scholarly journals Anterior cruciate ligament injury mechanisms through a neurocognition lens: implications for injury screening

2021 ◽  
Vol 7 (2) ◽  
pp. e001091
Author(s):  
Alli Gokeler ◽  
Anne Benjaminse ◽  
Francesco Della Villa ◽  
Fillippo Tosarelli ◽  
Evert Verhagen ◽  
...  
Keyword(s):  
Injury Risk ◽  
Time Pressure ◽  
Cruciate Ligament ◽  
Team Sports ◽  
Acl Injury ◽  
Ligament Injury ◽  
Attentional Processing ◽  
Prevention Programmes ◽  
Continuous Actions ◽  
Injury Screening

Athletes in team sports have to quickly visually perceive actions of opponents and teammates while executing their own movements. These continuous actions are performed under time pressure and may contribute to a non-contact ACL injury. However, ACL injury screening and prevention programmes are primarily based on standardised movements in a predictable environment. The sports environment provides much greater cognitive demand because athletes must attend their attention to numerous external stimuli and inhibit impulsive actions. Any deficit or delay in attentional processing may contribute to an inability to correct potential errors in complex coordination, resulting in knee positions that increase the ACL injury risk. In this viewpoint, we advocate that ACL injury screening should include the sports specific neurocognitive demands.

Recent Advances in Prevention of Primary and Secondary Anterior Cruciate Ligament Injury: What Does the Future Hold for Optimizing Knee-Joint Function?

2020 ◽  
Vol 9 (1) ◽  
pp. 72-78
Author(s):  
Sandra J. Shultz ◽  
Randy J. Schmitz
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Acl Injury ◽  
Risk Identification ◽  
Ligament Injury ◽  
The Future ◽  
Anterior Cruciate ◽  
Acl Injury Prevention

Despite considerable advances in anterior cruciate ligament (ACL) injury-risk identification and prevention over the past 20 years, the annual incidence of ACL injury has continued to rise, and females remain at greater risk of both primary and secondary ACL injury. Important questions remain regarding ancillary risk factors we should target, the most effective training and rehabilitation approaches to ensure retention and transfer of learned skills from the rehabilitation setting to real-world sporting environment, and the development of more evidence-based criteria for return to sport that consider the whole athlete. As we look to the future, the optimization of primary and secondary ACL-injury prevention represents a complex, multidisciplinary problem with many unique and exciting opportunities to engage the various subdisciplines of kinesiology to address these emerging questions.

scholarly journals The Incidence of Second Anterior Cruciate Ligament Injury in Young Athletes is Not Influenced by Time to Return to Sport

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0018
Author(s):  
Christin M. Zwolski ◽  
Laura C. Schmitt ◽  
Staci Thomas ◽  
Mark V. Paterno
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Acl Injury ◽  
International Knee Documentation Committee ◽  
Ligament Injury ◽  
Young Athletes ◽  
Patient Reported ◽  
Anterior Cruciate

Background: Incidence of second anterior cruciate ligament (ACL) injury among the population of young athletes is reported to be as high as 30%. Time between ACL reconstruction (ACLR) and return to sport (RTS) has been considered as a factor in second injury risk. Hypothesis/Purpose: The purpose of this study was to investigate the effect of time between ACLR and RTS on incidence of 2nd ACL injury. The tested hypothesis was that incidence of 2nd ACL injury among young athletes would not be influenced by time to RTS or patient-reported function following primary ACLR. Methods: 188 participants (mean age=16.8±3.0 years; 124 females) underwent ACLR, completed rehabilitation, and were medically cleared to RTS. Subjects were enrolled in the study within 4 weeks of their medical clearance to RTS. At this time, each subject completed the International Knee Documentation Committee (IKDC) Survey, the Knee injury and Osteoarthritis Outcome Score (KOOS) and was grouped into an early RTS group (<6 months post-operative (PO)) (n=19), an average RTS group (6-9 months PO)(n=106), and a late RTS group (≥9 months PO)(n=63). Subjects were then tracked for 24 months to record the incidence of a second ACL injury to either the involved limb or contralateral limb. One-way ANOVA was used to identify differences in demographics and patient-reported outcomes among the groups. Crude incidence of 2nd ACL injury was identified within each group and chi-squared analyses were used to determine the difference in proportion of 2nd ACL injuries between groups. Results: No significant differences in age (p=0.40), height (p=0.65) or weight (p=0.92) existed among the groups. At time of RTS, no differences between the early RTS, average RTS and late RTS groups were seen in patient-reported function on the IKDC (84.9±10.8, 90.5±9.5, 88.7±10.9; p= 0.08) and all KOOS subscales (p=0.05-0.41). With respect to 2nd ACL injury, there were no group differences (p=0.716) in the proportion of patients within each group who suffered a 2nd ACL injury within 24 months of RTS date (26.3% (5/19) of patients in the early RTS group, 18.9% (20/106) in the average RTS group and 22.2% (14/63) in the late RTS group). Conclusion: In accordance with our hypothesis, length of time between ACLR and RTS had no influence on incidence of second ACL injury among a population of young athletes after ACLR. Furthermore, patient-reported function at time of RTS was similar among groups, regardless of time between ACLR and RTS.

scholarly journals A Machine-Learning Approach to Measure the Anterior Cruciate Ligament Injury Risk in Female Basketball Players

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3141
Author(s):  
Juri Taborri ◽  
Luca Molinaro ◽  
Adriano Santospagnuolo ◽  
Mario Vetrano ◽  
Maria Chiara Vulpiani ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Learning Approach ◽  
Basketball Players ◽  
Machine Learning Approach ◽  
Anterior Cruciate ◽  
Ellipse Area

Anterior cruciate ligament (ACL) injury represents one of the main disorders affecting players, especially in contact sports. Even though several approaches based on artificial intelligence have been developed to allow the quantification of ACL injury risk, their applicability in training sessions compared with the clinical scale is still an open question. We proposed a machine-learning approach to accomplish this purpose. Thirty-nine female basketball players were enrolled in the study. Leg stability, leg mobility and capability to absorb the load after jump were evaluated through inertial sensors and optoelectronic bars. The risk level of athletes was computed by the Landing Error Score System (LESS). A comparative analysis among nine classifiers was performed by assessing the accuracy, F1-score and goodness. Five out nine examined classifiers reached optimum performance, with the linear support vector machine achieving an accuracy and F1-score of 96 and 95%, respectively. The feature importance was computed, allowing us to promote the ellipse area, parameters related to the load absorption and the leg mobility as the most useful features for the prediction of anterior cruciate ligament injury risk. In addition, the ellipse area showed a strong correlation with the LESS score. The results open the possibility to use such a methodology for predicting ACL injury.

scholarly journals Risk of Anterior Cruciate Ligament Injury in Female Soccer Athletes: A Review

2021 ◽  
Vol 2 (1) ◽  
pp. 13-21
Author(s):  
Sophia L. Mancini ◽  
Clark Dickin ◽  
Dorice A. Hankemeier ◽  
Lindsey Rolston ◽  
Henry Wang
Keyword(s):  
Anterior Cruciate Ligament ◽  
High Risk ◽  
Injury Risk ◽  
Muscle Activation ◽  
Cruciate Ligament ◽  
Relevant Literature ◽  
Acl Injury ◽  
Ligament Injury ◽  
Muscle Activation Patterns ◽  
Anterior Cruciate

Soccer is becoming an increasingly popular sport amongst women. Common movements during play, such as jumping and cutting, require rapid acceleration and deceleration of multiple lower-limb joints. The anterior cruciate ligament (ACL), which contributes to stabilization of the knee, is often injured during these events. ACL injury typically requires costly surgery, extended time away from sports, and jeopardizes long-term joint health. Due to sex-specific factors such as menstruation and anatomical disadvantages, women are more susceptible to tearing their ACL. Injury often occurs in non-contact scenarios during rapid acceleration or deceleration movements. Research has examined these movements and established several kinematic and kinetic mechanisms as well as muscle activation patterns that frequently occur at the time of injury, however results tend to vary based on population. This article summarizes recent and relevant literature of ACL injury mechanisms and highlights the lack of specific research in the high-risk female soccer athlete population. Due to inconclusive risk factors, injury prevention programs within this population have been inconsistent. ACL injury risk for female soccer athletes should be closer examined so that more specific injury risks can be established, and effective protective measures can be taken. Raised awareness of this need may capture attention in the research and medical communities and potentially stimulate the development of strategies that limit future ACL injury and thus the challenges it brings to the high-risk female soccer athlete.

scholarly journals Reflecting on side-cutting variability on ACL injury risk: A case study

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Muhammad Hamdan ◽  
Raja Mohammed Firhad Raja Azidin
Keyword(s):  
Injury Risk ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Task Execution ◽  
Soccer Match ◽  
Laboratory Session ◽  
Increased Risk

This case study aims to discuss a proposal for identifying anterior cruciate ligament injury (ACL) risk by observing the variability of side cutting kinematics with respect to the development of fatigue. One participant (n=1) sustained an ACL injury while performing a side-cutting task during the latter stages of a soccer match a few months after a recorded laboratory session. Data from his laboratory session was then compared to matched samples of seventeen healthy, uninjured participants (n=17). The injured participant was found to have performed his side-cutting task with a lower deviation than mean variability right before the later stages of the second half of simulated soccer match-play. Over time, the participant performed side-cutting tasks with increased variability in sagittal plane kinematics, suggesting that compensatory actions may have been implemented to facilitate the task execution. This elevated variability may be indicative of an increased risk of ACL injury. The further prospective investigation is warranted to gain a deeper understanding of how variabilities may play a role in task execution performance with respect to injury mechanisms.

Anterior cruciate ligament injury risk factors in football

2019 ◽  
Vol 59 (10) ◽  
Author(s):  
Gian Nicola Bisciotti ◽  
Karim Chamari ◽  
Emanuele Cena ◽  
Andrea Bisciotti ◽  
Alessandro Bisciotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Injury Risk Factors ◽  
Anterior Cruciate

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.

Diagnostic of Injury Risk in the Anterior Cruciate Ligament Based On Shape Context Description of the Intercondylar Notch Curvature

2021 ◽  
Author(s):  
Joao Paulo Dias ◽  
Ariful Bhuiyan ◽  
Nabila Shamim
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
False Positives ◽  
Intercondylar Notch ◽  
Mr Images ◽  
Shape Context ◽  
Similarity Factor ◽  
Anterior Cruciate

Abstract An estimated number of 300,000 new anterior cruciate ligament (ACL) injuries occur each year in the United States. Although several magnetic resonance (MR) imaging-based ACL diagnostics methods have already been proposed in the literature, most of them are based on machine learning or deep learning strategies, which are computationally expensive. In this paper, we propose a diagnostics framework for the risk of injury in the anterior cruciate ligament (ACL) based on the application of the inner-distance shape context (IDSC) to describe the curvature of the intercondylar notch from MR images. First, the contours of the intercondylar notch curvature from 91 MR images of the distal end of the femur (70 healthy and 21 with confirmed ACL injury) were extracted manually using standard image processing tools. Next, the IDSC was applied to calculate the similarity factor between the extracted contours and reference standard curvatures. Finally, probability density functions of the similarity factor data were obtained through parametric statistical inference, and the accuracy of the ACL injury risk diagnostics framework was assessed using receiver operating characteristic analysis (ROC). The overall results for the area under the curve (AUC) showed that method reached a maximum accuracy of about 66%. Furthermore, the sensitivity and specificity results showed that an optimum discrimination threshold value for the similarity factor can be pursued that minimizes the incidence of false positives and false positives simultaneously.

Examining the Dynamic Nature of Anterior Cruciate Ligament Injury Risk Factors in Women’s Collegiate Soccer

2021 ◽  
pp. 1-8
Author(s):  
Elena M. D’Argenio ◽  
Timothy G. Eckard ◽  
Barnett S. Frank ◽  
William E. Prentice ◽  
Darin A. Padua
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Range Of Motion ◽  
Injury Risk ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Dynamic Risk Factors ◽  
Dynamic Risk ◽  
Anterior Cruciate

Context: Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women’s soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. Design: Prospective cohort study. Methods: Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women’s soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10 weeks of a competitive soccer season. Results: Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. Conclusions: Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women’s collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.

scholarly journals No Association Between Risk of Anterior Cruciate Ligament Rupture and Selected Candidate Collagen Gene Variants in Female Elite Athletes From High-Risk Team Sports

2018 ◽  
Vol 47 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Einar Andreas Sivertsen ◽  
Kari Bente Foss Haug ◽  
Eirik Klami Kristianslund ◽  
Anne-Marie Siebke Trøseid ◽  
Jari Parkkari ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
High Risk ◽  
Elite Athletes ◽  
Cruciate Ligament ◽  
Team Sports ◽  
Acl Injury ◽  
Acl Rupture ◽  
Acl Injuries ◽  
Genes Encoding ◽  
Anterior Cruciate

Background: Several single-nucleotide variants (SNVs) in collagen genes have been reported as predisposing factors for anterior cruciate ligament (ACL) tears. However, the evidence is conflicting and does not support a clear association between genetic variants and risk of ACL ruptures. Purpose: To assess the association of previously identified candidate SNVs in genes encoding for collagen and the risk of ACL injury in a population of elite female athletes from high-risk team sports. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 851 female Norwegian and Finnish elite athletes from team sports were included from 2007 to 2011. ACL injuries acquired before inclusion in the cohort were registered by interview. The participants were followed prospectively through 2015 to record new complete ACL injuries. Six selected SNVs were genotyped ( COL1A1: rs1800012, rs1107946; COL3A1: rs1800255; COL5A1: rs12722, rs13946; COL12A1: rs970547). Results: No associations were found between ACL rupture and the SNVs tested. Conclusion: The study does not support a role of the 6 selected SNVs in genes encoding for collagen proteins as risk factors for ACL injury. Clinical Relevance: Genetic profiling to identify athletes at high risk for ACL rupture is not yet feasible.

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