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Tsarbou C, Liveris NI, Xergia SA, Papageorgiou G, Kvist J, Tsepis E. ACL Injury Etiology in Its Context: A Systems Thinking, Group Model Building Approach. J Clin Med 2024; 13:4928. [PMID: 39201070 PMCID: PMC11355078 DOI: 10.3390/jcm13164928] [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: 07/29/2024] [Revised: 08/15/2024] [Accepted: 08/19/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: Given the complex nature of Anterior Cruciate Ligament (ACL) injury, it is important to analyze its etiology with suitable approaches in order to formulate intervention strategies for effective prevention. The present study employs system thinking techniques to develop a Causal Loop Diagram (CLD) Model for investigating the risk factors for ACL Injury (CLD-ACLI), through a Group Model Building approach. Methods: A two-stage procedure was applied involving a comprehensive literature review followed by several systems thinking group-modeling co-creation workshops with stakeholders. Results: Based on input from experts and stakeholders, combined with the latest scientific findings, the derived CLD-ACLI model revealed a series of interesting complex nonlinear interrelationships causal loops between the likelihood of ACL injury and the number of risk factors. Particularly, the interaction among institutional, psychological, neurocognitive, neuromuscular, malalignment factors, and trauma history seem to affect neuromuscular control, which subsequently may alter the biomechanics of landing, predisposing the ACL to injury. Further, according to the proposed CLD-ACLI model, the risk for injury may increase further if specific environmental and anatomical factors affect the shear forces imposed on the ACL. Conclusions: The proposed CLD-ACLI model constitutes a rigorous useful conceptual presentation agreed upon among experts on the dynamic interactions among potential intrinsic and extrinsic risk factors for ACL injury. The presented causal loop model constitutes a vital step for developing a validated quantitative system dynamics simulation model for evaluating ACL injury-prevention strategies prior to implementation.
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Affiliation(s)
- Charis Tsarbou
- Physiotherapy Department, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece; (C.T.); (N.I.L.); (E.T.)
| | - Nikolaos I. Liveris
- Physiotherapy Department, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece; (C.T.); (N.I.L.); (E.T.)
| | - Sofia A. Xergia
- Physiotherapy Department, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece; (C.T.); (N.I.L.); (E.T.)
| | | | - Joanna Kvist
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 58183 Linköping, Sweden;
| | - Elias Tsepis
- Physiotherapy Department, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece; (C.T.); (N.I.L.); (E.T.)
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Weisman A, Lin E, Yona T, Gottlieb U, Impellizzeri FM, Masharawi Y. Healthcare providers have insufficient up-to-date knowledge of lower limb sports injuries, and their knowledge is similar to that of athletes. Musculoskelet Sci Pract 2023; 65:102750. [PMID: 37003161 DOI: 10.1016/j.msksp.2023.102750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Being up-to-date with evidence-based knowledge of lower limb sports injuries is essential for Healthcare professionals (HCPs). PURPOSE To assess whether HCPs possess up-to-date knowledge of lower limb sports injuries by comparing their knowledge to that of athletes. METHODS With an expert panel, we developed an online quiz of 10 multiple-choice questions on various topics related to lower-limb sports injuries. Maximal score was 100. We used social media to invite HCPs (5 groups: Physiotherapists, Chiropractors, Medical Doctors, Trainers, and Other therapists) and athletes of all levels (amateur, semi-pro, and pro) to participate. We drafted the questions according to conclusions from the latest systematic reviews and meta-analyses. RESULTS 1526 participants completed the study. Final quiz scores ranged from zero (n = 28, 1.8%) to 100 (n = 2, 0.1%) and were distributed normally with a mean score of 45.4 ± 20.6. None of the 6 groups' means surpassed the set threshold of 60 points. Multiple linear regressions of covariates indicated that age, gender, engagement in physical activity, learning hours per week, reading scientific journals, reading popular magazines and blogs, trainers, and other therapists' groups explained 19% of the variances (-5.914<β < 15.082, 0.000<p < 0.038). CONCLUSIONS HCPs have insufficient up-to-date knowledge of lower limb sports injuries, and their knowledge is similar to that of athletes of all levels. HCPs probably do not possess the proper tools to assess scientific literature Academic and sports medicine societies should look into ways to improve the scientific knowledge integration of HCPs.
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Affiliation(s)
- Asaf Weisman
- Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Eshed Lin
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Tomer Yona
- Department of Biomedical Engineering, Technion, Israel Institute of Technology, Haifa, Israel
| | - Uri Gottlieb
- Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Israel
| | - Franco M Impellizzeri
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Australia
| | - Youssef Masharawi
- Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel.
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Chia L, Myer GD, Hewett TE, McKay MJ, Sullivan J, Ford KR, Pappas E. Do Cutting Kinematics Change as Boys Mature? A Longitudinal Cohort Study of High-School Athletes. Clin J Sport Med 2023; 33:e8-e13. [PMID: 36367778 PMCID: PMC9991932 DOI: 10.1097/jsm.0000000000001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Examine longitudinal changes in trunk, hip, and knee kinematics in maturing boys during an unanticipated cutting task. DESIGN Prospective cohort study. SETTING Biomechanical laboratory. PARTICIPANTS Forty-two high-school male basketball, volleyball, and soccer athletes. ASSESSMENT OF RISK FACTORS Trunk, hip, and knee range-of-motion (RoM), peak angles, and angles at initial contact during an unanticipated 45 degrees sidestep cutting task were estimated using laboratory-based three-dimensional optoelectronic motion capture. Maturation was classified using a modified Pubertal Maturational Observational Scale (PMOS) into prepubertal, midpubertal, or postpubertal stages. MAIN OUTCOME MEASURES Trunk total RoM in frontal, sagittal, and transverse planes; peak trunk flexion, right lateral flexion and right rotation angles; hip total RoM in frontal, sagittal, and transverse planes; hip flexion angle at initial contact; peak hip flexion and adduction angles; knee total RoM in frontal, sagittal, and transverse planes; knee flexion angle at initial contact; peak knee flexion and abduction angles. RESULTS As boys matured, there was a decrease in hip sagittal-plane RoM (49.02 degrees to 43.45 degrees, Benjamini-Hochberg adjusted P = 0.027), hip flexion at initial contact (29.33 degrees to 23.08 degrees, P = 0.018), and peak hip flexion (38.66 degrees to 32.71 degrees, P = 0.046), and an increase in trunk contralateral rotation (17.47 degrees to 25.05 degrees, P = 0.027). CONCLUSIONS Maturing male athletes adopted a more erect cutting strategy that is associated with greater knee joint loading. Knee kinematic changes that increase knee joint loading were not observed in this cohort.
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Affiliation(s)
- Lionel Chia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, AUS
- Cleveland Guardians Baseball Company, Cleveland, OH, USA
| | - Gregory D. Myer
- Emory Sport Performance and Research Center, Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
- The Micheli Center for Sports Injury Prevention, Waltham, MA
| | - Timothy E. Hewett
- Hewett Global Consulting, Minneapolis & Rochester, MN, USA
- The Rocky Mountain Consortium for Sports Research, Edwards, CO, USA
| | - Marnee J. McKay
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, AUS
| | - Justin Sullivan
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, AUS
| | - Kevin R. Ford
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | - Evangelos Pappas
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, AUS
- The University of Wollongong, School of Medicine and Illawarra Health and Medical Research Institute, NSW, AUS
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Chia L, Silva DDO, Whalan M, McKay MJ, Sullivan J, Fuller CW, Pappas E. Epidemiology of gradual-onset knee injuries in team ball-sports: A systematic review with meta-analysis of prevalence, incidence, and burden by sex, sport, age, and participation level. J Sci Med Sport 2022; 25:834-844. [DOI: 10.1016/j.jsams.2022.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 08/07/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
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Medeiros HBO, Silvano GA, Herzog W, Nunes MO, de Brito Fontana H. Hip torques and the effect of posture in side-stepping with elastic resistance. Gait Posture 2022; 93:119-125. [PMID: 35134651 DOI: 10.1016/j.gaitpost.2022.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The way movement-based exercises affect targeted muscles is not always obvious. Side stepping with an elastic band around the forefeet is aimed at strengthening hip abductors and lateral rotator muscles, with the premise that it creates an external torque of adduction and medial rotation of the femur around the pelvis that needs to be counteracted by hip muscles. However, hip torques during this exercise have not been previously quantified. RESEARCH QUESTION Is the premise that the side-stepping exercise creates an external torque of adduction and medial rotation of the femur around the pelvis correct? METHODS Thirty-six adults performed the exercise in an upright and a squat posture while 3D kinetic and kinematic data were collected. Hip muscle torques were calculated using inverse dynamics. The effect of posture and potential interactions with sex, side-stepping phases, and trailing/leading directions were analyzed using Pearson correlation and mixed-model ANOVAs. RESULT A hip net muscle torque of extension, abduction and medial rotation was required to perform the exercise, regardless of phase and direction. The net muscle torque towards medial rotation required during the exercise was smaller (P < 0.001) in the upright (0.05-0.12 N m kg-1 m-1 across phases) compared to the squat posture (0.10-0.24 N m kg-1 m-1). In contrast, hip abductor torque was not affected by posture. When averaged across phases and directions, the normalized hip medial rotator muscle torque was highly correlated with knee flexion (r = 0.93, P < 0.001). SIGNIFICANCE The assumption that the side-stepping with the elastic band on the forefeet creates an external hip torque of medial rotation is erroneous. The resistance imposed to the hip during this exercise is consistent with the goal of strengthening the muscles that contribute to hip abduction and hip medial (not lateral) rotation. Changing the knee flexion angle is an effective way to manipulate hip rotator torque when prescribing this exercise in strength training and rehabilitation programs.
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Affiliation(s)
- Heron B O Medeiros
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Géssica A Silvano
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Walter Herzog
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil; Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Marcio O Nunes
- Physical Education Department, University Center of Brusque, Brusque, Santa Catarina, Brazil
| | - Heiliane de Brito Fontana
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil; Morphological Sciences Department, School of Biological Sciences, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
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Comparison between side-lying and standing positions for hip abductor strength assessment. J Bodyw Mov Ther 2022; 30:181-186. [DOI: 10.1016/j.jbmt.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 11/08/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022]
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Kuntze G, Nettel-Aguirre A, Lorenzen KN, Küpper J, Ronsky JL, Whittaker JL, Emery CA. Vertical Drop Jump Biomechanics of Patients With a 3- to 10-Year History of Youth Sport-Related Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med 2021; 9:23259671211058105. [PMID: 34917690 PMCID: PMC8669131 DOI: 10.1177/23259671211058105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background A better understanding of movement biomechanics after anterior cruciate ligament reconstruction (ACLR) could inform injury prevention, knee injury rehabilitation, and osteoarthritis prevention strategies. Purpose To investigate differences in vertical drop jump (VDJ) biomechanics between patients with a 3- to 10-year history of youth sport-related ACLR and uninjured peers of a similar age, sex, and sport. Study Design Cross-sectional study. Level of evidence III. Methods Lower limb kinematics and bilateral ground-reaction forces (GRFs) were recorded for participants performing 10 VDJs. Joint angles and GRF data were analyzed, and statistical analysis was performed using 2 multivariate models. Dependent variables included sagittal (ankle, knee, and hip) and coronal (knee and hip) angles at initial contact and maximum knee flexion, the rate of change of coronal knee angles (35%-90% of the support phase; ie, slopes of linear regression lines), and vertical and mediolateral GRFs (normalized to body weight [BW]). Fixed effects included group, sex, and time since injury. Participant clusters, defined by sex and sport, were considered as random effects. Results Participants included 48 patients with a history of ACLR and 48 uninjured age-, sex-, and sport-matched controls (median age, 22 years [range, 18-26 years]; 67% female). Patients with ACLR demonstrated steeper negative coronal knee angle slopes (β = -0.04 deg/% [95% CI, -0.07 to -0.00 deg/%]; P = .025). A longer time since injury was associated with reduced knee flexion (β = -0.2° [95% CI, -0.3° to -0.0°]; P = .014) and hip flexion (β = -0.1° [95% CI, -0.2° to -0.0°]; P = .018). Regardless of ACLR history, women displayed greater knee valgus at initial contact (β = 2.1° [95% CI, 0.4° to 3.8°]; P = .017), greater coronal knee angle slopes (β = 0.05 deg/% [95% CI, 0.02 to 0.09 deg/%]; P = .004), and larger vertical GRFs (landing: β = -0.34 BW [95% CI, -0.61 to -0.07 BW]; P = .014) (pushoff: β = -0.20 BW [95% CI, -0.32 to -0.08 BW]; P = .001). Conclusion Women and patients with a 3- to 10-year history of ACLR demonstrated VDJ biomechanics that may be associated with knee motion control challenges. Clinical Relevance It is important to consider knee motion control during activities such as VDJs when developing injury prevention and rehabilitation interventions aimed at improving joint health after youth sport-related ACLR.
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Affiliation(s)
- Gregor Kuntze
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Alberto Nettel-Aguirre
- Centre for Health and Social Analytics, National Institute for Applied Statistics Research Australia, School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kristin N Lorenzen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jessica Küpper
- Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Janet L Ronsky
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.,Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
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Chia L, Myer GD, Hewett TE, McKay MJ, Sullivan J, Ford KR, Pappas E. When puberty strikes: Longitudinal changes in cutting kinematics in 172 high-school female athletes. J Sci Med Sport 2021; 24:1290-1295. [PMID: 34384683 PMCID: PMC11148810 DOI: 10.1016/j.jsams.2021.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Young female athletes involved in high-speed cutting and change-of-direction sports are particularly susceptible to anterior cruciate ligament (ACL) injuries. Little is known if maturational changes in cutting technique contribute to the increased injury risk. Our objective was to examine longitudinal changes in cutting kinematics in female athletes as they matured through puberty. DESIGN Longitudinal cohort study METHODS: High school female athletes (n=172) performed an unanticipated 45° cutting task in the biomechanics laboratory across two or more pubertal stages. Pubertal stages were classified using a modified Pubertal Maturational Observational Scale (pre-, mid-, or post-pubertal stages). Generalized linear mixed models were used to compare kinematics across pubertal stages. RESULTS As girls matured through puberty, they displayed a decrease in sagittal-plane hip (1.8-2.6°, p<0.03) and knee range-of-motion (ROM) (2.7-2.9°, p≤0.01), and decreased peak hip (2.9-3.2°, p≤0.02) and knee flexion angles (2.7-2.9°, p≤0.01), which is indicative of greater quadriceps dominance. Peak knee abduction angles also increased as girls progressed through puberty (0.9-1.4°, p≤0.02), suggesting greater ligament dominance. In terms of trunk dominance, there were mixed findings with a decrease in trunk frontal- (2.5-5.7°, p≤0.03) and sagittal-plane ROM (2.0°, p≤0.01), but an increase in trunk transverse-plane ROM (2.8-3.6°, p≤0.02) observed as girls mature. Other significant changes in cutting technique were decreased peak trunk flexion (3.8-7.8°, p≤0.01), and decreased hip flexion (2.9-3.3°, p≤0.02) and knee flexion angles (2.0-3.0°, p≤0.03) at initial contact, suggesting a more upright and stiffer cutting posture. CONCLUSIONS As girls mature through puberty, there is a change in cutting strategy characterized by greater quadriceps and ligament dominance.
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Affiliation(s)
- Lionel Chia
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Gregory D Myer
- Emory Sport Performance and Research Center, USA; Emory Sports Medicine Center, USA; Department of Orthopaedics, Emory University School of Medicine, USA; The Micheli Center for Sports Injury Prevention, USA
| | - Timothy E Hewett
- Hewett Global Consulting, USA; The Rocky Mountain Consortium for Sports Research, USA
| | - Marnee J McKay
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Justin Sullivan
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Kevin R Ford
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, USA
| | - Evangelos Pappas
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia
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Trunk muscle endurance in individuals with and without patellofemoral pain: Sex differences and correlations with performance tests. Phys Ther Sport 2021; 52:248-255. [PMID: 34656829 DOI: 10.1016/j.ptsp.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To compare trunk muscle endurance among females and males with and without patellofemoral pain (PFP), and to investigate the correlations between trunk muscle endurance and performance of the single leg hop test (SLHT) and forward step-down test (FSDT). DESIGN Cross-sectional. SETTING Laboratory-based study. PARTICIPANTS 110 females and 38 males with PFP, 61 females and 31males without PFP. MAIN OUTCOME MEASURES Anterior and lateral trunk muscle endurance were assessed with the prone and bilateral side-bridge tests, respectively. Performance during the SLHT and FSDT was also assessed. RESULTS Lower anterior and lateral trunk muscle endurance were identified in females (p < .001; d = -0.74 to -0.86), but not in males (p ≥ .806; d = -0.04 to 0.05) with PFP as compared to sex-matched controls. Moderate to large, positive correlations between anterior and lateral trunk muscle endurance with performance in the SLHT and FSDT were identified in females (r = .27 to .50; p < .004) and males (r = 0.27 to 0.59; p < .031) with PFP and females without PFP (r = 0.26 to 0.40; p < .044). CONCLUSION Our findings highlight that assessing trunk muscle endurance is advised in females with PFP. Trunk muscle endurance of individuals with PFP may have a role in the performance of hopping and stepping down tasks.
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Fadaei Dehcheshmeh P, Gandomi F, Maffulli N. Effect of lumbopelvic control on landing mechanics and lower extremity muscles' activities in female professional athletes: implications for injury prevention. BMC Sports Sci Med Rehabil 2021; 13:101. [PMID: 34455978 PMCID: PMC8403466 DOI: 10.1186/s13102-021-00331-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/16/2021] [Indexed: 12/13/2022]
Abstract
Background
Lumbopelvic control (LPC) has recently been associated with function, kinesiology, and load distribution on the limb. However, poor LPC has not been studied as a risk factor for lower limb injury in sports requiring frequent jump landings. The present study investigated the effects of LPC on landing mechanics and lower limb muscle activity in professional athletes engaged in sport requiring frequent landing. Methods This study was conducted on 34 professional female athletes aged 18.29 ± 3.29 years with the height and body mass of 173.5 ± 7.23 cm and 66.79 ± 13.37 kg, respectively. The landing error scoring system (LESS) and ImageJ software were used to assess landing mechanics. Wireless electromyography was also used to record the activity of the gluteus medius (GMed), rectus femoris, and semitendinosus. Lumbopelvic control was evaluated using the knee lift abdominal test, bent knee fall-out, active straight leg raising, and the PRONE test using a pressure biofeedback unit. Based on the LPC tests results, the participants were divided into two groups of proper LPC (n = 17) and poor LPC (n = 17). Results There were significant differences between the groups with proper and poor LPC in terms of the LESS test scores (P = 0.0001), lateral trunk flexion (P = 0.0001), knee abduction (P = 0.0001), knee flexion (P = 0.001), trunk flexion (P = 0.01), and GMed muscle activity (P = 0.03). There were no significant differences in the activity of the rectus femoris and semitendinosus muscles, and ankle dorsiflexion (P > 0.05). Conclusions Poor lumbopelvic control affects the kinematics and activity of the lower limb muscles, and may be a risk factor for lower limb injuries, especially of the knee.
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Affiliation(s)
- Paria Fadaei Dehcheshmeh
- Department of Sport Injuries and Corrective Exercises, Sports Sciences Faculty, Razi University, Kermanshah, Iran
| | - Farzaneh Gandomi
- Department of Sport Injuries and Corrective Exercises, Sports Sciences Faculty, Razi University, Kermanshah, Iran.
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Via Salvador Allende, 43, 84081, Baronissi, Italy.,Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Largo Città di Ippocrate, 84131, Salerno, Italy.,Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, 275 Bancroft Road, London, E14DG, England.,School of Pharmacy and Bioengineering, Faculty of Medicine, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Hartshill, Stoke-on-Trent, ST4 7QB, England
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Activation of the gluteus maximus, gluteus medius and tensor fascia lata muscles during hip internal and external rotation exercises at three hip flexion postures. J Bodyw Mov Ther 2021; 27:487-492. [PMID: 34391276 DOI: 10.1016/j.jbmt.2021.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/25/2021] [Accepted: 05/08/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Hip internal and external rotation exercises are usually performed in clinical practice. However, given the synergies required to stabilize the hip in the frontal plane, it is not clear how the activation of target muscles will differ between the two exercise directions. OBJECTIVE I) Compare the activation of the upper and lower fibers of gluteus maximus (GMax), gluteus medius (GMed) and tensor fascia lata muscles between the hip internal and external rotation exercises; ii) Compare the maximal isometric force between hip internal and external rotation exercises and; iii) Assess the effect of varying hip flexion angles on muscle activation and maximal isometric force. STUDY DESIGN A cross sectional study. METHODS Electromyography and force production of twenty-one participants were measured during maximum isometric hip internal and external rotation in three postures: 0°, 45° and 90° of hip flexion. RESULTS MANOVA results showed a larger activation of the GMed, tensor fascia lata and upper GMax (p < .001) for hip internal rotation compared to external rotation regardless of hip flexion angle. For the lower GMax, the same was observed when the hip was kept at 90° of flexion. Maximal isometric force during hip external rotation was greater than during hip internal rotation at 0° posture, and lower at 90° posture (p < .001). CONCLUSION The gluteus and the tensor fascia lata muscles were substantially recruited during the hip internal rotation exercise, and barely recruited during the hip external rotation exercise. Hip flexion influences the myoeletric activity and isometric force production during the internal rotation exercise.
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Trunk endurance, posterior chain flexibility, and previous history of musculoskeletal pain predict overuse low back and lower extremity injury: a prospective cohort study of 545 Navy Cadets. J Sci Med Sport 2020; 24:555-560. [PMID: 33358586 DOI: 10.1016/j.jsams.2020.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/11/2020] [Accepted: 11/30/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate predictors of low back and lower extremity musculoskeletal injury in a cohort of Naval cadets. DESIGN Prospective Cohort Study METHODS: 545 Naval cadets (Males, n = 394, 72%) were followed-up over eight months. Nine variables were investigated as predictors: history of musculoskeletal symptoms in the last 12 months, ankle dorsiflexion range of motion, sit and reach test, isometric hip abduction and external rotation strength, alignment during the single leg squat test, single leg hop test for distance, prone plank and side plank tests. All injuries that required medical attention were registered. Predictive associations were examined using univariable and multivariable logistic regression analyses. RESULTS The incidence of all injuries was 7%. Cadets who failed the 60-second plank test (OR = 3.3; 95% CI, 1.2-8.8, P = 0.04), had ≤18 cm in the sit and reach test (OR = 4.0; 95% CI, 1.4-11.2, P = 0.01), or reported pain in the last 12 months in two or more body regions (OR = 2.7; 95% CI, 1.02-7.3, P = 0.04), had greater odds of sustaining an overuse injury. No predictors were identified for acute injuries. CONCLUSION Decreased trunk endurance on the prone plank test, reduced posterior chain flexibility on the sit and reach test, and a history of pain reported in two or more sites in the last 12 months were predictors of overuse injuries in Naval cadets. Assessment and intervention of these modifiable risk factors may be clinically relevant in injury screening and prevention.
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Bianco A, Lorenzetti S, Seiler J, Fontana HDB, Herzog W, Silvano GA, Medeiros HBDO, Musumeci G. The " Journal of Functional Morphology and Kinesiology" Journal Club Series: Highlights on Recent Papers in Corrective Exercise. J Funct Morphol Kinesiol 2020; 5:E74. [PMID: 33467289 PMCID: PMC7739344 DOI: 10.3390/jfmk5040074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/09/2020] [Indexed: 01/11/2023] Open
Abstract
We are glad to introduce the Journal Club of Volume Five, fourth Issue. This edition is focused on relevant studies published in the last few years in the field of corrective exercise, chosen by our Editorial Board members and their colleagues. We hope to stimulate your curiosity in this field and to share a passion for sport with you, seen also from the scientific point of view. The Editorial Board members wish you an inspiring lecture.
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Affiliation(s)
- Antonino Bianco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli, 6, 90144 Palermo, Italy;
| | - Silvio Lorenzetti
- Swiss Federal Institute of Sport Magglingen (SFISM), 2532 Magglingen, Switzerland; (S.L.); (J.S.)
| | - Jan Seiler
- Swiss Federal Institute of Sport Magglingen (SFISM), 2532 Magglingen, Switzerland; (S.L.); (J.S.)
| | - Heiliane de Brito Fontana
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis 88040400, Brazil; (H.d.B.F.); (G.A.S.); (H.B.d.O.M.)
| | - Walter Herzog
- Faculty of Kinesiology, Engineering, Medicine and Veterinary Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Gessica Aline Silvano
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis 88040400, Brazil; (H.d.B.F.); (G.A.S.); (H.B.d.O.M.)
| | | | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Anatomy, Histology and Movement Sciences Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123 Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, 95123 Catania, Italy
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
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