Landing Technique Improvements After an Aquatic-Based Neuromuscular Training Program in Physically Active Women

2017 ◽  
Vol 26 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Samantha E. Scarneo ◽  
Hayley J. Root ◽  
Jessica C. Martinez ◽  
Craig Denegar ◽  
Douglas J. Casa ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Injury Risk ◽  
Repeated Measure ◽  
Neuromuscular Training ◽  
Physically Active ◽  
Joint Stress ◽  
Jump Landing ◽  
Movement Screening ◽  
Reaction Forces

Context:Neuromuscular training programs (NTPs) improve landing technique and decrease vertical ground-reaction forces (VGRFs), resulting in injury-risk reduction. NTPs in an aquatic environment may elicit the same improvements as land-based programs with reduced joint stress.Objective:To examine the effects of an aquatic NTP on landing technique as measured by the Landing Error Scoring System (LESS) and VGRFs, immediately and 4 mo after the intervention.Design and Setting:Repeated measures, pool and laboratory.Participants:Fifteen healthy, recreationally active women (age 21 ± 2 y, mass 62.02 ± 8.18 kg, height 164.74 ± 5.97 cm) who demonstrated poor landing technique (LESS-Real Time > 4).Interventions:All participants completed an aquatic NTP 3 times/wk for 6 wk.Main Outcome Measures:Participants’ landing technique was evaluated using a jump-landing task immediately before (PRE), immediately after (POST), and 4 mo after (RET) the intervention period. A single rater, blinded to time point, graded all videos using the LESS, which is a valid and reliable movement-screening tool. Peak VGRFs were measured during the stance phase of the jump-landing test. Repeated-measure analyses of variance with planned comparisons were performed to explore differences between time points.Results:LESS scores were lower at POST (4.46 ± 1.69 errors) and at RET (4.2 ± 1.72 errors) than at PRE (6.30 ± 1.78 errors) (P < .01). No significant differences were observed between POST and RET (P > .05). Participants also landed with significantly lower peak VGRFs (P < .01) from PRE (2.69 ± .72 N) to POST (2.23 ± .66 N).Conclusions:The findings introduce evidence that an aquatic NTP improves landing technique and suggest that improvements are retained over time. These results show promise of using an aquatic NTP when there is a desire to reduce joint loading, such as early stages of rehabilitation, to improve biomechanics and reduce injury risk.

A Treatment-Based Classification Algorithm to Treat Achilles Tendinopathy: An Exploratory Case Series

2017 ◽  
Vol 26 (3) ◽  
pp. 260-268
Author(s):  
Patti Syvertson ◽  
Emily Dietz ◽  
Monica Matocha ◽  
Janet McMurray ◽  
Russell Baker ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Rating Scale ◽  
Case Series ◽  
Numeric Rating Scale ◽  
Achilles Tendinopathy ◽  
Global Rating ◽  
Physically Active ◽  
Indirect Treatment

Context:Achilles tendinopathy is relatively common in both the general and athletic populations. The current gold standard for the treatment of Achilles tendinopathy is eccentric exercise, which can be painful and time consuming. While there is limited research on indirect treatment approaches, it has been proposed that tendinopathy patients do respond to indirect approaches in fewer treatments without provoking pain.Objective:To determine the effectiveness of using a treatment-based-classification (TBC) algorithm as a strategy for classifying and treating patients diagnosed with Achilles tendinopathy.Participants:11 subjects (mean age 28.0 ±15.37 y) diagnosed with Achilles tendinopathy.Design:Case series.Setting:Participants were evaluated, diagnosed, and treated at multiple clinics.Main Outcome Measures:Numeric Rating Scale (NRS), Disablement in the Physically Active Scale (DPA Scale), Victorian Institute of Sport Assessment–Achilles (VISA-A), Global Rating of Change (GRC), and Nirschl Phase Rating Scale were recorded to establish baseline scores and evaluate participant progress.Results:A repeated-measures ANOVA was conducted to analyze NRS scores from initial exam to discharge and at 1-mo follow-up. Paired t tests were analyzed to determine the effectiveness of using a TBC algorithm from initial exam to discharge on the DPA Scale and VISA-A. Descriptive statistics were evaluated to determine outcomes as reported on the GRC.Conclusion:The results of this case series provide evidence that using a TBC algorithm can improve function while decreasing pain and disability in Achilles tendinopathy participants.

Assessment and Training of Visuomotor Reaction Time for Football Injury Prevention

2017 ◽  
Vol 26 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Gary B. Wilkerson ◽  
Kevin A. Simpson ◽  
Ryan A. Clark
Keyword(s):  
Reaction Time ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Injury Risk ◽  
Football Players ◽  
Injury Incidence ◽  
Training Methods ◽  
Characteristic Analysis ◽  
Cut Point ◽  
And Training

Context:Neurocognitive reaction time has been associated with musculoskeletal injury risk, but visuomotor reaction time (VMRT) derived from tests that present greater challenges to visual stimulus detection and motor response execution may have a stronger association.Objective:To assess VMRT as a predictor of injury and the extent to which improvement may result from VMRT training.Design:Cohort study.Setting:University athletic performance center.Participants:76 National Collegiate Athletic Association Division-I FCS football players (19.5 ± 1.4 y, 1.85 ± 0.06 m, 102.98 ± 19.06 kg).Interventions:Preparticipation and postseason assessments. A subset of players who exhibited slowest VMRT in relation to the cohort’s postseason median value participated in a 6-wk training program.Main Outcome Measures:Injury occurrence was related to preparticipation VMRT, which was represented by both number of target hits in 60 s and average elapsed time between hits (ms). Receiver operating characteristic analysis identified the optimum cut point for a binary injury risk classification. A nonparametric repeated-measures analysis of ranks procedure was used to compare posttraining VMRT values for slow players who completed at least half of the training sessions (n = 15) with those for untrained fast players (n = 27).Results:A preparticipation cut point of ≤85 hits (≥705 ms) discriminated injured from noninjured players with odds ratio = 2.30 (90% confidence interval, 1.05–5.06). Slow players who completed the training exhibited significant improvement in visuomotor performance compared with baseline (standardized response mean = 2.53), whereas untrained players exhibited a small performance decrement (group × trial interaction effect, L2 = 28.74; P < .001).Conclusions:Slow VMRT appears to be an important and modifiable injury risk factor for college football players. More research is needed to refine visuomotor reaction-time screening and training methods and to determine the extent to which improved performance values can reduce injury incidence.

Toe-in Landing Increases the Ankle Inversion Angle and Moment During Single-Leg Landing: Implications in the Prevention of Lateral Ankle Sprains

2017 ◽  
Vol 26 (6) ◽  
pp. 530-535 ◽  
Author(s):  
Yuta Koshino ◽  
Tomoya Ishida ◽  
Masanori Yamanaka ◽  
Mina Samukawa ◽  
Takumi Kobayashi ◽  
...  
Keyword(s):  
Angular Velocity ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Transverse Plane ◽  
Ankle Sprains ◽  
Lateral Ankle ◽  
Ankle Inversion ◽  
Reaction Forces ◽  
Vertical Ground Reaction Forces ◽  
Foot Position

Context:Identifying the foot positions that are vulnerable to lateral ankle sprains is important for injury prevention. The effects of foot position in the transverse plane on ankle biomechanics during landing are unknown.Objective:To examine the effects of toe-in or toe-out positioning on ankle inversion motion and moment during single-leg landing.Design:Repeated measures.Setting:Motion analysis laboratory.Participants:18 healthy participants (9 men and 9 women).Interventions:Participants performed single-leg landing trials from a 30-cm high box under 3 conditions: natural landing, foot internally rotated (toe-in), and foot externally rotated (toe-out).Main Outcome Measures:4 toe-in or toe-out angles were calculated against 4 reference coordinates (laboratory, pelvis, thigh, and shank) in the transverse plane. Ankle inversion angle, angular velocity, and external moment in the 200 ms after initial foot-to-ground contact were compared between the 3 landing conditions.Results:All toe-in or toe-out angles other than those calculated against the shank were significantly different between each of the 3 landing conditions (P < .001). Ankle inversion angle, angular velocity, and moment were highest during toe-in landings (P < .01), while eversion angle and moment were highest during toe-out landings (P < .001). The effect sizes of these differences were large. Vertical ground reaction forces were not different between the 3 landing conditions (P = .290).Conclusions:Toe-in or toe-out positioning during single-leg landings impacts on ankle inversion and eversion motion and moment. Athletes could train not to land with the toe-in positioning to prevent lateral ankle sprains.

Temporal Influences of Functional Knee Bracing on Torque Production of the Lower Extremity

2006 ◽  
Vol 15 (3) ◽  
pp. 215-227
Author(s):  
Brian Campbell ◽  
James Yaggie ◽  
Daniel Cipriani
Keyword(s):  
Lower Extremity ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Exercise Intervention ◽  
Three Dimensional ◽  
Exercise Program ◽  
Joint Moments ◽  
Repeated Measures Design ◽  
Reaction Forces ◽  
Vertical Ground Reaction Forces

Context:Functional knee braces (FKB) are used prophylactically and in rehabilitation to aide in the functional stability of the knee.Objective:To determine if alterations in select lower extremity moments persist throughout a one hour period in healthy individuals.Design:2X5 repeated measures design.Setting:Biomechanics Laboratory.Subjects:Twenty subjects (14 male and 6 female, mean age 26.5±7 yrs; height 172.4±13 cm; weight 78.6±9 kg), separated into braced (B) and no brace (NB) groups.Intervention:A one-hour exercise program divided into three 20 minute increments.Main Outcome Measures:Synchronized three-dimensional kinematic and kinetic data were collected at 20-minute increments to assess the effect of the FKB on select lower extremity moments and vertical ground reaction forces.Results:Increase in hip moment and a decrease in knee moment were noted immediately after brace application and appeared to persist throughout a one hour bout of exercise.Conclusions:The FKB and the exercise intervention caused decreases in knee joint moments and increases in hip joint moments.

Difference in Ratio of Evertor to Invertor Activity Between the Dominant and Nondominant Legs During Simulated Lateral Ankle Sprain

2013 ◽  
Vol 22 (4) ◽  
pp. 272-278 ◽  
Author(s):  
Adam C. Knight ◽  
Wendi H. Weimar
Keyword(s):  
Outcome Measures ◽  
Ankle Sprain ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Previous History ◽  
Physically Active ◽  
Lateral Ankle ◽  
History Of ◽  
University Laboratory

Context:The dominant and nondominant legs respond asymmetrically during landing tasks, and this difference may occur during an inversion perturbation and provide insight into the role of ankle-evertor and -invertor muscle activity.Objective:To determine if there is a difference in the ratio of evertor to invertor activity between the dominant and nondominant legs and outer-sole conditions when the ankle is forced into inversion.Design:Repeated-measures single-group design.Setting:University laboratory.Participants:15 physically active healthy volunteers with no previous history of an ankle sprain or lower extremity surgery or fracture.Interventions:An outer sole with fulcrum was used to cause 25° of inversion at the subtalar joint after landing from a 27-cm step-down task. Participants performed 10 fulcrum trials on both the dominant and nondominant leg.Main Outcome Measures:The ratio of evertor to invertor muscle activity 200 ms before and 200 ms after the inversion perturbation was measured using electromyography. This ratio was the dependent variable. Independent variables included outer-sole condition (fulcrum, flat), leg (dominant, nondominant), and time (prelanding, postlanding). The data were analyzed with separate 2-way repeated-measures ANOVA, 1 for the prelanding ratios and 1 for the postlanding ratios.Results:For the postlanding ratios, the fulcrum outer sole had a significantly greater (P < .05) ratio than the flat outer sole, and the nondominant leg had a significantly greater (P < .05) ratio than the dominant leg.Conclusions:These results indicate that a greater evertor response is produced when the ankle is forced into inversion, and a greater response is produced for the nondominant leg, which may function better during a postural-stabilizing task than the dominant leg.

scholarly journals CAN A WEARABLE NEUROMUSCUAR DEVICE REPLACE NEUROMUSCULAR TRAINING PROGRAMS?

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0012
Author(s):  
Sean Higinbotham ◽  
Ryan S. Wexler ◽  
Danny Blake ◽  
Carlie Harrison ◽  
Justin Hollenbeck ◽  
...  
Keyword(s):  
Injury Risk ◽  
Acl Injury ◽  
Young Female ◽  
Risk Scores ◽  
Neuromuscular Training ◽  
Video Cameras ◽  
Jump Landing ◽  
Post Test ◽  
Acl Injury Risk ◽  
Factor Difference

Background: Scientific studies have shown female soccer athletes to be 3 times more likely to injure their anterior cruciate ligament (ACL) than their male counterparts and the majority of these injuries are from a non-contact mechanism. The biomechanical factors of this phenomenon have been extensively studied in a laboratory-based setting, but there has been little progress in reducing the incidence of ACL injury in young female athletes. It is plausible, therefore, to suggest that the biomechanical improvements noted in a laboratory-based setting do not directly translate to a field-based setting. Preventive neuromuscular training programs are typically field-based and have been shown to be an effective intervention for reducing ACL injury risk by improving dynamic, frontal-plane knee stability. However, these programs are time consuming and prone to compliance and implementation issues. For these reasons, researchers have attempted to identify the minimum viable training program or wearable device that can be studied in the field using video cameras to determine their influence on movement-related risk factors for ACL injury. Purpose: The aim of this study was to evaluate the effectiveness of a wearable neuromuscular device (WND) with or without the addition of a field-based, preventive neuromuscular training program on jump-landing risk assessment in young female soccer athletes. Methods: Thirty-nine female soccer players (161.0 +/- 6.6 cm; 49.4 kg +/- 5.9; 13.3 +/- 0.5 y) from two different teams in a local soccer club volunteered to participate in this study. Team 1 (n = 25) performed a 6-week, field-based NMT program while wearing a WND. The NMT was instructed by a trained exercise specialist. The NMT program was divided into three, two-week blocks of progressively increasing levels of exercise complexity and intensity focused on improving the strength and activation behavior of the trunk, hip and thigh muscles. Field-based movement testing was performed in the first week before training began (pre-test) and in the seventh week upon completion of the NMT program (post-test). During testing video cameras recorded a jump-landing task in the frontal and sagittal planes. The Landing Error Scoring System (LESS) and a novel version of the LESS (LESS-RMC) was used to asses movement quality related to ACL injury risk. Team 2 (n=14) wore the WND for an equal amount of athletic exposures over 7 weeks but did not perform the NMT program. Four different raters were recruited to visually score all jump landing trials using the two different rating protocols during the pre-test and post-test. For each visual assessment (LESS & LESS-RMC) a repeated measures ANOVA was conducted to explore within group (test) and between group (team) differences. Results: Repeated measure ANOVA results for the LESS score scale indicated a significant within factor difference in pretest and post test scores F(7.398, 27.533) = 8.598, P < 0.05. Pretest scores for team 1 (6.18 +/- 1.68) and team 2 (6.95 +/- 0.94) both saw a significant reduction in ACL risk scores to 5.44 +/- 1.70 and 6.31 +/- 1.75, respectively. ANOVA results for the LESS-RMC scale also indicated a significant within factor difference in pretest and posttests F(6.756, 35.624) = 6.069, p < 0.05. Pretest scores for Team 1 (6.02 +/- 1.99) and Team 2 (6.49 +/- 1.33) both saw a significant reduction in ACL risk scores to 5.10 +/- 1.77 and 6.09 +/- 1.50, respectively. ANOVA results revealed no significant differences between team scores for the LESS (F(0.031,27.533) = 0.036, p > 0.05) or LESS-RMC (F(1.053,35.624) = .946, p > 0.05) scales. Conclusion: The results reveal that the NMT program utilized in this study had no statistically significant additive effect on the visual risk assessment scores for Team 1 compared to Team 2, who had no NMT intervention and only wore the WND. Collectively, these results suggest that simply wearing a WND during 6 weeks of practice may be a less evasive and cheaper alternative to a NMT program.

Hip- and Thigh-Muscle Activation During the Star Excursion Balance Test

2011 ◽  
Vol 20 (4) ◽  
pp. 428-441 ◽  
Author(s):  
Beth Norris ◽  
Elaine Trudelle-Jackson
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Muscle Activation ◽  
Neuromuscular Control ◽  
Repeated Measure ◽  
Thigh Muscle ◽  
Balance Test ◽  
Retest Reliability ◽  
Star Excursion Balance Test ◽  
Test Retest Reliability

Context:The Star Excursion Balance Test (SEBT) is often used to train and assess dynamic balance and neuromuscular control. Few studies have examined hip- and thigh-muscle activation during the SEBT.Objective:To quantify hip- and thigh-muscle activity during the SEBT.Design:Repeated measures.Setting:Laboratory.Participants:22 healthy individuals, 11 men and 11 women.Methods:EMG measurements were taken as participants completed 3 trials of the anterior (A), medial (M), and posteromedial (PM) reach directions of the SEBT.Main Outcome Measures:Mean EMG data (% maximal voluntary isometric contraction) from the gluteus medius (Gmed), gluteus maximus (Gmax), and vastus medialis (VM) were measured during the eccentric phase of each SEBT reach direction. Test–retest reliability of EMG data across the 3 trials in each direction was calculated. EMG data from each muscle were compared across the 3 reach directions.Results:Test–retest reliability ranged from ICC3,1 values of .91 to .99. A 2-way repeated-measure ANOVA revealed a significant interaction between muscle activation and reach direction. One-way ANOVAs showed no difference in GMed activity between the A and M directions. GMed activity in the A and M directions was greater than in the PM direction. There was no difference in GMax and VM activity across the 3 directions.Conclusion:GMed was recruited most effectively when reaching was performed in the A and M directions. The A, M, and PM directions elicited similar patterns of muscle recruitment for the GMax and VM. During all 3 SEBT directions, VM activation exceeded the 40–60% threshold suggested for strengthening effects. GMed activity also exceeded the threshold in the M direction. GMax activation, however, was below the 40% threshold for all 3 reach directions, suggesting that performing dynamic lower extremity reaching in the A, M, and PM directions may not elicit strengthening effects for the GMax.

Comparison of Hip- and Back-Muscle Activity and Pelvic Compensation in Healthy Subjects During 3 Different Prone Table Hip-Extension Exercises

2017 ◽  
Vol 26 (4) ◽  
pp. 216-222 ◽  
Author(s):  
In-cheol Jeon ◽  
Oh-yun Kwon ◽  
Jong-hyuck Weon ◽  
Ui-jae Hwang ◽  
Sung-hoon Jung
Keyword(s):  
Outcome Measures ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Motion Tracking ◽  
Gluteus Maximus ◽  
Biceps Femoris ◽  
Erector Spinae ◽  
Repeated Measure ◽  
Significant Difference ◽  
Hip Extension

Context:Prone hip extension has been recommended for strengthening the back and hip muscles. Previous studies have investigated prone hip extension conducted with subjects on the floor in the prone position. However, no study has compared 3 different table hip-extension (THE) positions in terms of the activities of the back- and hip-joint muscles with lumbopelvic motion.Objective:To identify more effective exercises for strengthening the gluteus maximus (GM) by comparing 3 different exercises (THE alone, THE with the abdominal drawing-in maneuver [THEA], and THEA with chair support under the knee [THEAC]) based on electromyographic muscle activity and pelvic compensation.Design:Repeated-measure within-subject intervention.Setting:University research laboratory.Participants:16 healthy men.Main Outcome Measures:Surface electromyography (EMG) was used to obtain data on the GM, erector spinae (ES), multifidus, biceps femoris (BF), and semitendinosus (ST). Pelvic compensation was monitored using an electromagnetic motion-tracking device. Exertion during each exercise was recorded. Any significant difference in electromyographic muscle activity and pelvic motion among the 3 conditions (THE vs THEA vs THEAC) was assessed using a 1-way repeated-measures analysis of variance (ANOVA) with Bonferroni post hoc test.Results:The muscle activities recorded by EMG differed significantly among the 3 exercises (P < .01). GM activity was increased significantly during THEAC (P < .01). There was a significant difference in lumbopelvic kinematics in terms of anterior tilting (F = 19.49, P < .01) and rotation (F= 27.38, P < .01) among the 3 exercises.Conclusions:The THEAC exercise was the most effective for strengthening the GM without overactivity of the ES, BF, and ST muscles and lumbopelvic compensation compared with THE and THEA.

Lower-Extremity-Joint Cryotherapy Does Not Affect Vertical Ground-Reaction Forces during Landing

2001 ◽  
Vol 10 (2) ◽  
pp. 132-142 ◽  
Author(s):  
Andrew G Jameson ◽  
Stephen J Kinzey ◽  
Jeffrey S Hallam
Keyword(s):  
Repeated Measures ◽  
Vertical Jump ◽  
Reaction Force ◽  
Vertical Ground Reaction Force ◽  
Physically Active ◽  
Before And After ◽  
Reaction Forces ◽  
Vertical Ground ◽  
Chronic Injuries ◽  
Vertical Ground Reaction Forces

Context:Cryotherapy is commonly used in the care of acute and chronic injuries. It decreases pain, reduces swelling, and causes vasoconstriction of blood vessels. Its detrimental effects on motor activity might predispose physically active individuals to further injury.Objective:To examine the effects of cryotherapy on vertical-ground-reaction-force (VGRF) during a 2-legged landing from a 2-legged targeted vertical jump.Design:2 × 4 MANOVA with repeated measures.Setting:Biomechanics laboratory.Participants:10 men, means: 22.40 ± 1.26 years, 76.01 ± 26.95 kg, 182.88 ± 6.88 cm.Intervention:VGRF during landing from a targeted vertical jump (90% of maximum) was measured before and after four 20-minute cryotherapy treatments.Results:There were no significant differences in VGRF as a result of cryotherapy.Conclusion:Under the constraints of this study there is no evidence that returning to activity immediately after cryotherapy predisposes an athlete to injury because of a change in VGRF.

Difference in Response Latency of the Peroneus Longus Between the Dominant and Nondominant Legs

2011 ◽  
Vol 20 (3) ◽  
pp. 321-332 ◽  
Author(s):  
Adam C. Knight ◽  
Wendi H. Weimar
Keyword(s):  
Outcome Measures ◽  
Ankle Sprain ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Previous History ◽  
Ankle Sprains ◽  
Physically Active ◽  
Lateral Ankle ◽  
Peroneus Longus ◽  
The Moment

Context:The latency of the peroneus longus in response to an inversion perturbation is a key component in the prevention of lateral ankle sprains. In addition, the dominant ankle is sprained more frequently than the nondominant ankle, but the cause of this has not been examined.Objective:To investigate the combination of these 2 research-supported statements, the purpose of this study was to use an inversion perturbation that replicates the mechanism of a lateral ankle sprain to determine whether there is a difference in the latency of the peroneus longus between the dominant and nondominant legs.Design:Repeated-measures single-group design.Setting:University laboratory.Participants:15 physically active healthy volunteers with no previous history of an ankle sprain or lower extremity surgery or fracture.Interventions:Outer sole with fulcrum was used to cause 25° of inversion at the subtalar joint on landing from a 27-cm step-down task. Participants performed 10 trials on both the dominant and nondominant leg.Main Outcome Measures:2 latency measures of the peroneus longus of both the dominant and nondominant leg, calculated as the amount of time from the moment of touchdown of the fulcrum until muscle activity exceeded 5 and 10 SD above baseline muscle activity.Results:The latency of the peroneus longus of the nondominant leg was significantly shorter when using both 5 SD (F1,14 = 9.34, P = .009, d = .895) and 10 SD (F1,14 = 18.56, P = .001, d = .920) above baseline muscle activity.Conclusions:This difference in latency may be a result of the different demands placed on the dominant and nondominant legs during activity and may predispose the dominant ankle to a greater number of ankle sprains than the nondominant ankle.

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