A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

Abstract Purpose The deceleration (pressing) is a common situational pattern leading to anterior cruciate ligament (ACL) injury in football. Although mainly assessed for performance purposes, a stronger focus on movement quality might support the screening of at-risk athletes. The aim of the present study was to describe a 2D scoring system for the assessment of the deceleration task and to associate it with the knee joint loading (knee abduction moment) evaluated through the gold standard 3D motion capture. The hypothesis was that lower 2D scores would be associated with higher knee joint loading. Methods Thirty-four competitive football (soccer) players (age 22.8 ± 4.1, 16 females) performed a series of deceleration tasks. 3D motion analysis was recorded using ten stereophotogrammetric cameras, a force platform, and three high-speed cameras. The 2D qualitative assessment was performed via a scoring system based on the video analysis of frontal and lateral planes joint kinematics for five scoring criteria. The intra- and inter-rater reliabilities were calculated for each 2D scoring criteria. The peak knee abduction moment was extracted and grouped according to the results of the 2D evaluation. Results An ICC > 0.94 was found for all the 2D scoring criteria, both for intra-rater and inter-rater reliability. The players with low 2D frontal plane scores and low total scores (0–4) showed significantly higher peak knee abduction moment values (p < 0.001). A significant negative rank correlation was found between the total score and the peak knee abduction moment (ρ = − 0.25, p < 0.001). Conclusions The qualitative 2D scoring system described successfully discerned between athletes with high and low knee joint loading during a deceleration task. The application of this qualitative movement assessment based on a detailed and accurate scoring system is suitable to identify players and patients with high knee joint loading (high knee abduction moments) and target additional training in the scenario of the primary and secondary ACL injury risk reduction. Level of evidence Level IV.

Download Full-text

Gender dimorphic ACL strain in response to combined dynamic 3D knee joint loading: Implications for ACL injury risk

The Knee ◽

10.1016/j.knee.2009.04.008 ◽

2009 ◽

Vol 16 (6) ◽

pp. 432-440 ◽

Cited By ~ 24

Author(s):

Kiyonori Mizuno ◽

Jack T. Andrish ◽

Antonie J. van den Bogert ◽

Scott G. McLean

Keyword(s):

Knee Joint ◽

Injury Risk ◽

Acl Injury ◽

Joint Loading ◽

Acl Injury Risk ◽

Knee Joint Loading

Download Full-text

A 2D video-analysis scoring system of 90° change of direction technique identifies football players with high knee abduction moment

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-021-06571-2 ◽

2021 ◽

Author(s):

Francesco Della Villa ◽

Stefano Di Paolo ◽

Dario Santagati ◽

Edoardo Della Croce ◽

Nicola Francesco Lopomo ◽

...

Keyword(s):

Motion Analysis ◽

Video Analysis ◽

Scoring System ◽

High Speed ◽

Acl Injury ◽

Rater Reliability ◽

3D Motion ◽

Change Of Direction ◽

3D Motion Analysis ◽

Knee Abduction

Abstract Purpose Abnormal joint biomechanics and poor neuromuscular control are modifiable risk factors for Anterior Cruciate Ligament (ACL) injury. Although 3D motion capture is the gold standard for the biomechanical evaluation of high-speed multidirectional movements, 2D video analysis is a growing-interest alternative because of its higher cost-effectiveness and interpretability. The aim of the present study was to explore the possible association between a 2D evaluation of a 90° change of direction (COD) and the KAM measured with gold standard 3D motion analysis. Methods Thirty-four competitive football (soccer) players (age 22.8 ± 4.1, 18 male and 16 females) were enrolled. Each athlete performed a series of pre-planned 90° COD at the maximum speed possible in a laboratory equipped with artificial turf. 3D motion analysis was recorded using 10 stereophotogrammetric cameras, a force platform, and three high-speed cameras. The 2D evaluation was performed through a scoring system based on the video analysis of frontal and sagittal plane joint kinematics. Five scoring criteria were adopted: limb stability (LS), pelvis stability (PS), trunk stability (TS), shock absorption (SA), and movement strategy (MS). For each criterion, a sub-score of 0/2 (non-adequate), 1/2 (partially adequate), or 2/2 (adequate) was attributed to the movement, based on objective measurements. The intra-rater and inter-rater reliability were calculated for each criterion and the total score. The Knee Abduction Moment (KAM) was extracted from the 3D motion analysis and grouped according to the results of the 2D evaluation. Results Excellent intra-rater reliability (ICC > 0.88) and good-to-excellent inter-rater reliability (ICC 0.68–0.92) were found. Significantly higher KAM was found for athletes obtaining a 0/2 score compared to those obtaining a 2/2 score in all the sub-criteria and the total score (20–47% higher, p < 0.05). The total score and the LS score showed the best discriminative power between the three groups. Conclusion The 2D video-analysis scoring system here described was a simple and effective tool to discriminate athletes with high and low KAM in the assessment of a 90° COD and could be a potential method to identify athletes at high risk of non-contact ACL injury. Level of evidence IV.

Download Full-text

Effect of knee joint loading on chondrocyte mechano-vulnerability and severity of post-traumatic osteoarthritis induced by ACL-injury in mice

Osteoarthritis and Cartilage Open ◽

10.1016/j.ocarto.2021.100227 ◽

2021 ◽

pp. 100227

Author(s):

Alexander Kotelsky ◽

Anissa Elahi ◽

Can Nejat Yigit ◽

Ashley Proctor ◽

Sandeep Mannava ◽

...

Keyword(s):

Knee Joint ◽

Acl Injury ◽

Joint Loading ◽

Post Traumatic ◽

Knee Joint Loading

Download Full-text

Biomechanical Determinants of Performance and Injury Risk During Cutting: A Performance-Injury Conflict?

Sports Medicine ◽

10.1007/s40279-021-01448-3 ◽

2021 ◽

Author(s):

Thomas Dos’Santos ◽

Christopher Thomas ◽

Alistair McBurnie ◽

Paul Comfort ◽

Paul A. Jones

Keyword(s):

Regression Analysis ◽

Knee Joint ◽

Knee Flexion ◽

Injury Risk ◽

Cutting Performance ◽

Stepwise Multiple Regression ◽

Joint Loading ◽

Knee Abduction ◽

Acl Injury Risk ◽

Knee Joint Loading

Abstract Background Most cutting biomechanical studies investigate performance and knee joint load determinants independently. This is surprising because cutting is an important action linked to performance and non-contact anterior cruciate ligament (ACL) injuries. The aim of this study was to investigate the relationship between cutting biomechanics and cutting performance (completion time, ground contact time [GCT], exit velocity) and surrogates of non-contact ACL injury risk (knee abduction [KAM] and internal rotation [KIRM] moments) during 90° cutting. Design Mixed, cross-sectional study following an associative design. 61 males from multidirectional sports performed six 90° pre-planned cutting trials, whereby lower-limb and trunk kinetics and kinematics were evaluated using three-dimensional (3D) motion and ground reaction force analysis over the penultimate (PFC) and final foot contact (FFC). Pearson’s and Spearman’s correlations were used to explore the relationships between biomechanical variables and cutting performance and injury risk variables. Stepwise regression analysis was also performed. Results Faster cutting performance was associated (p ≤ 0.05) with greater centre of mass (COM) velocities at key instances of the cut (r or ρ = 0.533–0.752), greater peak and mean propulsive forces (r or ρ = 0.449–0.651), shorter FFC GCTs (r or ρ = 0.569–0.581), greater FFC and PFC braking forces (r = 0.430–0.551), smaller hip and knee flexion range of motion (r or ρ = 0.406–0.670), greater knee flexion moments (KFMs) (r = 0.482), and greater internal foot progression angles (r = − 0.411). Stepwise multiple regression analysis revealed that exit velocity, peak resultant propulsive force, PFC mean horizontal braking force, and initial foot progression angle together could explain 64% (r = 0.801, adjusted 61.6%, p = 0.048) of the variation in completion time. Greater peak KAMs were associated with greater COM velocities at key instances of the cut (r or ρ = − 0.491 to − 0.551), greater peak knee abduction angles (KAA) (r = − 0.468), and greater FFC braking forces (r = 0.434–0.497). Incidentally, faster completion times were associated with greater peak KAMs (r = − 0.412) and KIRMs (r = 0.539). Stepwise multiple regression analysis revealed that FFC mean vertical braking force and peak KAA together could explain 43% (r = 0.652, adjusted 40.6%, p < 0.001) of the variation peak KAM. Conclusion Techniques and mechanics associated with faster cutting (i.e. faster COM velocities, greater FFC braking forces in short GCTs, greater KFMs, smaller hip and knee flexion, and greater internal foot progression angles) are in direct conflict with safer cutting mechanics (i.e. reduced knee joint loading, thus ACL injury risk), and support the “performance-injury conflict” concept during cutting. Practitioners should be conscious of this conflict when instructing cutting techniques to optimise performance while minimising knee joint loading, and should, therefore, ensure that their athletes have the physical capacity (i.e. neuromuscular control, co-contraction, and rapid force production) to tolerate and support the knee joint loading during cutting.

Download Full-text