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Silveira AMC, Luz BC, Martinez AF, Serrão FV. Effect of augmented feedback on classical ballet jump kinematics: A single-blind randomized controlled trial. Knee 2024; 46:71-79. [PMID: 38061167 DOI: 10.1016/j.knee.2023.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/12/2023] [Accepted: 11/13/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Augmented feedback strategies have been demonstrated to enhance jump-related biomechanics. Nevertheless, its effect on classical ballet is still unknown. The purpose of this study was to investigate whether a multimodal augmented feedback session is effective for improving lower limb and trunk kinematics during a classical ballet single-leg jump. METHODS In a single-blind randomized controlled trial, 36 amateur classical ballet dancers were randomly assigned to either a control group (n = 18) to receive a brief warm-up session, or an augmented feedback group (n = 18) to receive, in addition to a brief warm-up session, a combined visual feedback session associated with verbal instruction. Hip kinematics in the frontal and transversal planes and knee and trunk kinematics in the frontal plane were analysed at baseline, immediate post-intervention, and one-week post-intervention. Intervention effects were analysed using a two-way, mixed model, repeated-measures analysis of variance. RESULTS No interaction effects were observed, indicating that a single session of multimodal augmented feedback was insufficient to improve lower limb and trunk kinematics during a classical ballet single-leg jump in amateur classical ballet dancers. CONCLUSION A single session of multimodal augmented feedback should not be used as the sole component in prevention programs intended to improve jump-related kinematics in amateur classical ballet dancers.
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Affiliation(s)
- Anelise Moreti Cabral Silveira
- Graduate Program of Physical Therapy, Federal University of São Carlos, Washington Luís Highway, Km 235, SP-310, 13565-905, São Carlos, SP, Brazil. https://twitter.com/Anelise_Moreti
| | - Bruna Calazans Luz
- Graduate Program of Physical Therapy, Federal University of São Carlos, Washington Luís Highway, Km 235, SP-310, 13565-905, São Carlos, SP, Brazil
| | - Adalberto Felipe Martinez
- Graduate Program of Physical Therapy, Federal University of São Carlos, Washington Luís Highway, Km 235, SP-310, 13565-905, São Carlos, SP, Brazil
| | - Fábio Viadanna Serrão
- Graduate Program of Physical Therapy, Federal University of São Carlos, Washington Luís Highway, Km 235, SP-310, 13565-905, São Carlos, SP, Brazil.
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2
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Hatefi M, Hadadnezhad M, Shojaedin S, Babakhani F, Tazji MK. The effects of the Posterior X Taping versus augmented feedback on lower-extremity kinematic and muscle activity pattern during unilateral weight-bearing activities in men with tibiofemoral varus malalignment. J Exp Orthop 2023; 10:70. [PMID: 37468708 DOI: 10.1186/s40634-023-00636-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE Tibiofemoral Varus Malalignment (TFRV) contributes to overuse injuries by altering lower limb biomechanics. Both Posterior X Taping (PXT) and Real Time Feedback (RTF), have each been recommended for subjects with TFRV as they are thought to enhance control of excessive tibiofemoral rotations. This paper evaluates this claim. METHODS A total of recreational male 24 athletes with TFRV participated in the current study. Kinematic and electromyography variables of lower extremity were synchronously recorded on five consecutive repetitions of the single-legged-squat (SLS) and forward-step-down) FSD) tasks before and after applications of PXT and RTF. RESULTS The subjects at post-intervention in RTF group exhibited decreased hip adduction during FSD, and decreased hip adduction and internal rotation during eccentric and concentric phases of the SLS; Additionally, we observed increased gluteus medius activity during eccentric phase of the SLS and FSD tasks. In contrast, subjects at the post-intervention in PXT group exhibited decreased tibiofemoral external rotation and increased ankle external rotation during all the phases of both SLS and FSD tasks. CONCLUSION These results suggest that the PXT and RTF interventions are recommended to immediately improve the functional defects of the subjects with TFRV during SLS and FSD tasks.
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Affiliation(s)
- Mohamadreza Hatefi
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran.
| | - Malihe Hadadnezhad
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| | - Sadredin Shojaedin
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| | - Farideh Babakhani
- Department of Sport Injuries and Corrective Exercises, Faculty of Physical Education, Allameh Tabataba'i University, Tehran, Iran
| | - Mehdi Khaleghi Tazji
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
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3
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Hatefi M, Hadadnezhad M, Shojaedin S, Babakhani F, Tazji MK. Effects of the real-time feedback and knee taping on lower-extremity function during ergometer pedaling in subjects with tibiofemoral varus alignment. Gait Posture 2022; 96:322-329. [PMID: 35785656 DOI: 10.1016/j.gaitpost.2022.05.028] [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: 12/30/2021] [Revised: 05/09/2022] [Accepted: 05/23/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The effect of the Posterior X Taping (PXT) used for subjects with Tibiofemoral Varus Malalignment (TFRV) aimed to control excessive tibiofemoral rotations is still unclear. Further, it is critical to use evidence-based therapeutic exercises to prevent non-contact injuries, especially in repetitive movements. OBJECTIVE To investigate whether the PXT and real-time feedback (RTF) interventions would improve lower extremity functions during the pedaling task in subjects with TFRV. METHODS Twenty-four male recreational athletes with TFRV participated in this study; Kinematic and muscle activity were synchronously recorded on ten consecutive pedal cycles during the last 30 s of 2-min pedaling. RESULTS The present study indicated that the subjects at the post-intervention of the RTF group exhibited significant decreased hip adduction and internal rotation, significant decreased tibiofemoral external rotation between 144° and 216° of crank angle, significant increased vastus medialis activity between 144° and 288° of crank angle, and significant increased gluteus medius activity between 180° and 144° of crank angle; In contrast, the subjects at the post-intervention of the PXT group exhibited significant decreased tibiofemoral external rotation and increased ankle external rotation at all the crank angles. No between-group differences were observed in pre-and post-intervention. SIGNIFICANCE These results suggest that the PXT and RTF interventions are recommended to immediately improve the functional defects of the subjects with TFRV during the pedaling task.
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Affiliation(s)
- Mohamadreza Hatefi
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| | - Malihe Hadadnezhad
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| | - Sadredin Shojaedin
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran.
| | - Farideh Babakhani
- Department of Sports Injury and Corrective Exercise, Faculty of Physical education, Allameh Tabataba'i University, Tehran, Iran
| | - Mehdi Khaleghi Tazji
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
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4
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Pichardo AW, Oliver JL, Harrison CB, Maulder PS, Lloyd RS, Kandoi R. Effects of Combined Resistance Training and Weightlifting on Injury Risk Factors and Resistance Training Skill of Adolescent Males. J Strength Cond Res 2021; 35:3370-3377. [PMID: 31453940 DOI: 10.1519/jsc.0000000000003341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Pichardo, AW, Oliver, JL, Harrison, CB, Maulder, PS, Lloyd, RS, and Kandoi, R. Effects of combined resistance training and weightlifting on injury risk factors and resistance training skill of adolescent males. J Strength Cond Res 35(12): 3370-3377, 2021-The purpose of this study was to investigate the effects of resistance training with or without weightlifting on risk factors for injury and resistance training skill in circa-peak height velocity boys. Sixty-seven boys (aged 12-14 years) from a local secondary school were divided into 3 groups: combined resistance training (CRT), combined resistance training with weightlifting movements (CRT&WL), or a control group (CON). Experimental groups completed twice-weekly training programs over the course of an academic year. The tuck jump assessment, asymmetry measures for single-leg horizontal jump, isometric midthigh pull, and the Star Excursion Balance Test, and resistance training skill were measured pre-, mid-, and post-intervention. Only the CRT group significantly improved tuck jump assessment score pre- to post-test (p = 0.006, -20.4%, d = -0.39) but there were no clear effects on asymmetry measures for any group. Both groups significantly improved resistance training skill from pre- to post-test (CRT&WL: p = 0.002, 17.6%, d = 1.00; CRT: p = 0.026, 9.2%, d = 0.53). This study suggests that a school-based CRT program may provide significant improvements in jump landing kinematics, whereas the inclusion of weightlifting movements may provide greater improvements in resistance training skill.
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Affiliation(s)
- Andrew W Pichardo
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Jon L Oliver
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
- Youth Physical Development Center, School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom ; and
| | - Craig B Harrison
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Peter S Maulder
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
- Center for Sport Science and Human Performance, Waikato Institute of Technology, Hamilton, New Zealand
| | - Rhodri S Lloyd
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
- Youth Physical Development Center, School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom ; and
- Center for Sport Science and Human Performance, Waikato Institute of Technology, Hamilton, New Zealand
| | - Rohan Kandoi
- Center for Sport Science and Human Performance, Waikato Institute of Technology, Hamilton, New Zealand
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Jayanthi N, Schley S, Cumming SP, Myer GD, Saffel H, Hartwig T, Gabbett TJ. Developmental Training Model for the Sport Specialized Youth Athlete: A Dynamic Strategy for Individualizing Load-Response During Maturation. Sports Health 2021; 14:142-153. [PMID: 34763556 DOI: 10.1177/19417381211056088] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
CONTEXT Most available data on athletic development training models focus on adult or professional athletes, where increasing workload capacity and performance is a primary goal. Development pathways in youth athletes generally emphasize multisport participation rather than sport specialization to optimize motor skill acquisition and to minimize injury risk. Other models emphasize the need for accumulation of sport- and skill-specific hours to develop elite-level status. Despite recommendations against sport specialization, many youth athletes still specialize and need guidance on training and competition. Medical and sport professionals also recommend progressive, gradual increases in workloads to enhance resilience to the demands of high-level competition. There is no accepted model of risk stratification and return to play for training a specialized youth athlete through periods of injury and maturation. In this review, we present individualized training models for specialized youth athletes that (1) prioritize performance for healthy, resilient youth athletes and (2) are adaptable through vulnerable maturational periods and injury. EVIDENCE ACQUISITION Nonsystematic review with critical appraisal of existing literature. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS A number of factors must be considered when developing training programs for young athletes: (1) the effect of sport specialization on athlete development and injury, (2) biological maturation, (3) motor and coordination deficits in specialized youth athletes, and (4) workload progressions and response to load. CONCLUSION Load-sensitive athletes with multiple risk factors may need medical evaluation, frequent monitoring, and a program designed to restore local tissue and sport-specific capacity. Load-naive athletes, who are often skeletally immature, will likely benefit from serial monitoring and should train and compete with caution, while load-tolerant athletes may only need occasional monitoring and progress to optimum loads. STRENGTH OF RECOMMENDATION TAXONOMY (SORT) B.
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Affiliation(s)
- Neeru Jayanthi
- Departments of Orthopaedics and Family Medicine, Emory School of Medicine, Atlanta, Georgia.,Emory Sports Medicine Center, Johns Creek, Georgia.,Emory Sport Performance and Research Center, Flowery Branch, Georgia
| | | | - Sean P Cumming
- Department for Health, University of Bath, Bath, United Kingdom
| | - Gregory D Myer
- Emory Sports Medicine Center, Johns Creek, Georgia.,Emory Sport Performance and Research Center, Flowery Branch, Georgia.,Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia.,The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
| | - Heather Saffel
- South Bend-Notre Dame Sports Medicine Fellowship, Beacon Bone & Joint Specialists, South Bend, Indiana
| | - Tim Hartwig
- School of Behavioural and Health Sciences, Strathfield Campus, Australian Catholic University, Strathfield, New South Wales, Australia
| | - Tim J Gabbett
- Gabbett Performance Solutions, Brisbane, Queensland, Australia.,Centre for Health Research, University of Southern Queensland, Ipswich, Queensland, Australia
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Bates NA, Myer GD, Hale RF, Schilaty ND, Hewett TE. Prospective Frontal Plane Angles Used to Predict ACL Strain and Identify Those at High Risk for Sports-Related ACL Injury. Orthop J Sports Med 2020; 8:2325967120957646. [PMID: 33110927 PMCID: PMC7557696 DOI: 10.1177/2325967120957646] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 01/13/2023] Open
Abstract
Background: Knee abduction moment during landing has been associated with anterior cruciate ligament (ACL) injury. However, accurately capturing this measurement is expensive and technically rigorous. Less complex variables that lend themselves to easier clinical integration are desirable. Purpose: To corroborate in vitro cadaveric simulation and in vivo knee abduction angles from landing tasks to allow for estimation of ACL strain in live participants during a landing task. Study Design: Descriptive laboratory study. Methods: A total of 205 female high school athletes previously underwent prospective 3-dimensional motion analysis and subsequent injury tracking. Differences in knee abduction angle between those who went on to develop ACL injury and healthy controls were assessed using Student t tests and receiver operating characteristic analysis. A total of 11 cadaveric specimens underwent mechanical impact simulation while instrumented to record ACL strain and knee abduction angle. Pearson correlation coefficients were calculated between these variables. The resultant linear regression model was used to estimate ACL strain in the 205 high school athletes based on their knee abduction angles. Results: Knee abduction angle was greater for athletes who went on to develop injury than for healthy controls (P < .01). Knee abduction angle at initial contact predicted ACL injury status with 78% sensitivity and 83% specificity, with a threshold of 4.6° of knee abduction. ACL strain was significantly correlated with knee abduction angle during cadaveric simulation (P < .01). Subsequent estimates of peak ACL strain in the high school athletes were greater for those who went on to injury (7.7-8.1% ± 1.5%) than for healthy controls (4.1-4.5% ± 3.6%) (P < .01). Conclusion: Knee abduction angle exhibited comparable reliability with knee abduction moment for ACL injury risk identification. Cadaveric simulation data can be extrapolated to estimate in vivo ACL strain. Athletes who went on to ACL injury exhibited greater knee abduction and greater ACL strain than did healthy controls during landing. Clinical Relevance: These important associations between the in vivo and cadaveric environments allow clinicians to estimate peak ACL strain from observed knee abduction angles. Neuromuscular control of knee abduction angle during dynamic tasks is imperative for knee joint health. The present associations are an important step toward the establishment of a minimal clinically important difference value for ACL strain during landing.
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Affiliation(s)
- Nathaniel A Bates
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Biomedical Engineering and Physiology, Mayo Clinic, Rochester, Minnesota, USA.,Sports Medicine Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Gregory D Myer
- The Sport Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
| | - Rena F Hale
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Nathan D Schilaty
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Biomedical Engineering and Physiology, Mayo Clinic, Rochester, Minnesota, USA.,Sports Medicine Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy E Hewett
- Sparta Science, Menlo Park, California, USA.,The Rocky Mountain Consortium for Sports Research, Edwards, Colorado, USA
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Comparison of Drop Jump and Tuck Jump Knee Joint Kinematics in Elite Male Youth Soccer Players: Implications for Injury Risk Screening. J Sport Rehabil 2020; 29:760-765. [PMID: 31629336 PMCID: PMC9892797 DOI: 10.1123/jsr.2019-0077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/07/2019] [Accepted: 05/20/2019] [Indexed: 02/04/2023]
Abstract
CONTEXT Despite the popularity of jump-landing tasks being used to identify injury risk factors, minimal data currently exist examining differences in knee kinematics during commonly used bilateral jumping tasks. This is especially the case for rebounding-based protocols involving young athletes. OBJECTIVE To compare the frontal plane projection angles (FPPAs) during the drop vertical jump (DVJ) and tuck jump assessment (TJA) in a cohort of elite male youth soccer players of varying maturity status. METHODS A total of 57 male youth soccer players from an English championship soccer club participated in this study. Participants performed 3 trials of the DVJ and TJA, during which movement was recorded with 2-dimensional video cameras. FPPA for both right (FPPA-r) and left (FPPA-l) legs, with values <180° indicative of medial knee displacement. RESULTS On a whole-group level, FPPA-r (172.7° [7.4°] vs 177.2° [11.7°]; P < .05; effect size [ES] = 0.46) and FPPA-l (173.4° [7.3°] vs 179.2° [11.0°]; P < .05; ES = 0.62) were significantly greater for both limbs in the TJA compared with the DVJ; however, these differences were less consistent when grouped by maturity status. FPPA-r during the TJA was significantly and moderately greater in the circa-peak height velocity (PHV) group compared with the post-PHV cohorts (169.4° [6.4°] vs 175.3° [7.8°]; P < .05; ES = 0.49). Whole-group data showed moderate relationships for FPPA-r and FPPA-l between the TJA and DVJ; however, stronger relationships were shown in circa- and post-PHV players compared with the pre-PHV cohort. CONCLUSIONS Considering that the TJA exposed players to a larger FPPA and was sensitive to between-group differences in FPPA-r, the TJA could be viewed as a more suitable screen for identifying FPPA in young male soccer players.
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Barillas SR, Oliver JL, Lloyd RS, Pedley JS. Cueing the Youth Athlete During Strength and Conditioning: A Review and Practical Application. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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9
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Bonnette S, Diekfuss JA, Grooms DR, Kiefer AW, Riley MA, Riehm C, Moore C, Foss KDB, DiCesare CA, Baumeister J, Myer GD. Electrocortical dynamics differentiate athletes exhibiting low- and high- ACL injury risk biomechanics. Psychophysiology 2020; 57:e13530. [PMID: 31957903 PMCID: PMC9892802 DOI: 10.1111/psyp.13530] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/19/2019] [Accepted: 12/18/2019] [Indexed: 02/04/2023]
Abstract
Anterior cruciate ligament (ACL) injuries are physically and emotionally debilitating for athletes,while motor and biomechanical deficits that contribute to ACL injury have been identified, limited knowledge about the relationship between the central nervous system (CNS) and biomechanical patterns of motion has impeded approaches to optimize ACL injury risk reduction strategies. In the current study it was hypothesized that high-risk athletes would exhibit altered temporal dynamics in their resting state electrocortical activity when compared to low-risk athletes. Thirty-eight female athletes performed a drop vertical jump (DVJ) to assess their biomechanical risk factors related to an ACL injury. The athletes' electrocortical activity was also recorded during resting state in the same visit as the DVJ assessment. Athletes were divided into low- and high-risk groups based on their performance of the DVJ. Recurrence quantification analysis was used to quantify the temporal dynamics of two frequency bands previously shown to relate to sensorimotor and attentional control. Results revealed that high-risk participants showed more deterministic electrocortical behavior than the low-risk group in the frontal theta and central/parietal alpha-2 frequency bands. The more deterministic resting state electrocortical dynamics for the high-risk group may reflect maladaptive neural behavior-excessively stable deterministic patterning that makes transitioning among functional task-specific networks more difficult-related to attentional control and sensorimotor processing neural regions.
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Affiliation(s)
- Scott Bonnette
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jed A. Diekfuss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dustin R. Grooms
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, GA, USA,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Adam W. Kiefer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA,Department of Psychology, Center for Cognition, Action & Perception, University of Cincinnati, Cincinnati, OH, USA,Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael A. Riley
- Department of Psychology, Center for Cognition, Action & Perception, University of Cincinnati, Cincinnati, OH, USA
| | - Christopher Riehm
- Department of Psychology, Center for Cognition, Action & Perception, University of Cincinnati, Cincinnati, OH, USA
| | - Charles Moore
- Department of Psychology, Center for Cognition, Action & Perception, University of Cincinnati, Cincinnati, OH, USA
| | - Kim D. Barber Foss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher A. DiCesare
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jochen Baumeister
- Exercise Science and Neuroscience, Department Exercise & Health, Paderborn University, Paderborn, Germany
| | - Gregory D. Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA,The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
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10
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Marshall AN, Hertel J, Hart JM, Russell S, Saliba SA. Visual Biofeedback and Changes in Lower Extremity Kinematics in Individuals With Medial Knee Displacement. J Athl Train 2020; 55:255-264. [PMID: 31986103 DOI: 10.4085/1062-6050-383-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Increased frontal-plane knee motion during functional tasks, or medial knee displacement, is a predictor of noncontact anterior cruciate ligament injury and patellofemoral pain. Intervention studies that resulted in a reduced risk of knee injury included some form of feedback to address aberrant lower extremity movement patterns. Research on integrating feedback into single-legged tasks and the ability to train 1 task and test another is limited. OBJECTIVE To determine if adding real-time visual biofeedback to common lower extremity exercises would improve single-legged landing mechanics in females with medial knee displacement. DESIGN Cohort study. SETTING University laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-four recreationally active females with medial knee displacement were randomized to a visual-biofeedback group (n = 12; age = 19.75 ± 0.87 years, height = 165.32 ± 8.69 cm, mass = 62.41 ± 8.91 kg) or a control group (n = 12; age = 19.75 ± 0.97 years, height = 166.98 ± 6.89 cm, mass = 59.98 ± 6.24 kg). INTERVENTION(S) Individuals in the feedback group viewed a real-time digital model of their body segments generated by Microsoft Kinect. The skeletal model changed color according to the knee-abduction angle of the test limb during the exercise tasks. MAIN OUTCOME MEASURE(S) Participants completed 3 trials of the single-legged drop vertical jump (SL-DVJ) while triplanar kinematics at the trunk, hip, knee, and ankle were collected via 3-dimensional motion capture. The feedback and control groups completed lower extremity exercises with or without real-time visual biofeedback, respectively. After the intervention, participants completed 3 additional trials of the SL-DVJ. RESULTS At baseline, the feedback group had 3.83° more ankle eversion than the control group after initial contact. After the intervention, the feedback group exhibited 13.03° more knee flexion during the flight phase of the SL-DVJ and 6.16° less knee abduction after initial contact than the control group. The feedback group also demonstrated a 3.02° decrease in peak knee-abduction excursion compared with the baseline values (P = .008). CONCLUSIONS Real-time visual biofeedback immediately improved faulty lower extremity kinematics related to knee-injury risk. Individuals with medial knee displacement adjusted their movement patterns after a single training session and reduced their medial knee motion during a dynamic task.
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Affiliation(s)
- Ashley N Marshall
- Department of Health and Exercise Science, Appalachian State University, Boone, NC
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, Charlottesville
| | - Joseph M Hart
- Department of Kinesiology, University of Virginia, Charlottesville.,Department of Orthopedic Surgery, University of Virginia, Charlottesville
| | - Shawn Russell
- Department of Orthopedics and Mechanical Engineering, University of Virginia, Charlottesville
| | - Susan A Saliba
- Department of Kinesiology, University of Virginia, Charlottesville
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11
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Dos'Santos T, McBurnie A, Comfort P, Jones PA. The Effects of Six-Weeks Change of Direction Speed and Technique Modification Training on Cutting Performance and Movement Quality in Male Youth Soccer Players. Sports (Basel) 2019; 7:sports7090205. [PMID: 31489929 PMCID: PMC6783855 DOI: 10.3390/sports7090205] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 12/31/2022] Open
Abstract
Cutting manoeuvres are important actions associated with soccer performance and a key action associated with non-contact anterior cruciate ligament injury; thus, training interventions that can improve cutting performance and movement quality are of great interest. The aim of this study, therefore, was to determine the effects of a six-week change of dire[ction (COD) speed and technique modification training intervention on cutting performance and movement quality in male youth soccer players (U17s, n = 8) in comparison to a control group (CG) (U18s, n = 11) who continued ‘normal’ training. Cutting performance was assessed based on completion time and COD deficit, and the field-based cutting movement assessment score (CMAS) qualitative screening tool was used to assess cutting movement quality. Significant main effects for time (pre-to-post changes) (p ≤ 0.041, η2 = 0.224–0.839) and significant interaction effects of time and group were observed for cutting completion times, COD deficits, and CMASs. Improvements in completion time (p < 0.001, g = 1.63–1.90, −9% to −11% vs. −5% to 6%) and COD deficit (p ≤ 0.012, g = −1.63 to −2.43, −40–52% vs. −22% to −28%) for the COD intervention group (IG) were approximately two-times greater than the CG. Furthermore, lower CMASs (i.e., improved cutting movement quality) were only observed in the IG (p ≤ 0.025, g = −0.85 to −1.46, −23% to −34% vs. 6–19%) compared to the CG. The positive changes in CMASs were attributed to improved cutting technique and reduced incidences of high-risk deficits such as lateral trunk flexion, extended knee postures, knee valgus, hip internal rotation, and improved braking strategies. The results of this study indicate that COD speed and technique modification training, in addition to normal skills and strength training, improves cutting performance and movement quality in male youth soccer players. Practitioners working with male youth soccer players should implement COD speed and technique modification training to improve cutting performance and movement quality, which may decrease potential injury-risk.
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Affiliation(s)
- Thomas Dos'Santos
- Directorate of Sport, Exercise & Physiotherapy, University of Salford, Salford, Greater Manchester M6 6PU, UK.
| | - Alistair McBurnie
- Directorate of Sport, Exercise & Physiotherapy, University of Salford, Salford, Greater Manchester M6 6PU, UK.
| | - Paul Comfort
- Directorate of Sport, Exercise & Physiotherapy, University of Salford, Salford, Greater Manchester M6 6PU, UK.
| | - Paul A Jones
- Directorate of Sport, Exercise & Physiotherapy, University of Salford, Salford, Greater Manchester M6 6PU, UK.
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Bonnette S, DiCesare CA, Diekfuss JA, Grooms DR, MacPherson RP, Riley MA, Myer GD. Advancing Anterior Cruciate Ligament Injury Prevention Using Real-Time Biofeedback for Amplified Sensorimotor Integration. J Athl Train 2019; 54:985-986. [PMID: 31437016 PMCID: PMC6795095 DOI: 10.4085/1062-6050-54.083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Scott Bonnette
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
| | - Christopher A. DiCesare
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
| | - Jed A. Diekfuss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
| | - Dustin R. Grooms
- Ohio Musculoskeletal & Neurological Institute and Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens
| | - Ryan P. MacPherson
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
| | - Michael A. Riley
- Center for Cognition, Action, & Perception, Department of Psychology, University of Cincinnati, OH
| | - Gregory D. Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
- Department of Pediatrics and Orthopaedic Surgery, University of Cincinnati, OH
- The Micheli Center for Sports Injury Prevention, Waltham, MA
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Sex and Maturation Differences in Performance of Functional Jumping and Landing Deficits in Youth Athletes. J Sport Rehabil 2019; 28:606-613. [PMID: 30222476 PMCID: PMC9892800 DOI: 10.1123/jsr.2017-0292] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 07/13/2018] [Accepted: 07/24/2018] [Indexed: 02/04/2023]
Abstract
CONTEXT Understanding how neuromuscular and biomechanical deficits that are associated with knee injuries change as youth mature may improve injury prevention strategies in this population. OBJECTIVE To investigate sex and maturation differences in jump-landing technique performance in youths using a practical clinical tool. DESIGN Cross-sectional study. SETTING High Performance Center Laboratory. PARTICIPANTS A total of 165 youth athletes were included in this study. MAIN OUTCOME MEASURES The main outcome measures were each of the 10 items of the modified tuck jump assessment and the total score. These measures include (1) knee valgus at landing, (2) thighs do not reach parallel, (3) thighs not equal side to side, (4) foot placement not shoulder width apart, (5) foot placement not parallel, (6) foot contact timing not equal, (7) excessive landing contact noise, (8) pause between jumps, (9) technique declines prior to 10 seconds, and (10) does not land in same footprint. RESULTS Only knee valgus at landing had a significant sex × maturation interaction. The main effect of maturation was significant for items 2, 3, 6, 7, 9, and total score. Plyometric technique performance improved with increasing maturation. The main effect of sex was significant for items 1 and 9, with males performing better than females. CONCLUSIONS Female athletes demonstrate increased knee valgus at landing and fatigue relative to males during jump-landing performance. Overall, there was a trend of improved jump-landing performance with maturation.
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Read PJ, Oliver JL, De Ste Croix MBA, Myer GD, Lloyd RS. A Review of Field-Based Assessments of Neuromuscular Control and Their Utility in Male Youth Soccer Players. J Strength Cond Res 2019; 33:283-299. [PMID: 28658071 DOI: 10.1519/jsc.0000000000002069] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Read, PJ, Oliver, JL, Croix, MS, Myer, GD, and Lloyd, RS. A review of field-based assessments of neuromuscular control and their utility in male youth soccer players. J Strength Cond Res 33(1): 283-299, 2019-Lower-extremity injuries in male youth soccer are common and equate to a substantial time loss from training and competitions during the course of a season. Extended periods of absence will impact player involvement in skill and physical development activities, as well as participation in competitive match play. Neuromuscular risk factors for lower-extremity injury in male youth soccer players can be categorized into quadriceps dominance, leg dominance, ligament dominance, trunk dominance, and reduced dynamic stability. Valid screening methods to identify risk factors that are practically viable are needed for youth athletes who may be at a greater risk of injury in soccer. Although field-based tests of neuromuscular control provide a reliable option for the assessment of injury risk in adults and females, less data are available in male youth soccer players, and further research is required to examine their ability to predict injury risk. This article provides a review of the current literature pertaining to field-based screening tests and critically appraises their suitability for use with male youth soccer players. Currently, the only method that has been validated in male youth soccer players is the landing error scoring system. Asymmetrical anterior reach measured during the Y-Balance test may also be considered because of its strong predictive ability in male youth basketball players; however, further research is required to fully support its use with soccer players.
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Affiliation(s)
- Paul J Read
- School of Sport, Health and Applied Science, St Mary's University, London, United Kingdom.,Athlete Health and Performance Research Center, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Jon L Oliver
- Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, United Kingdom.,Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand
| | | | - Gregory D Myer
- Division of Sports Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio.,Department of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio.,The Micheli Center for Sports Injury Prevention, Boston, Massachusetts.,Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rhodri S Lloyd
- Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, United Kingdom.,Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand.,Center for Sport Science and Human Performance, Waikato Institute of Technology, New Zealand
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Popovic T, Caswell SV, Benjaminse A, Siragy T, Ambegaonkar J, Cortes N. Implicit video feedback produces positive changes in landing mechanics. J Exp Orthop 2018; 5:12. [PMID: 29721781 PMCID: PMC5931948 DOI: 10.1186/s40634-018-0129-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implicit (IF) and explicit (EF) feedback are two motor learning strategies demonstrated to alter movement patterns. There is conflicting evidence on which strategy produces better outcomes. The purpose of this study was to examine the effects of reduced IF and EF video feedback on lower extremity landing mechanics. METHODS Thirty participants (24 ± 2 years, 1.7 ± 0.1 m, 70 ± 11 kg) were randomly assigned to three groups: IF (n = 10), EF (n = 10), and control (CG) (n = 10). They performed twelve box-drop jumps three times a week on the training sessions for six weeks. Only IF and EF groups received video feedback on the training sessions. IF was cued to focus their attention on the overall jump, while EF was cued to focus on position of their knees. 3D lower extremity biomechanics were tested on testing sessions with no feedback. All sessions were at least 24 h apart from another. Testing sessions included baseline testing (pretest), testing after 3 training sessions with 100% feedback (pst1), testing after 6 training sessions with 33.3% feedback (pst2), testing after 6 training sessions with 16.6% feedback (Pst3), and testing 1 month after with no feedback (retention - ret). ANOVA compared differences between groups and time at initial contact and peak for hip flexion (HF, °) and abduction angle (HA, °), hip abduction moment (HAM, Nm/kgm), knee flexion (KF, °) and abduction angle (KA, °), knee abduction moment (KAM, Nm/kgm) and VGRF (N) (p < 0.05). RESULTS A significant main effect for group was found between IF and EF groups for HA (IF = - 6.7 ± 4; EF = - 9.4 ± 4.1) and KAM (IF = 0.05 ± 0.2; EF = - 0.07 ± 0.2) at initial contact, and peaks HA (IF = - 3.5 ± 4.5; EF = - 7.9 ± 4.7) and HAM (IF = 1.1 ± 0.6; EF = 0.9 ± 0.4). A significant main effect for time at initial contact for HF (pre = 32.4 ± 3.2; pst2 = 36.9 ± 3.2; pst3 = 37.9 ± 3.7; ret. = 34.1 ± 3.7), HAM (pre = 0.1 ± 0.1; pst1 = 0.04 ± 0.1; pst3 = 0.1 ± 0.01), KA (pre = 0.7 ± 1.1; pst1 = 0.2 ± 1.2; pst3 = 1.7 ± 1), and KAM (pre = 0.003 ± 0.1; pst3 = 0.01 ± 0.1) was found. DISCUSSION/CONCLUSION We found that implicit feedback produced positive changes in landing mechanics while explicit feedback degraded motor learning. Our results indicate that implicit feedback should be used in programs to lower the ACL injury risk. We suggest that implicit feedback should be frequent in the beginning and not be reduced as much following the acquisition phase.
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Affiliation(s)
- Tijana Popovic
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA.,Department of Radiology and Biomedical Imaging, University of California, 185 Berry Street, Lobby 6, Suite 391, San Francisco, CA, 94107, USA
| | - Shane V Caswell
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA
| | | | - Tarique Siragy
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA.,School of Human Kinetics, Faculty of Health Sciences at the University of Ottawa, 75 Laurier Avenue East, Ottawa, ON, K1N 6N5, Canada
| | - Jatin Ambegaonkar
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA
| | - Nelson Cortes
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA.
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Change-of-Direction Biomechanics: Is What’s Best for Anterior Cruciate Ligament Injury Prevention Also Best for Performance? Sports Med 2018; 48:1799-1807. [DOI: 10.1007/s40279-018-0931-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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17
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Read PJ, Oliver JL, De Ste Croix MBA, Myer GD, Lloyd RS. Landing Kinematics in Elite Male Youth Soccer Players of Different Chronologic Ages and Stages of Maturation. J Athl Train 2018; 53:372-378. [PMID: 29693423 PMCID: PMC5967279 DOI: 10.4085/1062-6050-493-16] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Despite the high frequency of knee injuries in athletes, few researchers have studied the effects of chronologic age and stage of maturation on knee-joint kinematics in male youth soccer players. OBJECTIVE To use a coach-friendly screening tool to examine knee-valgus scores for players of different ages and at different stages of maturation. DESIGN Cross-sectional study. SETTING Academy soccer clubs. PATIENTS OR OTHER PARTICIPANTS A total of 400 elite male youth soccer players aged 10 to 18 years categorized by chronologic age and stage of maturation based on their years from peak height velocity (PHV). MAIN OUTCOME MEASURE(S) Knee valgus was evaluated during the tuck-jump assessment via 2-dimensional analysis. Frontal-plane projection angles were subjectively classified as minor (<10°), moderate (10°-20°), or severe (>20°), and using these classifications, we scored knee valgus in the tuck jump as 0 ( no valgus), 1 ( minor), 2 ( moderate), or 3 ( severe). RESULTS A trend toward higher valgus scores was observed in the younger age groups and the pre-PHV group. The lowest frequency of no valgus occurred in the U18 and post-PHV groups. The highest percentages of severe scores were in the U13 and pre-PHV groups for the right limb. Knee-valgus scores were lower for both lower extremities in the U18 group than in all other age groups ( P < .001) except the U16 group. Scores were lower for the post-PHV than the pre-PHV group for the right limb ( P < .001) and both pre-PHV and circa-PHV groups for the left limb ( P < .001). Noteworthy interlimb asymmetries were evident in the U14, U15, and circa-PHV groups. CONCLUSIONS Reductions in knee valgus with incremental age and during the later stages of maturation indicated that this risk factor was more prevalent in younger players. Interlimb asymmetry may also emerge around the time of the peak growth spurt and early adolescence, potentially increasing the risk of traumatic injury.
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Affiliation(s)
- Paul J. Read
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Youth Physical Development Centre, School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom
| | - Jon L. Oliver
- Youth Physical Development Centre, School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland
| | | | - Gregory D. Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Ohio; Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, OH; The Micheli Center for Sports Injury Prevention, Waltham, MA
| | - Rhodri S. Lloyd
- Youth Physical Development Centre, School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, New Zealand
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Storberget M, Grødahl LHJ, Snodgrass S, van Vliet P, Heneghan N. Verbal augmented feedback in the rehabilitation of lower extremity musculoskeletal dysfunctions: a systematic review. BMJ Open Sport Exerc Med 2017; 3:e000256. [PMID: 29018544 PMCID: PMC5623330 DOI: 10.1136/bmjsem-2017-000256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2017] [Indexed: 11/16/2022] Open
Abstract
Background Verbal augmented feedback (VAF) is commonly used in physiotherapy rehabilitation of individuals with lower extremity musculoskeletal dysfunction or to induce motor learning for injury prevention. Its effectiveness for acquisition, retention and transfer of learning of new skills in this population is unknown. Objectives First, to investigate the effect of VAF for rehabilitation and prevention of lower extremity musculoskeletal dysfunction. Second, to determine its effect on motor learning and the stages of acquisition, retention and transfer in this population. Design Systematic review designed in accordance with the Centre for Reviews and Dissemination and reported in line with Preferred Reporting Items for Systematic Review and Meta-analysis. Method MEDLINE, Embase, PubMed and five additional databases were searched to identify primary studies with a focus on VAF for prevention and rehabilitation of lower extremity musculoskeletal dysfunction. One reviewer screened the titles and abstracts. Two reviewers retrieved full text articles for final inclusion. The first reviewer extracted data, whereas the second reviewer audited. Two reviewers independently assessed risk of bias and quality of evidence using Cochrane Collaboration’s tool and Grading of Recommendations Assessment, Development and Evaluation, respectively. Results Six studies were included, with a total sample of 304 participants. Participants included patients with lateral ankle sprain (n=76), postoperative ACL reconstruction (n=16) and healthy individuals in injury prevention (n=212). All six studies included acquisition, whereas retention was found in five studies. Only one study examined transfer of the achieved motor learning (n=36). VAF was found to be effective for improving lower extremity biomechanics and postural control with moderate evidence from five studies. Conclusion VAF should be considered in the rehabilitation of lower extremity musculoskeletal dysfunctions. However, it cannot be unequivocally confirmed that VAF is effective in this population, owing to study heterogeneity and a lack of high-quality evidence. Nevertheless, positive effects on lower extremity biomechanics and postural control have been identified. This suggests that further research into this topic is warranted where an investigation of long-term effects of interventions is required. All stages (acquisition, retention and transfer) should be evaluated.
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Affiliation(s)
- Marianne Storberget
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Linn Helen J Grødahl
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Suzanne Snodgrass
- School of Health Sciences (Physiotherapy), University of Newcastle, Callaghan, New South Wales, Australia
| | - Paulette van Vliet
- School of Health Sciences (Physiotherapy), University of Newcastle, Callaghan, New South Wales, Australia
| | - Nicola Heneghan
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Smith CA, Chimera NJ, Lininger MR, Warren M. Modified Tuck Jump Assessment: Reliability and Training of Raters. J Sports Sci Med 2017; 16:440-442. [PMID: 28912664 PMCID: PMC5592298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/31/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Craig A. Smith
- Smith Performance Center, Tucson AZ USA
- Department of Physical Therapy and Athletic Training, Northern Arizona University, USA
| | | | - Monica R. Lininger
- Department of Physical Therapy and Athletic Training, Northern Arizona University, USA
| | - Meghan Warren
- Department of Physical Therapy and Athletic Training, Northern Arizona University, USA
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20
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Herrero-Herrero M, García-Massó X, Martínez-Corralo C, Prades-Piñón J, Sanchis-Alfonso V. Relationship between the practice of physical activity and quality of movement in adolescents: a screening tool using self-organizing maps. PHYSICIAN SPORTSMED 2017; 45:271-279. [PMID: 28471700 DOI: 10.1080/00913847.2017.1327303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to determine whether the most physically active adolescents have better lower limb control. METHODS 31 high school students (12 males and 19 females) participated in this study. The Anterior Knee Pain Scale was used to find any cases of knee pain. Only subjects with high scores were selected, to exclude those with knee pain or lower limb injuries. Single Leg Squat and Tuck Jump Assessment were used to evaluate movements with two cameras in a two-dimensional assessment. The IPAQ Questionnaire was used to score the physical activity and to classify it into MET total, MET moderate activity, MET vigorous activity and MET walking. These scores were related to knee angle at landing, age and body mass index by self-organizing maps analysis. RESULTS The subjects were classified into 4 clusters and the descriptive statistics of the different clusters were determined to find any differences. The subjects in cluster 3 were classified as those with the highest risk factors of suffering lower limb musculoskeletal disorders or knee pain, even though injuries do not only depend on quality of movement. Physical activity was not related to healthy movements during jump and single leg squat. CONCLUSION Physical activity alone cannot be an indicator of good quality lower limb movement, as the knee valgus angle plays a determining role, as it could also depend on neuromuscular control and anatomical characteristics. The analytical method described in the study could be used by physical education teachers to detect potential risk factors for musculoskeletal problems in the lower limbs, especially in the knees.
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Affiliation(s)
- María Herrero-Herrero
- a Departamento de Didàctica de l'Expressió Musical, Plàstica i Corporal , Universitat de València , Valencia , Spain.,b EFIR_Estudi de Fisioteràpia i Rendiment , Valencia , Spain
| | - Xavier García-Massó
- a Departamento de Didàctica de l'Expressió Musical, Plàstica i Corporal , Universitat de València , Valencia , Spain
| | | | | | - Vicente Sanchis-Alfonso
- c Department of Orthopaedic Surgery , Hospital Arnau de Vilanova and Hospital 9 de Octubre , Valencia , Spain
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Hewett TE, Bates NA. Preventive Biomechanics: A Paradigm Shift With a Translational Approach to Injury Prevention. Am J Sports Med 2017; 45:2654-2664. [PMID: 28199800 PMCID: PMC6405413 DOI: 10.1177/0363546516686080] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Preventive medicine techniques have alleviated billions of dollars' worth of the economic burden in the medical care system through the implementation of vaccinations and screenings before the onset of disease symptoms. Knowledge of biomechanical tendencies has progressed rapidly over the past 20 years such that clinicians can identify, in healthy athletes, the underlying mechanisms that lead to catastrophic injuries such as anterior cruciate ligament (ACL) ruptures. As such, preventive medicine concepts can be applied to noncontact musculoskeletal injuries to reduce the economic burden of sports medicine treatments and enhance the long-term health of athletes. PURPOSE To illustrate the practical medical benefits that could be gained from preventive biomechanics applied to the ACL as well as the need and feasibility for the broad implementation of these principles. STUDY DESIGN Literature review. METHODS The recent literature pertinent to the screening and prevention of musculoskeletal injuries was reviewed and compiled into a clinical commentary on the current state and applicability of preventive biomechanics. RESULTS Investigators have identified neuromuscular training protocols that screen for and correct the underlying biomechanical deficits that lead to ACL injuries. The literature shows that when athletes comply with these prescribed training protocols, the incidence of injuries is significantly reduced within that population. Such preventive biomechanics practices employ basic training methods that would be familiar to athletic coaches and have the potential to save billions of dollars in cost in sports medicine. CONCLUSION The widespread implementation of preventive biomechanics concepts could profoundly affect the field of sports medicine with a minimum of initial investment.
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Affiliation(s)
- Timothy E. Hewett
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota,Department of Sports Medicine, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio,Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Nathaniel A. Bates
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
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Lininger MR, Smith CA, Chimera NJ, Hoog P, Warren M. Tuck Jump Assessment: An Exploratory Factor Analysis in a College Age Population. J Strength Cond Res 2017; 31:653-659. [DOI: 10.1519/jsc.0000000000001186] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Fort-Vanmeerhaeghe A, Montalvo AM, Lloyd RS, Read P, Myer GD. Intra- and Inter-Rater Reliability of the Modified Tuck Jump Assessment. J Sports Sci Med 2017; 16:117-124. [PMID: 28344460 PMCID: PMC5358021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/08/2017] [Indexed: 06/06/2023]
Abstract
The Tuck Jump Assessment (TJA) is a clinician-friendly screening tool that was designed to support practitioners with identification of neuromuscular deficits associated with anterior cruciate ligament injury. This study aimed to evaluate the inter- and intra-rater reliability of the modified scoring (0 to 2) TJA to add an additional range of objectivity for each criterion. A total of 24 elite youth volleyball athletes (12 males and 12 females) were included in this study. Each participant's recorded performance of the TJA was scored independently by two raters across ten criteria using the modified scale. The two raters then scored the same videos one week later. Another investigator who was blind to the identity of the raters analyzed the scores from both raters for each participant. Kappa coefficient (k) and percentage of exact agreement (PEA) for both intra- and inter-rater reliability were analyzed for each item. Intraclass correlation coefficients (ICC) were calculated to determine intra- and inter-rater reliability of the modified TJA total score. Intra- and inter-rater k was good to excellent for most items (0.65-0.91). Average PEA between the two raters and two sessions ranged from 83.3 to 100% in all scored items. The ICC for the total score was excellent in both inter- and inter-rater correlations (0.94-0.96). This research demonstrated that the modified version of the TJA predominantly shows good to excellent intra- and inter-rater reliability in all analyzed criteria.
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Affiliation(s)
- Azahara Fort-Vanmeerhaeghe
- School of Health and Sport Sciences (EUSES) Universitat de Girona, Salt, Spain; Blanquerna Faculty of Psychology, Education Sciences and Sport (FPCEE), Universitat Ramon Llull, Barcelona, Spain
| | - Alicia M Montalvo
- Florida International University, Nicole Wertheim College of Nursing and Health Sciences , Department of Athletic Training, Miami, FL
| | - Rhodri S Lloyd
- Youth Physical Development Unit, Cardiff Metropolitan University, Cardiff, Wales; UK; Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand; Centre for Sport Science and Human Performance, Waikato Institute of Technology, New Zealand
| | - Paul Read
- School of Sport, Health and Applied Science, St Mary's University, London, UK; Research Department, Aspetar Sports Medicine Hospital, Doha, Qatar
| | - Gregory D Myer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH; Sports Health and Performance Institute, Ohio State University, Sports Medicine, Ohio State University Medical Center, Columbus, OH; Micheli Center for Sports Injury Prevention, Waltham, MA, USA
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Read PJ, Oliver JL, de Ste Croix MBA, Myer GD, Lloyd RS. Reliability of the Tuck Jump Injury Risk Screening Assessment in Elite Male Youth Soccer Players. J Strength Cond Res 2016; 30:1510-6. [PMID: 26562715 DOI: 10.1519/jsc.0000000000001260] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Read, PJ, Oliver, JL, de Ste Croix, MBA, Myer, GD, and Lloyd, RS. Reliability of the tuck jump injury risk screening assessment in elite male youth soccer players. J Strength Cond Res 30(6): 1510-1516, 2016-Altered neuromuscular control has been suggested as a mechanism for injury in soccer players. Ligamentous injuries most often occur during dynamic movements, such as decelerations from jump-landing maneuvers where high-risk movement patterns are present. The assessment of kinematic variables during jump-landing tasks as part of a preparticipation screen is useful in the identification of injury risk. An example of a field-based screening tool is the repeated tuck jump assessment. The purpose of this study was to analyze the within-subject variation of the tuck jump screening assessment in elite male youth soccer players. Twenty-five pre-peak height velocity (PHV) and 25 post-PHV elite male youth soccer players from the academy of a professional English soccer club completed the assessment. A test-retest design was used to explore the within-subject intersession reliability. Technique was graded retrospectively against the 10-point criteria set out in the screening protocol using two-dimensional video cameras. The typical error range reported for tuck jump total score (0.90-1.01 in pre-PHV and post-PHV players respectively) was considered acceptable. When each criteria was analyzed individually, kappa coefficient determined that knee valgus was the only criterion to reach substantial agreement across the two test sessions for both groups. The results of this study suggest that although tuck jump total score may be reliably assessed in elite male youth soccer players, caution should be applied in solely interpreting the composite score due to the high within-subject variation in a number of the individual criteria. Knee valgus may be reliably used to screen elite youth male soccer players for this plyometric technique error and for test-retest comparison.
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Affiliation(s)
- Paul J Read
- 1School of Sport, Health and Applied Science, St Mary's University, London, United Kingdom; 2Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom; 3Exercise and Sport Research Centre, School of Sport and Exercise, University of Gloucestershire, Gloucester United Kingdom; 4Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; 5Department of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio; 6The Micheli Center for Sports Injury Prevention, Boston, Massachusetts; 7Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand; and 8Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania
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Fox AS, Bonacci J, McLean SG, Saunders N. Efficacy of ACL injury risk screening methods in identifying high-risk landing patterns during a sport-specific task. Scand J Med Sci Sports 2016; 27:525-534. [PMID: 27292768 DOI: 10.1111/sms.12715] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2016] [Indexed: 12/24/2022]
Abstract
Screening methods sensitive to movement strategies that increase anterior cruciate ligament (ACL) loads are likely to be effective in identifying athletes at-risk of ACL injury. Current ACL injury risk screening methods are yet to be evaluated for their ability to identify athletes' who exhibit high-risk lower limb mechanics during sport-specific maneuvers associated with ACL injury occurrences. The purpose of this study was to examine the efficacy of two ACL injury risk screening methods in identifying high-risk lower limb mechanics during a sport-specific landing task. Thirty-two female athletes were screened using the Landing Error Scoring System (LESS) and Tuck Jump Assessment. Participants' also completed a sport-specific landing task, during which three-dimensional kinematic and kinetic data were collected. One-dimensional statistical parametric mapping was used to examine the relationships between screening method scores, and the three-dimensional hip and knee joint rotation and moment data from the sport-specific landing. Higher LESS scores were associated with reduced knee flexion from 30 to 57 ms after initial contact (P = 0.003) during the sport-specific landing; however, no additional relationships were found. These findings suggest the LESS and Tuck Jump Assessment may have minimal applicability in identifying athletes' who exhibit high-risk landing postures in the sport-specific task examined.
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Affiliation(s)
- A S Fox
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - J Bonacci
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - S G McLean
- Human Innovation, Fitbit, San Francisco, California, USA
| | - N Saunders
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
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Sugimoto D, Myer GD, Barber Foss KD, Pepin MJ, Micheli LJ, Hewett TE. Critical components of neuromuscular training to reduce ACL injury risk in female athletes: meta-regression analysis. Br J Sports Med 2016; 50:1259-1266. [PMID: 27251898 DOI: 10.1136/bjsports-2015-095596] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 04/23/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of this study was to determine key components in neuromuscular training that optimise ACL injury reduction in female athletes using meta-regression analyses. DESIGN Systematic review and meta-regression. DATA SOURCES The literature search was performed in PubMed and EBSCO. ELIGIBILITY CRITERIA Inclusion criteria for the current analysis were: (1) documented the number of ACL injuries, (2) employed a neuromuscular training intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective control study design and (5) recruited female athletes as participants. Two independent reviewers extracted studies which met the inclusion criteria. Methodological quality of included study and strength of recommendation were evaluated. Number of ACL injuries and participants in control and intervention groups, age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and status of verbal feedback were extracted. RESULTS The meta-regression analyses identified age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback as significant predictors of ACL injury reduction (p=0.01 in fixed-effects model, p=0.03 in random-effects model). Inclusion of 1 of the 4 components in neuromuscular training could reduce ACL injury risk by 17.2-17.7% in female athletes. No significant heterogeneity and publication bias effects were detected. Strength of recommendation was rated as A (recommendation based on consistent and good-quality patient-oriented study evidence). CONCLUSIONS Age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback are predictors that influence the optimisation of prophylactic effects of neuromuscular training and the resultant ACL injury reduction in female athletes.
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Affiliation(s)
- Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA
| | - Gregory D Myer
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Human Performance Laboratory, Sports Medicine Biodynamics Center, Cincinnati, Ohio, USA Department of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kim D Barber Foss
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Human Performance Laboratory, Sports Medicine Biodynamics Center, Cincinnati, Ohio, USA
| | - Michael J Pepin
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Lyle J Micheli
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA
| | - Timothy E Hewett
- Biomechanics Laboratories and Sports Medicine Center, Orthopedic Surgery, Physical Medicine & Rehabilitation Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
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Fox AS, Bonacci J, McLean SG, Spittle M, Saunders N. A Systematic Evaluation of Field-Based Screening Methods for the Assessment of Anterior Cruciate Ligament (ACL) Injury Risk. Sports Med 2016; 46:715-35. [PMID: 26626070 DOI: 10.1007/s40279-015-0443-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Laboratory-based measures provide an accurate method to identify risk factors for anterior cruciate ligament (ACL) injury; however, these methods are generally prohibitive to the wider community. Screening methods that can be completed in a field or clinical setting may be more applicable for wider community use. Examination of field-based screening methods for ACL injury risk can aid in identifying the most applicable method(s) for use in these settings. OBJECTIVE The objective of this systematic review was to evaluate and compare field-based screening methods for ACL injury risk to determine their efficacy of use in wider community settings. DATA SOURCES An electronic database search was conducted on the SPORTDiscus™, MEDLINE, AMED and CINAHL databases (January 1990-July 2015) using a combination of relevant keywords. A secondary search of the same databases, using relevant keywords from identified screening methods, was also undertaken. STUDY SELECTION Studies identified as potentially relevant were independently examined by two reviewers for inclusion. Where consensus could not be reached, a third reviewer was consulted. Original research articles that examined screening methods for ACL injury risk that could be undertaken outside of a laboratory setting were included for review. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers independently assessed the quality of included studies. Included studies were categorized according to the screening method they examined. A description of each screening method, and data pertaining to the ability to prospectively identify ACL injuries, validity and reliability, recommendations for identifying 'at-risk' athletes, equipment and training required to complete screening, time taken to screen athletes, and applicability of the screening method across sports and athletes were extracted from relevant studies. RESULTS Of 1077 citations from the initial search, a total of 25 articles were identified as potentially relevant, with 12 meeting all inclusion/exclusion criteria. From the secondary search, eight further studies met all criteria, resulting in 20 studies being included for review. Five ACL-screening methods-the Landing Error Scoring System (LESS), Clinic-Based Algorithm, Observational Screening of Dynamic Knee Valgus (OSDKV), 2D-Cam Method, and Tuck Jump Assessment-were identified. There was limited evidence supporting the use of field-based screening methods in predicting ACL injuries across a range of populations. Differences relating to the equipment and time required to complete screening methods were identified. LIMITATIONS Only screening methods for ACL injury risk were included for review. Field-based screening methods developed for lower-limb injury risk in general may also incorporate, and be useful in, screening for ACL injury risk. CONCLUSIONS Limited studies were available relating to the OSDKV and 2D-Cam Method. The LESS showed predictive validity in identifying ACL injuries, however only in a youth athlete population. The LESS also appears practical for community-wide use due to the minimal equipment and set-up/analysis time required. The Clinic-Based Algorithm may have predictive value for ACL injury risk as it identifies athletes who exhibit high frontal plane knee loads during a landing task, but requires extensive additional equipment and time, which may limit its application to wider community settings.
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Affiliation(s)
- Aaron S Fox
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia
| | - Jason Bonacci
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia
| | - Scott G McLean
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Michael Spittle
- College of Sport and Exercise Science, Victoria University, Melbourne, VIC, Australia
| | - Natalie Saunders
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia.
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Sex Differences in Landing Biomechanics and Postural Stability During Adolescence: A Systematic Review with Meta-Analyses. Sports Med 2015; 46:241-53. [DOI: 10.1007/s40279-015-0416-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nyman E, Armstrong CW. Real-time feedback during drop landing training improves subsequent frontal and sagittal plane knee kinematics. Clin Biomech (Bristol, Avon) 2015; 30:988-94. [PMID: 26144663 DOI: 10.1016/j.clinbiomech.2015.06.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/19/2015] [Accepted: 06/23/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although neuromuscular training featuring visual feedback may benefit modification of anterior cruciate ligament injury-risk linked knee kinematics, wide-spread clinical intervention has been limited to date. This study evaluated the effects of a Microsoft Kinect-based feedback system for modification of drop vertical jump knee kinematics traditionally consistent with predisposition to non-contact anterior cruciate ligament injury in female athletes. We hypothesized that a four-week feedback training protocol would increase peak knee flexion angle and frontal plane valgus-correlated knee separation distance during drop jump landing performance. METHODS Twenty-four female athletes were randomly divided equally into control or Kinect-based feedback groups. Subjects were pre-screened for peak knee flexion angle and minimum knee separation distance during drop landing and later performed twenty 31cm drop landings three days per week for four weeks. The feedback group received Kinect-based visual feedback, while controls did not. Kinematics were re-assessed immediately following the end of the training period. FINDINGS The feedback group increased peak knee flexion and experienced a greater improvement in peak knee flexion. The feedback group improved normalized knee separation distance with greater improvement in post-training peak knee separation distance as compared with controls. INTERPRETATION Kinect-based feedback training significantly improved drop vertical jump knee kinematics associated with non-contact anterior cruciate ligament injury. The Kinect-based feedback approach demonstrates promise for mitigating non-contact anterior cruciate ligament injury predisposing knee biomechanics in female athletes within the clinical environment.
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Affiliation(s)
- Edward Nyman
- Motion Analysis Laboratory, Department of Kinesiology, College of Health Sciences, The University of Toledo, Toledo, OH, USA.
| | - Charles W Armstrong
- Motion Analysis Laboratory, Department of Kinesiology, College of Health Sciences, The University of Toledo, Toledo, OH, USA
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Shultz SJ, Schmitz RJ, Benjaminse A, Collins M, Ford K, Kulas AS. ACL Research Retreat VII: An Update on Anterior Cruciate Ligament Injury Risk Factor Identification, Screening, and Prevention. J Athl Train 2015; 50:1076-93. [PMID: 26340613 PMCID: PMC4641546 DOI: 10.4085/1062-6050-50.10.06] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Sandra J. Shultz
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Randy J. Schmitz
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Anne Benjaminse
- The Department of Human Movement Sciences, University of Groningen, and The School of Sports Studies, Hanze University, Groningen, The Netherlands
| | - Malcolm Collins
- Department of Human Biology, University of Cape Town, South Africa
| | - Kevin Ford
- Human Biomechanics and Physiology Laboratory, Department of Physical Therapy, High Point University, NC
| | - Anthony S. Kulas
- Department of Health Education and Promotion, Eastern Carolina University, Greenville, NC
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Kushner AM, Kiefer AW, Lesnick S, Faigenbaum AD, Kashikar-Zuck S, Myer GD. Training the developing brain part II: cognitive considerations for youth instruction and feedback. Curr Sports Med Rep 2015; 14:235-43. [PMID: 25968858 PMCID: PMC4435822 DOI: 10.1249/jsr.0000000000000150] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Growing numbers of youth participating in competitive, organized physical activity have led to a concern for the risk of sports-related injuries during important periods of human development. Recent studies have demonstrated the ability of integrative neuromuscular training (INT) to enhance athletic performance and reduce the risk of sports-related injuries in youth. Successful implementation of INT necessitates instruction from knowledgeable and qualified instructors who understand the unique physical, cognitive, and psychosocial characteristics of the youth to provide appropriate training instruction and feedback. Principles of a classical theory of cognitive development provide a useful context for discussion of developmentally appropriate methods and strategies for INT instruction of youth. INT programs that consider these developmentally appropriate approaches will provide a controlled efficacious environment for youth to improve athletic performance and reduce risk of sports-related injury, thus promoting a healthy active lifestyle beyond an individual's formative years.
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Affiliation(s)
- Adam M. Kushner
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Adam W. Kiefer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Center for Cognition, Action and Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH USA
| | - Samantha Lesnick
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Avery D. Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, New Jersey, USA
| | - Susmita Kashikar-Zuck
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Gregory D. Myer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Sports medicine Sports Health & Performance Institute, The Ohio State University, Columbus, Ohio
- The Micheli Center for Sports Injury Prevention, Boston, MA
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Kiefer AW, Kushner AM, Groene J, Williams C, Riley MA, Myer GD. A Commentary on Real-Time Biofeedback to Augment Neuromuscular Training for ACL Injury Prevention in Adolescent Athletes. J Sports Sci Med 2015; 14:1-8. [PMID: 25729282 PMCID: PMC4306760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/02/2014] [Indexed: 06/04/2023]
Abstract
Anterior cruciate ligament injury and the associated long-term sequelae, such as immediate reductions in physical inactivity, increased adiposity and increased risk of osteoarthritis throughout adulthood, are a major health concern for adolescent athletes. Current interventions for injury prevention may have limited effectiveness, are susceptible to issues of compliance and have not achieved the widespread acceptance necessary to promote full adoption. Neuromuscular training (NMT) is a well-established training intervention introduced to affect change in modifiable biomechanical risk factors to reduce the risk of injury in these athletes. Despite moderate success, neuromuscular training is still limited by its reliance on subjective feedback and after the fact (i.e., offline) objective feedback techniques. The purpose of this commentary is to discuss technological tools that could be used to enhance and objectify targeted biofeedback interventions to complement NMT. Electromyography, force plates, motion sensors, and camera-based motion capture systems are innovative tools that may have realistic feasibility for integration as biofeedback into NMT programs to improve training outcomes. Improved functional deficit identification and corrective analysis may further improve and optimize athletic performance, and decrease the risk of sports-related injury during sport performance. Key pointsSpecific, targeted interventions that isolate injury risk factors and can help correct modifiable neuromuscular deficits are essential.Current training interventions for anterior cruciate ligament (ACL) injury prevention have only demonstrated limited effectiveness and have not achieved the widespread acceptance necessary to promote full adoption to reduce ACL injury rates.The paper provides an overview of innovative strategies and technological tools that could be used to enhance and objectify targeted biofeedback interventions to complement neuromuscular training (NMT) including electromyography, force plates, motion sensors, and camera-based motion capture systems.These strategies utilize biomechanical, physiological, or neuromotor variables for training, automate the quantitative measurement of those variables through a variety of technological modalities, and then feed those measured variables via software to provide information in simplified form for online, visual biofeedback displays.
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Affiliation(s)
| | - Adam M Kushner
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, OH USA
| | - John Groene
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, OH USA
| | - Christopher Williams
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, OH USA
| | - Michael A Riley
- Center for Cognition, Action and Perception, Department of Psychology, University of Cincinnati , Cincinnati, OH USA
| | - Gregory D Myer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, OH USA ; Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH USA ; The Sports Health and Performance Institute, OSU Sports Medicine, The Ohio State University Medical Center , Columbus, OH USA ; The Micheli Center for Sports Injury Prevention , Waltham, MA, USA
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Myer GD, Ford KR, Di Stasi SL, Foss KDB, Micheli LJ, Hewett TE. High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: is PFP itself a predictor for subsequent ACL injury? Br J Sports Med 2015; 49:118-22. [PMID: 24687011 PMCID: PMC4182160 DOI: 10.1136/bjsports-2013-092536] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Identifying risk factors for knee pain and anterior cruciate ligament (ACL) injury can be an important step in the injury prevention cycle. OBJECTIVE We evaluated two unique prospective cohorts with similar populations and methodologies to compare the incidence rates and risk factors associated with patellofemoral pain (PFP) and ACL injury. METHODS The 'PFP cohort' consisted of 240 middle and high school female athletes. They were evaluated by a physician and underwent anthropometric assessment, strength testing and three-dimensional landing biomechanical analyses prior to their basketball season. 145 of these athletes met inclusion for surveillance of incident (new) PFP by certified athletic trainers during their competitive season. The 'ACL cohort' included 205 high school female volleyball, soccer and basketball athletes who underwent the same anthropometric, strength and biomechanical assessment prior to their competitive season and were subsequently followed up for incidence of ACL injury. A one-way analysis of variance was used to evaluate potential group (incident PFP vs ACL injured) differences in anthropometrics, strength and landing biomechanics. Knee abduction moment (KAM) cut-scores that provided the maximal sensitivity and specificity for prediction of PFP or ACL injury risk were also compared between the cohorts. RESULTS KAM during landing above 15.4 Nm was associated with a 6.8% risk to develop PFP compared to a 2.9% risk if below the PFP risk threshold in our sample. Likewise, a KAM above 25.3 Nm was associated with a 6.8% risk for subsequent ACL injury compared to a 0.4% risk if below the established ACL risk threshold. The ACL-injured athletes initiated landing with a greater knee abduction angle and a reduced hamstrings-to-quadriceps strength ratio relative to the incident PFP group. Also, when comparing across cohorts, the athletes who suffered ACL injury also had lower hamstring/quadriceps ratio than the players in the PFP sample (p<0.05). CONCLUSIONS In adolescent girls aged 13.3 years, >15 Nm of knee abduction load during landing is associated with greater likelihood of developing PFP. Also, in girls aged 16.1 years who land with >25 Nm of knee abduction load during landing are at increased risk for both PFP and ACL injury.
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Affiliation(s)
- Gregory D Myer
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA
- The Sports Health and Performance Institute, OSU Sports Medicine, Ohio State University Medical Center, Columbus, Ohio, USA
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
| | - Kevin R Ford
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Physical Therapy, School of Health Sciences, High Point University, High Point, North Carolina, USA
| | - Stephanie L Di Stasi
- The Sports Health and Performance Institute, OSU Sports Medicine, Ohio State University Medical Center, Columbus, Ohio, USA
| | - Kim D Barber Foss
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lyle J Micheli
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Division of Sports Medicine, Department of Orthopaedics, Boston Children’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Timothy E Hewett
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA
- The Sports Health and Performance Institute, OSU Sports Medicine, Ohio State University Medical Center, Columbus, Ohio, USA
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Departments of Physiology and Cell Biology, Family Medicine and of Orthopaedic Surgery and Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA
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Sugimoto D, Myer GD, Foss KDB, Hewett TE. Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: meta-analysis and subgroup analysis. Br J Sports Med 2014; 49:282-9. [PMID: 25452612 DOI: 10.1136/bjsports-2014-093461] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
CONTEXT Clinical trials have demonstrated that preventive neuromuscular training (PNMT) can be effective to reduce ACL injuries in young females. However, the magnitude of the overall effect of PNMT for ACL injury reduction has not reached consensus. In addition, the effects of individual exercises in PNMT that optimise ACL injury reduction are unknown. OBJECTIVE The purpose of this project was to systematically review previously published clinical trials and evaluate types of exercises that best support ACL injury reduction in young females. DATA SOURCES The key words 'knee', 'anterior cruciate ligament', 'ACL', 'prospective', 'neuromuscular', 'training', 'female', and 'prevention' were used for studies published from 1995 to May 2012 in PubMed and EBSCO host. STUDY SELECTION Inclusion criteria for the current analysis were: (1) documented number of ACL injuries, (2) employed a PNMT intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective controlled study design, (5) recruited female athletes and (6) recorded exercises implemented in the PNMT. DATA EXTRACTION The number of ACL injuries and female athletes in each group (control and intervention) were extracted. In addition, exercises were categorised into four types and analysed for each investigation. DATA SYNTHESIS A total of 14 clinical trials met the inclusion criteria. The subgroup analyses identified fewer ACL injuries in PNMT that focused on strengthening (OR 0.32, 95% CI 0.23 to 0.46, p=0.001), proximal control exercises (OR 0.33, 95% CI 0.23 to 0.47, p=0.001) and multiple exercise interventions (OR 0.32, CI 0.22 to 0.46, p=0.001). CONCLUSIONS The current subgroup analyses indicate strengthening, proximal control exercises and multi exercise genres increased efficacy in PNMT intervention designed to reduce ACL injury in young female athletes.
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Affiliation(s)
- Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, Ohio, USA College of Health Science, University of Kentucky, Lexington, Kentucky, USA
| | - Gregory D Myer
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, Ohio, USA Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA Departments of Orthopaedic Surgery, Biomedical Engineering and Rehabilitation Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kim D Barber Foss
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, Ohio, USA
| | - Timothy E Hewett
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, Ohio, USA College of Health Science, University of Kentucky, Lexington, Kentucky, USA Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA Departments of Orthopaedic Surgery, Biomedical Engineering and Rehabilitation Sciences, University of Cincinnati, Cincinnati, Ohio, USA Department of Physiology and Cell Biology, Orthopaedic Surgery, Family Medicine, Anatomy and Biomedical Engineering, OSU Sports Medicine Sports Health & Performance Institute, The Ohio State University, Columbus, Ohio, USA
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The impact of sex and knee injury history on jump-landing patterns in collegiate athletes: a clinical evaluation. Clin J Sport Med 2014; 24:373-9. [PMID: 24284948 DOI: 10.1097/jsm.0000000000000053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine whether jump-landing patterns, as assessed by the Landing Error Scoring System (LESS), differ based on sex and knee injury history. DESIGN Cross-sectional. SETTING College. PARTICIPANTS Two hundred fifteen intercollegiate athletes were grouped by sex (male = 116 and female = 99) and self-reported knee injury history (no = 148, mild = 31, and severe = 36). INTERVENTIONS Participants performed 3 trials of a standardized jump-landing task that were videotaped and later scored using the LESS. MAIN OUTCOME MEASURES Overall, individual item, sagittal total error, and frontal total error scores of the LESS. RESULTS An interaction effect was reported for trunk flexion at initial ground contact. Main effects for sex indicated that males demonstrated more at-risk landing movement patterns on the sagittal plane (ie, limited trunk, knee and hip flexion at initial contact, and limited hip flexion throughout the landing), whereas females demonstrated more at-risk landing movement patterns on the frontal plane (ie, knee valgus at initial ground contact and maximum knee flexion, and more frontal plane movement throughout the landing). No main effects were reported for injury history. CONCLUSIONS Jump-landing patterns seem to be impacted by sex but not knee injury history. Findings related to sex differences corroborate with previous laboratory-based investigations. Furthermore, findings support the clinical use of the LESS to screen for individuals who may be at risk for a lower extremity injury. Future studies should further investigate the clinical utility of the LESS, particularly its ability to predict lower extremity injuries.
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Training the developing brain, part I: cognitive developmental considerations for training youth. Curr Sports Med Rep 2014; 12:304-10. [PMID: 24030303 DOI: 10.1097/01.csmr.0000434106.12813.69] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Based on the fundamental principles of pediatric exercise science and developmental physiology, childhood provides a critical window to develop the physical readiness of youth through age-related training programs that are designed purposely to teach and reinforce fundamental movement skills to enhance preparedness for physical activity and sport. Successful implementation of developmental programs requires age-related instruction by qualified professionals who understand the physical and psychosocial uniqueness of children and adolescents. An understanding of the interaction of physical and cognitive development is needed to design and implement training strategies that optimize training outcomes. Regular training with structured and integrative modalities throughout the developmental years as part of physical education, recreation, and sports practice can improve athletic performance while reducing common sports-related injuries and can facilitate the adoption of healthy lifestyles throughout adulthood. In this commentary, we outline cognitive developmental considerations in youth that may influence the design and implementation of training programs aimed at optimizing motor skill development in youth.
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Kiefer AW, Gualberto Cremades J, Myer GD. Train the Brain: Novel Electroencephalography Data Indicate Links between Motor Learning and Brain Adaptations. JOURNAL OF NOVEL PHYSIOTHERAPIES 2014; 4:198. [PMID: 25309823 PMCID: PMC4193380 DOI: 10.4172/2165-7025.1000198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
EEG differences were examined between part and whole practice in the learning of a novel motor task. Recording was done at 4 sites (i.e., O1, O2, C3, and C4) on 30 participants who performed a novel mirror star tracer task. Individuals were randomly assigned to 3 groups: whole practice, part practice, and control (no practice). Whole practice is defined as practicing a skill in its entirety. Part practice is defined as practicing separate, independent parts of the skill, and gradually combining those parts with parts that are dependent on one another. Each group was assessed during a pretest and posttest. EEG data was analyzed using a 2×2×2×3 (trials×hemisphere×site×practice) repeated measures mixed model ANOVA for each of the wave bands (lower alpha, upper alpha, lower beta, upper beta). All participants performed the task faster as no practice effect was found across the three groups; however the part practice group exhibited a significant decrease in errors. Reduced activation in the occipital and central sites was observed for lower alpha in the posttest compared to the pretest, for all participants. Hemispheric differences were present for all wavebands, with greater activation in the left hemisphere independent of practice type. The results of our study indicate that task learning was likely associated with the observed changes in the lower alpha waveband. Further, a concomitant behavior between the hemispheric lateralization of alpha and beta waveforms was observed. These results have implications for athlete training and rehabilitation. They indicate the utility of EEG for learning assessment in athletes. They also indicate learning strategies with a partial movement focus may be a beneficial strategy to support the development of complex sport skills training and rehabilitation strategies focused on reacquisition of skills prior to sport reintegration.
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Affiliation(s)
- Adam W Kiefer
- Director of the TEAM VR Laboratory, Division of Sports Medicine, Cincinnati, Children’s Hospital Medical Center, Cincinnati, OH, USA
- Assistant Professor, Center for Cognition, Action and Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
- Assistant Professor, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - J Gualberto Cremades
- Associate Professor, Department of Sport and Exercise Sciences, Barry University, Miami Shores, FL, USA
| | - Gregory D Myer
- Director of Research, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Director of the Human Performance Laboratory, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Visiting Professor, the Sports Health and Performance Institute, OSU Sports Medicine, Ohio State University Medical Center, Columbus, OH, USA
- Senior Research Advisor, the Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
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Effects of periodic task-specific test feedback on physical performance in older adults undertaking band-based resistance exercise. J Aging Res 2014; 2014:171694. [PMID: 24616808 PMCID: PMC3927558 DOI: 10.1155/2014/171694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 12/04/2013] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to determine the effects of periodic task-specific test feedback on performance improvement in older adults undertaking community- and home-based resistance exercises (CHBRE). Fifty-two older adults (65–83 years) were assigned to a muscular perfsormance feedback group (MPG, n = 32) or a functional mobility feedback group (FMG, n = 20). Both groups received exactly the same 9-week CHBRE program comprising one community-based and two home-based sessions per week. Muscle performance included arm curls and chair stands in 30 seconds, while functional mobility was determined by the timed up and go (TUG) test. MPG received fortnightly test feedback only on muscle performance and FMG received feedback only on the TUG. Following training, there was a significant (P < 0.05) interaction for all performance tests with MPG improving more for the arm curls (MPG 31.4%, FMG 15.9%) and chair stands (MPG 33.7%, FMG 24.9%) while FMG improved more for the TUG (MPG-3.5%, FMG-9.7%). Results from this nonrandomized study suggest that periodic test feedback during resistance training may enhance task-specific physical performance in older persons, thereby augmenting reserve capacity or potentially reducing the time required to recover functional abilities.
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Neuromuscular training to target deficits associated with second anterior cruciate ligament injury. J Orthop Sports Phys Ther 2013; 43:777-792, A1-11. [PMID: 24175599 PMCID: PMC4163697 DOI: 10.2519/jospt.2013.4693] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
SYNOPSIS Successful return to previous level of activity following anterior cruciate ligament (ACL) reconstruction is not guaranteed, and the prevalence of second ACL injury may be as high as 30%. In particular, younger athletes who return to sports activities within the first several months after ACL reconstruction may be at significantly greater risk of a second ACL rupture compared to older, less active individuals. Significant neuromuscular deficits and functional limitations are commonly identified in athletes following ACL reconstruction, and these abnormal movement and neuromuscular control profiles may be both residual of deficits existing prior to the initial injury and exacerbated by the injury and subsequent ACL reconstruction surgery. Following ACL reconstruction, neuromuscular deficits are present in both the surgical and nonsurgical limbs, and accurately predict second-ACL injury risk in adolescent athletes. While second ACL injury in highly active individuals may be predicated on a number of modifiable and nonmodifiable factors, clinicians have the greatest potential to address the modifiable postsurgical risk factors through targeted neuromuscular interventions. This manuscript will (1) summarize the neuromuscular deficits commonly identified at medical discharge to return to sport, (2) provide the evidence underlying second-ACL injury risk factors, (3) propose a method to assess the modifiable deficits related to second-ACL injury risk, and (4) outline a method of intervention to prevent second ACL injury. The program described in this clinical commentary was developed with consideration for the modifiable factors related to second-injury risk, the principles of motor learning, and careful selection of the exercises that may most effectively modify aberrant neuromuscular patterns. Future validation of this evidence-based, late-phase rehabilitation program may be a critical factor in maximizing return-to-activity success and reduction of second-injury risk in highly active individuals. LEVEL OF EVIDENCE Therapy, level 5.
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Myer GD, Stroube BW, DiCesare CA, Brent JL, Ford KR, Heidt RS, Hewett TE. Augmented feedback supports skill transfer and reduces high-risk injury landing mechanics: a double-blind, randomized controlled laboratory study. Am J Sports Med 2013; 41:669-77. [PMID: 23371471 PMCID: PMC4166501 DOI: 10.1177/0363546512472977] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND There is a current need to produce a simple, yet effective method for screening and targeting possible deficiencies related to increased anterior cruciate ligament (ACL) injury risk. HYPOTHESIS Frontal plane knee angle (FPKA) during a drop vertical jump will decrease upon implementing augmented feedback into a standardized sport training program. STUDY DESIGN Controlled laboratory study. METHODS Thirty-seven female participants (mean ± SD: age, 14.7 ± 1.5 years; height, 160.9 ± 6.8 cm; weight, 54.5 ± 7.2 kg) were trained over 8 weeks. During each session, each participant received standardized training consisting of strength training, plyometrics, and conditioning. They were also videotaped running on a treadmill at a standardized speed and performing a repeated tuck jump for 10 seconds. Study participants were randomized into 2 groups and received augmented feedback on either their jumping (AF) or sprinting (CTRL) form. Average (mean of 3 trials) and most extreme (trial with greatest knee abduction) FPKA were calculated from 2-dimensional video captured during performance of the drop vertical jump. RESULTS After testing, a main effect of time was noted, with the AF group reducing their FPKA average by 37.9% over the 3 trials while the CTRL group demonstrated a 26.7% reduction average across the 3 trials (P < .05). Conversely, in the most extreme drop vertical jump trial, a significant time-by-group interaction was noted (P < .05). The AF group reduced their most extreme FPKA by 6.9° (pretest, 18.4° ± 12.3°; posttest, 11.4° ± 10.1°) on their right leg and 6.5° (pretest, 16.3° ± 14.5°; posttest, 9.8° ± 10.7°) on their left leg, which represented a 37.7% and 40.1% reduction in FPKA, respectively. In the CTRL group, no similar changes were noted in the right (pretest, 16.9° ± 14.3°; posttest, 14.0° ± 12.3°) or left leg (pretest, 9.8° ± 11.1°; posttest, 7.2° ± 9.2°) after training. CONCLUSION Providing athletes with augmented feedback on deficits identified by the tuck jump assessment has a positive effect on their biomechanics during a different drop vertical jump task that is related to increased ACL injury risk. The ability of the augmented feedback to support the transfer of skills and injury risk factor reductions across different tasks provides exciting new evidence related to how neuromuscular training may ultimately cross over into retained biomechanics that reduce ACL injuries during sport. CLINICAL RELEVANCE The tuck jump assessment's ease of use makes it a timely and economically favorable method to support ACL prevention strategies in young girls.
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Affiliation(s)
- Gregory D Myer
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
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