1
|
Ho CY, Sum RKW, Yang Y. Effects of stiffness-altered sport compression garments on lower-limb biomechanics in cutting maneuvers. J Biomech 2024; 175:112292. [PMID: 39191073 DOI: 10.1016/j.jbiomech.2024.112292] [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: 01/28/2024] [Revised: 08/14/2024] [Accepted: 08/21/2024] [Indexed: 08/29/2024]
Abstract
Athletes commonly use compression garments (CGs) for perceived effectiveness in preventing injury occurrence. However, limited evidence is available on whether lower-limb CGs reduce the risk of injury. This study aimed at (1) evaluating the effects of CGs on mitigating the risk factors of cutting-related knee injuries; (2) identifying undesirable side-effects of CGs on other joints and cutting performance; and (3) identifying possible interactions between sex and condition. 62 healthy adults performed pre-planned 90˚ cutting tasks under four conditions: control, knee sleeves, placebo leggings and stiffness-altered leggings. Joint angle at initial contact, range of motion, moments, and ground reaction force were measured. A mixed two-way (sex*condition) ANOVA was performed, followed by post-hoc comparisons and subset analyses for sexes. Results showed that the leggings restricted hip sagittal (45.4 ± 1.3 vs. control 50.0 ± 1.3˚, p = 0.001) and rotational (16.8 ± 0.8 vs. control 22.5 ± 1.1˚, p < 0.001) motion. At initial contact, the stiffness-altered leggings reduced knee valgus (0.4 ± 0.8 vs. control -2.1 ± 0.8˚, p = 0.031). However, the altered alignment of lower-limb joints did not reduce multiplanar knee joint moments (p > 0.05). CGs were not effective protective equipment yet. There was no significant difference between knee sleeves and control, nor between leggings conditions (p > 0.05). Force plate measurements, such as increased rate of force development (stiffness-altered 42.6 ± 1.1 & placebo 42.9 ± 1.1 vs. control 39.9 ± 1.0 BW/s, p < 0.028), implied the possibility of performance enhancement through CGs. While further investigations on the optimal compression and stiffness alterations are warranted, athletes are recommended to be aware of the discrepancies between the claimed and actual biomechanical effects of CGs.
Collapse
Affiliation(s)
- Cheuk-Yin Ho
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Raymond Kim-Wai Sum
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yijian Yang
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
2
|
Kim S, So J, Jeon Y, Moon J. Effect of changes in motor skill induced by educational video program to decrease lower-limb joint load during cutting maneuvers: based on musculoskeletal modeling. BMC Musculoskelet Disord 2024; 25:527. [PMID: 38982445 PMCID: PMC11232243 DOI: 10.1186/s12891-024-07642-4] [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: 02/09/2024] [Accepted: 06/28/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND This study investigated the effects of changes in motor skills from an educational video program on the kinematic and kinetic variables of the lower extremity joints and knee ligament load. METHODS Twenty male participants (age: 22.2 ± 2.60 y; height: 1.70 ± 6.2 m; weight: 65.4 ± 7.01 kg; BMI: 23.32 ± 2.49 [Formula: see text]) were instructed to run at 4.5 ± 0.2 m/s from a 5 m distance posterior to the force plate, land their foot on the force plate, and perform the cutting maneuver on the left. The educational video program for cutting maneuvers consisted of preparatory posture, foot landing orientation, gaze and trunk directions, soft landing, and eversion angle. The measured variables were the angle, angular velocity of lower extremity joints, ground reaction force (GRF), moment, and anterior cruciate ligament (ACL) and medial collateral ligament (MCL) forces through musculoskeletal modeling. RESULTS After the video feedback, the hip joint angles increased in flexion, abduction, and external rotation (p < 0.05), and the angular velocity increased in extension (p < 0.05). The ankle joint angles increased in dorsiflexion (p < 0.05), and the angular velocity decreased in dorsiflexion (p < 0.05) but increased in abduction (p < 0.05). The GRF increased in the anterior-posterior and medial-lateral directions and decreased vertically (p < 0.05). The hip joint moments decreased in extension and external rotation (p < 0.05) but increased in adduction (p < 0.05). The knee joint moments were decreased in extension, adduction, and external rotation (p < 0.05). The abduction moment of the ankle joint decreased (p < 0.001). There were differences in the support zone corresponding to 64‒87% of the hip frontal moment (p < 0.001) and 32‒100% of the hip horizontal moment (p < 0.001) and differences corresponding to 32‒100% of the knee frontal moment and 21‒100% of the knee horizontal moment (p < 0.001). The GRF varied in the support zone at 44‒95% in the medial-lateral direction and at 17‒43% and 73‒100% in the vertical direction (p < 0.001). CONCLUSIONS Injury prevention feedback reduced the load on the lower extremity joints during cutting maneuvers, which reduced the knee ligament load, mainly on the MCL.
Collapse
Affiliation(s)
- Sungmin Kim
- Institute of School Physical Education, Korea National University of Education, Cheongju, Republic of Korea
| | - Jiho So
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Youngju Jeon
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jeheon Moon
- Department of Physical Education, Korea National University of Education, Cheongju, Republic of Korea.
| |
Collapse
|
3
|
Slovák L, Zahradník D, Land WM, Sarvestan J, Hamill J, Abdollahipour R. Response of Knee Joint Biomechanics to Landing Under Internal and External Focus of Attention in Female Volleyball Players. Motor Control 2024; 28:341-361. [PMID: 38702047 DOI: 10.1123/mc.2023-0151] [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: 12/20/2023] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 05/06/2024]
Abstract
The aim of this study was to examine the effect of attentional focus instructions on the biomechanical variables associated with the risk of anterior cruciate ligament injury of the knee joint during a drop landing task using a time series analysis. Ten female volleyball players (age: 20.4 ± 0.8 years, height: 169.7 ± 7.1 cm, mass: 57.6 ± 3.1 kg, experience: 6.3 ± 0.8 years) performed landings from a 50 cm height under three different attentional focus conditions: (1) external focus (focus on landing as soft as possible), (2) internal focus (focus on bending your knees when you land), and (3) control (no-focus instruction). Statistical parameter mapping in the sagittal plane during the crucial first 30% of landing time showed a significant effect of attentional focus instructions. Despite the similarity in landing performance across foci instructions, adopting an external focus instruction promoted reduced vertical ground reaction force and lower sagittal flexion moment during the first 30% of execution time compared to internal focus, suggesting reduced knee loading. Therefore, adopting an external focus of attention was suggested to reduce most biomechanical risk variables in the sagittal plane associated with anterior cruciate ligament injuries, compared to internal focus and control condition. No significant differences were found in the frontal and horizontal planes between the conditions during this crucial interval.
Collapse
Affiliation(s)
- Lukáš Slovák
- Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
| | - David Zahradník
- Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
| | - William M Land
- Department of Kinesiology, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Javad Sarvestan
- Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
- Biomechanics and Functional Morphology Laboratory, CIPER, Faculdade de Motricidade Humana, University of Lisbon, Lisboa, Portugal
| | - Joseph Hamill
- Human Motion Diagnostic Centre, University of Ostrava, Ostrava, Czech Republic
- Biomechanics Laboratory, University of Massachusetts, Amherst, MA, USA
| | - Reza Abdollahipour
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
| |
Collapse
|
4
|
Kikumoto T, Kobayashi M, Omori G, Kubo M. Single-legged landing behavior of high school basketball players with chronic ankle instability. J Bodyw Mov Ther 2024; 39:454-462. [PMID: 38876668 DOI: 10.1016/j.jbmt.2024.03.054] [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: 12/21/2022] [Revised: 02/20/2024] [Accepted: 03/19/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES Anterior cruciate ligament injury is one of the most serious ligamentous injuries. The purpose is to compare the impact of the ankle joint on the knee during landing between athletes with chronic instability and a control group (coper group) and to verify the effects of the kinetic chain from other joints. DESIGN Prospective study. SETTING High school basketball. PARTICIPANTS Participants were 62 female high school basketball players who had participated in team sports for >6 months. MAIN OUTCOME MEASURES Player joint angles, movements, and moments. RESULTS The knee valgus moment was significantly higher in the chronic ankle instability group than in the coper group (20%-60% [p < 0.01]; 80%-100% [p < 0.05]) during landing motion. The knee valgus moment was also significantly higher during the change from the maximum knee joint flexion position to the maximum extension (p < 0.05). In addition, the landing motions of the chronic instability group may have utilized suboptimal compensatory motor strategy on the sagittal plane, depending heavily on the knee joint's abduction moment. CONCLUSIONS Our findings indicate that the chronic ankle instability group uses a different landing strategy pattern than the coper group by changing the joint moment and joint angle during landing, which may increase the risk of anterior cruciate ligament injury.
Collapse
Affiliation(s)
- Takanori Kikumoto
- Institute for Human Movement and Medical Sciences, Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan.
| | - Marina Kobayashi
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Go Omori
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Masayoshi Kubo
- Institute for Human Movement and Medical Sciences, Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| |
Collapse
|
5
|
Ramachandran AK, Pedley JS, Moeskops S, Oliver JL, Myer GD, Lloyd RS. Changes in Lower Limb Biomechanics Across Various Stages of Maturation and Implications for ACL Injury Risk in Female Athletes: a Systematic Review. Sports Med 2024; 54:1851-1876. [PMID: 38671176 PMCID: PMC11257789 DOI: 10.1007/s40279-024-02022-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Female athletes are four to six times more likely to sustain an anterior cruciate ligament (ACL) injury than male athletes. Jump-landing biomechanics are influenced by maturation, with post-pubertal female athletes at a heightened risk of ACL injuries. OBJECTIVE The aim of our systematic review was to identify and summarise the current evidence regarding the changes in kinematic and kinetic risk factors associated with ACL injuries during jump-landing tasks in female athletes at various stages of maturity. METHODS A systematic search was conducted in PubMed, CINAHL, Web of Science, SPORTDiscus, EMBASE and Scopus. Articles were included if they: (1) conducted the research on uninjured female athletes with no restriction on playing level/experience; (2) provided information regarding the stage of the maturity and the scale used for estimating the maturity status of the participants; and (3) reported a biomechanical risk factor associated with ACL injuries during jump-landing tasks across at least two different maturity groups (e.g. pre-pubertal vs post-pubertal). RESULTS Sixteen articles involving 2323 female athletes were included in our review. A total of 12 kinematic and 8 kinetic variables were identified across these studies. Of the 12 kinematic variables reported in our review, we found strong evidence for higher peak knee abduction angle in post-pubertal female individuals compared with pre-pubertal girls (p < 0.05). With regard to the 8 kinetic variables, we found strong evidence for lower relative peak vertical ground reaction force, higher external knee abduction moment and internal rotation moment in post-pubertal compared with pre-pubertal athletes. The strength of evidence for the remaining kinematic and kinetic variables ranged from conflicting to moderate and, in some instances, could not be determined. CONCLUSIONS Our study provides an overview of the changes in biomechanical risk factors in female athletes during jump-landing tasks at various stages of maturity. We found moderate-to-limited evidence for most kinematic and kinetic variables, highlighting the need for further research.
Collapse
Affiliation(s)
- Akhilesh Kumar Ramachandran
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, Cardiff, CF23 6XD, UK.
| | - Jason S Pedley
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, Cardiff, CF23 6XD, UK
| | - Sylvia Moeskops
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, Cardiff, CF23 6XD, UK
| | - Jon L Oliver
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, Cardiff, CF23 6XD, UK
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand
| | - Gregory D Myer
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, Cardiff, CF23 6XD, UK
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
| | - Rhodri S Lloyd
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, Cardiff, CF23 6XD, UK
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, Hamilton, New Zealand
| |
Collapse
|
6
|
Turner JA, Chaaban CR, Padua DA. Validation of OpenCap: A low-cost markerless motion capture system for lower-extremity kinematics during return-to-sport tasks. J Biomech 2024; 171:112200. [PMID: 38905926 DOI: 10.1016/j.jbiomech.2024.112200] [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: 01/28/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
Low-cost markerless motion capture systems offer the potential for 3D measurement of joint angles during human movement. This study aimed to validate a smartphone-based markerless motion capture system's (OpenCap) derived lower extremity kinematics during common return-to-sport tasks, comparing it to an established optoelectronic motion capture system. Athletes with prior anterior cruciate ligament reconstruction (12-18 months post-surgery) performed three movements: a jump-landing-rebound, single-leg hop, and lateral-vertical hop. Kinematics were recorded concurrently with two smartphones running OpenCap's software and with a 10-camera, marker-based motion capture system. Validity of lower extremity joint kinematics was assessed across 437 recorded trials using measures of agreement (coefficient of multiple correlation: CMC) and error (mean absolute error: MAE, root mean squared error: RMSE) across the time series of movement. Agreement was best in the sagittal plane for the knee and hip in all movements (CMC > 0.94), followed by the ankle (CMC = 0.84-0.93). Lower agreement was observed for frontal (CMC = 0.47-0.78) and transverse (CMC = 0.51-0.6) plane motion. OpenCap presented a grand mean error of 3.85° (MAE) and 4.34° (RMSE) across all joint angles and movements. These results were comparable to other available markerless systems. Most notably, OpenCap's user-friendly interface, free software, and small physical footprint have the potential to extend motion analysis applications beyond conventional biomechanics labs, thus enhancing the accessibility for a diverse range of users.
Collapse
Affiliation(s)
- Jeffrey A Turner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Courtney R Chaaban
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Darin A Padua
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
7
|
Paredes R, Crasto C, Mesquita Montes A, Arias-Buría JL. Changes in co-contraction magnitude during functional tasks following anterior cruciate ligament reconstruction: A systematic review. Knee 2024; 48:243-256. [PMID: 38781829 DOI: 10.1016/j.knee.2024.05.005] [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: 10/10/2023] [Revised: 03/24/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Anterior cruciate ligament reconstruction (ACLR) is a common orthopedic surgery procedure whose incidence has increased over the past few decades. Nevertheless, it is believed that neuromuscular control remains altered from the early stages after ACLR to later years. Therefore, the aim of this study was to systematically evaluate the magnitude of co-contraction during functional tasks in subjects with unilateral ACLR. METHODS A systematic review design was followed. The search strategy was conducted in PubMed, Scopus, EBSCO, PEDro, Cochrane Library, and Web of Science databases from inception to March 2024. The inclusion criteria involved studies using electromyography (EMG) data to calculate muscle pair activation via the co-contraction index (CCI) in ACLR individuals during functional tasks. The Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and study quality was evaluated using National Institutes of Health (NIH) Study Quality Assessment Tools. RESULTS The search strategy found a total of 792 studies, of which 15 were included in this systematic review after reviewing the eligibility criteria. The magnitude of co-contraction was assessed in a total of 433 ACLR individuals and 206 controls during functional tasks such as hop, drop-land, step-up/step-down, and gait. Overall, approximately 79.6% of individuals who had undergone ACLR exhibited increased levels of co-contraction magnitude in the ACLR limb, while 8.5% showed low co-contraction levels. CONCLUSIONS The findings of the review suggest that, during functional tasks, most individuals who have undergone ACLR exhibit changes of co-contraction magnitude in the involved limb.
Collapse
Affiliation(s)
- Ricardo Paredes
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Alcorcón, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.
| | - Carlos Crasto
- Escola Superior de Saúde de Santa Maria, Oporto, Portugal; Escola Superior de Saúde do Politécnico do Porto, Oporto, Portugal
| | - António Mesquita Montes
- Escola Superior de Saúde de Santa Maria, Oporto, Portugal; Escola Superior de Saúde do Politécnico do Porto, Oporto, Portugal
| | - José L Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| |
Collapse
|
8
|
Alimoradi M, Hosseini E, Sahebozamani M, Dos’Santos T, Sheikhbahaie S, Bigtashkhani R, Kabiri A. The effects of two different fatigue protocols on movement quality during anticipated and unanticipated change of directions in female soccer players. PLoS One 2024; 19:e0302144. [PMID: 38776356 PMCID: PMC11111049 DOI: 10.1371/journal.pone.0302144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/28/2024] [Indexed: 05/24/2024] Open
Abstract
OBJECTIVE This study compared neuromuscular control under two fatigue protocols during anticipated and unanticipated change of direction (COD) maneuvers and evaluated their effects on the risk of non-contact ACL injuries. METHOD Forty-five female soccer players (mean age: 22.22 ± 2.24 years; mean height: 166.24 ± 3.33 cm; mean mass: 59.84 ± 5.03 kg) were divided into three groups: functional fatigue (Soccer specific fatigue ptotocol-SOFT90), non-functional fatigue (Bruce protocol), and control group. Before and after the implementation of neuromuscular control fatigue protocols were evaluated using the cutting motion assessment score tool (CMAS). Two-dimensional (2D) videos were recorded during anticipated and unanticipated COD trials for both dominant and non-dominant legs. RESULTS Significant time effects (p < 0.05) and group-time interactions (p < 0.05) were observed in both anticipated and unanticipated conditions for both dominant and non-dominant legs after the fatigue protocols. The functional fatigue group exhibited higher CMAS changes, indicating poorer movement quality following fatigue. Notably, the non-dominant leg displayed amplified deficits during unanticipated COD maneuvers following the functional fatigue protocol. CONCLUSIONS Fatigue significantly impairs neuromuscular control, particularly in unanticipated COD situations, which increases the risk of non-contact ACL injuries. To mitigate this risk, coaches, trainers, and medical professionals should prioritize targeted training and injury prevention strategies, focusing on the non-dominant leg during unanticipated COD maneuvers.
Collapse
Affiliation(s)
- Mohammad Alimoradi
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Elham Hosseini
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Mansour Sahebozamani
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Thomas Dos’Santos
- Musculoskeletal Science and Sports Medicine Research Centre, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Shima Sheikhbahaie
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Roya Bigtashkhani
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Aryan Kabiri
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| |
Collapse
|
9
|
Donelon TA, Edwards J, Brown M, Jones PA, O'Driscoll J, Dos'Santos T. Differences in Biomechanical Determinants of ACL Injury Risk in Change of Direction Tasks Between Males and Females: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2024; 10:29. [PMID: 38561438 PMCID: PMC10984914 DOI: 10.1186/s40798-024-00701-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Change of direction (COD) movements are associated with non-contact anterior cruciate ligament (ACL) injuries in multidirectional sports. Females appear at increased risk compared to males, which could be attributable to whole body kinematic strategies and greater multiplanar knee joint loads (KJLs) during COD which can increase ACL loading. OBJECTIVE The aim of this systematic review and meta-analysis was to examine and quantitatively synthesise the evidence for differences between males and females regarding KJLs and their biomechanical determinants (whole body kinematic strategies determining KJLs) during COD tasks. METHODS Databases including SPORTDiscus, Web of Science, and PubMed were systematically searched (July 2021-June 2023) for studies that compared differences in knee joint loads and biomechanical determinants of KJLs during COD between males and females. Inclusion criteria were: (1) females and males with no prior history of ACL injury (18-40 years); (2) examined biomechanical determinants of KJLs and/ or KJLs during COD tasks > 20°; (3) compared ≥ 1 outcome measure between males and females. Studies published between 2000 and 2023 examining a cutting task > 20° with a preceding approach run that compared KJLs or the whole body multiplanar kinematics associated with them, between sexes, using three-dimensional motion analysis. RESULTS This meta-analysis included 17 studies with a pooled sample size of 451 participants (227 males, 224 females). Meta-analysis revealed females displayed significantly less peak knee flexion during stance (SMD: 0.374, 95% CI 0.098-0.649, p = 0.008, I2: 0%); greater knee abduction at initial contact (IC) (SMD: 0.687, 95% CI 0.299-1.076, p = 0.001, I2: 55%); less hip internal rotation (SMD: 0.437, 95% CI 0.134-0.741, p = 0.005, I2: 34%) and hip abduction at IC (SMD: -0.454, 95% CI 0.151-0.758, p = 0.003, I2: 33%). No significant differences were observed between males and females for any internal or externally applied KJLs. All retrieved studies failed to control for strength, resistance training or skill history status. CONCLUSION No differences were observed in KJLs between males and females despite females displaying greater knee abduction at IC and less peak knee flexion during the stance phase of CODs, which are visual characteristics of non-contact ACL injury. Further research is required to examine if this translates to a similar injury risk, considering morphological differences in strain characteristics of the ACL between males and females. This observation may in part explain the disproportionate ACL injury incidence in female multidirectional athletes. Further higher quality controlled research is required whereby participants are matched by skill training history, resistance training history and strength status to ensure an appropriate comparison between males and females.
Collapse
Affiliation(s)
- Thomas A Donelon
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK.
| | - Jamie Edwards
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Mathew Brown
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Paul A Jones
- School of Health Sciences, C702 Allerton Building, University of Salford, Salford, M6 6PU, UK
| | - Jamie O'Driscoll
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Thomas Dos'Santos
- Department of Sport and Exercise Sciences | Manchester Metropolitan University, 2.01 Institute of Sport, 99 Oxford Road, Manchester, M1 7EL, UK
| |
Collapse
|
10
|
Aquino MRC, Resende RA, Van Emmerik R, Souza TR, Fonseca ST, Kirkwood RN, Ocarino JM. Influence of reduced passive ankle dorsiflexion range of motion on lower limb kinetics and stiffness during gait. Gait Posture 2024; 109:147-152. [PMID: 38309125 DOI: 10.1016/j.gaitpost.2024.01.020] [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: 03/09/2023] [Revised: 11/24/2023] [Accepted: 01/17/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The ankle dorsiflexion range of motion (ADF-ROM) during single support phase allows elastic energy storage in the calcaneal tendon, contributing to advance the body forward. Reduced ADF-ROM may influence lower limb kinetics and stiffness. RESEARCH QUESTION What is the influence of reduced passive ADF-ROM on lower limb internal moments and stiffness during gait? METHODS Thirty-two participants, classified into two groups according to passive ADF-ROM (smaller than 10° and greater than 15°), were submitted to gait assessment at self-selected speed with a force platform and a three-dimensional motion analysis system. Statistical parametrical mapping (SPM) analyses were used to compare the lower limbs' internal moments between groups. Independent t-tests analyzed the differences between groups on lower limb stiffness during gait. RESULTS The lower ADF-ROM group had greater knee flexor moment (terminal stance and push-off), greater ankle abductor (i.e., shank internal rotator) moment in terminal stance and greater knee internal rotator moment in mid to terminal stance. The lower ADF-ROM group also had higher lower limb stiffness during gait. SIGNIFICANCE Individuals with reduced passive ADF-ROM had greater lower limb stiffness and adopted a gait pattern with increased knee and ankle moments, suggesting increased loading at these joints.
Collapse
Affiliation(s)
- Mariana R C Aquino
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
| | - Renan A Resende
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
| | - Richard Van Emmerik
- University of Massachusetts Amherst, Department of Kinesiology, 30 Eastman Lane, 01003 Amherst, MA, USA
| | - Thales R Souza
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
| | - Sergio T Fonseca
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
| | - Renata N Kirkwood
- McMaster University, Hamilton School of Rehabilitation Science, 1280 Main Street West, L8S 4L8 ON, Canada
| | - Juliana M Ocarino
- Universidade Federal de Minas Gerais, School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Avenida Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil.
| |
Collapse
|
11
|
Chiu LZF. "Knees Out" or "Knees In"? Volitional Lateral vs. Medial Hip Rotation During Barbell Squats. J Strength Cond Res 2024; 38:435-443. [PMID: 38416444 DOI: 10.1519/jsc.0000000000004655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
ABSTRACT Chiu, LZF. "Knees out" or "Knees in"? Volitional lateral versus medial hip rotation during barbell squats. J Strength Cond Res 38(3): 435-443, 2024-Medial or lateral hip rotation may be present during barbell squats, which could affect the hip frontal and transverse plane moments. Male (n = 14) and female (n = 18) subjects performed squats using their normal technique and with volitional medial and lateral hip rotation. Hip net joint moments (NJM) were calculated from 3-dimensional motion capture and force platform measurements. Statistical significance was set for omnibus tests (α = 0.05) and Bonferroni's corrected for pairwise comparisons (αt-test = 0.0056). Normal squats required hip extensor, adductor, and lateral rotator NJM. Lateral rotation squats had smaller hip extensor (p = 0.002) and lateral rotator (p < 0.001) NJM and larger hip adductor (p < 0.001) NJM than normal squats. Medial rotation squats had smaller hip extensor (p = 0.002) and adductor (p < 0.001) NJM and larger hip lateral rotator (p < 0.001) NJM than normal squats. These differences exceeded the minimum effects worth detecting. As gluteus maximus exerts hip extensor and lateral rotator moments, and the adductor magnus exerts hip extensor and adductor moments, these muscles combined would be required to meet these hip demands, supporting previous research that has established these muscles as the primary contributors to the hip extensor NJM. Lateral rotation squats reduce hip lateral rotator and increase hip adductor NJM, which may be hypothesized as preferentially loading adductor magnus. Medial rotation squats increase hip lateral rotator and decrease hip adductor NJM; therefore, this variant may shift loading to the gluteus maximus.
Collapse
Affiliation(s)
- Loren Z F Chiu
- Neuromusculoskeletal Mechanics Research Program, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
12
|
Wang D, Fan H, Hu L, Liang X, Huang W, Li K. Increased knee torsional misalignment associated with femoral torsion is related to non-contact anterior cruciate ligament injury: a case-control study. J Orthop Surg Res 2024; 19:124. [PMID: 38321464 PMCID: PMC10845642 DOI: 10.1186/s13018-024-04609-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 01/31/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Altered axial biomechanics of the knee are recognized as a risk factor for non-contact anterior cruciate ligament (ACL) injury. However, the relationship of knee and segmental torsion to non-contact ACL and combined anterolateral ligament (ALL) injury is unclear. This study aims to determine the relationship of knee and segmental torsion to non-contact ACL injury and to explore their relationship with ALL injuries. METHODS We divided 122 patients with arthroscopically confirmed non-contact ACL injuries into an ACL injury group (isolated ACL injury, 63 patients) and an ACL + ALL injury group (ACL combined with ALL injury,59 patients). Additionally, 90 normal patients with similar age, gender and body mass index (BMI) were matched as a control group. The tibial tubercle-trochlear groove (TT-TG) distance, distal femoral torsion (DFT), posterior femoral condylar torsion (PFCT) and proximal tibial torsion (PTT) were measured using magnetic resonance imaging (MRI). We assessed the differences between the groups using an independent samples t test and utilized receiver operating characteristic (ROC) curves to determine the cut-off value for the increased risk of ACL injury. RESULTS In patients with ACL injury, the measurements of the TT-TG (11.8 ± 3.1 mm), DFT (7.7° ± 3.5°) and PFCT (3.6° ± 1.3°) were significantly higher compared to the control group (9.1 ± 2.4 mm, 6.3° ± 2.7° and 2.8° ± 1.3°, respectively; P < 0.05), but the PTT did not differ between the two groups. The TT-TG, DFT and PFCT were not significantly larger in patients combined with ALL injury. ROC curve analysis revealed ACL injury is associated with TT-TG, DFT and PFCT. CONCLUSIONS Knee torsional alignment is associated with ACL injury, predominantly in the distal femur rather than the proximal tibia. However, its correlation with ALL injury remains unclear. These findings may help identify patients at high risk for non-contact ACL injury and inform the development of targeted prevention and treatment strategies.
Collapse
Affiliation(s)
- Dehua Wang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang Yuzhong District, Chongqing, 400016, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
| | - Hengkai Fan
- Department of Orthopaedics, Lanzhou University Second Hospital, Orthopaedics Key Laboratory of Gansu Province, Gansu, China
| | - Linlin Hu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xi Liang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang Yuzhong District, Chongqing, 400016, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
| | - Wei Huang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang Yuzhong District, Chongqing, 400016, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
| | - Ke Li
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang Yuzhong District, Chongqing, 400016, China.
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China.
| |
Collapse
|
13
|
Ajdaroski M, Baek SY, Ashton-Miller JA, Esquivel AO. Predicting Leg Forces and Knee Moments Using Inertial Measurement Units: An In Vitro Study. J Biomech Eng 2024; 146:021006. [PMID: 38019183 PMCID: PMC10750790 DOI: 10.1115/1.4064145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 11/30/2023]
Abstract
We compared the ability of seven machine learning algorithms to use wearable inertial measurement unit (IMU) data to identify the severe knee loading cycles known to induce microdamage associated with anterior cruciate ligament rupture. Sixteen cadaveric knee specimens, dissected free of skin and muscle, were mounted in a rig simulating standardized jump landings. One IMU was located above and the other below the knee, the applied three-dimensional action and reaction loads were measured via six-axis load cells, and the three-dimensional knee kinematics were also recorded by a laboratory motion capture system. Machine learning algorithms were used to predict the knee moments and the tibial and femur vertical forces; 13 knees were utilized for training each model, while three were used for testing its accuracy (i.e., normalized root-mean-square error) and reliability (Bland-Altman limits of agreement). The results showed the models predicted force and knee moment values with acceptable levels of error and, although several models exhibited some form of bias, acceptable reliability. Further research will be needed to determine whether these types of models can be modified to attenuate the inevitable in vivo soft tissue motion artifact associated with highly dynamic activities like jump landings.
Collapse
Affiliation(s)
- Mirel Ajdaroski
- Department of Mechanical Engineering, University of Michigan – Dearborn, 4901 Evergreen Road, Dearborn, MI 48128
| | - So Young Baek
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109
| | | | - Amanda O. Esquivel
- Department of Mechanical Engineering, University of Michigan – Dearborn, 4901 Evergreen Road, Dearborn, MI 48128
| |
Collapse
|
14
|
Albright JA, Chang K, Byrne RA, Quinn MS, Meghani O, Daniels AH, Owens BD. A Diagnosis of Vitamin D Deficiency Is Associated With Increased Rates of Anterior Cruciate Ligament Tears and Reconstruction Failure. Arthroscopy 2023; 39:2477-2486. [PMID: 37127241 DOI: 10.1016/j.arthro.2023.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE To characterize the association between a diagnosis of hypovitaminosis D and primary anterior cruciate ligament (ACL) tear, primary anterior cruciate ligament reconstruction (ACLR), and revision ACLR in different sex and age cohorts. METHODS In this retrospective cohort study of the PearlDiver claims database, records were queried between January 1, 2011, and October 31, 2018 for all patients aged 10 to 59 years who received a diagnosis of hypovitaminosis D. Rates of primary ACL tears, primary reconstruction, and revision reconstruction were calculated for sex- and age-specific cohorts and compared with a control of patients without a diagnosis of hypovitaminosis D. Incidence rates for primary ACL injuries were calculated, and multivariable logistic regression was used to compare rates of ACL injury, primary reconstruction, and revision reconstruction while controlling for age, sex, Charlson Comorbidity Index, and several other comorbidities. RESULTS Among the 328,011 patients (mean age 41.9 ± 12.6 years, 65.8% female) included in both the hypovitaminosis D and control cohorts, the incidence of ACL tears was 115.2 per 100,000 person-years (95% confidence interval [CI] 107.2-123.7) compared with 61.0 (95% CI 55.2-67.2) in the demographic- and comorbidity-matched control cohort. The study cohort was significantly more likely to suffer an ACL tear over a 1- (aOR 1.67, 95% CI 1.41-1.99, P < .001) and 2-year (aOR 1.81, 95% CI 1.59-2.06, P < .001) period. This trend remained for both male patients at the 1- (aOR 1.66, 95% CI 1.29-2.14, P < .001) and 2-year (aOR 1.68, 95% CI 1.37-2.06, P < .001) mark and female patients at the 1- (aOR 1.69, 95% CI 1.33-2.14, P < .001) and 2-year (aOR 1.80, 95% CI 1.51-2.14, P < .001) mark. Finally, patients with vitamin D deficiency had a significantly increased likelihood of undergoing a revision ACLR within 2 years of a primary reconstruction (aOR 1.28, 95% CI 1.05-1.55, P = .012). CONCLUSIONS This study reports an association between patients previously diagnosed with hypovitaminosis D and significantly increased rates of both index ACL tears (81% increase within 2 years of diagnosis) and revision ACLR (28% within 2 years). These results identify a population with increased odds of injury and provide valuable knowledge as we expand our understanding of the relationship between vitamin D and musculoskeletal health. LEVEL OF EVIDENCE Level III, retrospective database study.
Collapse
Affiliation(s)
- J Alex Albright
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, U.S.A.
| | - Kenny Chang
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, U.S.A
| | - Rory A Byrne
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, Rhode Island, U.S.A
| | - Matthew S Quinn
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, Rhode Island, U.S.A
| | - Ozair Meghani
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, Rhode Island, U.S.A
| | - Alan H Daniels
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, Rhode Island, U.S.A
| | - Brett D Owens
- Department of Orthopaedics, Brown University Warren Alpert Medical School, Providence, Rhode Island, U.S.A
| |
Collapse
|
15
|
Xu D, Zhou H, Quan W, Gusztav F, Wang M, Baker JS, Gu Y. Accurately and effectively predict the ACL force: Utilizing biomechanical landing pattern before and after-fatigue. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 241:107761. [PMID: 37579552 DOI: 10.1016/j.cmpb.2023.107761] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND AND OBJECTIVE As a fundamental exercise technique, landing can commonly be associated with anterior cruciate ligament (ACL) injury, especially during after-fatigue single-leg landing (SL). Presently, the inability to accurately detect ACL loading makes it difficult to recognize the risk degree of ACL injury, which reduces the effectiveness of injury prevention and sports monitoring. Increased risk of ACL injury during after-fatigue SL may be related to changes in ankle motion patterns. Therefore, this study aims to develop a highly accurate and easily implemented ACL force prediction model by combining deep learning and the explored relationship between ACL force and ankle motion pattern. METHODS First, 56 subjects' during before and after-fatigue SL data were collected to explore the relationship between the ankle initial contact angle (AIC), ankle range of motion (AROM) and peak ACL force (PAF). Then, the musculoskeletal model was developed to simulate and calculate the ACL force. Finally, the ACL force prediction model was constructed by combining the explored relationship and sparrow search algorithm (SSA) to optimize the extreme learning machine (ELM) and long short-term memory (LSTM). RESULTS There was almost a stronger linear relationship between the PAF and AIC (R = -0.70), AROM (R2 = -0.61). By substituting AIC and AROM as independent variables in the SSA-ELM prediction model, the model shows excellent prediction performance because of very strong correlation (R2 = 0.9992, MSE = 0.0023, RMSE = 0.0474). Based on the equal scaling by combining results of SSA-ELM and SSA-LSTM, the prediction model achieves excellent performance in ACL force prediction of the overall waveform (R2 = 0.9947, MSE = 0.0076, RMSE = 0.0873). CONCLUSION By increasing the AIC and AROM during SL, the lower limb joint energy dissipation can be increased and the PAF reduced, thus reducing the impact loads on the lower limb joints and reducing ACL injuries. The proposed ACL dynamic load force prediction model has low input variable demands (sagittal joint angles), excellent generalization capabilities and superior performance in terms of high accuracy. In the future, we plan to use it as an accurate ACL injury risk assessment tool to promote and apply it to a wider range of sports training and injury monitoring.
Collapse
Affiliation(s)
- Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Faculty of Engineering, University of Pannonia, Veszprém, 8201, Hungary; Savaria Institute of Technology, Eötvös Loránd University, Szombathely, 9700, Hungary
| | - Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; School of Health and Life Sciences, University of the West of Scotland, Scotland, G72 0LH, United Kingdom
| | - Wenjing Quan
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Faculty of Engineering, University of Pannonia, Veszprém, 8201, Hungary; Savaria Institute of Technology, Eötvös Loránd University, Szombathely, 9700, Hungary
| | - Fekete Gusztav
- Faculty of Engineering, University of Pannonia, Veszprém, 8201, Hungary; Savaria Institute of Technology, Eötvös Loránd University, Szombathely, 9700, Hungary
| | - Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong, China
| | - Julien S Baker
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, 999077, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China.
| |
Collapse
|
16
|
Liu S, Yan H, Wang Z, Zhang Y, Johnson RS, Wei S, Pan J. Effects of shoe collar types on ankle and knee biomechanics characteristics when performing the side-step cutting task. Sports Biomech 2023:1-17. [PMID: 37736666 DOI: 10.1080/14763141.2023.2249860] [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: 10/26/2022] [Accepted: 08/10/2023] [Indexed: 09/23/2023]
Abstract
This study aimed to examine the effect of football shoes with different collar types on ankle and knee kinematic and kinetics features during 45° and 135° side-step cutting tasks. Fifteen healthy college football players volunteered for the study. Each participant was instructed to perform side-step cutting tasks with high, low, and no collar football shoes. The kinematic and ground reaction force data were measured using a Vicon motion capture system and a Kistler force plate, respectively. Two-way MANOVAs with repeated measures were used to examine the effect of shoe collar type and task conditions. There were no interaction effects. The high collar football shoe showed decreased ankle range of motion in the sagittal plane (p = 0.010) and peak ankle external rotation moment (p = 0.009) compared to the no collar football shoe. The high (p = 0.025) and low (p = 0.029) collar football shoes presented greater peak ankle external rotation angles than the no collar football shoe. These results imply that football shoes with high collars made of high intensity knitted fabric could be used to restrict ankle joint movement, with potential implications for decreasing the risk of ankle sprain injuries in football players.
Collapse
Affiliation(s)
- Shuangen Liu
- College of Physical Education, Jinzhong University, Jinzhong, China
| | - Hui Yan
- College of Physical Education, Jinzhong University, Jinzhong, China
| | - Zhikang Wang
- Center for Research & Innovation, 316º(CHINA) CO. LTD, Xiamen, China
| | - Yifang Zhang
- Center for Research & Innovation, 316º(CHINA) CO. LTD, Xiamen, China
| | - Rachel S Johnson
- Center for Orthopaedic & Biomechanics Research, Boise State University, Boise, Idaho, USA
| | - Shutao Wei
- Center for Research & Innovation, 316º(CHINA) CO. LTD, Xiamen, China
| | - Jiahao Pan
- Center for Orthopaedic & Biomechanics Research, Boise State University, Boise, Idaho, USA
| |
Collapse
|
17
|
Ajdaroski M, Esquivel A. Can Wearable Sensors Provide Accurate and Reliable 3D Tibiofemoral Angle Estimates during Dynamic Actions? SENSORS (BASEL, SWITZERLAND) 2023; 23:6627. [PMID: 37514921 PMCID: PMC10383318 DOI: 10.3390/s23146627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
The ability to accurately measure tibiofemoral angles during various dynamic activities is of clinical interest. The purpose of this study was to determine if inertial measurement units (IMUs) can provide accurate and reliable angle estimates during dynamic actions. A tuned quaternion conversion (TQC) method tuned to dynamics actions was used to calculate Euler angles based on IMU data, and these calculated angles were compared to a motion capture system (our "gold" standard) and a commercially available sensor fusion algorithm. Nine healthy athletes were instrumented with APDM Opal IMUs and asked to perform nine dynamic actions; five participants were used in training the parameters of the TQC method, with the remaining four being used to test validity. Accuracy was based on the root mean square error (RMSE) and reliability was based on the Bland-Altman limits of agreement (LoA). Improvement across all three orthogonal angles was observed as the TQC method was able to more accurately (lower RMSE) and more reliably (smaller LoA) estimate an angle than the commercially available algorithm. No significant difference was observed between the TQC method and the motion capture system in any of the three angles (p < 0.05). It may be feasible to use this method to track tibiofemoral angles with higher accuracy and reliability than the commercially available sensor fusion algorithm.
Collapse
Affiliation(s)
- Mirel Ajdaroski
- Department of Mechanical Engineering, College of Engineering and Computer Science, University of Michigan-Dearborn, Dearborn, MI 48128, USA
| | - Amanda Esquivel
- Department of Mechanical Engineering, College of Engineering and Computer Science, University of Michigan-Dearborn, Dearborn, MI 48128, USA
| |
Collapse
|
18
|
Jeong J, Choi DH, Shin CS. Association Between the Medial-Lateral Quadriceps and Hamstring Muscle Thickness and the Knee Kinematics and Kinetics During Single-Leg Landing. Sports Health 2023; 15:519-526. [PMID: 36856193 PMCID: PMC10293562 DOI: 10.1177/19417381231152476] [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: 03/02/2023] Open
Abstract
BACKGROUND Muscle thickness can influence the joint kinematics and/or kinetics during dynamic activities. The relationship between the muscle thickness of individual quadriceps and hamstrings or medial-to-lateral thigh muscle thickness ratio and the knee kinematics/kinetics with respect to anterior cruciate ligament (ACL) injury risk remains unclear. HYPOTHESIS Higher medial-to-lateral thigh muscle thickness ratio would be associated with lower knee valgus angle/moment and lower tibial internal rotation angle/moment during single-leg landing. STUDY DESIGN Cross-sectional. LEVEL OF EVIDENCE Level 4. METHODS Muscle thickness of the vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and semitendinosus (ST) of 30 healthy participants (16 males and 14 females) were measured using ultrasound. Knee joint kinematics and kinetics during single-leg landing were obtained. Stepwise multiple regression analysis, a follow-up Fisher's r to z test to examine the sex as a moderator, and independent t tests to evaluate sex difference were performed. RESULTS Both knee valgus moment (R2 = 0.466, P < 0.001) and tibial external rotation moment (R2 = 0.330, P < 0.001) at peak anterior tibial shear force during single-leg landing were negatively correlated with medial-to-lateral (ie, (VM+ST):(VL+BF)) thickness ratio regardless of sex, whereas medial-to-lateral thigh muscle thickness ratio was not correlated with knee valgus and tibial external rotation angles. Male participants exhibited higher (VM+ST):(VL+BF) thickness ratio than female participants (P = 0.005), and lower knee valgus moment (P = 0.04) and tibial external rotation moment (P = 0.05), as well. CONCLUSION The knee joint moments in frontal and transverse planes during single-leg landing were associated with the medial-to-lateral thigh muscle thickness ratio; thus, the medial-lateral thigh muscle thickness could be a potential contributor to frontal and transverse plane knee joint loading during dynamic movement. CLINICAL RELEVANCE Strength training that aims to selectively strengthen the medial/lateral thigh muscles might be considered in a new ACL injury prevention training program to alter the biomechanical parameters associated with ACL injuries.
Collapse
Affiliation(s)
- Jiyoung Jeong
- Department of Mechanical Engineering, Sogang University, Seoul, Republic of Korea
| | - Dai-Hyuk Choi
- Department of Physical Education, Graduate School of Education, Sogang University, Seoul, Republic of Korea
| | - Choongsoo S. Shin
- Department of Mechanical Engineering, Sogang University, Seoul, Republic of Korea
| |
Collapse
|
19
|
Leite CBG, Merkely G, Farina EM, Smith R, Görtz S, Hazzard S, Asnis P, Lattermann C. Effect of Tibiofemoral Rotation Angle on Graft Failure After Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2023; 51:2291-2299. [PMID: 37454271 DOI: 10.1177/03635465231163856] [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: 07/18/2023]
Abstract
BACKGROUND Coronal and sagittal malalignment of the knee are well-recognized risk factors for failure after anterior cruciate ligament (ACL) reconstruction (ACLR). However, the effect of axial malalignment on graft survival after ACLR is yet to be determined. PURPOSE To evaluate whether increased tibiofemoral rotational malalignment, namely, tibiofemoral rotation angle (TFA) and tibial tubercle-trochlear groove (TT-TG) distance, is associated with graft failure after ACLR. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS In this retrospective matched control study of a single center's database, 151 patients who underwent revision ACLR because of graft failure (ACLR failure group, defined as symptomatic patients with anterior knee instability and an ACL graft tear appreciated on magnetic resonance imaging [MRI] and confirmed during arthroscopic surgery) were compared with a matched control group of 151 patients who underwent primary ACLR with no evidence of failure after ≥2-year follow-up (intact ACLR group). Patients were matched by sex, age, and meniscal injury during primary ACLR. Axial malalignment was assessed on preoperative MRI through the TFA and the TT-TG distance. Sagittal alignment was measured through the posterior tibial slope on MRI. The optimal TFA cutoff associated with graft failure was identified by a receiver operating characteristic curve. The Kaplan-Meier curve with log-rank analysis was performed to evaluate the influence of the TFA on ACLR longevity. RESULTS The mean age was 25.7 ± 10.4 years for the ACLR failure group and 25.9 ± 10.0 years for the intact ACLR group. Among all the included patients, 174 (57.6%) were male. In the ACLR failure group, the mean TFA was 5.8°± 4.5° (range, -5° to 16°), while it was 3.0°± 3.3° (range, -3° to 15°) in the intact ACLR group (P < .001). Neither the TT-TG distance nor the posterior tibial slope presented statistical differences between the groups. The receiver operating characteristic curve suggested an optimal TFA cutoff of 4.5° for graft failure (area under the curve = 0.71; P < .001; sensitivity, 68.2%; specificity, 75.5%). Considering this a threshold, patients who had a TFA ≥4.5° had 6.6 times higher odds of graft failure compared with patients with a TFA <4.5° (P < .001). Survival analysis demonstrated a 5-year survival rate of 81% in patients with a TFA <4.5°, while it was 44% in those with a TFA ≥4.5° (P < .001). CONCLUSION An increased TFA was associated with increased odds of ACLR failure when the TFA was ≥4.5°. Measuring the TFA in patients with ACL tears undergoing reconstruction may inform the surgeon about additional factors that may require consideration before ACLR for a successful outcome.
Collapse
Affiliation(s)
- Chilan Bou Ghosson Leite
- Center for Cartilage Repair and Sports Medicine, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gergo Merkely
- Center for Cartilage Repair and Sports Medicine, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Evan M Farina
- Center for Cartilage Repair and Sports Medicine, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Richard Smith
- Center for Cartilage Repair and Sports Medicine, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Simon Görtz
- Center for Cartilage Repair and Sports Medicine, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sean Hazzard
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter Asnis
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Christian Lattermann
- Center for Cartilage Repair and Sports Medicine, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
20
|
Beaulieu ML, Ashton-Miller JA, Wojtys EM. Loading mechanisms of the anterior cruciate ligament. Sports Biomech 2023; 22:1-29. [PMID: 33957846 PMCID: PMC9097243 DOI: 10.1080/14763141.2021.1916578] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/08/2021] [Indexed: 01/26/2023]
Abstract
This review identifies the three-dimensional knee loads that have the highest risk of injuring the anterior cruciate ligament (ACL) in the athlete. It is the combination of the muscular resistance to a large knee flexion moment, an external reaction force generating knee compression, an internal tibial torque, and a knee abduction moment during a single-leg athletic manoeuvre such as landing from a jump, abruptly changing direction, or rapidly decelerating that results in the greatest ACL loads. While there is consensus that an anterior tibial shear force is the primary ACL loading mechanism, controversy exists regarding the secondary order of importance of transverse-plane and frontal-plane loading in ACL injury scenarios. Large knee compression forces combined with a posteriorly and inferiorly sloped tibial plateau, especially the lateral plateau-an important ACL injury risk factor-causes anterior tibial translation and internal tibial rotation, which increases ACL loading. Furthermore, while the ACL can fail under a single supramaximal loading cycle, recent evidence shows that it can also fail following repeated submaximal loading cycles due to microdamage accumulating in the ligament with each cycle. This challenges the existing dogma that non-contact ACL injuries are predominantly due to a single manoeuvre that catastrophically overloads the ACL.
Collapse
Affiliation(s)
- Mélanie L. Beaulieu
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - James A. Ashton-Miller
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Edward M. Wojtys
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
21
|
Aiello F, Impellizzeri FM, Brown SJ, Serner A, McCall A. Injury-Inciting Activities in Male and Female Football Players: A Systematic Review. Sports Med 2023; 53:151-176. [PMID: 36315396 PMCID: PMC9807506 DOI: 10.1007/s40279-022-01753-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND A comprehensive examination of the sport-specific activities performed around the time of injury is important to hypothesise injury mechanisms, develop prevention strategies, improve management, and inform future investigations. The aim of this systematic review is to summarise the current literature describing the activities performed around the time of injury in football (soccer). METHODS A systematic search was carried out in PubMed, Web of Science, SPORTDiscus, and OpenGrey. Studies were included if participants were football players aged > 13 years old and the activities performed at the time of injury were reported together with the total number of injuries. Risk of bias was assessed using an adapted version of checklists developed for prevalence studies. The activities reported by the studies were grouped to account for inconsistent reporting, and the proportion of each injury activity was calculated. Data were not meta-analysed due to high heterogeneity of methods and classification criteria. RESULTS We included 64 studies reporting on 56,740 injuries in total. ACL injures were analysed by 12 studies, ankle/foot and knee injuries were analysed by five studies, thigh injuries were analysed by four studies, hip/groin injuries were analysed by three studies, and hamstring injuries were analysed by two studies. Five studies analysed more than one type of injury and 38 studies did not specify the type of injuries analysed. Running and kicking were the predominant activities leading to thigh and hamstring injuries. Changing direction and kicking were the predominant activities leading to hip and groin injuries and duels were the predominant activities leading to ankle injuries. Duels and pressing seem the predominant activities leading to ACL injuries, while results for other knee and general injuries were inconsistent. CONCLUSIONS A qualitative summary of the activities performed at the time of injury has been reported. The results need to be interpreted carefully due to the risk of bias observed in the included studies. If we are to meaningfully progress our knowledge in this area, it is paramount that future research uses consistent methods to record and classify injuries and activities leading up to and performed at the time of injury. REGISTRATION The protocol of this systematic review was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/U96KV ).
Collapse
Affiliation(s)
- Francesco Aiello
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Franco M Impellizzeri
- Faculty of Health, Sport and Exercise Discipline Group, University of Technology Sydney, Sydney, Australia
| | - Susan J Brown
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Andreas Serner
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
| | - Alan McCall
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK.
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK.
| |
Collapse
|
22
|
Shinde T, Saito A, Okada K, Wakasa M, Kimoto M, Kamada T, Shibata K, Okura K, Sato H, Takahashi Y. Influence of lower extremity rotation on knee kinematics in single-leg landing. Phys Ther Sport 2022; 58:87-92. [DOI: 10.1016/j.ptsp.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 10/02/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
|
23
|
Ogasawara I, Nambo M, Uno Y, Revankar GS, Umegaki K, Cheng H, Konda S, Matsuo T, Mae T, Hashizume K, Nakata K. The counteracting effect of the friction moment against the tibial rotational moment driven by the ground reaction force in an early stance phase of cutting maneuver among healthy male athletes. J Sports Sci 2022; 40:2072-2084. [DOI: 10.1080/02640414.2022.2133392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Issei Ogasawara
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
- Department of Sports Medical Biomechanics, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka 565-0871, Suita, Osaka, Japan
| | - Megumi Nambo
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
| | - Yuki Uno
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
| | - Gajanan S. Revankar
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
- Institute for Transdisciplinary Graduate Degree Programs, Osaka University, Osaka, Japan
| | - Kaho Umegaki
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
| | - Haotian Cheng
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
| | - Shoji Konda
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
- Department of Sports Medical Biomechanics, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka 565-0871, Suita, Osaka, Japan
| | - Tomoyuki Matsuo
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
| | - Tatsuo Mae
- Department of Sports Medical Biomechanics, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka 565-0871, Suita, Osaka, Japan
| | - Ken Hashizume
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
| | - Ken Nakata
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama-cho 560-0043, Toyonaka, Osaka, Japan
| |
Collapse
|
24
|
Yang T, Huang Y, Zhong G, Kong L, Yan Y, Lai H, Zeng X, Huang W, Zhang Y. 6DOF knee kinematic alterations due to increased load levels. Front Bioeng Biotechnol 2022; 10:927459. [PMID: 36213071 PMCID: PMC9533867 DOI: 10.3389/fbioe.2022.927459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/25/2022] [Indexed: 11/23/2022] Open
Abstract
Whether load carriage leads to six-degrees-of-freedom (6DOF) knee kinematic alterations remains unclear. Exploring this mechanism may reveal meaningful knee kinematic information that can be used to improve load carriage conditions, the design of protective devices, and the knowledge of the effects of load carriage on knees. We recruited 44 subjects to explore kinematic alterations from an unloaded state to 60% bodyweight (BW) load carriage. A three-dimensional gait analysis system was used to collect the knee kinematic data. One-way repeated analysis of variance (ANOVA) was used to explore the effects of load levels on knee kinematics. The effects of increasing load levels on knee kinematics were smooth with decreased or increased trends. We found that knees significantly exhibited increased lateral tibial translation (up to 1.2 mm), knee flexion angle (up to 1.4°), internal tibial rotation (up to 1.3°), and tibial proximal translation (up to 1.0 mm) when they went from an unloaded state to 60%BW load carriage during the stance phase (p < 0.05). Significant small knee adduction/abduction angle and posterior tibial translation alterations (<1°/mm) were also identified (p < 0.05). Load carriage can cause significant 6DOF knee kinematic alterations. The results showed that knee kinematic environments are challenging during increased load. Our results contain kinematic information that could be helpful for knee-protection-related activities, such as target muscle training to reduce abnormal knee kinematics and knee brace design.
Collapse
Affiliation(s)
- Tao Yang
- Department of Orthopaedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Key Lab of Orthopedic Technology and Implant Materials, Key Laboratory of Trauma & Tissue Repair of Tropical Area of PLA, Hospital of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangzhou, China
| | - Yaxiang Huang
- Department of Orthopaedics, The First People’s Hospital of Jiujiang, Affiliated Jiujiang Hospital of Nanchang University, Jiujiang, China
| | - Guoqing Zhong
- Department of Orthopaedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lingchuang Kong
- Guangdong Key Lab of Orthopedic Technology and Implant Materials, Key Laboratory of Trauma & Tissue Repair of Tropical Area of PLA, Hospital of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangzhou, China
| | - Yuan Yan
- Department of Orthopaedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Huahao Lai
- Department of Orthopaedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaolong Zeng
- Department of Orthopaedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Key Lab of Orthopedic Technology and Implant Materials, Key Laboratory of Trauma & Tissue Repair of Tropical Area of PLA, Hospital of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangzhou, China
- School of Medicine, South China University of Technology, Guangzhou, China
- *Correspondence: Xiaolong Zeng, ; Wenhan Huang, ; Yu Zhang,
| | - Wenhan Huang
- Department of Orthopaedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Key Lab of Orthopedic Technology and Implant Materials, Key Laboratory of Trauma & Tissue Repair of Tropical Area of PLA, Hospital of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangzhou, China
- *Correspondence: Xiaolong Zeng, ; Wenhan Huang, ; Yu Zhang,
| | - Yu Zhang
- Department of Orthopaedics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Key Lab of Orthopedic Technology and Implant Materials, Key Laboratory of Trauma & Tissue Repair of Tropical Area of PLA, Hospital of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangzhou, China
- School of Medicine, South China University of Technology, Guangzhou, China
- *Correspondence: Xiaolong Zeng, ; Wenhan Huang, ; Yu Zhang,
| |
Collapse
|
25
|
Influence of Bone Morphology on In Vivo Tibio-Femoral Kinematics in Healthy Knees during Gait Activities. J Clin Med 2022; 11:jcm11175082. [PMID: 36079016 PMCID: PMC9457019 DOI: 10.3390/jcm11175082] [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: 07/18/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 12/03/2022] Open
Abstract
An improved understanding of the relationships between bone morphology and in vivo tibio-femoral kinematics potentially enhances functional outcomes in patients with knee disorders. The aim of this study was to quantify the influence of femoral and tibial bony morphology on tibio-femoral kinematics throughout complete gait cycles in healthy subjects. Twenty-six volunteers underwent clinical examination, radiographic assessment, and dynamic video-fluoroscopy during level walking, downhill walking, and stair descent. Femoral computer-tomography (CT) measurements included medial condylar (MC) and lateral condylar (LC) width, MC and LC flexion circle, and lateral femoral condyle index (LFCI). Tibial CT measurements included both medial (MTP) and lateral tibial plateau (LTP) slopes, depths, lengths, and widths. The influence of bony morphology on tibial internal/external rotation and anteroposterior (AP)-translation of the lateral and medial compartments were analyzed in a multiple regression model. An increase in tibial internal/external rotation could be demonstrated with decreasing MC width β: −0.30 (95% CI: −0.58 to −0.03) (p = 0.03) during the loaded stance phase of level walking. An increased lateral AP-translation occurred with both a smaller LC flexion circle β: −0.16 (95% CI: −0.28 to −0.05) (p = 0.007) and a deeper MTP β: 0.90 (95% CI: 0.23 to 1.56) (p = 0.01) during the loaded stance phase of level walking. The identified relationship between in vivo tibio-femoral kinematics and bone morphology supports a customized approach and individual assessment of these factors in patients with knee disorders and potentially enhances functional outcomes in anterior cruciate ligament injuries and total knee arthroplasty.
Collapse
|
26
|
Strutzenberger G, David S, Borcard LM, Fröhlich S, Imhoff FB, Scherr J, Spörri J. Breaking new grounds in injury risk screening in soccer by deploying unsupervised learning with a special focus on sex and fatigue effects. Sports Biomech 2022:1-17. [PMID: 36004395 DOI: 10.1080/14763141.2022.2112748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/08/2022] [Indexed: 10/15/2022]
Abstract
In injury prevention, a vertical drop jump (DJ) is often used for screening athletes at risk for injury; however, the large variation in individual movement patterns might mask potentially relevant strategies when analysed on a group-based level. Two movement strategies are commonly discussed as predisposing athletes to ACL injuries: a deficient leg axis and increased leg stiffness during landing. This study investigated the individual movement pattern of 39 female and male competitive soccer players performing DJs at rest and after being fatigued. The joint angles were used to train a Kohonen self-organising map. Out of 19,596 input vectors, the SOM identified 700 unique postures. Visualising the movement trajectories and adding the latent parameters contact time, medial knee displacement (MKD) and knee abduction moment allow identification of zones with presumably increased injury risk and whether the individual movement patterns pass these zones. This information can be used, e.g., for individual screening and for feedback purposes. Additionally, an athlete's reaction to fatigue can be explored by comparing the rested and fatigued movement trajectories. The results highlight the ability of unsupervised learning to visualise movement patterns and to give further insight into an individual athlete's status without the necessity of a priori assumptions.
Collapse
Affiliation(s)
- Gerda Strutzenberger
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, Balgrist University Hospital, University Centre for Prevention and Sports Medicine, University of Zurich, Zurich, Switzerland
- Motion Analysis Zurich, Department of Orthopaedics, Balgrist University Hospital, Children's Hospital, University of Zurich, Zurich, Switzerland
- UMIT Tirol, Psychology and Medical Sciences, Research Unit Sports Medicine, Innsbruck, Hall in Tirol, Austria
| | - Sina David
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, HV Amsterdam, The Netherlands
| | - Lana Mei Borcard
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Fröhlich
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, Balgrist University Hospital, University Centre for Prevention and Sports Medicine, University of Zurich, Zurich, Switzerland
| | - Florian B Imhoff
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Johannes Scherr
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, Balgrist University Hospital, University Centre for Prevention and Sports Medicine, University of Zurich, Zurich, Switzerland
- Motion Analysis Zurich, Department of Orthopaedics, Balgrist University Hospital, Children's Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Orthopaedics, Balgrist University Hospital, University Centre for Prevention and Sports Medicine, University of Zurich, Zurich, Switzerland
- Motion Analysis Zurich, Department of Orthopaedics, Balgrist University Hospital, Children's Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
27
|
Nguyen T, Haider S, Tietze D, Xi Y, Thakur U, Shah J, Chhabra A. Anterior cruciate ligament foot plate anatomy: 3-dimensional and 2-dimensional MRI evaluation with arthroscopy assessment in a subset of patients. Eur Radiol 2022; 32:8386-8393. [PMID: 35713663 DOI: 10.1007/s00330-022-08920-2] [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: 02/21/2022] [Revised: 04/06/2022] [Accepted: 05/30/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES ACL reconstruction tunnel location is an important predictor for outcomes after surgery. The aim was to establish 3D and 2D MRI radiological measurements for native ACL tibial footprint that can provide information to facilitate pre-operative planning for anatomical graft placement. The measurements were also correlated in a subset of patients on arthroscopy. METHODS Retrospective evaluation of a consecutive series of knee MRIs with both 2D and 3D MR imaging was performed in 101 patients with 43 men and 66 women and ages 39.5 ± 11.9 years. Two measurements were obtained, tibial to ACL and intermeniscal ligament to ACL (T-ACL) and (IM-ACL), respectively. In a cohort of 18 patients who underwent knee arthroscopy, the T-ACL and IML-ACL distances were also determined by an orthopedic surgeon using a standard scale. ICC, Pearson correlation, and Bland-Altman plot were generated. RESULTS For readers 1 and 2, the mean differences between 2D and 3D measurements of T-ACL and IM-ACL were 1.17 and 1.03 mm and 0.65 and 0.65 mm, respectively. The 2D measurements of T-ACL and IM-ACL were larger than the 3D measurements for both readers. The inter-reader reliability was excellent on 2D (0.81-0.96) and fair to excellent on 3D MRI (0.59-0.90). The mean arthroscopic IML-ACL was closer to that of 3D MRI compared to 2D MRI. The mean arthroscopic T-ACL was closer to 2D MRI than 3D MRI. CONCLUSIONS Both 2D and 3D MRI show inter-reader reliability with small inter-modality mean differences in the measurements from the tibial or inter-meniscal ligament margins. KEY POINTS • The mean differences between 2D and 3D measurements of tibia-ACL and intermeniscal ligament-ACL are small (< 1.2 mm). • As compared to arthroscopy, the mean T-ACL and IML-ACL were closer to measurements from 2D and 3D MRI, respectively. • Both 2D and 3D MRI can be reliably used to delineate ACL foot plate anatomy.
Collapse
Affiliation(s)
- Toan Nguyen
- Department of Radiology, UT Southwestern Medical Center, Dallas, USA
| | - Shamrez Haider
- Department of Radiology, UT Southwestern Medical Center, Dallas, USA
| | - David Tietze
- Department of Orthopedic Surgery, UT Southwestern Medical Center, UT Southwestern, 5323 Harry Hines Blvd, Dallas, TX, USA
| | - Yin Xi
- Department of Radiology, UT Southwestern Medical Center, Dallas, USA
| | - Uma Thakur
- Department of Radiology, UT Southwestern Medical Center, Dallas, USA
| | - Jay Shah
- Department of Orthopedic Surgery, UT Southwestern Medical Center, UT Southwestern, 5323 Harry Hines Blvd, Dallas, TX, USA
| | - Avneesh Chhabra
- Department of Radiology, UT Southwestern Medical Center, Dallas, USA. .,Department of Orthopedic Surgery, UT Southwestern Medical Center, UT Southwestern, 5323 Harry Hines Blvd, Dallas, TX, USA. .,Johns Hopkins University, Baltimore, USA. .,Walton Centre for Neuroscience, Liverpool, UK.
| |
Collapse
|
28
|
Lambert C, Riesterer J, Mauch M, Lambert M, Paul J, Ritzmann R. Modified defense reaction reduces biomechanical and myoelectrical ACL injury risk factors in elite Judo. J Sports Sci 2022; 40:1325-1335. [PMID: 35616597 DOI: 10.1080/02640414.2022.2080160] [Citation(s) in RCA: 2] [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
In judo, an anterior cruciate ligament (ACL) injury is the most severe injury an athlete could experience. Most ACL ruptures occur when defending against an osoto-gari attack. This study aims to identify ACL risk factors during osoto-gari defence and implement a modified osoto-gari defence reaction, which is assumed to improve myoelectric patterns and ameliorate critical biomechanical risk factors for ACL injuries. Twenty-six elite judokas were enrolled in the cross-over trial (female: 6; male: 20). 3D kinematics and force dynamometrics were combined with electromyographical recordings to assess the effects of the common and the modified osoto-gari defence reaction. Compared to the common osoto-gari defence reaction (maximal knee flexion: 29 ± 12°; maximal valgus: 10 ± 5°; maximal valgus moment: 58 ± 17 Nm; peak internal rotation: 9 ± 5°), the modified osoto-gari defence reaction showed significantly reduced knee angles (31 ± 10° p < 0.05; 1 ± 0° p < 0.05; 31 ± 9 Nm p < 0.05; 3 ± 0° p < 0.05). The myoelectric activity of the hamstring increased (+5±% to +27±%, p < 0.05) in the modified compared to common defence reaction. The modified osoto-gari defence reaction reduced critical biomechanical risk factors and increased hamstring myoelectric activity. We recommend the implementation of the modified osoto-gari defence reaction in judo practice and seek to evaluate its long-term effectiveness in decreasing ACL injury incidences in elite judo.
Collapse
Affiliation(s)
- Christophe Lambert
- Department of Functional Diagnostics, Rennbahnklinik, Muttenz, Switzerland.,Department of Trauma and Orthopedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Centre, Cologne, Germany
| | - Janine Riesterer
- Department of Functional Diagnostics, Rennbahnklinik, Muttenz, Switzerland
| | - Marlene Mauch
- Department of Functional Diagnostics, Rennbahnklinik, Muttenz, Switzerland
| | - Maxime Lambert
- Department of Trauma and Orthopedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Centre, Cologne, Germany
| | - Jochen Paul
- Department of Functional Diagnostics, Rennbahnklinik, Muttenz, Switzerland
| | - Ramona Ritzmann
- Department of Functional Diagnostics, Rennbahnklinik, Muttenz, Switzerland
| |
Collapse
|
29
|
Rolley TL, Saunders N, Bonacci J, Keast M, Fox AS. Video Analysis of Anterior Cruciate Ligament Injury Situations in the Women's Australian Football League. SCI MED FOOTBALL 2022; 7:106-123. [PMID: 35544763 DOI: 10.1080/24733938.2022.2076897] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Anterior cruciate ligament (ACL) injury rates in the Women's Australian Football League (AFLW) are alarmingly high. Understanding injuries within their sporting context is important to develop effective injury prevention strategies, yet there is currently little knowledge of how ACL injuries occur to AFLW players. This study addressed the common scenarios and characteristics of ACL injuries in the AFLW. Online match and AFLW club injury reports identified 38 ACL injury cases. After excluding injuries where footage was unavailable (i.e. training, pre-season games), a video analysis of 21 match ACL injuries from the 2017-2020 AFLW seasons was performed. We examined match characteristics, and the player's movements and body postures preceding and at the estimated time of injury. Descriptive frequencies and relative proportions were determined across the assessed categories. Non-contact ACL injuries were frequently observed (n=13, 61.9%), while contact preceding the injury event (i.e. indirect contact) was also common (n=10, 47.6%). The most common game situation was direct defence (i.e. defending an opponent in possession) (n=14, 66.7%). Sidestep cutting was the most prevalent movement (n=11, 52.4%), with this commonly performed while applying defensive pressure (n=6 of 11, 54.6%). Sidestep cutting when applying defensive pressure is the most common non-contact ACL injury scenario in the AFLW. Preceding contact potentially contributing to a player's loss of balance was another prominent AFLW scenario. AFLW players may benefit from injury prevention programs emphasising appropriate sidestep cutting technique during reactive defensive scenarios, and maintenance of lower limb postures known to withstand knee loading relative to the sporting task.
Collapse
Affiliation(s)
- Tess L Rolley
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Natalie Saunders
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jason Bonacci
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Meghan Keast
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Aaron S Fox
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| |
Collapse
|
30
|
Abstract
Anterior cruciate ligament (ACL) injuries are one of the most common knee pathologies sustained during athletic participation and are characterised by long convalescence periods and associated financial burden. Muscles have the ability to increase or decrease the mechanical loads on the ACL, and thus are viable targets for preventative interventions. However, the relationship between muscle forces and ACL loading has been investigated by many different studies, often with differing methods and conclusions. Subsequently, this review aimed to summarise the evidence of the relationship between muscle force and ACL loading. A range of studies were found that investigated muscle and ACL loading during controlled knee flexion, as well as a range of weightbearing tasks such as walking, lunging, sidestep cutting, landing and jumping. The quadriceps and the gastrocnemius were found to increase load on the ACL by inducing anterior shear forces at the tibia, particularly when the knee is extended. The hamstrings and soleus appeared to unload the ACL by generating posterior tibial shear force; however, for the hamstrings, this effect was contingent on the knee being flexed greater than ~ 20° to 30°. The gluteus medius was consistently shown to oppose the knee valgus moment (thus unloading the ACL) to a magnitude greater than any other muscle. Very little evidence was found for other muscle groups with respect to their contribution to the loading or unloading of the ACL. It is recommended that interventions aiming to reduce the risk of ACL injury consider specifically targeting the function of the hamstrings, soleus and gluteus medius.
Collapse
|
31
|
Ajdaroski M, Ashton-Miller JA, Baek SY, Shahshahani PM, Esquivel AO. Testing a Quaternion Conversion Method to Determine Human Three-Dimensional Tibiofemoral Angles During an In Vitro Simulated Jump Landing. J Biomech Eng 2022; 144:1120497. [PMID: 34549272 DOI: 10.1115/1.4052496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Indexed: 11/08/2022]
Abstract
Lower limb joint kinematics have been measured in laboratory settings using fixed camera-based motion capture systems; however, recently inertial measurement units (IMUs) have been developed as an alternative. The purpose of this study was to test a quaternion conversion (QC) method for calculating the three orthogonal knee angles during the high velocities associated with a jump landing using commercially available IMUs. Nine cadaveric knee specimens were instrumented with APDM Opal IMUs to measure knee kinematics in one-legged 3-4× bodyweight simulated jump landings, four of which were used in establishing the parameters (training) for the new method and five for validation (testing). We compared the angles obtained from the QC method to those obtained from a commercially available sensor and algorithm (APDM Opal) with those calculated from an active marker motion capture system. Results showed a significant difference between both IMU methods and the motion capture data in the majority of orthogonal angles (p < 0.01), though the differences between the QC method and Certus system in the testing set for flexion and rotation angles were smaller than the APDM Opal algorithm, indicating an improvement. Additionally, in all three directions, both the limits of agreement and root-mean-square error between the QC method and the motion capture system were smaller than between the commercial algorithm and the motion capture.
Collapse
Affiliation(s)
- Mirel Ajdaroski
- Department of Mechanical Engineering, University of Michigan-Dearborn, 4901 Evergreen Road, Dearborn, MI 48128
| | - James A Ashton-Miller
- Department of Mechanical Engineering, University of Michigan-Ann Arbor, 3443 GGB (George G. Brown Laboratory), 2350 Hayward Street, Ann Arbor, MI 48109
| | - So Young Baek
- Department of Mechanical Engineering, University of Michigan-Ann Arbor, 3443 GGB (George G. Brown Laboratory), 2350 Hayward Street, Ann Arbor, MI 48109
| | - Payam Mirshams Shahshahani
- Department of Mechanical Engineering, University of Michigan-Ann Arbor, 3443 GGB (George G. Brown Laboratory), 2350 Hayward Street, Ann Arbor, MI 48109
| | - Amanda O Esquivel
- Department of Mechanical Engineering, University of Michigan-Dearborn, 4901 Evergreen Road, Dearborn, MI 48128
| |
Collapse
|
32
|
Central vs. Peripheral Vision during a Singe-Leg Drop Jump: Implications of Dynamics and Patellofemoral Joint Stress. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Landing on a single-leg without receiving direct visual information (e.g., not looking at the ground) may increase the risk of injury. We examined whether visual focus contributed to the changing lower-extremity dynamics and patellofemoral joint stress during a single-leg drop jump task. Twenty healthy volunteers visited the laboratory for three separate sessions. During each session, participants randomly performed either of two types of a single-leg drop jump task from a 30 cm high wooden box. Subsequently, participants looked at the landing spot (central vision condition) or kept their heads up (peripheral vision condition) when performing the task. Sagittal and frontal plane lower-extremity joint angles and joint moments (in the ankle, knee, and hip), including the vertical ground reaction force, and patellofemoral joint stress during the first landing phase (from initial contact to peak knee flexion) were compared. Greater ankle inversion and hip adduction were observed when landing with the peripheral vision condition. However, the magnitudes were negligeable (Cohen’s d effect size <0.35). No statistical difference was observed in other comparisons. Landing on a single-leg from a 30 cm height without receiving full visual attention (peripheral vision condition) does not increase the risk of lower-extremity traumatic and overuse injuries.
Collapse
|
33
|
Irawan DS, Huoth C, Sinsurin K, Kiratisin P, Vachalathiti R, Richards J. Concurrent Validity and Reliability of Two-dimensional Frontal Plane Knee Measurements during Multi-directional Cutting Maneuvers. Int J Sports Phys Ther 2022; 17:148-155. [PMID: 35136683 PMCID: PMC8805110 DOI: 10.26603/001c.31651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Excessive knee valgus has been strongly suggested as a contributing key factor for anterior cruciate ligament (ACL) injuries. Three-dimensional (3D) motion analysis is considered the "gold standard" to assess joint kinematics, however, this is difficult for on-field assessments and for clinical setting. PURPOSE To investigate the concurrent validity of 2D measurements of knee valgus angle during cutting in different directions and to explore intra-rater and inter-rater reliability of the 2D measurements. STUDY DESIGN Descriptive laboratory study. METHOD Seven recreational soccer players participated in this study. Participants performed three trials of cutting maneuvers in three different directions (30º, 60º, and 90º) with the dominant leg. Cutting maneuvers were recorded simultaneously with a video camera and a ViconTM motion capture system. Knee valgus angle from 2D and 3D measurements at initial contact and at peak vertical ground reaction force (vGRF) were extracted. The Pearson's correlation was used to explore the relationship between the 2D and 3D measurements, and reliability of the 2D measurements were performed using intraclass correlation coefficients (ICC). RESULT Significant correlations between 2D and 3D knee valgus measurements were noted for 60º (r = 0.45) and 90º (r = 0.77) cutting maneuvers at initial contact. At peak vGRF, significant correlations between 2D and 3D knee valgus measurements were noted for 30º, 60º, and 90º cutting maneuvers (r=0.45, r=0.74, r=0.78), respectively. Good-to-excellent intra-rater and inter-rater reliability of the 2D knee valgus measurements was observed during cutting in all directions (ICCs: 0.821-0.997). CONCLUSION Moderate-to-strong correlation between 2D and 3D knee valgus measurements during 60°-90° cutting maneuvers, and good-to-excellent intra-rater and excellent inter-rater reliability for the 2D measurements in the present study supports the use of 2D knee valgus measurements in the evaluation of targeted interventions, although the limitations of examining cutting maneuvers using 2D measurement in complex movement still need to be considered. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- Dimas Sondang Irawan
- Biomechanics and Sports Research unit, Faculty of Physical Therapy, Mahidol University
| | - Chantheng Huoth
- Biomechanics and Sports Research unit, Faculty of Physical Therapy, Mahidol University
| | - Komsak Sinsurin
- Biomechanics and Sports Research unit, Faculty of Physical Therapy, Mahidol University
| | | | - Roongtiwa Vachalathiti
- Musculoskeletal Physical Therapy Research unit, Faculty of Physical Therapy, Mahidol University
| | - Jim Richards
- Allied Health Research unit, University of Central Lancashire
| |
Collapse
|
34
|
Nishizawa K, Hashimoto T, Hakukawa S, Nagura T, Otani T, Harato K. Effects of foot progression angle on kinematics and kinetics of a cutting movement. J Exp Orthop 2022; 9:11. [PMID: 35041099 PMCID: PMC8766617 DOI: 10.1186/s40634-022-00447-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/07/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose Foot progression angle is a key factor for biomechanical knee load, which is associated with noncontact anterior cruciate ligament (ACL) injury during sports-specific tasks. The purpose of the present study was to assess the biomechanics of trunk, pelvis, and lower extremities during a cutting maneuver under different foot progression angles. Methods Nineteen male collegiate athletes (ages 18–24) participated in the present study. Cutting motion was analyzed using eight infrared cameras (250 Hz), two force plates (1250 Hz), and 44 reflective markers. Subjects performed 45-degree side cutting maneuvers under three foot progression angles, including 20 degrees (toe-out: TO), 0 degrees (neutral: TN), and − 20 degrees (toe-in: TI). Peak values of each biomechanical parameters in trunk, pelvis, hip, and knee within a first 40% stance phase and each parameter at the timing of the peak vertical ground reaction force were assessed. A statistical analysis was performed to compare data among the three-foot progression angles using the Friedman test. Results Peak angles of knee abduction, tibial internal rotation, hip internal rotation, and hip adduction were significantly greater for TI position than for TO position (p < 0.01). Peak moments of knee abduction and tibial internal rotation under TI position were also significantly larger than TO position (p < 0.01). Moreover, greater peak pelvis-trunk rotation was found for TI position than for TN and TO positions (p < 0.01). Conclusion From the present study, TI position could lead to an increased risk of ACL injury during a pre-planned cut maneuver, compared to TO position.
Collapse
Affiliation(s)
- Kohei Nishizawa
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanagawa, 252-0883, Japan.
| | - Takeshi Hashimoto
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanagawa, 252-0883, Japan.,Sports Medicine Research Center, Keio University, Yokohama, Kanagawa, Japan
| | - Satoshi Hakukawa
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Takeo Nagura
- Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Toshiro Otani
- International University of Health and Welfare Ichikawa Hospital, Ichikawa, Chiba, Japan
| | - Kengo Harato
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| |
Collapse
|
35
|
Dadfar M, Sheikhhoseini R, Jafarian M, Esmaeili A. Lower extremity kinematic coupling during single and double leg landing and gait in female junior athletes with dynamic knee valgus. BMC Sports Sci Med Rehabil 2021; 13:152. [PMID: 34886878 PMCID: PMC8662875 DOI: 10.1186/s13102-021-00385-y] [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: 09/07/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dynamic knee valgus (DKV) is a common lower extremity movement disorder among females. This study aimed to investigate kinematic couplings between lower extremity joints in female junior athletes with DKV during single and double-leg landing and gait. METHODS Twenty-six physically active female junior athletes (10-14 years old) with DKV were recruited. Kinematic couplings between rearfoot, tibia, knee, and hip were extracted using eight Vicon motion capture cameras and two force plates. Zero-lag cross-correlation coefficient and vector coding were used to calculate kinematic couplings between joints during physical tasks. Paired t-test and Wilcoxon tests were run to find significant couplings between joint motions and coupling strengths. Bonferroni posthoc was used to determine significance with α ≤ 0.05. RESULTS The results showed that the strongest kinematic relationship existed between rearfoot eversion/inversion and tibial internal/external rotation during all three tasks. Correlations of the rearfoot supination/pronation with tibial rotations, knee, and hip motions in sagittal, frontal, and transverse planes were very strong to strong during double-leg landing and moderate to weak during gait. A weak correlation was observed between rearfoot supination/pronation and hip adduction/abduction during single-leg landing. CONCLUSIONS Coupling relationships between rearfoot, knee, and hip vary by the task intensity and alignment profiles in female juniors with DKV.
Collapse
Affiliation(s)
- Mahdis Dadfar
- Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Western Azadi Sport Complex Boulevard, Hakim Highway, Tehran, Iran
| | - Rahman Sheikhhoseini
- Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Western Azadi Sport Complex Boulevard, Hakim Highway, Tehran, Iran
| | - Mohadeseh Jafarian
- Department of Electrical Engineering, Faculty of Electrical Engineering, Sharif University of Technology, Tehran, Iran
| | - Alireza Esmaeili
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
- Australian Football League (AFL), Melbourne, Australia
| |
Collapse
|
36
|
Single-Leg Drop Jump Biomechanics After Ankle or Knee Joint Cooling in Healthy Young Adults. J Sport Rehabil 2021; 31:271-278. [PMID: 34853186 DOI: 10.1123/jsr.2020-0529] [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: 12/14/2020] [Revised: 08/21/2021] [Accepted: 08/31/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT It is unclear if lower-extremity joint cooling alters biomechanics during a functional movement. OBJECTIVE To investigate the effects of unilateral lower-extremity cryotherapy on movement alterations during a single-leg drop jump. DESIGN A crossover design. SETTING Laboratory. PATIENTS Twenty healthy subjects (10 males and 10 females; 23 y, 169 cm, 66 kg). INTERVENTION(S) Subjects completed a single-leg drop jump before and after a 20-minute ankle or knee joint cooling on the right leg, or control (seated without cooling) on 3 separate days. MAIN OUTCOME MEASURES Time to peak knee flexion, vertical ground reaction force, lower-extremity joint angular velocity (sagittal plane only), and angle and moment (sagittal and frontal planes) in the involved leg over the entire ground contact (GC; from initial contact to jump-off) during the first landing. Time to peak knee flexion was compared using an analysis of variance; the rest of the outcome measures were analyzed using functional analyses of variance (P < .05). RESULTS Neither joint cooling condition changed the time to peak knee flexion (F2,95 = 0.73, P = .49). Ankle joint cooling reduced vertical ground reaction force (55 N at 4% of GC), knee joint angular velocity (44°/s during 5%-9% of GC), and knee varus moment (181 N·m during 18%-20% of GC). Knee joint cooling resulted in a reduction in knee joint angular velocity (24°/s during 37%-40% of GC) and hip adduction moment (151 N·m during 46%-48% of GC), and an increase in hip joint angular velocity (16°/s during 49%-53% of GC) and plantarflexion angle (1.5° during 11%-29% of GC). CONCLUSION Resuming activity immediately after lower-extremity joint cooling does not seem to predispose an individual to injury during landing because altered mechanics are neither overlapping with the injury time period nor of sufficient magnitude to lead to an injury.
Collapse
|
37
|
Immediate Effect of Anterior Cruciate Ligament Protective Knee Taping on Knee Landing Mechanics and Muscle Activations during Side Hops. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910110. [PMID: 34639413 PMCID: PMC8508252 DOI: 10.3390/ijerph181910110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 12/02/2022]
Abstract
Athletic taping is widely used in sports to prevent injury. However, the effect of anterior cruciate ligament (ACL) protective taping on neuromuscular control during dynamic tasks remains unclear. Therefore, this study aimed to investigate the immediate effect of ACL protective taping on landing mechanics and muscle activations during side hops in healthy individuals. Fifteen healthy individuals (11 males and 4 females; age, 23.1 ± 1.4 years; height, 175.1 ± 10.4 cm; weight, 66.3 ± 11.2 kg) volunteered to participate in this study. Landing mechanics and muscle activations were measured while each participant performed single-leg hops side-to-side for ten repetitions with and without taping. An optical motion capture system and two force plates were used to collect the kinematic and kinetic data during the side hops. Surface electromyogram recordings were performed using a wireless electromyography system. Paired t-tests were performed to determine the differences in landing mechanics and muscle activations between the two conditions (taping and non-taping). The level of significance was set at p < 0.05. Compared with the non-taping condition, participants landed with a smaller knee abduction angle, greater knee external rotation angle, and smaller knee extensor moment in the taping condition. Given that greater knee abduction, internal rotation, and knee extension moment are associated with a greater risk of ACL injury, our findings suggest that ACL protective taping can have an immediate effect on dynamic knee stability. Clinicians should consider using ACL protective taping to facilitate the use of favorable landing mechanics for ACL injuries.
Collapse
|
38
|
Hirtler L, Kainberger F, Röhrich S. The intercondylar fossa-A narrative review. Clin Anat 2021; 35:2-14. [PMID: 34374453 PMCID: PMC9291140 DOI: 10.1002/ca.23773] [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: 04/07/2021] [Revised: 07/22/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
The intercondylar fossa (“intercondylar notch,” IN) is a groove at the distal end of the femur, housing important stabilizing structures: cruciate ligaments and meniscofemoral ligaments. As the risk for injury to these structures correlates with changes to the IN, exact knowledge of its morphology, possible physiological and pathological changes and different approaches for evaluating it are important. The divergent ways of assessing the IN and the corresponding measurement methods have led to various descriptions of its possible shapes. Ridges at the medial and lateral wall are considered clinically important because they can help with orientation during arthroscopy, whereas ridges at the osteochondral border could affect the risk of ligament injury. Changes related to aging and sex differences have been documented, further emphasizing the importance of individual assessment of the knee joint. Overall, it is of the utmost importance to remember the interactions between the osseous housing and the structures within.
Collapse
Affiliation(s)
- Lena Hirtler
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Franz Kainberger
- Department of Radiology and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Sebastian Röhrich
- Department of Radiology and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
39
|
Giesche F, Stief F, Groneberg DA, Wilke J. Effect of unplanned athletic movement on knee mechanics: a systematic review with multilevel meta-analysis. Br J Sports Med 2021; 55:1366-1378. [PMID: 34344709 DOI: 10.1136/bjsports-2021-103933] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare the effects of pre-planned and unplanned movement tasks on knee biomechanics in uninjured individuals. DESIGN Systematic review with meta-analysis. DATA SOURCES Five databases (PubMed, Google Scholar, Cochrane Library, ScienceDirect and Web of Science) were searched from inception to November 2020. Cross-sectional, (randomised) controlled/non-controlled trials comparing knee angles/moments of pre-planned and unplanned single-leg landings/cuttings were included. Quality of evidence was assessed using the tool of the Grading of Recommendations Assessment, Development and Evaluation working group. METHODS A multilevel meta-analysis with a robust random-effects meta-regression model was used to pool the standardised mean differences (SMD) of knee mechanics between pre-planned and unplanned tasks. The influence of possible effect modifiers (eg, competitive performance level) was examined in a moderator analysis. RESULTS Twenty-five trials (485 participants) with good methodological quality (Downs and Black) were identified. Quality of evidence was downgraded due to potential risk of bias (eg, confounding). Moderate-quality evidence indicates that unplanned tasks evoked significantly higher external knee abduction (SMD: 0.34, 95% CI: 0.16 to 0.51, 14 studies) and tibial internal rotation moments (SMD: 0.51, 95% CI: 0.23 to 0.79, 11 studies). No significant between-condition differences were detected for sagittal plane mechanics (p>0.05). According to the moderator analysis, increased abduction moments particularly occurred in non-professional athletes (SMD: 0.55, 95% CI: 0.14 to 0.95, 5 studies). CONCLUSION Unplanned movement entails higher knee abduction and tibial internal rotation moments, which could predispose for knee injury. Exercise professionals designing injury-prevention protocols, especially for non-elite athletes, should consider the implementation of assessments and exercises requiring time-constrained decision-making. PROSPERO REGISTRATION NUMBER CRD42019140331.
Collapse
Affiliation(s)
- Florian Giesche
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Felix Stief
- University Hospital Frankfurt, Department of Orthopedics (Friedrichsheim), Movement Analysis Lab, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - David A Groneberg
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Wilke
- Division of Health and Performance, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| |
Collapse
|
40
|
Dos'Santos T, Thomas C, Comfort P, Jones PA. Biomechanical Effects of a 6-Week Change-of-Direction Technique Modification Intervention on Anterior Cruciate Ligament Injury Risk. J Strength Cond Res 2021; 35:2133-2144. [PMID: 34127609 DOI: 10.1519/jsc.0000000000004075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Dos'Santos, T, Thomas, C, Comfort, P, and Jones, PA. Biomechanical effects of a 6-week change-of-direction technique modification intervention on anterior cruciate ligament injury risk. J Strength Cond Res 35(8): 2133-2144, 2021-The aim of this study was to evaluate the biomechanical effects of a 6-week change-of-direction (COD) technique modification intervention on anterior cruciate ligament (ACL) injury risk (i.e., multiplanar knee joint loads) during 45° (CUT45) and 90° (CUT90) side-step cutting. A nonrandomized, controlled 6-week intervention study was administrated. Fifteen male multidirectional sport athletes formed the intervention group (IG) who participated in two 30-minute COD technique modification sessions per week, whereas 12 male multidirectional sport athletes formed the control group and continued their normal training. Subjects performed 6 trials of the CUT45 and CUT90 task whereby pre-to-post intervention changes in lower-limb and trunk kinetics and kinematics were evaluated using three-dimensional motion and ground reaction force analysis. Two-way mixed analyses of variance revealed no significant interaction effects of group for CUT45 and CUT90 multiplanar knee joint loads (p ≥ 0.116, η2 ≤ 0.096); however, considerable individual variation was observed (positive (n = 5-8) and negative responders (n = 7-8)). Based on IG group means, COD technique modification resulted in no meaningful reductions in multiplanar knee joint loads. However, individually, considerable variation was observed, with "higher-risk" subjects generally responding positively, and subjects initially considered "low-risk" tending to increase their multiplanar knee joint loads, albeit to magnitudes not considered hazardous or "high-risk." Change-of-direction technique modification training is a simple, effective training method, requiring minimal equipment that can reduce knee joint loads and potential ACL injury risk in "higher-risk" subjects without compromising performance.
Collapse
Affiliation(s)
- Thomas Dos'Santos
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, United Kingdom
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom ; and
| | - Christopher Thomas
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, United Kingdom
| | - Paul Comfort
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, United Kingdom
- Edith Cowan University, School of Medical and Health Science, Western Australia, Australia
| | - Paul A Jones
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, United Kingdom
| |
Collapse
|
41
|
Mueske NM, Abousamra O, Katzel MJ, Vandenberg CD, Pace JL, Feifer D, Wren TAL. Effect of Static Alignment on Dynamic Knee Abduction Moments in Adolescent Athletes with Recent ACL Reconstruction. Med Sci Sports Exerc 2021; 53:1555-1560. [PMID: 34261988 DOI: 10.1249/mss.0000000000002642] [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: 11/21/2022]
Abstract
PURPOSE Dynamic limb valgus, particularly high knee abduction moments, is a known risk factor for anterior cruciate ligament (ACL) injury and may result from poor static anatomic limb alignment, faulty biomechanics, or a combination of both. The purpose of this study was to assess the influence of static lower extremity anatomic alignment and dynamic kinematic/kinetic measures on knee abduction moments during sidestep cutting in adolescent athletes with recent ACL reconstruction. METHODS This retrospective study included 50 adolescents with recent unilateral ACL reconstruction (18/50 female, mean age = 15.8 yr, 7.6 months postsurgery). Frontal plane hip-to-ankle imaging was used to measure mechanical axis deviation and tibial-femoral angle. Three-dimensional motion capture provided lower extremity kinematics and kinetics during quiet standing and during the loading phase (initial contact to peak knee flexion) of an anticipated 45° sidestep cut. Imaging, static motion capture, and dynamic motion capture measures were investigated as potential predictors of average dynamic knee abduction moment using correlation and backward stepwise linear regression. RESULTS Dynamic knee abduction moment was best predicted by a combination of younger age and dynamic measures: trunk lean toward the planting limb, knee abduction and external rotation, and ankle inversion. Although static measures were correlated with dynamic knee abduction moment in univariate analysis, no static/anatomic variables entered the model once the dynamic measures were included. CONCLUSION Knee abduction moments during sidestep cutting were related to dynamic factors reflecting frontal and transverse plane motion. Static (anatomic) lower limb alignment did not influence knee abduction moments once these dynamic factors were considered. Knee abduction moments and ACL injury risk are therefore not dictated by anatomic alignment and can be altered through neuromuscular/biomechanical training.
Collapse
Affiliation(s)
- Nicole M Mueske
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA
| | | | - Mia J Katzel
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA
| | | | - J Lee Pace
- Connecticut Children's Medical Center, Farmington, CT
| | - Daniel Feifer
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA
| | | |
Collapse
|
42
|
Dos'Santos T, Thomas C, Jones PA. The effect of angle on change of direction biomechanics: Comparison and inter-task relationships. J Sports Sci 2021; 39:2618-2631. [PMID: 34278968 DOI: 10.1080/02640414.2021.1948258] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of this was study to examine the inter-task relationships and compare change of direction (COD) biomechanics between different angles (45°, 90°, and 180°). Twenty-seven men performed three COD tasks, whereby lower-limb and trunk kinematics and kinetics were assessed via 3D motion and ground reaction force (GRF) analysis. Key mechanical differences (p ≤ 0.025, η2 = 0.024-0.940) in velocity profiles, GRF, sagittal joint angles and moments, multiplanar knee joint moments, and technical parameters existed between CODs. The primary findings were that as COD angle increased, velocity profiles decreased (p < 0.001, d = 1.56-8.96), ground contact times increased (p < 0.001, d = 3.00-5.04), vertical GRF decreased (p < 0.001, d = 0.87-3.48), and sagittal peak knee joint moments decreased (p ≤ 0.040, d = 0.62-2.73). Notably, the greatest peak knee internal rotation (KIRMs) and abduction moments (KAMs) and angles were observed during the 90° COD (p < 0.001, d = 0.88-1.81), indicating that this may be the riskiest COD angle. Small to very large (r = 0.260-0.702) associations in KAMs and KIRMs were observed between tasks, indicating that evaluations at different angles are needed to develop an athlete's biomechanical injury risk profile. The results support the concept that COD biomechanics and potential surrogates of non-contact anterior cruciate ligament injury risk are "angle-dependent"; which have important implications for COD coaching, screening, and physical preparation.
Collapse
Affiliation(s)
- Thomas Dos'Santos
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK.,Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Christopher Thomas
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK
| | - Paul A Jones
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK
| |
Collapse
|
43
|
Asymmetries in Dynamic Valgus Index After Anterior Cruciate Ligament Reconstruction: A Proof-of-Concept Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137047. [PMID: 34280984 PMCID: PMC8297279 DOI: 10.3390/ijerph18137047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 01/01/2023]
Abstract
Individuals with anterior cruciate ligament reconstruction (ACLR) are at a higher risk for subsequent anterior cruciate ligament (ACL) tears. Risk factors for ACL injuries likely involve a combination of anatomical, biomechanical, and neuromuscular factors. Dynamic knee valgus has been indicated as a possible biomechanical factor for future ACL injuries. Given that knee valgus is often accompanied by contralateral pelvic drop during single-leg activities, a dynamic valgus index (DVI) that quantifies combined kinematics of the knee and hip in the frontal plane has recently been developed. As the premise of asymmetrical DVI between limbs in the ACLR population has not been examined, this cross-sectional study was conducted with the aim to compare DVI between individuals with ACLR and healthy controls. Videos were taken for 12 participants with ACLR and 20 healthy controls when they performed single-leg hopping. One-way ANOVA revealed a higher DVI in the injured limb of the ACLR group when compared to their non-injured limb and to the healthy limb of the control group. As our data showed increased DVI in the injured limb of the ACLR group, the DVI approach accounting for hip and knee kinematics may be used to identify frontal plane movement deficits during single-leg hopping in individuals with ACLR.
Collapse
|
44
|
|
45
|
Clark NC. Noncontact Knee Ligament Injury Prevention Screening in Netball: A Clinical Commentary with Clinical Practice Suggestions for Community-Level Players. Int J Sports Phys Ther 2021; 16:911-929. [PMID: 34123542 PMCID: PMC8169033 DOI: 10.26603/001c.23553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 04/22/2021] [Indexed: 12/20/2022] Open
Abstract
Netball is a predominantly female team court-sport which is played worldwide. Netball is becoming more popular in the United States following its countrywide introduction to schools and community centers. A unique characteristic of netball is the footwork rule which restricts players to a one-step landing after catching the ball. Most netball landings are single-leg landings resulting in high vertical ground reaction forces and high skeletal tissue forces. Thus, high-risk landing events that have the biomechanical potential for injury occur frequently. Noncontact knee ligament injuries are common following a knee abduction collapse when landing. Because the consequences of noncontact knee ligament injury are profound, strategies are needed to mitigate the burden of such injury for players, teams, and society. The purpose of this clinical commentary is to demonstrate how theoretical principles, different types of research, and different levels of evidence underpin a rational clinical reasoning process for developing noncontact knee ligament injury prevention screening procedures in netball. The theoretical principles that are discussed in this commentary include injury control, the sequence of prevention, principles of screening in injury prevention, the multifactorial model of injury etiology, complex systems theory, and systems science. The different types of research that are reviewed include descriptive and analytic-observational studies. The different levels of evidence that are discussed include prospective studies, cross-sectional studies, and clinicians' own kinesiological modelling. Subsequently, an integrated approach to the evidence-informed development of noncontact knee ligament injury prevention screening procedures is presented. Clinical practice suggestions include a selection of evidence-informed screening tests that are quickly and easily implemented with netball players in local communities. The need for repeated screening at strategic timepoints across a season/year is explained. Sports physical therapists will find this commentary useful as an example for how to undertake clinical reasoning processes that justify the content of screening procedures contributing to noncontact knee ligament injury prevention in community-level netball. LEVEL OF EVIDENCE 5.
Collapse
|
46
|
Guillén-Rogel P, Barbado D, Franco-Escudero C, San Emeterio C, Marín PJ. Are Core Stability Tests Related to Single Leg Squat Performance in Active Females? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115548. [PMID: 34067492 PMCID: PMC8196943 DOI: 10.3390/ijerph18115548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 12/02/2022]
Abstract
Core stability (CS) deficits can have a significant impact on lower limb function. The aim of this study was to investigate the relationship between two dynamic core exercise assessments and dynamic knee valgus during single-leg squats. In total, 20 physically active female students participated in this study. The OCTOcore smartphone application assesses CS during two dynamic exercise tests, the partial range single-leg deadlift (SLD) test and the bird-dog (BD) test. A two-dimensional assessment of a single-leg squat test was used to quantify participants’ hip frontal angle (HFASLS) and knee frontal plane projection angle (FPPASLS). Ankle dorsiflexion was evaluated through the weight-bearing dorsiflexion test. The correlational analyses indicated that the HFASLS was significantly related to the partial range single-leg deadlift test (r = 0.314, p < 0.05) and ankle dorsiflexion (r = 0.322, p < 0.05). The results showed a significant difference (p < 0.05) in the CS test between cases categorised as dynamic knee valgus (>10°) and normal (≤10°). The CS deficit may influence the neuromuscular control of the lumbopelvic-hip complex during single-leg movements. The link between CS and kinematic factors related to knee injuries was only observed when CS was measured in the SLD test but not in the BD test.
Collapse
Affiliation(s)
- Paloma Guillén-Rogel
- Laboratory of Physiology, Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (P.G.-R.); (C.F.-E.); (C.S.E.)
| | - David Barbado
- Sport Research Centre, Miguel Hernández University, 03202 Elche, Spain;
| | - Cristina Franco-Escudero
- Laboratory of Physiology, Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (P.G.-R.); (C.F.-E.); (C.S.E.)
| | - Cristina San Emeterio
- Laboratory of Physiology, Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (P.G.-R.); (C.F.-E.); (C.S.E.)
| | - Pedro J. Marín
- Development Research, CYMO Research Institute, 47140 Valladolid, Spain
- Correspondence:
| |
Collapse
|
47
|
Mohammadi Orangi B, Yaali R, Bahram A, Aghdasi MT, van der Kamp J, Vanrenterghem J, Jones PA. Motor learning methods that induce high practice variability reduce kinematic and kinetic risk factors of non-contact ACL injury. Hum Mov Sci 2021; 78:102805. [PMID: 33965757 DOI: 10.1016/j.humov.2021.102805] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 01/01/2023]
Abstract
The prevention of non-contact anterior cruciate ligament (ACL) injuries often involves movement training, but the effectiveness of different motor learning methods has not been fully investigated. The purpose of this study was therefore to examine the effects of linear pedagogy (LP), nonlinear pedagogy (NLP) and differential learning (DL) motor learning methods on changing kinetic and kinematic factors during expected sidestep cutting related to non-contact ACL injuries. These methods primarily differ in the amount and type of movement variability they induce during practice. Sixty-six beginner male soccer players (27.5 ± 2.7 years, 180.6 ± 4.9 cm, 78.2 ± 4.6 kg) were randomly allocated to a group that trained for 12 weeks with either a LP, NLP or DL type of motor learning methods. All participants completed a biomechanical evaluation of side-step cutting before and after the training period. Analysis of covariance was used to compare post-testing outcomes among the groups while accounting for group differences in baseline performance. Changes in all kinematic and kinetic variables in NLP and DL groups were significantly higher compared to the LP group. Most comparisons were also different between NLP and DL group with the exception of vertical ground reaction force, the knee extension/flexion, knee valgus, and ankle dorsiflexion moments. Our findings indicate that beginner male soccer players may benefit from training programs incorporating NLP or DL versus LP to lower biomechanical factors associated with non-contact ACL injury, most likely because of the associated increased execution variability during training. We discuss that practitioners should consider using the NLP or DL methods, and particular the NLP, during which variability is induced to guide search, when implementing training programs to prevent ACL injuries in soccer.
Collapse
Affiliation(s)
- Behzad Mohammadi Orangi
- Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran
| | - Rasoul Yaali
- Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran.
| | - Abbas Bahram
- Faculty of Physical Education and Sport Sciences, Kharazmi University of Tehran, Tehran, Iran
| | | | - John van der Kamp
- Department of Human Movement Sciences, Vrije University Amsterdam, the Netherlands
| | - Jos Vanrenterghem
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Belgium
| | - Paul A Jones
- Centre for Health Sciences Research, School of Health & Society, University of Salford, UK
| |
Collapse
|
48
|
Robinson MA, Sharir R, Rafeeuddin R, Vanrenterghem J, Donnelly CJ. The non-sagittal knee moment vector identifies 'at risk' individuals that the knee abduction moment alone does not. Sports Biomech 2021; 22:80-90. [PMID: 33947315 DOI: 10.1080/14763141.2021.1903981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Multi-planar forces and moments are known to injure the anterior cruciate ligament (ACL). In ACL injury risk studies, however, the uni-planar frontal plane external knee abduction moment is frequently studied in isolation. This study aimed to determine if the frontal plane knee moment (KM-Y) could classify all individuals crossing a risk threshold compared to those classified by a multi-planar non-sagittal knee moment vector (KM-YZ). Recreationally active females completed three sports tasks-drop vertical jumps, single-leg drop vertical jumps and planned sidesteps. Peak knee abduction moments and peak non-sagittal resultant knee moments were obtained for each task, and a risk threshold of the sample mean plus 1.6 standard deviations was used for classification. A sensitivity analysis of the threshold from 1-2 standard deviations was also conducted. KM-Y did not identify all participants who crossed the risk threshold as the non-sagittal moment identified unique individuals. This result was consistent across tasks and threshold sensitivities. Analysing the peak uni-planar knee abduction moment alone is therefore likely overly reductionist, as this study demonstrates that a KM-YZ threshold identifies 'at risk' individuals that a KM-Y threshold does not. Multi-planar moment metrics such as KM-YZ may help facilitate the development of screening protocols across multiple tasks.
Collapse
Affiliation(s)
- Mark A Robinson
- School of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Raihana Sharir
- Faculty of Sport Science and Recreation, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Radin Rafeeuddin
- Faculty of Sport Science and Recreation, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Jos Vanrenterghem
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
| | - Cyril J Donnelly
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore
| |
Collapse
|
49
|
Dos'Santos T, Thomas C, McBurnie A, Comfort P, Jones PA. Biomechanical Determinants of Performance and Injury Risk During Cutting: A Performance-Injury Conflict? Sports Med 2021; 51:1983-1998. [PMID: 33811615 PMCID: PMC8363537 DOI: 10.1007/s40279-021-01448-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Most cutting biomechanical studies investigate performance and knee joint load determinants independently. This is surprising because cutting is an important action linked to performance and non-contact anterior cruciate ligament (ACL) injuries. The aim of this study was to investigate the relationship between cutting biomechanics and cutting performance (completion time, ground contact time [GCT], exit velocity) and surrogates of non-contact ACL injury risk (knee abduction [KAM] and internal rotation [KIRM] moments) during 90° cutting. DESIGN Mixed, cross-sectional study following an associative design. 61 males from multidirectional sports performed six 90° pre-planned cutting trials, whereby lower-limb and trunk kinetics and kinematics were evaluated using three-dimensional (3D) motion and ground reaction force analysis over the penultimate (PFC) and final foot contact (FFC). Pearson's and Spearman's correlations were used to explore the relationships between biomechanical variables and cutting performance and injury risk variables. Stepwise regression analysis was also performed. RESULTS Faster cutting performance was associated (p ≤ 0.05) with greater centre of mass (COM) velocities at key instances of the cut (r or ρ = 0.533-0.752), greater peak and mean propulsive forces (r or ρ = 0.449-0.651), shorter FFC GCTs (r or ρ = 0.569-0.581), greater FFC and PFC braking forces (r = 0.430-0.551), smaller hip and knee flexion range of motion (r or ρ = 0.406-0.670), greater knee flexion moments (KFMs) (r = 0.482), and greater internal foot progression angles (r = - 0.411). Stepwise multiple regression analysis revealed that exit velocity, peak resultant propulsive force, PFC mean horizontal braking force, and initial foot progression angle together could explain 64% (r = 0.801, adjusted 61.6%, p = 0.048) of the variation in completion time. Greater peak KAMs were associated with greater COM velocities at key instances of the cut (r or ρ = - 0.491 to - 0.551), greater peak knee abduction angles (KAA) (r = - 0.468), and greater FFC braking forces (r = 0.434-0.497). Incidentally, faster completion times were associated with greater peak KAMs (r = - 0.412) and KIRMs (r = 0.539). Stepwise multiple regression analysis revealed that FFC mean vertical braking force and peak KAA together could explain 43% (r = 0.652, adjusted 40.6%, p < 0.001) of the variation peak KAM. CONCLUSION Techniques and mechanics associated with faster cutting (i.e. faster COM velocities, greater FFC braking forces in short GCTs, greater KFMs, smaller hip and knee flexion, and greater internal foot progression angles) are in direct conflict with safer cutting mechanics (i.e. reduced knee joint loading, thus ACL injury risk), and support the "performance-injury conflict" concept during cutting. Practitioners should be conscious of this conflict when instructing cutting techniques to optimise performance while minimising knee joint loading, and should, therefore, ensure that their athletes have the physical capacity (i.e. neuromuscular control, co-contraction, and rapid force production) to tolerate and support the knee joint loading during cutting.
Collapse
Affiliation(s)
- Thomas Dos'Santos
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, All Saints Building, Manchester Campus John Dalton Building, Manchester Campus, Manchester, M15 6BH, UK. .,Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Salford, Greater Manchester, UK.
| | - Christopher Thomas
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Salford, Greater Manchester, UK
| | | | - Paul Comfort
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Salford, Greater Manchester, UK
| | - Paul A Jones
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Salford, Greater Manchester, UK
| |
Collapse
|
50
|
Cong Y, Lam WK. Effects of shear reduction shoes on joint loading, ground reaction force and free moment across different cutting angles. J Sports Sci 2021; 39:1386-1394. [PMID: 33459193 DOI: 10.1080/02640414.2021.1874716] [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] [Indexed: 10/22/2022]
Abstract
This study examined the effects of shear reduction shoes on braking and propulsion ground reaction forces (GRFs), free moments, and joint moments when cutting towards different directions. Fifteen male university basketball players performed sidestep cutting towards 45°, 90° and 135° directions with maximum-effort in shear reduction and control shoes. Two-way (angle x shoe) ANOVAs with repeated measures were performed to determine the interaction and main effects of cutting angle and shoe for all tested variables. Results showed that cutting angles had significant influence on most of the variables, except for the peak-free moment, peak ankle eversion moment and maximum loading rate of resultant shear GRF. The shear reduction shoes significantly delayed the timing to the first peaks of vertical and resultant shear GRFs compared with the control shoes. During propulsion, the shear reduction shoes generated smaller peak propulsion resultant shear and vertical ground reaction forces. Additionally, the shear reduction shoes did not induce distinct frontal and transverse moments at the ankle and knee joints compared with the control shoes. These results suggest that the application of shear reduction structure could be beneficial to attenuate vertical and shear impact peaks, offering additional insights to reduce shear-related injuries.
Collapse
Affiliation(s)
- Yan Cong
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China.,Key laboratory of Prosthetics and Orthotics Technology of the Ministry of Civil Affairs, Beijing College of Social Administration, Beijing, China
| | - Wing-Kai Lam
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China.,Department of Kinesiology, Shenyang Sport University, Shenyang, China.,Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company, Beijing, China
| |
Collapse
|