Forward Lunge Research Articles

Peak Patellofemoral and ACL/PCL Forces While Performing the Forward Lunge Exercise With Varying Techniques

PURPOSE: To compare peak patellofemoral and ACL/PCL forces among varying lunging techniques involving lunging with a long and short stride both on flat ground and up to a 4 inch platform. METHODS: Sixteen male and female subjects (mean bodyweight 678N, 69.1 kg mass; 175.9 cm height; 28.9 years old) using bodyweight only performed a forward lunge with a long stride (shank vertical at bottom position) and a short stride (1/2 the long stride distance) on flat ground and up to a 4 inch platform. Force platform and video data were collected and input into a biomechanical model, and peak patellofemoral and ACL/PCL were calculated as a function of knee angle. A One-Way Repeated measures ANOVA assessed significant differences among lunging techniques (p<0.05). RESULTS: Peak patellofemoral force occurred between 79°-96° knee angles and was significantly greater (p<0.001) with a short stride lunge on flat ground (1668±479N) and up to a 4 inch platform (1553±580N) compared to lunging with a long stride lunge on flat ground (1193±512N) and up to a 4 inch platform (1061±523N), but no significant differences in peak patellofemoral force were found between the two short stride lunges (p=0.99) and between the two long stride lunges (p=0.99). Peak ACL force occurred between 7°-12° knee angles and was not significantly different (p=0.70) among any of the lunging techniques. Peak PCL force occurred between 62°-83° knee angles and was significantly greater (p<0.001) with a long stride lunge on flat ground (554±220N) and up to a 4 inch platform (609±265N) compared to lunging with a long stride lunge on flat ground (402±114N) and up to a 4 inch platform (458±145N), but no significant differences in peak PCL force were found between the two short stride lunges (p=0.99) and between the two long stride lunges (p=.99). CONCLUSIONS: Lunge technique variations did affect peak patellofemoral and cruciate ligament forces. Compared to a long stride lunge, lunging with a short stride, which caused the knees to translate forward approximately 8 cm beyond the knees at bottom lunge position, resulted in greater peak patellofemoral force but less PCL force. Lunging technique variations did not affect peak ACL force. There were no patellofemoral or PCL differences in peak force between the two long stride lunges or between the two short stride lunges.

Patellar tendon stress between two variations of the forward step lunge

BackgroundPatellar tendinopathy (PT) or “jumper's knee” is generally found in active populations that perform jumping activities. Graded exposure of patellar tendon stress through functional exercise has been demonstrated to be effective for the treatment of PT. However, no studies have compared how anterior knee displacement variations during the commonly performed forward step lunge (FSL) affect patellar tendon stress. MethodsTwenty-five subjects (age: 22.69 ± 0.74 years; height: 169.39 ± 6.44 cm; mass: 61.55 ± 9.74 kg) performed 2 variations of an FSL with the anterior knee motion going in front of the toes (FSL-FT) and the knee remaining behind the toes (FSL-BT). Kinematic and kinetic data were used with an inverse-dynamics based static optimization technique to estimate individual muscle forces to determine patellar tendon stress during both lunge techniques. A repeated measures multivariate analysis was used to analyze these data. ResultsThe peak patellar tendon stress, stress impulse, quadriceps force, knee moment, knee flexion, and ankle dorsiflexion angle were significantly greater (p < 0.001) during the FSL-FT as compared to the FSL-BT. The peak patellar tendon stress rate did not differ between the FSL-FT and FSL-BT. ConclusionThe use of an FSL-FT as compared to an FSL-BT increased the load and stress on the patellar tendon. Because a graded exposure of patellar tendon loading with other closed kinetic chain exercises has proven to be effective in treating PT, consideration for the prescription of variations of the FSL and further clinical evaluation of this exercise is warranted in individuals with PT.

Effects of shoes on kinetics and kinematics of the squash forward lunge in male players

Squash is associated with a high incidence of chronic injuries. Currently there is a trend in many sports for players to select minimalist footwear. The aim of the current investigation was to examine the effects of squashspecific, running shoes and minimalist footwear on the kinetics and 3-D kinematics of the lunge movement in squash players. Twelve male squash players performed lunge movements whilst wearing minimalist, running shoe and squash-specific footwear. 3-D kinematics of the lower extremities were measured using an eightcamera motion analysis system alongside kinetic and tibial acceleration information which were obtained using a force platform and an accelerometer. Differences between footwear were examined using one-way repeated measures ANOVA. The results show firstly that loading rate parameters were significantly greater in the minimalist (average = 85.36B.W/s and instantaneous = 179.09B.W/s) footwear in relation to the squashspecific (average = 38.66 B.W/s and instantaneous = 50.73B.W/s) and running footwear (average = 37.62B.W/s and instantaneous = 48.14B.W/s). In addition, tibial acceleration parameters were also significantly greater in the minimalist (peak tibial acceleration = 8.45 g and tibial acceleration slope = 422.28g/s) footwear in relation to the squash-specific (peak tibial acceleration = 4.33 g and tibial acceleration slope = 182.57g/s) and running footwear (peak tibial acceleration = 4.81 g and tibial acceleration slope = 226.72g/s). The significant increase in impact loading in the minimalist footwear therefore suggests this type of shoe may place squash players at an increased risk of developing impact-related chronic injuries.

Loading Patterns of the Posterior Cruciate Ligament in the Healthy Knee: A Systematic Review.

BackgroundThe posterior cruciate ligament (PCL) is the strongest ligament of the knee, serving as one of the major passive stabilizers of the tibio-femoral joint. However, despite a number of experimental and modelling approaches to understand the kinematics and kinetics of the ligament, the normal loading conditions of the PCL and its functional bundles are still controversially discussed.ObjectivesThis study aimed to generate science-based evidence for understanding the functional loading of the PCL, including the anterolateral and posteromedial bundles, in the healthy knee joint through systematic review and statistical analysis of the literature.Data sourcesMEDLINE, EMBASE and CENTRALEligibility criteria for selecting studiesDatabases were searched for articles containing any numerical strain or force data on the healthy PCL and its functional bundles. Studied activities were as follows: passive flexion, flexion under 100N and 134N posterior tibial load, walking, stair ascent and descent, body-weight squatting and forward lunge.MethodStatistical analysis was performed on the reported load data, which was weighted according to the number of knees tested to extract average strain and force trends of the PCL and identify deviations from the norms.ResultsFrom the 3577 articles retrieved by the initial electronic search, only 66 met all inclusion criteria. The results obtained by aggregating data reported in the eligible studies indicate that the loading patterns of the PCL vary with activity type, knee flexion angle, but importantly also the technique used for assessment. Moreover, different fibres of the PCL exhibit different strain patterns during knee flexion, with higher strain magnitudes reported in the anterolateral bundle. While during passive flexion the posteromedial bundle is either lax or very slightly elongated, it experiences higher strain levels during forward lunge and has a synergetic relationship with the anterolateral bundle. The strain patterns obtained for virtual fibres that connect the origin and insertion of the bundles in a straight line show similar trends to those of the real bundles but with different magnitudes.ConclusionThis review represents what is now the best available understanding of the biomechanics of the PCL, and may help to improve programs for injury prevention, diagnosis methods as well as reconstruction and rehabilitation techniques.

Trunk and Shank Position Influences Patellofemoral Joint Stress in the Lead and Trail Limbs During the Forward Lunge Exercise.

Study Design Controlled laboratory study, repeated-measures design. Background The effects of trunk and shank position on patellofemoral joint stress of the lead limb have been well studied; however, the effects on the trail limb are not well understood. Objectives To test the hypothesis that trunk and shank position may influence patellofemoral joint stress in both limbs during the forward lunge exercise. Methods Patellofemoral kinetics were quantified from 18 healthy participants performing the lunge exercise with different combinations of trunk and shank positions (vertical or forward). A 2-by-3 (limb-by-lunge variation) repeated-measures analysis of variance was performed, using paired t tests for post hoc comparisons. Results The trail limb experienced greater total patellofemoral joint stress relative to the lead limb, regardless of trunk and shank position (P<.0001). The lunge variation with a vertical shank position resulted in significantly greater peak patellofemoral joint stress in the trail limb relative to the lead limb (P<.0001). A forward trunk and shank position resulted in the highest patellofemoral stress in the lead limb (P<.0001). Conclusion Trunk and shank positions have a significant influence on patellofemoral joint loading of both limbs during the forward lunge, with the trail limb generally experiencing greater total joint stress. Restricting forward translation of the lead-limb shank may reduce patellofemoral joint stress at the expense of increased stress in the trail limb. Technique recommendations should consider the demands imposed on both knees during this exercise. J Orthop Sports Phys Ther 2017;47(1):31-40. Epub 4 Nov 2016. doi:10.2519/jospt.2017.6336.

Resistance Training For Older Adults

Resistance training (RT) has been shown to increase muscular strength and concurrently improve functional ability in older adults (OA). However, there is relatively little research available regarding the impact of RT on confidence and quality of life in older adults. PURPOSE: The aim of this study was to examine the impact of a 10-week RT intervention on strength, ROM, balance, balance confidence, and quality of life in OA. METHODS: 15 subjects (mean 82.4 yrs) were recruited for this study, 12 of which were female. The following outcome measures were assessed prior to, and immediately following the intervention: balance, using the Berg Balance Scale (BBS), balance confidence, using the Activities Specific Balance Confidence Scale (ABC), quality of life using the SF-36 questionnaire, grip strength using a hand dynamometer, and sagittal plane ROM for both hips, ankles, and shoulders using a digital inclinometer. Participants trained twice a week for 10 weeks, for a total of 20 sessions. Each session consisted of the following 10 exercises: squat, bent over row, forward lunge, diagonal shoulder raise, step-ups, hammer curls, knee extensions, calf raises, toe raises, and a standing balance progression, each of which was done for a total of 15 repetitions on each limb. Pre- and post-intervention data were compared using paired t-tests, with an alpha set at P < 0.05. RESULTS: Following the 10-week intervention a significant increase was found for left hand grip strength, ROM at both hips, and scores for the BBS, ABC and SF-36 tests. CONCLUSION: The findings from this study indicate that participation in a 10-week RT intervention may lead to enhanced balance, balance confidence and quality of life for OA, in addition to strength and range of motion. Therefore OA should be encouraged to participate in RT as it may enhance characteristics thought to reduce falls and facilitate greater longevity.

The Musculoskeletal Readiness Screening Tool- Injury Predictor for United States Military Academy Preparatory Cadets?

Unique aspects of military service put our nation’s military at increased risk for injury that may not already be captured in the FMS and other injury prediction tools. The Musculoskeletal Readiness Screening Tool (MRST) was developed to combine evidence from physical performance tests used to predict injury and tasks unique to military personnel. Tests include the weight bearing forward lunge, modified deep squat, closed kinetic chain upper extremity stability test (CKCUEST), forward step down with eyes closed, stationary tuck jump, unilateral wall sit hold, and individual perceived level of risk for injury. The Feagin hop and self-reported history of injury were added to the screen. PURPOSE: To examine whether MRST scores, as a composite or further broken down into individual components, were predictive of a United States Military Academy Preparatory School (USMAPS) cadet candidate sustaining a future musculoskeletal injury. METHODS: MRST scores were collected for 141 cadet candidates (mean age 18.63 ±1.31) at USMAPS. Injuries were tracked for the academic school year. Preparatory cadets participated in military specific training and various sports. After 9 months, mean scores were compared between injured and uninjured groups, a ROC curve analysis, and a logistic regression model was analyzed. RESULTS: Seventy preparatory cadets sustained an injury. Top sports resulting in injury included football (36%) and basketball (11%) with injuries predominantly in the lower extremity including the knee (24%), hip (15%), and ankle (14%). Composite MRST scores were no different between injured (10.83) and uninjured (10.93) groups (p=0.78), 95% CI (-0.64,0.85). No association observed for those with a personal concern for future injury and actual injury (p=.13), (df=2), 95% CI (-0.3, 0.04). However, there was an association between those reporting a previous injury in the previous 12 months and those incurring an injury at USMAPS (p=.04), (df=1), 95% CI (-0.3, -0.01). A score of ≤12 revealed a sensitivity .50, specificity .57, +LR 1.17, and -LR .89. The ROC area under the curve was .53 with 95% CI(0.44,0.63). CONCLUSION: The 6 components of the MRST and the Feagin hop were not predictive of injury in this military academy prep school population; previous injury was the only significant injury predictor.

Immediate effect of valgus bracing on knee joint moments in meniscectomised patients: An exploratory study.

Patients undergoing medial arthroscopic partial meniscectomy are at increased risk of developing and/or progressing knee osteoarthritis, with increased medial compartment load being a potential contributor. The aim of this study was to evaluate the immediate effect of a valgus unloader knee brace on knee joint moments in patients following medial arthroscopic partial meniscectomy. Within-participant design. Twenty-two patients (age 35-55 years) who had undergone medial arthroscopic partial meniscectomy within the previous 8-15 months completed three-dimensional analysis of gait, forward lunge and one-leg rise during two conditions: with and without a valgus unloader knee brace. Outcome measures included the peak and impulse of the knee adduction moment and the peak knee flexion moment. The peak knee flexion moment increased during brace condition for forward lunge (mean difference [95% CI]) 0.54 [0.27-0.82] (Nm/(BW×HT)%), p<0.001 and one-leg rise (mean difference 0.45 [95% CI 0.08-0.82] (Nm/(BW×HT)%), p=0.022). No other significant differences were found between conditions in any of the included tasks. A significant effect of the knee brace was detected in terms of an increase in peak knee flexion moment during the more demanding tasks such as forward lunge and one-leg rise. This increase implies enhanced stability of the knee provided by the brace, which may induce increased knee function and knee-related confidence during strenuous tasks. Future research is required to explore the structural implications.

Does the Dumbbell-Carrying Position Change the Muscle Activity in Split Squats and Walking Lunges?

Stastny, P, Lehnert, M, Zaatar, AMZ, Svoboda, Z, and Xaverova, Z. Does the dumbbell-carrying position change the muscle activity in split squats and walking lunges? J Strength Cond Res 29(11): 3177–3187, 2015—The forward walking lunge (WL) and split squat (SSq) are similar exercises that have differences in the eccentric phase, and both can be performed in the ipsilateral or contralateral carrying conditions. This study aimed to determine the effects of dumbbell-carrying position on the kinematics and electromyographic (EMG) amplitudes of the gluteus medius (Gmed), vastus medialis (VM), vastus lateralis (VL), and biceps femoris during WLs and SSqs. The resistance-trained (RT) and the non–resistance-trained (NT) groups (both n = 14) performed ipsilateral WLs, contralateral WLs, ipsilateral SSqs, and contralateral SSqs in a randomized order in a simulated training session. The EMG amplitude, expressed as a percentage of the maximal voluntary isometric contraction (%MVIC), and the kinematics, expressed as the range of motion (ROM) of the hip and knee, were measured during 5 repetition maximum for both legs. The repeated measure analyses of variance showed significant differences between the RT and NT groups. The NT group showed a smaller knee flexion ROM (p < 0.001, η2 = 0.36) during both types of WLs, whereas the RT group showed a higher eccentric Gmed amplitude (p < 0.001, η2 = 0.46) during all exercises and a higher eccentric VL amplitude (p < 0.001, η2 = 0.63) during contralateral WLs. Further differences were found between contralateral and ipsilateral WLs in both the RT (p < 0.001, η2 = 0.69) and NT groups (p < 0.001, η2 = 0.80), and contralateral WLs resulted in higher eccentric Gmed amplitudes. Contralateral WLs highly activated the Gmed (90% MVIC); therefore, this exercise can increase the Gmed maximal strength. The ipsilateral loading condition did not increase the Gmed or VM activity in the RT or NT group.

Sagittal kinematics of mobile unicompartmental knee replacement in anterior cruciate ligament deficient knees

BackgroundThere is a greater risk of tibial component loosening when mobile unicompartmental knee replacement is performed in anterior cruciate ligament deficient knees. We previously reported on a cohort of anterior cruciate ligament deficient patients (n=46) who had undergone surgery, but no difference was found in implant survivorship at a mean 5-year follow-up. The purpose of this study was to examine the kinematic behaviour of a subcohort of these patients. MethodsThe kinematic behaviour of anterior cruciate deficient knees (n=16) after mobile unicompartmental knee replacement was compared to matched intact knees (n=16). Sagittal plane knee fluoroscopy was taken while patients performed step-up and forward lunge exercises. The patellar tendon angle, knee flexion angle and implant position was calculated for each video frame. FindingsThe patellar tendon angle was 5° lower in the deficient group, indicating greater anterior tibial translation compared to the intact group between 30 and 40° of flexion. Large variability, particularly from 40–60° of flexion, was observed in the bearing position of the deficient group, which may represent different coping mechanisms. The deficient group took 38% longer to perform the exercises. InterpretationKinematic differences were found between the deficient and intact knees after mobile unicompartmental knee replacement; but these kinematic changes do not seem to affect the medium-term clinical outcome. Whether these altered knee kinematics will have a clinical impact is as yet undetermined, but more long-term outcome data is required before mobile unicompartmental knee replacement can be recommended for an anterior cruciate ligament deficient patient.

Joint Kinetics and Kinematics During Common Lower Limb Rehabilitation Exercises.

Unilateral body-weight exercises are commonly used to strengthen the lower limbs during rehabilitation after injury, but data comparing the loading of the limbs during these tasks are limited. To compare joint kinetics and kinematics during 3 commonly used rehabilitation exercises. Descriptive laboratory study. Laboratory. A total of 9 men (age = 22.1 ± 1.3 years, height = 1.76 ± 0.08 m, mass = 80.1 ± 12.2 kg) participated. Participants performed the single-legged squat, forward lunge, and reverse lunge with kinetic data captured via 2 force plates and 3-dimensional kinematic data collected using a motion-capture system. Peak ground reaction forces, maximum joint angles, and peak sagittal-joint moments. We observed greater eccentric and concentric peak vertical ground reaction forces during the single-legged squat than during both lunge variations (P ≤ .001). Both lunge variations demonstrated greater knee and hip angles than did the single-legged squat (P < .001), but we observed no differences between lunges (P > .05). Greater dorsiflexion occurred during the single-legged squat than during both lunge variations (P < .05), but we noted no differences between lunge variations (P = .70). Hip-joint moments were greater during the forward lunge than during the reverse lunge (P = .003) and the single-legged squat (P = .011). Knee-joint moments were greater in the single-legged squat than in the reverse lunge (P < .001) but not greater in the single-legged squat than in the forward lunge (P = .41). Ankle-joint moments were greater during the single-legged squat than during the forward lunge (P = .002) and reverse lunge (P < .001). Appropriate loading progressions for the hip should begin with the single-legged squat and progress to the reverse lunge and then the forward lunge. In contrast, loading progressions for the knee and ankle should begin with the reverse lunge and progress to the forward lunge and then the single-legged squat.

Characteristics of Plantar Loads in Maximum Forward Lunge Tasks in Badminton.

BackgroundBadminton players often perform powerful and long-distance lunges during such competitive matches. The objective of this study is to compare the plantar loads of three one-step maximum forward lunges in badminton.MethodsFifteen right-handed male badminton players participated in the study. Each participant performed five successful maximum lunges at three directions. For each direction, the participant wore three different shoe brands. Plantar loading, including peak pressure, maximum force, and contact area, was measured by using an insole pressure measurement system. Two-way ANOVA with repeated measures was employed to determine the effects of the different lunge directions and different shoes, as well as the interaction of these two variables, on the measurements.ResultsThe maximum force (MF) on the lateral midfoot was lower when performing left-forward lunges than when performing front-forward lunges (p = 0.006, 95% CI = −2.88 to −0.04%BW). The MF and peak pressures (PP) on the great toe region were lower for the front-forward lunge than for the right-forward lunge (MF, p = 0.047, 95% CI = −3.62 to −0.02%BW; PP, p = 0.048, 95% CI = −37.63 to −0.16 KPa) and left-forward lunge (MF, p = 0.015, 95% CI = −4.39 to −0.38%BW; PP, p = 0.008, 95% CI = −47.76 to −5.91 KPa).ConclusionsThese findings indicate that compared with the front-forward lunge, left and right maximum forward lunges induce greater plantar loads on the great toe region of the dominant leg of badminton players. The differences in the plantar loads of the different lunge directions may be potential risks for injuries to the lower extremities of badminton players.

Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge.

Background:Despite several studies with different methods, the effect of functional knee braces on knee joint kinematics is not clear. Direct visualization of joint components through medical imaging modalities may provide the clinicians with more useful information.Objectives:In this study, for the first time in the literature, video fluoroscopy was used to investigate the effect of knee bracing on the sagittal plane kinematics of anterior cruciate ligament (ACL) injured patients.Patients and Methods:For twelve male unilateral ACL deficient subjects, the anterior tibial translation was measured during lunge exercise in non-braced and braced conditions. Fluoroscopic images were acquired from the subjects using a digital fluoroscopy system with a rate of 10 fps. The image of each frame was scaled using a calibration coin and analyzed in AutoCAD environment. The angle between the two lines, tangent to the posterior cortexes of the femoral and tibial shafts was measured as the flexion angle. For the fluoroscopic images associated with 0°, 15°, 30°, 45° and 60° knee flexion angles, the relative anterior-posterior configuration of the tibiofemoral joint was assessed by measuring the position of landmarks on the tibia and femur.Results:Results indicated that the overall anterior translations of the tibia during the eccentric (down) and concentric (up) phases of lunge exercise were 10.4 ± 1.7 mm and 9.0 ± 2.2 mm for non-braced, and 10.1 ± 3.4 mm and 7.4 ± 2.5 mm, for braced conditions, respectively. The difference of the tibial anterior-posterior translation behaviors of the braced and non-braced knees was not statistically significant.Conclusion:Fluoroscopic imaging provides an effective tool to measure the dynamic behavior of the knee joint in the sagittal plane and within the limitations of this study, the pure mechanical stabilizing effect of functional knee bracing is not sufficient to control the anterior tibial translation of the ACL deficient patients during lunge exercise.

The dynamic characteristics of adolescent patients with spondylolysis during forward lunge—the point aimed at trunk extension angle

Background: Spondylolysis is a fatigue fracture caused by the repetitive motion of trunk extension and rotation, and it's a common adolescent sports injury. There are some reports about the biomechanical analysis of spondylolysis, but there are few reports about the dynamic characteristics of patients with spondylolysis. Therefore, it's important to investigate the dynamic characteristics of patients with spondylolysis by analyzing the forward lunge (FL) frequently used in physical therapy, and this study will help to prevent the onset of spondylolysis.

Frontal Plane Analysis During Lunging After Knee Replacement Surgeries

It is reported that 70% of the Knee OA patients have cartilage degeneration isolated to the medial and patellofemoral (PF) compartments. Majority of these patients receive total knee replacements (TKR). The iDuo knee is a customized, individually made bi-compartmental knee replacement (BKR) treating OA at medial/lateral and PF compartments. The BKR keeps the contra-lateral compartment intact, retains the anterior and posterior cruciate ligaments, and regains normal knee geometry with good knee alignment. Thus, the BKR knee could have similar knee mechanics to that of a normal healthy knee. To date, there is no information regarding the mechanics during daily activities (e.g. lunging) with a BKR. There are no in vivo biomechanical comparisons between a BKR and a limb with an off-the-shelf TKR. PURPOSE: To examine differences in frontal plane knee moment between three participant groups during a lunging exercise: (1) BKR, (2) TKR, and (3) healthy controls. METHODS: To date, 21 participants have been tested, which included 5 TKR patients (66±12 yr.; 105±42 kg; 1.75±0.12 m) (Persona, Zimmer Inc.) (post-op: 11±4 mo.), 4 BKR patients (63±7 yr.; 93±18 kg; 1.66±0.06 m) (iDuo, ConforMIS Inc.) (post-op: 21±3 mo.), and 12 healthy controls (57±6 yr.; 82±12 kg; 1.75±0.11 m). 3D motion data (100Hz) and ground reaction forces (2000Hz) were collected during forward lunges. Peak internal knee abduction moments (ABDM) were calculated during both the down and up phases of a lunge. Student t tests were performed. α = 0.05. RESULTS: he means ± SDs of the ABDM of the BKR, TKR, and control participants were: 0.10±0.03, 0.15±0.06, 0.11±0.10 Nm/kg during down phase, respectively; and 0.11±0.05, 0.23±0.13, 0.08±0.09 Nm/kg during up phase, respectively. No differences were found between the BKR and control participants for either the down (p=0.43) or up phases (p=0.31). The TKR patients showed greater ABDM than the controls during the up phase (p=0.01). There was a trend that the BKR was associated with smaller ABDM than the TKR (p=0.06). CONCLUSION: Normal frontal plane mechanics appear to be achievable outcomes with customized BKR surgeries. BKR patients demonstrated similar frontal plane mechanics to the healthy controls during lunging. Off-the-shelf TKR patients showed significantly different mechanics from healthy controls.

Forward lunge knee biomechanics before and after partial meniscectomy

BackgroundPatients following meniscectomy are at increased risk of developing knee osteoarthritis in the tibiofemoral compartment and at the patellofemoral joint. As osteoarthritis is widely considered a mechanical disease, it is important to understand the potential effect of arthroscopic partial meniscectomy (APM) on knee joint mechanics. The purpose of this study was to evaluate changes in knee joint biomechanics during a forward lunge in patients with a suspected degenerative meniscal tear from before to three months after APM. MethodsTwenty-two patients (35–55years old) with a suspected degenerative medial meniscal tear participated in this study. Three dimensional knee biomechanics were assessed on the injured and contralateral leg before and three months after APM. The visual analogue scale was used to assess knee pain and the Knee Injury Osteoarthritis Outcome Score was used to assess sport/recreation function and knee-related confidence before and after APM. ResultsThe external peak knee flexion moment reduced in the APM leg compared to the contralateral leg (mean difference (95% CI)) −1.08 (−1.80 to −0.35) (Nm/(BW×HT)%), p=0.004. Peak knee flexion angle also reduced in the APM leg compared to the contralateral leg −3.94 (−6.27 to −1.60) degrees, p=0.001. There was no change in knee pain between the APM leg and contralateral leg (p=0.118). Self-reported sport/recreation function improved (p=0.004). ConclusionsAlthough patients self-reported less difficulty during strenuous tasks following APM, patients used less knee flexion, a strategy that may limit excessive patellar loads during forward lunge in the recently operated leg.

English

Physiotherapists must learn the biomechanics of lunge in detail to clearly understand its significance in human life and implement effective training measures to overcome the limiting factors of proper lunge of their clientele. To understand the biomechanical value of every movement, interesting experimental learning methods must be employed to kindle the Physiotherapists to actively take part in research activities from the undergraduate level onwards. Lungeometry is a novel, simple and inexpensive experimental investigation of lunge, applying basic geometrical methods taking near normal lower limb length dimensions and rationale approaches into consideration. Lungeometry can give a foundation to learn other forms of lunges like forward lunge, weighted lunges, lateral lunges. This model of learning biomechanics of movements using fundamental geometry techniques is expected to strongly connect with any futuristic Physiotherapy curricular structure.

DENGE DİSKİ EGZERSİZLERİNİN DİNAMİK DENGE VE DURUŞ KONTROLÜ ÜZERİNDEKİ ETKİSİNİN İNCELENMESİ

The aim of this study was to investigate the effect of balance disc exercise on postural stabilization and dynamic balance. Twenty healthy female university students who were not in a regular exercise program participated in the study voluntarily. The women were divided into two groups as exercise (10 women) and control groups (10 women). Exercise group participated in balance exercise program by using vestibular balance disc for 6 weeks, 3 sessions a week which lasted for 50 minutes. Lunge distance, multiple single-leg hop stabilization error and star excursion balance test distance were measured before and after 6-week exercise program. The control group did not participate in the exercise program. The data were analyzed using The Mann Whitney U and Wilcoxon test. The results showed that there was significant difference between before and post exercise lunge test distances in exercise group (p 0.05). There were significant differences in forward lunge with right and left leg distance between exercise group and the control group (p 0.05). There was significant difference in right and left leg landing errors between exercise and control group (p 0.05). There were significant differences in anterior, anteromedial, medial, anterolateral distance in right leg and anterior, anteromedial, medial, posterolateral, lateral and anterolateral distance in left leg between exercise group and the control group (p<0.05). As a result, 6 week balance exercise with balance disc affects dynamic balance and postural stability positively

Association between sensory function and medio-lateral knee position during functional tasks in patients with anterior cruciate ligament injury.

BackgroundPatients with anterior cruciate ligament (ACL) injury often exhibit reduced movement quality during functional tasks in the form of a knee-medial-to-foot position (KMFP). This movement pattern is suggested to be more common in women than in men, but the possible contributing sensorimotor factors for this altered knee position are poorly studied in these patients. The aim of this study was to evaluate the association between sensory function and medio-lateral knee position during functional tasks in men and women with ACL injury.MethodsFifty-one patients (23 women) aged 18–40 years with ACL injury were included in this cross-sectional study. Measures of sensory function were assessed by the threshold to detection of passive motion (TDPM) for knee kinesthesia and by the vibration perception threshold (VPT) for vibration sense. Movement quality was assessed by visual observation of the position of the knee relative to the foot during the following four functional tasks with different degrees of difficulty: the single-limb mini-squat, stair descending, the forward lunge, and the drop-jump. Spearman’s rank correlation coefficient was used to determine the relationship between the sensory measures and the medio-lateral knee position during the functional tasks. Differences in TDPM and/or VPT between subjects with good and poor movement quality were evaluated using the independent t-test. Separate gender analyses were performed.ResultsWorse TDPM was associated with a KMFP during the drop jump in men. Worse VPT at the toe and ankle was associated with a KMFP during stair descending and the forward lunge in women, but no associations were found in men.ConclusionWorse kinesthesia, measured by TDPM, might be associated with KMFP during the drop jump in men with ACL injury while worse vibration sense, measured by the VPT, at the foot and ankle might be related to KMFP in women. Further studies are needed to confirm these results.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-430) contains supplementary material, which is available to authorized users.

Intralimb joint coordination of the lower extremities in resistance training exercises

To facilitate the greatest transfer of improvements to athletic performance or daily activity, the resistance training exercises employed by athletic or recreationally trained individuals must be selected considering biomechanical similarity to meet the specific demands of their sport or activity. The purpose of this study was to compare intralimb joint coordination in eight experienced lifters performing three conventional strength-training exercises: the forward lunge, the dead lift, and the forward step-up. Lower-extremity angular displacement curves, maximum joint excursions, and mean absolute relative phases were determined. Results revealed general in-phase, interjoint relationships while comparing exercises. Forward lunge interjoint relationships were more out-of-phase when compared with the other two exercises. It is suggested that in-phase coordination was the predominant pattern employed while performing the closed kinetic chain exercises normally used in strength training, in particular for knee-hip relationship. Nevertheless the forward component of movement can change the coordination strategy when performing lunges.