Effect of attending to a ball during a side-cut maneuver on lower extremity biomechanics in male and female athletes

Many sports associated with anterior cruciate ligament (ACL) injury require athletes attend to a ball during participation. We investigated effects of attending to a ball on lower extremity mechanics during a side-cut maneuver and if these effects are consistent for males and females. Sagittal and frontal plane hip and knee kinematics and joint moments were measured during side-cut maneuvers in 19 male and 19 female National Collegiate Athletic Association division III basketball players. Participants also experienced two side-cut conditions that required attention to a ball. Our results did not indicate that the effect of attention varies with gender. However, during side-cut conditions while attending to a ball, internal knee adductor moment was 20% greater (p = 0.03) and peak knee flexion angle was 4 degrees larger (p < 0.01). Females demonstrated 5 degrees less hip flexion (p = 0.046), 12 degrees less knee flexion (p < 0.01), and 4 degrees more knee abduction (p = 0.026) at initial contact during all side-cut conditions than males. Attention to a ball may affect lower extremity mechanics relevant to ACL injury. The validity of laboratory studies of lower extremity mechanics for sports that include attention to a ball may be increased if participants are required to attend to a ball during the task.     

Divided attention during cutting influences lower extremity mechanics in female athletes

Anterior cruciate ligament (ACL) injuries in basketball appear to be more common when players are in possession of the ball. The greater risk of ACL injury when in possession of the ball may result from the athlete’s inability to fully attend to their movement. However, it is also possible that having to carry/manipulate the ball restricts the athlete’s ability to utilise their upper extremities for stability during a manoeuvre. The purpose of this study was to explore how possession of a basketball and divided attention influence lower extremity mechanics during cutting and landing. Twenty uninjured females with basketball experience performed a baseline lateral cutting task, as well as lateral cuts while carrying a basketball, with and without a subsequent chest pass. Requiring participants to carry the basketball in isolation (i.e., without the additional pass) had minimal influence on lower extremity mechanics compared to baseline. However, participants demonstrated less knee flexion (40.9° vs. 47.3°) and greater knee abduction (12.2° vs. 10.1°) for trials that included the additional pass (divided attention condition) compared to trials conducted while carrying the basketball in isolation. Athletes may be at greater risk for ACL injury when they are unable to solely attend to their movement.     

The effects of an unanticipated side-cut on lower extremity kinematics and ground reaction forces during a drop landing

Unanticipated direction to cut after landing may alter the lower extremity landing biomechanics when performing landing motions. These alterations may potentially increase the risk of ACL injury. The purpose of this study was to determine if an unanticipated side-cut affects lower extremity landing biomechanics in females. Eighteen recreational female athletes participated in two blocks of testing: the first block of testing consisted of three acceptable trials of anticipated dominant limb and non-dominant limb 45-degree diagonal cutting after landing, which were performed in a counterbalanced order. The second block of testing consisted of three acceptable trials of unanticipated dominant limb and non-dominant limb diagonal cutting after landing. Data analysis mainly focused on the dominant limb landing biomechanics. Unanticipated side-cut landing, compared (paired t-test, p < 0.05) to the anticipated landings, resulted in less hip abduction and tibial internal rotation angle at initial contact (IC) and a lower maximum ankle inversion angle and a greater maximum knee abduction angle, and knee and hip displacement. Also, greater posterior GRF and a longer time to peak medial GRF were exhibited. These outcomes indicate that athletes may adapt their landing mechanics to land unsafely when encountering an unanticipated event.     

Frontal plane comparison between drop jump and vertical jump: implications for the assessment of ACL risk of injury

The potential to use the vertical jump (VJ) to assess both athletic performance and risk of anterior cruciate ligament (ACL) injury could have widespread clinical implications since VJ is broadly used in high school, university, and professional sport settings. Although drop jump (DJ) and VJ observationally exhibit similar lower extremity mechanics, the extent to which VJ can also be used as screening tool for ACL injury risk has not been assessed. This study evaluated whether individuals exhibit similar knee joint frontal plane kinematic and kinetic patterns when performing VJs compared with DJs. Twenty-eight female collegiate athletes performed DJs and VJs. Paired t-tests indicated that peak knee valgus angles did not differ significantly between tasks (p = 0.419); however, peak knee internal adductor moments were significantly larger during the DJ vs. VJ (p < 0.001). Pearson correlations between the DJ and VJ revealed strong correlations for knee valgus angles (r = 0.93, p < 0.001) and for internal knee adductor moments (r = 0.82, p < 0.001). Our results provide grounds for investigating whether frontal plane knee mechanics during VJ can predict ACL injuries and thus can be used as an effective tool for the assessment of risk of ACL injury in female athletes.     

The effect of a secondary cognitive task on landing mechanics and jump performance

Anterior cruciate ligament (ACL) injuries commonly occur during jump-landing tasks when individuals’ attention is simultaneously allocated to other objects and tasks. The purpose of the current study was to investigate the effect of allocation of attention imposed by a secondary cognitive task on landing mechanics and jump performance. Thirty-eight recreational athletes performed a jump-landing task in three conditions: no counting, counting backward by 1 s from a randomly given number, and counting backward by 7 s from a randomly given number. Three-dimensional kinematics and ground reaction forces were collected and analysed. Participants demonstrated decreased knee flexion angles at initial contact (p = 0.001) for the counting by 1 s condition compared with the no counting condition. Participants also showed increased peak posterior and vertical ground reaction forces during the first 100 ms of landing (p ≤ 0.023) and decreased jump height (p < 0.001) for the counting by 1 s and counting by 7 s conditions compared with the no counting condition. Imposition of a simultaneous cognitive challenge resulted in landing mechanics associated with increased ACL loading and decreased jump performance. ACL injury risk screening protocols and injury prevention programmes may incorporate cognitive tasks into jump-landing tasks to better simulate sports environments.     

Knee joint coordination during single-leg landing in different directions

ABSTRACT

Knee joint coordination during jump landing in different directions is an important consideration for injury prevention. The aim of the current study was to investigate knee and hip kinematics on the non-dominant and dominant limbs during landing. A total of 19 female volleyball athletes performed single-leg jump-landing tests in four directions; forward (0°), diagonal (30° and 60°) and lateral (90°) directions. Kinematic and ground reaction force data were collected using a 10-camera Vicon system and an AMTI force plate. Knee and hip joint angles, and knee angular velocities were calculated using a lower extremity model in Visual3D. A two factor repeated measures ANOVA was performed to explore limb dominance and jump direction. Significant differences were seen between the jump directions for; angular velocity at initial contact (p < 0.001), angular velocity at peak vertical ground reaction force (p < 0.001), and knee flexion excursion (p = 0.016). Knee coordination was observed to be poorer in the early phase of velocity-angle plot during landing in lateral direction compared to forward and diagonal directions. The non-dominant limb seemed to have better coordination than the dominant limb during multi-direction jump landing. Therefore, dominant limbs appear to be at a higher injury risk than non-dominant limbs.     

The collision forces and lower-extremity inter-joint coordination during running

The purpose of this study was to compare the lower extremity inter-joint coordination of different collision forces runners during running braking phase. A dynamical system approach was used to analyse the inter-joint coordination parameters. Data were collected with six infra-red cameras and two force plates. According to the impact peak of the vertical ground reaction force, twenty habitually rearfoot-strike runners were categorised into three groups: high collision forces runners (HF group, n = 8), medium collision forces runners (MF group, n = 5), and low collision forces runners (LF group, n = 7). There were no significant differences among the three groups in the ankle and knee joint angle upon landing and in the running velocity (p > 0.05). The HF group produced significantly smaller deviation phase (DP) of the hip flexion/extension-knee flexion/extension during the braking phase compared with the MF and LF groups (p < 0.05). The DP of the hip flexion/extension-knee flexion/extension during the braking phase correlated negatively with the collision force (p < 0.05). The disparities regarding the flexibility of lower extremity inter-joint coordination were found in high collision forces runners. The efforts of the inter-joint coordination and the risk of running injuries need to be clarified further.     

Increasing hip and knee flexion during a drop-jump task reduces tibiofemoral shear and compressive forces: implications for ACL injury prevention training

Although most ACL injury prevention programmes encourage greater hip and knee flexion during landing, it remains unknown how this technique influences tibiofemoral joint forces. We examined whether a landing strategy utilising greater hip and knee flexion decreases tibiofemoral anterior shear and compression. Twelve healthy women (25.9 ± 3.5 years) performed a drop-jump task before and after a training session (10–15 min) that emphasised greater hip and knee flexion. Peak tibiofemoral anterior shear and compressive forces were calculated using an electromyography (EMG)-driven knee model that incorporated joint kinematics, EMG and participant-specific muscle volumes and patella tendon orientation measured using magnetic resonance imaging (MRI). Participants demonstrated a decrease in peak anterior tibial shear forces (11.1 ± 3.3 vs. 9.6 ± 2.7 N · kg^?1; P = 0.008) and peak tibiofemoral compressive forces (68.4 ± 7.6 vs. 62.0 ± 5.5 N · kg^?1; P = 0.015) post-training. The decreased peak anterior tibial shear was accompanied by a decrease in the quadriceps anterior shear force, while the decreased peak compressive force was accompanied by decreased ground reaction force and hamstring forces. Our data provide justification for injury prevention programmes that encourage greater hip and knee flexion during landing to reduce tibiofemoral joint loading.     

Kinematic characteristics of anterior cruciate ligament deficient knees with concomitant meniscus deficiency during ascending stairs

It is commonly believed that a torn ACL or a damaged meniscus may be associated with altered knee joint movements. The purpose of this study was to measure the tibiofemoral kinematics of ACL deficiency with concomitant meniscus deficiency. Unilateral knees of 28 ACL deficient participants were studied while ascending stairs. Among these patients, 6 had isolated ACL injuries (group I), 8 had combined ACL and medial meniscus injuries (group II), 8 had combined ACL and lateral meniscus injuries (group III) and 6 had combined ACL and medial-lateral meniscus injuries (group IV). Both knees were then scanned during a stair climb activity using single fluoroscopic image system. Knee kinematics were measured at 0°, 5°, 10°, 15°, 30° and 60° of flexion during ascending stairs. At 0°, 15° and 30° flexion of the knee, the tibia rotated externally by 13.9 ± 6.1°,13.8 ± 9.5° and 15.9 ± 9.8° in Group I. Group II and III exhibited decreased external rotation from 60° to full extension. Statistical differences were found in 0°, 15°and 30° of flexion for the 2 groups compared with Group I. In general, the tibia showed anterior translation with respect to the femur during ascending stairs. It was further determined that Group III had larger anterior translation compared with Group IV at 0° and 5° of flexion (?6.9 ± 1.7 mm vs. 6.2 ± 11.3 mm, P = 0.041; ?9.0 ± 1.8 mm vs. 8.1 ± 13.4 mm, P = 0.044). During ascending stairs the ACL deficient knee with different deficiencies in the meniscus will show significantly different kinematics compared with that of uninjured contralateral knee. Considering the varying effect of meniscus injuries on knee joint kinematics, future studies should concentrate on specific treatment of patients with combined ACL and meniscus injuries to protect the joint from abnormal kinematics and subsequent postoperative degeneration.     

Association between knee-to-hip flexion ratio during single-leg vertical landings,and strength and range of motion in professional soccer players

Abstract

The aim of this study was to test the correlation between knee-to-hip flexion ratio during a single leg landing task and hip and knee strength, and ankle range of motion. Twenty-four male participants from a professional soccer team performed a continuous single leg jump-landing test during 10s, while lower limb kinematics data were collected using a motion analysis system. After biomechanical testing, maximal isometric hip (abduction, extension, external rotation), knee extension and flexion strength were measured. Maximum ankle dorsiflexion range of motion was assessed statically using the weight bearing lunge test. Pearson correlation coefficients were calculated to determine the associations between the predictor variables (knee and hip strength, and ankle ROM) and the main outcome measure (knee-to-hip flexion ratio). Correlation between knee-to-hip flexion ratio and hip abductors strength was significant (r = ?0.47; p = 0.019). No other significant correlations were observed among the variables (p > 0.05). These results demonstrated that a lower hip abductors strength in male soccer players was correlated with a high knee-to-hip flexion ratio during landing from a single leg jump, potentially increasing knee overload by decreasing energy absorption at the hip. The results provide a novel proposal for the functioning of hip muscles to control knee overload.     

Three-dimensional kinematic comparison of treadmill and overground running

The treadmill is an attractive device for the investigation of human locomotion, yet the extent to which lower limb kinematics differ from overground running remains a controversial topic. This study aimed to provide an extensive three-dimensional kinematic comparison of the lower extremities during overground and treadmill running. Twelve participants ran at 4.0 m/s ( ± 5%) in both treadmill and overground conditions. Angular kinematic parameters of the lower extremities during the stance phase were collected at 250 Hz using an eight-camera motion analysis system. Hip, knee, and ankle joint kinematics were quantified in the sagittal, coronal, and transverse planes, and contrasted using paired t-tests. Of the analysed parameters hip flexion at footstrike and ankle excursion to peak angle were found to be significantly reduced during treadmill running by 12° (p = 0.001) and 6.6° (p = 0.010), respectively. Treadmill running was found to be associated with significantly greater peak ankle eversion (by 6.3°, p = 0.006). It was concluded that the mechanics of treadmill running cannot be generalized to overground running.     

The association between lower limb biomechanics and ball release speed in cricket fast bowlers: a comparison of high-performance and amateur competitors

The aim of this study was to compare the associations between lower limb biomechanics and ball release speed in 15 high-performance (HP) and 15 amateur fast bowlers. Kinematic and kinetic variables of the lower limbs collected in the laboratory environment with a 3D Vicon motion analysis system were compared between groups, as well as their associations with ball release speed. HP bowlers had a significantly higher run-up velocity at back foot impact but this difference became non-significant at ball release. Front knee kinematics were not statistically different, however effect sizes revealed medium-large differences with the HP group displaying a more extended knee joint at maximum flexion (d = 0.72) and ball release (d = 0.76). Only front hip positive power was significantly higher in the HP group and it was suggested that the probable cause was the HP bowlers having less knee flexion after front foot impact. From a joint power analysis, the extensor muscle groups of the hip and knee were shown to be important in developing ball release speed. This highlights the need for lower limb/core strength programmes to be multifaceted and focus on the muscles associated with both power and stability.     

The effects of limb dominance and a short term,high intensity exercise protocol on both landings of the vertical drop jump: implications for the vertical drop jump as a screening tool

The effectiveness of vertical drop jumps (VDJs) to screen for non-contact ACL injuries is unclear. This may be contributed to by discrete point analysis, which does not evaluate patterns of movement. Also, limited research exists on the second landing of VDJs, potential lower limb performance asymmetries and the effect of fatigue. Statistical parametric mapping investigated the main effects of landing, limb dominance and a high intensity, intermittent exercise protocol (HIIP) on VDJ biomechanics. Twenty-two male athletes (21.9 ± 1.1 years, 180.5 ± 5.5 cm, 79.4 ± 7.8 kg) performed VDJs pre- and post-HIIP. Repeated measures ANOVA identified pattern differences during the eccentric phases of the first and second landings bilaterally. The first landing displayed greater (internal) knee flexor (η² = 0.165), external rotator (η² = 0.113) and valgus (η² = 0.126) moments and greater hip (η² = 0.062) and knee (η² = 0.080) flexion. The dominant limb generated greater knee flexor (η² = 0.062), external rotator (η² = 0.110) and valgus (η² = 0.065) moments. The HIIP only had one effect, increased thoracic flexion relative to the pelvis (η² = 0.088). Finally, the dominant limb demonstrated greater knee extensor moments during the second landing (η² = 0.100). ACL injury risk factors were present in both landings of VDJs with the dominant limb at potentially greater injury risk. Therefore, VDJ screenings should analyse both landings bilaterally.     

Sex differences in lower extremity kinematics and patellofemoral kinetics during running

The incidence of patellofemoral pain (PFP) is 2 times greater in females compared with males of similar activity levels; however, the exact reason for this discrepancy remains unclear. Abnormal mechanics of the hip and knee in the sagittal, frontal, and transverse planes have been associated with an increased risk of PFP. The purpose of this study was to compare the mechanics of the lower extremity in males and females during running in order to better understand the reason(s) behind the sex discrepancy in PFP. Three-dimensional kinematic and kinetic data were collected as male and female participants completed overground running trials at a speed of 4.0 m · s^?1 (±5%). Patellofemoral joint stress (PFJS) was estimated using a sagittal plane knee model. The kinematics of the hip and knee in the frontal and transverse planes were also analysed. Male participants demonstrated significantly greater sagittal plane peak PFJS in comparison with the female participants (P < .001, ES = 1.9). However, the female participants demonstrated 3.5° greater peak hip adduction and 3.4° greater peak hip internal rotation (IR). As a result, it appears that the sex discrepancy in PFP is more likely to be related to differences in the kinematics of the hip in the frontal and transverse planes than differences in sagittal plane PFJS.     

Comparison of three-dimensional lower extremity running kinematics of young adult and elderly runners

Abstract

The objective of this study was to compare the three-dimensional lower extremity running kinematics of young adult runners and elderly runners. Seventeen elderly adults (age 67–73 years) and 17 young adults (age 26–36 years) ran at 3.1 m · s^?1 on a treadmill while the movements of the lower extremity during the stance phase were recorded at 120 Hz using three-dimensional video. The three-dimensional kinematics of the lower limb segments and of the ankle and knee joints were determined, and selected variables were calculated to describe the movement. Our results suggest that elderly runners have a different movement pattern of the lower extremity from that of young adults during the stance phase of running. Compared with the young adults, the elderly runners had a substantial decrease in stride length (1.97 vs. 2.23 m; P = 0.01), an increase in stride frequency (1.58 vs. 1.37 Hz; P = 0.002), less knee flexion/extension range of motion (26 vs. 33°; P = 0.002), less tibial internal/external rotation range of motion (9 vs. 12°; P < 0.001), larger external rotation angle of the foot segment (toe-out angle) at the heel strike (?5.8 vs. ?1.0°; P = 0.009), and greater asynchronies between the ankle and knee movements during running. These results may help to explain why elderly individuals could be more susceptible to running-related injuries.     

Identification of types of landings after blocking in volleyball associated with risk of ACL injury

Landing with a low knee flexion angle after volleyball block jumps may be associated with an increased risk of anterior cruciate ligament (ACL) injury. The aim of the present study was to identify the types of volleyball landings after blocks where the knee flexion angle is found to be under a critical knee flexion angle value of 30° at the instant of the first peak of the ground reaction force (GRF). Synchronized kinematic and kinetic data were collected for each trial. T-tests were used to determine if each knee flexion angle at the instant of the peak GRF was significantly different from the critical value of 30°. A repeated measures ANOVA was used to compare knee flexion angle, time to first peak and the magnitude of the first peak of the resultant GRF and knee stiffness. Significantly lower knee flexion angles were found in the “go” landing (p?=?.01, ES?=?0.6) and the “reverse” landing (p?=?.02, ES?=?0.6) only. The results for knee flexion angle and GRF parameters indicated a significant difference between a “reverse” and “go” and other types of landings, except the “side stick” landing for GRF. The “reverse” and “go” landings may present a risk for ACL injury due to the single-leg landing of these activities that have an associated mediolateral movement.     

Evaluating the contribution of lower extremity kinetics to whole body power output during the power snatch

This study evaluated the contribution of lower extremity (hip, knee and ankle) net joint torques (NJT) to whole body power (WBP) output during the power snatch (PS). Ten experienced weightlifters (five males and five females) performed five trials of the PS with 60% of one repetition maximum. Lower extremity NJT and WBP were extracted through a three-dimensional motion analyses and used for data analyses. Pearson correlation coefficients were obtained to observe the relationship between lower extremity NJT and WBP. Multiple-regression (stepwise) analyses was also conducted to evaluate the contribution of lower extremity NJT to WBP during the PS with the hip, knee and ankle NJT being the independent variables. Hip NJT was characterised as a significant positive correlation with WBP (r = 0.47, p < 0.01), while knee NJT showed a significant negative correlation with WBP (r = ?0.34, p < 0.05). A significant inter-correlation was also observed between hip NJT and knee NJT (r = ?0.66, p < 0.01). Hip NJT was identified as a significant contributor to WBP during the PS. Practically, this study suggested that training skills allowing weightlifters to utilise hip extensor muscle action would help to improve WBP during the PS.     

Side-sloped surfaces substantially affect lower limb running kinematics

Running on side-sloped surfaces is a common obstacle in the environment; however, how and to what extent the lower extremity kinematics adapt is not well known. The purpose of this study was to determine the effects of side-sloped surfaces on three-dimensional kinematics of hip, knee, and ankle during stance phase of running. Ten healthy adult males ran barefoot along an inclinable runway in level (0°) and side-sloped (10° up-slope and down-slope inclinations, respectively) configurations. Right hip, knee, and ankle angles along with their time of occurrence were analysed using repeated measures MANOVA. Up-slope hip was more adducted (p = 0.015) and internally rotated (p = 0.030). Knee had greater external rotations during side-sloped running at heel-strike (p = 0.005), while at toe-off, it rotated externally and internally during up-slope and down-slope running, respectively (p = 0.001). Down-slope ankle had greatest plantar flexion (p = 0.001). Up-slope ankle had greatest eversion compared with down-slope (p = 0.043), while it was more externally rotated (p = 0.030). These motion patterns are necessary to adjust the lower extremity length during side-sloped running. Timing differences in the kinematic events of hip adduction and external rotation, and ankle eversion were observed (p = 0.006). Knowledge on these alterations is a valuable tool in adopting strategies to enhance performance while preventing injury.     

Age and gender differences in kinematics of powerful instep kicks in soccer

Soccer kicking training should be adjusted to the characteristics of the athletes. Therefore, examination of differences in kicking kinematics of females and pubertal players relative to males is worthwhile. The purpose of the study was to compare kicking kinematics and segmental sequence parameters between male, female, and pubertal players. Ten adult male, ten adult female, and ten male pubertal players participated in the study. Participants performed five consecutive kicking trials of a stationary ball, as powerful as they could. Analysis of variance showed significantly higher ball velocity, higher joint linear velocities for the knee and the hip, and higher angular velocities of the knee and the ankle for males compared to female and pubertal players (p < 0.05). Similarly, the peak joint velocity was achieved significantly closer to ball impact in males compared to other groups (p < 0.05). Males also showed a more plantarflexed ankle immediately before ball impact (p < 0.05). Females and pubertal players may benefit from skill training aiming to increase ankle plantarflexion and hip flexion prior to ball impact, and to adjust thigh and shank motion, such that the shank–foot segment travels through a higher range of motion and with a greater velocity.     

A biomechanical investigation of right-forward lunging step among badminton players

This study presents the kinematics and plantar pressure characteristics of eight elite national-level badminton athletes and eight recreational college-level badminton players while performing a right-forward lunge movement in a laboratory-simulated badminton court. The hypothesis was that recreational players would be significantly different from elite players in kinematics and plantar pressure measures. Vicon^® motion capture and Novel^® insole plantar pressure measurement were simultaneously taken to record the lower extremity kinematics and foot loading during stance. Recreational players showed significantly higher peak pressure in the lateral forefoot (P = 0.002) and force time integral in the lateral forefoot (P = 0.013) and other toes (P = 0.005). Elite athletes showed higher peak pressure in the medial forefoot (P = 0.003), hallux (P = 0.037) and force time integral in the medial forefoot (P = 0.009). The difference in landing techniques for the lunge step between elite athletes and recreational players was observed with peak ankle eversion (?38.2°±2.4° for athletes and ?11.1°±3.9° for players, P = 0.015); smaller knee range of motion in the coronal and transverse planes, with differences in peak knee adduction (28.9°±6.8° for athletes and 15.7°±6.2° for players, P = 0.031); peak knee internal rotation (20.3°±1.3° for athletes and 11.8°±3.2° for players, P = 0.029) and peak hip flexion (77.3°±4.1° for athletes and 91.3°±9.3° for players, P = 0.037).