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Kuwik P, Florkiewicz E, Benedict T, Mason J, Morris J, Crowell M. Assessing the Relationship of Psychological Sport Readiness, Single-leg Vertical Jump, and Non-Sagittal Single-Leg Hops to Quadriceps Strength After Anterior Cruciate Ligament Reconstruction. Int J Sports Phys Ther 2024; 19:942-955. [PMID: 39100937 PMCID: PMC11297365 DOI: 10.26603/001c.121597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 06/21/2024] [Indexed: 08/06/2024] Open
Abstract
Background Limitations exist with current ACLR functional testing assessments that may be mitigated by including single-leg multi-directional testing. Hypothesis/Purpose To compare Anterior Cruciate Ligament-Return to Sport after Injury Scale (ACL-RSI) scores, limb symmetry index (LSI) of the single-leg vertical jump (SLVJ), single-leg medial rotation hop (SLMRH), single-leg lateral hop (SLLH), and isokinetic quadriceps strength between participants with an ACLR and healthy controls and assess predictors of quadriceps strength asymmetry. It was hypothesized that ACL-RSI scores and LSIs for all tests would differ between ACLR and healthy control groups and within the ACLR group a strong correlation would exist between all outcome measures and quadriceps strength. Study Design Cross-Sectional Study. Methods Twenty-six participants with an ACLR (median 13 months after surgery) and twenty-six matched healthy controls were recruited to participate in this study. Performance was assessed via SLVJ, SLMRH, SLLH, and isokinetic quadriceps strength. Between-group comparisons were made with independent t-tests and Mann-Whitney U test. Within the ACLR group, bivariate correlation and multivariate regression analysis were performed to assess the relationship between the outcome measures and quadriceps strength asymmetry. Results Significant between-limb differences were only identified in the ACLR group (p< 0.05): SLVJ LSI: 88.5%, SLMRH LSI: 93.6%, SLLH LSI: 92.7%, quadriceps strength LSI 80.9% - 83.9%, which were significantly lower (p <0.05) than the healthy control group. Within the ACLR group, a moderate-strong significant (p < 0.05) correlations existed with quadriceps strength and SLVJ (r=0.44-0.65), SLMRH (r =0.43-0.83), and SLLH (r=0.54-0.63); while ACL-RSI had a weak non-significant (p > 0.05) correlation with quadriceps strength (r= 0.12-0.30). Conclusion Single-leg multidirectional test LSIs were less in ACLR participants than matched healthy controls and all were directly related to quadriceps strength. Psychological readiness to return to sport was not related to quadriceps strength.
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Affiliation(s)
- Paul Kuwik
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
| | - Erin Florkiewicz
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
- Doctor of Philosophy in Health Sciences ProgramRocky Mountain University of Health Professions, Provo, Utah
| | - Timothy Benedict
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
| | - John Mason
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
| | - Jamie Morris
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
| | - Michael Crowell
- Baylor University – Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship
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Petrucci A, Guglielmino D, Pecci J, Pareja-Galeano H. The effects of isokinetic training in athletes after knee surgery: a systematic review. PHYSICIAN SPORTSMED 2024; 52:309-316. [PMID: 38124233 DOI: 10.1080/00913847.2023.2297666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To review the effectiveness of isokinetic training as an alternative method to traditional isotonic resistance training. MATERIALS AND METHODS Researchers examined data from PubMed, CENTRAL, MEDLINE COMPLETE, and Web of Science until February 2023. A total of 365 entries were obtained from databases, including studies that analyzed the effects of isokinetic vs. isotonic-based rehabilitation in athletes (16-50 years) after a surgical knee intervention. Return to sport (RTS), strength of the flex/extensor compartment of the thigh, muscle mass of the thigh, and knee function were screened as main outcomes. Two reviewers independently screened the studies for eligibility and assessed the risk of bias of the included ones. RESULTS Six studies involving 181 athletes were included. Isokinetic training demonstrated significant benefits in peak torque for knee flexor-extensor muscles in four studies. Two studies favored isokinetic training over isotonic for strength. Muscle mass findings were mixed, with one study favoring isokinetic significantly and two showing no significant differences. In terms of returning to sport, the isotonic group displayed slightly better limb symmetry index values, but without significance. Isokinetic training outperformed isotonic in two functionality questionnaire studies, while two others showed no significant differences. CONCLUSIONS Isokinetic training appears equally, if not more effective than isotonic, for restoring strength balance between hamstrings and quadriceps. This could lead to more favorable muscle mass changes. Isokinetic training also parallels isotonic rehabilitation for functional outcomes and meeting return-to-sport criteria. Therefore, isokinetic training should be included as one of the main strength restoration strategies after knee surgery, especially in early and middle rehabilitation stages. REGISTRATION NUMBER The present systematic review was registered on PROSPERO (registration number: CRD42022370398).
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Affiliation(s)
- Angelo Petrucci
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Dario Guglielmino
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Javier Pecci
- Department of Physical Education, Sport and Human Movement. Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid, Spain
- Department of Physical Education and Sport, Universidad de Sevilla, Sevilla, Spain
| | - Helios Pareja-Galeano
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Department of Physical Education, Sport and Human Movement. Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid, Spain
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Chen P, Wang L, Dong S, Ding Y, Jia S, Zheng C. Can Symmetry of Single-Leg Vertical Jump Height Represent Normal Lower Limb Biomechanics of Athletes After Anterior Cruciate Ligament Reconstruction? Sports Health 2024; 16:596-605. [PMID: 37554095 PMCID: PMC11195865 DOI: 10.1177/19417381231190119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND After anterior cruciate ligament reconstruction (ACLR), single-leg horizontal hop distance limb symmetry index (LSI) >90% is recommended as a cutoff point for safe return to sport (RTS). However, athletes after ACLR have abnormal lower limb biomechanics despite an adequate single-leg hop distance LSI, implying that athletes are at high risk of reinjury. Symmetry of single-leg vertical jump height appears to be more difficult to achieve and can be a better representation of knee function than single-leg horizontal hop distance. HYPOTHESIS Athletes after ACLR with single-leg jump height LSI >90% had similar biomechanical characteristics to healthy athletes. STUDY DESIGN Controlled laboratory study. LEVEL OF EVIDENCE Level 3. METHODS A total of 46 athletes after ACLR were divided into low jump height (LJH, jump height LSI <90%, n = 23) and high jump height (HJH, jump height LSI >90%, n = 23) groups according to symmetry of single-leg vertical jump height, while 24 healthy athletes acted as a control (CONT) group. One-way analysis of variance was used to compare the kinematic and kinetic characteristics of the LJH, HJH, and CONT groups during single-leg vertical jump. RESULTS Both the LJH and HJH groups demonstrated greater limb asymmetry (lower LSI) during landing compared with the CONT group in knee extension moment (P < 0.05), peak knee flexion angle (P < 0.05), and knee power (P < 0.05). CONCLUSION Symmetry in single-leg vertical jump height does not represent normal lower limb biomechanics in athletes after ACLR. CLINICAL RELEVANCE Symmetrical jump height may not signify ideal biomechanical or RTS readiness, but single-leg vertical jump test can be used as a supplement to horizontal hop test or other functional tests to reduce the likelihood of false-negative results in the absence of detailed biomechanical evaluation.
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Affiliation(s)
- Peng Chen
- School of Sports Medicine, Wuhan Sports University, Wuhan, Hubei Province, China
- Key Laboratory of Sports Engineering of General Administration of Sport of China, Wuhan Sports University, Wuhan, Hubei Province, China
| | - Ling Wang
- School of Sports Medicine, Wuhan Sports University, Wuhan, Hubei Province, China
- Key Laboratory of Sports Engineering of General Administration of Sport of China, Wuhan Sports University, Wuhan, Hubei Province, China
| | - Shiyu Dong
- College of Basic Medicine of Fujian Medical University, Fuzhou, Fujian Province, China
| | - Yue Ding
- School of Sports Medicine, Wuhan Sports University, Wuhan, Hubei Province, China
- Key Laboratory of Sports Engineering of General Administration of Sport of China, Wuhan Sports University, Wuhan, Hubei Province, China
| | - Shaohui Jia
- School of Sports Medicine, Wuhan Sports University, Wuhan, Hubei Province, China
- Hubei Provincial Key Laboratory of Sports Training and Monitoring, Wuhan Sports University, Wuhan, Hubei Province, China
| | - Cheng Zheng
- Department of Sports Medicine, Affiliated Hospital, Wuhan Sports University, Wuhan, Hubei Province, China
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Flore Z, Hambly K, De Coninck K, Welsch G. A Rehabilitation Algorithm After Lateral Ankle Sprains in Professional Football (Soccer): An Approach Based on Clinical Practice Guidelines. Int J Sports Phys Ther 2024; 19:910-922. [PMID: 38966831 PMCID: PMC11221331 DOI: 10.26603/001c.120205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/20/2024] [Indexed: 07/06/2024] Open
Abstract
Lateral ankle sprain (LAS) is one of the most common types of injury in professional football (soccer) players with high risk of recurrence. The rehabilitation after LAS in professional football players is often still time-based and relies on anecdotal experience of clinicans. There is still a lack of utilization of criteria-based rehabilitation concepts after LAS in professional football. The aims of this clinical commentary are (1) to critically discuss the need for criteria-based rehabilitation concepts after LAS in professional football players, (2) to highlight the current lack of these approaches and (3) to present a novel clinical guideline-based rehabilitation algorithm. Short time-loss (15 days) and high recurrence rate (17%) raise the question of trivialization of LAS in professional football. Despite consequences for many stakeholders involved (players, teams, clubs, insurers), there is still a lack of of criteria-based, step-by-step approaches. The use of a criteria-based rehabilitation approach might reduce the high recurrence rate after LAS in professional football players and will lead, in turn, to increased long-term player availability. Practical experiences of he authors demonstrate the feasibility of such an approach. The effectiveness of this novel rehabilitation algorithm remains to be evaluated in future studies. Level of Evidence: 5.
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Affiliation(s)
- Zacharias Flore
- School of Sport and Exercise SciencesUniversity of Kent
- Medical Department1. FC Magdeburg
| | - Karen Hambly
- School of Sport and Exercise SciencesUniversity of Kent
| | | | - Götz Welsch
- UKE-AthleticumUniversity Medical Center Hamburg-Eppendorf
- Department of Trauma and Orthopaedic SurgeryUniversity Medical Center Hamburg-Eppendorf
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5
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Zhu S, Garofalo J, Abuhantash M, McRae S, MacDonald P, Longstaffe R, Ogborn D. Functional Performance and Tendon Morphology After Operative or Nonoperative Treatment of Achilles Tendon Ruptures. Int J Sports Phys Ther 2024; 19:670-680. [PMID: 38835984 PMCID: PMC11144663 DOI: 10.26603/001c.117549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/03/2024] [Indexed: 06/06/2024] Open
Abstract
Background While controversy remains as to the relative benefit of operative (OM) versus non-operative management (NOM) of Achilles tendon (AT) ruptures (ATR), few studies have examined the effect on high impact maneuvers such as jumping and hopping. Hypothesis/Purpose The purpose of this study was to determine if functional performance including strength, jumping, and hopping outcomes differed between OM and NOM of acute ATR. The secondary objective was to assess the degree of association between AT morphology and performance outcomes. Study Design Retrospective cohort with a single prospective evaluation. Methods All patients were treated at an institutional secondary care center. Eligible participants (n=12 OM; 12 NOM) who were treated with OM or NOM of ATR within three weeks of injury were evaluated a minimum 20 months following ATR. AT length, thickness and gastrocnemius muscle thickness were assessed with B-mode ultrasound. Isokinetic plantar flexor strength, hop tests and countermovement and drop jumps were completed. Two-way ANOVAS were completed on all tests with unilateral values, independent t-tests were used for bilateral outcomes, and linear regressions were completed to assess the relationship between normalized AT length and performance. Results Affected limb AT was elongated and thickened (p\<0.01), gastrocnemius was atrophied (p\< 0.01) and angle-specific plantar flexor torque was reduced at 120°/s when measured at 20° plantar flexion (p = 0.028). Single leg drop vertical jump was higher in OM (p = 0.015) with no difference for hop and jump tests. AT length was related to plantar flexor torque but had no relationship with hopping performance. Conclusions Hop test performance was maintained despite plantarflexion weakness, gastrocnemius atrophy, and AT elongation. This may be the result of compensatory movement patterns. AT length holds limited explanatory power in plantar flexor strength, although this relationship should be evaluated further. Level of Evidence Level III.
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Affiliation(s)
- Sophie Zhu
- Department of Surgery, Orthopedic SectionUniversity of Manitoba
| | | | | | | | - Peter MacDonald
- Department of Surgery, Orthopedic SectionUniversity of Manitoba
- Pan Am Clinic
| | - Rob Longstaffe
- Department of Surgery, Orthopedic SectionUniversity of Manitoba
- Pan Am Clinic
| | - Dan Ogborn
- Department of Surgery, Orthopedic SectionUniversity of Manitoba
- Pan Am Clinic Foundation
- Faculty of Kinesiology and Recreation ManagementUniversity of Manitoba
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Graham MC, Reeves KA, Janatova T, Noehren B. The Relationship of Open- and Closed-Kinetic-Chain Rate of Force Development With Jump Performance Following Anterior Cruciate Ligament Reconstruction. Int J Sports Physiol Perform 2024; 19:585-592. [PMID: 38594016 DOI: 10.1123/ijspp.2023-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE To determine between-limbs differences in isometric rate of force development (RFD) measured during open- (OKC) and closed-kinetic-chain (CKC) strength testing and establish which method had the strongest relationship to single-leg vertical-jump performance and knee mechanics after anterior cruciate ligament (ACL) reconstruction. METHODS Subjects (n = 19) 1 to 5 years from ACL reconstruction performed isometric knee extensions (OKC), unilateral isometric midthigh pulls (CKC), and single-leg vertical jumps on the ACL-involved and -noninvolved limbs. Between-limbs differences were assessed using paired t tests, and the relationship between RFD, jump performance, and knee mechanics was assessed using correlation coefficients (r; P ≤ .05). RESULTS There were significant between-limbs differences in OKC RFD (P = .008, d = -0.69) but not CKC RFD. OKC RFD in the ACL-involved limb had a strong association with jump height (r = .64, P = .003), knee-joint power (r = .72, P < .001), and peak knee-flexion angle (r = .72, P = .001). CKC RFD in the ACL-involved limb had a strong association with jump height (r = .65, P = .004) and knee-joint power (r = .67, P = .002) but not peak knee-flexion angle (r = .40, P = .09). CONCLUSIONS While both OKC and CKC RFD were strongly related to jump performance and knee-joint power, OKC RFD was able to detect between-limbs RFD asymmetries and was strongly related to knee-joint kinematics. These findings indicate that isometric knee extension may be optimal for assessing RFD after ACL reconstruction.
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Affiliation(s)
- Megan C Graham
- Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
| | - Kelsey A Reeves
- Department of Orthopaedics, University of North Carolina, Chapel Hill, NC, USA
| | - Tereza Janatova
- Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
| | - Brian Noehren
- Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
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7
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Tourillon R, Michel A, Fourchet F, Edouard P, Morin JB. Human foot muscle strength and its association with sprint acceleration, cutting and jumping performance, and kinetics in high-level athletes. J Sports Sci 2024; 42:814-824. [PMID: 38874271 DOI: 10.1080/02640414.2024.2367365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
The primary objective of this study was to investigate the relationship between metatarsophalangeal joint (MTPj) flexion torque and sprint acceleration, cutting and jumping performance, and kinetics. A secondary aim was to explore this relationship when MTP flexion strength was associated with other foot and lower limb neuromuscular outputs. After an initial MTPj flexion torque assessment using a custom-built dynamometer, 52 high-level athletes performed the following tasks on a force platform system: maximal sprint acceleration, 90-degree cutting, vertical and horizontal jumps, and foot-ankle hops. Their foot posture, foot passive stiffness and foot-ankle reactive strength were assessed using the Foot Posture Index, the Arch Height Index Measurement System and the Foot-Ankle Rebound Jump Test. Ankle plantarflexion and knee extension isometric torque were assessed using an isokinetic dynamometer. During maximal speed sprinting, multiple linear regressions suggested a major contribution of MTPj flexion torque, foot passive stiffness and foot-ankle reactive strength to explain 28% and 35% of the total variance in the effective vertical impulse and contact time. Ankle plantarflexor and quadriceps isometric torques were aggregately contributors of acceleration performance and separate contributors of cutting and jumping performance. In conclusion, MTPj flexion torque was more strongly associated with sprinting performance kinetics especially at high-speed.
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Affiliation(s)
- Romain Tourillon
- Interuniversity Laboratory of Human Movement Sciences, University Jean Monnet Saint-Etienne, Lyon 1, University Savoie Mont-Blanc, Saint-Etienne, France
- Physiotherapy department and motion analysis lab, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
| | - Antoine Michel
- Interuniversity Laboratory of Human Movement Sciences, University Jean Monnet Saint-Etienne, Lyon 1, University Savoie Mont-Blanc, Saint-Etienne, France
| | - François Fourchet
- Physiotherapy department and motion analysis lab, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
- SFMKS Lab, French Sport Physiotherapy Association, Paris, France
| | - Pascal Edouard
- Interuniversity Laboratory of Human Movement Sciences, University Jean Monnet Saint-Etienne, Lyon 1, University Savoie Mont-Blanc, Saint-Etienne, France
- Faculty of Medicine, Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jean-Benoît Morin
- Interuniversity Laboratory of Human Movement Sciences, University Jean Monnet Saint-Etienne, Lyon 1, University Savoie Mont-Blanc, Saint-Etienne, France
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
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Tondelli E, Feroldi A, García F, Meza F, Dingenen B. Rehabilitation and return-to-sport after anterior cruciate ligament injury and reconstruction: Exploring physical therapists' approaches in Argentina. Phys Ther Sport 2024; 67:131-140. [PMID: 38703448 DOI: 10.1016/j.ptsp.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/18/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES To investigate the current clinical practice regarding pre- and post-surgical rehabilitation and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR). DESIGN Cross-sectional design. Online survey. SETTING Survey platform. PARTICIPANTS Argentinian physical therapists (PTs). OUTCOME MEASURES The survey consisted of a combination of 39 open- and closed-ended questions, divided across 3 sections: (1) demographic and professional information, (2) clinical practice and rehabilitation strategies, and (3) return-to-running (RTR) and RTS. RESULTS A total of 619 PTs completed the survey. Considerable variability was observed in preoperative rehabilitation, criteria used for rehabilitation progression and RTS decision-making criteria used by PTs. From the total surveyed, 336 (54.3%) carried out RTS assessment in their clinical practice. Most of PTs (53.3%) use visual estimation to assess knee range of motion. Only 20% of the PTs reported incorporating patient-reported outcome measures in their decision-making. From PTs who use strength assessment as a criterion of RTS (68.8%), 16.6% extrapolate this from jump tests and 15.3% use manual muscle testing. Less than the 50% of the PTs recommended nine months or more to allow patients to RTS. CONCLUSIONS Current rehabilitation practices of Argentinian PTs following ACLR are largely variable and not aligned with current evidence and scientific guidelines. To achieve better rehabilitation and RTS practices better knowledge dissemination and implementation are required.
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Affiliation(s)
- Eduardo Tondelli
- Sport Physiotherapy, Faculty of Medical Sciences, Pontifical Catholic University of Argentina, Buenos Aires, Argentina; Sport Physiotherapy (CPC), School of Physiotherapy, Faculty of Medical Sciences, University of Buenos Aires, Buenos Aires, Argentina.
| | - Alejo Feroldi
- Sport Physiotherapy (CPC), School of Physiotherapy, Faculty of Medical Sciences, University of Buenos Aires, Buenos Aires, Argentina; Functional Anatomy and Biomechanics, Faculty of Medical Sciences, Favaloro University, Buenos Aires, Argentina
| | - Felipe García
- Sport Physiotherapy (CPC), School of Physiotherapy, Faculty of Medical Sciences, University of Buenos Aires, Buenos Aires, Argentina; New Performance Argentina Athletic Center, Buenos Aires, Argentina
| | - Franco Meza
- Sport Physiotherapy (CPC), School of Physiotherapy, Faculty of Medical Sciences, University of Buenos Aires, Buenos Aires, Argentina; Physical Therapy and Medical Department, Club Atlético Huracán, Buenos Aires, Argentina
| | - Bart Dingenen
- Reval Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
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Tondelli E, Kenny IC, Comyns TM, Zabaloy S. Differences and correlations between horizontal and vertical single-leg jump performance, dynamic balance, and ankle dorsiflexion range of motion in male amateur rugby players according to playing positions. J Bodyw Mov Ther 2024; 38:281-288. [PMID: 38763571 DOI: 10.1016/j.jbmt.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/17/2024] [Accepted: 01/25/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES To explore the differences and correlations in the Y-Balance Test (YBT) scores, ankle-dorsiflexion range of motion (ADFROM), single-leg drop jump (SLDJ) and single-leg hop for distance (SLHD) in amateur male rugby players by playing positions and limb dominance. DESIGN Cross-sectional study. SETTING Argentinian amateur rugby club. PARTICIPANTS Male (n = 58) senior amateur rugby players. MAIN OUTCOME MEASURES ADFROM, YBT (anterior [AN], posteromedial, posterolateral, and composite [COM]), SLDJ and SLHD performances. RESULTS Forwards demonstrated different anthropometric traits than backs (p < 0.001 to 0.003; ES: -0.508 to -1.331), whereas the latter attained better jump performance (p < 0.001-0.05; ES: 0.297-1.349) and YBTCOM scores compared to the former, irrespective of limb dominance (p: 0.007-0.034; ES: 0.569-0.730). With regards to the associations, forwards' BMI (rho: -0.35 to -0.52, ES: 0.184) and ADFROM values (rho: 0.41 to 0.53, ES: 0.184; r: 0.43 to 0.50, ES: 0.184) were associated to jump performance among both limbs. In contrast, for the backs, leg length was associated with SLHD (rho: 0.42-0.45, ES: 0.214) and YBTCOM (rho: -0.67 to -0.76, ES: 0.215). Likewise, ADFROM values (r: 0.44-0.56, ES: 0.185) were moderately associated to YBTAN in both limbs. CONCLUSIONS Backs attained better dynamic balance, wider ADFROM, and better unilateral vertical and horizontal jumps performances in dominant and non-dominant limb, compared to forwards. Additionally, ADFROM maybe an important aspect to consider when aiming to improve balance and jump performance among forwards and backs.
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Affiliation(s)
- Eduardo Tondelli
- Discipline of Sport Physiotherapy, Faculty of Medical Sciences, Pontifical Catholic University of Argentina, Buenos Aires, Argentina.
| | - Ian C Kenny
- Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland; Sport and Human Performance Research Centre, University of Limerick, Ireland
| | - Thomas M Comyns
- Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland; Sport and Human Performance Research Centre, University of Limerick, Ireland
| | - Santiago Zabaloy
- Faculty of Physical Activity and Sports, University of Flores, Buenos Aires, Argentina
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10
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Suits WH, Roe ON, Snyder CM, Voss LJ. The Interruption of Rehabilitation Following Anterior Cruciate Ligament Reconstruction due to COVID-19 Restrictions: Association With Return-to-Sport Testing. J Sport Rehabil 2024; 33:149-154. [PMID: 38194957 DOI: 10.1123/jsr.2023-0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024]
Abstract
CONTEXT Among many unanticipated changes, access to rehabilitation was disrupted during the onset of the COVID-19 pandemic. It is unclear how the timing of late-stage rehabilitation following anterior cruciate ligament with surgical reconstruction (ACLR) during the initial months of the pandemic affected outcomes. The purpose of this study was to compare physical performance outcome measures in patients following ACLR prior to and following COVID-19-related restrictions. DESIGN Retrospective cohort study. METHODS Data from patients who underwent return-to-sport testing following ACLR were analyzed based on date. December 2018 through March of 2020 (n = 66) was defined as the baseline period, and June through October 2020 (n = 27) was defined as the surveillance period. Outcome measures included single leg hop, triple hop, single leg vertical jump, and the lower-extremity functional test (LEFT). Linear mixed models were used to compare outcome measures before and after the onset of pandemic-related restrictions, clustered by sex and sport. A 1-way analysis of variance was performed to analyze the association between the number of virtual rehabilitation visits and outcome measures for subjects in the surveillance period. RESULTS Subjects in the surveillance period performed significantly worse in the LEFT (+7.88 s; 95% confidence interval, 1.11 to 14.66; P = .02) and single leg vertical jump on the unaffected side (-4.32 cm; 95% confidence interval, -7.44 to -1.19, P < .01), and performed better with single leg vertical jump symmetry (+6.3%; 95% confidence interval, 1.0% to 11.5%; P = .02). There were no other statistically significant differences. There was no significant association between having virtual rehabilitation visits and any of the performance outcomes. CONCLUSIONS There was a decline in physical performance outcome measures in patients following ACLR who did not attend regular in-person physical therapy sessions in the late-stage rehabilitation due to COVID-19-related restrictions. Other factors during this unique time period, such as access to training facilities or psychosocial stressors, may have also influenced outcomes.
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Affiliation(s)
- William H Suits
- Department of Physical Therapy, University of Michigan-Flint, Flint, MI, USA
| | - Olivia N Roe
- Department of Physical Therapy, University of Michigan-Flint, Flint, MI, USA
| | - Corey M Snyder
- Michigan Medicine MedSport, Michigan Medicine, Ann Arbor, MI, USA
| | - Luke J Voss
- Michigan Medicine MedSport, Michigan Medicine, Ann Arbor, MI, USA
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11
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Chen P, Wang L, Dong S, Ding Y, Zuo H, Jia S, Wang G, Chen C, Zheng C. Abnormal Lower Limb Biomechanics During a Bilateral Vertical Jump Despite the Symmetry in Single-Leg Vertical Hop Height in Athletes After ACL Reconstruction. Orthop J Sports Med 2024; 12:23259671241230989. [PMID: 38414664 PMCID: PMC10898320 DOI: 10.1177/23259671241230989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 08/30/2023] [Indexed: 02/29/2024] Open
Abstract
Background A limb symmetry index (LSI) of >90% for single-leg horizontal hop distance is recommended as a cutoff point for safe return to sports after anterior cruciate ligament reconstruction (ACLR). Despite achieving this threshold, abnormal lower limb biomechanics continue to persist in athletes after ACLR. Symmetry in single-leg vertical hop height appears to be more difficult to achieve and can be a better representation of knee function than single-leg horizontal hop distance. Purpose To explore whether an LSI of >90% for single-leg vertical hop height can represent normal lower limb biomechanics in athletes during a bilateral vertical jump after ACLR. Study Design Controlled laboratory study. Methods According to the LSI for single-leg vertical hop height, 46 athletes who had undergone ACLR with an autologous ipsilateral bone-patellar tendon-bone or hamstring tendon graft were divided into a low symmetry group (LSI <90%; n = 23) and a high symmetry group (LSI >90%; n = 23), and 24 noninjured athletes were selected as the control group. The kinematic and kinetic characteristics during a bilateral vertical jump were compared between the low symmetry, high symmetry, and control groups. Results During the propulsion phase of the bilateral vertical jump, the operated side in the high symmetry group showed a lower knee extension moment than the nonoperated side (P = .001). At peak vertical ground-reaction force, the operated side in the high symmetry group showed a lower knee internal rotation moment compared with the control group (P = .016). Compared with the nonoperated side, the operated side in the high symmetry group showed a higher hip extension moment (P = .002), lower knee extension moment (P < .001), lower ankle plantarflexion moment (P < .001), and lower vertical ground-reaction force (P = .023). Conclusion Despite achieving an LSI of >90% for single-leg vertical hop height, athletes after ACLR showed abnormal lower limb biomechanical characteristics during the bilateral vertical jump. Clinical Relevance Symmetrical single-leg vertical hop height may not signify ideal biomechanical or return-to-sports readiness in this population.
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Affiliation(s)
- Peng Chen
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Key Laboratory of Sports Engineering of the General Administration of Sport of China, Wuhan Sports University, Wuhan, China
| | - Ling Wang
- Key Laboratory of Sports Engineering of the General Administration of Sport of China, Wuhan Sports University, Wuhan, China
- School of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Shiyu Dong
- College of Basic Medicine, Fujian Medical University, Fuzhou, China
| | - Yue Ding
- Key Laboratory of Sports Engineering of the General Administration of Sport of China, Wuhan Sports University, Wuhan, China
- School of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Huiwu Zuo
- School of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Shaohui Jia
- School of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Guanglan Wang
- School of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Can Chen
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Cheng Zheng
- Department of Sports Medicine, Affiliated Hospital, Wuhan Sports University, Wuhan, China
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12
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Menek MY, Menek B. Effects of percussion massage therapy, dynamic stretching, and static stretching on physical performance and balance. J Back Musculoskelet Rehabil 2024; 37:183-193. [PMID: 37661870 DOI: 10.3233/bmr-230069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND Percussion massage therapy is a popular approach in sport medicine for physical therapists, but few researchers have investigated the comparison with other intervention methods. OBJECTIVE This study aimed to examine the comparison of the effects of dynamic stretching, static stretching and percussive massage therapy on balance and physical performance in individuals. METHODS The participants who were 18-25 years of age, able to perform performance tests, did not have any orthopedic surgery, did not have problems during running and sudden turning, and did not have a professional sports history were included in the study. Participants were assigned randomly to three groups as dynamic stretching (DS) (n= 16), static stretching (SS) (n= 16) and percussive massage therapy (PMT) (n= 16) groups. Horizontal jumping test, T drill test and balance measurements on a single leg with open and closed eyes of all participants were recorded before and after applications. RESULTS When the values of the pre and post-treatment of all groups in the study were compared, significant improvements were observed in the t-test, horizontal jumping test and right/left foot balance with eyes open in DS group (p< 0.05). Significant improvements were observed in all values in the PMT group (p< 0.05). In the comparison of the differences between the groups, PMT group values were more significant than the SS group in all parameters. CONCLUSION Percussive massage therapy would be an alternative that can be used to increase the performance and balance of individuals before exercise.
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Affiliation(s)
- M Yilmaz Menek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - B Menek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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13
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Junge N, Jørgensen TB, Nybo L. Performance Implications of Force-Vector-Specific Resistance and Plyometric Training: A Systematic Review with Meta-Analysis. Sports Med 2023; 53:2447-2461. [PMID: 37594654 DOI: 10.1007/s40279-023-01902-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND According to the principle of specific adaptations to imposed demands, training induces specific adaptations that predominantly transfer towards performance tasks of similar physiological and/or biomechanical characteristics. Functional performance improvements secondary to resistance and plyometric training have been hypothesized to be force-vector specific; however, the literature pertaining to this matter appears somewhat equivocal. OBJECTIVE The objective of the present systematic review with meta-analysis was to synthesize the available body of literature regarding the performance implications of vertically and horizontally oriented resistance- and plyometric training. DATA SOURCES The review drew from the following sources: PubMed, Web of Science, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), SPORTDiscus and Google Scholar. STUDY ELIGIBILITY CRITERIA To qualify for inclusion, studies had to compare the efficacy of vertically and horizontally oriented resistance and/or plyometric training, with one or multiple outcome measures related to vertical/horizontal jumping, sprinting and/or change of direction speed (CODS). STUDY APPRAISAL AND SYNTHESIS For each outcome measure, an inverse-variance random effects model was applied, with between-treatment effects quantified by the standardized mean difference (SMD) and associated 95% confidence- and prediction intervals. RESULTS Between-treatment effects were of trivial magnitude for vertical jumping (SMD = - 0.04, P = 0.69) and long-distance (≥ 20 m) sprinting (0.03, P = 0.83), whereas small to moderate effects in favor of horizontal training were observed for horizontal jumping (0.25, P = 0.07), short-distance (≤ 10 m) sprinting (0.72, P = 0.01) and CODS (0.31, P = 0.06), although only the short-distance sprint outcome reached statistical significance. CONCLUSIONS In conclusion, our meta-analysis reveals a potential superiority of horizontally oriented training for horizontal jumping, short-distance sprinting and CODS, whereas vertically oriented training is equally efficacious for vertical jumping and long-distance sprinting. From an applied perspective, the present analysis provides an advanced basis for weighting of vertical and horizontal force-vector exercises as an integrated component for optimizing sport-specific performances. The present systematic review with meta-analysis was not a priori registered.
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Affiliation(s)
- Nicklas Junge
- Department of Integrative Physiology, Institute for Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
| | - Tobias B Jørgensen
- Department of Integrative Physiology, Institute for Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lars Nybo
- Department of Integrative Physiology, Institute for Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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14
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Zarro M, Dickman M, Hulett T, Rowland R, Larkins D, Taylor J, Nelson C. Hop to It! The Relationship Between Hop Tests and The Anterior Cruciate Ligament - Return to Sport Index After Anterior Cruciate Ligament Reconstruction in NCAA Division 1 Collegiate Athletes. Int J Sports Phys Ther 2023; 18:1076-1084. [PMID: 37795334 PMCID: PMC10547069 DOI: 10.26603/001c.86130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/05/2023] [Indexed: 10/06/2023] Open
Abstract
Background Outcomes after anterior cruciate ligament reconstruction (ACLR) may not be optimal, with poor physical and psychological function potentially affecting return to sport (RTS) ability. Understanding the relationship between commonly used hop tests and the Anterior Cruciate Ligament - Return to Sport Index (ACL-RSI) may improve rehabilitation strategies and optimize patient outcomes. Hypothesis/Purpose The purpose of this study was to examine the relationship between ACL-RSI scores and limb symmetry index (LSI) for the single hop for distance (SHD), triple hop for distance (THD), crossover hop for distance (CHD), timed 6-meter hop (T6H), and single leg vertical hop (SLVH) in a cohort of National Collegiate Athletic Association (NCAA) Division 1 collegiate athletes after ACLR. The hypothesis was that SLVH LSI would be more highly correlated with ACL-RSI score than all horizontal hop tests. Study design Cross-Sectional Study. Methods Twenty-one National Collegiate Athletic Association (NCAA) Division 1 collegiate athletes (7 males, 14 females) at 6.62 ± 1.69 months after ACLR were included in this retrospective study. Primary outcomes were ACL-RSI score and LSI for SHD, THD, CHD, T6H, and SLVH. The relationship between ACL-RSI scores and performance on hop tests (LSIs) was evaluated using correlation analysis and step-wise linear regression (p ≤ 0.05). Results There were significant correlations found when comparing ACL-RSI and the LSI for SHD (rs = 0.704, p < 0.001), THD (rs = 0.617, p = 0.003), CHD (rs = 0.580, p = 0.006), and SLVH (rs = 0.582, p = 0.006). The CHD explained 66% (R2 value of 0.660) of the variance in the ACL-RSI, while the other hop tests did not add to the predictive model. Conclusions Physical function has the capacity to influence psychological status after ACLR. Clinicians should recognize that SLVH, SHD, THD, and CHD are correlated with ACL-RSI and improvements in physical function during rehabilitation may improve psychological status and optimize RTS after ACLR. Level of evidence Level 3.
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Affiliation(s)
- Michael Zarro
- Physical Therapy and Rehabilitation Science University of Maryland, Baltimore
- Orthopaedics University of Maryland, Baltimore
| | - Madelyn Dickman
- Physical Therapy and Rehabilitation Science University of Maryland, Baltimore
| | - Timothy Hulett
- Physical Therapy and Rehabilitation Science University of Maryland, Baltimore
| | - Robert Rowland
- Physical Therapy and Rehabilitation Science University of Maryland, Baltimore
- Orthopaedics University of Maryland, Baltimore
| | - Derrick Larkins
- Physical Therapy and Rehabilitation Science University of Maryland, Baltimore
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15
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Kotsifaki R, Sideris V, King E, Bahr R, Whiteley R. Performance and symmetry measures during vertical jump testing at return to sport after ACL reconstruction. Br J Sports Med 2023; 57:1304-1310. [PMID: 37263763 DOI: 10.1136/bjsports-2022-106588] [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] [Accepted: 05/06/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Vertical jump tests are more sensitive in revealing asymmetries in performance metrics at the time of return to sport after anterior cruciate ligament (ACL) reconstruction (ACLR) than horizontal hop tests. However, it remains unclear which vertical tests (bilateral or unilateral) and which metrics (kinetics or performance) are most effective in informing the rehabilitation status and readiness for return to sport. We aimed to investigate the status of athletes during vertical jump testing at return to sport after ACLR. METHODS A dual force platform system was used to evaluate jumping performance of 126 recreational and professional athletes at the time of return to sport after ACLR, as well as 532 healthy control participants. Performance and kinetic metrics were collected during four jump tests: double-leg countermovement jump, single-leg countermovement jump, double-leg 30 cm drop jump and single-leg 15 cm drop jump. Between-limb and between-group differences were explored using mixed models analyses. RESULTS At the time of return to sport after ACLR, athletes still presented significant differences favouring the uninvolved side, particularly in the symmetry of the concentric impulse (p<0.001) in all jumps compared with the control group. Peak landing force asymmetry was greater in the ACLR group than the controls during the countermovement (p<0.001, MD=-11.6; 95% CI -15.4 to -7.9) and the double-leg drop jump (p=0.023, MD=-8.9; 95% CI -14.9 to -2.8). The eccentric impulse asymmetry was significantly greater (p=0.018, MD=-3.8; 95% CI -5.8 to -1.7) in the ACLR group during the single-leg drop jump only. Jump height was significantly lower (p<0001) in the ACLR group compared with controls in all tests except the double-leg drop jump. CONCLUSION At the time of return to sport after ACLR, despite passing the traditional discharge criteria, athletes remained asymmetrical during all vertical jump tests, in the concentric (push-off) phase, during landing from bilateral jumps and for most performance metrics. Clinicians should aim to restore not only symmetry in ground reaction forces but also absolute performance metrics such as jump height, reactive strength index and contact times, to potentially reduce injury risk and improve overall athletic performance.
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Affiliation(s)
- Roula Kotsifaki
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Vasileios Sideris
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Enda King
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Department of Life Sciences, Roehampton University, London, UK
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Aspetar, Orthopeadic and Sports Medicine Hospital, Doha, Qatar
| | - Rod Whiteley
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- School of Human Movement & Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
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16
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Wang T, Zhao C, Guo Z. Comparative analysis of ankle injury kinematics and dynamics in basketball players: forefoot landing vs. rearfoot landing modes. Am J Transl Res 2023; 15:5843-5849. [PMID: 37854222 PMCID: PMC10579024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/30/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To compare the differences in ankle joint parameters of basketball athletes between the forefoot and rearfoot landing and to investigate the injury mechanism of ankle joints in different landing modes. METHODS Twenty level II male basketball athletes were selected as subjects in this study. The landing movements of these athletes were assigned into a forefoot landing mode and a rearfoot landing mode. The former includes movements such as running emergency stop, two-leg jump and forefoot landing, while the latter includes actions such as running emergency stop, two-leg jump and rearfoot landing. The motion capture system and three-dimensional force measuring table were used for collecting the kinematic and dynamic data of the subjects. RESULTS The initial landing angles, including ankle dorsiflexion and medial ankle rotation of the forefoot were larger than those of the rearfoot (all P<0.05). Compared to those in the rearfoot landing mode, the forefoot landing exhibited a greater peak angle of ankle plantar flexion and ankle varus, as well as a smaller peak angle of ankle dorsiflexion and ankle internal rotation (all P<0.05). In comparison to the rearfoot landing mode, the forefoot landing showed a larger range of ankle varus and valgus, as well as a smaller range of ankle dorsiflexion and plantar flexion (all P<0.05). The ankle plantar flexion torque of forefoot landing was higher than that of rearfoot landing, while the peak ankle dorsiflexion torque of forefoot landing was smaller than that of rearfoot landing (all P<0.05). Compared to those in the rearfoot landing mode, the outward peak ground reaction force was smaller and the forward peak ground reaction was larger in forefoot landing mode (all P<0.05). No obvious differences were observed in other indicators between two landing modes. CONCLUSIONS There are kinematic and dynamic differences between the forefoot and rearfoot landing. Forefoot landing may increase the risk of ankle injury during landing.
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Affiliation(s)
- Tongling Wang
- Institute of Physical Education, Huzhou UniversityHuzhou, Zhejiang, China
| | - Cuiqing Zhao
- Sport and Leisure Industry Studies of Myongji UniversitySeoul, South Korea
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17
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Patel S, Marrone W. The Evolution of Rehabilitation and Return to Sport Following Cartilage Surgery. Int J Sports Phys Ther 2023; V18:551-557. [PMID: 37425101 PMCID: PMC10324289 DOI: 10.26603/001c.77508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Rehabilitation after knee cartilage repair or restoration can be a challenging and nuanced process. Historically, conservative rehabilitation protocols have been characterized by limited weightbearing and restricted range of motion (ROM) were created to primarily protect the repaired cartilage but did little for progression into higher level activity. Recent literature has supported accelerated protocols in a variety of cartilage procedures ranging from osteochondral allograft (OCA) Osteochondral autograft surgery (OATS) to matrix-based scaffolding procedures such as Matrix Induced Chondrocyte Implantation (MACI) or Denovo procedures. Advances in technology such as blood flow restriction (BFR) and testing equipment with progressive rehabilitation from the acute phase through the return to sport continuum have made it possible to return to a higher level of activity and performance than first thought of for these procedures. This clinical viewpoint discusses the evolution of knee cartilage rehabilitation characterized by early but progressive weightbearing and early ROM while maintaining early homeostasis in the knee, and then its progression to return to sport and performance in the higher-level athlete. Level of evidence V.
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Affiliation(s)
- Snehal Patel
- Sports Rehabilitation Center Hospital for Special Surgery
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18
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Ren R, Spaan J, Jordan A, Shafiro A, Su EP. Novel Use of an Accelerometer to Assess Load Asymmetry Over Time After Hip Resurfacing Arthroplasty. J Arthroplasty 2023:S0883-5403(23)00356-X. [PMID: 37068566 DOI: 10.1016/j.arth.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/05/2023] [Accepted: 04/08/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION There is limited knowledge regarding usage of wearable technology to guide return to sport after hip resurfacing arthroplasty (HRA). This study evaluated the use of accelerometers to identify when symmetry is restored between operative and non-operative limbs. METHODS A total of 26 primary HRA patients performed five validated physical tests before, 3 and 6 months after HRA: broad jump, double leg vertical jump (DLVJ), hop test, lateral single leg jump (LSLJ), and vertical single leg jump (VSLJ). Impact load and average intensity data (g-force units) were collected using accelerometers. Strength data (pounds (lbs.)) for internal and external rotation was collected with a dynamometer. Univariate and correlation analyses analyzed interlimb asymmetries. RESULTS At pre-operation, there were significant impact load asymmetries for DLVJ (P=.008), hop test (P=.021), and LSLJ (P=.003), and intensity asymmetry for DLVJ (P=.010) and LSLJ (P=.003). At 3 months, there was impact load asymmetry for DLVJ (P=.005) and LSLJ (P=.005), and intensity asymmetry for broad jump (P=.020), hop test (P=.042), and LSLJ (P=.005). There were significant strength asymmetries at pre- and 3 months post-operation for internal (P=.013) and external rotation (P=.037). All significant asymmetries indicated the non-operative leg had greater output. No significant asymmetries were found for any exercises at 6 months post-operation. An increase in Harris Hip Score was significantly associated with a decrease in impact asymmetry (rs = -0.269, P=.006). DISCUSSION AND CONCLUSION Impact loads and strength reach interlimb symmetry at 6 months post-HRA. Wearable accelerometers provide useful metrics to distinguish limb asymmetries for recovery monitoring.
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Affiliation(s)
- Renee Ren
- Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, United States.
| | - Jonathan Spaan
- Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, United States
| | - Andrew Jordan
- Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, United States
| | - Alexander Shafiro
- Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, United States
| | - Edwin P Su
- Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, United States
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19
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Eek MN, Augustsson J, Zügner R, Tranberg R. Single-leg vertical jumping in young adults with spastic cerebral palsy. Gait Posture 2023; 103:1-5. [PMID: 37075552 DOI: 10.1016/j.gaitpost.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Maximum-strength tests are commonly used to detect muscle weakness in persons with cerebral palsy (CP). Tests of explosive strength (power) in the lower extremities, such as vertical jump tests, are more uncommon but might supplement maximum-strength testing by providing additional information about motor function. RESEARCH QUESTION Is it feasible and useful to measure single-leg vertical jumping in young adults with CP? METHODS Eleven persons with spastic CP (18-30 years), able to walk without support, were compared with a reference group. Jump height and power generation in jumping were measured using a 3D motion-analysis system and force plates. Maximum strength in plantarflexors was measured on the same occasion. Data were analysed using non-parametric statistics. RESULTS Jump height was significantly greater in the reference group than in the group with CP, both relative to the less-involved leg of the participants with CP (p = .007) and relative to their more-involved leg (p < .001). In the group with CP, jump height was twice as great for the less-involved leg than for the more-involved leg (p = .008). Power generation at the hip joint was similar between the groups but differed for the knee and ankle joints (p = .001-.033). In the reference group, most of the power was generated at the ankle joint, while the hip was the dominant power generator for the more-involved leg in the group with CP. Muscle strength in the group with CP showed a high correlation with jump height (rho = .745, p < .001) and power generation at the ankle (rho = .780, p = .001). SIGNIFICANCE The single-leg vertical jump test proved capable of measuring jump height and power generation in participants with CP. It also identified explosive muscle weakness both relative to a reference group and between legs. Hence the jump test may provide information additional to common tests of maximal muscle strength in persons with CP.
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Affiliation(s)
- Meta N Eek
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Jesper Augustsson
- Department of Sport Science at the Faculty of Social Sciences, Linnaeus University, Kalmar, Sweden
| | - Roland Zügner
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Roy Tranberg
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Forelli F, Le Coroller N, Gaspar M, Memain G, Kakavas G, Miraglia N, Marine P, Maille P, Hewett TE, Rambaud AJ. Ecological and Specific Evidence-Based Safe Return To Play After Anterior Cruciate Ligament Reconstruction In Soccer Players: A New International Paradigm. Int J Sports Phys Ther 2023; 18:526-540. [PMID: 37020454 PMCID: PMC10069338 DOI: 10.26603/001c.73031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/15/2023] [Indexed: 04/04/2023] Open
Abstract
Existing return to play (RTP) assessments have not demonstrated the ability to decrease risk of subsequent anterior cruciate ligament (ACL) injury after reconstruction (ACLR). RTP criteria are standardized and do not simulate the physical and cognitive activity required by the practice of sport. Most RTP criteria do not include an ecological approach. There are scientific algorithms as the "5 factor maximum model" that can identify risk profiles and help reduce the risk of a second anterior cruciate ligament injury. Nevertheless, these algorithms remain too standardized and do not include the situations experienced in games by soccer players. This is why it is important to integrate ecological situations specific to the environment of soccer players in order to evaluate players under conditions closest to their sporting activity, especially with high cognitive load. One should identify high risk players under two conditions: Clinical analyses commonly include assessments such as isokinetic testing, functional tests (hop tests, vertical force-velocity, profile), running, clinical assessments (range of motion and graft laxity), proprioception and balance (Star Excursion Balance Test modified, Y-Balance, stabilometry) and psychological parameters (kinesophobia, quality of life and fear of re-injury). Field testing usually includes game simulation, evaluation under dual-task conditions, fatigue and workload analysis, deceleration, timed-agility-test and horizontal force-velocity profiles. Although it seems important to evaluate strength, psychological variables and aerobic and anaerobic capacities, evaluation of neuromotor control in standard and ecological situations may be helpful for reducing the risk of injury after ACLR. This proposal for RTP testing after ACLR is supported by the scientific literature and attempts to approximate the physical and cognitive loads during a soccer match. Future scientific investigation will be required to demonstrate the validity of this approach. Level of Evidence 5.
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Machado EDM, Haik MN, Ferreira JK, da Silva Santos JF, Camargo PR, Mendonça LDM. Association of trunk and lower limb factors with shoulder complaints and sport performance in overhead athletes: A systematic review including GRADE recommendations and meta-analysis. Phys Ther Sport 2023; 60:112-131. [PMID: 36791672 DOI: 10.1016/j.ptsp.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To identify the association of trunk and lower limb factors with shoulder complaints and sport performance in overhead athletes. METHODS Search performed at PubMed/Medline, Embase, CINAHL, LILACS, Cochrane, Web of Science and SPORTDiscus for observational studies. Methodological quality and strength of the evidence was assessed with the Newcastle-Ottawa Scale and GRADE. Meta-analysis and effects sizes analysis were calculated when possible. RESULTS Sixty-five studies were included. Low to very-low evidence suggests no association of trunk/lower limb strength, endurance, power, jump or balance with shoulder complaints and/or throwing performance. Athletes with shoulder complaints performed worse in trunk stability and endurance tests (mean difference: -6.83 (95%CI: -8.78, -4.88)). Athletes with high throwing performance presented better results in CMJ, horizontal jump, power measures and knee extension strength. For swimmers, there was no association of trunk/lower limb endurance with shoulder complaints (moderate evidence) and no association of balance and swimming performance (low evidence). Better trunk/lower limb strength, power and vertical jumps measures were associated with better swimming performance. CONCLUSIONS In methodologically similar studies, some trunk/lower limb outcomes are associated with shoulder complaint or sport/swimming performance. Results should be considered with caution and future studies should use better methodologies.
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Affiliation(s)
- Eliane de Morais Machado
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Sao Carlos, Brazil
| | - Melina Nevoeiro Haik
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Sao Carlos, Brazil
| | - Julia Kortstee Ferreira
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Sao Carlos, Brazil
| | - Jonatas Ferreira da Silva Santos
- Physical Training and Sport Performance Research Group, Department of Physical Education, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e do Mucuri, Diamantina, MG, Brazil
| | - Paula Rezende Camargo
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, Sao Carlos, Brazil
| | - Luciana De Michelis Mendonça
- Post-Graduate Program in Physical Therapy (PPGFt), Universidade Federal de Sao Carlos (UFSCar), Sao Carlos, Brazil; Physical Therapy Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Riera J, Duclos NC, Néri T, Rambaud AJ. Is there any biomechanical justification to use hopping as a return to running test? A cross-sectional study. Phys Ther Sport 2023; 61:135-141. [PMID: 37030039 DOI: 10.1016/j.ptsp.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To assess the agreement and the correlation between asymmetry indexes of leg stiffness (AI(Kleg)) in running and hopping and the correlation between leg stiffness (Kleg) in running and hopping. DESIGN Cross-sectional study. SETTING Clinical facility. PARTICIPANTS Twelve healthy runners (5 women and 7 men; mean (SD) age = 36.6 (10.1) years; activity level = 6.4 (0.9) on Tegner scale). MAIN OUTCOME MEASURES A treadmill instrumented by photoelectric cells was used to collect data (flight and contact times) during running assessment (preferential and imposed velocity (3.33 m s-1) and during a hopping test. Kleg and AI(Kleg) were computed for each modality. Correlation tests were performed, and Bland Altman's plot was created. RESULTS A significant and large correlation was found between Kleg in hopping and running at imposed speed (r = 0.6, p = 0.001). An acceptable agreement was found between the AIs in hopping and running, with a bias of 0.04 (-0.15-0.06) at imposed speed and 0.03 (-0.13-0.07) at preferred speed. CONCLUSION Our results suggest that testing an athlete for asymmetry in hopping might help to understand what happens in running. For this purpose, further research is needed, especially in an injured population, to better understand the association between biomechanical asymmetry in hopping and running.
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Almansoof HS, Nuhmani S, Muaidi Q. Correlation of ankle dorsiflexion range of motion with lower-limb kinetic chain function and hop test performance in healthy male recreational athletes. PeerJ 2023; 11:e14877. [PMID: 36846443 PMCID: PMC9951801 DOI: 10.7717/peerj.14877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/20/2023] [Indexed: 02/23/2023] Open
Abstract
Background The study aims to identify the correlation of ankle dorsiflexion range-of-motion (ADROM) (with its related gastrocnemius and soleus extensibility) with lower-limb kinetic chain function and hop test performance in young healthy recreational athletes. Methods Twenty-one young male healthy recreational athletes were tested for ADROM, gastrocnemius and soleus extensibility, lower-limb kinetic chain function with the closed kinetic chain lower extremity stability test (CKCLEST) and hop test performance with the single-leg hop for distance test (SHDT) and side hop test (SHT). Results There was a positive significant (rho = 0.514, 95% CI [0.092-0.779], P < 0.01) correlation between the dominant lower-limb weight-bearing/closed-chain ADROM (that represented the soleus extensibility) and the CKCLEST. There were no significant correlations between the study performance-based tests and open-chain ADROM (P > 0.05). Conclusion The CKCLEST is positively and significantly correlated with SHT and weight-bearing ADROM with knee flexion (and its related soleus extensibility) which suggests comparability among them. Open-chain ADROM has a negligible and non-significant correlation with the readings of this study performance-based tests suggesting that it is probably not an essential construct of their execution. To the best of our knowledge, this study is the first to investigate these correlations.
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Affiliation(s)
- Haifa Saleh Almansoof
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Qassim Muaidi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
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West TJ, Bruder AM, Crossley KM, Culvenor AG. Unilateral tests of lower-limb function as prognostic indicators of future knee-related outcomes following anterior cruciate ligament injury: a systematic review and meta-analysis of 13 150 adolescents and adults. Br J Sports Med 2023:bjsports-2022-105736. [PMID: 36669871 DOI: 10.1136/bjsports-2022-105736] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate the prognostic capacity of individual hop tests, hop test batteries and other unilateral functional performance tests following anterior cruciate ligament (ACL) injury. DESIGN Systematic review with meta-analysis. DATA SOURCES Six databases searched up to June 2021. ELIGIBILITY CRITERIA Studies reporting associations between unilateral lower-limb function (eg, hop tests) following ACL injury and future (≥3 months) knee-related outcomes. RESULTS Of 42 included studies (13 150 participants), all assessed the single-forward hop test and 32 assessed a repeated-forward hop test (crossover hop, triple hop, 6m-timed hop), mostly within a year after ACL injury/reconstruction. Results of meta-analyses indicated that higher single-forward and repeated-forward hop limb symmetry were associated with higher odds of return-to-sport 1-3 years post-ACL reconstruction (OR 2.15; 95% CI 1.30 to 3.54; OR 2.11; 95% CI 1.23 to 3.60, respectively). Higher single-forward and repeated-forward hop limb symmetry was associated with better self-reported symptoms and function 1-37 years after ACL injury (OR 2.51; 95% CI 1.62 to 3.88; OR 4.28; 95% CI 1.65 to 11.08, respectively). Higher limb symmetry on a repeated-forward hop does not appear to be associated with higher odds of successful rehabilitation without ACL reconstruction (OR 1.51; 95% CI 0.94 to 2.44). Achieving ≥90% limb symmetry on the single-forward hop was associated with reduced odds of knee osteoarthritis 5-37 years after ACL injury (OR 0.46; 95% CI 0.23 to 0.94). CONCLUSION Very low certainty evidence suggests single-forward and repeated-forward hop tests are prognostic indicators for important knee-related outcomes in individuals after ACL injury and may help stratify individuals at risk of poor outcomes to target rehabilitation interventions. PROSPERO REGISTRATION NUMBER CRD42018092197.
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Affiliation(s)
- Thomas J West
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.,Australian IOC Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Andrea M Bruder
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.,Australian IOC Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.,Australian IOC Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia .,Australian IOC Research Centre, La Trobe University, Bundoora, Victoria, Australia
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25
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Cadens M, Planas-Anzano A, Peirau-Terés X, Benet-Vigo A, Fort-Vanmeerhaeghe A. Neuromuscular and Biomechanical Jumping and Landing Deficits in Young Female Handball Players. BIOLOGY 2023; 12:biology12010134. [PMID: 36671826 PMCID: PMC9855848 DOI: 10.3390/biology12010134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023]
Abstract
Neuromuscular and biomechanical imbalances that exist in jumping and landing actions should be examined in order to intervene to decrease the risk of ACL injury. The main aim of this study was to analyse and compare, by chronological age, jumping and landing deficits in young female handball players using the Tuck Jump Assessment (TJA). A secondary aim was to relate the qualitative asymmetry values detected using the TJA to the quantitative asymmetry values detected starting from the single leg countermovement jump (SL-CMJ). Sixty-one young female handball players (age: 14.3 ± 1.5 years) were distributed into three groups: U12, U14 and U16 and performed the TJA test and the single leg countermovement jump (SL-CMJ). The female U12 category players obtained the highest scores in the TJA and there were significant differences between the U12 (12.11 ± 1.97) and U14 (10.89 ± 1.74) categories (p = 0.017; ES = 0.374). In the U12 category, the female players presented larger interlimb asymmetry magnitudes in the SL-CMJ test; they also obtained higher scores in the qualitative criteria of the TJA test that referred to asymmetry (r = 0.43; p = 0.027). The analysis of the jumping and landing pattern using TJA allowed us to identify that the lower extremity valgus at landing, foot contact timing not equal and landing contact noise are the main biomechanical deficits in young female handball players. Furthermore, the asymmetry values assessed qualitatively (TJA) are associated with the asymmetry values assessed quantitatively (difference in jump achieved with each limb in the SL-CMJ test) in younger categories.
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Affiliation(s)
- Maria Cadens
- Research Group into Human Movement, National Institute of Physical Education of Catalonia (INEFC), University of Lleida (UdL), 25192 Lleida, Spain
- Correspondence:
| | - Antoni Planas-Anzano
- Research Group into Human Movement, National Institute of Physical Education of Catalonia (INEFC), University of Lleida (UdL), 25192 Lleida, Spain
| | - Xavier Peirau-Terés
- Research Group into Human Movement, National Institute of Physical Education of Catalonia (INEFC), University of Lleida (UdL), 25192 Lleida, Spain
| | - Ariadna Benet-Vigo
- Department of Sports Sciences, FCS Blanquerna, Ramon Llull University, 08022 Barcelona, Spain
| | - Azahara Fort-Vanmeerhaeghe
- Department of Sports Sciences, FPCEE and FCS Blanquerna, Ramon Llull University, 08022 Barcelona, Spain
- Segle XXI Female Basketball Team, Catalan Federation of Basketball, 08950 Esplugues de Llobregat, Spain
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26
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Contreras-Díaz G, Chirosa-Ríos LJ, Chirosa-Ríos I, Riego-Ruiz A, Intelangelo L, Tuesta-Roa M, Morales-Zúñiga J, Jerez-Mayorga D. Dynamometric Strength Profile of Hip Muscles in Youth Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1291. [PMID: 36674053 PMCID: PMC9859035 DOI: 10.3390/ijerph20021291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Soccer is the most widely practiced sport in the world, demanding high-speed activities such as jumps, sprints and changes of direction. Therefore, having optimal levels of muscle strength improves performance and reduces the injury rate. OBJECTIVES The objectives of our study were (i) to determine the dynamometric profile of hip muscle strength in young soccer players by position, evaluated at different isokinetic speeds, (ii) to describe the conventional and functional unilateral muscle strength ratios, (iii) to analyze the bilateral balance. METHODS Thirty-seven male soccer players (age 17.02 ± 0.92 years) participated in the study. Strength assessment was performed with a functional electromechanical dynamometer, and concentric and eccentric strength of abductors, adductors, extensors and hip flexors were measured bilaterally at 0.5 m/s and 1 m/s. RESULTS For eccentric right hip abduction at 0.5 m/s, defenders are significantly stronger than midfielders (p = 0.013) and stronger than forwards (p = 0.140). For eccentric right hip adduction at 0.5 m/s, defenders are significantly stronger than midfielders (p = 0.005) and stronger than forwards (p = 0.253), as for eccentric right hip adduction at 1 m/s, defenders are significantly stronger than midfielders (p = 0.014) and stronger than forwards (p = 0.084). There is a significant effect for the conventional strength ratio of left abduction/adduction at 1 m/s. The conventional strength ratio of forwards is significantly higher than that of defenders (p = 0.045) and higher than that of midfielders (p = 0.152). CONCLUSIONS Concentric and eccentric hip strength values differ according to playing position.
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Affiliation(s)
- Guido Contreras-Díaz
- Department Physical Education and Sports, Faculty of Sport Science, University of Granada, 18011 Granada, Spain
- Department of Health, University of Los Lagos, Puerto Montt 5500000, Chile
| | - Luis Javier Chirosa-Ríos
- Department Physical Education and Sports, Faculty of Sport Science, University of Granada, 18011 Granada, Spain
| | - Ignacio Chirosa-Ríos
- Department Physical Education and Sports, Faculty of Sport Science, University of Granada, 18011 Granada, Spain
| | - Antonio Riego-Ruiz
- Department Physical Education and Sports, Faculty of Sport Science, University of Granada, 18011 Granada, Spain
| | - Leonardo Intelangelo
- Musculoskeletal Research Group, University Center for Assistance, Teaching and Research, University of Gran Rosario, Rosario S2000, Argentina
| | - Marcelo Tuesta-Roa
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Science, University Andres Bello, Santiago 7591538, Chile
| | - Jorge Morales-Zúñiga
- Laboratory of Sport Sciences, Center of Medicine Sports MD, Viña del Mar 2521156, Chile
| | - Daniel Jerez-Mayorga
- Department Physical Education and Sports, Faculty of Sport Science, University of Granada, 18011 Granada, Spain
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Science, University Andres Bello, Santiago 7591538, Chile
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Lin J, Shen J, Zhang J, Zhou A, Guo W. Correlations between horizontal jump and sprint acceleration and maximal speed performance: a systematic review and meta-analysis. PeerJ 2023; 11:e14650. [PMID: 36748088 PMCID: PMC9899053 DOI: 10.7717/peerj.14650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/06/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives The purpose of this study is to determine the associations between horizontal jump and sprint acceleration, as well as maximal speed performance. Methods A systematic literature search was performed using PubMed, MEDLINE (EBSCOhost), and Web of Science. The studies that were included in this review must meet the following criteria: (1) well-trained individuals over the age of 18 years old; (2) Pearson's correlation coefficients between sprint time and horizontal jump distance were provided; (3) the sprint distance was limited to 0-100 m. The quality of the studies was assessed using a modified version of the Downs and Black Quality Index test. A random-effects model was used to determine the effect sizes, and heterogeneity between studies was examined using the Q statistic and I2. Results From the identified 2,815 studies, 27 studies were included in this study (two from reference lists). The sprint time of the sprint acceleration phase was moderately and negatively correlated with the standing long jump (r = - 0.45, z = 7.48, p < 0.001), single leg standing long jump (r = - 0.48, z = 3.49, p < 0.001) and horizontal drop jump distance (r = - 0.48, z = 3.49, p < 0.001), and was largely and negatively correlated with multiple jump distance (r = - 0.69, z = 6.02, p < 0.001). Out of five studies assessed the standing triple jump, three studies reported significant positive association with the sprint acceleration performance. The sprint time of maximal speed phase was very largely and negatively associated with standing long jump distance (r = - 0.73, z = 4.44, p < 0.001) and multiple jump distance (r = - 0.76, z = 6.86, p < 0.001). Conclusions This review indicates the moderate to very large associations between horizontal jump and sprint acceleration and maximal speed performance, and the highest magnitude of associations between them is found in the multiple jump. Moreover, compared to the sprint acceleration performance, there are greater associations between maximal speed performance and standing long jump and multiple jump distance.
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Affiliation(s)
- Junlei Lin
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Jie Shen
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Junjie Zhang
- Capital University of Physical Education and Sports, Beijing, China
| | - Aiguo Zhou
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Wenxia Guo
- Beijing University of Chemical Technology, Beijing, China
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Thomas E, Ficarra S, Scardina A, Bellafiore M, Palma A, Maksimovic N, Drid P, Bianco A. Positional transversal release is effective as stretching on range of movement, performance and balance: a cross-over study. BMC Sports Sci Med Rehabil 2022; 14:202. [PMID: 36451202 PMCID: PMC9714235 DOI: 10.1186/s13102-022-00599-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
Abstract
Background
The aim of this study was to compare the positional transversal release (PTR) technique to stretching and evaluate the acute effects on range of movement (ROM), performance and balance.
Methods
Thirty-two healthy individuals (25.3 ± 5.6 years; 68.8 ± 12.5 kg; 172.0 ± 8.8 cm) were tested on four occasions 1 week apart. ROM through a passive straight leg raise, jumping performance through a standing long jump (SLJ) and balance through the Y-balance test were measured. Each measure was assessed before (T0), immediately after (T1) and after 15 min (T2) of the provided intervention. On the first occasion, no intervention was administered (CG). The intervention order was randomized across participants and comprised static stretching (SS), proprioceptive neuromuscular facilitation (PNF) and the PTR technique. A repeated measure analysis of variance was used for comparisons.
Results
No differences across the T0 of the four testing sessions were observed. No differences between T0, T1 and T2 were present for the CG session. A significant time × group interaction for ROM in both legs from T0 to T1 (mean increase of 5.4° and 4.9° for right and left leg, respectively) was observed for SS, PNF and the PTR. No differences for all groups were present between T1 and T2. No differences in the SLJ and in measures of balance were observed across interventions.
Conclusions
The PTR is equally effective as SS and PNF in acutely increasing ROM of the lower limbs. However, the PTR results less time-consuming than SS and PNF. Performance and balance were unaffected by all the proposed interventions.
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Camuncoli F, Barni L, Nutarelli S, Rocchi JE, Barcillesi M, Di Dio I, Sambruni A, Galli M. Validity of the Baiobit Inertial Measurements Unit for the Assessment of Vertical Double- and Single-Leg Countermovement Jumps in Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14720. [PMID: 36429447 PMCID: PMC9690780 DOI: 10.3390/ijerph192214720] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
Jump tests are simple, quick to execute, and considered the most reliable tool to measure lower extremities power and explosiveness in athletes. Wearable inertial sensors allow the assessment of jumping performance on any surface. The validity of inertial sensors measurements is a pivotal prerequisite to reliably implement their utilization in the clinical practice. Twenty-seven athletes (20 M/7 F, age: 27 ± 7 years old) performed five double-leg countermovement jumps (CMJs) and three single-leg CMJs per side with their hands on their hips. Jump height was measured/computed simultaneously with the optoelectronic system, force platforms, and the Baiobit inertial sensor system. The athletes completed the international physical activity questionnaire (IPAQ). When comparing the methods (Baiobit vs. force platforms), a non-statistically significant bias of 1.8 cm was found for two-leg CMJs and -0.6 cm for single-leg CMJs. The intraclass correlation coefficients (ICCs) was "excellent" for double-leg CMJs (ICC = 0.92, 95% CI = 0.89-0.94) and "good" for single-leg CMJs (ICC = 0.89, 95% CI = 0.85-0.91). When comparing the methods (Baiobit vs. force platforms + optoelectronic system), a non-statistically significant bias of -0.9 cm was found for two-leg CMJs and -1.2 cm for single-leg CMJs. The intraclass correlation coefficient (ICC) was "good" for both double-leg CMJs (ICC = 0.80, 95% CI = 0.73-0.85) and for single-leg CMJs (ICC = 0.86, 95% CI = 0.80-0.89). Baiobit tends to overestimate double- and single-leg CMJ height measurements; however, it can be recommended in the world of rehabilitation and sport analysis.
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Affiliation(s)
- Federica Camuncoli
- Department of Electronics Information Technology and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
- E4Sport Lab, Politecnico di Milano, 23900 Lecco, Italy
| | - Luca Barni
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
| | - Sebastiano Nutarelli
- Service of Orthopaedics and Traumatology, Department of Surgery, (Ente Ospedaliero Cantonale) EOC, 6900 Lugano, Switzerland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Jacopo Emanuele Rocchi
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
- Villa Stuart Sport Clinic—FIFA Medical Centre of Excellence, 00136 Rome, Italy
| | - Matteo Barcillesi
- Department of Electronics Information Technology and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Irene Di Dio
- Department of Electronics Information Technology and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Andrea Sambruni
- Department of Medicine, Surgery and Neuroscience, Università degli Studi di Siena, 53100 Siena, Italy
| | - Manuela Galli
- Department of Electronics Information Technology and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
- E4Sport Lab, Politecnico di Milano, 23900 Lecco, Italy
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Efficacy of Patellar Taping and Electromyographic Biofeedback Training at Various Knee Angles on Quadriceps Strength and Functional Performance in Young Adult Male Athletes with Patellofemoral Pain Syndrome: A Randomized Controlled Trial. Pain Res Manag 2022; 2022:8717932. [PMID: 35958675 PMCID: PMC9359859 DOI: 10.1155/2022/8717932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/19/2022] [Indexed: 11/17/2022]
Abstract
Background The severity of the articular lesion is the single most essential element in investigating the extent of flexion that is required for activities. However, a prior study found no differences in muscle strength gains of quadriceps muscles at different knee angles in people with patellofemoral pain syndrome (PFPS). Objective The effects of patellar taping and electromyographic biofeedback (EMG-BF)-guided isometric quadriceps strengthening at different knee angles (e.g., 30°, 60°, and 90° of knee flexion) on quadriceps strength and functional performance in people with PFPS were compared in this single-blind randomized controlled parallel trial. Methods Sixty adult male athletes with PFPS (age: 26.9 ± 1.4 years) were randomly divided into two groups. The experimental group (n = 30) received patellar taping and EMG-BF-guided isometric contraction exercise at 30°, 60°, and 90° angles, and the control group (n = 30) received sham patellar taping without EMG-BF-guided exercises for six weeks. Pain intensity, knee function, muscle strength, and the single-leg triple hop (SLTH) test were assessed. Results The pain intensity and SLTH scores between the groups were significantly different at the end of the trial (p ≤ 0.001). The EMG-BF and control groups had mean pain scores of 1.3 (0.8) and 4.5 (0.8), respectively. The EMG-BF and control groups had mean functional scores of 80.4 (5.1) and 69.1 (6.1), respectively. The mean SLTH score for the EMG-BF group was 540.7 (51.2) and for the control group it was 509.4 (49.8) after the trial. Quadriceps muscle strength was significantly higher in those who performed quadriceps strength training at 60° of knee flexion after six weeks than in those who performed strength training at 30° or 90° of knee flexion. Conclusion The findings indicated that individuals who trained their quadriceps at a 60° knee angle had significantly stronger quadriceps muscles than individuals who trained at 30° or 90° of knee flexion. Trial Registration. This trial is registered at Clinical Trials.gov under the identifier NCT05055284.
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Berg B, Urhausen AP, Øiestad BE, Whittaker JL, Culvenor AG, Roos EM, Crossley KM, Juhl CB, Risberg MA. What tests should be used to assess functional performance in youth and young adults following anterior cruciate ligament or meniscal injury? A systematic review of measurement properties for the OPTIKNEE consensus. Br J Sports Med 2022; 56:1454-1464. [PMID: 35697502 DOI: 10.1136/bjsports-2022-105510] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To critically appraise and summarise measurement properties of functional performance tests in individuals following anterior cruciate ligament (ACL) or meniscal injury. DESIGN Systematic review. DATA SOURCES Systematic searches were performed in Medline (Ovid), Embase (Ovid), CINAHL (EBSCO) and SPORTSDiscus (EBSCO) on 7 July 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies evaluating at least one measurement property of a functional performance test including individuals following an ACL tear or meniscal injury with a mean injury age of ≤30 years. The COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias checklist was used to assess methodological quality. A modified Grading of Recommendations Assessment, Development and Evaluation assessed evidence quality. RESULTS Thirty studies evaluating 26 functional performance tests following ACL injury were included. No studies were found in individuals with an isolated meniscal injury. Included studies evaluated reliability (n=5), measurement error (n=3), construct validity (n=26), structural validity (n=1) and responsiveness (n=1). The Single Leg Hop and Crossover Hop tests showed sufficient intrarater reliability (high and moderate quality evidence, respectively), construct validity (low-quality and moderate-quality evidence, respectively) and responsiveness (low-quality evidence). CONCLUSION Frequently used functional performance tests for individuals with ACL or meniscal injury lack evidence supporting their measurement properties. The Single Leg Hop and Crossover Hop are currently the most promising tests following ACL injury. High-quality studies are required to facilitate stronger recommendations of performance-based outcomes following ACL or meniscal injury.
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Affiliation(s)
- Bjørnar Berg
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Centre for Intelligent Musculoskeletal Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anouk P Urhausen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Centre, Vancouver, Vancouver, Canada
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Bundoora, Victoria, Australia
| | - Ewa M Roos
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Bundoora, Victoria, Australia
| | - Carsten B Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Kobenhavn, Denmark
| | - May Arna Risberg
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Read PJ, Pedley JS, Eirug I, Sideris V, Oliver JL. Impaired Stretch-Shortening Cycle Function Persists Despite Improvements in Reactive Strength After Anterior Cruciate Ligament Reconstruction. J Strength Cond Res 2022; 36:1238-1244. [PMID: 35482544 DOI: 10.1519/jsc.0000000000004208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Read, PJ, Pedley, JS, Eirug, I, Sideris, V, and Oliver, JL. Impaired stretch-shortening cycle function persists despite improvements in reactive strength followingafter anterior cruciate ligament reconstruction. J Strength Cond Res 36(5): 1238-1244, 2022-Reactive strength index (RSI) during a single-leg drop jump (SLDJ) has been indicated to determine return-to-sport readiness after anterior cruciate ligament (ACL) reconstruction, but only cross-sectional studies are available. Ground reaction force data and characterization of stretch-shortening cycle (SSC) function also remain sparse. Single-leg drop jump performance, ground reaction force, and SSC function were examined in soccer players with ACL reconstruction (n = 26) and matched controls (n = 25). Injured players were tested at 2 time points (32 and 42 weeks postsurgery). Stretch-shortening cycle function was classified as good (no impact peak and spring like), moderate (impact peak but still spring like or no impact peak and not spring like), or poor (impact peak and not spring like). The involved limb displayed lower-jump height, poorer RSI, less spring-like behavior, earlier peak landing force, and a greater ratio of landing peak to take-off peak force compared with the uninvolved limb and controls at the initial assessment (p < 0.001). Proportionally, more involved limbs were categorized as poor or moderate at the initial assessment (69.2%) and follow-up (50%) in comparison with the control limbs (14%). The reactive strength index was the only variable to change significantly between the initial assessment and follow-up on the involved limb (p < 0.05). No changes in the proportion of ACL reconstructed individuals categorized as poor or moderate SSC function at the follow-up assessment were observed. Residual deficits are present in SLDJ performance, SSC function, and ground reaction force characteristics after ACL reconstruction. The reactive strength index should not be the sole metric, as observed increases did not correspond with changes in SSC function.
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Affiliation(s)
- Paul J Read
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Institute of Sport Exercise and Health, London, United Kingdom
- Division of Surgery & Interventional Science, University College London, London, United Kingdom
- School of Sport and Exercise, University of Gloucestershire, Gloucester, United Kingdom
| | - Jason S Pedley
- Youth Physical Development Center, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom ; and
| | - Ifan Eirug
- Youth Physical Development Center, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom ; and
| | | | - Jon L Oliver
- Youth Physical Development Center, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom ; and
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand
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Di Paolo SS, Nijmeijer E, Bragonzoni L, Dingshoff E, Gokeler A, Benjaminse A. Comparing lab and field agility kinematics in young talented female football players: implications for ACL injury prevention. Eur J Sport Sci 2022; 23:859-868. [PMID: 35400311 DOI: 10.1080/17461391.2022.2064771] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Modifiable (biomechanical and neuromuscular) anterior cruciate ligament (ACL) injury risk factors have been identified in laboratory settings. These risk factors were subsequently used in ACL injury prevention measures. Due to the lack of ecological validity, the use of on-field data in the ACL injury risk screening is increasingly advocated. Though, the kinematic differences between laboratory and on-field settings have never been investigated. The aim of the present study was to investigate the lower-limb kinematics of female footballers during agility movements performed both in laboratory and football field environments.Twenty-eight healthy young female talented football (soccer) players (14.9 ± 0.9 years) participated. Lower-limb joint kinematics was collected through wearable inertial sensors (Xsens Link) in three conditions: 1) laboratory setting during unanticipated sidestep cutting at 40-50°; on the football pitch 2) football-specific exercises (F-EX) and 3) football games (F-GAME). A hierarchical two-level random effect model in Statistical Parametric Mapping was used to compare joint kinematics among the conditions. Waveform consistency was investigated through Pearson's correlation coefficient and standardized z-score vector.In-lab kinematics differed from the on-field ones, while the latter were similar in overall shape and peaks. Lower sagittal plane range of motion, greater ankle eversion, and pelvic rotation were found for on-field kinematics (p<0.044). The largest differences were found during landing and weight acceptance.The biomechanical differences between lab and field settings suggest the application of context-related adaptations in female footballers and have implications in ACL injury prevention strategies.Highlights- Talented youth female football players showed kinematical differences between the lab condition and the on-field ones, thus adopting a context-related motor strategy.- Lower sagittal plane range of motion, greater ankle eversion, and pelvic rotation were found on the field. Such differences pertain to the ACL injury mechanism and prevention strategies.- Preventative training should support the adoption of non-linear motor learning to stimulate greater self-organization and adaptability- It is recommended to test football players in an ecological environment to improve subsequent primary ACL injury prevention programs.
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Affiliation(s)
- S Stefano Di Paolo
- Department for Life Quality Studies, University of Bologna, Via di Barbiano 1/10, Bologna, Italy
| | - Eline Nijmeijer
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Laura Bragonzoni
- Department for Life Quality Studies, University of Bologna, Via di Barbiano 1/10, Bologna, Italy
| | - Evelien Dingshoff
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Alli Gokeler
- Department Exercise & Health, Faculty of Science, Exercise and Neuroscience unit, Warburger Str 100, 33098 Paderborn, Germany.,Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam, Netherlands.,OCON Centre for Orthopaedic Surgery and Sports Medicine Clinic, Hengelo, Netherlands
| | - Anne Benjaminse
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.,School of Sport Studies, Hanze University Groningen, Groningen, The Netherlands
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Chaaban CR, Hearn D, Goerger B, Padua DA. Are Elite Collegiate Female Athletes PRIME for a Safe Return to Sport after ACLR? An Investigation of Physical Readiness and Integrated Movement Efficiency (PRIME). Int J Sports Phys Ther 2022; 17:445-455. [PMID: 35391856 PMCID: PMC8975580 DOI: 10.26603/001c.32529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
Background Elite female athletes who successfully return to sport after anterior cruciate ligament reconstruction (ACLR) represent a high-risk group for secondary injury. Little is known about how the functional profile of these athletes compares to their teammates who have not sustained ACL injuries. Purpose To compare elite collegiate female athletes who were able to successfully return to sport for at least one season following ACLR to their teammates with no history of ACLR with regard to self-reported knee function, kinetics, and kinematics during a double limb jump-landing task. Study Design Cross-Sectional Study. Level of Evidence Level 3. Methods Eighty-two female collegiate athletes (17 ACLR, 65 control) completed the knee-specific SANE (single assessment numeric evaluation) and three trials of a jump-landing task prior to their competitive season. vGRF data on each limb and the LESS (Landing Error Scoring System) score were collected from the jump-landing task. Knee-SANE, vGRF data, and LESS scores were compared between groups. All athletes were monitored for the duration of their competitive season for ACL injuries. Results Athletes after ACLR reported worse knee-specific function. Based on vGRF data, they unloaded their involved limb during the impact phase of the landing, and they were more asymmetrical between limbs during the propulsion phase as compared to the control group. The ACLR group, however, had lower LESS scores, indicative of better movement quality. No athletes in either group sustained ACL injuries during the following season. Conclusion Despite reporting worse knee function and demonstrating worse kinetics, the ACLR group demonstrated better movement quality relative to their uninjured teammates. This functional profile may correspond to short-term successful outcomes following ACLR, given that no athletes sustained ACL injuries in the competition season following assessment.
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Affiliation(s)
| | - Darren Hearn
- Human Performance and Sports Medicine, Fort Bragg
| | - Benjamin Goerger
- Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Darin A Padua
- Exercise and Sport Science, University of North Carolina at Chapel Hill
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35
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Measson MV, Ithurburn MP, Rambaud AJ. Intra-rater Reliability of a Qualitative Landing Scale for the Single-Hop Test: A Pilot Study. Int J Sports Phys Ther 2022; 17:493-500. [PMID: 35391866 PMCID: PMC8975581 DOI: 10.26603/001c.33066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 01/23/2022] [Indexed: 11/30/2022] Open
Abstract
Background The test battery classically used for return-to-sport (RTS) decision-making after anterior cruciate ligament (ACL) reconstruction (ACLR) may not be sufficient, as it does not include a qualitative analysis of movement. Therefore, the Landing Error Scoring System (LESS) scale was adapted to a primary functional test in the typical RTS test battery: the single leg hop for distance (SHD). Hypothesis/ Purpose The aim of this study was to determine the intra-rater reliability of the LESS scale adapted to the SHD (SHD-LESS scale) in healthy young athletes. Study Design Reliability analysis. Methods Nineteen healthy individuals (14 men, 5 women; mean age: 22.4 years) participated in the study. Participants performed the SHD tasks on both limbs (dominant and non-dominant) using a standardized protocol in two sessions that were one week apart (single reviewer; 2-dimensional video). Intra-class correlation coefficients (ICC2,1) were used to measure the reproducibility of the scale in the dominant (dom) and non-dominant (nondom) limbs. Additionally, limb data (dom and nondom) were pooled and evaluated collectively with intra-class correlation coefficients. The Kappa coefficient was used to assess the reproducibility of each individual item of SHD-LESS scale. Results The intra-rater reliability was good (ICCdom = 0.77; ICCnondom = 0.87; ICCpooled = 0.87) for the overall SHD-LESS scale scores. Agreement of SHD-LESS individual items ranged from 62% to 100%. Dorsiflexion at initial contact (97% agreement; kappa value=0.79) and knee valgus after landing (88% agreement; kappa value=0.65) had excellent agreement and kappa values. Conclusion The newly-adapted SHD-LESS scale showed good intra-rater reliability overall. Further studies should evaluate the impact of using the SHD-LESS scale within the RTS test battery on outcomes in patients after ACLR. Level of Evidence 3.
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Affiliation(s)
- Maxime V Measson
- Externat Saint Michel, Institut de Formation en Masso-Kinésithérapie de Saint Etienne, Saint Etienne, France
| | - Matthew P Ithurburn
- Department of Physical Therapy and Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alexandre Jm Rambaud
- Externat Saint Michel, Institut de Formation en Masso-Kinésithérapie de Saint Etienne; Department of Clinical and Exercise Physiology, Sports Medicine Unity, University Hospital of Saint Etienne, Faculty of Medicine; SFMKS Lab, Société Française des Masseurs-kinésithérapeutes du Sport
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36
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Giustino V, Messina G, Patti A, Padua E, Zangla D, Drid P, Battaglia G, Palma A, Bianco A. Effects of a Postural Exercise Program on Vertical Jump Height in Young Female Volleyball Players with Knee Valgus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073953. [PMID: 35409635 PMCID: PMC8997520 DOI: 10.3390/ijerph19073953] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023]
Abstract
Background: Although a knee valgus position is related to the increase in injury risk in volleyball players, there is a lack of studies on the relationship between knee valgus and vertical jump (VJ) performance. Hence, the aim of this study was to investigate the effects of a postural exercise program on VJ height in young female volleyball players with knee valgus. Methods: This pilot study included 19 young female volleyball players divided into the following groups: the Valgus Experimental Group (VEG); the Valgus Control Group (VCG); and the Neutral Control Group (NCG). All three groups carried out the same volleyball training program. In addition, only the VEG underwent a 3-month postural exercise program of 30–45 min/session, twice/week. VJ performance was measured through the Sargent test before (T0), at 6 weeks (T1), and at 12 weeks (T2). Results: A significant effect from T0 to T1 (p = 0.0017) and from T0 to T2 (p = 0.0001) was found in the VEG. No significant differences were found over time in the VCG and in the NCG. Conclusion: An integrated postural exercise program might lead to a more balanced muscle efficiency inducing athletes to obtain a higher VJ performance.
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Affiliation(s)
- Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Giuseppe Messina
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
- Correspondence:
| | - Elvira Padua
- Department of Human Sciences and Promotion of Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Daniele Zangla
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Giuseppe Battaglia
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy; (V.G.); (G.M.); (D.Z.); (G.B.); (A.P.); (A.B.)
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Kotsifaki A, Van Rossom S, Whiteley R, Korakakis V, Bahr R, Sideris V, Jonkers I. Single leg vertical jump performance identifies knee function deficits at return to sport after ACL reconstruction in male athletes. Br J Sports Med 2022; 56:490-498. [PMID: 35135826 PMCID: PMC9016240 DOI: 10.1136/bjsports-2021-104692] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 01/14/2023]
Abstract
Objectives Vertical jump performance (height) is a more representative metric for knee function than horizontal hop performance (distance) in healthy individuals. It is not known what the biomechanical status of athletes after anterior cruciate ligament (ACL) reconstruction (ACLR) is at the time they are cleared to return to sport (RTS) or whether vertical performance metrics better evaluate knee function. Methods Standard marker-based motion capture and electromyography (EMG) were collected from 26 male athletes cleared to RTS after ACLR and 22 control healthy subjects during single leg vertical jumps (SLJ) and single leg drop jumps (SLDJ). Performance outcomes, jump height and the Reactive Strength Index, were calculated. Sagittal plane kinematics, joint moments and joint work were obtained using inverse dynamics and lower limb muscle forces were computed using an EMG-constrained musculoskeletal model. Muscle contribution was calculated as a percentage of the impulse of all muscle forces in the model. Between-limb and between-group differences were explored using mixed models analyses. Results Jump performance, assessed by jump height and Reactive Strength Index, was significantly lower in the involved than the uninvolved limb and controls, with large effect sizes. For the ACLR group, jump height limb symmetry index was 83% and 77% during the SLJ and SLDJ, respectively. Work generation was significantly less in the involved knee compared to uninvolved limb and controls during the SLJ (p<0.001; d=1.19; p=0.003, d=0.91, respectively) and during the SLDJ (p<0.001; d=1.54; p=0.002, d=1.05, respectively). Hamstrings muscle contribution was greater in the involved compared to the uninvolved limb and controls, whereas soleus contribution was lower in the involved limb compared to controls. Conclusions During vertical jumps, male athletes after ACLR at RTS still exhibit knee biomechanical deficits, despite symmetry in horizontal functional performance and strength tests. Vertical performance metrics like jump height and RSI can better identify interlimb asymmetries than the more commonly used hop distance and should be included in the testing battery for the RTS.
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Affiliation(s)
- Argyro Kotsifaki
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar .,Department of Movement Sciences, KU Leuven Biomedical Sciences Group, Leuven, Belgium
| | - Sam Van Rossom
- Department of Movement Sciences, KU Leuven Biomedical Sciences Group, Leuven, Belgium
| | - Rod Whiteley
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,School of Human Movement & Nutrition Science, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Vasileios Korakakis
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Roald Bahr
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Vasileios Sideris
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Ilse Jonkers
- Department of Movement Sciences, KU Leuven Biomedical Sciences Group, Leuven, Belgium
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Kotsifaki A, Van Rossom S, Whiteley R, Korakakis V, Bahr R, Sideris V, Smith PG, Jonkers I. Symmetry in Triple Hop Distance Hides Asymmetries in Knee Function After ACL Reconstruction in Athletes at Return to Sports. Am J Sports Med 2022; 50:441-450. [PMID: 34889652 DOI: 10.1177/03635465211063192] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND After anterior cruciate ligament reconstruction (ACLR), a battery of strength and hop tests is frequently used to determine the readiness of an athlete to successfully return to sports. However, the anterior cruciate ligament reinjury rate remains alarmingly high. PURPOSE To evaluate the lower limb function of athletes after ACLR at the time when they had been cleared to return to sports (RTS). We aimed to evaluate if passing discharge criteria ensures restoration of normal lower limb biomechanics in terms of kinematics, kinetics, work, and percentage work contribution during a triple hop for distance. STUDY DESIGN Controlled laboratory study. METHODS Integrated 3-dimensional motion analysis was performed in 24 male athletes after ACLR when cleared to RTS and 23 healthy male controls during the triple-hop test. The criteria for RTS were (1) clearance by the surgeon and the physical therapist, (2) completion of a sports-specific on-field rehabilitation program, and (3) limb symmetry index >90% after quadriceps strength and hop battery tests. Lower limb and trunk kinematics, as well as knee joint moments and work, were calculated. Between-limb differences (within athletes after ACLR) and between-group differences (between ACLR and control groups) were evaluated using mixed linear models. RESULTS Although achieving 97% limb symmetry in distance hopped and displaying almost 80% symmetry for knee work absorption in the second rebound and third landing, the ACLR cohorts demonstrated only 51% and 66% limb symmetry for knee work generation in the first and second rebound phases, respectively. During both work generation phases of the triple hop, the relative contribution of the involved knee was significantly smaller, with a prominent compensation from the hip joint (P < .001, for all phases) as compared with the uninvolved limb and the controls. In addition, patients deployed a whole body compensatory strategy to account for the between-limb differences in knee function, mainly at the hip, pelvis, and trunk. CONCLUSION Symmetry in the triple hop for distance masked important deficits in the knee joint work. These differences were more prominent during work generation (concentric-propulsive) than work absorption (eccentric-landing). CLINICAL RELEVANCE Symmetry in hop distance during the triple hop test masked significant asymmetries in knee function after ACLR and might not be the appropriate outcome to use as a discharge criterion. Differences between limbs in athletes after ACLR were more prominent during the power generation than the absorption phase.
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Affiliation(s)
- Argyro Kotsifaki
- Rehabilitation Department, Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Department of Movement Sciences, Human Movement Biomechanics Research Group, KU Leuven, Leuven, Belgium
| | - Sam Van Rossom
- Department of Movement Sciences, Human Movement Biomechanics Research Group, KU Leuven, Leuven, Belgium
| | - Rodney Whiteley
- Rehabilitation Department, Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Australia
| | - Vasileios Korakakis
- Rehabilitation Department, Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Roald Bahr
- Aspetar Sports Injury and Illness Prevention Program, Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Vasileios Sideris
- Rehabilitation Department, Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | | | - Ilse Jonkers
- Department of Movement Sciences, Human Movement Biomechanics Research Group, KU Leuven, Leuven, Belgium
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Chaaban CR, Turner JA, Padua DA. Think outside the box: Incorporating secondary cognitive tasks into return to sport testing after ACL reconstruction. Front Sports Act Living 2022; 4:1089882. [PMID: 36873910 PMCID: PMC9975395 DOI: 10.3389/fspor.2022.1089882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/30/2022] [Indexed: 02/17/2023] Open
Abstract
The optimal set of return to sport (RTS) tests after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) remains elusive. Many athletes fail to pass current RTS test batteries, fail to RTS, or sustain secondary ACL injuries if they do RTS. The purpose of this review is to summarize current literature regarding functional RTS testing after ACLR and to encourage clinicians to have patients "think" (add a secondary cognitive task) outside the "box" (in reference to the box used during the drop vertical jump task) when performing functional RTS tests. We review important criteria for functional tests in RTS testing, including task-specificity and measurability. Firstly, tests should replicate the sport-specific demands the athlete will encounter when they RTS. Many ACL injuries occur when the athlete is performing a dual cognitive-motor task (e.g., attending to an opponent while performing a cutting maneuver). However, most functional RTS tests do not incorporate a secondary cognitive load. Secondly, tests should be measurable, both through the athlete's ability to complete the task safely (through biomechanical analyses) and efficiently (through measures of performance). We highlight and critically examine three examples of functional tests that are commonly used for RTS testing: the drop vertical jump, single-leg hop tests, and cutting tasks. We discuss how biomechanics and performance can be measured during these tasks, including the relationship these variables may have with injury. We then discuss how cognitive demands can be added to these tasks, and how these demands influence both biomechanics and performance. Lastly, we provide clinicians with practical recommendations on how to implement secondary cognitive tasks into functional testing and how to assess athletes' biomechanics and performance.
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Affiliation(s)
- Courtney R Chaaban
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jeffrey A Turner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Darin A Padua
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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The Return-to-Sport Clearance Continuum Is a Novel Approach Toward Return to Sport and Performance for the Professional Athlete. Arthrosc Sports Med Rehabil 2022; 4:e93-e101. [PMID: 35141541 PMCID: PMC8811516 DOI: 10.1016/j.asmr.2021.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/29/2021] [Indexed: 11/22/2022] Open
Abstract
The concept of returning to sport for a professional athlete is still under debate for the professional athlete in today’s sports environment. It is critical for the professional athlete to be able to return to sport at a highly competitive level but also to return in a safe and timely measure. With no “gold standard” of sport testing, it is difficult to determine what the right progression or testing regimen should be. The Return to Sport Clearance Continuum does not look at one moment in time, but looks throughout the continuum of healing to determine readiness for sport. The purpose of this article is to explore the concept of RTS being part of an evolving continuum rather than the traditional notion that RTS is a single decision made at a discrete point in time. The principles of progressive but regular testing procedures including qualitative and quantitative movement are presented to help the professional athlete return to sport at their maximal performance level. Level of Evidence V, expert opinion.
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Zarro MJ, Stitzlein MG, Lee JS, Rowland RW, Gray VL, Taylor JB, Meredith SJ, Packer JD, Nelson CM. Single-Leg Vertical Hop Test Detects Greater Limb Asymmetries Than Horizontal Hop Tests After Anterior Cruciate Ligament Reconstruction in NCAA Division 1 Collegiate Athletes. Int J Sports Phys Ther 2021; 16:1405-1414. [PMID: 34909247 PMCID: PMC8637251 DOI: 10.26603/001c.29595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Knee function deficits may persist after anterior cruciate ligament reconstruction (ACLR). Return to sport (RTS) testing batteries assess recovery after ACLR and can guide RTS progression, but the ideal test components are debatable. The single leg vertical hop for height (SLVH) test using a commercially available jump mat may provide a valuable assessment of knee function. HYPOTHESIS/PURPOSE The purpose of this study was to compare the limb symmetry index (LSI) of SLVH to horizontal hop testing in a cohort of National Collegiate Athletic Association (NCAA) Division 1 collegiate athletes after ACLR. The hypothesis was the SLVH would elicit significantly lower LSI than horizontal hop tests. STUDY DESIGN Cross-Sectional Study. METHODS Eighteen National Collegiate Athletic Association (NCAA) Division 1 collegiate athletes (7 males, 11 females) at 7.33 ± 2.05 months after ACLR were included in this retrospective study. LSI was calculated for single hop for distance (SHD), triple hop for distance (THD), cross-over hop for distance (CHD), timed 6-meter hop (T6H), and SLVH. A repeated measures ANOVA was performed to identify differences in LSI for each test. Spearman's Rho correlation coefficient was calculated to examine the relationship between LSIs for each test. RESULTS The LSI for SLVH (84.48% ± 11.41%) was significantly lower than LSI for SHD (95.48 ± 8.02%, p = 0.003), THD (94.40 ± 3.70%, p = 0.002), CHD (95.85 ± 7.00, p = 0.007), and T6H (97.69 ± 6.60%, p = 0.001). The correlation of LSI between SLVH and the horizontal hop tests was weak and non-significant for SHD (rs = 0.166, p = 0.509), CHD (rs = 0.199, p = 0.428), and T6H (rs = 0.211, p = 0.401) and moderate and non-significant for THD (rs = 0.405, p = 0.096). CONCLUSIONS Individuals after ACLR had lower LSI on the SLVH than on horizontal hop tests and weak to moderate correlations between the tests suggest SLVH detects performance deficits not identified by the horizontal hop tests. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Michael J Zarro
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine; Department of Orthopaedics, University of Maryland School of Medicine
| | - Matthew G Stitzlein
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine
| | - Jason S Lee
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine
| | - Robert W Rowland
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine; Department of Orthopaedics, University of Maryland School of Medicine
| | - Vicki L Gray
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine
| | | | - Sean J Meredith
- Department of Orthopaedics, University of Maryland School of Medicine
| | - Jonathan D Packer
- Department of Orthopaedics, University of Maryland School of Medicine
| | - Christa M Nelson
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine
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Knee proprioceptive function and physical performance of patients with patellofemoral pain: A matched case-control study. Knee 2021; 33:49-57. [PMID: 34543992 DOI: 10.1016/j.knee.2021.08.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/07/2021] [Accepted: 08/31/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Patients with patellofemoral pain (PFP) present pain, functional limitation, and alteration in knee proprioception. PURPOSE To compare the knee joint position sense and lower extremity functionality between patients with PFP and controls. Secondarily, investigate the relationship between proprioceptive acuity and physical performance. METHODS This is a matched case-control study including 48 patients with PFP and 48 healthy individuals matched by age, sex, weight, height, and limb dominance. The proprioceptive evaluation was performed using the joint position sense test (absolute error and relative error) and functionality was assessed using the Single-Leg Triple-Hop test and the Y-Balance Test. The groups were compared using the independent student's T-test. Proprioceptive acuity and physical performance correlations were determined by Pearson correlation coefficient. RESULTS Participants were on average 31 years old and 62.5% were men. There was no statistically difference for absolute and relative angular error between groups. Patients presented lower relative reached distance on the anterior direction of the Y-Balance Test than controls [patients=58.6 (6.6) % versus controls=61.7 (5.9) %, p=.020]. No differences between groups were found for other functional measures. Significant correlation was found between absolute angular error and anterior component at 60° (r=0.225, p=.028) and relative angular error at 60° with the posterolateral component of the Y- Balance Test (r=0.231, p=.024). CONCLUSION Proprioceptive acuity of patients with PFP was not reduced. The anterior direction of the Y-Balance Test was impaired compared to matched controls. Proprioceptive sense is related to dynamic balance but not to jump ability.
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Jones HSR, Moore IS, King E, Stiles VH, Laudani L, McCarthy-Ryan M, McFadden C, Daniels KAJ. Movement strategy correspondence across jumping and cutting tasks after anterior cruciate ligament reconstruction. Scand J Med Sci Sports 2021; 32:612-621. [PMID: 34797936 DOI: 10.1111/sms.14104] [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] [Received: 09/15/2021] [Revised: 11/12/2021] [Accepted: 11/17/2021] [Indexed: 01/18/2023]
Abstract
There are currently a multitude of tests used to assess readiness to return to sport (RTS) following anterior cruciate ligament reconstruction (ACLR). The aim of this study was to establish the extent to which movement strategies transfer between three common assessment tasks to help improve design of athlete testing batteries following ACLR. A cohort of 127 male patients 8-10 months post-ACLR and 45 non-injured controls took part in the study. Three movement tasks were completed (unilateral and bilateral drop jump, and 90° pre-planned cut), while ground reaction forces and three-dimensional kinematics (250 Hz) were recorded. Compared to the bilateral drop jump and cut, the unilateral drop jump had a higher proportion of work done at the ankle (d = 0.29, p < 0.001 and d = -1.87, p < 0.001, respectively), and a lower proportion of work done at the knee during the braking phase of the task (d = 0.447, p < 0.001 and d = 1.56, p < 0.001, respectively). The ACLR group had higher peak hip moments than the non-injured controls, although the proportion of work done at the ankle, knee and hip joints were similar. Movement strategies were moderately and positively related at the ankle (rs = 0.728, p < 0.001), knee (rs = 0.638, p < 0.001) and hip (rs = 0.593, p < 0.001) between the unilateral and bilateral drop jump, but there was no relationship at the ankle (rs = 0.10, p = 0.104), knee (rs = 0.106, p = 0.166) and hip (rs = -0.019, p = 0.808) between the unilateral drop jump and the cut. Clinicians could therefore consider omitting one of the drop jumps from assessment batteries but should include both jumping and cutting tasks.
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Affiliation(s)
- Holly S R Jones
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Enda King
- Sports Surgery Clinic, Dublin, Ireland
| | | | - Luca Laudani
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Molly McCarthy-Ryan
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Ciarán McFadden
- Sports Surgery Clinic, Dublin, Ireland.,Sport and Exercise Science Research Centre, University of Roehampton, London, UK
| | - Katherine A J Daniels
- Sports Surgery Clinic, Dublin, Ireland.,Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
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Reliability of Isokinetic Hip Flexor and Extensor Strength Measurements in Healthy Subjects and Athletes: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111326. [PMID: 34769842 PMCID: PMC8583605 DOI: 10.3390/ijerph182111326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The objective of this systematic review and meta-analysis was to examine the reliability of isokinetic measurements of hip strength in flexion and extension in healthy subjects and athletes. METHODS The databases used were Web of Science, SCOPUS, Medline and PubMed. R was used for all statistical analyses. RESULTS Hip flexion shows moderate reliability in the supine position (ICC = 0.72; 95% CI: 0.46-0.99) and good reliability in the standing position (ICC = 0.79; 95% CI: 0.54-1.04). Hip extension shows excellent reliability in the supine position (ICC = 0.90; 95% CI: 0.85-0.96) and moderate reliability in the standing position (ICC = 0.72; 95% CI: 0.48-0.96). Flexion of 120°/s and 180°/s showed excellent reliability (ICC = 0.93; 95% CI: 0.85-1.00), (ICC = 0.96; 95% CI: 0.92-1.01). The 60°/s and 120°/s extension showed good reliability (ICC = 0.90; 95% CI: 0.82-0.98), (ICC = 0.87; 95% CI: 0.75-0.99). The 180°/s extension presented excellent reliability (ICC = 0.93; 95% CI: 0.82-1.03). CONCLUSIONS The standing position shows good reliability for hip flexion and the supine position shows excellent reliability for hip extension, both movements have excellent reliability at velocities between 120°/s to 180°/s.
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Current perspectives and clinical practice of physiotherapists on assessment, rehabilitation, and return to sport criteria after anterior cruciate ligament injury and reconstruction. An online survey of 538 physiotherapists. Phys Ther Sport 2021; 52:103-114. [PMID: 34479178 DOI: 10.1016/j.ptsp.2021.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To evaluate the perspectives and clinical practice of physiotherapists regarding rehabilitation after anterior cruciate ligament reconstruction (ACLR). DESIGN Online survey. SETTING Survey platform. PARTICIPANTS Greek physiotherapists. OUTCOME MEASURES The survey consisted of 7 sections: participant demographics, importance of ACLR rehabilitation, clinical measurements, practice, criteria to progress rehabilitation, return to running and return to sport. RESULTS Significant variability in measures and criteria used for clinical decision-making were found including: limb symmetry in strength and function, knee range of motion and effusion, progression, and return to sport criteria. The majority of the practitioners (28.3%) extrapolate knee strength from hop capacity. Return to running ranged from 3 to 5 months post-operatively reflecting that this was tied to physical capacities, not time from surgery. 70.0% of the Greek physiotherapists would allow return to sport ≤9 months after ACLR. Agreement was found in using: physical measures, function, and dynamic stability in ACLR rehabilitation, but the mode and interpretation varied substantially. Less than 29.0% of the physiotherapists reported using patient-reported outcome measures in their decision-making. CONCLUSION Current ACLR rehabilitation practices in Greece are largely not aligned with the contemporary scientific evidence and guidelines.
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Schelin L, Pini A, Markström JL, Häger CK. Test-retest reliability of entire time-series data from hip, knee and ankle kinematics and kinetics during one-leg hops for distance: Analyses using integrated pointwise indices. J Biomech 2021; 124:110546. [PMID: 34171677 DOI: 10.1016/j.jbiomech.2021.110546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 05/20/2021] [Accepted: 05/31/2021] [Indexed: 11/26/2022]
Abstract
Motion capture systems enable in-depth interpretations of human movements based on data from three-dimensional joint angles and moments. Such analyses carry important bearings for evaluation of movement control during for instance hop landings among sports-active individuals from a performance perspective but also in rehabilitation. Recent statistical development allows analysis of entire time-series of angle and moment during hops using functional data analysis, but the reliability of such multifaceted data is not established. We used integrated pointwise indices (intra-class correlation, ICC; standard error of measurement, SEM) to establish the test-retest reliability of three-dimensional hip, knee and ankle angle and moment curves during landings of one-leg hop for distance (OLHD) in 23 asymptomatic individuals aged 18-28. We contrasted these findings to reliability of discrete variables extracted at specific events (initial contact, peak value). We extended the calculations of ICC and SEM to handle unbalanced situations (varying number of repetitions) to include all available data. Hip and knee angle curves proved reliable with stable ICC curves throughout the landing, with integrated ICCs ≥ 0.71 for all planes except for knee internal/external rotation (ICC = 0.57). Hip and knee moment curves and ankle angle and moments were less reliable and less stable, particularly in the first ~ 10-25% of the landing (integrated ICCs 0.44-0.57). Curve data were generally not in agreement with the results for discrete event data, thus advocating analysis of curve data which contains more information. To conclude, hip and knee angle curve data during OLHD landings can reliably be evaluated, while moment curves necessitate careful consideration.
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Affiliation(s)
- Lina Schelin
- Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Samhällsvetarhuset, 901 87 Umeå, Sweden.
| | - Alessia Pini
- Department of Statistical Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Jonas L Markström
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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Pérez-Castilla A, García-Ramos A, Janicijevic D, Miras-Moreno S, De la Cruz JC, Rojas FJ, Cepero M. Unilateral or Bilateral Standing Broad Jumps: Which Jump Type Provides Inter-Limb Asymmetries with a Higher Reliability? J Sports Sci Med 2021; 20:317-327. [PMID: 34211325 PMCID: PMC8219272 DOI: 10.52082/jssm.2021.317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/15/2021] [Indexed: 11/24/2022]
Abstract
This study aimed to compare the between-session reliability of performance and asymmetry variables between unilateral and bilateral standing broad jumps (SBJ). Twenty-four amateur basketball players (12 males and females) completed two identical sessions which consisted of four unilateral SBJs (two with each leg) and two bilateral SBJs. Mean and peak values of force, velocity and power, and impulse were obtained separately for each leg using a dual force platform. Inter-limb asymmetries were computed using the standard percentage difference for the unilateral SBJ, and the bilateral asymmetry index-1 for the bilateral SBJ. All performance variables generally presented an acceptable absolute reliability for both SBJs (CV range = 3.65-9.81%) with some exceptions for mean force, mean power, and peak power obtained with both legs (CV range = 10.00-15.46%). Three out of 14 variables were obtained with higher reliability during the unilateral SBJ (CVratio ≥ 1.18), and 5 out of 14 during the bilateral SBJ (CVratio ≥ 1.27). Asymmetry variables always showed unacceptable reliability (ICCrange = -0.40 to 0.58), and slight to fair levels of agreement in their direction (Kappa range = -0.12 to 0.40) except for unilateral SBJ peak velocity [Kappa = 0.52] and bilateral SBJ peak power [Kappa = 0.51]) that showed moderate agreement for both SBJs. These results highlight that single-leg performance variables can be generally obtained with acceptable reliability regardless of the SBJ variant, but the reliability of the inter-limb asymmetries in the conditions examined in the present study is unacceptable to track individual changes in performance.
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Affiliation(s)
- Alejandro Pérez-Castilla
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Amador García-Ramos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Danica Janicijevic
- University of Belgrade, Faculty of Sport and Physical Education, The Research Centre, Belgrade, Serbia
| | - Sergio Miras-Moreno
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Juan Carlos De la Cruz
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - F Javier Rojas
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Mar Cepero
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Educational Sciences, University of Granada, Granada, Spain
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Strandberg J, Pini A, Häger CK, Schelin L. Analysis Choices Impact Movement Evaluation: A Multi-Aspect Inferential Method Applied to Kinematic Curves of Vertical Hops in Knee-Injured and Asymptomatic Persons. Front Bioeng Biotechnol 2021; 9:645014. [PMID: 34055756 PMCID: PMC8160465 DOI: 10.3389/fbioe.2021.645014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/15/2021] [Indexed: 11/19/2022] Open
Abstract
Three-dimensional human motion analysis provides in-depth understanding in order to optimize sports performance or rehabilitation following disease or injury. Recent developments of statistical methods for functional data allow for novel ways to analyze often complex biomechanical data. Even so, for such methods as well as for traditional well-established statistical methods, the interpretations of the results may be influenced by analysis choices made prior to the analysis. We evaluated the consequences of three such choices when comparing one-leg vertical hop (OLVH) performance in individuals who had ruptured their anterior cruciate ligament (ACL), to that of asymptomatic controls, and also athletes. Kinematic data were analyzed using a statistical approach for functional data, targeting entire curve data. This was done not only for one joint at a time but also for multiple lower limb joints and movement planes simultaneously using a multi-aspect methodology, testing for group differences while also accounting for covariates. We present the results of when an individual representative curve out of three available was either: (1) a mean curve (Mean), (2) a curve from the highest hop (Max), or (3) a curve describing the variability (Var), as a representation of performance stability. We also evaluated choice of sample leg comparison; e.g., ACL-injured leg compared to either the dominant or non-dominant leg of asymptomatic groups. Finally, we explored potential outcome effects of different combinations of included joints. There were slightly more pronounced group differences when using Mean compared to Max, while the specifics of the observed differences depended on the outcome variable. For Var there were less significant group differences. Generally, there were more disparities throughout the hop movement when comparing the injured leg to the dominant leg of controls, resulting in e.g., group differences for trunk and ankle kinematics, for both Mean and Max. When the injured leg was instead compared to the non-dominant leg of controls, there were trunk, hip and knee joint differences. For a more stringent comparison, we suggest considering to compare the injured leg to the non-dominant leg. Finally, the multiple-joint analyses were coherent with the single-joint analyses. The direct effects of analysis choices can be explored interactively by the reader in the Supplementary Material. To summarize, the choices definitively have an impact on the interpretation of a hop test results commonly used in rehabilitation following knee injuries. We therefore strongly recommend well-documented methodological analysis choices with regards to comparisons and representative values of the measures of interests.
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Affiliation(s)
- Johan Strandberg
- Department of Mathematics and Mathematical Statistics, Umeå University, Umeå, Sweden
| | - Alessia Pini
- Department of Statistical Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Charlotte K Häger
- Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Lina Schelin
- Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
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