scholarly journals Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures

2009 ◽  
Vol 44 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Jennifer M. Medina McKeon ◽  
Jay Hertel
Keyword(s):  
Lower Extremity ◽  
Pelvic Tilt ◽  
Cruciate Ligament ◽  
Femoral Anteversion ◽  
Injury Rates ◽  
Men And Women ◽  
Lower Extremity Alignment ◽  
Genu Recurvatum ◽  
Anterior Pelvic Tilt ◽  
Anterior Cruciate

Abstract Context: A discrepancy in anterior cruciate ligament (ACL) injury rates exists between men and women. Structural differences between the sexes often are implicated as a factor in this discrepancy. Researchers anecdotally assume that men and women tend to display different normative values for certain lower extremity alignments, but published information about these values is limited. Objective: To evaluate the effect of sex on 6 measures of lower extremity alignment and to report representative values of these measures from a sample of active adults and elite athletes. Design: Descriptive cohort design. Setting: University research laboratory. Patients or Other Participants: A total of 118 healthy adults (57 men: age  =  21.1 ± 3.0 years, height  =  179.1 ± 7.3 cm, mass  =  79.8 ± 13.0 kg; 61 women: age  =  20.0 ± 1.6 years, height  =  167.7 ± 6.7 cm, mass  =  62.7 ± 5.5 kg) volunteered. Main Outcome Measure(s): Six common measures of lower extremity posture (navicular drop, tibial varum, quadriceps angle, genu recurvatum, anterior pelvic tilt, femoral anteversion) were collected using established methods. One measurement was taken for each participant for each lower extremity alignment. We measured the right lower extremity only. Results: Compared with men, women demonstrated larger quadriceps angles, more genu recurvatum, greater anterior pelvic tilt, and more femoral anteversion. Conclusions: We observed differences between men and women for 4 of the 6 lower extremity alignments that we measured. Future researchers should focus on identifying how sex and skeletal alignment affect biomechanical performance of functional tasks and what these differences specifically mean regarding the discrepancy in anterior cruciate ligament injury rates between the sexes.

scholarly journals The Relationship Between Lower Extremity Alignment Characteristics and Anterior Knee Joint Laxity

2009 ◽  
Vol 1 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Sandra J. Shultz ◽  
Anh-Dung Nguyen ◽  
Beverly J. Levine
Keyword(s):  
Lower Extremity ◽  
Pelvic Tilt ◽  
Knee Laxity ◽  
Tibiofemoral Angle ◽  
Navicular Drop ◽  
Lower Extremity Alignment ◽  
Anterior Knee Laxity ◽  
Genu Recurvatum ◽  
Anterior Pelvic Tilt ◽  
Anterior Knee

Background: Lower extremity alignment may influence the load distribution at the knee, potentially predisposing the anterior cruciate ligament to greater stress. We examined whether lower extremity alignment predicted the magnitude of anterior knee laxity in men and women. Hypothesis: Greater anterior pelvic angle, hip anteversion, tibiofemoral angle, genu recurvatum, and navicular drop will predict greater anterior knee laxity. Study Design: Descriptive laboratory study. Methods: Women (n = 122) and men (n = 97) were measured for anterior knee laxity and 7 lower extremity alignment variables on their dominant stance leg. Linear regression determined the extent to which the alignment variables predicted anterior knee laxity for each sex. Results: Lower anterior pelvic tilt and tibiofemoral angle, and greater genu recurvatum and navicular drop were related to greater anterior knee laxity in women, explaining 28.1% of the variance ( P < .001). Lower anterior pelvic tilt and greater hip anteversion, genu recurvatum and navicular drop were predictors of greater anterior knee laxity in men, explaining 26.5% of the variance ( P < .001). Conclusion: Lower anterior pelvic tilt, greater knee hyperextension, and foot pronation predicted greater anterior knee laxity in both men and women, with genu recurvatum and navicular drop having the greatest impact on anterior knee laxity. Greater hip anteversion was also a strong predictor in men, while a lower tibiofemoral angle was a significant predictor in women. Clinical Relevance: The associations between lower extremity alignment and anterior knee laxity suggest that alignment of the hip, knee, and ankle may be linked to or contribute to abnormal loading patterns at the knee, potentially stressing the capsuloligamentous structures and promoting greater joint laxity.

Differences in Kinematics and Electromyographic Activity between Men and Women during the Single-Legged Squat

2003 ◽  
Vol 31 (3) ◽  
pp. 449-456 ◽  
Author(s):  
Brian L. Zeller ◽  
Jean L. McCrory ◽  
W. Ben Kibler ◽  
Timothy L. Uhl
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Muscle Activation ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Rectus Femoris ◽  
Ligament Injury ◽  
Electromyographic Activity ◽  
Men And Women ◽  
Anterior Cruciate

Background Numerous factors have been identified as potentially increasing the risk of anterior cruciate ligament injury in the female athlete. However, differences between the sexes in lower extremity coordination, particularly hip control, are only minimally understood. Hypothesis There is no difference in kinematic or electromyographic data during the single-legged squat between men and women. Study Design Descriptive comparison study. Methods We kinematically and electromyographically analyzed the single-legged squat in 18 intercollegiate athletes (9 male, 9 female). Subjects performed five single-legged squats on their dominant leg, lowering themselves as far as possible and then returning to a standing position without losing balance. Results Women demonstrated significantly more ankle dorsiflexion, ankle pronation, hip adduction, hip flexion, hip external rotation, and less trunk lateral flexion than men. These factors were associated with a decreased ability of the women to maintain a varus knee position during the squat as compared with the men. Analysis of all eight tested muscles demonstrated that women had greater muscle activation compared with men. When each muscle was analyzed separately, the rectus femoris muscle activation was found to be statistically greater in women in both the area under the linear envelope and maximal activation data. Conclusions Under a physiologic load in a position commonly assumed in sports, women tend to position their entire lower extremity and activate muscles in a manner that could increase strain on the anterior cruciate ligament.

scholarly journals Identifying Relationships Among Lower Extremity Alignment Characteristics

2009 ◽  
Vol 44 (5) ◽  
pp. 511-518 ◽  
Author(s):  
Anh-Dung Nguyen ◽  
Sandra J. Shultz
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Femoral Anteversion ◽  
Tibial Torsion ◽  
Tibiofemoral Angle ◽  
Navicular Drop ◽  
Lower Extremity Alignment ◽  
Select Group ◽  
Genu Recurvatum ◽  
The Relationship

Abstract Context: The relationship between lower extremity alignment and lower extremity injury risk remains poorly understood, perhaps because most authors have examined only individual or a select group of alignment variables. Examining the relationships among alignment variables may allow us to more accurately describe lower extremity posture and clarify the relationship between lower extremity alignment and injury risk in future studies. Objective: To measure lower extremity alignment variables and examine whether relationships could be identified among these variables. Design: Observational study. Setting: Laboratory. Patients or Other Participants: Two hundred eighteen (102 males: age  =  23.1 ± 3.2 years, height  =  177.3 ± 8.4 cm, mass  =  80.8 ± 13.0 kg; 116 females: age  =  21.8 ± 2.7 years, height  =  163.5 ± 7.4 cm, mass  =  63.4 ± 12.4 kg) healthy, college-aged participants. Main Outcome Measure(s): We measured pelvic angle, femoral anteversion, quadriceps angle, tibiofemoral angle, genu recurvatum, and tibial torsion to the nearest degree and navicular drop to the nearest millimeter on the right and left lower extremities. Separate principal components factor analyses were performed for each sex and side (left, right). Results: A distinct lower extremity factor was identified, with relationships observed among increased pelvic angle, increased quadriceps angle, and increased tibiofemoral angle. A second distinct lower extremity factor was identified, with relationships observed among increased supine genu recurvatum, decreased tibial torsion, and increased navicular drop. Femoral anteversion loaded as an independent third factor. These distinct lower extremity alignment factors were consistent across side and sex. Conclusions: Factor analysis identified 3 distinct lower extremity alignment factors that describe the potential interactions among lower extremity alignment variables. Future authors should examine how these collective alignment variables, both independently and in combination, influence dynamic knee function and risk for lower extremity injuries.

The Incidence of Anterior Cruciate Ligament Injuries among Competitive Alpine Skiers

2007 ◽  
Vol 35 (7) ◽  
pp. 1070-1074 ◽  
Author(s):  
Nicolas Pujol ◽  
Marie Philippe Rousseaux Blanchi ◽  
Pierre Chambat
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Injury Rate ◽  
Ligament Injury ◽  
Ligament Injuries ◽  
Injury Rates ◽  
Anterior Cruciate Ligament Injuries ◽  
Alpine Skiers ◽  
Anterior Cruciate

Background Little is known about the evolution of anterior cruciate ligament injury rates among elite alpine skiers. Purpose To evaluate epidemiologic aspects of anterior cruciate ligament injuries among competitive alpine skiers during the last 25 years. Study Design Descriptive epidemiology study. Methods Data were collected from elite French national teams (379 athletes: 188 women and 191 men) from 1980 to 2005. Results Fifty-three of the female skiers (28.2%) and 52 of the male skiers (27.2%) sustained at least 1 anterior cruciate ligament injury. The overall anterior cruciate ligament injury incidence was 8.5 per 100 skier-seasons. The primary anterior cruciate ligament injury rate was 5.7 per 100 skier-seasons. The prevalence of reinjury (same knee) was 19%. The prevalence of a bilateral injury (injury of the other knee) was 30.5%. At least 1 additional anterior cruciate ligament surgery (mean, 2.4 procedures) was required for 39% of the injured athletes. Men and women were similar with regard to primary anterior cruciate ligament injury rate (P = .21), career remaining after the injury (P = .44), and skiing specialty (P = .5). There were more anterior cruciate ligament injuries (primary, bilateral, reinjuries) among athletes ranking in the world Top 30 (P < .001). Anterior cruciate ligament-injured athletes had a career length of 7.5 years, whereas athletes with no anterior cruciate ligament injury had a career of 4.5 years (P < .001). Finally, injury rates remained constant over time. Conclusion Anterior cruciate ligament injury rates (primary injury, bilateral injury, reinjury) among national competitive alpine skiers are high and have not declined in the last 25 years. Finding a way to prevent anterior cruciate ligament injury in this population is a very important goal.

Relative muscle contribution of lower extremity muscles during isokinetic single leg squat in patients following reconstruction of the anterior cruciate ligament

2014 ◽  
Vol 22 (4) ◽  
pp. 343-349
Author(s):  
Sanaz Shanbehzadeh ◽  
Ali Amiri ◽  
Milad Pirali ◽  
Gholamhossein Nassadj ◽  
Hamid Reza Yazdi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Cruciate Ligament ◽  
Single Leg Squat ◽  
Anterior Cruciate

Examining the Relationship Between a Neuromuscular Control Baseline Battery for Sport-Related Concussion and Anterior Cruciate Ligament Injury Risk

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S21.2-S22
Author(s):  
Ryan Moran
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Ligament Injury ◽  
Jump Landing ◽  
Eyes Closed ◽  
Eyes Open ◽  
Anterior Cruciate ◽  
The Relationship

ObjectiveTo examine the relationship between the m-CTSIB and Landing Error Scoring System in a sample of collegiate female athletes.BackgroundRecent literature has linked concussion and neuromuscular deficits in the lower extremity after injury. Neuromuscular control is frequently assessed using balance measures for concussion, but also dynamically to identify anterior cruciate ligament injury (ACL) risk via jump-landing movement screening.Design/MethodsThirty-nine healthy, collegiate female soccer (n = 22) and volleyball (n = 17) athletes completed the modified-Clinical Test of Sensory Interaction of Balance (m-CTSIB) and the Landing Error Scoring System (LESS). Measures consisted of total m-CTSIB sway index scores on individual conditions (firm surface eyes open [condition 1] and eyes closed [2], foam surface eyes open [3] and eyes closed [4]), m-CTSIB overall score, and total LESS errors. LESS scores were also categorized into a low (0–4 errors) and high (5 + errors) risk to determine if athletes with worse neuromuscular control on the LESS has worse balance on the m-CTSIB. A Spearman's rank-order correlation was conducted to determine the strength of the relationship between LESS and m-CTSIB performance. A series of Mann-Whitney U test were performed to determine differences between low and high LESS performance on m-CTSIB performance.ResultsThere was a weak, negative correlation between LESS and m-CTSIB performance (rs(37) = −0.153, p = 0.35). Further, there were no differences between the low and high risk LESS groups on sway index scores on conditions 1 (U = 158.5, p = 0.39), 2 (U = 156.0, p = 0.36), 3 (U = 165.5, p = 0.51), or 4 (U = 128.5, p = 0.08), as well as overall m-CTSIB scores (U = 150.5, p = 0.28).ConclusionsThere appears to be a lack of relationship between the LESS and m-CTSIB tests, revealing the independence of static and dynamic lower extremity neuromuscular function. Athletes who may be more at risk for ACL injury due to abnormal jump-landing biomechanics, do not differ from low-risk athletes on baseline balance assessment.

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