1
|
Bingzheng Z, Xinzhuo Z, Zhuo J, Xing Y, Bin L, Lunhao B. The effects of sex hormones during the menstrual cycle on knee kinematics. Front Bioeng Biotechnol 2023; 11:1209652. [PMID: 37744250 PMCID: PMC10512414 DOI: 10.3389/fbioe.2023.1209652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
The effects of the menstrual cycle and sex hormones on knee kinematics remain unclear. The purpose of the study was to investigate the effects of the menstrual cycle and serum sex hormone concentrations on knee kinematic parameters of the 90°cutting in female college soccer athletes. Three female college soccer teams (53 subjects) participated in the study. During the first menstrual cycle, a three-step method was used to exclude subjects with anovulatory and luteal phase-deficient (LPD) (12 subjects). The subjects' menstrual cycle was divided into the menstrual phase, late-follicular phase, ovulatory phase, and mid-luteal phase (group 1, 2, 3, 4). In each phase of the second menstrual cycle, we used a portable motion analysis system to enter the teams and tested the sex hormones concentrations and knee kinematics parameters in three universities in turn. We found that subjects had a lower maximum knee valgus in group 4 compared with other groups. This meant that subjects had a lower biomechanical risk of non-contact anterior cruciate ligament (ACL) injury in the mid-luteal phase. There was no significant correlation between serum estrogen, progesterone concentration, and knee kinematic parameters. This meant that sex hormones did not have a protective effect. Future studies need to incorporate more factors (such as neuromuscular control, etc.) to investigate.
Collapse
Affiliation(s)
- Zhou Bingzheng
- Department of Orthopaedic Surgery and Sports Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao Xinzhuo
- Department of Biomedical Engineering, Shenyang University of Technology, Shenyang, Liaoning, China
| | - Jin Zhuo
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xing
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, China
| | - Li Bin
- Department of Orthopaedic Surgery and Sports Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bai Lunhao
- Department of Orthopaedic Surgery and Sports Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
2
|
Hu Z, Zhang Y, Dong T, Dong M, Kim S, Kim Y. Gender Differences in Neuromuscular Control during the Preparation Phase of Single-Leg Landing Task in Badminton. J Clin Med 2023; 12:jcm12093296. [PMID: 37176736 PMCID: PMC10179252 DOI: 10.3390/jcm12093296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Studies on the biomechanical mechanisms of an anterior cruciate ligament (ACL) injury have been extensively studied, but studies on the neuromuscular control-related risk factors for an ACL injury in specific maneuvers have not been reported for badminton players. STUDY DESIGN Controlled laboratory study. METHODS Sixteen badminton players (8 male, 8 female) performed a single-leg badminton ball landing task, and lower limb muscle activity, kinematic data, and ground reaction force were measured during this procedure using marker-based movement analysis, force plates, and electromyography (EMG). Gender differences in the lower limb kinematic data, mean values of normalized lower limb muscle activation (MVC%), and co-contraction values during the landing preparation phase (100 ms before initial contact) were analyzed using MANOVA. RESULTS In the badminton landing task, the knee valgus angle was greater in females than in males (6.27 ± 2.75 vs. 1.72 ± 3.20) in the pre-landing preparation position. Compared to male badminton players, females exhibited greater gluteus maximus (44.92 ± 18.00 vs. 20.34 ± 11.64), rectus femoris (41.56 ± 9.84 vs. 26.14 ± 10.46), and medial gastrocnemius (37.39 ± 17.31 vs. 19.11 ± 11.17) lateral gastrocnemius (36.86 ± 17.82 vs. 13.59 ± 2.71) muscle activity (MVC%). CONCLUSION Female badminton players exhibit neuromuscular control strategies that may be inadequate for ACL protection and may be a potential risk factor for a high incidence of ACL injury In the future, when devising injury prevention plans for female badminton players, optimizing neuromuscular control during the pre-landing phase can be targeted.
Collapse
Affiliation(s)
- Zhe Hu
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Yanan Zhang
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Tengfei Dong
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Maolin Dong
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Sukwon Kim
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - Youngsuk Kim
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| |
Collapse
|
3
|
Impact of the Menstrual Cycle Phases on the Movement Patterns of Sub-Elite Women Soccer Players during Competitive Matches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084465. [PMID: 35457332 PMCID: PMC9025339 DOI: 10.3390/ijerph19084465] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this study was to evaluate the influence of the menstrual cycle phases on the movement patterns of sub-elite women soccer players during competitive matches over three consecutive seasons. Individual movement data were analyzed and compared in eight players from the second French League at the early follicular (EF), late follicular (LF) and mid-luteal (ML) phases of their menstrual cycle, determined by the calendar method. The movement patterns, expressed as meters per minute, were recorded during competitive matches using devices placed on the player’s ankle. Our results showed significantly lower distances covered at moderate and high velocity in the EF phase than in the LF and ML phases (Cohen’s d effect size = 1.03 and 0.79, respectively). The total distance covered during matches and the number of sprints also were reduced during EF compared with LF (d = 0.78 and 0.7, respectively). Overall, the total distance and distance covered at low velocity were significantly lower during the second half-time of the matches (d = 1.51), but no menstrual cycle phase × game period interaction was noted. In conclusion, our study suggests that EF may impact the movement pattern of sub-elite women soccer players during competitive matches, without any modulation of this effect by the playing time. Despite the low sample size, these results can be useful for coaches and support staff to modulate training loads and player rotation during soccer games.
Collapse
|
4
|
Shams F, Hadadnezhad M, Letafatkar A, Hogg J. Valgus Control Feedback and Taping Improves the Effects of Plyometric Exercises in Women With Dynamic Knee Valgus. Sports Health 2021; 14:747-757. [PMID: 34651505 DOI: 10.1177/19417381211049805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Female athletes are more predisposed to anterior cruciate ligament (ACL) injuries in comparison with their male counterparts. Research on ACL injury prevention strategies has demonstrated beneficial effects of plyometric exercises and feedback (FB) during the exercises. FB has resulted in reductions in vertical ground-reaction force and kinematic risk factors associated with ACL injury. Furthermore, taping (TP) may draw attention to the restriction created by the tape and serve as real-time biofeedback. The additional influence of FB and TP on plyometric exercises has not been determined. HYPOTHESIS FB and TP interventions delivered during plyometric exercises would result in positive changes in biomechanics and muscle onset in female athletes displaying dynamic knee valgus. DESIGN Controlled trial. SETTING University research laboratory. LEVEL OF EVIDENCE Level 2. METHODS Forty-eight active female athletes were divided into 3 groups: control (n = 16), plyometric training with FB (n = 16), and plyometric training with TP (n = 16). The 2 experimental groups performed a 6-week exercise program with either FB or TP. The control group continued its regular team schedule. Knee joint position sense, landing error scoring system (LESS), and the onset of muscle activation (the point at which muscle activation exceeds 3 standard deviations over baseline and continued above this threshold for at least 25 ms) before landing for the rectus femoris, vastus medialis, vastus lateralis, gluteus medius, semitendinosus, and biceps femoris during pre- and posttests were measured. RESULTS The vastus lateralis onset later in the TP group compared with the FB group (d [95% CI] = 0.64 [0.35-0.82], P = 0.01). Joint position sense accuracy improved only in the TP group (d = -0.63, P = 0.001). Both the FB (d = -0.85, P = 0.001), and TP (d = -0.82, P = 0.001) groups improved in LESS scores. CONCLUSION The results of the present study showed that plyometric exercises with FB or TP affect LESS and the onset of the vastus lateralis in active uninjured women with dynamic knee valgus, while TP improves joint position sense. Therefore, when more accurate joint position sense is desired, practitioners may use plyometric with TP. If an improved LESS score is desired, plyometrics with either TP or FB are acceptable. CLINICAL RELEVANCE Our findings indicate that female athletes may benefit more when completing a plyometric training program with a TP versus an FB. Trainers, coaches, and clinicians should consider utilizing instructions that promote an external focus when implementing plyometric training programs with male athletes.
Collapse
Affiliation(s)
- Fereshteh Shams
- Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Malihe Hadadnezhad
- Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Amir Letafatkar
- Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Jennifer Hogg
- Graduate Athletic Training Program, Health & Human Performance Department, University of Tennessee Chattanooga, Chattanooga, Tennessee
| |
Collapse
|
5
|
Knee joint kinematics during the sidestep maneuver in professional futsal athletes: Effect of sport-specific sidestep cutting. Sci Sports 2021. [DOI: 10.1016/j.scispo.2021.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
6
|
Restrictions in Ankle Dorsiflexion Range of Motion Alter Landing Kinematics But Not Movement Strategy When Fatigued. J Sport Rehabil 2021; 30:911-919. [PMID: 33571960 DOI: 10.1123/jsr.2020-0429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 12/16/2022]
Abstract
CONTEXT Ankle dorsiflexion range of motion (DF ROM) has been associated with a number of kinematic and kinetic variables associated with landing performance that increase injury risk. However, whether exercise-induced fatigue exacerbates compensatory strategies has not yet been established. OBJECTIVES (1) Explore differences in landing performance between individuals with restricted and normal ankle DF ROM and (2) identify the effect of fatigue on compensations in landing strategies for individuals with restricted and normal ankle DF ROM. DESIGN Cross-sectional. SETTING University research laboratory. PATIENTS OR OTHER PARTICIPANTS Twelve recreational athletes with restricted ankle DF ROM (restricted group) and 12 recreational athletes with normal ankle DF ROM (normal group). MAIN OUTCOME MEASURE(S) The participants performed 5 bilateral drop-landings, before and following a fatiguing protocol. Normalized peak vertical ground reaction force, time to peak vertical ground reaction force, and loading rate were calculated, alongside sagittal plane initial contact angles, peak angles, and joint displacement for the ankle, knee, and hip. Frontal plane projection angles were also calculated. RESULTS At the baseline, the restricted group landed with significantly less knee flexion (P = .005, effect size [ES] = 1.27) at initial contact and reduced peak ankle dorsiflexion (P < .001, ES = 1.67), knee flexion (P < .001, ES = 2.18), and hip-flexion (P = .033, ES = 0.93) angles. Sagittal plane joint displacement was also significantly less for the restricted group for the ankle (P < .001, ES = 1.78), knee (P < .001, ES = 1.78), and hip (P = .028, ES = 0.96) joints. CONCLUSIONS These findings suggest that individuals with restricted ankle DF ROM should adopt different landing strategies than those with normal ankle DF ROM. This is exacerbated when fatigued, although the functional consequences of fatigue on landing mechanics in individuals with ankle DF ROM restriction are unclear.
Collapse
|
7
|
Influence of Side Uncertainty on Knee Kinematics of Female Handball Athletes During Sidestep Cutting Maneuvers. J Appl Biomech 2021; 37:188-195. [PMID: 33567404 DOI: 10.1123/jab.2020-0141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 11/18/2022]
Abstract
Noncontact anterior cruciate ligament ruptures generally occur during unanticipated sidestep cutting maneuvers when athletes have their visual attention focused on the opponent. The authors investigated the influence of uncertainty related to the side to perform the sidestep cutting maneuver on knee kinematics of female handball athletes. A total of 31 female handball athletes performed the sidestep cutting maneuver during anticipated and uncertain conditions. During the uncertain condition, visual cues indicated the direction of the reactive sidestep cutting maneuver. Between-condition differences were compared using the Student t test for paired samples calculated with statistical parametric mapping. Lower knee flexion angle was detected during the uncertain condition compared with the anticipated condition for the nondominant limb (0%-8% of the sidestep cycle). Knee abduction was larger during the uncertain condition for both the dominant (15%-41% of the sidestep cycle) and nondominant (0%-18% of the sidestep cycle) limbs compared with the anticipated condition. The nondominant leg showed higher knee abduction (36%-68% of the sidestep cycle) during the uncertain condition compared with the anticipated condition. The athletes' approach velocity was slower during the uncertain condition. The uncertain condition impacted knee kinematics and potentially positioned the joint at greater risk of injury by decreasing the flexion angle in the nondominant leg and increasing the joint valgus bilaterally.
Collapse
|
8
|
Quigley A, McArthur C, Parker R, Gahagan J. Sex cells: Why we need sex- and gender-based analyses in rehabilitation research now. Ann Phys Rehabil Med 2020; 64:101472. [PMID: 33333208 DOI: 10.1016/j.rehab.2020.101472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/11/2020] [Accepted: 11/14/2020] [Indexed: 10/20/2022]
Affiliation(s)
- Adria Quigley
- McGill University Health Center, Montreal, PQ Canada
| | - Caitlin McArthur
- Department of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | - Robin Parker
- Dalhousie Libraries, Dalhousie University, Halifax, NS, Canada
| | - Jacqueline Gahagan
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
9
|
A Comparative Study on Loadings of the Lower Extremity during Deep Squat in Asian and Caucasian Individuals via OpenSim Musculoskeletal Modelling. BIOMED RESEARCH INTERNATIONAL 2020. [DOI: 10.1155/2020/7531719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Populations of different ethnicities may present different movement capacities and muscular function adaptations. The purpose of this study was to investigate the differences of motion and loading in the lower extremity during dynamic deep squats between Asian and Caucasian individuals using OpenSim modelling technique with a customized squat-specific musculoskeletal model. Twenty-four participants joined the test performing the step-squat test, with right foot stepping side, squatting, and returning. The one-dimensional statistical parametric mapping package was used for statistical analysis. The main findings of the current study were as follows: (1) significant lower squat depth was observed in the Asian individuals, (2) the greater knee range of motion and contact forces were found in the Asian individuals, and (3) the greater ankle contact forces in the Caucasian individuals were notable while performing the deep squat compared to the Asian group. Knowledge found in the current study may provide implication for exercise practitioners and physiotherapists while designing schemes for the prevention of loading accumulation in the lower extremity.
Collapse
|
10
|
ElDeeb AM, Osman DM, Atta HK, Hamada HA. Effect of reproductive hormones variation during menstrual cycle on hip abductor and adductor muscles performance in college students. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2019. [DOI: 10.4103/bfpt.bfpt_28_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Ankle dorsiflexion range of motion is associated with kinematic but not kinetic variables related to bilateral drop-landing performance at various drop heights. Hum Mov Sci 2019; 64:320-328. [PMID: 30836206 DOI: 10.1016/j.humov.2019.02.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/15/2019] [Accepted: 02/24/2019] [Indexed: 11/24/2022]
Abstract
Limited evidence is available concerning ankle dorsiflexion range of motion (DF ROM) and its relationship with landing performance from varying drop heights. The aim of this investigation was to determine the relationship between ankle DF ROM and both kinetic and kinematic variables measured during bilateral drop-landings from 50%, 100% and 150% of countermovement jump height. Thirty-nine participants were measured for their ankle DF ROM using the weight-bearing lunge test, after which five bilateral drop-landings were performed from 50%, 100% and 150% of maximal countermovement jump height. Normalized peak vertical ground reaction force (vGRF), time to peak vGRF and loading rate was calculated for analysis, alongside sagittal-plane initial contact angles, peak angles and joint displacement for the hip, knee and ankle. Frontal-plane projection angles were also calculated. Ankle DF ROM was not related to normalized peak vGRF, time to peak vGRF or loading rate (P > 0.05), regardless of the drop height. However, at drop heights of 100% and 150% of countermovement jump height, there were numerous significant (P < 0.05) moderate to large correlations between ankle DF ROM and initial contact angles (r = -0.34 to -0.40) and peak angles (r = -0.42 to -0.52) for the knee and ankle joint. Knee joint displacement (r = 0.39-0.47) and frontal-plane projection angle (r = 0.37-0.40) had a positive relationship with ankle DF ROM, which was consistent across all drop heights. Ankle DF ROM influences coordination strategies that allow for the management of vGRF during bilateral drop-landings, with alterations in alignment for the knee and ankle joints at both initial contact and peak angles.
Collapse
|
12
|
Letafatkar A, Mantashloo Z, Moradi M. Comparison the time to stabilization and activity of the lower extremity muscles during jump-landing in subjects with and without Genu Varum. Gait Posture 2018; 65:256-261. [PMID: 30558941 DOI: 10.1016/j.gaitpost.2018.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 07/24/2018] [Accepted: 08/02/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Knee muscles activity changes from Genu Varum deformity(GVD), may cause this individual more exposed to lower extremity injuries especially in high-risk activities like landing. OBJECTIVE The aim of this study was to compare the activity of the lower limb stabilizer muscles during jump-landing and time to stabilization(TTS) in subjects with and without GVD. METHOD A total of 44 men (group 1, with GVD n = 22 and group 2, without GVD n = 22); with mean age = 17.6 ± 3.12 years, height = 178.2 ± 5.39 cm, mass = 80.39 ± 8.3 kg) participated in this study. Subjects were asked to do a jump-landing task and Quadratus Lumborum(QL), Gluteus Maximus(GMax), Gluteus Medius(GMed), Biceps Femoris (BF), Semitendinosus, and Medial Gastrocnemius(MG) muscles activity was recorded. Also, changes in the amount of ground reaction force(GRF) were used to an indicator for TTS. RESULTS Our results showed that subjects with GVD had increased QL activity before(P = 0.008) and after(P = 0.017) landing. But, these subjects had a decreased activity of GMed compared to the healthy ones before(P = 0.033) and after(P = 0.005) landing. but there was no statistically significant difference before landing in gluteus maximus(P = 0.252), biceps femoris(P = 0.613), semitendinosus(P = 0.313), and medial gastrocnemius(P = 0.140) muscles and after landing in gluteus maximus (P = 0.246), biceps femoris(P = 0.512), semitendinosus(P = 0.214), and medial gastrocnemius(P = 0.209) muscles between the two groups. Also, the TTS was higher in subjects with GV than healthy ones in the Resultant Vector TTS (P = 0.015) and medial-lateral(P = 0.013) directions. CONCLUSIONS The altered activity of the QL and GMed, in subjects with GVD may indicate instability of the spinal column, pelvis and hip during jump-landing task. Although the GVD is referred to the frontal plane deformity, the results showed that this complication might affect stability in other motion planes.
Collapse
Affiliation(s)
- Amir Letafatkar
- Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran.
| | - Zahed Mantashloo
- Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran.
| | - Mohsen Moradi
- Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran.
| |
Collapse
|
13
|
Cronström A, Creaby MW, Nae J, Ageberg E. Modifiable Factors Associated with Knee Abduction During Weight-Bearing Activities: A Systematic Review and Meta-Analysis. Sports Med 2018; 46:1647-1662. [PMID: 27048463 DOI: 10.1007/s40279-016-0519-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Increased knee abduction angle during activity is suggested to be a risk factor for sustaining an anterior cruciate ligament (ACL) injury or developing patellofemoral pain syndrome (PFPS). Knowledge of the modifiable mechanisms that are associated with increased knee abduction will aid in the appropriate design of preventive and rehabilitative strategies for these injuries. OBJECTIVE Our objective was to systematically review modifiable mechanisms contributing to increased knee abduction in healthy people and in individuals with an ACL injury or PFPS. METHODS We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the databases MEDLINE, CINAHL, and Embase until September 2015. Inclusion criteria were studies in healthy individuals and/or those with ACL injury or PFPS reporting (1) muscle strength, muscle activation, proprioception, and/or range of motion (ROM) and (2) knee abduction angle assessed with either motion analysis or visual observation during weight-bearing activity. RESULTS In total, 33 articles were included. Reduced trunk strength, reduced gluteus maximus amplitude, decreased ankle ROM, and increased hip external rotation ROM were moderately associated with increased knee abduction angle (r -0.34 or higher, standardized difference in means (SDM) greater than -0.39, p < 0.05, articles n = 3, total sample size n = 101-114) in healthy individuals. Decreased strength of hip abductors, external rotators, and extensors and knee flexors were at most weakly associated with increased knee abduction angle (r ≤ 0.21, p = 0.013-0.426, articles n = 2-9, total sample size n = 80-311). Too few articles included patients with knee injury to be included in any meta-analysis. CONCLUSION The associations identified in this review indicate that investigation of strengthening of the trunk muscles, and improvement of gluteus maximus activation and ankle ROM to change knee kinematics is merited. Studies on modifiable factors associated with increased knee abduction angle in people with knee injury are needed.
Collapse
Affiliation(s)
- Anna Cronström
- Department of Health Sciences, Lund University, PO Box 157, 221 00, Lund, Sweden.
| | - Mark W Creaby
- School of Exercise Science, Australian Catholic University, Brisbane, QLD, Australia
| | - Jenny Nae
- Department of Health Sciences, Lund University, PO Box 157, 221 00, Lund, Sweden
| | - Eva Ageberg
- Department of Health Sciences, Lund University, PO Box 157, 221 00, Lund, Sweden
| |
Collapse
|
14
|
Rabin A, Einstein O, Kozol Z. The association of visually-assessed quality of movement during jump-landing with ankle dorsiflexion range-of-motion and hip abductor muscle strength among healthy female athletes. Phys Ther Sport 2018. [PMID: 29525640 DOI: 10.1016/j.ptsp.2018.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To explore the association between ankle dorsiflexion (DF) range of motion (ROM), and hip abductor muscle strength, to visually-assessed quality of movement during jump-landing. DESIGN Cross-sectional. SETTING Gymnasium of participating teams. PARTICIPANTS 37 female volleyball players. MAIN OUTCOME MEASURES Quality of movement in the frontal-plane, sagittal-plane, and overall (both planes) was visually rated as "good/moderate" or "poor". Weight-bearing Ankle DF ROM and hip abductor muscle strength were compared between participants with differing quality of movement. RESULTS Weight-bearing DF ROM on both sides was decreased among participants with "poor" sagittal-plane quality of movement (dominant side: 50.8° versus 43.6°, P = .02; non-dominant side: 54.6° versus 45.9°, P = .01), as well as among participants with an overall "poor" quality of movement (dominant side: 51.8° versus 44.0°, P < .01; non-dominant side: 56.5° versus 45.1°, P < .01). Weight-bearing ankle DF on the non-dominant side was decreased among participants with a "poor" frontal-plane quality of movement (53.9° versus 46.0°, P = .02). No differences in hip abductor muscle strength were noted between participants with differing quality of movement. CONCLUSIONS Visual assessment of jump-landing can detect differences in quality of movement that are associated with ankle DF ROM. Clinicians observing a poor quality of movement may wish to assess ankle DF ROM.
Collapse
Affiliation(s)
- Alon Rabin
- Department of Physiotherapy, Ariel University, Israel.
| | | | - Zvi Kozol
- Department of Physiotherapy, Ariel University, Israel.
| |
Collapse
|
15
|
Lessi GC, Serrão FV. Effects of fatigue on lower limb, pelvis and trunk kinematics and lower limb muscle activity during single-leg landing after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2017; 25:2550-2558. [PMID: 26298713 DOI: 10.1007/s00167-015-3762-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/13/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Because there are no studies that have evaluated the effects of fatigue on the kinematics of the trunk and pelvis or on muscle activation in subjects with ACL reconstruction, the aim of this study was to evaluate the effects of fatigue on the lower limb, pelvis and trunk kinematics and lower limb muscle activation in subjects with ACL reconstruction during a single-leg landing compared to a healthy control group. METHODS The participants included 20 subjects with ACL reconstruction (ACL reconstruction group-ACLRG) and 20 healthy subjects (control group-CG) who were aged between 18 and 35 years. Kinematic and electromyographic analyses were performed during a single-leg landing before and after fatigue. The fatigue protocol included a series of 10 squats, two vertical jumps, and 20 steps. RESULTS The effects of fatigue were increased peak trunk flexion and increased activation of the vastus lateralis, biceps femoris (BF) and gluteus maximus (GMax) during the landing phase. CONCLUSION After the fatigue protocol, an increase in peak trunk flexion and activation of the GMax and BF were observed, most likely as a strategy to reduce the load on the ACL. ACL injury prevention programs should include strength and endurance exercises for the hip and trunk extensor muscles so that they can efficiently control trunk flexion during landing. LEVEL OF EVIDENCE Prospective comparative study, Level II.
Collapse
Affiliation(s)
- Giovanna Camparis Lessi
- Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luis, km 235, São Carlos, SP, CEP: 13565-905, Brazil
| | - Fábio Viadanna Serrão
- Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luis, km 235, São Carlos, SP, CEP: 13565-905, Brazil.
| |
Collapse
|
16
|
Balachandar V, Marciniak JL, Wall O, Balachandar C. Effects of the menstrual cycle on lower-limb biomechanics, neuromuscular control, and anterior cruciate ligament injury risk: a systematic review. Muscles Ligaments Tendons J 2017; 7:136-146. [PMID: 28717621 DOI: 10.11138/mltj/2017.7.1.136] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Anterior cruciate ligament (ACL) injury has a devastating impact on physical and psychological disability. Rates of ACL rupture are significantly greater in females than males during the same sports. Hormonal mechanisms have been proposed but are complex and poorly understood. This systematic review evaluates the effects of menstrual cycle on: 1) lower-limb biomechanics, 2) neuromuscular control, and 3) ACL injury risk. METHODS The MEDLINE, CINAHL, SPORTSDiscus, Web of Science, and Google Scholar databases were searched from inception to August 2016 for studies investigating the effects of the menstrual cycle on lower-limb biomechanics, neuromuscular control, and ACL injury risk in females. Three independent reviewers assessed each paper for inclusion and two assessed for quality. RESULTS Seventeen studies were identified. There is strong evidence that: 1) greatest risk of ACL injury is within the pre-ovulatory phase of the menstrual cycle, and 2) females with greater ACL laxity in the pre-ovulatory phase experience greater knee valgus and greater tibial external rotation during functional activity. CONCLUSION Females are at greatest risk of ACL injury during the pre-ovulatory phase of the menstrual cycle through a combination of greater ACL laxity, greater knee valgus, and greater tibial external rotation during functional activity. LEVEL OF EVIDENCE Ib.
Collapse
Affiliation(s)
- Vivek Balachandar
- Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Owen Wall
- Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | |
Collapse
|
17
|
Froehle AW, Grannis KA, Sherwood RJ, Duren DL. Relationships Between Age at Menarche, Walking Gait Base of Support, and Stance Phase Frontal Plane Knee Biomechanics in Adolescent Girls. PM R 2016; 9:444-454. [PMID: 27485675 DOI: 10.1016/j.pmrj.2016.07.532] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 07/01/2016] [Accepted: 07/19/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Age at menarche impacts patterns of pubertal growth and skeletal development. These effects may carry over into variation in biomechanical profiles involved in sports-related traumatic and overuse knee injuries. The present study investigated whether age at menarche is a potential indicator of knee injury risk through its influence on knee biomechanics during normal walking. OBJECTIVE To test the hypothesis that earlier menarche is related to postpubertal biomechanical risk factors for knee injuries, including a wider, more immature gait base of support, and greater valgus knee angles and moments. DESIGN Cross-sectional observational study. SETTING University research facility. PARTICIPANTS Healthy, postmenarcheal, adolescent girls. METHODS Age at menarche was obtained by recall questionnaire. Pubertal growth and anthropometric data were collected by using standard methods. Biomechanical data were taken from tests of walking gait at self-selected speed. Reflective marker position data were collected with a 3-dimensional quantitative motion analysis system, and 3 force plates recorded kinetic data. MAIN OUTCOME MEASURES Age at menarche; growth and anthropometric measurements; base of support; static knee frontal plane angle; and dynamic knee frontal plane angles and moments during stance. RESULTS Earlier menarche was correlated significantly with abbreviated pubertal growth and postpubertal retention of immature traits, including a wider base of support. Earlier menarche and wider base of support were both correlated with more valgus static knee angles, more valgus knee abduction angles and moments at foot-strike, and a more valgus peak knee abduction angle during stance. Peak knee abduction moment during stance was not correlated with age at menarche or base of support. CONCLUSIONS Earlier menarche and its effects on growth are associated with retention of a relatively immature gait base of support and a tendency for static and dynamic valgus knee alignment. This biomechanical profile may put girls with earlier menarche at greater risk for sports-related knee injuries. LEVEL OF EVIDENCE Not applicable.
Collapse
Affiliation(s)
- Andrew W Froehle
- Lifespan Health Research Center, Department of Community Health and Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation, Wright State University Boonshoft School of Medicine, 3171 Research Blvd, Kettering, OH 45420(∗).
| | - Kimberly A Grannis
- Department of Orthopaedic Surgery, University of California, San Francisco Fresno Medical Education and Research, Fresno, CA(†)
| | - Richard J Sherwood
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO(‡)
| | - Dana L Duren
- Department of Orthopaedic Surgery, School of Medicine, University of Missouri, Columbia, MO(§)
| |
Collapse
|
18
|
Cesar GM, Tomasevicz CL, Burnfield JM. Frontal plane comparison between drop jump and vertical jump: implications for the assessment of ACL risk of injury. Sports Biomech 2016; 15:440-9. [DOI: 10.1080/14763141.2016.1174286] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
19
|
Spanó NV, Mariano FP, Andrade VLD, Bedo BLDS, Vieira LHP, Santiago PRP. EFEITO DO TREINO NEUROMUSCULAR NA ROTAÇÃO DO JOELHO DURANTE A ATERRISSAGEM EM MULHERES. REV BRAS MED ESPORTE 2016. [DOI: 10.1590/1517-869220162202143722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introdução: O grande índice de lesões do ligamento cruzado anterior sem envolver contato em mulheres é motivo de curiosidade entre os cientistas, pois avaliações de aterrissagem podem sugerir a predisposição ao risco dessa lesão. Neste sentido, vários protocolos de treinamento foram utilizados como intervenção e obtiveram resultados diversificados na alteração desse fator de risco. Objetivo: O objetivo deste projeto foi avaliar as possíveis alterações de rotação do joelho na aterrissagem unipodal após a intervenção de um programa de treinamento neuromuscular. Métodos: Participaram do estudo 18 mulheres com idade entre 18 e 51 anos, que foram distribuídas em dois grupos: grupo de treinamento neuromuscular de oito semanas (GTN) (n = 11) e grupo controle (GC) (n = 7). Além disso, não apresentavam lesão musculoesquelética ou dores nos membros inferiores. Cada participante realizou cinco aterrissagens unipodais válidas de uma plataforma de 40 cm de altura. O processo de captura de movimento foi realizado com 12 câmeras infravermelho do sistema OptiTrack(tm) para obter as coordenadas tridimensionais de marcadores fixados nos pontos anatômicos de interesse. Os sistemas de coordenadas locais da coxa e da perna foram definidos por meio dos respectivos marcadores fixados nos pontos anatômicos. Dessa forma, foram calculados os ângulos de rotação do joelho nos planos sagital, frontal e transverso através das sequências dos ângulos de Euler e as velocidades angulares através das formulações dos quatérnions. Resultados: Os resultados mostraram que houve um aumento na velocidade de rotação do joelho após o treinamento neuromuscular. Conclusão: Conclui-se que o treinamento neuromuscular resultou em maior velocidade de rotação no joelho nos 40 milissegundos que sucedem a aterrissagem unipodal.
Collapse
|
20
|
Vermand S, Ferrari FJ. Le cycle menstruel féminin peut-il influencer l’analyse de la posture debout ? Neurophysiol Clin 2015. [DOI: 10.1016/j.neucli.2015.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
21
|
Bell-Jenje T, Olivier B, Wood W, Rogers S, Green A, McKinon W. The association between loss of ankle dorsiflexion range of movement, and hip adduction and internal rotation during a step down test. ACTA ACUST UNITED AC 2015; 21:256-61. [PMID: 26432547 DOI: 10.1016/j.math.2015.09.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 09/09/2015] [Accepted: 09/10/2015] [Indexed: 10/23/2022]
Abstract
A pattern of excessive hip adduction and internal rotation with medial deviation of the knee has been associated with numerous musculo-skeletal dysfunctions. Research into the role that ankle dorsiflexion (DF) range of motion (ROM) play in lower limb kinematics is lacking. The objective of this cross-sectional, observational study was to investigate the relationship between ankle DF ROM, and hip adduction and hip internal rotation during a step-down test with and without heel elevation in a healthy female population. Hip and ankle ROM was measured kinematically using a ten-camera Optitrack motion analysis system. Thirty healthy female participants (mean age = 20.4 years; SD = 0.9 years) first performed a step-down test with the heel of the weight bearing foot flat on the step and then with the heel elevated on a platform. Ankle DF, hip adduction and hip internal rotation were measured kinematically for the supporting leg. Participants who had 17° or less of ankle DF ROM displayed significantly more hip adduction ROM (p = 0.001; Cohen's d effect size = 1.2) than the participants with more than 17° of DF during the step-down test. Participants with limited DF ROM showed a significant reduction in hip adduction ROM during the elevated-heel step-down test (p = 0.008). Hip internal rotation increased in both groups during the EHSD compared to the step-down test (p > 0.05) Reduced ankle DF ROM is associated with increased hip adduction utilised during the step-down test. Ankle DF should be taken into account when assessing patients with aberrant frontal plane lower limb alignment.
Collapse
Affiliation(s)
- T Bell-Jenje
- Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa
| | - B Olivier
- Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa.
| | - W Wood
- Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa
| | - S Rogers
- Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa
| | - A Green
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa
| | - W McKinon
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa
| |
Collapse
|
22
|
Lobato DFM, Baldon RDM, Wun PYL, Santiago PRP, Serrão FV. Effects of the use of oral contraceptives on hip and knee kinematics in healthy women during anterior stair descent. Knee Surg Sports Traumatol Arthrosc 2013; 21:2823-30. [PMID: 23108708 DOI: 10.1007/s00167-012-2248-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 10/09/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE Our aim was to evaluate the effects of the use of oral contraceptives (OC) on the hip and knee kinematics of healthy women during anterior stair descent. METHODS Forty volunteers aged from 18 to 26 years were divided into two groups: 1-Group of women who had used OC for at least 3 months prior to evaluation (n = 20) and 2-Group of women who did not use OC (n = 20). The knee flexion/extension and abduction/adduction, hip flexion/extension, abduction/adduction and medial/lateral rotation excursions (degrees) were calculated for the dominant (supporting) limb during anterior stair descent. T tests for independent samples were used to compare the kinematic differences between the groups (α = 0.05). RESULTS No significant difference was verified between the groups regarding the maximum excursion of knee flexion (n.s.) and abduction (n.s.) or hip flexion (n.s.), adduction (n.s.) and medial rotation (n.s.). When considering the knee flexion at 50°, no significant difference was verified between the groups regarding the excursion of knee abduction (n.s.) or hip flexion (n.s.) adduction (n.s.) and medial/lateral rotation (n.s.). CONCLUSION These results suggest that the use of OC does not influence the hip and knee kinematics during anterior stair descent. Therefore, the role of this medication as a protective factor against anterior cruciate ligament injuries remains questionable.
Collapse
|
23
|
Menstrual cycle and knee joint position sense in healthy female athletes. Knee Surg Sports Traumatol Arthrosc 2012; 20:1647-52. [PMID: 22159554 DOI: 10.1007/s00167-011-1811-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Accepted: 11/24/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE The aim of this study was to investigate the effect of menstrual cycle on knee joint position sense (JPS) in healthy female athletes. METHODS Sixteen healthy female athletes participated in this study. Serum estrogen and progesterone levels were collected during the three phases of menstrual cycle. The knee JPS was also measured during the same phases using a system comprise of skin markers, digital photography, and AutoCAD software. Absolute angular errors were calculated as well as changes in hormone levels between the three phases. RESULTS Serum estrogen concentration was significantly higher during the mid-luteal (179.5 Pg/ml) and mid-follicular (125.6 Pg/ml) phases as compared with the early-follicular (menses) (22.8 Pg/ml) phase (P = 0.0001). Also serum progesterone concentration was significantly higher during the mid-luteal phase (7.35 Ng/ml) as compared with the menses (0.58 Ng/ml) and mid-follicular (0.5 Ng/ml) phases (P = 0.0001). The greatest amount of mean (SD) value of absolute error was at menses (4.2°), and the least amount of it was at mid-luteal (2.5°) phase. Also, a significant difference was observed within three phases of menstrual cycle (P = 0.025). CONCLUSION The result of this study suggests that healthy female athletes have different levels of knee JPS across a menstrual cycle. JPS accuracy decreases in menses, when circulating sex-hormones levels are low. Therefore, female athletes are at higher risk of injury at menses and improving their awareness regarding the knee injury risk factors can be a fundamental step toward preventing injuries. LEVEL OF EVIDENCE Case series, Level IV.
Collapse
|