes TJA, Simic M, Myer GD, Ford KR, Hewett TE, Pappas E. The Effects of Injury Prevention Programs on the Biomechanics of Landing Tasks: A Systematic Review With Meta-analysis. Am J Sports Med 2018; 46:1492-1499. [PMID: 28759729 PMCID: PMC6604048 DOI: 10.1177/0363546517716930] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Anterior cruciate ligament (ACL) tear is a common injury in sports and often occurs during landing from a jump. PURPOSE To synthesize the evidence on the effects of injury prevention programs (IPPs) on landing biomechanics as they relate to the ligament, quadriceps, trunk, and leg dominance theories associated with ACL injury risk. STUDY DESIGN Meta-analysis. METHODS Six electronic databases were searched for studies that investigated the effect of IPPs on landing task biomechanics. Prospective studies that reported landing biomechanics at baseline and post-IPP were included. Results from trunk, hip, and knee kinematics and kinetics related to the ACL injury theories were extracted, and meta-analyses were performed when possible. RESULTS The criteria were met by 28 studies with a total of 466 participants. Most studies evaluated young females, bilateral landing tasks, and recreational athletes, while most variables were related to the ligament and quadriceps dominance theories. An important predictor of ACL injury, peak knee abduction moment, decreased ( P = .01) after the IPPs while other variables related to the ligament dominance theory did not change. Regarding the quadriceps dominance theory, after the IPPs, angles of hip flexion at initial contact ( P = .009), peak hip flexion ( P = .002), and peak knee flexion ( P = .007) increased, while knee flexion at initial contact did not change ( P = .18). Moreover, peak knee flexion moment decreased ( P = .005) and peak vertical ground-reaction force did not change ( P = .10). CONCLUSION The exercises used in IPPs might have the potential to improve landing task biomechanics related to the quadriceps dominance theory, especially increasing peak knee and hip flexion angles. Importantly, peak knee abduction moment decreased, which indicates that IPPs influence a desired movement strategy to help athletes overcome dangerous ligament dominance loads arising from lack of frontal plane control during dynamic tasks. The lack of findings for some biomechanical variables suggests that future IPPs may be enhanced by targeting participants' baseline profile deficits, highlighting the need to deliver an individualized and task-specific IPP.
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Affiliation(s)
- Thiago Jambo Alves Lopes
- University of Sydney, Faculty of Health Sciences, Discipline of Physiotherapy, Sydney, Australia., Research Laboratory of Exercise Science, CEFAN, Brazilian Navy, Rio de Janeiro, Brazil.,Address correspondence to Thiago Jambo Alves Lopes, MSc, University of Syndey, Faculty of Health Sciences, 75 East Street, Room S227, S Block, Lidcombe, NSW 2141, Australia ()
| | - Milena Simic
- University of Sydney, Faculty of Health Sciences, Discipline of Physiotherapy, Sydney, Australia
| | - Gregory D. Myer
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA., Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA., The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA., Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kevin R. Ford
- Department of Physical Therapy, High Point University, High Point, North Carolina, USA
| | - Timothy E. Hewett
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA., Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Evangelos Pappas
- University of Sydney, Faculty of Health Sciences, Discipline of Physiotherapy, Sydney, Australia
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Aizawa J, Hirohata K, Ohji S, Ohmi T, Yagishita K. Limb-dominance and gender differences in the ground reaction force during single-leg lateral jump-landings. J Phys Ther Sci 2018; 30:387-392. [PMID: 29581656 PMCID: PMC5857443 DOI: 10.1589/jpts.30.387] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 12/12/2017] [Indexed: 01/14/2023] Open
Abstract
[Purpose] The purpose of this study was to examine limb-dominance and gender differences
in the magnitude of the ground reaction force during single-leg lateral jump-landings. We
hypothesized that the peak ground reaction force would be larger in the non-dominant leg
compared to that in the dominant leg and would be larger in females compared to that in
men. [Subjects and Methods] Fifteen females and 15 males performed jump-landings sideways
from a height of 20 cm, with a lateral distance of 60 cm. Vertical and medial ground
reaction forces were measured, and the elapsed time from the initial contact to the peak
ground reaction force was determined. The loading rate was calculated as the peak ground
reaction force divided by the elapsed time from the initial contact to the peak ground
reaction force. [Results] The vertical and medial peak ground reaction forces during
single-leg lateral jump-landings were larger in females compared to that in males. In
addition, the medial peak ground reaction force was larger for the non-dominant leg
compared to that for the dominant leg. [Conclusion] The results suggest that in
rehabilitation and conditioning settings, evaluations and instructions regarding
attenuation are especially important for females and the non-dominant leg.
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Affiliation(s)
- Junya Aizawa
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University: 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kenji Hirohata
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University: 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Shunsuke Ohji
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University: 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Takehiro Ohmi
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University: 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kazuyoshi Yagishita
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University: 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
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McCurdy K, Walker J, Yuen D. Gluteus Maximus and Hamstring Activation During Selected Weight-Bearing Resistance Exercises. J Strength Cond Res 2018; 32:594-601. [DOI: 10.1519/jsc.0000000000001893] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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59
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Numata H, Nakase J, Kitaoka K, Shima Y, Oshima T, Takata Y, Shimozaki K, Tsuchiya H. Two-dimensional motion analysis of dynamic knee valgus identifies female high school athletes at risk of non-contact anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc 2018; 26:442-447. [PMID: 28840276 DOI: 10.1007/s00167-017-4681-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 08/16/2017] [Indexed: 01/14/2023]
Abstract
PURPOSE Female athletes are at greater risk of non-contact ACL injury. Three-dimensional kinematic analyses have shown that at-risk female athletes have a greater knee valgus angle during drop jumping. The purpose of this study was to evaluate the relationship between knee valgus angle and non-contact ACL injury in young female athletes using coronal-plane two-dimensional (2D) kinematic analyses of single-leg landing. METHODS Two hundred ninety-one female high school athletes newly enrolled in basketball and handball clubs were assessed. Dynamic knee valgus was analysed during single-leg drop jumps using 2D coronal images at hallux-ground contact and at maximal knee valgus. All subjects were followed up for 3 years for ACL injury. Twenty-eight (9.6%) of 291 athletes had ACL rupture, including 27 non-contact ACL injuries. The injured group of 27 knees with non-contact ACL injury was compared with a control group of 27 randomly selected uninjured knees. The relationship between initial 2D movement analysis results and subsequent ACL injury was investigated. RESULTS Dynamic knee valgus was significantly greater in the injured group compared to the control group at hallux-ground contact (2.1 ± 2.4 vs. 0.4 ± 2.2 cm, P = 0.006) and at maximal knee valgus (8.3 ± 4.3 vs. 5.1 ± 4.1 cm, P = 0.007). CONCLUSION The results of this study confirm that dynamic knee valgus is a potential risk factor for non-contact ACL injury in female high school athletes. Fully understanding the risk factors that increase dynamic knee valgus will help in designing more appropriate training and interventional strategies to prevent injuries in at-risk athletes. LEVEL OF EVIDENCE Prognostic studies, Level II.
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Affiliation(s)
- Hitoaki Numata
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Junsuke Nakase
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Katsuhiko Kitaoka
- Department of Orthopaedic Surgery, Kijima Hospital, Kanazawa, Ishikawa, 920-0011, Japan
| | - Yosuke Shima
- Department of Orthopaedic Surgery, KKR Hokuriku Hospital, Kanazawa, Ishikawa, 921-8035, Japan
| | - Takeshi Oshima
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Yasushi Takata
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Kengo Shimozaki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
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Kamelska AM, Kot B. The effect of motor learning and fatigue on preactivation of the lower extremity muscles during different jumps. J Sports Med Phys Fitness 2017; 58:1592-1601. [PMID: 28944647 DOI: 10.23736/s0022-4707.17.07712-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The first step in identifying risk factors for injuries is to characterize the myoelectric activity of different muscles after ground contact, especially when fatigue is a limiting factor. This study aimed at recording the myoelectric activity of calf muscles after ground contact during different types of jumps and investigating the effect of motor learning and fatigue on muscle preactivation. METHODS Twenty four male students aged 24.3±1.2 years old performed three different motor activities: A) jump from a box with counter landing (JCL) on 30x30 cm plate; B) drop jump with bounce drop jump (BDJ); and C) BDJ followed by a jump on 51-cm step. The surface electromyography was used to examine the following muscles: m. tibialis anterior (TA), m. gastrocnemius medialis, m. gastrocnemius lateralis, and m. soleus (SO). The measurements were taken during different jumps before and after motor learning and fatigue stimulus. RESULTS There were significant differences in preactivation for TA between JCL and BDJ followed by a jump under the influence of fatigue (P<0.05). The differences were observed also during BDJ between non-fatigued and fatigued conditions. There was a statistically significant difference for GL between BDJ pre- and postmovement motor learning and BDJ pre- and postfatigue influence. CONCLUSIONS Current results indicate that myoelectric activity of muscles during motor activities is different, and the effect of motor learning and fatigue was shown. Thus, it could be important in the injury prevention in sport.
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Affiliation(s)
- Anna M Kamelska
- Clinic of Rehabilitation, Provincial Specialist Children's Hospital in Olsztyn, Olsztyn, Poland -
| | - Bartosz Kot
- Department of Biomechanics, Jozef Pilsudski University of Physical Education, Warsaw, Poland.,Fizjoterapia Bartosz Kot, Warsaw, Poland
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Pollard CD, Sigward SM, Powers CM. ACL Injury Prevention Training Results in Modification of Hip and Knee Mechanics During a Drop-Landing Task. Orthop J Sports Med 2017; 5:2325967117726267. [PMID: 28959697 PMCID: PMC5593213 DOI: 10.1177/2325967117726267] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Injury prevention training has been shown to be effective in reducing the incidence of noncontact anterior cruciate ligament (ACL) injury; however, the underlying reason for the success of these training programs is unclear. Purpose: To investigate whether an ACL injury prevention program that has been shown to reduce the incidence of ACL injury alters sagittal plane hip and knee biomechanics during a drop-landing task. Study Design: Descriptive laboratory study. Methods: Thirty female club soccer players (age range, 11-17 years) with no history of knee injury participated in this study. Kinematics and ground-reaction forces were collected while each participant performed a drop-landing task prior to and immediately after participation in a 12-week ACL injury prevention training program. Results: After ACL injury prevention training, participants demonstrated decreased knee extensor moments (P = .03), increased energy absorption at the hip (P = .04), decreased knee-to-hip extensor moment ratios (P = .05), and decreased knee-to-hip energy absorption ratios (P = .03). Conclusion: Participation in an ACL injury prevention training program decreased reliance on the knee extensor muscles and improved use of the hip extensor muscles, which may explain the protective effect of this type of training program on ACL injury. Clinical Relevance: Based on these findings, clinicians can better understand how ACL injury prevention training, such as the Prevent Injury and Enhance Performance (PEP) Program, may change movement behavior at both the hip and knee. Furthermore, the study findings may support the implementation of the PEP Program, or a similar program, for clinicians aiming to improve use of the hip in an effort to reduce knee loading and consequent injuries.
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Affiliation(s)
- Christine D Pollard
- College of Public Health and Human Sciences, Program in Kinesiology, Oregon State University-Cascades, Bend, Oregon, USA
| | - Susan M Sigward
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
| | - Christopher M Powers
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
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Schwartz C, Forthomme B, Paulus J, Kaux JF, Brüls O, Denoël V, Croisier JL. Reliability of unipodal and bipodal counter movement jump landings in a recreational male population. Eur J Sport Sci 2017; 17:1143-1152. [PMID: 28780886 DOI: 10.1080/17461391.2017.1353134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Movement patterns during landing have been suggested to be related to injury risk. The purpose of this study was to determine the inter-session reliability of kinematic variables and ground reaction forces during landing in a population of male recreational athletes after a counter movement jump. Both unipodal and bipodal landings were evaluated. Furthermore, the possibility to improve landing reliability with a verbal instruction was also studied. Twenty-four male volunteers with no history of lower extremity trauma were randomly assigned to two groups (with and without verbal landing instruction). An optoelectronic 3D system and force plates were used to measure the lower limb joint angles and the ground reaction forces during landing. Intraclass correlation values show moderate to excellent inter-session reliability for the bipodal task (ICC average: 0.80, range: 0.46-0.97) and poor to excellent reliability for the unipodal task (ICC average: >0.75, range: 0.20-0.95). However, large standard errors of measurement values at the ankle joint at impact (27.6 ± 11.5°) and for the vertical ground reaction forces (394 ± 1091 N) show that some variables may not be usable in practice. The verbal instruction had a negative effect on the reliability of unipodal landing but improved the reliability of bipodal landing. These findings show that the reliability of a landing task is influenced by its motor complexity as well as the instruction given to the subject.
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Affiliation(s)
- Cédric Schwartz
- a Laboratory of Human Motion Analysis (LAMH) , University of Lige , Lige , Belgium.,b Department of Architecture, Geology, Environment and Constructions , University of Liège , Liège , Belgium
| | - Bénédicte Forthomme
- a Laboratory of Human Motion Analysis (LAMH) , University of Lige , Lige , Belgium.,c Department of Physical Medicine and Rehabilitation , University of Liège , Liège , Belgium
| | - Julien Paulus
- a Laboratory of Human Motion Analysis (LAMH) , University of Lige , Lige , Belgium.,b Department of Architecture, Geology, Environment and Constructions , University of Liège , Liège , Belgium
| | - Jean-François Kaux
- c Department of Physical Medicine and Rehabilitation , University of Liège , Liège , Belgium
| | - Olivier Brüls
- a Laboratory of Human Motion Analysis (LAMH) , University of Lige , Lige , Belgium.,d Department of Aerospace and Mechanical Engineering , University of Liège , Liège , Belgium
| | - Vincent Denoël
- a Laboratory of Human Motion Analysis (LAMH) , University of Lige , Lige , Belgium.,b Department of Architecture, Geology, Environment and Constructions , University of Liège , Liège , Belgium
| | - Jean-Louis Croisier
- a Laboratory of Human Motion Analysis (LAMH) , University of Lige , Lige , Belgium.,c Department of Physical Medicine and Rehabilitation , University of Liège , Liège , Belgium
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Teng PSP, Kong PW, Leong KF. Effects of foot rotation positions on knee valgus during single-leg drop landing: Implications for ACL injury risk reduction. Knee 2017; 24:547-554. [PMID: 28336150 DOI: 10.1016/j.knee.2017.01.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/09/2017] [Accepted: 01/13/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Non-contact anterior cruciate ligament (ACL) injuries commonly occur when athletes land in high risk positions such as knee valgus. The position of the foot at landing may influence the transmission of forces from the ankle to the knee. Using an experimental approach to manipulate foot rotation positions, this study aimed to provide new insights on how knee valgus during single-leg landing may be influenced by foot positions. METHODS Eleven male recreational basketball players performed single-leg drop landings from a 30-cm high platform in three foot rotation positions (toe-in, toe-forward and toe-out) at initial contact. A motion capture system and a force plate were used to measure lower extremity kinematics and kinetics. Knee valgus angles at initial contact (KVA) and maximum knee valgus moments (KVM), which were known risk factors associated with ACL injury, were measured. A one-way repeated measures Analysis of Variance was conducted (α=0.05) to compare among the three foot positions. RESULTS Foot rotation positions were found to have a significant effect on KVA (p<0.001, η2=0.66) but the difference between conditions (about 1°) was small and not clinically meaningful. There was a significant effect of foot position on KVM (p<0.001, η2=0.55), with increased moment observed in the toe-out position as compared to toe-forward (p=0.012) or toe-in positions (p=0.002). CONCLUSIONS When landing with one leg, athletes should avoid extreme toe-out foot rotation positions to minimise undesirable knee valgus loading associated with non-contact ACL injury risks.
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Affiliation(s)
- P S P Teng
- Institute for Sports Research, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore; School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore.
| | - P W Kong
- Institute for Sports Research, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore; Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore.
| | - K F Leong
- Institute for Sports Research, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore; School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore.
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De Castro FMP, Aquino R, Berti JA, Gonçalves LGC, Puggina EF. Strength Training with Vascular Occlusion: A Review of Possible Adaptive Mechanisms. HUMAN MOVEMENT 2017. [DOI: 10.1515/humo-2017-0010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractStrength training with blood flow restriction, or KAATSU training, has been shown to be as effective as conventional strength training to promote muscular strength and hypertrophy. Several mechanisms have been suggested as hypotheses to explain the adaptations arising from this training method. Among these is metabolic stress, which exerts important physiological effects and may influence the training adaptations in question. In addition, hypoxia produced by the technique may change the neural recruitment pattern. Growth hormone (GH) concentrations increase as a result of practicing this method, which can trigger an increase in plasmatic and, perhaps, muscular insulin-like growth factor-1 (IGF-1) concentrations. The increase in concentrations of these factors can play a leading role in responses to KAATSU training. Among the effects of the GH/IGF-1 axis in muscle cells is the increase in the signalling pathway activity of the mammalian target of rapamycin (mTOR), which has been associated with increased protein synthesis. On the other hand, the decrease in the activity of the myostatin pathway, which has an antagonistic effect to mTOR, has been demonstrated after training with occlusion. Other factors, such as increases in the expression of heat shock proteins, may play an important role in adaptations to exercise. Nitric oxide synthase could increase nitric oxide concentration, which in turn has an effect on satellite cells and blood flow. However, despite the results obtained, the transfer to other situations (e.g. speed sports) is not yet clear.
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McPherson AL, Dowling B, Tubbs TG, Paci JM. Sagittal plane kinematic differences between dominant and non-dominant legs in unilateral and bilateral jump landings. Phys Ther Sport 2016; 22:54-60. [DOI: 10.1016/j.ptsp.2016.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 03/19/2016] [Accepted: 04/01/2016] [Indexed: 10/22/2022]
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Jenkins WL, Williams DSB, Williams K, Hefner J, Welch H. Sex differences in total frontal plane knee movement and velocity during a functional single-leg landing. Phys Ther Sport 2016; 24:1-6. [PMID: 28013024 DOI: 10.1016/j.ptsp.2016.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 07/10/2016] [Accepted: 09/05/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Females land with more knee valgus than males. While most studies have evaluated lower extremity mechanics during double leg landing, most sports require single-leg landing from a double or single leg takeoff. Further, knee movement occurs toward both varus and valgus during functional landing. The purpose of this study was to determine if differences exist between females and males in total frontal plane movement and velocity of the knee during single-leg landing. DESIGN Experimental cohort. SETTING Motion analysis laboratory. PARTICIPANTS Forty healthy, physically-active females (n = 20) and males (n = 20). MAIN OUTCOME MEASURES Three-dimensional motion analysis was completed on the lower extremities during double-leg jumping followed by a single-leg landing. Student's t-tests (p ≤ 0.05) were used to determine if differences exist in frontal plane knee angles (valgus and varus excursion) and angular velocities between females and males. RESULTS Females demonstrated greater knee valgus and varus excursion, and valgus and varus velocities compared to males (p < 0.05). CONCLUSIONS These findings suggest that total movement in the frontal plane at the knee may be an important factor in injury mechanics in females. Further, single-leg landing from a functional jump should be considered when comparing landing biomechanics between females and males.
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Affiliation(s)
- Walter L Jenkins
- Department of Physical Therapy, College of Allied Health Sciences East Carolina University, Greenville, NC 27834, USA.
| | - D S Blaise Williams
- VCU RUN LAB, Department of Physical Therapy, Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Kelsey Williams
- Nova Medical Center, 1900 Oates Drive, Suite 100, Mesquite, TX 75150, USA.
| | - Josh Hefner
- Kinetic Physical Therapy and Wellness, 1350-A East Arlington Blvd, Greenville, NC 27858, USA.
| | - Hannah Welch
- Lenox Baker Children's Hospital, Duke University Health System, 3000 Erwin Road, Durham, NC 27705, USA.
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Cronström A, Creaby MW, Nae J, Ageberg E. Gender differences in knee abduction during weight-bearing activities: A systematic review and meta-analysis. Gait Posture 2016; 49:315-328. [PMID: 27479217 DOI: 10.1016/j.gaitpost.2016.07.107] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 07/20/2016] [Accepted: 07/22/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Increased knee abduction during weight-bearing activities is suggested to be a contributing factor for the high knee injury risk reported in women. However, studies investigating gender difference in knee abduction are inconclusive. OBJECTIVE To systematically review gender-differences in knee abduction during weight-bearing activities in individuals with or without knee injury. METHODS A systematic review and meta-analysis were conducted according to the PRISMA guidelines. A search in the databases Medline, CINAHL and EMBASE was performed until September 2015. Inclusion criteria were studies that reported (1) gender differences, (2) healthy individuals and/or those with anterior cruciate ligament (ACL) deficiency or reconstruction or patellofemoral pain PFP, and (3) knee abduction assessed with either motion analysis or visual observation during weight-bearing activity. RESULTS Fifty-eight articles met the inclusion criteria. Women with PFP had greater peak knee abduction compared to men (Std diff in mean; -1.34, 95%CI; -1.83 to -0.84). In healthy individuals, women performed weight-bearing tasks with greater knee abduction throughout the movement (initial contact, peak abduction, excursion) (Std diff in mean; -0.68 to -0.79, 95%CI; -1.04 to -0.37). In subgroup analyses by task, differences in knee abduction between genders were present for most tasks, including running, jump landings and cutting movements. There were too few studies in individuals with ACL injury to perform meta-analysis. CONCLUSION The gender difference in knee abduction during weight-bearing activities should be considered in training programs aimed at preventing or treating knee injury.
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Affiliation(s)
- Anna Cronström
- Department of Health Sciences, Lund University, Lund, Sweden.
| | - Mark W Creaby
- School of Exercise Science, Australian Catholic University, Brisbane, Australia.
| | - Jenny Nae
- Department of Health Sciences, Lund University, Lund, Sweden.
| | - Eva Ageberg
- Department of Health Sciences, Lund University, Lund, Sweden.
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de Britto MA, Lemos AL, Dos Santos CS, Stefanyshyn DJ, Carpes FP. Effect of a Compressive Garment on Kinematics of Jump-Landing Tasks. J Strength Cond Res 2016; 31:2480-2488. [PMID: 27552212 DOI: 10.1519/jsc.0000000000001620] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
de Britto, MA, Lemos, AL, dos Santos, CS, Stefanyshyn, DJ, and Carpes, FP. Effect of a compressive garment on kinematics of jump-landing tasks. J Strength Cond Res 31(9): 2480-2488, 2017-During jump-landing tasks, knee kinematics such as excessive valgus have been linked to knee injury in females. We determine the influence of a compressive garment on knee valgus during landing. Physically active women (n = 27, mean age 23 years) performed 4 different jump-landing tasks with 2 apparel conditions (compressive garment and regular sports shorts). Kinematic data were collected to determine knee flexion and valgus angles and the maximum jump height. Results showed that the compressive garment decreased knee flexion and knee valgus range of motion, without significant changes in the maximum jump height. As a practical application, we suggest that compression could be a strategy to reduce dynamic valgus without influencing jump performance, which motivates further study of its potential for knee injury prevention.
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Affiliation(s)
- Morgana A de Britto
- 1Laboratory of Neuromechanics, Applied Neuromechanics Research Group, Federal University of Pampa, Uruguaiana, Rio Grande do Sul, Brazil; 2Post-Graduate Program in Physical Education, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil; and 3Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Alberta, Canada
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Stracciolini A, Yen YM, d'Hemecourt PA, Lewis CL, Sugimoto D. Sex and growth effect on pediatric hip injuries presenting to sports medicine clinic. J Pediatr Orthop B 2016; 25:315-21. [PMID: 27058819 PMCID: PMC4889549 DOI: 10.1097/bpb.0000000000000315] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
UNLABELLED To compare sports-related hip injuries on the basis of sex and age in a cohort of young athletes. A 5% random probability sample of all new patients' charts over a 10-year time period was selected for investigation. The most common hip injury diagnoses, sport at time of injury, mechanism (acute/traumatic vs. overuse), and types (bony vs. soft tissue) were compared by sex and age (preadolescent vs. adolescent). Descriptive and χ-analyses were carried out. The interaction of sex and age with respect to hip injury over time was examined by two-way (sex, age) analysis of variance. A total of 2133 charts were reviewed; N=87 hip injuries. The main diagnoses for males included labral tear (23.1%), avulsion fracture (11.5%), slipped capital femoral epiphysis (11.5%), dislocation (7.7%), and tendonitis (7.7%). The main diagnoses for females were labral tear (59.0%), tendonitis (14.8%), snapping hip syndrome (6.6%), strain (4.9%), and bursitis (4.9%). The five most common sports/activities at the time of hip injury were dancing/ballet (23.0%), soccer (18.4%), gymnastics (9.2%), ice hockey (8.1%), and track and field (6.9%). Age by sex comparisons showed a greater proportion of the total hip injuries (38.5%) in males compared with females (8.2%) during preadolescence (5-12 years). However, in adolescence (13-17 years), the hip injury proportion was significantly higher in females (91.8%) compared with males (61.5%; P<0.001). Injury mechanism and type differed by sex, with females sustaining more chronic/overuse (95.1%) and soft tissue type injuries (93.4%) compared with males (50.0 and 53.8%, respectively; P<0.001). Females were found to have a sharper increase in hip injury proportion as they progressed through puberty compared with males (analysis of variance sex-by-age interaction; P<0.001). Hip injury mechanism and type differed significantly between males and females during growth. Notably, the proportion of hip injuries in the young female athletes showed a significantly greater increase with advancing age compared with males. Hip injuries in children and the interplay with growth, as it relates to injury predisposition, require further investigation to facilitate efforts aimed at prevention. LEVEL OF EVIDENCE III Cross-sectional epidemiological study.
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Affiliation(s)
- Andrea Stracciolini
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA
- Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Yi-Meng Yen
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Pierre A. d'Hemecourt
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Cara L. Lewis
- Department of Physical Therapy & Athletic Training, Boston University, Boston, MA
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA
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Taylor JB, Ford KR, Nguyen AD, Shultz SJ. Biomechanical Comparison of Single- and Double-Leg Jump Landings in the Sagittal and Frontal Plane. Orthop J Sports Med 2016; 4:2325967116655158. [PMID: 27482527 PMCID: PMC4954550 DOI: 10.1177/2325967116655158] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Double-leg forward or drop-jump landing activities are typically used to screen for high-risk movement strategies and to determine the success of neuromuscular injury prevention programs. However, research suggests that these tasks that occur primarily in the sagittal plane may not adequately represent the lower extremity biomechanics that occur during unilateral foot contact or non-sagittal plane movements that are characteristic of many multidirectional sports. PURPOSE To examine the extent to which lower extremity biomechanics measured during a jump landing on a double leg (DL) after a sagittal plane (SAG) movement is representative of biomechanics measured during single-leg (SL) or frontal plane (FRONT) jump landing tasks. STUDY DESIGN Controlled laboratory study. METHODS Lower extremity biomechanics were measured in 15 recreationally active females (mean age [±SD], 19.4 ± 2.1 years; mean height, 163.3 ± 5.9 cm; mean weight, 61.1 ± 7.1 kg) while performing SAGDL, SAGSL, FRONTDL, and FRONTSL jump landing tasks. Repeated-measures analyses of variance examined differences in lower extremity biomechanics between the 4 tasks, and linear regressions examined the extent to which an individual's biomechanics during SAGDL were representative of their biomechanics during SAGSL, FRONTDL, and FRONTSL. RESULTS Lower extremity kinematics and kinetics differed by condition, with the SAGDL task generally eliciting greater hip and knee flexion angles and lower hip and knee forces than the other tasks (P < .05). Although biomechanics during the SAGDL task were strongly associated with those during the FRONTDL task (R (2), 0.41-0.82), weaker associations were observed between SAGDL and single-leg tasks for hip kinematics (R (2), 0.03-0.25) and kinetics (R (2), 0.05-0.20) and knee abduction moments (R (2), 0.06-0.18) (P < .05). CONCLUSION Standard double-leg sagittal plane jump landing tasks used to screen for ACL injury risk and the effectiveness of ACL injury prevention programs may not adequately represent the lower extremity biomechanics that occur during single-leg activities. CLINICAL RELEVANCE These results support further investigation of single-leg multidirectional landings to identify high-risk movement strategies in female athletes playing multidirectional sports.
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Affiliation(s)
- Jeffrey B Taylor
- Department of Physical Therapy, High Point University, High Point, North Carolina, USA.; Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Kevin R Ford
- Department of Physical Therapy, High Point University, High Point, North Carolina, USA
| | - Anh-Dung Nguyen
- Department of Athletic Training, High Point University, High Point, North Carolina, USA
| | - Sandra J Shultz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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O'Kane JW, Tencer A, Neradilek M, Polissar N, Sabado L, Schiff MA. Is Knee Separation During a Drop Jump Associated With Lower Extremity Injury in Adolescent Female Soccer Players? Am J Sports Med 2016; 44:318-23. [PMID: 26620296 DOI: 10.1177/0363546515613076] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Knee injuries are common in older adolescent and adult female soccer players, and abnormal valgus knee appearance characterized by low normalized knee separation (NKS) is a proposed injury risk factor. What constitutes normal NKS in younger adolescents and whether low NKS is an injury risk factor are unknown. PURPOSE To determine the normal range of NKS using a drop-jump test in female perimenarchal youth soccer players and whether low NKS contributes to lower extremity injuries or knee injuries. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS From 2008 to 2012, a total of 351 female elite youth soccer players (age range, 11-14 years) were followed for 1 season, with complete follow-up on 92.3% of players. Baseline drop-jump testing was performed preseason. Lower extremity injuries during the season were identified using a validated, Internet-based injury surveillance system with weekly email reporting. Normalized knee separation at prelanding, landing, and takeoff was categorized 2 ways: as ≤10th percentile (most extreme valgus appearance) compared with >10th percentile and as a continuous measure of 1 SD. Poisson regression modeling with adjustment for clustering by team estimated the relative risk (RR) and 95% confidence interval (CI) of the association between the NKS and the risk of lower extremity and knee injury, stratified by menarche. RESULTS Of the study participants, 134 players experienced 173 lower extremity injuries, with 43 (24.9%) knee injuries. For postmenarchal players (n = 210), those with NKS ≤10th percentile were at 92% increased risk of lower extremity injury (RR, 1.92; 95% CI, 1.17-3.15) and a 3.62-fold increased risk of knee injury (RR, 3.62; 95% CI, 1.18-11.09) compared with NKS >10th percentile at prelanding and landing, respectively. Among postmenarchal players, there was an 80% increased risk of knee injury (RR, 1.80; 95% CI, 1.01-3.23) with a decrease of 1 SD in landing NKS and a 66% increased risk of knee injury (RR, 1.66; 95% CI, 1.04-2.64) with a decrease of 1 SD in takeoff NKS. Among premenarchal players (n = 141), there was no statistically significant association between the NKS at prelanding, landing, and takeoff and the risk of lower extremity or knee injury. CONCLUSION Low NKS was associated with increased risk of lower extremity and knee injury only among postmenarchal players.
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Affiliation(s)
- John W O'Kane
- Department of Family Medicine and Orthopedics and Sports Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Allan Tencer
- Department of Orthopedics and Sports Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Moni Neradilek
- The Mountain-Whisper-Light Statistics, Seattle, Washington, USA
| | - Nayak Polissar
- The Mountain-Whisper-Light Statistics, Seattle, Washington, USA
| | - Lori Sabado
- Department of Orthopedics and Sports Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Melissa A Schiff
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA Harborview Injury Prevention and Research Center, Seattle, Washington, USA
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Ford KR, Nguyen AD, Dischiavi SL, Hegedus EJ, Zuk EF, Taylor JB. An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus. Open Access J Sports Med 2015; 6:291-303. [PMID: 26346471 PMCID: PMC4556293 DOI: 10.2147/oajsm.s72432] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of several knee pathologies, specifically anterior cruciate ligament ruptures and patellofemoral pain. Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies. The purpose of the review was to identify and discuss hip-focused exercise interventions that aim to address dynamic lower extremity valgus. Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus. Further studies should be developed to identify and understand the mechanistic relationship between optimized biomechanics during sports and hip-focused neuromuscular exercise interventions.
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Affiliation(s)
- Kevin R Ford
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Anh-Dung Nguyen
- Department of Athletic Training, School of Health Sciences, High Point University, High Point, NC, USA
| | - Steven L Dischiavi
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Eric J Hegedus
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Emma F Zuk
- Department of Athletic Training, School of Health Sciences, High Point University, High Point, NC, USA
| | - Jeffrey B Taylor
- Department of Physical Therapy, High Point University, High Point, NC, USA
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Yin L, Sun D, Mei QC, Gu YD, Baker JS, Feng N. The Kinematics and Kinetics Analysis of the Lower Extremity in the Landing Phase of a Stop-jump Task. Open Biomed Eng J 2015; 9:103-7. [PMID: 25937849 PMCID: PMC4412954 DOI: 10.2174/1874120701509010103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/30/2014] [Accepted: 02/16/2014] [Indexed: 11/24/2022] Open
Abstract
Large number of studies showed that landing with great impact forces may be a risk factor for knee injuries. The purpose of this study was to illustrate the different landing loads to lower extremity of both genders and examine the relationships among selected lower extremity kinematics and kinetics during the landing of a stop-jump task. A total of 35 male and 35 female healthy subjects were recruited in this study. Each subject executed five experiment actions. Lower extremity kinematics and kinetics were synchronously acquired. The comparison of lower extremity kinematics for different genders showed significant difference. The knee and hip maximum flexion angle, peak ground reaction force and peak knee extension moment have significantly decreased during the landing of the stop-jump task among the female subjects. The hip flexion angle at the initial foot contact phase showed significant correlation with peak ground reaction force during landing of the stop-jump task (r=-0.927, p<0.001). The knee flexion angle at the initial foot contact phase had significant correlation with peak ground reaction force and vertical ground reaction forces during landing of the stop-jump task (r=-0.908, p<0.001; r=0.812, P=0.002). A large hip and knee flexion angles at the initial foot contact with the ground did not necessarily reduce the impact force during landing, but active hip and knee flexion motions did. The hip and knee flexion motion of landing was an important technical factor that affects anterior cruciate ligament (ACL) loading during the landing of the stop-jump task.
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Affiliation(s)
- L Yin
- Human Movement Research Center, Faculty of Sports Science, Ningbo University, Zhejiang 315211, China ; School of Science and Sport, University of the West of Scotland, Hamilton, ML3 OJB, Scotland
| | - D Sun
- Human Movement Research Center, Faculty of Sports Science, Ningbo University, Zhejiang 315211, China
| | - Q C Mei
- Human Movement Research Center, Faculty of Sports Science, Ningbo University, Zhejiang 315211, China
| | - Y D Gu
- Human Movement Research Center, Faculty of Sports Science, Ningbo University, Zhejiang 315211, China
| | - J S Baker
- School of Science and Sport, University of the West of Scotland, Hamilton, ML3 OJB, Scotland
| | - N Feng
- Rehabilitation Center, Ningbo Ninth Hospital, Zhejiang 315020, China
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Fox AS, Bonacci J, McLean SG, Spittle M, Saunders N. What is normal? Female lower limb kinematic profiles during athletic tasks used to examine anterior cruciate ligament injury risk: a systematic review. Sports Med 2014; 44:815-32. [PMID: 24682949 DOI: 10.1007/s40279-014-0168-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND It has been proposed that the performance of athletic tasks where normal motion is exceeded has the potential to damage the anterior cruciate ligament (ACL). Determining the expected or 'normal' kinematic profile of athletic tasks commonly used to assess ACL injury risk can provide an evidence base for the identification of abnormal or anomalous task performances in a laboratory setting. OBJECTIVE The objective was to conduct a systematic review of studies examining lower limb kinematics of females during drop landing, drop vertical jump, and side-step cutting tasks, to determine 'normal' ranges for hip and knee joint kinematic variables. DATA SOURCES An electronic database search was conducted on the SPORTDiscus(TM), MEDLINE, AMED and CINAHL (January 1980-August 2013) databases using a combination of relevant keywords. STUDY SELECTION Studies identified as potentially relevant were independently examined by two reviewers for inclusion. Where consensus could not be reached, a third reviewer was consulted. Original research articles that examined three-dimensional hip and knee kinematics of female subjects during the athletic tasks of interest were included for review. Articles were excluded if subjects had a history of lower back or lower limb joint injury or isolated data from the female cohort could not be extracted. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers independently assessed the quality of included studies. Data on subject characteristics, the athletic task performed, and kinematic data were extracted from included studies. Studies were categorised according to the athletic task being examined and each study allocated a weight within categories based on the number of subjects assessed. Extracted data were used to calculate the weighted means and standard deviations for hip and knee kinematics (initial contact and peak values). 'Normal' motion was classified as the weighted mean plus/minus one standard deviation. RESULTS Of 2,920 citations, a total of 159 articles were identified as potentially relevant, with 29 meeting all inclusion/exclusion criteria. Due to the limited number of studies available examining double-leg drop landings and single-leg drop vertical jumps, insufficient data was available to include these tasks in the review. Therefore, a total of 25 articles were included. From the included studies, 'normal' ranges were calculated for the kinematic variables of interest across the athletic tasks examined. LIMITATIONS Joint forces and other additional elements play a role in ACL injuries, therefore, focusing solely on lower limb kinematics in classifying injury risk may not encapsulate all relevant factors. Insufficient data resulted in no normal ranges being calculated for double-leg drop land and single-leg drop vertical jump tasks. No included study examined hip internal/external rotation during single-leg drop landings, therefore ranges for this kinematic variable could not be determined. Variation in data between studies resulted in wide normal ranges being observed across certain kinematic variables. CONCLUSIONS The ranges calculated in this review provide evidence-based values that can be used to identify abnormal or anomalous athletic task performances on a multi-planar scale. This may be useful in identifying neuromuscular factors or specific muscular recruitment strategies that contribute to ACL injury risk.
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Affiliation(s)
- Aaron S Fox
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, 3125, Melbourne, VIC, Australia
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Pappas E, Nightingale EJ, Simic M, Ford KR, Hewett TE, Myer GD. Do exercises used in injury prevention programmes modify cutting task biomechanics? A systematic review with meta-analysis. Br J Sports Med 2014; 49:673-80. [PMID: 25492646 DOI: 10.1136/bjsports-2014-093796] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Some injury prevention programmes aim to reduce the risk of ACL rupture. Although the most common athletic task leading to ACL rupture is cutting, there is currently no consensus on how injury prevention programmes influence cutting task biomechanics. To systematically review and synthesise the scientific literature regarding the influence of injury prevention programme exercises on cutting task biomechanics. DESIGN The three largest databases (Medline, EMBASE and CINAHL) were searched for studies that investigated the effect of injury prevention programmes on cutting task biomechanics. When possible meta-analyses were performed. RESULTS Seven studies met the inclusion criteria. Across all studies, a total of 100 participants received exercises that are part of ACL injury prevention programmes and 76 participants served in control groups. Most studies evaluated variables associated with the quadriceps dominance theory. The meta-analysis revealed decreased lateral hamstrings electromyography activity (p ≤ 0.05) while single studies revealed decreased quadriceps and increased medial hamstrings activity and decreased peak knee flexion moment. Findings from single studies reported that ACL injury prevention exercises reduce neuromuscular deficits (knee valgus moment, lateral trunk leaning) associated with the ligament and trunk dominance theories, respectively. The programmes we analysed appear most effective when they emphasise individualised biomechanical technique correction and target postpubertal women. CONCLUSIONS The exercises used in injury prevention programmes have the potential to improve cutting task biomechanics by ameliorating neuromuscular deficits linked to ACL rupture, especially when they emphasise individualised biomechanical technique correction and target postpubertal female athletes.
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Affiliation(s)
- Evangelos Pappas
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia Department of Orthopaedic Surgery, Orthopaedic Sports Medicine Center of Ioannina, School of Medicine, Ioannina, Greece
| | - Elizabeth J Nightingale
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
| | - Milena Simic
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
| | - Kevin R Ford
- Department of Physical Therapy, School of Health Sciences, High Point University, High Point, North Carolina, USA Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Timothy E Hewett
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Departments of Physiology & Cell Biology, Orthopaedic Surgery, Family Medicine and Biomedical Engineering OSU Sports Medicine, The Sports Health & Performance Institute, The Ohio State University, Columbus, Ohio, USA
| | - Gregory D Myer
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Departments of Physiology & Cell Biology, Orthopaedic Surgery, Family Medicine and Biomedical Engineering OSU Sports Medicine, The Sports Health & Performance Institute, The Ohio State University, Columbus, Ohio, USA The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
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Brock E, Zhang S, Milner C, Liu X, Brosnan JT, Sorochan JC. Effects of two football stud configurations on biomechanical characteristics of single-leg landing and cutting movements on infilled synthetic turf. Sports Biomech 2014; 13:362-79. [PMID: 25301011 DOI: 10.1080/14763141.2014.965727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Multiple playing surfaces and footwear used in American football warrant a better understanding of relationship between different combinations of turf and footwear. The purpose of this study was to examine effects of shoe and stud types on ground reaction force (GRF) and ankle and knee kinematics of a 180° cut and a single-leg 90° land-cut on synthetic turf. Fourteen recreational football players performed five trials of the 180° cut and 90° land-cut in three shoe conditions: non-studded running shoe, and football shoe with natural and synthetic turf studs. Variables were analyzed with a 3 × 2 (shoe × movement) repeated measures analysis of variance (p < 0.05). Peak vertical GRF (p < 0.001) and loading rate (p < 0.001) were greater during 90° land-cut than 180° cut. For 180° cut, natural turf studs produced smaller peak medial GRFs compared to synthetic turf studs and non-studded shoe (p = 0.012). For land-cut, peak eversion velocity was reduced in running shoes compared to natural (p = 0.016) and synthetic (p = 0.002) turf studs. The 90° land-cut movement resulted in greater peak vertical GRF and loading rate compared to the 180° cut. Overall, increased GRFs in the 90° land-cut movement may increase the chance of injury.
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Affiliation(s)
- Elizabeth Brock
- a Department of Kinesiology, Recreation, and Sport Studies , The University of Tennessee , Knoxville , TN , USA
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78
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Richter C, O׳Connor NE, Marshall B, Moran K. Comparison of discrete-point vs. dimensionality-reduction techniques for describing performance-related aspects of maximal vertical jumping. J Biomech 2014; 47:3012-7. [DOI: 10.1016/j.jbiomech.2014.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 06/17/2014] [Accepted: 07/01/2014] [Indexed: 10/25/2022]
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Peterson JR, Krabak BJ. Anterior cruciate ligament injury: mechanisms of injury and strategies for injury prevention. Phys Med Rehabil Clin N Am 2014; 25:813-28. [PMID: 25442160 DOI: 10.1016/j.pmr.2014.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Anterior cruciate ligament (ACL) injury is a common sports injury which can have severe negative consequences. Neuromuscular factors that increase risk, such as knee landing kinematics, may be ameliorated through training. Effective ACL injury prevention programs exist, although the ideal program is yet to be determined. It is recommended that athletes engaged in high-risk sports participate in an ACL injury prevention program to reduce the risk of sustaining this injury.
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Affiliation(s)
- Judith R Peterson
- Department of Neurosciences, Sanford School of Medicine, University of South Dakota, 1400 West 22nd Street, Sioux Falls, SD 57105, USA; Yankton Medical Clinic, 1104 West 8th Street, Yankton, SD 57078, USA.
| | - Brian J Krabak
- Rehabilitation, Orthopedics, and Sports Medicine, University of Washington Sports Medicine, 3800 Montlake Boulevard Northeast, Box 354060, Seattle, WA 98195, USA; Seattle Children's Sports Medicine, 4800 Sand Point Way Northeast, Seattle, WA 98145, USA
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81
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Quadriceps and hamstrings prelanding myoelectric activity during landing from different heights among male and female athletes. J Electromyogr Kinesiol 2014; 24:508-12. [DOI: 10.1016/j.jelekin.2014.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 02/24/2014] [Accepted: 04/13/2014] [Indexed: 01/14/2023] Open
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Analysis of the response speed of musculature of the knee in professional male and female volleyball players. BIOMED RESEARCH INTERNATIONAL 2014; 2014:239708. [PMID: 25003109 PMCID: PMC4070587 DOI: 10.1155/2014/239708] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/09/2014] [Accepted: 05/06/2014] [Indexed: 11/18/2022]
Abstract
The aim of this study was to evaluate the normalized response speed (Vrn) of the knee musculature (flexor and extensor) in high competitive level volleyball players using tensiomyography (TMG) and to analyze the muscular response of the vastus medialis (VM), rectus femoris (RF), vastus lateralis (VL), and biceps femoris (BF) in accordance with the specific position they play in their teams. One hundred and sixty-six players (83 women and 83 men) were evaluated. They belonged to eight teams in the Spanish women's superleague and eight in the Spanish men's superleague. The use of Vrn allows avoiding possible sample imbalances due to anatomical and functional differences and demands. We found differences between Vrn in each of the muscles responsible for extension (VM, RF, and VL) and flexion (BF) regardless of the sex. Normalized response speed differences seem to be larger in setters, liberos and outside players compared to middle blockers and larger in males when compared to females. These results of Vrn might respond to the differences in the physical and technical demands of each specific position, showing an improved balance response of the knee extensor and flexor musculature in male professional volleyball players.
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83
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Orishimo KF, Liederbach M, Kremenic IJ, Hagins M, Pappas E. Comparison of landing biomechanics between male and female dancers and athletes, part 1: Influence of sex on risk of anterior cruciate ligament injury. Am J Sports Med 2014; 42:1082-8. [PMID: 24590005 DOI: 10.1177/0363546514523928] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The incidence of anterior cruciate ligament (ACL) injuries among dancers is much lower than among team sport athletes, and no clear disparity between sexes has been reported in the dance population. Although numerous studies have observed differences in landing biomechanics of the lower extremity between male and female team sport athletes, there is currently little research examining the landing biomechanics of male and female dancers and none comparing athletes to dancers. Comparing the landing biomechanics within these populations may help explain the lower overall ACL injury rates and lack of sex disparity. HYPOTHESIS The purpose was to compare the effects of sex and group (dancer vs team sport athlete) on single-legged drop-landing biomechanics. The primary hypothesis was that female dancers would perform a drop-landing task without demonstrating typical sex-related risk factors associated with ACL injuries. A secondary hypothesis was that female team sport athletes would display typical ACL risk factors during the same task. STUDY DESIGN Controlled laboratory study. METHODS Kinematics and kinetics were recorded as 40 elite modern and ballet dancers (20 men and 20 women) and 40 team sport athletes (20 men and 20 women) performed single-legged drop landings from a 30-cm platform. Joint kinematics and kinetics were compared between groups and sexes with a group-by-sex multivariate analysis of variance (MANOVA) followed by pairwise t tests. RESULTS Dancers of both sexes and male team sport athletes landed similarly in terms of frontal-plane knee alignment, whereas female team sport athletes landed with a significantly greater peak knee valgus (P = .007). Female dancers were found to have a lower hip adduction torque than those of the other 3 groups (P = .003). Dancers (male and female) exhibited a lower trunk side flexion (P = .002) and lower trunk forward flexion (P = .032) compared with team sport athletes. CONCLUSION In executing a 30-cm drop landing, female team sport athletes displayed a greater knee valgus than did the other 3 groups. Dancers exhibited better trunk stability than did athletes. CLINICAL RELEVANCE These biomechanical findings may provide insight into the cause of the epidemiological differences in ACL injuries between dancers and athletes and the lack of a sex disparity within dancers.
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Affiliation(s)
- Karl F Orishimo
- Karl F. Orishimo, MS, Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, 100 East 77th Street, 2nd Floor, New York, NY 10075, USA.
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84
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Hughes G. A Review of Recent Perspectives on Biomechanical Risk Factors Associated with Anterior Cruciate Ligament Injury. Res Sports Med 2014; 22:193-212. [DOI: 10.1080/15438627.2014.881821] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Gerwyn Hughes
- Sport, Health and Exercise Subject Group, University of Hertfordshire, Hatfield, UK
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85
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Schmitz RJ, Cone JC, Tritsch AJ, Pye ML, Montgomery MM, Henson RA, Shultz SJ. Changes in drop-jump landing biomechanics during prolonged intermittent exercise. Sports Health 2014; 6:128-35. [PMID: 24587862 PMCID: PMC3931337 DOI: 10.1177/1941738113503286] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: As injury rates rise in the later stages of sporting activities, a better understanding of lower extremity biomechanics in the later phases of gamelike situations may improve training and injury prevention programs. Hypothesis: Lower extremity biomechanics of a drop-jump task (extracted from a principal components analysis) would reveal factors associated with risk of anterior cruciate ligament injury during a 90-minute individualized intermittent exercise protocol (IEP) and for 1 hour following the IEP. Study Design: Controlled laboratory study. Level of Evidence: Level 4. Methods: Fifty-nine athletes (29 women, 30 men) completed 3 sessions. The first session assessed fitness for an IEP designed to simulate the demands of a soccer match. An experimental session assessed drop-jump biomechanics, after a dynamic warm-up, every 15 minutes during the 90-minute IEP, and for 1 hour following the IEP. A control session with no exercise assessed drop-jump performance at the same intervals. Results: Two biomechanical factors early in the first half (hip flexion at initial contact and hip loading; ankle loading and knee shear force) decreased at the end of the IEP and into the 60-minute recovery period, while a third factor (knee loading) decreased only during the recovery period (P ≤ 0.05). Conclusion: The individualized sport-specific IEP may have more subtle effects on landing biomechanics when compared with short-term, exhaustive fatigue protocols. Clinical Relevance: Potentially injurious landing biomechanics may not occur until the later stages of soccer activity.
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Affiliation(s)
- Randy J Schmitz
- Applied Neuromechanics Research Laboratory, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - John C Cone
- Portland Timbers Football Club, Portland, Oregon
| | - Amanda J Tritsch
- Department of Orthopaedics and Sports Medicine, University of South Florida, Tampa, Florida
| | - Michele L Pye
- Applied Neuromechanics Research Laboratory, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | | | - Robert A Henson
- Department of Educational Research Methodology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Sandra J Shultz
- Applied Neuromechanics Research Laboratory, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
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Scholes CJ, McDonald MD, Parker AW. Young men utilise limited neuromuscular preparation to regulate post-impact knee mechanics during step landing. Gait Posture 2014; 39:284-90. [PMID: 23978695 DOI: 10.1016/j.gaitpost.2013.07.127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 06/20/2013] [Accepted: 07/26/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE The neuromuscular mechanisms determining the mechanical behaviour of the knee during landing impact remain poorly understood. It was hypothesised that neuromuscular preparation is subject-specific and ranges along a continuum from passive to active. METHODS A group of healthy men (N=12) stepped-down from a knee-high platform for 60 consecutive trials. Surface EMG of the quadriceps and hamstrings was used to determine pre-impact onset timing, activation amplitude and cocontraction for each trial. Partial least squares regression was used to associate pre-impact preparation with post-impact knee stiffness and coordination. RESULTS The group analysis revealed few significant changes in pre-impact preparation across trial blocks. Single-subject analyses revealed changes in muscle activity that varied in size and direction between individuals. Further, the association between pre-impact preparation and post-impact knee mechanics was subject-specific and ranged along a continuum of strategies. CONCLUSION The findings suggest that neuromuscular preparation during step landing is subject-specific and its association to post-impact knee mechanics occurs along a continuum, ranging from passive to active control strategies. Further work should examine the implications of these strategies on the distribution of knee forces in vivo.
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Affiliation(s)
- Corey J Scholes
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Sydney Orthopaedic Research Institute, Chatswood, NSW, Australia.
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87
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Ali N, Robertson DGE, Rouhi G. Sagittal plane body kinematics and kinetics during single-leg landing from increasing vertical heights and horizontal distances: implications for risk of non-contact ACL injury. Knee 2014; 21:38-46. [PMID: 23274067 DOI: 10.1016/j.knee.2012.12.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Revised: 11/21/2012] [Accepted: 12/01/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE This study identified kinematic and knee energetic variables that reduce the risk of non-contact anterior cruciate ligament (ACL) injury during single-leg landings from increasing vertical heights and horizontal distances. METHODS Nine subjects performed single-leg landings from takeoff platforms with vertical heights of 20, 40, and 60 cm onto a force plate. Subjects also performed single-leg landings from a 40 cm high takeoff platform placed at horizontal distances of 30, 50 and 70 cm from a force plate. Kinematic and kinetic data were measured. RESULTS Vertical height had a significant and positive effect on peak vertical ground reaction force (VGRF) (p<0.001), peak posterior ground reaction force (PGRF) (p=0.004), knee flexion angle (p=0.0043), trunk flexion angle (p=0.03), knee power (p<0.001) and knee work (p<0.001). There was also a significant and positive effect of horizontal distance on peak PGRF (p<0.001), ankle plantar flexion angle (p=0.008), hip flexion angle (p=0.007), and trunk flexion angle (p=0.001). At increasing vertical height, peak VGRF was significantly correlated to ankle plantar flexion and knee flexion angles (r=-0.77, p=0.02 and r=-0.78, p=0.01, respectively). At increasing horizontal distance, peak PGRF was significantly correlated to ankle plantar flexion angle, knee power and knee work (r=-0.85, p=0.003; r=0.67, p=0.04; and r=0.73, p=0.02, respectively). CLINICAL RELEVANCE A better understanding of the risk factors to non-contact ACL injury during single-leg landings from increasing vertical heights and horizontal distances can aid in the design of injury prevention regimen.
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Affiliation(s)
- Nicholas Ali
- School of Human Kinetics, University of Ottawa, Ottawa, Canada.
| | | | - Gholamreza Rouhi
- School of Human Kinetics, University of Ottawa, Ottawa, Canada; Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
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88
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Grooms DR, Palmer T, Onate JA, Myer GD, Grindstaff T. Soccer-specific warm-up and lower extremity injury rates in collegiate male soccer players. J Athl Train 2013; 48:782-9. [PMID: 23848519 PMCID: PMC3867089 DOI: 10.4085/1062-6050-48.4.08] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effects but have had limited adoption across athletic settings. This may be due to program noncompliance, minimal exercise supervision, lack of exercise progression, and sport specificity. A soccer-specific program described as the F-MARC 11+ was developed by an expert group in association with the Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) to require minimal equipment and implementation as part of regular soccer training. The F-MARC 11+ has been shown to reduce injury risk in youth female soccer players but has not been evaluated in an American male collegiate population. OBJECTIVE To investigate the effects of a soccer-specific warm-up program (F-MARC 11+) on lower extremity injury incidence in male collegiate soccer players. DESIGN Cohort study. SETTING One American collegiate soccer team followed for 2 seasons. PATIENTS OR OTHER PARTICIPANTS Forty-one male collegiate athletes aged 18-25 years. INTERVENTION(S) The F-MARC 11+ program is a comprehensive warm-up program targeting muscular strength, body kinesthetic awareness, and neuromuscular control during static and dynamic movements. Training sessions and program progression were monitored by a certified athletic trainer. MAIN OUTCOME MEASURE(S) Lower extremity injury risk and time lost to lower extremity injury. RESULTS The injury rate in the referent season was 8.1 injuries per 1000 exposures with 291 days lost and 2.2 injuries per 1000 exposures and 52 days lost in the intervention season. The intervention season had reductions in the relative risk (RR) of lower extremity injury of 72% (RR = 0.28, 95% confidence interval = 0.09, 0.85) and time lost to lower extremity injury (P < .01). CONCLUSIONS This F-MARC 11+ program reduced overall risk and severity of lower extremity injury compared with controls in collegiate-aged male soccer athletes.
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Affiliation(s)
| | | | | | - Gregory D. Myer
- The Ohio State University, Columbus
- Cincinnati Children's Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, OH
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Norcross MF, Lewek MD, Padua DA, Shultz SJ, Weinhold PS, Blackburn JT. Lower extremity energy absorption and biomechanics during landing, part II: frontal-plane energy analyses and interplanar relationships. J Athl Train 2013; 48:757-63. [PMID: 23944381 DOI: 10.4085/1062-6050-48.4.10] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
CONTEXT Greater sagittal-plane energy absorption (EA) during the initial impact phase (INI) of landing is consistent with sagittal-plane biomechanics that likely increase anterior cruciate ligament (ACL) loading, but it does not appear to influence frontal-plane biomechanics. We do not know whether frontal-plane INI EA is related to high-risk frontal-plane biomechanics. OBJECTIVE To compare biomechanics among INI EA groups, determine if women are represented more in the high group, and evaluate interplanar INI EA relationships. DESIGN Descriptive laboratory study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Participants included 82 (41 men, 41 women; age = 21.0 ± 2.4 years, height = 1.74 ± 0.10 m, mass = 70.3 ± 16.1 kg) healthy, physically active volunteers. INTERVENTION(S) We assessed landing biomechanics with an electromagnetic motion-capture system and force plate. MAIN OUTCOME MEASURE(S) We calculated frontal- and sagittal-plane total, hip, knee, and ankle INI EA. Total frontal-plane INI EA was used to create high, moderate, and low tertiles. Frontal-plane knee and hip kinematics, peak vertical and posterior ground reaction forces, and peak internal knee-varus moment (pKVM) were identified and compared across groups using 1-way analyses of variance. We used a χ (2) analysis to evaluate male and female allocation to INI EA groups. We used simple, bivariate Pearson product moment correlations to assess interplanar INI EA relationships. RESULTS The high-INI EA group exhibited greater knee valgus at ground contact, hip adduction at pKVM, and peak hip adduction than the low-INI EA group (P < .05) and greater peak knee valgus, pKVM, and knee valgus at pKVM than the moderate- (P < .05) and low- (P < .05) INI EA groups. Women were more likely than men to be in the high-INI EA group (χ(2) = 4.909, P = .03). Sagittal-plane knee and frontal-plane hip INI EA (r = 0.301, P = .006) and sagittal-plane and frontal-plane ankle INI EA were associated (r = 0.224, P = .04). No other interplanar INI EA relationships were found (P > .05). CONCLUSIONS Greater frontal-plane INI EA was associated with less favorable frontal-plane biomechanics that likely result in greater ACL loading. Women were more likely than men to use greater frontal-plane INI EA. The magnitudes of sagittal- and frontal-plane INI EA were largely independent.
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Affiliation(s)
- Marc F Norcross
- College of Public Health and Human Sciences, Oregon State University, Corvallis
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Gender, Vertical Height and Horizontal Distance Effects on Single-Leg Landing Kinematics: Implications for Risk of non-contact ACL Injury. J Hum Kinet 2013; 37:27-38. [PMID: 24146702 PMCID: PMC3796838 DOI: 10.2478/hukin-2013-0022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
There is a lack of studies investigating gender differences in whole-body kinematics during single-leg landings from increasing vertical heights and horizontal distances. This study determined the main effects and interactions of gender, vertical height, and horizontal distance on whole-body joint kinematics during single-leg landings, and established whether these findings could explain the gender disparity in non-contact anterior cruciate ligament (ACL) injury rate. Recreationally active males (n=6) and females (n=6) performed single-leg landings from a takeoff deck of vertical height of 20, 40, and 60 cm placed at a horizontal distance of 30, 50 and 70 cm from the edge of a force platform, while 3D kinematics and kinetics were simultaneously measured. It was determined that peak vertical ground reaction force (VGRF) and the ankle flexion angle exhibited significant gender differences (p=0.028, partial η
2
=0.40 and p=0.035, partial η
2
=0.37, respectively). Peak VGRF was significantly correlated to the ankle flexion angle (r= −0.59, p=0.04), hip flexion angle (r= −0.74, p=0.006), and trunk flexion angle (r= −0.59, p=0.045). Peak posterior ground reaction force (PGRF) was significantly correlated to the ankle flexion angle (r= −0.56, p=0.035), while peak knee abduction moment was significantly correlated to the knee flexion angle (r= −0.64, p=0.03). Rearfoot landings may explain the higher ACL injury rate among females. Higher plantar-flexed ankle, hip, and trunk flexion angles were associated with lower peak ground reaction forces, while higher knee flexion angle was associated with lower peak knee abduction moment, and these kinematics implicate reduced risk of non-contact ACL injury.
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91
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Contributions of the Soleus and Gastrocnemius muscles to the anterior cruciate ligament loading during single-leg landing. J Biomech 2013; 46:1913-20. [DOI: 10.1016/j.jbiomech.2013.04.010] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 04/11/2013] [Accepted: 04/14/2013] [Indexed: 11/20/2022]
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92
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Sex differences in the kinematics and neuromuscular control of landing: biological, environmental and sociocultural factors. J Electromyogr Kinesiol 2013; 23:747-58. [PMID: 23731700 DOI: 10.1016/j.jelekin.2013.04.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 04/17/2013] [Accepted: 04/25/2013] [Indexed: 11/21/2022] Open
Abstract
Potential sex differences in patterns of movement of recreational and competitive athletes were investigated in a systematic review of lower limb kinematics, muscle activation and stiffness during landing and hopping tasks. Little support for sex-specific lower limb kinematic patterns was found in 17 studies retrieved on landing and hopping. Ten studies retrieved on muscle activation during landing provided no support for sex-specific patterns. Four articles retrieved on leg stiffness established that absolute stiffness was lower in females, but differences in stiffness normalized to body mass were less clear. The wider literature indicates that a combination of biological, environmental and sociocultural constraints may shape movement patterns differently in females and males. Sociocultural factors differentially affect accumulated motor experience, practice opportunities and focus of attention in females, leading to differences in motor skill that confound the comparison of female and male movements. The findings of the review support the hypothesis that such sex differences in athletic performance are likely to diminish or disappear with increasing skill. In everyday movement tasks, however, where level of skill is a less meaningful dimension than in sport, differences in movement patterns observed between females and males point instead to the influence of subtle societal expectations on movement patterns.
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93
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STEARNS KRISTENM, KEIM ROBERTG, POWERS CHRISTOPHERM. Influence of Relative Hip and Knee Extensor Muscle Strength on Landing Biomechanics. Med Sci Sports Exerc 2013. [DOI: 10.1249/mss.0b013e31827c0b94] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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94
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Pappas E, Zampeli F, Xergia SA, Georgoulis AD. Lessons learned from the last 20 years of ACL-related in vivo-biomechanics research of the knee joint. Knee Surg Sports Traumatol Arthrosc 2013; 21:755-66. [PMID: 22437657 DOI: 10.1007/s00167-012-1955-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 02/28/2012] [Indexed: 02/06/2023]
Abstract
PURPOSE Technological advances in recent years have allowed the easy and accurate assessment of knee motion during athletic activities. Subsequently, thousands of studies have been published that greatly improved our understanding of the aetiology, surgical reconstruction techniques and prevention of anterior cruciate ligament (ACL) injuries. The purpose of this review is to summarize the evidence from biomechanical studies on ACL-related research. METHODS High-impact articles that enhanced understanding of ACL injury aetiology, rehabilitation, prevention and adaptations after reconstruction were selected. RESULTS The importance of restoring internal tibial rotation after ACL reconstruction has emerged in several studies. Criteria-based, individualized rehabilitation protocols have replaced the traditional time-based protocols. Excessive knee valgus, poor trunk control, excessive quadriceps forces and leg asymmetries have been identified as potential high risk biomechanical factors for ACL tear. Injury prevention programmes have emerged as low cost and effective means of preventing ACL injuries, particularly in female athletes. CONCLUSION As a result of biomechanical research, clinicians have a better understanding of ACL injury aetiology, prevention and rehabilitation. Athletes exhibiting neuromuscular deficits predisposing them to ACL injury can be identified and enrolled into prevention programmes. Clinicians should assess ACL-reconstructed patients for excessive internal tibial rotation that may lead to poor outcomes.
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Affiliation(s)
- Evangelos Pappas
- Division of Physical Therapy, Long Island University-Brooklyn Campus, Brooklyn, NY 11201, USA.
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95
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A. Mothersole G, B. Cronin J, K. Harris N. Key Prerequisite Factors Influencing Landing Forces in Netball. Strength Cond J 2013. [DOI: 10.1519/ssc.0b013e318289b79e] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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96
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Etnoyer J, Cortes N, Ringleb SI, Van Lunen BL, Onate JA. Instruction and jump-landing kinematics in college-aged female athletes over time. J Athl Train 2013; 48:161-71. [PMID: 23672380 DOI: 10.4085/1062-6050-48.2.09] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
CONTEXT Instruction can be used to alter the biomechanical movement patterns associated with anterior cruciate ligament (ACL) injuries. OBJECTIVE To determine the effects of instruction through combination (self and expert) feedback or self-feedback on lower extremity kinematics during the box-drop-jump task, running-stop-jump task, and sidestep-cutting maneuver over time in college-aged female athletes. DESIGN Randomized controlled clinical trial. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS Forty-three physically active women (age = 21.47 ± 1.55 years, height = 1.65 ± 0.08 m, mass = 63.78 ± 12.00 kg) with no history of ACL or lower extremity injuries or surgery in the 2 months before the study were assigned randomly to 3 groups: self-feedback (SE), combination feedback (CB), or control (CT). INTERVENTION(S) Participants performed a box-drop-jump task for the pretest and then received feedback about their landing mechanics. After the intervention, they performed an immediate posttest of the box-drop-jump task and a running-stop-jump transfer test. Participants returned 1 month later for a retention test of each task and a sidestep-cutting maneuver. Kinematic data were collected with an 8-camera system sampled at 500 Hz. MAIN OUTCOME MEASURE(S) The independent variables were feedback group (3), test time (3), and task (3). The dependent variables were knee- and hip-flexion, knee-valgus, and hip- abduction kinematics at initial contact and at peak knee flexion. RESULTS For the box-drop-jump task, knee- and hip-flexion angles at initial contact were greater at the posttest than at the retention test (P < .001). At peak knee flexion, hip flexion was greater at the posttest than at the pretest (P = .003) and was greater at the retention test than at the pretest (P = .04); knee valgus was greater at the retention test than at the pretest (P = .03) and posttest (P = .02). Peak knee flexion was greater for the CB than the SE group (P = .03) during the box-drop-jump task at posttest. For the running-stop-jump task at the posttest, the CB group had greater peak knee flexion than the SE and CT (P ≤ .05). CONCLUSIONS Our results suggest that feedback involving a combination of self-feedback and expert video feedback with oral instruction effectively improved lower extremity kinematics during jump-landing tasks.
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Affiliation(s)
- Jena Etnoyer
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA, USA
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97
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Ali N, Andersen MS, Rasmussen J, Robertson DGE, Rouhi G. The application of musculoskeletal modeling to investigate gender bias in non-contact ACL injury rate during single-leg landings. Comput Methods Biomech Biomed Engin 2013; 17:1602-16. [PMID: 23387967 DOI: 10.1080/10255842.2012.758718] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The central tenet of this study was to develop, validate and apply various individualised 3D musculoskeletal models of the human body for application to single-leg landings over increasing vertical heights and horizontal distances. While contributing to an understanding of whether gender differences explain the higher rate of non-contact anterior cruciate ligament (ACL) injuries among females, this study also correlated various musculoskeletal variables significantly impacted by gender, height and/or distance and their interactions with two ACL injury-risk predictor variables; peak vertical ground reaction force (VGRF) and peak proximal tibia anterior shear force (PTASF). Kinematic, kinetic and electromyography data of three male and three female subjects were measured. Results revealed no significant gender differences in the musculoskeletal variables tested except peak VGRF (p = 0.039) and hip axial compressive force (p = 0.032). The quadriceps and the gastrocnemius muscle forces had significant correlations with peak PTASF (r = 0.85, p < 0.05 and r = - 0.88, p < 0.05, respectively). Furthermore, hamstring muscle force was significantly correlated with peak VGRF (r = - 0.90, p < 0.05). The ankle flexion angle was significantly correlated with peak PTASF (r = - 0.82, p < 0.05). Our findings indicate that compared to males, females did not exhibit significantly different muscle forces, or ankle, knee and hip flexion angles during single-leg landings that would explain the gender bias in non-contact ACL injury rate. Our results also suggest that higher quadriceps muscle force increases the risk, while higher hamstring and gastrocnemius muscle forces as well as ankle flexion angle reduce the risk of non-contact ACL injury.
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Affiliation(s)
- Nicholas Ali
- a School of Human Kinetics, University of Ottawa , Ottawa , Canada
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98
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Beaulieu ML, Palmieri-Smith RM. Real-time feedback on knee abduction moment does not improve frontal-plane knee mechanics during jump landings. Scand J Med Sci Sports 2013; 24:692-9. [PMID: 23347094 DOI: 10.1111/sms.12051] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2012] [Indexed: 12/31/2022]
Abstract
Excessive knee abduction loading is a contributing factor to anterior cruciate ligament (ACL) injury risk. The purpose of this study was to determine whether a double-leg landing training program with real-time visual feedback improves frontal-plane mechanics during double- and single-leg landings. Knee abduction angles and moments and vertical ground reaction forces (GRF) of 21 recreationally active women were quantified for double- and single-leg landings before and after the training program. This program consisted of two sessions of double-leg jump landings with real-time visual feedback on knee abduction moments for the experimental group and without real-time feedback for the control group. No significant differences were found between training groups. In comparison with pre-training data, peak knee abduction moments decreased 12% post-training for both double- and single-leg landings; whereas peak vertical GRF decreased 8% post-training for double-leg landings only, irrespective of training group. Real-time feedback on knee abduction moments, therefore, did not significantly improve frontal-plane knee mechanics during landings. The effect of the training program on knee abduction moments, however, transferred from the double-leg landings (simple task) to single-leg landings (more complex task). Consequently, ACL injury prevention efforts may not need to focus on complex tasks during which injury occurs.
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Affiliation(s)
- M L Beaulieu
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
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99
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Sañudo B, Feria A, Carrasco L, de Hoyo M, Santos R, Gamboa H. Gender differences in knee stability in response to whole-body vibration. J Strength Cond Res 2012; 26:2156-65. [PMID: 21997457 DOI: 10.1519/jsc.0b013e31823b0716] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to determine whether there are kinematic and electromyographic (EMG) differences between men and women in how the knee is controlled during a single-legged drop landing in response to whole-body vibration (WBV). Forty-five healthy volunteers, 30 men (age 22 ± 3 years; weight 76.8 ± 8.8 kg; height 179.0 ± 6.8 cm) and 15 women (age 22 ± 3 years; weight 61.0 ± 7.7 kg; height 161.9 ± 7.2 cm) were recruited for this study. Knee angles, vertical ground reaction forces, and the time to stabilize the knee were assessed after single-legged drop landings from a 30-cm platform. Surface EMG data in rectus femoris (RF) and hamstrings (H) and knee and ankle accelerometry signals were also acquired. The participants performed 3 pretest landings, followed by a 3-minute recovery and then completed 1 minute of WBV (30 Hz to 4 mm). Before vibration, the female subjects had a significantly higher peak vertical force value, knee flexion angles, and greater H preactivity (EMG(RMS) 50 milliseconds before activation) than did the male subjects. In addition, although not significant, the medial-lateral (ML) acceleration in both knee and ankle was also higher in women. After WBV, no significant differences were found for any of the other variables. However, there was a decrease in the RF to H activation ratio during the precontact phase and an increase in the ratio during the postcontact phase just in women, which leads to a decrement in ML acceleration. The gender differences reported in knee stability in response to WBV underline the necessity to perform specific neuromuscular training programs based on WBV together with instruction of the proper technique, which can assist the clinician in the knee injury prevention.
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Affiliation(s)
- Borja Sañudo
- Department of Physical Education and Sport, University of Seville, Seville, Spain.
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100
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Lower Extremity Kinematics and Kinetics When Landing From Unloaded and Loaded Jumps. J Appl Biomech 2012; 28:687-93. [DOI: 10.1123/jab.28.6.687] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Countermovement jumps loaded with a weighted vest are often used for the training of lower body power to improve jump performance. However, it is currently unknown how this added load affects the lower extremity kinematics and kinetics, in particular whether this results in an increased injury risk. Therefore, the purpose of this investigation was to determine how lower extremity kinematics and kinetics during landing are affected by loaded jumps as demonstrated in a volleyball block jump landing. Ten elite male volleyball players performed block jump landings in an unloaded and loaded (9.89 kg) condition. Kinematic and kinetic landing data from the three highest jumps were collected and assessed. Paired samplesttest was used to establish whether load condition had a significant effect on lower extremity kinematics and kinetics. Hip flexion was significantly greater in the unloaded condition compared with the loaded condition (p= .004). There was no significant difference in any other kinematic or kinetic variables measures between the unloaded and loaded conditions. These results suggest that landing from loaded volleyball block jumps does not increase injury risk compared with unloaded jumps in elite male volleyball players.
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