Single-leg Hop Research Articles

Advanced Neuromuscular Training Differentially Changes Performance on Visuomotor Reaction Tests and Single-leg Hop Tests in Patients with ACL Reconstruction.

Advanced neuromuscular training prepares patients with anterior cruciate ligament reconstruction (ACLR) for sport participation. Return-to-sport testing often includes single-leg hop tests, yet combining motor and cognitive tasks (i.e., dual-task) might reveal neurocognitive reliance. This study examined changes in performance on visuomotor reactions tests and single-leg hop tests following advanced neuromuscular training in patients with ACLR. The hypothesis was that performance would improve less on reaction tests than on single-leg hop tests. Quasi experimental, Pretest-Posttest. Twenty-five patients with ACLR (11 males) completed 10 sessions of advanced neuromuscular training and pre-and post-training testing. Reaction tests outcomes were from a platform and visual display. The double-leg reaction test involved touching target dots with either leg for 20 seconds; correct touches and errors were recorded. The single-leg reaction test involved hopping on the test leg to 10 target dots; hop time and errors were recorded. Single-leg hop tests included forward, triple, crossover triple, and timed hop; limb symmetry index was recorded. Effect sizes were calculated for corrected touches on the double-leg reaction test, surgical side hop time on the single-leg reaction test, and surgical side hop distance or time on single-leg hop tests. Correct touches on the double-leg reaction test significantly increased from pre- to post-training (20.4 +/- 4.3 vs.23.9 +/- 2.8, p<0.001). Hop time on the single-leg reaction test significantly decreased from pre- to post-training (Surgical leg 13.2 vs.12.3 seconds, non-surgical leg 13.0 vs.12.1 seconds, p=0.003). Mean errors did not significantly change on either reaction test (p> 0.05). Cohens d effect sizes in descending order was single-leg hop tests (d=0.9 to 1.3), double-leg reaction test (d=0.9), and single-leg reaction test (d=0.5). Motor performance improved after advanced neuromuscular training, but the effect size was less on visuomotor reaction tests than single-leg hop tests. The results suggest persistence of neurocognitive reliance after ACLR and a need for more dual-task challenges in training. 3.

Assessing the Effect of Short-Term Interval Training on Acceleration Ability and Anaerobic Power of Novice Sprinters

Background. Acceleration ability and anaerobic power are critical determinants of sprinting performance, particularly for novice sprinters. Objectives. The purpose of the study was to examine the effects of a four-week interval training program on acceleration ability and anaerobic power among novice sprinters. Materials and methods. A within-subjects quasi-experimental design was used to fulfil the study’s objectives. A total of fifteen participants (age: 20.5 ± 1.4 years) underwent baseline assessments of acceleration ability (50 m dash) and anaerobic power (Running-Based Anaerobic Sprint Test). The adopted progressive interval training protocol consisted of four weekly sessions conducted over a four-week period, focusing on striding, high knees, single-leg hops, curve sprints and double-leg jumps to enhance acceleration ability and anaerobic power. Results. Following the intervention, significant improvements were observed in acceleration ability over a distance of 10 m (pre: 2.14 ± 0.16 s, post: 2.02 ± 0.14 s, p &lt; 0.05, Cohen’s d = 1.02) and 20 m segments (pre: 3.47 ± 0.23 s, post: 3.32 ± 0.20 s, p &lt; 0.05, Cohen’s d = 0.78), indicating moderate to large effect sizes. However, no considerable enhancements were found in anaerobic power parameters (average power, maximum power, minimum power, fatigue index, relative peak power, and anaerobic capacity) at the post-intervention stage (p &gt; 0.05). Conclusions. The study highlights the effectiveness of the interval training protocol in enhancing initial acceleration among novice sprinters, although it suggests a limited impact on anaerobic power within the study period. Further research should investigate the longer-term effects and tailored training approaches to optimize comprehensive sprint performance strategies.

Validity and reliability of trunk and lower-limb kinematics during squatting, hopping, jumping and side-stepping using OpenCap markerless motion capture application

ABSTRACT OpenCap is a web-based markerless motion capture platform that estimates 3D kinematics from videos recorded from at least two iOS devices. This study aimed to determine the concurrent validity and inter-session reliability of OpenCap for measuring trunk and lower-limb kinematics during squatting, hopping, countermovement jumping, and cutting. Nineteen participants (10 males, 9 females; age 27.7 ± 4.1 years) were included. Countermovement jump, single-leg triple vertical hop, single-leg squat, sidestep cutting and side hop tasks were assessed. For validity, OpenCap was compared to a marker-based motion capture system using root-mean-square error. Test–retest reliability of OpenCap was determined using intraclass correlations and minimum detectable change (MDC) from two testing sessions. The squat had the lowest RMSE across joint angles (mean = 7.0°, range = 2.9° to 13.6°). For peak angles, the countermovement jump (jump phase) (ICC = 0.62–0.93) and the squat (ICC = 0.60–0.92) had the best reliability across all joints. For initial contact, the side hop had the best inter-session reliability (ICC = 0.70–0.94) across all joint angles. As such, OpenCap validity and reliability are joint and task specific.

Autograft Choice and Jumping Performance After Anterior Cruciate Ligament Reconstruction: A Comparative Study on Professional Athletes.

The extensor apparatus of the knee is of paramount importance in generating the torque needed for a countermovement jump (CMJ), especially in jumping athletes. In anterior cruciate ligament reconstruction (ACLR) procedures, graft harvesting from the extensor apparatus may dramatically affect extensor strength and jumping performance. The focused jump training of professional jumping athletes would increase the likelihood of restoring jumping performance after ACLR, despite the graft choice (autologous bone-patellar tendon-bone [BPTB] or hamstring [HS] tendon). Cohort study; Level of evidence, 3. A retrospective evaluation of prospectively collected data was carried out. Only professional athletes were included, and all surgical procedures were performed by a single experienced surgeon. Data collection considered the type of surgery, sports activity, and functional evaluation at 3 months after surgery. From the functional evaluation, data on single-leg hop (SLH) test, triple hop (TH) test, and CMJ were extracted. Limb symmetry index (LSI) for maximal voluntary isometric contraction of the quadriceps and for each of the jumping tests was calculated. Multiple analysis of covariance (ANCOVA) models were used to assess mean differences among groups for the LSI in CMJ, SLH, and TH and estimate the effect of confounders. From a subsequent series of 208 athletes, 44 professional athletes were included for data collection. Of these, 26 were male and 18 were female. A jumping sport (basketball, volleyball) was played by 17 athletes, while a running sport (soccer, judo, rugby, tennis, ski) was performed by 27 athletes. The mean time from injury to surgery was 17.8 ± 14.5 days. At 90 days from surgery, the overall mean LSI for CMJ was 85.3% ± 8.9%, for SLH was 92.2% ± 6.4%, and for TH was 90.8% ± 6.1%. When ANCOVA was fitted using the interaction term with BPTB autograft and jumping sport, a nonsignificant effect on LSI for CMJ (P = .56), SLH (P = .72), and TH (P = .98) was observed. The results of the present investigation on professional athletes showed that no difference occurred within the study cohort in overall jumping performance between jumping and running athletes undergoing ACLR either with BPTB or with HS tendon grafts. Although some evidence suggests that quadriceps strength may be dramatically affected by the harvesting of BPTB, the overall performance of the jump was not compromised.

Impact Of Neurocognitive Loading On Lower Limb Coordination And Variability During A Single Leg Hop

Impact Of Neurocognitive Loading On Lower Limb Coordination And Variability During A Single Leg Hop

Joint Work Distribution During Single Leg Hop Landing After Anterior Cruciate Ligament Reconstruction

Joint Work Distribution During Single Leg Hop Landing After Anterior Cruciate Ligament Reconstruction

Successful ACL repair by dynamic intraligamentary stabilisation is non-inferior in functional performance and worse in proprioception compared to healthy controls in a case-matched study.

The primary aim of this study was to assess non-inferiority in functional performance of the knee after dynamic intraligamentary stabilisation (DIS) surgery at a minimal follow-up of 1 year compared to healthy controls, based on limb symmetry index (LSI) of the single leg hop test (SLH). Additionally, functional performance based on the single leg triple hop test (SLTH) and side hop test (SH), proprioception and subjective outcome were evaluated. A total of 45 DIS patients were 1-to-1 matched to a healthy control. Functional performance was evaluated by LSI and absolute values on the SLH, SLTH and SH. Proprioception was assessed by joint position sense (JPS) test and International Knee Documentation Committee (IKDC) scores were obtained. Non-inferiority in functional performance after DIS compared to healthy controls was confirmed based on the mean LSI of the SLH and SLTH (97.6% vs. 99.6% and 97.5% vs. 100.6%, respectively) and non-confirmed on the SH (98.8% vs. 100.0%, respectively). No significant differences were found in absolute value of the SLH and SLTH and a significantly higher absolute value of the SH was found in the DIS group (p = 0.01). JPS absolute angular error was significantly higher in the DIS group compared to the control group (p = 0.01). The median IKDC score of the DIS group was significantly lower (92, IQR 85-95) than the control group (100, IQR 99-100), p < 0.001. In conclusion, functional performance after DIS was confirmed non-inferior compared to healthy controls based on the SLH and SLTH, although non-confirmed on the SH. Level III.

Fatigue-induced neuromuscular alterations in single-leg hop for distance jumps suggest an increased risk of anterior cruciate ligament injury

Fatigue-induced neuromuscular alterations in single-leg hop for distance jumps suggest an increased risk of anterior cruciate ligament injury

Effectiveness of In-Home, Augmented Reality-Based Telerehabilitation After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.

New digital technology-based rehabilitation may be a viable option for patients after anterior cruciate ligament reconstruction (ACLR), with advantages such as easy access to treatment and learning as well as cost-effectiveness. To investigate the effects of an augmented reality (AR)-based, telerehabilitation system in patients after ACLR compared with a brochure-based rehabilitation program in terms of patient-reported outcomes and functional performance measures. Randomized controlled trial; Level of evidence, 2. This was a multicenter, assessor-blinded study. Enrolled participants were allocated randomly to either the intervention group, who underwent AR-based telerehabilitation system, or to the control group, who underwent a brochure-based rehabilitation program with a self-log. Both groups performed the same postoperative rehabilitation exercise protocol. Subjective knee function was assessed using the International Knee Documentation Committee (IKDC) as the primary outcome; secondary outcomes were a numeric rating scale for pain, the EuroQol 5-Dimension 5-Level, isometric knee strength, range of motion, and the single-leg hop test. The intervention group also completed a satisfaction survey. Follow-up was conducted at 2, 6, 12, and 24 weeks postoperatively. A total of 28 patients were enrolled in each group; 1 patient in the control group was lost to follow-up. Patients in both groups demonstrated improvement on all outcomes over time. There were no significant between-group differences in the IKDC score from baseline to 12 weeks postoperatively. The intervention group saw a greater increase in the relative isometric strength of the quadriceps on the involved limb at 6, 12, and 24 weeks postoperatively (P < .05 for all). No significant group differences were observed in the remaining secondary outcomes. Study findings indicated that patients who underwent AR-based telerehabilitation in the early rehabilitation phase after ACLR demonstrated similar improvements as those who followed a brochure-based rehabilitation program and had a quicker recovery of knee extensor strength. NCT04513327 (ClinicalTrials.gov identifier).

Relationship Between Single-Leg Vertical Jump and Drop Jump Performance, and Return to Sports After Primary Anterior Cruciate Ligament Reconstruction Using Hamstring Graft.

After anterior cruciate ligament reconstruction (ACLR), asymmetry is likely to persist in single-leg (SL) vertical jump and drop jump performance than in SL hop distance. However, its relationship with the return to sport (RTS) remains unclear. This study aimed to determine the association between vertical jump performance after primary ACLR using hamstring tendon autograft and RTS at a pre-injury competitive level. Cross-sectional study. Patients who underwent primary ACLR using hamstring tendon autograft were recruited for this study. Participants who returned to pre-injury competition after ACLR were recruited at least eight months postoperatively. Knee condition was assessed, including joint laxity, range of motion, muscle strength, and knee pain intensity during sports activities. Performance variables were also assessed, including SL hop distance, jump height in SL vertical jump, and reactive strength index (RSI; jump height/contact time) in SL drop jump. Participants were asked to subjectively report whether they had returned to the same level of competition as pre-injury and their perceived sport performance intensity. Those who answered "Yes" to the dichotomous question and had a postoperative subjective athletic performance of > 80% were categorized into the Yes-RTS group. The primary outcome was the ability to achieve RTS at the preinjury level. Sixty-five patients (female, 35; male, 30) at 13.0 (13.0) [median (interquartile)] months after ACLR participated in this study. Thirty-nine (60%) were assigned to the Yes-RTS group. Regarding knee conditions, the No-RTS group had a significantly higher knee pain intensity, as assessed using a numerical rating scale (p<0.001, effect size -0.45). In the performance tests, the No-RTS group exhibited a significantly lower limb symmetry index of RSI during the SL drop jump compared to the Yes-RTS group (p=0.002, effect size 0.81). Patients unable to achieve RTS after primary ACLR using hamstring grafts are more likely to exhibit asymmetric performance during the SL drop jump test, suggesting the significance of assessing jump symmetry when evaluating post-ACLR rehabilitation success. 3c.

Longitudinal Evaluation Using the Forgotten Joint Score-12 for Double-Bundle Primary Anterior Cruciate Ligament Reconstruction: A Retrospective Observational Study.

Introduction There are several postoperative evaluation methods for anterior cruciate ligament reconstruction (ACLR), and patient-reported outcome measurement (PROM) is one of the most important for evaluating postoperative clinical results. However, conventional PROMs have a high risk ofa ceiling effect at one and two years postoperatively and do not accurately reflect functional improvement over time. Therefore, a longitudinal evaluation using PROM with a low risk of ceiling effect is necessary. The forgotten joint score-12 (FJS) was developedfor clinical evaluation after arthroplasty. It is considered an evaluation method after arthroplasty with a low risk of demonstrating a ceiling effect. However, few studies have used the FJS as an evaluation method after ACLR, particularly those tracking changes over time. This study aimed to longitudinally evaluate FJS at one and two years after ACLR. Methods This is a retrospective observational study of postoperative patients using existing data and a questionnaire-based survey.This studyincluded patients who underwent primary double-bundle ACLRbetween August 2017 and August 2021. We compared the FJS, knee injury and osteoarthritis outcome score (KOOS), and Lysholm knee scale (LKS) scores at one and two years post-surgery using the Wilcoxon signed-rank test. The ceiling effect for each PROM was calculated at one and two years post-surgery.A ceiling was defined as obtaining a perfect score in PROMs, and the risk of demonstrating a ceiling effect was the percentage of perfect scores among all cases. The risk of demonstrating a ceiling effect for each PROM was compared using the McNemar test. To identify factors influencing FJS one-year post-ACLR across all cases, multivariate linear regression analysis was conducted for the FJS. Results Finally, 87 patients were included in this study.Fifty-six participants were women, and 31 were men, with an average age of 28.5 ± 11.8 years at the time of surgery and a BMI of 23.2 ± 3.7 kg/m2. Fifty-eight patients with meniscus injuries requiring treatment were observed. A total of 54 patients were used to compare the results at one and two years, while 87 patients were included in the multivariate analysis for FJS at one year.The median of FJS at one and two years post-surgery were 90.6 and 95.8, respectively. The FJS showed a statistically significant improvement from one to two years (p = 0.033). Question #12 in FJS showed a significant improvement from the first to the second year postoperatively (1.74 ± 1.46 vs 1.15 ± 1.25 at one year vs two years, respectively; p = 0.0016). FJS had a lower risk of demonstrating a ceiling effect than KOOS ADL at one and two years (FJS vs KOOS ADL; at first year: 20.4% and 48.1%, p < 0.001; at second year: 33.3% and 63.0%, p = 0.0013). There was no difference compared to the other PROMs. According to the multivariate linear regression analysis,predictive factors for higher FJS scoresat one year post-surgery were younger age and limb symmetry index of single-leg hop test(SLH-LSI) on the affected side that was close to that of the healthy side (SLH-LSI > 0.9). Conclusions The FJS continued to improve over two years after ACLR. The FJS post-ACLR was higher in younger individuals and those with SLH-LSI of 0.9 or higher.

Aerobic Exercise Versus Plyometrics in Reducing Anxiety Levels in College Students With Mild Generalized Anxiety Disorder.

Background Generalized anxiety disorder is one of the most prevalentmental disorders, characterized byexcessive anxiety and worry that affectboth mental and physical health. These pervasive illnesses have a crippling effect on people's everyday lives, quality of life, and wellness and are also highly linked with cardiovascular risk factors. Physical activity-based therapies have shown promising effects in treating a range of mental disorders, from psychosis to dementia. Out of many conventional therapies, aerobic exercise and plyometrics have been found to be effective in reducing anxiety levels. Aim This study aims to compare the effectiveness of aerobic exercise and plyometrics in reducing anxiety levels in college students with mild generalized anxiety disorder. Materials and methods A total of 96 subjects were selected for the studyusing a stratified sampling technique;48 subjects were assigned to the aerobic exercise group (Group A) and 48 to the plyometric group (Group P). Randomization was done using the sealed envelope method. This study includes students aged 18-25 years, both genders, with a body mass index of <30, a Beck Anxiety Inventory (BAI) score of 8-15, and at least six months without practicing any kind of physical activity. The exclusion criteria are subjects with other psychotic disorders, a history of cardiovascular disease, chronic kidney disease, inflammatory disease, malignant conditions, neurological disorders, anemia, with comorbid conditions, who were involved in supportive therapy for anxiety such as cognitive behavioral therapy, use of anxiolytic drugs, females with menstrual disorders, and subjects with recent trauma or injuries (fracture, ligament sprain, or muscle strain). The treatment duration for both groups was three days per week for a total of four weeks. Group A consists of five minutes of warm-up, 30 minutes of walking, and five minutes of cool-down, for a total of 40 minutes. Group P consists of warm-up of five minutes, high knees, single leg hop and jump squats of two sets and 10 repetitions for 30 minutes, and a cool-down of five minutes, for a total of 40 minutes. Conclusion The anxiety levels were analyzed using the BAI, revealing that bothgroups have shown improvements in Beck anxiety scores; however,Group A has shown a comparatively more significant improvement than Group P.

Which jump test is most sensitive for classifying ACL injury history in fatigued or non-fatigued athletes?

Introduction &amp; Purpose In fast-paced clinical decision-making, jump-landing movement assessments are rarely used to guide return-to-sport (RTS) decisions after an anterior cruciate ligament (ACL) injury. While these tests are crucial for identifying deficits in movement execution (e.g., dynamic valgus, extended knee, knee internal rotation) that could predispose to ACL re-rupture (Kaplan &amp; Witvrouw, 2019), identifying these deficits can be challenging. To integrate RTS movement assessments into clinical practice, the first step is to identify the most sensitive jump-landing test that can best expose remaining deficits in neuromuscular control and resulting landing kinematics associated with ACL injury. Further, RTS tests are mostly performed in a non-fatigued state although fatigued individuals often fail to reach the RTS criteria (Dingenen &amp; Gokeler, 2017). This exploratory study aimed to rank common jump-landing tests in their ability to identify (sensitivity and classification rate) deficits in whole-body landing kinematics following ACL injury, under both fatigued and non-fatigued conditions. Methods A total of 43 volunteers were recruited into ACL group (n = 21, 11 females, 3.9 years post ACL injury) and control group (n = 22, 12 females). 3D motion data (Vicon, 250 Hz) were recorded during a single-leg forward hop (SH), single-leg countermovement jump (CMJ), single-leg triple crossover hop (COH), and single-leg 90° medial rotation hop (MRH) before and after a fatigue-inducing intervention (single-leg squats and step-ups). Thirteen joint angles (50 ms after initial contact) from the lower body, trunk, and pelvis representing the landing kinematics were calculated in OpenSim. A correlation analysis was performed to check for multicollinearity issues. Eight distinct logistic regression models (four jumps, fatigued/non-fatigued, α = .05) were computed to predict ACL injury history based on a combination of joint angles. For each model, a backward stepwise method was employed to determine which combination of joint angles resulted in the highest classification rates. Results ACL injury history was successfully predicted in seven (χ² &gt; 4.4, p &lt; .036) of the eight logistic regression models (Figure 1). The SH in the fatigued condition (χ² = 22.5, p = .008) demonstrated the highest sensitivity of 85.7% and a classification rate of 86%. Significant predictors for this model were knee rotation (Odds ratios [OR] = 1.537), hip abduction (OR = 1.385), hip rotation (OR = 1.525), and ankle flexion (OR = 0.771). The CMJ (non-fatigued) showed the second-highest sensitivity of 81% and a classification rate of 81.4% (p = .027). Significant predictors were knee rotation (OR = 1.440), hip abduction (OR = 1.428), hip rotation (OR = 1.297), and pelvis rotation (OR = 0.664). The MRH in the non-fatigued condition exhibited the lowest sensitivity, and no classification was possible in the non-fatigued COH model (χ² = 3.6, p = .056). Discussion &amp; Conclusion The fatigued SH was the most sensitive jump-landing test for classifying groups and detecting kinematic differences due to previous ACL injury. Thus, we recommended the SH over other tests for RTS decision-making, as it is most likely to reveal kinematic abnormalities. Higher classification rates in the fatigued condition support RTS testing in fatigued states to better identify movement deficits. To integrate jump-landing assessments into RTS decisions in a feasible way, our future work will involve 3D motion capture using pose estimation algorithms on video data.

Single Leg Hop Performance After Anterior Cruciate Ligament Reconstruction: Ready for Landing but Cleared for Take-Off?

Understanding former professional football players engagement with health promoting behaviors (physical exercise, high quality diet, and good sleep hygiene) will be helpful for developing lifestyle interventions to improve their feelings of well-being, a relatively understudied facet of health among this population. Examine associations among health-promoting behaviors and subjective outcomes related to well-being among former National Football League (NFL) players. Cross-sectional. Online or hard-copy survey. Former NFL players. Self-reported health-promoting behaviors (exercise frequency, diet quality, sleep duration and disturbance) and factors related to well-being (PROMIS ® Meaning and Purpose [MP], Self-Efficacy [SE], Ability to Participate in Social Roles and Activities [SRA]). Multivariable linear regression models were fit for each well-being-related factor with health-promoting behaviors as explanatory variables alongside select demographic, behavioral, and functional covariates. Models were fit for the full sample and separately for individual age groups: <30 years; 30-39 years; 40-49 years; 50-59 years; 60-69 years; and 70+ years. A total of 1,784 former NFL players (aged 52.3±16.3 years) completed the survey. Lower sleep disturbance was associated with better MP (β[standard error]=-0.196[0.024]), SE (β[standard error]=-0.185[0.024]), and SRA (β[standard error]=-0.137[0.017]) in the full sample and almost all the individual age groups. More frequent moderate-to-vigorous exercise was associated with higher MP (β[standard error]=0.068[0.025]) and SRA (β[standard error]=0.151[0.065]) in the full sample, and with better MP, SE, and SRA among select middle-aged groups (between 40-69 years old). Diet quality, resistance training exercise frequency, other wellness activity frequency, and sleep duration were not associated with well-being-related factors in the full-group and sparse significant associations were observed in individual age group models. Lower sleep disturbance and more frequent moderate-to-vigorous exercise frequency may be important targets for improving overall health and well-being among former NFL players.

Assessing the Impact of Psychological Readiness on Performance and Symmetry in Functional Testing After ACL Reconstruction in Pediatric and Adolescent Patients.

Readiness for return to sports involves both physical and psychological aspects of recovery; however, the relationship between psychological and physical variables after anterior cruciate ligament (ACL) reconstruction (ACLR) is poorly understood. ACLR patients with a higher psychological readiness would demonstrate better functional testing results at 6 months. Cross-sectional study; Level of evidence, 3. Participants were evaluated at 6 months after ACLR with various patient-reported outcome metrics: Hospital for Special Surgery Pediatric Functional Activity Brief Scale, pediatric or adult International Knee Documentation Committee Questionnaire (IKDC), Patient-Reported Outcomes Measurement Information System (PROMIS) - Psychological Stress Experience and ACL - Return to Sport After Injury (ACL-RSI) scale. Functional testing included quadriceps, hamstrings, and gluteal strength testing; Y-balance test; single-leg single hop, crossover hop, and triple hop tests; and timed 6-m hop test. Pearson correlation coefficient and multivariable regression were used to determine associations between the limb symmetry index (LSI) on functional testing and patient-reported outcomes. Those with LSI deficits <20% (better performance) were compared with those with deficits >20% (worse performance). A total of 229 participants (89 male, 140 female) with a median age of 17 years (range, 10.3-30.6 years) were enrolled. IKDC had a moderate negative correlation with PROMIS - Psychological Stress Experience (r = -0.39; 95% CI = -0.49, -0.27; P < .001) and a moderate positive correlation with ACL-RSI (r = 0.55; 95% CI = 0.46, 0.64; P < .001). A total of 151 patients completed functional testing. ACL-RSI demonstrated a positive correlation with single-hop LSI (r = 0.21; 95% CI = 0.05, 0.35; P = .01) and timed 6-m hop (r = 0.28; 95% CI, 0.42; P = .001). When adjusting for sex, age, and graft type, patients who had <20% deficit on the single-hop test scored 16.6 points higher on ACL-RSI (P = .001), and those with <20% deficit on crossover hop testing scored a mean 13.9 points higher on ACL-RSI (P = .04). Higher psychological readiness for return to sport was associated with better performance and greater symmetry on hop testing 6 months after ACLR, suggesting a potential link between physical and psychological recovery.

Neurocognitive demands reducejump distance and coordination variability of the injured leg in athletes after anterior cruciate ligament reconstruction.

The study aimed to evaluate the impact of neurocognitive reliance on jump distance and lower extremity kinematics in individuals who had undergone anterior cruciate ligament reconstruction (ACLR). This was achieved by comparing hop performance under standard and neurocognitive conditions. Thirty-two patients after ACLR and 32 healthy controls (CTRL) participated. Both groups performed a single-leg hop for distance (SLHD) and two neurocognitive hop tests, each designed to evaluate distinct aspects of neurocognition. The neurocognitive tests included the reaction SLHD (R-SLHD), measuring reaction to a central stimulusand working memory SLHD (WM-SLHD) assessing response to a memorized stimulus amidst distractor stimuli. Distances were assessed for the three-hop tests. In addition, joint kinematics were collected to calculate lower extremity coordination of the lower extremity. SLHD performance was defined as the mean hop distance per condition per leg for each participant and was analyzed using a mixed ANOVA with condition and leg as the within-subjects factors and the group (ACLR or CTRL) as the between-subjects factor. Differences in joint coordination variability were analyzed using two-sample t-test statistical parametric mapping (SPM) with linear regression. The WM-SLHD resulted in a significantly decreased jump distance compared with the standard hop test both for ACLR and CTRL. Furthermore, the leg difference within the ACLR group increased under higher cognitive load as tested with the WM-SLHD, indicating leg-specific adaptations in lower extremity coordination. Neurocognitive single-leg hop tests resulted in reduced jump distance in CTRL and ACLR. The neurocognitive hop test revealed changes in coordination variability for the CTRL and the uninjured leg of ACLR individuals, whereas the injured leg's coordination variability remained unaltered, suggesting persistent cognitive control of movements post-ACLR. Level III.

EXAMINING THE CORRELATION BETWEEN HIP ADDUCTOR MUSCLE STRENGTH, CORE STABILIZATION, AND LOWER EXTREMITY PERFORMANCE IN HEALTHY INDIVIDUALS

Purpose: This study aimed to investigate the correlation between hip adductor muscle strength and endurance, core stabilization, and lower extremity performance. Methodsː One hundred thirty-three healthy individuals were included in the study. Bilateral hip adductor muscle strength was evaluated with a compression test by using a sphygmomanometer, and endurance was evaluated by the number of hip adduction repetitions for each extremity performed in the side-lying position in one minute. Core stabilization was evaluated by the endurance of the trunk muscles (the time of maintaining the flexion of the trunk 60 degrees, the lateral bridge position, and the trunk extension against gravity). Lower extremity dynamic balance (Y balance test) and performance (single-leg and triple-crossover hop test) were also evaluated. Resultsː A positive and moderate correlation was found between hip adductor muscle strength and endurance of nondominant (r=0.529, p

In the medium term, more than half of males report kinesiophobia after anterior cruciate ligament reconstruction

ObjectivesAnterior cruciate ligament rupture is a serious trauma with long-term consequences for the patient. Psychological and physiological factors may negatively affect patient recovery after anterior cruciate ligament reconstruction (ACLR), and development of kinesiophobia is possible. The aim of this study was to examine the presence of kinesiophobia and lower-leg muscle strength recovery in both sexes after ACLR. Methods140 ACLR patients agreed to participate in the study. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TSK). The Knee injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS) and Tegner Activity Scale (TAS) were used for patient-related outcome measurements. In both legs quadriceps and hamstring muscle strength at 60°/s and 180°/s were measured with an isokinetic dynamometer. For dynamic balance and leg function, the Y-balance test and single-leg hop test were used. Results100 (71%) males and 40 (29%) females—mean age 32.5 (±8.3)—were examined 5.5 (±1.25) years after ACLR. 68/140 patients (48.6%) reported a TSK kinesiophobia score equal to or higher than 37 points: 54/100 (54%) males and 14/40 (35%) females (p ​= ​0.04). Patients with kinesiophobia had significantly lower KOOS values (p ​< ​0.001). In terms of the TAS no significant differences were found between those with or without kinesiophobia. Knee strength deficiency at 180°/sec and 60°/sec was significantly higher in the kinesiophobia group in knee extension in males (p ​= ​0.009) and knee flexion in females (p ​= ​0.001). Normalized body weight isokinetic average peak torque strength tests were significantly better in males compared to females in both groups (p ​< ​0.001). ConclusionBoth sexes reported high rates of kinesiophobia, but males are at higher risk of developing kinesiophobia than females in the medium term after ACLR. Furthermore, patients with kinesiophobia have significantly lower total KOOS scores, and females were significantly weaker than males in knee flexion and extension according to normalized body weight muscle strength tests. Also, a longer time from injury to surgery increases the risk of kinesiophobia in females. Level of evidenceLevel IV. Type of studyRetrospective case series study. Clinical trial registrationTrial registration in ClinicalTrials.gov. Identifier: NCT05762809.

Assessing the Relationship of Psychological Sport Readiness, Single-leg Vertical Jump, and Non-Sagittal Single-Leg Hops to Quadriceps Strength After Anterior Cruciate Ligament Reconstruction.

Limitations exist with current ACLR functional testing assessments that may be mitigated by including single-leg multi-directional testing. To compare Anterior Cruciate Ligament-Return to Sport after Injury Scale (ACL-RSI) scores, limb symmetry index (LSI) of the single-leg vertical jump (SLVJ), single-leg medial rotation hop (SLMRH), single-leg lateral hop (SLLH), and isokinetic quadriceps strength between participants with an ACLR and healthy controls and assess predictors of quadriceps strength asymmetry. It was hypothesized that ACL-RSI scores and LSIs for all tests would differ between ACLR and healthy control groups and within the ACLR group a strong correlation would exist between all outcome measures and quadriceps strength. Cross-Sectional Study. Twenty-six participants with an ACLR (median 13 months after surgery) and twenty-six matched healthy controls were recruited to participate in this study. Performance was assessed via SLVJ, SLMRH, SLLH, and isokinetic quadriceps strength. Between-group comparisons were made with independent t-tests and Mann-Whitney U test. Within the ACLR group, bivariate correlation and multivariate regression analysis were performed to assess the relationship between the outcome measures and quadriceps strength asymmetry. Significant between-limb differences were only identified in the ACLR group (p< 0.05): SLVJ LSI: 88.5%, SLMRH LSI: 93.6%, SLLH LSI: 92.7%, quadriceps strength LSI 80.9% - 83.9%, which were significantly lower (p <0.05) than the healthy control group. Within the ACLR group, a moderate-strong significant (p < 0.05) correlations existed with quadriceps strength and SLVJ (r=0.44-0.65), SLMRH (r =0.43-0.83), and SLLH (r=0.54-0.63); while ACL-RSI had a weak non-significant (p > 0.05) correlation with quadriceps strength (r= 0.12-0.30). Single-leg multidirectional test LSIs were less in ACLR participants than matched healthy controls and all were directly related to quadriceps strength. Psychological readiness to return to sport was not related to quadriceps strength.

Two-Year Functional Outcomes of Nonsurgical Treatment in Concomitant Anterior Cruciate Ligament and Medial Collateral Ligament Injuries: A Case-Control Study.

The anterior cruciate ligament (ACL) is a common knee injury in high-intensity sports, which can cause early career loss in young athletes. Concomitant damage to other knee stabilizers may occur, such as the medial collateral ligament (MCL). Recent studies have shown that knee stability can increase without surgical intervention in patients with ACL and MCL injuries. Regarding the importance of functional tests in return to exercise prediction, this study aims to measure nonsurgical approach's long-term outcome for concomitant ACL and MCL injuries with a focus on functional tests. This is a case-control study with a 2-year follow-up. The case group consisted of patients who had provided written consent and completed their 2-year follow-up, and the control group was made up of healthy people who did not have any knee medical conditions and were matched by age, gender, and activity level. Physical examinations, Tegner and International Knee Documentation Committee questionnaires, and knee magnetic resonance imaging were conducted, and functional performance tests were performed after a 10-minute warm-up. Lody's index (the ratio of injured-to-uninjured knee results) was calculated. The data were analyzed using independent t-test, one-way analysis of variance, chi-squared test, and Fisher's exact test. The study involved 11 patients in each concomitant ACL and MCL injury cases and healthy control groups with a mean age of 32.4 and 28 years, respectively. None of the patients reported knee instability symptoms in the 2-year follow-up. More than half of the patients continued their sports field without reinjury, with no significant difference in activity levels between case and control groups. The 6-meter hop test and single-leg hop test showed no significant difference between case and control groups (p-value: 0.326, 0.859), and no significant difference was observed in the three Carioca, cocontraction, and Shuttle tests in the 2-year follow-up. Functional tests in ACL and MCL injuries revealed normal outcomes, implying a nonsurgical approach for patients with proximal ACL tears, better knee stability, and no significant differences between the injured and control groups.