Hip Abductor and Adductor Muscles Activity Patterns During Landing After Anterior Cruciate Ligament Injury

2019 ◽  
Vol 28 (8) ◽  
pp. 871-876 ◽  
Author(s):  
Komeil Dashti Rostami ◽  
Aynollah Naderi ◽  
Abbey Thomas
Keyword(s):  
Anterior Cruciate Ligament ◽  
Athletic Training ◽  
Muscle Activity ◽  
Cruciate Ligament ◽  
Activity Patterns ◽  
Acl Injury ◽  
Initial Contact ◽  
Adductor Muscles ◽  
Anterior Cruciate ◽  
Adductor Longus

Context: Hamstring and quadriceps activity adaptations are well known in individuals with anterior cruciate ligament deficiency (ACLD) and reconstructed (ACLR) to potentially compensate for knee joint instability. However, few studies have explored hip muscles activity patterns after ACL injury. Objective: To examine the activation characteristics of gluteus medius (GMED) and adductor longus in ACLR and ACLD subjects compared with controls. Design: Case–control study. Setting: Athletic training room and university lab. Participants: Twelve healthy and 24 ACL-injured (12 ACLR and 12 ACLD) recreationally active male volunteers. Interventions: Surface electromyography of the GMED and adductor longus were recorded during a single-leg vertical drop landing and normalized to maximum voluntary isometric contractions. Main Outcome Measures: Preparatory and reactive muscle activity and coactivation were analyzed from 100 milliseconds prior to initial contact to 250 milliseconds postcontact. Results: During reactive activity, ACL-injured (ACLR and ACLD) participants demonstrated significantly lower peak GMED activity compared with controls (F = 4.33, P = .02). In addition, ACLR participants exhibited significantly lower reactive GMED:adductor longus coactivation muscle activity compared with controls (F = 4.09, P = .03). Conclusion: Our findings suggest neuromuscular adaptations of the hip musculature are present in people at least 2 years from ACL injury. GMED activation exercises should be considered in designing rehabilitation programs for ACL-injured individuals.

Effects of Anterior Cruciate Ligament (ACL) Injury on Muscle Activity of Head, Neck and Trunk Muscles: A Cross-Sectional Evaluation

CRANIO® ◽  
2007 ◽  
Vol 25 (3) ◽  
pp. 177-185 ◽  
Author(s):  
Simona Tecco ◽  
Vincenzo Salini ◽  
Stefano Teté ◽  
Felice Festa ◽  
Christian Colucci
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Activity ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Trunk Muscles ◽  
Cross Sectional ◽  
Anterior Cruciate ◽  
Head Neck

scholarly journals Hip and Ankle Kinematics in Noncontact Anterior Cruciate Ligament Injury Situations: Video Analysis Using Model-Based Image Matching

2017 ◽  
Vol 46 (2) ◽  
pp. 333-340 ◽  
Author(s):  
Hideyuki Koga ◽  
Atsuo Nakamae ◽  
Yosuke Shima ◽  
Roald Bahr ◽  
Tron Krosshaug
Keyword(s):  
Anterior Cruciate Ligament ◽  
Image Matching ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Heel Strike ◽  
Initial Contact ◽  
Model Based ◽  
Ankle Kinematics ◽  
Anterior Cruciate ◽  
Foot Position

Background: Detailed kinematic descriptions of real anterior cruciate ligament (ACL) injury situations are limited to the knee only. Purpose: To describe hip and ankle kinematics as well as foot position relative to the center of mass (COM) in ACL injury situations through use of a model-based image-matching (MBIM) technique. The distance between the projection of the COM on the ground and the base of support (BOS) (COM_BOS) normalized to the femur length was also evaluated. Study Design: Descriptive laboratory study. Methods: Ten ACL injury video sequences from women’s handball and basketball were analyzed. Hip and ankle joint kinematic values were obtained by use of MBIM. Results: The mean hip flexion angle was 51° (95% CI, 41° to 63°) at initial contact and remained constant over the next 40 milliseconds. The hip was internally rotated 29° (95% CI, 18° to 39°) at initial contact and remained unchanged for the next 40 milliseconds. All of the injured patients landed with a heel strike with a mean dorsiflexion angle of 2° (95% CI, –9° to 14°), before reaching a flatfooted position 20 milliseconds later. The foot position was anterior and lateral to the COM in all cases. However, none of the results showed larger COM_BOS than 1.2, which has been suggested as a criterion for ACL injury risk. Conclusions: Hip kinematic values were consistent among the 10 ACL injury situations analyzed; the hip joint remained unchanged in a flexed and internally rotated position in the phase leading up to injury, suggesting that limited energy absorption took place at the hip. In all cases, the foot contacted the ground with the heel strike. However, relatively small COM_BOS distances were found, indicating that the anterior and lateral foot placement in ACL injury situations was not different from what can be expected in noninjury game situations.

scholarly journals Altered Neuromuscular Activity of the Lower-Extremities During Landing Tasks in Patients With Anterior Cruciate Ligament Reconstruction: A Systematic Review of Electromyographic Studies

2020 ◽  
Vol 29 (8) ◽  
pp. 1194-1203
Author(s):  
Xin He ◽  
Hio Teng Leong ◽  
On Yue Lau ◽  
Michael Tim-Yun Ong ◽  
Patrick Shu-Hang Yung
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Activity ◽  
Activity Pattern ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Activity Patterns ◽  
Contralateral Side ◽  
Cruciate Ligament Reconstruction ◽  
Neuromuscular Activity ◽  
Anterior Cruciate

Context: Altered lower-limb biomechanics have been observed during landing task in patients with anterior cruciate ligament reconstruction (ACLR), which increases the risk of secondary anterior cruciate ligament injury. However, the alteration in neuromuscular activity of the lower-extremity during landing task is not clear. Objective: To compare the muscle activity pattern assessed by electromyography between the involved limb of patients with ACLR and the contralateral limb or control limb of matched healthy subjects during landing task. Evidence Acquisition: Database of PubMed, Ovid, Scopus, and Web of Science from the inception of the databases until July 2019, using a combination of keywords and their variations: (anterior cruciate ligament OR ACL) AND (electromyography OR EMG) AND (landing OR land). Studies that assessed lower-extremity muscle activity patterns during landing task in patients with ACLR and compared them either with the contralateral side or healthy controls were included. Evidence Synthesis: Of the 21 studies, 16 studies reported altered muscle activity pattern during landing tasks when compared with either the healthy controls or the contralateral side. For the specific muscle activity patterns, the majority of the studies showed no significant difference in reactive muscle activity, and comparisons across studies revealed a possible trend toward the early onset of quadriceps and hamstring activity and increased cocontraction of the involved limb. There are inconsistent findings regarding the alteration in muscle timing and preparatory muscle activity. Conclusions: Patients with ACLR displayed an altered muscle activity pattern during landing tasks, even though they were considered to be capable for sport return. Nevertheless, a firm conclusion could not be drawn due to great heterogeneity in the subject selection and study methods.

scholarly journals Rapid Posterior Tibial Reduction After Noncontact Anterior Cruciate Ligament Rupture: Mechanism Description From a Video Analysis

2020 ◽  
Vol 12 (5) ◽  
pp. 462-469 ◽  
Author(s):  
Alberto Grassi ◽  
Filippo Tosarelli ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Video Analysis ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Initial Contact ◽  
Acl Injuries ◽  
Posterior Tibial ◽  
Anterior Cruciate

Background: The mechanisms of noncontact anterior cruciate ligament (ACL) injuries are an enormously debated topic in sports medicine; however, the late phases of injury have not yet been investigated. Hypothesis: A well-defined posterior tibial translation can be visualized with its timing and patterns of knee flexion after ACL injury. Study Design: Case series. Level of Evidence: Level 4. Methods: A total of 137 videos of ACL injuries in professional male football (soccer) players were screened for a sudden posterior tibial reduction (PTR) in the late phase of noncontact ACL injury mechanism. The suitable videos were analyzed using Kinovea software for sport video analysis. The time of initial contact of the foot with the ground, the foot lift, the start of tibial reduction, and the end of tibial reduction were assessed. Results: A total of 21 videos exhibited a clear posterior tibial reduction of 42 ± 11 ms, after an average of 229 ± 81 ms after initial contact. The tibial reduction occurred consistently within the first 50 to 60 ms after foot lift (55 ± 30 ms) and with the knee flexed between 45° and 90° (62%) or more than 90° (24%). Conclusion: A rapid posterior tibial reduction is consistently present in the late phases of noncontact ACL injuries in some male soccer players, with a consistent temporal relationship between foot lift from the ground and consistent degrees of knee flexion near or above 90°. Clinical Relevance: This study provides insight into the late phases of ACL injury. The described mechanism, although purely theoretical, could be responsible for commonly observed intra-articular lesions.

scholarly journals Hamstring Muscle Activity After Primary Anterior Cruciate Ligament Reconstruction—A Protective Mechanism in Those Who Do Not Sustain a Secondary Injury? A Preliminary Study

2019 ◽  
Vol 11 (4) ◽  
pp. 316-323 ◽  
Author(s):  
Riann M. Palmieri-Smith ◽  
Meagan Strickland ◽  
Lindsey K. Lepley
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Activity ◽  
Muscle Activation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Quadriceps Muscle ◽  
Protective Mechanism ◽  
Secondary Injury ◽  
Ground Contact ◽  
Anterior Cruciate

Background:Individuals who experience a subsequent ipsilateral anterior cruciate ligament (ACL) reinjury may use hazardous muscle activation strategies after primary ACL reconstruction (ACLR). The purpose of this study was to compare electromyograms (EMGs) of the quadriceps, hamstrings, and gastrocnemius muscles during a dynamic hopping task among individuals with a single ACL injury (ACLx1), individuals who went on to have secondary ipsilateral ACL injury (ACLx2), and individuals who have never sustained an ACL injury (ACLx0).Hypothesis:We expected that individuals who went on to experience a secondary ACL injury would use less quadriceps muscle activity as compared with individuals who experienced a single ACL injury.Study Design:Cross-sectional study.Level of Evidence:Level 3.Methods:Fourteen individuals that were returned to play post-ACLR and 7 non-ACL-injured individuals participated. Individuals who had undergone an ACLR were placed into groups depending on whether they had experienced a secondary ipsilateral ACL reinjury postprimary ACLR. EMG data of the vastus lateralis, biceps femoris, and lateral gastrocnemius were measured during 2 phases of a single-leg dynamic hopping task: preactivity (100 ms prior to ground contact) and reactivity (250 ms post–ground contact). Processed EMG data were compared across groups using 1-way analyses of variance, with post hoc independent t tests where appropriate ( P ≤ 0.05).Results:At preactivity, ACLx1 (0.48% ± 0.2%max) was found to use significantly more hamstring activity than ACLx2 (0.20% ± 0.1%max, P = 0.018), but not than ACLx0 (0.38% ± 0.1%max, P > 0.05). At reactivity, both ACL groups were found to use less quadriceps activity than ACLx0 (ACLx1: 0.38% ± 0.1%max, P = 0.016; ACLx2: 0.40% ± 0.1%max, P = 0.033; ACLx0: 0.58% ± 0.1%max), but not than each other ( P > 0.05).Conclusion:Quadriceps muscle activity during landing was diminished in all ACL participants as compared with participants who had never sustained an ACL injury. Individuals who did not experience a secondary ipsilateral ACL reinjury (ACLx1) used greater levels of hamstring activity prior to landing.Clinical Relevance:The higher hamstring activity in patients who did not experience a secondary injury may be interpreted as a protective mechanism that is used to dynamically stabilize the reconstructed limb.

Quadriceps Control: A Key Factor in Coping With Anterior Cruciate Ligament Deficiency

2003 ◽  
Author(s):  
Glenn N. Williams ◽  
Peter J. Barrance ◽  
Lynn Snyder-Mackler ◽  
Thomas S. Buchanan
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Activity Patterns ◽  
Neuromuscular Control ◽  
Acl Injury ◽  
The United States ◽  
Circular Statistics ◽  
Return To Sports ◽  
Acl Injuries ◽  
Anterior Cruciate

Approximately 250,000 anterior cruciate ligament (ACL) injuries occur in the United States each year. Most people cannot return to sports after an ACL injury without surgical intervention (Non-copers), but some can (Copers). Recent research suggests that the ability to cope with ACL injury is most likely related to neuromuscular function. The purpose of this study was to evaluate the neuromuscular control strategies of ACL deficient (ACL-D) Non-copers, ACL-D Copers, and people with uninjured knees using an established target-matching protocol, electromyography (EMG) of 10 muscles acting at the knee, and circular statistics methods. Thirty-two people (12 Non-Copers, 8 Copers, and 12 people without a history of knee injury) volunteered to participate in the study. The ACL-D subjects demonstrated diminished neuromuscular control when their muscle activity patterns were compared to those of the uninjured subjects. The key difference between the Copers and Non-copers was that Copers demonstrated better quadriceps control than the Non-copers. This study may have important implications for the treatment of people who sustain ACL injuries.

scholarly journals Electromyographic Assessment of Anterior Cruciate Ligament Injury Risk in Male Tennis Players: Which Role for Visual Input? A Proof-of-Concept Study

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 997
Author(s):  
Alessandro de Sire ◽  
Nicola Marotta ◽  
Andrea Demeco ◽  
Lucrezia Moggio ◽  
Pasquale Paola ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Visual Input ◽  
Proof Of Concept ◽  
Tennis Players ◽  
Concept Study ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury incidence is often underestimated in tennis players, who are considered as subjects conventionally less prone to knee injuries. However, evaluation of the preactivation of knee stabilizer muscles by surface electromyography (sEMG) showed to be a predictive value in the assessment of the risk of ACL injury. Therefore, this proof-of-concept study aimed at evaluating the role of visual input on the thigh muscle preactivation through sEMG to reduce ACL injury risk in tennis players. We recruited male, adult, semiprofessional tennis players from July to August 2020. They were asked to drop with the dominant lower limb from a step, to evaluate—based on dynamic valgus stress—the preactivation time of the rectus femoris (RF), vastus medialis, biceps femoris, and medial hamstrings (MH), through sEMG. To highlight the influence of visual inputs, the athletes performed the test blindfolded and not blindfolded on both clay and grass surfaces. We included 20 semiprofessional male players, with a mean age 20.3 ± 4.8 years; results showed significant early muscle activation when the subject lacked visual input, but also when faced with a less-safe surface such as clay over grass. Considering the posteromedial–anterolateral relationship (MH/RF ratio), tennis players showed a significant higher MH/RF ratio if blindfolded (22.0 vs. 17.0% not blindfolded; p < 0.01) and percentage of falling on clay (17.0% vs. 14.0% in grass; p < 0.01). This proof-of-principle study suggests that in case of absence of visual input or falling on a surface considered unsafe (clay), neuro-activation would tend to protect the anterior stress of the knee. Thus, the sEMG might play a crucial role in planning adequate athletic preparation for semiprofessional male athletes in terms of reduction of ACL injury risk.

scholarly journals Anterior Cruciate Ligament Injury Prevention Exercises: Could a Neuromuscular Warm-Up Improve Muscle Pre-Activation before a Soccer Game? A Proof-of-Principle Study on Professional Football Players

2021 ◽  
Vol 11 (11) ◽  
pp. 4958
Author(s):  
Alessandro de Sire ◽  
Andrea Demeco ◽  
Nicola Marotta ◽  
Lucrezia Moggio ◽  
Arrigo Palumbo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Football Players ◽  
Professional Football ◽  
Activation Time ◽  
Exercise Protocol ◽  
Warm Up ◽  
Anterior Cruciate ◽  
Proof Of Principle

Neuromuscular warm-up has been shown to decrease the risk of anterior cruciate ligament (ACL) injury improving muscular firing patterns. All preventive training programs described in the literature have a duration of several weeks. To date, no studies have explored the immediate effect of a neuromuscular warm-up exercise on pre-activation time of the knee stabilizer muscles. Thus, this proof-of-principle study aimed at evaluating the acute effects of a neuromuscular warm-up exercises on the electromyographic activation of knee stabilizer muscles’ activation pattern. We included 11 professional football players, mean aged 23.2 ± 4.5 years, from a Southern Italy football team. All of them underwent a standard warm-up exercise protocol at the first day of the evaluation. At 1 week, they underwent a structured neuromuscular warm-up exercise protocol. We assessed as outcome measure the pre-activation time (ms) of rectus femoris (RF), vastus medialis (VM), biceps femoris (BF), and medial hamstrings (MH) upon landing. Outcomes were assessed before and after the standard warm-up and neuromuscular warm-up. Pre-activation time of RF, VM, BF and MH significantly improved only after neuromuscular warm-up (p < 0.05); moreover, there was a significant (p < 0.05) between-group difference in pre-activation time of all muscles after the neuromuscular warm-up compared with the standard warm-up. These findings suggested that physical exercise consisting of a structured injury prevention neuromuscular warm-up might have an immediate effect in improving the activation time of the knee stabilizer muscles, thus potentially reducing the risk of ACL injury.

Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears

2021 ◽  
pp. 194173812110295
Author(s):  
Patrick Ward ◽  
Peter Chang ◽  
Logan Radtke ◽  
Robert H. Brophy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Bone Bruises ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are common injuries; they are often associated with concomitant injuries to other structures in the knee, including bone bruises. While there is limited evidence that bone bruises are associated with slightly worse clinical outcomes, the implications of bone bruises for the articular cartilage and the risk of developing osteoarthritis (OA) in the knee are less clear. Recent studies suggest that the bone bruise pattern may be helpful in predicting the presence of meniscal ramp lesions. Evidence Acquisition: A literature review was performed in EMBASE using the keyword search phrase (acl OR (anterior AND cruciate AND ligament)) AND ((bone AND bruise) OR (bone AND contusion) OR (bone AND marrow AND edema) OR (bone AND marrow AND lesion) OR (subchondral AND edema)). Study Design: Clinical review. Level of Evidence: Level 4. Results: The literature search returned 93 articles of which 25 were ultimately included in this review. Most studies identified a high prevalence of bone bruises in the setting of acute ACL injury. Individual studies have found relationships between bone bruise volume and functional outcomes; however, these results were not supported by systematic review. Similarly, the literature has contradictory findings on the relationship between bone bruises and the progression of OA after ACL reconstruction. Investigations into concomitant injury found anterolateral ligament and meniscal ramp lesions to be associated with bone bruise presence on magnetic resonance imaging. Conclusion: Despite the ample literature identifying the prevalence of bone bruises in association with ACL injury, there is little evidence to correlate bone bruises to functional outcomes or progression of OA. Bone bruises may best be used as a marker for concomitant injury such as medial meniscal ramp lesions that are not always well visualized on magnetic resonance imaging. Further research is required to establish the longitudinal effects of bone bruises on ACL tear recovery. Strength of Recommendation Taxonomy: 2.

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