Reliability of Using a Handheld Tablet and Application to Measure Lower-Extremity Alignment Angles

2015 ◽  
Vol 24 (4) ◽  
Author(s):  
Deborah L. King ◽  
Barbara C. Belyea
Keyword(s):  
At Risk ◽  
Lower Extremity ◽  
Knee Flexion ◽  
Interrater Reliability ◽  
Knee Injury ◽  
Vertical Jump ◽  
Frontal Plane ◽  
Initial Contact ◽  
Experience Level ◽  
Lower Extremity Injuries

Context: Landing kinematics have been identified as a risk factor for knee injury. Detecting atypical kinematics in clinical settings is important for identifying individuals at risk for these injuries. Objective: To determine the reliability of a handheld tablet and application (app) for measuring lower-extremity kinematics during drop vertical-jump landings. Design: Measurement reliability. Setting: Laboratory. Participants: 23 healthy young adults with no lower-extremity injuries and no contraindications for jumping and landing. Intervention: Subjects performed 6 drop vertical jumps that were captured with an iPad2 and analyzed with a KinesioCapture app by 2 novice and 2 experienced raters. Three trials each were captured in the frontal and sagittal planes. Main Outcome Measures: Frontal-plane projection angles, knee flexion, and hip flexion at initial contact and maximum knee flexion were measured. ICC and SEM were calculated to determine intertrial and interrater reliability. One-way ANOVAs were used to examine differences between the measured angles of the raters. Results: Average intertrial reliability ranged from .71 to .98 for novice raters and .77 to .99 for experienced raters. SEMs were 2.3-4.3° for novice raters and 1.6-3.9° for experienced raters. Interrater ICC2,1 was .39-.98 for the novice raters and .69-.93 for the experienced raters. SEMs were smallest with the experienced raters, all less than 1.5°. Conclusion: A handheld tablet and app is promising for evaluating landing kinematics and identifying individuals at risk for knee injury in a clinical setting. Intertrial reliability is good to excellent when using average trial measures. Interrater reliability is fair to excellent depending on experience level. Multiple trials should be assessed by a single rater when assessing lower-extremity mechanics with a handheld tablet and app, and results may vary with experience level or training.

scholarly journals Sex and Limb Differences in Lower Extremity Alignment and Kinematics during Drop Vertical Jumps

2021 ◽  
Vol 18 (7) ◽  
pp. 3748
Author(s):  
Youngmin Chun ◽  
Joshua P. Bailey ◽  
Jinah Kim ◽  
Sung-Cheol Lee ◽  
Sae Yong Lee
Keyword(s):  
Lower Extremity ◽  
Internal Rotation ◽  
Knee Flexion ◽  
Mixed Model ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Vertical Jump ◽  
Initial Contact ◽  
Knee Abduction ◽  
Drop Vertical Jump

Sex and limb differences in lower extremity alignments (LEAs) and dynamic lower extremity kinematics (LEKs) during a drop vertical jump were investigated in participants of Korean ethnicity. One hundred healthy males and females participated in a drop vertical jump, and LEAs and LEKs were determined in dominant and non-dominant limbs. A 2-by-2 mixed model MANOVA was performed to compare LEAs and joint kinematics between sexes and limbs (dominant vs. non-dominant). Compared with males, females possessed a significantly greater pelvic tilt, femoral anteversion, Q-angle, and reduced tibial torsion. Females landed on the ground with significantly increased knee extension and ankle plantarflexion with reduced hip abduction and knee adduction, relatively decreased peak hip adduction, knee internal rotation, and increased knee abduction and ankle eversion. The non-dominant limb showed significantly increased hip flexion, abduction, and external rotation; knee flexion and internal rotation; and ankle inversion at initial contact. Further, the non-dominant limb showed increased peak hip and knee flexion, relatively reduced peak hip adduction, and increased knee abduction and internal rotation. It could be suggested that LEAs and LEKs observed in females and non-dominant limbs might contribute to a greater risk of anterior cruciate ligament injuries.

scholarly journals Reliability of the Landing Error Scoring System-Real Time, a Clinical Assessment Tool of Jump-Landing Biomechanics

2011 ◽  
Vol 20 (2) ◽  
pp. 145-156 ◽  
Author(s):  
Darin A. Padua ◽  
Michelle C. Boling ◽  
Lindsay J. DiStefano ◽  
James A. Onate ◽  
Anthony I. Beutler ◽  
...  
Keyword(s):  
At Risk ◽  
Lower Extremity ◽  
Real Time ◽  
Clinical Assessment ◽  
Scoring System ◽  
Interrater Reliability ◽  
Assessment Tool ◽  
Lower Extremity Injuries ◽  
Jump Landing ◽  
Extremity Injuries

Context:There is a need for reliable clinical assessment tools that can be used to identify individuals who may be at risk for injury. The Landing Error Scoring System (LESS) is a reliable and valid clinical assessment tool that was developed to identify individuals at risk for lower extremity injuries. One limitation of this tool is that it cannot be assessed in real time and requires the use of video cameras.Objective:To determine the interrater reliability of a real-time version of the LESS, the LESS-RT.Design:Reliability study.Setting:Controlled research laboratory.Participants:43 healthy volunteers (24 women, 19 men) between the ages of 18 and 23.Intervention:The LESS-RT evaluates 10 jump-landing characteristics that may predispose an individual to lower extremity injuries. Two sets of raters used the LESS-RT to evaluate participants as they performed 4 trials of a jump-landing task.Main Outcome Measures:Intraclass correlation coefficient (ICC2,1) values for the final composite score of the LESS-RT were calculated to assess interrater reliability of the LESS-RT.Results:Interrater reliability (ICC2,1) for the LESS-RT ranged from .72 to .81 with standard error of measurements ranging from .69 to .79.Conclusions:The LESS-RT is a quick, easy, and reliable clinical assessment tool that may be used by clinicians to identify individuals who may be at risk for lower extremity injuries.

scholarly journals Lower Extremity Fatigue, Sex, and Landing Performance in a Population With Recurrent Low Back Pain

2015 ◽  
Vol 50 (4) ◽  
pp. 378-384 ◽  
Author(s):  
Ram Haddas ◽  
C. Roger James ◽  
Troy L. Hooper
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lower Extremity ◽  
Ground Reaction Force ◽  
Knee Flexion ◽  
Reaction Force ◽  
Initial Contact ◽  
Low Back ◽  
Lower Extremity Injuries ◽  
Extremity Injuries

Context Low back pain and lower extremity injuries affect athletes of all ages. Previous authors have linked a history of low back pain with lower extremity injuries. Fatigue is a risk factor for lower extremity injuries, some of which are known to affect female athletes more often than their male counterparts. Objective To determine the effects of lower extremity fatigue and sex on knee mechanics, neuromuscular control, and ground reaction force during landing in people with recurrent low back pain (LBP). Design Cross-sectional study. Setting A clinical biomechanics laboratory. Patients or Other Participants Thirty-three young adults with recurrent LBP but without current symptoms. Intervention(s) Fatigue was induced using a submaximal free-weight squat protocol with 15% body weight until task failure was achieved. Main Outcome Measure(s) Three-dimensional knee motion, knee and ankle moments, ground reaction force, and trunk and lower extremity muscle-activity measurements were collected during 0.30-m drop vertical-jump landings. Results Fatigue altered landing mechanics, with differences in landing performance between sexes. Women tended to have greater knee-flexion angle at initial contact, greater maximum knee internal-rotation angle, greater maximum knee-flexion moment, smaller knee-adduction moment, smaller ankle-inversion moment, smaller ground reaction force impact, and earlier multifidus activation. In men and women, fatigue produced a smaller knee-abduction angle at initial contact, greater maximum knee-flexion moment, and delays in semitendinosus, multifidus, gluteus maximus, and rectus femoris activation. Conclusions Our results provide evidence that during a fatigued 0.30-m landing sequence, women who suffered from recurrent LBP landed differently than did men with recurrent LBP, which may increase women's exposure to biomechanical factors that can contribute to lower extremity injury.

scholarly journals Relationship Between 2-Dimensional Frontal Plane Measures and the Knee Abduction Angle During the Drop Vertical Jump

2019 ◽  
Vol 28 (4) ◽  
Author(s):  
Brad W. Willis ◽  
Katie Hocker ◽  
Swithin Razu ◽  
Aaron D. Gray ◽  
Marjorie Skubic ◽  
...  
Keyword(s):  
Motion Capture ◽  
Vertical Jump ◽  
Frontal Plane ◽  
Ligament Injury ◽  
Coefficient Of Determination ◽  
Abduction Angle ◽  
Initial Contact ◽  
Knee Abduction ◽  
The Relationship ◽  
Drop Vertical Jump

Context: Knee abduction angle (KAA), as measured by 3-dimensional marker-based motion capture systems during jump-landing tasks, has been correlated with an elevated risk of anterior cruciate ligament injury in females. Due to the high cost and inefficiency of KAA measurement with marker-based motion capture, surrogate 2-dimensional frontal plane measures have gained attention for injury risk screening. The knee-to-ankle separation ratio (KASR) and medial knee position (MKP) have been suggested as potential frontal plane surrogate measures to the KAA, but investigations into their relationship to the KAA during a bilateral drop vertical jump task are limited. Objective: To investigate the relationship between KASR and MKP to the KAA during initial contact of the bilateral drop vertical jump. Design: Descriptive. Setting: Biomechanics laboratory. Participants: A total of 18 healthy female participants (mean age: 24.1 [3.88] y, mass: 65.18 [10.34] kg, and height: 1.63 [0.06] m). Intervention: Participants completed 5 successful drop vertical jump trials measured by a Vicon marker-based motion capture system and 2 AMTI force plates. Main Outcome Measure: For each jump, KAA of the tibia relative to the femur was measured at initial contact along with the KASR and MKP calculated from planar joint center data. The coefficient of determination (r2) was used to examine the relationship between the KASR and MKP to KAA. Results: A strong linear relationship was observed between MKP and KAA (r2 = .71), as well as between KASR and KAA (r2 = .72). Conclusions: Two-dimensional frontal plane measures show strong relationships to the KAA during the bilateral drop vertical jump.

scholarly journals Lower Extremity Biomechanics During a Drop-Vertical Jump and Muscle Strength in Women With Patellofemoral Pain

2020 ◽  
Vol 55 (6) ◽  
pp. 615-622
Author(s):  
Andrea Baellow ◽  
Neal R. Glaviano ◽  
Jay Hertel ◽  
Susan A. Saliba
Keyword(s):  
Lower Extremity ◽  
Knee Flexion ◽  
Vertical Jump ◽  
Gluteus Maximus ◽  
Biceps Femoris ◽  
Trunk Flexion ◽  
Healthy Group ◽  
Lower Extremity Biomechanics ◽  
Hip Internal Rotation ◽  
Kinematics And Kinetics

Context Patellofemoral pain (PFP) is one of the most prevalent knee conditions observed in women. Current research suggests that individuals with PFP have altered muscle activity, kinematics, and kinetics during functional tasks. However, few authors have examined differences in lower extremity biomechanics in this population during the drop-vertical jump (DVJ). Objective To determine how lower extremity electromyography, kinematics, and kinetics during a DVJ and lower extremity isometric strength differed between women with and those without PFP. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants Fifteen healthy women (age = 20.23 ± 1.39 years, height = 169.32 ± 5.38 cm, mass = 67.73 ± 9.57 kg) and 15 women with PFP (age = 22.33 ± 3.49 years, height = 166.42 ± 6.01 cm, mass = 65.67 ± 13.75 kg). Intervention(s) Three trials of a DVJ. Main Outcome Measure(s) Surface electromyography, kinematics, and kinetics were collected simultaneously during a DVJ. Lower extremity strength was measured isometrically. Independent-samples t tests were performed to assess group differences. Results Normalized muscle activity in the vastus medialis (healthy group = 120.84 ± 80.73, PFP group = 235.84 ± 152.29), gluteus maximus (healthy group = 43.81 ± 65.63, PFP group = 13.37 ± 13.55), and biceps femoris (healthy group = 36.68 ± 62.71, PFP group = 11.04 ± 8.9) during the landing phase of the DVJ differed between groups. Compared with healthy women, those with PFP completed the DVJ with greater hip internal-rotation moment (0.04 ± 0.28 N/kg versus 0.06 ± 0.14 N/kg, respectively) and had decreased knee-flexion excursion (76.76° ± 7.50° versus PFP = 74.14° ± 19.85°, respectively); they took less time to reach peak trunk flexion (0.19 ± 0.01 seconds versus 0.19 ± 0.02 seconds, respectively) and lateral trunk flexion (0.12 ± 0.07 seconds versus 0.11 ± 0.04 seconds, respectively). Conclusions During the DVJ, women with PFP had increased hip internal-rotation moment and decreased knee-flexion excursion with less time to peak trunk flexion and lateral flexion. Muscle activation was increased in the vastus medialis but decreased in the gluteus maximus and biceps femoris. This suggests that altered motor-unit recruitment in the hip and thigh may result in changes in biomechanics during a DVJ that are often associated with an increased risk of injury.

scholarly journals Youth Baseball Pitching Stride Length: Normal Values and Correlation With Field Testing

2016 ◽  
Vol 9 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Karl E. Fry ◽  
Andrew Pipkin ◽  
Kelcie Wittman ◽  
Scott Hetzel ◽  
Marc Sherry
Keyword(s):  
Lower Extremity ◽  
Injury Prevention ◽  
Interrater Reliability ◽  
Stride Length ◽  
Normal Values ◽  
Vertical Jump ◽  
Leg Length ◽  
Positive Correlation ◽  
Significant Difference ◽  
Youth Baseball

Background: Pitching biomechanical analysis has been recommended as an important component of performance, injury prevention, and rehabilitation. Normal values for youth pitching stride length have not been established, leading to application of normative values found among professional pitchers to youth pitchers. Hypotheses: The average youth pitching stride length will be significantly less than that of college and professional pitchers. There will be a positive correlation between stride length, lower extremity power, balance, and pitching experience. Study Design: Prospective cohort study. Level of Evidence: Level 3. Methods: Ninety-two youth baseball pitchers (aged 9-14 years) met the inclusion/exclusion criteria and completed the study. Stride length was recorded using a Dartfish video system over 3 maximal effort pitches. Both intra- and interrater reliability was calculated for the assessment of stride length. Double-leg vertical jump, single-leg stance time, leg length, weight, age, and pitching experience were also recorded. Results: Mean (SD) stride length was 66.0% (7.1%) of height. Stride length was correlated ( P < 0.01) with vertical jump (0.38), pitching experience (0.36), and single-leg balance (0.28), with excellent intra- and interrater reliability (0.985 or higher). No significant correlations between stride length and body weight, leg length, or age existed. Conclusions: There was a significant difference between youth pitching stride length and the current published norms for older and more elite throwers. There was a positive correlation between stride length and lower extremity power, pitching experience, and single-leg balance. Clinical Relevance: Two-dimensional analysis of stride length allows for the assessment of pitching biomechanics in a practical manner. These values can be used for return to pitching parameters after an injury and designing injury prevention and performance programs.

scholarly journals Changes in Lower Extremity Biomechanics Due to a Short-Term Fatigue Protocol

2013 ◽  
Vol 48 (3) ◽  
pp. 306-313 ◽  
Author(s):  
Nelson Cortes ◽  
Eric Greska ◽  
Roger Kollock ◽  
Jatin Ambegaonkar ◽  
James A. Onate
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Initial Contact ◽  
Fatigue Protocol ◽  
Lower Extremity Biomechanics ◽  
Anterior Cruciate ◽  
Hip Flexion

Context: Noncontact anterior cruciate ligament injury has been reported to occur during the later stages of a game when fatigue is most likely present. Few researchers have focused on progressive changes in lower extremity biomechanics that occur throughout fatiguing. Objective: To evaluate the effects of a sequential fatigue protocol on lower extremity biomechanics during a sidestep-cutting task (SS). Design: Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: Eighteen uninjured female collegiate soccer players (age = 19.2 ± 0.9 years, height = 1.66 ± 0.5 m, mass = 61.6 ± 5.1 kg) volunteered. Intervention(s): The independent variable was fatigue level, with 3 levels (prefatigue, 50% fatigue, and 100% fatigue). Using 3-dimensional motion capture, we assessed lower extremity biomechanics during the SS. Participants alternated between a fatigue protocol that solicited different muscle groups and mimicked actual sport situations and unanticipated SS trials. The process was repeated until fatigue was attained. Main Outcome Measure(s): Dependent variables were hip- and knee-flexion and abduction angles and internal moments measured at initial contact and peak stance and defined as measures obtained between 0% and 50% of stance phase. Results: Knee-flexion angle decreased from prefatigue (−17° ± 5°) to 50% fatigue (−16° ± 6°) and to 100% fatigue (−14° ± 4°) (F2,34 = 5.112, P = .004). Knee flexion at peak stance increased from prefatigue (−52.9° ± 5.6°) to 50% fatigue (−56.1° ± 7.2°) but decreased from 50% to 100% fatigue (−50.5° ± 7.1°) (F2,34 = 8.282, P = 001). Knee-adduction moment at peak stance increased from prefatigue (0.49 ± 0.23 Nm/kgm) to 50% fatigue (0.55 ± 0.25 Nm/kgm) but decreased from 50% to 100% fatigue (0.37 ± 0.24) (F2,34 = 3.755, P = 03). Hip-flexion angle increased from prefatigue (45.4° ± 10.9°) to 50% fatigue (46.2° ± 11.2°) but decreased from 50% to 100% fatigue (40.9° ± 11.3°) (F2,34 = 6.542, P = .004). Hip flexion at peak stance increased from prefatigue (49.8° ± 9.9°) to 50% fatigue (52.9° ± 12.1°) but decreased from 50% to 100% fatigue (46.3° ± 12.9°) (F2,34 = 8.639, P = 001). Hip-abduction angle at initial contact decreased from prefatigue (−13.8° ± 6.6°) to 50% fatigue (−9.1° ± 6.5°) and to 100% fatigue (−7.8° ± 6.5°) (F2,34 = 11.228, P &lt; .001). Hip-adduction moment decreased from prefatigue (0.14 ± 0.13 Nm/kgm) to 50% fatigue (0.08 ± 0.13 Nm/kgm) and to 100% fatigue (0.06 ± 0.05 Nm/kg) (F2,34 = 5.767, P = .007). Conclusions: The detrimental effects of fatigue on sagittal and frontal mechanics of the hip and knee were visible at 50% of the participants' maximal fatigue and became more marked at 100% fatigue. Anterior cruciate ligament injury-prevention programs should emphasize feedback on proper mechanics throughout an entire practice and not only at the beginning of practice.

Gender and Foot Orthotic Device Effect on Frontal Plane Hip Motion During Landing From a Vertical Jump

2011 ◽  
Vol 27 (2) ◽  
pp. 130-136 ◽  
Author(s):  
Walter L. Jenkins ◽  
D.S. Williams ◽  
Brandon Bevil ◽  
Sara Stanley ◽  
Michael Blemker ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Vertical Jump ◽  
Three Dimensional ◽  
Frontal Plane ◽  
Foot Orthoses ◽  
Functional Activities ◽  
Hip Motion ◽  
Hip Kinematics ◽  
Biomechanical Effect ◽  
Foot Orthotic

Excessive hip motion has been linked to lower extremity pathology. Foot orthoses are commonly used to control motion within lower extremity joints when lower extremity pathology and dysfunction are present. Few studies have investigated the effect of foot orthoses on hip angular kinematics during functional activities. Eighteen females and 18 males performed a vertical jump with and without a prefabricated foot orthoses to determine the biomechanical effect of foot orthoses on hip kinematics when landing from a jump. Data collection included three-dimensional motion analysis of the lower extremity. Pairedttests were performed to determine if differences existed within genders with and without foot orthoses. At the hip joint, there was significantly less hip adduction motion in the foot orthoses condition as compared with the no foot orthoses condition in females (p< .05). There were no differences between foot orthoses conditions in males. Females appear to have a different proximal response to foot orthoses when landing from a forward jump than males.

scholarly journals Expert Versus Novice Interrater Reliability and Criterion Validity of the Landing Error Scoring System

2010 ◽  
Vol 19 (1) ◽  
pp. 41-56 ◽  
Author(s):  
James Onate ◽  
Nelson Cortes ◽  
Cailee Welch ◽  
Bonnie Van Lunen
Keyword(s):  
Range Of Motion ◽  
Scoring System ◽  
Knee Flexion ◽  
Interrater Reliability ◽  
Assessment Tool ◽  
Outcome Measurement ◽  
Acl Injury ◽  
Initial Contact ◽  
Knee Valgus ◽  
Trunk Flexion

Context:A clinical assessment tool that would allow for efficient large-group screening is needed to identify individuals potentially at risk for anterior cruciate ligament (ACL) injury.Objective:To assess the criterion validity of a jumplanding assessment tool compared with 3-dimensional (3D) motion analysis and evaluate interrater reliability across an expert vs novice rater using the Landing Error Scoring System (LESS).Design:Validity protocol.Setting:Controlled, laboratory.Participants:Nineteen female (age 19.58 ± .84 y, height 1.67 ± .05 m, mass 63.66 ± 10.11 kg) college soccer athletes volunteered.Main Outcome Measurement:Interrater reliability between expert rater (5 y LESS experience) vs novice rater (no LESS experience). LESS scores across 13 items and total score. 3D lower extremity kinematics were reduced to dichotomous values to match LESS items.Interventions:Participants performed drop-box landings from a 30-cm height with standard video-camera and 3D kinematic assessment.Results:Intrarater item reliability, assessed by kappa correlation, between novice and experienced LESS raters ranged from moderate to excellent (κ = .459–.875). Overall LESS score, assessed by intraclass correlation coefficient, was excellent (ICC2,1 = .835, P < .001). Statistically significant phi correlation (P < .05) was found between rater and 3D scores for knee-valgus range of motion; however, percent agreement between expert rater and 3D scores revealed excellent agreement (range of 84–100%) for ankle flexion at initial contact, knee-flexion range of motion, trunk flexion at maximum knee flexion, and foot position at initial contact for both external and internal rotation of tibia. Moderate agreement was found between rater and 3D scores for trunk flexion at initial contact, stance width less than shoulder width, knee valgus at initial contact, and knee-valgus range of motion.Conclusions:Our findings support moderate to excellent validity and excellent expert vs novice interrater reliability of the LESS to accurately assess 3D kinematic motion patterns. Future research should evaluate the efficacy of the LESS to assess individuals at risk for ACL injury.

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