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Franklin E, Stebbings GK, Morse CI, Runacres A, Dos’Santos T. Between-Session Reliability of Athletic Performance and Injury Mitigation Measures in Female Adolescent Athletes in the United States. Life (Basel) 2024; 14:892. [PMID: 39063645 PMCID: PMC11278427 DOI: 10.3390/life14070892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Adolescence is a fundamental period for female athletes to develop athletic performance, mitigate injury risk, and gain collegiate sport scholarships, but there is also a high incidence of sport-related injuries. Physical profiling and athlete screening can support the individualisation of training programmes; however, there is a lack of data pertaining to the reliability of athletic performance and injury surrogate measures in adolescent female athletes. The aim of this study was to quantify the between-session reliability of an athletic performance and injury mitigation testing battery in female adolescent athletes. A total of 31 post-peak height velocity (PHV) (3.00 ± 0.82 years) female athletes (age: 16.20 ± 1.20 years; standing height: 166.00 ± 6.00 cm; mass: 65.5 ± 10.70 kg) from various sports (track and field = 1; lacrosse = 2; basketball = 2; soccer = 3; softball = 11; volleyball = 12) completed two sessions of a multicomponent testing battery 48 h to 1 week apart including the assessment of 33 measures addressing lower-limb isometric strength, eccentric strength, reactive strength, linear sprint and change of direction speed, and lower limb control. Of the 33 measures, between sessions, 29 had a high to nearly perfect intraclass correlation coefficient (ICC) (0.508-0.979), and 26 measures were not statistically significantly different between sessions (p ≤ 0.05). All measures demonstrated low to acceptable coefficient variation (CV%) (0.61-14.70%). The testing battery used can be utilised for recruitment and longitudinal monitoring within sports organisations for female adolescent athletes.
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Affiliation(s)
| | | | | | | | - Thomas Dos’Santos
- Department of Sport and Exercise Sciences, Manchester Institute of Sport, Manchester Metropolitan University, Manchester M1 7EL, UK; (E.F.); (G.K.S.); (C.I.M.); (A.R.)
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Arboix-Alió J, Buscà B, Miró A, Bishop C, Fort-Vanmeerhaeghe A. Ground Reaction Forces, Asymmetries and Performance of Change of Direction Tasks in Youth Elite Female Basketball Players. Sports (Basel) 2024; 12:21. [PMID: 38251295 PMCID: PMC10819480 DOI: 10.3390/sports12010021] [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: 12/08/2023] [Revised: 12/19/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
The magnitude and direction of inter-limb asymmetries in a change of direction (COD) have increased interest in scientific research in recent years. This present study aimed to investigate the magnitude of asymmetries in an elite youth female basketball sample (n = 18, age = 17.79 ± 0.67 y) and determine its directionality using force platform technology. Participants performed 70° and 180° COD tests analyzing the following variables: time, ground contact time (GCT) and ground reaction forces (GRF) along the anterior-posterior, mediolateral, and vertical axes. Inter-limb asymmetries were evident in both COD tests, with substantial differences observed between limbs (p < 0.01). The asymmetry values ranged from 3.02% to 24.31% in COD 180° and from 1.99% to 21.70% in COD 70°, with anterior-posterior GRF consistently exhibiting the highest asymmetry magnitude. Additionally, the directionality exhibited variability between the tests, indicating poor agreement and suggesting the independent directionality of asymmetries across tasks. Moreover, players required more time to complete the COD 180°, the GCT was noticeably longer for the COD 180° than for the COD 70°, and GRF varied across the axis, suggesting that players adapt uniquely to the specific demands of each task. The utilization of force platforms presents a comprehensive approach to assess asymmetries and COD variables performance variables which are "angle-dependent", which could have important implications for COD screening and effective training interventions.
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Affiliation(s)
- Jordi Arboix-Alió
- Department of Sports Science, Ramon Llull University, 08022 Barcelona, Spain; (B.B.); (A.M.); (A.F.-V.)
- School of Health Sciences, Ramon Llull University, 08022 Barcelona, Spain
- F.C. Barcelona, Sport Performance Area, 08970 Barcelona, Spain
| | - Bernat Buscà
- Department of Sports Science, Ramon Llull University, 08022 Barcelona, Spain; (B.B.); (A.M.); (A.F.-V.)
| | - Adrià Miró
- Department of Sports Science, Ramon Llull University, 08022 Barcelona, Spain; (B.B.); (A.M.); (A.F.-V.)
| | - Chris Bishop
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London NW4 4BT, UK;
| | - Azahara Fort-Vanmeerhaeghe
- Department of Sports Science, Ramon Llull University, 08022 Barcelona, Spain; (B.B.); (A.M.); (A.F.-V.)
- School of Health Sciences, Ramon Llull University, 08022 Barcelona, Spain
- Segle XXI Female Basketball Team, Catalan Federation of Basketball, 08950 Esplugues de Llobregat, Spain
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Bittmann FN, Dech S, Schaefer LV. Another Way to Confuse Motor Control: Manual Technique Supposed to Shorten Muscle Spindles Reduces the Muscular Holding Stability in the Sense of Adaptive Force in Male Soccer Players. Brain Sci 2023; 13:1105. [PMID: 37509036 PMCID: PMC10377256 DOI: 10.3390/brainsci13071105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Sensorimotor control can be impaired by slacked muscle spindles. This was shown for reflex responses and, recently, also for muscular stability in the sense of Adaptive Force (AF). The slack in muscle spindles was generated by contracting the lengthened muscle followed by passive shortening. AF was suggested to specifically reflect sensorimotor control since it requires tension-length control in adaptation to an increasing load. This study investigated AF parameters in reaction to another, manually performed slack procedure in a preselected sample (n = 13). The AF of 11 elbow and 12 hip flexors was assessed by an objectified manual muscle test (MMT) using a handheld device. Maximal isometric AF was significantly reduced after manual spindle technique vs. regular MMT. Muscle lengthening started at 64.93 ± 12.46% of maximal voluntary isometric contraction (MVIC). During regular MMT, muscle length could be maintained stable until 92.53 ± 10.12% of MVIC. Hence, muscular stability measured by AF was impaired after spindle manipulation. Force oscillations arose at a significantly lower level for regular vs. spindle. This supports the assumption that they are a prerequisite for stable adaptation. Reduced muscular stability in reaction to slack procedures is considered physiological since sensory information is misled. It is proposed to use slack procedures to test the functionality of the neuromuscular system, which is relevant for clinical practice.
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Affiliation(s)
- Frank N Bittmann
- Regulative Physiology and Prevention, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
| | - Silas Dech
- Regulative Physiology and Prevention, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
- Health Education in Sports, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
| | - Laura V Schaefer
- Regulative Physiology and Prevention, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
- Health Education in Sports, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
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Bhanushali A, Bright R, Xu L, Cundy P, Williams N. Return to sport after forearm fractures in children: A scoping review and survey. J Child Orthop 2023; 17:164-172. [PMID: 37034195 PMCID: PMC10080236 DOI: 10.1177/18632521231156434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 01/25/2023] [Indexed: 04/11/2023] Open
Abstract
Purpose A common question faced by clinicians is when a child may return to sport after treatment for a pediatric forearm fracture. There are few published recommendations and fewer supported by evidence. The aims of this study were to summarize existing published recommendation for return to sport after pediatric forearm fractures and to conduct a survey to determine usual clinical recommendations. Methods A scoping review was performed on Ovid MEDLINE, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Google Scholar in accordance with the Joanna Briggs Institute guidelines. In addition, 64 orthopedic surgeons were anonymously surveyed asking for recommendations regarding return to sport after pediatric forearm fractures. Participants were to assume children were 9 years old and played a sport with an average risk of forearm injury. Results Twenty-two publications for return to sport were retrieved. Children with distal radius buckle fractures safely commonly returned to sport by 4 weeks after initial injury, while survey respondents recommended over 6 weeks. Survey respondents valued fracture stability the highest when making return to sport recommendations. Children with simple, metaphyseal, single-bone fractures were usually allowed to return to sport at 8-10 weeks post-injury. Diaphyseal and complete fractures were prescribed longer return to sport intervals. Australian respondents also prescribed longer return to sport intervals. Conclusion Children with distal radius buckle fractures may return to sport by 4 weeks after initial injury, sooner than recommended. Published recommendations remain limited for other fractures. However, our survey suggests children with simple, metaphyseal, single-bone fractures may return to sport at 8-10 weeks. Children with diaphyseal and complete fractures should abstain from sport for longer than metaphyseal and greenstick fractures, respectively. Level of evidence level V.
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Affiliation(s)
- Ameya Bhanushali
- University of Adelaide, Adelaide, SA,
Australia
- Department of Orthopaedic Surgery,
Women’s and Children’s Hospital, Adelaide, SA, Australia
- Department of Orthopaedics and Trauma,
Flinders Medical Centre, Adelaide, SA, Australia
| | | | - Louis Xu
- Department of Orthopaedic Surgery,
Women’s and Children’s Hospital, Adelaide, SA, Australia
| | - Peter Cundy
- University of Adelaide, Adelaide, SA,
Australia
- Department of Orthopaedic Surgery,
Women’s and Children’s Hospital, Adelaide, SA, Australia
| | - Nicole Williams
- University of Adelaide, Adelaide, SA,
Australia
- Department of Orthopaedic Surgery,
Women’s and Children’s Hospital, Adelaide, SA, Australia
- Nicole Williams, Department of Orthopaedic
Surgery, Women’s and Children’s Hospital, 72 King William Road, North Adelaide,
SA 5006, Australia.
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Bittmann FN, Dech S, Schaefer LV. How to Confuse Motor Control: Passive Muscle Shortening after Contraction in Lengthened Position Reduces the Muscular Holding Stability in the Sense of Adaptive Force. Life (Basel) 2023; 13:life13040911. [PMID: 37109439 PMCID: PMC10143964 DOI: 10.3390/life13040911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Adaptation to external forces relies on a well-functioning proprioceptive system including muscle spindle afferents. Muscle length and tension control in reaction to external forces is most important regarding the Adaptive Force (AF). This study investigated the effect of different procedures, which are assumed to influence the function of muscle spindles, on the AF. Elbow flexors of 12 healthy participants (n = 19 limbs) were assessed by an objectified manual muscle test (MMT) with different procedures: regular MMT, MMT after precontraction (self-estimated 20% MVIC) in lengthened position with passive return to test position (CL), and MMT after CL with a second precontraction in test position (CL-CT). During regular MMTs, muscles maintained their length up to 99.7% ± 1.0% of the maximal AF (AFmax). After CL, muscles started to lengthen at 53.0% ± 22.5% of AFmax. For CL-CT, muscles were again able to maintain the static position up to 98.3% ± 5.5% of AFmax. AFisomax differed highly significantly between CL vs. CL-CT and regular MMT. CL was assumed to generate a slack of muscle spindles, which led to a substantial reduction of the holding capacity. This was immediately erased by a precontraction in the test position. The results substantiate that muscle spindle sensitivity seems to play an important role for neuromuscular functioning and musculoskeletal stability.
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Affiliation(s)
- Frank N. Bittmann
- Regulative Physiology and Prevention, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
| | - Silas Dech
- Regulative Physiology and Prevention, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
- Sports Education, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
| | - Laura V. Schaefer
- Regulative Physiology and Prevention, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
- Sports Education, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany
- Correspondence:
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Cadens M, Planas-Anzano A, Peirau-Terés X, Benet-Vigo A, Fort-Vanmeerhaeghe A. Neuromuscular and Biomechanical Jumping and Landing Deficits in Young Female Handball Players. BIOLOGY 2023; 12:biology12010134. [PMID: 36671826 PMCID: PMC9855848 DOI: 10.3390/biology12010134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023]
Abstract
Neuromuscular and biomechanical imbalances that exist in jumping and landing actions should be examined in order to intervene to decrease the risk of ACL injury. The main aim of this study was to analyse and compare, by chronological age, jumping and landing deficits in young female handball players using the Tuck Jump Assessment (TJA). A secondary aim was to relate the qualitative asymmetry values detected using the TJA to the quantitative asymmetry values detected starting from the single leg countermovement jump (SL-CMJ). Sixty-one young female handball players (age: 14.3 ± 1.5 years) were distributed into three groups: U12, U14 and U16 and performed the TJA test and the single leg countermovement jump (SL-CMJ). The female U12 category players obtained the highest scores in the TJA and there were significant differences between the U12 (12.11 ± 1.97) and U14 (10.89 ± 1.74) categories (p = 0.017; ES = 0.374). In the U12 category, the female players presented larger interlimb asymmetry magnitudes in the SL-CMJ test; they also obtained higher scores in the qualitative criteria of the TJA test that referred to asymmetry (r = 0.43; p = 0.027). The analysis of the jumping and landing pattern using TJA allowed us to identify that the lower extremity valgus at landing, foot contact timing not equal and landing contact noise are the main biomechanical deficits in young female handball players. Furthermore, the asymmetry values assessed qualitatively (TJA) are associated with the asymmetry values assessed quantitatively (difference in jump achieved with each limb in the SL-CMJ test) in younger categories.
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Affiliation(s)
- Maria Cadens
- Research Group into Human Movement, National Institute of Physical Education of Catalonia (INEFC), University of Lleida (UdL), 25192 Lleida, Spain
- Correspondence:
| | - Antoni Planas-Anzano
- Research Group into Human Movement, National Institute of Physical Education of Catalonia (INEFC), University of Lleida (UdL), 25192 Lleida, Spain
| | - Xavier Peirau-Terés
- Research Group into Human Movement, National Institute of Physical Education of Catalonia (INEFC), University of Lleida (UdL), 25192 Lleida, Spain
| | - Ariadna Benet-Vigo
- Department of Sports Sciences, FCS Blanquerna, Ramon Llull University, 08022 Barcelona, Spain
| | - Azahara Fort-Vanmeerhaeghe
- Department of Sports Sciences, FPCEE and FCS Blanquerna, Ramon Llull University, 08022 Barcelona, Spain
- Segle XXI Female Basketball Team, Catalan Federation of Basketball, 08950 Esplugues de Llobregat, Spain
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Nascimento N, Sideris V, Read PJ. Biomechanical Analysis of the Tuck Jump Assessment. J Strength Cond Res 2022; 36:2946-2949. [PMID: 36135038 DOI: 10.1519/jsc.0000000000003947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Nascimento, N, Sideris, V, and Read, PJ. Biomechanical analysis of the tuck jump assessment. J Strength Cond Res 36(10): 2946-2949, 2022-The tuck jump assessment (TJA) examines plyometric technique flaws associated with the increased risk of anterior cruciate ligament injury. Biomechanical data to investigate the mechanics used during the TJA are limited and assessing each jump individually across the entire test period is time inefficient. This study examined performance characteristics and movement mechanics in 16 professional soccer players during a standardized TJA protocol (10 jumps) to determine if sensitive periods exist within the test period (first 5 vs. last 5). Jump height, average power (PW) reactive strength index (RSI), frontal plane projection angle (FPPA), knee angular velocity (AV), and peak knee flexion angle (PKA) were analyzed using an optoelectrical and inertial measurement unit device. Jump height and PW increased in the past 5 jumps displaying a medium effect size (d = > 0.5). A trend was observed of increased AV, FPPA, and PKA during the past 5 jumps; however, no meaningful differences were observed between respective jump phases, and effect sizes were small (d ≤ 0.2). This study indicates that performance metrics increase during the past 5 jumps of a standardized TJA 10-jump protocol; thus, analyzing the entire test period may not be required, providing a time-efficient approach. Caution should be applied if using this protocol as an injury risk screening tool or to identify fatigue related alterations in male professional soccer players as no obvious movement abnormalities were apparent and minimal differences were present between jump phases in a range of kinematic variables across the recorded test duration.
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Affiliation(s)
- Nuno Nascimento
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | | | - Paul J Read
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- School of Sport and Exercise, University of Gloucestershire, Gloucester, United Kingdom; and
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
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Duggan JD, Collins K, Keane K. Factors influencing performance and injury risk in elite female Gaelic team sport players and future research directions: a narrative review. BMC Sports Sci Med Rehabil 2022; 14:164. [PMID: 36056384 PMCID: PMC9438325 DOI: 10.1186/s13102-022-00553-8] [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: 10/27/2021] [Accepted: 08/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sports science research in elite female Gaelic team sports has increased in recent years, but still a large disparity exists between the volume of studies involving male and female players. As a consequence of this, it is difficult for practitioners to develop an evidence-based approach when working with female players. MAIN BODY In this review, we discuss the current research available in elite female Gaelic team sports with focus on seven specific areas including physical and physiological demands, anthropometric and performance characteristics, injury risk, nutritional considerations, and female physiology. There appears to be unique physical demands data in match play across positions in Camogie, however, there is currently no comparative data available in ladies Gaelic football. Similarly, there is no research available on the physiological demands of both elite female Gaelic team sports. According to existing literature, performance characteristics such as speed and power are lower in this population compared to other elite female team sports. Although data is limited, the anthropometric characteristics of elite female Gaelic team sport players appear homogenous with some positional differences observed at a sub-elite level. Previous research has demonstrated a high prevalence of lower limb injuries in female elite Gaelic team sports and the provision of quality, evidence-based strength & conditioning could help mitigate these injury risks. Female Gaelic team sport players have been shown to have poor nutrition knowledge and inadequate intakes of micronutrients. Finally, although menstrual cycle phase and oral contraceptives have been shown to influence performance in other female intermittent sports, to date there has not been any research carried out in elite female Gaelic team sport players. CONCLUSIONS It is evident that limited research has been carried out on elite female Gaelic sport players. More up-to-date, high-quality investigations are needed to address the research gaps, which in turn should enable practitioners in the field to apply sound, evidence-based practice/theory when working with this population.
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Affiliation(s)
- John David Duggan
- Department of Sport, Exercise & Nutrition, School of Science & Computing, Atlantic Technological University Galway, Dublin Road, Galway, Ireland.
| | - Kieran Collins
- Gaelic Sports Research Centre, Technological University Dublin-Tallaght Campus, Tallaght, Dublin 24, Dublin, Ireland
| | - Karen Keane
- Department of Sport, Exercise & Nutrition, School of Science & Computing, Atlantic Technological University Galway, Dublin Road, Galway, Ireland
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Coach Education Improves Adherence to Anterior Cruciate Ligament Injury Prevention Programs: A Cluster-Randomized Controlled Trial. Clin J Sport Med 2022; 32:348-354. [PMID: 34009795 DOI: 10.1097/jsm.0000000000000936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/25/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effect of an educational workshop on adherence to neuromuscular training (NMT) among high-school coaches. DESIGN Cluster-randomized controlled trial. SETTING High school. PARTICIPANTS A total of 21 teams in 8 high schools (unit of randomization) were randomized to the intervention or control group. Twelve boys' and 9 girls' teams in a variety of sports were enrolled. INTERVENTION Coaches in the intervention group participated in a 60-minute education workshop to teach effective implementation of a NMT program and also received print materials. Coaches in the control group received the same print materials. MAIN OUTCOME MEASURES Eight data collectors were trained to observe each team's practice/game 2 to 3 times a week. They completed a study questionnaire to identify the NMT exercise and whether the coach (1) delivered exercise instructions and (2) provided alignment cues (both yes/no). RESULTS A total of 399 practices/games were observed over 2 seasons. A greater proportion of coaches in the intervention group provided alignment cues to correct improper technique compared with the control group {difference = 0.04 [95% confidence interval (CI), 0.01-0.07], P = 0.006}. There was a similar proportion of coaches in the intervention and control groups who provided exercise instructions [difference = 0.01 (95% CI, -0.02 to 0.04), P = 0.44]. More coaches in the intervention group completed a full NMT program [OR = 4.62 (1.22, 17.50), P = 0.02]. CONCLUSIONS Coach education can improve adherence to a NMT program and delivery of alignment cues. Coaches should receive in-person training on NMT and how to deliver alignment cues to their athletes while performing the exercises.
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Mattu AT, Ghali B, Linton V, Zheng A, Pike I. Prevention of Non-Contact Anterior Cruciate Ligament Injuries among Youth Female Athletes: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084648. [PMID: 35457516 PMCID: PMC9027388 DOI: 10.3390/ijerph19084648] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 02/01/2023]
Abstract
Anterior cruciate ligament (ACL) injuries account for a large percentage of knee injuries, disproportionately affecting female athletes. To help health professionals stay current, we performed an umbrella review to evaluate the effectiveness of ACL injury prevention programs in reducing non-contact ACL injury rates, determine the effective components within interventions, and provide clinical recommendations. Twelve databases (Medline, Embase, Cochrane Database of Systematic Reviews, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature, PEDro, Web of Science Core Collection, Epistemonikos, TRIP, BC Guidelines and Protocols, CPG Infobase, ProQuest Dissertations and Theses Global) were searched in May 2021 to identify relevant systematic reviews and meta-analyses. Four databases were searched again in September 2021 to identify recent primary literature. Non-contact ACL injury data were extracted to calculate incidence rate ratios (IRRs) and these were combined using an inverse variance random-effects model. A qualitative assessment of included reviews was performed. The methodological quality of the studies was assessed using a Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) or Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2). Sixteen reviews and two primary studies met the inclusion criteria. Across 11 primary studies, prevention programs were effective in reducing non-contact ACL injuries by 64% (IRR = 0.36 (95% CI: 0.18–0.70)). A multi-faceted exercise program, beginning in the pre-season and containing at least three exercise types, may be beneficial in reducing ACL injury risk.
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Affiliation(s)
- Anmol T. Mattu
- MD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Correspondence:
| | - Brianna Ghali
- Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Vanessa Linton
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC V6H 3V4, Canada; (V.L.); (A.Z.); (I.P.)
| | - Alex Zheng
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC V6H 3V4, Canada; (V.L.); (A.Z.); (I.P.)
| | - Ian Pike
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC V6H 3V4, Canada; (V.L.); (A.Z.); (I.P.)
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H 3V4, Canada
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11
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Neuromuscular control and hop performance in youth and adult male and female football players. Phys Ther Sport 2022; 55:189-195. [DOI: 10.1016/j.ptsp.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
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Duggan JD, Moody J, Byrne P, McGahan JH, Kirszenstein L. Considerations and Guidelines on Athletic Development for Youth Gaelic Athletic Association Players. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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13
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Zhang L, Soselia D, Wang R, Gutierrez-Farewik EM. Lower-limb Joint Torque Prediction using LSTM Neural Networks and Transfer Learning. IEEE Trans Neural Syst Rehabil Eng 2022; 30:600-609. [PMID: 35239487 DOI: 10.1109/tnsre.2022.3156786] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Estimation of joint torque during movement provides important information in several settings, such as effect of athletes' training or of a medical intervention, or analysis of the remaining muscle strength in a wearer of an assistive device. The ability to estimate joint torque during daily activities using wearable sensors is increasingly relevant in such settings. In this study, lower limb joint torques during ten daily activities were predicted by long short-term memory (LSTM) neural networks and transfer learning. LSTM models were trained with muscle electromyography signals and lower limb joint angles. Hip flexion/extension, hip abduction/adduction, knee flexion/extension and ankle dorsiflexion/plantarflexion torques were predicted. The LSTM models' performance in predicting torque was investigated in both intra-subject and inter-subject scenarios. Each scenario was further divided into intra-task and inter-task tests. We observed that LSTM models could predict lower limb joint torques during various activities accurately with relatively low error (root mean square error ≤ 0.14 Nm/kg, normalized root mean square error ≤8.7%) either through a uniform model or through ten separate models in intra-subject tests. Furthermore, a transfer learning technique was adopted in the inter-task and inter-subject tests to further improve the generalizability of LSTM models by pre-training a model on multiple subjects and/or tasks and transferring the learned knowledge to a target task/subject. Particularly in the inter-subject tests, we could predict joint torques accurately in several movements after training from only a few movements from new subjects.
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Perry A, DeFroda S, Leporace G, Metsavaht L, Coxe CR, Bierman AM, Chahla J. ACL Rehabilitation: How Can We Lessen Injury Rates? OPER TECHN SPORT MED 2022. [DOI: 10.1016/j.otsm.2022.150892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pullen BJ, Oliver JL, Lloyd RS, Knight CJ. Assessing Athletic Motor Skill Competencies in Youths. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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16
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Sheikhi B, Letafatkar A, Thomas AC, Ford KR. Altered trunk and lower extremity movement coordination after neuromuscular training with and without external focus instruction: a randomized controlled trial. BMC Sports Sci Med Rehabil 2021; 13:92. [PMID: 34404477 PMCID: PMC8369650 DOI: 10.1186/s13102-021-00326-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 08/07/2021] [Indexed: 11/11/2022]
Abstract
Background This study sought to determine the effects of a 6-week neuromuscular training (NMT) and NMT plus external focus (NMT plus EF) programs on trunk and lower extremity inter-segmental movement coordination in active individuals at risk of injury. Methods Forty-six active male athletes (controls = 15, NMT = 16, NMT plus EF = 15) participated (age = 23.26 ± 2.31 years) in this controlled, laboratory study. Three-dimensional kinematics were collected during a drop vertical jump (DVJ). A continuous relative phase (CRP) analysis quantified inter-segmental coordination of the: (1) thigh (flexion/extension)—shank (flexion/extension), (2) thigh (abduction/adduction)—shank (flexion/extension), (3) thigh (abduction/adduction)—trunk (flexion/extension), and (4) trunk (flexion/extension)—pelvis (posterior tilt/anterior tilt). Analysis of covariance compared biomechanical data between groups. Results After 6 weeks, inter-segmental coordination patterns were significantly different between the NMT and NMT plus EF groups (p < 0.05). No significant differences were observed in CRP for trunk-pelvis coupling comparing between NMT and NMT plus EF groups (p = 0.134), while significant differences were observed CRP angle of the thigh-shank, thigh-trunk couplings (p < 0.05). Conclusions Trunk and lower extremity movement coordination were more in-phase during DVJ in the NMT plus EF compared to NMT in active individuals at risk of anterior cruciate ligament injury. Trial registration: The protocol was prospectively registered at UMIN_RCT website with ID number: UMIN000035050, Date of provisional registration 2018/11/27. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00326-9.
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Affiliation(s)
- Bahram Sheikhi
- Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sports Sciences, Kharazmi University, Mirdamad Blvd., Hesari St, Tehran, Iran
| | - Amir Letafatkar
- Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sports Sciences, Kharazmi University, Mirdamad Blvd., Hesari St, Tehran, Iran.
| | - Abbey C Thomas
- Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Kevin R Ford
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, One University Parkway, High Point, NC, 27268, USA
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Assessing the Magnitude and Direction of Asymmetry in Unilateral Jump and Change of Direction Speed Tasks in Youth Female Team-Sport Athletes. J Hum Kinet 2021; 79:15-27. [PMID: 34400983 PMCID: PMC8336540 DOI: 10.2478/hukin-2021-0061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The direction of inter-limb asymmetries and the change of direction (COD) deficit are two aspects that have increased in recent years. The main objective of the present study was to assess the magnitude of neuromuscular asymmetries in an elite youth female team-sports sample and determine its directionality. Secondary objectives were to evaluate the relationship between COD deficit, linear speed and COD time performance. Elite female youth basketball and handball players (n = 33, age = 16 ± 1.17 y) performed the Single Leg Countermovement Jump in vertical (SLCJ-V), horizontal (SLCJ-H), and lateral (SLCJ-L) directions, the COD and the 10-m sprint. Results showed statistical differences between limbs in all the neuromuscular tests (p < 0.001). The Kappa coefficient showed poor to fair levels of agreement between tasks (K range = -0.087 to 0.233), indicating that asymmetries rarely favoured the same limb between skills. Additionally, small and non-significant correlations were found between the linear sprint capacity and the COD ability. The findings of the present study highlight the independent directionality of asymmetries across tests. The COD deficit does not appear to be much more advantageous than COD total time to measure asymmetry. Practitioners are encouraged to use a fitness testing battery to detect existing side differences and each ability should be specifically trained with functional tasks.
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Bulow A, Bellemare A, Anderson JE, Leiter JRS, MacDonald PB, Peeler JD. Lower Extremity Kinematics of the Y-Balance Test in Healthy and ACL Injured Adolescent Females. Int J Sports Phys Ther 2021; 16:381-392. [PMID: 33842034 PMCID: PMC8016411 DOI: 10.26603/001c.21529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/08/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adolescent females are at significant risk for sustaining an ACL injury. The Y-Balance Test (YBT) is frequently used to evaluate neuromuscular control and lower extremity function. However, few studies have quantified 2D lower extremity kinematics during performance of the YBT, and there is an absence of kinematic data specific to at-risk adolescent females. PURPOSE To examine lower extremity joint kinematics during execution of the YBT by healthy and ACL-injured adolescent females. STUDY DESIGN Prospective cohort. METHODS Twenty-five healthy and ten ACL-injured (mean time from injury 143 days) adolescent females were assessed using the YBT. Sagittal and frontal plane knee and ankle motion was video recorded during execution of the YBT anterior reach movement. Ankle dorsi-flexion, knee flexion, and knee valgus angles were quantified via kinematic analysis. ANOVAs with a post hoc Bonferroni correction were used to compare YBT scoring (%LL) and kinematic data between groups. Pearson product-moment correlations determined the relationship between kinematic data and YBT scoring. RESULTS Healthy and ACL-injured subjects demonstrated similar YBT scores and lower extremity kinematic data. Healthy subjects demonstrated a weak positive correlation between ankle dorsiflexion and YBT scoring, and a weak negative correlation between knee valgus and YBT scoring. These relationships did not exist for ACL-injured subjects. Kinematic data for both groups also demonstrated a large degree of variability, regardless of YBT score. CONCLUSIONS Adolescent females frequently utilize a variety of lower extremity movement strategies when performing a functional movement task, and scoring on the YBT offers limited insight regarding lower extremity joint kinematics and ACL-injury risk in a physically active adolescent female population. LEVEL OF EVIDENCE Level 3.
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Cone SM, Lee S. Lower Limb Force Asymmetries During Landing and Jumping Exercises: A Pilot Study. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:544-551. [PMID: 34055145 PMCID: PMC8136551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Significant asymmetries can exist between the lower limbs' force production during the take-off phase of bilateral jumping exercises. Some studies have indicated that similar asymmetries can also exist during the landing phase. It has not been demonstrated if the magnitude of lower body asymmetry was similar between the landing (L) and take-off (TO) phases of bilateral jumping movements. The main purpose of this study was to compare the asymmetry measured during the L and TO phases of bilateral jumping exercises to determine if there was a difference in asymmetry between the phases. In order to quantify the degree of the asymmetry, the vertical ground reaction force (vGRF) produced by each leg was measured during execution of vertical-jump (VJ) and drop-jump (DJ) exercises. Eleven recreationally trained individuals completed three VJ and DJ trials while two force plates recorded vGRF. A two-way repeated measures ANOVA was used to compare the asymmetry levels with the phase (within- subject: L and TO) and the exercise (within- subject: VJ and DJ) being factors. A significant difference in the asymmetry was found between the L and TO phases (p < .05). These findings suggested that there was greater asymmetry in the distribution of vGRF during landing than during take-off.
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Affiliation(s)
- Simon M Cone
- Department of Human Performance and Health Education, Western Michigan University, Kalamazoo, MI, USA
| | - Sangwoo Lee
- Department of Human Performance and Health Education, Western Michigan University, Kalamazoo, MI, USA
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The Immediate Effects of Expert and Dyad External Focus Feedback on Drop Landing Biomechanics in Female Athletes: An Instrumented Field Study. Int J Sports Phys Ther 2021. [PMID: 33604139 PMCID: PMC7872449 DOI: 10.26603/001c.18717] [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] [Indexed: 11/18/2022] Open
Abstract
Background Anterior Cruciate Ligament (ACL) injury prevention interventions have used trained experts to ensure quality feedback. Dyad (peer) feedback may be a more cost-effective method to deliver feedback to athletes. Purpose To determine the immediate effects of dyad versus expert feedback on drop landing kinematics and kinetics in female athletes. Study Design Cohort study Setting College gymnasium Methods Two teams (one female basketball and one female volleyball), from a local college, were team randomized to dyad feedback (volleyball team) or expert feedback (basketball team) (13 expert, 19±0.87years, 1.7±0.09m, 68.04±7.21kg) (10 dyad 19.4±1.07years, 1.73±0.08m, 72.18±11.23kg). Participants completed drop vertical jumps at two different time points (pre- and post-feedback). Knee flexion and abduction displacement were assessed with Inertial Measurement Units (IMUs) and vertical ground reaction force (vGRF) was assessed with a force plate during the landing phase of the drop vertical jump and compared across groups and condition (pre- and post-feedback) with a repeated measures ANCOVA a priori α <0.02 was set for multiple tests conducted. Results There were no significant differences between groups for flexion displacement. There was a significant change pre- to post- (decrease 4.65˚ p=0.01) in abduction displacement, with no group effect. There was a significant interaction of group by condition (p=0.01) for vGRF with no difference between groups before feedback (p>0.05). Between groups there was a decrease of vGRF in the expert group (difference 0.45 N*bw-1, p=0.01) at post-feedback relative to dyad. Within the expert group there was a significant difference between pre- and post-feedback (difference 0.72 N*bw-1, p=0.01), while the dyad group did not change pre- to post-feedback (difference 0.18 N*bw-1, p=0.67). Conclusion Movement screening experts giving real-time feedback were successful in improving key injury-risk kinematics and kinetics in female athletes, while dyad feedback only improved kinematics, indicating that expert feedback may be needed to ensure changes in kinematics and kinetics. Level of Evidence 2
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Standard RTS criteria effectiveness verification using FMS, Y-balance and TJA in footballers following ACL reconstruction and mild lower limb injuries. Sci Rep 2021; 11:1558. [PMID: 33452381 PMCID: PMC7810698 DOI: 10.1038/s41598-021-81152-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 01/04/2021] [Indexed: 01/07/2023] Open
Abstract
The anterior cruciate ligament (ACL) is the most frequently injured knee ligament. In previous studies, it was demonstrated that patients following ACL reconstruction may present motor deficits which may be related to increased risk of injury. The objective of the study was to determine whether players who have passed RTS assessment still have deficits in movement patterns or in neuromuscular control after such a serious injury as ACL rupture and reconstruction,. Sixty-five male football players (age 18-25 years), recruited from regional teams, were divided into three groups: (1) ACL group-subjects after ACL rupture and reconstruction (n = 24); (2) Mild Injury (MI) group-subjects after mild lower limb injuries (n = 21); and (3) Control (C) group-subjects without injuries (n = 20). For all groups, the Y-balance test, Functional Movement Screen (FMS) and Tuck Jump Assessment (TJA) were performed. For the Y-balance test in ACL group for the injured leg, significantly lower values were demonstrated for anterior reach ((ACL) 69.2 ± 5.7% vs. (MI) 74.8 ± 4.5% vs. (C) 74.0 ± 5.6%), at posterior-lateral reach ((ACL) 103.2 ± 6.4% vs. (C) 108.5 ± 6.0%) and composite score ((ACL) 93.9 ± 4.4% vs. (MI) 97.9 ± 4.3%) in comparison to the remaining two groups. In the FMS test, the ACL group had significantly lower composite score (12 ± 4 points) compared to the C group (15 ± 2 points). Also, compared to the remaining groups, subjects following ACL reconstruction demonstrated significantly lower performance in the TJA test related to the following elements: thighs do not reach parallel, thighs not equal side-to-side, foot placement not shoulder width apart, technique declines prior to 10 s and lower extremity valgus at landing. The authors have observed that athletes after ACL reconstruction still have deficits in movement patterns or in neuromuscular control despite passing the RTS and being cleared to perform sports. Creating a set of sufficiently sensitive assessment methods may significantly reduce the potential risk of injury due to the fact that diagnosed and monitored deficits may be treated on an ongoing basis. The authors suggest that individual elements of the Y-balance and TJA tests may be suitable for such specific assessment.
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Performance on sprint, agility and jump tests have moderate to strong correlations in youth football players but performance tests are weakly correlated to neuromuscular control tests. Knee Surg Sports Traumatol Arthrosc 2021; 29:1659-1669. [PMID: 33030610 PMCID: PMC8038985 DOI: 10.1007/s00167-020-06302-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/22/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed at evaluating the correlation between seven different performance tests and two neuromuscular control tests in youth football players and to evaluate the influence of sex and age groups on test results. METHODS One-hundred and fifteen football players (66 boys, 49 girls) mean age 14 ± 0.7 (range 13-16) years from youth teams were tested at the start of the second half of the competitive season. A test battery including agility t-test, 505 agility test, single-leg hop for distance test, side-hop test, countermovement jump test, 10-m sprint test, 20-m sprint test, tuck jump assessment (TJA) and drop vertical jump (DVJ) was completed. RESULTS Correlations between the seven different performance tests of agility, jump and sprint ability were generally moderate to strong (r = 0.534-0.971). DVJ did not correlate with the performance tests (rho = 0.004 to - 0.101) or with TJA total score (rho = 0.127). There were weak to moderate correlations between TJA total score and the performance tests (r = - 0.323-0.523). Boys performed better than girls in all performance tests (p < 0.001) and in TJA total score (p = 0.002). In boys, older players performed better than younger players in the majority of the tests, while there was no clear age influence among girls. CONCLUSION Sprint performance was moderately to strongly correlated with agility and jump performance, and performance tests were weakly to moderately correlated to TJA, while DVJ did not correlate with the other tests. Boys performed better than girls on performance tests and TJA. An age effect on performance was evident in boys but not in girls. LEVEL OF EVIDENCE Level IV TRIAL REGISTRATION: Clinical Trials gov identifier: NCT03251404.
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Intra- and interrater reliability of subjective assessment of the drop vertical jump and tuck jump in youth athletes. Phys Ther Sport 2021; 47:156-164. [DOI: 10.1016/j.ptsp.2020.11.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 01/16/2023]
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INTER AND INTRA-RATER RELIABILITY OF THE DROP VERTICAL JUMP (DVJ) ASSESSMENT. Int J Sports Phys Ther 2020; 15:770-775. [PMID: 33110696 DOI: 10.26603/ijspt20200770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Non-contact injuries are common in sports as abnormal lower extremity joint mechanics can place athletes at risk for injury. It is important to have reliable, feasible, cost-effective assessment tools to determine lower limb control and injury risk. Hypothesis/Purpose The purpose of the study was to assess the intra- and inter-rater reliability of a three-tiered anterior cruciate ligament (ACL) injury risk rating assessment of the drop vertical jump using frontal plane, two-dimensional (2-D) motion capture. Study Design Repeated measures. Methods Twenty male elite basketball athletes performed the drop vertical jump during a 2-D video assessment at Mayo Clinic Sports Medicine Center in Minneapolis, Minnesota. DVJ scores indicated the following: 1 no visible knee valgus, 2 slight wobble, inward motion of the knees, and 3 knee collision or large frontal plane knee excursion. Score assessment from video of the drop vertical jump was obtained by four independent investigators. The four raters then re-examined the same videos 1 month later, blinded to their original scores. Results Intra-rater reliability Fleiss Kappa measure of agreement was substantial amongst all four raters at all scoring time points: initial contact (0.672), first landing (0.728), second landing (0.670), and peak valgus (0.662) (p < 0.001). The intra-rater ICC values were good at initial contact (0.809), second landing (0.874), and max valgus (0.885), however were excellent at first landing (0.914) (p < 0.001). Inter-rater reliability Fleiss Kappa measurement scores were slight at initial contact (0.173), fair at max valgus (0.343), and moderate at first landing (0.532) and second landing (0.514; p < 0.001). Inter-rater ICC values were moderate at initial contact (0.588), excellent at first landing (0.919), and good at second landing (0.883) and max valgus (0.882; p<0.001). Conclusion When comparing scores of the drop vertical jump between four independent raters across two sessions, the study demonstrated substantial Kappa and good to excellent ICC intra-rater reliability. Inter-rater reliability demonstrated slight to moderate Kappa measurements of agreement and moderate to excellent ICC's. Thus, for excellent reliability using this assessment, patients should be scored by one individual. For moderate reliability between multiple raters, the first landing of the DVJ should be scored. Findings indicate that the proposed drop vertical jump assessment may be used for reliable identification of abnormal landing mechanics. Level of Evidence Level 3.
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Petrovic M, Sigurðsson HB, Sigurðsson HJ, Sveinsson T, Briem K. Effect of Sex on Anterior Cruciate Ligament Injury-Related Biomechanics During the Cutting Maneuver in Preadolescent Athletes. Orthop J Sports Med 2020; 8:2325967120936980. [PMID: 32754625 PMCID: PMC7378718 DOI: 10.1177/2325967120936980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: There are 2 movement patterns associated with an anterior cruciate ligament
(ACL) injury: dynamic valgus and stiff landing. Although sex-dependent
differences have been identified for adults, less is known for preadolescent
athletes regarding movement patterns known to load the ACL. Hypothesis: We hypothesized that girls would demonstrate greater vertical ground reaction
forces and knee valgus angles. We further hypothesized that the exercise
intervention would affect girls more than boys and that this would primarily
be demonstrated in less sagittal plane excursions, increased vertical ground
reaction forces and knee valgus moments for girls than for boys. Study Design: Controlled laboratory study. Methods: Male and female soccer and handball players (n = 288; age range, 9-12 years)
were recruited. A motion capture system synchronized to a force platform was
used to record 5 trials of a cutting maneuver before and after a 5-minute
fatigue intervention. Linear mixed models were constructed, and analysis of
variance was used to analyze differences in outcomes associated with the sex
of the athletes. Results: Boys showed greater peak knee valgus moment (0.26 vs 0.22 N·m/kg,
respectively; P = .048), peak knee internal rotation moment
(–0.13 vs –0.10 N·m/kg, respectively; P = .021), knee
rotation excursion (–7.9° vs –6.9°, respectively; P =
.014), and knee extension excursion (2.7° vs 1.4°, respectively;
P < .001) compared with that in girls. A significant
sex × fatigue intervention interaction (F = 7.6;
P = .006) was found, which was caused by a greater
increase in first peak vertical ground-reaction force (vGRF) from before to
after the fatigue intervention for girls (15.3 to 16.0 N/kg) compared with
boys (16.4 to 16.5 N/kg). Conclusion: Differences detected for biomechanical factors during the cutting maneuver do
not point to a greater ACL injury risk for prepubescent or early pubescent
girls than for boys. Nonetheless, girls go on to develop more detrimental
movement patterns in adolescence than those in boys in terms of
biomechanical risk factors. Clinical Relevance: Early adolescence is a good target age to learn and develop muscular control;
balance, strength; flexibility; and jumping, running, and landing control.
This time of physical and athletic growth may therefore be an appropriate
period to influence biomechanical factors and thereby task execution and the
injury risk.
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Affiliation(s)
- Milos Petrovic
- Department of Physical Therapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
| | - Haraldur B Sigurðsson
- Department of Physical Therapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
| | - Hjálmar J Sigurðsson
- Department of Physical Therapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
| | - Thorarinn Sveinsson
- Department of Physical Therapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
| | - Kristín Briem
- Department of Physical Therapy, Research Centre of Movement Science, University of Iceland, Reykjavik, Iceland
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Duggan JD, Moody J, Byrne PJ, Ryan L. Strength and Conditioning Recommendations for Female GAA Athletes: The Camogie Player. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000577] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Schilaty ND, Bates NA, Kruisselbrink S, Krych AJ, Hewett TE. Linear Discriminant Analysis Successfully Predicts Knee Injury Outcome From Biomechanical Variables. Am J Sports Med 2020; 48:2447-2455. [PMID: 32693617 PMCID: PMC7566284 DOI: 10.1177/0363546520939946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The most commonly damaged structures of the knee are the anterior cruciate ligament (ACL), medial collateral ligament (MCL), and menisci. Given that these injuries present as either isolated or concomitant, it follows that these events are driven by specific mechanics versus coincidence. This study was designed to investigate the multiplanar mechanisms and determine the important biomechanical and demographic factors that contribute to classification of the injury outcome. HYPOTHESIS Linear discriminant analysis (LDA) would accurately classify each injury type generated by the mechanical impact simulator based on biomechanical input variables (ie, ligament strain and knee kinetics). STUDY DESIGN Controlled laboratory study. METHODS In vivo kinetics and kinematics of 42 healthy, athletic participants were measured to determine stratification of injury risk (ie, low, medium, and high) in 3 degrees of knee forces/moments (knee abduction moment, anterior tibial shear, and internal tibial rotation). These stratified kinetic values were input into a cadaveric impact simulator to assess ligamentous strain and knee kinetics during a simulated landing task. Uniaxial and multiaxial load cells and implanted strain sensors were used to collect mechanical data for analysis. LDA was used to determine the ability to classify injury outcome by demographic and biomechanical input variables. RESULTS From LDA, a 5-factor model (Entropy R2 = 0.26) demonstrated an area under the receiver operating characteristic curve (AUC) for all 5 injury outcomes (ACL, MCL, ACL+MCL, ACL+MCL+meniscus, ACL+meniscus) of 0.74 or higher, with "good" prediction for 4 of 5 injury classifications. A 10-factor model (Entropy R2 = 0.66) improved the AUC to 0.86 or higher, with "excellent" prediction for 5 injury classifications. The 15-factor model (Entropy R2 = 0.85), produced 94.1% accuracy with the AUC 0.98 or higher for all 5 injury classifications. CONCLUSION Use of LDA accurately predicted the outcome of knee injury from kinetic data from cadaveric simulations with the use of a mechanical impact simulator at 25° of knee flexion. Thus, with clinically relevant kinetics, it is possible to determine clinical risk of injury and also the likely presentation of singular or concomitant knee injury. CLINICAL RELEVANCE LDA demonstrates that injury outcomes are largely characterized by specific mechanics that can distinguish ACL, MCL, and medial meniscal injury. Furthermore, as the mechanics of injury are better understood, improved interventional prehabilitation can be designed to reduce these injuries.
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Affiliation(s)
- Nathan D. Schilaty
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
- Sports Medicine Center, Mayo Clinic, Rochester, Minnesota
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, Minnesota
| | - Nathaniel A. Bates
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
- Sports Medicine Center, Mayo Clinic, Rochester, Minnesota
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | | | - Aaron J. Krych
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
- Sports Medicine Center, Mayo Clinic, Rochester, Minnesota
| | - Timothy E. Hewett
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky
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Dos'Santos T, Thomas C, Comfort P, Jones PA. The Effect of Training Interventions on Change of Direction Biomechanics Associated with Increased Anterior Cruciate Ligament Loading: A Scoping Review. Sports Med 2020; 49:1837-1859. [PMID: 31493206 PMCID: PMC6851221 DOI: 10.1007/s40279-019-01171-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Change of direction (COD) manoeuvres are associated with anterior cruciate ligament (ACL) injury risk due to the propensity to generate large multiplanar knee joint loads. Given the short- and long-term consequences of ACL injury, practitioners are interested in methods that reduce knee joint loads and subsequent ACL loading. An effective strategy to reduce ACL loading is modifying an athlete’s movement mechanics to reduce knee joint loading. The purpose of this scoping review was to critically appraise and comprehensively synthesise the existing literature related to the effects of training interventions on COD biomechanics associated with increased knee joint loads and subsequent ACL loading, and identify gaps and recommend areas for future research. A review of the literature was conducted using Medline and Sport DISCUS databases. Inclusion criteria consisted of pre-post analysis of a COD task, a minimum 4-week training intervention, and assessments of biomechanical characteristics associated with increased ACL loading. Of the 1,027 articles identified, 22 were included in the scoping review. Based on current literature, balance training and COD technique modification are the most effective training modalities for reducing knee joint loading (small to moderate effect sizes). One study reported dynamic core stability training was effective in reducing knee joint loads, but further research is needed to definitively confirm the efficacy of this method. Perturbation-enhanced plyometric training, the F-MARC 11 + soccer specific warm-up, Oslo Neuromuscular warm-up, and resistance training are ineffective training modalities to reduce COD knee joint loads. Conflicting findings have been observed for the Core-Pac and mixed training programme. Consequently, practitioners should consider incorporating balance and COD technique modification drills into their athletes’ training programmes to reduce potentially hazardous knee joint loads when changing direction. However, training intervention studies can be improved by investigating larger sample sizes (> 20), including a control group, acknowledging measurement error when interpreting their findings, and considering performance implications, to confirm the effectiveness of training interventions and improve adherence.
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Affiliation(s)
- Thomas Dos'Santos
- Human Performance Laboratory, University of Salford, Greater Manchester, UK.
| | - Christopher Thomas
- Human Performance Laboratory, University of Salford, Greater Manchester, UK
| | - Paul Comfort
- Human Performance Laboratory, University of Salford, Greater Manchester, UK
| | - Paul A Jones
- Human Performance Laboratory, University of Salford, Greater Manchester, UK
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A Critically Appraised Topic on the Tuck Jump Assessment: Does the Tuck Jump Assessment Demonstrate Interrater and Intrarater Reliability in Healthy Individuals? J Sport Rehabil 2020; 29:503-508. [PMID: 31624223 DOI: 10.1123/jsr.2019-0099] [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: 03/04/2019] [Revised: 06/11/2019] [Accepted: 08/04/2019] [Indexed: 11/18/2022]
Abstract
Clinical Scenario: Lower-extremity injuries in the United States costs millions of dollars each year. Athletes should be screened for neuromuscular deficits and trained to correct them. The tuck jump assessment (TJA) is a plyometric tool that can be used with athletes. Clinical Question: Does the TJA demonstrate both interrater and intrarater reliability in healthy individuals? Summary of Key Findings: Four of the 5 articles included in this critically appraised topic showed good to excellent reliability; however, caution should be taken in interpreting these results. Although composite scores of the TJA were found to be reliable, individual flaws do not demonstrate reliability on their own, with the exception of knee valgus at landing. Aspects of the TJA itself, including rater training, scoring system, playback speed, volume, and number of views allotted, need to be standardized before the reliability of this clinical assessment can be further researched. Clinical Bottom Line: The TJA has shown varying levels of reliability, from poor to excellent, for both interrater and intrarater reliability, given current research. Strength of Recommendation: According to the Centre for Evidence Based Medicine levels of evidence, there is level 2b evidence for research into the reliability of the TJA. This evidence has been demonstrated in elite, adolescent, and college-level athletics in the United Kingdom, Spain, and the United States. The recommendation of level 2b was chosen because these studies utilized cohort design for interrater and intrarater reliability across populations. An overall grade of B was recommended because there were consistent level 2 studies.
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Panagoulis C, Chatzinikolaou A, Avloniti A, Leontsini D, Deli CK, Draganidis D, Stampoulis T, Oikonomou T, Papanikolaou K, Rafailakis L, Kambas A, Jamurtas AZ, Fatouros IG. In-Season Integrative Neuromuscular Strength Training Improves Performance of Early-Adolescent Soccer Athletes. J Strength Cond Res 2020; 34:516-526. [DOI: 10.1519/jsc.0000000000002938] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Limited positive effects on jump-landing technique in girls but not in boys after 8 weeks of injury prevention exercise training in youth football. Knee Surg Sports Traumatol Arthrosc 2020; 28:528-537. [PMID: 31541293 PMCID: PMC6994440 DOI: 10.1007/s00167-019-05721-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/11/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To evaluate changes in jump-landing technique in football-playing boys and girls after 8 weeks of injury prevention training. METHODS Four boys' and four girls' teams (mean age 14.1 ± 0.8 years) were instructed to use either the original Knee Control injury prevention exercise programme (IPEP) or a further developed IPEP, Knee Control + , at every training session for 8 weeks. Baseline and follow-up testing of jump-landing technique included drop vertical jumps (DVJ), assessed subjectively and with two-dimensional movement analysis, and tuck jump assessment (TJA). RESULTS Only minor differences in intervention effects were seen between the two IPEPs, and results are therefore presented for both intervention groups combined. At baseline 30% of the boys showed good knee control during the DVJ, normalised knee separation distances of 77-96% (versus hip) and a median of 3 flaws during the TJA. Among girls, 22% showed good knee control, normalised knee separation distances of 67-86% and a median of 4 flaws during the TJA. At follow-up, boys and girls performed significantly more jumps during TJA. No changes in jump-landing technique were seen in boys, whereas girls improved their knee flexion angle at initial contact in the DVJ (mean change + 4.7°, p < 0.001, 95% CI 2.36-6.99, d = 0.7) and their TJA total score (- 1 point, p = 0.045, r = - 0.4). CONCLUSION The study showed small positive effects on jump-landing technique in girls, but not in boys, after 8 weeks of injury prevention training. LEVEL OF EVIDENCE Level II. TRIAL REGISTRATION Clinical Trials gov identifier: NCT03251404.
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Arundale AJH, Kvist J, Hägglund M, Fältström A. Jump performance in male and female football players. Knee Surg Sports Traumatol Arthrosc 2020; 28:606-613. [PMID: 31667569 PMCID: PMC6994508 DOI: 10.1007/s00167-019-05747-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/09/2019] [Indexed: 01/05/2023]
Abstract
PURPOSE To examine differences between men and women football players in clinically feasible jumping measures. METHODS Female football players (N = 46, ages 16-25) were matched based on age, training frequency, and playing position with 46 male players. All players performed the tuck jump and drop vertical jump (DVJ). DVJ was assessed quantitatively for valgus knee motion and probability of a high peak knee abduction moment (pKAM), as well as sagittal plane hip, knee, and ankle angles, and qualitatively with visual assessment of the player's knees upon landing; graded as good, reduced, or poor control. RESULT Women had higher total tuck jump scores (5 ± 2) (more technique flaws), than men (3 ± 2, P < 0.01). The quantitative analysis of the DVJ found that men had greater asymmetries between limbs, but women landed bilaterally in more knee valgus (interaction P = 0.04, main effect of sex P = 0.02). There was no difference in pKAM (interaction n.s.). Women also landed in less hip flexion (P = 0.01) and ankle dorsiflexion (P = 0.01) than men. The qualitative DVJ analysis found that more women (48%) had poor knee control compared to men (11%, P < 0.01). CONCLUSIONS The results indicate that women perform worse on the tuck jump assessment than men. The results support previous findings that women land in more knee valgus than men, but also found that men may have larger asymmetries in knee valgus. These results from clinically feasible measures provide some suggestions for clinicians to consider during ACL reconstruction rehabilitation to enhance performance.
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Affiliation(s)
- Amelia J. H. Arundale
- Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Joanna Kvist
- Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden ,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Martin Hägglund
- Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden ,Football Research Group, Linköping University, Linköping, Sweden
| | - Anne Fältström
- Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. .,Region Jönköping County, Rehabilitation Centre, Ryhov County Hospital, 551 85, Jönköping, Sweden.
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Everard E, Lyons M, Harrison AJ. An Examination of the Relationship Between the Functional Movement Screen, Landing Error Scoring System, and 3D Kinematic Data During a Drop Jump Task. J Strength Cond Res 2019; 35:3012-3020. [PMID: 31498222 DOI: 10.1519/jsc.0000000000003261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Everard, E, Lyons, M, and Harrison, AJ. An examination of the relationship between the functional movement screen, landing error scoring system and 3D kinematic data during a drop jump task. J Strength Cond Res XX(X): 000-000, 2019-Tests such as the Functional Movement Screen (FMS) and Landing Error Scoring System (LESS) have become an established component of preparticipation screening. Despite their practical use, there is a lack of empirical evidence examining their relationship to established assessments of movement, such as 3D kinematics of a drop jump. Fifty-two male collegiate athletes undertook the LESS, FMS, and a drop jump where 3D lower-limb kinematic variables were assessed. Spearman correlations were conducted to examine the relationship between LESS, FMS, and drop-jump 3D kinematic variables. A series of independent t-tests examined differences in hip and knee kinematic variables in acceptable and poor FMS and LESS groups as determined by established cut-off scores. Landing Error Scoring System scores had significant moderate correlations with most kinematic variables (r = 0.35-0.64; p < 0.01). Subjects with poor LESS scores displayed significantly worse lower-limb kinematics compared with their high-scoring counterparts (effect size = 1.99-2.76, large effect). There were significant moderate correlations with maximal hip and knee flexion (r = 0.46 and 0.39 respectively; p < 0.01) and small or nonsignificant correlations between all other kinematic variables and FMS scores. Hip flexion and knee valgus at maximal displacement were the only kinematic variables significantly different between FMS groups (ES = 0.70-0.72, small-to-moderate effect). The results confirm limitations in the ability of the FMS to distinguish between groups for landing biomechanics.
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Affiliation(s)
- Eoin Everard
- Department of Physical Education and Sports Science, Physical Education and Sports Science, University of Limerick, Limerick, Ireland.,Department of Sports, Limerick Institute of Technology, Thurles, Ireland
| | - Mark Lyons
- Department of Physical Education and Sports Science, Physical Education and Sports Science, University of Limerick, Limerick, Ireland
| | - Andrew J Harrison
- Department of Physical Education and Sports Science, Physical Education and Sports Science, University of Limerick, Limerick, Ireland
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Neilson V, Ward S, Hume P, Lewis G, McDaid A. Effects of augmented feedback on training jump landing tasks for ACL injury prevention: A systematic review and meta-analysis. Phys Ther Sport 2019; 39:126-135. [DOI: 10.1016/j.ptsp.2019.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 07/16/2019] [Accepted: 07/16/2019] [Indexed: 11/16/2022]
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Bonnette S, DiCesare CA, Diekfuss JA, Grooms DR, MacPherson RP, Riley MA, Myer GD. Advancing Anterior Cruciate Ligament Injury Prevention Using Real-Time Biofeedback for Amplified Sensorimotor Integration. J Athl Train 2019; 54:985-986. [PMID: 31437016 PMCID: PMC6795095 DOI: 10.4085/1062-6050-54.083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Scott Bonnette
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
| | - Christopher A. DiCesare
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
| | - Jed A. Diekfuss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
| | - Dustin R. Grooms
- Ohio Musculoskeletal & Neurological Institute and Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens
| | - Ryan P. MacPherson
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
| | - Michael A. Riley
- Center for Cognition, Action, & Perception, Department of Psychology, University of Cincinnati, OH
| | - Gregory D. Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, OH
- Department of Pediatrics and Orthopaedic Surgery, University of Cincinnati, OH
- The Micheli Center for Sports Injury Prevention, Waltham, MA
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Dos’Santos T, McBurnie A, Donelon T, Thomas C, Comfort P, Jones PA. A qualitative screening tool to identify athletes with ‘high-risk’ movement mechanics during cutting: The cutting movement assessment score (CMAS). Phys Ther Sport 2019; 38:152-161. [DOI: 10.1016/j.ptsp.2019.05.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/07/2019] [Accepted: 05/20/2019] [Indexed: 01/14/2023]
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Between-session and inter-rater reliability of the modified tuck jump assessment in healthy adult athletes. Phys Ther Sport 2019; 37:10-14. [DOI: 10.1016/j.ptsp.2019.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/11/2019] [Accepted: 02/11/2019] [Indexed: 11/20/2022]
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Sabet S, Letafatkar A, Eftekhari F, Khosrokiani Z, Gokeler A. Trunk and hip control neuromuscular training to target inter limb asymmetry deficits associated with anterior cruciate ligament injury. Phys Ther Sport 2019; 38:71-79. [PMID: 31055061 DOI: 10.1016/j.ptsp.2019.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/21/2019] [Accepted: 04/21/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The primary aim of this study was to determine the effect of NMT on female basketball players (performing at least 3 exercise sessions per week for at least 90 min) with inter limb asymmetry. DESIGN Controlled laboratory study. SETTING University research laboratory. PARTICIPANTS 40 female basketball players (age 22.4 ± 1.7 years, height 168.4 ± 5.31 cm, weight 66.6 ± 6.6 kg) who demonstrated neuromuscular deficits on the tuck jump test were allocated to a control group (n = 20), and the NMT group (n = 20). INTERVENTION Experimental group participate in an 8-week NMT program including 6 weeks (18 sessions), each session almost lasted for 30 min. MAIN OUTCOME MEASURES The peak torque as well as time to peak torques of hip abductors and external rotators as well as knee flexors and extensors muscles, and the performance were measured before and at the end of a 6-week NMT using the isokinetic dynamometer and the hop test battery respectively. RESULTS A significant improvement was observed in the NMT group for the peak torque and time to peak torque in hip and knee muscles both concentric and eccentric states at 60 and 180ºsec. Also, they showed a significant improvement in the distance of single leg hop and single leg triple crossover hop tests. However, no significant 20 and 21. change was seen in the control group. CONCLUSIONS An NMT program can significantly improve muscle strength, hop tests scores, and the inter limb asymmetry in female basketball players. The NMT may be used in ACL prevention in female basketball players with lower limb asymmetry.
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Affiliation(s)
- Sonia Sabet
- Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
| | - Amir Letafatkar
- Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran.
| | - Fereshteh Eftekhari
- Faculty of Physical Education and Sport Sciences, Shiraz University, Shiraz, Iran
| | - Zohre Khosrokiani
- Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
| | - Alli Gokeler
- Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science, Luxembourg
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Read PJ, Oliver JL, De Ste Croix MBA, Myer GD, Lloyd RS. A Review of Field-Based Assessments of Neuromuscular Control and Their Utility in Male Youth Soccer Players. J Strength Cond Res 2019; 33:283-299. [PMID: 28658071 DOI: 10.1519/jsc.0000000000002069] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Read, PJ, Oliver, JL, Croix, MS, Myer, GD, and Lloyd, RS. A review of field-based assessments of neuromuscular control and their utility in male youth soccer players. J Strength Cond Res 33(1): 283-299, 2019-Lower-extremity injuries in male youth soccer are common and equate to a substantial time loss from training and competitions during the course of a season. Extended periods of absence will impact player involvement in skill and physical development activities, as well as participation in competitive match play. Neuromuscular risk factors for lower-extremity injury in male youth soccer players can be categorized into quadriceps dominance, leg dominance, ligament dominance, trunk dominance, and reduced dynamic stability. Valid screening methods to identify risk factors that are practically viable are needed for youth athletes who may be at a greater risk of injury in soccer. Although field-based tests of neuromuscular control provide a reliable option for the assessment of injury risk in adults and females, less data are available in male youth soccer players, and further research is required to examine their ability to predict injury risk. This article provides a review of the current literature pertaining to field-based screening tests and critically appraises their suitability for use with male youth soccer players. Currently, the only method that has been validated in male youth soccer players is the landing error scoring system. Asymmetrical anterior reach measured during the Y-Balance test may also be considered because of its strong predictive ability in male youth basketball players; however, further research is required to fully support its use with soccer players.
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Affiliation(s)
- Paul J Read
- School of Sport, Health and Applied Science, St Mary's University, London, United Kingdom.,Athlete Health and Performance Research Center, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Jon L Oliver
- Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, United Kingdom.,Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand
| | | | - Gregory D Myer
- Division of Sports Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio.,Department of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio.,The Micheli Center for Sports Injury Prevention, Boston, Massachusetts.,Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rhodri S Lloyd
- Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, United Kingdom.,Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand.,Center for Sport Science and Human Performance, Waikato Institute of Technology, New Zealand
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Carrasco-Huenulef C, Poblete-Garrido M, Monrroy-Uarac M, Ramirez-Campillo R, Moran J, Gajardo-Burgos R. Effects of a neuromuscular training program on anterior cruciate ligament injury risk factors in youth female basketball players: a pilot study. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03731-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Barfield JW, Oliver GD. Tuck Jump Assessment as an Indicator for Upper Extremity Injury. Sports Med Int Open 2018; 2:E113-E116. [PMID: 30539127 PMCID: PMC6225970 DOI: 10.1055/a-0655-7345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 06/17/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022] Open
Abstract
The purpose of this study was to determine if tuck jumps can be used as a dynamic movement assessment to ascertain a previous history of upper extremity injury in an overhead throwing sport. Seventy-one youth baseball and softball athletes (28 baseball/43 softball; 12.41±2.22 yrs.; 161.98±13.65 cm; 59.17 ± 14.90 kg) were recruited to participate and were placed in either the previous injury (N=18) or no previous injury (N=53) groups. Kinematic data were collected from jumps 4 through 8 during a trial of 10 tuck jumps performed at 100 Hz using an electromagnetic tracking system (trakSTAR TM , Ascension Technologies, Inc., Burlington, VT, USA) synced with the MotionMonitor ® (Innovative Sports Training, Chicago, IL, USA). A logistic regression showed no significance in trunk flexion or upper leg elevation in the ability to determine upper extremity injury ( χ 2 (1, N =71)=3.55, p =0.315). In conclusion, examining only trunk flexion and upper leg elevation during the tuck jump assessment (TJA) is not enough for clinicians to recognize previous upper extremity injury. Even though the body behaves as a kinetic chain, simplifying the dynamic movement assessment while not specifying the type of upper extremity injury is not favorable for the clinician to identify previous injury.
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Affiliation(s)
- Jeff W Barfield
- School of Kinesiology, Auburn University, Auburn, United States
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Armitano CN, Haegele JA, Russell DM. The Use of Augmented Information for Reducing Anterior Cruciate Ligament Injury Risk During Jump Landings: A Systematic Review. J Athl Train 2018; 53:844-859. [PMID: 30273010 DOI: 10.4085/1062-6050-320-17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT: A comprehensive systematic review of the literature on the use of augmented information in anterior cruciate ligament (ACL) injury-prevention programs to improve jump-landing technique was conducted. The use of motor-learning concepts could provide more robust means of preventing ACL injuries. OBJECTIVE: To systematically summarize the effectiveness of augmented information in improving the biomechanical factors associated with an increased risk for ACL injury. DATA SOURCES: Articles were retrieved using the electronic databases of PubMed, MEDLINE, CINAHL, and Google Scholar and 3 lines of truncated search words: (a) lower extremity, knee, ACL, and anterior cruciate ligament; (b) prevention, injury prevention, and prehab; and (c) augmented information, augmented feedback, feedback, cue, and instruction. We also performed a hand search of the reference lists of the screened articles. DATA EXTRACTION: We independently assessed the methodologic quality using the Cochrane Group on Screening and Diagnostic Test Methods list. Articles were placed in 1 of 3 augmented-information categories: prescriptive, feedback, or transition. Articles were also categorized based on whether the information likely encouraged an internal or external focus of attention. DATA SYNTHESIS: The searches identified a total of 353 studies, of which 18 were included. Most researchers found that augmented information could lead to technique changes to reduce the biomechanical risk factors associated with ACL injury. The average methodologic quality of the studies was 11.8 out of 17, with a range from 8 to 15. The authors of only 7 studies examined retention of the improved techniques. CONCLUSIONS: The evidence suggests that augmented information can be used to significantly improve the biomechanical indicators associated with ACL injury and to enhance current ACL injury-prevention programs. Combined prescriptive and feedback information that encouraged both internal and external foci led to the largest retention effect sizes.
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Affiliation(s)
- Cortney N Armitano
- School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA
| | - Daniel M Russell
- School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA
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Warren M, Lininger MR, Chimera NJ, Smith CA. Utility of FMS to understand injury incidence in sports: current perspectives. Open Access J Sports Med 2018; 9:171-182. [PMID: 30233259 PMCID: PMC6135213 DOI: 10.2147/oajsm.s149139] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Functional Movement Screen (FMS) is a popular movement screen used by rehabilitation, as well as strength and conditioning, professionals. The FMS, like other movement screens, identifies movement dysfunction in those at risk of, but not currently experiencing, signs or symptoms of a musculoskeletal injury. Seven movement patterns comprise the FMS, which was designed to screen fundamental movement requiring a balance between stability and mobility. The 7 movement patterns are summed to a composite FMS score. For an instrument to have wide applicability and acceptability, there must be high levels of reliability, validity, and accuracy. The FMS is certainly a reliable tool, and can be consistently scored within and between raters. Although the FMS has high face and content validity, the criterion validity (discriminant and convergent) is low. Additionally, the FMS does not appear to be studying a single construct, challenging the use of the summed composite FMS score. The accuracy of the FMS in screening for injury is also suspect, with low sensitivity in almost all studies, although specificity is higher. Finally, within the FMS literature, the concepts of prediction and association are conflated, combined with flawed cohort studies, leading to questions about the efficacy of the FMS to screen for injury. Future research on the use of the FMS, either the composite score or the individual movement patterns, to screen for injury or injury risk in adequately powered, well-designed studies are required to determine if the FMS is appropriate for use as a movement screen.
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Affiliation(s)
- Meghan Warren
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, USA,
| | - Monica R Lininger
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, USA,
| | - Nicole J Chimera
- Department of Athletic Training, Daemen College, Amherst, NY, USA
| | - Craig A Smith
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, USA, .,Smith Performance Center, Tuscon, AZ, USA
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Terry AC, Thelen MD, Crowell M, Goss DL. THE MUSCULOSKELETAL READINESS SCREENING TOOL- ATHLETE CONCERN FOR INJURY & PRIOR INJURY ASSOCIATED WITH FUTURE INJURY. Int J Sports Phys Ther 2018; 13:595-604. [PMID: 30140553 PMCID: PMC6088131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The Musculoskeletal Readiness Screening Tool (MRST) was developed in an effort to consistently predict injury among military personnel. Current injury prediction tools have not consistently predicted injury in this population. The MRST is comprised of the weight bearing forward lunge, modified deep squat, closed kinetic chain upper extremity stability test (CKCUEST), forward step down with eyes closed, stationary tuck jump, unilateral wall sit hold, and subjective, individual perceived level of risk for injury. The Feagin hop and self-reported history of injury were also included in this study protocol. The Feagin hop was a functional test used consistently by the orthopedic department located at the testing site as well as used in a recent study aimed at defining a return to duty screen; self-reported history of injury has been identified as a potential predictor of injury. PURPOSE To examine whether MRST scores, as a composite as individual components, were predictive of a United States Military Academy Preparatory School (USMAPS) student athlete sustaining a future musculoskeletal injury. STUDY DESIGN Prospective Cohort Study. METHODS MRST scores were collected for 141 student athletes (mean age 18.63 ± 1.31) at USMAPS. The injury surveillance period was nine months. Students participated in regularly occurring military specific training and various sports. Mean scores were compared between injured and uninjured groups; binary logistic regression model was also completed. RESULTS Seventy students sustained an injury. The top activities resulting in injury included football (36%) and basketball (11%) with injuries predominantly located in the lower extremity including the knee (24%), hip (15%), and ankle (14%). Composite MRST scores were not statistically different between injured (12.58 ± 2.16) and uninjured (13 ± 2.27) groups. There was an association between those with a personal concern for future injury and actual injury (p = .04). There was an association between those reporting a prior injury in the preceding 12 months and those incurring an injury at USMAPS (p = .04). CONCLUSION The MRST composite scores were not predictive of injury in this population. Previous injury and personal concern for injury were significant injury predictors. LEVEL OF EVIDENCE 2a.
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Affiliation(s)
- Aspen C. Terry
- 48th Rescue Squadron, Davis-Monthan Air Force Base, AZ, USA
| | - Mark D. Thelen
- Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, TX, USA
| | - Michael Crowell
- Baylor University-Keller Army Community Hospital, Division 1 Sports Physical Therapy Fellowship, West Point, NY, USA
| | - Donald L. Goss
- Baylor University-Keller Army Community Hospital, Division 1 Sports Physical Therapy Fellowship, West Point, NY, USA
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Read PJ, Oliver JL, De Ste Croix MBA, Myer GD, Lloyd RS. Landing Kinematics in Elite Male Youth Soccer Players of Different Chronologic Ages and Stages of Maturation. J Athl Train 2018; 53:372-378. [PMID: 29693423 PMCID: PMC5967279 DOI: 10.4085/1062-6050-493-16] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Despite the high frequency of knee injuries in athletes, few researchers have studied the effects of chronologic age and stage of maturation on knee-joint kinematics in male youth soccer players. OBJECTIVE To use a coach-friendly screening tool to examine knee-valgus scores for players of different ages and at different stages of maturation. DESIGN Cross-sectional study. SETTING Academy soccer clubs. PATIENTS OR OTHER PARTICIPANTS A total of 400 elite male youth soccer players aged 10 to 18 years categorized by chronologic age and stage of maturation based on their years from peak height velocity (PHV). MAIN OUTCOME MEASURE(S) Knee valgus was evaluated during the tuck-jump assessment via 2-dimensional analysis. Frontal-plane projection angles were subjectively classified as minor (<10°), moderate (10°-20°), or severe (>20°), and using these classifications, we scored knee valgus in the tuck jump as 0 ( no valgus), 1 ( minor), 2 ( moderate), or 3 ( severe). RESULTS A trend toward higher valgus scores was observed in the younger age groups and the pre-PHV group. The lowest frequency of no valgus occurred in the U18 and post-PHV groups. The highest percentages of severe scores were in the U13 and pre-PHV groups for the right limb. Knee-valgus scores were lower for both lower extremities in the U18 group than in all other age groups ( P < .001) except the U16 group. Scores were lower for the post-PHV than the pre-PHV group for the right limb ( P < .001) and both pre-PHV and circa-PHV groups for the left limb ( P < .001). Noteworthy interlimb asymmetries were evident in the U14, U15, and circa-PHV groups. CONCLUSIONS Reductions in knee valgus with incremental age and during the later stages of maturation indicated that this risk factor was more prevalent in younger players. Interlimb asymmetry may also emerge around the time of the peak growth spurt and early adolescence, potentially increasing the risk of traumatic injury.
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Affiliation(s)
- Paul J. Read
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Youth Physical Development Centre, School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom
| | - Jon L. Oliver
- Youth Physical Development Centre, School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland
| | | | - Gregory D. Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Ohio; Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, OH; The Micheli Center for Sports Injury Prevention, Waltham, MA
| | - Rhodri S. Lloyd
- Youth Physical Development Centre, School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, New Zealand
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Schneider DK, Gokeler A, Otten E, Ford KR, Hewett TE, Divine JG, Colosimo AJ, Heidt RS, Myer GD. A Novel Mass-Spring-Damper Model Analysis to Identify Landing Deficits in Athletes Returning to Sport After Anterior Cruciate Ligament Reconstruction. J Strength Cond Res 2018; 31:2590-2598. [PMID: 27465632 DOI: 10.1519/jsc.0000000000001569] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Schneider, DK, Gokeler, A, Otten, E, Ford, KR, Hewett, TE, Divine, JG, Colosimo, AJ, Heidt, RS, and Myer, GD. A Novel mass-spring-damper model analysis to identify landing deficits in athletes returning to sport after anterior cruciate ligament reconstruction. J Strength Cond Res 31(9): 2590-2598, 2017-A mass-spring-damper (MSD) model may serve as an extension of biomechanical data from 3-dimensional motion analysis and epidemiological data which helps to delineate populations at risk for anterior cruciate ligament (ACL) injuries. The purpose of this study was to evaluate such a model. Thirty-six ACL reconstruction (ACLR) group subjects and 67 controls (CTRL) completed single-leg drop landing and single-leg broad jump tasks. Landing ground reaction force data were collected and analyzed with an MSD model. Medians, interquartile ranges, and limb symmetry indices (LSIs) were calculated and comparisons were made within and between groups. During a single-leg drop landing, the ACLR group had a lower spring LSI than the CTRL group (p = 0.015) and landed with decreased stiffness in the involved limb relative to the uninvolved limb (p = 0.021). The ACLR group also had an increased damping LSI relative to the CTRL group (p = 0.045). The ACLR subjects landed with increased stiffness (p = 0.006) and decreased damping (p = 0.003) in their involved limbs compared to CTRL subjects' nondominant limbs. During a single-leg forward broad jump, the ACLR group had a greater spring LSI value than the CTRL group (p = 0.045). The CTRL group also recorded decreased damping values in their nondominant limbs compared with the involved limbs of the ACLR group (p = 0.046). Athletes who have undergone ACLR display different lower-limb dynamics than healthy controls, according to an MSD model. Quadriceps dominance and leg dominance are components of ACLR athletes' landing strategies and may be identified with an MSD model and addressed during rehabilitation.
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Affiliation(s)
- Daniel K Schneider
- 1Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; 2Division of Sports Medicine, The Sport Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; 3College of Medicine, University of Cincinnati, Cincinnati, Ohio; 4Center for Human Movement Sciences, University of Groningen, Groningen, the Netherlands; 5Department of Physical Therapy, High Point University, High Point, North Carolina; 6Departments of Orthopaedic Surgery, Physical Medicine and Rehabilitation, and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota; 7Department of Sports Medicine, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio; 8Division of Sports Medicine, Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio; 9Wellington Orthopaedic Surgery and Sports Medicine, Mercy Health, Cincinnati, Ohio; 10Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio; and 11The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
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47
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Abstract
As female athlete sports participation has continued to increase, the rate of anterior cruciate ligament (ACL) rupture in female athletes has also increased. Individualized, patient-specific treatment is crucial to achieving optimal outcomes; ACL reconstruction must accurately restore native ACL anatomy and address any concomitant injury to secondary stabilizers. Rehabilitation programs should target hip, core, and trunk neuromuscular control; allow adequate time for graft ligamentization; and address the psychosocial needs of the athlete.
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48
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Smith CA, Chimera NJ, Lininger MR, Warren M. Modified Tuck Jump Assessment: Reliability and Training of Raters. J Sports Sci Med 2017; 16:440-442. [PMID: 28912664 PMCID: PMC5592298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/31/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Craig A. Smith
- Smith Performance Center, Tucson AZ USA
- Department of Physical Therapy and Athletic Training, Northern Arizona University, USA
| | | | - Monica R. Lininger
- Department of Physical Therapy and Athletic Training, Northern Arizona University, USA
| | - Meghan Warren
- Department of Physical Therapy and Athletic Training, Northern Arizona University, USA
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49
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Herrero-Herrero M, García-Massó X, Martínez-Corralo C, Prades-Piñón J, Sanchis-Alfonso V. Relationship between the practice of physical activity and quality of movement in adolescents: a screening tool using self-organizing maps. PHYSICIAN SPORTSMED 2017; 45:271-279. [PMID: 28471700 DOI: 10.1080/00913847.2017.1327303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to determine whether the most physically active adolescents have better lower limb control. METHODS 31 high school students (12 males and 19 females) participated in this study. The Anterior Knee Pain Scale was used to find any cases of knee pain. Only subjects with high scores were selected, to exclude those with knee pain or lower limb injuries. Single Leg Squat and Tuck Jump Assessment were used to evaluate movements with two cameras in a two-dimensional assessment. The IPAQ Questionnaire was used to score the physical activity and to classify it into MET total, MET moderate activity, MET vigorous activity and MET walking. These scores were related to knee angle at landing, age and body mass index by self-organizing maps analysis. RESULTS The subjects were classified into 4 clusters and the descriptive statistics of the different clusters were determined to find any differences. The subjects in cluster 3 were classified as those with the highest risk factors of suffering lower limb musculoskeletal disorders or knee pain, even though injuries do not only depend on quality of movement. Physical activity was not related to healthy movements during jump and single leg squat. CONCLUSION Physical activity alone cannot be an indicator of good quality lower limb movement, as the knee valgus angle plays a determining role, as it could also depend on neuromuscular control and anatomical characteristics. The analytical method described in the study could be used by physical education teachers to detect potential risk factors for musculoskeletal problems in the lower limbs, especially in the knees.
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Affiliation(s)
- María Herrero-Herrero
- a Departamento de Didàctica de l'Expressió Musical, Plàstica i Corporal , Universitat de València , Valencia , Spain.,b EFIR_Estudi de Fisioteràpia i Rendiment , Valencia , Spain
| | - Xavier García-Massó
- a Departamento de Didàctica de l'Expressió Musical, Plàstica i Corporal , Universitat de València , Valencia , Spain
| | | | | | - Vicente Sanchis-Alfonso
- c Department of Orthopaedic Surgery , Hospital Arnau de Vilanova and Hospital 9 de Octubre , Valencia , Spain
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50
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Schreurs MJ, Benjaminse A, Lemmink KAPM. Sharper angle, higher risk? The effect of cutting angle on knee mechanics in invasion sport athletes. J Biomech 2017; 63:144-150. [PMID: 28886868 DOI: 10.1016/j.jbiomech.2017.08.019] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/15/2017] [Accepted: 08/19/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Cutting is an important skill in team-sports, but unfortunately is also related to non-contact ACL injuries. The purpose was to examine knee kinetics and kinematics at different cutting angles. MATERIAL AND METHODS 13 males and 16 females performed cuts at different angles (45°, 90°, 135° and 180°) at maximum speed. 3D kinematics and kinetics were collected. To determine differences across cutting angles (45°, 90°, 135° and 180°) and sex (female, male), a 4×2 repeated measures ANOVA was conducted followed by post hoc comparisons (Bonferroni) with alpha level set at α≤0.05a priori. RESULTS At all cutting angles, males showed greater knee flexion angles than females (p<0.01). Also, where males performed all cutting angles with no differences in the amount of knee flexion -42.53°±8.95°, females decreased their knee flexion angle from -40.6°±7.2° when cutting at 45° to -36.81°±9.10° when cutting at 90°, 135° and 180° (p<0.01). Knee flexion moment decreased for both sexes when cutting towards sharper angles (p<0.05). At 90°, 135° and 180°, males showed greater knee valgus moments than females. For both sexes, knee valgus moment increased towards the sharper cutting angles and then stabilized compared to the 45° cutting angle (p<0.01). Both females and males showed smaller vGRF when cutting to sharper angles (p<0.01). CONCLUSION It can be concluded that different cutting angles demand different knee kinematics and kinetics. Sharper cutting angles place the knee more at risk. However, females and males handle this differently, which has implications for injury prevention.
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Affiliation(s)
- Mervin J Schreurs
- Center for Human Movement Science, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Anne Benjaminse
- Center for Human Movement Science, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; School of Sport Studies, Hanze University Groningen, Zernikeplein 17, 9747 AS Groningen, The Netherlands.
| | - Koen A P M Lemmink
- Center for Human Movement Science, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
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