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Bill K, Mai P, Mausehund L, Solbakken S, Krosshaug T, Kersting UG. Individualized Technique Feedback for Instant Technique Improvements and Knee Abduction Moment Reductions - A New Approach for 'Sidestepping' ACL Injuries? Int J Sports Phys Ther 2024; 19:535-547. [PMID: 38707847 PMCID: PMC11065769 DOI: 10.26603/001c.116274] [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: 11/22/2023] [Accepted: 03/18/2024] [Indexed: 05/07/2024] Open
Abstract
Background Sidestep cutting technique is highly individual and has been shown to influence knee joint loading. However, studies assessing whether individualized technique feedback improves technique and ACL injury-relevant knee joint loads instantly in a sport-specific task are lacking. Purpose To determine the instant effects of individualized augmented technique feedback and instructions on technique and the peak external knee abduction moment (pKAM) in a handball-specific sidestep cut. Additionally, to determine the effects of technique modifications on the resultant ground reaction force and its frontal plane moment arm to the knee joint center. Study Design Controlled laboratory cohort study. Methods Three-dimensional biomechanics of 48 adolescent female handball players were recorded during a handball-specific sidestep cut. Following baseline cuts to each side, leg-specific visual and verbal technique feedback on foot strike angle, knee valgus motion, or vertical impact velocity using a hierarchically organized structure accounting for the variables' association with performance was provided. Subsequently, sidestep cuts were performed again while verbal instructions were provided to guide technique modifications. Combined effects of feedback and instructions on technique and pKAM as well as on the resultant ground reaction force and its frontal plane moment arm to the knee joint center were assessed. Results On average, each targeted technique variable improved following feedback and instructions, leading to instant reductions in pKAM of 13.4% to 17.1%. High inter-individual differences in response to feedback-instruction combinations were observed. These differences were evident in both the adherence to instructions and the impact on pKAM and its components. Conclusion Most players were able to instantly adapt their technique and decrease ACL injury-relevant knee joint loads through individualized augmented technique feedback, thereby potentially reducing the risk of injury. More research is needed to assess the retention of these adaptations and move towards on-field technique assessments using low-cost equipment. Level of Evidence Level 3.
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Affiliation(s)
- Kevin Bill
- Institute of Biomechanics and OrthopaedicsGerman Sport University Cologne
| | - Patrick Mai
- Institute of Biomechanics and OrthopaedicsGerman Sport University Cologne
- Department of Physical PerformanceNorwegian School of Sport Sciences
- Institute of Advanced Biomechanics and Motion StudiesOffenburg University of Applied Sciences
| | - Lasse Mausehund
- Oslo Sports Trauma Research Center, Department of Sports MedicineNorwegian School of Sport Sciences
| | | | - Tron Krosshaug
- Oslo Sports Trauma Research Center, Department of Sports MedicineNorwegian School of Sport Sciences
| | - Uwe G. Kersting
- Institute of Biomechanics and OrthopaedicsGerman Sport University Cologne
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Bathe C, Fennen L, Heering T, Greif A, Dubbeldam R. 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. BMJ Open Sport Exerc Med 2023; 9:e001508. [PMID: 37304892 PMCID: PMC10254820 DOI: 10.1136/bmjsem-2022-001508] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 06/13/2023] Open
Abstract
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.
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Affiliation(s)
- Chantal Bathe
- Movement Science, Westfälische Wilhelms University Münster, Münster, Germany
| | - Lena Fennen
- Movement Science, Westfälische Wilhelms University Münster, Münster, Germany
| | - Theresa Heering
- Coventry University, Coventry, UK
- Deakin University School of Health and Social Development, Melbourne, Victoria, Australia
| | - Alexander Greif
- Movement Science, Westfälische Wilhelms University Münster, Münster, Germany
| | - Rosemary Dubbeldam
- Movement Science, Westfälische Wilhelms University Münster, Münster, Germany
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Garcia S, Delattre N, Berton E, Divrechy G, Rao G. Comparison of landing kinematics and kinetics between experienced and novice volleyball players during block and spike jumps. BMC Sports Sci Med Rehabil 2022; 14:105. [PMID: 35690791 PMCID: PMC9188216 DOI: 10.1186/s13102-022-00496-0] [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] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 06/01/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The practice of volleyball requires many jumps. During landing, anterior cruciate ligament injuries may occur with high-risk lower limb kinematics and kinetics. Differences in landing strategies between experienced and novice volleyball players have not been fully explored. The purpose of the study was to compare lower limb kinematics and kinetics in experienced and novice volleyball players when performing volleyball specific jumps. METHODS A total of 30 healthy males, 15 experienced and 15 novice volleyball players, participated in the study. Participants performed block and spike jumps at a controlled jump height. Hip, knee and ankle joints angles at initial ground contact and ranges of motion in the sagittal plane, knee joint angles and moments in the frontal plane, vertical ground reaction force peak and loading rate were analyzed to investigate the expertise effect. RESULTS Experienced volleyball players landed with larger ankle dorsiflexion range of motion compared to novices. For the spike jump, experienced players landed with larger ankle plantarflexion angles at initial contact and larger ankle dorsiflexion ranges of motion, and for the block jump, they landed with larger knee flexion ranges of motion. Experienced players jumped significantly higher than novices. No difference was found in vertical ground reaction force peaks and loading rates. CONCLUSIONS Although the experienced group jumped higher than the novice group, no difference was found in ground reaction force parameters. These findings highlight that the experience of volleyball players acquired during regular trainings and competitions may play an important role in landing kinematics and kinetics to reduce the injury risk.
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Affiliation(s)
- Sébastien Garcia
- Movement Sciences Department, Decathlon SportsLab, 59000, Lille, France. .,CNRS, Insitute of Movement Sciences, Aix-Marseille University, 13007, Marseille, France.
| | - N Delattre
- Movement Sciences Department, Decathlon SportsLab, 59000, Lille, France
| | - E Berton
- CNRS, Insitute of Movement Sciences, Aix-Marseille University, 13007, Marseille, France
| | - G Divrechy
- Movement Sciences Department, Decathlon SportsLab, 59000, Lille, France
| | - G Rao
- CNRS, Insitute of Movement Sciences, Aix-Marseille University, 13007, Marseille, France
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Plyometrics Did Not Improve Jump-Landing Biomechanics in Individuals With a History of Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2022. [DOI: 10.1123/ijatt.2020-0072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Second anterior cruciate ligament (ACL) injury has similar biomechanical risk factors as primary injury. Standard of care rehabilitation does not adequately mitigate these biomechanical risks. This study examined the effectiveness of a 4-week plyometric intervention on biomechanical risk factors of second ACL injury versus no intervention in patients with a history of ACL reconstruction. Thirty adults post-ACL reconstruction received 12 sessions of plyometric (age: 19.9 ± 1.62 years; body mass index: 23.9 ± 2.6 kg/m2; months postoperative: 35.7 ± 24.2) or no (age: 21.3 ± 3.5 years; body mass index: 27.7 ± 4.8 kg/m2; months postoperative: 45.3 ± 25.4) exercise intervention. Hip and knee biomechanics were quantified during a jump-landing task before and after the intervention. Individual response to the intervention was evaluated via minimal detectable change. Hip flexion angle had the greatest response to plyometric training. Overall, focused plyometric intervention did not adequately mitigate biomechanical risk factors of second ACL injury; thus, development of interventions capable of modifying biomechanics known to contribute to ACL injury risk remains necessary.
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Seyedahmadi M, Minoonejad H, Karimizadeh Ardakani M, Heidari Z, Bayattork M, Akbari H. What are gender differences in lower limb muscle activity during jump-landing tasks? A systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2022; 14:77. [PMID: 35484569 PMCID: PMC9052696 DOI: 10.1186/s13102-022-00469-3] [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: 09/27/2021] [Accepted: 04/19/2022] [Indexed: 11/18/2022]
Abstract
Background Gender differences in muscle activity during landing have been proposed as a possible contributing factor to the greater incidence of anterior cruciate ligament injuries in women. Conflicting results among a few studies in this regard makes it impossible to reach correct conclusions.
Objectives The aim of this study was systematic review and the meta-analysis of previous studies which have compared the electromyographic activity of lower limb muscles in gluteus muscles (maximus and medius), quadriceps (rectus femoris, vastus medialis and lateralis), hamstrings (biceps femoris and semimembranosus), and gastrocnemius in men and women in jump–landing task. Methods A systematic search of the PubMed, SCOPUS, Science Direct databases was performed for eligible articles in October 2020. Cross-sectional studies that compared the muscle activity of male and female athletes without a history of previous injury in the jump–landing task were included. Unisex and non-athlete's studies were extracted from the included studies. The data were synthesized using a fixed and random effects model. Results Eight studies involving 145 participants were included. All participants were people who participated in regular exercises. The meta-analysis of timing and muscle activity was performed in the feedforward (pre contact) and feedback (post contact) stages. There were no significant differences in the muscle activity of biceps femoris (MD = −12.01; 95% CI − 51.49 to 27.47; p = 0.55; I2 = 87%), vastus medialis (MD = −53.46; 95% CI − 129.73 to 22.81; p = 0.17; I2 = 91%), semimembranosus (MD = 1.81; 95% CI − 6.44 to 10.07; p = 0.67; I2 = 0%), gluteus medius (MD = −3.14; 95% CI − 14.24 to 7.96; p = 0.58; I2 = 48%), and rectus femoris (MD = −5.83; 95% CI − 14.57 to 2.92; p = 0.19; I2 = 87%) in the pre contact phase between two sexes. There was a significant difference between men and women in the activity of vastus lateralis muscle in the post contact phase (MD = −34.90; 95% CI − 48.23 to − 21.57). No significant difference was observed between the men and women in the timing of semimembranosus (MD = 23.53; 95% CI − 14.49 to 61.54; p = 0.23; I2 = 56%) and biceps femoris muscle activity (MD = −46.84; 95% CI − 97.50 to 3.83; p = 0.07; I2 = 82%). Conclusion The results showed that in all lower limb muscles except vastus lateralis there were no significant differences between muscle activity and muscle contraction timing in both sexes before and after foot contact. Therefore, it can be concluded that the reason for the greater susceptibility of ACL injuries in women than men is maybe related to other factors such as biomechanical and hormonal. Additional good quality research in this regard is required to strengthen these conclusions.
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Affiliation(s)
| | - Hooman Minoonejad
- Department of Health and Sport Medicine, University of Tehran, Tehran, Iran.
| | | | - Zahra Heidari
- Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Bayattork
- Department of Sport Sciences, University of Hormozgan, Bandar Abbas, Iran
| | - Hadi Akbari
- Department of Sport Sciences, University of Zabol, Zabol, Iran
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Brazalovich P, Simon JE, Criss CR, Yom JP, Grooms DR. The effects of virtual reality immersion on drop landing mechanics. Sports Biomech 2022:1-17. [PMID: 35139757 DOI: 10.1080/14763141.2022.2035427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
Abstract
Virtual reality (VR) can be used to alter the environment and challenge sensory calibration which rehabilitation and return-to-sport testing lack. The purpose was to establish how VR manipulation of the environment changes knee landing biomechanics. Twenty-nine healthy active adults (22 males; 20.52 ± 1.21 years; 1.75 ± 0.09 m; 78.34 ± 14.33 kg) were recruited. Three drop landing trials (31 cm height box) were performed for three conditions: eyes-open (EO), eyes-closed (EC), and VR, consisting of a head-mounted display of a 360° photo of a steep man-made edge or drop. Knee kinematics and kinetics were evaluated using 3D motion capture. The VR condition significantly increased Landing Error Score System errors relative to EO (1.28 ± 0.20, p < 0.001) and EC (0.98 ± 0.22, p < 0.001) and increased vertical ground reaction force relative to EO (0.41 ± 0.09 N·bw-1, p < 0.001) and EC (0.34 ± 0.07 N·bw-1, p < 0.001). The VR condition had less knee flexion at initial contact compared to EO (4.39 ± 0.75°, p = 0.001) and EC (1.83 ± 0.63°, p = 0.021). The VR condition had more knee abduction at initial contact compared to EO (0.71 ± 0.24°, p = 0.002) and EC (0.69 ± 0.22°, p = 0.002) and increased knee abduction at maximum flexion compared to EO (2.01 ± 0.58°, p = 0.026). Landing in VR increased injury risk landing biomechanics, indicating that VR may option to incorporate into return-to-play or injury risk assessment.
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Affiliation(s)
- Philip Brazalovich
- School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Janet E Simon
- School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
| | - Cody R Criss
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
| | - Jae P Yom
- Department of Allied Health, University of Illinois Springfield, Springfield, IL, USA
| | - Dustin R Grooms
- School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
- School of Rehabilitation and Communications Science, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
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Stephenson SD, Kocan JW, Vinod AV, Kluczynski MA, Bisson LJ. A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies. Orthop J Sports Med 2021; 9:23259671211035776. [PMID: 34734094 PMCID: PMC8558815 DOI: 10.1177/23259671211035776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/03/2021] [Indexed: 12/26/2022] Open
Abstract
Background A large volume of systematic reviews and meta-analyses has been published on the effectiveness of sports injury prevention programs. Purpose To provide a qualitative summary of published systematic reviews and meta-analyses that have examined the effectiveness of sports injury prevention programs on reducing musculoskeletal injuries. Study Design Systematic review; Level of evidence, 4. Methods We searched the PubMed, CINAHL, EMBASE, and the Cochrane databases for systematic reviews and meta-analyses that evaluated the effectiveness of sports injury prevention programs. We excluded published abstracts, narrative reviews, articles not published in English, commentaries, studies that described sports injury prevention strategies but did not assess their effectiveness, studies that did not assess musculoskeletal injuries, and studies that did not assess sports-related injuries. The most relevant results were extracted and summarized. Levels of evidence were determined per the Oxford Centre for Evidence-Based Medicine, and methodological quality was assessed using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews, revised version). Results A total of 507 articles were retrieved, and 129 were included. Articles pertaining to all injuries were divided into 9 topics: sports and exercise in general (n = 20), soccer (n = 13), ice hockey (n = 1), dance (n = 1), volleyball (n = 1), basketball (n = 1), tackle collision sports (n = 1), climbing (n = 1), and youth athletes (n = 4). Articles on injuries by anatomic site were divided into 11 topics: general knee (n = 8), anterior cruciate ligament (n = 34), ankle (n = 14), hamstring (n = 11), lower extremity (n = 10), foot (n = 6), groin (n = 2), shoulder (n = 1), wrist (n = 2), and elbow (n = 1). Of the 129 studies, 45.7% were ranked as evidence level 1, and 55.0% were evidence level 2. Based on the AMSTAR-2, 58.9% of the reviews reported a priori review methods, 96.1% performed a comprehensive literature search, 47.3% thoroughly described excluded articles, 79.1% assessed risk of bias for individual studies, 48.8% reported a valid method for statistical combination of data (ie, meta-analysis), 45.0% examined the effect of risk of bias on pooled study results, and 19.4% examined the risk for publication bias. Conclusion This comprehensive review provides sports medicine providers with a single source of the most up-to-date publications in the literature on sports injury prevention.
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Affiliation(s)
- Samuel D Stephenson
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Joseph W Kocan
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Amrit V Vinod
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Melissa A Kluczynski
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Leslie J Bisson
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
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Liu X, Huang H, Li X, Li J, Shi H, Wang A. Effects of Video Task With a High-Level Exercise Illustration on Knee Movements in Male Volleyball Spike Jump. Front Psychol 2021; 12:644188. [PMID: 34526927 PMCID: PMC8435894 DOI: 10.3389/fpsyg.2021.644188] [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: 12/20/2020] [Accepted: 06/17/2021] [Indexed: 11/13/2022] Open
Abstract
Hazardous knee biomechanics, such as excessive knee affordance link with injuries in volleyball spike jumps (SPJs) and can be reconfigured by the enhancement of internal focus. The study aimed to explore the effects of video tasks illustrating a high-level SPJ on knee movement in the volleyball SPJ with 15 elite male volleyball athletes. This study investigated the knee movements in sagittal, coronal, and transverse planes before and after the video task in SPJ using one-dimensional statistical parametric mapping (SPM 1D) and discrete statistics. The SPM 1D indicated a larger knee flexion angle (31.17–73.19%, t = 2.611, and p = 0.012), increased knee flexion moment (19.72–21.38%, t = 0.029, and p = 0.029), and increased knee adduction angular velocity (49.07–62.64%, t = 3.148, and p = 0.004) after video task; alternatively, smaller knee external rotation angular velocity (45.85–49.96%, t = 5.199, and p = 0.017) and vertical ground reaction (vGRF) (3.13–5.94%, t = 4.096, and p = 0.014; 19.83–21.97%, t = 4.096, and p = 0.024) were found after the task. With discrete value statistics, the video task increased the peak of knee flexion angle while decreased the peak of extension moment, flexion moment, abduction moment, external moment, the first peak vGRF, and related loading rate. Conclusions: The results indicate that knee biomechanics in volleyball SPJ positively influenced by the video task. The task has the athletes control the knee movements more actively and improves the original hazardous movement strategies. Therefore, the video task presumably can abate the occurrence of knee injuries in volleyball SPJ. Further validation especially in the exercise effect is needed in the future.
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Affiliation(s)
- Xiangyu Liu
- Research Academy of Grand Health, Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Huiming Huang
- Research Academy of Grand Health, Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Xiaohan Li
- Research Academy of Grand Health, Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Jianshe Li
- Research Academy of Grand Health, Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Huijuan Shi
- Beijing Key Laboratory of Sports Injuries, Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Aiwen Wang
- Research Academy of Grand Health, Faculty of Sports Science, Ningbo University, Ningbo, China
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Drop Landing Biomechanics in Individuals With and Without a Concussion History. J Appl Biomech 2021; 37:450-457. [PMID: 34504042 DOI: 10.1123/jab.2021-0097] [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: 03/18/2021] [Revised: 06/21/2021] [Accepted: 06/30/2021] [Indexed: 11/18/2022]
Abstract
Research has identified an increased risk of lower extremity injury postconcussion, which may be due to aberrant biomechanics during dynamic tasks. The purpose of this study was to compare the drop landing biomechanics between individuals with and without a concussion history. Twenty-five individuals with and 25 without a concussion history were matched on age (±3 y), sex, and body mass index (±1 kg/m2). Three-dimensional landing biomechanics were recorded to obtain dependent variables (peak vertical ground reaction force, loading rate, knee flexion angle and external moment, knee abduction angle and external moment, and knee flexion and abduction angle at ground contact). A 1-way multivariate analysis of variance compared outcomes between groups. There was no difference in drop landing biomechanics between individuals with and without a concussion history (F10,39 = 0.460, P = .877, Wilk Λ= .918). There was an effect of time since concussion on knee flexion characteristics. Time since most recent concussion explained a significant amount of variation in both peak (ΔR2 = .177, β = -0.305, ΔP = .046) and initial ground contact (ΔR2 = .292, β = -0.204, ΔP = .008) knee flexion angle after covarying for sex and body mass index. Therefore, time since concussion should be considered when evaluating biomechanical patterns.
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10
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Heinert B, Rutherford D, Cleereman J, Lee M, Kernozek TW. Changes in landing mechanics using augmented feedback: 4-Week training and retention study. Phys Ther Sport 2021; 52:97-102. [PMID: 34450562 DOI: 10.1016/j.ptsp.2021.08.007] [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: 03/30/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/23/2022]
Abstract
CONTEXT Non-contact ACL injuries are common in female athletes during landing tasks. Post-trial performance-based feedback may be an effective method to reduce landing forces and knee valgus during landing. Information regarding the retention of these changes based on such training is generally lacking for weekly and monthly retention. OBJECTIVE To determine the effectiveness of post-trial feedback training to promote and retain changes in vertical ground reaction force (vGRF) and knee to ankle (K:A) ratio during a dual task drop landing in female collegiate athletes. DESIGN Repeated measures; SETTING: University campus. PARTICIPANTS 22 female collegiate athletes. MATERIALS AND METHODS Dual task drop landings were performed over 4 successive weeks with immediate post trial feedback on peak vGRF, symmetry, and K:A ratio. K:A ratio was a surrogate measure for knee valgus in drop landing. RESULTS Significant decreases in vGRF and increases in K:A ratio were found within training sessions (p = .000). Both variables were retained each week over the 4 weeks. CONCLUSION Using a custom portable clinical feedback system may be an effective tool in reducing peak vGRFs and knee abduction angles during a drop landing over a 4-week period in female collegiate athletes.
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Affiliation(s)
- Becky Heinert
- La Crosse Institute for Movement Science, Physical Therapy Program, Department of Health Professions, University of Wisconsin-La Crosse, La Crosse, WI, 54601, USA; Gundersen Health System, La Crosse, WI, 54601, USA
| | - Drew Rutherford
- La Crosse Institute for Movement Science, Physical Therapy Program, Department of Health Professions, University of Wisconsin-La Crosse, La Crosse, WI, 54601, USA
| | - Jacqueline Cleereman
- La Crosse Institute for Movement Science, Physical Therapy Program, Department of Health Professions, University of Wisconsin-La Crosse, La Crosse, WI, 54601, USA
| | - Maria Lee
- La Crosse Institute for Movement Science, Physical Therapy Program, Department of Health Professions, University of Wisconsin-La Crosse, La Crosse, WI, 54601, USA
| | - Thomas W Kernozek
- La Crosse Institute for Movement Science, Physical Therapy Program, Department of Health Professions, University of Wisconsin-La Crosse, La Crosse, WI, 54601, USA.
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Garcia S, Rao G, Berton E, Delattre N. Foot landing patterns in experienced and novice volleyball players during spike jumps. FOOTWEAR SCIENCE 2021. [DOI: 10.1080/19424280.2021.1917690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sébastien Garcia
- Movement Sciences Department, Decathlon SportsLab Research and Development, Villeneuve d'Ascq, France
| | - Guillaume Rao
- Institute of Movement Sciences, Aix-Marseille-University, Marseille, France
| | - Eric Berton
- Institute of Movement Sciences, Aix-Marseille-University, Marseille, France
| | - Nicolas Delattre
- Movement Sciences Department, Decathlon SportsLab Research and Development, Villeneuve d'Ascq, France
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12
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Females Decrease Vertical Ground Reaction Forces Following 4-Week Jump-Landing Feedback Intervention Without Negative Affect on Vertical Jump Performance. J Sport Rehabil 2021; 28:866-870. [PMID: 30300051 DOI: 10.1123/jsr.2018-0140] [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: 04/16/2018] [Revised: 08/07/2018] [Accepted: 08/27/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT High vertical ground reaction force (vGRF) when initiating ground contact during jump landing is one biomechanical factor that may increase risk of anterior cruciate ligament injury. Intervention programs have been developed to decrease vGRF to reduce injury risk, yet generating high forces is still critical for performing dynamic activities such as a vertical jump task. OBJECTIVE To evaluate if a jump-landing feedback intervention, cueing a decrease in vGRF, would impair vertical jump performance in a separate task (Vertmax). DESIGN Randomized controlled trial. Patients (or Other Participants): Forty-eight recreationally active females (feedback: n = 31; 19.63 [1.54] y, 1.6 [0.08] cm, 58.13 [7.84] kg and control: n = 15; 19.6 [1.68] y, 1.64 [0.05] cm, 60.11 [8.36] kg) participated in this study. INTERVENTION Peak vGRF during a jump landing and Vertmax were recorded at baseline and 4 weeks post. The feedback group participated in 12 sessions over the 4-week period consisting of feedback provided for 6 sets of 6 jumps off a 30-cm box. The control group was instructed to return to the lab 28 days following the baseline measurements. MAIN OUTCOME MEASURES Change scores (postbaseline) were calculated for peak vGRF and Vertmax. Group differences were evaluated for peak vGRF and Vertmax using a Mann-Whitney U test (P < .05). RESULTS There were no significant differences between groups at baseline (P > .05). The feedback group (-0.5 [0.3] N/kg) demonstrated a greater decrease in vGRF compared with the control group (0.01 [0.3] N/kg) (t(46) = -5.52, P < .001). There were no significant differences in change in Vertmax between groups (feedback = 0.9 [2.2] cm, control = 0.06 [2.1] cm; t(46) = 0.46, P = .64). CONCLUSIONS While the feedback intervention was effective in decreasing vGRF when landing from a jump, these participants did not demonstrate changes in vertical jump performance when assessed during a different task. Practitioners should consider implementing feedback intervention programs to reduce peak vGRF, without worry of diminished vertical jump performance.
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Biomechanical Characteristics between Bionic Shoes and Normal Shoes during the Drop-Landing Phase: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063223. [PMID: 33804696 PMCID: PMC8003960 DOI: 10.3390/ijerph18063223] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/13/2021] [Accepted: 03/17/2021] [Indexed: 12/19/2022]
Abstract
With the development of unstable footwear, more research has focused on the advantages of this type of shoe. This type of shoe could improve the muscle function of the lower limb and prevent injury risks in dynamic situations. Therefore, the purpose of this study was to investigate differences in lower-limb kinetics and kinematics based on single-leg landing (SLL) using normal shoes (NS) and bionic shoes (BS). The study used 15 male subject volunteers (age 23.4 ± 1.14 years, height 177.6 ± 4.83cm, body weight (BW) 73.6 ± 7.02 kg). To ensure the subject standardization of the participants, there were several inclusion criteria used for selection. There were two kinds of experimental shoes used in the landing experiment to detect the change of lower limbs when a landing task was performed. Kinetics and kinematic data were collected during an SLL task, and statistical parametric mapping (SPM) analysis was used to evaluate the differences between NS and BS. We found that the flexion and extension angles of the knee (p = 0.004) and hip (p = 0.046, p = 0.018) joints, and the dorsiflexion and plantarflexion of ankle (p = 0.031) moment were significantly different in the sagittal planes. In the frontal plane, the eversion and inversion of the ankle (p = 0.016), and the abduction and adduction of knee (p = 0.017, p = 0.007) angle were found significant differences. In the horizontal plane, the external and internal rotation of hip (p = 0.036) and knee (p < 0.001, p = 0.029) moment were found significant differences, and knee angle (p = 0.043) also. According to our results, we conclude that using BS can cause bigger knee and hip flexion than NS. Also, this finding indicates that BS might be considered to reduce lower-limb injury risk during the SLL phase.
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Kernozek TW, Rutherford D, Heinert B, Onsager J, Lee M, Schiedermayer J, Dietrich S, Dade R, Almonroeder TG. Post-Trial Feedback Alters Landing Performance in Adolescent Female Athletes Using a Portable Feedback System. Int J Sports Phys Ther 2021; 16:87-95. [PMID: 33604138 PMCID: PMC7872461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/25/2020] [Indexed: 11/11/2023] Open
Abstract
BACKGROUND Post-performance verbal and visual feedback based on data collected via lab-based instruments have been shown to improve landing patterns related to non-contact ACL injury. Biomechanical methods are often complex, difficult to transport and utilize in field settings, and costly, which limits their use for injury prevention. Developing systems that can readily provide feedback outside of the lab setting may support large scale use of feedback training for ACL injury prevention. PURPOSE/HYPOTHESIS The purpose of this study was to investigate the effectiveness of a single training session using a custom portable feedback training system that provides performance cues to promote changes in impact kinetics and lower extremity position during landing in female athletes. STUDY DESIGN Repeated measures. METHODS One hundred fifty female athletes (ages 13-18 years old) landed from a 50 cm platform with and without feedback related to vertical ground reaction force (vGRF), vGRF symmetry and lower extremity position. Feedback was provided via a portable, low-cost system that included two custom-built force plates interfaced with a digital camera. Each athlete performed six pre-test trials followed by two blocks of six trials where they received visual feedback from the training system and individualized verbal cues from an investigator. Following training blocks, athletes completed six post-test trials without feedback and then six dual-task trials where a ball was randomly thrown to the performer during the landing (transfer task). vGRF and knee to ankle (K:A) separation ratio were measured and the average responses were reported for each trial block. RESULTS Differences in vGRF between baseline, post-test and transfer task trial blocks were observed (F(2,298)=181.68, p < .0001). Mean (SD) peak vGRF (body weight) were 4.43 (0.90), 3.28 (0.61), and 3.80 (0.92), respectively. Differences in K:A ratio between baseline, post-test and transfer task trial blocks were shown (F(2,298)=68.47, p < .0001). Mean (SD) K:A ratio were 0.87 (0.21), 0.98 (0.19), and 0.92 (0.19), respectively. CONCLUSION A portable feedback system may be effective in reducing peak vGRFs and promoting a more desirable K:A ratio during landing and transfer task landing in adolescent female athletes. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
- Thomas W Kernozek
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA; La Crosse Institute for Movement Science (LIMS), University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA
| | - Drew Rutherford
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA; La Crosse Institute for Movement Science (LIMS), University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA
| | - Becky Heinert
- La Crosse Institute for Movement Science (LIMS), University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA; Gundersen Health System, Sports Medicine, La Crosse, WI, USA
| | - Jessica Onsager
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA; La Crosse Institute for Movement Science (LIMS), University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA
| | - Maria Lee
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA; La Crosse Institute for Movement Science (LIMS), University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA
| | - Jeremie Schiedermayer
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA; La Crosse Institute for Movement Science (LIMS), University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA
| | - Stephanie Dietrich
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA; La Crosse Institute for Movement Science (LIMS), University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA
| | - Renee Dade
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA; La Crosse Institute for Movement Science (LIMS), University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA
| | - Thomas Gus Almonroeder
- Department of Health Professions, Physical Therapy Program, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA; La Crosse Institute for Movement Science (LIMS), University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI, USA
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Leonard KA, Simon JE, Yom J, Grooms DR. The Immediate Effects of Expert and Dyad External Focus Feedback on Drop Landing Biomechanics in Female Athletes: An Instrumented Field Study. Int J Sports Phys Ther 2021; 16:96-105. [PMID: 33604139 PMCID: PMC7872449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/21/2020] [Indexed: 11/11/2023] Open
Abstract
BACKGROUND Anterior Cruciate Ligament (ACL) injury prevention interventions have used trained experts to ensure quality feedback. Dyad (peer) feedback may be a more cost-effective method to deliver feedback to athletes. PURPOSE To determine the immediate effects of dyad versus expert feedback on drop landing kinematics and kinetics in female athletes. STUDY DESIGN Cohort study. SETTING College gymnasium. METHODS Two teams (one female basketball and one female volleyball), from a local college, were team randomized to dyad feedback (volleyball team) or expert feedback (basketball team) (13 expert, 19±0.87years, 1.7±0.09m, 68.04±7.21kg) (10 dyad 19.4±1.07years, 1.73±0.08m, 72.18±11.23kg). Participants completed drop vertical jumps at two different time points (pre- and post-feedback). Knee flexion and abduction displacement were assessed with Inertial Measurement Units (IMUs) and vertical ground reaction force (vGRF) was assessed with a force plate during the landing phase of the drop vertical jump and compared across groups and condition (pre- and post-feedback) with a repeated measures ANCOVA a priori α <0.02 was set for multiple tests conducted. RESULTS There were no significant differences between groups for flexion displacement. There was a significant change pre- to post- (decrease 4.65˚ p=0.01) in abduction displacement, with no group effect. There was a significant interaction of group by condition (p=0.01) for vGRF with no difference between groups before feedback (p>0.05). Between groups there was a decrease of vGRF in the expert group (difference 0.45 N*bw-1, p=0.01) at post-feedback relative to dyad. Within the expert group there was a significant difference between pre- and post-feedback (difference 0.72 N*bw-1, p=0.01), while the dyad group did not change pre- to post-feedback (difference 0.18 N*bw-1, p=0.67). CONCLUSION Movement screening experts giving real-time feedback were successful in improving key injury-risk kinematics and kinetics in female athletes, while dyad feedback only improved kinematics, indicating that expert feedback may be needed to ensure changes in kinematics and kinetics. LEVEL OF EVIDENCE 2.
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Affiliation(s)
| | | | - Jae Yom
- University of Illinois-Springfield
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16
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Li L, Baur M, Baldwin K, Kuehn T, Zhu Q, Herman D, Dai B. Falling as a strategy to decrease knee loading during landings: Implications for ACL injury prevention. J Biomech 2020; 109:109906. [PMID: 32807342 DOI: 10.1016/j.jbiomech.2020.109906] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/13/2020] [Accepted: 06/17/2020] [Indexed: 01/14/2023]
Abstract
Anterior cruciate ligament (ACL) injuries often occur when individuals land primarily on a single leg. Falling has been proposed as a potential strategy to decrease knee loading during landings. The purpose of this study was to compare impact forces, knee angles, and knee moments during natural landings, soft landings, and landings followed by falling after forward and vertical jumps, each under single or double-leg conditions. Sixteen male and sixteen female participants (age: 22.0 ± 2.9 years) completed each landing condition while kinematics and ground reaction forces were collected. In the natural landing condition, participants landed as they would in a sport setting. In the soft landing condition, participants landed as softly as possible with increased knee and hip flexion. In the falling condition, participants landed softly and then fell forward or backward onto a mat after forward and vertical jumps, respectively. The falling condition demonstrated the greatest initial and peak knee flexion angles, the least peak vertical ground reaction forces, and the least peak knee extension and adduction moments compared to the natural landing and soft landing conditions. The soft landing condition resulted in similar changes in landing mechanics compared to the natural landing, but the effect was limited for single-leg landings compared to double-leg landings. When the sports environment allows, falling appears to be a potential strategy to decrease knee loading when individuals must land on a single leg with sub-optimal body postures. Future studies are needed to develop progressive training of effective and safe falling techniques.
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Affiliation(s)
- Ling Li
- Division of Kinesiology and Health, University of Wyoming, Laramie, USA
| | - Marten Baur
- Division of Kinesiology and Health, University of Wyoming, Laramie, USA
| | - Kevin Baldwin
- Division of Kinesiology and Health, University of Wyoming, Laramie, USA
| | - Taylor Kuehn
- Division of Kinesiology and Health, University of Wyoming, Laramie, USA
| | - Qin Zhu
- Division of Kinesiology and Health, University of Wyoming, Laramie, USA
| | - Daniel Herman
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, USA
| | - Boyi Dai
- Division of Kinesiology and Health, University of Wyoming, Laramie, USA.
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Diekfuss JA, Grooms DR, Bonnette S, DiCesare CA, Thomas S, MacPherson RP, Ellis JD, Kiefer AW, Riley MA, Schneider DK, Gadd B, Kitchen K, Barber Foss KD, Dudley JA, Yuan W, Myer GD. Real-time biofeedback integrated into neuromuscular training reduces high-risk knee biomechanics and increases functional brain connectivity: A preliminary longitudinal investigation. Psychophysiology 2020; 57:e13545. [PMID: 32052868 DOI: 10.1111/psyp.13545] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 01/13/2020] [Accepted: 01/22/2020] [Indexed: 12/21/2022]
Abstract
Prospective evidence indicates that functional biomechanics and brain connectivity may predispose an athlete to an anterior cruciate ligament injury, revealing novel neural linkages for targeted neuromuscular training interventions. The purpose of this study was to determine the efficacy of a real-time biofeedback system for altering knee biomechanics and brain functional connectivity. Seventeen healthy, young, physically active female athletes completed 6 weeks of augmented neuromuscular training (aNMT) utilizing real-time, interactive visual biofeedback and 13 served as untrained controls. A drop vertical jump and resting state functional magnetic resonance imaging were separately completed at pre- and posttest time points to assess sensorimotor adaptation. The aNMT group had a significant reduction in peak knee abduction moment (pKAM) compared to controls (p = .03, d = 0.71). The aNMT group also exhibited a significant increase in functional connectivity between the right supplementary motor area and the left thalamus (p = .0473 after false discovery rate correction). Greater percent change in pKAM was also related to increased connectivity between the right cerebellum and right thalamus for the aNMT group (p = .0292 after false discovery rate correction, r2 = .62). No significant changes were observed for the controls (ps > .05). Our data provide preliminary evidence of potential neural mechanisms for aNMT-induced motor adaptations that reduce injury risk. Future research is warranted to understand the role of neuromuscular training alone and how each component of aNMT influences biomechanics and functional connectivity.
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Affiliation(s)
- Jed A Diekfuss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dustin R Grooms
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, OH, USA.,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Scott Bonnette
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher A DiCesare
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Staci Thomas
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ryan P MacPherson
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Jonathan D Ellis
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Adam W Kiefer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Exercise Science and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Center for Cognition, Action & Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Michael A Riley
- Center for Cognition, Action & Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | | | - Brooke Gadd
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Katie Kitchen
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kim D Barber Foss
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jonathan A Dudley
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Weihong Yuan
- College of Medicine, University of Cincinnati, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Gregory D Myer
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,College of Medicine, University of Cincinnati, Cincinnati, OH, USA.,Department of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA.,The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
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The Effects of Instruction Exercises on Performance and Kinetic Factors Associated With Lower-Extremity Injury in Landing After Volleyball Blocks. J Sport Rehabil 2020; 29:51-64. [PMID: 30526280 DOI: 10.1123/jsr.2018-0163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/15/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Female volleyball players are more predisposed to anterior cruciate ligament injury in comparison with their male counterparts. Recent research on anterior cruciate ligament injury prevention strategies has shown the positive results of adopting the external focus (EF) of attention in sports. OBJECTIVE To determine the effect of 6-week EF instruction exercises on performance and kinetic factors associated with lower-extremity injury in landing after the volleyball blocks of female athletes. DESIGN Pretest and posttest control study. SETTING University research laboratory. PARTICIPANTS Thirty-two female volleyball players (18-24 y old) from the same team randomly divided into experimental (n = 16) and control (n = 16) groups. INTERVENTION The experimental group performed a 6-week exercise program with EF instructions. The control group continued its regular volleyball team schedule. MAIN OUTCOME MEASURES To assess function, single-leg triple hop test for distance was used. A force plate was used to evaluate kinetic variables including vertical ground reaction forces, the rate of loading, and dynamic postural stability index. All data were assessed at baseline and after the intervention. RESULTS There was a significant increase in single-leg triple hop test (P < .05) and in the first and second peak ground reaction force, rate of loadings, dynamic postural stability index (P < .05). CONCLUSION According to the results of this study, anterior cruciate ligament injury prevention programs should incorporate EF instruction exercises to enhance the kinetics and to increase athletes' functional performance.
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19
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Neilson V, Ward S, Hume P, Lewis G, McDaid A. Effects of augmented feedback on training jump landing tasks for ACL injury prevention: A systematic review and meta-analysis. Phys Ther Sport 2019; 39:126-135. [DOI: 10.1016/j.ptsp.2019.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 07/16/2019] [Accepted: 07/16/2019] [Indexed: 11/16/2022]
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20
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Rees D, Younis A, MacRae S. Is there a correlation in frontal plane knee kinematics between running and performing a single leg squat in runners with patellofemoral pain syndrome and asymptomatic runners? Clin Biomech (Bristol, Avon) 2019; 61:227-232. [PMID: 30634094 DOI: 10.1016/j.clinbiomech.2018.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Knee kinematics when running, specifically knee valgus, have been linked to patellofemoral pain syndrome. Assessing running biomechanics requires skill, equipment and time. Clinically, the single leg squat is used to make inferences about knee kinematics during running. No evidence supports this practice. METHODS Sixteen asymptomatic runners and sixteen runners with patellofemoral pain syndrome were recruited. Asymptomatic runners were sub-divided by dominant and non-dominant leg and runners with patellofemoral pain syndrome by painful and non-painful leg. This gave four groups. Participants were videoed performing single leg squats and running on a treadmill. Frontal plane knee kinematics were calculated using the frontal plane projection angle. Correlation in frontal plane projection angle between running and single leg squat were calculated using Pearson's correlation coefficient. Differences in frontal plane projection angle between groups for running and single leg squat were calculated using multiple independent t-tests with Bonferroni correction. FINDINGS Correlation in frontal plane projection angle between running and the single leg squat was not statistically significant for the painful leg group (p = 0.19) but was for the remaining groups (p < 0.05). There was no statistically significant difference in frontal plane projection angle between the four groups when running. Single leg squat frontal plane projection angle was significantly larger for the painful leg group (10.3°) than the dominant leg (-0.2° (p = 0.003)) and non-dominant leg (-0.4° (p = 0.004)) in the asymptomatic runners group. INTERPRETATION The single leg squat cannot be used to make inferences about frontal plane knee kinematics in running gait in patellofemoral pain syndrome sufferers.
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Affiliation(s)
- David Rees
- School of Rehabilitation Sciences, Faculty of Health, Social Care and Education, a partnership between Kingston University and St George's, University of London, SW17 0RE, United Kingdom.
| | - Ahmed Younis
- School of Rehabilitation Sciences, Faculty of Health, Social Care and Education, a partnership between Kingston University and St George's, University of London, SW17 0RE, United Kingdom.
| | - Siân MacRae
- College of Health and Life Sciences, Brunel University London, Mary Seacole Building, Kingston Lane, Uxbridge UB8 3PH, United Kingdom; Therapy Department, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, United Kingdom.
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21
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Armitano CN, Haegele JA, Russell DM. The Use of Augmented Information for Reducing Anterior Cruciate Ligament Injury Risk During Jump Landings: A Systematic Review. J Athl Train 2018; 53:844-859. [PMID: 30273010 DOI: 10.4085/1062-6050-320-17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT: A comprehensive systematic review of the literature on the use of augmented information in anterior cruciate ligament (ACL) injury-prevention programs to improve jump-landing technique was conducted. The use of motor-learning concepts could provide more robust means of preventing ACL injuries. OBJECTIVE: To systematically summarize the effectiveness of augmented information in improving the biomechanical factors associated with an increased risk for ACL injury. DATA SOURCES: Articles were retrieved using the electronic databases of PubMed, MEDLINE, CINAHL, and Google Scholar and 3 lines of truncated search words: (a) lower extremity, knee, ACL, and anterior cruciate ligament; (b) prevention, injury prevention, and prehab; and (c) augmented information, augmented feedback, feedback, cue, and instruction. We also performed a hand search of the reference lists of the screened articles. DATA EXTRACTION: We independently assessed the methodologic quality using the Cochrane Group on Screening and Diagnostic Test Methods list. Articles were placed in 1 of 3 augmented-information categories: prescriptive, feedback, or transition. Articles were also categorized based on whether the information likely encouraged an internal or external focus of attention. DATA SYNTHESIS: The searches identified a total of 353 studies, of which 18 were included. Most researchers found that augmented information could lead to technique changes to reduce the biomechanical risk factors associated with ACL injury. The average methodologic quality of the studies was 11.8 out of 17, with a range from 8 to 15. The authors of only 7 studies examined retention of the improved techniques. CONCLUSIONS: The evidence suggests that augmented information can be used to significantly improve the biomechanical indicators associated with ACL injury and to enhance current ACL injury-prevention programs. Combined prescriptive and feedback information that encouraged both internal and external foci led to the largest retention effect sizes.
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Affiliation(s)
- Cortney N Armitano
- School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA
| | - Daniel M Russell
- School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA
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Grooms DR, Chaudhari A, Page SJ, Nichols-Larsen DS, Onate JA. Visual-Motor Control of Drop Landing After Anterior Cruciate Ligament Reconstruction. J Athl Train 2018; 53:486-496. [PMID: 29749751 DOI: 10.4085/1062-6050-178-16] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Visual feedback is crucial in the control of human movement. When vision is obstructed, alterations in landing neuromuscular control may increase movements that place individuals at risk for injury. Anterior cruciate ligament (ACL) injury may further alter the motor-control response to alterations in visual feedback. The development of stroboscopic glasses that disrupt visual feedback without fully obscuring it has enabled researchers to assess visual-motor control during movements that simulate the dynamic demands of athletic activity. OBJECTIVE To investigate the effect of stroboscopic visual-feedback disruption (SVFD) on drop vertical-jump landing mechanics and to determine whether injury history influenced the effect. DESIGN Cohort study. SETTING Movement-analysis laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 15 participants with ACL reconstruction (ACLR; 7 men, 8 women; age = 21.41 ± 2.60 years, height = 1.72 ± 0.09 m, mass = 69.24 ± 15.24 kg, Tegner Activity Scale score = 7.30 ± 1.30, time since surgery = 36.18 ± 26.50 months, hamstrings grafts = 13, patellar tendon grafts = 2) and 15 matched healthy control participants (7 men, 8 women; age = 23.15 ± 3.48 years, height = 1.73 ± 0.09 m, mass = 69.98 ± 14.83 kg, Tegner Activity Scale score = 6.77 ± 1.48). INTERVENTION(S) Drop vertical-jump landings under normal and SVFD conditions. MAIN OUTCOME MEASURE(S) The SVFD effect for knee sagittal- and frontal-plane excursions, peak moments, and vertical ground reaction force were calculated during landing and compared with previously established measurement error and between groups. RESULTS The SVFD altered knee sagittal-plane excursion (4.04° ± 2.20°, P = .048) and frontal-plane excursion (1.98° ± 1.53°, P = .001) during landing above within-session measurement error. Joint-moment difference scores from full vision to the SVFD condition were not greater than within-session error. We observed an effect of ACLR history only for knee flexion (ACLR group = 3.12° ± 3.76°, control group = -0.84° ± 4.45°; P = .001). We did not observe an effect of side or sex. CONCLUSIONS The SVFD altered sagittal- and frontal-plane landing knee kinematics but did not alter moments. Anterior cruciate ligament reconstruction may induce alterations in sagittal-plane visual-motor control of the knee. The group SVFD effect was on a level similar to that of an in-flight perturbation, motor-learning intervention, or plyometric-training program, indicating that visual-motor ability may contribute to knee neuromuscular control on a clinically important level. The individual effects of the SVFD indicated possible unique sensorimotor versus visual-motor movement strategies during landing.
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Affiliation(s)
- Dustin R Grooms
- Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens
| | - Ajit Chaudhari
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus
| | - Stephen J Page
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus
| | | | - James A Onate
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus
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Popovic T, Caswell SV, Benjaminse A, Siragy T, Ambegaonkar J, Cortes N. Implicit video feedback produces positive changes in landing mechanics. J Exp Orthop 2018; 5:12. [PMID: 29721781 PMCID: PMC5931948 DOI: 10.1186/s40634-018-0129-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implicit (IF) and explicit (EF) feedback are two motor learning strategies demonstrated to alter movement patterns. There is conflicting evidence on which strategy produces better outcomes. The purpose of this study was to examine the effects of reduced IF and EF video feedback on lower extremity landing mechanics. METHODS Thirty participants (24 ± 2 years, 1.7 ± 0.1 m, 70 ± 11 kg) were randomly assigned to three groups: IF (n = 10), EF (n = 10), and control (CG) (n = 10). They performed twelve box-drop jumps three times a week on the training sessions for six weeks. Only IF and EF groups received video feedback on the training sessions. IF was cued to focus their attention on the overall jump, while EF was cued to focus on position of their knees. 3D lower extremity biomechanics were tested on testing sessions with no feedback. All sessions were at least 24 h apart from another. Testing sessions included baseline testing (pretest), testing after 3 training sessions with 100% feedback (pst1), testing after 6 training sessions with 33.3% feedback (pst2), testing after 6 training sessions with 16.6% feedback (Pst3), and testing 1 month after with no feedback (retention - ret). ANOVA compared differences between groups and time at initial contact and peak for hip flexion (HF, °) and abduction angle (HA, °), hip abduction moment (HAM, Nm/kgm), knee flexion (KF, °) and abduction angle (KA, °), knee abduction moment (KAM, Nm/kgm) and VGRF (N) (p < 0.05). RESULTS A significant main effect for group was found between IF and EF groups for HA (IF = - 6.7 ± 4; EF = - 9.4 ± 4.1) and KAM (IF = 0.05 ± 0.2; EF = - 0.07 ± 0.2) at initial contact, and peaks HA (IF = - 3.5 ± 4.5; EF = - 7.9 ± 4.7) and HAM (IF = 1.1 ± 0.6; EF = 0.9 ± 0.4). A significant main effect for time at initial contact for HF (pre = 32.4 ± 3.2; pst2 = 36.9 ± 3.2; pst3 = 37.9 ± 3.7; ret. = 34.1 ± 3.7), HAM (pre = 0.1 ± 0.1; pst1 = 0.04 ± 0.1; pst3 = 0.1 ± 0.01), KA (pre = 0.7 ± 1.1; pst1 = 0.2 ± 1.2; pst3 = 1.7 ± 1), and KAM (pre = 0.003 ± 0.1; pst3 = 0.01 ± 0.1) was found. DISCUSSION/CONCLUSION We found that implicit feedback produced positive changes in landing mechanics while explicit feedback degraded motor learning. Our results indicate that implicit feedback should be used in programs to lower the ACL injury risk. We suggest that implicit feedback should be frequent in the beginning and not be reduced as much following the acquisition phase.
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Affiliation(s)
- Tijana Popovic
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA.,Department of Radiology and Biomedical Imaging, University of California, 185 Berry Street, Lobby 6, Suite 391, San Francisco, CA, 94107, USA
| | - Shane V Caswell
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA
| | | | - Tarique Siragy
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA.,School of Human Kinetics, Faculty of Health Sciences at the University of Ottawa, 75 Laurier Avenue East, Ottawa, ON, K1N 6N5, Canada
| | - Jatin Ambegaonkar
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA
| | - Nelson Cortes
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA.
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Transfer of improved movement technique after receiving verbal external focus and video instruction. Knee Surg Sports Traumatol Arthrosc 2018; 26:955-962. [PMID: 28799030 PMCID: PMC5847206 DOI: 10.1007/s00167-017-4671-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 08/01/2017] [Indexed: 01/15/2023]
Abstract
PURPOSE It is unknown how movement patterns that are learned carry over to the field. The objective was to determine whether training during a jump-landing task would transfer to lower extremity kinematics and kinetics during sidestep cutting. METHODS Forty healthy athletes were assigned to the verbal internal focus (IF, n = 10), verbal external focus (EF, n = 10), video (VI, n = 10) or control (CTRL, n = 10) group. A jump-landing task was performed as baseline followed by training blocks (TR1 and TR2) and a post-test. Group-specific instructions were given in TR1 and TR2. In addition, participants in the IF, EF and VI groups were free to ask for feedback after every jump during TR1 and TR2. Retention was tested after 1 week. Transfer of learned skill was determined by having participants perform a 45° unanticipated sidestep cutting task. 3D hip, knee and ankle kinematics and kinetics were the main outcome measures. RESULTS During sidestep cutting, the VI group showed greater hip flexion ROM compared to the EF and IF groups (p < 0.001). The EF (p < 0.036) and VI (p < 0.004) groups had greater knee flexion ROM compared to the IF group. CONCLUSIONS Improved jump-landing technique carried over to sidestep cutting when stimulating an external attentional focus combined with self-controlled feedback. Transfer to more sport-specific skills may demonstrate potential to reduce injuries on the field. Clinicians and practitioners are encouraged to apply instructions that stimulate an external focus of attention, of which visual instructions seem to be very powerful. LEVEL OF EVIDENCE II.
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Welling W, Benjaminse A, Gokeler A, Otten B. RETENTION OF MOVEMENT TECHNIQUE: IMPLICATIONS FOR PRIMARY PREVENTION OF ACL INJURIES. Int J Sports Phys Ther 2017; 12:908-920. [PMID: 29158953 PMCID: PMC5675367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Retention of movement technique is crucial in anterior cruciate ligament (ACL) injury prevention programs. It is unknown if specific instructions or video instructions result in changes in kinematic and kinetic measures during a relatively short training session, and in a retention test one week later. HYPOTHESIS/PURPOSE The purpose was to determine the effects of verbal external focus (EF), verbal internal focus (IF) and video instructions (VI) on landing technique (i.e. kinematics and kinetics) during training and retention. STUDY DESIGN Randomized Controlled Trial. METHODS This study compared verbal EF, verbal IF, VI and CTRL group. Forty healthy athletes were assigned to the IF (n=10), EF (n=10), VI (n=10) or CTRL group (n=10). A jump-landing task was performed as a baseline, followed by two training blocks (TR1 and TR2) and a post test. Group specific instructions were offered in TR1 and TR2. In addition, subjects in the IF, EF and VI groups were free to ask for feedback after every jump in TR1 and TR2. One week later, a retention test was conducted without specific instructions or feedback. Kinematics and kinetics were captured using an 8-camera motion analysis system. RESULTS Males and females in the EF and VI instruction group showed beneficial results during and after the training session, in terms of improved landing technique. Retention was achieved after only a short training session. CONCLUSION ACL injury prevention programs should include EF and/or VI instructions to improve kinematics and kinetics and achieve retention. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
| | | | - Alli Gokeler
- University of Groningen, University Medical Center Groningen, Center for Human Movement Science, Groningen, The Netherlands
| | - Bert Otten
- University of Groningen, University Medical Center Groningen, Center for Human Movement Science, Groningen, The Netherlands
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Hsu CJ, George SZ, Chmielewski TL. Association of Quadriceps Strength and Psychosocial Factors With Single-Leg Hop Performance in Patients With Meniscectomy. Orthop J Sports Med 2016; 4:2325967116676078. [PMID: 28210647 PMCID: PMC5298555 DOI: 10.1177/2325967116676078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Clinicians use the single-leg hop test to assess readiness for return to sports after knee injury. Few studies have reported the results of single-leg hop testing after meniscectomy. Additionally, the contributions of impairments in quadriceps strength and psychosocial factors to single-leg hop performance are unknown. Purpose: To compare single-leg hop performance (distance and landing mechanics) between limbs and to examine the association of single-leg hop performance with quadriceps strength and psychosocial factors in patients with meniscectomy. Study Design: Descriptive laboratory study. Methods: A total of 22 subjects who underwent meniscectomy for traumatic meniscal tears received either standard rehabilitation alone or with additional quadriceps strengthening. Testing was conducted immediately postrehabilitation and at 1 year postsurgery. A single-leg hop test was performed bilaterally, and hop distance was used to create a hop symmetry index. Landing mechanics (peak knee flexion angle, knee extension moment, and peak vertical ground-reaction force) were analyzed with a motion-capture system and a force plate. An isokinetic dynamometer (60 deg/s) assessed knee extensor peak torque and rate of torque development (RTD0-200ms and RTD0–peak torque). Questionnaires assessed fear of reinjury (Tampa Scale for Kinesiophobia [TSK-11]) and self-efficacy (Knee Activity Self-Efficacy [KASE]). Results: Rehabilitation groups did not significantly differ in single-leg hop performance; therefore, groups were combined for further analyses. The mean hop symmetry index was 88.6% and 98.9% at postrehabilitation and 1 year postsurgery, respectively. Compared with the nonsurgical limb, the surgical limb showed decreased peak knee flexion angle at postrehabilitation and decreased knee extension moment at 1 year postsurgery. The hop symmetry index was positively associated with peak torque, RTD0-200ms, and the KASE score at postrehabilitation. Moreover, at postrehabilitation, the peak knee flexion angle was positively associated with peak torque and RTD0-200ms, and the knee extension moment was positively associated with RTD0-200ms. At 1 year postsurgery, peak knee flexion angle and knee extension moment were both positively associated with peak torque, RTD0-200ms, and RTD0–peak torque. Conclusion: Although the hop symmetry index could be considered satisfactory for returning to sports, asymmetries in landing mechanics still exist in the first year postmeniscectomy. Greater quadriceps strength was associated with greater single-leg hop distance and better landing mechanics at both postrehabilitation and 1 year postsurgery. Knee activity self-efficacy was the only psychosocial factor associated with single-leg hop performance and isolated to a positive association with single-leg hop distance at postrehabilitation. Clinical Relevance: Rate of development is not typically measured in the clinic but can be an additional quadriceps measure to monitor for single-leg hop performance. Quadriceps strength and psychosocial factors appear to have separate influence on single-leg hop performance after meniscectomy, which has implications for developing appropriate interventions for optimal single-leg hop performance.
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Affiliation(s)
- Chao-Jung Hsu
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
| | - Steven Z George
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA.; Brooks Rehabilitation, Jacksonville, Florida, USA
| | - Terese L Chmielewski
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA.; TRIA Orthopaedic Center, Bloomington, Minnesota, USA
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Sinsurin K, Vachalathiti R, Jalayondeja W, Limroongreungrat W. Knee Muscular Control During Jump Landing in Multidirections. Asian J Sports Med 2016; 7:e31248. [PMID: 27625758 PMCID: PMC5003310 DOI: 10.5812/asjsm.31248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 12/25/2015] [Accepted: 01/02/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Jump landing is a complex movement in sports. While competing and practicing, athletes frequently perform multi-planar jump landing. Anticipatory muscle activity could influence the amount of knee flexion and prepare the knee for dynamic weight bearing such as landing tasks. OBJECTIVES The aim of the present study was to examine knee muscle function and knee flexion excursion as athletes naturally performed multi-direction jump landing. MATERIALS AND METHODS Eighteen male athletes performed the jump-landing test in four directions: forward (0°), 30° diagonal, 60° diagonal, and lateral (90°). Muscles tested were vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), semitendinosus (ST), and biceps femoris (BF). A Vicon(TM) 612 workstation collected the kinematic data. An electromyography was synchronized with the Vicon(TM) Motion system to quantify dynamic muscle function. Repeated measure ANOVA was used to analyze the data. RESULTS Jump-landing direction significantly influenced (P < 0.05) muscle activities of VL, RF, and ST and knee flexion excursion. Jumpers landed with a trend of decreasing knee flexion excursion and ST muscle activity 100 ms before foot contact progressively from forward to lateral directions of jump landing. CONCLUSIONS A higher risk of knee injury might occur during lateral jump landing than forward and diagonal directions. Athletes should have more practice in jump landing in lateral direction to avoid injury. Landing technique with high knee flexion in multi-directions should be taught to jumpers for knee injury prevention.
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Affiliation(s)
- Komsak Sinsurin
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Roongtiwa Vachalathiti
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
- Corresponding author: Roongtiwa Vachalathiti, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand. Tel: +66-24415450, Fax: +66-24415454, E-mail:
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Aizawa J, Ohji S, Koga H, Masuda T, Yagishita K. Correlations between sagittal plane kinematics and landing impact force during single-leg lateral jump-landings. J Phys Ther Sci 2016; 28:2316-21. [PMID: 27630422 PMCID: PMC5011586 DOI: 10.1589/jpts.28.2316] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/14/2016] [Indexed: 01/14/2023] Open
Abstract
[Purpose] The correlations of peak vertical ground reaction force and sagittal angles during single-leg lateral jump-landing with noncontact anterior cruciate ligament injury remain unknown. This study aimed to clarify the correlations between kinematics and impact force during lateral jump-landing. [Subjects and Methods] Twenty active males were included in the analysis. A sagittal-view movie camera and force plate were time synchronized. Trunk and lower extremity sagittal angles were measured 100 ms before initial contact and at peak vertical ground reaction force. Peak vertical ground reaction force, time between initial contact and peak vertical ground reaction force, and loading rate were calculated. [Results] The mean sagittal angle was 40.7° ± 7.7° for knee flexion during the flight phase and 16.4° ± 6.3° for pelvic anterior inclination during the landing phase. The mean peak vertical ground reaction force was four times the body weight. The median time to peak vertical ground reaction force was 63.8 ms. The knee flexion during the flight phase and pelvic anterior inclination angles during the landing phase were related to the peak vertical ground reaction force. [Conclusion] Increasing knee flexion and decreasing pelvic anterior inclination might reduce the impact during single-leg lateral jump-landing.
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Affiliation(s)
- Junya Aizawa
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, Japan
| | - Shunsuke Ohji
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, Japan
| | - Hideyuki Koga
- Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Tadashi Masuda
- Department of Symbiotic Systems Science, Fukushima University, Japan
| | - Kazuyoshi Yagishita
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, Japan
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Khuu S, Musalem LL, Beach TAC. Verbal Instructions Acutely Affect Drop Vertical Jump Biomechanics--Implications for Athletic Performance and Injury Risk Assessments. J Strength Cond Res 2016; 29:2816-26. [PMID: 26398699 DOI: 10.1519/jsc.0000000000000938] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Biomechanical quantities acquired during the drop vertical jump (DVJ) are used in the assessment of athletic performance and injury risk. The objective was to examine the impact of different verbal instructions on spatiotemporal, kinematic, and kinetic variables commonly included in such assessments. Ten men and 10 women from local varsity and club volleyball, basketball, figure skating, and track and field teams volunteered to participate. The athletes performed DVJs after given instructions to minimize ground contact time (CT), maximize jump height (HT), and synchronously extend the lower extremity joints (EX). Between the CT, HT, and EX conditions, body segment and joint angles were compared together with characteristics of vertical ground reaction force (GRF), whole-body power output, stiffness, and center-of-mass displacement time histories. Verbal instructions were found to influence nearly all of the spatiotemporal, body segment and joint kinematic, and kinetic variables that were statistically analyzed. Particularly noteworthy was the finding that athletic performance indices (e.g., jump height, power output, vertical stiffness, and reactive strength index) and lower extremity injury risk markers (e.g., peak vertical GRF and frontal plane knee angle) were significantly different (p ≤ 0.05) between the CT, HT, and EX conditions. The findings of this study suggest that verbal instructions should be controlled and/or clearly documented when using the DVJ to assess athletic performance potential and injury risk. Moreover, practitioners who devise performance enhancement and injury prevention strategies based on DVJ assessments are advised to consider that "coaching" or "cueing" during the task execution could impact conclusions drawn.
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Affiliation(s)
- Steven Khuu
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Ericksen HM, Thomas AC, Gribble PA, Armstrong C, Rice M, Pietrosimone B. Jump-landing biomechanics following a 4-week real-time feedback intervention and retention. Clin Biomech (Bristol, Avon) 2016; 32:85-91. [PMID: 26859853 DOI: 10.1016/j.clinbiomech.2016.01.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 01/13/2016] [Accepted: 01/18/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Poor neuromuscular control can increase the risk of anterior cruciate ligament (ACL) injury. Landing with decreased knee and hip flexion may increase the risk of lower extremity injury. Feedback interventions have demonstrated changes in jump-landing biomechanics. Traditional feedback (TF), provided after task completion, includes critical factors to focus on during jump-landing. Real-time feedback (RTF), provided while completing the task, may be superior for improving jump-landing biomechanics. This investigation evaluated the effect of RTF+TF compared to TF and a control group in changing lower extremity jump-landing biomechanics following a 4-week feedback intervention and a 1-week no feedback retention. METHODS Participants completed 12 feedback sessions over 4 weeks. At each session, participants performed 6 sets of 6 jumps off a 30 cm box. Participants were provided TF or RTF+TF following each set of jumps. Participants were tested at baseline, immediately following the 4-week intervention and following a 1-week retention. The control group was tested at two time points 4 weeks apart. FINDINGS Acquisition analysis: RTF+TF and TF groups demonstrated greater change in peak hip flexion angles and peak knee flexion angles compared to the control group following the intervention. TF and RTF+TF groups demonstrated a greater decrease in peak vertical ground reaction force compared to the control group. No significant differences were observed between groups in the retention analysis. INTERPRETATION This study provides evidence of acquisition of biomechanical changes following a 4-week feedback intervention. Future research should further investigate the retention of biomechanical changes, the optimal length of feedback interventions and transfer of learned biomechanics to similar athletic tasks.
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Affiliation(s)
| | - Abbey C Thomas
- University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | | | | | - Brian Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Optimization of the anterior cruciate ligament injury prevention paradigm: novel feedback techniques to enhance motor learning and reduce injury risk. J Orthop Sports Phys Ther 2015; 45:170-82. [PMID: 25627151 DOI: 10.2519/jospt.2015.4986] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Primary anterior cruciate ligament (ACL) injury prevention programs effectively reduce ACL injury risk in the short term. Despite these programs, ACL injury incidence is still high, making it imperative to continue to improve current prevention strategies. A potential limitation of current ACL injury prevention training may be a deficit in the transfer of conscious, optimal movement strategies rehearsed during training sessions to automatic movements required for athletic activities and unanticipated events on the field. Instructional strategies with an internal focus of attention have traditionally been utilized, but may not be optimal for the acquisition of the control of complex motor skills required for sports. Conversely, external-focus instructional strategies may enhance skill acquisition more efficiently and increase the transfer of improved motor skills to sports activities. The current article will present insights gained from the motor-learning domain that may enhance neuromuscular training programs via improved skill development and increased retention and transfer to sports activities, which may reduce ACL injury incidence in the long term.
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Abstract
STUDY DESIGN Randomized controlled trial. OBJECTIVE To determine if the addition of real-time feedback (RTF) to postresponse feedback (PRF) improves jump-landing kinematics compared to PRF alone and a no-feedback control group. BACKGROUND Injury-prevention programs to reduce risk of anterior cruciate ligament injury have shown promising results in altering jump-landing biomechanics. Real-time feedback provided during the task may allow participants to more easily understand and execute new movement strategies compared to PRF provided after the task is completed. METHODS Thirty-six healthy females were randomized to 1 of 3 groups: RTF plus PRF, PRF, or control. Sagittal plane moments and angles at the knee and hip, frontal plane angles at the knee, and vertical ground reaction forces during a jump-landing task were quantified at baseline and postintervention. The RTF plus PRF and PRF groups received a PowerPoint presentation containing the goals of correct landing technique. In addition to the PowerPoint presentation, the RTF plus PRF group was provided real-time visualization of their frontal plane knee angle. Participants in the control group performed the jump-landing task without feedback. RESULTS Posttraining, the RTF plus PRF and PRF groups demonstrated similar improvements in hip and knee flexion and decreased vertical ground reaction forces compared to the control group. There were no changes in frontal plane knee kinematics between groups posttraining. CONCLUSION The addition of RTF to PRF did not result in significant changes in jump-landing kinematics compared to PRF alone. LEVEL OF EVIDENCE Prevention, level 5.
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The impact of sex and knee injury history on jump-landing patterns in collegiate athletes: a clinical evaluation. Clin J Sport Med 2014; 24:373-9. [PMID: 24284948 DOI: 10.1097/jsm.0000000000000053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine whether jump-landing patterns, as assessed by the Landing Error Scoring System (LESS), differ based on sex and knee injury history. DESIGN Cross-sectional. SETTING College. PARTICIPANTS Two hundred fifteen intercollegiate athletes were grouped by sex (male = 116 and female = 99) and self-reported knee injury history (no = 148, mild = 31, and severe = 36). INTERVENTIONS Participants performed 3 trials of a standardized jump-landing task that were videotaped and later scored using the LESS. MAIN OUTCOME MEASURES Overall, individual item, sagittal total error, and frontal total error scores of the LESS. RESULTS An interaction effect was reported for trunk flexion at initial ground contact. Main effects for sex indicated that males demonstrated more at-risk landing movement patterns on the sagittal plane (ie, limited trunk, knee and hip flexion at initial contact, and limited hip flexion throughout the landing), whereas females demonstrated more at-risk landing movement patterns on the frontal plane (ie, knee valgus at initial ground contact and maximum knee flexion, and more frontal plane movement throughout the landing). No main effects were reported for injury history. CONCLUSIONS Jump-landing patterns seem to be impacted by sex but not knee injury history. Findings related to sex differences corroborate with previous laboratory-based investigations. Furthermore, findings support the clinical use of the LESS to screen for individuals who may be at risk for a lower extremity injury. Future studies should further investigate the clinical utility of the LESS, particularly its ability to predict lower extremity injuries.
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