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]

scholarly journals Anterior Cruciate Ligament Loading Increases With Pivot-Shift Mechanism During Asymmetrical Drop Vertical Jump in Female Athletes

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198909
Author(s):  
Ryo Ueno ◽  
Alessandro Navacchia ◽  
Nathan D. Schilaty ◽  
Gregory D. Myer ◽  
Timothy E. Hewett ◽  
...  
Keyword(s):  
Female Athletes ◽  
Cruciate Ligament ◽  
Vertical Jump ◽  
Frontal Plane ◽  
Element Model ◽  
Anterior Tibial Translation ◽  
Tibial Rotation ◽  
Knee Abduction ◽  
Tibial Translation ◽  
Drop Vertical Jump

Background: Frontal plane trunk lean with a side-to-side difference in lower extremity kinematics during landing increases unilateral knee abduction moment and consequently anterior cruciate ligament (ACL) injury risk. However, the biomechanical features of landing with higher ACL loading are still unknown. Validated musculoskeletal modeling offers the potential to quantify ACL strain and force during a landing task. Purpose: To investigate ACL loading during a landing and assess the association between ACL loading and biomechanical factors of individual landing strategies. Study Design: Descriptive laboratory study. Methods: Thirteen young female athletes performed drop vertical jump trials, and their movements were recorded with 3-dimensional motion capture. Electromyography-informed optimization was performed to estimate lower limb muscle forces with an OpenSim musculoskeletal model. A whole-body musculoskeletal finite element model was developed. The joint motion and muscle forces obtained from the OpenSim simulations were applied to the musculoskeletal finite element model to estimate ACL loading during participants’ simulated landings with physiologic knee mechanics. Kinematic, muscle force, and ground-reaction force waveforms associated with high ACL strain trials were reconstructed via principal component analysis and logistic regression analysis, which were used to predict trials with high ACL strain. Results: The median (interquartile range) values of peak ACL strain and force during the drop vertical jump were 3.3% (–1.9% to 5.1%) and 195.1 N (53.9 to 336.9 N), respectively. Four principal components significantly predicted high ACL strain trials, with 100% sensitivity, 78% specificity, and an area of 0.91 under the receiver operating characteristic curve ( P < .001). High ACL strain trials were associated with (1) knee motions that included larger knee abduction, internal tibial rotation, and anterior tibial translation and (2) motion that included greater vertical and lateral ground-reaction forces, lower gluteus medius force, larger lateral pelvic tilt, and increased hip adduction. Conclusion: ACL loads were higher with a pivot-shift mechanism during a simulated landing with asymmetry in the frontal plane. Specifically, knee abduction can create compression on the posterior slope of the lateral tibial plateau, which induces anterior tibial translation and internal tibial rotation. Clinical Relevance: Athletes are encouraged to perform interventional and preventive training to improve symmetry during landing.

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 Relationship Between 2-Dimensional Frontal Plane Measures and the Knee Abduction Angle During the Drop Vertical Jump

2019 ◽  
Vol 28 (4) ◽  
Author(s):  
Brad W. Willis ◽  
Katie Hocker ◽  
Swithin Razu ◽  
Aaron D. Gray ◽  
Marjorie Skubic ◽  
...  
Keyword(s):  
Motion Capture ◽  
Vertical Jump ◽  
Frontal Plane ◽  
Ligament Injury ◽  
Coefficient Of Determination ◽  
Abduction Angle ◽  
Initial Contact ◽  
Knee Abduction ◽  
The Relationship ◽  
Drop Vertical Jump

Context: Knee abduction angle (KAA), as measured by 3-dimensional marker-based motion capture systems during jump-landing tasks, has been correlated with an elevated risk of anterior cruciate ligament injury in females. Due to the high cost and inefficiency of KAA measurement with marker-based motion capture, surrogate 2-dimensional frontal plane measures have gained attention for injury risk screening. The knee-to-ankle separation ratio (KASR) and medial knee position (MKP) have been suggested as potential frontal plane surrogate measures to the KAA, but investigations into their relationship to the KAA during a bilateral drop vertical jump task are limited. Objective: To investigate the relationship between KASR and MKP to the KAA during initial contact of the bilateral drop vertical jump. Design: Descriptive. Setting: Biomechanics laboratory. Participants: A total of 18 healthy female participants (mean age: 24.1 [3.88] y, mass: 65.18 [10.34] kg, and height: 1.63 [0.06] m). Intervention: Participants completed 5 successful drop vertical jump trials measured by a Vicon marker-based motion capture system and 2 AMTI force plates. Main Outcome Measure: For each jump, KAA of the tibia relative to the femur was measured at initial contact along with the KASR and MKP calculated from planar joint center data. The coefficient of determination (r2) was used to examine the relationship between the KASR and MKP to KAA. Results: A strong linear relationship was observed between MKP and KAA (r2 = .71), as well as between KASR and KAA (r2 = .72). Conclusions: Two-dimensional frontal plane measures show strong relationships to the KAA during the bilateral drop vertical jump.

Optimizing Whole-Body Kinematics During Single-Leg Jump Landing to Reduce Peak Abduction/Adduction and Internal Rotation Knee Moments: Implications for Anterior Cruciate Ligament Injury Risk

2021 ◽  
pp. 1-8
Author(s):  
Dhruv Gupta ◽  
Jeffrey A. Reinbolt ◽  
Cyril J. Donnelly
Keyword(s):  
Internal Rotation ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Whole Body ◽  
Jump Landing ◽  
Peak Knee ◽  
Knee Abduction ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Knee abduction/adduction moment and knee internal rotation moment are known surrogate measures of anterior cruciate ligament (ACL) load during tasks like sidestepping and single-leg landing. Previous experimental literature has shown that a variety of kinematic strategies are associated or correlated with ACL injury risk; however, the optimal kinematic strategies needed to reduce peak knee moments and ACL injury are not well understood. To understand the complex, multifaceted kinematic factors underpinning ACL injury risk and to optimize kinematics to prevent the ACL injury, a musculoskeletal modeling and simulation experimental design was used. A 14-segment, 37-degree-of-freedom, dynamically consistent skeletal model driven by force/torque actuators was used to simulate whole-body single-leg jump landing kinematics. Using the residual reduction algorithm in OpenSim, whole-body kinematics were optimized to reduce the peak knee abduction/adduction and internal/external rotation moments simultaneously. This optimization was repeated across 30 single-leg jump landing trials from 10 participants. The general optimal kinematic strategy was to bring the knee to a more neutral alignment in the transverse plane and frontal plane (featured by reduced hip adduction angle and increased knee adduction angle). This optimized whole-body kinematic strategy significantly reduced the peak knee abduction/adduction and internal rotation moments, transferring most of the knee load to the hip.

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 &lt; .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 Volitional Spine Stabilization During a Drop Vertical Jump From Different Landing Heights: Implications for Anterior Cruciate Ligament Injury

2016 ◽  
Vol 51 (12) ◽  
pp. 1003-1012 ◽  
Author(s):  
Ram Haddas ◽  
Troy Hooper ◽  
C. Roger James ◽  
Phillip S. Sizer
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Injury Risk ◽  
Muscle Activation ◽  
Cruciate Ligament ◽  
Vertical Jump ◽  
Ligament Injury ◽  
Lower Extremity Muscle ◽  
Anterior Cruciate ◽  
Drop Vertical Jump

Context:Volitional preemptive abdominal contraction (VPAC) during dynamic activities may alter trunk motion, but the role of the core musculature in positioning the trunk during landing tasks is unclear.Objective:To determine whether volitional core-muscle activation incorporated during a drop vertical jump alters lower extremity kinematics and kinetics, as well as trunk and lower extremity muscle activity at different landing heights.Design:Controlled laboratory study.Setting:Clinical biomechanics laboratory.Patients or Other Participants:Thirty-two young healthy adults, consisting of 17 men (age = 25.24 ± 2.88 years, height = 1.85 ± 0.06 m, mass = 89.68 ± 16.80 kg) and 15 women (age = 23.93 ± 1.33 years, height = 1.67 ± 0.08 m, mass = 89.68 ± 5.28 kg).Intervention(s):Core-muscle activation using VPAC.Main Outcome Measure(s):We collected 3-dimensional ankle, knee, and hip motions, moments, and powers; ground reaction forces; and trunk and lower extremity muscle activity during 0.30- and 0.50-m drop vertical-jump landings.Results:During landing from a 0.30-m height, VPAC performance increased external oblique and semitendinosis activity, knee flexion, and knee internal rotation and decreased knee-abduction moment and knee-energy absorption. During the 0.50-m landing, the VPAC increased external oblique and semitendinosis activity, knee flexion, and hip flexion and decreased ankle inversion and hip-energy absorption.Conclusions:The VPAC performance during landing may protect the anterior cruciate ligament during different landing phases from different heights, creating a protective advantage just before ground contact and after the impact phase. Incorporating VPAC during high injury-risk activities may enhance pelvic stability, improve lower extremity positioning and sensorimotor control, and reduce anterior cruciate ligament injury risk while protecting the lumbar spine.

scholarly journals Validity and Reliability of a Virtual Reality Game in Evaluating the Projected Frontal Plane Knee Angle When Landing From a Drop Vertical Jump

2018 ◽  
Vol 27 (4) ◽  
Author(s):  
Kathryn Mills ◽  
Aula Idris ◽  
Thu-An Pham ◽  
John Porte ◽  
Mark Wiggins ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Vertical Jump ◽  
Frontal Plane ◽  
Knee Angle ◽  
Validity And Reliability ◽  
Limits Of Agreement ◽  
Specificity And Sensitivity ◽  
Peak Knee ◽  
Knee Abduction ◽  
Vertical Jumps

Objectives: To determine the validity and reliability of the peak frontal plane knee angle evaluated by a virtual reality (VR) netball game when landing from a drop vertical jump. Study Design: Laboratory. Methods: Forty participants performed 3 drop vertical jumps evaluated by 3-dimensional motion analysis and 3 drop vertical jumps evaluated by the VR game. Limits of agreement for the peak projected frontal plane knee angle and peak knee abduction were determined. Participants were given a consensus category of “above threshold” or “below threshold” based on a prespecified threshold angle of 9° during landing. Classification agreement was determined using kappa coefficient, and accuracy was determined using specificity and sensitivity. Ten participants returned 1 week later to determine intrarater reliability, standard error of the measure, and typical error. Results: The mean difference in detected frontal plane knee angle was 3.39° (95% confidence interval [CI], 1.03° to 5.74°). Limits of agreement were −10.27° (95% CI, −14.36° to −6.19°) to 17.05° (95% CI, 12.97° to 21.14°). Substantial agreement, specificity, and sensitivity were observed for the threshold classification (κ = .66; 95% CI, .42 to .88; specificity = 0.96; 95% CI, 0.78 to 1.0; and sensitivity = 0.75; 95% CI, 0.43 to 0.95). The game exhibited acceptable reliability over time (intraclass correlation coefficient, ICC3,1 = .844), and error was approximately 2°. Conclusion: The VR game reliably evaluated a projected frontal plane knee angle. Although the knee angle detected by the VR game is strongly related to peak knee abduction, the accuracy of detecting the exact angle was limited. A threshold approach may be a more accurate approach for gaming technology to evaluate frontal plane knee angles when landing from a jump.

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

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.

scholarly journals Immediate effect of ACL kinesio taping technique on knee joint biomechanics during a drop vertical jump: a randomized crossover controlled trial

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Weerawat Limroongreungrat ◽  
Chuanpis Boonkerd
Keyword(s):  
Knee Joint ◽  
Vertical Jump ◽  
Abduction Angle ◽  
Kinesio Taping ◽  
Peak Knee ◽  
Significant Difference ◽  
Joint Biomechanics ◽  
Knee Abduction ◽  
Taping Technique ◽  
Drop Vertical Jump

Abstract Background The purpose of this study was to investigate the effect of an ACL Kinesio Taping technique (ACL-KT) on knee joint biomechanics during a drop vertical jump (DVJ). Methods Twenty healthy male participants (age 21.1±0.3 years; mass 64.2±4.3 kg; height 174.2±5.5 cm) participated in this study. The participants performed a DVJ and landed onto 2 adjacent force platforms under both ACL-KT and placebo (PT) conditions. All data were collected with 3-D motion analysis and comparison peak knee joint angles and moments, and knee joint angle at initial contact (IC) between conditions analyzed using a paired sample t-test. Statistical parametric mapping (SPM) was selected to assess difference between groups for the entire three-component knee trajectory during the contact phase. Results ACL-KT had a significant effect on decreasing knee abduction angle at IC (1.43±2.12 deg.) compared with the PT (−1.24±2.42 deg.) (p=0.04). A significant difference in knee abduction angle between the taping conditions was found between 100 ms before IC, at IC and 100 ms after IC (p<0.05). There were no significant differences (p>0.05) found between conditions in any of the other variables. Conclusion This result confirmed that the application of ACL-KT is useful to reduce knee abduction angle at IC during a DVJ in healthy participants. Therefore, ACL-KT may be an acceptable intervention to reduce ACL injury risk. Trial registration Retrospective registered on 25 September 2018. Trial number: TCTR20180926005

High-Risk Lower-Extremity Biomechanics Evaluated in Simulated Soccer-Specific Virtual Environments

2020 ◽  
Vol 29 (3) ◽  
pp. 294-300 ◽  
Author(s):  
Christopher A. DiCesare ◽  
Adam W. Kiefer ◽  
Scott Bonnette ◽  
Gregory D. Myer
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Medical Center ◽  
Vertical Jump ◽  
Frontal Plane ◽  
Female Adolescent ◽  
Lower Extremity Injury ◽  
Skill Transfer ◽  
Targeted Interventions ◽  
Drop Vertical Jump

Context: Laboratory-based biomechanical analyses of sport-relevant movements such as landing and cutting have classically been used to quantify kinematic and kinetic factors in the context of injury risk, which are then used to inform targeted interventions designed to improve risky movement patterns during sport. However, the noncontextual nature of standard assessments presents challenges for assessing sport-relevant skill transfer. Objective: To examine injury-risk biomechanical differences exhibited by athletes during a jump-landing task performed as part of both a standard biomechanical assessment and a simulated, sport-specific virtual reality (VR)-based assessment. Design: Observational study. Setting: Medical center laboratory. Participants: Twenty-two female adolescent soccer athletes (age = 16.0 [1.4] y, height = 165.6 [4.9] cm, and weight = 60.2 [11.4] kg). Interventions: The landing performance was analyzed for a drop vertical jump task and a VR-based, soccer-specific corner-kick scenario in which the athletes were required to jump to head a virtual soccer ball and land. Main Outcome Measures: Hip, knee, and ankle joint kinematic differences in the frontal and sagittal planes. Results: Athletes exhibited reduced hip and ankle flexion, hip abduction, and frontal plane ankle excursion during landing in realistic sport scenario compared with the standard drop vertical jump task. Conclusion: VR-based assessments can provide a sport-specific context in which to assess biomechanical deficits that predispose athletes for lower-extremity injury and offer a promising approach to better evaluate skill transfer to sport that can guide future injury prevention efforts.

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