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Mitchell A, Greig M. Peak instantaneous PlayerLoad metrics highlight movement strategy deficits in professional male soccer players. Res Sports Med 2024; 32:61-71. [PMID: 35593507 DOI: 10.1080/15438627.2022.2079985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
To investigate the influence of task, limb dominance and previous injury on single leg hop task performance and loading response, 25 professional male soccer players completed anterior, medial and lateral hop tests with an accelerometer at mid-calf. Performance outcome was defined as hop distance with loading response defined as the magnitude of, and time to peak instantaneous planar PlayerLoad. The performance was sensitive to task and previous injury (P < 0.001) but not limb dominance, with no evidence of bilateral asymmetry (P = 0.668). Despite impaired performance, previously injured players did not exhibit lower peak instantaneous PlayerLoad after impact in any plane (P ≥ 0.110). There was however a significantly (P = 0.001) longer time to peak medio-lateral loading after impact in previously injured players' affected limb. This observation was exacerbated when the injury was to the non-dominant limb (P = 0.041). Lower-limb accelerometry enhances understanding of movement strategy beyond task outcome, with practical implications in player screening and objective rehabilitation.
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Affiliation(s)
- Andy Mitchell
- Medical Department, RB Leipzig Football Club, Leipzig, Germany
| | - Matt Greig
- Sports Injuries Research Group, Edge Hill University, Ormskirk, UK
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Moreno-Azze A, Prad-Lucas E, Fandos Soñén D, Pradas de la Fuente F, Falcón-Miguel D. Plyometric Training's Effects on Young Male Karatekas' Jump, Change of Direction, and Inter-Limb Asymmetry. Sports (Basel) 2023; 12:1. [PMID: 38275980 PMCID: PMC10821271 DOI: 10.3390/sports12010001] [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: 10/02/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 01/27/2024] Open
Abstract
This study analysed the effects of performing a plyometric training programme on different types of jumping and specific changes of direction, and their respective asymmetries in karatekas. Twenty male karatekas (age 19 ± 4 years) were distributed in two groups, the control group (CG) and the experimental group (EG). The EG group (n = 10) performed a 6-week intervention of unilateral plyometric training, performing countermovement jumps (CMJ), drop jumps (DJ), and long jumps (SH). The tests performed at the beginning and at the end of the intervention were a unilateral and bilateral countermovement jump test (CMJ), single-leg hop test (SH), single-leg side-hop test (SSH), triple hop test (TH), and change of direction in a karate position test (MKUKS). The EG group obtained improvements in the CMJ with the stronger (p = 0.01; ES = 0.39) and weaker leg (p = 0.01; ES = 0.59), in the SH with the weaker leg (p = 0.01; ES = 0.45), in the SSH with the weaker leg (p = 0.03; ES = 0.33), in the MKUKS (p = 0.00; ES = 0.98), and improved the asymmetries obtained in the TH (p = 0.02; ES = -0.85). The GC group obtained significant differences in the CMJ with the stronger (p = 0.03; ES = 0.46) and weaker leg (p = 0.00; ES = 0.69), in the bilateral CMJ (p = 0.02; ES = 0.24), in the SH with the weaker leg (p = 0.00; ES = 0.34), in the TH with the stronger (p = 0.00; ES = -0.15) and weaker leg (p = 0.01; ES = 0.09), and in the MKUKS test (p = 0.04; ES = -0.94). A between-group analysis showed improvements of the EG over the GC in the TH with the stronger leg (p = 0.02; ES = 1.05). Performing plyometric training provides improvements in jumping, mainly in horizontal jumps, reducing inter-limb asymmetries in repetitive jumps.
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Affiliation(s)
- Alejandro Moreno-Azze
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (F.P.d.l.F.); (D.F.-M.)
- Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (E.P.-L.); (D.F.S.)
| | - Estela Prad-Lucas
- Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (E.P.-L.); (D.F.S.)
| | - David Fandos Soñén
- Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (E.P.-L.); (D.F.S.)
| | - Francisco Pradas de la Fuente
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (F.P.d.l.F.); (D.F.-M.)
- Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (E.P.-L.); (D.F.S.)
| | - David Falcón-Miguel
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (F.P.d.l.F.); (D.F.-M.)
- Faculty of Education, University of Zaragoza, 50009 Zaragoza, Spain
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Taberner M, Spencer N, Murphy B, Antflick J, Cohen DD. Progressing On-Court Rehabilitation After Injury: The Control-Chaos Continuum Adapted to Basketball. J Orthop Sports Phys Ther 2023; 53:498–509. [PMID: 37555664 DOI: 10.2519/jospt.2023.11981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
BACKGROUND: Sport-specific training is an integral component of returning to sport following injury. Frameworks designed to guide sport-specific rehabilitation need to integrate and adapt to the specific context of elite sport. The control-chaos continuum (CCC) is a flexible framework originally designed for on-pitch rehabilitation in elite football (soccer). The concepts underpinning the CCC transfer to other elite sport rehabilitation environments. CLINICAL QUESTION: How can practitioners and clinicians transfer the CCC to elite basketball, to support planning and return to sport? On-court rehabilitation is a critical sport-specific rehabilitation component of return to sport, yet there are no frameworks to guide practitioners when planning and delivering on-court rehabilitation. KEY RESULTS: Based on our experience working in the National Basketball Association, we report how the CCC framework can apply to elite basketball. We focus on the design and delivery of progressive training in the presence of injury in this basketball-specific edition of the CCC. Given the challenges when quantifying "load" in basketball, we encourage practitioners and clinicians to consider the qualitative aspects of performance such as skill, sport-specific movement, contact, and decision making. CLINICAL APPLICATION: The 5-phase framework describes training progression from high control, a return to on-court running, to high chaos, a return to "live" unrestricted basketball. The model can be adapted to both short- and long-term injuries based on injury and progression criteria. Strength and power "diagnostics" can be strategically implemented to enhance decision making throughout the return to sport continuum. J Orthop Sports Phys Ther 2023;53(9):1-12. Epub: 9 August 2023. doi:10.2519/jospt.2023.11981.
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Bishop C, Jordan M, Torres-Ronda L, Loturco I, Harry J, Virgile A, Mundy P, Turner A, Comfort P. Selecting Metrics That Matter: Comparing the Use of the Countermovement Jump for Performance Profiling, Neuromuscular Fatigue Monitoring, and Injury Rehabilitation Testing. Strength Cond J 2023. [DOI: 10.1519/ssc.0000000000000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Jordan MJ, Morris N, Barnert J, Lawson D, Aldrich Witt I, Herzog W. Forecasting neuromuscular recovery after anterior cruciate ligament injury: Athlete recovery profiles with generalized additive modeling. J Orthop Res 2022; 40:2803-2812. [PMID: 35194823 PMCID: PMC9790559 DOI: 10.1002/jor.25302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 08/28/2021] [Accepted: 02/02/2022] [Indexed: 02/04/2023]
Abstract
A retrospective analysis of longitudinally collected athlete monitoring data was conducted to generate a model of neuromuscular recovery after anterior cruciate ligament (ACL) injury and reconstruction (ACLR). Neuromuscular testing data including countermovement jump (CMJ) force-time asymmetries and knee extensor strength (maximum voluntary contractionext ) asymmetries (between-limb asymmetry index-AI) were obtained from athletes with ACLR using semitendinosus (ST) autograft (n = 29; AI measurements: n = 494), bone patellar tendon bone autograft (n = 5; AI measurements: n = 88) and noninjured controls (n = 178; AI measurements: n = 3188). Explosive strength measured as the rate of torque development was also calculated. CMJ force-time asymmetries were measured over discrete movement phases (eccentric deceleration phase, concentric phase). Separate additive mixed effects models (additive mixed effects model [AMM]) were fit for each AI with a main effect for the surgical technique and a smooth term for the time since surgery (days). The models explained between 43% and 91% of the deviance in neuromuscular recovery after ACLR. The mean time course was generated from the AMM. Comparative neuromuscular recovery profiles of an athlete with an accelerated progression and an athlete with a delayed progression after a serious multiligament injury were generated. Clinical Significance: This paper provides a new perspective on the utility of longitudinal athlete monitoring including routine testing to develop models of neuromuscular recovery after ACLR that can be used to characterize individual progression throughout rehabilitation.
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Affiliation(s)
- Matthew J. Jordan
- Canadian Sport Institute CalgaryCalgaryAlbertaCanada,Sport Medicine Centre, Faculty of KinesiologyThe University of CalgaryCalgaryAlbertaCanada,School of Medical and Health Science, Centre for Human PerformanceEdith Cowan UniversityJoondalupAustralia,Human Performance Laboratory, Faculty of KinesiologyThe University of CalgaryCalgaryCanada
| | | | | | - Drew Lawson
- Canadian Sport Institute CalgaryCalgaryAlbertaCanada
| | - Isabel Aldrich Witt
- Canadian Sport Institute CalgaryCalgaryAlbertaCanada,Human Performance Laboratory, Faculty of KinesiologyThe University of CalgaryCalgaryCanada
| | - Walter Herzog
- Human Performance Laboratory, Faculty of KinesiologyThe University of CalgaryCalgaryCanada
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Bird MB, Mi Q, Koltun KJ, Lovalekar M, Martin BJ, Fain A, Bannister A, Vera Cruz A, Doyle TLA, Nindl BC. Unsupervised Clustering Techniques Identify Movement Strategies in the Countermovement Jump Associated With Musculoskeletal Injury Risk During US Marine Corps Officer Candidates School. Front Physiol 2022; 13:868002. [PMID: 35634154 PMCID: PMC9132209 DOI: 10.3389/fphys.2022.868002] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/05/2022] [Indexed: 11/15/2022] Open
Abstract
Musculoskeletal injuries (MSKI) are a significant burden on the military healthcare system. Movement strategies, genetics, and fitness level have been identified as potential contributors to MSKI risk. Screening measures associated with MSKI risk are emerging, including novel technologies, such as markerless motion capture (mMoCap) and force plates (FP) and allow for field expedient measures in dynamic military settings. The aim of the current study was to evaluate movement strategies (i.e., describe variables) of the countermovement jump (CMJ) in Marine officer candidates (MOCs) via mMoCap and FP technology by clustering variables to create distinct movement strategies associated with MSKI sustained during Officer Candidates School (OCS). 728 MOCs were tested and 668 MOCs (Male MOCs = 547, Female MOCs = 121) were used for analysis. MOCs performed 3 maximal CMJs in a mMoCap space with FP embedded into the system. De-identified MSKI data was acquired from internal OCS reports for those who presented to the OCS Physical Therapy department for MSKI treatment during the 10 weeks of OCS training. Three distinct clusters were formed with variables relating to CMJ kinetics and kinematics from the mMoCap and FPs. Proportions of MOCs with a lower extremity and torso MSKI across clusters were significantly different (p < 0.001), with the high-risk cluster having the highest proportions (30.5%), followed by moderate-risk cluster (22.5%) and low-risk cluster (13.8%). Kinetics, including braking rate of force development (BRFD), braking net impulse and propulsive net impulse, were higher in low-risk cluster compared to the high-risk cluster (p < 0.001). Lesser degrees of flexion and shorter CMJ phase durations (braking phase and propulsive phase) were observed in low-risk cluster compared to both moderate-risk and high-risk clusters. Male MOCs were distributed equally across clusters while female MOCs were primarily distributed in the high-risk cluster. Movement strategies (i.e., clusters), as quantified by mMoCap and FPs, were successfully described with MOCs MSKI risk proportions between clusters. These results provide actionable thresholds of key performance indicators for practitioners to use for screening measures in classifying greater MSKI risk. These tools may add value in creating modifiable strength and conditioning training programs before or during military training.
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Affiliation(s)
- Matthew B. Bird
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
- *Correspondence: Matthew B. Bird,
| | - Qi Mi
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kristen J. Koltun
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mita Lovalekar
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brian J. Martin
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
| | - AuraLea Fain
- Biomechanics, Physical Performance and Exercise Research Group, Department of Health Sciences, Macquarie University, Sydney, NSW, Australia
| | | | | | - Tim L. A. Doyle
- Biomechanics, Physical Performance and Exercise Research Group, Department of Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Bradley C. Nindl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
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Robyn AD, Louw QA, Baumeister J. Return to play in elite rugby players after severe knee injuries. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1629. [PMID: 35547961 PMCID: PMC9082221 DOI: 10.4102/sajp.v78i1.1629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Medical professionals working in an elite sport environment have the challenging task to balance the athlete's readiness to return to the playing field after severe injury with other stakeholders' (coaches, sponsors, teammates) opinions and objectives. Objectives Our study aimed to evaluate differences in the physical profiles of elite rugby players at return to play (RTP) after a severe knee injury, compared with their pre-injury profiles and matched controls. Method Before the injury, participants performed four performance tests during their preseason screening. These tests were repeated and compared to baseline once a player was declared fit to play. Results Significant differences (p ≤ 0.05) were found in the injured players' group who were slower over 10 m speed, in their decision-making time and the total time of the reactive agility tests at RTP, whilst controls were significantly faster over 10 m and 30 m speed tests. The countermovement jump outcomes showed significant improvement in the uninjured participants (p ≤ 0.05). Conclusion Our study highlights that injured players' running speeds and decision-making times are slower after injury. The uninjured players have a positive outcome to training and match stimulus by improving their running speed and lower body explosive power during the season. Clinical implications Our study provides insight into the RTP profile of elite rugby players, and a novel finding was the decision-making time deficit. This highlights the importance of cognitive training during injury rehabilitation as athletes make numerous decisions in a pressured and uncontrolled environment during a match. Speed training development is recommended as the athletes were slower after severe knee injury.
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Affiliation(s)
- Aneurin D Robyn
- Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Quinette A Louw
- Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jochen Baumeister
- Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Exercise and Health, Faculty of Science, Paderborn University, Paderborn, Germany
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Force, Power, and Morphology Asymmetries as Injury Risk Factors in Physically Active Men and Women. Symmetry (Basel) 2022. [DOI: 10.3390/sym14040787] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This study aimed to investigate whether asymmetry of force, power, and tissue morphology are lower limbs (LL) injury risk factors in physically active adults. Fifty-eight men aged 23.8 ± 1.2 years and forty-seven women aged 23.3 ± 1.0 years were examined. Physical activity level was measured by the International Physical Activity Questionnaire, and injury data were collected with the Injury History Questionnaire. The countermovement jump was performed to evaluate force and power. LL tissue composition was evaluated by a bioimpedance analyzer. The symmetry indices were calculated. A comparison between injured and non-injured subjects in both sexes was conducted to determine indices associated with injuries. The symmetry indices cut-off points were calculated to establish values indicating a significant injury risk increase, and logistic regression was performed. The relative peak force asymmetry above 4.049% was associated with increased injury risk in men. The LL skeletal muscle mass asymmetry above 3.584% was associated with a higher injury risk in women. Increased asymmetry in indicated indices by 1% was associated with 19.8% higher injury risk in men and 82.6% in women. Asymmetry proved to be an injury risk factor. However, a more suitable index for men is relative peak force asymmetry, whereas LL skeletal muscle mass asymmetry is more suitable for women.
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Positive Impulse Phase versus Propulsive Impulse Phase: Correlations between Asymmetry and Countermovement Jump Performance. J Funct Morphol Kinesiol 2022; 7:jfmk7020031. [PMID: 35466266 PMCID: PMC9036280 DOI: 10.3390/jfmk7020031] [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: 01/16/2022] [Revised: 04/01/2022] [Accepted: 04/01/2022] [Indexed: 11/19/2022] Open
Abstract
The relationship between asymmetry and performance is still undetermined in the literature. Methods of assessing asymmetry have been inconsistent and focused on the analysis of jumping asymmetry. Dual ground reaction forces are prevalent in athlete monitoring, though underutilized in asymmetry research. The purpose of this study was to assess the relationship of countermovement jump (CMJ) impulse asymmetry to performance in collegiate soccer athletes. Male and female athletes were selected from an ongoing athlete research repository database of NCAA D-I soccer athletes. All athletes contributed two maximal effort unweighted (CMJ0) and weighted countermovement jumps (CMJ20) using the mean for calculations. Propulsive phase asymmetry scores (PrPAS) and positive impulse asymmetry scores (PIAS) were calculated to determine the magnitude of asymmetry for each prospective phase. Statistically significant correlations were found between CMJ0 jump height and unweighted PIAS (r = −0.43) in females. Males had statistically significant correlations between CMJ20 jump height and weighted PIAS (r = −0.49). Neither unweighted PrPAS nor weighted PrPAS produced statistically significant correlations (r < 0.26) to their prospective jump heights. When assessing CMJ asymmetry, it is recommended to conduct both weighted and unweighted CMJ testing, utilizing PIAS as the metric to be assessed.
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Jordan MJ, Morris N, Nimphius S, Aagaard P, Herzog W. Attenuated Lower Limb Stretch-Shorten-Cycle Capacity in ACL Injured vs. Non-Injured Female Alpine Ski Racers: Not Just a Matter of Between-Limb Asymmetry. Front Sports Act Living 2022; 4:853701. [PMID: 35434617 PMCID: PMC9008592 DOI: 10.3389/fspor.2022.853701] [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: 01/12/2022] [Accepted: 02/03/2022] [Indexed: 11/24/2022] Open
Abstract
A retrospective analysis of routine countermovement jump (CMJ) testing, a coupled eccentric-concentric (stretch-shorten-cycle: SSC) movement, was performed in female elite alpine skiers with anterior cruciate ligament (ACL) reconstruction (ACLR) and without ACLR. A total of 567 tests obtained from the daily training environment were analyzed in 41 elite female athletes (non-injured control: n = 30, ACLR: n = 17), including n = 6 athletes with pre-injury data, between 16 and 32 years of age from alpine ski racing (n = 32) and skier cross (n = 9). Bilateral CMJ testing was conducted on a dual force plate system, and the limb-specific vertical ground reaction force (Fz) was analyzed to obtain the net eccentric deceleration impulse (Ecc), lower limb stiffness (Stiff), maximal vertical jump height (JH), peak external mechanical power (PP) exerted on the body center of mass (BCM), modified-reactive-strength-index (RSImod), and the loss in BCM velocity during the final phase of the takeoff Δ(Vmax-Vtakeoff). Eccentric and concentric phase-specific between-limb asymmetry indexes (AIs) were also calculated. Additive mixed effects models (AMMs) were used to compare the age-dependent and post-injury time course change between groups. The mean values for non-injured controls >25 years of age were used as a comparative benchmark for recovery given the absence of pre-injury data. Net eccentric deceleration impulse increased and Δ(Vmax-Vtakeoff) decreased with age for the non-injured control group (p < 0.001) while between-limb AI (mean ± SD) fell between 1 ± 5% for the concentric phase and 3 ± 7% for the eccentric deceleration phase. Between-limb asymmetry became smaller in ACLR skiers with time-from-surgery to reach non-injured control values by 2 years, but SSC function, such as JH and PP, remained depressed up to 5 years post-surgery (p < 0.01), indicating impairments in SSC function. This highlights the importance of evaluating SSC performance capacity alongside vertical jump force-time asymmetries in female ACLR alpine skiers.
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Affiliation(s)
- Matthew J. Jordan
- Canadian Sport Institute Calgary, Calgary, AB, Canada
- Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
- School of Medical and Health Science, Centre for Human Performance, Edith Cowan University, Joondalup, WA, Australia
| | | | - Sophia Nimphius
- School of Medical and Health Science, Centre for Human Performance, Edith Cowan University, Joondalup, WA, Australia
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Walter Herzog
- Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
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Monson JK, Schoenecker J, Matheson JW, O'Keefe J, Schwery N, Hickmann A. Modern Principles for Rehabilitation for Medial and Lateral Knee Ligament Surgery: How to Optimize Outcomes. OPER TECHN SPORT MED 2022. [DOI: 10.1016/j.otsm.2022.150915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Collings TJ, Diamond LE, Barrett RS, Timmins RG, Hickey JT, du Moulin WS, Gonçalves BAM, Cooper C, Bourne MN. Impact of prior anterior cruciate ligament, hamstring or groin injury on lower limb strength and jump kinetics in elite female footballers. Phys Ther Sport 2021; 52:297-304. [PMID: 34742028 DOI: 10.1016/j.ptsp.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare lower limb strength and countermovement jump (CMJ) kinetics between elite female footballers with and without a history of anterior cruciate ligament reconstruction (ACLR), hamstring strain, or hip/groin injury. DESIGN Cross-sectional. SETTING Field-based. PARTICIPANTS 369 elite female Australian football, soccer and rugby league players aged 15-35. MAIN OUTCOME MEASURES Isometric hip adductor and abductor strength, eccentric knee flexor strength, and CMJ vertical ground reaction forces, including between-leg asymmetry. Players reported their lifetime history of ACLR, and whether they had sustained a hamstring strain, or hip/groin injury in the previous 12-months. RESULTS Players with a unilateral history of ACLR (n = 24) had significant between-leg asymmetry in eccentric knee flexor strength (mean = -6.3%, 95%CI = -8.7 to -3.9%, P < .001), isometric hip abductor strength (mean = -2.5%, 95%CI = -4.3 to -0.7%, P = .008), and CMJ peak landing force (mean = -5.5%, 95%CI = -10.9 to -0.1%, P = .046). Together, between-leg asymmetry in eccentric knee flexor strength, isometric hip abductor strength, and CMJ peak landing force distinguished between players with and without prior ACLR with 93% accuracy. CONCLUSION Elite female footballers with a history of ACLR, but not hamstring or hip/groin injury, exhibit persistent between-leg asymmetries in lower limb strength and jump kinetics following a return to sport.
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Affiliation(s)
- Tyler J Collings
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Laura E Diamond
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia; Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Rod S Barrett
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Ryan G Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia; Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, Victoria, Australia.
| | - Jack T Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia.
| | - William S du Moulin
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Basílio A M Gonçalves
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Christopher Cooper
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia.
| | - Matthew N Bourne
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia.
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Bishop C, Turner A, Jordan M, Harry J, Loturco I, Lake J, Comfort P. A Framework to Guide Practitioners for Selecting Metrics During the Countermovement and Drop Jump Tests. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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The Influence of Injury History on Countermovement Jump Performance and Movement Strategy in Professional Soccer Players: Implications for Profiling and Rehabilitation Foci. J Sport Rehabil 2021; 30:768-773. [PMID: 33494043 DOI: 10.1123/jsr.2020-0243] [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: 05/28/2020] [Revised: 09/09/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Professional soccer players who have sustained a lower limb injury are up to 3× more likely to suffer a reinjury, often of increased severity. Previous injury has been shown to induce compensatory strategies during neuromuscular screening tests, which might mask deficits and lead to misinterpretation of readiness to play based on task outcome measures. OBJECTIVE To investigate the influence of previous injury in professional soccer players on countermovement jump (CMJ) performance and movement strategy. DESIGN Cross-sectional. SETTING Professional soccer club competing in the English Championship (tier 2). Patients (or Other Participants): Outfield players with a minimum of 6 years as a professional. INTERVENTION(S) Players were categorized as previously injured (n = 10) or not injured (n = 10). All players completed double- and single-leg CMJ trials. MAIN OUTCOME MEASURES CMJ performance was quantified as jump height and flight time:contraction time ratio. CMJ movement strategy was quantified as force-time history, differentiating eccentric and concentric phases and CMJ depth. RESULTS Double-leg CMJ was not sensitive to previous injury in performance or movement strategy. In contrast, single-leg CMJ performance was impaired in players with previous injury, who generated significantly lower eccentric and concentric peak force and rate of force development, and a deeper countermovement. Impaired single-leg CMJ performance was also evident in the nonaffected limb of previously injured players, suggesting cross-contamination. Hierarchical ordering revealed that the eccentric phase of the CMJ contributed little to performance in previously injured players. In noninjured players, the eccentric rate of force development and concentric peak force were able to account for up to 89% of the variation in CMJ performance. CONCLUSIONS Single-leg CMJ is advocated for player profiling, being more sensitive to previous injury, and negating the opportunity for interlimb compensation strategies. Movement strategy deficits in previously injured players suggest rehabilitation foci specific to eccentric force development.
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Relationships between physical capacities and biomechanical variables during movement tasks in athletic populations following anterior cruciate ligament reconstruction. Phys Ther Sport 2021; 48:209-218. [PMID: 33529930 DOI: 10.1016/j.ptsp.2021.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Anterior cruciate ligament (ACL) reconstruction has a detrimental impact on athletic performance. Despite rehabilitation guidelines and criterion-based progressions to ensure safe restoration of fundamental physical capacities and maladaptive movement strategies, residual deficits in maximal strength, rate of force development (RFD), power and reactive strength are commonly reported. These combined with associated compensatory inter and intra-limb strategies increase the risk of re-injury. OBJECTIVE The aim of this article is to examine the relationships between fundamental physical capacities and biomechanical variables during dynamic movement tasks. DESIGN Narrative review. RESULTS The available data suggests that quadriceps strength and rate of torque development, explain a moderate portion of the variance in aberrant kinetic and kinematic strategies commonly detected in ACL reconstructed cohorts in the later stages of rehabilitation and RTS CONCLUSION: The available data suggests that quadriceps strength and rate of torque development, explain a moderate portion of the variance in aberrant kinetic and kinematic strategies commonly detected in ACL reconstructed cohorts in the later stages of rehabilitation and RTS.
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Influence of Load and Phase of Contraction on Lateral Symmetries in Flywheel Squats. Symmetry (Basel) 2021. [DOI: 10.3390/sym13010111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Assessment of lateral symmetries (LS) of lower limbs has been widely investigated. However, there are no studies about LS during exposure to high eccentric and concentric loads during flywheel (FW) squats. A total of 422 young, physically active participants performed squats on an FW device with different equidistant loads (0.05, 0.125 and 0.2 kg∙m2). The mean and peak force of the left and right leg were assessed for the concentric and eccentric contaction phase. LS values were calculated for each load and phase of squat. Our results showed that the absolute mean and peak force of the concentric and eccentric phase of contraction had excellent reliability, while LS values were more reliable when eccentric force was used for their calculation. Mean and peak forces were increased with the higher FW load. In general, we found a decrease in LS values in the concentric phase of contraction with the higher load. Moreover, values of LS are similar to a wide range of other functional movements. Nevertheless, symmetrical force application during squatting on a FW device should be satisfied regardless of the FW load. Due to the large sample size, our results are valuable as a reference point when athletes are evaluated during training.
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Read PJ, McAuliffe S, Bishop C, Oliver JL, Graham-Smith P, Farooq MA. Asymmetry Thresholds for Common Screening Tests and Their Effects on Jump Performance in Professional Soccer Players. J Athl Train 2021; 56:46-53. [PMID: 33264407 PMCID: PMC7863609 DOI: 10.4085/1062-6050-0013.20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Arbitrary asymmetry thresholds are regularly used in professional soccer athletes, notwithstanding the sparse literature available to examine their prevalence. OBJECTIVE To establish normative and positional asymmetry values for commonly used screening tests and investigate their relationships with jumping performance. DESIGN Cross-sectional study. SETTING Elite soccer screening. PATIENTS OR OTHER PARTICIPANTS A total of 203 professional male soccer players. MAIN OUTCOME MEASURE(S) Bilateral and unilateral jumping; range of motion; and hamstrings (HAM), quadriceps (QUAD), and hip-adductor and -abductor strength tests were used to quantify asymmetry. Players were divided into 4 quartiles (Q1-Q4) based on the magnitude of their asymmetry for each test. Single composite scores were also developed to group tests by range of motion and HAM, QUAD, hip-adduction, and hip-abduction strength, and differences in jump performance were examined among players in each quartile. RESULTS Large variability (range = 5.2%-14.5%) was evident in asymmetry scores across the different tests and physical qualities. Forwards displayed greater asymmetry in concentric quadriceps and eccentric hip-abduction strength (P < .05). The HAM and QUAD composite scores indicated that Q4 players' jumps were shorter than those in other quartiles during a single-legged countermovement jump and 10-second hop (P < .05). No decrements in unilateral jump performance were shown among players in each quartile for range of motion or hip-adduction and -abduction strength, and no composite measures of asymmetry affected bilateral jump performance. CONCLUSIONS No single asymmetry threshold was present for all tests; the outcomes were task, variable, and population specific. Larger asymmetries in HAM and QUAD strength appeared to be detrimental to unilateral jump performance.
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Affiliation(s)
- Paul J. Read
- Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Seán McAuliffe
- Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Chris Bishop
- London Sport Institute, Middlesex University, United Kingdom
| | - Jon L. Oliver
- Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, United Kingdom
| | | | - Mohammed Abdulaziz Farooq
- Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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18
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Jordan MJ, Morris N, Lane M, Barnert J, MacGregor K, Heard M, Robinson S, Herzog W. Monitoring the Return to Sport Transition After ACL Injury: An Alpine Ski Racing Case Study. Front Sports Act Living 2020; 2:12. [PMID: 33345007 PMCID: PMC7739580 DOI: 10.3389/fspor.2020.00012] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/28/2020] [Indexed: 11/29/2022] Open
Abstract
Alpine ski racing is an extreme sport and ski racers are at high risk for ACL injury. ACL injury impairs neuromuscular function and psychological readiness putting alpine skiers with ACL injury at high risk for ACL reinjury. Consequently, return to sport training and testing protocols are recommended to safeguard ACL injured athletes against reinjury. The aim of this paper was to present a real-world example of a return to sport training plan for a female elite alpine ski racer who sustained an ACL injury that was supported by an interdisciplinary performance team (IPT) alongside neuromuscular testing and athlete monitoring. A multi-faceted return to sport training plan was developed by the IPT shortly after the injury event that accounted for the logistics, healing, psychological readiness, functional milestones, work capacity and progression to support the return to sport/return to performance transition. Neuromuscular testing was conducted at several timepoints post-injury. Importantly, numerous pre-injury tests provided a baseline for comparison throughout the recovery process. Movement competencies and neuromuscular function were assessed, including an evaluation of muscle properties (e.g., the force-velocity and force-length relationships) to assist the IPT in pinpointing trainable deficits and managing the complexities of the return to sport transition. While the athlete returned to snow 7 months post-injury, presenting with interlimb asymmetries below 10%, functional and strength deficits persisted up to 18 months post-injury. More research is required to establish a valid return to sport protocol for alpine ski racers with ACL injury to safeguard against the high risk for ACL reinjury.
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Affiliation(s)
- Matthew J Jordan
- Canadian Sport Institute Calgary, Calgary, AB, Canada.,Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
| | - Nathaniel Morris
- Canadian Sport Institute Calgary, Calgary, AB, Canada.,Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
| | - Mike Lane
- Canadian Sport Institute Calgary, Calgary, AB, Canada
| | | | | | - Mark Heard
- Banff Sports Medicine Centre, Banff, AB, Canada
| | | | - Walter Herzog
- Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada
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Mitchell A, Holding C, Greig M. Factors influencing optimum countermovement jump performance and movement strategy in Championship professional football players: implications for player profiling. Res Sports Med 2020; 30:30-40. [PMID: 33302721 DOI: 10.1080/15438627.2020.1860049] [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: 10/22/2022]
Abstract
Single leg countermovement jump (CMJ) is a common profiling test influenced by sport, age, sex and playing level. Controlling for these confounding variables, outfield players from an English Championship squad (n = 36) were retrospectively categorized as best (n = 10) or worst (n = 10), based on mean single leg CMJ height and flight time:contraction time ratio. Movement strategy was quantified as force-time history metrics differentiating eccentric and concentric phases. Jump height revealed that best performers elicited greater rate of force development in both phases (P ≤ 0.033), with concentric impulse the strongest predictor of performance. Time ratio also differentiated best performers as utilizing a shallower (P = 0.002) countermovement, with concentric rate of force development the strongest predictor of good performance. Successful jump height performance can mask ineffectual eccentric and stretch shortening cycle neuromuscular characteristics. Time ratio is therefore advocated as the key performance indicator, with movement strategy prioritized over gross outcome measures.
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Affiliation(s)
- Andy Mitchell
- Medical Department, Blackburn Rovers Football Club, Blackburn, UK
| | - Craig Holding
- Medical Department, Blackburn Rovers Football Club, Blackburn, UK
| | - Matt Greig
- Sports Injuries Research Group, Edge Hill University, Ormskirk, UK
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20
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Taberner M, van Dyk N, Allen T, Jain N, Richter C, Drust B, Betancur E, Cohen DD. Physical preparation and return to performance of an elite female football player following ACL reconstruction: a journey to the FIFA Women's World Cup. BMJ Open Sport Exerc Med 2020; 6:e000843. [PMID: 34422284 PMCID: PMC8323467 DOI: 10.1136/bmjsem-2020-000843] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 01/08/2023] Open
Abstract
ACL injuries are among the most severe knee injuries in elite sport, with a high injury burden and re-injury risk. Despite extensive literature on the injury and the higher incidence of injury and re-injury in female athletes, there is limited evidence on the return to sport (RTS) of elite female football players following ACL reconstruction (ACLR). RTS is best viewed on a continuum aligning the recovery and rehabilitation process with the ultimate aim — a return to performance (RTPerf). We outline the RTS and RTPerf of an elite female football player following ACLR and her journey to the FIFA Women’s World Cup, including the gym-based physical preparation and the on-pitch/sports-specific reconditioning. We used the ‘control–chaos continuum’ as a framework for RTS, guiding a return above pre-injury training load demands while considering the qualitative nature of movement in competition. We then implemented the ‘RTPerf pathway’ to facilitate a return to team training, competitive match play and a RTPerf. Objective information, clinical reasoning and shared decision-making contributed to this process and helped the player to reach her goal of representing her country at the FIFA Women’s World Cup.
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Affiliation(s)
- Matt Taberner
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
| | - Tom Allen
- Performance and Research Department, Arsenal Football Club, London, UK
| | - Neil Jain
- The Manchester Institute of Health and Performance, Manchester, UK
| | - Chris Richter
- Sports Surgery Clinic, Dublin, Ireland.,University of Roehampton, London, UK
| | - Barry Drust
- School of Sports, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Esteban Betancur
- Sports Science Center (CCD), Colombian Ministry of Sport (Mindeporte), Colombia
| | - Daniel D Cohen
- Sports Science Center (CCD), Colombian Ministry of Sport (Mindeporte), Colombia.,Masira Research Institute, Universidad de Santander, Bucaramanga, Colombia
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Harper DJ, Cohen DD, Carling C, Kiely J. Can Countermovement Jump Neuromuscular Performance Qualities Differentiate Maximal Horizontal Deceleration Ability in Team Sport Athletes? Sports (Basel) 2020; 8:E76. [PMID: 32471190 PMCID: PMC7353628 DOI: 10.3390/sports8060076] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/29/2022] Open
Abstract
This investigation aimed to determine the countermovement jump (CMJ) neuromuscular performance (NMP) qualities that differentiate between athletes with high or low horizontal deceleration ability. Twenty-seven male university team sport athletes performed a CMJ on vertical axis force plates and a maximal horizontal deceleration following a 20 m maximal horizontal sprint acceleration. The instantaneous velocity throughout the maximal horizontal deceleration test was measured using a radar device. The deceleration ability was evaluated using the average deceleration (HDEC, m·s-2) and change in momentum-referred to as the horizontal braking impulse (HBI, N·s·kg-1). Participants were dichotomised into high and low HDEC and HBI according to a median-split analysis, and CMJ variables calculated for the overall eccentric, eccentric-deceleration and concentric phases. When horizontal deceleration ability was defined by HDEC, the CMJ concentric (effect size (ES) = 0.95) and eccentric (ES = 0.72) peak forces were the variables with the largest difference between groups. However, when defined using HBI, the largest difference was the concentric (ES = 1.15) and eccentric (ES = -1.00) peak velocities. Only the concentric mean power was significantly different between the high and low groups for both HDEC (ES = 0.85) and HBI (ES = 0.96). These findings show that specific eccentric and concentric NMP qualities may underpin the horizontal deceleration abilities characterised by HDEC and HBI. Specific NMP training interventions may be beneficial to target improvements in either of these measures of horizontal deceleration abilities.
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Affiliation(s)
- Damian J. Harper
- Institute of Coaching and Performance, School of Sport and Health Sciences, University of Central Lancashire, Preston PR1 2HE, UK;
| | - Daniel D. Cohen
- Masira Research Institute, Faculty of Health Sciences, University of Santander (UDES), Bucaramanga 680005, Colombia;
- Mindeporte (Colombian Ministry of Sport) High Performance Centre, Bogota 111071, Colombia
| | - Christopher Carling
- Centre for Elite Performance, French Football Federation, 75015 Paris, France;
| | - John Kiely
- Institute of Coaching and Performance, School of Sport and Health Sciences, University of Central Lancashire, Preston PR1 2HE, UK;
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