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Ericksen HM, Earl-Boehm JE, Lally EM. The Effect of External Focus Versus Internal Focus Instruction on Jump-Landing Biomechanics in Healthy Females. J Athl Train 2024; 59:941-947. [PMID: 38291791 DOI: 10.4085/1062-6050-0154.23] [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] [Indexed: 02/01/2024]
Abstract
CONTEXT There are different ways to deliver external focus (EF) and internal focus (IF) instruction. Understanding each modality better will help to develop more effective interventions to reduce injury risk. OBJECTIVES To investigate the difference in landing biomechanics between participants who received EF and IF instruction and control participants. A secondary aim was to evaluate participant perceptions of focus of attention. DESIGN Randomized controlled trial. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS Forty-one healthy women (EF: n = 14, 23.0 ± 2.9 years, 1.69 ± 0.07 m, 64.0 ± 6.8 kg; IF: n = 15, 22.9 ± 3.2 years, 1.66 ± 0.08 m, 66.2 ± 12.4 kg; control: n = 12, 21.1 ± 2.9 years, 1.67 ± 0.11 m, 74.3 ± 15.1 kg). MAIN OUTCOME MEASURE(S) Participants scoring greater than or equal to 5 on the Landing Error Scoring System were allocated into the EF, IF, or control group. Knee and hip flexion and abduction were collected pre- and postintervention during 5 drop vertical jumps. For the intervention, each group was provided separate instructions. In between the intervention jumps, participants answered, "What strategy were you focusing on when completing the previous jump-landing trials?" Postintervention minus preintervention change scores were calculated, and separate 1-way analysis of variance assessments were performed to determine differences in the dependent variables. RESULTS Individuals in the EF group had a greater change in hip and knee flexion angles than individuals in the control group. There was no significant difference between the EF and IF groups for any variables. There were no significant differences in frontal plane variables. In the EF group, 71.4% aligned with the instructions given; in the IF group, 80% aligned; and in the control group, 50% aligned. CONCLUSIONS External focus instruction may not produce immediate changes in movement compared with IF instruction. Hip and knee flexion were greater in the EF group than in the control group but was not better than that in the IF group. Clinicians should provide instructions to patients, but the mode of instruction may not be as critical to see positive biomechanical changes. Patients may not always focus on the instruction being given; therefore, the relationship between instruction and patient experience should be further explored.
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Kal E, Ellmers T, Hogg J, Slutsky-Ganesh AB, Bonnette S, Thomas S, Riehm CD, Myer GD, Diekfuss JA. Optimal Training for Movement Acquisition and Transfer: Does "Externally Focused" Visual Biofeedback Promote Implicit Motor Learning? J Athl Train 2023; 58:648-654. [PMID: 36094615 PMCID: PMC10569250 DOI: 10.4085/1062-6050-0166.22] [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] [Indexed: 11/09/2022]
Abstract
CONTEXT Visual biofeedback has been shown to facilitate injury-resistant movement acquisition in adolescent athletes. Visual biofeedback is typically thought to foster implicit learning by stimulating athletes to focus attention externally (on movement outcome). However, biofeedback may also induce explicit learning if the athlete uses the visual information to consciously guide movement execution (via an internal focus). OBJECTIVE To determine the degree to which athletes reported statements indicating implicit or explicit motor learning after engaging in a visual biofeedback intervention. DESIGN Prospective cohort study. SETTING Three-dimensional motion-analysis laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-five adolescent female soccer athletes (age = 15.0 ± 1.5 years, height = 165.7 ± 5.9 cm, mass = 59.4 ± 10.6 kg). INTERVENTIONS Standard 6-week neuromuscular training intervention (three 90-minute sessions/wk), with added visual biofeedback sessions (2 sessions/wk). For the biofeedback training, participants performed squatting and jumping movements while interacting with a visual rectangular stimulus that mapped key parameters associated with injury risk. After the last biofeedback session in each week, participants answered open-ended questions to probe learning strategies. MAIN OUTCOME MEASURE(S) Responses to the open-ended questions were categorized as externally focused (ie, on movement outcome, suggestive of implicit learning), internally focused (ie, on movement itself, suggestive of explicit learning), mixed focus, or other. RESULTS A total of 171 open-ended responses were collected. Most of the responses that could be categorized (39.2%) were externally focused (41.8%), followed by mixed (38.8%) and internally focused (19.4%). The frequency of externally focused statements increased from week 1 (18%) to week 6 (50%). CONCLUSIONS Although most statements were externally focused (suggesting implicit learning), the relatively large proportion of internal- and mixed-focus statements suggested that many athletes also engaged in explicit motor learning, especially in early practice sessions. Therefore, biofeedback may affect motor learning through a mixture of implicit and explicit learning.
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Affiliation(s)
- Elmar Kal
- College of Health, Medicine and Life Sciences, Brunel University London, United Kingdom
- Centre for Cognitive Neuroscience, Brunel University London, United Kingdom
| | - Toby Ellmers
- College of Health, Medicine and Life Sciences, Brunel University London, United Kingdom
- Centre for Cognitive Neuroscience, Brunel University London, United Kingdom
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, United Kingdom
| | - Jennifer Hogg
- Department of Health and Human Performance, University of Tennessee, Chattanooga
| | - Alexis B. Slutsky-Ganesh
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
- Emory Sports Medicine Center, Atlanta, GA
- Department of Kinesiology, University of North Carolina, Greensboro
| | - Scott Bonnette
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, OH
| | - Staci Thomas
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, OH
| | - Christopher D. Riehm
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
- Emory Sports Medicine Center, Atlanta, GA
| | - Gregory D. Myer
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
- Emory Sports Medicine Center, Atlanta, GA
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, OH
| | - Jed A. Diekfuss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
- Emory Sports Medicine Center, Atlanta, GA
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Han S, Lee H, Hopkins JT. Acute effects of external visual feedback using cross-line laser on landing neuromechanics and postural control in chronic ankle instability. Sports Biomech 2022:1-16. [PMID: 35678240 DOI: 10.1080/14763141.2022.2085620] [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: 02/05/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022]
Abstract
Although neuromuscular training (NMT) programmes positively enhance clinical deficits in chronic ankle instability (CAI) patients, the effectiveness of NMTs in restoring movement patterns during jump landing is still questionable. Before developing new prolonged motor-learning interventions, it is important to determine the immediate effects of intervention on movement patterns during jump-landing in patients with CAI. Therefore, the purpose of this study was to determine whether real-time external feedback using a crossline laser device changes the movement patterns during jump-landing and balance tasks in patients with CAI. Eighteen patients with CAI completed three successful single-leg jump-landing tasks and single-leg balance tasks under the conditions of with and without external feedback. Lower-extremity joint angles, moments, and EMG activation of six muscles were collected during the single leg jump-landing task and centre of pressure data were collected during the single-leg balance test. Real-time external feedback allowed to change neuromechanical characteristics in the entire lower-extremity (i.e., ankle, knee, and hip joints) during jump-landing. However, there were no differences in static postural control between the two conditions. Clinicians should carefully consider incorporating a cost-effective laser device into an augmented NMT programme of longer duration to improve movement patterns during functional tasks in patients with CAI.
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Affiliation(s)
- Seunguk Han
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Jon Tyson Hopkins
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
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Plyometrics Did Not Improve Jump-Landing Biomechanics in Individuals With a History of Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2022. [DOI: 10.1123/ijatt.2020-0072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Second anterior cruciate ligament (ACL) injury has similar biomechanical risk factors as primary injury. Standard of care rehabilitation does not adequately mitigate these biomechanical risks. This study examined the effectiveness of a 4-week plyometric intervention on biomechanical risk factors of second ACL injury versus no intervention in patients with a history of ACL reconstruction. Thirty adults post-ACL reconstruction received 12 sessions of plyometric (age: 19.9 ± 1.62 years; body mass index: 23.9 ± 2.6 kg/m2; months postoperative: 35.7 ± 24.2) or no (age: 21.3 ± 3.5 years; body mass index: 27.7 ± 4.8 kg/m2; months postoperative: 45.3 ± 25.4) exercise intervention. Hip and knee biomechanics were quantified during a jump-landing task before and after the intervention. Individual response to the intervention was evaluated via minimal detectable change. Hip flexion angle had the greatest response to plyometric training. Overall, focused plyometric intervention did not adequately mitigate biomechanical risk factors of second ACL injury; thus, development of interventions capable of modifying biomechanics known to contribute to ACL injury risk remains necessary.
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Pfeiffer SJ, Spang JT, Nissman D, Lalush D, Wallace K, Harkey MS, Pietrosimone LS, Padua D, Blackburn T, Pietrosimone B. Association of Jump-Landing Biomechanics With Tibiofemoral Articular Cartilage Composition 12 Months After ACL Reconstruction. Orthop J Sports Med 2021; 9:23259671211016424. [PMID: 34368382 PMCID: PMC8299897 DOI: 10.1177/23259671211016424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Excessively high joint loading during dynamic movements may negatively influence articular cartilage health and contribute to the development of posttraumatic osteoarthritis after anterior cruciate ligament reconstruction (ACLR). Little is known regarding the link between aberrant jump-landing biomechanics and articular cartilage health after ACLR. PURPOSE/HYPOTHESIS The purpose of this study was to determine the associations between jump-landing biomechanics and tibiofemoral articular cartilage composition measured using T1ρ magnetic resonance imaging (MRI) relaxation times 12 months postoperatively. We hypothesized that individuals who demonstrate alterations in jump-landing biomechanics, commonly observed after ACLR, would have longer T1ρ MRI relaxation times (longer T1ρ relaxation times associated with less proteoglycan density). STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS A total of 27 individuals with unilateral ACLR participated in this cross-sectional study. Jump-landing biomechanics (peak vertical ground-reaction force [vGRF], peak internal knee extension moment [KEM], peak internal knee adduction moment [KAM]) and T1ρ MRI were collected 12 months postoperatively. Mean T1ρ relaxation times for the entire weightbearing medial femoral condyle, lateral femoral condyle (global LFC), medial tibial condyle, and lateral tibial condyle (global LTC) were calculated bilaterally. Global regions of interest were further subsectioned into posterior, central, and anterior regions of interest. All T1ρ relaxation times in the ACLR limb were normalized to the uninjured contralateral limb. Linear regressions were used to determine associations between T1ρ relaxation times and biomechanics after accounting for meniscal/chondral injury. RESULTS Lower ACLR limb KEM was associated with longer T1ρ relaxation times for the global LTC (ΔR 2 = 0.24; P = .02), posterior LTC (ΔR 2 = 0.21; P = .03), and anterior LTC (ΔR 2 = 0.18; P = .04). Greater ACLR limb peak vGRF was associated with longer T1ρ relaxation times for the global LFC (ΔR 2 = 0.20; P = .02) and central LFC (ΔR 2 = 0.15; P = .05). Peak KAM was not associated with T1ρ outcomes. CONCLUSION At 12 months postoperatively, lower peak KEM and greater peak vGRF during jump landing were related to longer T1ρ relaxation times, suggesting worse articular cartilage composition.
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Affiliation(s)
- Steven J. Pfeiffer
- Ohio Musculoskeletal & Neurological Institute, Athens, Ohio, USA
- Division of Exercise Physiology, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Athens, Ohio, USA
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jeffrey T. Spang
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniel Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David Lalush
- Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, North Carolina, USA
| | - Kyle Wallace
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Matthew S. Harkey
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Laura S. Pietrosimone
- Doctor of Physical Therapy Division, Department of Orthopedic Surgery, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Darin Padua
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Troy Blackburn
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brian Pietrosimone
- MOTION Science Institute, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Baus J, Harry JR, Yang J. Optimization-based subject-specific planar human vertical jumping prediction: Model development and validation. Proc Inst Mech Eng H 2021; 235:805-818. [PMID: 33863254 DOI: 10.1177/09544119211010924] [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] [Indexed: 11/16/2022]
Abstract
Jumping biomechanics may differ between individuals participating in various sports. Jumping motion can be divided into different phases for research purposes when seeking to understand performance, injury risk, or both. Experimental-based methods are used to study different jumping situations for their capabilities of testing other conditions intended to improve performance or further prevent injuries. External loading training is commonly used to simulate jumping performance improvement. This paper presents the optimization-based subject-specific planar human vertical jumping to develop the prediction model with and without a weighted vest and validate it through experiments. The skeletal model replicates the human motion for jumping (weighting, unweighting, breaking, propulsion) in the sagittal plane considering four different loading conditions (0% and 10% body mass): unloaded, split-loaded, front-loaded, and back-loaded. The multi-objective optimization problem is solved using MATLAB® with 35 design variables and 197 nonlinear constraints. Results show that the model is computationally efficient, and the predicted jumping motion matches the experimental data trend. The simulation model can predict vertical jumping motion and can test the effect of different loading conditions with weighted vests and arm-swing strategy on the ground reaction forces. This work is novel in the sense that it can predict ground reaction forces, joints angles, and center of mass position without any experimental data.
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Affiliation(s)
- Juan Baus
- Department of Mechanical Engineering, Human-Centric Design Research Lab, Texas Tech University, Lubbock, TX, USA
| | - John R Harry
- Department of Kinesiology and Sport Management, Human Performance & Biomechanics Lab, Texas Tech University, Lubbock, TX, USA
| | - James Yang
- Department of Mechanical Engineering, Human-Centric Design Research Lab, Texas Tech University, Lubbock, TX, USA
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Females Decrease Vertical Ground Reaction Forces Following 4-Week Jump-Landing Feedback Intervention Without Negative Affect on Vertical Jump Performance. J Sport Rehabil 2021; 28:866-870. [PMID: 30300051 DOI: 10.1123/jsr.2018-0140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/07/2018] [Accepted: 08/27/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT High vertical ground reaction force (vGRF) when initiating ground contact during jump landing is one biomechanical factor that may increase risk of anterior cruciate ligament injury. Intervention programs have been developed to decrease vGRF to reduce injury risk, yet generating high forces is still critical for performing dynamic activities such as a vertical jump task. OBJECTIVE To evaluate if a jump-landing feedback intervention, cueing a decrease in vGRF, would impair vertical jump performance in a separate task (Vertmax). DESIGN Randomized controlled trial. Patients (or Other Participants): Forty-eight recreationally active females (feedback: n = 31; 19.63 [1.54] y, 1.6 [0.08] cm, 58.13 [7.84] kg and control: n = 15; 19.6 [1.68] y, 1.64 [0.05] cm, 60.11 [8.36] kg) participated in this study. INTERVENTION Peak vGRF during a jump landing and Vertmax were recorded at baseline and 4 weeks post. The feedback group participated in 12 sessions over the 4-week period consisting of feedback provided for 6 sets of 6 jumps off a 30-cm box. The control group was instructed to return to the lab 28 days following the baseline measurements. MAIN OUTCOME MEASURES Change scores (postbaseline) were calculated for peak vGRF and Vertmax. Group differences were evaluated for peak vGRF and Vertmax using a Mann-Whitney U test (P < .05). RESULTS There were no significant differences between groups at baseline (P > .05). The feedback group (-0.5 [0.3] N/kg) demonstrated a greater decrease in vGRF compared with the control group (0.01 [0.3] N/kg) (t(46) = -5.52, P < .001). There were no significant differences in change in Vertmax between groups (feedback = 0.9 [2.2] cm, control = 0.06 [2.1] cm; t(46) = 0.46, P = .64). CONCLUSIONS While the feedback intervention was effective in decreasing vGRF when landing from a jump, these participants did not demonstrate changes in vertical jump performance when assessed during a different task. Practitioners should consider implementing feedback intervention programs to reduce peak vGRF, without worry of diminished vertical jump performance.
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Targeted Application of Motor Learning Theory to Leverage Youth Neuroplasticity for Enhanced Injury-Resistance and Exercise Performance: OPTIMAL PREP. ACTA ACUST UNITED AC 2021. [DOI: 10.1007/s42978-020-00085-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Norte GE, Frendt TR, Murray AM, Armstrong CW, McLoughlin TJ, Donovan LT. Influence of Anticipation and Motor-Motor Task Performance on Cutting Biomechanics in Healthy Men. J Athl Train 2021; 55:834-842. [PMID: 32688389 DOI: 10.4085/1062-6050-569-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Biomechanical analyses of cutting tasks have demonstrated kinematic differences associated with the noncontact knee-injury risk when the movement direction is unanticipated. Motor-motor dual tasks occur within dynamic environments and change the demand for attentional resources needed to complete athletic maneuvers, which may contribute to injury risk. OBJECTIVE To investigate the influence of anticipation and motor-motor task performance on cutting biomechanics. DESIGN Cross-sectional study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 32 healthy, recreationally active men (age = 23.1 ± 3.6 years, height = 180.0 ± 7.0 cm, mass = 81.3 ± 17.3 kg) who self-reported regular participation in cutting sports. INTERVENTION(S) Participants performed a 45° side-step cut on the dominant limb in a random order of conditions: anticipation (anticipated, unanticipated) and task (no ball throw, ball fake, ball throw). MAIN OUTCOME MEASURE(S) Triplanar trunk, hip, and knee angles were assessed throughout the stance phase using 3-dimensional motion capture. Data were analyzed using a time series of means calculated from initial contact to toe-off (0%-100%) with 90% confidence intervals. Mean differences between conditions were identified as regions of nonoverlapping confidence intervals, and those that occurred during the region of peak vertical ground reaction force (0%-25%) are presented. RESULTS Regardless of anticipation, attending to a ball (ball throw) resulted in more trunk extension (range = 2.9°-3.7°) and less lateral trunk flexion toward the cutting direction (range = 5.2°-5.9°). Planning to attend to a ball (ball fake) resulted in less lateral trunk flexion toward the cutting direction (4.7°). During unanticipated cutting, more trunk rotation away from the cutting direction was observed when attending to a ball (range = 5.3°-7.1°). The interaction of anticipation and task had a similar influence on sagittal- and frontal-plane trunk position. CONCLUSIONS Motor-motor task performance and its interaction with anticipation induced an upright, neutral trunk position during side-step cutting, which has been associated with the risk for noncontact knee injury. Promoting task complexity during rehabilitation and injury-prevention programs may better prepare individuals to succeed when performing high-risk athletic maneuvers.
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Affiliation(s)
| | | | | | - Charles W Armstrong
- Exercise Science Program, School of Exercise and Rehabilitation Sciences, University of Toledo, OH
| | - Thomas J McLoughlin
- Exercise Science Program, School of Exercise and Rehabilitation Sciences, University of Toledo, OH
| | - Luke T Donovan
- Department of Kinesiology, University of North Carolina at Charlotte
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VALIDITY OF AN MRI-COMPATIBLE MOTION CAPTURE SYSTEM FOR USE WITH LOWER EXTREMITY NEUROIMAGING PARADIGMS. Int J Sports Phys Ther 2020; 15:936-946. [PMID: 33344010 DOI: 10.26603/ijspt20200936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Emergent linkages between musculoskeletal injury and the nervous system have increased interest to evaluate brain activity during functional movements associated with injury risk. Functional magnetic resonance imaging (fMRI) is a sophisticated modality that can be used to study brain activity during functional sensorimotor control tasks. However, technical limitations have precluded the precise quantification of lower-extremity joint kinematics during active brain scanning. The purpose of this study was to determine the validity of a new, MRI-compatible motion tracking system relative to a traditional multi-camera 3D motion capture system for measuring lower extremity joint kinematics. Methods Fifteen subjects (9 females, 6 males) performed knee flexion-extension and leg press movements against guided resistance while laying supine. Motion tracking data were collected simultaneously using the MRI-compatible and traditional multi-camera 3D motion systems. Participants' sagittal and frontal plane knee angles were calculated from data acquired by both multi-camera systems. Resultant range of angular movement in both measurement planes were compared between both systems. Instrument agreement was assessed using Bland-Altman plots and intraclass correlation coefficients (ICC). Results The system demonstrated excellent validity in the sagittal plane (ICCs>0.99) and good to excellent validity in the frontal plane (0.84 < ICCs < 0.92). Mean differences between corresponding range of angular movement measurements ranged from 0.186 ° to 0.295 °. Conclusions The present data indicate that this new, MRI-compatible system is valid for measuring lower extremity movements when compared to the gold standard 3D motion analysis system. As there is growing interest regarding the neural substrates of lower extremity movement, particularly in relation to injury and pathology, this system can now be integrated into neuroimaging paradigms to investigate movement biomechanics and its relation to brain activity. Level of Evidence 3.
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MOPED25: A multimodal dataset of full-body pose and motion in occupational tasks. J Biomech 2020; 113:110086. [PMID: 33157418 DOI: 10.1016/j.jbiomech.2020.110086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/24/2020] [Accepted: 10/16/2020] [Indexed: 11/24/2022]
Abstract
In recent years, there has been a trend of using images and deep neural network-based computer vision algorithms to perform postural evaluation in workplace safety and ergonomics community. The performance of the computer vision algorithms, however, heavily relies on the generalizability of the posture dataset that was used for algorithm training. Current open-access posture datasets from the computer vision community mainly focus on the pose and motion of daily activities and lack the context in workplaces. In this study, a new posture dataset named, MOPED25 (Multimodal Occupational Posture Dataset with 25 tasks) is presented. This dataset includes full-body kinematics data and the synchronized videos of 11 participants, performing commonly seen tasks at workplaces. All the data has been made publicly available online. This dataset can serve as a benchmark for developing more robust computer vision algorithms for postural evaluation at workplaces.
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12
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Diekfuss JA, Bonnette S, Hogg JA, Riehm C, Grooms DR, Singh H, Anand M, Slutsky-Ganesh AB, Wilkerson GB, Myer GD. Practical Training Strategies to Apply Neuro-Mechanistic Motor Learning Principles to Facilitate Adaptations Towards Injury-Resistant Movement in Youth. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42978-020-00083-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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13
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Diekfuss JA, Grooms DR, Bonnette S, DiCesare CA, Thomas S, MacPherson RP, Ellis JD, Kiefer AW, Riley MA, Schneider DK, Gadd B, Kitchen K, Barber Foss KD, Dudley JA, Yuan W, Myer GD. Real-time biofeedback integrated into neuromuscular training reduces high-risk knee biomechanics and increases functional brain connectivity: A preliminary longitudinal investigation. Psychophysiology 2020; 57:e13545. [PMID: 32052868 DOI: 10.1111/psyp.13545] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 01/13/2020] [Accepted: 01/22/2020] [Indexed: 12/21/2022]
Abstract
Prospective evidence indicates that functional biomechanics and brain connectivity may predispose an athlete to an anterior cruciate ligament injury, revealing novel neural linkages for targeted neuromuscular training interventions. The purpose of this study was to determine the efficacy of a real-time biofeedback system for altering knee biomechanics and brain functional connectivity. Seventeen healthy, young, physically active female athletes completed 6 weeks of augmented neuromuscular training (aNMT) utilizing real-time, interactive visual biofeedback and 13 served as untrained controls. A drop vertical jump and resting state functional magnetic resonance imaging were separately completed at pre- and posttest time points to assess sensorimotor adaptation. The aNMT group had a significant reduction in peak knee abduction moment (pKAM) compared to controls (p = .03, d = 0.71). The aNMT group also exhibited a significant increase in functional connectivity between the right supplementary motor area and the left thalamus (p = .0473 after false discovery rate correction). Greater percent change in pKAM was also related to increased connectivity between the right cerebellum and right thalamus for the aNMT group (p = .0292 after false discovery rate correction, r2 = .62). No significant changes were observed for the controls (ps > .05). Our data provide preliminary evidence of potential neural mechanisms for aNMT-induced motor adaptations that reduce injury risk. Future research is warranted to understand the role of neuromuscular training alone and how each component of aNMT influences biomechanics and functional connectivity.
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Affiliation(s)
- Jed A Diekfuss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dustin R Grooms
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, OH, USA.,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Scott Bonnette
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher A DiCesare
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Staci Thomas
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ryan P MacPherson
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Jonathan D Ellis
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Adam W Kiefer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Exercise Science and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Center for Cognition, Action & Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Michael A Riley
- Center for Cognition, Action & Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | | | - Brooke Gadd
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Katie Kitchen
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kim D Barber Foss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jonathan A Dudley
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Weihong Yuan
- College of Medicine, University of Cincinnati, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Gregory D Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,College of Medicine, University of Cincinnati, Cincinnati, OH, USA.,Department of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA.,The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
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14
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Marshall AN, Hertel J, Hart JM, Russell S, Saliba SA. Visual Biofeedback and Changes in Lower Extremity Kinematics in Individuals With Medial Knee Displacement. J Athl Train 2020; 55:255-264. [PMID: 31986103 DOI: 10.4085/1062-6050-383-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Increased frontal-plane knee motion during functional tasks, or medial knee displacement, is a predictor of noncontact anterior cruciate ligament injury and patellofemoral pain. Intervention studies that resulted in a reduced risk of knee injury included some form of feedback to address aberrant lower extremity movement patterns. Research on integrating feedback into single-legged tasks and the ability to train 1 task and test another is limited. OBJECTIVE To determine if adding real-time visual biofeedback to common lower extremity exercises would improve single-legged landing mechanics in females with medial knee displacement. DESIGN Cohort study. SETTING University laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-four recreationally active females with medial knee displacement were randomized to a visual-biofeedback group (n = 12; age = 19.75 ± 0.87 years, height = 165.32 ± 8.69 cm, mass = 62.41 ± 8.91 kg) or a control group (n = 12; age = 19.75 ± 0.97 years, height = 166.98 ± 6.89 cm, mass = 59.98 ± 6.24 kg). INTERVENTION(S) Individuals in the feedback group viewed a real-time digital model of their body segments generated by Microsoft Kinect. The skeletal model changed color according to the knee-abduction angle of the test limb during the exercise tasks. MAIN OUTCOME MEASURE(S) Participants completed 3 trials of the single-legged drop vertical jump (SL-DVJ) while triplanar kinematics at the trunk, hip, knee, and ankle were collected via 3-dimensional motion capture. The feedback and control groups completed lower extremity exercises with or without real-time visual biofeedback, respectively. After the intervention, participants completed 3 additional trials of the SL-DVJ. RESULTS At baseline, the feedback group had 3.83° more ankle eversion than the control group after initial contact. After the intervention, the feedback group exhibited 13.03° more knee flexion during the flight phase of the SL-DVJ and 6.16° less knee abduction after initial contact than the control group. The feedback group also demonstrated a 3.02° decrease in peak knee-abduction excursion compared with the baseline values (P = .008). CONCLUSIONS Real-time visual biofeedback immediately improved faulty lower extremity kinematics related to knee-injury risk. Individuals with medial knee displacement adjusted their movement patterns after a single training session and reduced their medial knee motion during a dynamic task.
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Affiliation(s)
- Ashley N Marshall
- Department of Health and Exercise Science, Appalachian State University, Boone, NC
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, Charlottesville
| | - Joseph M Hart
- Department of Kinesiology, University of Virginia, Charlottesville.,Department of Orthopedic Surgery, University of Virginia, Charlottesville
| | - Shawn Russell
- Department of Orthopedics and Mechanical Engineering, University of Virginia, Charlottesville
| | - Susan A Saliba
- Department of Kinesiology, University of Virginia, Charlottesville
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15
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The Effects of Instruction Exercises on Performance and Kinetic Factors Associated With Lower-Extremity Injury in Landing After Volleyball Blocks. J Sport Rehabil 2020; 29:51-64. [PMID: 30526280 DOI: 10.1123/jsr.2018-0163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/15/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Female volleyball players are more predisposed to anterior cruciate ligament injury in comparison with their male counterparts. Recent research on anterior cruciate ligament injury prevention strategies has shown the positive results of adopting the external focus (EF) of attention in sports. OBJECTIVE To determine the effect of 6-week EF instruction exercises on performance and kinetic factors associated with lower-extremity injury in landing after the volleyball blocks of female athletes. DESIGN Pretest and posttest control study. SETTING University research laboratory. PARTICIPANTS Thirty-two female volleyball players (18-24 y old) from the same team randomly divided into experimental (n = 16) and control (n = 16) groups. INTERVENTION The experimental group performed a 6-week exercise program with EF instructions. The control group continued its regular volleyball team schedule. MAIN OUTCOME MEASURES To assess function, single-leg triple hop test for distance was used. A force plate was used to evaluate kinetic variables including vertical ground reaction forces, the rate of loading, and dynamic postural stability index. All data were assessed at baseline and after the intervention. RESULTS There was a significant increase in single-leg triple hop test (P < .05) and in the first and second peak ground reaction force, rate of loadings, dynamic postural stability index (P < .05). CONCLUSION According to the results of this study, anterior cruciate ligament injury prevention programs should incorporate EF instruction exercises to enhance the kinetics and to increase athletes' functional performance.
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16
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Drury B, Ratel S, Clark CC, Fernandes JF, Moran J, Behm DG. Eccentric Resistance Training in Youth: Perspectives for Long-Term Athletic Development. J Funct Morphol Kinesiol 2019; 4:E70. [PMID: 33467385 PMCID: PMC7739302 DOI: 10.3390/jfmk4040070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023] Open
Abstract
The purpose of this narrative review is to discuss the role of eccentric resistance training in youth and how this training modality can be utilized within long-term physical development. Current literature on responses to eccentric exercise in youth has demonstrated that potential concerns, such as fatigue and muscle damage, compared to adults are not supported. Considering the importance of resistance training for youth athletes and the benefits of eccentric training in enhancing strength, power, speed, and resistance to injury, its inclusion throughout youth may be warranted. In this review we provide a brief overview of the physiological responses to exercise in youth with specific reference to the different responses to eccentric resistance training between children, adolescents, and adults. Thereafter, we discuss the importance of ensuring that force absorption qualities are trained throughout youth and how these may be influenced by growth and maturation. In particular, we propose practical methods on how eccentric resistance training methods can be implemented in youth via the inclusion of efficient landing mechanics, eccentric hamstrings strengthening and flywheel inertia training. This article proposes that the use of eccentric resistance training in youth should be considered a necessity to help develop both physical qualities that underpin sporting performance, as well as reducing injury risk. However, as with any other training modality implemented within youth, careful consideration should be given in accordance with an individual's maturity status, training history and technical competency as well as being underpinned by current long-term physical development guidelines.
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Affiliation(s)
- Benjamin Drury
- Department of Applied Sport Sciences, Hartpury University, Gloucestershire GL19 3BE, England, UK;
| | - Sébastien Ratel
- Laboratoire des Adaptations Métaboliques à l’Exercice en conditions Physiologiques et Pathologiques (AME2P, EA 3533), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Cain C.T. Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5RW, England, UK;
| | - John F.T. Fernandes
- Department of Applied Sport Sciences, Hartpury University, Gloucestershire GL19 3BE, England, UK;
| | - Jason Moran
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s Newfoundland and Labrador, A1C 5S7C, Canada;
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17
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Bonnette S, DiCesare CA, Kiefer AW, Riley MA, Barber Foss KD, Thomas S, Kitchen K, Diekfuss JA, Myer GD. Injury Risk Factors Integrated Into Self-Guided Real-Time Biofeedback Improves High-Risk Biomechanics. J Sport Rehabil 2019; 28:831-839. [PMID: 29952696 PMCID: PMC6667313 DOI: 10.1123/jsr.2017-0391] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 05/03/2018] [Accepted: 05/17/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Existing anterior cruciate ligament (ACL) injury prevention programs have failed to reverse the high rate of ACL injuries in adolescent female athletes. OBJECTIVE This investigation attempts to overcome factors that limit efficacy with existing injury prevention programs through the use of a novel, objective, and real-time interactive visual feedback system designed to reduce the biomechanical risk factors associated with ACL injuries. DESIGN Cross-over study. SETTING Medical center laboratory. PARTICIPANTS A total of 20 females (age = 19.7 [1.34] y; height = 1.74 [0.09] m; weight = 72.16 [12.45] kg) participated in this study. METHODS Participants performed sets of 10 bodyweight squats in each of 8 training blocks (ie, 4 real-time and 4 control blocks) and 3 testing blocks for a total of 110 squats. Feedback conditions were blocked and counterbalanced with half of participants randomly assigned to receive the real-time feedback block first and half receiving the control (sham) feedback first. RESULTS Heat map analysis revealed that during interaction with the real-time feedback, squat performance measured in terms of key biomechanical parameters was improved compared with performance when participants squatted with the sham stimulus. CONCLUSIONS This study demonstrates that the interactive feedback system guided participants to significantly improve movement biomechanics during performance of a body weight squat, which is a fundamental exercise for a longer term ACL injury risk reduction intervention. A longer training and testing period is necessary to investigate the efficacy of this feedback approach to effect long-term adaptations in the biomechanical risk profile of athletes.
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Affiliation(s)
- Scott Bonnette
- The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH
| | - Christopher A. DiCesare
- The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH
| | - Adam W. Kiefer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH
- Center for Cognition, Action, & Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH
- University of Cincinnati College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Michael A. Riley
- Center for Cognition, Action, & Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH
| | - Kim. D. Barber Foss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH
| | - Staci Thomas
- The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH
| | - Katie Kitchen
- The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH
| | - Jed A. Diekfuss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH
| | - Gregory D. Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH
- University of Cincinnati College of Medicine, University of Cincinnati, Cincinnati, OH
- Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Department of Orthopaedics, University of Pennsylvania, Philadelphia, PA, USA
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18
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Peel SA, Weinhandl JT. Task but not arm restriction influences lower extremity joint mechanics during bilateral landings. Sports Biomech 2019; 21:637-653. [PMID: 31560257 DOI: 10.1080/14763141.2019.1659394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Box and jump landing tasks are commonly used to study lower extremity injury mechanisms, such as anterior cruciate ligament (ACL) injuries. Arm restriction during these tasks is typically determined via researcher preference. Therefore, the purpose of this study was to compare three-dimensional lower extremity kinematics and kinetics during bilateral box and jump landings, and to determine the effects of arm restriction. Twenty-eight participants (14 males, 14 females) completed three bilateral landings tasks: box landings with arms unrestricted (BLA), box landings with arms restricted against the trunk (BLNA) and jump landings (JL). Right leg joint kinematics and kinetics were collected and compared between landing tasks. No statistically significant differences were found between BLA and BLNA, therefore arm restriction did not appear to influence lower extremity variables during bilateral box landings. However, specific injury-related variables, such as peak knee adduction moment differed between box and jump landings (BLNA: 0.31 ± 0.3 Nm/(kg·m)); JL: 0.45 ± 0.3 Nm/(kg·m); p = 0.020). Our results suggest that based on study purpose, careful consideration is needed when determining what bilateral landing task to choose during data collection.
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Affiliation(s)
- Shelby A Peel
- Department of Kinesiology, Recreation, & Sports Studies, University of Tennessee , Knoxville , TN , USA
| | - Joshua T Weinhandl
- Department of Kinesiology, Recreation, & Sports Studies, University of Tennessee , Knoxville , TN , USA
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19
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Neilson V, Ward S, Hume P, Lewis G, McDaid A. Effects of augmented feedback on training jump landing tasks for ACL injury prevention: A systematic review and meta-analysis. Phys Ther Sport 2019; 39:126-135. [DOI: 10.1016/j.ptsp.2019.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 07/16/2019] [Accepted: 07/16/2019] [Indexed: 11/16/2022]
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20
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Morgan AM, O'Connor KM. Evaluation of an accelerometer to assess knee mechanics during a drop landing. J Biomech 2019; 86:125-131. [PMID: 30777341 DOI: 10.1016/j.jbiomech.2019.01.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 12/31/2022]
Abstract
Non-contact anterior cruciate ligament (ACL) injuries account for 70% of all ACL injuries, and can lead to missed time from activity for athletes and a predisposition for knee osteoarthritis. Prior research has shown that athletes who land in a stiff manner, with larger internal knee adduction and extension moments, are at greater risk for an ACL injury. A three-dimensional accelerometer placed at the tibial tuberosity may prove to be a low-cost means of assessing these risk factors. The primary purpose of this study was to compare tibial accelerations during drop landings with kinematic and kinetic risk factors for ACL injury measured with three-dimensional motion capture. The secondary purpose of this study was to compare these measures between soft and stiff landings. Participants were instructed to land bilaterally in preferred, soft, and stiff manners. Peak knee flexion decreased significantly from soft to stiff landings. Peak internal knee extension moment, peak anterior/posterior knee acceleration, and peak medial knee acceleration all increased significantly from soft to stiff landings. No associations were found between landing condition and either frontal plane knee angle at maximum vertical ground reaction force or peak internal knee adduction moment. Significant positive associations between kinetics and accelerations were found only in the sagittal plane. As such, while a three-dimensional accelerometer could discern between soft and stiff landings in both planes, it may be better suited to predict kinetic risk factors in the sagittal plane.
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Affiliation(s)
- Alexander M Morgan
- Department of Kinesiology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Kristian M O'Connor
- Department of Kinesiology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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21
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Evaluation of Agreement Between Participant and Expert on Jump-Landing Characteristics During a 4-Week Intervention. J Sport Rehabil 2018; 27:536-540. [PMID: 28952862 DOI: 10.1123/jsr.2017-0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
CONTEXT Feedback is an important factor in interventions designed to reduce anterior cruciate ligament injury risk. Self-analysis feedback requires participants to self-critique their jump-landing mechanics; however, it is unknown if individuals can effectively self-analyze their own biomechanics and if this self-analysis agrees with observed biomechanical changes by an expert. OBJECTIVE To determine agreement between an expert and participants on biomechanical errors committed during 3 of 12 sessions, which were part of an intervention to change jump-landing biomechanics in healthy females. DESIGN Descriptive analysis. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Healthy recreationally active females with no history of lower-extremity fracture or surgery. INTERVENTIONS Participants completed a 4-week, 12-session feedback intervention. Each intervention session lasted approximately 15 minutes and included asking participants to perform 6 sets of 6 jumps off a 30-cm-high box placed 50% of their height away from the target landing area. Participants performed self-analysis feedback and received expert feedback on 7 different jump-landing criteria following each set of jumps. MAIN OUTCOME MEASURES Data were coded, and agreement between the expert and the participant was assessed using Cohen's unweighted kappa for sessions 1, 6, and 12. RESULTS There was agreement between the expert and participants for 0/7 criteria for session 1, 3/7 criteria for session 6, and 4/7 criteria for session 12. CONCLUSIONS Participants demonstrated some agreement with the expert when evaluating their jump-landing biomechanics. Self-analysis feedback may not replace what an expert can provide; both types of feedback may be better used in conjunction to produce significant biomechanical changes. Changes made by the participant may not translate into biomechanical changes during a real-life game or practice situation. Future research should continue to investigate effective interventions to reduce injury risk.
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22
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Armitano CN, Haegele JA, Russell DM. The Use of Augmented Information for Reducing Anterior Cruciate Ligament Injury Risk During Jump Landings: A Systematic Review. J Athl Train 2018; 53:844-859. [PMID: 30273010 DOI: 10.4085/1062-6050-320-17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT: A comprehensive systematic review of the literature on the use of augmented information in anterior cruciate ligament (ACL) injury-prevention programs to improve jump-landing technique was conducted. The use of motor-learning concepts could provide more robust means of preventing ACL injuries. OBJECTIVE: To systematically summarize the effectiveness of augmented information in improving the biomechanical factors associated with an increased risk for ACL injury. DATA SOURCES: Articles were retrieved using the electronic databases of PubMed, MEDLINE, CINAHL, and Google Scholar and 3 lines of truncated search words: (a) lower extremity, knee, ACL, and anterior cruciate ligament; (b) prevention, injury prevention, and prehab; and (c) augmented information, augmented feedback, feedback, cue, and instruction. We also performed a hand search of the reference lists of the screened articles. DATA EXTRACTION: We independently assessed the methodologic quality using the Cochrane Group on Screening and Diagnostic Test Methods list. Articles were placed in 1 of 3 augmented-information categories: prescriptive, feedback, or transition. Articles were also categorized based on whether the information likely encouraged an internal or external focus of attention. DATA SYNTHESIS: The searches identified a total of 353 studies, of which 18 were included. Most researchers found that augmented information could lead to technique changes to reduce the biomechanical risk factors associated with ACL injury. The average methodologic quality of the studies was 11.8 out of 17, with a range from 8 to 15. The authors of only 7 studies examined retention of the improved techniques. CONCLUSIONS: The evidence suggests that augmented information can be used to significantly improve the biomechanical indicators associated with ACL injury and to enhance current ACL injury-prevention programs. Combined prescriptive and feedback information that encouraged both internal and external foci led to the largest retention effect sizes.
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Affiliation(s)
- Cortney N Armitano
- School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA
| | - Daniel M Russell
- School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA
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23
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Galloway RT, Xu Y, Hewett TE, Foss KB, Kiefer AW, DiCesare CA, Magnussen RA, Khoury J, Ford KR, Diekfuss JA, Grooms D, Myer GD, Montalvo AM. Age-Dependent Patellofemoral Pain: Hip and Knee Risk Landing Profiles in Prepubescent and Postpubescent Female Athletes. Am J Sports Med 2018; 46:2761-2771. [PMID: 30091937 PMCID: PMC9709661 DOI: 10.1177/0363546518788343] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Female athletes are at an increased risk of developing patellofemoral pain (PFP) relative to male athletes. The unique effects of maturation may compound that risk. Hypothesis/Purpose: The purpose was to evaluate the neuromuscular control mechanisms that are adaptive to pubertal maturation and determine their relative contribution to PFP development. It was hypothesized that aberrant landing mechanics (reduced sagittal-plane and increased frontal- and transverse-plane kinematics and kinetics) would be associated with an increased risk for PFP. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS There were 506 high school female athletes who completed a detailed medical history, the Anterior Knee Pain Scale, and a knee examination for the diagnosis of PFP and attended follow-up appointments. Athletes performed a drop vertical jump task instrumented with force plates, and biomechanical measures generated from standard 3-dimensional biomechanical analyses were used to classify participants into high- or low-risk knee and hip landing profiles for the development of PFP. The biomechanical measures used in the knee landing profile included sagittal-plane knee range of motion, peak knee abduction angle, peak knee abduction moment, and peak-to-peak transverse-plane knee moment. The biomechanical measures used in the hip landing profile included sagittal-plane hip range of motion, peak hip extensor moment, peak abductor moment, and peak hip rotator moment. Testing was conducted at sport-specific preseason appointments over the course of 2 years, and changes in pubertal status, landing profile, and PFP development were documented. RESULTS Female athletes with high-risk hip landing profiles experienced increased hip flexion and decreased abductor, rotator, and extensor moments. Participants with high-risk hip landing profiles who transitioned to postpubertal status at follow-up had higher odds (odds ratio, 2.1 [95% CI, 1.1-4.0]; P = .02) of moving to a low-risk hip landing profile compared with those who had not reached postpubertal status at follow-up. Participants with high-risk knee landing profiles experienced decreased knee flexion and increased knee abduction, external abductor, and external rotator moments. Pubertal maturation was not associated with a change in the high-risk knee landing profile at follow-up. CONCLUSION The progression from prepubertal to postpubertal status may have a protective effect on high-risk hip mechanics but no similar adaptations in high-risk knee mechanics during maturation. These data indicate that before puberty, maladaptive hip mechanics may contribute to PFP, while aberrant knee mechanics associated with PFP are sustained throughout the maturational process in young female athletes.
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Affiliation(s)
- Ryan T. Galloway
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA,Duke University School of Medicine, Durham, North Carolina, USA
| | - Yingying Xu
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Timothy E. Hewett
- Orthopedic Biomechanics Laboratory, Mayo Clinic, Rochester, Minnesota, USA,Departments of Orthopedic Surgery, Physical Medicine & Rehabilitation, and Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Kim Barber Foss
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA,Rocky Mountain University of Health Professions, Provo, Utah, USA,Department of Allied Health, Northern Kentucky University, Highland Heights, Kentucky, USA
| | - Adam W. Kiefer
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA,Center for Cognition, Action & Perception, University of Cincinnati, Cincinnati, Ohio, USA
| | - Christopher A. DiCesare
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Robert A. Magnussen
- Department of Orthopaedics, The Ohio State University College of Medicine, Columbus, Ohio, USA,Sports Health and Performance Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Jane Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Kevin R. Ford
- Department of Physical Therapy, High Point University, High Point, North Carolina, USA
| | - Jed A. Diekfuss
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Dustin Grooms
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, Ohio, USA,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA
| | - Gregory D. Myer
- Address correspondence to Gregory D. Myer, PhD, FACSM, CSCS*D, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 10001, Cincinnati, OH 45229, USA ()
| | - Alicia M. Montalvo
- Department of Athletic Training, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, Florida, USA
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24
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Lepley AS, Kuenze CM. Hip and Knee Kinematics and Kinetics During Landing Tasks After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis. J Athl Train 2018; 53:144-159. [PMID: 29350551 DOI: 10.4085/1062-6050-334-16] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the current evidence concerning kinematic and kinetic strategies adopted during dynamic landing tasks by patients with anterior cruciate ligament reconstruction (ACLR). DATA SOURCES PubMed, Web of Science. STUDY SELECTION Original research articles that evaluated kinematics or kinetics (or both) during a landing task in those with a history of ACLR were included. DATA EXTRACTION Methodologic quality was assessed using the modified Downs and Black checklist. Means and standard deviations for knee or hip (or both) kinematics and kinetics were used to calculate Cohen d effect sizes and corresponding 95% confidence intervals between the injured limb of ACLR participants and contralateral or healthy matched limbs. Data were further stratified by landing tasks, either double- or single-limb landing. A random-effects-model meta-analysis was used to calculate pooled effect sizes and 95% confidence intervals. DATA SYNTHESIS The involved limbs of ACLR patients demonstrated clinically and significantly lower knee-extension moments during double-legged landing compared with healthy contralateral limbs and healthy control limbs (Cohen d range = -0.81 to -1.23) and decreased vertical ground reaction forces when compared with healthy controls, regardless of task (Cohen d range = -0.39 to -1.75). CONCLUSIONS During single- and double-legged landing tasks, individuals with ACLR demonstrated meaningful reductions in injured-limb knee-extension moments and vertical ground reaction forces. These findings indicate potential unloading of the injured limb after ACLR, which may have significant implications for secondary ACL injury and long-term joint health.
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25
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Benjaminse A, Postma W, Janssen I, Otten E. Video Feedback and 2-Dimensional Landing Kinematics in Elite Female Handball Players. J Athl Train 2017; 52:993-1001. [PMID: 29035582 DOI: 10.4085/1062-6050-52.10.11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT In team handball, an anterior cruciate ligament injury often occurs during landing after a jump shot. Many intervention programs try to reduce the injury rate by instructing athletes to land more safely. Video is an effective way to provide feedback, but little is known about its influence on landing technique in sport-specific situations. OBJECTIVE To test the effectiveness of a video-overlay feedback method on landing technique in elite handball players. DESIGN Controlled laboratory study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 16 elite female handball players assigned to a control group (n = 8; age = 17.61 ± 1.34 years, height = 1.73 ± 0.06 m, mass = 69.55 ± 4.29 kg) or video group (n = 8; age = 17.81 ± 0.86 years, height = 1.71 ± 0.03 m, mass = 64.28 ± 6.29 kg). INTERVENTION(S) Both groups performed jump shots in a pretest, 2 training sessions, and a posttest. The video group received video feedback of an expert model with an overlay of their own jump shots in training sessions 1 and 2, whereas the control group did not. MAIN OUTCOME MEASURE(S) We measured ankle, knee, and hip angles in the sagittal plane at initial contact and peak flexion; range of motion; and Landing Error Scoring System (LESS) scores. One 2 × 4 repeated-measures analysis of variance was conducted to analyze the group, time, and interaction effects of all kinematic outcome measures and the LESS score. RESULTS The video group improved knee and hip flexion at initial contact and peak flexion and range of motion. In addition, the group's average peak ankle flexion (12.0° at pretest to 21.8° at posttest) and LESS score (8.1 pretest to 4.0 posttest) improved. When we considered performance variables, no differences between groups were found in shot accuracy or vertical jump height, whereas horizontal jump distance in the video group increased over time. CONCLUSIONS Overlay visual feedback is an effective method for improving landing kinematics during a sport-specific jump shot. Further research is warranted to determine the long-term effects and transfer to training and game situations.
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Affiliation(s)
- Anne Benjaminse
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, the Netherlands.,School of Sport Studies, Hanze University Groningen, the Netherlands
| | - Wytze Postma
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Ina Janssen
- Sports Science and Innovation, Netherlands Olympic Committee, Netherlands Sports Confederation, Arnhem
| | - Egbert Otten
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, the Netherlands
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