scholarly journals Vertical Drop Jump Biomechanics of Patients With a 3- to 10-Year History of Youth Sport–Related Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 9 (12) ◽  
pp. 232596712110581
Author(s):  
Gregor Kuntze ◽  
Alberto Nettel-Aguirre ◽  
Kristin N. Lorenzen ◽  
Jessica Küpper ◽  
Janet L. Ronsky ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Youth Sport ◽  
Initial Contact ◽  
Drop Jump ◽  
Knee Angle ◽  
Knee Motion ◽  
History Of ◽  
Anterior Cruciate ◽  
Time Since Injury

Background: A better understanding of movement biomechanics after anterior cruciate ligament reconstruction (ACLR) could inform injury prevention, knee injury rehabilitation, and osteoarthritis prevention strategies. Purpose: To investigate differences in vertical drop jump (VDJ) biomechanics between patients with a 3- to 10-year history of youth sport–related ACLR and uninjured peers of a similar age, sex, and sport. Study Design: Cross-sectional study. Level of evidence III. Methods: Lower limb kinematics and bilateral ground-reaction forces (GRFs) were recorded for participants performing 10 VDJs. Joint angles and GRF data were analyzed, and statistical analysis was performed using 2 multivariate models. Dependent variables included sagittal (ankle, knee, and hip) and coronal (knee and hip) angles at initial contact and maximum knee flexion, the rate of change of coronal knee angles (35%-90% of the support phase; ie, slopes of linear regression lines), and vertical and mediolateral GRFs (normalized to body weight [BW]). Fixed effects included group, sex, and time since injury. Participant clusters, defined by sex and sport, were considered as random effects. Results: Participants included 48 patients with a history of ACLR and 48 uninjured age-, sex-, and sport-matched controls (median age, 22 years [range, 18-26 years]; 67% female). Patients with ACLR demonstrated steeper negative coronal knee angle slopes (β = –0.04 deg/% [95% CI, –0.07 to –0.00 deg/%]; P = .025). A longer time since injury was associated with reduced knee flexion (β = –0.2° [95% CI, –0.3° to –0.0°]; P = .014) and hip flexion (β = –0.1° [95% CI, –0.2° to –0.0°]; P = .018). Regardless of ACLR history, women displayed greater knee valgus at initial contact (β = 2.1° [95% CI, 0.4° to 3.8°]; P = .017), greater coronal knee angle slopes (β = 0.05 deg/% [95% CI, 0.02 to 0.09 deg/%]; P = .004), and larger vertical GRFs (landing: β = –0.34 BW [95% CI, –0.61 to –0.07 BW]; P = .014) (pushoff: β = –0.20 BW [95% CI, –0.32 to –0.08 BW]; P = .001). Conclusion: Women and patients with a 3- to 10-year history of ACLR demonstrated VDJ biomechanics that may be associated with knee motion control challenges. Clinical Relevance: It is important to consider knee motion control during activities such as VDJs when developing injury prevention and rehabilitation interventions aimed at improving joint health after youth sport–related ACLR.

scholarly journals Sex Differences on the Landing Error Scoring System Among Individuals With Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 53 (9) ◽  
pp. 837-843 ◽  
Author(s):  
Christopher M. Kuenze ◽  
Stephanie Trigsted ◽  
Caroline Lisee ◽  
Eric Post ◽  
David R. Bell
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sex Differences ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Initial Contact ◽  
Medial Knee ◽  
Cruciate Ligament Reconstruction ◽  
History Of ◽  
Anterior Cruciate

Context:  After anterior cruciate ligament reconstruction (ACLR), women have a greater risk of incurring a second anterior cruciate ligament injury and they display different landing movement patterns than men. It remains unclear if clinical movement-assessment tools, such as the Landing Error Scoring System (LESS), can detect sex differences in movement patterns after ACLR. Objective:  To compare total LESS scores and individual LESS errors between men and women with a history of ACLR. Design:  Cross-sectional study. Setting:  Laboratory. Patients or Other Participants:  A total of 168 individuals (41 men and 127 women; mean age: men = 20 years [range, 19–25 years], women = 19 years [range, 18–20 years]; mean time since surgery: men = 21 months [range, 12–36 months], women = 27.5 months [range, 17–39 months]) with a history of primary, unilateral ACLR. Main Outcome Measure(s):  Participants completed a minimum of 3 trials of a drop vertical-jump task scored using the LESS. The between-sexes difference in LESS score was assessed using analysis of covariance, whereas the associations between participant sex and errors on each LESS item were assessed using logistic or multinomial regression. Results:  Women displayed a greater number of total landing errors (men = 4.6 ± 2.3, women = 6.1 ± 2.3; P < .001) and were more likely to commit errors in trunk flexion at initial contact (men = 4.9%, women = 23.6%; odds ratio [OR] = 4.94), medial knee position at initial contact (men = 17.1%, women = 42.5%; OR = 6.01), medial knee displacement (men = 24.4%, women = 73.2%; OR = 7.88), total joint displacement (1 error: men = 58.5%, women = 71.7%, OR = 2.10; 2 errors: men = 7.3%, women = 14.2%, OR = 3.71), and overall impression (1 error: men = 75.6%, women = 84.3%, OR = 3.24; 2 errors: men = 2.4%, women = 10.2%, OR = 12.89) compared with men. Conclusions:  Women with ACLR displayed worse LESS scores and were more likely to commit errors related to medial knee displacement and overall landing quality than men with ACLR.

scholarly journals Biomechanical Symmetry during Drop Jump Landing and Takeoff in Adolescent Athletes Following Recent Anterior Cruciate Ligament Reconstruction

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 639
Author(s):  
Eva M. Ciccodicola ◽  
Nicole M. Mueske ◽  
Mia J. Katzel ◽  
Curtis D. VandenBerg ◽  
James Lee Pace ◽  
...  
Keyword(s):  
Power Generation ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Jump Height ◽  
Drop Jump ◽  
Adolescent Athletes ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

This study investigated asymmetry between lower extremities during the landing and takeoff phases of a vertical drop jump (VDJ) in adolescent athletes following anterior cruciate ligament reconstruction (ACLR) and examined if performance was affected by reducing jump height. Thirty-three athletes who underwent ACLR and were referred for 3D biomechanical assessment before returning to play (mean age 15.9, SD 1.3 years; 16/33 female; mean time since surgery 7.4, SD 1.2 months) completed the VDJ while kinematics and kinetics were collected using motion capture. Lower extremity symmetry was compared between phases using paired t-tests. Jump height was calculated to measure performance. Asymmetries in ankle inversion, ankle adduction, knee adduction, hip adduction, hip adduction moment, and hip rotation moment were observed in both phases. Asymmetry was also observed in both phases for sagittal moments and power integrals at the knee and ankle and total power integral, with the magnitude of asymmetry being smaller during takeoff for power absorption/generation. Jump height was related to power generation integrals during takeoff but not to the asymmetry of power generation. Since asymmetries are translated from landing through takeoff, rehabilitation should address both phases to decrease injury risk and maximize performance after return to play.

scholarly journals The Utility of Functional Data Analyses to Reveal Between-Limbs Asymmetries in Those With a History of Anterior Cruciate Ligament Reconstruction

2021 ◽  
Author(s):  
McKenzie S. White ◽  
William Z. Horton ◽  
Julie P. Burland ◽  
Matthew K. Seeley ◽  
Lindsey K. Lepley
Keyword(s):  
Anterior Cruciate Ligament ◽  
Functional Data ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Cruciate Ligament Reconstruction ◽  
Data Analyses ◽  
History Of ◽  
Anterior Cruciate ◽  
Single Time Point ◽  
Time Point

Context Researchers have traditionally used motion capture to quantify discrete biomechanical data points (peak values) during hop testing. However, these analyses restrict the evaluation to a single time point (ie, certain percentage of stance) and provide only a narrow view of movement. Applying more comprehensive analyses may help investigators identify important characteristics that are masked by the discrete analyses often used to screen patients for activity. Objective To examine the utility of functional data analyses to reveal asymmetries that are undetectable using discrete (ie, single time point) evaluations in participants with a history of anterior cruciate ligament reconstruction (ACLR) who achieved clinical hop symmetry. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants Fifteen participants with unilateral ACLR (age = 21 ± 3 years, time from surgery = 4 ± 3 years) and 15 control participants without ACLR (age = 23 ± 2 years). Intervention(s) Lower extremity biomechanics during the triple–hop-for-distance task for the ACLR and contralateral limbs of patients and a representative limb of control participants were measured. Main Outcome Measure(s) Peak sagittal-plane joint power, joint work, and power profiles were determined. Results Using discrete analyses, we identified lower peak knee power and work in the ACLR limb compared with the contralateral and control limbs (P < .05) but were unable to demonstrate differences at the ankle or hip. Using functional data analyses, we observed asymmetries at the ankle, knee, and hip between the ACLR and contralateral or control limbs throughout stance (P < .05) and revealed that these asymmetries stemmed from knee power deficits that were prominent during early loading. Conclusions Despite achieving hop-distance symmetry, the ACLR limbs absorbed less power. Although this information was revealed using the discrete analyses, underlying asymmetries at the ankle and hip were masked. Using functional data analyses, we found interlimb asymmetries at the ankle, knee, and hip throughout ground contact and more fully elucidated the extent and source of asymmetries that can be used by clinicians and researchers alike to guide clinical decision making.

scholarly journals Knee-Extension Torque Variability and Subjective Knee Function in Patients With a History of Anterior Cruciate Ligament Reconstruction

2016 ◽  
Vol 51 (1) ◽  
pp. 22-27 ◽  
Author(s):  
John Goetschius ◽  
Joseph M. Hart
Keyword(s):  
Anterior Cruciate Ligament ◽  
Motor Control ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Extension ◽  
Knee Function ◽  
Cruciate Ligament Reconstruction ◽  
History Of ◽  
Anterior Cruciate

Context  When returning to physical activity, patients with a history of anterior cruciate ligament reconstruction (ACL-R) often experience limitations in knee-joint function that may be due to chronic impairments in quadriceps motor control. Assessment of knee-extension torque variability may demonstrate underlying impairments in quadriceps motor control in patients with a history of ACL-R. Objective  To identify differences in maximal isometric knee-extension torque variability between knees that have undergone ACL-R and healthy knees and to determine the relationship between knee-extension torque variability and self-reported knee function in patients with a history of ACL-R. Design  Descriptive laboratory study. Setting  Laboratory. Patients or Other Participants  A total of 53 individuals with primary, unilateral ACL-R (age = 23.4 ± 4.9 years, height = 1.7 ± 0.1 m, mass = 74.6 ± 14.8 kg) and 50 individuals with no history of substantial lower extremity injury or surgery who served as controls (age = 23.3 ± 4.4 years, height = 1.7 ± 0.1 m, mass = 67.4 ± 13.2 kg). Main Outcome Measure(s)  Torque variability, strength, and central activation ratio (CAR) were calculated from 3-second maximal knee-extension contraction trials (90° of flexion) with a superimposed electrical stimulus. All participants completed the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and we determined the number of months after surgery. Group differences were assessed using independent-samples t tests. Correlation coefficients were calculated among torque variability, strength, CAR, months after surgery, and IKDC scores. Torque variability, strength, CAR, and months after surgery were regressed on IKDC scores using stepwise, multiple linear regression. Results  Torque variability was greater and strength, CAR, and IKDC scores were lower in the ACL-R group than in the control group (P < .05). Torque variability and strength were correlated with IKDC scores (P < .05). Torque variability, strength, and CAR were correlated with each other (P < .05). Torque variability alone accounted for 14.3% of the variance in IKDC scores. The combination of torque variability and number of months after surgery accounted for 21% of the variance in IKDC scores. Strength and CAR were excluded from the regression model. Conclusions  Knee-extension torque variability was moderately associated with IKDC scores in patients with a history of ACL-R. Torque variability combined with months after surgery predicted 21% of the variance in IKDC scores in these patients.

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