Lower Extremity Kinematics Research Articles

Differences in Pivot Leg Kinematics and Electromyography Activation in Various Round House Kicking Heights.

The round house kick (RHK) is a common technique in taekwondo (TKD). The kicking action originates from the dynamic stability of the pivot leg. However, some knee injuries are caused by more difficult kicking strategies, such as kicks to the opponent's head. This study analyses the effects on TKD players in the lower extremity kinematic and neuromuscular reactions from different kicking heights. This study recruited 12 TKD players (age=20.3 ± 1.3 years, height = 1.72 ± 0.09 m, mass = 62.17 ± 9.45 kg) with no previous lower extremity ligament injuries. All athletes randomly performed 3 RHK at different heights (head, chest, and abdomen), repeating each kick 5 times. During the RHK action, the kinematics and muscle activations of the pivot leg were collected using six high-speed cameras and electromyography devices. The results found that during the RHK return period a high kicking position demonstrated larger knee valgus with the straight knee, and more hamstring activation on the pivot leg. The RHK pivot foot for TKD players encountered more risk of injury from high target kicking. The hamstring muscle played an important stabilizing role. It is recommended that sports medicine clinicians or sports coaches use this information to provide further protective injury prevention strategies.

Overground Walking Biomechanics of Dissatisfied Persons With Total Knee Replacements.

Patient dissatisfaction following total knee replacement (TKR) procedures is likely influenced by both subjective and objective aspects. Increased pain and reduced performance on clinical tests have been shown in persons who are dissatisfied with the outcome of their surgery. However, it is unknown how overground walking kinematics and kinetics might differ in the dissatisfied versus satisfied patients following TKR surgery. This study compared the lower-extremity walking kinematics and kinetics of patients dissatisfied with their TKR to that of satisfied patients and healthy controls. Thirty nine subjects completed walking trials, including nine dissatisfied and 15 satisfied TKR patients and 15 healthy controls. A 2 × 3 repeated -measures analysis of variance was used to assess differences between groups and limbs (P < .05). Dissatisfied persons showed significantly reduced loading-response and push-off peak vertical ground reaction forces, flexion range of motion, loading-response extension moments, and loading-response abduction moments compared to the controls. Peak loading-response and push-off vertical ground reaction forces and flexion range of motion were reduced in the replaced limb of dissatisfied patients compared with their nonreplaced limb. Push-off plantar flexion moments were reduced in the dissatisfied patients compared with the satisfied and healthy controls. Dissatisfied patients also reported increased knee joint pain and reduced preferred gait speed. Moreover, dissatisfied patients experienced mechanical limb asymmetries not present in those satisfied with their surgery result. Thus, patients dissatisfied with their total knee replacement outcome were found to be experiencing significant negative physiological changes.

Prelanding movement strategies among chronic ankle instability, coper, and control subjects

ABSTRACT We describe feedforward neuromuscular control during a maximal jump landing/cutting task among groups of chronic ankle instability (CAI), coper, and uninjured control subjects. Sixty-six volunteers participated (22 CAI, 22 copers, and 22 uninjured controls). The subjects completed five trials of a maximal jump landing/cutting manoeuvre. Three-dimensional ground reaction force, lower-extremity joint angles, and activation of eight muscles were collected from 150 ms prelanding to initial contact. Functional analyses of variance (FANOVA) were used to evaluate between-group differences for these outcome variables. Compared to uninjured controls, both CAI patients and copers demonstrated altered sagittal lower-extremity movements. However, only copers exhibited unique kinematic alterations in frontal lower-extremity kinematics in the ankle and hip joints. While CAI patients demonstrated decreased most of lower-extremity EMG activation, copers displayed increased EMG activation during prelanding. Current data suggest that both CAI patients and copers demonstrated alterations in feedforward neuromuscular control prior to initial contact during a demanding jump landing/cutting task. Altered movement strategies during prelanding were observed in both proximal (e.g., knee and hip) and distal (e.g., ankle) joints in CAI patients and copers, while copers presumably had more protective jump landing/cutting movement strategies than CAI patients.

Adults with knee osteoarthritis use different coordinative strategies to transition from swing to stance compared to young asymptomatic adults.

Neuromuscular changes that occur with aging or joint pathology likely alter the coordinative strategies that adults use to walk and to recover from perturbations during gait. Differences in coordination patterns or in how coordination changes in response to a challenge may provide insight into neuromuscular targets for falls prevention interventions. Do young asymptomatic adults, older asymptomatic adults, and older adults with knee OA alter their lower extremity segment coordination differently in response to an increase in walking speed?. We captured lower extremity kinematics using inertial measurement units as 29 participants (10 young, 10 older, 9 older with knee osteoarthritis) walked on a treadmill at self-selected preferred and faster speeds. We calculated lower extremity segment coordination and coordination variability using vector coding. We compared coordination and its variability among groups and speeds. There were no significant interactions between group and speed. Overall group or speed differences in coordination or variability occurred mostly during terminal swing or early stance. Coordination patterns differed between young adults and adults with knee osteoarthritis in all segment couples during terminal swing and at the foot vs. shank during early stance. During these same gait cycle phases for the foot vs. shank and shank vs. thigh segment couples, coordination patterns shifted towards those of young adults when participants walked faster. Where coordination variability differed by group or speed, it was lower in the young adults than in the older adults with or without knee osteoarthritis and at faster walking speed. Our results identified that older adults with knee osteoarthritis have a different strategy for transitioning from swing to stance compared to young adults, especially at distal limb segments. These results may help target fall prevention interventions to specific gait cycle phases or strategies.

Biomechanical and perceptual cushioning sensitivity based on mechanical running shoe properties

Mechanical shoe properties impact running biomechanics, triggering subjective shoe perception. Regarding midsole hardness little is known about the minimal mechanical alteration needed to change running biomechanics and perception. Three ethylene-vinyl acetate midsoles differing in rearfoot hardness (47, 53, 57 Asker C), and peak rearfoot impact acceleration (11.65, 12.40, 12.96 g), were used to create experimental shoe conditions (softer, medium, harder), featuring differing peak rearfoot impact accelerations (12.83, 13.49, 13.95 g) when measured with insoles. Twenty-five male rearfoot runners ran on a concrete loop, while capturing ground reaction forces and lower extremity kinematics of eight valid right foot ground contacts in each shoe. Perception of shoe cushioning and shoe rebound was also assessed during these runs using a 15 cm visual analogue scale. Variable magnitude means were compared for main effects (p < 0.05) by repeated measures analysis of variance, Bonferroni post-hoc tests, and effect size estimation (ηp2). No lower limb kinematic effects were induced by the shoes. Kinetically the softer shoe significantly reduced maximal vertical loading rate 1 compared to the medium and harder shoe (131.28 to 138.40 and 139.54 bw/s). Runners significantly perceived the difference in shoe cushioning between the softer and harder shoe (6.32 to 8.06 cm). For the running shoe model in this research a difference in mechanical peak impact acceleration of 0.66 g was sufficient to elicit different biomechanical loading. To elicit different cushioning perception a mechanical difference of 1.12 g was sufficient, resulting in a maximal vertical loading rate 1 difference of 8.26 bw/s. Knowing a shoe model’s biomechanical and perceptual sensitivity to mechanical alteration allows better informed design, development, and manufacturing decisions.

Coupled Gluteus Maximus and Gluteus Medius Recruitment Patterns Modulate Hip Adduction Variability During Single-Limb Step-Downs: A Cross-Sectional Study.

Examining the coordinated coupling of muscle recruitment patterns may provide insight into movement variability in sport-related tasks. The purpose of this study was to examine the relationship between coupled gluteus maximus and medius recruitment patterns and hip-adduction variability during single-limb step-downs. Cross-sectional. Biomechanics laboratory. Forty healthy adults, including 26 women and 14 men, mean age 23.8 (1.6) years, mean body mass index 24.2 (3.1)kg/m2, participated. Lower-extremity kinematics were acquired during 20 single-limb step-downs from a 19-cm step height. Electromyography (EMG) signals were captured with surface electrodes. Isometric hip-extension strength was obtained. Hip-adduction variability, measured as the SD of peak hip adduction across 20 repetitions of the step-down task, was measured. The mean amplitudes of gluteus maximus and gluteus medius EMG recruitment were examined. Determinism and entropy of the coupled EMG signals were computed with cross-recurrence quantification analyses. Hip-adduction variability correlated inversely with determinism (r = -.453, P = .018) and positively with entropy (r = .409, P = .034) in coupled gluteus maximus/medius recruitment patterns but not with hip-extensor strength nor with magnitudes of mean gluteus maximus or medius recruitment (r = -.003, .081, and .035; P = .990, .688, and .864, respectively). Hip-adduction variability during single-limb step-downs correlated more strongly with measures of coupled gluteus maximus and medius recruitment patterns than with hip-extensor strength or magnitudes of muscle recruitment. Examining coupled recruitment patterns may provide an alternative understanding of the extent to which hip neuromuscular control modulates lower-extremity kinematics beyond examining muscle strength or EMG recruitment magnitudes.

Foot Posture and Plantar Loading With Ankle Bracing.

Arch height is one important aspect of foot posture. An estimated 20% of the population has pes planus and 20% has pes cavus. These abnormal foot postures can alter lower extremity kinematics and plantar loading and contribute to injury risk. Ankle bracing is commonly used in sport to prevent these injuries, but no researchers have examined the effects of ankle bracing on plantar loading. To evaluate the effects of ankle braces on plantar loading during athletic tasks. Cross-sectional study. Laboratory. A total of 36 participants (11 men, 25 women; age = 23.1 ± 2.5 years, height = 1.72 ± 0.09 m, mass = 66.3 ± 14.7 kg) were recruited for this study. Participants completed walking, running, and cutting tasks in 3 bracing conditions: no brace, lace-up ankle-support brace, and semirigid brace. We analyzed the plantar-loading variables of contact area, maximum force, and force-time integral for 2 midfoot and 3 forefoot regions and assessed the displacement of the center of pressure. A 3 × 3 mixed-model repeated-measures analysis of variance was used to determine the effects of brace and foot type (α = .05). Foot type affected force measures in the middle (P range = .003-.047) and the medial side of the foot (P range = .004-.04) in all tasks. Brace type affected contact area in the medial midfoot during walking (P = .005) and cutting (P = .01) tasks, maximum force in the medial and lateral midfoot during all tasks (P < .001), and force-time integral in the medial midfoot during all tasks (P < .001). Portions of the center-of-pressure displacement were affected by brace wear in both the medial-lateral and anterior-posterior directions (P range = .001-.049). Ankle braces can be worn to redistribute plantar loading. Additional research should be done to evaluate their effectiveness in injury prevention.

Differences in lower-extremity kinematics between the male military personnel with and without plantar fasciitis

ObjectiveTo evaluate the factors that influence gait by comparing lower extremity kinematics during the stance phase of the gait cycle between individuals with and without plantar fasciitis. DesignA cross-sectional study. SettingMotion analysis research laboratory. ParticipantsThirty subjects with plantar fasciitis and 30 aged-matched controls. Main outcome measure(s)Range of motion of the lower extremity and multi-segment foot during gait using a three-dimensional motion analysis system. ResultsThe plantar fasciitis group showed significant differences in motion in the multi-segment foot, ankle, knee, and hip from the control group during various subphases of the stance phase. Specifically, relative to the control group, the plantar fasciitis group had more rearfoot adduction, forefoot eversion, ankle abduction, and hip abduction. They also had less midfoot dorsiflexion, forefoot dorsiflexion, knee extension, knee external rotation, and hip extension (all Ps < 0.05). ConclusionsIndividuals with plantar fasciitis exhibited more flexibility in the ankle-foot complex and poorer quality of lower-extremity movement than the group that did not have plantar fasciitis. Thus, differences in structures in both the ankle-foot complex as well as those in the hip and knee joints appear to be associated with the presence of plantar fasciitis.

Early biomechanical outcome in patients with acetabular fractures treated using the pararectus approach: a gait and stair climb analysis study

PurposePatients with surgically treated acetabular fractures using extensive dissection of hip muscles demonstrate an incomplete biomechanical recovery and limited joint mobility during movement. The purpose of this study was to evaluate the early biomechanical outcome in a series of patients with acetabular fractures treated using the less invasive anatomical pararectus approach.MethodsEight patients (48 ± 14 years, BMI 25.8 ± 3 kg/m2) were investigated 3.8 ± 1.3 months after surgery and compared to matched controls (49 ± 13 years, BMI 26 ± 2.8 kg/m2). Trunk and lower extremity kinematics and kinetics during gait and stair climb were calculated. SF-12 and the Merle d’Aubigné score were used for functional evaluation. Statistical analysis was conducted using Mann–Whitney test and Student’s t test. Effect sizes were calculated using Cohen’s d.ResultsNo group differences for lower extremity kinematics during walking and stair climbing were found. During walking, patients showed significant reductions (p < 0.05) of the vertical ground reaction force (8%) and knee and hip extension moments (29 and 27%). Ipsilateral trunk lean was significantly increased by 3.1° during stair descend while reductions of vertical ground reaction force were found for stair ascend (7%) and descend (20%). Hip extension moment was significantly reduced during stair descend by 37%. Patients revealed acceptable SF-12 physical and mental component outcomes and a good rating for the Merle d’Aubigné score (15.9 ± 1.7).ConclusionPatients showed some biomechanical restrictions that can be related to residual deficits in weight bearing capacity and strength of the hip muscles. In contrast, an immediate recovery of mobility was achieved by preserving lower extremity and pelvic movement. Therefore, the pararectus approach can serve as a viable strategy in the surgical treatment of acetabular fractures.Clinical trialTrial registration number DRKS00011308, 11/14/2016, prospectively registered.

Sex and Limb Differences in Lower Extremity Alignment and Kinematics during Drop Vertical Jumps.

Sex and limb differences in lower extremity alignments (LEAs) and dynamic lower extremity kinematics (LEKs) during a drop vertical jump were investigated in participants of Korean ethnicity. One hundred healthy males and females participated in a drop vertical jump, and LEAs and LEKs were determined in dominant and non-dominant limbs. A 2-by-2 mixed model MANOVA was performed to compare LEAs and joint kinematics between sexes and limbs (dominant vs. non-dominant). Compared with males, females possessed a significantly greater pelvic tilt, femoral anteversion, Q-angle, and reduced tibial torsion. Females landed on the ground with significantly increased knee extension and ankle plantarflexion with reduced hip abduction and knee adduction, relatively decreased peak hip adduction, knee internal rotation, and increased knee abduction and ankle eversion. The non-dominant limb showed significantly increased hip flexion, abduction, and external rotation; knee flexion and internal rotation; and ankle inversion at initial contact. Further, the non-dominant limb showed increased peak hip and knee flexion, relatively reduced peak hip adduction, and increased knee abduction and internal rotation. It could be suggested that LEAs and LEKs observed in females and non-dominant limbs might contribute to a greater risk of anterior cruciate ligament injuries.

The influence of kinesio taping on trunk and lower extremity motions during different landing tasks: implications for anterior cruciate ligament injury

PurposeThe purpose of the study was to investigate the influence of a 72-h KT application on trunk and lower extremity kinematics during different landing tasks.MethodsTwenty-nine competitive male athletes participated in this study. The sum of knee valgus and lateral trunk lean, symmetry index (SI), and peak angles of lateral trunk lean, hip flexion, knee abduction and flexion were assessed for all participants during single-leg drop landing (SLDL), single-leg vertical drop jump (SLVDJ), vertical drop jump (DLVDJ), and double leg forward jump (DLFJ), at baseline and seventy-two hours following KT application.ResultsThe KT application resulted in more knee flexion and abduction, sum of knee valgus and lateral trunk lean as compared with the non-KT condition during SLDL (P < 0.05). Nonetheless, there were no differences in SI, maximum angle of the lateral trunk lean during SLDL, SLVDJ, nor hip flexion, knee abduction, and flexion during DLVDJ, and DLFJ tasks (P > 0.05).ConclusionsThe research findings suggest that KT after 72-h application may improve knee abduction and sum of knee valgus and lateral trunk lean during SLDL, knee flexion during SLDL and SLVDJ in individuals displaying risky single-leg kinematics. Therefore, KT application may marginally improve high-risk landing kinematics in competitive male athletes.Level of evidenceLevel III.

Changes in the Trunk and Lower Extremity Kinematics Due to Fatigue Can Predispose to Chronic Injuries in Cycling.

Kinematic analysis of the cycling position is a determining factor in injury prevention and optimal performance. Fatigue caused by high volume training can alter the kinematics of the lower body and spinal structures, thus increasing the risk of chronic injury. However, very few studies have established relationships between fatigue and postural change, being these in 2D analysis or incremental intensity protocols. Therefore, this study aimed to perform a 3D kinematic analysis of pedaling technique in a stable power fatigue protocol 23 amateur cyclists (28.3 ± 8.4 years) participated in this study. For this purpose, 3D kinematics in hip, knee, ankle, and lumbar joints, and thorax and pelvis were collected at three separate times during the protocol. Kinematic differences at the beginning, middle, and end of the protocol were analyzed for all joints using one-dimensional statistical parametric mapping. Significant differences (p < 0.05) were found in all the joints studied, but not all of them occur in the same planes or the same phase of the cycle. Some of the changes produced, such as greater lumbar and thoracic flexion, greater thoracic and pelvic tilt, or greater hip adduction, could lead to chronic knee and lumbar injuries. Therefore, bike fitting protocols should be carried out in fatigue situations to detect risk factor situations.

Lower Extremity Kinematics of the Y-Balance Test in Healthy and ACL Injured Adolescent Females.

BackgroundAdolescent females are at significant risk for sustaining an ACL injury. The Y-Balance Test (YBT) is frequently used to evaluate neuromuscular control and lower extremity function. However, few studies have quantified 2D lower extremity kinematics during performance of the YBT, and there is an absence of kinematic data specific to at-risk adolescent females.PurposeTo examine lower extremity joint kinematics during execution of the YBT by healthy and ACL-injured adolescent females.Study DesignProspective cohort.MethodsTwenty-five healthy and ten ACL-injured (mean time from injury 143 days) adolescent females were assessed using the YBT. Sagittal and frontal plane knee and ankle motion was video recorded during execution of the YBT anterior reach movement. Ankle dorsi-flexion, knee flexion, and knee valgus angles were quantified via kinematic analysis. ANOVAs with a post hoc Bonferroni correction were used to compare YBT scoring (%LL) and kinematic data between groups. Pearson product-moment correlations determined the relationship between kinematic data and YBT scoring.ResultsHealthy and ACL-injured subjects demonstrated similar YBT scores and lower extremity kinematic data. Healthy subjects demonstrated a weak positive correlation between ankle dorsiflexion and YBT scoring, and a weak negative correlation between knee valgus and YBT scoring. These relationships did not exist for ACL-injured subjects. Kinematic data for both groups also demonstrated a large degree of variability, regardless of YBT score.ConclusionsAdolescent females frequently utilize a variety of lower extremity movement strategies when performing a functional movement task, and scoring on the YBT offers limited insight regarding lower extremity joint kinematics and ACL-injury risk in a physically active adolescent female population.Level of EvidenceLevel 3.

Effect of different forefoot rocker radii on lower-limb joint biomechanics in healthy individuals

IntroductionPrevious studies showed that rocker shoes with a stiff forefoot rocker profile significantly reduce peak plantar flexion moment at the ankle (PFM) and peak ankle dorsiflexion (DF). Both parameters are related to Achilles tendon and Plantar Fascia unloading. The shape of an outsole with a forefoot rocker is described with multiple rocker design parameters. The aim of this research is, to determine the relation between different forefoot rocker radii on peak DF and peak PFM at a self-selected walking speed. Methods10 participants walked in standard shoes and three experimental pairs of shoes with different forefoot rocker radii. Lower extremity kinematics and kinetics were collected while walking on an instrumented treadmill at preferred walking speed and analysed with Statistical Parametric Mapping (SPM) (α = .05; post-hoc α = .05/6). ResultsPeak value analyses showed significant decreases in peak DF, peak PFM, and peak ankle power generation for the rocker conditions. No relevant significant differences were found in spatio-temporal parameters and total work at the ankle joint. SPM showed a significant decrease (% gait cycle) in DF (40–69 %), PFM (7–15 %; 41–68 %; 69–81 %), ankle power (10–15 %; 32–51 %; 55–64 %; 64–67 %; 72–80 %) and foot-to-horizontal angle (FHA) (0–4 %; 40–62 %; 92–100 %) and an increased shank-to-vertical angle (SVA) (44–84 %) for the rocker conditions. ConclusionThe results of this study suggest that rocker shoes with a proximally placed apex significantly reduce DF and PFM during the third rocker compared with control shoes. This effect is mainly explained by a change in the FHA. Smaller radii cause the largest reductions in DF and PFM, so therefore, a uniform standardisation of the forefoot rocker radius is essential.

Influences of Different Drop Height Training on Lower Extremity Kinematics and Stiffness during Repetitive Drop Jump.

Drop jump (DJ) is often used as a plyometric exercise to improve jumping performance. Training from improper drop heights and for improper durations lead to unfavorable biomechanical changes in the lower extremities when landing, which result in reduced training effects and even lower extremity injuries. Purpose. To study the effects of repeated DJ training at drop heights of 30 cm, 40 cm, and 50 cm (drop jump height (DJH) 30, DJH40, and DJH50) on lower extremity kinematics and kinetics. The 1st, 50th, 100th, 150th, and 200th DJs (DJ1, DJs50, DJs100, DJs150, and DJs200) were recorded by using a BTS motion capture system and force platform. The MATLAB software was used to compare the kinematic and stiffness data of DJ1, DJs50, DJs100, DJs150, and DJs200 with one-way ANOVA repeated measure. If there were significant differences, the LSD method was used for post hoc comparisons. Methods. Twenty healthy male Division III athlete volunteers were selected as subjects, and 200 drop jumps (DJs200) were performed from DJH30, DJH40, and DJH50. Results. The jumping height (JH), contact time (CT), and GRF increased with drop height, and the stiffness of the legs and ankle at DJH30 was higher than that at DJH40 and DJH50 (p < 0.05). Conclusion. Within DJs200, training at DJH50 yield the high impact easily leads to lower extremity injury; training at DJH30 can increase the stiffnesses of the legs and ankle joints, thus effectively utilizing the SSC benefits to store and release elastic energy, reducing the risk of lower extremity musculoskeletal injury. Therefore, coaches can choose different drop heights and training quantities for each person to better prevent lower extremity injury.

Effects of attentional focus cues on lower extremity kinematics during inside of the foot soccer trap among expert soccer players

Numerous studies have demonstrated improved performance results for sport skills through attentional focus instructions. However, few studies have examined the effects of cueing on expert kinematic performance, and this is the first to assess cueing’s kinematic effects on expert soccer players performing .common techniques This study assessed the lower extremity kinematics of an inside of the foot soccer trap via motion capture cameras under different attentional focus cues to analyze how the cues affect the movement pattern among expert performers. 10 NCAA Division 1 soccer players trapped a launched ball on a scoring mat after receiving coaching cues inducing an internal, external, holistic, or control focus of attention. Statistical analysis revealed movement differences between the internal and external cue conditions for the ankle and knee joints during the movement. The difference at the knee was a steeper flexion followed by a correction and, at the ankle, a steeper flexion, both during the internal cue condition. Attentional focus cues inducing a conscious control of the movement may disrupt the movement patterns of highly skilled expert performers. Coaches should be acutely aware of the language they use in instruction, even among expert performers.

Anterior Cruciate Ligament Loading Increases With Pivot-Shift Mechanism During Asymmetrical Drop Vertical Jump in Female Athletes.

Background:Frontal plane trunk lean with a side-to-side difference in lower extremity kinematics during landing increases unilateral knee abduction moment and consequently anterior cruciate ligament (ACL) injury risk. However, the biomechanical features of landing with higher ACL loading are still unknown. Validated musculoskeletal modeling offers the potential to quantify ACL strain and force during a landing task.Purpose:To investigate ACL loading during a landing and assess the association between ACL loading and biomechanical factors of individual landing strategies.Study Design:Descriptive laboratory study.Methods:Thirteen young female athletes performed drop vertical jump trials, and their movements were recorded with 3-dimensional motion capture. Electromyography-informed optimization was performed to estimate lower limb muscle forces with an OpenSim musculoskeletal model. A whole-body musculoskeletal finite element model was developed. The joint motion and muscle forces obtained from the OpenSim simulations were applied to the musculoskeletal finite element model to estimate ACL loading during participants’ simulated landings with physiologic knee mechanics. Kinematic, muscle force, and ground-reaction force waveforms associated with high ACL strain trials were reconstructed via principal component analysis and logistic regression analysis, which were used to predict trials with high ACL strain.Results:The median (interquartile range) values of peak ACL strain and force during the drop vertical jump were 3.3% (–1.9% to 5.1%) and 195.1 N (53.9 to 336.9 N), respectively. Four principal components significantly predicted high ACL strain trials, with 100% sensitivity, 78% specificity, and an area of 0.91 under the receiver operating characteristic curve (P < .001). High ACL strain trials were associated with (1) knee motions that included larger knee abduction, internal tibial rotation, and anterior tibial translation and (2) motion that included greater vertical and lateral ground-reaction forces, lower gluteus medius force, larger lateral pelvic tilt, and increased hip adduction.Conclusion:ACL loads were higher with a pivot-shift mechanism during a simulated landing with asymmetry in the frontal plane. Specifically, knee abduction can create compression on the posterior slope of the lateral tibial plateau, which induces anterior tibial translation and internal tibial rotation.Clinical Relevance:Athletes are encouraged to perform interventional and preventive training to improve symmetry during landing.

Movement direction impacts knee joint kinematics during elliptical exercise at varying incline angles

BackgroundElliptical trainers are a popular cardiovascular exercise for individuals with injuries or those post-operation. There is currently limited data on the impacts of direction while on elliptical trainers for knee joint kinematic risk factors. This study compared lower extremity kinematics between the forward and reverse direction at varying inclines on an elliptical trainer modified with converging footpath and reduced inter-pedal distance. MethodsTwenty-four college age participants exercised on the modified elliptical in both directions at four ramp inclines: 6°, 12°, 25°, and 35°. Three-dimensional kinematics were collected for each direction and ramp incline. A 2 × 4 (direction × incline) repeated measures analysis of variance was run with an alpha of 0.05. Simple effects analysis was run with Bonferroni correction for significant interaction or main effect of ramp incline. ResultsThe reverse direction had significantly greater peak knee valgus at 6° incline (mean difference [MD] = 1.35°, p < 0.014, d = 0.31) and 12° (MD = 2.41°, p < 0.001, d = 0.55), peak hip abduction at 6° (MD = 2.86°, p = 0.002, d = 0.49) and 12° (MD = 2.91°, p < 0.001, d = 0.51), but decreased peak knee flexion angles (p = 0.032) at all inclines. ConclusionsIndividuals with knee pathologies such as knee osteoarthritis or anterior knee pain should exercise in the reverse direction at lower inclines. However, switching to the forward direction and/or increasing incline may increase quadriceps strength during a safe activity such as elliptical trainers.

Movement Patterns During a Jump-Landing Task in Athletes After Sport-Related Concussion and Healthy Control Individuals.

A relationship between a history of sport-related concussion (SRC) and lower extremity injury has been well established in the literature. To determine if biomechanical differences existed during a double-limb jump landing between athletes who had been released to return to play after SRC and healthy matched control individuals. Cross-sectional study. Health system-based outpatient sports medicine center. A total of 21 participants with SRC (age = 15.38 ± 1.77 years, height = 169.23 ± 8.59 cm, mass = 63.43 ± 7.39 kg, time since release to return to sport after SRC = 16.33 ± 12.7 days) were compared with 21 age-, sex-, and activity-matched healthy participants serving as controls (age = 15.36 ± 1.73 years, height = 169.92 ± 11.1 cm, mass = 65.62 ± 12.08 kg). Biomechanical performance during the double-limb jump landing was assessed using a motion-capture system and force plates. The average of 3 consecutive trials was used to calculate lower extremity joint kinetics and kinematics. The variables of interest were internal knee-extension moment, internal varus moment, and total sagittal-plane knee displacement for the dominant and nondominant limbs. Independent t tests were performed to examine the differences between SRC and control groups for the variables of interest. No differences existed between groups for the descriptive data. The SRC group demonstrated greater internal knee-extension moments in the dominant (-0.028 ± 0.009 Nm/kg, P = .003) and nondominant (-0.018 ± 0.007, P = .02) limbs. The SRC group also exhibited greater internal varus moments in the dominant (0.012 ± 0.004 Nm/kg, P = .005) and nondominant (0.010 ± 0.003, P = .005) limbs. For sagittal-plane knee displacement, the SRC group displayed less knee-flexion displacement in the dominant (-12.56 ± 4.67°, P = .01) but not the nondominant (-8.30 ± 4.91°, P = .10) limb. Athletes who had been released for return to sport after SRC landed with greater knee valgus than healthy matched control participants.

Effect of Static Alignment on Dynamic Knee Abduction Moments in Adolescent Athletes with Recent ACL Reconstruction.

Dynamic limb valgus, particularly high knee abduction moments, is a known risk factor for anterior cruciate ligament (ACL) injury and may result from poor static anatomic limb alignment, faulty biomechanics, or a combination of both. The purpose of this study was to assess the influence of static lower extremity anatomic alignment and dynamic kinematic/kinetic measures on knee abduction moments during sidestep cutting in adolescent athletes with recent ACL reconstruction. This retrospective study included 50 adolescents with recent unilateral ACL reconstruction (18/50 female, mean age = 15.8 yr, 7.6 months postsurgery). Frontal plane hip-to-ankle imaging was used to measure mechanical axis deviation and tibial-femoral angle. Three-dimensional motion capture provided lower extremity kinematics and kinetics during quiet standing and during the loading phase (initial contact to peak knee flexion) of an anticipated 45° sidestep cut. Imaging, static motion capture, and dynamic motion capture measures were investigated as potential predictors of average dynamic knee abduction moment using correlation and backward stepwise linear regression. Dynamic knee abduction moment was best predicted by a combination of younger age and dynamic measures: trunk lean toward the planting limb, knee abduction and external rotation, and ankle inversion. Although static measures were correlated with dynamic knee abduction moment in univariate analysis, no static/anatomic variables entered the model once the dynamic measures were included. Knee abduction moments during sidestep cutting were related to dynamic factors reflecting frontal and transverse plane motion. Static (anatomic) lower limb alignment did not influence knee abduction moments once these dynamic factors were considered. Knee abduction moments and ACL injury risk are therefore not dictated by anatomic alignment and can be altered through neuromuscular/biomechanical training.