EFFECT OF STATIC ANATOMIC ALIGNMENT ON DYNAMIC LIMB VALGUS DURING SIDE-STEP CUTTING IN UNINJURED ADOLESCENT ATHLETES

BACKGROUND Dynamic limb valgus, combining hip adduction and internal rotation with knee abduction posture and moments, has been implicated in ACL injury. However, the contribution of static lower extremity alignment to dynamic limb valgus is unknown. This study assessed the relationships among lower extremity static alignment and dynamic kinematics and kinetics during side-step cutting in uninjured adolescent athletes. METHODS This prospective study included 88 limbs from 44 uninjured athletes aged 8-15 years (mean 12.3, SD 2.3; 19 (44%) female) who were evaluated during an anticipated 45° side-step cut. 3D lower extremity kinematics and kinetics from a custom 6 degree of freedom model were assessed while standing and during the loading phase of the cut from initial contact to peak knee flexion; 2-3 trials per limb were averaged for analysis. Femoral anteversion was measured for each limb with the participant lying prone. Relationships among static and dynamic measures were investigated using correlation and multiple linear regression. RESULTS In terms of static alignment, more static hip internal rotation and more static knee external rotation (tibia external relative to femur) were associated with more internal hip rotation and external knee rotation dynamically during cutting (r=0.34, p=0.001) (Table 1). Static hip adduction was also related to more external hip rotation and less hip flexion dynamically (p=0.24, p=0.02). More static knee abduction, external hip rotation and hip adduction were associated with higher average knee abduction angles during cutting (r=0.25, p=0.02). However, only static external knee rotation was associated with higher dynamic knee abduction moments (r=0.48, p<0.0001) (Figure 1). During cutting, positive associations were observed between hip flexion, knee flexion, and hip internal rotation (r=0.24, p=0.03). Knee adduction angles were related to more hip flexion, internal hip rotation, and knee external rotation (r=0.25, p=0.02). Additionally, lower peak knee flexion was associated with higher peak ground reaction force and more external knee rotation (r=0.24, p=0.02). Both simple correlation and multiple regression analysis indicated that higher knee abduction moments were related dynamically to higher knee abduction angles, greater knee external rotation, higher hip abduction angles, and greater hip internal rotation (R2=0.72, p<0.001). After considering dynamic metrics, no static measure remained significantly related to knee abduction moments. CONCLUSION/SIGNIFICANCE Static knee rotation was the only anatomic alignment measure associated with knee abduction moments during side-step cutting in uninjured adolescent athletes. Knee abduction moments were influenced more by dynamic posture than static alignment. As knee abduction moments have been implicated in ACL injury, this study supports the notion of dynamic limb valgus, specifically increased knee abduction and hip internal rotation, relating to ACL injury. Motion analysis can be used to identify these risky biomechanical patterns, and neuromuscular training can be used to correct them. Since knee abduction moments are primarily determined by dynamic posture, neuromuscular training can be used to reduce these moments and ACL injury risk. [Figure: see text][Table: see text]

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073748 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3748

Author(s):

Youngmin Chun ◽

Joshua P. Bailey ◽

Jinah Kim ◽

Sung-Cheol Lee ◽

Sae Yong Lee

Keyword(s):

Lower Extremity ◽

Internal Rotation ◽

Knee Flexion ◽

Mixed Model ◽

External Rotation ◽

Cruciate Ligament ◽

Vertical Jump ◽

Initial Contact ◽

Knee Abduction ◽

Drop Vertical Jump

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

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Structure, Sex, and Strength and Knee and Hip Kinematics During Landing

Journal of Athletic Training ◽

10.4085/1062-6050-46.4.376 ◽

2011 ◽

Vol 46 (4) ◽

pp. 376-385 ◽

Cited By ~ 21

Author(s):

Jennifer S. Howard ◽

Melisa A. Fazio ◽

Carl G. Mattacola ◽

Timothy L. Uhl ◽

Cale A. Jacobs

Keyword(s):

Internal Rotation ◽

Knee Flexion ◽

External Rotation ◽

Tracking System ◽

Three Dimensional ◽

Medial Knee ◽

Peak Knee ◽

Hip Abduction ◽

Knee Abduction ◽

Hip Rotation

Context: Researchers have observed that medial knee collapse is a mechanism of knee injury. Lower extremity alignment, sex, and strength have been cited as contributing to landing mechanics. Objective: To determine the relationship among measurements of asymmetry of unilateral hip rotation (AUHR); mobility of the foot, which we described as relative arch deformity (RAD); hip abduction–external rotation strength; sex; and me-dial collapse of the knee during a single-leg jump landing. We hypothesized that AUHR and RAD would be positively correlated with movements often associated with medial collapse of the knee, including hip adduction and internal rotation excursions and knee abduction and rotation excursions. Design: Descriptive laboratory study. Setting: Research laboratory. Patients or Other Participants: Thirty women and 15 men (age = 21 ± 2 years, height = 171.7 ± 9.5 cm, mass = 68.4 ± 9.5 kg) who had no history of surgery or recent injury and who participated in regular physical activity volunteered. Intervention(s): Participants performed 3 double-leg forward jumps with a single-leg landing. Three-dimensional kinematic data were sampled at 100 Hz using an electromagnetic tracking system. We evaluated AUHR and RAD on the preferred leg and evaluated isometric peak hip abductor–external rotation torque. We assessed AUHR by calculating the difference between internal and external hip rotation in the prone position (AUHR = internal rotation – external rotation). We evaluated RAD using the Arch Height Index Measurement System. Correlations and linear regression analyses were used to assess relationships among AUHR, RAD, sex, peak hip abduction–external rotation torque, and kinematic variables for 3-dimensional motion of the hip and knee. Main Outcome Measure(s): The dependent variables were joint angles at contact and joint excursions between contact and peak knee flexion. Results: We found that AUHR was correlated with hip adduction excursion (R = 0.36, P = .02). Asymmetry of unilateral hip rotation, sex, and peak hip abduction–external rotation torque were predictive of knee abduction excursion (adjusted R2 = 0.47, P < .001). Asymmetry of unilateral hip rotation and sex were predictive of knee external rotation excursion (adjusted R2 = 0.23, P = .001). The RAD was correlated with hip adduction at contact (R2 = 0.10, R = 0.32, P = .04) and knee flexion excursion (R2 = 0.11, R = −0.34, P = .03). Conclusions: Asymmetry of unilateral hip rotation, sex, and hip strength were associated with kinematic components of medial knee collapse.

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Legal Update: North Dakota Supreme Court: Third Edition of Guides is “Most Current”

Guides Newsletter ◽

10.1001/amaguidesnewsletters.1999.janfeb04 ◽

1999 ◽

Vol 4 (1) ◽

pp. 6-7

Author(s):

James J. Mangraviti

Keyword(s):

Internal Rotation ◽

External Rotation ◽

Measurement Techniques ◽

Fourth Edition ◽

Hip Motion ◽

The Difference ◽

The Right ◽

Hip Flexion ◽

Hip Rotation ◽

Hip Extension

Abstract The accurate measurement of hip motion is critical when one rates impairments of this joint, makes an initial diagnosis, assesses progression over time, and evaluates treatment outcome. The hip permits all motions typical of a ball-and-socket joint. The hip sacrifices some motion but gains stability and strength. Figures 52 to 54 in AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, illustrate techniques for measuring hip flexion, loss of extension, abduction, adduction, and external and internal rotation. Figure 53 in the AMA Guides, Fourth Edition, illustrates neutral, abducted, and adducted positions of the hip and proper alignment of the goniometer arms, and Figure 52 illustrates use of a goniometer to measure flexion of the right hip. In terms of impairment rating, hip extension (at least any beyond neutral) is irrelevant, and the AMA Guides contains no figures describing its measurement. Figure 54, Measuring Internal and External Hip Rotation, demonstrates proper positioning and measurement techniques for rotary movements of this joint. The difference between measured and actual hip rotation probably is minimal and is irrelevant for impairment rating. The normal internal rotation varies from 30° to 40°, and the external rotation ranges from 40° to 60°.

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Sport Specialization and Coordination Differences in Multisport Adolescent Female Basketball, Soccer, and Volleyball Athletes

Journal of Athletic Training ◽

10.4085/1062-6050-407-18 ◽

2019 ◽

Vol 54 (10) ◽

pp. 1105-1114 ◽

Cited By ~ 9

Author(s):

Christopher A. DiCesare ◽

Alicia Montalvo ◽

Kim D. Barber Foss ◽

Staci M. Thomas ◽

Timothy E. Hewett ◽

...

Keyword(s):

Knee Joint ◽

Internal Rotation ◽

Knee Flexion ◽

Injury Risk ◽

Vertical Jump ◽

Contact Forces ◽

Female Adolescent ◽

Adolescent Female ◽

Knee Abduction ◽

Hip Flexion

Context Early sport specialization, or the participation in 1 sport year-round to the exclusion of all others, is a growing concern in youth athletics because of its possible association with musculoskeletal injury. The underlying injury risk may be the result of coordination differences that sport-specialized athletes have been speculated to exhibit relative to multisport athletes; however, little evidence exists to support or refute this notion. Objective To examine relative hip- and knee-joint angular-motion variability among adolescent sport-specialized and multisport female adolescent athletes to determine how sport specialization may affect coordination. Design Cohort study. Setting Research laboratory. Patients or Other Participants A total of 366 sport-specialized and 366 multisport adolescent female basketball, soccer, and volleyball players. Intervention(s) Drop–vertical-jump (DVJ) assessment. Main Outcome Measure(s) Average coupling-angle variability (CAV) for hip flexion and knee flexion, knee flexion and ankle flexion, hip flexion and knee abduction, knee flexion and knee abduction, knee flexion and knee internal rotation, and knee abduction and knee internal rotation. Results The sport-specialized group exhibited increased coupling variability in dominant-limb hip flexion and knee flexion (P = .015), knee flexion and knee abduction (P = .014), and knee flexion and knee internal rotation (P = .048) while landing during the DVJ, although they had small effect sizes (η2 = 0.010, 0.010, and 0.007, respectively). No differences were present between groups for any of the other CAV measures of the dominant limb, and no differences were found for any CAV measures of the nondominant limb (all P values > .05). Conclusions Sport specialization was associated with increased variability of critical hip- and knee-joint couplings responsible for effective landing during the DVJ. Altered coordination strategies that involve the hip and knee joints may underlie unstable landings, inefficient force-absorption strategies, or greater contact forces that can place the lower extremities at risk for injury (or a combination of these).

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Comparison of Lower Extremity Muscle Flexibility in Amateur and Trained Bharatanatyam Dancers and Nondancers

Medical Problems of Performing Artists ◽

10.21091/mppa.2018.1005 ◽

2018 ◽

Vol 33 (1) ◽

pp. 20-25

Author(s):

Monica Sharma ◽

Shibili Nuhmani ◽

Deepti Wardhan ◽

Qassim I Muaidi

Keyword(s):

Internal Rotation ◽

Lower Limb ◽

Knee Flexion ◽

External Rotation ◽

Lower Limb Muscle ◽

Limb Muscle ◽

Lower Extremity Muscle ◽

Significant Difference ◽

Flexion Extension ◽

Hip Flexion

OBJECTIVE: This study compared lower limb muscle flexibility between amateur and trained female Bharatanatyam dancers and nondancers. METHODS: Subjects consisted of 105 healthy female volunteers, with 70 female Bharatanatyam dancers (35 trained, 35 amateurs) and 35 controls, with a mean (±SD) age of 16.2±1.04 yrs, height 155.05±4.30 cm, and weight 54.54±2.77 kg. Participants were assessed for range of motion (ROM) in hip flexion, hip extension, hip abduction and adduction, hip external rotation, hip internal rotation, knee flexion, knee extension, ankle dorsiflexion (DF), and ankle plantar flexion (PF) by using a standardized goniometer. To assess for significant difference between groups, one-way ANOVA was applied, and multiple comparisons were made using Bonferroni correction. RESULTS: Trained dancers had a significantly greater hip flexion, extension, abduction, and external rotation ROM than amateurs and nondancers (p<0.05). Also, internal rotation and adduction were markedly less in trained dancers (p<0.05). Knee flexion, extension, and ankle DF were higher and ankle PF ROM was lesser in trained dancers. However, not much variation was found in ankle DF and PF between amateur dancers and nondancers (p>0.05). CONCLUSION: Results showed that there are significant differences in lower limb muscle flexibility between trained and amateur Bharatanatyam dancers and nondancers. These differences may be due to individual dance postures such as araimandi and muzhumandi.

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The Effects of Injury Prevention Programs on the Biomechanics of Landing Tasks: A Systematic Review With Meta-analysis

The American Journal of Sports Medicine ◽

10.1177/0363546517716930 ◽

2017 ◽

Vol 46 (6) ◽

pp. 1492-1499 ◽

Cited By ~ 24

Author(s):

Thiago Jambo Alves Lopes ◽

Milena Simic ◽

Gregory D. Myer ◽

Kevin R. Ford ◽

Timothy E. Hewett ◽

...

Keyword(s):

Injury Prevention ◽

Knee Flexion ◽

Meta Analysis ◽

Acl Injury ◽

Prevention Programs ◽

Initial Contact ◽

Landing Biomechanics ◽

Peak Knee ◽

Knee Abduction ◽

Hip Flexion

Background: Anterior cruciate ligament (ACL) tear is a common injury in sports and often occurs during landing from a jump. Purpose: To synthesize the evidence on the effects of injury prevention programs (IPPs) on landing biomechanics as they relate to the ligament, quadriceps, trunk, and leg dominance theories associated with ACL injury risk. Study Design: Meta-analysis. Methods: Six electronic databases were searched for studies that investigated the effect of IPPs on landing task biomechanics. Prospective studies that reported landing biomechanics at baseline and post-IPP were included. Results from trunk, hip, and knee kinematics and kinetics related to the ACL injury theories were extracted, and meta-analyses were performed when possible. Results: The criteria were met by 28 studies with a total of 466 participants. Most studies evaluated young females, bilateral landing tasks, and recreational athletes, while most variables were related to the ligament and quadriceps dominance theories. An important predictor of ACL injury, peak knee abduction moment, decreased ( P = .01) after the IPPs while other variables related to the ligament dominance theory did not change. Regarding the quadriceps dominance theory, after the IPPs, angles of hip flexion at initial contact ( P = .009), peak hip flexion ( P = .002), and peak knee flexion ( P = .007) increased, while knee flexion at initial contact did not change ( P = .18). Moreover, peak knee flexion moment decreased ( P = .005) and peak vertical ground-reaction force did not change ( P = .10). Conclusion: The exercises used in IPPs might have the potential to improve landing task biomechanics related to the quadriceps dominance theory, especially increasing peak knee and hip flexion angles. Importantly, peak knee abduction moment decreased, which indicates that IPPs influence a desired movement strategy to help athletes overcome dangerous ligament dominance loads arising from lack of frontal plane control during dynamic tasks. The lack of findings for some biomechanical variables suggests that future IPPs may be enhanced by targeting participants’ baseline profile deficits, highlighting the need to deliver an individualized and task-specific IPP.

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The Influence of Hip Structure on Functional Valgus Collapse During a Single-Leg Forward Landing in Females

Journal of Applied Biomechanics ◽

10.1123/jab.2019-0069 ◽

2019 ◽

Vol 35 (6) ◽

pp. 370-376

Author(s):

Jennifer A. Hogg ◽

Randy J. Schmitz ◽

Sandra J. Shultz

Keyword(s):

Internal Rotation ◽

External Rotation ◽

Three Dimensional ◽

Femoral Anteversion ◽

3 Dimensional ◽

Hip Range Of Motion ◽

Peak Knee ◽

Knee Abduction ◽

The Individual ◽

Hip Internal Rotation

Clinical femoral anteversion (Craig test) and hip range of motion (ROM) have been associated with valgus collapse, but their clinical usefulness in predicting biomechanics is unknown. Our purpose was to determine the individual and combined predictive power of femoral anteversion and passive hip ROM on 3-dimensional valgus collapse (hip internal rotation and adduction, knee rotation, and abduction) during a single-leg forward landing in females. Femoral anteversion and passive hip ROM were measured on 20 females (24.9 [4.1] y, 168.7 [8.0] cm, 63.8 [11.6] kg). Three-dimensional kinematics and kinetics were collected over 5 trials of the task. Each variable was averaged across trials. Backward, stepwise regressions determined the extent to which our independent variables were associated with valgus collapse. The combination of greater hip internal and external rotation ROM (partial r = .52 and .56) predicted greater peak knee internal rotation moment (R2 = .38, P = .02). Less hip internal rotation ROM (partial r = −.44) predicted greater peak knee abduction moments (R2 = .20, P = .05). Greater total hip ROM (internal and external rotation ROM) was not consistently associated with combined motions of valgus collapse but was indicative of isolated knee moments. Passive hip ROM is more associated with knee moments than is femoral anteversion as measured with Craig test.

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The Bipolar Hip: Combined Acetabular and Femoral Pathomorphology Determine Hip Motion

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00421 ◽

2019 ◽

Vol 7 (7_suppl5) ◽

pp. 2325967119S0042

Author(s):

Jessica Shin ◽

Temitope F. Adeyemi ◽

Taylor Hobson ◽

Christopher L. Peters ◽

Travis G. Maak

Keyword(s):

Logistic Regression ◽

Femoral Head ◽

Internal Rotation ◽

External Rotation ◽

Alpha Angle ◽

Acetabular Version ◽

Femoral Version ◽

Hip Flexion ◽

Hip Internal Rotation ◽

Head Neck

Objectives: Prior studies have suggested femoral version may outweigh the effect of cam impingement on hip internal rotation; however, the effects of acetabular morphology were considered. This study investigates the influences of acetabular and femoral morphology on hip range of motion (ROM) in patients with femoroacetabular impingement syndrome (FAIS). Methods: With IRB approval, a retrospective chart review and radiographic analysis was performed of patients presenting with hip pain to the clinic of a single surgeon. Patients were included in the study if their hip pain was thought to be intra-articular in origin, had full physical exam documentation (including bilateral hip evaluations and measurements of passive hip ROM), Tönnis grade ≤ 1, and had full imaging including: AP pelvis, 45⁰ Dunn lateral, and false profile radiographs and a CT scan with 3-D reconstructions of the affected hip. Patients were excluded if they had prior hip surgery, prior hip trauma or other underlying hip pathology. Femoral head/neck angle, femoral version, size and clock-face location of the maximum femoral alpha angle, mid-coronal center edge angle (CEA), mid-sagittal CEA, acetabular version at the 1, 2 and 3 o’clock positions and the McKibbin index were measured on CT scan. Univariable and multivariable logistic regression analyses were performed to determine which measurements correlated with hip ROM. Results: 200 hips from 200 patients were included in the final analysis. Mean age was 31.9 ±10 years, 145 (72%) patients were female, and mean BMI of the cohort was 25.2 ± 5. Univariable logistic regression analysis found femoral head/neck angle, mid-sagittal CEA, acetabular version at 1 and 2 o’clock, and McKibbin Index all significantly correlated with hip flexion (all q’s > 0.05 after adjusting for false discovery rate). Femoral head-neck angle, femoral version, and McKibbin index all significantly correlated with external rotation. Femoral neck version, mid-sagittal CEA, acetabular version at all three clock positions, McKibbin index, max femoral alpha angle, and alpha position all significantly correlated with internal rotation. In the multivariate logistic regression analysis mid-sagittal CEA was the only measurement correlating with flexion, femoral head/neck angle and McKibbin index were the only significant variables correlating with external rotation, and McKibbin index and maximum femoral alpha angle were the only variables correlating with internal rotation. The results of the logistic regressions are summarized in Figure 1. Conclusion: Our univariate data supported previous data that suggested femoral version significantly correlated with hip internal rotation. However, multivariate analysis including acetabular version demonstrated that combined acetabular and femoral version significantly correlated with internal and external rotation while femoral version in isolation did not. In contrast to prior studies, an increased cam deformity, as defined by max femoral alpha angle, remained a significant contributor to reduced internal rotation but did not affect hip flexion. Rather, the increased mid-sagittal CEA remained the sole significant contributor to reduced hip flexion in the multivariable analysis. These data suggest that hip ROM is affected in a bipolar fashion and careful multiplanar evaluation of the femoral and acetabular pathomorpohlogy should be conducted prior to attempting to increase hip ROM with corrective osteoplasty or osteotomy. [Figure: see text]

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The influence of kinesio taping on trunk and lower extremity motions during different landing tasks: implications for anterior cruciate ligament injury

Journal of Experimental Orthopaedics ◽

10.1186/s40634-021-00339-w ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Bahram Sheikhi ◽

Amir Letafatkar ◽

Jennifer Hogg ◽

Esmaiel Naseri-Mobaraki

Keyword(s):

Lower Extremity ◽

Knee Flexion ◽

Cruciate Ligament ◽

Ligament Injury ◽

Knee Valgus ◽

Drop Jump ◽

Male Athletes ◽

Maximum Angle ◽

Knee Abduction ◽

Hip Flexion

Abstract Purpose The purpose of the study was to investigate the influence of a 72-h KT application on trunk and lower extremity kinematics during different landing tasks. Methods Twenty-nine competitive male athletes participated in this study. The sum of knee valgus and lateral trunk lean, symmetry index (SI), and peak angles of lateral trunk lean, hip flexion, knee abduction and flexion were assessed for all participants during single-leg drop landing (SLDL), single-leg vertical drop jump (SLVDJ), vertical drop jump (DLVDJ), and double leg forward jump (DLFJ), at baseline and seventy-two hours following KT application. Results The KT application resulted in more knee flexion and abduction, sum of knee valgus and lateral trunk lean as compared with the non-KT condition during SLDL (P < 0.05). Nonetheless, there were no differences in SI, maximum angle of the lateral trunk lean during SLDL, SLVDJ, nor hip flexion, knee abduction, and flexion during DLVDJ, and DLFJ tasks (P > 0.05). Conclusions The research findings suggest that KT after 72-h application may improve knee abduction and sum of knee valgus and lateral trunk lean during SLDL, knee flexion during SLDL and SLVDJ in individuals displaying risky single-leg kinematics. Therefore, KT application may marginally improve high-risk landing kinematics in competitive male athletes. Level of evidence Level III.

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Gender Differences in Kinematic Analysis of the Lower Limbs during the Chasse Step in Table Tennis Athletes

Healthcare ◽

10.3390/healthcare9060703 ◽

2021 ◽

Vol 9 (6) ◽

pp. 703

Author(s):

Xiaoyi Yang ◽

Yuqi He ◽

Shirui Shao ◽

Julien S. Baker ◽

Bíró István ◽

...

Keyword(s):

Female Athletes ◽

External Rotation ◽

Rotational Velocity ◽

Knee Extension ◽

Lower Limbs ◽

Table Tennis ◽

Male Athletes ◽

Analysis System ◽

Hip Flexion ◽

Hip Internal Rotation

The chasse step is one of the most important footwork maneuvers used in table tennis. The purpose of this study was to investigate the lower limb kinematic differences of table tennis athletes of different genders when using the chasse step. The 3D VICON motion analysis system was used to capture related kinematics data. The main finding of this study was that the step times for male athletes (MA) were shorter in the backward phase (BP) and significantly longer in the forward phase (FP) than for female athletes (FA) during the chasse step. Compared with FA, knee external rotation for MA was larger during the BP. MA showed a smaller knee flexion range of motion (ROM) in the BP and larger knee extension ROM in the FP. Moreover, hip flexion and adduction for MA were significantly greater than for FA. In the FP, the internal rotational velocity of the hip joint was significantly greater. MA showed larger hip internal rotation ROM in the FP but smaller hip external rotation ROM in the BP. The differences between genders can help coaches personalize their training programs and improve the performance of both male and female table tennis athletes.

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