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McClean ZJ, Pasanen K, Lun V, Charest J, Herzog W, Werthner P, Black A, Vleuten RV, Lacoste E, Jordan MJ. A Biopsychosocial Model for Understanding Training Load, Fatigue, and Musculoskeletal Sport Injury in University Athletes: A Scoping Review. J Strength Cond Res 2024; 38:1177-1188. [PMID: 38781473 DOI: 10.1519/jsc.0000000000004789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
ABSTRACT McClean, ZJ, Pasanen, K, Lun, V, Charest, J, Herzog, W, Werthner, P, Black, A, Vleuten, RV, Lacoste, E, and Jordan, MJ. A biopsychosocial model for understanding training load, fatigue, and musculoskeletal sport injury in university athletes: A scoping review. J Strength Cond Res 38(6): 1177-1188, 2024-The impact of musculoskeletal (MSK) injury on athlete health and performance has been studied extensively in youth sport and elite sport. Current research examining the relationship between training load, injury, and fatigue in university athletes is sparse. Furthermore, a range of contextual factors that influence the training load-fatigue-injury relationship exist, necessitating an integrative biopsychosocial model to address primary and secondary injury prevention research. The objectives of this review were (a) to review the scientific literature examining the relationship between training load, fatigue, and MSK injury in university athletes and (b) to use this review in conjunction with a transdisciplinary research team to identify biopsychosocial factors that influence MSK injury and develop an updated, holistic biopsychosocial model to inform injury prevention research and practice in university sport. Ten articles were identified for inclusion in this review. Key findings were an absence of injury surveillance methodology and contextual factors that can influence the training load-fatigue-MSK injury relationship. We highlight the inclusion of academic load, social load, and mental health load as key variables contributing to a multifactorial, gendered environmental, scientific inquiry on sport injury and reinjury in university sport. An integrative biopsychosocial model for MSK injury in university sport is presented that can be used to study the biological, psychological, and social factors that modulate injury and reinjury risk in university athletes. Finally, we provide an example of how causal inference can be used to maximize the utility of longitudinally collected observational data that is characteristic of sport performance research in university sport.
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Affiliation(s)
- Zachary J McClean
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Kati Pasanen
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Victor Lun
- Sport Medicine Center, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Charest
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- École de Psychologie, Université Laval, Québec, Quebec, Canada; and
- Center for Sleep & Human Performance, Calgary, Alberta, Canada
| | - Walter Herzog
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Penny Werthner
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Amanda Black
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Reid Vander Vleuten
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Elise Lacoste
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Matthew J Jordan
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Sport Medicine Center, University of Calgary, Calgary, Alberta, Canada
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Alimoradi M, Hosseini E, Sahebozamani M, Dos’Santos T, Sheikhbahaie S, Bigtashkhani R, Kabiri A. The effects of two different fatigue protocols on movement quality during anticipated and unanticipated change of directions in female soccer players. PLoS One 2024; 19:e0302144. [PMID: 38776356 PMCID: PMC11111049 DOI: 10.1371/journal.pone.0302144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/28/2024] [Indexed: 05/24/2024] Open
Abstract
OBJECTIVE This study compared neuromuscular control under two fatigue protocols during anticipated and unanticipated change of direction (COD) maneuvers and evaluated their effects on the risk of non-contact ACL injuries. METHOD Forty-five female soccer players (mean age: 22.22 ± 2.24 years; mean height: 166.24 ± 3.33 cm; mean mass: 59.84 ± 5.03 kg) were divided into three groups: functional fatigue (Soccer specific fatigue ptotocol-SOFT90), non-functional fatigue (Bruce protocol), and control group. Before and after the implementation of neuromuscular control fatigue protocols were evaluated using the cutting motion assessment score tool (CMAS). Two-dimensional (2D) videos were recorded during anticipated and unanticipated COD trials for both dominant and non-dominant legs. RESULTS Significant time effects (p < 0.05) and group-time interactions (p < 0.05) were observed in both anticipated and unanticipated conditions for both dominant and non-dominant legs after the fatigue protocols. The functional fatigue group exhibited higher CMAS changes, indicating poorer movement quality following fatigue. Notably, the non-dominant leg displayed amplified deficits during unanticipated COD maneuvers following the functional fatigue protocol. CONCLUSIONS Fatigue significantly impairs neuromuscular control, particularly in unanticipated COD situations, which increases the risk of non-contact ACL injuries. To mitigate this risk, coaches, trainers, and medical professionals should prioritize targeted training and injury prevention strategies, focusing on the non-dominant leg during unanticipated COD maneuvers.
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Affiliation(s)
- Mohammad Alimoradi
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Elham Hosseini
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Mansour Sahebozamani
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Thomas Dos’Santos
- Musculoskeletal Science and Sports Medicine Research Centre, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Shima Sheikhbahaie
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Roya Bigtashkhani
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Aryan Kabiri
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
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Nardon M, Ferri U, Caffi G, Bartesaghi M, Perin C, Zaza A, Alessandro C. Kinematics but not kinetics alterations to single-leg drop jump movements following a subject-tailored fatiguing protocol suggest an increased risk of ACL injury. Front Sports Act Living 2024; 6:1418598. [PMID: 38832309 PMCID: PMC11144872 DOI: 10.3389/fspor.2024.1418598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction Neuromuscular fatigue causes a transient reduction of muscle force, and alters the mechanisms of motor control. Whether these alterations increase the risk of anterior cruciate ligament (ACL) injury is still debated. Here we compare the biomechanics of single-leg drop jumps before and after the execution of a fatiguing exercise, evaluating whether this exercise causes biomechanical alterations typically associated with an increased risk of ACL lesion. The intensity of the fatiguing protocol was tailored to the aerobic capacity of each participant, minimizing potential differential effects due to inter-individual variability in fitness. Methods Twenty-four healthy male volunteers performed single leg drop jumps, before and after a single-set fatiguing session on a cycle ergometer until exhaustion (cadence: 65-70 revolutions per minute). For each participant, the intensity of the fatiguing exercise was set to 110% of the power achieved at their anaerobic threshold, previously identified by means of a cardiopulmonary exercise test. Joint angles and moments, as well as ground reaction forces (GRF) before and after the fatiguing exercise were compared for both the dominant and the non-dominant leg. Results Following the fatiguing exercise, the hip joint was more extended (landing: Δ=-2.17°, p = 0.005; propulsion: Δ=-1.83°, p = 0.032) and more abducted (landing: Δ=-0.72°, p = 0.01; propulsion: Δ=-1.12°, p = 0.009). Similarly, the knee joint was more extended at landing (non-dominant leg: Δ=-2.67°, p < 0.001; dominant: Δ=-1.4°, p = 0.023), and more abducted at propulsion (both legs: Δ=-0.99°, p < 0.001) and stabilization (both legs: Δ=-1.71°, p < 0.001) hence increasing knee valgus. Fatigue also caused a significant reduction of vertical GRF upon landing (Δ=-0.21 N/kg, p = 0.003), but not during propulsion. Fatigue did not affect joint moments significantly. Conclusion The increased hip and knee extension, as well as the increased knee abduction we observed after the execution of the fatiguing exercise have been previously identified as risk factors for ACL injury. These results therefore suggest an increased risk of ACL injury after the execution of the participant-tailored fatiguing protocol proposed here. However, the reduced vertical GRF upon landing and the preservation of joint moments are intriguing, as they may suggest the adoption of protective strategies in the fatigued condition to be evaluated in future studied.
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Affiliation(s)
- Mauro Nardon
- School of Medicine and Surgery/Sport and Exercise Medicine, University of Milano-Bicocca, Milan, Italy
| | - Umberto Ferri
- School of Medicine and Surgery/Sport and Exercise Medicine, University of Milano-Bicocca, Milan, Italy
| | - Giovanni Caffi
- School of Medicine and Surgery/Sport and Exercise Medicine, University of Milano-Bicocca, Milan, Italy
| | - Manuela Bartesaghi
- School of Medicine and Surgery/Sport and Exercise Medicine, University of Milano-Bicocca, Milan, Italy
| | - Cecilia Perin
- School of Medicine and Surgery/Physical and Rehabilitative Medicine, University of Milano-Bicocca, Milan, Italy
- Istituti Clinici Zucchi - GDS, Carate Brianza, Monza e Brianza, Italy
| | - Antonio Zaza
- Department of Biotechnology and Biosciences/Sport and Exercise Medicine, University of Milano-Bicocca, Milan, Italy
| | - Cristiano Alessandro
- School of Medicine and Surgery/Sport and Exercise Medicine, University of Milano-Bicocca, Milan, Italy
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Asaeda M, Hirata K, Ohnishi T, Ito H, Miyahara S, Mikami Y. Differences in lower-limb biomechanics during single-leg landing considering two peripheral fatigue tasks. PLoS One 2024; 19:e0297910. [PMID: 38603690 PMCID: PMC11008898 DOI: 10.1371/journal.pone.0297910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 01/15/2024] [Indexed: 04/13/2024] Open
Abstract
Dynamic knee valgus (DKV) occurs during landing after a fatigue task involving the lower extremity. However, the manner in which different peripheral fatigue tasks affect DKV remains unknown. In this study, we investigated the DKV via electromyography during single-leg landing considering the hip-joint fatigue task (HFT) and knee-joint fatigue task (KFT) performed by healthy men. We recruited 16 healthy male participants who performed a single-leg jump-landing motion from a height of 20 cm before and after an isokinetic hip abduction/adduction task (HFT) and knee extension/flexion task (KFT). Three-dimensional motion analysis systems were attached to the left gluteus medius and quadriceps, and surface electromyography was used to analyze the lower limb kinematics, kinetics, and muscle activity. The primary effects and interactions of the task and fatigue were identified based on the two-way repeated-measures analysis of variance. The results of the average angle during landing indicated that DKV occurs in KFT, whereas HFT applies external forces that adduct and internally rotate the knee at peak vertical ground reaction force (vGRF). Furthermore, both KFT and HFT exhibited an increase in muscle activity in the quadriceps. The analysis revealed that the occurrence of DKV varies depending on the peripheral fatigue task, and the effects on average DKV during landing and DKV at peak vGRF vary depending on the peripheral fatigue task.
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Affiliation(s)
- Makoto Asaeda
- Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health, Wakayama, Japan
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuhiko Hirata
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Tomoya Ohnishi
- Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health, Wakayama, Japan
| | - Hideyuki Ito
- Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health, Wakayama, Japan
| | - So Miyahara
- Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health, Wakayama, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
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Raeder C, Kämper M, Praetorius A, Tennler JS, Schoepp C. Metabolic, cognitive and neuromuscular responses to different multidirectional agility-like sprint protocols in elite female soccer players - a randomised crossover study. BMC Sports Sci Med Rehabil 2024; 16:64. [PMID: 38448940 PMCID: PMC10916312 DOI: 10.1186/s13102-024-00856-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Resistance to fatigue is a key factor in injury prevention that needs to be considered in return-to-sport (RTS) scenarios, especially after severe knee ligament injuries. Fatigue should be induced under game-like conditions. The SpeedCourt (SC) is a movement platform for assessing multidirectional sprint performance, typical of game-sports, due to change-of-direction movements in response to a visual stimulus. Designing adequate fatigue protocols requires the suitable arrangement of several loading variables such as number of intervals, sprint distance or work/relief ratio (W:R). Therefore, this study analysed the acute fatigue effects of different SC protocols on metabolic load, cognitive function and neuromuscular performance. METHODS Eighteen female soccer players (mean ± SD; age: 23.1 ± 4.6 years) of the 1st German Division participated in this randomised, crossover study. Using a random allocation sequence, players completed four volume-equated protocols differing in W:R and sprint distance per interval (P1:12 × 30 m, W:R = 1:2 s; P2:12 × 30 m, W:R = 1:3 s; P3:18 × 20 m, W:R = 1:2 s; P4:18 × 20 m, W:R = 1:3 s). Pre- and post-exercise, metabolic load was measured per blood lactate concentration (BLaC), cognitive function per reaction time (RT), and neuromuscular performance including multiple rebound jumps (MRJ height, primary outcome variable; Reactive Strength Index, RSI) and 5 m sprint times (SP5). RESULTS Repeated-measures ANOVA revealed significant main time effects (p < .05) with improved performance post-exercise in RT (504 vs. 482 ms, d = 1.95), MRJ height (24.0 vs. 24.8 cm, d = 0.77), RSI (1.39 vs. 1.43, d = 0.52), and SP5 (1.19 vs. 1.17 s, d = 0.56). There was significant main time (p < .001) and time x protocol interaction effects in BLaC (p < .001). P1 induced higher BLaC values (4.52 ± 1.83 mmol/L) compared to P2 (3.79 ± 1.83 mmol/L; d = 0.74) and P4 (3.12 ± 1.83 mmol/L; d = 1.06), whereas P3 (4.23 ± 1.69 mmol/L) elicited higher BLaC values compared to P4 (d = 0.74). CONCLUSION All protocols caused an improved cognitive function and neuromuscular performance. The former may be related to enhanced noradrenergic activation or exercise specificity which induced an improved stimulus processing. The latter may be explained by a possible post-activation performance enhancement effect on jump and sprint performance. A shorter relief duration in W:R as opposed to sprint distance per interval produced higher BLaC values. The protocols may serve as reference data for improved RTS decision-making in elite female soccer players. TRIAL REGISTRATION Deutsches Register Klinischer Studien (DRKS), No.: DRKS00033496 , Registered 19. Februar 2024, Retrospectively Registered.
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Affiliation(s)
- Christian Raeder
- Department of Arthroscopy Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany.
| | - Meike Kämper
- Women´s Soccer Department, MSV Duisburg, Duisburg, Germany
| | - Arthur Praetorius
- Department of Arthroscopy Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
| | - Janina-Sophie Tennler
- Department of Arthroscopy Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
| | - Christian Schoepp
- Department of Arthroscopy Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
- Department of Trauma and Reconstructive Surgery, University Hospital Essen, Essen, Germany
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Kaiyala M, Hannigan J, Traut A, Pollard C. Bilateral movement asymmetries exist in recreational athletes during a 45° sidestep cut post-anterior cruciate ligament reconstruction. PeerJ 2024; 12:e16948. [PMID: 38436020 PMCID: PMC10908263 DOI: 10.7717/peerj.16948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/24/2024] [Indexed: 03/05/2024] Open
Abstract
Individuals post-ACL reconstruction (ACLR) are at elevated risk for ACL re-injury. While several studies have examined biomechanical asymmetries post-ACLR during landing, less is known about asymmetries during a sidestep cut. Therefore, the purpose of this study was to compare sagittal and frontal plane biomechanics at the hip and knee during a 45° sidestep cut in post-ACLR participants and healthy controls. Nineteen athletes post-ACLR and nineteen healthy controls performed a bilateral 45° sidestep cut while three-dimensional kinematics and kinetics were measured. Sagittal and frontal plane kinematics and kinetics were examined at the hip and knee during stance phase. A linear mixed model compared biomechanical differences between the limbs of ACLR and healthy control participants (α = 0.05). In the post-ACLR group, peak hip extension, peak knee flexion, sagittal hip and knee excursion, and the peak knee extensor moment were significantly lower in the ACLR surgical limb compared to the non-surgical limb (p < 0.05). The peak knee flexion angle and peak knee extensor moment were also lower in the ACLR surgical limb compared to the matched control limb (p < 0.05). In summary, post-ACLR participants exhibited altered sagittal plane movement in their surgical limb that was not demonstrated in the non-surgical limb or in control participants, which may suggest avoidance, or reduced utilization of the ACLR limb.
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Affiliation(s)
- Montana Kaiyala
- Program in Physical Therapy, College of Health, Oregon State University—Cascades, Bend, Oregon, United States
| | - J.J. Hannigan
- Program in Physical Therapy, College of Health, Oregon State University—Cascades, Bend, Oregon, United States
| | - Andrew Traut
- Program in Kinesiology, College of Health, Oregon State University, Corvallis, Oregon, United States
| | - Christine Pollard
- Program in Physical Therapy, College of Health, Oregon State University—Cascades, Bend, Oregon, United States
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Kowal M, Morgiel E, Winiarski S, Dymarek R, Bajer W, Madej M, Sebastian A, Madziarski M, Wedel N, Proc K, Madziarska K, Wiland P, Paprocka-Borowicz M. Ebbing Strength, Fading Power: Unveiling the Impact of Persistent Fatigue on Muscle Performance in COVID-19 Survivors. SENSORS (BASEL, SWITZERLAND) 2024; 24:1250. [PMID: 38400407 PMCID: PMC10892381 DOI: 10.3390/s24041250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
The total number of confirmed cases of COVID-19 caused by SARS-CoV-2 virus infection is over 621 million. Post-COVID-19 syndrome, also known as long COVID or long-haul COVID, refers to a persistent condition where individuals experience symptoms and health issues after the acute phase of COVID-19. The aim of this study was to assess the strength and fatigue of skeletal muscles in people recovered from COVID-19. A total of 94 individuals took part in this cross-sectional study, with 45 participants (referred to as the Post-COVID Cohort, PCC) and 49 healthy age-matched volunteers (Healthy Control Cohort, HCC). This research article uses the direct dynamometry method to provide a detailed analysis of post-COVID survivors' strength and power characteristics. The Biodex System 4 Pro was utilized to evaluate muscle strength characteristics during the fatigue test. The fatigue work in extensors and flexors was significantly higher in the PCC. The PCC also showed significantly less power in both extensors and flexors compared to the HCC. In conclusion, this study provides compelling evidence of the impact of post-COVID-19 fatigue on muscle performance, highlighting the importance of considering these effects in the rehabilitation and care of individuals recovering from the virus. PCC achieved lower muscle strength values than HCC.
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Affiliation(s)
- Mateusz Kowal
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.K.); (W.B.); (M.P.-B.)
| | - Ewa Morgiel
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
| | - Sławomir Winiarski
- Biomechanics Department, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland;
| | - Robert Dymarek
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.K.); (W.B.); (M.P.-B.)
| | - Weronika Bajer
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.K.); (W.B.); (M.P.-B.)
| | - Marta Madej
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
| | - Agata Sebastian
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
| | - Marcin Madziarski
- Department of Rheumatology and Internal Medicine, University Teaching Hospital, 50-556 Wroclaw, Poland; (M.M.); (K.P.)
| | - Nicole Wedel
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Krzysztof Proc
- Department of Rheumatology and Internal Medicine, University Teaching Hospital, 50-556 Wroclaw, Poland; (M.M.); (K.P.)
| | - Katarzyna Madziarska
- Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Piotr Wiland
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
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Li X, Cao W, Zhou H, Ji R, Xiao J, Zhao C. The healing effect of the all inside technique is superior to the traditional technique in the reconstruction of the anterior cruciate ligament. Eur J Transl Myol 2024; 34:11970. [PMID: 38351844 PMCID: PMC11017173 DOI: 10.4081/ejtm.2024.11970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 03/28/2024] Open
Abstract
Our main objective was to examine the curative effect of all inside technique and traditional technique in anterior cruciate ligament (ACL) reconstruction. In our retrospective study at the First People's Hospital of Jiashan County, we analyzed 88 participants with ACL injuries (50 males, 38 females, average age 27 years). They were randomly divided into two groups: traditional ACL reconstruction (42 participants) and all inside ACL reconstruction (46 participants). We measured and recorded the Visual Analog Scores (VAS), International Knee Documentation Committee (IKDC), Lysholm scores, operation time, graft diameter and length between the traditional technique group and all inside technique group. There were statistically significant differences in the Lysholm scores and IKDC scores between traditional and all inside technique groups. The all inside technique showed a higher efficacy and effective post-operative recovery with minimal pain and recurrent injuries. Our findings showed that the differences in gender, age, side of injury and operation time were not significant (p> 0.05). Follow-up was conducted at 6 months and 12 months post operations (mean, 7.5 ± 1.1 months). All inside technique minimizing tissue disruption, optimizing graft placement and facilitating early recovery have a significant impact on patient outcomes.
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Affiliation(s)
- Xiong Li
- Department of Orthopedics, Jiashan County First People's Hospital, Jiaxing, Zhejiang.
| | - Wu Cao
- Department of Orthopedics, Jiashan County First People's Hospital, Jiaxing, Zhejiang.
| | - Hongyu Zhou
- Department of Orthopedics, Jiashan County First People's Hospital, Jiaxing, Zhejiang.
| | - Ruida Ji
- Department of Orthopedics, Jiashan County First People's Hospital, Jiaxing, Zhejiang.
| | - Jian Xiao
- Department of Orthopedics, Jiashan County First People's Hospital, Jiaxing, Zhejiang.
| | - Chen Zhao
- Department of Orthopedics, Center for Rehabilitation Medicine, Zhejiang Provincial People's Hospital(Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang.
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Miralles-Iborra A, Elvira JLL, Del Coso J, Hernandez-Sanchez S, Pino-Ortega J, Moreno-Pérez V. Influence of a football match on landing biomechanics and jump performance in female football players. Scand J Med Sci Sports 2024; 34:e14518. [PMID: 37828778 DOI: 10.1111/sms.14518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023]
Abstract
This study aimed to assess the acute effect of a competitive football match on jump performance and kinematic parameters during jump landing in semiprofessional female football players. Twenty-two semiprofessional players (20 ± 3 years) underwent a drop jump task for a posterior video analysis of the landing phase. These measurements were obtained at (1) baseline, (2) after, and (3) 48 h after a competitive football match. A one-way ANOVA with repeated measures was employed to detect differences over the time. There was a main effect of time for maximal knee flexion angle during drop landing (p = 0.001). In comparison with baseline, maximal knee flexion angle was reduced immediately post-match and was still reduced 48 h after the match (63.4 ± 8.6 vs 57.0 ± 11.7 vs 48.9 ± 19.1, p ≤ 0.038). There was also a main effect of time for drop jump height (p < 0.001). Drop jump height was reduced immediately post-match and remained low 48 h after the match in comparison with baseline (27.3 ± 3.6 vs 24.5 ± 2.8 ~ 25.5 ± 3.0 cm, p ≤ 0.002). There was a main effect of time on hip flexion angle during landing (p = 0.001), but the pairwise comparison revealed that this variable was not affected immediately post-match but was lower 48 h after the match than at baseline (50.1 ± 10.1 ~ 50.8 ± 13.2 vs 38.1 ± 17.8 °, p ≤ 0.005). A competitive football match worsened jump performance and several landing biomechanical parameters in female football players, which were still decreased in comparison with baseline even 48 h after the match.
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Affiliation(s)
- Aaron Miralles-Iborra
- Sports Research Centre (Department of Sport Sciences), Miguel Hernandez University of Elche, Alicante, Spain
| | - Jose L L Elvira
- Sports Research Centre (Department of Sport Sciences), Miguel Hernandez University of Elche, Alicante, Spain
| | - Juan Del Coso
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Spain
| | - Sergio Hernandez-Sanchez
- Traslational Research Centre of Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
| | - Jose Pino-Ortega
- Physical Activity and Sports Department, International Excellence Campus "Mare Nostrum", Faculty of Sports Science, University of Murcia, Murcia, Spain
| | - Victor Moreno-Pérez
- Sports Research Centre (Department of Sport Sciences), Miguel Hernandez University of Elche, Alicante, Spain
- Traslational Research Centre of Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
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10
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Phillips DA, Buckalew BR, Keough B, Alencewicz JS. Preparing to Land: Hamstring Preactivation Is Higher in Females and Is Inhibited by Fatigue. J Appl Biomech 2023; 39:370-376. [PMID: 37491013 DOI: 10.1123/jab.2022-0287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/27/2023] [Accepted: 06/23/2023] [Indexed: 07/27/2023]
Abstract
The hamstring plays an important role in reducing loads born by the anterior cruciate ligament. As anterior cruciate ligament injuries occur rapidly after ground contact, how the hamstring is activated prior to landing can influence injury risk. The purpose was to determine sex-related differences in hamstring activation immediately before landing and the effect of fatigue on "preactivation." Twenty-four participants (13 males and 11 females, age = 24.3 [6.5] y, mass = 72.2 [19.3] kg, height = 169 [9.7] cm) participated in this study. Participants completed a drop-vertical jump protocol before and after a lower body fatigue protocol. Hamstring electromyography (EMG) amplitude at 5 periods prior to landing, peak vertical ground reactions forces (in newtons/body weight), rate of loading (in body weight/second), and landing error scoring system were measured. Females had higher EMG amplitude before and after fatigue (P < .024), with decreased EMG amplitude for both sexes after fatigue (P = .025). There was no change on vertical ground reaction force, rate of loading, or landing error scoring system. Males and females demonstrated similar landing performance before and after fatigue but have different hamstring neuromuscular coordination strategies. The acute reduction in hamstring EMG amplitude following fatigue may increase loading on the anterior cruciate ligament.
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Affiliation(s)
- David Alan Phillips
- Program in Kinesiology, College of Public Health and Human Sciences, Oregon State University-Cascades, Bend, OR,USA
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, NJ,USA
| | - Bridgette Rae Buckalew
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, NJ,USA
| | - Bridget Keough
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, NJ,USA
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11
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Becker S, Simon S, Dindorf C, Dully J, Bartaguiz E, Schmitz L, Kothe N, Fröhlich M, Ludwig O. Fatigue as a key factor for testing knee stability with single leg drop landing for injury prevention and return to play tests. Front Sports Act Living 2023; 5:1243732. [PMID: 38022784 PMCID: PMC10657893 DOI: 10.3389/fspor.2023.1243732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Fatigue can decrease knee stability and increase the injury risk. However, fatigue is rarely being applied throughout movement analysis. The aim of this study was to investigate if the knee stability throughout SLDLs differ between cyclic and acyclic sports, before and after fatigue in general, and between the dominant and non-dominant leg of soccer players. Methods A total of 43 active male (n = 34) and female (n = 9) athletes (age: 26.5 ± 7.2) participated in this study with a pre-post-design. Subjects performed a single leg drop landing (SLDL) from a plyobox. For each leg, the two-dimensional frontal plane projection angle (FPPA) was analyzed. After pretesting the shuttle run test was performed until exhaustion, before repeating the measurements. Results ANOVA with repeated measures was applied and identified no significance difference for the FPPA between cyclic and acyclic sports (F = 0.98, p = 0.33), a significant difference before and after fatigue (F = 12.49, p = 0.002) and no significant difference between the dominant and non dominant leg of soccer players (F = 4.35, p = 0.26). Discussion Fatigue seems to be able to have a significant influence on knee stability in the frontal axis. Therefore, fatigue should be included in motion analysis for injury prevention and return to play tests because during this physical state most injuries happen.
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Affiliation(s)
- S. Becker
- Department of Sport Science, RPTU Kaiserslautern-Landau, Kaiserslautern, Germany
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12
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Bertozzi F, Fischer PD, Hutchison KA, Zago M, Sforza C, Monfort SM. Associations Between Cognitive Function and ACL Injury-Related Biomechanics: A Systematic Review. Sports Health 2023; 15:855-866. [PMID: 36680310 PMCID: PMC10606969 DOI: 10.1177/19417381221146557] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
CONTEXT Does lower baseline cognitive function predispose athletes to ACL injury risk, especially when performing unplanned or dual-task movements? OBJECTIVE To evaluate the association between cognitive function and biomechanics related to ACL injuries during cognitively challenging sports movements. DATA SOURCES PubMed (MEDLINE), Web of Science, Scopus, and SciELO databases were searched; additional hand searching was also conducted. STUDY SELECTION The following inclusion criteria had to be met: participants completed (1) a neurocognitive test, (2) a cognitively challenging sport-related task involving lower limbs, and (3) a biomechanical analysis. The following criteria determined exclusion from the review: studies involving participants with (1) recent or current musculoskeletal injuries; (2) recent or current concussion; (3) ACL surgical reconstruction, reviews of the literature, commentary or opinion articles, and case studies. STUDY DESIGN Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statement and registered at the International Prospective Register of Systematic Reviews (PROSPERO). LEVEL OF EVIDENCE Level 3. DATA EXTRACTION Two of authors independently extracted data and assessed the methodological quality of the articles with the Downs and Black and ROBINS-I checklists, to assess methodological quality and risk of bias, respectively. RESULTS Six studies with different methodologies and confounding factors were included in this review. Of these 6 studies, 3 were ranked as high-quality, 3 demonstrated a low risk of bias, 2 a moderate risk, and 1 a severe risk. Five studies found a cognitive-motor relationship, with worse cognitive performance associated with increased injury risk, with 1 study reporting the opposite directionality for 1 variable. One study did not identify any interaction between cognitive function and biomechanical outcomes. CONCLUSION Worse cognitive performance is associated with an increased injury risk profile during cognitively challenging movements.
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Affiliation(s)
- Filippo Bertozzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
- E4Sport Laboratory, Politecnico di Milano, Milan, Italy
| | - Patrick D. Fischer
- Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, Montana
| | | | - Matteo Zago
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Scott M. Monfort
- Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, Montana
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13
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Vermeulen S, De Bleecker C, Spanhove V, Segers V, Willems T, Roosen P, Vanrenterghem J, De Ridder R. The effect of fatigue on spike jump biomechanics in view of patellar tendon loading in volleyball. Scand J Med Sci Sports 2023; 33:2208-2218. [PMID: 37522308 DOI: 10.1111/sms.14458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/04/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND AND OBJECTIVE Patellar tendinopathy (PT) is a highly prevalent overuse injury in volleyball and is often linked with overloading of the patellar tendon. Little is known, however, about whether and how patellar tendon loading is affected by fatigue during the most challenging jump activity in volleyball. Therefore, this study investigates the effect of a high-intensity, intermittent fatigue protocol on movement alterations in terms of patellar tendon loading during a volleyball spike jump. METHODS Forty-three male volleyball players participated in this study. Three-dimensional full-body kinematics and kinetics were collected when performing a spike jump before and after the fatigue protocol. Sagittal plane joint angles, joint work and patellar tendon loading were calculated and analyzed with curve analyses using paired sample t-tests to investigate fatigue effects (p < 0.05). RESULTS Fatigue induced a stiffer lower extremity landing strategy together with prolonged pelvis-trunk flexion compared to baseline (p = 0.001-0.005). Decreased patellar tendon forces (p = 0.001-0.010) and less eccentric knee joint work (-5%, p < 0.001) were observed after the fatigue protocol compared to baseline. CONCLUSION Protective strategies seem to be utilized in a fatigued state to avoid additional tensile forces acting on the patellar tendon, including proximal compensations and stiff lower extremity landings. We hypothesize that players might be more prone for developing PT if eccentric patellar tendon loads are high in the non-fatigued state and/or these loads are somehow not decreased after fatigue.
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Affiliation(s)
- Stefan Vermeulen
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Camilla De Bleecker
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | - Veerle Segers
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Tine Willems
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Philip Roosen
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Roel De Ridder
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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Shibata S, Kodai S, Takemura M. The effect of a basketball game on balance ability: A study using a dual task paradigm. J Bodyw Mov Ther 2023; 36:343-348. [PMID: 37949582 DOI: 10.1016/j.jbmt.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 05/02/2023] [Accepted: 05/11/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Sports activity can affect balance ability, increasing injury risk. Single session of acute exercise can also alter cognitive function, potentially linked to balance ability. In this study, we examined the changes in cognitive function and static and dynamic balance abilities before and after the basketball game, and a dual-task was used to evaluate static balance ability. METHOD We measured the rating of perceived exertion (RPE), static and dynamic balance ability, and cognitive function in 12 male university basketball players before and after basketball game. We compared the differences in each measurement before and after the game using a t-test and examined the correlation between RPE, cognitive function, and balance ability. RESULTS We found RPE and cognitive function increased after the game. However, static balance ability in the dual-task and dynamic balance ability did not change before and after the game. Positive correlation found pre-RPE with SC-total and DO-locus length, and SEBT-ANT. Negative correlation found post-RPE with SEBT-PL, and positive correlation found ΔRPE with DO-peripheral area. DISCUSSION To enhance post-game balance ability, it is crucial to assess pre-game RPE for each player. Also, the understanding game-induced load is imperative as high post-game RPE negatively affects static and dynamic balance ability. Therefore, game load management strategies must be employed to ensure optimal balance ability. CONCLUSION Because RPE before and after a basketball game is related to balance ability after the game, it is important to understand the amount of load on the players.
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Affiliation(s)
- Satoshi Shibata
- Ibaraki Prefectural University of Health Sciences, Department of Physical Therapy, 4669-2 Ami, Ami-machi, Inashiki-gun, Ibaraki, 300-0394, Japan.
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15
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Gao L, Ye J, Bálint K, Radak Z, Mao Z, Gu Y. Biomechanical effects of exercise fatigue on the lower limbs of men during the forward lunge. Front Physiol 2023; 14:1182833. [PMID: 37664426 PMCID: PMC10470642 DOI: 10.3389/fphys.2023.1182833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
Background: During competition and training, exercises involving the lungs may occur throughout the sport, and fatigue is a major injury risk factor in sport, before and after fatigue studies of changes in the lungs are relatively sparse. This study is to investigate into how fatigue affects the lower limb's biomechanics during a forward lunge. Methods: 15 healthy young men participate in this study before and after to exposed to a fatigue protocol then we tested the forward lunge to obtain kinematic, kinetic changing during the task, and to estimate the corresponding muscles' strength changes in the hip, knee, and ankle joints. The measurement data before and after the fatigue protocol were compared with paired samples t-test. Results: In the sagittal and horizontal planes of the hip and knee joints, in both, the peak angles and joint range of motion (ROM) increased, whereas the moments in the sagittal plane of the knee joint smaller. The ankle joint's maximum angle smaller after fatigue. Peak vertical ground reaction force (vGRF) and peak contact both significantly smaller after completing the fatigue protocol and the quadriceps mean and maximum muscular strength significantly increased. Conclusion: After completing a fatigue protocol during lunge the hip, knee, and ankle joints become less stable in both sagittal and horizontal planes, hip and knee range of motion becomes greater. The quadriceps muscles are more susceptible to fatigue and reduced muscle force. Trainers should focus more on the thigh muscle groups.
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Affiliation(s)
- Lidong Gao
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Jingyi Ye
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Kovács Bálint
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Zsolt Radak
- Research Institute of Sport Science, University of Physical Education, Budapest, Hungary
| | - Zhuqing Mao
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Medicine Combining Sports, Ningbo No 2 Hospital, Ningbo, China
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Nyland J, Pyle B, Richards J, Yoshida K, Brey J, Carter S. A clinical practice review of therapeutic movement-based anterior cruciate ligament reconstruction return to sports bridge program: the biological, biomechanical and behavioral rationale. ANNALS OF JOINT 2023; 8:23. [PMID: 38529232 PMCID: PMC10929313 DOI: 10.21037/aoj-23-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/12/2023] [Indexed: 03/27/2024]
Abstract
This clinical practice review describes the biological, biomechanical and behavioral rationale behind a return to sport bridge program used predominantly with non-elite, youth and adolescent high school and college athletes following anterior cruciate ligament (ACL) reconstruction. Post-physiotherapy, this program has produced outcomes that meet or exceed previous reports. With consideration for athletic identity and the Specific Adaptations to Imposed Demands (SAID) principle, the early program focus was on restoring non-impaired bilateral lower extremity joint mobility and bi-articular musculotendinous extensibility. Building on this foundation, movement training education, fundamental bilateral lower extremity strength and power, and motor learning was emphasized with use of external focus cues and ecological dynamics-social cognition considerations. Plyometric and agility tasks were integrated to enhance fast twitch muscle fiber recruitment, anaerobic metabolic energy system function, and fatigue resistance. The ultimate goal was to achieve the lower extremity neuromuscular control and activation responsiveness needed for bilateral dynamic knee joint stability. The rationale and conceptual basis of selected movement tasks and general philosophy of care concepts are described and discussed in detail. Based on the previously reported efficacy of this movement-based therapeutic exercise program we recommend that supplemental programs such as this become standard practice following release from post-surgical physiotherapy and before return to sports decision-making.
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Affiliation(s)
- John Nyland
- Norton Orthopedic Institute, Louisville, KY, USA
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
| | - Brandon Pyle
- MSAT Program, Spalding University, Louisville, KY, USA
| | - Jarod Richards
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
| | - Kei Yoshida
- MSAT Program, Spalding University, Louisville, KY, USA
| | - Jennifer Brey
- Norton Orthopedic Institute, Louisville, KY, USA
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
| | - Sam Carter
- Norton Orthopedic Institute, Louisville, KY, USA
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
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Kamitani A, Hara K, Fujii Y, Yoshida S. Landing Posture in Elite Female Athletes During a Drop Vertical Jump Before and After a High-Intensity Ergometer Fatigue Protocol: A Study of 20 Japanese Women's Soccer League Players. Orthop J Sports Med 2023; 11:23259671231171859. [PMID: 37435587 PMCID: PMC10331781 DOI: 10.1177/23259671231171859] [Citation(s) in RCA: 2] [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: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 07/13/2023] Open
Abstract
Background Even elite athletes, who usually show stable postural control, sometimes cannot control their posture after high-load training. This instability may contribute to anterior cruciate ligament injury. Purpose/Hypothesis The purpose of this study was to evaluate the landing posture of elite female soccer players before and after a novel high-intensity fatigue-inducing exercise protocol. We hypothesized that the landing posture will change before versus after the fatigue protocol. Study Design Descriptive laboratory study. Method The study participants were 20 female elite soccer players. All athletes performed 3 drop vertical jumps (DVJs), pedaled an ergometer 8 times with full force for 10 seconds each (fatigue protocol), and then repeated the 3 DVJs. We measured and compared the athletes' blood lactate levels before and after the fatigue protocol, as well as the hip flexion, knee flexion, and ankle dorsiflexion angles and final landing posture during the DJVs. Results Blood lactate levels increased significantly pre- to postprotocol (from 2.7 ± 1.9 to 15.0 ± 3.6 mmol/L; P < .001), while there were decreases in hip flexion angle (from 35.0° ± 11.2° to 22.4° ± 8.8°; P < .001) and ankle dorsiflexion angle (from 26.4° ± 3.9° to 20.0° ± 3.7°; P < .001). The number of athletes who could not maintain a stable DVJ final landing posture increased from 10% before the fatigue protocol to 70% after. Conclusion The elite female athletes in our study showed significant decreases in hip flexion and ankle dorsiflexion angles in the DVJ landing after a fatigue-inducing protocol. Most elite athletes were unable to maintain a stable posture on the DVJ landing after the fatigue protocol. Clinical Relevance This study advances our understanding of how elite athletes land in a fatigued state.
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Affiliation(s)
- Aguri Kamitani
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Orthopaedics, Japan Community Heath Care Organization, Kyoto Kuramaguchi Medical Center, Kyoto, Japan
| | - Kunio Hara
- Department of Orthopaedics, Japan Community Heath Care Organization, Kyoto Kuramaguchi Medical Center, Kyoto, Japan
| | - Yuta Fujii
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shohei Yoshida
- Department of Sports Rehabilitation, Kyoto Interdisciplinary Institute of Community Medicine, Kyoto, Japan
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18
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Hu Z, Zhang Y, Dong T, Dong M, Kim S, Kim Y. Gender Differences in Neuromuscular Control during the Preparation Phase of Single-Leg Landing Task in Badminton. J Clin Med 2023; 12:jcm12093296. [PMID: 37176736 PMCID: PMC10179252 DOI: 10.3390/jcm12093296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Studies on the biomechanical mechanisms of an anterior cruciate ligament (ACL) injury have been extensively studied, but studies on the neuromuscular control-related risk factors for an ACL injury in specific maneuvers have not been reported for badminton players. STUDY DESIGN Controlled laboratory study. METHODS Sixteen badminton players (8 male, 8 female) performed a single-leg badminton ball landing task, and lower limb muscle activity, kinematic data, and ground reaction force were measured during this procedure using marker-based movement analysis, force plates, and electromyography (EMG). Gender differences in the lower limb kinematic data, mean values of normalized lower limb muscle activation (MVC%), and co-contraction values during the landing preparation phase (100 ms before initial contact) were analyzed using MANOVA. RESULTS In the badminton landing task, the knee valgus angle was greater in females than in males (6.27 ± 2.75 vs. 1.72 ± 3.20) in the pre-landing preparation position. Compared to male badminton players, females exhibited greater gluteus maximus (44.92 ± 18.00 vs. 20.34 ± 11.64), rectus femoris (41.56 ± 9.84 vs. 26.14 ± 10.46), and medial gastrocnemius (37.39 ± 17.31 vs. 19.11 ± 11.17) lateral gastrocnemius (36.86 ± 17.82 vs. 13.59 ± 2.71) muscle activity (MVC%). CONCLUSION Female badminton players exhibit neuromuscular control strategies that may be inadequate for ACL protection and may be a potential risk factor for a high incidence of ACL injury In the future, when devising injury prevention plans for female badminton players, optimizing neuromuscular control during the pre-landing phase can be targeted.
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Affiliation(s)
- Zhe Hu
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Yanan Zhang
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Tengfei Dong
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Maolin Dong
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Sukwon Kim
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Youngsuk Kim
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
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Forelli F, Le Coroller N, Gaspar M, Memain G, Kakavas G, Miraglia N, Marine P, Maille P, Hewett TE, Rambaud AJ. Ecological and Specific Evidence-Based Safe Return To Play After Anterior Cruciate Ligament Reconstruction In Soccer Players: A New International Paradigm. Int J Sports Phys Ther 2023; 18:526-540. [PMID: 37020454 PMCID: PMC10069338 DOI: 10.26603/001c.73031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/15/2023] [Indexed: 04/04/2023] Open
Abstract
Existing return to play (RTP) assessments have not demonstrated the ability to decrease risk of subsequent anterior cruciate ligament (ACL) injury after reconstruction (ACLR). RTP criteria are standardized and do not simulate the physical and cognitive activity required by the practice of sport. Most RTP criteria do not include an ecological approach. There are scientific algorithms as the "5 factor maximum model" that can identify risk profiles and help reduce the risk of a second anterior cruciate ligament injury. Nevertheless, these algorithms remain too standardized and do not include the situations experienced in games by soccer players. This is why it is important to integrate ecological situations specific to the environment of soccer players in order to evaluate players under conditions closest to their sporting activity, especially with high cognitive load. One should identify high risk players under two conditions: Clinical analyses commonly include assessments such as isokinetic testing, functional tests (hop tests, vertical force-velocity, profile), running, clinical assessments (range of motion and graft laxity), proprioception and balance (Star Excursion Balance Test modified, Y-Balance, stabilometry) and psychological parameters (kinesophobia, quality of life and fear of re-injury). Field testing usually includes game simulation, evaluation under dual-task conditions, fatigue and workload analysis, deceleration, timed-agility-test and horizontal force-velocity profiles. Although it seems important to evaluate strength, psychological variables and aerobic and anaerobic capacities, evaluation of neuromotor control in standard and ecological situations may be helpful for reducing the risk of injury after ACLR. This proposal for RTP testing after ACLR is supported by the scientific literature and attempts to approximate the physical and cognitive loads during a soccer match. Future scientific investigation will be required to demonstrate the validity of this approach. Level of Evidence 5.
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20
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García-Sánchez C, Navarro RM, Karcher C, de la Rubia A. Physical Demands during Official Competitions in Elite Handball: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3353. [PMID: 36834047 PMCID: PMC9965087 DOI: 10.3390/ijerph20043353] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 06/10/2023]
Abstract
An understanding of physical demands during official competitions is essential to achieving the highest performance in handball. The aim of this systematic review was to summarise the available scientific evidence associated with physical demands during official competitions in elite handball according to playing positions, competition level and gender. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 17 studies were selected after a systematic search and selection process of three digital databases: PubMed, Web of Science and Sport Discus. The quality of the selected studies was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology checklist; the average score was 18.47 points. The sample consisted of 1175 handball players, of whom 1042 were men (88.68%) and 133 were women (11.32%). The results show that an elite handball player covered on average 3664.4 ± 1121.6 m during a match. The average running pace was 84.8 ± 17.2 m∙min-1. The total distance covered was largely greater in national competitions (4506.7 ± 647.9 m) compared with international competitions (2190.3 ± 1950.5 m) (effect size (ES) = 1.2); however, the running pace did not present any significant difference between the international or national level (ES = 0.06). In regard to gender, the total distance covered was moderately greater in female competitions (4549.1 ± 758.6 m) compared with male competitions (3332.6 ± 1257.7 m) (ES = 0.9), and the running pace was largely greater in female competitions (110.5 ± 7.2 m∙min-1) compared with male competitions (78.4 ± 19.7 m∙min-1) (ES = 1.6). In relation to playing position, backs and wings covered a moderately greater total distance (ES = 0.7 and 0.6) and slightly more meters per minute (ES = 0.4 and 0.2) than pivots. Moreover, the technical activity profile differed between playing positions. Backs performed moderately more throws than pivots and wings (ES = 1.2 and 0.9), pivots exhibited largely more body contact than backs and wings, and wings performed moderately more fast breaks (6.7 ± 3.0) than backs (2.2 ± 2.3) (ES = 1.8). Therefore, this research study provides practical applications for handball coaches and strength and conditioning professionals with respect to designing and implementing more individualised training programmes to maximise performance and reduce injury risk.
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Affiliation(s)
- Carlos García-Sánchez
- Deporte y Entrenamiento Research Group, Departamento de Deportes, Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, C/Martín Fierro 7, 28040 Madrid, Spain
| | - Rafael Manuel Navarro
- Department of Sports Sciences, European University of Madrid, 28670 Villaviciosa de Odón, Spain
| | - Claude Karcher
- Oxidative Stress and Muscular Protection Laboratory (EA 3072), Faculty of Medicine, Mitochondria, University of Strasbourg, 67081 Strasbourg, France
- European Centre for Education, Research and Innovation in Exercise Physiology (CEERIPE), Faculty of Sport Sciences, University of Strasbourg, 67000 Strasbourg, France
- Centre de Ressources, d’Expertises et de Performances Sportives, CREPS de Strasbourg, 67200 Strasbourg, France
| | - Alfonso de la Rubia
- Deporte y Entrenamiento Research Group, Departamento de Deportes, Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, C/Martín Fierro 7, 28040 Madrid, Spain
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21
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The Effect of Fatigue on Trunk and Pelvic Jump-Landing Biomechanics in View of Lower Extremity Loading: A Systematic Review. J Hum Kinet 2023; 86:73-95. [PMID: 37181257 PMCID: PMC10170549 DOI: 10.5114/jhk/159460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Fatigue has often been considered a risk factor for developing sports injuries, modulating lower extremity jump-landing biomechanics. The impact of fatigue on proximal trunk and pelvic biomechanics has been suggested to play an important role in lower extremity loading and injury risk, yet the available evidence remains ambiguous as the trunk and pelvis were often not the primary focus of research. Therefore, the purpose of this systematic review was to determine how fatigue affects trunk and pelvic three-dimensional jump-landing biomechanics. PubMed (MEDLINE), Web of Science, Embase, CINAHL and SPORTDiscus were consulted up to and including April 2022 for potential studies investigating the effect of fatigue on trunk and pelvic kinematics, kinetics and/or muscular activity during jump-landing tasks in healthy, physically active populations. Methodological quality of the studies was assessed by the modified Downs and Black checklist. Twenty-one studies were included and methodological quality was moderate to high among these studies. The results indicate prevailing evidence for more trunk flexion during standardized jump-landing tasks after lower extremity muscle fatigue. Otherwise, lumbo-pelvic-hip muscle fatigue does not seem to elicit major detrimental changes to these jump-landing biomechanics. Although a wide variability of trunk and pelvic jump-landing strategies was observed, the results provide evidence for increased trunk flexion after lower extremity muscle fatigue. This proximal strategy is suggested to help unload fatigued lower extremity structures and lack of this compensation might increase knee injury risk.
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Li R. DIAGNOSIS OF SPORTS FATIGUE AND NUTRITIONAL INTERVENTION IN TRACK AND FIELD. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
ABSTRACT Introduction As a high-intensity physical sport, athletics can easily cause serious physical injuries and even psychological problems if not diagnosed after sports fatigue. Objective Study the relationship between sports fatigue and nutritional intervention in track and field. Methods One hundred track and field athletes in a province were investigated. Through literature survey, questionnaire survey, and other data testing, track and field athletes’ sports fatigue and nutritional status were analyzed to determine the necessary relationship between sports fatigue and nutritional intervention. Results The coach’s judgment of sports fatigue during athletes’ training is characterized by a lack of technical accuracy, leading to the decline of athletes’ physical recovery ability and aggravating sports fatigue to a certain extent. As a high-intensity physical exercise, athletics must diagnose sports fatigue in time and provide effective nutritional intervention. Conclusion The research shows that after high-intensity exercise, the diagnosis of sports fatigue in track and field athletes is of great importance in judging the athletes’ physical function, and scientific nutritional intervention plays an important role in athletes’ excessive physical function, improving their sports ability and relieving sports fatigue. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
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Affiliation(s)
- Rui Li
- Hebei Vocational College of Politics and Law, China; Jiangxi New Energy Technology Institute, China
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Wen Z. INJURIES BY FATIGUE FROM AEROBIC TRAINING IN JUMPING ATHLETES. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228062022_0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction The increasingly tense and aggressive competition in the competitive sports field has led to a continuous increase in the athletes’ exercise load. Sports injuries resulting from this increased load are also increasing. Research in this area helps prevent jumping sports injuries and guides protocols for treatment. Currently, research on sports injuries in athletics jumping events is relatively rare. Objective This paper examines sports injuries in sport jumping athletes. Methods This article investigates injuries in 16 vault athletes with 5 to 10 years of training. Results Distance jumping is a significant risk factor for anterior cruciate ligament injuries. The risk of injury when landing on one foot is more significant than when landing on both feet. Especially when the body is in a state of neuromuscular fatigue, this will significantly increase the risk of anterior cruciate ligament injury. Conclusion Excessive local exercise load, incorrect technical movements, and physical fatigue are the leading causes of sports injuries. Coaches should organize training and competitions reasonably. Athletes need to reinforce the protection of the knees, ankles, and other frequently injured parts. Evidence Level II; Therapeutic Studies - Investigating the result.
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Affiliation(s)
- Zhendi Wen
- Boda College Jilin Normal University, China
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Ping N, Yang J. EXERCISE FATIGUE INJURY UNDER SPORT RESISTANCE. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228062022_0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction Athletes are prone to local muscle fatigue due to high-intensity training and to long-term accumulation of musculoskeletal injuries. Musculoskeletal complications represent a large proportion of occupational health problems and, for this reason, have received increased attention from the sports industry. In this sense, studies on muscle fatigue should be intensified. Objective Verify muscle fatigue and injury involving the strain characteristics of lower limb joints in the eccentric and centripetal contraction of the jump. Methods A total of 691 individuals aged 20 to 40 years were selected. Fatigue was caused by active muscle contraction. The characteristic curves of active muscle contraction in different isometric, isotonic, and isokinetic training were analyzed. The degree of fatigue caused by three different sports states was tested by experimentation. The corresponding active muscle contraction characteristics were also analyzed. The potential for homeostasis at different ages was compared. Results The delay in recovery to fatigue is directly proportional to the athlete’s age. The return to post-exercise relief proportion from fatigue gradually decreases. Conclusion The experimental results showed that active muscle contraction could reduce exercise fatigue to some extent. This beneficial biochemical property of active muscle contraction is not found in people with advanced age. The findings have a guiding potential for the relief of sports fatigue. Evidence Level II; Therapeutic Studies - Investigating the result.
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Affiliation(s)
- Na Ping
- Shijiazhuang University, China
| | - Juan Yang
- Shijiazhuang Preschool Teachers College, China
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Jiang Y. INJURIES IN AEROBIC EXERCISE: CAUSES AND PREVENTIONS. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228052022_0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Professional aerobic exercises require high performance from exercisers. Injuries are common during their execution. Understanding the causal reasons is essential for prevention methods to reduce athletes’ injuries. Objective: Investigate the influential factors of ligament injuries caused by aerobic exercise. Methods: This paper analyzes the injuries caused by aerobic exercise through mathematical statistics. Time, course, degree of injury, location of the injury, cause, early treatment time, primary approach, treatment methods, recovery conditions, and speed in recovery time of sports injuries were investigated. Results: Injuries are mainly concentrated at the hip, knee, and ankle joint level; sprains are the first injuries, followed by muscle strains, lower back muscle contractures, kneecap deformities, and joint ligament injuries. The leading causes of injuries were poor warm-up, excessive load, technical errors, and fatigue. Conclusion: Various physiotherapy methods can improve the recovery rate from ligament injuries. This method can also improve sports ligament injuries’ prevention and treatment effects. Evidence Level II; Therapeutic Studies - Investigating the result.
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Bedo BLS, Catelli DS, Lamontagne M, Moraes R, Pereira DR, Graça JB, Santiago PRP. Fatigue modifies hip and knee kinematics during single- and double-leg dynamic tasks: An investigation with female handball players. J Sports Sci 2022; 40:1964-1972. [DOI: 10.1080/02640414.2022.2123506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Bruno L. S. Bedo
- Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Human Movement Biomechanics Laboratory, University of Ottawa, Ottawa, Canada
- School of Physical Education and Sports of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Department of Sport, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Danilo S. Catelli
- Human Movement Biomechanics Laboratory, University of Ottawa, Ottawa, Canada
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Mario Lamontagne
- Human Movement Biomechanics Laboratory, University of Ottawa, Ottawa, Canada
| | - Renato Moraes
- Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- School of Physical Education and Sports of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Dayanne Rodrigues Pereira
- School of Physical Education and Sports of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Julia Barachini Graça
- School of Physical Education and Sports of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Paulo Roberto Pereira Santiago
- Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- School of Physical Education and Sports of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Heil J, Büsch D. Dynamic postural control and physical stress: an approach to determining injury risk in real sporting conditions. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00833-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractDynamic postural control is one of the essential factors in situations where non-contact injuries mainly occur, i.e., landing, cutting, or stopping. Therefore, testing of dynamic postural control should be implemented in injury risk assessment. Moreover, non-contact injuries mainly occur under loaded conditions when the athlete is physically stressed. Therefore, risk factors and mechanisms of these injuries should also be regarded under loading conditions and not only when the athlete is recovered. Current studies examining the influence of physical load on risk factors, such as dynamic postural control, often use cycling protocols to stress the participants. Nevertheless, most types of sports require running as a central element and the induced internal load after cycling might not be the same after running. Therefore, the current study aimed to examine the influence of a running and a cycling protocol on dynamic postural control and to determine the potential injury risk under representative conditions. In total, 128 sport students (64 males and 64 females, age: 23.64 ± 2.44, height: 176.54 ± 8.96 cm, weight: 68.85 ± 10.98 kg) participated in the study. They were tested with the Y Balance Test before and after one loading protocol. A total of 64 participants completed a protocol on a cycle ergometer and the other 64 on a treadmill. A mixed ANOVA showed significant interactions of time and load type. Dynamic postural control was reduced immediately after cycling but did not change after running. These findings indicate a load type dependence of dynamic postural control that must be considered while assessing an athlete’s potential injury risk and they support the need for more representative designs.
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Heil J. Load-Induced Changes of Inter-Limb Asymmetries in Dynamic Postural Control in Healthy Subjects. Front Hum Neurosci 2022; 16:824730. [PMID: 35360281 PMCID: PMC8963187 DOI: 10.3389/fnhum.2022.824730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/22/2022] [Indexed: 11/21/2022] Open
Abstract
Inter-limb asymmetries are associated with a higher potential risk for non-contact injuries. Differences in function or performance between the limbs might lead to imbalances and promote instability, increasing the potential risk for injuries. Consequently, an investigation of inter-limb asymmetries should be included in injury risk assessment. Furthermore, since non-contact injuries mainly occur under loaded conditions, an investigation of load-induced changes of inter-limb asymmetries can provide additional information on the athlete’s potential injury risk. Therefore, the current study aimed to investigate the influence of physical load on inter-limb asymmetries in dynamic postural control, which is essential in situations with a high risk for non-contact injuries such as landing, cutting, or stopping. In total, dynamic postural control of 128 active and healthy subjects (64 males and 64 females, age: 23.64 ± 2.44, height: 176.54 ± 8.96 cm, weight: 68.85 ± 10.98 kg) was examined. Dynamic postural control was tested with the Y-Balance Test (YBT) before and after a loading protocol on a bicycle ergometer or a treadmill. The results showed no significant increase of the inter-limb asymmetries in anterior direction [F(1, 126) = 4.44, p = 0.04, η2p = 0.03]. Moreover, there is high variation between the subjects regarding the magnitude and the direction of the asymmetries and the changes due to load. Therefore, a more individual analysis considering the magnitude and the direction of the asymmetries is required. Thereby, considering different modifying factors, e.g., sex, injury history, and baseline level of asymmetries, can be helpful. Moreover, an analysis of the changes during load might provide further insights, reveal possible differences, and help detect the reasons and mechanisms underlying inter-limb asymmetries and asymmetrical loading.
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Fort-Vanmeerhaeghe A, Arboix-Alió J, Montalvo AM. Return-to-sport following anterior cruciate ligament reconstruction in team sport athletes. Part II: Progressive framework. APUNTS SPORTS MEDICINE 2022. [DOI: 10.1016/j.apunsm.2021.100361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Della Villa F, Tosarelli F, Ferrari R, Grassi A, Ciampone L, Nanni G, Zaffagnini S, Buckthorpe M. Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Male Rugby Players: Pattern, Injury Mechanism, and Biomechanics in 57 Consecutive Cases. Orthop J Sports Med 2021; 9:23259671211048182. [PMID: 34805419 PMCID: PMC8597070 DOI: 10.1177/23259671211048182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/16/2021] [Indexed: 01/13/2023] Open
Abstract
Background: Anterior cruciate ligament (ACL) injuries represent a significant burden to rugby players. Improving our understanding of the patterns and biomechanics that result in ACL injury may aid in the design of effective prevention programs. Purpose: To describe, using video analysis, the mechanisms, situational patterns, and biomechanics of ACL injuries in professional rugby matches. Further aims were to document injuries according to pitch location and timing within the match. Study Design: Case series; Level of evidence, 4. Methods: A total of 62 ACL injuries were identified in players of the 4 most important rugby leagues across 4 consecutive seasons. We analyzed 57 (92%) injury videos for injury mechanism and situational patterns; biomechanical analysis was performed on indirect and noncontact ACL injuries only (38 cases available). Three reviewers independently evaluated each video. Results: More injuries occurred while attacking than defending (41 [72%] vs 16 [28%]; P < .01). Regarding mechanism, 18 (32%) injuries were direct contact; 15 (26%), indirect contact; and 24 (42%), noncontact. Most direct contact injuries involved being tackled directly to the knee (n = 10). Three situational patterns were identified for players who had a noncontact or indirect contact injury: offensive change of direction (COD) (n = 18), being tackled (n = 10), and pressing/tackling (n = 8). Injuries generally involved a knee-loading strategy in the sagittal plane, which was accompanied by knee valgus loading in most cases (94%). Overall, 73% of injuries occurred during the first 40 minutes of effective playing time. Conclusion: Most ACL injuries in professional male rugby players happened through a noncontact or indirect contact mechanism (68%). Three situational patterns were described, including offensive change of direction, being tackled, and pressing/tackling. Biomechanical analysis confirmed a multiplanar mechanism, with a knee-loading pattern in the sagittal plane accompanied by dynamic valgus. As most injuries occurred in the first 40 minutes, accumulated fatigue appears not to be a major risk factor for ACL injury.
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Affiliation(s)
- Francesco Della Villa
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Filippo Tosarelli
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Rocco Ferrari
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy.,Zebre Rugby Club, Parma, Italy
| | - Alberto Grassi
- II Clinica Ortopedica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luca Ciampone
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Gianni Nanni
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Stefano Zaffagnini
- II Clinica Ortopedica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Matthew Buckthorpe
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy.,Faculty of Sport, Health and Applied Science, St Mary's University, London, UK
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Merrigan JJ. Effects of Maximal Effort Running on Special Agents' Loaded and Unloaded Drop Jump Performance and Mechanics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910090. [PMID: 34639390 PMCID: PMC8508569 DOI: 10.3390/ijerph181910090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022]
Abstract
The purpose was to investigate the effect of load and fatigue on landing forces and mechanics. Thirteen Department of State special agents first completed drop jump testing, a maximal treadmill test, and another round of drop jump testing. During drop jump testing, agents performed 3 maximal effort drop jumps from 30 cm with body mass only (unloaded) or a 15 kg weight-vest (loaded). A force plate was used to collect force–time data, while two laptops were placed 3 m from the force plate from frontal and sagittal planes. Two-way analyses of variance were used to analyze the effect of load and fatigue on landing forces and Landing Error Scoring System (LESS) with alpha of p < 0.05. Dropping from 30 cm with 15 kg resulted in greater landing impulse, which was driven by increases in contact time. The loaded condition also resulted in lower jump height and reactive strength indexes. After the maximal graded treadmill test there were no further changes in drop jump ground reaction forces or performance. However, relative aerobic capacity was related to impulse changes following the treadmill test in unloaded (R2 = 0.41; p = 0.018) and loaded conditions (R2 = 0.32; p = 0.044). External loads of 15 kg increased impulse and contact time and resultantly decreased drop jump height and reactive strength indexes. It is encouraged that training protocols be aimed to concomitantly improve aerobic capacity and lower body power. Plyometric training with progressive overloading using external loads may be helpful, but further research is warranted.
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Affiliation(s)
- Justin J Merrigan
- Human Performance Innovation Center, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26505, USA
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Mohr M, Federolf P. Fatigue-related reductions in movement smoothness during a lateral shuffle and side-cutting movement. Eur J Sport Sci 2021; 22:1522-1531. [PMID: 34294007 DOI: 10.1080/17461391.2021.1960427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Although movement smoothness is considered a hallmark of well-coordinated motor tasks, it is unknown whether markers of movement smoothness can be used to assess the quality of neuromuscular control in athletes. As a first step into this direction, the purpose of this study was to test whether movement smoothness is reduced following a fatiguing lateral shuffle protocol due to fatigue-related adaptations in neuromuscular control. Sixteen healthy adults (7 females) completed a submaximal 3-minute lateral shuffle trial and a maximal fatiguing shuffle trial until task failure. The movement of the pelvis and feet was determined using 3D motion capture at 250 Hz. Movement smoothness was quantified using the log-dimensionless jerk, which represents how often and abruptly the segment acceleration changes over time. Pelvis and foot movement smoothness along with spatiotemporal variables characterizing the shuffling pattern were compared between the beginning and end of the fatiguing shuffle trial using Wilcoxon signed-rank tests (α = 0.05). Pelvis movement smoothness was significantly reduced in all movement directions (p ≤ 0.005, strong effects) while foot movement smoothness was predominantly reduced in the shuffle direction (p ≤ 0.018, moderate to strong effects). Reductions in movement smoothness coincided with a lower peak pelvis speed in shuffle direction (p = 0.007, strong effect) and shorter contact times when changing direction (p = 0.049, moderate effect). These reductions in movement smoothness may be explained by a change in the overall shuffle pattern characterized by "harder" side-cuts as well as by a muscle fatigue-related decline in the ability to precisely plan and execute foot trajectories.
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Affiliation(s)
- Maurice Mohr
- Department of Sport Science, Universität Innsbruck, Innsbruck, Austria
| | - Peter Federolf
- Department of Sport Science, Universität Innsbruck, Innsbruck, Austria
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Kozinc Ž, Trajković N, Smajla D, Šarabon N. The Effect of Fatigue on Single-Leg Postural Sway and Its Transient Characteristics in Healthy Young Adults. Front Physiol 2021; 12:720905. [PMID: 34489739 PMCID: PMC8418113 DOI: 10.3389/fphys.2021.720905] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Neuromuscular fatigue is known to impair balance ability, which is reflected in increased postural sway during quiet standing tasks. Recently, quantifying transient characteristics of postural sway has been suggested as an approach to obtain additional information regarding postural control. However, this approach is currently vastly unexplored. The purpose of this study was to investigate the effects of fatigue (induced by a repeated change of direction task) on postural sway and its transient characteristics during single-leg standing, including whole-trial estimates and indexes of transient behavior in young healthy active adults. The study involved 28 physically active students (14 females). Single-leg postural sway was recorded for 30s before and after a fatiguing protocol, which consisted of a repeated change of direction tasks. We calculated the traditional whole-trial estimates of postural sway [center-of-pressure (CoP) velocity and amplitude in anterior-posterior (AP) and medial-lateral (ML) directions] and corresponding transient behavior indexes, based on three 10-s intervals. Statistically significant sex×fatigue interaction with medium effect sizes was found for whole-trial CoP velocity in AP (p=0.028; η2=0.17) and ML directions (p=0.019; η2=0.19). Post-hoc test showed that both variables substantially decreased in female participants (p=0.041–0.045; d=0.54–0.56), but remained similar in males (p=0.194–0.294). There were small to medium statistically significant main effects of fatigue on transient index for CoP amplitude in both directions (p=0.042–0.049; η2=0.02–0.14). Notably, CoP AP amplitude increased in the first 10-s interval for males (before fatigue: 5.6±1.3mm; after fatigue: 6.3±1.6mm), while the CoP AP amplitude in the third interval remained similar after fatigue (before fatigue: 5.5±1.4mm; after fatigue: 5.1±1.2mm). In conclusion, the responses to fatigue in terms of postural sway were time interval specific, and there were certain sex-differences in responses to fatigue, which could be related to better ability to adapt balance strategies in females. Moreover, our results demonstrate that the indexes of transient behavior could perhaps detect smaller fatigue-induced changes in postural sway that are seen in whole-trial estimates.
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Affiliation(s)
- Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Nebojša Trajković
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Darjan Smajla
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Human Health Department, InnoRenew CoE, Izola, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Human Health Department, InnoRenew CoE, Izola, Slovenia.,Laboratory for Motor Control and Motor Behavior, S2P, Science to Practice, Ltd., Ljubljana, Slovenia
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Liveris NI, Tsarbou C, Tsimeas PD, Papageorgiou G, Xergia SA, Tsiokanos A. Evaluating the Effects of Match-Induced Fatigue on Landing Ability; the Case of the Basketball Game. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:768-778. [PMID: 34567377 PMCID: PMC8439679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This paper examines the effect of match-induced fatigue on lower limb biomechanics, in the case of a basketball game. For this purpose, sixteen male basketball athletes, ages 18 to 22, performed a jump-landing task prior and post a recreational basketball game. The Landing Error Scoring System (LESS) was used to examine the biomechanics of landing. The Vertical jump (VJ) and the Borg Rating of Perceived Exertion (RPE) scale pre- and post-game were employed to assess the level of fatigue induced by the basketball game. In order to compare pre and post measurements, t-tests for dependent samples were used. The performance of the VJ test post-game was found to be significantly lower (t (15) = 3.83, p = 0.002) showing a large effect (Cohen's d = 0.9) compared to pre-game measurements. Further, the LESS scores were significantly (t (15) = 2.33, p = 0.034) higher post-game with a medium effect (d = 0.5). The differences in LESS scores were due to errors in the landing technique which is bound to be influenced by biomechanics. Moreover, the Borg RPE scale was found to be significantly higher (t (15) = 10.77, p < 0.001) postgame showing a very large effect (d =2.6). It is important to note, that these significant differences occurred with a merely medium level of fatigue (6.6 ± 0.3 pre-game vs 11.9 ± 1.0 post-game). The results of this study would be of great benefit to sports science teams and coaches for formulating effective strategies to improve athletes' performance and reduce the likelihood of injury.
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Affiliation(s)
- Nikolaos I Liveris
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, GREECE
| | - Charis Tsarbou
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, GREECE
| | - Panagiotis D Tsimeas
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, GREECE
| | | | - Sofia A Xergia
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, GREECE
| | - Athanasios Tsiokanos
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, GREECE
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Silvers-Granelli H. Why Female Athletes Injure Their ACL's More Frequently? What can we do to mitigate their risk? Int J Sports Phys Ther 2021; 16:971-977. [PMID: 34386276 PMCID: PMC8329328 DOI: 10.26603/001c.25467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 01/13/2023] Open
Affiliation(s)
- Holly Silvers-Granelli
- Velocity Physical Therapy, Santa Monica, CA; Major League Soccer Medical Research Committee, New York, New York
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36
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Zago M, David S, Bertozzi F, Brunetti C, Gatti A, Salaorni F, Tarabini M, Galvani C, Sforza C, Galli M. Fatigue Induced by Repeated Changes of Direction in Élite Female Football (Soccer) Players: Impact on Lower Limb Biomechanics and Implications for ACL Injury Prevention. Front Bioeng Biotechnol 2021; 9:666841. [PMID: 34291039 PMCID: PMC8287513 DOI: 10.3389/fbioe.2021.666841] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background The etiology of Anterior Cruciate Ligament (ACL) injury in women football results from the interaction of several extrinsic and intrinsic risk factors. Extrinsic factors change dynamically, also due to fatigue. However, existing biomechanical findings concerning the impact of fatigue on the risk of ACL injuries remains inconsistent. We hypothesized that fatigue induced by acute workload in short and intense game periods, might in either of two ways: by pushing lower limbs mechanics toward a pattern close to injury mechanism, or alternatively by inducing opposed protective compensatory adjustments. Aim In this study, we aimed at assessing the extent to which fatigue impact on joints kinematics and kinetics while performing repeated changes of direction (CoDs) in the light of the ACL risk factors. Methods This was an observational, cross-sectional associative study. Twenty female players (age: 20-31 years, 1st-2nd Italian division) performed a continuous shuttle run test (5-m) involving repeated 180°-CoDs until exhaustion. During the whole test, 3D kinematics and ground reaction forces were used to compute lower limb joints angles and internal moments. Measures of exercise internal load were: peak post-exercise blood lactate concentration, heart rate (HR) and perceived exertion. Continuous linear correlations between kinematics/kinetics waveforms (during the ground contact phase of the pivoting limb) and the number of consecutive CoD were computed during the exercise using a Statistical Parametric Mapping (SPM) approach. Results The test lasted 153 ± 72 s, with a rate of 14 ± 2 CoDs/min. Participants reached 95% of maximum HR and a peak lactate concentration of 11.2 ± 2.8 mmol/L. Exercise duration was inversely related to lactate concentration (r = -0.517, p < 0.01), while neither%HR max nor [La-] b nor RPE were correlated with test duration before exhaustion (p > 0.05). Alterations in lower limb kinematics were found in 100%, and in lower limb kinetics in 85% of the players. The most common kinematic pattern was a concurrent progressive reduction in hip and knee flexion angle at initial contact (10 players); 5 of them also showed a significantly more adducted hip. Knee extension moment decreased in 8, knee valgus moment increased in 5 players. A subset of participants showed a drift of pivoting limb kinematics that matches the known ACL injury mechanism; other players displayed less definite or even opposed behaviors. Discussion Players exhibited different strategies to cope with repeated CoDs, ranging from protective to potentially dangerous behaviors. While the latter was not a univocal effect, it reinforces the importance of individual biomechanical assessment when coping with fatigue.
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Affiliation(s)
- Matteo Zago
- Dipartimento di Meccanica, Politecnico di Milano, Milan, Italy.,E4Sport Laboratory, Politecnico di Milano, Lecco, Italy
| | - Sina David
- Department of Human Movement Sciences, VU University Amsterdam, Amsterdam, Netherlands
| | - Filippo Bertozzi
- Dipartimento di Scienze Biomediche per la Salute, Politecnico di Milano, Milan, Italy
| | - Claudia Brunetti
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Alice Gatti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Francesca Salaorni
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Marco Tarabini
- Dipartimento di Meccanica, Politecnico di Milano, Milan, Italy.,E4Sport Laboratory, Politecnico di Milano, Lecco, Italy
| | - Christel Galvani
- Dipartimento di Psicologia, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Chiarella Sforza
- Dipartimento di Scienze Biomediche per la Salute, Politecnico di Milano, Milan, Italy
| | - Manuela Galli
- E4Sport Laboratory, Politecnico di Milano, Lecco, Italy.,Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
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The effect of fatigue on jump height and the risk of knee injury after a volleyball training game: A pilot study. BIOMEDICAL HUMAN KINETICS 2021. [DOI: 10.2478/bhk-2021-0024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Study aim: To investigate the effect of fatigue, induced by a volleyball training game on the risk of Anterior Cruciate Ligament (ACL) injury.
Material and methods: Thirteen female volleyball college athletes, ages 18 to 21 years old, completed jump landings from a box 30 cm height, prior and post a 60-minute volleyball training game. The clinical tool Landing Error Scoring System (LESS) was employed in order to evaluate the technique of landing prior and post the game. The level of fatigue induced by the volleyball game was assessed by vertical jump test and Borg Rating of Perceived Exertion (RPE) Scale pre and post-game. In order to compare measurements pre and post-game t-tests for dependent samples were used.
Results: Participants performed lower vertical jumps post-game with a Confidence Interval of 26.2 ± 2.3 cm (pre-game) and 24.9 ± 2.2 cm (post game). The difference between pre and post-game was found to be statistically significant with a t12 = 2.55 and a p-value of 0.026. In the case of assessing fatigue, the Borg RPE scale scores were found to be statistically significant (t12 = 14.05, p < 0.001) higher post-game (10.2 ± 0.6), as compared to pre-game (6.5 ± 0.4). Similarly, LESS scores increased significantly (t12 = 2.21, p = 0.047), post-game (6.3 ± 1.1) compared to pre-game (5.8 ± 1.0) that prove poorer landing ability.
Conclusion: It seems that a short duration volleyball training game induces fatigue and negatively affects the jumping and landing ability.
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Vereijken A, Aerts I, van Trijffel E, Tassignon B, Verschueren J, Meeusen R. Pre- and post-match hop test outcomes in soccer players returning to performance after lower extremity injury. J Sports Med Phys Fitness 2021; 62:953-960. [PMID: 34137573 DOI: 10.23736/s0022-4707.21.12576-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Most soccer injuries concern the lower extremity with a higher injury rate during the second half of matches. In advising safe return to sport, hop tests are usually assessed at the point of return to sport under non-fatigued conditions. No studies exist investigating hop test outcomes before and after a match in soccer players returning to performance after lower extremity injury and non-injured teammates. The objective is to assess differences in hop test outcomes before and after a match in and between soccer players returning to performance after lower extremity injury and their non-injured teammates. METHODS A repeated-measures design was used to measure outcomes on five hop tests before and after a soccer match. For analyzing differences in hop tests before and after a match, paired sample t-tests were used. Independent t-tests were used to analyze differences between soccer players after injury and non-injured teammates. Effect sizes were calculated using Cohen's d. RESULTS Hop tests were completed by 61 amateur soccer players after injury and 121 non-injured teammates. Differences in hop tests before and after the match within both groups had negligible to small effect sizes (d=0.00-0.49), except for the figure of 8 and 30 seconds side hop in the injured leg of RTPf soccer players (d=0.56 and d=0.71 respectively). Differences between both groups were negligible to small (d=0.00-0.36). CONCLUSIONS Soccer players returning to performance after a lower extremity injury showed similar scores on hop tests than their non-injured teammates. More demanding sport-specific performance test and measurement of quality of movement are additionally recommended for safe return to sport decision-making.
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Affiliation(s)
- Astrid Vereijken
- SOMT University of Physiotherapy, Amersfoort, the Netherlands - .,Human Physiology and Sports Physiotherapy research group, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium - .,Annatommie MC, Amersfoort, the Netherlands -
| | - Inne Aerts
- SOMT University of Physiotherapy, Amersfoort, the Netherlands
| | | | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy research group, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Verschueren
- SOMT University of Physiotherapy, Amersfoort, the Netherlands.,Human Physiology and Sports Physiotherapy research group, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy research group, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium.,Strategic Research Program Exercise and the Brain in Health & Disease, the added value of Human-Centered Robotics, Vrije Universiteit Brussel, Brussels, Belgium
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Bertozzi F, Porcelli S, Marzorati M, Pilotto AM, Galli M, Sforza C, Zago M. Whole-body kinematics during a simulated sprint in flat-water kayakers. Eur J Sport Sci 2021; 22:817-825. [PMID: 33980124 DOI: 10.1080/17461391.2021.1930190] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Success in sprint kayaking depends on the propulsive power generated by trunk, pelvis, shoulder and lower limb movements. However, no studies have examined whole-body kinematics over a simulated distance. We aimed to study the changes in movement patterns of kayakers performing a 500-m kayak sprint. Eleven young K1 sprint kayakers (three females; age: 16.5 ± 1.9 years, height: 174.1 ± 7.1 cm and weight: 66.1 ± 6.2 kg) performed an incremental test on a kayak ergometer to assess their Peak Oxygen Uptake (V̇O2peak). They then performed a 500-m sprint trial on the same ergometer, and the positions of 40 reflective markers were recorded to assess whole-body kinematics. Joint angles over time were computed for the trunk and right shoulder, hip, knee, and ankle. Changes of joint kinematics during the test were assessed with Statistical Parametric Mapping, calculating at each time node the linear regression between joint angles waveforms and the time of the rowing cycle, p < .05. Cardiometabolic responses confirmed that the participants achieved a maximal effort (V̇O2 and HR reached 99 ± 11% and 94 ± 6% of peak values, respectively). Paddle velocity negatively correlated with sprint time. The shoulder (elevation, rotation and flexion), trunk (lateral flexion and rotation) and hip (abduction) angles significantly changed over time in different phases of the stroke cycle during the simulated sprint. No significant differences over time were found for knee and ankle flexion. A high-intensity sprint may affect the shoulder, trunk and hip kinematics of kayak paddling. The kinematic analysis of kayakers' paddling during simulated metabolic-demanding tasks can provide useful insights to coaches and athletes.
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Affiliation(s)
- Filippo Bertozzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Simone Porcelli
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Mauro Marzorati
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy
| | - Andrea M Pilotto
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy.,Department of Medicine, University of Udine, Udine, Italy
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy.,E4Sport Lab, Politecnico di Milano, Milano, Italy
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,Institute of Biomedical Technologies, National Research Council, Segrate, Italy
| | - Matteo Zago
- E4Sport Lab, Politecnico di Milano, Milano, Italy.,Department of Mechanics, Politecnico di Milano, Milan, Italy
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Lucarno S, Zago M, Buckthorpe M, Grassi A, Tosarelli F, Smith R, Della Villa F. Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Female Soccer Players. Am J Sports Med 2021; 49:1794-1802. [PMID: 33989090 DOI: 10.1177/03635465211008169] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Female soccer players are particularly susceptible to anterior cruciate ligament (ACL) injuries, accounting for 16% to 43% of the injury burden during the season. Despite the advancements in injury prevention programs, the rate of ACL injuries continues to rise. PURPOSE To provide a comprehensive description of the mechanisms, situational pattern, and biomechanics of ACL injuries in women's soccer. STUDY DESIGN Case series; Level of evidence, 4. METHODS We identified 57 consecutive ACL injuries that occurred in matches of 6 top female leagues across 3 seasons (2017-2020). A total of 35 (61%) injury videos were analyzed for the mechanism and situational pattern, while biomechanical analysis was possible in 29 cases. Three independent reviewers evaluated each video. The distribution of ACL injuries according to month, timing within the match, and field location at the time of injury was also reported. RESULTS In the 35 injury videos, there were 19 (54%) noncontact injuries, 12 (34%) indirect contact injuries, and 4 (11%) direct contact injuries. We identified 3 main situations in players who suffered a noncontact/indirect contact injury: (1) pressing and tackling (n = 18), (2) regaining balance after kicking (n = 7), and (3) being tackled (n = 4). Biomechanical analysis indicated multiplanar mechanisms with frequent knee valgus loading (88%). Additionally, 64% of injuries occurred in the first half of matches and most frequently within the first 30 minutes. CONCLUSION Female athletes showed remarkable similarities with elite male players in terms of the ACL mechanism and situational pattern of injury, and 88% of injuries involved no direct contact to the knee, with noncontact injuries being highly prevalent. Injuries occurred during 3 main situations, with accompanying alterations in multiplanar biomechanics. Interventions aimed at reducing ACL injuries in women's soccer should consider high-intensity defensive play at the beginning of a match. Instruction in the 3 main situations should be applied alongside appropriate neuromuscular training interventions.
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Affiliation(s)
| | - Matteo Zago
- Department of Mechanics, Politecnico di Milano, Milan, Italy.,E4Sport Laboratory, Politecnico di Milano, Lecco, Italy
| | - Matthew Buckthorpe
- Education and Research Department, Isokinetic Medical Group, Bologna, Italy
| | - Alberto Grassi
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, FIFA Medical Center of Excellence, Bologna, Italy
| | - Filippo Tosarelli
- Education and Research Department, Isokinetic Medical Group, Bologna, Italy
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The Temporal Pattern of Recovery in Directional Dynamic Stability Post Football-Specific Fatigue. J Sport Rehabil 2021; 30:1047-1052. [PMID: 34050039 DOI: 10.1123/jsr.2020-0284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 03/04/2021] [Accepted: 03/21/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Rising injury rates within football require further understanding of the etiological risk factors associated with lower-limb injury. AIM To examine the temporal pattern of recovery of directional dynamic stability measures post football-specific fatigue. METHODS Eighteen male elite footballers completed baseline assessments of directional dynamic stability measures (Overall Stability Index, anterior-posterior stability [A-P], medial-lateral stability [M-L] on level 1 of the Biodex Stability System). Post Soccer-Specific Aerobic Field Test90 measures were repeated immediately, +24 hours, +48 hours, and +72 hours. The main effects for the recovery time and direction of stability were supplemented by regression modeling to describe the temporal pattern of recovery. RESULTS Significant main effects for time were identified for all directions of stability (Overall Stability Index, A-P, and M-L) up to +48 hours postexercise (P ≤ .05). The quadratic pattern of temporal recovery highlights a minimum of 37.55 to 38.67 hours and maximum of 75.09 to 77.33 hours. Additionally, a main effect for direction of stability was observed, with significant differences identified between A-P and M-L stability at all time points (P ≤ .001). CONCLUSIONS Reductions in directional dynamic stability +48 hours postfatigue highlight implications for training design, recovery strategies, and injury management for performance practitioners. Interestingly, A-P stability has been highlighted as being significantly reduced compared with M-L stability at all time points, regardless of the fatigue exposure. Practitioners should consider the reduction of stability in this plane in relation to common mechanisms of injury in the knee to inform injury-risk-reduction strategies.
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Buckthorpe M. Recommendations for Movement Re-training After ACL Reconstruction. Sports Med 2021; 51:1601-1618. [PMID: 33840081 DOI: 10.1007/s40279-021-01454-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 12/18/2022]
Abstract
It is important to optimise the functional recovery process to enhance patient outcomes after major injury such as anterior cruciate ligament reconstruction (ACLR). Restoring movement quality during sporting-type movements is important prior to return-to-sport (RTS) after ACLR. Alterations in movement quality during an array of functional tasks are common amongst ACLR patients at or near the time of RTS and are associated with worse outcomes after ACLR. The inability to correct movement issues prior to RTS is likely due to the use of incomplete programmes or a lack of volume and intensity of movement re-training programmes. Although most clinicians and researchers understand that re-training movement after ACLR is important (e.g., the 'why'), there is often a disconnect with understanding the 'how' and 'what' of movement re-training post ACLR. The aim of this paper was to discuss factors relevant to movement dysfunction and re-training after ACLR and provide recommendations for clinicians to restore movement quality of patients after ACLR, prior to RTS. The paper recommends: (i) considering the factors which influence the expression of movement quality, which revolve around individual (e.g., neuromuscular, biomechanical, sensorimotor and neurocognitive factors), task-specific and environmental constraints; (ii) incorporating a three-staged movement re-training approach aligned to the ACLR functional recovery process: (1) addressing the neuromuscular and biomechanical and sensorimotor control factors which affect movement quality and motor learning, (2) including a progressive movement re-training approach to re-learn an array of functional tasks optimising coordination and motor learning (3) performing the final aspect of rehabilitation and movement training on the field, in realistic environments progressively simulating the sporting movement demands and environmental constraints; and (iii) effectively designing the movement programme for optimal load management, employing effective coach and feedback techniques and utilising qualitative movement analysis for transition between exercises, stages and for RTS.
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Affiliation(s)
- Matthew Buckthorpe
- Faculty of Sport, Health and Applied Science, St Marys University, Twickenham, London, TW1 4SX, UK.
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Franck F, Saithna A, Vieira TD, Pioger C, Vigne G, Le Guen M, Rogowski I, Fayard JM, Thaunat M, Sonnery-Cottet B. Return to Sport Composite Test After Anterior Cruciate Ligament Reconstruction (K-STARTS): Factors Affecting Return to Sport Test Score in a Retrospective Analysis of 676 Patients. Sports Health 2021; 13:364-372. [PMID: 33550916 DOI: 10.1177/1941738120978240] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Return to sport (RTS) to the preinjury level is the main purpose after anterior cruciate ligament (ACL) reconstruction but the factors affecting the RTS are not completely known. Knee Santy Athletic Return to Sport (K-STARTS) is a composite test designed to assess readiness for RTS after ACL reconstruction. PURPOSE To determine the key factors that influence K-STARTS scores in a large cohort of patients after ACL reconstruction. STUDY DESIGN Case-control study. LEVEL OF EVIDENCE Level 3. METHODS A retrospective analysis of prospectively collected data was undertaken. All patients who underwent ACL reconstruction surgery between March 2016 and May 2017 and also had a K-STARTS assessment at 6 months postoperatively were included. To identify factors influencing the K-STARTS score, an analysis of variance was performed. Age, sex, sports level, delay between injury and surgery, concomitant lesions, graft type, additional lateral tenodesis procedure, and participation in the RTS program were analyzed to identify factors influencing the K-STARTS score. RESULTS A total of 676 patients were included in the study. The K-STARTS score was significantly higher in male patients than in female patients (13.9 vs 12.4; P < 0.001), in younger patients (those aged <30 years vs older patients; 14.2 vs 12; P < 0.001), ACL reconstructions performed with hamstring tendon autografts compared with bone-patellar tendon-bone (13.5 vs 13.1; P = 0.03) and in those who completed a specific RTS program in addition to standard rehabilitation, compared with those who did not participate (17.1 vs 13.1; P < 0.001). However, the only factor that significantly influenced the K-STARTS score beyond the minimal detectable change threshold was the completion of the additional RTS program. The preinjury frequency of sports participation, whether the dominant limb was injured, time from injury to surgery, the presence of associated meniscal injuries, and whether a lateral tenodesis was performed did not significantly influence the K-STARTS score. CONCLUSION Completion of a specific RTS program, in addition to standard rehabilitation, was the most important factor influencing the K-STARTS composite functional and psychological RTS test score at 6 months after ACL reconstruction. CLINICAL RELEVANCE This study shows that the completion of a specific RTS program affects positively the RTS test score at 6 months after ACL reconstruction.
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Affiliation(s)
- Florent Franck
- Centre Orthopédique Santy, Lyon, France.,Hopital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France
| | - Adnan Saithna
- Arizona Brain, Spine & Sports Injuries Center, Scottsdale, Arizona
| | - Thais Dutra Vieira
- Centre Orthopédique Santy, Lyon, France.,Hopital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France
| | - Charles Pioger
- Centre Orthopédique Santy, Lyon, France.,Hopital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France
| | | | | | - Isabelle Rogowski
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université de Lyon, Villeurbanne Cedex, France
| | - Jean-Marie Fayard
- Centre Orthopédique Santy, Lyon, France.,Hopital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France
| | - Mathieu Thaunat
- Centre Orthopédique Santy, Lyon, France.,Hopital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France
| | - Bertrand Sonnery-Cottet
- Centre Orthopédique Santy, Lyon, France.,Hopital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France
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Altered Drop Jump Landing Biomechanics Following Eccentric Exercise-Induced Muscle Damage. Sports (Basel) 2021; 9:sports9020024. [PMID: 33562760 PMCID: PMC7915566 DOI: 10.3390/sports9020024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/24/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022] Open
Abstract
Limited research exists in the literature regarding the biomechanics of the jump-landing sequence in individuals that experience symptoms of muscle damage. The present study investigated the effects of knee localized muscle damage on sagittal plane landing biomechanics during drop vertical jump (DVJ). Thirteen regional level athletes performed five sets of 15 maximal eccentric voluntary contractions of the knee extensors of both legs at 60°/s. Pelvic and lower body kinematics and kinetics were measured pre- and 48 h post-eccentric exercise. The examination of muscle damage indicators included isometric torque, muscle soreness, and serum creatine kinase (CK) activity. The results revealed that all indicators changed significantly following eccentric exercise (p < 0.05). Peak knee and hip joint flexion as well as peak anterior pelvic tilt significantly increased, whereas vertical ground reaction force (GRF), internal knee extension moment, and knee joint stiffness significantly decreased during landing (p < 0.05). Therefore, the participants displayed a softer landing pattern following knee-localized eccentric exercise while being in a muscle-damaged state. This observation provides new insights on how the DVJ landing kinematics and kinetics alter to compensate the impaired function of the knee extensors following exercise-induced muscle damage (EIMD) and residual muscle soreness 48 h post-exercise.
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Alsubaie SF, Abdelbasset WK, Alkathiry AA, Alshehri WM, Azyabi MM, Alanazi BB, Alomereni AA, Asiri FY. Anterior cruciate ligament injury patterns and their relationship to fatigue and physical fitness levels - a cross-sectional study. Medicine (Baltimore) 2021; 100:e24171. [PMID: 33429801 PMCID: PMC7793338 DOI: 10.1097/md.0000000000024171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 12/11/2020] [Indexed: 01/05/2023] Open
Abstract
Anterior cruciate ligament (ACL) injury is one of the most common knee injuries that leads to many consequences such as early osteoarthritis and knee joint instability.To explore the association of the types of ACL tear (complete and partial) and side of injury (dominant vs nondominate) with types of playing surfaces, sports, shoes, and mechanism of injuries as well as to determine whether higher levels of fatigue and physical fitness are risk factors for complete ACL tear.This cross-sectional study used a questionnaire to collect information from young male adults with a confirmed ACL injury who were attending rehabilitation programs. The outcomes of interest were patterns of ACL injury, levels of fatigue before the injury on a 0 to 10 scale, and levels of physical fitness (hours per week). Mann-Whitney U and Kruskal Wallis tests were used to assess the differences between groups, while the odds ratios were calculated to evaluate risk factors for complete ACL tear.One hundred thirteen young male adults with a confirmed ACL injury were enrolled. Most of the reported ACL injuries in this study were complete tear (80.5%) and occurred more frequently in the dominant leg (74.6%) due to noncontact mechanism (63.6%). More ACL injuries happened while playing soccer (97.2%) on artificial turf (53.3%). The level of fatigue before ACL injury was significantly higher in partial ACL tear injuries compared to complete ACL tear injuries (P = .014). For every 1-point increase in the level of fatigue on a 0-10 scale, there was a 25% reduction in complete ACL injury risk (P = .023).The pattern of ACL types of tear and side of injury varies in different playing surfaces and mechanisms of injuries. Higher levels of fatigue seem to be associated with a partial tear of the ACL and reduction of a complete ACL tear risk factor.
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Affiliation(s)
- Saud F. Alsubaie
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Walid Kamal Abdelbasset
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Abdulaziz A. Alkathiry
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Waleed M. Alshehri
- Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh
| | - Mohammed M. Azyabi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Basil B. Alanazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Abdulaziz A. Alomereni
- Department of Rehabilitation Medical Science, College of Applied Medical Sciences, Najran University, Najran
| | - Faisal Y. Asiri
- Rehabilitation Sciences Department, King Khalid University, Abha, Saudi Arabia
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Bodkin SG, Weltman AL, Hart JM. ISB clinical biomechanics award winner 2019: Knee extensor fatigue resistance in individuals following anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon) 2021; 81:105242. [PMID: 33309931 DOI: 10.1016/j.clinbiomech.2020.105242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals following anterior cruciate ligament reconstruction demonstrate quadriceps weakness throughout the post-operative recovery and at the time of returning to sport. This is often accompanied with patterns of quadriceps fatigue resistance. As such, fatigue may be an identifier of individuals with delayed recovery. The purpose was to assess quadriceps fatigue in anterior cruciate ligament reconstructed patients at the time of return to sport in comparison to healthy controls. METHODS A total of 215 individuals, 120 following anterior cruciate ligament reconstruction (21.0 (2.9) years, 63 Female, 5.96 (0.48) months post-surgery) and 95 healthy controls (21.5 (8.4) years, 49 Female), participated in this study. All participants completed a 30-s knee extensor maximum voluntary isometric contraction. Knee extensor strength, limb symmetry index, and fatigue (%) were compared between groups. Between-limb fatigue comparisons were made through the Fatigue Index Limb Difference = [(Involved Limb Fatigue Index) - (Uninvolved Limb Fatigue Index)]. FINDINGS Individuals following anterior cruciate ligament reconstruction (18.7 (10.9)%, -5.6 (11.2)) demonstrated lower values of unilateral fatigue and Fatigue Index Limb Difference compared to healthy participants (22.5 (8.2)%, P = .002; 2.2 (7.9), P < .001). For anterior cruciate ligament reconstructed patients, there was a weak, negative, significant relationship between the involved limb strength and fatigue (r = -0.184, P = .048). There was no relationship between limb symmetry and Fatigue Index Limb Difference (r = 0.137, P = .142). For Healthy individuals, there was a positive, moderate relationship between limb symmetry and Fatigue Index Limb Difference (r = 0.400, P < .001). INTERPRETATION Individuals following anterior cruciate ligament reconstruction demonstrate fatigue resistance compared to healthy active controls and greater resistance to fatigue in their involved limb compared to their contralateral limb.
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Affiliation(s)
- Stephan G Bodkin
- Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
| | - Arthur L Weltman
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
| | - Joe M Hart
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
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Heil J, Schulte S, Büsch D. The Influence of Physical Load on Dynamic Postural Control-A Systematic Replication Study. J Funct Morphol Kinesiol 2020; 5:jfmk5040100. [PMID: 33467315 PMCID: PMC7804868 DOI: 10.3390/jfmk5040100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/09/2020] [Accepted: 12/17/2020] [Indexed: 12/21/2022] Open
Abstract
Dynamic postural control is challenged during many actions in sport such as when landing or cutting. A decrease of dynamic postural control is one possible risk factor for non-contact injuries. Moreover, these injuries mainly occur under loading conditions. Hence, to assess an athlete's injury risk properly, it is essential to know how dynamic postural control is influenced by physical load. Therefore, the study's objective was to examine the influence of maximal anaerobic load on dynamic postural control. Sixty-four sport students (32 males and 32 females, age: 24.11 ± 2.42, height: 175.53 ± 8.17 cm, weight: 67.16 ± 10.08 kg) were tested with the Y-Balance Test before and after a Wingate Anaerobic Test on a bicycle ergometer. In both legs, reach distances (anterior) and composite scores were statistically significantly reduced immediately after the loading protocol. The values almost returned to pre-load levels in about 20 min post-load. Overall, findings indicate an acute negative effect of load on dynamic postural control and a higher potential injury risk during a period of about 20 min post-load. To assess an athlete's sports-specific injury risk, we recommend testing dynamic postural control under loaded conditions.
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Dynamic Knee Valgus in Single-Leg Movement Tasks. Potentially Modifiable Factors and Exercise Training Options. A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218208. [PMID: 33172101 PMCID: PMC7664395 DOI: 10.3390/ijerph17218208] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/29/2020] [Accepted: 11/04/2020] [Indexed: 12/19/2022]
Abstract
Dynamic knee valgus (DKV) as an incorrect movement pattern is recognized as a risk factor for lower limb injuries. Therefore, it is important to find the reasons behind this movement to select effective preventive procedures. There is a limited number of publications focusing on specific tasks, separating the double-leg from the single-leg tasks. Test patterns commonly used for DKV assessment, such as single-leg squat (SLS) or single leg landings (SLL), may show different results. The current review presents the modifiable factors of knee valgus in squat and landing single-leg tests in healthy people, as well as exercise training options. The authors used the available literature from PubMed, Scopus, PEDro and clinicaltrials.gov databases, and reviewed physiotherapy journals and books. For the purpose of the review, studies were searched for using 2D or 3D motion analysis methods only in the SLL and SLS tasks among healthy active people. Strengthening and activating gluteal muscles, improving trunk lateral flexion strength, increasing ROM dorsiflexion ankle and midfoot mobility should be taken into account when planning training programs aimed at reducing DKV occurring in SLS. In addition, knee valgus during SLL may occur due to decreased hip abductors, extensors, external rotators strength and higher midfoot mobility. Evidence from several studies supports the addition of biofeedback training exercises to reduce the angles of DKV.
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Player Wellness (Soreness and Stress) and Injury in Elite Junior Australian Football Players Over 1 Season. Int J Sports Physiol Perform 2020. [DOI: 10.1123/ijspp.2019-0828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: To investigate the association between player wellness and injury in elite junior Australian football players over 1 competitive season. Methods: Prospective cohort study. Elite junior Australian football players (N = 196, average age = 17.7 y, range = 16–18 y) were recruited in the under-18 state league competition in Victoria, Australia. They recorded their wellness (sleep, fatigue, soreness, stress, and mood) according to a 5-point Likert scale 3 times weekly, with injuries (missed match/training session) entered into an online sport-injury surveillance system. A logistic generalized estimating equation was used to examine the association (expressed as odds ratio [OR]) between wellness and injury (yes/no). Results: Soreness was associated with injury at each time point across the week, with the strongest association evident for soreness reported 6 d postmatch (OR = 1.30; 95% confidence interval [CI], 1.17–1.44; P < .001). Stress and injury were associated with injury for average stress values across the week, as well as specifically on day 1 postmatch (OR = 1.10; 95% CI, 1.01–1.21; P = .038). Mood reported in the middle of the week (3 d postmatch) was associated with injury (OR = 0.87; 95% CI, 0.78–0.97; P = .014), as was fatigue (OR = 1.10; 95% CI, 1.00–1.22; P = .044). Conclusions: This study demonstrates key associations between wellness and injury in elite junior Australian football, specifically soreness, stress, fatigue, and mood. Monitoring strategies help identify injury-risk profiles, which can help decision makers (coaches or medical staff) intervene when relevant to reduce injury risk.
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Comstock RD, Fields SK. The Eternally Wounded Athlete: How Medical Professionals and Sports Injury Researchers Have Limited Female Athletes’ Sport Participation and Biased the Interpretation of Sports Injury Research. CURR EPIDEMIOL REP 2020; 7:327-333. [DOI: 10.1007/s40471-020-00255-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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