Biomechanical jumping differences among elite female handball players with and without previous anterior cruciate ligament reconstruction: a novel inertial sensor unit study

Reliability of Xsens inertial measurement unit in measuring trunk accelerations: a sex-based differences study during incremental treadmill running

Introduction

Inertial measurement units (IMUs) are utilized to measure trunk acceleration variables related to both running performances and rehabilitation purposes. This study examined both the reliability and sex-based differences of these variables during an incremental treadmill running test.

Methods

Eighteen endurance runners performed a test-retest on different days, and 30 runners (15 females) were recruited to analyze sex-based differences. Mediolateral (ML) and vertical (VT) trunk displacement and root mean square (RMS) accelerations were analyzed at 9, 15, and 21 km·h-1.

Results

No significant differences were found between test-retests [effect size (ES)<0.50)]. Higher intraclass correlation coefficients (ICCs) were found in the trunk displacement (0.85-0.96) compared to the RMS-based variables (0.71-0.94). Male runners showed greater VT displacement (ES = 0.90-1.0), while female runners displayed greater ML displacement, RMS ML and anteroposterior (AP), and resultant euclidean scalar (RES) (ES = 0.83-1.9).

Discussion

The IMU was found reliable for the analysis of the studied trunk acceleration-based variables. This is the first study that reports different results concerning acceleration (RMS) and trunk displacement variables for a same axis in the analysis of sex-based differences.

Agreement between force and deceleration measures during backward somersault landings

This study examined the agreement between force platform and inertial measurement unit (IMU) measures of backward somersault landings. Seven female gymnasts performed three trials, taking off from a 90 cm vaulting box and using competition landing technique. Two force platforms (1000 Hz) covered with a 6.4 cm thick carpeted landing surface measured the ground reaction forces. One inertial measurement unit (500 Hz) fixed on the second thoracic vertebra measured peak resultant deceleration of the gymnast. Measurement agreement between vertical and resultant peak force measures, and resultant peak force and peak deceleration was assessed using mean differences, Pearson's correlation, and Cohen's effect size (ES) statistics. There was perfect measurement agreement between vertical and resultant peak forces (R = 1.0, p < 0.001; ES = 0.005), but only moderate measurement agreement between resultant peak force and peak resultant deceleration (Mean Difference = -2.16%, R = 0.4, p = ns; ES = 0.121). Backward somersault landings can be assessed using either uni-axial or tri-axial force platforms to measure ground impact load/force, as the landing movements are almost purely vertical. However, force measures are not the same as peak resultant decelerations from IMUs which give an indication of impact shock. Landing load/shock measures are potentially important for injury prevention.

Trunk Biomechanics in Individuals with Knee Disorders: A Systematic Review with Evidence Gap Map and Meta-analysis

BACKGROUND

The trunk is the foundation for transfer and dissipation of forces throughout the lower extremity kinetic chain. Individuals with knee disorders may employ trunk biomechanical adaptations to accommodate forces at the knee or compensate for muscle weakness. This systematic review aimed to synthesize the literature comparing trunk biomechanics between individuals with knee disorders and injury-free controls.

METHODS

Five databases were searched from inception to January 2022. Observational studies comparing trunk kinematics or kinetics during weight-bearing tasks (e.g., stair negotiation, walking, running, landings) between individuals with knee disorders and controls were included. Meta-analyses for each knee disorder were performed. Outcome-level certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and evidence gap maps were created.

RESULTS

A total of 81 studies investigating trunk biomechanics across six different knee disorders were included (i.e., knee osteoarthritis [OA], total knee arthroplasty [TKA], patellofemoral pain [PFP], patellar tendinopathy [PT], anterior cruciate ligament deficiency [ACLD], and anterior cruciate ligament reconstruction [ACLR]). Individuals with knee OA presented greater trunk flexion during squatting (SMD 0.88, 95% CI 0.58-1.18) and stepping tasks (SMD 0.56, 95% CI 0.13-.99); ipsilateral and contralateral trunk lean during walking (SMD 1.36; 95% CI 0.60-2.11) and sit-to-stand (SMD 1.49; 95% CI 0.90-2.08), respectively. Greater trunk flexion during landing tasks in individuals with PFP (SMD 0.56; 95% CI 0.01-1.12) or ACLR (SMD 0.48; 95% CI 0.21-.75) and greater ipsilateral trunk lean during single-leg squat in individuals with PFP (SMD 1.01; 95% CI 0.33-1.70) were also identified. No alterations in trunk kinematics of individuals with TKA were identified. Evidence gap maps outlined the lack of investigations for individuals with PT or ACLD, as well as for trunk kinetics across knee disorders.

CONCLUSION

Individuals with knee OA, PFP, or ACLR present with altered trunk kinematics in the sagittal and frontal planes. The findings of this review support the assessment of trunk biomechanics in these individuals in order to identify possible targets for rehabilitation and avoidance strategies.

TRIAL REGISTRATION

PROSPERO registration number: CRD42019129257.

The Use of Wearable Sensors for Preventing, Assessing, and Informing Recovery from Sport-Related Musculoskeletal Injuries: A Systematic Scoping Review

Wearable technologies are often indicated as tools that can enable the in-field collection of quantitative biomechanical data, unobtrusively, for extended periods of time, and with few spatial limitations. Despite many claims about their potential for impact in the area of injury prevention and management, there seems to be little attention to grounding this potential in biomechanical research linking quantities from wearables to musculoskeletal injuries, and to assessing the readiness of these biomechanical approaches for being implemented in real practice. We performed a systematic scoping review to characterise and critically analyse the state of the art of research using wearable technologies to study musculoskeletal injuries in sport from a biomechanical perspective. A total of 4952 articles were retrieved from the Web of Science, Scopus, and PubMed databases; 165 were included. Multiple study features-such as research design, scope, experimental settings, and applied context-were summarised and assessed. We also proposed an injury-research readiness classification tool to gauge the maturity of biomechanical approaches using wearables. Five main conclusions emerged from this review, which we used as a springboard to propose guidelines and good practices for future research and dissemination in the field.

Differences in high trunk acceleration during single-leg landing after an overhead stroke between junior and adolescent badminton athletes

The magnitude of trunk acceleration reflects the ground reaction force. This study compared the frequency of high trunk accelerations during single-leg landing after an overhead stroke between junior and adolescent badminton players, and examined the difference in each directive magnitude according to age and landing leg. Thirty-eight female badminton players (17 junior and 21 adolescent athletes) played two singles games while wearing a tri-axial accelerometer on their upper back. The frequency and 95% confidence interval (CI) of single-leg landings that generated >4-G resultant acceleration, and each directive magnitude were calculated. A two-factorial analysis of variance (factor 1: group, factor 2: landing leg) was performed to determine the effects of age and different landing patterns. Frequency of single-leg landings following an overhead stroke in the adolescent athletes (mean, 1.71 cases/min; 95% CI, 1.59-1.83 cases/min) was higher than that in the junior athletes (mean, 1.13 cases/min; 95% CI, 1.01-1.25 cases/min). The adolescent athletes exhibited greater mediolateral acceleration in the movement towards racket-hand leg and anteroposterior acceleration in the movement towards the opposite leg than the junior athletes. This cross-sectional study suggests that the frequency and movement pattern associated with high-load landing in badminton games differ between junior and adolescent athletes.

Horizontal jumping biomechanics among elite female handball players with and without anterior cruciate ligament reconstruction: an ISU based study

Background

Handball is a strenuous body-contact team sport that places high loads on the knee joint. Anterior cruciate ligament (ACL) tear is one of the most devastating injuries that any handball player can suffer, and female athletes are at particular risk due to their intrinsic anatomical, hormonal, neuromuscular and biomechanical characteristics. The purpose of this study was to analyze the horizontal jumping biomechanics of female elite handball players with or without previous ACL reconstruction.

Methods

Twenty-one female participants (6 with previous ACL reconstruction and 15 uninjured controls) were recruited. Two horizontal hopping tasks were evaluated using inertial sensor unit (ISU)-based technology to assess jumping biomechanics through a direct mechanics-based approach.

Results

The athletes with previous ACL reconstruction demonstrated a significant (P < 0.05) reduction in the unilateral triple hop for distance compared with the healthy controls. Furthermore, during the initial propulsive phase of the unilateral cross-over hop, the control participants generated significantly (P < 0.05) higher force values in the mediolateral direction (the X axis) with their dominant limb compared with the ACL-reconstructed (ACL-R) limb of previously injured participants.

Conclusions

Three-dimensional horizontal jumping biomechanics analyses using ISU-based technologies could provide clinicians with more accurate information regarding the horizontal jumping biomechanical patterns among elite handball female athletes. Furthermore, several mechanical alterations could still be observed among those players who had undergone previous ACL reconstruction, even when several years have passed since the original ACL injury.

Exploring the potential utility of a wearable accelerometer for estimating impact forces in ballet dancers

Excessive forces and/or loading rates during landing may place ballet dancers at risk for overuse injury. The ability to estimate and monitor the landing forces of ballet dancers could help to improve injury prevention and rehabilitation; however, force platforms are not conducive to testing outside of a laboratory. Fortunately, it may be possible to indirectly assess landing forces via a wearable accelerometer. The purposes of this study were to examine the relationship between impact accelerations, recorded via a pelvis-worn accelerometer, and the peak forces and loading rates during performance of a common ballet manoeuvre, and to examine if a wearable accelerometer is sensitive to fatigue-related changes in landing forces. Fifteen ballet dancers continuously performed a ballet manoeuvre until self-determined exhaustion while impact accelerations and landing forces were simultaneously recorded using an accelerometer and force platforms. We observed very strong, positive relationships between the impact accelerations and the peak forces and loading rates during the landings. In addition, the changes in impact accelerations with fatigue paralleled the changes in the peak forces and loading rates. As a result, it appears that a wearable accelerometer could be used to estimate and monitor landing forces in ballet dancers.

Relationship between Kinematic Variables of Jump Throwing and Ball Velocity in Elite Handball Players

The purpose of this pilot study was to evaluate the relationship between the kinematic variables of the right hand and left leg with ball velocity during jump-throwing phases in handball for better-informed training. We investigated ball velocity and the key kinematic variables of jump throwing during different throwing phases in three strides. Ten right-handed male handball professional players who had competed in the Egyptian Handball Super League participated in this study. Jump throwing performance was divided into three phases (cocking, acceleration and follow-through), which included eight events during the throwing. Five trials were captured for each player, and a 3D analysis was performed on the best trial. Results indicated that the velocity of the throwing hand was the most important variable during jump throwing, which was correlated with ball velocity during the three phases of performance in four events: Initial contact (IC) (r = 0.66*), initial flight (IF) (r = 63*), maximum height of the throwing hand (Max-HH) (r = 0.78*) and ground contact (GC) (r = 0.83*). In addition, the initial flight was the most important event in which players need to be using the best angles during performance, particularly the shoulder angle.

Horizontal jumping biomechanics among elite male handball players with and without anterior cruciate ligament reconstruction. An inertial sensor unit-based study

OBJECTIVES

Anterior cruciate ligament (ACL) tears are one of the most devastating injuries that any handball player can suffer during landing and pivoting actions. The aim of this study was to analyze the horizontal jumping biomechanics among male elite handball players with or without previous ACLR.

DESIGN

Descriptive study.

SETTING

Spanish elite male handball players.

PARTICIPANTS

Twenty-six male participants (6 ACL-R and 20 uninjured controls) were recruited.

MAIN OUTCOME MEASURES

Two horizontal hopping tasks were evaluated using an inertial sensor unit (ISU)-based technology to assess jumping biomechanics through a direct mechanics-based approach.

RESULTS

Non-significant differences were found in relation to any of the biomechanical or performance related analyzed variables.

CONCLUSIONS

Previously ACL-R elite male handball players who have returned to the top level of sports participation do not seem to possess lasting biomechanical and/or performance deficits 6 years after the original surgical ligament repair.

Countermovement Jump Recovery in Professional Soccer Players Using an Inertial Sensor

PURPOSE

To assess the utility of an inertial sensor for assessing recovery in professional soccer players.

METHODS

In a randomized, crossover design, 11 professional soccer players wore shorts fitted with phase change material (PCM) cooling packs or uncooled packs (control) for 3 h after a 90-min match. Countermovement jump (CMJ) performance was assessed simultaneously with an inertial sensor and an optoelectric system: prematch and 12, 36, and 60 h postmatch. Inertial sensor metrics were flight height, jump height, low force, countermovement distance, force at low point, rate of eccentric force development, peak propulsive force, maximum power, and peak landing force. The only optoelectric metric was flight height. CMJ decrements and the effect of PCM cooling were assessed with repeated-measures analysis of variance. Jump heights were also compared between devices.

RESULTS

For the inertial sensor data, there were decrements in CMJ height on the days after matches (88% [10%] of baseline at 36 h, P = .012, effect size = 1.2, for control condition) and accelerated recovery with PCM cooling (105% [15%] of baseline at 36 h, P = .018 vs control, effect size = 1.1). Flight heights were strongly correlated between devices (r = .905, P < .001), but inertial sensor values were 1.8 [1.8] cm lower (P = .008). Low force during countermovement was increased (P = .031) and landing force was decreased (P = .043) after matches, but neither was affected by the PCM cooling intervention. Other CMJ metrics were unchanged after matches.

CONCLUSIONS

This small portable inertial sensor provides a practical means of assessing recovery in soccer players.

Loading differences in single-leg landing in the forehand- and backhand-side courts after an overhead stroke in badminton: A novel tri-axial accelerometer research

Anterior cruciate ligament (ACL) injuries in badminton commonly occur during single-leg landing after an overhead stroke in the backhand-side court. This study compared differences in trunk acceleration and kinematic variables during single-leg landing in the forehand- and backhand-side courts after an overhead stroke. Eighteen female junior badminton players performed two singles games while wearing a tri-axial accelerometer. The moment that over 4g of resultant acceleration was generated was determined using synchronised video cameras. Trunk lateral inclination and hip abduction angles at the point of landing with over 4g of resultant acceleration were analysed. Mediolateral acceleration in the backhand-side court was greater than that in the opposite-side court (p < 0.001, ES = 0.840). Both trunk lateral angles were larger than those previously reported in injured participants and the hip abduction angle in the backhand-side court was larger than that in the forehand-side court (p < 0.001, ES = 2.357). The lateral and vertical acceleration in the backhand-side court showed moderate-to-strong correlations with the trunk and hip angles. The mediolateral physical demand and high-risk posture in the backhand-side court may be associated with a higher incidence of knee injuries during badminton games.

Sprint mechanics evaluation using inertial sensor-based technology: A laboratory validation study

Advances in micro-electromechanical systems have turned magnetic inertial measurement units (MIMUs) into a suitable tool for vertical jumping biomechanical evaluation. Thus, this study aimed to determine whether appropriate reliability and agreement reports could also be obtained when analyzing 20-m sprint mechanics. Four bouts of 20-m sprints were evaluated to determine whether the data provided by a MIMU placed at the lumbar spine could reliably assess sprint mechanics and to examine the validity of the MIMU sensor compared to force plate recordings. Maximal power (P₀ ), force (F₀ ), and velocity (V₀ ), as well as other mechanical determinants of sprint performance associated with the force-velocity, power-velocity, and ratio of forces-velocity, such as applied horizontal force loss (S_fv ) and decrease in ratio of forces (D_rf ), were calculated and compared between instrumentations. Extremely large-to-very large correlation levels between MIMU sensor-based sprint mechanics variables and force plate recordings were obtained (mean±SD, force plate vs MIMU; V_0, 8.61±0.85 vs 8.42±0.69; F₀ , 383±110 vs 391±103; P₀ , 873±246 vs 799±241; S_fv, -44.6±12.7 vs -46.2±10.7), ranging from 0.88 to 0.94, except for D_rf, which showed weak-to-moderate correlation level (r=.45; -6.32±1.08 vs -5.76±0.68). Step-averaged force values measured with both systems were highly correlated (r=.88), with a regression slope close to the identity (1.01). Bland and Altman graphical representation showed a no random distribution of measured force values. Finally, very large-to-extremely large retest correlation coefficients were found for the intertrial reliability of MIMU measurements of sprint performance variables (r value ranging from .72 to .96). Therefore, MIMUs showed appropriate validity and reliability values for 20-m sprint performance variables.

Phase-Specific Ground Reaction Force Analyses of Bilateral and Unilateral Jumps in Patients With ACL Reconstruction

Background:

In patients who have undergone anterior cruciate ligament (ACL) reconstruction, there is a weak correlation between subjective evaluation of knee function on questionnaires and clinical or biomechanical test results.

Hypothesis:

Patients with lower subjective knee function will demonstrate lower ground-reaction forces (GRFs) in the operated leg and greater GRF asymmetries in both phase-specific and functional data analysis (FDA) approaches compared with patients with higher subjective knee function.

Study Design:

Descriptive laboratory study.

Methods:

The GRFs of the operated and nonoperated legs of 40 patients who previously underwent ACL reconstruction (patellar tendon) were analyzed during unilateral and bilateral countermovement jumps at a mean 2.5 years after surgery. The patients were separated into 2 groups depending on their International Knee Documentation Committee (IKDC) Subjective Form score: low IKDC and high IKDC.

Results:

Both phase-specific and FDA approaches showed lower GRF values in the operated compared with the nonoperated leg within the low-IKDC group during bilateral jumps. Moreover, lower GRF values were also present in the operated and nonoperated legs in the low-IKDC group compared with those of the high-IKDC group. Differences in GRFs were predominantly observed during the eccentric deceleration phase of jumping.

Conclusion:

Patients with previous ACL reconstruction who have limited subjective knee function have lower GRF values and greater GRF asymmetries, suggesting the use of interlimb compensation strategies.

Clinical Relevance:

The study results lead to a better understanding of the motor control needed during the eccentric and concentric movement phases of unilateral and bilateral jumps in patients who have undergone ACL reconstruction.