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Hosseini H, Heydari S, Raesi R, Hushmandi K, Payande A, Gholami A, Daneshi S. Comparison of spring ankle braces versus splints and casts in treating ankle sprains in patients diagnosed with ankle sprains. BMC Musculoskelet Disord 2024; 25:786. [PMID: 39367359 PMCID: PMC11451001 DOI: 10.1186/s12891-024-07901-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/23/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Various treatment approaches for individuals with ankle sprains can reduce treatment costs and enhance recovery. This study aimed to compare the efficacy of spring ankle braces with splints and casts in treating ankle sprains. MATERIALS AND METHODS This cross-sectional study involved 60 patients diagnosed with ankle sprains at the orthopedic clinic of Imam Khomeini Hospital in Jiroft in 2022. Following diagnosis confirmation through additional examinations and imaging, patients with ankle sprains not requiring surgery were selected and placed in two groups: one treated with spring ankle braces and the other with splints or casts. Both groups underwent a 4-week treatment regimen, comprising 30 individuals each. Data were collected and analyzed using SPSS version 26. RESULTS The average age of patients was 32.5 ± 13.4 years. Of the ankle sprain patients, 56.7% were male. Patients reported the highest satisfaction levels with the plaster cast treatment method. A statistically significant relationship was found between patient satisfaction and the treatment methods of spring ankle braces and plaster casting (P < 0.05). Patients treated with plaster casts reported the lowest pain levels, with a significant relationship between pain levels and the two treatment methods (P < 0.05). Range of motion results were similar for both treatment methods, while the cast treatment showed the highest incidence of skin complications. A significant relationship was observed between spring ankle braces and plaster casts regarding skin complications (P < 0.05). CONCLUSION Treating ankle sprains with plaster casts leads to higher satisfaction and lower pain levels compared to using spring ankle braces.
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Affiliation(s)
- Hasan Hosseini
- Department of Orthopedics, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sina Heydari
- School of Medicine, Imam Khomeini Hospital, Jiroft University of Medical Science, Jiroft, Iran
| | - Rasoul Raesi
- Department of Nursing, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
- Department of Health Services Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiavash Hushmandi
- Nephrology and Urology Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amirhossein Payande
- School of Medicine, Imam Khomeini Hospital, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Akram Gholami
- Department of Nursing, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Salman Daneshi
- Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran.
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2
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Bolt R, Heuvelmans P, Benjaminse A, Robinson MA, Gokeler A. An ecological dynamics approach to ACL injury risk research: a current opinion. Sports Biomech 2024; 23:1592-1605. [PMID: 34375159 DOI: 10.1080/14763141.2021.1960419] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/21/2021] [Indexed: 01/13/2023]
Abstract
Research of non-contact anterior cruciate ligament (ACL) injury risk aims to identify modifiable risk factors that are linked to the mechanisms of injury. Information from these studies is then used in the development of injury prevention programmes. However, ACL injury risk research often leans towards methods with three limitations: 1) a poor preservation of the athlete-environment relationship that limits the generalisability of results, 2) the use of a strictly biomechanical approach to injury causation that is incomplete for the description of injury mechanisms, 3) and a reductionist analysis that neglects profound information regarding human movement. This current opinion proposes three principles from an ecological dynamics perspective that address these limitations. First, it is argued that, to improve the generalisability of findings, research requires a well-preserved athlete-environment relationship. Second, the merit of including behaviour and the playing situation in the model of injury causation is presented. Third, this paper advocates that research benefits from conducting non-reductionist analysis (i.e., more holistic) that provides profound information regarding human movement. Together, these principles facilitate an ecological dynamics approach to injury risk research that helps to expand our understanding of injury mechanisms and thus contributes to the development of preventative measures.
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Affiliation(s)
- Ruben Bolt
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Pieter Heuvelmans
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anne Benjaminse
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- School of Sport Studies, Hanze University Groningen, Groningen, The Netherlands
| | - Mark A Robinson
- Research Institute for Sport and Exercise Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - Alli Gokeler
- Exercise Science and Neuroscience Unit, Department Exercise & Health, Paderborn University, Paderborn, Germany
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam, The Netherlands
- Department of Sports Medicine, OCON Centre of Orthopaedic Surgery and Sports Medicine, Hengelo, The Netherlands
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Ino T, Samukawa M, Ishida T, Wada N, Koshino Y, Kasahara S, Tohyama H. Validity and Reliability of OpenPose-Based Motion Analysis in Measuring Knee Valgus during Drop Vertical Jump Test. J Sports Sci Med 2024; 23:515-525. [PMID: 39228769 PMCID: PMC11366844 DOI: 10.52082/jssm.2024.515] [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: 07/03/2023] [Accepted: 06/14/2024] [Indexed: 09/05/2024]
Abstract
OpenPose-based motion analysis (OpenPose-MA), utilizing deep learning methods, has emerged as a compelling technique for estimating human motion. It addresses the drawbacks associated with conventional three-dimensional motion analysis (3D-MA) and human visual detection-based motion analysis (Human-MA), including costly equipment, time-consuming analysis, and restricted experimental settings. This study aims to assess the precision of OpenPose-MA in comparison to Human-MA, using 3D-MA as the reference standard. The study involved a cohort of 21 young and healthy adults. OpenPose-MA employed the OpenPose algorithm, a deep learning-based open-source two-dimensional (2D) pose estimation method. Human-MA was conducted by a skilled physiotherapist. The knee valgus angle during a drop vertical jump task was computed by OpenPose-MA and Human-MA using the same frontal-plane video image, with 3D-MA serving as the reference standard. Various metrics were utilized to assess the reproducibility, accuracy and similarity of the knee valgus angle between the different methods, including the intraclass correlation coefficient (ICC) (1, 3), mean absolute error (MAE), coefficient of multiple correlation (CMC) for waveform pattern similarity, and Pearson's correlation coefficients (OpenPose-MA vs. 3D-MA, Human-MA vs. 3D-MA). Unpaired t-tests were conducted to compare MAEs and CMCs between OpenPose-MA and Human-MA. The ICCs (1,3) for OpenPose-MA, Human-MA, and 3D-MA demonstrated excellent reproducibility in the DVJ trial. No significant difference between OpenPose-MA and Human-MA was observed in terms of the MAEs (OpenPose: 2.4° [95%CI: 1.9-3.0°], Human: 3.2° [95%CI: 2.1-4.4°]) or CMCs (OpenPose: 0.83 [range: 0.99-0.53], Human: 0.87 [range: 0.24-0.98]) of knee valgus angles. The Pearson's correlation coefficients of OpenPose-MA and Human-MA relative to that of 3D-MA were 0.97 and 0.98, respectively. This study demonstrated that OpenPose-MA achieved satisfactory reproducibility, accuracy and exhibited waveform similarity comparable to 3D-MA, similar to Human-MA. Both OpenPose-MA and Human-MA showed a strong correlation with 3D-MA in terms of knee valgus angle excursion.
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Affiliation(s)
- Takumi Ino
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
- Department of Physical Therapy, Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Naofumi Wada
- Department of Information and Computer Science, Faculty of Engineering, Hokkaido University of Science, Sapporo, Japan
| | - Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Kong PW, Tang Y, Lam WK. Biomechanics of step-off drop landings are affected by limb dominance and lead limb in task initiation. J Sports Sci 2024; 42:1147-1156. [PMID: 39087569 DOI: 10.1080/02640414.2024.2386211] [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: 01/11/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
This study examines the effects of limb dominance and lead limb in task initiation on the kinetics and kinematics of step-off drop landings. Nineteen male participants performed drop landings led by the dominant and non-dominant limbs at 45-cm and 60-cm drop heights. Ground reaction force (GRF) and lower body kinematic data were collected. Between-limb time differences at the initial ground contact were calculated to indicate temporal asymmetry. Statistical Parametric Mapping (SPM) was applied for waveform analysis while two-way repeated measures ANOVA was used for discrete parameters. SPM results revealed greater GRF and lesser ankle dorsiflexion in the lead limb compared to the trail limb in 3 out of 4 landing conditions. The dominant limb displayed a greater forefoot loading rate (45 cm: p=.009, ηp2 = 0.438; 60 cm: p=.035, ηp2 = 0.225) and greater ankle joint quasi-stiffness (45 cm: p < .001, ηp2 = 0.360; 60 cm: p < .001, ηp2 = 0.597) than the non-dominant limb. Not all 380 trials were lead-limb first landings, with a smaller between-limb time difference (p=.009, d = 0.60) at 60 cm (4.1 ± 2.3 ms) than 45 cm (5.6 ± 2.7 ms). In conclusion, the step-off drop landing is not an ideal protocol for examining bilateral asymmetry in lower limb biomechanics due to potential biases introduced by limb dominance and the step-off limb.
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Affiliation(s)
- Pui Wah Kong
- Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore
| | - Yunqi Tang
- College of Art and Design, Shaanxi University of Science and Technology, Xi'an, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institutes, Hong Kong, China
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5
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Ulman S, Loewen AM, Erdman AL, Õunpuu S, Chafetz R, Tulchin-Francis K, Wren TAL. Lower-extremity kinematics and kinetics differ based on drop vertical jump variation: An assessment of methodology for a return-to-play protocol using motion analysis. Gait Posture 2024; 108:132-138. [PMID: 38042067 DOI: 10.1016/j.gaitpost.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/07/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND The drop vertical jump (DVJ) is commonly used in return-to-play evaluations to assess movement quality and risk during a dynamic task. However, across biomechanics literature, a multitude of DVJ variations have been used, influencing the generalizability and potential interpretation of the reported findings. RESEARCH QUESTION The purpose of this study was to identify differences in lower extremity kinematics and kinetics between DVJ variations that differ based on horizontal jump distance, verbal instructions, and the use of a jump target. METHODS A single-group repeated measures design was used in a laboratory setting. Twenty participants were tested, and three-dimensional angles and moments of the pelvis, hip, knee, and ankle were computed. Wilcoxon signed rank tests were performed to determine differences between DVJ variations. RESULTS Reduced knee flexion at initial contact and greater knee extensor moments across the descent phase were observed with increased horizontal jump distance. Additionally, both verbal instructions and a jump target influenced movement strategies at the pelvis, hip, and knee. Ground reaction forces were found to be similar across conditions and jump height following the first landing increased with a target. SIGNIFICANCE Although subtle, the biomechanical differences observed between task variations emphasize the importance of standardizing motion analysis protocols for research and clinical decision-making. Given the findings of the current study, the authors recommend using the Half Height variation in patients treated for a knee injury as it will likely be the most indicative of movement quality.
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Affiliation(s)
| | | | | | - Sylvia Õunpuu
- Connecticut Children's Medical Center, Farmington, CT, USA
| | - Ross Chafetz
- Shriners Hospitals for Children - Philadelphia, Philadelphia, PA, USA
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6
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Dennis JD, Choe KH, Montgomery MM, Lynn SK, Crews BM, Pamukoff DN. Lower extremity and trunk sagittal plane coordination strategies and kinetic distribution during landing in males and females. J Sports Sci 2024; 42:169-178. [PMID: 38423997 DOI: 10.1080/02640414.2024.2323857] [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: 10/10/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
Force attenuation during landing requires coordinated motion of the ankle, knee, hip, and trunk, and strategies may differ between sexes. Sagittal plane coordination of the ankle/knee, knee/hip, and knee/trunk, and lower extremity and trunk kinematics and kinetics was compared throughout landing between 28 males and 28 females. Coordination was assessed with a modified vector coding technique and binning analysis. Total support moments (TSM), each joint's percent contribution, and timing of the TSM were compared. Females landed with less isolated knee flexion in the ankle/knee, knee/hip, and knee/trunk couplings, but more simultaneous ankle/knee flexion, less simultaneous knee flexion/hip extension, and more simultaneous trunk/knee flexion. Females landed with larger plantarflexion angles from 0-16% and smaller trunk flexion angles from 0-78%. In females, absolute TSM were larger from 0-6% and smaller from 42-100%, and normalized TSM were larger from 0-8% and 26-42%. Females had greater ankle contribution to the TSM from 14-15% and 29-35%, smaller absolute peak TSM, and the peak TSM occurred earlier. Females compensated for less isolated knee flexion with greater simultaneous ankle/knee flexion early in landing and knee/trunk flexion later in landing. Coordination and TSM differences may influence force attenuation strategies and have implications for knee injury disparity between sexes.
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Affiliation(s)
- Justin D Dennis
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - Kevin H Choe
- Department of Kinesiology, California State University, Fullerton, CA, USA
- Department of Kinesiology, Whittier College, Whittier, CA, USA
| | | | - Scott K Lynn
- Department of Kinesiology, California State University, Fullerton, CA, USA
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7
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Dewig DR, Boltz AJ, Moffit RE, Rao N, Collins CL, Chandran A. Epidemiology of Anterior Cruciate Ligament Tears in National Collegiate Athletic Association Athletes: 2014/2015-2018/2019. Med Sci Sports Exerc 2024; 56:29-36. [PMID: 37616175 DOI: 10.1249/mss.0000000000003281] [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: 08/26/2023]
Abstract
PURPOSE This study aimed to describe the epidemiology of ACL tears in NCAA men's and women's sports. METHODS Injury and exposure data collected within the NCAA Injury Surveillance Program from 2014/2015 to 2018/2019 were analyzed. ACL tear frequencies, injury rates (IR), and injury proportions were used to describe injury incidence by sport, event type, injury mechanism, and injury history. Injury rate ratios (IRR) were used to examine differential injury rates, and injury proportion ratios (IPR) were used to examine differential distributions. RESULTS A total of 729 ACL tears were reported from 8,474,401 recorded athlete exposures (AE) during the study period (IR = 0.86 per 10,000 AE), and the competition-related ACL tear rate was higher than the practice-related rate (IRR = 5.52, 95% confidence interval [CI] = 4.75-6.39). Among men's sports, the highest overall ACL tear rate was observed in men's football (IR = 1.44 per 10,000 AE), whereas among women's sports, the highest overall rate was observed in women's soccer (IR = 2.60 per 10,000 AE). Among sex-comparable sports, ACL tear rates were higher in women's basketball, softball, and soccer, as compared with their men's counterparts. ACL tears were more prevalently attributed to player contact mechanisms in men's sports than women's sports (IPR = 1.73, 95% CI = 1.37-2.19), but more prevalently attributed to noncontact mechanisms in women's sports than men's sports (IPR = 1.17, 95% CI = 1.01-1.35). CONCLUSIONS ACL tear risk in women's sports continues to warrant attention and prevention efforts. Given the differential rates by event type, future research efforts may also evaluate initiatives to reduce competition-related injury burden in NCAA sports.
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Affiliation(s)
- Derek R Dewig
- College of Education, Health and Human Performance, Fairmont State University, Fairmont WV
| | | | - Reagan E Moffit
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Neel Rao
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
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Amerian Z, ShahAli S, Rezaeian ZS, Shanbehzadeh S. Dynamic postural control in women athletes with and without nonspecific low back pain with high and low pain-related anxiety- A case-control study. BMC Sports Sci Med Rehabil 2023; 15:149. [PMID: 37936206 PMCID: PMC10631043 DOI: 10.1186/s13102-023-00764-7] [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: 10/03/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Low back pain is common among athletes and it has been shown that postural control is altered in the general population with nonspecific low back pain (NSLBP). Psychological factors may also predispose individuals to risk of altered postural control. Dynamic postural control is essential to the performance of athletes. This study aimed to compare the dynamic postural control between women athletes with and without NSLBP with high and low pain-related anxiety. METHODS Forty-five female athletes (15 NSLBP with high pain-related anxiety, 15 NSLBP with low pain-related anxiety, and 15 healthy (control)) were included. Pain-related anxiety was assessed using the Pain Anxiety Symptom Scale-20 (PASS-20). Based on the cut-off score of 30 for the total score of PASS-20, NSLBP patients were classified into two groups of low and high pain-related anxiety. Participants performed double-leg vertical drop jump (DVJ) and single-leg vertical jump (SVJ) tests on a Kistler force plate (type 9260AA6, Kistler Instruments Inc, Switzerland). The total root mean square (RMS) of the center of pressure (COP), COP displacement in the anteroposterior (AP), and mediolateral (ML) directions, COP mean velocity, and time to stabilization (TTS) in vertical, AP, and total directions were extracted from COP and ground reaction force data using MATLAB software. One-way Analysis of variance (ANOVA) and Welch's ANOVA were employed to compare the groups. In case of significant findings, post hoc tests were performed. RESULTS The results showed that during DJV, athletes with high pain-related anxiety had significantly greater TTS in all total, AP, and ML directions than other groups (P < 0.05). Also, the control group showed greater total RMS distance during DJV than either NSLBP group. However, no significant differences in TTS and COP parameters were found between the groups during SVJ (P > 0.05). CONCLUSIONS The findings suggest that pain-related anxiety may contribute to athletes' postural control strategies. Therefore, it is important to consider the level of pain-related anxiety during planning postural control exercises for women athletes with NSLBP.
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Affiliation(s)
- Zahra Amerian
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam ShahAli
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Zahra Sadat Rezaeian
- Musculoskeletal Research Center, Rehabilitation Research Institute and Department of Physical Therapy, Faculty of Rehabilitation Sciences,, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sanaz Shanbehzadeh
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Feigel ED, Bird MB, Koltun KJ, Lovalekar M, Mi Q, Martin BJ, Forse JN, Steele EJ, Bannister A, Cruz AV, Burns I, Fain A, Doyle TLA, Nindl BC. Association of clinically-measured and dynamic ankle dorsiflexion assessed by markerless motion capture during the drop-jump task on landing biomechanics and risk of ankle injury in military personnel undergoing 10 weeks of physical training. J Sci Med Sport 2023; 26:476-481. [PMID: 37574406 DOI: 10.1016/j.jsams.2023.07.012] [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: 12/06/2022] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES Determine the influence of clinically-measured maximum dorsiflexion, dynamic peak dorsiflexion and percent of clinically-measured maximum dorsiflexion used during a drop-jump task on landing biomechanics and risk of ankle injury in military personnel. DESIGN Prospective cohort study. METHODS 672 participants (122 women) enrolled. The weightbearing lunge test assessed clinically-measured maximum dorsiflexion averaged across limbs (degrees). Markerless motion capture and force plates collected lower extremity kinematic and kinetic data during a drop-jump task. Percent of clinically-measured maximum dorsiflexion used during landing was calculated as dynamic peak dorsiflexion divided by clinically-measured value, multiplied by 100 (%). De-identified injury data was derived from military physical therapists. Simple linear regression analysis determined the association between dorsiflexion measures and landing biomechanics. Simple binary logistic regression analyses identified predictors of ankle injuries. Statistical significance was set at α = 0.05. RESULTS Eighteen participants sustained a traumatic ankle injury from a landing. All measures of dorsiflexion were associated with movement patterns that countered the stiff-legged landing strategy with dynamic measures showing a higher predictive value. Protective factors against ankle injury included height (odds ratio: 0.818, p = 0.006) and weight (odds ratio: 0.824, p = 0.023) for women. Relative braking impulse was a risk factor for men (odds ratio: 1.890, p = 0.001). CONCLUSIONS Greater clinically-measured and dynamic measures of dorsiflexion were associated with movement patterns that countered the stiff-legged landing strategy but neither measure of dorsiflexion predicted ankle injury risk. Resultant biomechanics and anthropometrics influenced ankle injury risk to warrant recognition for injury prevention initiatives.
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Affiliation(s)
- Evan D Feigel
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States.
| | - Matthew B Bird
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Kristen J Koltun
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Mita Lovalekar
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Qi Mi
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Brian J Martin
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Jennifer N Forse
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Elizabeth J Steele
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | | | | | - Ian Burns
- Marine Corps Base Quantico, United States
| | - AuraLea Fain
- Biomechanics, Physical Performance, and Exercise (BioPPEx) Research Group, Macquarie University, Australia; Faculty of Medicine, Health, and Human Sciences, Macquarie University, Australia
| | - Tim L A Doyle
- Biomechanics, Physical Performance, and Exercise (BioPPEx) Research Group, Macquarie University, Australia; Faculty of Medicine, Health, and Human Sciences, Macquarie University, Australia
| | - Bradley C Nindl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
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Louder T, Thompson BJ, Woster A, Bressel E. Kinetics of Depth Jumps Performed by Female and Male National Collegiate Athletics Association Basketball Athletes and Young Adults. J Funct Morphol Kinesiol 2023; 8:108. [PMID: 37606403 PMCID: PMC10443298 DOI: 10.3390/jfmk8030108] [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: 04/07/2023] [Revised: 06/07/2023] [Accepted: 07/27/2023] [Indexed: 08/23/2023] Open
Abstract
The depth jump (DJ) is commonly used to evaluate athletic ability, and has further application in rehabilitation and injury prevention. There is limited research exploring sex-based differences in DJ ground reaction force (GRF) measures. This study aimed to evaluate for sex-based differences in DJ GRF measures and determine sample size thresholds for binary classification of sex. Forty-seven participants from mixed-sex samples of NCAA athletes and young adults performed DJs from various drop heights. Force platform dynamometry and 2-dimensional videography were used to estimate GRF measures. Three-way mixed analysis of variance was used to evaluate main effects and interactions. Receiver operating characteristic (ROC) curve analysis was used to evaluate the combined sensitivity and specificity of dependent measures to sex. Results revealed that reactive strength index scores and rebound jump heights were greater in males than females (p < 0.001). Additionally, young adult females showed greater peak force reduction than young adult males (p = 0.002). ROC curve analysis revealed mixed results that appeared to be influenced by population characteristics and drop height. In conclusion, sex-based differences in DJ performance were observed, and the results of this study provide direction for future DJ investigations.
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Affiliation(s)
- Talin Louder
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (B.J.T.); (E.B.)
- Dennis G. Dolny Movement Research Clinic, Sorenson Legacy Foundation Center for Clinical Excellence, Utah State University, Logan, UT 84322, USA
| | - Brennan J. Thompson
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (B.J.T.); (E.B.)
- Dennis G. Dolny Movement Research Clinic, Sorenson Legacy Foundation Center for Clinical Excellence, Utah State University, Logan, UT 84322, USA
| | - Alex Woster
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (B.J.T.); (E.B.)
| | - Eadric Bressel
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (B.J.T.); (E.B.)
- Dennis G. Dolny Movement Research Clinic, Sorenson Legacy Foundation Center for Clinical Excellence, Utah State University, Logan, UT 84322, USA
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11
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Dennis JD, Choe KH, Montgomery MM, Lynn SK, Crews BM, Pamukoff DN. Lower extremity coordination strategies to mitigate dynamic knee valgus during landing in males and females. J Biomech 2023; 156:111689. [PMID: 37364395 DOI: 10.1016/j.jbiomech.2023.111689] [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: 11/22/2022] [Revised: 05/23/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
Frontal and sagittal plane landing biomechanics differ between sexes but reported values don't account for simultaneous segment or joint motion necessary for a coordinated landing. Frontal and sagittal plane coordination patterns, angles, and moments were compared between 28 males and 28 females throughout the landing phase of a drop vertical jump. Females landed with less isolated thigh abduction (p = 0.018), more in-phase motion (p < 0.001), and more isolated shank adduction (p = 0.028) between the thigh and shank in the frontal plane compared with males. Females landed with less in-phase (p = 0.012) and more anti-phase motion (p = 0.019) between the thigh and shank in the sagittal plane compared with males. Females landed with less isolated knee flexion (p = 0.001) and more anti-phase motion (p < 0.001) between the sagittal and frontal plane knee coupling compared with males. Waveform and discrete metric analyses revealed females land with less thigh abduction from 20 % to 100 % and more shank abduction from 0 to 100 % of landing, smaller knee adduction at initial contact (p = 0.002), greater peak knee abduction angles (p = 0.015), smaller knee flexion angles at initial contact (p = 0.035) and peak (p = 0.034), greater peak knee abduction moments (p = 0.024), greater knee abduction angles from 0 to 13 % and 19 to 30 %, greater knee abduction moments from 19 to 25 %, and smaller knee flexion moments from 3 to 5 % of landing compared with males. Females utilize greater frontal plane motion compared with males, which may be due to different inter-segmental joint coordination and smaller sagittal plane angles. Larger knee abduction angles and greater knee adduction motion in females are due to aberrant shank abduction rather than thigh adduction.
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Affiliation(s)
- Justin D Dennis
- Department of Kinesiology, California State University, Fullerton, CA, United States; Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Kevin H Choe
- Department of Kinesiology, California State University, Fullerton, CA, United States; Department of Kinesiology, Whittier College, Whittier, CA, United States
| | - Melissa M Montgomery
- Department of Kinesiology, California State University, Fullerton, CA, United States
| | - Scott K Lynn
- Department of Kinesiology, California State University, Fullerton, CA, United States
| | - Brock M Crews
- Department of Kinesiology, California State University, Fullerton, CA, United States; Sanford Sports, Sanford Health, Irvine, CA, United States
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12
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Chijimatsu M, Ishida T, Yamanaka M, Taniguchi S, Ueno R, Ikuta R, Samukawa M, Ino T, Kasahara S, Tohyama H. Subsequent Jumping Increases the Knee and Hip Abduction Moment, Trunk Lateral Tilt, and Trunk Rotation Motion During Single-Leg Landing in Female Individuals. J Appl Biomech 2023:1-7. [PMID: 37225171 DOI: 10.1123/jab.2022-0305] [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: 12/08/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/26/2023]
Abstract
Single-leg landings with or without subsequent jumping are frequently used to evaluate landing biomechanics. The purpose of this study was to investigate the effects of subsequent jumping on the external knee abduction moment and trunk and hip biomechanics during single-leg landing. Thirty young adult female participants performed a single-leg drop vertical jumping (SDVJ; landing with subsequent jumping) and single-leg drop landing (SDL; landing without subsequent jumping). Trunk, hip, and knee biomechanics were evaluated using a 3-dimensional motion analysis system. The peak knee abduction moment was significantly larger during SDVJ than during SDL (SDVJ 0.08 [0.10] N·m·kg-1·m-1, SDL 0.05 [0.10] N·m·kg-1·m-1, P = .002). The trunk lateral tilt and rotation angles toward the support-leg side and external hip abduction moment were significantly larger during SDVJ than during SDL (P < .05). The difference in the peak hip abduction moment between SDVJ and SDL predicted the difference in the peak knee abduction moment (P = .003, R2 = .252). Landing tasks with subsequent jumping would have advantages for evaluating trunk and hip control as well as knee abduction moment. In particular, evaluating hip abduction moment may be important because of its association with the knee abduction moment.
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Affiliation(s)
- Masato Chijimatsu
- Faculty of Health Sciences, Hokkaido University, Sapporo,Japan
- Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, Hirosaki,Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Sapporo,Japan
| | - Masanori Yamanaka
- Faculty of Health Sciences, Hokkaido Chitose College of Rehabilitation, Chitose,Japan
| | | | - Ryo Ueno
- Faculty of Health Sciences, Hokkaido University, Sapporo,Japan
| | - Ryohei Ikuta
- Hachioji Sports Orthopedic Clinic, Hachioji,Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo,Japan
| | - Takumi Ino
- Faculty of Health Sciences, Hokkaido University of Science, Sapporo,Japan
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13
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Prelanding Knee Kinematics and Landing Kinetics During Single-Leg and Double-Leg Landings in Male and Female Recreational Athletes. J Appl Biomech 2023; 39:34-41. [PMID: 36649716 DOI: 10.1123/jab.2022-0147] [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: 06/02/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 01/19/2023]
Abstract
Biomechanical behavior prior to landing likely contributes to anterior cruciate ligament (ACL) injuries during jump-landing tasks. This study examined prelanding knee kinematics and landing ground reaction forces (GRFs) during single-leg and double-leg landings in males and females. Participants performed landings with the dominant leg or both legs while kinematic and GRF data were collected. Single-leg landings demonstrated less time between prelanding minimal knee flexion and initial ground contact, decreased prelanding and early-landing knee flexion angles and velocities, and increased peak vertical and posterior GRFs compared with double-leg landings. Increased prelanding knee flexion velocities and knee flexion excursion correlated with decreased peak posterior GRFs during both double-leg and single-leg landings. No significant differences were observed between males and females. Prelanding knee kinematics may contribute to the increased risk of ACL injuries in single-leg landings compared with double-leg landings. Future studies are encouraged to incorporate prelanding knee mechanics to understand ACL injury mechanisms and predict future ACL injury risks. Studies of the feasibility of increasing prelanding knee flexion are needed to understand the potential role of prelanding kinematics in decreasing ACL injury risk.
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14
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Positive influence of neuromuscular training on knee injury risk factors during cutting and landing tasks in elite youth female handball players. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00851-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractAnterior cruciate ligament (ACL) ruptures are frequent in the age group of 15–19 years, particularly for female athletes. Although injury-prevention programs effectively reduce severe knee injuries, little is known about the underlying mechanisms and changes of biomechanical risk factors. Thus, this study analyzes the effects of a neuromuscular injury-prevention program on biomechanical parameters associated with ACL injuries in elite youth female handball players. In a nonrandomized, controlled intervention study, 19 players allocated to control (n = 12) and intervention (n = 7) group were investigated for single- and double-leg landings as well as unanticipated side-cutting maneuvers before and after a 12-week study period. The lower-extremity motion of the athletes was captured using a three-dimensional motion capture system consisting of 12 infrared cameras. A lower-body marker set of 40 markers together with a rigid body model, including a forefoot, rearfoot, shank, thigh, and pelvis segment in combination with two force plates was used to determine knee joint angles, resultant external joint moments, and vertical ground reaction forces. The two groups did not differ significantly during pretesting. Only the intervention group showed significant improvements in the initial knee abduction angle during single leg landing (p = 0.038: d = 0.518), knee flexion moment during double-leg landings (p = 0.011; d = −1.086), knee abduction moment during single (p = 0.036; d = 0.585) and double-leg landing (p = 0.006; d = 0.944) and side-cutting (p = 0.015;d = 0.561) as well as vertical ground reaction force during double-leg landing (p = 0.004; d = 1.482). Control group demonstrated no significant changes in kinematics and kinetics. However, at postintervention both groups were not significantly different in any of the biomechanical outcomes except for the normalized knee flexion moment of the dominant leg during single-leg landing. This study provides first indications that the implementation of a training intervention with specific neuromuscular exercises has positive impacts on biomechanical risk factors associated with ACL injury risk and, therefore, may help prevent severe knee injuries in elite youth female handball players.
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15
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Xiao M, Lemos JL, Hwang CE, Sherman SL, Safran MR, Abrams GD. Increased Risk of ACL Injury for Female but Not Male Soccer Players on Artificial Turf Versus Natural Grass: A Systematic Review and Meta-Analysis. Orthop J Sports Med 2022; 10:23259671221114353. [PMID: 35990873 PMCID: PMC9382072 DOI: 10.1177/23259671221114353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Both natural grass (NG) and artificial turf (AT) are popular playing surfaces
for soccer. Biomechanical studies have found increased frictional forces on
AT that may lead to anterior cruciate ligament (ACL) injury. The increased
risk of ACL injury during soccer in female participants may amplify this
effect. Purpose: To systematically review the literature for studies comparing ACL injury risk
in soccer players on AT versus NG and to specifically determine whether
there were differences in injury risk in male versus female players when
considering the playing surface. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed using PRISMA (Preferred Reporting Items for
Systematic Reviews and Meta-Analyses) guidelines. Three databases were
searched for studies with evidence level 1 to 3 that compared the incidence
of ACL injuries on AT versus NG in soccer players. Data recorded included
study characteristics, sex, competition level, exposure setting (games or
practices), turf type, and ACL injury information. Study methodological
quality was analyzed using the methodological index for non-randomized
studies (MINORS) score, and incidence rate ratios (IRRs) were
calculated. Results: Included were 7 articles (3 studying professional soccer, 3 collegiate
soccer, 1 youth-level soccer; 4 male cohorts, 2 female cohorts, and 1 male
and female cohort; mean MINORS score, 20 ± 0.8). Pooled ACL injury IRRs
demonstrated no significant differences in overall ACL injury risk when
playing soccer on AT compared with NG (IRR = 0.57 [95% CI, 0.21-1.53];
P = .31). A significantly increased risk of ACL injury
in games played on AT compared with NG was detected for female (IRR = 1.18
[95% CI, 1.05-1.31]; P = .004) but not for male players
(IRR = 1.18 [95% CI, 0.97-1.42]; P = .09). Subgroup
analyses showed no significant differences in injury risk for games (IRR =
1.07 [95% CI, 0.97-1.18]; P = .20) or practices (IRR = 0.21
[95% CI, 0.04-1.23]; P = .09). Conclusion: Findings indicated that female soccer players had a significantly higher risk
of ACL injury when playing games on AT versus NG, whereas no significant
difference was seen in male players. No differences were found for the
combined male/female cohort or for soccer games or training sessions played
on AT compared with NG.
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Affiliation(s)
- Michelle Xiao
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Jacie L Lemos
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Calvin E Hwang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Seth L Sherman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Marc R Safran
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Geoffrey D Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
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16
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Sole G, Lamb P, Pataky T, Pathak A, Klima S, Navarre P, Hammer N. Immediate and six-week effects of wearing a knee sleeve following anterior cruciate ligament reconstruction on knee kinematics and kinetics: a cross-over laboratory and randomised clinical trial. BMC Musculoskelet Disord 2022; 23:560. [PMID: 35689284 PMCID: PMC9186011 DOI: 10.1186/s12891-022-05488-2] [Citation(s) in RCA: 2] [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: 02/04/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Elastic knee sleeves are often worn following anterior cruciate ligament reconstruction (ACLR) but their effects on movement patterns are unclear. AIM To determine the immediate and six-week effects of wearing a knee sleeve on biomechanics of the knee during a step-down hop task. METHODS Using a cross-over design, we estimated sagittal plane knee kinematics and kinetics and stance duration during a step-down hop for 31 participants (age 26.0 [SD 6.6] years, 15 women) after ACLR (median 16 months post-surgery) with and without wearing a knee sleeve. In a subsequent randomised clinical trial, participants in the 'Sleeve Group' (n = 9) then wore the sleeve for 6 weeks at least 1 h daily, while a 'Control Group' (n = 9) did not wear the sleeve. We used statistical parametric mapping to compare (1) knee flexion/extension angle and external flexion/extension moment trajectories between three conditions at baseline (uninjured side, unsleeved injured side and sleeved injured side); (2) within-participant changes for knee flexion angles and external flexion/extension moment trajectories from baseline to follow-up between groups. We compared discrete flexion angles and moments, and stance duration between conditions and between groups. RESULTS Without sleeves, knee flexion was lower for the injured than the uninjured sides during mid-stance phase. When wearing the sleeve on the injured side, knee flexion increased during the loading phase of the stance phase. Discrete initial and peak knee flexion angles increased by (mean difference, 95% CIs) 2.7° (1.3, 4.1) and 3.0° (1.2, 4.9), respectively, when wearing the knee sleeve. Knee external flexion moments for the unsleeved injured sides were lower than the uninjured sides for 80% of stance phase, with no change when sleeved. The groups differenced for within-group changes in knee flexion trajectories at follow-up. Knee flexion angles increased for the Control group only. Stance duration decreased by 22% for the Sleeve group from baseline to follow-up (-89 ms; -153, -24) but not for the Controls. CONCLUSIONS Application of knee sleeves following ACLR is associated with improved knee flexion angles during hop landing training. Longer term (daily) knee sleeve application may help improve hop stance duration, potentially indicating improved hop performance. TRIAL REGISTRATION The trial was prospectively registered with the Australia New Zealand Clinical Trials Registry No: ACTRN12618001083280, 28/06/2018. ANZCTR.
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Affiliation(s)
- Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Peter Lamb
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Todd Pataky
- Graduate School of Medicine, Department of Human Health Sciences, Kyoto University, Kyoto, Japan
| | - Anupa Pathak
- School of Public Health, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | | | - Pierre Navarre
- Southland Hospital, Invercargill, New Zealand and Clinical Senior Lecturer, University of Otago, Dunedin, New Zealand
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
- Department of Orthopaedic and Trauma Surgery, University of Leipzig, Leipzig, Germany
- Fraunhofer IWU, Medical Branch, Dresden, Germany
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17
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Hogg JA, Avedesian JM, Diekfuss JA, Acocello SN, Shimmin RD, Kelley EA, Kostrub DA, Myer GD, Wilkerson GB. Sex Moderates the Relationship between Perceptual-Motor Function and Single-Leg Squatting Mechanics. J Sports Sci Med 2022; 21:104-111. [PMID: 35250339 PMCID: PMC8851119 DOI: 10.52082/jssm.2022.104] [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: 11/25/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
To examine the isolated and combined effects of sex and perceptual-motor function on single-leg squatting mechanics in males and females. We employed a cross-sectional design in a research laboratory. Fifty-eight females (22.2 ± 3.5 yrs, 1.60 ± .07 m, 64.1 ± 13.0 kg) and 35 males (23.5 ± 5.0 yrs, 1.80 ± .06m, 84.7 ± 15.3 kg) free from time-loss injury in the six months prior, vertigo, and vestibular conditions participated in this study. Independent variables were sex, perceptual-motor metrics (reaction time, efficiency index, conflict discrepancy), and interaction effects. Dependent variables were peak frontal plane angles of knee projection, ipsilateral trunk flexion, and contralateral pelvic drop during single-leg squatting. After accounting for the sex-specific variance and perceptual-motor function effects on frontal plane squatting kinematics, female sex amplified the associations of: higher reaction time, lower efficiency index, and higher conflict discrepancy with greater right ipsilateral peak trunk lean (R2 = .13; p = .05); higher reaction time, lower efficiency index, and higher conflict discrepancy with decreased right contralateral pelvic drop (R2 = .22; p < .001); higher reaction time and lower conflict discrepancy with greater right frontal plane knee projection angle (R2 = .12; p = .03); and higher reaction time with greater left frontal plane knee projection angle (R2 = .22; p < .001). Female sex amplified the relationship between perceptual-motor function and two-dimensional frontal plane squatting kinematics. Future work should determine the extent to which perceptual-motor improvements translate to safer movement strategies.
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Affiliation(s)
- Jennifer A Hogg
- Department of Health and Human Performance, The University of Tennessee Chattanooga, Chattanooga, TN, USA
| | | | - Jed A Diekfuss
- Emory Sports Performance And Research Center (SPARC), Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
| | - Shellie N Acocello
- Department of Health and Human Performance, The University of Tennessee Chattanooga, Chattanooga, TN, USA
| | | | | | | | - Gregory D Myer
- Emory Sports Performance And Research Center (SPARC), Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
| | - Gary B Wilkerson
- Department of Health and Human Performance, The University of Tennessee Chattanooga, Chattanooga, TN, USA
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18
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Mendonça LDM, Bittencourt NFN, Freire RL, Campos VC, Ferreira TV, Silva PL. Hip external rotation isometric torque for soccer, basketball, and volleyball athletes: normative data and asymmetry index. Braz J Phys Ther 2022; 26:100391. [PMID: 35121388 DOI: 10.1016/j.bjpt.2022.100391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/29/2021] [Accepted: 01/05/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Deficits in strength of the hip external rotators (ER) affect trunk, hip, and knee movement patterns, potentially contributing to injury in athletes. OBJECTIVES To provide normative data on isometric torque for hip ER in athletes of three distinct sports and to determine if isometric torque for the hip ER and torque asymmetry between legs differ among sports and between sexes. METHODS Basketball, soccer, and volleyball athletes (n=451) were evaluated. Hip ER torque was quantified bilaterally with athletes in prone and 90° of knee flexion using a hand-held dynamometer. RESULTS Data are expressed as mean and 95% confidence interval. Hip ER torque values in Nm/kg for the dominant and non-dominant limbs were, respectively, 0.46 (0.44, 0.48) and 0.42 (0.40, 0.44) for male soccer athletes; 0.35 (0.32, 0.37) and 0.27 (0.25, 0.29) for male basketball athletes; and 0.37 (0.34, 0.39) and 0.35 (0.32, 0.37) for male volleyball athletes. Hip ER torque in Nm/kg for the female volleyball athletes was 0.29 (0.26, 0.33) for the dominant and 0.29 (0.25, 0.32) for the non-dominant limb. The Limb Symmetry Index for male soccer, basketball, and volleyball players was, respectively, 94% (91, 97), 81% (75, 87), and 95% (91, 99). For female volleyball players the Limb Asymmetry Index was 102% (95, 108). Male volleyball athletes showed higher torque values than female volleyball athletes. CONCLUSIONS This study reported normative values for hip ER isometric torque of youth athletes. Clinicians can use the reported data as reference to identify torque deficits in athletes of the three reported sports.
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Affiliation(s)
- Luciana De Michelis Mendonça
- Physical Therapy Department, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Diamantina, MG, Brazil; Physical Therapy Department, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | | | - Roberta Lima Freire
- Physical Therapy Department, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Thiago Vinícius Ferreira
- Physical Therapy Department, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Paula Lanna Silva
- Department of Psychology, Center for the Ecological Study of Perception and Action, University of Connecticut, Storrs, Connecticut, United States
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19
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Peebles AT, Miller TK, Queen RM. Landing biomechanics deficits in anterior cruciate ligament reconstruction patients can be assessed in a non-laboratory setting. J Orthop Res 2022; 40:150-158. [PMID: 33738820 DOI: 10.1002/jor.25039] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 02/04/2023]
Abstract
Landing biomechanics provide important information pertaining to second anterior cruciate ligament (ACL) injury risk in patients following ACL reconstruction (ACLR). While traditional motion analysis technologies are often impractical for use in non-laboratory settings, methods to assess landing biomechanics which are inexpensive, portable, and user-friendly have recently been developed and validated. The purpose of this study was to compare landing kinematics and kinetics between ACLR patients and uninjured controls in a non-laboratory setting. Sixteen ACLR patients (7 male/9 female, 6-12 months post-ACLR) and 16 gender-matched controls completed seven bilateral drop vertical jumps and seven unilateral drop landings on each limb. Plantar force was measured bilaterally using force sensing insoles and frontal and sagittal-plane knee kinematics were measured using two tablets, six reflective markers, and automated point tracking software. Plantar force impulse normalized symmetry index (NSI) and knee frontal plane projection angle (FPPA) range of motion were computed during bilateral landing, and knee flexion range of motion NSI was computed during unilateral landing and compared between groups using independent samples t tests. ACLR patients had larger NSIs (reflecting less symmetry) for plantar force impulse during bilateral landing (p < 0.001) and knee flexion range of motion during unilateral landing (p = 0.004). No between-group differences were observed for knee FPPA range of motion (p = 0.111). This study is an important step towards assessing landing biomechanics in non-research settings with the goal of providing quantitative injury risk metrics in a clinical setting that can be used for return to sport decision making.
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Affiliation(s)
- Alexander T Peebles
- Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Thomas K Miller
- Department of Orthopedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Robin M Queen
- Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA.,Department of Orthopedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
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20
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Peebles AT, Savla J, Ollendick TH, Queen RM. Landing Asymmetry Is Associated with Psychological Factors after Anterior Cruciate Ligament Reconstruction. Med Sci Sports Exerc 2021; 53:1446-1451. [PMID: 33481481 PMCID: PMC8205954 DOI: 10.1249/mss.0000000000002603] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSES The goals of this work were to 1) determine the relationship between psychological readiness for return to sport and side-to-side symmetry during jump-landing in patients recovering from anterior cruciate ligament reconstruction (ACLR) and 2) determine whether psychological readiness for return to sport, graft type, meniscal pathology, sex, and time since surgery could predict landing symmetry in ACLR patients. METHODS Thirty-eight patients recovering from primary unilateral ACLR (22 men/16 women; 19 patellar tendon autograft/19 hamstring autograft; age: 16.3 ± 1.9 yr; 25.7 ± 6.2 wk postoperative) completed the Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) and 10 bilateral stop-jumps. Three-dimensional lower extremity kinematics and kinetics were collected at 240 and 1920 Hz, respectively. Peak knee extension moment limb symmetry index (LSI) was computed during the first landing of the stop-jump. The relationship between the ACL-RSI and peak knee extension moment LSI was determined using Pearson correlations. Multivariate regression was used to determine the ability of the ACL-RSI, graft type, meniscal pathology, sex, time since surgery, stop jump entry speed, and jump height to predict knee extension moment LSI. RESULTS There was a significant relationship between the ACL-RSI and peak knee extension moment LSI (r = 0.325; P = 0.047). The backward regression model found that 36.9% of the variance in knee extension moment LSI could be explained by the ACL-RSI (P = 0.040), graft type (P = 0.006), and jump height (P = 0.027). CONCLUSIONS There is a significant moderate association between psychological readiness for return to sport and asymmetric landing kinetics in patients after ACLR. Future work should investigate whether improving movement confidence results in improved kinetic landing symmetry.
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Affiliation(s)
- Alexander T Peebles
- Kevin P. Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA
| | - Jyoti Savla
- Department of Human Development and Family Science, Virginia Tech, Blacksburg, VA
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21
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Luftglass AR, Peebles AT, Miller TK, Queen RM. The impact of standardized footwear on load and load symmetry. Clin Biomech (Bristol, Avon) 2021; 88:105421. [PMID: 34246037 DOI: 10.1016/j.clinbiomech.2021.105421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 05/18/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The inability to standardize footwear is a potential issue when measuring landing kinetics in non-laboratory settings. This study determined the impact of not standardizing footwear on load and load symmetry during landing. A secondary purpose of this study was to introduce the Load Analysis Program, an open-source MATLAB® user-interface for computing kinetic and kinetic symmetry from data collected using loadsol® sensors. METHODS Forty uninjured participants completed bilateral and unilateral landing tasks in their own preferred athletic footwear and in laboratory-standardized footwear. Peak impact force, impulse, and a limb symmetry index of both kinetic outcomes were computed using loadsol® sensors (200 Hz) for both footwear conditions, and compared between footwear conditions using intraclass correlation coefficients and Bland-Altman plots. FINDINGS The agreement between the preferred and standardized conditions was good to excellent for peak impact force, peak impact force limb symmetry index, and impulse limb symmetry index during the bilateral task (intraclass correlation coefficient = 0.870-0.951). The agreement was moderate to poor for unilateral limb symmetry index measures (intraclass correlation coefficient = 0.399-0.516). During the preferred footwear condition, impulse was greater for the left limb during bilateral landing, and peak impact force during unilateral landing on the right limb was decreased, when compared to the standardized footwear condition (p < 0.05). INTERPRETATION These results suggest that while not standardizing footwear can alter the results of certain load metrics, laboratory-relevant landing mechanics information can be obtained with participants wearing their own footwear.
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Affiliation(s)
- Adam R Luftglass
- Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA; Department of Materials Science and Engineering, Virginia Tech, Blacksburg, VA, USA.
| | - Alexander T Peebles
- Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
| | - Thomas K Miller
- Department of Orthopaedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Robin M Queen
- Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA; Department of Orthopaedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
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Peebles AT, Williams B, Queen RM. Bilateral Squatting Mechanics Are Associated With Landing Mechanics in Anterior Cruciate Ligament Reconstruction Patients. Am J Sports Med 2021; 49:2638-2644. [PMID: 34236927 DOI: 10.1177/03635465211023761] [Citation(s) in RCA: 8] [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 Proper lower extremity biomechanics during bilateral landing is important for reducing injury risk in athletes returning to sports after anterior cruciate ligament reconstruction (ACLR). Although landing is a quick ballistic movement that is difficult to modify, squatting is a slower cyclic movement that is ideal for motor learning. HYPOTHESIS There is a relationship between lower extremity biomechanics during bilateral landing and bilateral squatting in patients with an ACLR. STUDY DESIGN Descriptive laboratory study. METHODS A total of 41 patients after a unilateral ACLR (24 men, 17 women; 5.9 ± 1.4 months after ACLR) completed 15 unweighted bilateral squats and 10 bilateral stop-jumps. Three-dimensional lower extremity kinematics and kinetics were collected, and peak knee abduction angle, knee abduction/adduction range of motion, peak vertical ground-reaction force limb symmetry index (LSI), vertical ground-reaction force impulse LSI, and peak knee extension moment LSI were computed during the descending phase of the squatting and landing tasks. Wilcoxon signed-rank tests were used to compare each outcome between limbs, and Spearman correlations were used to compare outcomes between the squatting and landing tasks. RESULTS The peak vertical ground reaction force, the vertical ground reaction force impulse, and the peak knee extension moment were reduced in the surgical (Sx) limb relative to the nonsurgical (NSx) limb during both the squatting and landing tasks (P < .001). The relationship between squatting and landing tasks was strong for the peak knee abduction angle (R = 0.697-0.737; P < .001); moderate for the frontal plane knee range of motion (NSx: R = 0.366, P = .019; Sx: R = 0.418, P = 0.007), the peak knee extension moment LSI (R = 0.573; P < .001), the vertical ground reaction force impulse LSI (R = 0.382; P < .014); and weak for the peak vertical ground reaction force LSI (R = 0.323; P = .039). CONCLUSION Patients who have undergone an ACLR continue to offload their surgical limb during both squatting and landing. Additionally, there is a relationship between movement deficits during squatting and movement deficits during landing in patients with an ACLR preparing to return to sports. CLINICAL RELEVANCE As movement deficits during squatting and landing were related before return to sports, this study suggests that interventional approaches to improve squatting biomechanics may translate to improved landing biomechanics in patients with an ACLR.
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Affiliation(s)
- Alexander T Peebles
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | | | - Robin M Queen
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA.,Department of Orthopaedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
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23
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Mesisca JK, Peebles AT, Queen RM. Including jump height when normalizing single hop impact kinetics can change the directionality of findings. Clin Biomech (Bristol, Avon) 2021; 88:105443. [PMID: 34388652 DOI: 10.1016/j.clinbiomech.2021.105443] [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: 03/05/2021] [Revised: 07/16/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Assessing landing kinetics during hop testing could improve return to sport decisions following anterior cruciate ligament reconstruction (ACL) reconstruction. However, different methods for normalizing kinetic outcomes could influence the interpretation of landing kinetics and therefore the clinical recommendations. METHODS Twenty-one females who had returned to sport following primary unilateral ACL reconstructed completed two single hops for maximum distance on each limb. Hop distance, hop height, peak impact force, and impulse were computed for each hop, and peak impact force and impulse magnitudes were assessed when 1) non-normalized 2) normalized by bodyweight, and 3) normalized by peak potential energy during the hop. FINDINGS Along with hop distance and height, peak impact force and impulse were found to be lower on the surgical limb relative to the non-surgical limb for both non-normalized data and when normalized to bodyweight only (p < 0.001, d > 0.95). However, peak impact force and impulse were found to be higher on the surgical limb relative to the non-surgical limb when normalizing outcomes to peak potential energy (p < 0.001, d > 1.03). INTERPRETATION Different normalization methods result in different interpretations of single hop kinetics. ACL reconstruction patients have shorter hop distances, lower hop heights, lower force magnitudes, and worse energy absorption when hopping on their surgical limb, relative to their non-surgical limb. We believe that normalizing landing kinetics using bodyweight and using peak potential energy provide different information, and as such, we suggest that future research use both methods based on the research question.
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Affiliation(s)
- Jenna K Mesisca
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
| | - Alexander T Peebles
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA.
| | - Robin M Queen
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA; Department of Orthopaedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
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Queen RM, Peebles AT, Miller TK, Savla J, Ollendick T, Messier SP, Williams DB. Reduction of Risk Factors for ACL Re-injuries using an Innovative Biofeedback Approach: Rationale and Design. Contemp Clin Trials Commun 2021; 22:100769. [PMID: 33997461 PMCID: PMC8100073 DOI: 10.1016/j.conctc.2021.100769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 01/01/2023] Open
Abstract
Nearly 1 in 60 adolescent athletes will suffer anterior cruciate ligament (ACL) injuries with 90% of these athletes electing to undergo an ACL reconstruction (ACLR) at an estimated annual cost of $3 billion. While ACLR and subsequent rehabilitation allow these athletes to return to sports, they have a 15-fold increased risk of second ACL injuries. The modification of post-operative rehabilitation to improve movement and loading symmetry using visual and tactile biofeedback could decrease the risk factors for sustaining a second ACL injury. Participants included 40 adolescent ACLR patients who were intending to return to full sport participation. This preliminary randomized controlled trial (RCT) examined the changes in knee extension moment symmetry, a known risk factor for second ACL injuries, during landing from a stop-jump task between the following time-points: pre-intervention, immediate post-intervention, and subsequent follow-up 6-weeks post-intervention. Participants met twice per week for six-weeks (12-session). The intervention included bilateral squat biofeedback (visual and tactile); the attention control group attended weekly educational sessions. This RCT enrolled and randomize 40 participants over a two-and-a-half-year period. All participants were greater than 4.5 months post-op from a primary, unilateral ACLR and were released to participate by their treating physician. The findings from this pilot biofeedback RCT will provide critical effect size estimates for use in subsequent larger clinical trials.
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Affiliation(s)
- Robin M Queen
- Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA.,Department of Orthopaedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Alexander T Peebles
- Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
| | - Thomas K Miller
- Department of Orthopaedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Jyoti Savla
- Department of Human Development and Family Science, Virginia Tech, Blacksburg, VA, USA
| | - Thomas Ollendick
- Department of Psychology, Virginia Tech Child Study Center, Virginia Tech, Blacksburg, VA, USA
| | - Stephen P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.,Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Rheumatology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Racial differences in gait mechanics. J Biomech 2020; 112:110070. [PMID: 33035843 DOI: 10.1016/j.jbiomech.2020.110070] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/09/2020] [Accepted: 09/23/2020] [Indexed: 11/23/2022]
Abstract
The effect of race has rarely been investigated in biomechanics studies despite racial health disparities in the incidence of musculoskeletal injuries and disease, hindering both treatment and assessment of rehabilitation. The purpose of this study was to test the hypothesis that racial differences in gait mechanics exist between African Americans (AA) and white Americans (WA). Ninety-two participants (18-30 years old) were recruited with equal numbers in each racial group and sex. Self-selected walking speed was measured for each participant. 3D motion capture and force plate data were recorded during 7 walking trials at regular and fast set speeds. Step length, step width, peak vertical ground reaction force, peak hip extension, peak knee flexion, and peak ankle plantarflexion were computed for all trials at both set speeds. Multivariate and post-hoc univariate ANOVA models were fit to determine main and interaction effects of sex and race (SPSS V26, α = 0.05). Self-selected walking speed was slower in AA (p = 0.004, ƞp2 = 0.088). No significant interactions between race and sex were identified. Males took longer steps (regular: p < 0.001, ƞp2 = 0.288, fast: p < 0.001, ƞp2 = 0.193) and had larger peak knee flexion (regular: p = 0.007, ƞp2 = 0.081, fast: p < 0.001, ƞp2 = 0.188) and ankle plantarflexion angles (regular: p = 0.050, ƞp2 = 0.044, fast: p = 0.049, ƞp2 = 0.044). Peak ankle plantarflexion angle (regular: p = 0.012, ƞp2 = 0.071, fast: p < 0.001, ƞp2 = 0.137) and peak hip extension angle during fast walking (p = 0.007, ƞp2 = 0.083) were smaller in AA. Equivalency in gait measures between racial groups should not be assumed. Racially diverse study samples should be prioritized in the development of future research and individualized treatment protocols.
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