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° larger (p < 0.01). Females demonstrated 5° less hip flexion (p = 0.046), 12° less knee flexion (p < 0.01), and 4° 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.     

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.     

Sport-specific biomechanical responses to an ACL injury prevention programme: A randomised controlled trial

Anterior cruciate ligament (ACL) injury prevention programmes have not been as successful at reducing injury rates in women’s basketball as in soccer. This randomised controlled trial (ClinicalTrials.gov #NCT02530333) compared biomechanical adaptations in basketball and soccer players during jump-landing activities after an ACL injury prevention programme. Eighty-seven athletes were cluster randomised into intervention (6-week programme) and control groups. Three-dimensional biomechanical analyses of drop vertical jump (DVJ), double- (SAG-DL) and single-leg (SAG-SL) sagittal, and double- (FRONT-DL) and single-leg (FRONT-SL) frontal plane jump landing tasks were tested before and after the intervention. Peak angles, excursions, and joint moments were analysed using two-way MANCOVAs of post-test scores while controlling for pre-test scores. During SAG-SL the basketball intervention group exhibited increased peak knee abduction angles (p = .004) and excursions (p = .003) compared to the basketball control group (p = .01) and soccer intervention group (p = .01). During FRONT-SL, the basketball intervention group exhibited greater knee flexion excursion after training than the control group (p = .01), but not the soccer intervention group (p = .11). Although women’s soccer players exhibit greater improvements in knee abduction kinematics than basketball players, these athletes largely exhibit similar biomechanical adaptations to ACL injury prevention programmes.     

Statistical modelling of knee valgus during a continuous jump test

Landing with the knee in a valgus position is recognized as a risk factor for anterior cruciate ligament (ACL) injury. Using linear and non-linear regression analyses, the purpose of this study was to examine the correlation between two-dimensional (2D) knee valgus and three-dimensional (3D) knee kinematics measured during a jump landing task. Twenty-eight female collegiate athletes participated. All participants were required to perform a continuous jump test. The average maximum angles of abduction and internal tibial rotation during landing were measured using the Point Cluster Technique. Average peak knee valgus angle was measured using a 2D approach. Linear and non-linear regression analyses between 2D valgus and 3D knee abduction, and between 2D valgus and 3D internal tibial rotation, were performed. The R ² value between 2D valgus and 3D knee abduction was significantly different from zero and had a moderate correlation for all models, whereas the R ² value between 2D valgus and 3D internal tibial rotation was not significantly different from zero. The 2D approach could be used to screen a specific group of individuals for risk of ACL injury; however, using frontal plane 2D analysis of valgus motion to evaluate internal tibial rotation is not advised.     

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.     

Comparing the magnitude and direction of asymmetry during the squat,countermovement and drop jump tests in elite youth female soccer players

ABSTRACT

The aims of the present study were to provide an in-depth comparison of inter-limb asymmetry and determine how consistently asymmetry favours the same limb during different vertical jump tests. Eighteen elite female under-17 soccer players conducted unilateral squat jumps (SJ), countermovement jumps (CMJ) and drop jumps (DJ) on a portable force platform, with jump height, peak force, concentric impulse and peak power as common metrics across tests. For the magnitude of asymmetry, concentric impulse was significantly greater during the SJ test compared to CMJ (p = 0.019) and DJ (p = 0.003). No other significant differences in magnitude were present. For the direction of asymmetry, Kappa coefficients revealed fair to substantial levels of agreement between the SJ and CMJ (Kappa = 0.35 to 0.61) tests, but only slight to fair levels of agreement between the SJ and DJ (Kappa = ?0.26 to 0.18) and CMJ and DJ (Kappa = ?0.13 to 0.26) tests. These results highlight that the mean asymmetry value may be a poor indicator of true variability of between-limb differences in healthy athletes. The direction of asymmetry may provide a useful monitoring tool for practitioners in healthy athletes, when no obvious between-limb deficit exists.     

Targeting associated mechanisms of anterior cruciate ligament injury in female community-level athletes

This study aims to determine if biomechanically informed injury prevention training can reduce associated factors of anterior cruciate ligament injury risk among a general female athletic population. Female community-level team sport athletes, split into intervention (n = 8) and comparison groups (n = 10), completed a sidestepping movement assessment prior to and following a 9-week training period, in which kinetic, kinematic and neuromuscular data were collected. The intervention group completed a biomechanically informed training protocol, consisting of plyometric, resistance and balance exercises, adjunct to normal training, for 15–20 min twice a week. Following the 9-week intervention, total activation of the muscles crossing the knee (n = 7) decreased for both the training (? ?15.02%, d = 0.45) and comparison (? ?9.68%, d = 0.47) groups. This decrease was accompanied by elevated peak knee valgus (? +27.78%, d = ?0.36) and internal rotation moments (? +37.50%, d = ?0.56) in the comparison group, suggesting that female community athletes are at an increased risk of injury after a season of play. Peak knee valgus and internal rotation knee moments among athletes who participated in training intervention did not change over the intervention period. Results suggest participation in a biomechanically informed training intervention may mitigate the apparent deleterious effects of community-level sport participation.     

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.     

Statistical modelling of knee valgus during a continuous jump test

Landing with the knee in a valgus position is recognized as a risk factor for anterior cruciate ligament (ACL) injury. Using linear and non-linear regression analyses, the purpose of this study was to examine the correlation between two-dimensional (2D) knee valgus and three-dimensional (3D) knee kinematics measured during a jump landing task. Twenty-eight female collegiate athletes participated. All participants were required to perform a continuous jump test. The average maximum angles of abduction and internal tibial rotation during landing were measured using the Point Cluster Technique. Average peak knee valgus angle was measured using a 2D approach. Linear and non-linear regression analyses between 2D valgus and 3D knee abduction, and between 2D valgus and 3D internal tibial rotation, were performed. The R2 value between 2D valgus and 3D knee abduction was significantly different from zero and had a moderate correlation for all models, whereas the R2 value between 2D valgus and 3D internal tibial rotation was not significantly different from zero. The 2D approach could be used to screen a specific group of individuals for risk of ACL injury; however, using frontal plane 2D analysis of valgus motion to evaluate internal tibial rotation is not advised.     

The effects of load on system and lower-body joint kinetics during jump squats

To investigate the effects of different loads on system and lower-body kinetics during jump squats, 12 resistance-trained men performed jumps under different loading conditions: 0%, 12%, 27%, 42%, 56%, 71%, and 85% of 1-repetition maximum (1-RM). System power output was calculated as the product of the vertical component of the ground reaction force and the vertical velocity of the bar during its ascent. Joint power output was calculated during bar ascent for the hip, knee, and ankle joints, and was also summed across the joints. System power output and joint power at knee and ankle joints were maximized at 0% 1-RM (p < 0.001) and followed the linear trends (p < 0.001) caused by power output decreasing as the load increased. Power output at the hip was maximized at 42% 1-RM (p = 0.016) and followed a quadratic trend (p = 0.030). Summed joint power could be predicted from system power (p < 0.05), while system power could predict power at the knee and ankle joints under some of the loading conditions. Power at the hip could not be predicted from system power. System power during loaded jumps reflects the power at the knee and ankle, while power at the hip does not correspond to system power.     

The Validity and Reliability of the MyJump2 Application to Assess Vertical Jumps in Trained Junior Athletes

This study aimed to assess the validity and reliability of jump assessments using the MyJump2 application. Eleven junior athletes (15 ± 1.4 years) performed five countermovement (CMJ) and drop jumps (DJ) measured simultaneously by a force platform and MyJump2. Additionally, intra- and inter-day reliability was assessed over two sessions, 7 days apart. Extremely high agreement between MyJump2 and the force platform (intra-class correlation coefficient, ICC ≥ 0.99) and the intra- and inter-operator agreement (ICC = 0.98–0.99) confirmed the validity and reliability of MyJump2. Mean typical errors (coefficient of variation percentage, CV%) within the first and second sessions were 4.9% and 4.5% respectively for CMJs, and 8.0% to 11.8% for DJ outcomes. CMJ height held acceptable inter-day reliability (CV < 10%; ICC > 0.8), while DJ did not. Results supported MyJump2 to be a valid and reliable tool for assessing jumps; however, with variability in DJs in this cohort, appropriate caution should be taken if including in a junior assessment battery.     

The effect of high intensity exercise and anticipation on trunk and lower limb biomechanics during a crossover cutting manoeuvre

We investigated the effects of high intensity, intermittent exercise (HIIP) and anticipation on trunk, pelvic and lower limb biomechanics during a crossover cutting manoeuvre. Twenty-eight male, varsity athletes performed crossover cutting manoeuvres in anticipated and unanticipated conditions pre- and post-HIIP. Kinematic and kinetic variables were captured using a motion analysis system. Statistical parametric mapping (repeated-measures ANOVA) was used to identify differences in biomechanical patterns. Results demonstrated that both unanticipation and fatigue (HIIP) altered the biomechanics of the crossover cutting manoeuvre, whereas no interactions effects were observed. Unanticipation resulted in less trunk and pelvic side flexion in the direction of cut (d = 0.70 – 0.79). This led to increased hip abductor and external rotator moments and increased knee extensor and valgus moments with small effects (d = 0.24–0.42), potentially increasing ACL strain. The HIIP resulted in trivial to small effects only with a decrease in internal knee rotator and extensor moment and decreased knee power absorption (d = 0.35), reducing potential ACL strain. The effect of trunk and hip control exercises in unanticipated conditions on the crossover cutting manoeuvre should be investigated with a view to refining ACL injury prevention programmes.     

Relationships between highly skilled golfers’ clubhead velocity and force producing capabilities during vertical jumps and an isometric mid-thigh pull

Whilst previous research has highlighted significant relationships between golfers’ clubhead velocity (CHV) and their vertical jump height and maximum strength, these field-based protocols were unable to measure the actual vertical ground reaction force (vGRF) variables that may correlate to performance. The aim of this study was to investigate relationships between isometric mid-thigh pull (IMTP), countermovement jump (CMJ), squat jump (SJ) and drop jump (DJ) vGRF variables and CHV in highly skilled golfers. Twenty-seven male category 1 golfers performed IMTP, CMJ, SJ and DJ on a dual force platform. The vertical jumps were used to measure positive impulse during different stretch-shortening cycle velocities, with the IMTP assessing peak force (PF) and rate of force development (RFD). Clubhead velocity was measured using a TrackMan launch monitor at a golf driving range. Pearsons correlation coefficient analyses revealed significant relationships between peak CHV and CMJ positive impulse (r = 0.788, p < 0.001), SJ positive impulse (r = 0.692; p < 0.001), DJ positive impulse (r = 0.561, p < 0.01), PF (r = 0.482, p < 0.01), RFD from 0–150 ms (r = 0.343, p < 0.05) and RFD from 0–200 ms (r = 0.398, p < 0.05). The findings from this investigation indicate strong relationships between vertical ground reaction force variables and clubhead velocity.     

Lower extremity power during the squat jump with various barbell loads

The purpose of this study was twofold: (1) to determine the barbell load that maximised the system power as well as the ankle, knee, and hip joint powers during the squat jump, and (2) to compare the system powers computed from two different methods: the centre of mass (COM) method and the barbell method. Seven male throwers were recruited in this study. The system power (COM method) and the ankle, knee, and hip joint powers were determined with the load incrementally set at 0%, 10%, 30%, 50%, 70%, and 90% of one repetition maximum. The largest system power was observed at the load of 30% (p < 0.008) while the largest ankle and knee powers were observed at 70% and 0% (p < 0.05). The barbell method overestimated the system power (p < 0.001) when compared to the COM method. It was concluded that the barbell method could influence load optimisation in squat jump. The optimal barbell load which maximised the system power did not maximise the ankle, knee, or hip power simultaneously.     

Effect of a Brazilian Jiu-jitsu-simulated tournament on strength parameters and perceptual responses

This study aimed to analyse the effects of a simulated Brazilian jiu-jitsu (BJJ) tournament on vertical jump performance, grip strength test and perceived effort responses. 22 male BJJ athletes participated in a simulated tournament consisting of three 7 min matches separated by 14 min of rest. Kimono grip strength test (KGST), counter movement jump (CMJ) and rate of perceived exertion (RPE) were measured before and after each match, while RPE of specific areas was assessed after three matches. ANOVA for repeated measures was used to compare strength parameters after each match with the level of significance set at 5%. The key results showed a significant decrease of jump height (p = 0.001) and net vertical impulse in the CMJ (p = 0.031), as well as a reduction of the number of reps in the KGST (p < 0.001). A significant increase of RPE was found throughout the matches (p < 0.001). Considering the RPE in specific areas, no differences were observed between the upper and lower body (p = 0.743). We conclude that the BJJ simulated tournament generated a decrease of performance in both upper and lower limbs and provoked a progressive increase in the effort perception over the matches.     

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.     

Do stiffness and asymmetries predict change of direction performance?

Change of direction speed (CODS) underpins performance in a wide range of sports but little is known about how stiffness and asymmetries affect CODS. Eighteen healthy males performed unilateral drop jumps to determine vertical, ankle, knee and hip stiffness, and a CODS test to evaluate left and right leg cutting performance during which ground reaction force data were sampled. A step-wise regression analysis was performed to ascertain the determinants of CODS time. A two-variable regression model explained 63% (R² = 0.63; P = 0.001) of CODS performance. The model included the mean vertical stiffness and jump height asymmetry determined during the drop jump. Faster athletes (n = 9) exhibited greater vertical stiffness (F = 12.40; P = 0.001) and less asymmetry in drop jump height (F = 6.02; P = 0.026) than slower athletes (n = 9); effect sizes were both “large” in magnitude. Results suggest that overall vertical stiffness and drop jump height asymmetry are the strongest predictors of CODS in a healthy, non-athletic population.     

Kinetics and kinematics analysis of incremental cycling to exhaustion

Technique changes in cyclists are not well described during exhaustive exercise. Therefore the aim of the present study was to analyze pedaling technique during an incremental cycling test to exhaustion. Eleven cyclists performed an incremental cycling test to exhaustion. Pedal force and joint kinematics were acquired during the last three stages of the test (75%, 90% and 100% of the maximal power output). Inverse dynamics was conducted to calculate the net joint moments at the hip, knee and ankle joints. Knee joint had an increased contribution to the total net joint moments with the increase of workload (5–8% increase, p < 0.01). Total average absolute joint moment and knee joint moment increased during the test (25% and 39%, for p < 0.01, respectively). Increases in plantar flexor moment (32%, p < 0.01), knee (54%, p < 0.01) and hip flexor moments (42%, p = 0.02) were found. Higher dorsiflexion (2%, for p = 0.03) and increased range of motion (19%, for p = 0.02) were observed for the ankle joint. The hip joint had an increased flexion angle (2%, for p < 0.01) and a reduced range of motion (3%, for p = 0.04) with the increase of workload. Differences in joint kinetics and kinematics indicate that pedaling technique was affected by the combined fatigue and workload effects.     

Correlation of axial impact forces with knee joint forces and kinematics during simulated ski-landing

Abstract

Anterior cruciate ligament (ACL) rupture, during ski-landing, is caused by excessive knee joint forces and kinematics, like anterior tibial translation, internal tibial rotation, and valgus rotation. It is not well understood how these forces/kinematics are directly related to ski-landing impact. In the present study, we applied simulated ski-landing impact to knee specimens, and examined joint force/kinematic responses and their correlations with impact force. Ten human cadaveric knees were subjected to axial impact loading at 70° of flexion to simulate ski-landing impact. Impact was repeated with incremental magnitude until ACL failure. Axial impact forces, anterior-posterior and medial-lateral tibial forces were measured using a tri-axial load cell. Anterior-posterior tibial translation, internal-external tibial rotation, and valgus-varus rotation were determined using a motion-capture system. We found positive correlations of axial impact force with anterior tibial force, medial tibial force, anterior tibial translation, internal tibial rotation, and valgus joint rotation. Axial impact forces were more strongly correlated with anterior tibial forces (R ² = 0.937 ± 0.050), anterior tibial translation (R ² = 0.916 ± 0.059), and internal tibial rotation (R ² = 0.831 ± 0.141) than medial tibial force (R ² = 0.677 ± 0.193) and valgus joint rotation (R ² = 0.630+0.271). During ski-landing, these joint forces/kinematics can synergistically act to increase ACL injury risk, whereby the failure mechanism would be dominated by anterior tibial forces, anterior tibial translation, and internal tibial rotation.     

The effects of weighted skates on ice-skating kinematics,kinetics and muscular activity

Sport-specific resistance training, through limb loading, can be a complimentary training method to traditional resistance training by loading the working muscles during all phases of a specific movement. The purpose of this study was to examine the acute effects of skating with an additional load on the skate, using a skate weight prototype, on kinematics, kinetics, and muscle activation during the acceleration phase while skating on a synthetic ice surface. 10 male hockey skaters accelerated from rest (standing erect with knees slightly bent) under four non-randomized load conditions: baseline 1 (no weight), light (0.9 kg per skate), heavy (1.8 kg per skate), and baseline 2 (no weight). Skating with additional weight caused athletes to skate slower (p < 0.001; η² = 0.551), and led to few changes in kinematics: hip sagittal range of motion (ROM) decreased (2.2°; p = 0.032; η² = 0.274), hip transverse ROM decreased (3.4°; p < 0.001; η² = 0.494), ankle sagittal ROM decreased (2.3°; p = 0.022; η² = 0.295), and knee sagittal ROM increased (7.8°; p < 0.001, η² = 0.761). Overall, weighted skates decreased skating velocity, but athletes maintained similar muscle activation profiles (magnitude and trends) with minor changes to their skating kinematics.