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Donelon TA, Edwards J, Brown M, Jones PA, O'Driscoll J, Dos'Santos T. Differences in Biomechanical Determinants of ACL Injury Risk in Change of Direction Tasks Between Males and Females: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2024; 10:29. [PMID: 38561438 PMCID: PMC10984914 DOI: 10.1186/s40798-024-00701-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Change of direction (COD) movements are associated with non-contact anterior cruciate ligament (ACL) injuries in multidirectional sports. Females appear at increased risk compared to males, which could be attributable to whole body kinematic strategies and greater multiplanar knee joint loads (KJLs) during COD which can increase ACL loading. OBJECTIVE The aim of this systematic review and meta-analysis was to examine and quantitatively synthesise the evidence for differences between males and females regarding KJLs and their biomechanical determinants (whole body kinematic strategies determining KJLs) during COD tasks. METHODS Databases including SPORTDiscus, Web of Science, and PubMed were systematically searched (July 2021-June 2023) for studies that compared differences in knee joint loads and biomechanical determinants of KJLs during COD between males and females. Inclusion criteria were: (1) females and males with no prior history of ACL injury (18-40 years); (2) examined biomechanical determinants of KJLs and/ or KJLs during COD tasks > 20°; (3) compared ≥ 1 outcome measure between males and females. Studies published between 2000 and 2023 examining a cutting task > 20° with a preceding approach run that compared KJLs or the whole body multiplanar kinematics associated with them, between sexes, using three-dimensional motion analysis. RESULTS This meta-analysis included 17 studies with a pooled sample size of 451 participants (227 males, 224 females). Meta-analysis revealed females displayed significantly less peak knee flexion during stance (SMD: 0.374, 95% CI 0.098-0.649, p = 0.008, I2: 0%); greater knee abduction at initial contact (IC) (SMD: 0.687, 95% CI 0.299-1.076, p = 0.001, I2: 55%); less hip internal rotation (SMD: 0.437, 95% CI 0.134-0.741, p = 0.005, I2: 34%) and hip abduction at IC (SMD: -0.454, 95% CI 0.151-0.758, p = 0.003, I2: 33%). No significant differences were observed between males and females for any internal or externally applied KJLs. All retrieved studies failed to control for strength, resistance training or skill history status. CONCLUSION No differences were observed in KJLs between males and females despite females displaying greater knee abduction at IC and less peak knee flexion during the stance phase of CODs, which are visual characteristics of non-contact ACL injury. Further research is required to examine if this translates to a similar injury risk, considering morphological differences in strain characteristics of the ACL between males and females. This observation may in part explain the disproportionate ACL injury incidence in female multidirectional athletes. Further higher quality controlled research is required whereby participants are matched by skill training history, resistance training history and strength status to ensure an appropriate comparison between males and females.
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Affiliation(s)
- Thomas A Donelon
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK.
| | - Jamie Edwards
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Mathew Brown
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Paul A Jones
- School of Health Sciences, C702 Allerton Building, University of Salford, Salford, M6 6PU, UK
| | - Jamie O'Driscoll
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Thomas Dos'Santos
- Department of Sport and Exercise Sciences | Manchester Metropolitan University, 2.01 Institute of Sport, 99 Oxford Road, Manchester, M1 7EL, UK
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Patsimas T, Howell DR, Hovater W, Drexelius K, Selberg C, Armento A, Mayer S. Recovery in Hip Range of Motion in Young Flexibility Athletes 1 Year After Periacetabular Osteotomy. J Dance Med Sci 2024; 28:51-56. [PMID: 37864457 DOI: 10.1177/1089313x231205101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Background: Periacetabular Osteotomy (PAO) is a well-established surgical intervention for the treatment of hip dysplasia. Purpose: Our primary objective was to assess whether a group of young flexibility athletes who underwent PAO for hip dysplasia recovered their pre-operative hip range of motion (ROM) within 1 year of surgery. Our secondary objective was to compare hip ROM recovery between a group of young flexibility athletes and a group of non-flexibility athletes who underwent PAO for hip dysplasia. Results: In our study, 100% of flexibility athletes regained preoperative hip external rotation at 1-year post-operation. This was also the first plane of motion to return to preoperative motion in flexibility athletes. A significantly higher percentage of non-flexibility athletes regained their preoperative hip internal rotation compared to flexibility athletes (100% compared to 54%; P = .02), but not flexion or external rotation at 1-year post-operation. Conclusion: Our findings may help providers to set expectations regarding the recovery of hip ROM in flexibility athletes who undergo PAO for hip dysplasia.Level of Evidence: Level IV.
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Affiliation(s)
- Tatiana Patsimas
- Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - David R Howell
- Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Whitney Hovater
- Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
| | - Katherine Drexelius
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Courtney Selberg
- Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Aubrey Armento
- Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Stephanie Mayer
- Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
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Póvoa AR, Costa CM, Simões S, Azevedo AM, Oliveira R. Irish Dancing Injuries and Associated Risk Factors: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6190. [PMID: 37372775 DOI: 10.3390/ijerph20126190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023]
Abstract
Irish dance is growing in popularity, evolving to a more athletic and demanding dance style. The aim of this study is to conduct a systematic review, previously registered with PROSPERO, to identify the prevalence, incidence, and the injury pattern among Irish dancers and analyse the associated risk factors. Six online databases and two dance-specific science publications were searched systematically. Studies were included if the patterns of injuries among Irish dancers were evaluated or the factors associated with injury were analysed, published in English or Portuguese, in peer-reviewed scientific journals. Four reviewers assessed the quality and level of evidence using the Downs and Black criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Eleven articles were included, eight of Level 3c (cross-sectional) and three of Level 3b (prospective). Mean DB percentage score was 63% ± 7.2%. Prevalence ranged from 72.2% to 92.6%, affecting mostly the foot/ankle complex. Only two articles reported incidence, which ranged from 3.4 to 10.6 injuries/1000 h danced depending on injury definition. Psychological factors, elite level, and insufficient/poor sleep were associated with musculoskeletal injury. Injury prevalence and incidence is high in Irish dancers, with the foot and ankle being more affected. Due to heterogeneity in injury definitions, methods, and populations, along with the need for improvement in studies quality, recommendations were made for future research.
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Affiliation(s)
- Ana Rita Póvoa
- Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
| | - Cláudia Maria Costa
- Hospital Garcia de Orta, 2805-267 Almada, Portugal
- CiiEM-Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Caparica, Portugal
| | - Sérgio Simões
- Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
| | - Ana Morais Azevedo
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne 3086, Australia
- The Australian Ballet, Melbourne 3006, Australia
| | - Raul Oliveira
- Interdisciplinary Centre for the Study of Human Performance, Neuromuscular Research Lab, Human Kinetics Faculty, University of Lisbon, 1499-002 Cruz Quebrada-Dafundo, Portugal
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Beaulieu ML, Ashton-Miller JA, Wojtys EM. Loading mechanisms of the anterior cruciate ligament. Sports Biomech 2023; 22:1-29. [PMID: 33957846 PMCID: PMC9097243 DOI: 10.1080/14763141.2021.1916578] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/08/2021] [Indexed: 01/26/2023]
Abstract
This review identifies the three-dimensional knee loads that have the highest risk of injuring the anterior cruciate ligament (ACL) in the athlete. It is the combination of the muscular resistance to a large knee flexion moment, an external reaction force generating knee compression, an internal tibial torque, and a knee abduction moment during a single-leg athletic manoeuvre such as landing from a jump, abruptly changing direction, or rapidly decelerating that results in the greatest ACL loads. While there is consensus that an anterior tibial shear force is the primary ACL loading mechanism, controversy exists regarding the secondary order of importance of transverse-plane and frontal-plane loading in ACL injury scenarios. Large knee compression forces combined with a posteriorly and inferiorly sloped tibial plateau, especially the lateral plateau-an important ACL injury risk factor-causes anterior tibial translation and internal tibial rotation, which increases ACL loading. Furthermore, while the ACL can fail under a single supramaximal loading cycle, recent evidence shows that it can also fail following repeated submaximal loading cycles due to microdamage accumulating in the ligament with each cycle. This challenges the existing dogma that non-contact ACL injuries are predominantly due to a single manoeuvre that catastrophically overloads the ACL.
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Affiliation(s)
- Mélanie L. Beaulieu
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - James A. Ashton-Miller
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Edward M. Wojtys
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
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Ruan M, Zhang Q, Zhang X, Hu J, Wu X. Differences in strength and landing biomechanics between female jumpers and swimmers. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-210149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: It remains unclear if plyometric training as a single component could improve landing mechanics that are potentially associated with lower risk of ACL injury in the long term OBJECTIVE: The purpose of this study was to investigate the influence of experience undertaking plyometrics on landing biomechanics in female athletes. METHODS: Non-jumpers with little experience in plyometric training (12 female college swimmers) and jumpers with five years of experience in plyometric training (12 female college long jumpers and high jumpers) were recruited to participate in two testing sessions: an isokinetic muscle force test for the dominant leg at 120∘/s and a 40-cm drop landing test. An independent t test was applied to detect any significant effects between cohorts for selected muscle force, kinematic, kinetic, and electromyography variables. RESULTS: While female jumpers exhibited greater quadriceps eccentric strength (P= 0.013) and hamstring concentric strength (P= 0.023) during isokinetic testing than female swimmers, no significant differences were observed in kinematics, kinetics, and muscle activities during both drop landing and drop jumping. CONCLUSIONS: The results suggest that the female jumpers did not present any training-induced modification in landing mechanics regarding reducing injury risks compared with the swimmers. The current study revealed that plyometric training as a single component may not guarantee the development of low-risk landing mechanics for young female athletes.
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Affiliation(s)
- Mianfang Ruan
- School of Physical Education and Health, Wenzhou University, Wenzhou, Zhejiang, China
- School of Physical Education and Health, Wenzhou University, Wenzhou, Zhejiang, China
| | - Qiang Zhang
- Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
- School of Physical Education and Health, Wenzhou University, Wenzhou, Zhejiang, China
| | - Xin Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jing Hu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xie Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Blanco P, Nimphius S, Seitz LB, Spiteri T, Haff GG. Countermovement Jump and Drop Jump Performances Are Related to Grand Jeté Leap Performance in Dancers With Different Skill Levels. J Strength Cond Res 2021; 35:3386-3393. [PMID: 31498221 DOI: 10.1519/jsc.0000000000003315] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Blanco, P, Nimphius, S, Seitz, LB, Spiteri, T, and Haff, GG. Countermovement jump and drop jump performances are related to grand jeté leap performance in dancers with different skill levels. J Strength Cond Res 35(12): 3386-3393, 2021-Thirty-five classical ballet dancers were chosen to investigate relationships between the grand jeté leap, countermovement jump (CMJ), and drop jump (DJ) and establish whether the magnitude of the relationship between these tests differed across 3 skill levels. Subjects (male: n = 11 and female: n = 24) were divided into 3 groups: novice (n = 12; age: 16.6 ± 1.5 years; height: 1.7 ± 0.1 m; body mass: 58.0 ± 13.0 kg), semiprofessional (n = 13; age: 20.0 ± 1.6 years; height: 1.7 ± 0.1 m; body mass: 64.1 ± 10.5 kg), and professional (n = 10; age: 23.8 ± 3.5 years; height: 1.8 ± 1.2 m; body mass: 63.3 ± 14.7 kg). Grand jeté leap height, followed by CMJ and DJ vertical displacement, was assessed. Significant relationships were found between the grand jeté, CMJ (r = 0.77, p = 0.001) and DJ (r = 0.76, p = 0.001). After a Fisher's r-z transformation, professional dancers and novice dancers showed greater r-value differences in CMJ (r2 - r1 = 0.27) compared with novice (r2 - r1 = 0.17) and semiprofessional dancers (r2 - r1 = 0.11), indicating larger strength of CMJ to grand jeté relationship in professionals. The grand jeté leap showed large to very large correlations with CMJ and DJ within groups. These common performance tests were determined to be practical and efficient methods for assessing the jumping ability of dancers. As dance skill increased, larger correlations were observed, suggesting that dancers with superior ballet skills may be more likely to use their underpinning physical capacities to jump higher within the context of ballet-specific jumping.
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Affiliation(s)
- Penelope Blanco
- Center for Exercise and Sports Science Research, Edith Cowan University, Joondalup, Western Australia, Australia ; and
| | - Sophia Nimphius
- Center for Exercise and Sports Science Research, Edith Cowan University, Joondalup, Western Australia, Australia ; and
| | - Laurent B Seitz
- Center for Exercise and Sports Science Research, Edith Cowan University, Joondalup, Western Australia, Australia ; and
| | - Tania Spiteri
- School of Health Science, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - G Gregory Haff
- Center for Exercise and Sports Science Research, Edith Cowan University, Joondalup, Western Australia, Australia ; and
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Kawaguchi K, Taketomi S, Mizutani Y, Uchiyama E, Ikegami Y, Tanaka S, Haga N, Nakamura Y. Sex-Based Differences in the Drop Vertical Jump as Revealed by Video Motion Capture Analysis Using Artificial Intelligence. Orthop J Sports Med 2021; 9:23259671211048188. [PMID: 34778472 PMCID: PMC8573498 DOI: 10.1177/23259671211048188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sex-based biomechanical differences during a drop vertical jump (DVJ) may explain the increased risk of anterior cruciate ligament injury in females. Video motion capture using artificial intelligence (VMocap) is a new method for accurate motion analysis. PURPOSE To use VMocap to identify sex-based differences in biomechanics during a DVJ in Asian athletes. STUDY DESIGN Controlled laboratory study. METHODS A total of 63 female and 61 male Asian soccer players volunteered for this study in 2018. Participants performed a bilateral DVJ using VMocap, and the knee valgus angle (KVA), knee flexion angle (KFA), hip flexion angle (HFA), and lower leg anterior inclination angle (LAIA) were calculated from the motion capture data. These joint angles and inclination angles were evaluated at the time of highest point of the first jump (H1), initial contact (IC), maximum knee flexion (MKF), toe-off (TO), and highest point of the second jump (H2). The unpaired t test was used to compare sex-based differences. RESULTS At H1, the KVA in females showed more valgus (-2.9° vs -5.4°) and the LAIA in females was greater (29.1° vs 25.7°) versus males (P < .01 for both). At IC, the KVA in females showed more valgus (-1.3° vs -3.0°) and females had a greater KFA (20.8° vs 14.3°) and LAIA (5.1° vs 0.0°) compared with males (P < .01 for all). At MKF, female KVA showed more valgus (6.2° vs -9.5°), and females had greater LAIA (36.6° vs 34.6°), smaller KFA (77.5° vs 87.5°), and smaller HFA (55.8° vs 82.0°) compared with males (P < .01 for all). At TO, female KVA showed more valgus (-0.7° vs -3.1°) and female KFA, HFA, and LAIA were greater (31.7° vs 19.2°; 19.9° vs 16.4°; and 18.2° vs 11.5°, respectively) than males (P < .01 for all). At H2, females had a greater KFA (18.6° vs 14.6°) and LAIA (13.3° vs 9.9°) than males (P < .04 for both). CONCLUSION Asian female soccer players showed increased KVA and LAIA, decreased KFA and HFA at MKF, and increased KFA at IC and TO compared with their male counterparts in this analysis of the DVJ. CLINICAL RELEVANCE Elucidation of kinematic differences between the sexes can aid in predicting injuries.
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Affiliation(s)
- Kohei Kawaguchi
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Taketomi
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuri Mizutani
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
| | - Emiko Uchiyama
- Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Yosuke Ikegami
- Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhiko Haga
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
- Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiko Nakamura
- University of Tokyo Sports Science Initiative (UTSSI), Tokyo, Japan
- Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
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Nagy P, Brogden C, Orr G, Greig M. Within- and between-day loading response to ballet choreography. Res Sports Med 2021; 30:616-627. [PMID: 34085896 DOI: 10.1080/15438627.2021.1929223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Overuse pathologies are prevalent in ballet injury. Ten amateur ballet dancers (age: 23.20 ± 3.08 years) completed a progressive 5-stage choreographed routine on two consecutive days. Tri-axial accelerometers positioned at C7 and the dominant and non-dominant lower-limb were used to calculate accumulated PlayerLoadTM (PLTOTAL) and uni-axial contributions of the anterior-posterior (PLAP), medial-lateral (PLML), and vertical (PLV) planes. PLTOTAL increased significantly (p = 0.001) as a function of exercise duration within-trial, however there was no significant change between trials (p = 0.18). PLTOTAL at C7 was significantly (p = 0.001) lower than both lower-limbs, with no bilateral asymmetry evident (p = 0.97). Planar contributions to PLTOTAL were significantly greater in PLV than PLAP and PLML (p = 0.001). PlayerLoadTM demonstrated within-trial sensitivity to the progressive routine, however no residual fatigue effect was observed between trials. The results of this study suggest that accelerometers have efficacy in athlete monitoring and injury screening protocols, however unit placement should be considered for practical interpretation.
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Affiliation(s)
- Philip Nagy
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, Lancashire, UK
| | - Chris Brogden
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, Lancashire, UK
| | - Gabrielle Orr
- Department of Creative Arts, Edge Hill University, Ormskirk, Lancashire, UK
| | - Matt Greig
- Sports Injuries Research Group, Department of Sport & Physical Activity, Edge Hill University, Ormskirk, Lancashire, UK
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Aksu N, Atansay V, Karalök I, Aksu T, Kara AN, Hamzaoglu A. Relationship of Patellofemoral Angles and Tibiofemoral Rotational Angles With Jumper's Knee in Professional Dancers: An MRI Analysis. Orthop J Sports Med 2021; 9:2325967120985229. [PMID: 33796584 PMCID: PMC7970196 DOI: 10.1177/2325967120985229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/31/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Jumper’s knee is a type of tendinopathy affecting the distal insertion of the
quadriceps tendon (25% of cases) or the patellar tendon. It has been shown
that frontal-plane measurements, such as genu valgum, genu varum, an
increased quadriceps angle, a protuberant tibial tuberosity, patella alta,
and short hamstring muscles, may be related to jumper’s knee. Purpose: To investigate the effects of tibiofemoral rotational angles and
patellofemoral (PF) angles on the development of jumper’s knee in
professional folk dancers. Study Design: Case-control study; Level of evidence, 3. Methods: We examined 26 dancers (16 male, 10 female) with knee pain using magnetic
resonance imaging (MRI), for a total of 32 knees. Of the knees, 21 with
quadriceps tendinopathy (QT) and 7 with patellar tendinopathy (PT) were
detected. Using MRI scans, we measured PF angles (PF sulcus angle, lateral
PF angle, patellar tilt angle, lateral trochlear inclination angle, lateral
patellar tilt angle, and PF congruence angle) and tibiofemoral rotational
angles (condylar twist angle, posterior condylar angle, femoral Insall
angle, tibial Insall angle, posterior tibiofemoral angle, and angle between
the Whiteside line and posterior femoral condylar line) and noted specifics
such as patella alta, patella baja, and the Wiberg classification of the
patellar shape between the patients with versus without QT and between
patients with versus without PT to understand if there was any relationship
with tendinopathy. Results: No statistically significant difference was observed in age, sex, patella
alta, or the Wiberg classification between the QT groups (with vs without)
and between the PT groups (with vs without) (P > .05).
Having QT was found to be significantly associated with the PF sulcus angle
(P = .009), and having PT was found to be significantly
associated with the femoral Insall angle (P = .029). Conclusion: Jumper’s knee was found to be associated with anatomic variations of the PF
sulcus angle and rotation of the patellar tendon in relation to the femur
(femoral Insall angle) on axial MRI scans in professional dancers. Unlike
those of other athletes, dancers’ knees are exposed more to external
rotation forces because of turnout, and this can be the cause of jumper’s
knee.
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Affiliation(s)
- Neslihan Aksu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Vefa Atansay
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Işık Karalök
- Department of Radiology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Taner Aksu
- Istanbul Neuro-orthopaedics Clinic, Istanbul, Turkey
| | - Ayhan Nedim Kara
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Azmi Hamzaoglu
- Orthopaedic and Spine Center, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
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Steinberg N, Tenenbaum S, Zeev A, Pantanowitz M, Waddington G, Dar G, Siev-Ner I. Generalized joint hypermobility, scoliosis, patellofemoral pain, and physical abilities in young dancers. BMC Musculoskelet Disord 2021; 22:161. [PMID: 33563260 PMCID: PMC7874653 DOI: 10.1186/s12891-021-04023-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 01/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Many young girls with generalized joint hypermobility (GJH) choose to participate in dance because their bodies are suited for this activity. Scoliosis tends to occur often in thin girls, who also are more likely to choose dance. Both anomalies (GJH and scoliosis) may be related to reduced abilities such as diminished strength and insufficient postural balance, with increased risk for musculoskeletal conditions. The main objectives of the present study were to determine the prevalence of dancers with GJH, the prevalence of dancers with scoliosis, and the prevalence of dancers with these two anomalies; and, to determine differences in physical abilities and the presence of patellofemoral pain (PFP) between young female dancers with and without such anomalies. Methods One hundred thirty-two female dancers, aged 12–14 years, were assessed for anthropometric parameters, GJH, scoliosis, knee muscle strength, postural balance, proprioception ability, and PFP. Results GJH was identified in 54 dancers (40.9%) and scoliosis in 38 dancers (28.8%). Significant differences were found in the proportion of dancers with no anomalies (74 dancers, 56.1%) and dancers with both anomalies (34 dancers, 25.8%) (p < .001). Dancers with both anomalies had reduced dynamic postural balance in the anterior direction (p = .023), reduced proprioception ability (p < .001), and weaker knee extensors (p = .036) and flexors (p = .040) compared with dancers with no anomalies. Among dancers with both anomalies, 73.5% suffered bilateral PFP, 17.6% suffered unilateral PFP, and 8.8% had no PFP (p < .001). Conclusions A high prevalence of young girls participating in dance classes had GJH, as the increased joint flexibility probably provides them with some esthetic advantages. The high prevalence of scoliosis found in these young dancers might be attributed to their relatively low body mass, their delayed maturation, and the selection process of dancers. Dancers with both GJH and scoliosis had decreased muscle strength, reduced postural balance, reduced proprioception, with higher risk of PFP. The main clinical implications are the need to reduce the risk of PFP among dancers by developing appropriate strength and stabilizing exercises combined with proprioceptive and postural balance training, to improve the correct alignment of the hyperextended and hypermobile joints, and to improve their supporting muscle strength.
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Affiliation(s)
- Nili Steinberg
- Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel.
| | - Shay Tenenbaum
- Department of Orthopedic Surgery, Chaim Sheba Medical Center Tel-Hashomer, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviva Zeev
- Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Michal Pantanowitz
- Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | | | - Gali Dar
- Department of Physical Therapy, Faculty of Social Welfare & Health Studies, University of Haifa, Haifa, Israel
| | - Itzhak Siev-Ner
- Orthopedic Rehabilitation Department, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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11
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Lim BO, An KO, Cho EO, Lim ST, Cho JH. Differences in anterior cruciate ligament injury risk factors between female dancers and female soccer players during single- and double-leg landing. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Lee J, Shin CS. Association between ankle angle at initial contact and biomechanical ACL injury risk factors in male during self-selected single-leg landing. Gait Posture 2021; 83:127-131. [PMID: 33130387 DOI: 10.1016/j.gaitpost.2020.08.130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 08/02/2020] [Accepted: 08/26/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Increasing the ankle plantar-flexion angle at initial contact (IC) during landing reduces the impact features associated with landing, such as the vertical ground reaction force and loading rate, potentially affecting the risk of anterior cruciate ligament (ACL) injury. However, the relationships between the ankle plantar-flexion angle at IC and the previously identified biomechanical factors related to noncontact ACL injury have not been studied. RESEARCH QUESTION Thus, the purpose of this study was to determine whether significant relationships exist between the ankle plantar-flexion angle at IC and the biomechanical factors related to noncontact ACL injury. METHODS The peak anterior tibial shear force, peak external knee valgus moment, peak knee valgus angle, and combined peak external knee valgus plus tibial internal rotation moments were measured in 26 individuals while performing self-selected, single-leg landing. Pearson correlation analyses were performed to assess the relationships between the ankle plantar-flexion angle at IC and the biomechanical factors mentioned above. RESULTS The greater ankle plantar-flexion angle at IC was related to smaller the peak knee valgus moment (r = -0.5, p = 0.009) and the combined peak knee valgus plus internal rotation moments (r = -0.58, p = 0.001). SIGNIFICANCE These results suggest that large ankle plantar-flexion angle at IC might be associated with lesser loading of the knee frontal plane and altering the self-selective ankle angle may result in biomechanical changes associated with ACL injury risk.
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Affiliation(s)
- Jinkyu Lee
- Department of Mechanical Engineering, Sogang University, Seoul, Republic of Korea
| | - Choongsoo S Shin
- Department of Mechanical Engineering, Sogang University, Seoul, Republic of Korea.
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The Effects of a 9-Week Hip Focused Weight Training Program on Hip and Knee Kinematics and Kinetics in Experienced Female Dancers. J Hum Kinet 2020; 75:29-39. [PMID: 33312293 PMCID: PMC7706665 DOI: 10.2478/hukin-2020-0035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Increased involvement of the hip musculature during some movements is associated with enhanced performance and reduced injury risk. However, the impact of hip dominant weight training methods on movement strategy has seen limited attention within the literature. The aim of this study was to evaluate if a 9-week hip dominant weight training intervention promotes a more hip dominant movement strategy leading to an improvement in countermovement jump performance. Twenty-two experienced female dancers were recruited and separated into an intervention (age 24.4 ± 6.3 years, body height 165.5 ± 5.8 cm, body mass 65.9 ± 5.6 kg) and a control (age 22.9 ± 5.6 years, body height 163.3 ± 5.4 cm, body mass 57.4 ± 6.8 kg) group. The intervention group participated in a 9-week hip dominant training intervention, which consisted of a wide stance back squat, Romanian deadlift, hip thrusters, and a bent over row. Hip and knee kinematics and kinetics, and countermovement jump performance were assessed pre and post training. Significant interaction effects were found for peak hip joint moment (p = 0.030, η2 = 0.214) and countermovement jump performance (p = 0.003, η2 = 0.356), indicating an increase in peak hip joint moment and countermovement jump performance for the intervention group. Specifically, the intervention group showed a mean increase in jump height of 11.5%. The data show that the use of a hip dominant weight training strategy can improve hip contribution in the propulsion phase of the countermovement jump. Strength and conditioning specialists should incorporate hip dominant weight training exercises to increase hip strength and improve performance.
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Fotaki A, Triantafyllou A, Papagiannis G, Stasi S, Georgios P, Olga S, Tsolakis CK, Koulouvaris P. The science of biomechanics can promote dancers’ injury prevention strategies. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1832707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Aspasia Fotaki
- 1st Department of Orthopaedic Surgery, Medical School, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Triantafyllou
- 1st Department of Orthopaedic Surgery, Medical School, Orthopaedic Research and Education Center “P.N.Soukakos”, Biomechanics and Gait Analysis Laboratory “Sylvia Ioannou”, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion, Physiotherapy Department, Faculty of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Georgios Papagiannis
- 1st Department of Orthopaedic Surgery, Medical School, Orthopaedic Research and Education Center “P.N.Soukakos”, Biomechanics and Gait Analysis Laboratory “Sylvia Ioannou”, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Laboratory of Neuromuscular and Cardiovascular Study of Motion, Physiotherapy Department, Faculty of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Sophia Stasi
- Laboratory of Neuromuscular and Cardiovascular Study of Motion, Physiotherapy Department, Faculty of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Papathanasiou Georgios
- Laboratory of Neuromuscular and Cardiovascular Study of Motion, Physiotherapy Department, Faculty of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Savvidou Olga
- 1st Department of Orthopaedic Surgery, Medical School, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Charilaos K. Tsolakis
- Sports Excellence Center, 1st Department of Orthopaedic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panayiotis Koulouvaris
- 1st Department of Orthopaedic Surgery, Medical School, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Abstract
Dancing, like athletics, is physically demanding, but dancing also involves aesthetics. Although athletes often use supplemental training, little information exists about its use in dancers. A review of types and effects of supplemental training on dancers' performance and injury risk indicates that, among largely female collegiate dancers, supplemental training enhances the dancers' performance, but limited evidence exists for injury risk reduction.
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16
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Fox A, Bonacci J, Hoffmann S, Nimphius S, Saunders N. Anterior cruciate ligament injuries in Australian football: should women and girls be playing? You're asking the wrong question. BMJ Open Sport Exerc Med 2020; 6:e000778. [PMID: 32341803 PMCID: PMC7173994 DOI: 10.1136/bmjsem-2020-000778] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Anterior cruciate ligament (ACL) injuries have been a rising concern in the early years of the women’s Australian Football League (AFLW), eliciting headlines of a ‘knee crisis’ surrounding the league. There has been a focus on female biology as the primary factor driving the high rate of ACL injuries in the AFLW. Emphasising Australian football (AF) as being dangerous predominantly due to female biology may be misrepresenting a root cause of the ACL injury problem, perpetuating gender stereotypes that can restrict physical development and participation of women and girls in the sport. We propose that an approach addressing environmental and sociocultural factors, along with biological determinants, is required to truly challenge the ACL injury problem in the AFLW. Sports science and medicine must therefore strive to understand the whole system of women in AF, and question how to address inequities for the benefit of the athletes.
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Affiliation(s)
- Aaron Fox
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Jason Bonacci
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Samantha Hoffmann
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sophia Nimphius
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Natalie Saunders
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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17
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Hendry D, Chai K, Campbell A, Hopper L, O'Sullivan P, Straker L. Development of a Human Activity Recognition System for Ballet Tasks. SPORTS MEDICINE-OPEN 2020; 6:10. [PMID: 32034560 PMCID: PMC7007459 DOI: 10.1186/s40798-020-0237-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/20/2020] [Indexed: 11/23/2022]
Abstract
Background Accurate and detailed measurement of a dancer’s training volume is a key requirement to understanding the relationship between a dancer’s pain and training volume. Currently, no system capable of quantifying a dancer’s training volume, with respect to specific movement activities, exists. The application of machine learning models to wearable sensor data for human activity recognition in sport has previously been applied to cricket, tennis and rugby. Thus, the purpose of this study was to develop a human activity recognition system using wearable sensor data to accurately identify key ballet movements (jumping and lifting the leg). Our primary objective was to determine if machine learning can accurately identify key ballet movements during dance training. The secondary objective was to determine the influence of the location and number of sensors on accuracy. Results Convolutional neural networks were applied to develop two models for every combination of six sensors (6, 5, 4, 3, etc.) with and without the inclusion of transition movements. At the first level of classification, including data from all sensors, without transitions, the model performed with 97.8% accuracy. The degree of accuracy reduced at the second (83.0%) and third (75.1%) levels of classification. The degree of accuracy reduced with inclusion of transitions, reduction in the number of sensors and various sensor combinations. Conclusion The models developed were robust enough to identify jumping and leg lifting tasks in real-world exposures in dancers. The system provides a novel method for measuring dancer training volume through quantification of specific movement tasks. Such a system can be used to further understand the relationship between dancers’ pain and training volume and for athlete monitoring systems. Further, this provides a proof of concept which can be easily translated to other lower limb dominant sporting activities
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Affiliation(s)
- Danica Hendry
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
| | - Kevin Chai
- Curtin Institute for Computations, Curtin University, Perth, Western Australia, Australia
| | - Amity Campbell
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Luke Hopper
- Western Australian Academy of Performing Arts, Perth, Western Australia, Australia
| | - Peter O'Sullivan
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
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18
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Hendry D, Leadbetter R, McKee K, Hopper L, Wild C, O’Sullivan P, Straker L, Campbell A. An Exploration of Machine-Learning Estimation of Ground Reaction Force from Wearable Sensor Data. SENSORS 2020; 20:s20030740. [PMID: 32013212 PMCID: PMC7038404 DOI: 10.3390/s20030740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 01/06/2023]
Abstract
This study aimed to develop a wearable sensor system, using machine-learning models, capable of accurately estimating peak ground reaction force (GRF) during ballet jumps in the field. Female dancers (n = 30) performed a series of bilateral and unilateral ballet jumps. Dancers wore six ActiGraph Link wearable sensors (100 Hz). Data were collected simultaneously from two AMTI force platforms and synchronised with the ActiGraph data. Due to sensor hardware malfunctions and synchronisation issues, a multistage approach to model development, using a reduced data set, was taken. Using data from the 14 dancers with complete multi-sensor synchronised data, the best single sensor was determined. Subsequently, the best single sensor model was refined and validated using all available data for that sensor (23 dancers). Root mean square error (RMSE) in body weight (BW) and correlation coefficients (r) were used to assess the GRF profile, and Bland–Altman plots were used to assess model peak GRF accuracy. The model based on sacrum data was the most accurate single sensor model (unilateral landings: RMSE = 0.24 BW, r = 0.95; bilateral landings: RMSE = 0.21 BW, r = 0.98) with the refined model still showing good accuracy (unilateral: RMSE = 0.42 BW, r = 0.80; bilateral: RMSE = 0.39 BW, r = 0.92). Machine-learning models applied to wearable sensor data can provide a field-based system for GRF estimation during ballet jumps.
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Affiliation(s)
- Danica Hendry
- Curtin University, School of Physiotherapy and Exercise Science, Perth WA 6845, Australia
- Correspondence:
| | - Ryan Leadbetter
- Curtin University, School of Mechanical and Civil Engineering, Perth WA 6845, Australia
| | - Kristoffer McKee
- Curtin University, School of Mechanical and Civil Engineering, Perth WA 6845, Australia
| | - Luke Hopper
- Western Australian Academy of Performing Arts, Edith Cowan University, Perth WA 6050, Australia
| | - Catherine Wild
- Curtin University, School of Physiotherapy and Exercise Science, Perth WA 6845, Australia
| | - Peter O’Sullivan
- Curtin University, School of Physiotherapy and Exercise Science, Perth WA 6845, Australia
| | - Leon Straker
- Curtin University, School of Physiotherapy and Exercise Science, Perth WA 6845, Australia
| | - Amity Campbell
- Curtin University, School of Physiotherapy and Exercise Science, Perth WA 6845, Australia
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19
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Azevedo AM, Oliveira R, Vaz JR, Cortes N. Oxford foot model kinematics in landings: A comparison between professional dancers and non-dancers. J Sci Med Sport 2019; 23:347-352. [PMID: 31734168 DOI: 10.1016/j.jsams.2019.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 10/14/2019] [Accepted: 10/22/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Dancers frequently perform jump-landing activities, with the foot-ankle complex playing an essential role to attenuate the landing forces. However, scarce research has been conducted in professional dancers multi-segmented foot in landings. The aim of this study was to compare the multi-segmented foot kinematics between professional dancers and non-dancers, during forward and lateral single-leg jump-landings. DESIGN Descriptive group comparison. METHODS Marker trajectories and synchronized ground reaction forces of 15 professional dancers and 15 non-dancers were collected using motion capture and a force plate, during multidirectional single-leg jump-landings. Sagittal and frontal hindfoot-tibia, forefoot-hindfoot, and hallux-forefoot kinematics of the multi-segmented foot model were computed at initial contact, peak vertical ground reaction force and peak knee flexion. Repeated measures ANOVAs were conducted (p < 0.05). RESULTS Professional dancers landed with higher hindfoot-tibia and forefoot-hindfoot plantarflexion angles at initial contact (p < 0.001), and hindfoot-tibia dorsiflexion angles at peak vertical ground reaction force and peak knee flexion (p < 0.001) than non-dancers. Also, dancers exhibited higher sagittal hindfoot-tibia and forefoot-hindfoot excursions than non-dancers (p < 0.001). No statistically significant differences were found in the frontal plane. CONCLUSIONS The multi-segmented foot allows a comprehensive kinematic analysis of the different foot joints. In jump-landings, professional dancers higher hindfoot-tibia, and forefoot-hindfoot plantarflexion at initial contact, compared to non-dancers, contributed to a subsequent higher foot joints excursion. This pattern is commonly linked to a better shock absorption mechanism in landings.
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Affiliation(s)
- Ana M Azevedo
- Faculty of Human Kinetics, University of Lisbon, Portugal; George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, USA
| | - Raúl Oliveira
- Faculty of Human Kinetics, University of Lisbon, Portugal; CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - João R Vaz
- CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal; Universidade Europeia, Portugal
| | - Nelson Cortes
- George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, USA; Department of Bioengineering, George Mason University.
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20
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Azevedo AM, Oliveira R, Vaz JR, Cortes N. Foot modeling affects ankle sagittal plane kinematics during jump-landing. J Biomech 2019; 96:109337. [PMID: 31547999 DOI: 10.1016/j.jbiomech.2019.109337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/18/2019] [Accepted: 09/02/2019] [Indexed: 10/26/2022]
Abstract
The foot-ankle complex is a key-element to mitigate impact forces during jump-landing activities. Biomechanical studies commonly model the foot as a single-segment, which can provide different ankle kinematics compared to a multi-segmented model. Also, it can neglect intersegmental kinematics of the foot-ankle joints, such as the hindfoot-tibia, forefoot-hindfoot, and hallux-forefoot joints, that are used during jump-landing activities. The purpose of this short communication was to compare ankle kinematics between a three- and single-segmented foot models, during forward and lateral single-leg jump-landings. Marker trajectories and synchronized ground reaction forces of 30 participants were collected using motion capture and a force plate, during multidirectional single-leg jump-landings. Ankle kinematics were computed using a three- (hindfoot-tibia) and a single-segmented (ankle) foot models, at initial contact (IC), peak vertical ground reaction force (PvGRF) and peak knee flexion (PKF). Repeated measures ANOVAs were conducted (p < 0.05). The findings of this study showed that during lateral and forward jump-landing directions, the three-segmented foot model exhibited lower hindfoot-tibia dorsiflexion angles (PvGRF and PKF, p < 0.001) and excursions (sagittal: p < 0.001; frontal: p < 0.05) during the weightbearing acceptance phase than the single-segmented model. Overall, the two foot models provided distinctive sagittal ankle kinematics, with lower magnitudes in the hindfoot-tibia of the three-segmented foot. Furthermore, the three-segmented foot model may provide additional and representative kinematic data of the ankle and foot joints, to better comprehend its function, particularly in populations whose foot-ankle complex plays an important role (e.g., dancers).
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Affiliation(s)
- Ana M Azevedo
- Faculty of Human Kinetics, University of Lisbon, Portugal; George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Manassas, VA, USA
| | - Raúl Oliveira
- Faculty of Human Kinetics, University of Lisbon, Portugal; CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - João R Vaz
- CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal; Universidade Europeia, Lisbon, Portugal
| | - Nelson Cortes
- George Mason University, Sports Medicine Assessment, Research & Testing (SMART) Laboratory, Manassas, VA, USA.
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21
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Han S, Kim RS, Harris JD, Noble PC. The envelope of active hip motion in different sporting, recreational, and daily-living activities: A systematic review. Gait Posture 2019; 71:227-233. [PMID: 31078827 DOI: 10.1016/j.gaitpost.2019.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/16/2019] [Accepted: 05/02/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND In treating patients with limitations of hip motion, it is generally assumed that correction of bony morphology will provide the patient with the joint motion required to resume their activities. However, the positions of impingement and the specific excursions of joint motion required by each sport may vary. This systematic review aimed to define the envelope of active hip joint motion for participation in different sporting, recreational, and daily-living activities. METHODS The EMBASE, PubMed, Google Scholar, and Cochrane databases were searched to identify studies that reported kinematics of the hip in sporting, recreational, and daily-living activities. Inclusion criteria were (1) peer-reviewed articles reporting hip kinematics in a certain type of activity, and (2) presented in English. To synthesize the kinematic data, the peak values of kinematic components (i.e. flexion/extension, abduction/adduction, and internal/external rotation) during an activity, as well as the concurrent values in a certain phase of the activity were collected from each study. RESULTS A total of 67 studies met the inclusion criteria, involving 32 different types of activities. Seventeen activities required at least one component of supra-physiologic hip motion, however, there were eight different combinations of flexion/extension, abduction/adduction, and internal/external rotation observed. Specifically, three activities (sex, sitting cross-legged, and grand ecart lateral of ballet dancing) required simultaneous extreme degrees of all three components, five activities (arabesque, developpe devant right, and developpe a la seconde right of ballet dancing, picking up something, and taekwondo) required high degrees of two components, most commonly hip abduction combined with flexion or internal rotation. SIGNIFICANCE This review highlighted that many activities place supraphysiologic demands on hip joint motion, however, the kinematic components affected differ dramatically with the specific activity. This suggests that the demands of each patient's individual activities must be assessed before recommending or planning treatment rather than assuming that a fixed value of "normal" hip motion is applicable to all.
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Affiliation(s)
- Shuyang Han
- Institute of Orthopedic Research & Education, Houston, TX, USA
| | - Ryan S Kim
- Institute of Orthopedic Research & Education, Houston, TX, USA
| | - Joshua D Harris
- Houston Methodist Orthopedics & Sports Medicine, Houston, TX, USA
| | - Philip C Noble
- Institute of Orthopedic Research & Education, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA.
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22
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Steiger CN, Ceroni D. Mechanism and predisposing factors for proximal tibial epiphysiolysis in adolescents during sports activities. INTERNATIONAL ORTHOPAEDICS 2019; 43:1395-1403. [PMID: 30267244 DOI: 10.1007/s00264-018-4168-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 09/18/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Proximal tibial epiphysiolysis (PTE) can have debilitating consequences for young athletes. The mechanism and predisposing factors for this lesion have yet to be determined. To find a common denominator and a biomechanical explanation for PTE, we were using a retrospective analysis of 15 cases in combination with a systematic review of literature. METHODS A retrospective review of medical charts was performed to identify all PTE between 2003 and 2012. Records were screened for patient age and gender, sports activity, mechanism of injury, and treatment protocols. Additionally, a literature review (MEDLINE/PubMed database, the Cochrane Library, online search engines) was conducted. RESULTS Medical charts of 14 adolescents (15 Salter-Harris I and II fractures) were analyzed. The literature review revealed additional 75 fractures. The predominant mechanisms were landing from a jump, takeoff for a jump, stop and go movements, and eccentric muscle contraction with the knee in flexion. The main sports-activities implicated in these injuries were basketball. CONCLUSIONS Landing from a jump with a decreased knee and hip flexion movement increases tensile forces on the proximal tibia epiphysis. During physiological epiphysiodesis, the growth plate displays an increased vulnerability and such increased tensile forces can lead to a growth plate failure. Neuromuscular fatigue can alter coordination and proprioceptive accuracy during landing from a vertical jump and thus perturbs sagittal shock absorption. In our opinion, trainers should instruct young athletes in techniques that help avoiding uncontrolled high impact landings. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Christina N Steiger
- Département de l'enfant et de l'adolescent, Service d'orthopédie pédiatrique, Hôpitaux Universitaires de Genève, Rue Willy Donzé 6, 1205, Genève, Switzerland.
| | - Dimitri Ceroni
- Département de l'enfant et de l'adolescent, Service d'orthopédie pédiatrique, Hôpitaux Universitaires de Genève, Rue Willy Donzé 6, 1205, Genève, Switzerland
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23
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AZEVEDO ANAM, OLIVEIRA RAÚL, VAZ JOÃOR, CORTES NELSON. Professional Dancers Distinct Biomechanical Pattern during Multidirectional Landings. Med Sci Sports Exerc 2019; 51:539-547. [DOI: 10.1249/mss.0000000000001817] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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Carter SL, Bryant AR, Hopper LS. An analysis of the foot in turnout using a dance specific 3D multi-segment foot model. J Foot Ankle Res 2019; 12:10. [PMID: 30740146 PMCID: PMC6360724 DOI: 10.1186/s13047-019-0318-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 01/20/2019] [Indexed: 12/03/2022] Open
Abstract
Introduction Recent three-dimensional (3D) kinematic research has revealed foot abduction is the strongest predictor of standing functional and forced turnout postures. However, it is still unknown how the internal foot joints enable a large degree of foot abduction in turnout. The primary purpose of this study was to use a dance specific multi-segment foot model to determine the lower leg and foot contributions to turnout that female university-level ballets use to accentuate their turnout. Methods Eighteen female dance students (mean age, 18.8 ± 1.6 years) volunteered for this study. Retro-reflective markers were attached to the dancers’ dominant foot. Each dancer performed three repetitions of functional turnout, forced turnout and ten consecutive sautés in first position. Repeated measures ANOVA with Bonferroni adjustments for the multiple comparisons were used to determine the kinematic adjustments, hindfoot eversion, midfoot and forefoot abduction, navicular drop (i.e. lowering of the medial longitudinal arch) and first metatarsophalangeal joint abduction between natural double leg up-right posture and the first position conditions. Results Hindfoot eversion (4.6°, p < 0.001) and midfoot abduction (2.8°, p < 0.001) significantly increased in functional turnout compared to the natural double leg up-right posture. Thirteen dancers demonstrated increased first metatarsophalangeal joint (MTPJ) abduction in forced turnout, however no statistically significant increase was found. Navicular drop during sautés in first position significantly increased by 11 mm (p < 0.001) compared to the natural double leg up-right posture. Conclusion Our findings suggest dancers do pronate, via hindfoot eversion and midfoot abduction in both functional and forced turnout, however, no immediate association was found between forced turnout and first MTPJ abduction. Foot pronation does play a role in achieving turnout. Further prospective research on in situ measures of the lower limb in turnout and injury surveillance is required to improve our understanding of the normal and abnormal dance biomechanics. Electronic supplementary material The online version of this article (10.1186/s13047-019-0318-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah L Carter
- 1Podiatric Medicine and Surgery Division, School of Allied Health, The University of Western Australia, Perth, Australia.,2Western Australian Academy of Performing Arts, Edith Cowan University, Perth, Australia.,Podiatric Medicine and Surgery Division, M422, 35 Stirling Highway, Crawley, WA 6009 Australia
| | - Alan R Bryant
- 1Podiatric Medicine and Surgery Division, School of Allied Health, The University of Western Australia, Perth, Australia
| | - Luke S Hopper
- 2Western Australian Academy of Performing Arts, Edith Cowan University, Perth, Australia
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Ward RE, Fong Yan A, Orishimo KF, Kremenic IJ, Hagins M, Liederbach M, Hiller CE, Pappas E. Comparison of lower limb stiffness between male and female dancers and athletes during drop jump landings. Scand J Med Sci Sports 2018; 29:71-81. [PMID: 30242920 DOI: 10.1111/sms.13309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 09/07/2018] [Accepted: 09/18/2018] [Indexed: 01/03/2023]
Abstract
Repetition of jumps in dance and sport training poses a potential injury risk; however, non-contact landing injuries are more common in athletes than dancers. This study aimed to compare the lower limb stiffness characteristics of dancers and athletes during drop landings to investigate possible mechanisms of impact-related injuries. Kinematics and kinetics were recorded as 39 elite modern and ballet dancers (19 men and 20 women) and 40 college-level team sport athletes (20 men and 20 women) performed single-legged drop landings from a 30-cm platform. Vertical leg stiffness and joint stiffness of the hip, knee, and ankle were calculated using a spring-mass model. Stiffness data, joint kinematics, and moments were compared with a group-by-sex 2-way analysis of variance. Multiple linear regression was used to assess the relative contribution of hip and knee and ankle joint stiffness to variance in overall vertical leg stiffness for dancers and athletes. Dancers had lower leg (P < 0.001), knee joint (P = 0.034), and ankle joint stiffness (P = 0.043) than athletes. This was facilitated by lower knee joint moments (P = 0.012) and greater knee (P = 0.029) and ankle joint (P = 0.048) range of motion in dancers. Males had higher leg (P < 0.001) and ankle joint stiffness (P < 0.001) than females. This occurred through lower ankle range of motion (P < 0.001) and greater ankle moment (P = 0.022) compared to females. Male and female dancers demonstrated reduced lower limb stiffness compared to athletes, indicating a more pliable landing technique. Dance training techniques could potentially inform approaches to injury prevention in athletes.
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Affiliation(s)
- Rachel E Ward
- School of Medical Sciences, UNSW Sydney, Sydney, New South Wales, Australia
| | - Alycia Fong Yan
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Karl F Orishimo
- Nicholas Institute for Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, New York
| | - Ian J Kremenic
- Nicholas Institute for Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, New York
| | - Marshall Hagins
- Division of Physical Therapy, Long Island University, Brooklyn, New York.,Harkness Center for Dance Injuries, NYU Langone Orthopedic Hospital, New York, New York
| | - Marijeanne Liederbach
- Harkness Center for Dance Injuries, NYU Langone Orthopedic Hospital, New York, New York
| | - Claire E Hiller
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Evangelos Pappas
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
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Harwood A, Campbell A, Hendry D, Ng L, Wild CY. Differences in lower limb biomechanics between ballet dancers and non-dancers during functional landing tasks. Phys Ther Sport 2018; 32:180-186. [PMID: 29800796 DOI: 10.1016/j.ptsp.2018.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/04/2018] [Accepted: 05/05/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the differences in the lower limb landing biomechanics of adolescent ballet dancers compared to non-dancers when performing a hop and a stop jump task. DESIGN Cross-sectional. SETTING Laboratory. PARTICIPANTS Thirteen adolescent female ballet dancers (11.8 ± 1.1 years) and 17 non-dancers (10.9 ± 0.8 years) performed hop and stop jump tasks. MAIN OUTCOME MEASURES Vertical ground reaction force, and three-dimensional ankle, knee and hip joint angles and moments during the landing phase. RESULTS Dancers displayed greater sagittal plane joint excursions during the hop and stop jump at the ankle (mean difference = 22.0°, P < 0.001, 14.8°, P < 0.001 respectively), knee (mean difference = 18.1°, P = 0.001, 9.8°, P = 0.002 respectively) and hip (stop jump task; mean difference = 8.3°, P = 0.008). Dancers displayed a larger hip extensor moment compared to non-dancers (P < 0.001) during the stop jump task only. Dancers also took longer to reach peak vGRF and jumped three times higher than non-dancers (P < 0.001) during the stop jump task. No difference in peak vGRF between groups was displayed for either task. CONCLUSIONS Adolescent dancers demonstrate a transfer of landing technique to non-ballet specific tasks, reflective of the greater jump height and sagittal plane joint excursions. This landing strategy may be associated with the low rate of non-contact ACL injuries in female dancers.
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Affiliation(s)
- Annissa Harwood
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Amity Campbell
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Danica Hendry
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Leo Ng
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Catherine Y Wild
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.
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Turner C, Crow S, Crowther T, Keating B, Saupan T, Pyfer J, Vialpando K, Lee SP. Preventing non-contact ACL injuries in female athletes: What can we learn from dancers? Phys Ther Sport 2018; 31:1-8. [DOI: 10.1016/j.ptsp.2017.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/14/2017] [Accepted: 12/19/2017] [Indexed: 12/17/2022]
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Hansberger BL, Acocello S, Slater LV, Hart JM, Ambegaonkar JP. Peak Lower Extremity Landing Kinematics in Dancers and Nondancers. J Athl Train 2018. [PMID: 29528687 DOI: 10.4085/1062-6050-465-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
CONTEXT Anterior cruciate ligament (ACL) injuries often occur during jump landings and can have detrimental short-term and long-term functional effects on quality of life. Despite frequently performing jump landings, dancers have lower incidence rates of ACL injury than other jump-landing athletes. Planned versus unplanned activities and footwear may explain differing ACL-injury rates among dancers and nondancers. Still, few researchers have compared landing biomechanics between dancers and nondancers. OBJECTIVE To compare the landing biomechanics of dancers and nondancers during single-legged (SL) drop-vertical jumps. DESIGN Cross-sectional study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 39 healthy participants, 12 female dancers (age = 20.9 ± 1.8 years, height = 166.4 ± 6.7 cm, mass = 63.2 ± 16.4 kg), 14 female nondancers (age = 20.2 ± 0.9 years, height = 168.9 ± 5.0 cm, mass = 61.6 ± 7.7 kg), and 13 male nondancers (age = 22.2 ± 2.7 years, height = 180.6 ± 9.7 cm, mass = 80.8 ± 13.2 kg). INTERVENTION(S) Participants performed SL-drop-vertical jumps from a 30-cm-high box in a randomized order in 2 activity (planned, unplanned) and 2 footwear (shod, barefoot) conditions while a 3-dimensional system recorded landing biomechanics. MAIN OUTCOME MEASURE(S) Overall peak sagittal-plane and frontal-plane ankle-, knee-, and hip-joint kinematics (joint angles) were compared across groups using separate multivariate analyses of variance followed by main-effects testing and pairwise-adjusted Bonferroni comparisons as appropriate ( P < .05). RESULTS No 3-way interactions existed for sagittal-plane or frontal-plane ankle (Wilks λ = 0.85, P = .11 and Wilks λ = 0.96, P = .55, respectively), knee (Wilks λ = 1.00, P = .93 and Wilks λ = 0.94, P = .36, respectively), or hip (Wilks λ = 0.99, P = .88 and Wilks λ = 0.97, P = .62, respectively) kinematics. We observed no group × footwear interactions for sagittal-plane or frontal-plane ankle (Wilks λ = 0.94, P = .43 and Wilks λ = 0.96, P = .55, respectively), knee (Wilks λ = 0.97, P = .60 and Wilks λ = 0.97, P = .66, respectively), or hip (Wilks λ = 0.99, P = .91 and Wilks λ = 1.00, P = .93, respectively) kinematics, and no group × activity interactions were noted for ankle frontal-plane (Wilks λ = 0.92, P = .29) and sagittal- and frontal-plane knee (Wilks λ = 0.99, P = .81 and Wilks λ = 0.98, P = .77, respectively) and hip (Wilks λ = 0.88, P = .13 and Wilks λ = 0.85, P = .08, respectively) kinematics. A group × activity interaction (Wilks λ = 0.76, P = .02) was present for ankle sagittal-plane kinematics. Main-effects testing revealed different ankle frontal-plane angles across groups ( F2,28 = 3.78, P = .04), with male nondancers having greater ankle inversion than female nondancers ( P = .05). CONCLUSIONS Irrespective of activity type or footwear, female nondancers landed with similar hip and knee kinematics but greater peak ankle eversion and less peak ankle dorsiflexion (ie, positions associated with greater ACL injury risk). Ankle kinematics may differ between groups due to different landing strategies and training used by dancers. Dancers' training should be examined to determine if it results in a reduced occurrence of biomechanics related to ACL injury during SL landing.
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Bruton MR, Adams RD, O'Dwyer NJ. Sex Differences in Drop Landing: More Apparent in Recreational Surfers Than in Competitive Surfers or Nonsurfers. Percept Mot Skills 2017; 124:992-1008. [PMID: 28675328 DOI: 10.1177/0031512517717853] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We suspected that the observed inconsistency of sex differences in drop-landing motor skills might be due to the confounding factor of prior experience. Thus, in this study, we explored the role of experience in shaping male and female surfboard riders' motor skill kinematics during drop landings while surfboard riding. We recruited 42 participants (21 females and 21 males) from three groups of surfing experience levels (competitive surfers, recreational surfers, and nonsurfers), each equally comprising seven males and seven females. Sagittal plane kinematics and vertical ground reaction force data were collected from all participants during a laboratory-based 60-cm drop-landing task. Knee flexion and ankle dorsiflexion at initial ground contact were greater among male participants, independent of experience level. In both sexes, greater range of motion at these joints was related to greater experience. Recreational female surfers landed in a more upright posture with more extended ankle and knee angles and less ankle dorsiflexion at the end of landing than participants in all other groups. We discuss our results in the context of possible remaining experience differences between male and female participants despite being grouped in the same experience levels in our study, individualized motor patterns that may still achieve similar success, and a need for continued research.
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Affiliation(s)
- Michaela R Bruton
- 1 School of Exercise and Sport Science, Australian Catholic University, Strathfield, NSW, Australia.,2 University of Sydney, Lidcombe, NSW, Australia
| | - Roger D Adams
- 2 University of Sydney, Lidcombe, NSW, Australia.,3 University of Canberra, ACT, Australia
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Cronström A, Creaby MW, Nae J, Ageberg E. Gender differences in knee abduction during weight-bearing activities: A systematic review and meta-analysis. Gait Posture 2016; 49:315-328. [PMID: 27479217 DOI: 10.1016/j.gaitpost.2016.07.107] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 07/20/2016] [Accepted: 07/22/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Increased knee abduction during weight-bearing activities is suggested to be a contributing factor for the high knee injury risk reported in women. However, studies investigating gender difference in knee abduction are inconclusive. OBJECTIVE To systematically review gender-differences in knee abduction during weight-bearing activities in individuals with or without knee injury. METHODS A systematic review and meta-analysis were conducted according to the PRISMA guidelines. A search in the databases Medline, CINAHL and EMBASE was performed until September 2015. Inclusion criteria were studies that reported (1) gender differences, (2) healthy individuals and/or those with anterior cruciate ligament (ACL) deficiency or reconstruction or patellofemoral pain PFP, and (3) knee abduction assessed with either motion analysis or visual observation during weight-bearing activity. RESULTS Fifty-eight articles met the inclusion criteria. Women with PFP had greater peak knee abduction compared to men (Std diff in mean; -1.34, 95%CI; -1.83 to -0.84). In healthy individuals, women performed weight-bearing tasks with greater knee abduction throughout the movement (initial contact, peak abduction, excursion) (Std diff in mean; -0.68 to -0.79, 95%CI; -1.04 to -0.37). In subgroup analyses by task, differences in knee abduction between genders were present for most tasks, including running, jump landings and cutting movements. There were too few studies in individuals with ACL injury to perform meta-analysis. CONCLUSION The gender difference in knee abduction during weight-bearing activities should be considered in training programs aimed at preventing or treating knee injury.
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Affiliation(s)
- Anna Cronström
- Department of Health Sciences, Lund University, Lund, Sweden.
| | - Mark W Creaby
- School of Exercise Science, Australian Catholic University, Brisbane, Australia.
| | - Jenny Nae
- Department of Health Sciences, Lund University, Lund, Sweden.
| | - Eva Ageberg
- Department of Health Sciences, Lund University, Lund, Sweden.
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Steinberg N, Adams R, Waddington G, Karin J, Tirosh O. Is There a Correlation Between Static and Dynamic Postural Balance Among Young Male and Female Dancers? J Mot Behav 2016; 49:163-171. [PMID: 27715659 DOI: 10.1080/00222895.2016.1161595] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aimed to investigate whether young male and female dancers have different patterns of association between static and dynamic postural balance (PB), 60 dancers from the Australian Ballet School (14-19 years old) were tested for static and dynamic PB with head and lumbar accelerometers. Monotonic relationships between static and dynamic PB were found in head movements among young female dancers in all three directions, but were found for young male dancers in the mediolateral (ML) and anteroposterior (AP) directions only. In lumbar movements, monotonic relationships were found for young female dancers in the AP direction only. Comparing head with lumbar movements in static PB, young male dancers demonstrated monotonic relationships between head and lumbar movements in all 3 directions; however, young female dancers demonstrated monotonic relationships in the AP direction only. In the dynamic measurements, both male and female dancers demonstrated monotonic relationships between head and lumbar movements for all parameters measured in the ML and vertical directions (p < .05). In conclusions, among female dancers static PB ability is correlated with their dynamic ability, whereas among male dancers, no relationship between the static and dynamic PB in the AP direction exists. Male dancers showed head and lumbar coordination in the static PB movement, but both genders manifested no head and lumbar coordination in the AP direction measured for dynamic PB.
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Affiliation(s)
- Nili Steinberg
- a Gait and Balance Research Group, College of Sport and Exercise Science , Institute of Sport, Exercise and Active Living, Victoria University , Melbourne , Australia.,b The Wingate College of Physical Education and Sport Sciences at the Wingate Institute , Netanya , Israel
| | - Roger Adams
- c Faculty of Health , Sydney University , Sydney , Australia
| | | | - Janet Karin
- d Faculty of Health , University of Canberra , Canberra , Australia.,e Australian Ballet School , Melbourne , Australia.,f Australian Catholic University , Banyo , Australia
| | - Oren Tirosh
- a Gait and Balance Research Group, College of Sport and Exercise Science , Institute of Sport, Exercise and Active Living, Victoria University , Melbourne , Australia
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32
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Kim K, Jeon K. Comparisons of knee and ankle joint angles and ground reaction force according to functional differences during single-leg drop landing. J Phys Ther Sci 2016; 28:1150-4. [PMID: 27190444 PMCID: PMC4868204 DOI: 10.1589/jpts.28.1150] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 12/23/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to determine potential predictors of functional instability of the knee and ankle joints during single-leg drop landing based on the prior history of injury. [Subjects and Methods] The subjects were 24 collegiate soccer players without pain or dysfunction. To compare the differences between the stable and unstable sides during single-leg drop landing, 8 motion analysis cameras and a force plate were used. The Cortex 4 software was used for a biomechanical analysis of 3 events. An independent t-test was used for statistical comparison between both sides; p<0.05 indicated significance. [Results] The knee joint movements showed gradual flexion in the sagittal plane. The unstable-side ankle joint showed plantar flexion of approximately 2° relative to the stable side. In the coronal plane, the unstable-side knee joint differed from the stable side in its tendency for valgus movement. The unstable-side ankle joint showed contrasting movement compared with the stable side, and the difference was significant. Regarding the vertical ground reaction force, the stable side showed maximum knee flexion that was approximately 0.1 BW lower than that of the unstable side. [Conclusion] Increasing the flexion angle of the knee joint can help prevent injury during landing.
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Affiliation(s)
- Kewwan Kim
- Division of Sport Science, Incheon National University, Republic of Korea
| | - Kyoungkyu Jeon
- Sport Science Institute, Incheon National University, Republic of Korea
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33
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Iunes DH, Elias IF, Carvalho LC, Dionísio VC. Postural adjustments in young ballet dancers compared to age matched controls. Phys Ther Sport 2015; 17:51-7. [PMID: 26586041 DOI: 10.1016/j.ptsp.2015.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 02/27/2015] [Accepted: 04/28/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The purpose of the study was to use photogrammetry to evaluate the posture of ballet practitioners compared to an age-matched control group. DESIGN One hundred and eleven 7- to 24-year-old female volunteers were evaluated and were divided into two groups: the ballet practising group (n = 52) and the control group (n = 59), divided into three subgroups according to age and years of ballet experience. RESULTS Dancers with 1-3 years experience compared to controls of the same age shows alterations in External Rotation Angle (P < 0.05). Dancers 4-9 years experience show alterations in Lumbar Lordosis, Pelvis Tilt Angle and Navicular Angle Right and Left (P < 0.05). Dancers with over 9 years experience show alterations in External Rotation and Navicular Angle Left (P < 0.05). CONCLUSIONS Research shows there are differences between dancers and controls. In the groups 1-3 years and over 9 years of experience, the External Rotation Angle is greater. In the group 4-9 years of experience the Lumbar Lordosis Angle is greater and Pelvis Tilt, Navicular Angle Left and Right are smaller. In more than 9 years of ballet experience, the Navicular Angle Left is smaller.
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Affiliation(s)
- Denise H Iunes
- Physiotherapy Course, Federal University of Alfenas, Jovino Fernandes Sales, 2600 Avenue, Bairro Santa Clara, Alfenas, Minas Gerais, 37130-000, Brazil.
| | - Iara F Elias
- Physiotherapy Course, Federal University of Alfenas, Jovino Fernandes Sales, 2600 Avenue, Bairro Santa Clara, Alfenas, Minas Gerais, 37130-000, Brazil
| | - Leonardo C Carvalho
- Physiotherapy Course, Federal University of Alfenas, Jovino Fernandes Sales, 2600 Avenue, Bairro Santa Clara, Alfenas, Minas Gerais, 37130-000, Brazil
| | - Valdeci C Dionísio
- Physiotherapy Course, Federal University of Uberlândia, R. Benjamin Constant, 1286 - Bairro Aparecida, Uberlândia, Minas Gerais, 38400-678, Brazil
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Abstract
Dancers require extreme ranges of motion in their hips. They require this for many styles and performances. Hip pain and hip injury in dancers can lead to lost work and performance time. There are many potential causes for hip pain in the dancer, including dysplasia, hyperlaxity, both intra- and extra-articular impingement, and soft tissue injuries. This article will review the current literature on these topics in dancers and how they can be applied to the dancer patient.
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Affiliation(s)
- Brad R Moser
- The Minnesota Dance Medicine Foundation, Minnesota Orthopedics Sports Medicine Institute at Twin Cities Orthopedics (MOSMI), Minneapolis, MN
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35
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Weber AE, Bedi A, Tibor LM, Zaltz I, Larson CM. The Hyperflexible Hip: Managing Hip Pain in the Dancer and Gymnast. Sports Health 2015; 7:346-58. [PMID: 26137181 PMCID: PMC4481673 DOI: 10.1177/1941738114532431] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Context: Dance, gymnastics, figure skating, and competitive cheerleading require a high degree of hip range of motion. Athletes who participate in these sports use their hips in a mechanically complex manner. Evidence Acquisition: A search of the entire PubMed database (through December 2013) and additional searches of the reference lists of pertinent articles. Study Design: Systematic review. Level of Evidence: Level 3. Results: Whether innate or acquired, dancers and gymnasts have some hypermobility that allows their hips to be placed in potentially impinging or unstable positions required for their given activity. Such extremes of motion can result in both intra-articular and extra-articular impingement as well as compensatory osseous and muscular pathology. In addition, dancers and gymnasts are susceptible to impingement-induced instability. Dancers with innate generalized hyperlaxity are at increased risk of injury because of their activities and may require longer recovery times to return to play. Both nonoperative and operative treatments (arthroscopic and open) have an important role in returning flexibility athletes to their preoperative levels of sport and dance. Conclusion: Because of the extreme hip motion required and the compensatory soft tissue laxity in dancers and gymnasts, these athletes may develop instability, impingement, or combinations of both. This frequently occurs in the setting of subtle pathoanatomy or in patients with normal bony anatomy. With appropriate surgical indications and the correct operative technique, the treating surgeon can anticipate high levels of return to play for the gymnast and dancer with hip pain.
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Affiliation(s)
- Alexander E Weber
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Asheesh Bedi
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Lisa M Tibor
- Kaiser Permanente Medical Center, South San Francisco, CA
| | - Ira Zaltz
- Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, Michigan
| | - Christopher M Larson
- Minnesota Orthopedic Sports Medicine Institute, Arthroscopic Hip Joint Preservation MOSMI, Twin Cities Orthopedics, Edina, Minnesota
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Fox AS, Bonacci J, McLean SG, Spittle M, Saunders N. What is normal? Female lower limb kinematic profiles during athletic tasks used to examine anterior cruciate ligament injury risk: a systematic review. Sports Med 2014; 44:815-32. [PMID: 24682949 DOI: 10.1007/s40279-014-0168-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND It has been proposed that the performance of athletic tasks where normal motion is exceeded has the potential to damage the anterior cruciate ligament (ACL). Determining the expected or 'normal' kinematic profile of athletic tasks commonly used to assess ACL injury risk can provide an evidence base for the identification of abnormal or anomalous task performances in a laboratory setting. OBJECTIVE The objective was to conduct a systematic review of studies examining lower limb kinematics of females during drop landing, drop vertical jump, and side-step cutting tasks, to determine 'normal' ranges for hip and knee joint kinematic variables. DATA SOURCES An electronic database search was conducted on the SPORTDiscus(TM), MEDLINE, AMED and CINAHL (January 1980-August 2013) databases using a combination of relevant keywords. 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 three-dimensional hip and knee kinematics of female subjects during the athletic tasks of interest were included for review. Articles were excluded if subjects had a history of lower back or lower limb joint injury or isolated data from the female cohort could not be extracted. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers independently assessed the quality of included studies. Data on subject characteristics, the athletic task performed, and kinematic data were extracted from included studies. Studies were categorised according to the athletic task being examined and each study allocated a weight within categories based on the number of subjects assessed. Extracted data were used to calculate the weighted means and standard deviations for hip and knee kinematics (initial contact and peak values). 'Normal' motion was classified as the weighted mean plus/minus one standard deviation. RESULTS Of 2,920 citations, a total of 159 articles were identified as potentially relevant, with 29 meeting all inclusion/exclusion criteria. Due to the limited number of studies available examining double-leg drop landings and single-leg drop vertical jumps, insufficient data was available to include these tasks in the review. Therefore, a total of 25 articles were included. From the included studies, 'normal' ranges were calculated for the kinematic variables of interest across the athletic tasks examined. LIMITATIONS Joint forces and other additional elements play a role in ACL injuries, therefore, focusing solely on lower limb kinematics in classifying injury risk may not encapsulate all relevant factors. Insufficient data resulted in no normal ranges being calculated for double-leg drop land and single-leg drop vertical jump tasks. No included study examined hip internal/external rotation during single-leg drop landings, therefore ranges for this kinematic variable could not be determined. Variation in data between studies resulted in wide normal ranges being observed across certain kinematic variables. CONCLUSIONS The ranges calculated in this review provide evidence-based values that can be used to identify abnormal or anomalous athletic task performances on a multi-planar scale. This may be useful in identifying neuromuscular factors or specific muscular recruitment strategies that contribute to ACL injury risk.
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Affiliation(s)
- Aaron S Fox
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, 3125, Melbourne, VIC, Australia
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Effects of menarcheal age on the anterior cruciate ligament injury risk factors during single-legged drop landing in female artistic elite gymnasts. Arch Orthop Trauma Surg 2014; 134:1565-71. [PMID: 25055755 DOI: 10.1007/s00402-014-2055-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Although numerous studies have demonstrated the relationship between maturation and lower extremity biomechanics during landing in team sport athletes, we are presently uninformed of any research that examined the single-legged drop landing biomechanics of gymnasts. The purpose of this study is to investigate the effects of the menarcheal age on the lower extremity biomechanics during a single-legged drop landing in female artistic elite gymnasts. MATERIALS AND METHODS Twenty-two female artistic elite gymnasts, between 9 and 36 years of age, participated in this study. The participants were divided into two groups pre- (n = 11) and post- (n = 11) menarche and asked to perform a single-legged drop landing on top of a 30 cm platform and land on a force plate. The statistical analysis consisted of the multivariate analysis with the level of significance set at p < 0.05. RESULTS The post-menarche group showed a decrease in their maximum knee flexion angle and increase in their maximum knee abduction angle, maximum internal tibial rotation angle, maximum knee abduction moment, and hamstring-quadriceps muscle activity ratio compared with the pre-menarche group during the single-legged drop landing. CONCLUSIONS The post-menarche group showed an increased noncontact anterior cruciate ligament injury risk, due to their greater knee loads, compared with the pre-menarche group.
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Kinematic analysis of basic rhythmic movements of hip-hop dance: motion characteristics common to expert dancers. J Appl Biomech 2014; 31:1-7. [PMID: 25102329 DOI: 10.1123/jab.2014-0027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In hip-hop dance contests, a procedure for evaluating performances has not been clearly defined, and objective criteria for evaluation are necessary. It is assumed that most hip-hop dance techniques have common motion characteristics by which judges determine the dancer's skill level. This study aimed to extract motion characteristics that may be linked to higher evaluations by judges. Ten expert and 12 nonexpert dancers performed basic rhythmic movements at a rate of 100 beats per minute. Their movements were captured using a motion capture system, and eight judges evaluated the performances. Four kinematic parameters, including the amplitude of the body motions and the phase delay, which indicates the phase difference between two joint angles, were calculated. The two groups showed no significant differences in terms of the amplitudes of the body motions. In contrast, the phase delay between the head motion and the other body parts' motions of expert dancers who received higher scores from the judges, which was approximately a quarter cycle, produced a loop-shaped motion of the head. It is suggested that this slight phase delay was related to the judges' evaluations and that these findings may help in constructing an objective evaluation system.
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Gorwa J, Dworak LB, Michnik R, Jurkojć J. Kinematic analysis of modern dance movement "stag jump" within the context of impact loads, injury to the locomotor system and its prevention. Med Sci Monit 2014; 20:1082-9. [PMID: 24971626 PMCID: PMC4085120 DOI: 10.12659/msm.890126] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background This paper presents a case study of kinematic analysis of the modern dance movement known as the “stag jump”. Detailed analysis of the kinematic structure of this movement as performed by the dancers, accompanied by measurements of impact forces during landing, will allow the authors to determine, in subsequent model-based research phases, the forces acting in knee joints of the lower landing limb. Material/Methods Two professional modern dancers participated in the study: a male and a female. The study consisted in recording the values of ground reaction and body motion, and then determining and analyzing kinematic parameters of performed movements. Results The results of measurement of joint angles in the landing lower limb, pelvis, and foot position in relation to the ground, as well as the level of vertical components of ground reaction, provided insight into the loading response phase of the “stag jump”. The measurements and obtained results show differences between the man and woman in ground reactions and kinematic quantities. Conclusions The results obtained during the research may be used in the development and teaching of dancing movements. Training sessions, carried out in the biomechanical laboratory, with active participation of dancing teachers, could form a basis for a prevention model of injuries and physical overloads occurring within this occupational group. Primary differences in the “stag jump” performance technique probably result from the different educational path the man and the woman went through.
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Affiliation(s)
- Joanna Gorwa
- Chair of Biomechanics, University School of Physical Education, Poznań, Poland
| | - Lechosław B Dworak
- Chair of Biomechanics, University School of Physical Education, Poznań, Poland
| | - Robert Michnik
- Department of Biomechatronics, Silesian Universit of Technology, Zabrze, Poland
| | - Jacek Jurkojć
- Department of Biomechatronics, Silesian Universit of Technology, Zabrze, Poland
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Analysis of the response speed of musculature of the knee in professional male and female volleyball players. BIOMED RESEARCH INTERNATIONAL 2014; 2014:239708. [PMID: 25003109 PMCID: PMC4070587 DOI: 10.1155/2014/239708] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/09/2014] [Accepted: 05/06/2014] [Indexed: 11/18/2022]
Abstract
The aim of this study was to evaluate the normalized response speed (Vrn) of the knee musculature (flexor and extensor) in high competitive level volleyball players using tensiomyography (TMG) and to analyze the muscular response of the vastus medialis (VM), rectus femoris (RF), vastus lateralis (VL), and biceps femoris (BF) in accordance with the specific position they play in their teams. One hundred and sixty-six players (83 women and 83 men) were evaluated. They belonged to eight teams in the Spanish women's superleague and eight in the Spanish men's superleague. The use of Vrn allows avoiding possible sample imbalances due to anatomical and functional differences and demands. We found differences between Vrn in each of the muscles responsible for extension (VM, RF, and VL) and flexion (BF) regardless of the sex. Normalized response speed differences seem to be larger in setters, liberos and outside players compared to middle blockers and larger in males when compared to females. These results of Vrn might respond to the differences in the physical and technical demands of each specific position, showing an improved balance response of the knee extensor and flexor musculature in male professional volleyball players.
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Orishimo KF, Liederbach M, Kremenic IJ, Hagins M, Pappas E. Comparison of landing biomechanics between male and female dancers and athletes, part 1: Influence of sex on risk of anterior cruciate ligament injury. Am J Sports Med 2014; 42:1082-8. [PMID: 24590005 DOI: 10.1177/0363546514523928] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The incidence of anterior cruciate ligament (ACL) injuries among dancers is much lower than among team sport athletes, and no clear disparity between sexes has been reported in the dance population. Although numerous studies have observed differences in landing biomechanics of the lower extremity between male and female team sport athletes, there is currently little research examining the landing biomechanics of male and female dancers and none comparing athletes to dancers. Comparing the landing biomechanics within these populations may help explain the lower overall ACL injury rates and lack of sex disparity. HYPOTHESIS The purpose was to compare the effects of sex and group (dancer vs team sport athlete) on single-legged drop-landing biomechanics. The primary hypothesis was that female dancers would perform a drop-landing task without demonstrating typical sex-related risk factors associated with ACL injuries. A secondary hypothesis was that female team sport athletes would display typical ACL risk factors during the same task. STUDY DESIGN Controlled laboratory study. METHODS Kinematics and kinetics were recorded as 40 elite modern and ballet dancers (20 men and 20 women) and 40 team sport athletes (20 men and 20 women) performed single-legged drop landings from a 30-cm platform. Joint kinematics and kinetics were compared between groups and sexes with a group-by-sex multivariate analysis of variance (MANOVA) followed by pairwise t tests. RESULTS Dancers of both sexes and male team sport athletes landed similarly in terms of frontal-plane knee alignment, whereas female team sport athletes landed with a significantly greater peak knee valgus (P = .007). Female dancers were found to have a lower hip adduction torque than those of the other 3 groups (P = .003). Dancers (male and female) exhibited a lower trunk side flexion (P = .002) and lower trunk forward flexion (P = .032) compared with team sport athletes. CONCLUSION In executing a 30-cm drop landing, female team sport athletes displayed a greater knee valgus than did the other 3 groups. Dancers exhibited better trunk stability than did athletes. CLINICAL RELEVANCE These biomechanical findings may provide insight into the cause of the epidemiological differences in ACL injuries between dancers and athletes and the lack of a sex disparity within dancers.
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Affiliation(s)
- Karl F Orishimo
- Karl F. Orishimo, MS, Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, 100 East 77th Street, 2nd Floor, New York, NY 10075, USA.
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Liederbach M, Kremenic IJ, Orishimo KF, Pappas E, Hagins M. Comparison of landing biomechanics between male and female dancers and athletes, part 2: Influence of fatigue and implications for anterior cruciate ligament injury. Am J Sports Med 2014; 42:1089-95. [PMID: 24595401 DOI: 10.1177/0363546514524525] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Fatigue is strongly linked to an increased risk of injuries, including anterior cruciate ligament (ACL) ruptures. Part 1 of this study identified differences in the biomechanics of landing from a jump between dancers and team athletes, particularly female athletes, which may explain the epidemiological differences in ACL injuries between dancers and team athletes and the lack of a sex disparity within dancers. However, it is not known if these biomechanical variables change differently between team athletes and dancers in the face of fatigue. PURPOSE/ HYPOTHESIS: The purpose of this study was to compare dancers' and team athletes' resistance to fatigue and its effect on the biomechanics of single-legged drop landings. The primary hypotheses were that dancers may be more resistant than team athletes to the onset of fatigue and/or may have different biomechanical responses than athletes in landing tasks once fatigue has been achieved. STUDY DESIGN Controlled laboratory study. METHODS Kinematics and kinetics were recorded as 40 elite modern and ballet dancers (20 men and 20 women) and 40 team sport athletes (20 men and 20 women; National Collegiate Athletic Association Division I-III) performed single-legged drop landings from a 30-cm platform before and after a fatigue protocol consisting of step-ups and vertical jumps. Unfatigued and fatigued joint kinematics and kinetics were compared between groups and sexes with multivariate analyses of variance, followed by pairwise t tests as appropriate. RESULTS Dancers took longer (P = .023) than team athletes to reach a similar state of fatigue. Multiple kinetic (eg, increased peak knee valgus moment; P < .001) and kinematic (eg, increased lateral and forward trunk flexion; P < .001 and P = .002, respectively) parameters of landing changed with fatigue, such that both fatigued dancers and athletes landed with mechanics that were more at risk for ACL injuries as compared with before fatigue. CONCLUSION Dancers took significantly longer to reach fatigue than team athletes. Female athletes consistently exhibited landing patterns associated with a risk for ACL injuries when compared with the other 3 groups. Fatigue changed landing mechanics similarly in both dancers and athletes, such that all groups landed with worse alignment after being fatigued. CLINICAL RELEVANCE Dancers are more resistant to lower extremity fatigue than athletes, and this may partially explain the lower incidence of ACL injuries in both male and female dancers compared to team athletes. The extensive training in landing technique and daily practice that dancers undergo from a young age may be responsible for the higher levels of endurance.
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Affiliation(s)
- Marijeanne Liederbach
- Marijeanne Liederbach,ATC, CSCS, Harkness Center for Dance Injuries, New York University Langone Medical Center Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA.
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Abstract
The evaluation of hip hop dancers presently lacks clearly defined criteria and is often dependent on the subjective impressions of judges. Our study objective was to extract hidden motion characteristics that could potentially distinguish the skill levels of hip hop dancers and to examine the relationship between performance kinematics and judging scores. Eleven expert, six nonexpert, and nine novice dancers participated in the study, where each performed the "wave" motion as an experimental task. The movements of their upper extremities were captured by a motion capture system, and several kinematic parameters including the propagation velocity of the wave were calculated. Twelve judges evaluated the performances of the dancers, and we compared the kinematic parameters of the three groups and examined the relationship between the judging scores and the kinematic parameters. We found the coefficient of variation of the propagation velocity to be significantly different among the groups (P < .01) and highly correlated with the judging scores (r = -0.800, P < .01). This revealed that the variation of propagation velocity was the most dominant variable representing the skill level of the dancers and that the smooth propagation of the wave was most closely related to the evaluation by judges.
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Wanke EM, Arendt M, Mill H, Groneberg DA. Occupational accidents in professional dance with focus on gender differences. J Occup Med Toxicol 2013; 8:35. [PMID: 24341391 PMCID: PMC3878499 DOI: 10.1186/1745-6673-8-35] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 12/06/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Classical dance comprises gender specific movement tasks. There is a lack of studies which investigate work related traumatic injuries in terms of gender specific differences in detail. OBJECTIVE To define gender related differences of occupational accidents. METHODS Basis for the evaluation were occupational injuries of professional dancers from three (n = 785; f: n = 358, m: n = 427) state theatres. RESULTS The incidence rate (0.36 per year) was higher in males (m: 0.45, f: 0.29). There were gender specific differences as to the localizations of injuries, particularly the spine region (m: 17.3%, f: 9.8%, p = 0.05) and ankle joint (m: 23.7%, f: 35.5%, p = 0.003). Compared to male dancers, females sustained more injuries resulting from extrinsic factors. Significant differences could specifically be observed with dance floors (m: 8.8%, f: 15.1%, p = 0.02). There were also significant gender differences observed with movement vocabulary. CONCLUSION The clearly defined gender specific movement activities in classical dance are reflected in occupational accidents sustained. Organisational structures as well as work environment represent a burden likewise to male and female dancers. The presented differences support the development of gender specific injury prevention measures.
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Affiliation(s)
- Eileen M Wanke
- Institute of Occupational Medicine, Charité - Universitätsmedizin Berlin, Thielallee 69, 14195 Berlin, Germany.
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Steinberg N, Siev-Ner I, Peleg S, Dar G, Masharawi Y, Zeev A, Hershkovitz I. Injuries in female dancers aged 8 to 16 years. J Athl Train 2013; 48:118-23. [PMID: 23672333 DOI: 10.4085/1062-6050-48.1.06] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Most studies of injured dancers have been carried out on professional adult dancers; data on young, nonprofessional injured dancers are sparse. OBJECTIVE To identify the types of injuries sustained by recreational dancers and to examine their association with age, joint range of motion, body structure, age at menarche, presence of anatomic anomalies, and physical burden (i.e., practice hours en pointe). DESIGN Descriptive epidemiology study. SETTING The Israel Performing Arts Medicine Center, Tel Aviv. PATIENTS OR OTHER PARTICIPANTS A total of 569 injured female dancers, aged 8 to 16 years. MAIN OUTCOME MEASURE(S) Dependent variables were 61 types of current injuries that were later classified into 4 major categories: knee injuries, foot and ankle tendinopathy, back injuries, and other injuries. Independent variables were age, joint range of motion, body size and shape, age at menarche, anatomic anomalies, and dance discipline (e.g., hours of practice per week en pointe). RESULTS At least 1 previous injury had been sustained by 42.4% of the dancers. The most common injuries involved the knee (40.4%), followed by other injuries (23.4%). The relative frequency of back injuries and tendinopathy decreased with age, whereas knee injuries increased. Types of injuries were significantly associated with ankle plantar flexion, hip external rotation, hip abduction, and knee flexion. Multinomial regression analysis revealed only 3 predictive variables (with other as baseline), all for back injury: scoliosis, age, and hip external rotation. CONCLUSIONS Joint range of motion and scoliosis may signal the potential for future injury. Young dancers (less than 10 years of age) should not be exposed to overload (especially of the back) or extensive stretching exercises.
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Affiliation(s)
- Nili Steinberg
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
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Lower limb kinematic variability in dancers performing drop landings onto floor surfaces with varied mechanical properties. Hum Mov Sci 2013; 32:866-74. [PMID: 23993251 DOI: 10.1016/j.humov.2013.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 06/26/2013] [Accepted: 07/04/2013] [Indexed: 11/20/2022]
Abstract
Elite dancers perform highly skilled and consistent movements. These movements require effective regulation of the intrinsic and extrinsic forces acting within and on the body. Customized, compliant floors typically used in dance are assumed to enhance dance performance and reduce injury risk by dampening ground reaction forces during tasks such as landings. As floor compliance can affect the extrinsic forces applied to the body, secondary effects of floor properties may be observed in the movement consistency or kinematic variability exhibited during dance performance. The aim of this study was to investigate the effects of floor mechanical properties on lower extremity kinematic variability in dancers performing landing tasks. A vector coding technique was used to analyze sagittal plane knee and ankle joint kinematic variability, in a cohort of 12 pre-professional dancers, through discrete phases of drop landings from a height of 0.2m. No effect on kinematic variability was observed between floors, indicating that dancers could accommodate the changing extrinsic floor conditions. Future research may consider repeat analysis under more dynamic task constraints with a less experienced cohort. However, knee/ankle joint kinematic variability was observed to increase late in the landing phase which was predominantly comprised of knee flexion coupled with the terminal range of ankle dorsiflexion. These findings may be the result of greater neural input late in the landing phase as opposed to the suggested passive mechanical interaction of the foot and ankle complex at initial contact with a floor. Analysis of joint coordination in discrete movement phases may be of benefit in identifying intrinsic sources of variability in dynamic tasks that involve multiple movement phases.
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Sex differences in the kinematics and neuromuscular control of landing: biological, environmental and sociocultural factors. J Electromyogr Kinesiol 2013; 23:747-58. [PMID: 23731700 DOI: 10.1016/j.jelekin.2013.04.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 04/17/2013] [Accepted: 04/25/2013] [Indexed: 11/21/2022] Open
Abstract
Potential sex differences in patterns of movement of recreational and competitive athletes were investigated in a systematic review of lower limb kinematics, muscle activation and stiffness during landing and hopping tasks. Little support for sex-specific lower limb kinematic patterns was found in 17 studies retrieved on landing and hopping. Ten studies retrieved on muscle activation during landing provided no support for sex-specific patterns. Four articles retrieved on leg stiffness established that absolute stiffness was lower in females, but differences in stiffness normalized to body mass were less clear. The wider literature indicates that a combination of biological, environmental and sociocultural constraints may shape movement patterns differently in females and males. Sociocultural factors differentially affect accumulated motor experience, practice opportunities and focus of attention in females, leading to differences in motor skill that confound the comparison of female and male movements. The findings of the review support the hypothesis that such sex differences in athletic performance are likely to diminish or disappear with increasing skill. In everyday movement tasks, however, where level of skill is a less meaningful dimension than in sport, differences in movement patterns observed between females and males point instead to the influence of subtle societal expectations on movement patterns.
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Pappas E, Zampeli F, Xergia SA, Georgoulis AD. Lessons learned from the last 20 years of ACL-related in vivo-biomechanics research of the knee joint. Knee Surg Sports Traumatol Arthrosc 2013; 21:755-66. [PMID: 22437657 DOI: 10.1007/s00167-012-1955-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 02/28/2012] [Indexed: 02/06/2023]
Abstract
PURPOSE Technological advances in recent years have allowed the easy and accurate assessment of knee motion during athletic activities. Subsequently, thousands of studies have been published that greatly improved our understanding of the aetiology, surgical reconstruction techniques and prevention of anterior cruciate ligament (ACL) injuries. The purpose of this review is to summarize the evidence from biomechanical studies on ACL-related research. METHODS High-impact articles that enhanced understanding of ACL injury aetiology, rehabilitation, prevention and adaptations after reconstruction were selected. RESULTS The importance of restoring internal tibial rotation after ACL reconstruction has emerged in several studies. Criteria-based, individualized rehabilitation protocols have replaced the traditional time-based protocols. Excessive knee valgus, poor trunk control, excessive quadriceps forces and leg asymmetries have been identified as potential high risk biomechanical factors for ACL tear. Injury prevention programmes have emerged as low cost and effective means of preventing ACL injuries, particularly in female athletes. CONCLUSION As a result of biomechanical research, clinicians have a better understanding of ACL injury aetiology, prevention and rehabilitation. Athletes exhibiting neuromuscular deficits predisposing them to ACL injury can be identified and enrolled into prevention programmes. Clinicians should assess ACL-reconstructed patients for excessive internal tibial rotation that may lead to poor outcomes.
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Affiliation(s)
- Evangelos Pappas
- Division of Physical Therapy, Long Island University-Brooklyn Campus, Brooklyn, NY 11201, USA.
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Bates NA, Ford KR, Myer GD, Hewett TE. Kinetic and kinematic differences between first and second landings of a drop vertical jump task: implications for injury risk assessments. Clin Biomech (Bristol, Avon) 2013; 28:459-66. [PMID: 23562293 PMCID: PMC3809751 DOI: 10.1016/j.clinbiomech.2013.02.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 02/21/2013] [Accepted: 02/26/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Though the first landing of drop vertical jump task is commonly used to assess biomechanical performance measures that are associated with anterior cruciate ligament injury risk in athletes, the implications of the second landing in this task have largely been ignored. We examined the first and second landings of a drop vertical jump for differences in kinetic and kinematic behaviors at the hip and knee. METHODS A cohort of 239 adolescent female basketball athletes (age=13.6 (1.6) years) completed drop vertical jump tasks from an initial height of 31 cm. A three dimensional motion capture system recorded positional data while dual force platforms recorded ground reaction forces for each trial. FINDINGS The first landing demonstrated greater hip adduction angle, knee abduction angle, and knee abduction moment than the second landing (P-values<0.028). The second landing demonstrated smaller flexion angles and moments at the hip and knee than the first landing (P-values<0.035). The second landing also demonstrated greater side-to-side asymmetry in hip and knee kinematics and kinetics for both the frontal and sagittal planes (P-values<0.044). INTERPRETATION The results have important implications for the future use of the drop vertical jump as an assessment tool for anterior cruciate ligament injury risk behaviors in adolescent female athletes. The second landing may be a more rigorous task and provides a superior tool to evaluate sagittal plane risk factors than the first landing, which may be better suited to evaluate frontal plane risk factors.
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Affiliation(s)
- Nathaniel A. Bates
- Cincinnati Children's Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH, United States,University of Cincinnati, Department of Biomedical Engineering, Cincinnati, OH, United States
| | - Kevin R. Ford
- Cincinnati Children's Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH, United States,High Point University, Department of Physical Therapy, High Point, NC, United States,Department of Pediatrics, College of Medicine, University of Cincinnati, OH, United States
| | - Gregory D. Myer
- Cincinnati Children's Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH, United States,Department of Pediatrics, College of Medicine, University of Cincinnati, OH, United States,Department Orthopaedic Surgery, College of Medicine, University of Cincinnati, OH, United States,Athletic Training Division, School of Allied Medical Professions, The Ohio State University, Columbus, OH, United States
| | - Timothy E. Hewett
- Cincinnati Children's Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH, United States,University of Cincinnati, Department of Biomedical Engineering, Cincinnati, OH, United States,High Point University, Department of Physical Therapy, High Point, NC, United States,Department of Pediatrics, College of Medicine, University of Cincinnati, OH, United States,The Sports Health and Performance Institute, The Ohio State University, Columbus, OH, United States,Sports Medicine, The Ohio State University, Columbus, OH, United States,The Department of Physiology and Cell Biology, The Ohio State University, Columbus, OH, United States,The Department of Orthopaedic Surgery, The Ohio State University, Columbus, OH, United States,The Department of Family Medicine, The Ohio State University, Columbus, OH, United States,The Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States,Corresponding author at: OSU Sports Medicine, 2050 Kenny Road, Suite 3100, Columbus, OH 43221, United States.
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Ambegaonkar JP, Caswell SV, Winchester JB, Shimokochi Y, Cortes N, Caswell AM. Balance comparisons between female dancers and active nondancers. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2013; 84:24-9. [PMID: 23611005 DOI: 10.1080/02701367.2013.762287] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE Female dancers have lower anterior cruciate ligament (ACL) injury rates compared with physically active women. Enhanced balance can decrease musculoskeletal injury risk. Dancers are proposed to have superior balance compared with physically active nondancers, and this may reduce their risk for ACL injury. However, whether female dancers actually have better balance than active nondancers is unclear. METHOD Thirty-three women (15 dancers, 18 nondancers) performed the Balance Error Scoring System (BESS; error scores), the Star Excursion Balance Test (SEBT; percent leg length), and the Modified Bass Test of Dynamic Balance (BASS; maximum score = 100). RESULTS Dancers had fewer errors on the BESS than did nondancers (p < .001, 12.0 +/- 6.9 vs. 25.3 +/- 9.1). Dancers also had greater SEBT reach distances in the medial (right, p = .03, 90.4 +/- 4.2% vs. 86.5 +/- 5.5%; left, p = .04, 90.7 +/- 4.5% vs. 86.7 +/- 5.9%) and posteromedial directions (right, p = .01, 92.6 +/- 5.6% vs. 87.0 +/- 6.4%; left, p = .01, 93.9 +/- 6.3% vs. 87.9 +/- 6.3%), but not in the anteromedial direction (right, p = .23, 84.5 +/- 4.4% vs. 86.2 +/- 3.5%; left, p = .51, 86.4 +/- 3.5% vs. 85.5 +/- 4.0%). BASS scores were similar between groups (p = .58, 90.6 +/- 5.5 vs. 91.7 +/- 56). CONCLUSIONS The novel findings of the study are that dancers had greater balance than did nondancers in some but not all tests. Although dancing may improve balance as compared with not dancing, it is not better than physical activity in improving balance. Thus, balance comparisons between dancers and nondancers may not fully explain why female dancers exhibit low ACL injury rates compared with physically active women. Other factors (e.g., anticipated/unanticipated movement demands) should be examined to understand the ACL injury disparity between dancers and physically active women.
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Affiliation(s)
- Jatin P Ambegaonkar
- Sports Medicine Assessment Research and Testing Laboratory, George Mason University, MS 4E5, Bull Run Hall, Manassas, VA 20110, USA.
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