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Kikumoto T, Kobayashi M, Omori G, Kubo M. Single-legged landing behavior of high school basketball players with chronic ankle instability. J Bodyw Mov Ther 2024; 39:454-462. [PMID: 38876668 DOI: 10.1016/j.jbmt.2024.03.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/20/2024] [Accepted: 03/19/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES Anterior cruciate ligament injury is one of the most serious ligamentous injuries. The purpose is to compare the impact of the ankle joint on the knee during landing between athletes with chronic instability and a control group (coper group) and to verify the effects of the kinetic chain from other joints. DESIGN Prospective study. SETTING High school basketball. PARTICIPANTS Participants were 62 female high school basketball players who had participated in team sports for >6 months. MAIN OUTCOME MEASURES Player joint angles, movements, and moments. RESULTS The knee valgus moment was significantly higher in the chronic ankle instability group than in the coper group (20%-60% [p < 0.01]; 80%-100% [p < 0.05]) during landing motion. The knee valgus moment was also significantly higher during the change from the maximum knee joint flexion position to the maximum extension (p < 0.05). In addition, the landing motions of the chronic instability group may have utilized suboptimal compensatory motor strategy on the sagittal plane, depending heavily on the knee joint's abduction moment. CONCLUSIONS Our findings indicate that the chronic ankle instability group uses a different landing strategy pattern than the coper group by changing the joint moment and joint angle during landing, which may increase the risk of anterior cruciate ligament injury.
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Affiliation(s)
- Takanori Kikumoto
- Institute for Human Movement and Medical Sciences, Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan.
| | - Marina Kobayashi
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Go Omori
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Masayoshi Kubo
- Institute for Human Movement and Medical Sciences, Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
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Di Paolo S, Grassi A, Tosarelli F, Crepaldi M, Bragonzoni L, Zaffagnini S, Della Villa F. Two-Dimensional and Three-Dimensional Biomechanical Factors During 90° Change of Direction are Associated to Non-Contact ACL injury in Female Soccer Players. Int J Sports Phys Ther 2023; 18:887-897. [PMID: 37547837 PMCID: PMC10399106 DOI: 10.26603/001c.84308] [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: 04/20/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Background The two-dimensional (2D) video-analysis of the change of direction (COD) technique has never been used to attempt to predict the risk of ACL injury in female football players. Hypothesis/Purpose The purpose of the present pilot study was to prospectively investigate the biomechanical predictors of ACL injury during a COD task in female football players using both gold standard 3D motion capture and a qualitative scoring system based on 2D video-analysis. Study Design Prospective cohort study. Methods Sixteen competitive female football (soccer) players (age 21.4 ± 4.3) performed a series of pre-planned 90° COD tasks. 3D motion data was recorded through 10 stereophotogrammetric cameras and a force platform. 2D frontal and transverse plane joint kinematics were computed through video-analysis from three high-speed cameras. A scoring system based on five criteria was adopted: limb stability, pelvis stability, trunk stability, shock absorption, and movement strategy. The players were prospectively followed for the next two consecutive football seasons and the occurrence of severe knee injuries was registered. Results Four players (25%) experienced an ACL injury. In 3D analysis, ACL-injured players showed greater knee valgus, knee internal rotation, and lower knee flexion (p= 0.017 - 0.029). Lower hip flexion coupled with greater external rotation (p= 0.003 - 0.042), ankle eversion, and contralateral pelvic drop (p<0.001) were also noted. In 2D analysis, ACL-injured players showed greater internal foot rotation, contralateral pelvic drop, lower knee flexion, and contralateral trunk tilt (moderate-to-large effect size). Pelvis stability and trunk stability showed the highest predictive value towards ACL injury. Total score was significantly lower in ACL-injured players with a moderate effect size (d=0.45). Conclusions Both 3D and 2D methodologies depicted biomechanical risk factors and offered predictive insights towards the ACL injury risk. Awareness should rise in women's football regarding the high risk of ACL injury and the strategies to assess and mitigate it. Level of Evidence 3©The Author(s).
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Affiliation(s)
| | - Alberto Grassi
- 2nd Orthopaedic and Traumatologic Clinic Istituto Ortopedico Rizzoli
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Takei S, Torii S, Taketomi S, Iizuka S, Tojima M, Iwanuma S, Iida Y, Tanaka S. Developmental stage and lower quadriceps flexibilities and decreased gastrocnemius flexibilities are predictive risk factors for developing Osgood-Schlatter disease in adolescent male soccer players. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07378-z. [PMID: 37002485 DOI: 10.1007/s00167-023-07378-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 03/01/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE This study aimed to elucidate the influential predictive risk factors of Osgood-Schlatter disease (OSD) on the support (non-kicking) leg among adolescent soccer players considering peak height velocity (PHV) age and investigate the cut-off values of the predictive variables. METHODS A cohort of 302 Japanese adolescent male soccer players aged 12-13 years were followed over 6 months. All players underwent physical examination, tibial tubercle ultrasonography, anthropometric and whole-body composition measurements, and muscle flexibility test of the support leg at the baseline. The developmental stage was evaluated from the PHV age. The OSD of the support leg was diagnosed 6 months later; players were divided into the OSD and control (CON) groups. The predictive risk factors were analyzed by multivariate logistic regression analysis. RESULTS There were 42 players who had developed OSD at baseline and they were excluded from the study. Among the 209 players, 43 and 166 belonged to the OSD and CON groups, respectively. The predictive risk factors of OSD development were PHV age ± 6 months at baseline (p = 0.046), apophyseal stage of tibial tuberosity maturity at baseline (p < 0.001), quadriceps flexibility ≥ 35° at baseline (p = 0.017), and decrease in gastrocnemius flexibility in 6 months (p = 0.009). CONCLUSION PHV age ± 6 months at baseline, apophyseal stage of the tibial tuberosity at baseline, quadriceps flexibility ≥ 35° at baseline, and decrease in gastrocnemius flexibility in 6 months are predictive risk factors of OSD development in the support leg among adolescent male soccer players. It is crucial to know the PHV age of each player, and not only the flexibility of quadriceps muscle but also the gastrocnemius should be monitored to predict OSD. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Seira Takei
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Waseda Institute of Human Growth and Development, Saitama, Japan
| | - Suguru Torii
- Waseda Institute of Human Growth and Development, Saitama, Japan.
- Faculty of Sport Sciences, Waseda University, Saitama, Japan.
| | - Shuji Taketomi
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Michio Tojima
- School of Health Sciences, Tokyo International University, Saitama, Japan
| | - Soichiro Iwanuma
- Department of School Education, Teikyo University of Science, Tokyo, Japan
| | - Yukako Iida
- Waseda Institute of Human Growth and Development, Saitama, Japan
- Faculty of Sport Science, Surugadai University, Saitama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Ota M, Tateuchi H, Hashiguchi T, Fujiwara K, Sasaki A, Okumura K, Ichihashi N. Validity of the frame subtraction method in dynamic postural stability. BMC Sports Sci Med Rehabil 2022; 14:174. [PMID: 36163189 PMCID: PMC9511721 DOI: 10.1186/s13102-022-00570-7] [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: 07/12/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022]
Abstract
Background The movement of targeted subjects can be calculated using the frame subtraction method. However, the validity of this evaluation method of dynamic postural stability has not been clarified yet. This study aimed to verify the validity of the evaluation method for jump landing using the frame subtraction score based on the ground reaction force (GRF). Methods Twenty subjects performed single-leg jump landing, and their dynamic postural stability index (DPSI), medial‒lateral stability index (MLSI), anterior‒posterior stability index, and vertical stability index (VSI) were calculated from the GRF. Simultaneously, motion images were captured using digital video cameras in the sagittal and frontal planes. After the motion images were analyzed using the frame subtraction method, the frame subtraction scores in the frontal, sagittal, and combined planes were calculated. To confirm its validity, the relationship between the frame subtraction scores and GRF parameters was investigated using Pearson's correlation analysis. Results The frame subtraction scores in the frontal and combined planes were significantly correlated with the DPSI, MLSI, and VSI (r = 0.46–0.75, P < 0.05). Conclusions Therefore, the frame subtraction method could be applied to the evaluation of dynamic postural stability. Markerless systems are deemed useful in clinical practice.
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Affiliation(s)
- Megumi Ota
- Department of Preventive Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Hiroshige Tateuchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takaya Hashiguchi
- Mixi Incorporated, Shibuya Scramble Square 36F, 2-24-12 Shibuya, Shibuya-ku, Tokyo, 150-6136, Japan
| | - Karen Fujiwara
- Kansai Medical University Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Ayano Sasaki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kiseki Okumura
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Grimandi R, Tissier F, Andro C, Tardy D, Gunepin FX, Rannou F, Giroux-Metges MA. The hamstrings are more impacted than the quadriceps after severe ankle sprain. Medicine (Baltimore) 2022; 101:e30251. [PMID: 36123917 PMCID: PMC9478271 DOI: 10.1097/md.0000000000030251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Ankle sprains (AS) are common in the military population, with a prevalence 5 to 8 times higher than that for civilians. The aim of this study was to evaluate in patients with severe AS the impact of disuse on thigh muscle induced by unloading and immobilization due to care. This study focused on muscle trophicity and dynamometric strength. In this observational prospective study, assessments were repeated at 3 visits: close to injury, 15 and 30 days following the sprain. The injured limb was compared to the contralateral limb. A dynamometer assessment was used to monitor changes in strength and fatigue of the thigh muscles of both limbs. Isometric and isokinetic concentric evaluation of peak torque (PTiso and PTdyn), total work (Wt), and peak torque time integral (IPT) of thigh muscles. Full follow-up was obtained in 30 subjects. The injured limbs showed significant deficits in the mean (SD). The quadriceps PTiso and IPT deficits were -12.6% ± 1.9% (P < .0001) and -13.27% ± 1.8% (P < .0001), respectively. The quadriceps PTdyn showed a significant deficit since V2 (-12.2.5% ± 2.0). The quadriceps Wt presented a significant deficit of -4.2% ± 2.4 (P < .0007) at 1 month. The hamstring PTdyn deficit presented a mean loss of -16.5% ± 2.4% (P < .0001). The hamstring Wt deficit was -13.7% ± 2.3% (P < .001). The analysis of variance showed that the grade of the sprain had a significant effect on the quadriceps PTq deficit (P < .016) but not the type of discharge. Our study showed that disuse leads to a significant deficit in the strength of knee muscles within 1 month. It is noteworthy that the hamstrings are more affected than the quadriceps. The rehabilitation protocol to prevent the risk of iterative ankle injuries and secondary knee injuries should incorporate early training of both quadriceps and hamstrings.
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Affiliation(s)
- Ronan Grimandi
- ORPHY, EA4324, University of Brest, Brest, France
- Médecine Physique et Réhabilitation, Hôpital d’Instruction des Armées Clermont-Tonnerre (HIA-CT), Brest, France
- *Correspondence: Ronan Grimandi, MSc, BPT. (e-mail: )
| | - Florine Tissier
- ORPHY, EA4324, University of Brest, Brest, France
- Explorations Fonctionnelles Respiratoires, Hôpital de La Cavale Blanche, CHRU DE Brest, Brest, France
| | - Christophe Andro
- Service de Chirurgie Orthopédie, Hôpital d’Instruction des Armées Clermont-Tonnerre (HIA-CT), Brest, France
| | - Dominique Tardy
- Médecine Physique et Réhabilitation, Hôpital d’Instruction des Armées Clermont-Tonnerre (HIA-CT), Brest, France
| | - François-Xavier Gunepin
- Clinique Mutualiste de la Porte de l’Orient, 3 rue Robert de La Croix, Lorient cedex, France
| | - Fabrice Rannou
- Médecine du Sport et Explorations Fonctionnelles-ASMS (UNH), Hôpital Gabriel Montpied, CHU Clermont-Ferrand, France
| | - Marie-Agnès Giroux-Metges
- ORPHY, EA4324, University of Brest, Brest, France
- Explorations Fonctionnelles Respiratoires, Hôpital de La Cavale Blanche, CHRU DE Brest, Brest, France
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Taylor JB, Wright ES, Waxman JP, Schmitz RJ, Groves JD, Shultz SJ. Ankle Dorsiflexion Affects Hip and Knee Biomechanics During Landing. Sports Health 2021; 14:328-335. [PMID: 34096370 DOI: 10.1177/19417381211019683] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Restricted ankle dorsiflexion range of motion (DFROM) has been linked to lower extremity biomechanics that place an athlete at higher risk for injury. Whether reduced DFROM during dynamic movements is due to restrictions in joint motion or underutilization of available ankle DFROM motion is unclear. HYPOTHESIS We hypothesized that both lesser total ankle DFROM and underutilization of available motion would lead to high-risk biomechanics (ie, greater knee abduction, reduced knee flexion). STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS Nineteen active female athletes (age, 20.0 ± 1.3 years; height, 1.61 ± 0.06 m; mass, 67.0 ± 10.7 kg) participated. Maximal ankle DFROM (clinical measure of ankle DFROM [DF-CLIN]) was measured in a weightbearing position with the knee flexed. Lower extremity biomechanics were measured during a drop vertical jump with 3-dimensional motion and force plate analysis. The percent of available DFROM used during landing (DF-%USED) was calculated as the peak DFROM observed during landing divided by DF-CLIN. Univariate linear regressions were performed to identify whether DF-CLIN or DF-%USED predicted knee and hip biomechanics commonly associated with injury risk. RESULTS For every 1.0° less of DF-CLIN, there was a 1.0° decrease in hip flexion excursion (r2 = 0.21, P = 0.05), 1.2° decrease in peak knee flexion angles (r2 = 0.37, P = 0.01), 0.9° decrease in knee flexion excursion (r2 = 0.40, P = 0.004), 0.002 N·m·N-1·cm-1 decrease in hip extensor work (r2 = 0.28, P = 0.02), and 0.001 N·m·N-1·cm-1 decrease in knee extensor work (r2 = 0.21, P = 0.05). For every 10% less of DF-%USED, there was a 3.2° increase in peak knee abduction angles (r2 = 0.26, P = 0.03) and 0.01 N·m·N-1·cm-1 lesser knee extensor work (r2 = 0.25, P = 0.03). CONCLUSION Lower levels of both ankle DFROM and DF-%USED are associated with biomechanics that are considered to be associated with a higher risk of sustaining injury. CLINICAL RELEVANCE While total ankle DFROM can predict some aberrant movement patterns, underutilization of available ankle DFROM can also lead to higher risk movement strategies. In addition to joint specific mobility training, clinicians should incorporate biomechanical interventions and technique feedback to promote the utilization of available motion.
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Affiliation(s)
- Jeffrey B Taylor
- Department of Physical Therapy, High Point University, High Point, North Carolina
| | - Elena S Wright
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina.,Department of Implementation Science, Division of Public Health Science, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Center for Healthcare Innovation, Wake Forest Baptist Health, Winston Salem, North Carolina
| | - Justin P Waxman
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Randy J Schmitz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - James D Groves
- Department of Physical Therapy, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Sandra J Shultz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
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Contribution of Lower Extremity Joints on Energy Absorption during Soft Landing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105130. [PMID: 34066090 PMCID: PMC8151821 DOI: 10.3390/ijerph18105130] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 11/21/2022]
Abstract
Soft landing after jumping is associated with the prevention of lower extremity injuries during sports activities in terms of the energy absorption mechanisms. In this study, the contribution of lower extremity joints during soft landing was investigated. Subjects comprised 20 healthy females. Kinetics and kinematics data were obtained during drop vertical jumps using a three-dimensional motion analysis system. Negative mechanical work values in the lower extremity joints were calculated during landing. A multiple regression analysis was performed to determine which lower extremity joints contributed more in achieving soft landing. The means of mechanical work of the hip, knee, and ankle in the sagittal plane were −0.30 ± 0.17, −0.62 ± 0.31, and −1.03 ± 0.22 J/kg, respectively. Results showed that negative mechanical work in the hip and knee is effective in achieving soft landing. These findings indicate that energy absorption in the hip and knee joints might be an important factor in achieving soft landing, whereas that in the ankle has a negative effect. Therefore, when improving soft landing techniques, we should consider energy absorption in the hip and knee via eccentric activation of the hip and knee extensors during landing.
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Pletcher ER, Dekker TJ, Lephart SM, Sell TC. Sex and Age Comparisons in Neuromuscular And Biomechanical Characteristics of the Knee in Young Athletes. Int J Sports Phys Ther 2021; 16:438-449. [PMID: 33842039 PMCID: PMC8016419 DOI: 10.26603/001c.21358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/10/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The identification of risk factors for injury is a key step for musculoskeletal injury prevention in youth sports. Not identifying and correcting for injury risk factors may result in lost opportunity for athletic development. Physical maturation and sex affect these characteristics, which may indicate the need for both age and sex-based injury prevention programs. HYPOTHESIS/PURPOSE This study examined age and sex differences in knee strength, static balance, jump height, and lower extremity landing biomechanics in school- and high school-age athletes. STUDY DESIGN Cross-sectional. METHODS Forty healthy school aged (10.8±0.8 yrs) and forty high school (16.8±0.8 yrs) athletes completed isokinetic knee flexion and extension strength tests, single-leg static balance and single-leg vertical stop jump tasks. RESULTS High school athletes were significantly stronger (~67% and 35% stronger for males and females, respectively) and jumped higher (regardless of sex) compared to school age athletes. High school males had worse balance (~28%) compared to their younger counterparts. High school females had lower strength (~23%) compared to males but had better balance (~46%). Conclusion: Maturation had different effects on the variables analyzed and sex differences were mainly observed after maturation. These differences may be minimized through appropriate age and sex specific training programs. LEVELS OF EVIDENCE 3a. CLINICAL RELEVANCE Neuromuscular and biomechanical differences between sex and age groups should be accounted for in injury prevention and rehabilitation. Inadequate training may be a primary factor contributing to injuries in a young athletic population. When designing training programs for long term athlete development, programs should be dependent on decrements seen at specific time points throughout maturation.What is known about the subject: Generally, both males and females get stronger and jump higher as they get older but the results comparing balance and biomechanics between genders or across age groups have been mixed.What this study adds to existing knowledge: The current study looks at multiple neuromuscular and biomechanical variables in male and female participants at different maturation statuses. The current data supports the significant changes observed in strength and jump height, as both genders age, but the data also demonstrates significant differences in balance between age groups in males and between genders in balance and knee flexion angles.
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