Jump-landing direction influences dynamic postural stability scores

Ankle Biomechanics During Multidirectional Landings in Athletes With Chronic Ankle Instability

BACKGROUND

Assessing and understanding the control of the ankle during multidirectional jump landings in athletes with chronic ankle instability (CAI) would help health professionals develop interventions to reduce the risk of recurrent injuries. The aim of this study was to investigate the angle, angular velocity, and movements of the ankle joint, and the muscle activity of peroneus longus (PL), tibialis anterior (TA), and gastrocnemius (GAS) muscles during multidirectional landings in athletes with CAI.

METHODS

Nineteen athletes with CAI (≤25 Cumberland Ankle Instability Tool-Thai Score) participated. A Vicon Nexus motion analysis system synchronously collected data with an AMTI force plate and surface electromyography (EMG) to capture kinematics, kinetics, and muscle activity, respectively. Participants were asked to perform single-leg jump-landing tests in forward (0°), 30° diagonal, 60° diagonal, and lateral (90°) directions. Ankle joint kinematics, kinetics, and muscle activity of PL, TA, and GAS were analyzed. Repeated measure ANOVA (analysis of variance) and Friedman tests were used to analyze the main effects of the jump-landing direction.

RESULTS

Athletes with CAI exhibited significant differences in ankle angles, angular velocities, ankle movements, and average muscle activity of GAS between directions. Greatest average EMG of GAS muscle was observed during landing in the lateral direction compared with the forward and 30° diagonal directions.

CONCLUSION

Lateral and diagonal direction movements showed the greatest risks associated with recurrent ankle sprains. Impairments of neuromuscular control in both pre-landing and landing phases were observed in athletes with CAI when considered alongside previously published data.

LEVEL OF EVIDENCE

Laboratory-based observational study.

The influence of jump-landing direction on dynamic postural stability following anterior cruciate ligament reconstruction

BACKGROUND

Traditional testing prior to return to sport following anterior cruciate ligament reconstruction typically involves jump-landing tasks in the forward direction. As injury is most likely the result of multiplanar neuromuscular control deficits, assessment of dynamic postural stability using landing tasks that require multiplanar stabilization may be more appropriate. The purpose of this study was to examine how dynamic postural stability is affected when performing jump-landing tasks in three different directions.

METHODS

Fifteen athletes [11 females (18.0 ± 3.0 years) and 4 males (18.5 ± 3.1 years)] following anterior cruciate ligament reconstruction performed a series of single-limb jump-landing tasks in 3 directions. Individual directional stability indices and a composite dynamic postural stability index were calculated using ground reaction force data and were compared using separate one-way repeated measures ANOVAs.

FINDINGS

All directional stability indices demonstrated a significant main effect for jump-landing direction (medial-lateral P < 0.001, η2p = 0.95; anterior-posterior P < 0.001, η2p = 0.97; vertical P = 0.021, η2p = 0.24). The diagonal jump-landing direction produced increased medial-lateral stability and vertical stability scores, while the forward and diagonal jump-landing directions produced increased anterior-posterior stability scores. There was no significant effect for the composite dynamic stability index score.

INTERPRETATION

Jump-landing direction affects dynamic postural stability in all 3 planes of movement in athletes following anterior cruciate ligament reconstruction. Results indicate the potential need to incorporate multiple jump-landing directions to better assess dynamic postural stability prior to return to sport.

Effects of non-extensible lumbar belts on static and dynamic postural stability

BACKGROUND

Previous studies have found that increased intra-abdominal pressure helps to reduce spinal loading and improve spine stability. Non-extensible lumbar belts (NEBs) could elevate intra-abdominal pressure and augment spinal stability. NEBs have been used in the healthcare field to help reduce pain and improve spine function for people with low back pain. However, the effect of NEBs on static and dynamic postural stability is not clear.

METHODS

This study aimed to investigate whether NEBs affect static and dynamic postural stability. Twenty-eight healthy male subjects were recruited to finish four static postural stability tasks and two dynamic postural stability tests. Center of pressure (COP) values during 30 s of quiet standing, dynamic postural stability index (DPSI) and Y balance test (YBT) score with and without NEBs were analyzed.

RESULTS

NEBs had no significant effect in all COP variables in the static postural tasks. The results of a repeated measure two-way ANOVA indicated the NEBs significantly improved the dynamic postural stability in YBT score and DPSI (F _(1,27) = 5.506, p = .027, [Formula: see text] and F _(1,27) = 83.94, p = .000, [Formula: see text] respectively).

CONCLUSIONS

The study results indicate that non-extensible belts improve dynamic stability in healthy male participants, with potential implications for rehabilitation and performance enhancement programs.

Effects of Transcranial Direct Current Stimulation over the Primary Motor Cortex in Improving Postural Stability in Healthy Young Adults

Transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) is of increasing interest to improve motor performance in healthy adults and patients with respective deficits. This study aimed to examine whether tDCS over M1 can improve static and dynamic postural stability in young healthy adults. Seventeen healthy participants (mean age = 25.14 ± 2.50 (standard deviation, SD) years) received sham and anodal tDCS (2 mA) over the vertex at the Cz electrode position for 15 min. Static and dynamic postural stability were evaluated before and immediately after tDCS. The center of pressure (COP) sway area (COPSA) and COP maximum displacements to medio-lateral (COPML) and antero-posterior directions (COPAP) were used to evaluate static postural stability. The anterior−posterior stability index (APSI), medial−lateral stability index (MLSI), vertical stability index (VSI), dynamic postural stability index (DPSI), and time to stabilization (TTS) in forward (FL), 45° anterior lateral (LL), and 45° anterior medial (ML) direction landing, as well as the Y-balance composite score (YBTCS) were used to assess dynamic postural stability. The results showed that the LL-TTS (p = 0.044), non-dominant leg COPSA (p = 0.015), and YBTCS (p < 0.0001) were significantly improved in the real stimulation as compared with the sham stimulation session, and anodal tDCS significantly changed dominant leg COPAP (p = 0.021), FL-APSI (p < 0.0001), FL-TTS (p = 0.008), ML-TTS (p = 0.002), non-dominant leg YBTCS (p < 0.0001), and dominant leg YBTCS (p = 0.014). There were no significant differences in all obtained balance values in the sham stimulation session, except for non-dominant leg YBTCS (p = 0.049). We conclude that anodal tDCS over M1 has an immediate improving effect on static postural stability and dynamic performance in young healthy adults. This makes tDCS a promising adjuvant rehabilitation treatment to enhance postural stability deficits in the future.

Lower limb kinematics during single leg landing in three directions in individuals with chronic ankle instability

OBJECTIVES

To compare the lower limb kinematics of participants with chronic ankle instability (CAI) and healthy participants during forward, lateral, and medial landings.

DESIGN

Cross-sectional study.

SETTING

Laboratory.

PARTICIPANTS

Eighteen athletes with CAI and 18 control athletes.

MAIN OUTCOME MEASURES

Hip, knee, and ankle joint kinematics during forward, lateral, and medial single-leg landings were compared between the groups using two-way ANOVA for discrete values and statistical parametric mapping two-sample t-tests for time-series data.

RESULTS

The CAI group had significantly greater ankle dorsiflexion than the control group (P ≤ 0.013), which was observed from the pre-initial contact (IC) for lateral and medial landings and post-IC for forward landing. The CAI group showed greater knee flexion than the control group from the IC for lateral landing and post-IC for forward landing (P ≤ 0.014). No significant differences in ankle inversion kinematics were found between the CAI and control groups. Lateral landing had a greater peak inversion angle and velocity than forward and medial landings (P < 0.001). Medial landing had a greater inversion velocity than forward landing (P < 0.001).

CONCLUSIONS

This study suggests that individuals with CAI show feedforward protective adaptations in the pre-landing phase for lateral and medial landings.

Influence of Landing in Neuromuscular Control and Ground Reaction Force with Ankle Instability: A Narrative Review

Ankle sprains are generally the most common injuries that are frequently experienced by competitive athletes. Ankle sprains, which are the main cause of ankle instability, can impair long-term sports performance and cause chronic ankle instability (CAI). Thus, a comprehensive understanding of the key factors involved in repeated ankle strains is necessary. During jumping and landing, adaptation to the landing force and control of neuromuscular activation is crucial in maintaining ankle stability. Ankle mobility provides a buffer during landing, and peroneus longus activation inhibits ankle inversion; together, they can effectively minimize the risk of ankle inversion injuries. Accordingly, this study recommends that ankle mobility should be enhanced through active and passive stretching and muscle recruitment training of the peroneus longus muscles for landing strategies should be performed to improve proprioception, which would in turn prevent ankle sprain and injury to neighboring joints.

Influence of jump-landing direction on dynamic postural stability and hamstring-to-quadriceps co-activation ratio

This study investigated the effect of jump landing direction and leg dominance on the Dynamic Postural Stability Index (DPSI) and the importance of the hamstring-to-quadriceps (H/Q) co-activation ratio. Fifteen female sports players performed unilateral jump landing, for the dominant (DL) and the non-dominant (NDL) legs in anterior (AJL), lateral (LJL), and vertical directions (DJL). The results indicated that the DPSI was higher in DJL compared to LJL and AJL. Besides, the DPSI score during DJL was higher in NDL indicating lower stabilization capacity associated with a lower H/Q co-activation ratio. A significant correlation was found between H/Q co-activation ratio and DPSI in the DL during AJL (r = -0.57). Current results suggest that DJL was more appropriate to evaluate dynamic postural stability since it highlights limb asymmetry. In addition, H/Q co-activation appears to play an essential role in the effectiveness of ground reaction force stabilization during jump landing.

Differences in the locomotion biomechanics and dynamic postural control between individuals with chronic ankle instability and copers: a systematic review

An empirical consensus of differences between chronic ankle instability (CAI) individuals and copers (individuals who sprained ankle once and without recurrent symptoms or injury) has not been reported. This study aimed to review the locomotion biomechanics and dynamic postural control between these two populations. Database of ScienceDirect, PubMed and Web of Science was used to search ('chronic ankle instability' OR 'ankle instability') AND ('ankle sprain' OR 'coper*') until 30 November 2020. Articles that made a comparison about changes in biomechanical parameters between Copers and CAI individuals during locomotor or functional tasks were included in this review. Twenty-three articles met the inclusion criteria. CAI individuals exhibited an increased hip flexion to maintain stability, suggesting the adopted hip strategy compared to copers during landing. Dorsiflexion angle and ankle frontal displacement increased considerably compared to copers, which might increase risks of lateral ankle sprain injury. CAI individuals reduced the ankle displacements in the sagittal plane and indicated worse performance of Star Excursion Balance Test in the posterior-lateral direction compared to copers. Identified motion deficits or altered motion strategies provide opportunities for targeted intervention and scheme after index sprain or in CAI individuals.

Female Adolescent Soccer Players Utilize Different Neuromuscular Strategies Between Limbs During the Propulsion Phase of a Lateral Vertical Jump

BACKGROUND

Multiplanar dynamic stability is an important unilateral function in soccer performance but has been scarcely examined in female soccer players. The lateral vertical jump task assesses unilateral functional performance, and energy generation contribution examines how each joint (hip, knee, ankle) contributes to the vertical component of the vertical jump phase to measure inter- and intra-limb differences.

PURPOSE

To examine dominant versus non-dominant limb performance using energy generation contribution of the hip, knee, and ankle during the vertical jump component of the lateral vertical jump.

STUDY DESIGN

Cross-sectional observational study.

METHODS

Seventeen healthy, adolescent female soccer players (age 13.4±1.7 years; height 160.6±6.0 cm; mass 53.1±8.2 kg) participated. Quadriceps strength was measured via isokinetic dynamometry. Energy generation contribution (measured from maximal knee flexion to toe off) and vertical jump height were measured during the vertical component of the lateral vertical jump.

RESULTS

There was no significant difference between limbs for quadriceps strength (p=0.64), jump height (p=0.59), or ankle energy generation contribution (p=0.38). Energy generation contribution was significantly greater in the dominant hip (dominant 29.7±8.6%, non-dominant 18.4±6.3%, p<0.001) and non-dominant knee (dominant 22.8±6.8%, non-dominant 36.2±8.5%, p<0.001).

CONCLUSION

High demand on coordination and motor control during the lateral vertical jump and inherent limb dominance may explain different intra-limb strategies for task performance despite jump height symmetry. Non-dominant affinity for stability and dominant compensatory performance may neutralize potential asymmetries. Implications for symmetry in observable outcomes such as jump height must consider underlying internal asymmetries.

LEVELS OF EVIDENCE

3B.

CLINICAL RELEVANCE

Symmetrical findings on functional tasks have underlying internal asymmetries observed here in female adolescent soccer players. The lateral vertical jump may highlight these internal asymmetries (hip- versus knee-dominant movement strategies) due to the high coordinative demand to perform the task. Clinicians should be cognizant of underlying, potentially inherent, asymmetries even when observing functional symmetry in a task.

WHAT IS KNOWN ABOUT THE SUBJECT

Female adolescent soccer players are a high-risk cohort for sustaining anterior cruciate ligament injuries. Limb dominance may play a role in the performance of functional tasks, and limb dominance in soccer players is quite specialized: the dominant limb is the preferred kicking limb, while the non-dominant limb is the preferred stabilizing limb (plant leg). Functional performance in female soccer players has been studied in kicking, dribbling, sprinting, change of direction, and jumping - however, these tasks were measured independent of limb dominance. It remains to be seen how unilateral functional tasks may be affected by limb dominance in female adolescent soccer players.

WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE

This study provides data on functional performance relative to limb dominance in female adolescent soccer players, and captures the lateral vertical jump task in both inter- and intra-limb measures. This highlights that intra-limb strategies to perform a coordinated motor task may be different between limbs, herein attributed to limb dominance. Even if gross motor outputs between limbs are symmetrical (i.e. jump height), the underlying movement strategies to achieve that output may be different (hip- versus knee-dominant movement strategies). These findings are important to research on functional performance measures related to attaining between-limb symmetry, as measures of energy generation contribution open the door for a more thorough understanding of joint-by-joint intra-limb contributions during a functional task.

Side-hops challenge knee control in the frontal and transversal plane more than hops for distance or height among ACL-reconstructed individuals

We compared knee landing mechanics with presumed relation to risk of anterior cruciate ligament (ACL) injury among three single-leg hop tests and between legs in individuals with unilateral ACL reconstruction. Thirty-four participants (>10 months' post-surgery, 23 females) performed the standardised rebound side hop (SRSH), maximal hop for distance (OLHD) and maximal vertical hop (OLVH). We calculated the following knee outcomes from motion capture and force plate data: finite helical axis inclination angles (approximates knee robustness), frontal and transversal plane angles at initial contact, peak angles of abduction and internal rotation during landing, and peak external moments of flexion, abduction and internal rotation during landing. Repeated-measures MANOVA analysis ('sex' as covariate) confirmed that SRSH induced greater angles and moments, particularly in the frontal plane, compared to OLHD and OLVH. There was between-leg asymmetry for peak knee flexion moment for males during OLHD and OLVH, and for females during SRSH. Our results advocate the SRSH over OLHD and OLVH for assessment of knee landing control to screen for movement patterns potentially related to ACL injury risk. However, clear differences in both knee kinematics and kinetics between OLHD and SRSH motivate the use of both tests to evaluate different aspects of landing control.

Temporal Kinematic Differences between Forward and Backward Jump-Landing

Backward jump-landing during sports performance will result in dynamic postural instability with a greater risk of injury, and most research studies have focused on forward landing. Differences in kinematic temporal characteristics between single-leg and double-leg backward jump-landing are seldom researched and understood. The purpose of this study was to compare and analyze lower extremity kinematic differences throughout the landing phases of forward and backward jumping using single-leg and double-leg landings (FS and BS, FD and BD). Kinematic data were collected during the landing phases of FS and BS, FD and BD in 45 participants. Through statistical parametric mapping (SPM) analysis, we found that the BS showed smaller hip and knee flexion and greater vertical ground reactive force (VGRF) than the FS during 0–37.42% (p = 0.031), 16.07–32.11% (p = 0.045), and 23.03–17.32% (p = 0.041) landing phases. The BD showed smaller hip and knee flexion than the FD during 0–20.66% (p = 0.047) and 0–100% (p < 0.001) landing phases. Most differences appeared within a time frame during the landing phase at 30–50 ms in which non-contact anterior cruciate ligament (ACL) injuries are thought to occur and are consistent with the identification of risk in biomechanical analysis. A landing strategy that consciously increases the knee and hip flexion angles during backward landing should be considered for people as a measure to avoid injury during the performance of this type of physical activity.

The Applications of Landing Strategies in Badminton Footwork Training on a Backhand Side Lateral Jump Smash

Previous research in badminton has associated unilateral landings following overhead strokes with the occurrence of knee injuries. Smashing involves tensing the abdomen muscles while swinging the racket rapidly and maintaining one’s balance while performing coordinated movements and steps; this process puts stress on the player’s lower limbs. However, few studies have compared the effects of different stroke training while performing various types of badminton strokes. This study investigated the influence of different stroke training on the smash action of badminton players. Three stroke training conditions were considered: shadow, target striking, and smashing. Sixteen male experienced badminton players were recruited for this study. One-way repeated-measures ANOVA with Bonferroni correction was used to identify the differences. At the initial contact with the ground, the knee flexion and knee valgus angles under the smash condition were significantly higher than target and shadow conditions. Under the smash condition, hip abduction was significantly higher than under the target and shadow conditions. Moreover, the hip abduction under the target condition was significantly higher than under the shadow condition. At the maximum knee flexion, the hip abduction under the smash and target conditions was significantly higher than under the shadow condition. Regarding the time from the moment of initial contact to the peak of vertical ground reaction force it was shorter under the smash condition than the target and shadow conditions. The vertical ground reaction force was higher under the smash condition than under the target and shadow conditions. The 50 ms impulse was higher under the smash condition than under the target and shadow conditions. The main findings of this study are that under the smash condition, the motion in the frontal plane increased, which produced higher loads on the joints in the lower limbs. Player performed the same footwork under the three conditions, but the landing strategies differed because of unique swing motions and techniques. The condition under which a player hits a shot to a target area can affect the landing. The results of this study suggest that target practice is more effective for improving the landing technique employed during actual shots than shadow practice.

Inverse optimal control with time-varying objectives: application to human jumping movement analysis

Analysis of complex human movements can provide valuable insights for movement rehabilitation, sports training, humanoid robot design and control, and human-robot interaction. To accomplish complex movement, the central nervous system must coordinate the musculo-skeletal system to achieve task and internal (e.g., effort minimisation) objectives. This paper proposes an inverse optimal control approach for analysing complex human movement that does not assume that the control objective(s) remains constant throughout the movement. The movement trajectory is assumed to be optimal with respect to a cost function composed of the sum of weighted basis cost functions, which may be time varying. The weights of the cost function are recovered using a sliding window. To illustrate the proposed approach, a dataset consisting of standing broad jump to targets at three different distances is collected. The method can be used to extract control objectives that influence task success, identify different motion strategies/styles, as well as to observe how control strategy changes during the motor learning process. Kinematic analysis confirms that the identified control objectives, including centre-of-mass takeoff vector and foot placement upon landing are important to ensure that a given participant lands on the target. The dataset, including nearly 800 jump trajectories from 22 participants is also provided.

Directions of single-leg landing affect multi-segment foot kinematics and dynamic postural stability in male collegiate soccer athletes

BACKGROUND

Understanding lower limb kinematics and postural control in different directions of single-leg landings is critical to evaluate postural control and prevent lower limb injuries. However, foot and ankle kinematics and postural control during single-leg landings in different directions are less known.

RESEARCH QUESTION

Does the difference in the direction of single-leg landing affect the foot kinematics on the frontal plane and dynamic postural stability?

METHODS

A cross-sectional study was conducted. Forty-nine male collegiate soccer players performed single-leg forward (FL), 45° lateral (LL), and medial (ML) direction landings. The lower limb, foot (rearfoot, midfoot, forefoot), and ankle kinematics during an impact phase were evaluated, and a curve analysis was performed using a statistical parametric mapping method to compare the three landings. The three landings were compared in terms of postural control parameters, including time to stabilization (TTS), peak of ground reaction forces (GRFs), root-mean-square of the mediolateral GRFs for 0-0.4 s (GRFML0.4), loading rate, and magnitude of horizontal GRFs from 0-0.4 s (HGRF-0.4), 0.4-2.4 s (HGRF-2.4), and 3.0-5.0 s.

RESULTS

Ankle and rearfoot kinematics in LL exhibited smaller eversion and pronation positions than FL and ML (p < 0.01). The TTS-mediolateral (TTS-ML) was longer in the LL than in FL and ML (p < 0.001). The GRFML0.4, HGRF-0.4, and -2.4 in the LL and ML were greater than those in the FL (p < 0.001).

SIGNIFICANCE

Directions of single-leg landing affect foot and ankle kinematics and postural stability. Specifically, the LL exhibits more inverted ankle and supinated rearfoot positions, and longer TTS-ML. Thus, the LL may induce stretching of the lateral ankle ligament. These findings can help understand foot kinematics and assess dynamic postural control.

Postural control is altered in females with excessive medial knee displacement

Knee valgus motion observed during landing tasks has been proposed as a predictor of future knee injury. It mainly involves excess motion in the frontal plane and is known to be greater in individuals with excessive medial knee displacement (MKD). This affects postural control during sports manoeuvres. Previous sports medicine-related research suggests that the nature of these fluctuations provide rich and more sensitive information to identify risk of (re)injury. We aimed to investigate the fluctuations of the centre of pressure (CoP) in individuals with and without excessive MKD. Twenty females (12 controls; 8 excessive MKD) were instructed to perform single-leg landing tasks from three different directions. The participants landed on a force plate and stayed still for 20 seconds. The fluctuations of the anterior-posterior and medial-lateral directions of the CoP were determined through the calculation of Sample Entropy. Mixed-model ANOVAs (3 [Landing Direction] x 2 [Group]) were used. We have found that only the entropy of the medial-lateral direction was different between groups. Individuals with excessive MKD exhibited an increase in entropy values, indicating greater randomness in CoP fluctuations. This suggests a decreased ability to adapt to environmental demands that likely result in an increased risk of injury.

Oxford foot model kinematics in landings: A comparison between professional dancers and non-dancers

OBJECTIVES

Dancers frequently perform jump-landing activities, with the foot-ankle complex playing an essential role to attenuate the landing forces. However, scarce research has been conducted in professional dancers multi-segmented foot in landings. The aim of this study was to compare the multi-segmented foot kinematics between professional dancers and non-dancers, during forward and lateral single-leg jump-landings.

DESIGN

Descriptive group comparison.

METHODS

Marker trajectories and synchronized ground reaction forces of 15 professional dancers and 15 non-dancers were collected using motion capture and a force plate, during multidirectional single-leg jump-landings. Sagittal and frontal hindfoot-tibia, forefoot-hindfoot, and hallux-forefoot kinematics of the multi-segmented foot model were computed at initial contact, peak vertical ground reaction force and peak knee flexion. Repeated measures ANOVAs were conducted (p < 0.05).

RESULTS

Professional dancers landed with higher hindfoot-tibia and forefoot-hindfoot plantarflexion angles at initial contact (p < 0.001), and hindfoot-tibia dorsiflexion angles at peak vertical ground reaction force and peak knee flexion (p < 0.001) than non-dancers. Also, dancers exhibited higher sagittal hindfoot-tibia and forefoot-hindfoot excursions than non-dancers (p < 0.001). No statistically significant differences were found in the frontal plane.

CONCLUSIONS

The multi-segmented foot allows a comprehensive kinematic analysis of the different foot joints. In jump-landings, professional dancers higher hindfoot-tibia, and forefoot-hindfoot plantarflexion at initial contact, compared to non-dancers, contributed to a subsequent higher foot joints excursion. This pattern is commonly linked to a better shock absorption mechanism in landings.

Foot modeling affects ankle sagittal plane kinematics during jump-landing

The foot-ankle complex is a key-element to mitigate impact forces during jump-landing activities. Biomechanical studies commonly model the foot as a single-segment, which can provide different ankle kinematics compared to a multi-segmented model. Also, it can neglect intersegmental kinematics of the foot-ankle joints, such as the hindfoot-tibia, forefoot-hindfoot, and hallux-forefoot joints, that are used during jump-landing activities. The purpose of this short communication was to compare ankle kinematics between a three- and single-segmented foot models, during forward and lateral single-leg jump-landings. Marker trajectories and synchronized ground reaction forces of 30 participants were collected using motion capture and a force plate, during multidirectional single-leg jump-landings. Ankle kinematics were computed using a three- (hindfoot-tibia) and a single-segmented (ankle) foot models, at initial contact (IC), peak vertical ground reaction force (PvGRF) and peak knee flexion (PKF). Repeated measures ANOVAs were conducted (p < 0.05). The findings of this study showed that during lateral and forward jump-landing directions, the three-segmented foot model exhibited lower hindfoot-tibia dorsiflexion angles (PvGRF and PKF, p < 0.001) and excursions (sagittal: p < 0.001; frontal: p < 0.05) during the weightbearing acceptance phase than the single-segmented model. Overall, the two foot models provided distinctive sagittal ankle kinematics, with lower magnitudes in the hindfoot-tibia of the three-segmented foot. Furthermore, the three-segmented foot model may provide additional and representative kinematic data of the ankle and foot joints, to better comprehend its function, particularly in populations whose foot-ankle complex plays an important role (e.g., dancers).

Test-retest reliability and discriminative ability of forward, medial and rotational single-leg hop tests

BACKGROUND

Single-leg hop tests are commonly performed in the forward direction to evaluate functional performance. However, athletes move in multiple directions during pivoting sports. The first aim of this study was to examine test-retest reliability of single-leg hop tests in the forward, medial and rotational direction in non-injured athletes. Second, the discriminative ability to detect leg asymmetries with these hop tests in anterior cruciate ligament (ACL) reconstructed athletes was determined.

METHODS

Sixteen recreational non-injured participants (eight females, eight males; 22.4 ± 1.9 years) were tested twice (one-week interval) and performed the single hop for distance (SH), triple hop for distance (TH), medial side triple hop for distance (MSTH) and 90° medial rotation hop for distance (MRH). Intraclass correlation coefficients (ICCs), standard errors of measurement (SEM) and smallest detectable differences (SDD) were calculated. Discriminative ability was determined in 32 ACL-reconstructed participants (four females, 28 males; 24.4 ± 4.6 years; six months postoperative) who performed the same hop tests once.

RESULTS

The ICCs ranged between 0.93 and 0.98. The SEM and SDD were respectively 2.6-4.1% and 7.2-11.3% of the mean hop distance of the group. The proportion (%) of ACL-reconstructed participants passing the ≥90% limb symmetry cut-off was 62.5 (SH), 59.4 (TH), 40.6 (MSTH) and 46.9 (MRH).

CONCLUSION

Excellent test-retest reliability of forward, medial and rotational hop tests was found. This allows clinicians to make informed interpretations of changes in hop test distances when retesting athletes. Medial and rotational hop tests are more likely to show limb asymmetries in ACL-reconstructed participants compared to forward hop tests.

Effect of Two Different Pose Estimation Approaches on Lower Extremity Biomechanics in Professional Dancers

Different algorithms can be used to estimate the pose of musculoskeletal models in biomechanical studies. Visual 3D uses segment optimization whereas OpenSim uses global optimization. Thus, our purpose was to study whether the two approaches would influence the estimation of lower extremity biomechanical parameters. Marker trajectories and ground reaction forces of 6 professional dancers were collected during a single-leg forward jump-landing. The same data set was processed using both approaches. Our findings suggested that the sagittal knee and ankle angles and moments were highly comparable between the two approaches. The ankle sagittal angle and moment showed the lowest offset. On the other hand, the choice of a kinematic model was likely to affect the hip, more evident in the frontal and transverse planes. This may be due to different factors such as the pelvis and femur positions or larger amount of soft tissue in the thigh.

Reviewing the Variability-Overuse Injury Hypothesis: Does Movement Variability Relate to Landing Injuries?

PURPOSE

Overuse injuries are common in sport, but complete understanding of injury risk factors remains incomplete. Although biomechanical studies frequently examine musculoskeletal injury mechanisms, human movement variability studies aim to better understand neuromotor functioning, with proposed connections between overuse injury mechanisms and changes in motor variability.

METHOD

In a narrative review, we discuss the variability-overuse injury hypothesis, which suggests repeated load application leads to mechanical tissue breakdown and subsequent injury when exceeding the rate of physiological adaptation. Due to the multidisciplinary nature of this hypothesis, we incorporate concepts from motor control, neurophysiology, biomechanics, as well as research design and data analysis. We therefore summarize multiple perspectives while proposing theoretical relationships between movement variability and lower extremity overuse injuries.

RESULTS

Experimental data are presented and summarized from published experiments examining interactions between experimental task demands and movement variability in the context of drop landing movements, along with comparisons to previous movement variability studies.

CONCLUSION

We provide a conceptual framework for sports medicine researchers interested in predicting and preventing sports injuries. Under performance conditions with greater task demands, we predict reduced trial-to-trial movement variability that could increase the likelihood of overuse injuries.

Anterior cruciate ligament reconstruction and dynamic stability at time of release for return to sport

OBJECTIVE

Examine dynamic stability using Dynamic Postural Stability Index (DPSI) in athletes following anterior cruciate ligament reconstruction (ACLR) at time of release for return-to-sport (RTS), compared to matched controls.

DESIGN

Cross-sectional case-control study.

SETTING

Sports medicine clinic.

SUBJECTS

Fifteen ACLR athletes who had completed post-operative rehabilitation and were within 6 weeks following release to RTS were age-, gender-, and activity-matched to 15 healthy controls.

MAIN OUTCOME MEASURES

Ground reaction forces (GRFs) were collected using a portable force plate during stabilization from three different single-leg landing tasks. A composite DPSI was calculated using GRFs.

RESULTS

Compared to matched controls, ACLR athletes within 6 weeks of release for RTS did not significantly differ in dynamic postural stability and there were no significant differences between the involved and uninvolved limbs in the ACLR group.

CONCLUSION

Current findings indicate that dynamic postural stability, as measured using the DPSI, is not significantly different in ACLR subjects at time of release for RTS compared to matched controls. In addition, the DPSI was not significantly different between the involved and uninvolved limbs in the ACLR subjects. The results suggest that the post-ACLR rehabilitation program utilized may have adequately restored postural stability in this particular sample.

Reliability, discriminant validity and sex comparisons of dynamic postural stability during a landing task designed to challenge transverse plane knee stability

Internal and external rotational knee stability is essential for sports performance and excessive rotation can lead to injury but is rarely assessed in injury risk analysis. The objectives of this study were to determine the between-session reliability, discriminant validity and potential sex differences of a dynamic postural stability (DPS) assessment that challenges transverse plane knee stability. Thirty-six individuals (21.7 ± 2.6 years) including 19 females (20.8 ± 1.3 years) and 17 males (22.6 ± 3.4 years) participated. We measured DPS during rotational jump tasks (RJT) over 2 test sessions utilising a force plate. Kinematic (motion analysis) and electromyographic measures were compared to a traditional anterior-posterior jump task (APJT) to assess the discriminant validity and comparisons were performed between sexes. The intraclass correlation coefficients were between 0.67 and 0.86. Significant differences in transverse rotation angle at initial contact transverse rotational velocity of the knee were observed between the 2 different RJT and between the RJT and the traditional APJT. No sex differences were observed. The new assessment had good between-session reliability and offers a different challenge than a traditional jump task. This RJT may offer a novel assessment of knee joint rotational stability in conjunction with traditional measures.

The influence of single-leg landing direction on lower limbs biomechanics

BACKGROUND

The purpose of this study was to investigate whether different directions of single-leg landing tasks would influence lower limbs joints biomechanics.

METHODS

Using a controlled and experimental design, thirty physically active male subjects (age: 26.4±4.4 years; height: 180.5±3.7 cm; weight: 79.8:±4.4 kg), by dropping down from the top of a wooden box of 31 cm height, performed three one-leg landing tasks featured by different landing directions: frontward (FL), lateral (LL), and rotational (RL). The trunk and lower limbs` joints biomechanical responses were assessed through a laboratory setup consisting in a 6-camera motion capture system synchronized with force plates. A repeated measures one-way Analysis of Variance (ANOVA) was used to investigate the main effects of the landing directions on the lower limbs joints biomechanics during the main phases of interest of the landing tasks.

RESULTS

The results indicated two major findings: 1) FL resulted in an advantageous active whole-body configuration; 2) the lower limbs' joints adopted different and specific energy absorption strategies between the landing tasks.

CONCLUSIONS

This study indicates that the different landing tasks likely generate meaningful changes in in whole body biomechanics and specific lower limbs joints kinetic and kinematic responses. Such outcomes might be used by clinicians towards a practical approach in selecting either assessment modalities or exercise interventions.

Limb-dominance and gender differences in the ground reaction force during single-leg lateral jump-landings

[Purpose] The purpose of this study was to examine limb-dominance and gender differences in the magnitude of the ground reaction force during single-leg lateral jump-landings. We hypothesized that the peak ground reaction force would be larger in the non-dominant leg compared to that in the dominant leg and would be larger in females compared to that in men. [Subjects and Methods] Fifteen females and 15 males performed jump-landings sideways from a height of 20 cm, with a lateral distance of 60 cm. Vertical and medial ground reaction forces were measured, and the elapsed time from the initial contact to the peak ground reaction force was determined. The loading rate was calculated as the peak ground reaction force divided by the elapsed time from the initial contact to the peak ground reaction force. [Results] The vertical and medial peak ground reaction forces during single-leg lateral jump-landings were larger in females compared to that in males. In addition, the medial peak ground reaction force was larger for the non-dominant leg compared to that for the dominant leg. [Conclusion] The results suggest that in rehabilitation and conditioning settings, evaluations and instructions regarding attenuation are especially important for females and the non-dominant leg.

Effects of wobble board training on single-leg landing neuromechanics

Balance training programs have been shown to reduce ankle sprain injuries in sports, but little is known about the transfer from this training modality to motor coordination and ankle joint biomechanics in sport-specific movements. This study aimed to investigate the effects of wobble board training on motor coordination and ankle mechanics during early single-leg landing from a lateral jump. Twenty-two healthy men were randomly assigned to either a control or a training group, who engaged in 4 weeks of wobble board training. Full-body kinematics, ground reaction force, and surface electromyography (EMG) from 12 lower limb muscles were recorded during landing. Ankle joint work in the sagittal, frontal, and transverse plane was calculated from 0 to 100 ms after landing. Non-negative matrix factorization (NMF) was applied on the concatenated EMG Pre- and Post-intervention. Wobble board training increased the ankle joint eccentric work 1.2 times in the frontal (P < .01) and 4.4 times in the transverse plane (P < .01) for trained participants. Wobble board training modified the modular organization of muscle recruitment in the early landing phase by separating the activation of plantar flexors and mediolateral ankle stabilizers. Furthermore, the activation of secondary muscles across motor modules was reduced after training, refocusing the activation on the main muscles involved in the mechanical main subfunctions for each module. These results suggest that wobble board training may modify motor coordination when landing from a lateral jump, focusing on the recruitment of specific muscles/muscle groups that optimize ankle joint stability during early ground contact in single-leg landing.

Comparison of dynamic postural stability scores between athletes with and without chronic ankle instability during lateral jump landing

BACKGROUNDS

Many ankle injuries occur while participating in sports that require jumping and landing such as basketball, volleyball and soccer. Most recent studies have investigated dynamic postural stability of patients with chronic ankle instability after landing from a forward jump. The present study aimed to investigate the dynamic postural stability of the athletes who suffer from chronic ankle sprain while landing from a lateral jump.

METHODS

Twelve athletes with self-reported unilateral chronic ankle instability (4 females and 8 males) and 12 matched controls (3 females and 9 males) voluntarily participated in the study. Dynamic postural stability index and its directional indices were measured while performing lateral jump landing test.

RESULTS

No differences were found between athletes with and without chronic ankle instability during our landing protocol by means of the dynamic postural stability index and its directional indices. Findings showed that in each group, medial/lateral stability index is significantly higher than anterior/posterior and vertical stability indexes.

CONCLUSION

Findings showed that dynamic postural stability was not significantly different between the two groups. Future studies should examine chronic ankle instability patients with more severe disabilities and expose them to more challenging dynamic balance conditions to further explore postural stability.

LEVEL OF EVIDENCE

IIIa.

Difference in Dynamic Body Balance between Forward and Lateral Single-Leg Hop Landing

Since the loss of balance can result in falls or lower extremity injuries during sports or daily activities, quantitative evaluation of one’s ability to maintain balance with changes in the direction of motion is crucial. The present study aimed to assess whether the trajectory length of the center of pressure (COP) and peak values of the ground reaction force (GRF) following a single-leg hop landing differ when hopping forward or laterally, and to ascertain disparities in balance characteristics due to differences in hop direction. Twenty-four young volunteers (mean age, 22.1 years) were asked to stand on one foot on a level floor, take a half step in the forward and lateral directions, and land on one foot, repeating this task ten times on each leg. Data measured in this study included COP trajectory length up to 200 ms (200msCOP) and 1 s (1sCOP), the peak value of the frontal GRF (pF_ML), the peak value of the sagittal GRF (pF_AP), and the peak value of the vertical GRF (pF_V). Means were calculated from the measured values of ten attempts. 200msCOP reflects postural sway immediately after landing, and pF_ML and pF_V reflect the force of impact upon landing. 200msCOP, pF_ML, and pF_V were significantly higher with lateral hopping versus forward hopping (p<0.01, p<0.05, and p<0.05), and hop direction yielded differences in dynamic balance.

Knee Muscular Control During Jump Landing in Multidirections

BACKGROUND

Jump landing is a complex movement in sports. While competing and practicing, athletes frequently perform multi-planar jump landing. Anticipatory muscle activity could influence the amount of knee flexion and prepare the knee for dynamic weight bearing such as landing tasks.

OBJECTIVES

The aim of the present study was to examine knee muscle function and knee flexion excursion as athletes naturally performed multi-direction jump landing.

MATERIALS AND METHODS

Eighteen male athletes performed the jump-landing test in four directions: forward (0°), 30° diagonal, 60° diagonal, and lateral (90°). Muscles tested were vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), semitendinosus (ST), and biceps femoris (BF). A Vicon(TM) 612 workstation collected the kinematic data. An electromyography was synchronized with the Vicon(TM) Motion system to quantify dynamic muscle function. Repeated measure ANOVA was used to analyze the data.

RESULTS

Jump-landing direction significantly influenced (P < 0.05) muscle activities of VL, RF, and ST and knee flexion excursion. Jumpers landed with a trend of decreasing knee flexion excursion and ST muscle activity 100 ms before foot contact progressively from forward to lateral directions of jump landing.

CONCLUSIONS

A higher risk of knee injury might occur during lateral jump landing than forward and diagonal directions. Athletes should have more practice in jump landing in lateral direction to avoid injury. Landing technique with high knee flexion in multi-directions should be taught to jumpers for knee injury prevention.

Reduce torques and stick the landing: limb posture during landing in toads

A controlled landing, where an animal does not crash or topple, requires enough stability to allow muscles to effectively dissipate mechanical energy. Toads (Rhinella marina) are exemplary models for understanding the mechanics and motor control of landing given their ability to land consistently during bouts of continuous hopping. Previous studies in anurans have shown that ground reaction forces (GRFs) during landing are significantly higher compared with takeoff and can potentially impart large torques about the center of mass (COM), destabilizing the body at impact. We predict that in order to minimize such torques, toads will align their COM with the GRF vector during the aerial phase in anticipation of impact. We combined high-speed videography and force-plate ergometry to quantify torques at the COM and relate the magnitude of torques to limb posture at impact. We show that modulation of hindlimb posture can shift the position of the COM by about 20% of snout–vent length. Rapid hindlimb flexion during the aerial phase of a hop moved the COM anteriorly and reduced torque by aligning the COM with the GRF vector. We found that the addition of extrinsic loads did not significantly alter landing behavior but did change the torques experienced at impact. We conclude that anticipatory hindlimb flexion during the aerial phase of a hop is a critical feature of a mechanically stable landing that allows toads to quickly string together multiple, continuous hops.

The effects of ankle Kinesio taping on ankle stiffness and dynamic balance

The purpose of this study was to determine the effects of Kinesio® taping on static restraint and dynamic postural control of the ankle joint. Thirty female subjects with no history of ankle injury participated in this study. Subjects were tested for passive ankle laxity and stiffness, and time to stabilization following forward, backward, medial, and lateral hops. Subjects were tested prior to tape application, immediately following application, and following 24 hours of use. Differences between taping conditions were investigated using analyses of variance and pairwise comparisons. Stiffness increased following initial application and 24 hours of Kinesio® tape use (F = 6.99, p = .003), despite no observed changes in ankle laxity (F = 0.77, p = .49); however, no changes were observed in time-to-stabilization (F = 0.03, p = .97). Our results suggest that Kinesio® tape may improve static restraint in the ankle joint without altering peak motion or dynamic postural control. A future investigation into Kinesio® tape efficacy in injury prevention or rehabilitation is warranted.

A diagonal landing task to assess dynamic postural stability in ACL reconstructed females

BACKGROUND

Previous research has used time to stabilization (TTS) from forward landing tasks to assess dynamic postural stability in ACL reconstructed (ACLR) athletes in order to identify impaired sensorimotor control and mechanical stability. This may not be an appropriate test due to the fact that research has suggested that ACL injury has a multi-planar mechanism of injury. The purpose of the present study was to compare TTS values from a forward land and a diagonal land to determine if diagonal landing TTS values are more sensitive to dynamic postural stability deficits in female ACLR athletes.

METHODS

A group of ACL reconstructed female athletes and a group of female control athletes performed three forward lands and three diagonal lands onto a force-plate and remained still on one foot for 15s. TTS was calculated for the anterior-posterior and medial-lateral ground reaction forces as well as the resultant vector of both forces.

RESULTS

All three TTS values were significantly increased in the ACLR group from the control group for the diagonal landing task. There was no difference in TTS values between the groups for the forward landing task.

CONCLUSION

TTS values from a diagonal landing are more sensitive at detecting impaired dynamic postural stability in a group of female ACLR athletes compared to TTS values from a forward land.

LEVEL OF EVIDENCE

III - Casecontrolled study.

Different Sagittal Angles and Moments of Lower Extremity Joints during Single-leg Jump Landing among Various Directions in Basketball and Volleyball Athletes

[Purpose] The purpose of this study was to assess the sagittal angles and moments of lower extremity joints during single-leg jump landing in various directions. [Subjects] Eighteen male athletes participated in the study. [Methods] Participants were asked to perform single-leg jump-landing tests in four directions. Angles and net joint moments of lower extremity joints in the sagittal plane were investigated during jump-landing tests from a 30-cm-high platform with a Vicon™ motion system. The data were analyzed with one-way repeated measures ANOVA. [Results] The results showed that knee joint flexion increased and hip joint flexion decreased at foot contact. In peak angle during landing, increasing ankle dorsiflexion and decreasing hip flexion were noted. In addition, an increase in ankle plantarflexor moment occurred. [Conclusion] Adjusting the dorsiflexion angle and plantarflexor moment during landing might be the dominant strategy of athletes responding to different directions of jump landing. Decreasing hip flexion during landing is associated with a stiff landing. Sport clinicians and athletes should focus on increasing knee and hip flexion angles, a soft landing technique, in diagonal and lateral directions to reduce risk of injury.

The Effect of Jump-Landing Directions on Dynamic Stability

Dynamic stability is often measured by time to stabilization (TTS), which is calculated from the dwindling fluctuations of ground reaction force (GRF) components over time. Common protocols of dynamic stability research have involved forward or vertical jumps, neglecting different jump-landing directions. Therefore, the purpose of the present investigation was to examine the influence of different jump-landing directions on TTS. Twenty healthy participants (9 male, 11 female; age = 28 ± 4 y; body mass = 73.3 ± 21.5 kg; body height = 173.4 ± 10.5 cm) completed the Multi-Directional Dynamic Stability Protocol hopping tasks from four different directions—forward, lateral, medial, and backward—landing single-legged onto the force plate. TTS was calculated for each component of the GRF (ap = anterior-posterior; ml = medial-lateral; v = vertical) and was based on a sequential averaging technique. All TTS measures showed a statistically significant main effect for jump-landing direction. TTSml showed significantly longer times for landings from the medial and lateral directions (medial: 4.10 ± 0.21 s, lateral: 4.24 ± 0.15 s, forward: 1.48 ± 0.59 s, backward: 1.42 ± 0.37 s), whereas TTSap showed significantly longer times for landings from the forward and backward directions (forward: 4.53 ± 0.17 s, backward: 4.34 0.35 s, medial: 1.18 ± 0.49 s, lateral: 1.11 ± 0.43 s). TTSv showed a significantly shorter time for the forward direction compared with all other landing directions (forward: 2.62 ± 0.31 s, backward: 2.82 ± 0.29 s, medial: 2.91 ± 0.31 s, lateral: 2.86 ± 0.32 s). Based on these results, multiple jump-landing directions should be considered when assessing dynamic stability.

Altered Peak Knee Valgus during Jump-Landing among Various Directions in Basketball and Volleyball Athletes

Purpose

Excessive knee valgus during landing tasks is a contributing factor to knee injuries. Most studies have examined lower extremity biomechanics during the forward direction of a jump-landing task. Athletes perform many movements in the air and land in multi-directions. Therefore, the purpose of this study was to assess the peak knee valgus angle (PKVA) during one leg jump-landing in various directions.

Methods

Eighteen male basketball and volleyball athletes participated in the study. Participants performed one leg jump-landing tests from a 30 cm height platform in four directions. Knee valgus motion was measured using Vicon™ motion system. The data were analyzed with repeated measures ANOVA.

Results

Direction significantly (P<0.001) influenced the PKVA during landing. Significantly higher PKVA was observed for the lateral (8.8°±4.7°) direction as compared to forward (5.8°±4.6°) direction (P<0.05). The PKVA in 30° diagonal (7.5°±4.6°) and 60° diagonal (7.7°±5.7°) directions was higher than in the forward direction (P<0.05).

Conclusion

One leg jump-landing in lateral and diagonal directions results in a higher PKVA compared to landing in a forward direction and could lead to a higher risk of knee injury.

Fatigue-induced alterations of static and dynamic postural control in athletes with a history of ankle sprain

CONTEXT

Sensorimotor control is impaired after ankle injury and in fatigued conditions. However, little is known about fatigue-induced alterations of postural control in athletes who have experienced an ankle sprain in the past.

OBJECTIVE

To investigate the effect of fatiguing exercise on static and dynamic balance abilities in athletes who have successfully returned to preinjury levels of sport activity after an ankle sprain.

DESIGN

Cohort study.

SETTING

University sport science research laboratory.

PATIENTS OR OTHER PARTICIPANTS

30 active athletes, 14 with a previous severe ankle sprain (return to sport activity 6-36 months before study entry; no residual symptoms or subjective instability) and 16 uninjured controls.

INTERVENTION(S)

Fatiguing treadmill running in 2 experimental sessions to assess dependent measures.

MAIN OUTCOME MEASURE(S)

Center-of-pressure sway velocity in single-legged stance and time to stabilization (TTS) after a unilateral jump-landing task (session 1) and maximum reach distance in the Star Excursion Balance Test (SEBT) (session 2) were assessed before and immediately after a fatiguing treadmill exercise. A 2-factorial linear mixed model was specified for each of the main outcomes, and effect sizes (ESs) were calculated as Cohen d.

RESULTS

In the unfatigued condition, between-groups differences existed only for the anterior-posterior TTS (P = .05, ES = 0.39). Group-by-fatigue interactions were found for mean SEBT (P = .03, ES = 0.43) and anterior-posterior TTS (P = .02, ES = 0.48). Prefatigue versus postfatigue SEBT and TTS differences were greater in previously injured athletes, whereas static sway velocity increased similarly in both groups.

CONCLUSIONS

Fatiguing running significantly affected static and dynamic postural control in participants with a history of ankle sprain. Fatigue-induced alterations of dynamic postural control were greater in athletes with a previous ankle sprain. Thus, even after successful return to competition, ongoing deficits in sensorimotor control may contribute to the enhanced ankle reinjury risk.

Examining the diagnostic accuracy of dynamic postural stability measures in differentiating among ankle instability status

BACKGROUND

Dynamic postural stability is defined as the ability to transition from a dynamic movement to a stable condition over one's base of support. Measures of dynamic stability have been used extensively to classify ankle instability status and assist clinicians with ankle injury interventions. Therefore, the purpose of this study was to determine if current methods of quantifying dynamic stability are accurate in differentiating among healthy, coper, and unstable ankles.

METHODS

One hundred ninety four Division-I collegiate athletes (football, volleyball, field hockey, men's/women's soccer, men's/women's lacrosse, men's/women's basketball) volunteered for this study. Participants were categorized into healthy, coper, and stable groups by a self-reported questionnaire and previous history of ankle injuries. Dynamic postural stability was assessed using the Multi-Directional Dynamic Stability Protocol by jumping and landing single-legged onto a force platform from four different directions. Receiver operator curves were used to analyze the accuracy of current techniques of calculating dynamic stability among groups.

FINDINGS

None of the existing methods were found to be accurate in differentiating ankle instability status in any of the jump landings.

INTERPRETATION

Researchers have commonly used these existing methods to quantify dynamic postural stability. None of the current calculation techniques worked with our jump landing protocol. Researchers need to pay attention to the protocol and calculation technique pairings in that using inaccurate measures of dynamic postural stability makes any findings of that research ineffective. Therefore, this challenges researchers to develop a more accurate calculation to quantify dynamic postural stability, or develop a jump landing protocol that exposes sensorimotor deficits in the more able-bodied population.

Balance measures for discriminating between functionally unstable and stable ankles

PURPOSE

To identify force plate measures that discriminate between ankles with functional instability and stable ankles and to determine the most accurate force plate measure for enabling this distinction.

METHODS

Twenty-two subjects (177 +/- 10 cm, 77 +/- 16 kg, 21 +/- 2 yr) without a history of ankle injury and 22 subjects (177 +/- 10 cm, 77 +/- 16 kg, 20 +/- 2 yr) with functional ankle instability (FAI) performed a single-leg static balance test and a single-leg jump-landing dynamic balance test. Static force plate measures analyzed in both anterior/posterior (A/P) and medial/lateral (M/L) directions included the following: ground reaction force (GRF) SD; center-of-pressure (COP) SD; mean, maximum, and total COP excursion; and mean and maximum COP velocity. COP area was also analyzed for static balance. A/P and M/L time to stabilization quantified dynamic balance. Greater values of force plate measures indicated impaired balance. A stepwise discriminant function analysis examined group differences, group classification, and accuracy of force plate measures for discriminating between ankle groups.

RESULTS

The FAI group had greater values than the stable ankle group for A/P GRF SD (P = 0.027), M/L GRF SD (P = 0.006), M/L COP SD (P = 0.046), A/P mean COP velocity (P = 0.015), M/L mean COP velocity (P = 0.016), A/P maximum COP velocity (P = 0.037), M/L mean COP excursion (P = 0.014), M/L total COP excursion (P = 0.016), A/P time to stabilization (P = 0.011), and M/L time to stabilization (P = 0.040). M/L GRF SD and A/P time to stabilization had the greatest accuracy scores of 0.73 and 0.72, respectively.

CONCLUSION

Although 10 measures identified group differences, M/L GRF SD and A/P time to stabilization were the most accurate in discriminating between ankle groups. These results provide evidence for choosing these GRF measures for evaluating static and dynamic balance deficits associated with FAI.