scholarly journals Immediate Effect of Anterior Cruciate Ligament Protective Knee Taping on Knee Landing Mechanics and Muscle Activations during Side Hops

2021 ◽  
Vol 18 (19) ◽  
pp. 10110
Author(s):  
Yu-Lun Huang ◽  
Kuang-Wei Lin ◽  
Li-Wei Chou ◽  
Eunwook Chang
Keyword(s):  
Anterior Cruciate Ligament ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Abduction Angle ◽  
Healthy Individuals ◽  
Landing Mechanics ◽  
Knee Abduction ◽  
Anterior Cruciate ◽  
Muscle Activations

Athletic taping is widely used in sports to prevent injury. However, the effect of anterior cruciate ligament (ACL) protective taping on neuromuscular control during dynamic tasks remains unclear. Therefore, this study aimed to investigate the immediate effect of ACL protective taping on landing mechanics and muscle activations during side hops in healthy individuals. Fifteen healthy individuals (11 males and 4 females; age, 23.1 ± 1.4 years; height, 175.1 ± 10.4 cm; weight, 66.3 ± 11.2 kg) volunteered to participate in this study. Landing mechanics and muscle activations were measured while each participant performed single-leg hops side-to-side for ten repetitions with and without taping. An optical motion capture system and two force plates were used to collect the kinematic and kinetic data during the side hops. Surface electromyogram recordings were performed using a wireless electromyography system. Paired t-tests were performed to determine the differences in landing mechanics and muscle activations between the two conditions (taping and non-taping). The level of significance was set at p < 0.05. Compared with the non-taping condition, participants landed with a smaller knee abduction angle, greater knee external rotation angle, and smaller knee extensor moment in the taping condition. Given that greater knee abduction, internal rotation, and knee extension moment are associated with a greater risk of ACL injury, our findings suggest that ACL protective taping can have an immediate effect on dynamic knee stability. Clinicians should consider using ACL protective taping to facilitate the use of favorable landing mechanics for ACL injuries.

scholarly journals A Comparison of Knee Abduction Angles Measured by a 3D Anatomic Coordinate System Versus Videographic Analysis: Implications for Anterior Cruciate Ligament Injury

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711881983 ◽  
Author(s):  
Zoë A. Englander ◽  
Hattie C. Cutcliffe ◽  
Gangadhar M. Utturkar ◽  
William E. Garrett ◽  
Charles E. Spritzer ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Coordinate System ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Coronal Plane ◽  
Ligament Injury ◽  
Abduction Angle ◽  
Knee Abduction ◽  
Anterior Cruciate

Background: Knee positions involved in noncontact anterior cruciate ligament (ACL) injury have been studied via analysis of injury videos. Positions of high ACL strain have been identified in vivo. These methods have supported different hypotheses regarding the role of knee abduction in ACL injury. Purpose/Hypothesis: The purpose of this study was to compare knee abduction angles measured by 2 methods: using a 3-dimensional (3D) coordinate system based on anatomic features of the bones versus simulated 2-dimensional (2D) videographic analysis. We hypothesized that knee abduction angles measured in a 2D videographic analysis would differ from those measured from 3D bone anatomic features and that videographic knee abduction angles would depend on flexion angle and on the position of the camera relative to the patient. Study Design: Descriptive laboratory study. Methods: Models of the femur and tibia were created from magnetic resonance images of 8 healthy male participants. The models were positioned to match biplanar fluoroscopic images obtained as participants posed in lunges of varying flexion angles (FLAs). Knee abduction angle was calculated from the positioned models in 2 ways: (1) varus-valgus angle (VVA), defined as the angle between the long axis of the tibia and the femoral transepicondylar axis by use of a 3D anatomic coordinate system; and (2) coronal plane angle (CPA), defined as the angle between the long axis of the tibia and the long axis of the femur projected onto the tibial coronal plane to simulate a 2D videographic analysis. We then simulated how changing the position of the camera relative to the participant would affect knee abduction angles. Results: During flexion, when CPA was calculated from a purely anterior or posterior view of the joint—an ideal scenario for measuring knee abduction from 2D videographic analysis—CPA was significantly different from VVA ( P < .0001). CPA also varied substantially with the position of the camera relative to the participant. Conclusion: How closely CPA (derived from 2D videographic analysis) relates to VVA (derived from a 3D anatomic coordinate system) depends on FLA and camera orientation. Clinical Relevance: This study provides a novel comparison of knee abduction angles measured from 2D videographic analysis and those measured within a 3D anatomic coordinate system. Consideration of these findings is important when interpreting 2D videographic data regarding knee abduction angle in ACL injury.

Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes: A Prospective Study

2005 ◽  
Vol 33 (4) ◽  
pp. 492-501 ◽  
Author(s):  
Timothy E. Hewett ◽  
Gregory D. Myer ◽  
Kevin R. Ford ◽  
Robert S. Heidt ◽  
Angelo J. Colosimo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Injury Risk ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Ligament Injury ◽  
Knee Abduction ◽  
Anterior Cruciate ◽  
Dynamic Valgus

Background Female athletes participating in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than do male athletes. Hypothesis Prescreened female athletes with subsequent anterior cruciate ligament injury will demonstrate decreased neuromuscular control and increased valgus joint loading, predicting anterior cruciate ligament injury risk. Study Design Cohort study; Level of evidence, 2. Methods There were 205 female athletes in the high-risk sports of soccer, basketball, and volleyball prospectively measured for neuromuscular control using 3-dimensional kinematics (joint angles) and joint loads using kinetics (joint moments) during a jump-landing task. Analysis of variance as well as linear and logistic regression were used to isolate predictors of risk in athletes who subsequently ruptured the anterior cruciate ligament. Results Nine athletes had a confirmed anterior cruciate ligament rupture; these 9 had significantly different knee posture and loading compared to the 196 who did not have anterior cruciate ligament rupture. Knee abduction angle (P <. 05) at landing was 8° greater in anterior cruciate ligament-injured than in uninjured athletes. Anterior cruciate ligament-injured athletes had a 2.5 times greater knee abduction moment (P <. 001) and 20% higher ground reaction force (P <. 05), whereas stance time was 16% shorter; hence, increased motion, force, and moments occurred more quickly. Knee abduction moment predicted anterior cruciate ligament injury status with 73% specificity and 78% sensitivity; dynamic valgus measures showed a predictive r2 of 0.88. Conclusion Knee motion and knee loading during a landing task are predictors of anterior cruciate ligament injury risk in female athletes. Clinical Relevance Female athletes with increased dynamic valgus and high abduction loads are at increased risk of anterior cruciate ligament injury. The methods developed may be used to monitor neuromuscular control of the knee joint and may help develop simpler measures of neuromuscular control that can be used to direct female athletes to more effective, targeted interventions.

scholarly journals Neuromuscular Training Improves Self-Reported Function and Single-Leg Landing Hip Biomechanics in Athletes After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095934
Author(s):  
Christopher Nagelli ◽  
Stephanie Di Stasi ◽  
Rachel Tatarski ◽  
Albert Chen ◽  
Samuel Wordeman ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Neuromuscular Training ◽  
Abduction Angle ◽  
Hip Biomechanics ◽  
Hip Abduction ◽  
Anterior Cruciate ◽  
Hip Flexion ◽  
Main Effects

Background: Neuromuscular training (NMT) has been shown to attenuate high-risk biomechanics in uninjured athletes. At the time that athletes return to sport after anterior cruciate ligament (ACL) reconstruction (ACLR), they demonstrate hip biomechanical deficits associated with injury to the reconstructed knee versus the uninjured contralateral knee. Purpose: The primary purpose of the study was to examine whether an NMT program can improve single-leg drop (SLD) landing hip biomechanics for athletes after ACLR. Secondarily, we compared the posttraining SLD hip biomechanics of athletes after ACLR with a control group of athletes who also completed the NMT program. Study Design: Controlled laboratory study. Methods: A total of 18 ACLR and 10 uninjured athletes were recruited and completed a 12-session NMT program. A knee-specific questionnaire and biomechanics of an SLD task was evaluated for each athlete before and after NMT. Paired t tests were used to compare pre- and posttraining International Knee Documentation Committee (IKDC) scores. Repeated-measures analysis of variance (ANOVA) was performed to assess the main effects and interactions of testing session × limb for the ACLR athletes. A 2-way ANOVA was conducted to quantify the interactions and main effects of group × limb. Results: There was a significant increase ( P = .03) in IKDC scores from pre- to posttraining. For the ACLR athletes, there was a significant session × limb interaction for hip external rotation moment ( P = .02) and hip abduction angle ( P = .013). Despite increases in hip external rotation moment, no significant changes from pre- to posttraining were observed for the involved limbs. No significant changes were observed for hip abduction angle of the involved limbs between training sessions. Significant main effects of session ( P < .05) revealed that athletes landed with greater hip excursion, lower hip flexion moment, and lower ground-reaction force after training. The posttraining comparison between the ACLR and control groups found no significant group × limb interactions for any of the hip kinematic or kinetic variables. A significant main effect of group ( P < .05) revealed that the ACLR athletes landed with greater hip flexion angle and hip external rotation moment. Conclusion: ACLR athletes demonstrated an improvement in SLD hip biomechanics and neuromuscular control after participating in an NMT program. Clinical Relevance: This evidence indicates a potential role for NMT to improve hip biomechanics during an SLD task so as to reduce ACL injury risk.

Examining the Dynamic Nature of Anterior Cruciate Ligament Injury Risk Factors in Women’s Collegiate Soccer

2021 ◽  
pp. 1-8
Author(s):  
Elena M. D’Argenio ◽  
Timothy G. Eckard ◽  
Barnett S. Frank ◽  
William E. Prentice ◽  
Darin A. Padua
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Range Of Motion ◽  
Injury Risk ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Dynamic Risk Factors ◽  
Dynamic Risk ◽  
Anterior Cruciate

Context: Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women’s soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. Design: Prospective cohort study. Methods: Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women’s soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10 weeks of a competitive soccer season. Results: Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. Conclusions: Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women’s collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.

Alterations in Quadriceps Neurologic Complexity After Anterior Cruciate Ligament Reconstruction

2020 ◽  
pp. 1-6
Author(s):  
Steven M. Davi ◽  
Colleen K. Woxholdt ◽  
Justin L. Rush ◽  
Adam S. Lepley ◽  
Lindsey K. Lepley
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Vastus Lateralis ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Electromyographic Activity ◽  
Vastus Medialis ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Context: Traditionally, quadriceps activation failure after anterior cruciate ligament reconstruction (ACLR) is estimated using discrete isometric torque values, providing only a snapshot of neuromuscular function. Sample entropy (SampEn) is a mathematical technique that can measure neurologic complexity during the entirety of contraction, elucidating qualities of neuromuscular control not previously captured. Objective: To apply SampEn analyses to quadriceps electromyographic activity in order to more comprehensively characterize neuromuscular deficits after ACLR. Design: Cross-sectional. Setting: Laboratory. Participants: ACLR: n = 18; controls: n = 24. Interventions: All participants underwent synchronized unilateral quadriceps isometric strength, activation, and electromyography testing during a superimposed electrical stimulus. Main Outcome Measures: Group differences in strength, activation, and SampEn were evaluated with t tests. Associations between SampEn and quadriceps function were evaluated with Pearson product–moment correlations and hierarchical linear regressions. Results: Vastus medialis SampEn was significantly reduced after ACLR compared with controls (P = .032). Vastus medialis and vastus lateralis SampEn predicted significant variance in activation after ACLR (r2 = .444; P = .003). Conclusions: Loss of neurologic complexity correlates with worse activation after ACLR, particularly in the vastus medialis. Electromyographic SampEn is capable of detecting underlying patterns of variability that are associated with the loss of complexity between key neurophysiologic events after ACLR.

scholarly journals Longitudinal Assessment of Noncontact Anterior Cruciate Ligament Injury Risk Factors During Maturation in a Female Athlete: A Case Report

2009 ◽  
Vol 44 (1) ◽  
pp. 101-109 ◽  
Author(s):  
Gregory D. Myer ◽  
Kevin R. Ford ◽  
Jon G. Divine ◽  
Eric J. Wall ◽  
Leamor Kahanov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Body Mass ◽  
Female Athlete ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Knee Abduction ◽  
Injury Risk Factors ◽  
Anterior Cruciate

Abstract Objective: To present a unique case of a young pubertal female athlete who was prospectively monitored for previously identified anterior cruciate ligament (ACL) injury risk factors for 3 years before sustaining an ACL injury. Background: In prospective studies, previous investigators have examined cross-sectional measures of anatomic, hormonal, and biomechanical risk factors for ACL injury in young female athletes. In this report, we offer a longitudinal example of measured risk factors as the participant matured. Differential Diagnosis: Partial or complete tear of the ACL. Measurements: The participant was identified from a cohort monitored from 2002 until 2007. No injury prevention training or intervention was included during this time in the study cohort. Findings: The injury occurred in the year after the third assessment during the athlete's club basketball season. Knee examination, magnetic resonance imaging findings, and arthroscopic evaluation confirmed a complete ACL rupture. The athlete was early pubertal in year 1 of the study and pubertal during the next 2 years; menarche occurred at age 12 years. At the time of injury, she was 14.25 years old and postpubertal, with closing femoral and tibial physes. For each of the 3 years before injury, she demonstrated incremental increases in height, body mass index, and anterior knee laxity. She also displayed decreased hip abduction and knee flexor strength, concomitant with increased knee abduction loads, after each year of growth. Conclusions: During puberty, the participant increased body mass and height of the center of mass without matching increases in hip and knee strength. The lack of strength and neuromuscular adaptation to match the increased demands of her pubertal stature may underlie the increased knee abduction loads measured at each annual visit and may have predisposed her to increased risk of ACL injury.

scholarly journals Acute effects of the Prevent injury and Enhance Performance warm-up on potential reinjury risk factors associated with unanticipated jump landings: Study protocol for a crossover randomized controlled trial in individuals cleared for return to sports after anterior cruciate ligament reconstruction.

2020 ◽  
Author(s):  
Evans Y. K. Ashigbi ◽  
Florian Giesche ◽  
Winfried Banzer ◽  
David A. Groneberg ◽  
Daniel Niederer
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Moderate Intensity ◽  
Return To Sports ◽  
Acute Effects ◽  
Warm Up ◽  
Randomized Controlled ◽  
Anterior Cruciate

Abstract BackgroundIn team-sports such as football or basketball, athletes need to rapidly adapt their motor plans and actions to unanticipated changes in the environment. Unanticipated jump-landing tasks have been found to elevate the risk of non-contact anterior cruciate ligament (ACL) injuries compared to an anticipated condition. ACL-reconstructed individuals may have greater difficulties to maintain neuromuscular control under unanticipated conditions exposing them to a higher reinjury risk during the game. The planned trial aims to investigate the acute effects of a team-sport specific injury prevention programme on potential ACL reinjury risk factors under anticipated and unanticipated jump-landings.Methods and design:Single center randomized controlled crossover trial. Female and male ACL-reconstructed participants cleared for return to sports (≥ 6 months and ≤ 24 months post-reconstruction) will be included. In a randomized sequence and with a washout phase of one week in between, the participants will perform an injury preventive warm-up protocol (PEP; strengthening, flexibility, plyometry and agility) and a standard warm-up program (bicycle ergometer). Both interventions will last for 12 minutes and will be conducted at moderate intensity (BORG scale: 12 to 14). After each warm-up, participants will perform counter movement jumps with single-leg landings on a force plate. Prior to the jump, a left or right footprint (equally distributed) will be indicated on a screen. Under the anticipated condition, the participants will be informed before the jump that the displayed footprint will not change after take-off. Under the unanticipated condition, the participants will not know whether the target landing side will remain the same (consistent with pre-movement expectations) or change (inconsistent). Under both unanticipated conditions, this information will be displayed 0.1 second after take-off and thus approximately 0.3 seconds before landing.Parametric/non-parametric crossover-analyses (carryover-tests and crossover test) for between-conditions comparisons will be applied. Trial registration: German Clinical Trials Register, identification number DRKS00016942. Registered on May 24, 2019.

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