Valgus Control Feedback and Taping Improves the Effects of Plyometric Exercises in Women With Dynamic Knee Valgus

Therapeutic exercise protocol for the prevention of anterior cruciate ligament injuries in female soccer players with dynamic knee valgus (RCT)

BACKGROUND

Women's football has experienced exponential growth over the last 10 years. Its popularity is associated with an increase in ACL injuries. They constitute a major current problem as they account for 43% of the injury burden during the sports season. Despite the existing training programs, no uniform criteria have been established to design a precise intervention protocol, with specific tasks linked to women's football, nor has it been proposed to optimize the current programs.

METHODS

Randomized, double-blind, single-center clinical trial protocol scheduled for the 2025-2026 women's football season. There will be 2 groups: a group that will follow a specific ACL injury prevention protocol and a control group. The intervention period will last 12 weeks. Measurements will be taken at 3 time points. The biomechanics of the lower limbs, the jump-landing dynamics, and the pre- and post-training satisfaction of the players will be evaluated. Image capture and processing systems will be used as well as tests such as the DVJ and the LESS scoring system, among others.

DISCUSSION

This protocol aims to be one of the first to implement an ACL injury prevention program for women footballers with DKV. Despite the scarcity of research in this area, studies support beneficial effects at a preventive level.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06083818. Registered on 03 October 2023.

Effects of stiffness-altered sport compression garments on lower-limb biomechanics in cutting maneuvers

Athletes commonly use compression garments (CGs) for perceived effectiveness in preventing injury occurrence. However, limited evidence is available on whether lower-limb CGs reduce the risk of injury. This study aimed at (1) evaluating the effects of CGs on mitigating the risk factors of cutting-related knee injuries; (2) identifying undesirable side-effects of CGs on other joints and cutting performance; and (3) identifying possible interactions between sex and condition. 62 healthy adults performed pre-planned 90˚ cutting tasks under four conditions: control, knee sleeves, placebo leggings and stiffness-altered leggings. Joint angle at initial contact, range of motion, moments, and ground reaction force were measured. A mixed two-way (sex*condition) ANOVA was performed, followed by post-hoc comparisons and subset analyses for sexes. Results showed that the leggings restricted hip sagittal (45.4 ± 1.3 vs. control 50.0 ± 1.3˚, p = 0.001) and rotational (16.8 ± 0.8 vs. control 22.5 ± 1.1˚, p < 0.001) motion. At initial contact, the stiffness-altered leggings reduced knee valgus (0.4 ± 0.8 vs. control -2.1 ± 0.8˚, p = 0.031). However, the altered alignment of lower-limb joints did not reduce multiplanar knee joint moments (p > 0.05). CGs were not effective protective equipment yet. There was no significant difference between knee sleeves and control, nor between leggings conditions (p > 0.05). Force plate measurements, such as increased rate of force development (stiffness-altered 42.6 ± 1.1 & placebo 42.9 ± 1.1 vs. control 39.9 ± 1.0 BW/s, p < 0.028), implied the possibility of performance enhancement through CGs. While further investigations on the optimal compression and stiffness alterations are warranted, athletes are recommended to be aware of the discrepancies between the claimed and actual biomechanical effects of CGs.

Influence of taping on joint proprioception: a systematic review with between and within group meta-analysis

Taping is increasingly used to manage proprioceptive deficits, but existing reviews on its impact have shortcomings. To accurately assess the effects of taping, a separate meta-analyses for different population groups and tape types is needed. Therefore, both between- and within-group meta-analyses are needed to evaluate the influence of taping on proprioception. According to PRISMA guidelines, a literature search was conducted across seven databases (Web of Science, PEDro, Pubmed, EBSCO, Scopus, ERIC, SportDiscus, Psychinfo) and one register (CENTRAL) using the keywords "tape" and "proprioception". Out of 1372 records, 91 studies, involving 2718 individuals, met the inclusion criteria outlined in the systematic review. The meta-analyses revealed a significant between and within-group reduction in repositioning errors with taping compared to no tape (Hedge's g: -0.39, p < 0.001) and placebo taping (Hedge's g: -1.20, p < 0.001). Subgroup and sensitivity analyses further confirmed the reliability of the overall between and within-group analyses. The between-group results further demonstrated that both elastic tape and rigid tape had similar efficacy to improve repositioning errors in both healthy and fatigued populations. Additional analyses on the threshold to detection of passive motion and active movement extent discrimination apparatus revealed no significant influence of taping. In conclusion, the findings highlight the potential of taping to enhance joint repositioning accuracy compared to no tape or placebo taping. Further research needs to uncover underlying mechanisms and refine the application of taping for diverse populations with proprioceptive deficits.

The effects of the Posterior X Taping versus augmented feedback on lower-extremity kinematic and muscle activity pattern during unilateral weight-bearing activities in men with tibiofemoral varus malalignment

PURPOSE

Tibiofemoral Varus Malalignment (TFRV) contributes to overuse injuries by altering lower limb biomechanics. Both Posterior X Taping (PXT) and Real Time Feedback (RTF), have each been recommended for subjects with TFRV as they are thought to enhance control of excessive tibiofemoral rotations. This paper evaluates this claim.

METHODS

A total of recreational male 24 athletes with TFRV participated in the current study. Kinematic and electromyography variables of lower extremity were synchronously ​recorded on five consecutive repetitions of the single-legged-squat (SLS) and forward-step-down) FSD) tasks before and after applications of PXT and RTF.

RESULTS

The subjects at post-intervention in RTF group exhibited decreased hip adduction during FSD, and decreased hip adduction and internal rotation during eccentric and concentric phases of the SLS; Additionally, we observed increased gluteus medius activity during eccentric phase of the SLS and FSD tasks. In contrast, subjects at the post-intervention in PXT group exhibited decreased tibiofemoral external rotation and increased ankle external rotation during all the phases of both SLS and FSD tasks.

CONCLUSION

These results suggest that the PXT and RTF interventions are recommended to immediately improve the functional defects of the subjects with TFRV during SLS and FSD tasks.

Training interventions to reduce the risk of injury to the lower extremity joints during landing movements in adult athletes: a systematic review and meta-analysis

Objective

Aim of this systematic review was to summarise training interventions designed to reduce biomechanical risk factors associated with increased risk of lower extremity landing injuries and to evaluate their practical implications in amateur sports.

Design

Systematic review and meta-analysis.

Data sources

MEDLINE, Scopus and SPORTDiscus.

Eligibility criteria

Training intervention(s) aimed at reducing biomechanical risk factors and/or injury rates included the following: (1) prospective or (non-)randomised controlled study design; (2) risk factors that were measured with valid two-dimensional or three-dimensional motion analysis systems or Landing Error Scoring System during jump landings. In addition, meta-analyses were performed, and the risk of bias was assessed.

Results

Thirty-one studies met all inclusion criteria, capturing 11 different training interventions (eg, feedback and plyometrics) and 974 participants. A significantly medium effect of technique training (both instruction and feedback) and dynamic strengthening (ie, plyometrics with/without strengthening) on knee flexion angle (g=0.77; 95% CI 0.33 to 1.21) was shown. Only one-third of the studies had training interventions that required minimal training setup and additional coaching educations.

Conclusion

This systematic review highlights that amateur coaches can decrease relevant biomechanical risk factors by means of minimal training setup, for example, instructing to focus on a soft landing, even within only one training session of simple technique training. The meta-analysis emphasises implementing technique training as stand-alone or combined with dynamic strengthening into amateur sport training routine.

Effects of the real-time feedback and knee taping on lower-extremity function during ergometer pedaling in subjects with tibiofemoral varus alignment

BACKGROUND

The effect of the Posterior X Taping (PXT) used for subjects with Tibiofemoral Varus Malalignment (TFRV) aimed to control excessive tibiofemoral rotations is still unclear. Further, it is critical to use evidence-based therapeutic exercises to prevent non-contact injuries, especially in repetitive movements.

OBJECTIVE

To investigate whether the PXT and real-time feedback (RTF) interventions would improve lower extremity functions during the pedaling task in subjects with TFRV.

METHODS

Twenty-four male recreational athletes with TFRV participated in this study; Kinematic and muscle activity were synchronously recorded on ten consecutive pedal cycles during the last 30 s of 2-min pedaling.

RESULTS

The present study indicated that the subjects at the post-intervention of the RTF group exhibited significant decreased hip adduction and internal rotation, significant decreased tibiofemoral external rotation between 144° and 216° of crank angle, significant increased vastus medialis activity between 144° and 288° of crank angle, and significant increased gluteus medius activity between 180° and 144° of crank angle; In contrast, the subjects at the post-intervention of the PXT group exhibited significant decreased tibiofemoral external rotation and increased ankle external rotation at all the crank angles. No between-group differences were observed in pre-and post-intervention.

SIGNIFICANCE

These results suggest that the PXT and RTF interventions are recommended to immediately improve the functional defects of the subjects with TFRV during the pedaling task.