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Cady KP, De Ste Croix M, Deighan M. Effect of Sex and Lateral Ankle Sprain History on Dorsiflexion Range Of Motion Asymmetry During the Weight Bearing Lunge Test. Int J Sports Phys Ther 2024; 19:714-723. [PMID: 38835979 PMCID: PMC11144664 DOI: 10.26603/001c.117775] [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: 11/09/2023] [Accepted: 04/24/2024] [Indexed: 06/06/2024] Open
Abstract
Background Reduced dorsiflexion range of motion (DFROM) which is commonly seen following lateral ankle sprain (LAS) has the potential to influence lower extremity biomechanics which have been linked to increased injury risk in the female athlete. Current research on the effect of sex and LAS history on DFROM is limited. Hypothesis/Purpose This study had three aims 1) to determine the effect of sex, leg dominance and LAS history on DFROM, 2) to determine the effect of sex and LAS history on magnitude of DFROM symmetry and 3) to examine the association of sex on direction (whether dominant or non-dominant limb had the higher DFROM) of symmetry. Study Design Cross-Sectional Study. Methods DFROM was measured bilaterally in 105 recreational athletes all participating in multidirectional sports using the tape measurement method during the weight bearing lunge test (WBLT). A mean of three measurements was used for analysis. A 3-way mixed ANOVA was carried out to determine the interaction between sex, LAS history and leg dominance on DFROM and a 2-way ANOVA for the effect of sex and LAS history on asymmetry. A chi-square test was used to determine the association of sex and direction of asymmetry. Results The results indicate no significant effect of sex, LAS history, and leg dominance on DFROM (p=0.65). Main effects were significant for sex and LAS on DFROM. The mean asymmetry for all participants was reported as 12.25±14.76cm. No significant effect of sex and LAS history on magnitude of asymmetry was reported. There was a significant association of sex and direction of asymmetry (χ2(1) = 11.26, p = 0.00). Sixty-five-point two percent of males were shown to have higher DFROM of their non-dominant limb compared to 75% of females who were higher in their dominant limb. Conclusion Findings from this study suggest that DFROM is affected by sex and LAS history. While females have increased DFROM compared to males, those with LAS history are more likely to have a decreased DFROM on the involved side. The results also indicate that interlimb asymmetries in DFROM are present in athletes, therefore practitioners should exercise caution when using bilateral comparisons in injury and return to play assessments. Level of Evidence 2b.
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Affiliation(s)
- kathrine P Cady
- Sports TherapyUniversity of Hertfordshire
- Education and Applied ScienceUniversity of Gloucestershire
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Obërtinca R, Meha R, Hoxha I, Shabani B, Meyer T, Aus der Fünten K. Efficacy of a new injury prevention programme (FUNBALL) in young male football (soccer) players: a cluster-randomised controlled trial. Br J Sports Med 2024; 58:548-555. [PMID: 38499320 PMCID: PMC11103335 DOI: 10.1136/bjsports-2023-107388] [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: 03/11/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To evaluate the efficacy of a new multicomponent, exercise-based injury prevention programme in football players 13-19 years old. METHODS Two-arm cluster-randomised controlled trial with clubs as the unit of randomisation. 55 football teams from Kosovo of the under 15, under 17 and under 19 age groups were randomly assigned to the intervention (INT; 28 teams) or the control group (CON; 27 teams) and were followed for one football season (August 2021-May 2022). The INT group performed the 'FUNBALL' programme after their usual warm-up at least twice per week, while the CON group followed their usual training routine. The primary outcome measure was the overall number of football-related injuries. Secondary outcomes were region-specific injuries of the lower limbs (hip/groin, thigh, knee, lower leg, ankle and foot) and injury severity. RESULTS 319 injuries occurred, 132 in the INT and 187 in the CON group. The INT group used the 'FUNBALL' programme in 72.2% of all training sessions, on average 2.2 times per week. There was a significantly lower incidence in the INT group regarding the overall number of injuries (incidence rate ratio (IRR) 0.69, 95% CI 0.55 to 0.87), the number of thigh injuries (IRR 0.62, 95% CI 0.39 to 0.98), of moderate (time loss between 7 and 28 days) (IRR 0.65, 95% CI 0.44 to 0.97) and of severe injuries (time loss >28 days) (IRR 0.51, 95% CI 0.28 to 0.91). CONCLUSION The 'FUNBALL' programme reduced the incidence of football-related injuries among male adolescent football players, and its regular use for injury prevention in this population is recommended. TRIAL REGISTRATION NUMBER NCT05137015.
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Affiliation(s)
- Rilind Obërtinca
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
- Department of Physiotherapy, University 'Fehmi Agani' in Gjakova, Gjakova, Kosovo
| | - Rina Meha
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
| | - Ilir Hoxha
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Evidence Synthesis Group, Prishtina, Kosovo
| | - Bujar Shabani
- Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
- Université Claude Bernard, Lyon, France
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
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Korontzi M, Kafetzakis I, Mandalidis D. Effects of Artificially Induced Leg Length Discrepancy on Treadmill-Based Walking and Running Symmetry in Healthy College Students: A Lab-Based Experimental Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:9695. [PMID: 38139541 PMCID: PMC10748201 DOI: 10.3390/s23249695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023]
Abstract
Leg length discrepancy (LLD) is a common postural deviation of musculoskeletal origin, which causes compensatory reactions and often leads to injury. The aim of the study was to investigate the effect of artificially induced LLD on gait symmetry by means of the spatiotemporal gait parameters and ground reaction forces (GRFs) using a treadmill equipped with capacitive sensors (instrumented) as well as the EMG activity of trunk and hip muscles during walking and running. Twenty-six healthy male and female college students were required to perform two sets of four 2.5-min walking and running trials on an instrumented treadmill at 5.6 and 8.1 km·h-1, respectively, without (0) and with 1, 2, and 3 cm LLD implemented by wearing a special rubber shoe. Statistical analysis was performed using one-way repeated measures or a mixed-design ANOVA. Most spatiotemporal gait parameters and GRFs demonstrated an increase or decrease as LLD increased either on the short-limb or the long-limb side, with changes becoming more apparent at ≥1 cm LLD during walking and ≥2 cm LLD during running. The EMG activity of trunk and hip muscles was not affected by LLD. Our findings showed that gait symmetry in terms of treadmill-based spatiotemporal parameters of gait and GRFs is affected by LLD, the magnitude of which depends on the speed of locomotion.
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Affiliation(s)
| | | | - Dimitris Mandalidis
- Sports Physical Therapy Laboratory, Department of Physical Education and Sports Science, School of Physical Education and Sports Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (M.K.); (I.K.)
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Shankar DS, Milton HA, Mojica ES, Buzin S, Strauss EJ, Campbell KA, Alaia MJ, Gonzalez-Lomas G, Jazrawi LM. Force plate jump testing metrics are predictive of performance on a multimodal return to sport testing protocol among anterior cruciate ligament reconstruction patients at minimum six-month follow-up. J Sports Med Phys Fitness 2023; 63:1208-1217. [PMID: 37526491 DOI: 10.23736/s0022-4707.23.14850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
BACKGROUND Force plate-based jump testing may serve as a potential alternative to traditional return to sport (RTS) testing batteries. The purpose of our study was to identify force plate jump metrics that were predictive of RTS test findings in patients who were at least six months postoperative following anterior cruciate ligament reconstruction (ACLR). METHODS We conducted a cross-sectional study of patients who underwent ACLR at our center and were at least six months postoperative. Subjects completed a multimodal Institutional RTS (IRTS) testing battery which included range of motion (ROM) testing and isokinetic quadriceps strength testing. Subjects also completed a countermovement jump testing protocol on a commercially-available force plate. Jump metrics predictive of IRTS test findings were identified using multivariable linear and logistic regression with stepwise selection. Model significance was assessed at α=0.002. RESULTS Sixteen patients (7M, 9F) were enrolled in our study with median age of 29 years (range 20-47). Relative concentric impulse was positively predictive of knee flexion active ROM (β=7.07, P=0.01) and passive ROM (β=9.79, P=0.003). Maximum power was positively predictive of quadriceps strength at 60 deg/s (β=3.27, P<0.001) and 180 deg/s (β=2.46, P<0.001). Center-of-pressure (COP) shift acceleration along the force plate X-axis was negatively predictive of Bunkie lateral test score (β=-945, P<0.001) and medial test score (β=-839, P=0.03). CONCLUSIONS Force plate-derived vertical jump testing metrics are predictive of certain components of a multimodal RTS physical assessment for ACLR patients, including knee flexion ROM, quadriceps strength on isokinetic testing, and Bunkie Test performance.
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Affiliation(s)
- Dhruv S Shankar
- Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA -
| | - Heather A Milton
- Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
| | - Edward S Mojica
- Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
| | - Scott Buzin
- Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
| | - Eric J Strauss
- Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
| | - Kirk A Campbell
- Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
| | - Michael J Alaia
- Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
| | - Guillem Gonzalez-Lomas
- Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
| | - Laith M Jazrawi
- Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY, USA
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Protocol for a Randomized Crossover Trial to Evaluate the Effect of Soft Brace and Rigid Orthosis on Performance and Readiness to Return to Sport Six Months Post-ACL-Reconstruction. Healthcare (Basel) 2023; 11:healthcare11040513. [PMID: 36833047 PMCID: PMC9957425 DOI: 10.3390/healthcare11040513] [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: 10/24/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Abstract
A randomized crossover trial was designed to investigate the influence of muscle activation and strength on functional stability/control of the knee joint, to determine whether bilateral imbalances still occur six months after successful anterior cruciate ligament reconstruction (ACLR), and to analyze whether the use of orthotic devices changes the activity onset of these muscles. Furthermore, conclusions on the feedforward and feedback mechanisms are highlighted. Therefore, twenty-eight patients will take part in a modified Back in Action (BIA) test battery at an average of six months after a primary unilateral ACLR, which used an autologous ipsilateral semitendinosus tendon graft. This includes double-leg and single-leg stability tests, double-leg and single-leg countermovement jumps, double-leg and single-leg drop jumps, a speedy jump test, and a quick feet test. During the tests, gluteus medius and semitendinosus muscle activity are analyzed using surface electromyography (sEMG). Motion analysis is conducted using Microsoft Azure DK and 3D force plates. The tests are performed while wearing knee rigid orthosis, soft brace, and with no aid, in random order. Additionally, the range of hip and knee motion and hip abductor muscle strength under isometric conditions are measured. Furthermore, patient-rated outcomes will be assessed.
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Ramadurai S, Jeong H, Kim M. Predicting the metabolic cost of exoskeleton-assisted squatting using foot pressure features and machine learning. Front Robot AI 2023; 10:1166248. [PMID: 37151375 PMCID: PMC10154631 DOI: 10.3389/frobt.2023.1166248] [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: 02/15/2023] [Accepted: 04/05/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction: Recent studies found that wearable exoskeletons can reduce physical effort and fatigue during squatting. In particular, subject-specific assistance helped to significantly reduce physical effort, shown by reduced metabolic cost, using human-in-the-loop optimization of the exoskeleton parameters. However, measuring metabolic cost using respiratory data has limitations, such as long estimation times, presence of noise, and user discomfort. A recent study suggests that foot contact forces can address those challenges and be used as an alternative metric to the metabolic cost to personalize wearable robot assistance during walking. Methods: In this study, we propose that foot center of pressure (CoP) features can be used to estimate the metabolic cost of squatting using a machine learning method. Five subjects' foot pressure and metabolic cost data were collected as they performed squats with an ankle exoskeleton at different assistance conditions in our prior study. In this study, we extracted statistical features from the CoP squat trajectories and fed them as input to a random forest model, with the metabolic cost as the output. Results: The model predicted the metabolic cost with a mean error of 0.55 W/kg on unseen test data, with a high correlation (r = 0.89, p < 0.01) between the true and predicted cost. The features of the CoP trajectory in the medial-lateral direction of the foot (xCoP), which relate to ankle eversion-inversion, were found to be important and highly correlated with metabolic cost. Conclusion: Our findings indicate that increased ankle eversion (outward roll of the ankle), which reflects a suboptimal squatting strategy, results in higher metabolic cost. Higher ankle eversion has been linked with the etiology of chronic lower limb injuries. Hence, a CoP-based cost function in human-in-the-loop optimization could offer several advantages, such as reduced estimation time, injury risk mitigation, and better user comfort.
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Affiliation(s)
- Sruthi Ramadurai
- Rehabilitation Robotics Laboratory, Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, IL, United States
| | - Heejin Jeong
- The Polytechnic School, Ira A. Fulton Schools of Engineering, Arizona State University, Mesa, AZ, United States
- *Correspondence: Myunghee Kim, ; Heejin Jeong,
| | - Myunghee Kim
- Rehabilitation Robotics Laboratory, Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Myunghee Kim, ; Heejin Jeong,
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