The effect of planning time on penultimate and ultimate step kinematics and subsequent knee moments during sidestepping

Effects of Anticipation and Dual-Tasking on Lower Limb Biomechanics While Performing Change-of-Direction Tasks in Physically Active Individuals: A Systematic Review with Meta-Analysis

BACKGROUND

Anterior cruciate ligament (ACL) injuries are highly prevalent in team sport athletes and often occur while performing change-of-direction (COD) tasks in combination with high cognitive demands, such as decision making or divided attention. Given the expanding body of research in this field, an updated literature review is warranted, as the most recent meta-analysis on this topic included original studies published up to November 2020.

OBJECTIVE

The aim of this systematic review was to examine the effects of anticipation and/or dual-tasking on lower limb biomechanics during COD tasks in healthy individuals.

DESIGN

Systematic review with meta-analysis.

DATA SOURCES

A systematic literature search was conducted in the electronic databases PubMed, Web of Science, CINAHL and SPORTDiscus from inception until February 2024. The included studies examined the effects of anticipation and/or dual-tasking on knee kinetics and kinematics in the frontal and sagittal planes during COD tasks.

METHODS

A multilevel meta-analysis was performed to aggregate the results of studies comparing unanticipated versus anticipated CODs on lower limb biomechanics. Due to the limited available literature on dual-task versus single-task conditions, this aspect was analyzed qualitatively.

RESULTS

The meta-analysis included 17 studies involving 355 individuals from different sports (e.g., soccer, American Football). No statistically significant differences were found between unanticipated and anticipated CODs for knee abduction and flexion moments as well as knee abduction angles (p > 0.05). Significantly higher knee flexion angles were found in unanticipated CODs (SMD = 0.74, 95% CI: 0.30-1.19; p < 0.01). Qualitative analyses of six studies including 171 individuals provided initial evidence for higher knee abduction moments and flexion angles during anticipated CODs while performing a secondary task concurrently.

CONCLUSION

Findings from quantitative and qualitative analyses indicate that anticipation and dual-tasking during COD performance have an impact on injury-related aspects of lower limb biomechanics. Hence, cognitive challenges should be implemented in injury risk screening and preventive strategies. Further studies with high methodological quality are needed to improve the understanding of the biomechanical and cognitive interplay in injury-threatening situations.

PROSPERO REGISTRATION NUMBER

CRD42023433074.

DATE OF REGISTRATION

13.10.2023.

Deceleration Profiles Between the Penultimate and Final Steps of Planned and Reactive Side-Step Cutting

CONTEXT

Noncontact anterior cruciate ligament injury often occurs during rapid deceleration and change-of-direction maneuvers. These activities require an athlete to generate braking forces to slow down the center of mass and change direction in a dynamic environment. During preplanned cutting, athletes can use the penultimate step for braking before changing direction, resulting in less braking demand during the final step. During reactive cutting, athletes use different preparatory movement strategies during the penultimate step when planning time is limited. However, possible differences in the deceleration profile between the penultimate and final steps of preplanned and reactive side-step cuts remain unknown.

OBJECTIVE

To comprehensively evaluate deceleration during the penultimate and final steps of preplanned and reactive cutting.

DESIGN

Cross-sectional study.

SETTING

Laboratory.

PATIENTS OR OTHER PARTICIPANTS

Thirty-six women (age = 20.9 ± 1.7 years, height = 1.66 ± 0.07 m, mass = 62.4 ± 8.7 kg).

INTERVENTION

Participants completed 90° side-step cutting maneuvers under preplanned and reactive conditions.

MAIN OUTCOME MEASURE(S)

Approach velocity, velocity at initial contact, and cutting angle were compared between conditions. Stance time, deceleration time, and biomechanical indicators of deceleration were assessed during the penultimate and final steps of preplanned and reactive 90° cuts. Separate repeated-measures analysis-of-variance models were used to assess the influence of step, condition, and their interaction on the biomechanical indicators of deceleration.

RESULTS

Approach velocity (P = .69) and velocity at initial contact of the penultimate step (P = .33) did not differ between conditions. During reactive cutting, participants achieved a smaller cutting angle (P < .001). We identified a significant step-by-condition interaction for all biomechanical indicators of deceleration (P values < .05).

CONCLUSIONS

A lack of planning time resulted in less penultimate step braking and greater final step braking during reactive cutting. As a result, participants exhibited a decreased cutting angle and longer stance time during the final step of reactive cutting. Improving an athlete's ability to respond to an external stimulus may facilitate a more effective penultimate step braking strategy that decreases the braking demand during the final step of reactive cutting.

Development of a Cutting Technique Modification Training Program and Evaluation of its Effects on Movement Quality and Cutting Performance in Male Adolescent American Football Players

This study developed a cutting technique modification training program and investigated its effects on cutting performance and movement quality in adolescent American football players. For six weeks, an intervention group (IG) of 11 players participated in 25 min cutting technique modification training sessions integrated into team training twice a week, while a control group (CG) of 11 players continued their usual team training. Movement quality was assessed by evaluating 2D high-speed videos, obtained during preplanned 45° and 90° cutting tests, using the Cutting Movement Assessment Score (CMAS) qualitative screening tool. Cutting performance was assessed based on change of direction deficit (CODD). Significant interaction effects of time × group were found for CMAS in 45° and 90° cuttings (p < 0.001, ηp2 = 0.76, p < 0.001, ηp2 = 0.64, respectively), with large improvements in the IG (p < 0.001, g = -2.16, p < 0.001, g = -1.78, respectively) and deteriorations in the CG for 45° cuttings (p = 0.002, g = 1.15). However, no statistically significant differences in CODD were observed pre-to-post intervention. The cutting technique modification training was effective at improving movement quality without impairing cutting performance, and it can be used by practitioners working with adolescent athletes.