scholarly journals The Influence of Asymptomatic Hypermobility on Unanticipated Cutting Biomechanics

2021 ◽  
pp. 194173812199906
Author(s):  
Ivana Hanzlíková ◽  
Jim Richards ◽  
Josie Athens ◽  
Kim Hébert-Losier
Keyword(s):  
Injury Risk ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Joint Hypermobility ◽  
Mean Difference ◽  
Initial Contact ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Acl Injuries ◽  
Peak Knee

Background: Generalized joint hypermobility is an important risk factor for knee injuries, including to the anterior cruciate ligament (ACL). Examining movement patterns specific to hypermobile individuals during sport-specific movements could facilitate development of targeted recommendations and injury prevention programs for this population. Hypothesis: Asymptomatic hypermobile participants will present kinematics measures suggestive of a greater risk of noncontact knee or ACL injuries. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Forty-two (15 asymptomatic hypermobile and 27 nonhypermobile) individuals performed unanticipated side-step cutting on their dominant and nondominant legs. Ankle, knee, hip, pelvis, and trunk angles in all planes of motion were collected during the first 100 ms after initial contact using a 3-dimensional infrared system. Precontact foot-ground angles were also extracted. Data from hypermobile and nonhypermobile groups were compared using multiple regression models with sex as a confounder. When nonsignificant, the confounder was removed from the model. Effect sizes (Hedge g) were calculated in the presence of significant between-group differences. Results: Hypermobile individuals presented with lower minimum knee valgus angles with a mean difference of 3.5° ( P = 0.03, Hedge g = 0.69) and greater peak knee external rotation angles with a mean difference of −4.5° ( P = 0.04, Hedge g = 0.70) during dominant leg cutting, and lower peak ankle plantarflexion angles with a mean difference of 4.5° ( P = 0.03, Hedge g = 0.73) during nondominant leg cutting compared with nonhypermobile individuals. Conclusions: Based on current scientific evidence, however, the identified differences are not crucial biomechanical injury risk factors that could predispose asymptomatic hypermobile individuals to noncontact knee or ACL injuries. Clinical Relevance: Further research is needed to highlight differences between hypermobility groups. Knowledge of the differences between these groups may change the physical activity recommendations, prevention of injury, and rehabilitation approaches.

scholarly journals Association of Quadriceps and Hamstrings Cocontraction Patterns With Knee Joint Loading

2009 ◽  
Vol 44 (3) ◽  
pp. 256-263 ◽  
Author(s):  
Riann M. Palmieri-Smith ◽  
Scott G. McLean ◽  
James A. Ashton-Miller ◽  
Edward M. Wojtys
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Female Athletes ◽  
Vastus Lateralis ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peak Knee ◽  
Knee Abduction

Abstract Context: Sex differences in neuromuscular control of the lower extremity have been identified as a potential cause for the greater incidence of anterior cruciate ligament (ACL) injuries in female athletes compared with male athletes. Women tend to land in greater knee valgus with higher abduction loads than men. Because knee abduction loads increase ACL strain, the inability to minimize these loads may lead to ACL failure. Objective: To investigate the activation patterns of the quadriceps and hamstrings muscles with respect to the peak knee abduction moment. Design: Cross-sectional study. Setting: Neuromuscular research laboratory. Patients or Other Participants: Twenty-one recreationally active adults (11 women, 10 men). Main Outcome Measure(s): Volunteers performed 3 trials of a 100-cm forward hop. During the hop task, we recorded surface electromyographic data from the medial and lateral hamstrings and quadriceps and recorded lower extremity kinematics and kinetics. Lateral and medial quadriceps-to-hamstrings (Q∶H) cocontraction indices, the ratio of medial-to-lateral Q∶H cocontraction, normalized root mean square electromyographic data for medial and lateral quadriceps and hamstrings, and peak knee abduction moment were calculated and used in data analyses. Results: Overall cocontraction was lower in women than in men, whereas activation was lower in the medial than in the lateral musculature in both sexes (P < .05). The medial Q∶H cocontraction index (R2  =  0.792) accounted for a significant portion of the variance in the peak knee abduction moment in women (P  =  .001). Women demonstrated less activation in the vastus medialis than in the vastus lateralis (P  =  .49) and less activation in the medial hamstrings than in the lateral hamstrings (P  =  .01). Conclusions: Medial-to-lateral Q∶H cocontraction appears to be unbalanced in women, which may limit their ability to resist abduction loads. Because higher abduction loads increase strain on the ACL, restoring medial-to-lateral Q∶H cocontraction balance in women may help reduce ACL injury risk.

scholarly journals Clinical and Instrumented Measurements of Hip Laxity and Their Associations With Knee Laxity and General Joint Laxity

2014 ◽  
Vol 49 (5) ◽  
pp. 590-598 ◽  
Author(s):  
Lixia Fan ◽  
Timothy J. Copple ◽  
Amanda J. Tritsch ◽  
Sandra J. Shultz
Keyword(s):  
Risk Factor ◽  
Injury Risk ◽  
External Rotation ◽  
Low Cost ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Joint Laxity ◽  
Ligament Injury ◽  
Limits Of Agreement ◽  
Cross Sectional

Context: Hip-joint laxity may be a relevant anterior cruciate ligament injury risk factor. With no devices currently available to measure hip laxity, it is important to determine if clinical measurements sufficiently capture passive displacement of the hip. Objective: To examine agreement between hip internal-external–rotation range of motion measured clinically (HIERROM) versus internal-external–rotation laxity measured at a fixed load (HIERLAX) and to determine their relationships with knee laxity (anterior-posterior [KAPLAX], varus-valgus [KVVLAX], and internal-external rotation [KIERLAX]) and general joint laxity (GJL). Design Cross-sectional study. Setting: Controlled research laboratory. Patients or Other Participants: Thirty-two healthy adults (16 women, 16 men; age = 25.56 ± 4.08 years, height = 170.94 ± 10.62 cm, weight = 68.86 ± 14.89 kg). Main Outcome Measure(s): Participants were measured for HIERROM, HIERLAX at 0° and 30° hip flexion (−10 Nm, 7 Nm), KAPLAX (−90 N to 133 N), KVVLAX (±10 Nm), KIERLAX (±5 Nm), and GJL. We calculated Pearson correlations and 95% limits of agreement between HIERROM and HIERLAX_0° and HIERLAX_30°. Correlation analyses examined the strength of associations between hip laxity, knee laxity, and GJL. Results: The HIERROM and HIERLAX had similar measurement precision and were strongly correlated (r > 0.78). However, HIERROM was systematically smaller in magnitude than HIERLAX at 0° (95% limits of agreement = 29.0° ± 22.3°) and 30° (21.4° ± 19.3°). The HIERROM (r = 0.51–0.66), HIERLAX_0° (r = 0.52–0.69) and HIERLAX_30° (r = 0.53–0.76) were similarly correlated with knee laxity measures and GJL. The combinations of KVVLAX and either HIERROM, HIERLAX_0°, or HIERLAX_30° (R2 range, 0.42–0.44) were the strongest predictors of GJL. Conclusions: Although HIERROM and HIERLAX differed in magnitude, they were measured with similar consistency and precision and were similarly correlated with knee laxity and GJL measures. Individuals with greater GJL also had greater hip laxity. These findings are relevant to clinicians and investigators conducting prospective risk factor studies, given the need for accessible, efficient, and low-cost alternatives for characterizing an individual's laxity profile.

Effect of Forearm Position on Glenohumeral External Rotation Measurements in Baseball Players

2021 ◽  
pp. 194173812110329
Author(s):  
W. Ben Kibler ◽  
Aaron Sciascia ◽  
John Stuart Mattison Pike ◽  
Michael Howell ◽  
Kevin E. Wilk
Keyword(s):  
Injury Risk ◽  
External Rotation ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Baseball Players ◽  
Minor League Baseball ◽  
Minor League ◽  
Level 3 ◽  
Motion Measurements ◽  
Throwing Motion

Background: Alterations in glenohumeral internal rotation (GIR), glenohumeral external rotation (GER), and the total arc of motion (TAM) have been linked with increased injury risk in the shoulder and elbow. These motions have been routinely measured with the forearm in neutral rotation (GIRN, GERN, TAMN). GER capacity appears to be especially important. The throwing motion, however, requires forearm pronation as GER occurs to achieve optimal cocking (GERP). No previous studies have evaluated GERP to determine GER capacity or pronated TAM (TAMP) values. Hypothesis: There would be significant differences between GERN and TAMN and between GERP and TAMP. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: Sixty asymptomatic male Minor League Baseball players (32 pitchers, 28 position players) participated in the study and were tested on the first day of spring training. Passive range of motion measurements were recorded using a long-arm bubble goniometer for GIRN, GERN, and GERP on both arms. TAM was calculated separately as the sum of internal and external rotational measurements under neutral and pronated conditions. Results: Within pitchers and position players, all measurements were statistically reduced for the throwing arm ( P ≤ 0.03) except for GERN of the pitchers. GERP measures were significantly less than GERN for both arms of each group ( P < 0.01): pitchers throwing arm +11.8°/nonthrowing arm +4.8°, position players throwing arm = +8.6°/nonthrowing arm +4.0°. Conclusion: The forearm position of pronation, which appears to be mediated by tightness of the biceps, decreases GER capacity and TAM. GER and TAM should be calculated in neutral and pronated positions, considering that 80% of the players have a demonstrated difference between 8° and 12°. Clinical Relevance: Measurement of GERP more accurately reflects the GER required in throwing, allows better quantification of the motion capacity necessary to withstand the loads in throwing, and may suggest interventions for at risk athletes.

scholarly journals Alpine Ski Racing Injuries

2019 ◽  
Vol 11 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Mitchell C. Tarka ◽  
Annabelle Davey ◽  
Geordie C. Lonza ◽  
Casey M. O’Brien ◽  
John P. Delaney ◽  
...  
Keyword(s):  
Risk Factors ◽  
Injury Prevention ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Injury Rate ◽  
Acl Injury ◽  
Prevention Strategies ◽  
Level Of Evidence ◽  
Acl Injuries ◽  
Ski Racers

Context: This article reviews the epidemiology of alpine ski racing–related injuries, risk factors, mechanisms of injury, and injury prevention strategies. Evidence Acquisition: Pertinent literature from peer-reviewed publications from 1976 through 2018. Study Design: Clinical review. Level of Evidence: Level 5. Results: The rate of injury in alpine ski racing is high. In general, knee injuries are the most common, with anterior cruciate ligament (ACL) disruptions being the most significant in terms of time loss from sport. Three specific mechanisms of ACL injury in alpine ski racers have recently been described (slip-catch, dynamic snowplow, and landing back-weighted). In contrast to other sports, female ski racers are not clearly at greater risk for ACL injury, especially at the highest level of competition. A high percentage of ski racers are able to return to their previous level of competition after ACL injury. Risk factors for injury and methods of injury prevention have been proposed; however, the rate of injury, particularly ACL injuries, has not decreased significantly. Conclusion: Alpine ski racing has a high injury rate. ACL injuries in particular remain problematic. Further study is needed to identify modifiable risk factors and implementation of injury prevention strategies.

scholarly journals Influential Articles on Pediatric and Adolescent Anterior Cruciate Ligament Injuries: A Bibliometric Analysis

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110107
Author(s):  
Sachin Allahabadi ◽  
Sonali E. Feeley ◽  
Drew A. Lansdown ◽  
Nirav K. Pandya ◽  
Brian T. Feeley
Keyword(s):  
Anterior Cruciate Ligament ◽  
Basic Science ◽  
Cruciate Ligament ◽  
Citation Data ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Acl Injuries ◽  
Methodologic Quality ◽  
Jadad Scale ◽  
Anterior Cruciate

Background: The understanding of pediatric anterior cruciate ligament (ACL) injuries and optimal treatment has evolved significantly. Influential articles have been previously evaluated using article citations to determine impact. Purpose: To identify and characterize the 50 most cited and recent influential articles relating to pediatric and adolescent ACL injuries, to examine trends in publication characteristics, and to evaluate correlations of study citations with quality of evidence. Study Design: Cross-sectional study. Methods: The top 50 most cited articles on pediatric and adolescent ACL injuries were gathered using the Web of Science and Scopus online databases by averaging the number of citations from each database. Articles from recent years were also aggregated and sorted by citation density (citations/year). Publication and study characteristics were recorded. Level of evidence and methodologic quality were assessed where applicable using the modified Coleman Methodology Score (mCMS), modified Jadad scale, and Methodological Index for Non-Randomized Studies (MINORS). Spearman correlation was used to evaluate the association between citation data and level of evidence or methodologic quality scorings. Results: The top 50 cited papers had a mean of 117.5 ± 58.8 citations (range, 58.5-288.5 citations), with a mean citation density of 9.4 ± 5.4 citations per year (range, 2.9-25.8 citations/year); 80% were published in 2000 or later, and 6% were considered basic science. Articles were mainly level 4 evidence (27/42; 64.3%), and none was level 1. There were moderate, significant associations between publication year and level of evidence ( r S = −0.45; P = .0030) and citation density and publication year ( r S = 0.59; P < .001). Mean methodologic quality scores were as follows: mCMS, 53 ± 7.2 (range, 39-68); modified Jadad scale, 3.2 ± 1.1 (range, 2-6); and MINORS, 11.2 ± 3.2 (range, 6-20). There was a significant, strong correlation between rank of mean citations and modified Jadad scale ( r S = 0.76; P < .0001), suggesting poorer score associated with more mean citations. Conclusion: Influential articles on pediatric and adolescent ACL injuries were relatively recent, with a low proportion of basic science–type articles. Most of the studies had a lower evidence level and poor methodologic quality scores. Higher methodologic quality did not correlate positively with citation data.

scholarly journals Timing of Strain Response of the ACL and MCL Relative to Impulse Delivery During Simulated Landings Leading up to ACL Failure

2020 ◽  
Vol 36 (3) ◽  
pp. 148-155 ◽  
Author(s):  
Nathaniel A. Bates ◽  
Nathan D. Schilaty ◽  
Ryo Ueno ◽  
Timothy E. Hewett
Keyword(s):  
Medial Collateral Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Time Frame ◽  
Risk Profile ◽  
Initial Contact ◽  
Peak Strain ◽  
Collateral Ligament ◽  
Acl Injuries ◽  
Time To Peak

Anterior cruciate ligament (ACL) injury videos estimate that rupture occurs within 50 milliseconds of initial contact, but are limited by imprecise timing and nondirect data acquisition. The objective of this study was to precisely quantify the timing associated with ligament strain during simulated landing and injury events. The hypotheses tested were that the timing of peak strain following initial contact would differ between ligaments and that peak strain timing would be independent of the injury-risk profile emulated during simulated landing. A mechanical impact simulator was used to perform landing simulations based on various injury-risk profiles that were applied to each specimen in a block-randomized order. The ACL and medial collateral ligament were instrumented with strain gauges that recorded continuously. The data from 35 lower-extremity specimens were included for analysis. Analysis of variance and Kruskal–Wallis tests were used to determine the differences between timing and profiles. The mean time to peak strain was 53 (24) milliseconds for the ACL and 58 (35) milliseconds for the medial collateral ligament. The time to peak ACL strain ranged from 48 to 61 milliseconds, but the timing differences were not significant between profiles. Strain timing was independent of injury-risk profile. Noncontact ACL injuries are expected to occur between 0 and 61 milliseconds after initial contact. Both ligaments reached peak strain within the same time frame.

scholarly journals VEGFA Promoter Polymorphisms rs699947 and rs35569394 Are Associated With the Risk of Anterior Cruciate Ligament Ruptures Among Indian Athletes: A Cross-sectional Study

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096447
Author(s):  
Manish Shukla ◽  
Rahul Gupta ◽  
Vivek Pandey ◽  
Jacques Rochette ◽  
Perundurai S. Dhandapany ◽  
...  
Keyword(s):  
Injury Risk ◽  
Cruciate Ligament ◽  
Cross Sectional Study ◽  
Control Group ◽  
Sectional Study ◽  
Promoter Polymorphisms ◽  
Cross Sectional ◽  
Acl Injuries ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Background: Associations of genetic variants within certain fibril-forming genes have previously been observed with anterior cruciate ligament (ACL) injuries. Evidence suggests a significant role of angiogenesis-associated cytokines in remodeling the ligament fibril matrix after mechanical loading and maintaining structural and functional integrity of the ligament. Functional polymorphisms within the vascular endothelial growth factor A (VEGFA) gene have emerged as plausible candidates owing to their role in the regulation of angiogenic responses. Hypothesis: VEGFA promoter polymorphisms rs699947 and rs35569394 are associated with ACL injury risk among athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 90 Indian athletes with radiologically confirmed or surgically proven isolated ACL tears and 76 matched-control athletes were selected for the present cross-sectional genetic association study. Oral mouthwash samples were collected from all the case and control athletes and genotyped for VEGFA rs699947 and rs35569394 using the polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) method. Results: The A allele (rs699947) was significantly overrepresented in the ACL group (C vs A allele: odds ratio [OR], 1.68 [95% CI, 1.08-2.60]; P = .021) (CC vs CA + AA: OR, 2.69 [95% CI, 1.37-5.26]; P = .004). There was a greater frequency of the AA genotype in the ACL group in comparison with the control group (OR, 3.38 [95% CI, 1.23-9.28]; P = .016) when only male athletes were compared. Likewise, there was a greater frequency of the I allele (rs35569394) in the ACL group (D vs I allele: OR, 1.64 [95% CI, 1.06-2.55]; P = .025) (DD vs ID + II: OR, 2.61 [95% CI, 1.31-5.21]; P = .006). The A-I haplotype was overrepresented in the ACL group compared with the control group (OR, 1.68 [95% CI, 1.08-2.60]; χ2 = 5.320; P = .021), and both the polymorphisms were found to be in complete linkage disequilibrium ( r 2 = 0.929; logarithm of the odds score = 63.74; D′ = 1.0). Female athletes did not show any difference in genotype or allele frequency. Conclusion: This is the first study to investigate the association of VEGFA promoter polymorphisms in ACL tears among Indian athletes. Increased frequencies of the A allele (rs699947) and I allele (rs35569394) were observed in the ACL group. These results suggest that sequence variants in the VEGF gene are associated with ACL injury risk among athletes. Further research with long-term follow-ups measuring VEGF expression levels during recovery is warranted to establish its role in ACL injuries and healing.

scholarly journals Landing Biomechanics During a Single-leg Landing With Lateral Trunk Obliquity in Female Athletes

2021 ◽  
Author(s):  
Shohei Taniguchi ◽  
Tomoya Ishida ◽  
Masanori Yamanaka ◽  
Ryo Ueno ◽  
Ryohei Ikuta ◽  
...  
Keyword(s):  
Hip Joint ◽  
Female Athletes ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Initial Contact ◽  
Vertical Ground Reaction Force ◽  
Acl Injuries ◽  
Male Subjects ◽  
Female Subjects

Abstract Background: Lateral trunk obliquity during landing is one of the characteristics of anterior cruciate ligament (ACL) injuries in female athletes. Knee biomechanics during landing with lateral trunk obliquity may be different between female and male subjects. The purpose of the present study was to compare kinetics and kinematics in female subjects during landing with lateral trunk obliquity with those in male subjects.Methods: Fifteen female (age 22.0 ± 1.6 years) and 15 male subjects (age 21.7 ± 1.1 years) participated in this study. The subjects performed a single-leg landing from a 30-cm-high box. Subjects were instructed to keep inclining their trunk to landing leg side at 15° from vertical line. Kinetics and kinematics of their hip and knee joints were analyzed using a three-dimensional motion analysis system with a force plate and compared between female and male subjects.Results: There were no significant differences in the angle of the laterally inclined trunk at initial contact (IC) and at the time of peak vertical ground reaction force (VGRF) (P = 0.341, 0.363). The peak VGRF was smaller in female subjects than male subjects (P = 0.047). Hip adduction moment at the time of peak VGRF was significantly larger in female subjects than male subjects (P = 0.042). Hip external rotation of female subjects at IC was significantly larger than that of male subjects (P = 0.012). There were no differences in knee moments or kinematics between female and male subjects.Conclusions: The findings of the present study indicated that female athletes are considered to avoid excessive knee abduction moment during landing with lateral trunk obliquity by kinematic and kinetic changes in their hip joint. Therefore, sports-medicine specialists should take more notice of kinematics and kinetic behaviors around hip joint in order to prevent noncontact ACL injuries for female athletes.

scholarly journals NEURAL ACTIVITY PROFILES ASSOCIATED WITH ACL INJURY-RISK MECHANICS IN ECOLOGICAL SPORT SPECIFIC VIRTUAL REALITY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0015
Author(s):  
Dustin R. Grooms ◽  
Jed A. Diekfuss ◽  
Alexis B. Slutsky-Ganesh ◽  
Cody R. Criss ◽  
Manish Anand ◽  
...  
Keyword(s):  
Motor Control ◽  
Neural Activity ◽  
Injury Risk ◽  
Neural Control ◽  
Acl Injury ◽  
Initial Contact ◽  
Leg Press ◽  
Visual Spatial ◽  
Peak Knee ◽  
Acl Injury Risk

Background: Anterior cruciate ligament (ACL) injury is secondary to a multifactorial etiology encompassing anatomical, biological, mechanical, and neurological factors. The nature of the injury being primarily due to non-contact mechanics further implicates neural control as a key injury-risk factor, though it has received considerably less study. Purpose: To determine the contribution of neural activity to injury-risk mechanics in ecological sport-specific VR landing scenarios. Methods: Ten female high-school soccer players (15.5±0.85 years; 165.0±6.09 cm; 59.1±11.84 kg) completed a neuroimaging session to capture neural activity during a bilateral leg press and a 3D biomechanics session performing a header within a VR soccer scenario. The bilateral leg press involved four 30 s blocks of repeated bilateral leg presses paced to a metronome beat of 1.2 Hz with 30 s rest between blocks. The VR soccer scenario simulated a corner-kick, requiring the participant to jump and head a virtual soccer ball into a virtual goal (Figure 1A-E). Initial contact and peak knee flexion and abduction angles were extracted during the landing from the header as injury-risk variables of interest and were correlated with neural activity. Results: Evidenced in Table 1 and Figure 1 (bottom row), increased initial contact abduction, increased peak abduction, and decreased peak flexion were associated with increased sensory, visual-spatial, and cerebellar activity (r2= 0.42-0.57, p corrected < .05, z max > 3.1, table & figure 1). Decreased initial contact flexion was associated with increased frontal cortex activity (r2= 0.68, p corrected < .05, z max > 3.1). Conclusion: Reduced neural efficiency (increased activation) of key regions that integrate proprioceptive, visual-spatial, and neurocognitive activity for motor control may influence injury-risk mechanics in sport. The regions found to increase in activity in relation to higher injury-risk mechanics are typically activated to assist with spatial navigation, environmental interaction, and precise motor control. The requirement for athletes to increase their activity for more basic knee motor control may result in fewer neural resources available to maintain knee joint alignment, allocate environmental attention, and handle increased motor coordination demands. These data indicate that strategies to enhance efficiency of visual-spatial and cognitive-motor control during high demand sporting activities is warranted to improve ACL injury-risk reduction. [Figure: see text][Table: see text]

scholarly journals NEURAL ACTIVITY AND LANDING BIOMECHANICS: EXPLORING THE RELATIONSHIPS BETWEEN THE BRAIN, BODY, AND ACL INJURY-RISK

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0015
Author(s):  
Cody R. Criss ◽  
Dustin R. Grooms ◽  
Jed A. Diekfuss ◽  
Manish Anand ◽  
Alexis B. Slutsky-Ganesh ◽  
...  
Keyword(s):  
Neural Activity ◽  
Injury Risk ◽  
Neural Control ◽  
Motor Coordination ◽  
Cruciate Ligament ◽  
Vertical Jump ◽  
Frontal Plane ◽  
Peak Knee ◽  
Knee Abduction ◽  
Drop Vertical Jump

Background: Anterior cruciate ligament (ACL) injuries predominantly occur via non-contact mechanisms, secondary to motor coordination errors resulting in aberrant frontal plane knee loads that exceed the thresholds of ligament integrity. However, central nervous system processing underlying high injury-risk motor coordination errors remain unknown, limiting the optimization of current injury reduction strategies. Purpose: To evaluate the relationships between brain activity during motor tasks with injury-risk loading during a drop vertical jump. Methods: Thirty female high school soccer players (16.10 ± 0.87 years, 165.10 ± 4.64 cm, 63.43 ± 8.80 kg) were evaluated with 3D biomechanics during a standardized drop vertical jump from a 30 cm box and peak knee abduction moment was extracted as the injury-risk variable of interest. A neuroimaging session to capture neural activity (via blood-oxygen-level-dependent signal) was then completed which consisted of 4 blocks of 30 seconds of repeated bilateral leg press action paced to a metronome beat of 1.2 Hz with 30 seconds rest between blocks. Knee abduction moment was evaluated relative to neural activity to identify potential neural contributors to injury-risk. Results: There was a direct relationship between increased landing knee abduction moment and increased neural activation within regions corresponding to the lingual gyrus, intracalcarine cortex, posterior cingulate cortex, and precuneus (r2= 0.68, p corrected < .05, z max > 3.1; Table 1 & Figure 1). Conclusion: Elevated activity in regions that integrate sensory, spatial, and attentional information may contribute to elevated frontal plane knee loads during landing. Interestingly, a similar activation pattern related to high-risk landing mechanics has been found in those following injury, indicating that predisposing factors to injury may be accentuated by injury or that modern rehabilitation does not recover prospective neural control deficits. These data uncover a potentially novel brain marker that could guide the discovery of neural-therapeutic targets that reduce injury risk beyond current prevention methods. [Table: see text][Figure: see text]

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