Concurrent Tactile Feedback Provided by a Simple Device Increased Knee Flexion and Decreased Impact Ground Reaction Forces During Landing

2016 ◽  
Vol 32 (3) ◽  
pp. 248-253 ◽  
Author(s):  
Boyi Dai ◽  
Mitchell L. Stephenson ◽  
Samantha M. Ellis ◽  
Michael R. Donohue ◽  
Xiaopeng Ning ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Low Cost ◽  
Cruciate Ligament ◽  
Tactile Feedback ◽  
Simple Device ◽  
Ground Reaction Forces ◽  
Knee Valgus ◽  
Peak Knee ◽  
Reaction Forces ◽  
Anterior Cruciate

Increased knee flexion and decreased knee valgus angles and decreased impact ground reaction forces (GRF) are associated with decreased anterior cruciate ligament (ACL) loading during landing. The purpose of this study was to determine the effect of tactile feedback provided by a simple device on knee flexion and valgus angles and impact GRF during landing. Kinematic and kinetic data were collected when 28 participants performed baseline, training, and evaluation jump-landing trials. During the training trials, the device was placed on participants’ shanks so that participants received tactile feedback when they reached a peak knee flexion angle of a minimum of 100°. During the evaluation trials, participants were instructed to maintain the movement patterns as they learned from the training trials. Participants demonstrated significantly (P < .008) increased peak knee flexion angles, knee flexion range of motion during early landing (first 100 ms of landing) and stance time, decreased impact posterior and vertical GRF during early landing and jump height, and similar knee valgus angles during the evaluation trials compared with the baseline trials. Immediately following training with tactile feedback, participants demonstrated landing patterns associated with decreased ACL loading. This device may have advantages in application because it provides low-cost, independent, and real-time feedback.

scholarly journals Effect of Sex on Anterior Cruciate Ligament Injury–Related Biomechanics During the Cutting Maneuver in Preadolescent Athletes

2020 ◽  
Vol 8 (7) ◽  
pp. 232596712093698
Author(s):  
Milos Petrovic ◽  
Haraldur B. Sigurðsson ◽  
Hjálmar J. Sigurðsson ◽  
Thorarinn Sveinsson ◽  
Kristín Briem
Keyword(s):  
Injury Risk ◽  
Cruciate Ligament ◽  
Movement Patterns ◽  
Knee Valgus ◽  
Peak Knee ◽  
Reaction Forces ◽  
Vertical Ground ◽  
Anterior Cruciate ◽  
Vertical Ground Reaction Forces ◽  
Biomechanical Factors

Background: There are 2 movement patterns associated with an anterior cruciate ligament (ACL) injury: dynamic valgus and stiff landing. Although sex-dependent differences have been identified for adults, less is known for preadolescent athletes regarding movement patterns known to load the ACL. Hypothesis: We hypothesized that girls would demonstrate greater vertical ground reaction forces and knee valgus angles. We further hypothesized that the exercise intervention would affect girls more than boys and that this would primarily be demonstrated in less sagittal plane excursions, increased vertical ground reaction forces and knee valgus moments for girls than for boys. Study Design: Controlled laboratory study. Methods: Male and female soccer and handball players (n = 288; age range, 9-12 years) were recruited. A motion capture system synchronized to a force platform was used to record 5 trials of a cutting maneuver before and after a 5-minute fatigue intervention. Linear mixed models were constructed, and analysis of variance was used to analyze differences in outcomes associated with the sex of the athletes. Results: Boys showed greater peak knee valgus moment (0.26 vs 0.22 N·m/kg, respectively; P = .048), peak knee internal rotation moment (–0.13 vs –0.10 N·m/kg, respectively; P = .021), knee rotation excursion (–7.9° vs –6.9°, respectively; P = .014), and knee extension excursion (2.7° vs 1.4°, respectively; P < .001) compared with that in girls. A significant sex × fatigue intervention interaction ( F = 7.6; P = .006) was found, which was caused by a greater increase in first peak vertical ground-reaction force (vGRF) from before to after the fatigue intervention for girls (15.3 to 16.0 N/kg) compared with boys (16.4 to 16.5 N/kg). Conclusion: Differences detected for biomechanical factors during the cutting maneuver do not point to a greater ACL injury risk for prepubescent or early pubescent girls than for boys. Nonetheless, girls go on to develop more detrimental movement patterns in adolescence than those in boys in terms of biomechanical risk factors. Clinical Relevance: Early adolescence is a good target age to learn and develop muscular control; balance, strength; flexibility; and jumping, running, and landing control. This time of physical and athletic growth may therefore be an appropriate period to influence biomechanical factors and thereby task execution and the injury risk.

Hip Abductor Rate of Torque Development as Opposed to Isometric Strength Predicts Peak Knee Valgus During Landing: Implications for Anterior Cruciate Ligament Injury

2021 ◽  
pp. 1-6
Author(s):  
Kristen M. Stearns-Reider ◽  
Rachel K. Straub ◽  
Christopher M. Powers
Keyword(s):  
Cruciate Ligament ◽  
Muscle Performance ◽  
Ligament Injury ◽  
Knee Valgus ◽  
Rate Of Torque Development ◽  
Peak Knee ◽  
Hip Abductor ◽  
Isometric Torque ◽  
Anterior Cruciate ◽  
Torque Development

Peak knee valgus has been shown to predict anterior cruciate ligament injury. The purpose of the current study was to compare peak rate of torque development (RTD) to peak isometric torque as a predictor of peak knee valgus during landing. Twenty-three healthy females participated. Hip abductor muscle performance was quantified using 2 types of isometric contractions: sustained and rapid. Peak isometric torque was calculated from the sustained isometric contraction. Peak RTD was calculated from the rapid isometric contraction (0–50 and 0–200 ms after force initiation). Kinematic data were collected during the deceleration phase of a double-leg drop jump task. Linear regression was used to assess the ability of hip abductor muscle performance variables to predict peak knee valgus. Increased peak RTD during the 0 to 50 milliseconds window after force initiation was found to significantly predict lower peak knee valgus (P = .011, R2 = .32). In contrast, neither peak RTD from 0 to 200 milliseconds after force initiation window (P = .45, R2 = .03) nor peak isometric torque (P = .49, R2 = .03) predicted peak knee valgus. The inability of the hip abductors to rapidly generate muscular force may be more indicative of “at-risk” movement behavior in females than measures of maximum strength.

Effect of Fatigue on Hip and Knee Joint Biomechanics in Anterior Cruciate Ligament Deficient Patients

2021 ◽  
pp. 1-8
Author(s):  
Komeil Dashti Rostami ◽  
Abbey Thomas
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Peak Knee ◽  
Flexion Moment ◽  
Protective Strategy ◽  
Joint Biomechanics ◽  
Anterior Cruciate ◽  
Anterior Cruciate Ligament Deficient

The influence of fatigue on landing biomechanics in anterior cruciate ligament deficient (ACLD) patients is poorly understood. The purpose of this study was to examine the effect of fatigue on hip and knee joint biomechanics in deficient patients. Twelve ACLD males and 12 healthy control subjects participated in the study. The ACLD patients landed with increased peak knee flexion angle (F = 15.71, p < .01) and decreased peak knee flexion moment (F = 9.13, p < .01) after fatigue. Furthermore, ACLD patients experienced lower vertical ground reaction forces compared with controls regardless of fatigue state (F = 9.75, p < .01). It seems that ACLD patients use protective strategy in response to fatigue in order to prevent further injury in knee point.

scholarly journals Landing Kinematics and Kinetics at the Knee During Different Landing Tasks

2017 ◽  
Vol 52 (12) ◽  
pp. 1101-1108 ◽  
Author(s):  
Nicholas R. Heebner ◽  
Deirdre M. Rafferty ◽  
Meleesa F. Wohleber ◽  
Andrew J. Simonson ◽  
Mita Lovalekar ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Air Force ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Ligament Injuries ◽  
Anterior Cruciate Ligament Injuries ◽  
Drop Landing ◽  
Us Air Force ◽  
Peak Knee ◽  
Anterior Cruciate

Context:  Several tasks have been used to examine landing biomechanics for evaluation and rehabilitation, especially as related to anterior cruciate ligament injuries. However, comparing results among studies in which different tasks were used can be difficult, and it is unclear which task may be most appropriate. Objective:  To compare lower extremity biomechanics across 5 commonly used landing tasks. Design:  Descriptive laboratory study. Setting:  University-operated US Air Force Special Operations Forces human performance research laboratory. Patients or Other Participants:  A total of 65 US Air Force Special Tactics Operators (age = 27.7 ± 5.0 years, height = 176.5 ± 5.7 cm, mass = 83.1 ± 9.1 kg). Intervention(s):  Kinematic and kinetic analysis of double- and single-legged drop landing, double- and single-legged stop jump, and forward jump to single-legged landing. Main Outcome Measure(s):  Hip-, knee-, and ankle-joint kinematics; knee-joint forces and moments; and ground reaction forces (GRFs) were the dependent measures. We used repeated-measures analyses of variance or Friedman tests, as appropriate, to assess within-subject differences across tasks. Results:  Peak vertical GRF and peak knee-flexion angle were different among all tasks (P &lt; .001). Single-legged landings generated higher vertical GRF (χ2 = 244.68, P &lt; .001) and lower peak knee-flexion values (F4,64 = 209.33, P &lt; .001) except for forward jump to single-legged landing, which had the second highest peak vertical GRF and the lowest peak knee-flexion value. The single-legged drop landing generated the highest vertical (χ2 = 244.68, P &lt; .001) and posterior (χ2 = 164.46, P &lt; .001) GRFs. Peak knee-valgus moment was higher during the double-legged drop landing (χ2 = 239.63, P &lt; .001) but similar for all others. Conclusions:  Different landing tasks elicited different biomechanical responses; no single task was best for assessing a wide range of biomechanical variables related to anterior cruciate ligament injuries. Therefore, depending on the goals of the study, using multiple assessment tasks should be considered.

scholarly journals Identification of strength and spatiotemporal gait parameters associated with knee loading during gait in persons after anterior cruciate ligament reconstruction

2021 ◽  
Vol 2021 (preprint) ◽  
pp. 0000-0000
Author(s):  
Mark A. Lyle ◽  
Jake C. Jensen ◽  
Jennifer L. Hunnicutt ◽  
Jonathan J. Brown ◽  
Cynthia P. Chambliss ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Step Width ◽  
Cruciate Ligament Reconstruction ◽  
Knee Extensor Strength ◽  
Gait Parameters ◽  
Peak Knee ◽  
Anterior Cruciate

ABSTRACT Context: Altered knee moments are common during gait in patients following anterior cruciate ligament reconstruction (ACLR). Modifiable factors that influence knee moments and are feasible to record in clinical settings such as strength and spatiotemporal parameters (e.g. step length, step width) have not been identified in persons after ACLR. Objective: The objective was to identify strength and spatiotemporal gait parameters that can predict knee moments in persons after ACLR. Design: Cross-Sectional Study Setting: Laboratory Patients: Twenty-three participants with ACLR (14.4 ± 17.2 months post-ACLR) participated. Main Outcome Measures: Peak knee flexion and adduction moments were measured while walking at self-selected speeds. Spatiotemporal gait parameters were recorded with a pressure walkway, and peak isokinetic knee extensor strength (60°/s) was recorded on a dynamometer. Pearson coefficients were used to examine the association of peak knee moments with strength and gait parameters. Variables correlated with peak knee flexion and adduction moments were entered into a stepwise regression model. Results: Step width and knee extensor strength were the strongest predictors of knee flexion moment accounting for 44% of data variance, whereas stance phase time and step width were the strongest predictors of knee adduction moment explaining 62% of data variance. Conclusions: The spatiotemporal variables that were identified could be clinically feasible targets for biofeedback to improve gait after ACLR.

scholarly journals Altered Knee and Ankle Kinematics During Squatting in Those With Limited Weight-Bearing–Lunge Ankle-Dorsiflexion Range of Motion

2014 ◽  
Vol 49 (6) ◽  
pp. 723-732 ◽  
Author(s):  
Karli E. Dill ◽  
Rebecca L. Begalle ◽  
Barnett S. Frank ◽  
Steven M. Zinder ◽  
Darin A. Padua
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Movement Patterns ◽  
Ligament Injury ◽  
Knee Valgus ◽  
Varus Displacement ◽  
Anterior Cruciate

Context: Ankle-dorsiflexion (DF) range of motion (ROM) may influence movement variables that are known to affect anterior cruciate ligament loading, such as knee valgus and knee flexion. To our knowledge, researchers have not studied individuals with limited or normal ankle DF-ROM to investigate the relationship between those factors and the lower extremity movement patterns associated with anterior cruciate ligament injury. Objective: To determine, using 2 different measurement techniques, whether knee- and ankle-joint kinematics differ between participants with limited and normal ankle DF-ROM. Design: Cross-sectional study. Setting: Sports medicine research laboratory. Patients or Other Participants: Forty physically active adults (20 with limited ankle DF-ROM, 20 with normal ankle DF-ROM). Main Outcome Measure(s): Ankle DF-ROM was assessed using 2 techniques: (1) nonweight-bearing ankle DF-ROM with the knee straight, and (2) weight-bearing lunge (WBL). Knee flexion, knee valgus-varus, knee internal-external rotation, and ankle DF displacements were assessed during the overhead-squat, single-legged squat, and jump-landing tasks. Separate 1-way analyses of variance were performed to determine whether differences in knee- and ankle-joint kinematics existed between the normal and limited groups for each assessment. Results: We observed no differences between the normal and limited groups when classifying groups based on nonweight-bearing passive-ankle DF-ROM. However, individuals with greater ankle DF-ROM during the WBL displayed greater knee-flexion and ankle-DF displacement and peak knee flexion during the overhead-squat and single-legged squat tasks. In addition, those individuals also demonstrated greater knee-varus displacement during the single-legged squat. Conclusions: Greater ankle DF-ROM assessed during the WBL was associated with greater knee-flexion and ankle-DF displacement during both squatting tasks as well as greater knee-varus displacement during the single-legged squat. Assessment of ankle DF-ROM using the WBL provided important insight into compensatory movement patterns during squatting, whereas nonweight-bearing passive ankle DF-ROM did not. Improving ankle DF-ROM during the WBL may be an important intervention for altering high-risk movement patterns commonly associated with noncontact anterior cruciate ligament injury.

scholarly journals Single-Leg Squat After Anterior Cruciate Ligament Reconstruction: An Analysis of the Knee Valgus Angle at 6 and 12 Months

2020 ◽  
Vol 8 (8) ◽  
pp. 232596712094632
Author(s):  
Lachlan M. Batty ◽  
Julian A. Feller ◽  
Iswadi Damasena ◽  
Gerrit Behrens ◽  
Brian M. Devitt ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Effect Size ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Knee Valgus ◽  
Contralateral Limb ◽  
Valgus Angle ◽  
Anterior Cruciate ◽  
Operative Limb

Background: Deficits in neuromuscular control are common after anterior cruciate ligament (ACL) reconstruction and may be associated with further knee injury. The knee valgus angle during a single-leg squat (SLS) is one measure of neuromuscular performance. Purpose: To determine whether the knee valgus angle during SLS changes between 6 and 12 months after ACL reconstruction and to assess how the operative knee valgus angle compares with that of the contralateral side. Study Design: Case series; Level of evidence, 4. Methods: A cohort of 100 patients with uninjured contralateral knees were assessed at 6 and 12 months after primary hamstring autograft ACL reconstruction. Participants performed the SLS on each leg, and the knee valgus angle was measured via frame-by-frame video analysis at 30° of flexion and at each patient’s maximum knee flexion angle. Results: For the operative limb at 30° of flexion, a small but statistically significant reduction was noted in the valgus angle between 6 and 12 months (5.46° vs 4.44°; P = .002; effect size = 0.24). At 6 months, a slightly higher valgus angle was seen in the operative limb compared with the nonoperative limb (5.46° vs 4.29°; P = .008; effect size = 0.27). At maximum flexion, no difference was seen between limbs in the valgus angle at either 6 or 12 months, and no change was seen in the operative limb between 6 and 12 months. At 6 months and 30° of knee flexion, 13 patients had a valgus angle greater than 10°. This group also had a higher mean valgus angle in the contralateral limb compared with the contralateral limb in the other 87 patients (8.5° vs 3.65°; P < .001). Conclusion: During a controlled SLS, the knee valgus angle remained essentially constant, and minimal limb asymmetries were present over the 6- to 12-month postoperative period, a time when athletes typically increase their activity levels. Whether changes or asymmetries will be seen with more dynamically challenging tasks remains to be determined. When present, high valgus angles were commonly bilateral.

scholarly journals The effect of anterolateral ligament integrity on the tibia displacement and reaction forces of anterior cruciate ligament

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0010
Author(s):  
Adem Aydın ◽  
Levent Uğur ◽  
Halil Atmaca
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Internal Rotation ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Anterolateral Ligament ◽  
Knee Flexion Angle ◽  
Anterior Drawer ◽  
Reaction Forces ◽  
Anterior Cruciate

Objective: Recent studies focused on rotational instability and remained positive pivot test in patients with anterior cruciate ligament (ACL) reconstruction. Clinical, radiological and biomechanical studies showed the importance of the anterolateral ligament (ALL) integrity. ALL is one of the stabilization structures against the internal rotation of the tibia under forces which was associated with Segond fracture previously. Even some authors claimed that ACL failure and risk of re-rupture increased if only ACL reconstruction performed in patients with simultaneous ALL injury. The aim of the study is to evaluate the importance of ALL on knee biomechanics during anterior drawer test and internal rotation forces with different flexion angles in terms of reaction forces on ACL and the amount of tibia displacement via finite element analysis. Methods: Three dimensional (3D) solid model of knee joint and ALL injured models were constructed based on DICOM formatted computed tomography (CT) images. 0°, 15°,30°,45°,60°,75° and 90° flexion angles were applied respectively to reference models. Then varied anterior drawer and internal rotational forces were used to investigate the effect of ALL. ANSYS ®Version 17 was used in analyses and same boundary conditions were used in all models. Results: In critical analyzing the all results; medial displacement and the amount of anterior drawer distance were increased in all ALL injured models when compared with references. Therewithal the rotational displacements were increased by increasing the knee flexion angle and rotational torque. But, it was not a significant change in the amount of displacement between the models with respect to anteroposterior displacement when the anterior drawer force was increased. Conclusion: ALL particular has an important role in the stability of the internal rotation occurs against the force and with increased contribution rate to the knee joint stability by increasing the knee flexion angle. But the reaction forces were not affected by ALL integrity. So this study do not support the previous studies which suggest simultaneously reconstruction of both ligaments to avoid re rupture of ACL in cases with ALL injured.

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