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Turner JA, Chaaban CR, Padua DA. Validation of OpenCap: A low-cost markerless motion capture system for lower-extremity kinematics during return-to-sport tasks. J Biomech 2024; 171:112200. [PMID: 38905926 DOI: 10.1016/j.jbiomech.2024.112200] [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: 01/28/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
Low-cost markerless motion capture systems offer the potential for 3D measurement of joint angles during human movement. This study aimed to validate a smartphone-based markerless motion capture system's (OpenCap) derived lower extremity kinematics during common return-to-sport tasks, comparing it to an established optoelectronic motion capture system. Athletes with prior anterior cruciate ligament reconstruction (12-18 months post-surgery) performed three movements: a jump-landing-rebound, single-leg hop, and lateral-vertical hop. Kinematics were recorded concurrently with two smartphones running OpenCap's software and with a 10-camera, marker-based motion capture system. Validity of lower extremity joint kinematics was assessed across 437 recorded trials using measures of agreement (coefficient of multiple correlation: CMC) and error (mean absolute error: MAE, root mean squared error: RMSE) across the time series of movement. Agreement was best in the sagittal plane for the knee and hip in all movements (CMC > 0.94), followed by the ankle (CMC = 0.84-0.93). Lower agreement was observed for frontal (CMC = 0.47-0.78) and transverse (CMC = 0.51-0.6) plane motion. OpenCap presented a grand mean error of 3.85° (MAE) and 4.34° (RMSE) across all joint angles and movements. These results were comparable to other available markerless systems. Most notably, OpenCap's user-friendly interface, free software, and small physical footprint have the potential to extend motion analysis applications beyond conventional biomechanics labs, thus enhancing the accessibility for a diverse range of users.
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Affiliation(s)
- Jeffrey A Turner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Courtney R Chaaban
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Darin A Padua
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Emamvirdi M, Hosseinzadeh M, Letafatkar A, Thomas AC, Dos'Santos T, Smania N, Rossettini G. Comparing kinematic asymmetry and lateral step-down test scores in healthy, chronic ankle instability, and patellofemoral pain syndrome female basketball players: a cross-sectional study. Sci Rep 2023; 13:12412. [PMID: 37524846 PMCID: PMC10390571 DOI: 10.1038/s41598-023-39625-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023] Open
Abstract
We aimed to understand whether ankle dorsiflexion range of motion (ROM) and dynamic knee valgus (DKV) kinematic inter-limb asymmetries would be associated with the Lateral Step-Down Test (LSD) in basketball players with chronic ankle instability (CAI), patellofemoral pain (PFP) and healthy controls (HC). An observational cross-sectional study with a between-subject design was employed. Female basketball athletes with CAI (n = 20), PFP (n = 20) and HC (n = 20) were recruited. Ankle dorsiflexion-ROM, DKV angle during a single-limb squat, and LSD quality were measured bilaterally. The Asymmetry index (ASI) was calculated to identify between-limb percentage imbalances. The correlation matrix between the tasks was calculated. Ankle dorsiflexion-ROM was less in the CAI and PFP than in the HC group regardless of limb (p < 0.001). DKV angle was greater in the CAI and PFP than in the HC group bilaterally (p < 0.001). LSDs were similar between the PFP and CAI groups (p = 0.698) but worse than the HC group (p = 0.001). The ASI showed asymmetry across all tasks (p < 0.001), with the greatest asymmetry for the DKV angle. The correlation matrix between tasks on both limbs was significant (p < 0.05). Our findings suggest significant asymmetries in ankle dorsiflexion-ROM and frontal plane knee control are present in female basketball athletes with CAI and PFP, and thus, highlights need to evaluate and reduce limb asymmetries in these populations.
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Affiliation(s)
- Mahsa Emamvirdi
- Department of Biomechanics and Sport Injuries, Kharazmi University, Tehran, Iran
| | - Mahdi Hosseinzadeh
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, No. 3, 5th Alley, Miremad Street, Motahhari Street, P O Box: 1587958711, Tehran, Iran.
| | - Amir Letafatkar
- Sports Injury and Corrective Exercises, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
| | - Abbey C Thomas
- Department of Applied Physiology, Health, and Clinical Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Thomas Dos'Santos
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Nicola Smania
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), University of Verona, Verona, Italy
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Guimaraes Araujo S, Rocha Nascimento L, Ramiro Felício L. Functional tests in women with patellofemoral pain: Which tests make a difference in physical therapy evaluation. Knee 2023; 42:347-356. [PMID: 37148617 DOI: 10.1016/j.knee.2023.04.012] [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: 10/18/2022] [Revised: 03/24/2023] [Accepted: 04/11/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Patellofemoral pain (PFP) is characterized by anterior knee, which intensifies during functional activities that require the eccentric action of the quadriceps muscle, specially. In ths way, quantitatively measurable functional tests that simulate these activities should be included in the physical therapy evaluation. OBJECTIVE To identify which functional tests are most indicated for the evaluation of women with PFD. METHOD This study evaluated 100 young women (50 with PFP), during the execution of the following functional performance tests: Triple hop, Vertical Jump, Single leg squat, Step Down, YBalance tests, Lunge test and running. Dynamic valgus was also assessed in the tests. The isometric muscle strength of the following muscle groups: hip abductors, extensors and lateral rotators, knee extensors, evertors, and plantar flexors were evaluated. Functional Perception were evaluated by Anterior Knee Pain Scale and Activities of Daily Living Scale. RESULTS PFP group showed lower performance during the Y-Balance, triple hop, vertical jump tests and running. Was observed an increase in dynamic valgus during Triple Hop, Vertical Jump tests and running in PFP group, besides a poorer perception of function. For all lower limb muscle groups, the PFP group showed a reduction in peak isometric force. CONCLUSION The YBalance, triple hop, vertical jump tests, and running should be included in the physical therapy evaluation, in addition to aspects of lower limb muscle strength.
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Affiliation(s)
- Samara Guimaraes Araujo
- Post Graduation Program in Physical Therapy, Universidade Federal de Uberlândia, Minas Gerais, Brazil
| | | | - Lilian Ramiro Felício
- Post Graduation Program in Physical Therapy, Universidade Federal de Uberlândia, Minas Gerais, Brazil; Physical Therapy Course, Universidade Federal de Uberlândia, Minas Gerais, Brazil.
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Silva NC, Silva MDC, Tamburús NY, Guimarães MG, Nascimento MBDO, Felicio LR. Adding neuromuscular training to a strengthening program did not produce additional improvement in clinical or kinematic outcomes in women with patellofemoral pain: A blinded randomised controlled trial. Musculoskelet Sci Pract 2023; 63:102720. [PMID: 36732139 DOI: 10.1016/j.msksp.2023.102720] [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: 08/24/2022] [Revised: 12/26/2022] [Accepted: 01/16/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND Patellofemoral pain (PFP) is a knee pain condition with multifactorial aetiology, twice common in women. The recommended conservative treatment is based on strengthening of the core, hip, and knee musculatures. Addition of neuromuscular training to a strengthening protocol might provide further benefits on pain, function, and kinematics in PFP individuals. However, evidence for the effectiveness of this protocol is lacking. OBJECTIVE To investigate whether adding neuromuscular training to strengthening program could provide any additional improvements of pain, function, and kinematics in PFP women. METHODS 71 PFP women were randomly into two groups and submitted to different interventions for 12 weeks. The strengthening group (SG) performed strengthening exercises for the trunk, hip, and knee muscles, while the neuromuscular training group (NMTG) performed the same exercises as SG, plus neuromuscular training from the 4th week onwards. The primary outcomes were pain intensity, function, and 2-D kinematics of the trunk and lower limb. The secondary outcomes were isometric muscle strength and patient satisfaction level. All outcomes were evaluated at 12 weeks, immediately post-treatment. RESULTS At 12 weeks, there was no evidence of between-group differences for any outcome, but both interventions provided clinically significant improvements for pain intensity (SG: mean difference -3.9, 95% confidence interval [CI] -5.0, -2.9; NMTG: mean difference -3.1, 95% CI -4.1, -2.0) and function (SG: mean difference 15.3, 95% CI 11.5, 19.2; NMTG: mean difference 16.9, 95% CI 13.2, 20.7). CONCLUSION Neuromuscular training did not produce any additional benefits for pain, function, or kinematics at 12 weeks of treatment.
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Affiliation(s)
- Natália Camin Silva
- Physiotherapy Postgraduate Program, Universidade Federal de Uberlândia, Minas Gerais, Brazil.
| | - Matheus de Castro Silva
- Physiotherapy Postgraduate Program, Universidade Federal de Uberlândia, Minas Gerais, Brazil
| | | | | | | | - Lilian Ramiro Felicio
- Physiotherapy Postgraduate Program, Universidade Federal de Uberlândia, Minas Gerais, Brazil.
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Mauro KR, de Menezes Cantusio L, de Brito Menezes KG, Jacon Sarro K. Reliability of the Frontal Plane Knee Alignment Measurement Based on a Remote Protocol. Int J Telerehabil 2022; 14:e6506. [PMID: 38026569 PMCID: PMC10681043 DOI: 10.5195/ijt.2022.6506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Introduction The analysis of movement quality is important for better exercise prescription. This study tested the reproducibility of a protocol for remote assessment of dynamic knee alignment using images taken by patients. Methods Thirteen women filmed themselves performing single-leg squats on two days at a 15-day interval. Three raters measured the knee frontal plane projection angle using the resultant images. Results Two participants (15.4%) were excluded for not performing the protocol correctly. The intraclass correlation coefficient was between 0.880 and 0.999 for the intra-rater comparison, and between 0.817 and 0.987 for the inter-rater comparison. Discussion The success of the protocol in 84.6% of participants and the excellent reproducibility suggest that the methodology of analyzing patient-captured cell phone images might be a plausible alternative for remote evaluation of dynamic knee alignment.
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Lally EM, Thorpe J, Ericksen H, Earl-Boehm J. Reliability and criterion validity of two-dimensional movement assessments in those with patellofemoral pain. Phys Ther Sport 2022; 58:134-140. [DOI: 10.1016/j.ptsp.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 10/31/2022]
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Ulman S, Erdman AL, Loewen A, Õunpuu S, Chafetz R, Wren TAL, Tulchin-Francis K. Trunk and lower-extremity kinematics differ based on step-down tap variation: An assessment of methodology for a return-to-play protocol using motion analysis. Gait Posture 2022; 98:180-186. [PMID: 36155000 DOI: 10.1016/j.gaitpost.2022.09.079] [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: 12/10/2021] [Revised: 08/22/2022] [Accepted: 09/19/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The step-down tap (SDT) is a commonly used task to assess unilateral neuromuscular control and to identify deficient movement patterns of the trunk and lower extremities. However, instruction of the SDT varies greatly in recent reports, which may alter the clinical interpretation of potential movement deficiencies. RESEARCH QUESTION The purpose of this study was to identify differences in trunk and lower extremity kinematics between variations of a step-down tap that differ based on step direction, fixing the arms or stance foot, and trial collection methods. METHODS This study followed a single-group repeated measures design in a laboratory setting. Three-dimensional angles of the trunk, hip, and knee of 18 participants were evaluated at 60 degrees of knee flexion and at maximum squat depth during six SDT variations. Wilcoxon signed rank tests were performed to determine the effects of an anterior verse lateral step direction, a fixed arm or stance foot position, and an individual verse continuous trial collection method. RESULTS Knee flexion, external pelvic rotation, and external trunk rotation were greater in the anterior SDT, while the lateral SDT elicited greater pelvic tilt and hip flexion. Additionally, overall squat depth was greater across participants during the anterior SDT. Few clinically significant differences (≥3°) were observed due to fixing arm or stance foot position, and no differences were identified based on trial collection methods. SIGNIFICANCE The standardization of task instructions for motion analysis protocols utilized for research purposes and/or clinical decision-making is crucial. Specifically, for the SDT, the authors recommend using the anterior step direction. A fixed arm and stance foot position is not necessary, and trials may be collected individually or continuously based on convenience for a small number of repetitions.
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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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The association and reliability of the frontal plane projection angle during the lateral step down test on knee function in patients with patellofemoral pain. Knee 2022; 36:87-96. [PMID: 35561562 DOI: 10.1016/j.knee.2022.04.010] [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: 08/02/2021] [Revised: 04/03/2022] [Accepted: 04/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The lateral step-down test is used by physical therapists (PT) to identify movement faults in patients with patellofemoral pain (PFP). The FPPA is a measure of knee valgus and PTs have access to open source video analysis software and high quality smart phones and video cameras to implement 2D video analysis into practice. The purpose of our study was to determine the reliability of PTs measuring the frontal plane projection angle (FPPA) during the lateral step-down test, and to determine if the FPPA was associated with pain, self-reported knee function and fear of movement. METHODS Twenty-two subjects (mean age[SD] = 27.8 [6.6] years, females n = 14, males n = 8) with PFP were analyzed by six PTs using 2D video analysis software. The FPPA was measured during the lateral step down test. Numeric Pain Rating Scale (NPRS), Anterior Knee Pain Scale (AKPS) and the Tampa Scale of Kinesiophobia (TSK) were collected. Intraclass correlation (ICC) was used to assess for PT measurement reliability. Correlations between outcomes were calculated using Spearman correlation coefficient and standard error of measurement (SEM) and minimal detectable change (MDC) were reported. RESULTS Reliability amongst PTs measuring the FPPA was good (ICC [95 %CI] = 0.85 [0.72-0.93]; SEM = 3.33°, MDC = 9.20°). There were no significant correlations (p > 0.05) between FPPA and NPRS(ρ = -0.046), AKPS(ρ = 0.066), or TSK(ρ = -0.204). CONCLUSIONS Although reliability measuring FPPA was good, the large SEM and MDC associated with this measurement may limit its clinical utility in those with PFP.
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Association between Selected Screening Tests and Knee Alignment in Single-Leg Tasks among Young Football Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116719. [PMID: 35682301 PMCID: PMC9179976 DOI: 10.3390/ijerph19116719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/28/2022] [Accepted: 05/28/2022] [Indexed: 01/25/2023]
Abstract
This study aimed to examine the relationship between knee valgus in the frontal plane projection angle (FPPA) during single-leg squat (SLS), single-leg landing (SLL), and other selected clinical tests in young athletes. Forty-three young healthy elite football players (age: 13.2 (1.7) years) that were regularly training in a local sports club participated in the study. The FPPA was assessed using 2D video analysis. The screening tests included the passive single-leg raise (PSLR), hip external and internal rotation (hip ER and IR), sit and reach test, weight-bearing lunge test (WBLT), modified star excursion balance test (mSEBT), countermovement jump (CMJ), single-leg hop for distance (SLHD), and age peak height velocity (APHV). There was a significant positive relationship between the knee valgus angles in the SLS test and the sit and reach test (r = 0.34) and a negative relationship with the hip ER ROM (r = −0.34) (p < 0.05). The knee valgus angles in the SLL were negatively associated with the hip IR (r = −0.32) and ER ROM (r = −0.34) and positive associated with the WBLT (r = 0.35) and sit and reach test (r = 0.33) (p < 0.05). Linear regression analysis showed that the results of the hip ER ROM and sit and reach tests were independent predictors of the FPPA in the SLS test (r2 = 0.11, p = 0.03 and r2 = 0.12, p = 0.02, respectively). The conducted study showed that individuals with more hip range of motion, more spine flexion extensibility, and less ankle dorsiflexion ROM may be more likely to experience high degrees of knee valgus in FPPA.
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Waldhelm A, Allen S, Grand L, Bopp C, Foster K, Muckridge G, Schwarz N. Reliability and Differences Between Sexes in Landing Mechanics when Performing the Lateral Bound Test. Int J Sports Phys Ther 2022; 17:466-473. [PMID: 35391862 PMCID: PMC8975571 DOI: 10.26603/001c.33067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background and Purpose Anterior cruciate ligament injuries are prevalent among the athletic population, imposing a heavy economic burden, and the risk of re-injury. Most current biomechanical screening tasks are performed in the sagittal plane, and there is a need for more screening tools that assess sports specific movements in the frontal plane. The purpose of this study was to determine the reliability of and examine differences between sexes in the performance of the Lateral Bound Test (LBT). Materials/Methods Each subject performed three trials of a LBT which included jumping laterally from one leg over a hurdle and landing on the opposite leg. Two cameras were placed six feet from the landing marker. Maximum dynamic knee valgus using the frontal plane projection angle and knee flexion angle at initial contact and maximal knee flexion were measured upon landing leg using 2D video analysis software. Additionally, video of 10 individuals' trials were analyzed twice with one week between the analyses to obtain intra-rater reliability while 12 participants were retested one week later to determine test-retest reliability. Results Thirty healthy subjects, 16 males, 14 females participated. Intra-rater reliability was determined to be excellent for all variables (ICC>0.96). In contrast, the test-retest reliability had greater disparity. Test-retest reliability ranged from poor (ICC = 0.47) to excellent (ICC > 0.90). Significant differences existed between the sexes, including males being significantly taller, weighing more, and demonstrating greater bilateral dynamic knee valgus (p < 0.05). No significant differences existed between sexes for knee flexion angles. Conclusion The new LBT had excellent intra-rater reliability for assessing dynamic knee valgus and initial and maximum knee flexion angle when performing a functional movement in the frontal plane. Furthermore, males landed with more dynamic knee valgus than females which is contradictory to what has been observed with functional screening tools performed in the sagittal plane. Level of Evidence 3b (reliability study).
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Affiliation(s)
- Andy Waldhelm
- South College, Doctor of Physical Therapy Program, Knoxville, TN, USA; University of South Alabama, Physical Therapy Department, Mobile, AL, USA
| | - Sydney Allen
- Physical Therapy Department, University of South Alabama, Mobile, AL, USA
| | - Lacy Grand
- Physical Therapy Department, University of South Alabama, Mobile, AL, USA
| | - Carolyn Bopp
- Physical Therapy Department, University of South Alabama, Mobile, AL, USA
| | - Kristian Foster
- Physical Therapy Department, University of South Alabama, Mobile, AL, USA
| | - Ginger Muckridge
- Physical Therapy Department, University of South Alabama, Mobile, AL, USA
| | - Neil Schwarz
- Department of Health, Kinesiology and Sport, University of South Alabama, Mobile, AL, USA
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Measurement Properties of Clinically Accessible Movement Assessment Tools for Analyzing Single-Leg Squats and Step-Downs: A Systematic Review. J Sport Rehabil 2022; 31:476-489. [PMID: 34996031 DOI: 10.1123/jsr.2021-0287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Poor lower-extremity biomechanics are predictive of increased risk of injury. Clinicians analyze the single-leg squat (SLS) and step-down (SD) with rubrics and 2D assessments to identify these poor lower-extremity biomechanics. However, evidence on measurement properties of movement assessment tools is not strongly outlined. Measurement properties must be established before movement assessment tools are recommended for clinical use. OBJECTIVE The purpose of this study was to systematically review the evidence on measurement properties of rubrics and 2D assessments used to analyze an SLS and SD. EVIDENCE ACQUISITION The search strategy was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The search was performed in PubMed, SPORTDiscus, and Web of Science databases. The COnsensus-based Standards for the selection of health Measurement INstruments multiphase procedure was used to extract relevant data, evaluate methodological quality of each study, score the results of each movement assessment, and synthesize the evidence. EVIDENCE SYNTHESIS A total of 44 studies were included after applying eligibility criteria. Reliability and construct validity of knee frontal plane projection angle was acceptable, but criterion validity was unacceptable. Reliability of the Chmielewski rubric was unacceptable. Content validity of the knee-medial-foot and pelvic drop rubrics was acceptable. The remaining rubrics and 2D measurements had inconclusive or conflicting results regarding reliability and validity. CONCLUSIONS Knee frontal plane projection angle is reliable for analyzing the SLS and SD; however, it does not serve as a substitute for 3D motion analysis. The Chmielewski rubric is not recommended for assessing the SLS or SD as it may be unreliable. Most movement assessment tools yield indeterminate results. Within the literature, standardized names, procedures, and reporting of movement assessment tool reliability and validity are inconsistent.
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Measurement Properties of Clinically Accessible Movement Assessment Tools for Analyzing Jump Landings: A Systematic Review. J Sport Rehabil 2022; 31:465-475. [PMID: 34996030 DOI: 10.1123/jsr.2021-0288] [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: 08/03/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Lower-extremity musculoskeletal injury is commonly associated with poor movement patterns at the trunk, hip, and knee. Efforts have been focused on identifying poor lower-extremity movement using clinically friendly movement assessments, such as rubrics and 2D measures. Assessments used clinically or for research should have acceptable measurement properties, such as reliability and validity. However, the literature on reliability and validity of movement assessments to analyze jump landings has not been summarized. OBJECTIVE To systematically review measurement properties of rubrics and 2D measurements that aim to classify movement quality during jump landings. EVIDENCE ACQUISITION The search strategy was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The search was performed in PubMed, SPORTDiscus, and Web of Science databases. The COnsensus-based Standards for the selection of health Measurement INstruments multiphase procedure was used to extract relevant data, evaluate methodological quality of each study, score the results of each movement assessment, and synthesize the evidence. EVIDENCE SYNTHESIS Twenty-two studies were included after applying eligibility criteria. Reliability and construct validity of the landing error scoring system were acceptable. Criterion validity of 2D knee flexion angle and medial knee displacement is acceptable. Reliability of 2D knee ankle separation ratio and knee frontal plane projection angle are acceptable. CONCLUSION The landing error scoring system is a valid way to determine poor movement quality and injury risk. Measures of 2D knee flexion angle and medial knee displacement are valid alternatives for 3D knee flexion angle and knee abduction moment, respectively. Knee ankle separation ratio and knee frontal plane projection angle are reliable but lack validity justifying their clinical use.
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Three-dimensional joint kinematic and two-dimensional quality of movement comparison between lateral and forward step-downs. Phys Ther Sport 2021; 52:162-167. [PMID: 34536631 DOI: 10.1016/j.ptsp.2021.09.005] [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: 05/28/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES While lateral and forward step-down tasks are commonly used, they may have different kinematic and performance demands that could influence clinical assessment and rehabilitation. Therefore, the purpose of this study was to compare 3D lower extremity kinematics and 2D quality of movement between the tasks. DESIGN Cross-sectional comparative study. SETTING Research laboratory. PARTICIPANTS Thirty healthy adults (18 females, age = 23.2 ± 1.4 years, BMI = 23.9 ± 2.2 kg/m2). MAIN OUTCOME MEASURES Participants underwent 3D and 2D motion analysis. 3D variables were peak hip, knee, and ankle angles. Dichotomous clinical criteria were used for 2D assessment. An alpha level of 0.05 was used for statistical analyses. RESULTS In the sagittal plane, the forward step-down averaged 7° more knee flexion (p < 0.001, d = 2.30) and 4° more ankle dorsiflexion (p < 0.001, d = 1.72), but 2° less hip flexion (p = 0.001, d = 0.64). In the frontal plane, forward step-downs averaged 1° more hip adduction (p = 0.006, d = 0.54) and 1° more ankle eversion (p < 0.001, d = 1.04). The forward step-down elicited 2D movement faults more often (p = 0.003). CONCLUSIONS The increased knee flexion and ankle dorsiflexion demands of the forward step-down were accompanied by increases in frontal plane aberrations. The forward step-down may be more challenging for individuals with reduced tolerance to loaded knee flexion and/or limited ankle mobility.
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Impact of Three Strengthening Exercises on Dynamic Knee Valgus and Balance with Poor Knee Control among Young Football Players: A Randomized Controlled Trial. Healthcare (Basel) 2021; 9:healthcare9050558. [PMID: 34068810 PMCID: PMC8151944 DOI: 10.3390/healthcare9050558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
The observed dynamic knee valgus and the limited dynamic balance described in the literature are modifiable risk factors for injuries in athletes. Therefore, identification and appropriate prevention are crucial in managing the development of young athletes. The aim of the study was to assess the effectiveness of three exercises strengthening the muscles: gluteal medius, popliteal and tibialis posterior to reduce dynamic knee valgus and improve the dynamic balance of the lower limbs in young football players with poor knee control. A total of 134 footballers were assessed for eligibility, and finally 45 participants (age 12–15) met the inclusion criteria. Participants were assessed with 2D video kinematic analysis during single-leg squats to assess the knee valgus angles and the dynamic balance (Y-Balance Test). No significant interactions between groups (Control and Exercise) and time (baseline and after 6 week) were noted for dynamic valgus for the left and right knee (p > 0.05). For the dynamic balance, there were statistically significant results, but not clinically relevant for anterior, posteromedial, and composite direction for the right lower limbs and for the anterior direction for left lower limbs in the exercise group. However, there were no significant differences (p > 0.05) in all of the YBT scores for both lower limbs between groups. This study demonstrated that there were no statistically significant differences in dynamic knee valgus angles and dynamic balance values after 6 weeks of exercise program in young footballers with poor knee control. Future randomized trials should focus on more comprehensive exercises, where possible using biofeedback methods to improve knee kinematics.
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Dynamic Knee Valgus in Single-Leg Movement Tasks. Potentially Modifiable Factors and Exercise Training Options. A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218208. [PMID: 33172101 PMCID: PMC7664395 DOI: 10.3390/ijerph17218208] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/29/2020] [Accepted: 11/04/2020] [Indexed: 12/19/2022]
Abstract
Dynamic knee valgus (DKV) as an incorrect movement pattern is recognized as a risk factor for lower limb injuries. Therefore, it is important to find the reasons behind this movement to select effective preventive procedures. There is a limited number of publications focusing on specific tasks, separating the double-leg from the single-leg tasks. Test patterns commonly used for DKV assessment, such as single-leg squat (SLS) or single leg landings (SLL), may show different results. The current review presents the modifiable factors of knee valgus in squat and landing single-leg tests in healthy people, as well as exercise training options. The authors used the available literature from PubMed, Scopus, PEDro and clinicaltrials.gov databases, and reviewed physiotherapy journals and books. For the purpose of the review, studies were searched for using 2D or 3D motion analysis methods only in the SLL and SLS tasks among healthy active people. Strengthening and activating gluteal muscles, improving trunk lateral flexion strength, increasing ROM dorsiflexion ankle and midfoot mobility should be taken into account when planning training programs aimed at reducing DKV occurring in SLS. In addition, knee valgus during SLL may occur due to decreased hip abductors, extensors, external rotators strength and higher midfoot mobility. Evidence from several studies supports the addition of biofeedback training exercises to reduce the angles of DKV.
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Kingston B, Murray A, Norte GE, Glaviano NR. Validity and reliability of 2-dimensional trunk, hip, and knee frontal plane kinematics during single-leg squat, drop jump, and single-leg hop in females with patellofemoral pain. Phys Ther Sport 2020; 45:181-187. [PMID: 32823213 DOI: 10.1016/j.ptsp.2020.07.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/15/2020] [Accepted: 07/18/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate validity and between-session reliability of frontal plane trunk, hip, and knee kinematics during three functional tasks in females with patellofemoral pain (PFP). DESIGN Observational. SETTING Research Laboratory. PARTICIPANTS 20 females with PFP (22.7 ± 3.2 years, 69.9 ± 9.2 kg, 167.7 ± 9.6 cm). MAIN OUTCOME MEASURES Trunk, hip, and knee frontal plane peak angles during the single leg squat (SLS), drop vertical jump (DVJ), and single leg hop (SLH) kinematics were evaluated using 2-dimensional (2D) and 3-dimensional (3D) motion capture. Participants returned to the lab one week later and competed a second 2D analysis of the functional tasks. Concurrent validity was assessed by evaluating relationship between 2D and 3D frontal plane kinematics with Pearson correlations. Between-session reliability was assessed by evaluating 2D kinematics with intraclass correlation coefficients by a single assessor. RESULTS Moderate to strong correlations (r = 0.55-0.76, p < .05) were found for frontal plane hip kinematics during all three tasks and the trunk during the SLH. Frontal plane kinematics demonstrated good to excellent test-retest reliability for each of the three tasks, (ICC (2,1) = 0.70-0.90). CONCLUSION 2D hip joint angles during the three functional tasks were the only valid frontal plane angles. Trunk, hip, and knee 2D frontal plane kinematics ranged between good-excellent reliability.
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Affiliation(s)
- Brianna Kingston
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, OH, USA
| | - Amanda Murray
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, OH, USA
| | - Grant E Norte
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, OH, USA
| | - Neal R Glaviano
- School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, OH, USA.
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