Biomechanical differences between military patients with patellar tendinopathy and asymptomatic controls during single-leg squatting and gait - A statistical parametric mapping study

Evaluating the relationship between the landing error scoring system and single leg squat in ROTC cadets

OBJECTIVES

To evaluate the correlation between the Landing Error Scoring System (LESS) and single leg squat (SLS) in assessing neuromuscular control deficits in Reserve Officers' Training Corps (ROTC) Cadets.

DESIGN

Cross-sectional observational study.

SETTING

University gymnasium.

PARTICIPANTS

Fifty-six ROTC members (Age, 20.16 ± 1.7 years; sex, 20 females, 36 males; height, 68.78 ± 3.32 inches; mass, 73.65 ± 12.98 kg; dominant limb length; 89.83 ± 5.1 cm) completed 3 jump-landings and 5 SLS trials.

MAIN OUTCOME MEASURES

The jump-landing and SLS were recorded using PhysiMax markerless motion capture, and errors in the frontal and sagittal planes were automatically graded on a dichotomous scale.

RESULTS

Average LESS scores were 5.36 ± 2.93 errors, while SLS errors were 3.93 ± 1.03 (left) and 4.30 ± 1.73 errors (right). No significant associations were found between LESS and SLS errors, including medial knee displacement errors in frontal plane or any sagittal plane errors.

CONCLUSIONS

The LESS and SLS likely capture different aspects of neuromuscular control due to task differences. Clinicians should utilize both screening methods to identify high-risk movements.

Knee biomechanics during rehabilitation exercise in individuals with and without anterior cruciate ligament reconstruction: A systematic review

BACKGROUND

Post-traumatic osteoarthritis rates are similar in individuals with anterior cruciate ligament injury who receive surgical reconstruction and those who opt for non-surgical management, indicating continuing changes in knee biomechanics post-surgery. There is no gold standard rehabilitation strategy for the post-reconstruction patient, however investigating the biomechanics of the knee during rehabilitation exercises will drive the development of more efficacious rehabilitation paradigms. This systematic review aimed to synthesise biomechanical data from healthy participants and participants with anterior cruciate ligament reconstruction during rehabilitation exercises to provide insights into knee biomechanical changes induced by injury and surgery.

METHODS

A systematic literature search was conducted in Web of Science, MEDLINE, EMBASE, PubMed, CINAHL and Scopus, using key terms relating to anterior cruciate ligament reconstruction, lower limb rehabilitation exercises, and knee biomechanics. 34 articles matching the inclusion criteria were identified following abstract and full text screening.

FINDINGS

The included studies reported data on 607 healthy participants and 175 participants with an anterior cruciate ligament reconstruction across five different exercises. Peak knee flexion angle was the most reported variable, whereas tibial anterior translation and adduction biomechanics were reported infrequently, despite their relevance to the ligament injury status.

INTERPRETATION

There is limited biomechanical data of rehabilitation exercise in the knee, with the exception of knee flexion angles. Furthermore, variations in data collection and reporting methods across studies cause difficulties in systematic analysis of results and demonstrate inconsistent kinematic results between articles.

One-dimension statistical parametric mapping in lower limb biomechanical analysis: A systematic scoping review

BACKGROUND

Biomechanics significantly impacts sports performance and injury prevention. Traditional methods like discrete point analysis simplify continuous kinetic and kinematic data, while one-dimensional Statistical Parametric Mapping (spm1d) evaluates entire movement curves. Nevertheless, spm1d's application in sports and injury research is limited. As no systematic review exists, we conducted a scoping systematic review, synthesizing the current applications of spm1d across various populations, activities, and injuries. This review concludes by identifying gaps in the literature and suggesting areas for future research.

RESEARCH QUESTION

What research exists using spm1d in sports biomechanics, focusing on the lower limbs, in what populations, and what are the current research gaps?

METHODS

We searched PubMed, Embase, Web of Science, and ProQuest databases for the following search string: "(((knee) OR (hip)) OR (ankle)) OR (foot) OR (feet) AND (statistical parametric mapping)". English peer-reviewed studies assessing lower limb kinetics or kinematics in different sports or sports-related injuries were included. Reviews, meta-analyses, conference abstracts, and grey literature were excluded.

RESULTS

Our search yielded 165 papers published since 2012. Among these, 112 examined healthy individuals (67 %), and 53 focused on injured populations (33 %). Running (n = 45), cutting (n = 25), and jumping/landing (n = 18) were the most common activities. The predominant injuries were anterior cruciate ligament rupture (n = 21), chronic ankle instability (n = 18), and hip-related pain (n = 9). The main research gaps included the unbalanced populations, underrepresentation of common sports and sport-related injuries, gender inequality, a lack of studies in non-laboratory settings, a lack of studies on varied sports gear, and a lack of reporting standardization.

SIGNIFICANCE

This review spotlights crucial gaps in spm1d research within sports biomechanics. Key issues include a lack of studies beyond laboratory settings, underrepresentation of various sports and injuries, and gender disparities in research populations. Addressing these gaps can significantly enhance the application of spm1d in sports performance, injury analysis, and rehabilitation.

Academic Department of Military Rehabilitation (ADMR): avoiding the pitfalls of 'the Walker Dip'

A key research theme identified during the 2021 Strategic Delivery Plan (SDP) for Defence Medical Services (DMS) Research was preventing and treating musculoskeletal injury (MSKI). MSKI is a significant burden to military populations globally, reducing both operational strength and force readiness. It is therefore essential that research is conducted to gain a greater understanding of the epidemiology, aetiology and risk factors associated with MSKI to develop targeted prevention strategies and rehabilitation interventions. The Academic Department of Military Rehabilitation (ADMR) and the recently established MSKI research-theme working group must use a combination of balance and flexibility when coordinating research priorities to ensure they align and reflect both higher level DMS and UK Defence Rehabilitation practitioner-driven priorities. This article describes the response ADMR have taken to meet and align with the requirements of the 2021 SDP.

Effects of a Total Motion Release (TMR®) Protocol for the Single Leg Squat on Asymmetrical Movement Patterns

BACKGROUND

Improving single leg squat (SLS) movement symmetry may benefit rehabilitation protocols. The Total Motion Release® (TMR®) protocol has been theorized to evaluate and improve patient-perceived movement asymmetries.

HYPOTHESIS/PURPOSE

The purpose of this study was to evaluate whether perceived asymmetries identified by a TMR® scoring protocol were related to biomechanical asymmetries and whether improving perceived asymmetries influenced movement mechanics. It was hypothesized that participants with perceived asymmetries would also present with biomechanical asymmetries. A secondary hypothesis was that participants would reduce their perceived asymmetries after performing the TMR® protocol and subsequently have greater biomechanical symmetry.

STUDY DESIGN

Descriptive Cohort (Laboratory Study).

METHODS

Twenty participants (10 female, 10 male) with self-identified bilateral differences of 10 points or greater on the TMR® scoring scale were recruited for the study. The non-preferred side was defined as the side that scored higher. 3Dimensional motion capture was used to bilaterally assess baseline SLS depth as well as hip, knee, and ankle kinematics and kinetics. For the TMR® protocol, sets of 10 SLSs were performed on the preferred leg until their perceived asymmetries were resolved (i.e., both sides scored equally), or four sets had been completed. Kinematics and kinetics were collected immediately after the intervention and after a 10-minute rest period.

RESULTS

Participants had biomechanical asymmetries at baseline for knee flexion, ankle flexion, and knee moments. Following the intervention, participants had reduced TMR® scores on the non-preferred leg, and this coincided with increased knee joint moments on that side. Although perceived asymmetries were resolved after the intervention, kinematic and kinetic asymmetries at the knee and ankle were still present.

CONCLUSIONS

A TMR® intervention could benefit rehabilitation protocols by reducing factors of dysfunction and increasing the ability of patients to load the non-preferred knee. Further investigations are necessary to elucidate the importance of asymmetrical movement patterns.

LEVEL OF EVIDENCE

3b.

Examining movement asymmetries during three single leg tasks using interlimb and single subject approaches

PURPOSE

s: To examine whether healthy individuals displayed asymmetric trunk and lower extremity kinematics in the frontal and sagittal planes using both interlimb and single subject models.

METHODS

Trunk, pelvis, and lower extremity kinematic waveforms were analyzed bilaterally during the single leg squat (SLS), forward step down (FSD), and lateral step down (LSD). Participants identified task specific preferred and non-preferred legs based on perceived stability for interlimb analyses. Movement patterns were also analyzed with a single subject approach that included Fisher's exact tests to assess whether asymmetries were related to the task.

RESULTS

Participants were found to have increased pelvic drop on the non-preferred leg during the LSD from 41 to 77% of the movement (p = 0.01). No other bilateral differences were found for interlimb analyses. Single subject analyses indicated that no task had a greater probability of finding or not finding asymmetries. Associations were found between the FSD and SLS for frontal plane hip (p < 0.01) and knee motion (p < 0.01).

CONCLUSIONS

Interlimb analyses can be influenced by intraparticipant movement variability between preferred and non-preferred legs. Movement asymmetries during single leg weightbearing are likely task dependent and a battery of tests is necessary for assessing bilateral differences.

Knee Kinetics and Kinematics of Young Asymptomatic Participants during Single-Leg Weight-Bearing Tasks: Task and Sex Comparison of a Cross-Sectional Study

This cross-sectional study aimed to describe and compare kinetic and kinematic variables of the knee joint during stair descent, single-leg step down, and single-leg squat tasks. It also aimed to investigate potential sex difference during the tasks. Thirty young asymptomatic individuals (15 males, 15 females) were assessed during the performance of single-leg weight-bearing tasks. The kinetic and kinematic data from the knee were evaluated at the peak knee moment and at peak knee flexion. Single-leg squat presented a higher peak knee moment (2.37 Nm/kg) and the greatest knee moment (1.91 Nm/kg) at knee peak angle in the frontal plane, but the lowest knee flexion (67°) than the other two tasks (p < 0.05). Additionally, the single-leg step down task presented a higher varus knee angle (5.70°) when compared to stair descent (3.71°) (p < 0.001). No substantial sex difference could be observed. In conclusion, in asymptomatic young individuals, single-leg squats presented the greatest demand in the frontal and sagittal planes. Single-leg step down demanded a greater angular displacement than stair descent in the frontal plane. We did not identify a significant difference among the sex and studied variables.