scholarly journals The Effect of External Focus Attention Exercise On the Kinetic Risk Factors Associated With ACL Injury

2021 ◽  
Vol 10 (3) ◽  
pp. 470-485
Author(s):  
Nazanin Dalvandpour ◽  
◽  
Mostafa Zarei ◽  
Behrouz Abdoli ◽  
Hamed Abbasi ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Ground Reaction Force ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Acl Injury ◽  
Control Group ◽  
External Focus ◽  
Time To Stabilization ◽  
Internal Focus ◽  
Anterior Cruciate

Background and Aims One of the most common and dangerous injuries in sports is an Anterior Cruciate Ligament (ACL) injury. Today, despite the ACL injury prevention programs, the prevalence of this injury remains high. Most of the instructions used in injury prevention programs are based on internal focus, while studies have shown that using external focus can improve performance in individuals. The purpose of this study was to investigate the effect of focus of attention on eight weeks of anterior cruciate ligament injury prevention training on landing skill kinetic variables in soccer players. Methods The current methodology included 35 players from 3 premier league teams in Tehran province. The teams were randomly divided into three groups of Prevent injury and Enhance Performance (PEP) exercises based on the External Focus (EF) (12 people), Internal Focus (IF) (12 people), and control group (11 people). In the pretest of ground reaction force, rate of loading, and time to stabilization during landing skill. The training groups performed pep injury prevention exercises for eight weeks and related instructions instead of warm-up exercises. Control group players were performing the regular activities. ANOVA with repeated measures and one-way ANOVA and Tukey post hoc tests were used to evaluate changes Results The test results showed significant changes in vertical, anterior-posterior ground reaction force and rate of loading in the external focus group (P≤0.05). But there was no critical difference in time to stabilization and internal-external ground reaction force. Conclusion According to the results, external focus instruction has positive effects on kinetic components. Therefore, it is recommended that exercises based on these instructions be used to reduce the risk of ACL injury and to repair this injury.

scholarly journals Effect of Fatigue on Ground Reaction Force Variables During Single-leg Landing in Athletes With the History of Anterior Cruciate Ligament Injury

2020 ◽  
Vol 11 (1) ◽  
pp. 13-22
Author(s):  
Komeil Dashti Rostami ◽  
◽  
Mohammad Hossein Alizadeh ◽  
Hooman Minoonejad ◽  
Hamidreza Yazdi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Ground Reaction Force ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Ligament Injury ◽  
Control Group ◽  
Vertical Force ◽  
History Of ◽  
Anterior Cruciate

Introduction: Since people experience fatigue after anterior cruciate ligament injury during exercises, it is important to understand how fatigue affects the biomechanical movement patterns. Therefore, this study aimed to investigate the effect of fatigue on ground reaction force variables during single-leg landing in athletes with a history of an anterior cruciate ligament sprain. Methods: it was a case-control study conducted in the University Laboratory. The sample consisted of 36 male athletes who were divided into three groups: 12 people with Anterior Cruciate Ligament Reconstruction (ACLR), 12 people with Anterior Cruciate Ligament Deficiency (ACLD), and 12 people as the control group. Fatigue was induced via the repetitive sets of double-leg squats (n=8), which were interspersed with the sets of countermovement jumps (n=2) and single-leg landings (n=3) until squats were no longer possible. A 2×2 repeated-measures multivariate analysis of variance was used to detect the main effects of group (ACLD, ACLR, control) and fatigue state (prefatigue, postfatigue) on the ground reaction forces variables. Results: The results showed a significant decrease in the peak vertical force and internal-external ground reaction force in the ACLD group after fatigue. Regardless of the fatigue state, the peak vertical ground reaction force in ACLD and ACLR groups was significantly lower than that in the control group. Conclusion: The athletes with the ACL injury, regardless of the selective treatment type, use compensatory strategies to reduce the contact forces on the lower extremity, compared with healthy athletes.

scholarly journals Biomechanically-Informed Training: The Four Pillars for Knee and ACL Injury Prevention Built Upon Behavior Change and Motivation Principles

2020 ◽  
Vol 10 (13) ◽  
pp. 4470
Author(s):  
Cyril J. Donnelly ◽  
Ben S. Jackson ◽  
Daniel F. Gucciardi ◽  
Jeff Reinbolt
Keyword(s):  
Behavior Change ◽  
Injury Prevention ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Musculoskeletal Injury ◽  
Rehabilitation Outcomes ◽  
Anterior Cruciate ◽  
Physics Based Simulation ◽  
And Behavior

Injury prevention frameworks are critical for preventing musculoskeletal injury and improving rehabilitation outcomes. However, their relative successes in translation arguably rely on two interlinked components: (1) the quality of the empirical evidence used to develop the intervention (content), and (2) the effective application of behavior change and motivation principles to optimise participant adherence and engagement (delivery). The purpose of this commentary is to develop an injury prevention and rehabilitation framework using the best available physics-based simulation, biomechanics, and behavior change research. The intervention as a whole is entitled biomechanically-informed training (BIT). While investigators have previously examined the relative merits of different training genres (e.g., plyometric, balance, resistance), what makes BIT novel is that it explicitly targets the biomechanical mechanisms that mitigate musculoskeletal injury risk (i.e., force) in ways that are underpinned by established behavior change principles. The four pillars of BIT refer to focused exercise use, irrespective of the training genre, to improve an individual’s: (1) knee flexion dynamics, (2) dynamic trunk control, (3) gastrocnemius muscle strength, and (4) hip muscular strength. We also present experimental data from two independent training studies verifying the efficacy of BIT for the prevention of knee and anterior cruciate ligament (ACL) injury.

scholarly journals Jump-Landing Biomechanics and Knee-Laxity Change Across the Menstrual Cycle in Women With Anterior Cruciate Ligament Reconstruction

2014 ◽  
Vol 49 (2) ◽  
pp. 154-162 ◽  
Author(s):  
David R. Bell ◽  
J. Troy Blackburn ◽  
Anthony C. Hackney ◽  
Stephen W. Marshall ◽  
Anthony I. Beutler ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Knee Laxity ◽  
Acl Injury ◽  
Initial Contact ◽  
Vertical Ground Reaction Force ◽  
Jump Landing ◽  
Anterior Knee Laxity ◽  
Anterior Cruciate

Context: Of the individuals able to return to sport participation after an anterior cruciate ligament(ACL) injury, up to 25% will experience a second ACL injury. This population may be more sensitive to hormonal fluctuations, which may explain this high rate of second injury. Objective: To examine changes in 3-dimensional hip and knee kinematics and kinetics during a jump landing and to examine knee laxity across the menstrual cycle in women with histories of unilateral noncontact ACL injury. Design  Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: A total of 20 women (age = 19.6 ± 1.3 years, height = 168.6 ± 5.3 cm, mass = 66.2 ± 9.1 kg) with unilateral, noncontact ACL injuries. Intervention(s) Participants completed a jump-landing task and knee-laxity assessment 3 to 5 days after the onset of menses and within 3 days of a positive ovulation test. Main Outcome Measure(s): Kinematics in the uninjured limb at initial contact with the ground during a jump landing, peak kinematics and kinetics during the loading phase of landing, anterior knee laxity via the KT-1000, peak vertical ground reaction force, and blood hormone concentrations (estradiol-β-17, progesterone, free testosterone). Results: At ovulation, estradiol-β-17 (t = −2.9, P = .009), progesterone (t = −3.4, P = .003), and anterior knee laxity (t = −2.3, P = .03) increased, and participants presented with greater knee-valgus moment (Z = −2.6, P = .01) and femoral internal rotation (t = −2.1, P = .047). However, during the menses test session, participants landed harder (greater peak vertical ground reaction force; t = 2.2, P = .04), with the tibia internally rotated at initial contact (t = 2.8, P = .01) and greater hip internal-rotation moment (Z = −2.4, P = .02). No other changes were observed across the menstrual cycle. Conclusions Knee and hip mechanics in both phases of the menstrual cycle represented a greater potential risk of ACL loading. Observed changes in landing mechanics may explain why the risk of second ACL injury is elevated in this population.

scholarly journals Anterior Cruciate Ligament Injury

2014 ◽  
Vol 2 (12_suppl4) ◽  
pp. 2325967114S0025
Author(s):  
Tomas Vilaseca ◽  
Jorge Chahla ◽  
Gustavo Gomez Rodriguez ◽  
Damián Arroquy ◽  
Gonzalo Perez Herrera ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Internal Rotation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
T Test ◽  
Control Group ◽  
Recreational Athletes ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Knee Pathology

Objectives: The objective of this study was to analyze whether it is more frequent the presence of a decreased range of motion in the hips of recreational athletes with primary injury of the anterior cruciate ligament (ACL) than in a control group of volunteers without knee pathology. Methods: We included prospectively recreational athletes between 18 and 40 years with an acute ACL injury between January 2011 and January 2013. They were compared with a control group of volunteers recreational athletes without lower limb pathology and in the same range of age. The internal and external rotations passively prior to the point at which the pelvis movement contributes were observed. The results were statistically analyzed using t test for related samples to the hips of patients with ACL injury and t test for independent variables for comparison with the control group. Results: 48 patients with ACL injury and 53 healthy volunteers were evaluated. The ACL group was composed of 32 males and 16 females with an average age of 29.3 years. In the control group 26 males and 27 females were studied with a mean age of 26.6 years. Internal (IR) and external (ER) rotation in the LCA group was 22,9º and 55,5º respectively in the ipsilateral hip and 27,9º and 57,7º in the contralateral. In the control group a 35,9º of IR and 55,2º of ER was observed. The analysis showed an association between ACL injury and hypomotility of the hip further expense of a decrease in internal rotation. The analysis showed an association between ACL injury and hypomotility of the hip at the expense to a greater decrease in internal rotation. Conclusion: We found a statistically significant difference in the mobility of the hips in patients with ACL injury predominantly due to internal rotation, pattern that allows us to interpret this injury not only as an intrinsic etiology of the knee but also of the adjacent joints. We consider very importance to incorporate prevention activities and screening of risk factors regarding to at least high performance athletes.

Effects of Sports Injury Prevention Training on the Biomechanical Risk Factors of Anterior Cruciate Ligament Injury in High School Female Basketball Players

2009 ◽  
Vol 37 (9) ◽  
pp. 1728-1734 ◽  
Author(s):  
Bee-Oh Lim ◽  
Yong Seuk Lee ◽  
Jin Goo Kim ◽  
Keun Ok An ◽  
Jin Yoo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Prevention ◽  
Cruciate Ligament ◽  
Sports Injury ◽  
Ligament Injury ◽  
Control Group ◽  
Basketball Players ◽  
Prevention Training ◽  
Anterior Cruciate ◽  
Experimental Group

Background Female athletes have a higher risk of anterior cruciate ligament injury than their male counterparts who play at similar levels in sports involving pivoting and landing. Hypothesis The competitive female basketball players who participated in a sports injury prevention training program would show better muscle strength and flexibility and improved biomechanical properties associated with anterior cruciate ligament injury than during the pretraining period and than posttraining parameters in a control group. Study Design Controlled laboratory study. Methods A total of 22 high school female basketball players were recruited and randomly divided into 2 groups (the experimental group and the control group, 11 participants each). The experimental group was instructed in the 6 parts of the sports injury prevention training program and performed it during the first 20 minutes of team practice for the next 8 weeks, while the control group performed their regular training program. Both groups were tested with a rebound-jump task before and after the 8-week period. A total of 21 reflective markers were placed in preassigned positions. In this controlled laboratory study, a 2-way analysis of variance (2 × 2) experimental design was used for the statistical analysis (P < .05) using the experimental group and a testing session as within and between factors, respectively. Post hoc tests with Sidak correction were used when significant factor effects and/or interactions were observed. Results A comparison of the experimental group's pretraining and posttraining results identified training effects on all strength parameters (P = .004 to .043) and on knee flexion, which reflects increased flexibility (P = .022). The experimental group showed higher knee flexion angles (P = .024), greater interknee distances (P = .004), lower hamstring-quadriceps ratios (P = .023), and lower maximum knee extension torques (P = .043) after training. In the control group, no statistical differences were observed between pretraining and posttraining findings (P = .084 to .873). At pretraining, no significant differences were observed between the 2 groups for any parameter (P = .067 to .784). However, a comparison of the 2 groups after training revealed that the experimental group had significantly higher knee flexion angles (P = .023), greater knee distances (P = .005), lower hamstring-quadriceps ratios (P = .021), lower maximum knee extension torques (P = .124), and higher maximum knee abduction torques (P = .043) than the control group. Conclusion The sports injury prevention training program improved the strength and flexibility of the competitive female basketball players tested and biomechanical properties associated with anterior cruciate ligament injury as compared with pretraining parameters and with posttraining parameters in the control group. Clinical Relevance This injury prevention program could potentially modify the flexibility, strength, and biomechanical properties associated with ACL injury and lower the athlete's risk for injury.

scholarly journals Increased Lateral and Medial Femoral Posterior Radius Ratios Are Risk Factors for Anterior Cruciate Ligament Injury

2021 ◽  
Author(s):  
Chunxu Fu ◽  
Xuguo Fan ◽  
Shigang Jiang ◽  
Junsen Wang ◽  
Tong Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Distal Femur ◽  
Cruciate Ligament ◽  
Morphological Characteristics ◽  
Acl Injury ◽  
Curve Analysis ◽  
Control Group ◽  
Roc Curve Analysis ◽  
Injury Group ◽  
Anterior Cruciate

Abstract Background Many studies have shown that the distal femoral sagittal morphological characteristics had a clear relationship with knee joint kinematics. The aim of this study was to determine the relationship between distal femoral sagittal morphological characteristics and noncontact anterior cruciate ligament (ACL) injury. Methods A retrospective case-control study of 148 patients was conducted. Two age- and sex-matched cohorts (each n = 74) were analysed: a noncontact ACL injury group and a control group. The lateral femoral posterior radius (LFPR), medial femoral posterior radius (MFPR), lateral height of the distal femur (LH), medial height of the distal femur (MH), lateral femoral anteroposterior diameter (LFAP), medial femoral anteroposterior diameter (MFAP), lateral femoral posterior radius ratio (LFPRR), and medial femoral posterior radius ratio (MFPRR) were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the significance of the LFPRR and MFPRR in predicting ACL injury. Results Compared with patients in the control group, patients in the ACL injury group had an increased LFPR, MFPR, MFAP, LFPRR, and MFPRR. ROC curve analysis revealed that an increased LFPRR above 31.7% was associated with noncontact ACL injury, with a sensitivity of 78.4% and a specificity of 58.1%, and an increased MFPRR above 33.4% was associated with noncontact ACL injury, with a sensitivity of 58.1% and a specificity of 70.3%. Conclusion This study showed that increased LFPRR and MFPRR were risk factors for noncontact ACL injury. These data could help identify individuals susceptible to ACL injuries.

scholarly journals Effects of a neuromuscular training program using external focus attention cues in male athletes with anterior cruciate ligament reconstruction: a randomized clinical trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohamad Ghaderi ◽  
Amir Letafatkar ◽  
Abbey C. Thomas ◽  
Sohrab Keyhani
Keyword(s):  
Training Program ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Neuromuscular Training ◽  
Control Group ◽  
Male Athletes ◽  
External Focus ◽  
Patient Reported ◽  
Anterior Cruciate ◽  
Experimental Group

Abstract Background Athletes who have undergone anterior cruciate ligament (ACL) reconstruction often exhibit persistent altered biomechanics and impaired function. Neuromuscular training programs appear to be effective for reducing high-risk landing mechanics and preventing primary ACL injuries; however, there have been few attempts to examine their effects in athletes who have undergone ACL reconstruction. The purpose of our study was to examine the effects of a neuromuscular training program that emphasizes external focus of attention cuing on biomechanics, knee proprioception, and patient-reported function in athletes who had undergone ACL reconstruction and completed conventional post-operative rehabilitation. Methods Twenty-four male athletes who had undergone primary, unilateral, hamstring autograft ACL reconstruction and completed conventional post-operative rehabilitation were randomly allocated to an experimental group (n = 12) who took part in an 8-week neuromuscular training program or a control group (n = 12) who continued a placebo program. The neuromuscular training program included lower extremity strengthening and plyometric exercises, balance training, and movement pattern re-training. Biomechanics during single-leg landing, knee proprioception, and patient-reported function were assessed before and after the 8-week training period. Results Athletes in the experimental group demonstrated increased trunk, hip, and knee flexion angles and decreased knee abduction, internal rotation angles and knee valgus during landing following the intervention. Further, the experimental group decreased their peak knee extension and abduction moments and vertical ground reaction force on landing post-intervention. International Knee Documentation Committee questionnaire (IKDC) scores increased in the experimental group following training. The control group demonstrated no changes in any variable over the same time period. Conclusions Neuromuscular training with external focus of attention cueing improved landing biomechanics in patients after ACL reconstruction. Neuromuscular training programs beneficially mitigate second ACL injury risk factors and should be emphasized during and after traditional post-operative rehabilitation. Trial registration Current Controlled Trials using the IRCT website with ID number of, IRCT20180412039278N1 “Prospectively registered” at 21/12/2018.

Is the Combination of COL1A1 Gene Polymorphisms a Marker of Injury Risk?

2017 ◽  
Vol 26 (3) ◽  
pp. 234-238 ◽  
Author(s):  
Marta Stepien-Slodkowska ◽  
Krzysztof Ficek ◽  
Pawel Zietek ◽  
Mariusz Kaczmarczyk ◽  
Wioletta Lubkowska ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Body Part ◽  
Acl Rupture ◽  
Control Group ◽  
Genotype Distribution ◽  
Anterior Cruciate ◽  
And Control

Context:The most commonly injured body part for skiing has been found to be the knee. The rupture of the anterior cruciate ligament (ACL) was the most frequent diagnosis. ACL ruptures are determined by several extrinsic and intrinsic risk factors including those that are hormonal, neuromuscular, anatomical, or genetic.Objectives:To examine the association of both COL1A1 rs1800012 (+1245G/T) and COL1A1 rs1107946 (–1997G/T) polymorphisms, individually and as haplotypes, with ACL ruptures in recreational Polish skiers.Design:Genomic DNA was extracted from buccal cells donated by the subjects, and genotyping was carried out using real-time polymerase chain reaction.Settings:University laboratory.Participants:138 male recreational skiers with surgically diagnosed primary ruptures and 183 apparently healthy male recreational skiers not differing markedly in age or level of exposure to ACL injury.Main Outcome Measures:COL1A1 rs1800012 and COL1A1 rs1107946 polymorphisms.Results:There were significant differences in genotype distribution of the COL1A1 rs1800012 polymorphism between the ACL rupture group and the control group. The GG homozygotes were underrepresented in the ACL rupture group compared with the control group. There were no significant differences in genotype distribution or allele frequency of COL1A1 rs1107946 polymorphisms between the ACL rupture group and the control group. The G-G (COL1A1 rs1800012G and COL1A1 rs1107946G) haplotype was the most common. There were no significant differences in haplotype distribution between the ACL-rupture and control groups.Conclusion:The study showed that GG homozygotes were underrepresented in the ACL-rupture group compared with the control group, which suggests an association with reduced risk of ACL injury.

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