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Wasser JG, Hendershot BD, Acasio JC, Dodd LD, Krupenevich RL, Pruziner AL, Miller RH, Goldman SM, Valerio MS, Senchak LT, Murphey MD, Heltzel DA, Fazio MG, Dearth CL, Hager NA. Exploring relationships among multi-disciplinary assessments for knee joint health in service members with traumatic unilateral lower limb loss: a two-year longitudinal investigation. Sci Rep 2023; 13:21177. [PMID: 38040780 PMCID: PMC10692131 DOI: 10.1038/s41598-023-48662-9] [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] [Received: 05/06/2023] [Accepted: 11/29/2023] [Indexed: 12/03/2023] Open
Abstract
Motivated by the complex and multifactorial etiologies of osteoarthritis, here we use a comprehensive approach evaluating knee joint health after unilateral lower limb loss. Thirty-eight male Service members with traumatic, unilateral lower limb loss (mean age = 38 yr) participated in a prospective, two-year longitudinal study comprehensively evaluating contralateral knee joint health (i.e., clinical imaging, gait biomechanics, physiological biomarkers, and patient-reported outcomes); seventeen subsequently returned for a two-year follow-up visit. For this subset with baseline and follow-up data, outcomes were compared between timepoints, and associations evaluated between values at baseline with two-year changes in tri-compartmental joint space. Upon follow-up, knee joint health worsened, particularly among seven Service members who presented at baseline with no joint degeneration (KL = 0) but returned with evidence of degeneration (KL ≥ 1). Joint space narrowing was associated with greater patellar tilt (r[12] = 0.71, p = 0.01), external knee adduction moment (r[13] = 0.64, p = 0.02), knee adduction moment impulse (r[13] = 0.61, p = 0.03), and CTX-1 concentration (r[11] = 0.83, p = 0.001), as well as lesser KOOSSport and VR-36General Health (r[16] = - 0.69, p = 0.01 and r[16] = - 0.69, p = 0.01, respectively). This longitudinal, multi-disciplinary investigation highlights the importance of a comprehensive approach to evaluate the fast-progressing onset of knee osteoarthritis, particularly among relatively young Service members with lower limb loss.
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Affiliation(s)
- Joseph G Wasser
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Brad D Hendershot
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA.
| | - Julian C Acasio
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
| | - Lauren D Dodd
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Rebecca L Krupenevich
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Alison L Pruziner
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
| | - Ross H Miller
- Department of Kinesiology, University of Maryland, College Park, MD, USA
| | - Stephen M Goldman
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Michael S Valerio
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Lien T Senchak
- Department of Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Mark D Murphey
- Department of Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - David A Heltzel
- Department of Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Michael G Fazio
- Department of Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Christopher L Dearth
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Nelson A Hager
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Roller Massage Prior to Running Does Not Affect Gait Mechanics in Well-Trained Runners. J Sport Rehabil 2021; 30:1178-1186. [PMID: 34525452 DOI: 10.1123/jsr.2021-0055] [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: 02/15/2021] [Revised: 04/18/2021] [Accepted: 06/07/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Understanding if roller massage prior to a run can mitigate fatigue-related decrements in muscle force production during prolonged running is important because of the association between fatigue and running-related injury. OBJECTIVE The authors investigated whether a bout of roller massage prior to running would (1) mitigate fatigue-related increases in vertical average load rate and free moment of the ground reaction force of running and (2) mitigate decreases in maximal countermovement jump height. DESIGN Repeated-measures study. SETTING Laboratory. PARTICIPANTS A total of 14 recreational endurance athletes (11 men and 3 women) volunteered for the study. INTERVENTIONS A 12.5-minute foam roller protocol for the lower extremities and a fatiguing 30-minute treadmill run. MAIN OUTCOME MEASURES Vertical average load rate, free moment, and maximal jump height before (PRE) and after (POST) the fatiguing treadmill run on separate experimental days: once where participants sat quietly prior to the fatiguing run (REST) and another where the foam roller protocol was performed prior to the run (ROLL). RESULTS A 2-way multiple analysis of variance found no significant differences in vertical average load rate, free moment, and jump height between PRE/POST times in both REST/ROLL conditions. CONCLUSIONS The authors concluded that recreational endurance athletes maintain running mechanics and jump performance after a fatiguing run regardless of prerun roller massage and may not rely on prerun roller massage as a form of injury prevention.
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Krupenevich RL, Miller RH. Habitual endurance running does not mitigate age-related differences in gait kinetics. Exp Gerontol 2021; 147:111275. [PMID: 33556533 DOI: 10.1016/j.exger.2021.111275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/18/2020] [Accepted: 02/02/2021] [Indexed: 11/29/2022]
Abstract
Older adults often walk with smaller ankle joint kinetics and larger hip joint kinetics compared to young adults. These age-related differences have been attributed, in part, to weaker plantarflexor muscles. While it is thought that regular physical activity helps to maintain muscle strength and mobility in older adults, physical activity levels on average decline with age. Therefore, understanding the effect of physical activity level on gait kinetics is an important objective for the management of mobility impairment in older adults. The purpose of this study was determine the effect of habitual endurance running on lower-extremity joint kinetics. 12 male older long-term runners (67 ± 5 yrs., 1.79 ± 0.07 m, 77.3 ± 13.7 kg) and 12 male older non-runners (70 ± 3 yrs., 1.78 ± 0.06 m, 79.68 ± 10.6 kg), performed overground walking trials at 1.3 m/s while kinematic and kinetic data were collected. Participants also performed maximal voluntary contractions at the hip, knee, and ankle joints on an isokinetic dynamometer. Older runners displayed similar ankle plantarflexor strength, similar hip extensor strength, and greater knee extensor strength compared to older non-runners, and walked with similar ankle joint kinetics (p > 0.05), and larger hip joint kinetics compared to older non-runners (p < 0.05). Thus, physical activity, in the form of running at least 20 miles/wk. and training for at least one race per year, did not mitigate the characteristic age-related differences in gait kinetics. Our findings may indicate that age-related differences in lower-extremity gait kinetics are a normal consequence of natural aging.
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Affiliation(s)
- Rebecca L Krupenevich
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.
| | - Ross H Miller
- Department of Kinesiology, University of Maryland, College Park, MD, USA; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA
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Hunter JG, Smith AMB, Sciarratta LM, Suydam S, Shim JK, Miller RH. Standardized Lab Shoes Do Not Decrease Loading Rate Variability in Recreational Runners. J Appl Biomech 2020; 36:340-344. [PMID: 32732455 DOI: 10.1123/jab.2019-0337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/11/2020] [Accepted: 05/13/2020] [Indexed: 10/27/2023]
Abstract
Studies of running mechanics often use a standardized lab shoe, ostensibly to reduce variance between subjects; however, this may induce unnatural running mechanics. The purpose of this study was to compare the step rate, vertical average loading rate, and ground contact time when running in standardized lab shoes versus participants' normal running shoes. Ground reaction forces were measured while the participants ran overground in both shoe conditions at a self-selected speed. The Student's t-test revealed that the vertical average loading rate magnitude was smaller in lab shoes versus normal shoes (42.09 [11.08] vs 47.35 [10.81] body weight/s, P = .013), while the step rate (170.92 [9.43] vs 168.98 [9.63] steps/min, P = .053) and ground contact time were similar (253 [25] vs 251 [20] ms, P = .5227) and the variance of all outcomes was similar in lab shoes versus normal shoes. Our results indicate that using standardized lab shoes during testing may underestimate the loads runners actually experience during their typical mileage.
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Miller RH, Krupenevich RL. Medial knee cartilage is unlikely to withstand a lifetime of running without positive adaptation: a theoretical biomechanical model of failure phenomena. PeerJ 2020; 8:e9676. [PMID: 32844066 PMCID: PMC7414768 DOI: 10.7717/peerj.9676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/16/2020] [Indexed: 01/24/2023] Open
Abstract
Runners on average do not have a high risk of developing knee osteoarthritis, even though running places very high loads on the knee joint. Here we used gait analysis, musculoskeletal modeling, and a discrete-element model of knee contact mechanics to estimate strains of the medial knee cartilage in walking and running in 22 young adults (age 23 ± 3 years). A phenomenological model of cartilage damage, repair, and adaptation in response to these strains then estimated the failure probability of the medial knee cartilage over an adult lifespan (age 23-83 years) for 6 km/day of walking vs. walking and running 3 km/day each. With no running, by age 55 the cumulative probability of medial knee cartilage failure averaged 36% without repair and 13% with repair, similar to reports on incidence of knee osteoarthritis in non-obese adults with no knee injuries, but the probability for running was very high without repair or adaptation (98%) and remained high after including repair (95%). Adaptation of the cartilage compressive modulus, cartilage thickness, and the tibiofemoral bone congruence in response to running (+1.15 standard deviations of their baseline values) was necessary for the failure probability of walking and running 3 km/day each to equal the failure probability of walking 6 km/day. The model results suggest two conclusions for further testing: (i) unlike previous findings on the load per unit distance, damage per unit distance on the medial knee cartilage is greater in running vs. walking, refuting the "cumulative load" hypothesis for long-term joint health; (ii) medial knee cartilage is unlikely to withstand a lifetime of mechanical loading from running without a natural adaptation process, supporting the "cartilage conditioning" hypothesis for long-term joint health.
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Affiliation(s)
- Ross H Miller
- Department of Kinesiology, University of Maryland, College Park, MD, United States of America.,Neuroscience & Cognitive Science Program, University of Maryland, College Park, MD, United States of America
| | - Rebecca L Krupenevich
- Joint Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, United States of America
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Wasser JG, Acasio JC, Hendershot BD, Miller RH. Single-leg forward hopping exposures adversely affect knee joint health among persons with unilateral lower limb loss: A predictive model. J Biomech 2020; 109:109941. [PMID: 32807307 DOI: 10.1016/j.jbiomech.2020.109941] [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: 02/13/2020] [Revised: 06/08/2020] [Accepted: 07/02/2020] [Indexed: 11/16/2022]
Abstract
Single-leg hopping is an atypical, yet convenient, method of ambulation for individuals who have sustained unilateral lower limb-loss. Hopping is generally discouraged by therapists but many patients report hopping, and the potential deleterious effects of frequent hopping on knee joint health remains unclear. Mechanical fatigue due to repeated exposures to increased or abnormal loading on the intact limb is thought to be a primary contributor to the high prevalence of knee osteoarthritis among individuals with unilateral lower limb amputation. We aimed to compare knee joint mechanics between single-leg hopping and walking at self-selected paces among individuals with unilateral lower limb-loss, and estimated the associated probability of knee cartilage failure. Thirty-two males with traumatic unilateral lower limb-loss (22 transtibial, 10 transfemoral) hopped and walked at a self-selected pace along a 15-m walkway. Peak knee moments were input to a phenomenological model of cartilage fatigue to estimate the damage and long-term failure probability of the medial knee cartilage when hopping vs. walking. We estimate that each hop accumulates as much damage as at least 8 strides of walking (p < 0.001), and each meter of hopping accumulates as much damage as at least 12 m of walking (p < 0.001). The 30-year failure probability of the medial knee cartilage exceeded a "coin-flip" chance (50%) when performing more than 197 hops per day. Although a convenient mode of ambulation for persons with unilateral lower limb-loss, to mitigate risk for knee osteoarthritis it is advisable to minimize exposure to single-leg forward hopping.
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Affiliation(s)
- Joseph G Wasser
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; Henry M. Jackson Foundation, for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Julian C Acasio
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; Henry M. Jackson Foundation, for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Brad D Hendershot
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; DoD-VA Extremity Trauma & Amputation Center of Excellence, USA; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Ross H Miller
- Department of Kinesiology, University of Maryland, College Park, MD, USA; Neuroscience & Cognitive Science Program, University of Maryland, College Park, MD, USA.
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Niederer D, Giesche F, Janko M, Niemeyer P, Wilke J, Engeroff T, Stein T, Frank J, Banzer W, Vogt L. Unanticipated jump-landing quality in patients with anterior cruciate ligament reconstruction: How long after the surgery and return to sport does the re-injury risk factor persist? Clin Biomech (Bristol, Avon) 2020; 72:195-201. [PMID: 31901699 DOI: 10.1016/j.clinbiomech.2019.12.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/05/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Inadequate reactions to unforeseen external stimuli are regarded as a major cause for non-contact anterior cruciate ligament (ACL) injuries. We aimed to delineate a potential deficit in the ability to perform unanticipated jump-landing manoeuvres, its sustainability and potential as a new outcome measure after ACL-reconstruction. METHODS Physically active adults (n = 27, 13 females, 14 males, 29.7 standard deviation 3.1 years) with a history of unilateral ACL rupture and subsequent reconstruction (6 months to 7 years ago), cleared for return to sports, were included. All participants performed counter-movement jumps with unanticipated single leg landings. Visual information shown after jump take-off indicated the required landing leg. Jump time [s] and successfulness [yes/no], vertical peak ground reaction forces at landing [N], as well as time to stabilisation after landing [s] and path length of the centre of pressure (CoP, [mm]) were calculated. Limb symmetry ratios were determined and analysed for their association with the time since surgery. FINDINGS Time since ACL reconstruction was logarithmically (basis 10) associated with side symmetry improvements in peak ground reaction force (R2 = 0.23, p < .01) and time to stabilisation (R2 = 0.18, p < .01) during and after landing in unanticipated/unpredictable single-leg jump landing tasks. The asymmetry found persists up to 18-26 months post-surgery. INTERPRETATION A deficit in unanticipated jump-landing ability seems to persist far beyond surgical restoration of mechanical stability and resumption of initial physical activities levels. The assessment of the ability to suddenly adapt movements to unanticipated visual stimuli may be a relevant complementary component within current functional testing canon in monitoring therapy success and return to sport testing.
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany.
| | - Florian Giesche
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Maren Janko
- Department of Trauma- Hand and Reconstructive Surgery, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Philipp Niemeyer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany
| | - Jan Wilke
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany
| | - Tobias Engeroff
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany
| | - Thomas Stein
- Department of Sport Traumatology-, Knee- and Shoulder-Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Germany
| | - Johannes Frank
- Department of Trauma- Hand and Reconstructive Surgery, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Winfried Banzer
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Goethe University, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt am Main, Germany
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Niemeyer P, Niederer D, Giesche F, Janko M, Frank J, Vogt L, Banzer W. Unanticipated jump-landing after anterior cruciate ligament reconstruction: Does unanticipated jump-landing testing deliver additional return to sport information to traditional jump performance tests? Clin Biomech (Bristol, Avon) 2019; 70:72-79. [PMID: 31408765 DOI: 10.1016/j.clinbiomech.2019.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/01/2019] [Accepted: 08/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND We aimed to delineate if unanticipated jump-landing assessments delivers complementary information to those of commonly used hop and jump tests after anterior cruciate ligament reconstruction. METHODS Eleven participants (5 males) performed a series of unanticipated jump-landings and traditional hop and jump performance tests (single leg hops for distance, triple crossover hops for distance and drop jumps). The number of mistrials, time to stabilization and peak ground reaction force (pGRF) at landing and jump/hop distance were measured. Pearson correlations to find potential associations between the unanticipated jump-landing-values and the traditional jump/hop performance tests were calculated twice: once for the affected and once for the unaffected legs. t-Tests for dependent samples were used to detect differences between affected and unaffected leg within each test condition. FINDINGS The pGRF at unanticipated landing significantly correlated to the pGRF at drop jump landing (r = 0.68) and the hopping distance after the triple crossover hops (r = 0.71, each p < .05). No other significant correlation occurred (p > .05). Hopping distance after single leg hops (mean: 110.2 cm vs. 95.5 cm) and triple crossover hops for distance (mean: 315.3 cm vs. 294.2 cm) showed significant differences between the unaffected and the reconstructed leg (p < .05). Other parameters showed no significant between-legs differences (p > .05). INTERPRETATION Both, the reconstructed and the contralateral leg seems to be affected. Unanticipated jump landing tasks deliver information beyond those of commonly used jump and hop tests, the thereby assessed abilities may thus be a complementary aspect of dynamic knee function than those assessed with classic tests.
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Affiliation(s)
- Philipp Niemeyer
- Department of Sports Medicine, Goethe University Frankfurt am Main, Germany.
| | - Daniel Niederer
- Department of Sports Medicine, Goethe University Frankfurt am Main, Germany; Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Germany
| | - Florian Giesche
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Germany
| | - Maren Janko
- Department of Trauma- Hand and Reconstructive Surgery, Hospital of the Goethe-University Frankfurt am Main, Germany
| | - Johannes Frank
- Department of Trauma- Hand and Reconstructive Surgery, Hospital of the Goethe-University Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt am Main, Germany
| | - Winfried Banzer
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Germany
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Niederer D, Willberg C, Kruse A, Exler N, Giesche F, Vogt L, Banzer W. Acute effects of preventive warm-up exercises on modifiable risk factors for anterior cruciate ligament injuries: a three-arm randomized-controlled crossover trial. J Sports Med Phys Fitness 2019; 60:92-101. [PMID: 31663311 DOI: 10.23736/s0022-4707.19.09949-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND We aimed to compare the potential acute effects of single bouts of a classic prevention and a risk factor-focus training aiming to target modifiable anterior cruciate ligament (ACL) rupture risk factors and the impact of neuromuscular fatigue on relevant ACL rupture risk factors. METHODS Two preventive warm-up (standard and ACL rupture risk factor training) and one inactive arm were compared; each of these were followed by a standardized neuromuscular fatigue protocol. The assessments included two Trail making tests (TMT-A; TMT-B, time to complete), drop jump landings (knee separation distance, normalized at hip width), as well as unanticipated counter movement jump landings (time to stabilization and peak ground reaction force). RESULTS We included 18 participants (25±2years). No differences were found between times and conditions for TMT (P>0.05). A significant time effect occurred in time to stabilization (F=2.6; P<0.05) and a significant time*baseline-value*jumping time interaction was seen in peak ground reaction force (F=3.1; P<0.05). No time effect was found for any knee separation distance (F=.1-2.4; P>0.05); but a significant time*baseline-value*jumping time interaction was seen at initial ground contact (F=2.8; P<0.05), and lowest point (F=4.2; P<0.01). CONCLUSIONS Risk factor-focus and classic warm-up may not differ in their acute effects on modifiable functional ACL (re-)injury risks factors.
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine, Goethe University, Frankfurt, Germany -
| | - Christina Willberg
- Department of Sports Medicine, Goethe University, Frankfurt, Germany.,Department of Movement and Training Science, Goethe University, Frankfurt, Germany
| | - Adele Kruse
- Department of Sports Medicine, Goethe University, Frankfurt, Germany
| | - Nicola Exler
- Department of Sports Medicine, Goethe University, Frankfurt, Germany
| | - Florian Giesche
- Department of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University, Frankfurt, Germany
| | - Winfried Banzer
- Department of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt, Germany
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HUNTER JESSICAG, GARCIA GINAL, SHIM JAEKUN, MILLER ROSSH. Fast Running Does Not Contribute More to Cumulative Load than Slow Running. Med Sci Sports Exerc 2019; 51:1178-1185. [DOI: 10.1249/mss.0000000000001888] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Guan Y, Guo L, Wu N, Zhang L, Warburton DER. Biomechanical insights into the determinants of speed in the fencing lunge. Eur J Sport Sci 2017; 18:201-208. [PMID: 29249174 DOI: 10.1080/17461391.2017.1414886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
For fencing, speed of the lunge is considered critical to success. The aim of this study is to investigate determinants of lunge speed based on biomechanics. Ground reaction force (GRF) and three-dimensional kinematic data were collected from 7 elite fencers and 12 intermediate-level fencers performing maximum-effort lunges. The results showed that elite fencers acquired a higher horizontal peak velocity of the centre of gravity (HPV) and concomitantly a higher horizontal peak GRF exerted by rear leg (PGRF) than intermediate-level fencers (P < .01). Studying the affecting factors, elite fencers obtained higher joint peak power, joint peak moment, and range of motion of rear knee than intermediate-level fencers (P < .05) during the lunge, and these parameters were significantly correlated with both HPV and PGRF (P < .05). Both elite and intermediate-level fencers had joint flexion before the extension in forward knee; however, the latter showed greater flexion, higher peak angular velocity and less time for extension compared to the former (P ≤ .05). Our findings suggest that training aimed at enhancing strength and power of rear knee extensors is important for fencers to improve speed of the lunge. Also, increasing the extension of rear knee during the lunge, at the same time decreasing the flexion of the forward knee before extension are positive for lunge performance.
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Affiliation(s)
- Yanfei Guan
- a Cardiovascular Physiology and Rehabilitation Laboratory , University of British Columbia , Vancouver , British Columbia , Canada
| | - Li Guo
- b School of Kinesiology, Shanghai University of Sport , Shanghai , People's Republic of China
| | - Nana Wu
- a Cardiovascular Physiology and Rehabilitation Laboratory , University of British Columbia , Vancouver , British Columbia , Canada
| | - Lingli Zhang
- b School of Kinesiology, Shanghai University of Sport , Shanghai , People's Republic of China
| | - Darren E R Warburton
- a Cardiovascular Physiology and Rehabilitation Laboratory , University of British Columbia , Vancouver , British Columbia , Canada
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