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1.
J Sport Rehabil ; 33(8): 654-662, 2024 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-39209282

RESUMEN

CONTEXT: The Y-Balance Test Lower Quarter (YBT-LQ) is a widely utilized tool for evaluating dynamic postural control, requiring a combination of mobility and strength. This study aimed to investigate the combined relationship between isometric thigh muscle strength and joint kinematics on YBT-LQ performance. DESIGN: Cross-sectional laboratory study. METHODS: Isometric quadriceps and hamstrings strength were measured before the YBT-LQ in 39 healthy participants (27 females and 12 males). The test was performed under 3-dimensional markerless motion capture, where joint kinematics were extracted from the maximum reach position from each direction. Three multivariable linear regression models were then used to determine the strongest combination of predictors for YBT-LQ performance. RESULTS: Greater hamstrings strength and increased knee flexion, ankle dorsiflexion, and trunk ipsilateral-flexion joint angles explained 56.8% (P < .001) of the variance in anterior reach. Hip flexion, knee flexion, and ankle dorsiflexion angles were the strongest predictors for posteromedial reach distance, explaining 73.0% of the variance (P < .001). Last, 43.3% (P < .001) of the variance in posterolateral reach distance was predicted by hamstring strength and knee-flexion angle. CONCLUSIONS: These results emphasize the importance of hamstring strength in YBT-LQ performance across different reach directions. Additionally, the kinematics illustrate a potential movement strategy for maximizing reach distance on the YBT-LQ in healthy individuals. Clinicians can utilize this information to guide interventions aimed at improving dynamic postural control, particularly by focusing on increasing hamstring strength and testing for impairments in specific movement patterns.


Asunto(s)
Músculos Isquiosurales , Fuerza Muscular , Equilibrio Postural , Humanos , Masculino , Femenino , Fenómenos Biomecánicos/fisiología , Fuerza Muscular/fisiología , Estudios Transversales , Equilibrio Postural/fisiología , Adulto Joven , Adulto , Músculos Isquiosurales/fisiología , Muslo/fisiología , Articulación de la Rodilla/fisiología , Articulación del Tobillo/fisiología , Músculo Cuádriceps/fisiología , Rango del Movimiento Articular/fisiología
2.
J Sport Rehabil ; 32(4): 467-473, 2023 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-37044380

RESUMEN

CONTEXT: Impact magnitude, such as peak tibial acceleration, may be associated with lower extremity injury risk and can be measured with an inertial sensor. An understanding of impact magnitude across functional tasks could guide clinicians in exercise prescription during rehabilitation of lower extremity injuries. OBJECTIVES: To determine (1) differences in impact magnitude based on task and (2) which tasks have asymmetrical impact magnitude based on limb dominance. DESIGN: Observational cohort design. Thirty-three healthy, recreationally active adult females participated in 1 testing session on a basketball court. METHODS: Participants wore inertial sensors with embedded accelerometers on bilateral distal shanks. Participants completed 9 plyometric, speed, and agility tasks commonly utilized during the return to sport phase of lower extremity rehabilitation. MAIN OUTCOME MEASURES: Average impact magnitude (peak tibial acceleration in multiples of gravity, g) for each limb for each task. ANALYSES: We used a repeated-measures analysis of variance (factor: task) to determine the differences in impact magnitude based on task. We categorized tasks by magnitude of impact into low, medium, high, and very high impact. We utilized paired t tests for each task to compare limbs (dominant vs nondominant). RESULTS: Impact magnitude differed based on task (P < .001). We classified tasks as low impact (≤10g; single-leg [SL] lateral jump, double-leg [DL] lateral jump); medium impact (11-20g; SL vertical jump, box drill); high impact (21-30g; modified T test, DL forward jump, SL forward jump); and very high impact (≥31g; sprint, DL tuck jump). Impact magnitude differed by limb in 3 tasks (DL forward jump, DL lateral jump, and box drill), with a higher impact on the dominant limb in each task. CONCLUSIONS: Impact magnitude differed based on task. While most tasks had symmetric impact magnitude between limbs, 3 tasks had a higher impact magnitude on the dominant limb.


Asunto(s)
Articulación de la Rodilla , Deportes , Adulto , Humanos , Femenino , Volver al Deporte , Atletas , Extremidad Inferior , Fenómenos Biomecánicos
3.
J Sport Rehabil ; 32(7): 797-801, 2023 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-37290771

RESUMEN

CONTEXT: Early identification of incoming military personnel at elevated odds for bone stress injury (BSI) is important for the health and readiness of the US military. DESIGN: Prospective cohort study. METHODS: Knee kinematic data of the incoming US Military Academy cadets were collected while performing a jump-landing task (The Landing Error Scoring System) using a markerless motion capture system and depth camera. Data on incidence of lower-extremity injury, including BSI, were collected throughout the study period. RESULTS: A total of 1905 participants (452 females, 23.7%) were examined for knee valgus and BSI status. A total of 50 BSI occurred during the study period (incidence proportion = 2.6%). The unadjusted odds ratio for BSI at initial contact was 1.03 (95% confidence interval [CI], 0.94-1.14; P = .49). Adjusted for sex, the odds ratio for BSI at initial contact was 0.97 (95% CI, 0.87-1.06; P = .47). At the instant of maximum knee-flexion angle, the unadjusted odds ratio was 1.06 (95% CI, 1.02-1.10; P = .01), and the odds ratio was 1.02 (95% CI, 0.98-1.07; P = .29) after adjusting for sex. This suggests that there was not a significant enough association for an increase in the odds of BSI based on either degree of knee valgus. CONCLUSIONS: Our results did not demonstrate an association between knee valgus angle data during a jump-landing task and future increased odds of BSI in a military training population. Further analysis is warranted, but the results suggests the association between kinematics and BSI cannot be effectively screened by knee valgus angle data in isolation.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Personal Militar , Femenino , Humanos , Estudios Prospectivos , Articulación de la Rodilla , Rodilla , Extremidad Inferior , Fenómenos Biomecánicos
4.
Br J Nutr ; : 1-11, 2022 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-35109945

RESUMEN

Few investigations have evaluated the validity of current body composition technology among racially and ethnically diverse populations. This study assessed the validity of common body composition methods in a multi-ethnic sample stratified by race and ethnicity. One hundred and ten individuals (55 % female, age: 26·5 (sd 6·9) years) identifying as Asian, African American/Black, Caucasian/White, Hispanic, Multi-racial and Native American were enrolled. Seven body composition models (dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), two bioelectrical impedance devices (BIS, IB) and three multi-compartment models) were evaluated against a four-compartment criterion model by assessing total error (TE) and standard error of the estimate. For the total sample, measures of % fat and fat-free mass (FFM) from multi-compartment models were all excellent to ideal (% fat: TE = 0·94-2·37 %; FFM: TE = 0·72-1·78 kg) compared with the criterion. % fat measures were very good to excellent for DXA, ADP and IB (TE = 2·52-2·89 %) and fairly good for BIS (TE = 4·12 %). For FFM, single device estimates were good (BIS; TE = 3·12 kg) to ideal (DXA, ADP, IB; TE = 1·21-2·15 kg). Results did not vary meaningfully between each race and ethnicity, except BIS was not valid for African American/Black, Caucasian/White and Multi-racial participants for % fat (TE = 4·3-4·9 %). The multi-compartment models evaluated can be utilised in a multi-ethnic sample and in each individual race and ethnicity to obtain highly valid results for % fat and FFM. Estimates from DXA, ADP and IB were also valid. The BIS may demonstrate greater TE for all racial and ethnic cohorts and results should be interpreted cautiously.

5.
J Sport Rehabil ; 31(3): 286-293, 2022 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-34768238

RESUMEN

CONTEXT: Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women's soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. DESIGN: Prospective cohort study. METHODS: Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women's soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10 weeks of a competitive soccer season. RESULTS: Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. CONCLUSIONS: Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women's collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Fútbol/lesiones , Lesiones del Ligamento Cruzado Anterior/epidemiología , Lesiones del Ligamento Cruzado Anterior/prevención & control , Estudios de Cohortes , Femenino , Humanos , Movimiento/fisiología , Estudios Prospectivos , Rango del Movimiento Articular , Factores de Riesgo
6.
Clin J Sport Med ; 31(1): 49-56, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30689611

RESUMEN

OBJECTIVE: To determine the association between selected biomechanical variables and risk of patellofemoral pain (PFP) in males and females. DESIGN: Prospective cohort. SETTING: US Service Academies. PARTICIPANTS: Four thousand five hundred forty-three cadets (1727 females and 2816 males). ASSESSMENT OF RISK FACTORS: Three-dimensional biomechanics during a jump-landing task, lower-extremity strength, Q-angle, and navicular drop. MAIN OUTCOME MEASURES: Cadets were monitored for diagnosis of PFP during their enrollment in a service academy. Three-dimensional hip and knee kinematic data were determined at initial contact (IC) and at 50% of the stance phase of the jump-landing task. Logistic regression analyses were performed for each risk factor variable in males and females (P < 0.05). RESULTS: Less than 10 degrees of hip abduction at IC [odds ratio (OR) = 1.86, P = 0.03] and greater than 10 degrees of knee internal rotation at 50% of the stance phase (OR = 1.71, P = 0.02) increased the risk of PFP in females. Greater than 20 degrees of knee flexion at IC (OR = 0.47, P < 0.01) and between 0 and 5 degrees of hip external rotation at 50% of the stance phase (OR = 0.52, P = 0.04) decreased the risk of PFP in males. No other variables were associated with risk of developing PFP (P > 0.05). CONCLUSIONS: The results suggest males and females have differing kinematic risk factor profiles for the development of PFP. CLINICAL RELEVANCE: To most effectively reduce the risk of developing PFP, the risk factor variables specific to males (decreased knee flexion and increased hip external rotation) and females (decreased hip abduction and increased knee internal rotation) should be addressed in injury prevention programs.


Asunto(s)
Síndrome de Dolor Patelofemoral/epidemiología , Factores Sexuales , Adolescente , Fenómenos Biomecánicos , Femenino , Humanos , Rodilla , Extremidad Inferior , Masculino , Personal Militar , Estudios Prospectivos , Rango del Movimiento Articular , Factores de Riesgo , Rotación , Adulto Joven
7.
Sensors (Basel) ; 21(13)2021 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-34206782

RESUMEN

(1) Background: Biomechanics during landing tasks, such as the kinematics and kinetics of the knee, are altered following anterior cruciate ligament (ACL) injury and reconstruction. These variables are recommended to assess prior to clearance for return to sport, but clinicians lack access to the current gold-standard laboratory-based assessment. Inertial sensors serve as a potential solution to provide a clinically feasible means to assess biomechanics and augment the return to sport testing. The purposes of this study were to (a) develop multi-sensor machine learning algorithms for predicting biomechanics and (b) quantify the accuracy of each algorithm. (2) Methods: 26 healthy young adults completed 8 trials of a double limb jump landing task. Peak vertical ground reaction force, peak knee flexion angle, peak knee extension moment, and peak sagittal knee power absorption were assessed using 3D motion capture and force plates. Shank- and thigh- mounted inertial sensors were used to collect data concurrently. Inertial data were submitted as inputs to single- and multiple- feature linear regressions to predict biomechanical variables in each limb. (3) Results: Multiple-feature models, particularly when an accelerometer and gyroscope were used together, were valid predictors of biomechanics (R2 = 0.68-0.94, normalized root mean square error = 4.6-10.2%). Single-feature models had decreased performance (R2 = 0.16-0.60, normalized root mean square error = 10.0-16.2%). (4) Conclusions: The combination of inertial sensors and machine learning provides a valid prediction of biomechanics during a double limb landing task. This is a feasible solution to assess biomechanics for both clinical and real-world settings outside the traditional biomechanics laboratory.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Articulación de la Rodilla , Fenómenos Biomecánicos , Humanos , Rodilla , Aprendizaje Automático , Adulto Joven
8.
J Appl Biomech ; 35(4): 272-279, 2019 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-31034324

RESUMEN

Although single-leg squats are a common dynamic balance clinical assessment, little is known about the relationship between parameters that influence squat movement and postural control performance. The objective of this study was to determine the relationships between squat parameters (speed and depth) and postural control under single task and dual task. A total of 30 healthy college students performed single-leg squats under single task and dual task with Stroop. Random-intercepts generalized linear mixed models determined the effect of squat parameters on center of pressure (CoP) parameters. For each 1-cm·s-1 increase in squat speed, sway range (mediolateral: ß = -0.03; anteroposterior: ß = -0.05) and area (ß = -0.25) decreased, whereas sway speed (mediolateral: ß = 0.05; anteroposterior: ß = 0.29; total: ß = 0.29) increased. For each 1-cm increase in squat depth, sway range (mediolateral: ß = 0.05; anteroposterior: ß = 0.20) and area (ß = 0.72) increased, whereas sway speed (anteroposterior: ß = -0.14; total: ß = -0.14) decreased. Compared with single task, the association between total and anteroposterior sway speed and squat speed was stronger under dual task. Clinicians and researchers should consider monitoring squat speed and depth when assessing dynamic balance during single-leg squats, as these parameters influence postural control, especially under dual task.


Asunto(s)
Movimiento/fisiología , Equilibrio Postural/fisiología , Postura/fisiología , Estudios Transversales , Femenino , Humanos , Masculino , Adulto Joven
9.
Res Sports Med ; 27(1): 21-33, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30084269

RESUMEN

The purpose of this study was to examine associations between ankle dorsiflexion (ankle-DF) displacement and knee and hip kinematics and kinetics during a jump-landing task in females following anterior cruciate ligament reconstruction (ACLR). Females (n = 23) with a history of unilateral ACLR (≥ 6-months post-ACLR) underwent a three-dimensional lower extremity biomechanical evaluation. Pearson Product Moment (r) correlations assessed associations between ankle-DF displacement and knee and hip kinematic and kinetic variables. On the involved-limb, individuals with lesser ankle-DF displacement demonstrated greater knee abduction displacement during the loading phase (r = -0.645, p = 0.001). On the uninvolved-limb, individuals with greater ankle-DF displacement demonstrated greater hip flexion displacement (r = 0.599, p = 0.003) and knee flexion displacement (r = -0.545, p = 0.007). There were no other significant associations between ankle-DF displacement and ankle, knee, or hip biomechanical variables on either limb (p > 0.05). Our findings demonstrate that reduced ankle-DF motion appears to share a different relationship between the involved- and uninvolved-limbs in females post-ACLR.


Asunto(s)
Articulación del Tobillo/fisiología , Reconstrucción del Ligamento Cruzado Anterior , Articulación de la Cadera/fisiología , Articulación de la Rodilla/fisiología , Rango del Movimiento Articular , Adolescente , Adulto , Fenómenos Biomecánicos , Prueba de Esfuerzo , Femenino , Humanos , Movimiento , Adulto Joven
10.
Artículo en Inglés | MEDLINE | ID: mdl-29511821

RESUMEN

In the original publication the name of the fourth reviewer was incorrectly published.

11.
Knee Surg Sports Traumatol Arthrosc ; 26(5): 1326-1334, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-28849248

RESUMEN

PURPOSE AND HYPOTHESIS: Individuals with an anterior cruciate ligament reconstruction (ACLR) are susceptible to persistent disability, weight gain and the development of knee osteoarthritis. It remains unclear whether body mass index (BMI) is a factor that influences disability following ACLR. The purpose of this study was to determine the association between BMI and self-reported disability [International Knee Documentation Committee (IKDC) Index] in individuals with a unilateral ACLR. We hypothesized that lower BMI would associate with higher IKDC. METHODS: BMI and IKDC were measured in 668 individuals with a unilateral ACLR (60.9% female, BMI 24.4 ± 3.7 kg/m2, IKDC 84.7 ± 11.9%). Bivariate associations were conducted between BMI and IKDC for the entire sample and selected subsets (gender, ACLR graft type and history of meniscal injury). Multiple regression analyses were used to determine the impact of potential covariates (Tegner score, age and months since ACLR) for significant bivariate associations. After accounting for covariates, there were no significant associations between BMI and IKDC when separately evaluating the cohort based on either gender or history of a concomitant meniscal injury. The odds of achieving age- and gender-matched healthy population average IKDC scores for those with low (<25) and high (≥25) BMI were determined. RESULTS: Lower BMI associated with higher IKDC (r = -0.08, P = 0.04). For the entire sample, BMI did not uniquely predict variance in IKDC (ΔR 2 > 0.001, n.s.) after accounting for covariates. BMI uniquely predicted a significant but negligible amount of variance in IKDC in individuals with a patellar tendon autograft (ΔR 2 = 0.015, n.s.). Individuals with low BMI demonstrated higher odds (odds ratio = 1.45; 1.05-1.99) of achieving population average IKDC scores compared to participants with high BMI. CONCLUSIONS: There was a significant but negligible correlation between lower BMI and lesser disability in individuals with unilateral ACLR and individuals who are underweight or of normal BMI demonstrated higher odds of achieving population average IKDC scores compared to overweight or obese individuals. While an overall association was found between lower BMI and lesser disability, the magnitude of the association remains negligible; therefore, BMI was not a strong clinical predictor of successful ACLR outcomes in this cohort of patients with unilateral ACLR. LEVEL OF EVIDENCE: Cross-sectional prognostic study, Level II.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior/rehabilitación , Reconstrucción del Ligamento Cruzado Anterior/rehabilitación , Índice de Masa Corporal , Evaluación de la Discapacidad , Articulación de la Rodilla/cirugía , Autoinforme , Lesiones del Ligamento Cruzado Anterior/diagnóstico , Lesiones del Ligamento Cruzado Anterior/fisiopatología , Reconstrucción del Ligamento Cruzado Anterior/métodos , Estudios Transversales , Femenino , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/fisiopatología , Masculino , Ligamento Rotuliano/trasplante , Pronóstico , Rango del Movimiento Articular , Trasplante Autólogo , Adulto Joven
12.
Arch Phys Med Rehabil ; 98(10): 2052-2065, 2017 10.
Artículo en Inglés | MEDLINE | ID: mdl-28483655

RESUMEN

OBJECTIVE: To determine whether anterior cruciate ligament-deficient (ACL-D) individuals and individuals with a reconstructed anterior cruciate ligament (ACL-R) rely more heavily on visual information to maintain postural control. DATA SOURCES: PubMed, CINAHL, and SPORTDiscus databases were searched from their earliest available date to May 24, 2016, using a combination of keywords. STUDY SELECTION: Articles were included if they reported any instrumented static single-leg balance outcome in both a patient and control sample. The means and SDs of these outcomes must have been reported with both eyes open and eyes closed. DATA EXTRACTION: Sample sizes, means, and SDs of single-leg balance measures for each group's eyes open and eyes closed testing conditions were extracted. The methodological quality of included studies was independently evaluated by multiple authors using an adapted version of the Quality Index. DATA SYNTHESIS: Effect sizes were calculated by dividing the differences in change between eyes closed and eyes open in the ACL-D and control group and the ACL-R and control group by the pooled SD from the eyes closed trials for each analysis. Significant differences between the ACL-D and control group (effect size, -1.66; 95% confidence interval [CI], -2.90 to -.41) were noted. The ACL-R and control group were not different (effect size, -.61; 95% CI, -2.17 to .95). CONCLUSIONS: ACL-D individuals but not individuals with ACL-R demonstrate a greater reliance on visual information during single-leg stance compared with healthy individuals.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior/fisiopatología , Reconstrucción del Ligamento Cruzado Anterior , Articulación de la Rodilla/fisiología , Equilibrio Postural/fisiología , Visión Ocular , Humanos
13.
Br J Sports Med ; 51(7): 580-585, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27935483

RESUMEN

BACKGROUND: Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. OBJECTIVE: To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. MATERIALS AND METHODS: 5 electronic databases were systematically searched. Studies selected included original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. 2 independent authors assessed the quality (Downs and Black (DB) criteria) and level of evidence (Oxford Centre of Evidence-Based Medicine model). RESULTS: Of 4361 potential studies, 17 were included. The majority were low-quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3-15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). 4 studies considered inter-relationships between risk factors, 7 reported diagnostic accuracy and none tested an intervention programme targeting individuals identified as high risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. CONCLUSIONS: Future research should focus on high-quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating preparticipation screening and LE injury prevention programmes through high-quality randomised controlled trials targeting individuals at greater risk of injury based on screening tests with validated test properties.


Asunto(s)
Traumatismos en Atletas/diagnóstico , Traumatismos de la Pierna/diagnóstico , Movimiento , Deportes , Atletas , Humanos , Personal Militar , Factores de Riesgo
14.
J Sports Sci ; 35(11): 1118-1124, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27498815

RESUMEN

Combining dynamic postural control assessments and cognitive tasks may give clinicians a more accurate indication of postural control under sport-like conditions compared to single-task assessments. We examined postural control, cognitive and squatting performance of healthy individuals during static and dynamic postural control assessments in single- and dual-task paradigms. Thirty participants (female = 22, male = 8; age = 20.8 ± 1.6 years, height = 157.9 ± 13.0 cm, mass = 67.8 ± 20.6 kg) completed single-leg stance and single-leg squat assessments on a force plate individually (single-task) and concurrently (dual-task) with two cognitive assessments, a modified Stroop test and the Brooks Spatial Memory Test. Outcomes included centre of pressure speed, 95% confidence ellipse, squat depth and speed and cognitive test measures (percentage of correct answers and reaction time). Postural control performance varied between postural control assessments and testing paradigms. Participants did not squat as deep and squatted slower (P < 0.001) during dual-task paradigms (≤12.69 ± 3.4 cm squat depth, ≤16.20 ± 4.6 cm · s-1 squat speed) compared to single-task paradigms (14.57 ± 3.6 cm squat depth, 19.65 ± 5.5 cm · s-1 squat speed). The percentage of correct answers did not change across testing conditions, but Stroop reaction time (725.81 ± 59.2 ms; F2,58 = 7.725, P = 0.001) was slowest during single-leg squats compared to baseline (691.64 ± 80.1 ms; P = 0.038) and single-task paradigms (681.33 ± 51.5 ms; P < 0.001). Dynamic dual-task assessments may be more challenging to the postural control system and may better represent postural control performance during dynamic activities.


Asunto(s)
Cognición/fisiología , Pierna/fisiología , Equilibrio Postural/fisiología , Análisis y Desempeño de Tareas , Estudios Transversales , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Memoria/fisiología , Pruebas Neuropsicológicas , Tiempo de Reacción , Test de Stroop , Adulto Joven
15.
Knee Surg Sports Traumatol Arthrosc ; 25(1): 192-199, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27423208

RESUMEN

PURPOSE: There is a lack of consensus regarding the appropriate criteria for releasing patients to return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). A test battery was developed to support decision-making. METHODS: Twenty-eight patients (22 males and 6 females) with a mean age of 25.4 ± 8.2 years participated and were 6.5 ± 1.0 months post-ACLR. All patients followed the same rehabilitation protocol. The test battery used consisted of the following: isokinetic test, 3 hop tests and the jump-landing task assessed with the LESS. The isokinetic tests and single-leg hop tests were expressed as a LSI (involved limb/uninvolved limb × 100 %). In addition, patients filled out the IKDC and ACL-Return to Sport after Injury (ACL-RSI) scale. RTS criteria to pass were defined as a LSI > 90 % on isokinetic and hop tests, LESS < 5, ACL-RSI > 56 and a IKDC within 15th percentile of healthy subjects. RESULTS: Two out of 28 patients passed all criteria of the test protocol. The pass criterion for the LESS < 5 was reached by 67.9 % of all patients. For the hop tests, 78.5 % of patients passed LSI > 90 % for SLH, 85.7 % for TLH and 50 % for the SH. For the isokinetic test, 39.3 % of patients passed criteria for LSI peak torque quadriceps at 60°/s, 46.4 % at 180°/s and 42.9 at 300°/s. In total, 35.7 % of the patients passed criterion for the peak torque at 60°/s normalized to BW (>3.0 Nm) for the involved limb. The H/Q ratio at 300°/s > 55 % for females was achieved by 4 out of 6 female patients, and the >62.5 % criterion for males was achieved by 75 %. At 6 months post-ACLR, 85.7 % of the patients passed the IKDC score and 75 % the ACL-RSI score >56 criteria. CONCLUSION: The evidence emerging from this study suggests that the majority of patients who are 6 months after ACLR require additional rehabilitation to pass RTS criteria. The RTS battery described in this study may serve as a framework for future studies to implement multivariate models in order to optimize the decision-making regarding RTS after ACLR with the aim to reduce incidence of second ACL injuries. LEVEL OF EVIDENCE: III.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior/cirugía , Reconstrucción del Ligamento Cruzado Anterior , Prueba de Esfuerzo/métodos , Evaluación de Resultado en la Atención de Salud/métodos , Recuperación de la Función , Volver al Deporte , Adolescente , Adulto , Femenino , Humanos , Traumatismos de la Rodilla/cirugía , Masculino , Músculo Cuádriceps/cirugía , Torque , Adulto Joven
16.
J Strength Cond Res ; 31(11): 3146-3157, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-29068865

RESUMEN

Peck, KY, DiStefano, LJ, Marshall, SW, Padua, DA, Beutler, AI, de la Motte, SJ, Frank, BS, Martinez, JC, and Cameron, KL. Effect of a lower extremity preventive training program on physical performance scores in military recruits. J Strength Cond Res 31(11): 3146-3157, 2017-Exercise-based preventive training programs are designed to improve movement patterns associated with lower extremity injury risk; however, the impact of these programs on general physical fitness has not been evaluated. The purpose of this study was to compare fitness scores between participants in a preventive training program and a control group. One thousand sixty-eight freshmen from a U.S. Service Academy were cluster-randomized into either the intervention or control group during 6 weeks of summer training. The intervention group performed a preventive training program, specifically the Dynamic Integrated Movement Enhancement (DIME), which is designed to improve lower extremity movement patterns. The control group performed the Army Preparation Drill (PD), a warm-up designed to prepare soldiers for training. Main outcome measures were the Army Physical Fitness Test (APFT) raw and scaled (for age and sex) scores. Independent t tests were used to assess between-group differences. Multivariable logistic regression models were used to control for the influence of confounding variables. Dynamic Integrated Movement Enhancement group participants completed the APFT 2-mile run 20 seconds faster compared with the PD group (p < 0.001), which corresponded with significantly higher scaled scores (p < 0.001). Army Physical Fitness Test push-up scores were significantly higher in the DIME group (p = 0.041), but there were no significant differences in APFT sit-up scores. The DIME group had significantly higher total APFT scores compared with the PD group (p < 0.001). Similar results were observed in multivariable models after controlling for sex and body mass index (BMI). Committing time to the implementation of a preventive training program does not appear to negatively affect fitness test scores.


Asunto(s)
Ejercicio Físico/fisiología , Extremidad Inferior/fisiología , Personal Militar , Movimiento/fisiología , Aptitud Física/fisiología , Adolescente , Índice de Masa Corporal , Prueba de Esfuerzo , Femenino , Humanos , Traumatismos de la Pierna , Masculino , Riesgo , Estados Unidos , Ejercicio de Calentamiento , Adulto Joven
17.
Br J Sports Med ; 49(3): 188-95, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24563391

RESUMEN

BACKGROUND: Information as to how anterior cruciate ligament (ACL) injury and reconstructive surgery (ACLR) alter lower extremity biomechanics may improve rehabilitation and return to play guidelines, reducing the risk for repeat ACL injury. AIM: To compare lower extremity biomechanics before ACL injury and after subsequent ACLR for the injured and uninjured leg. METHODS: Baseline unilateral lower extremity biomechanics were collected on the dominant leg of participants without ACL injury when they entered the Joint Undertaking to Monitor and Prevent ACL (JUMP-ACL) study. Thirty-one participants with subsequent ACL injury, reconstructive surgery and full return to physical activity completed repeat, follow-up biomechanical testing, as did 39 uninjured, matched controls. Not all injured participants suffered injury to the dominant leg, requiring separation of those with ACL injury into two groups: ACLR-injured leg group (n=12) and ACLR-uninjured leg group (n=19). We compared the landing biomechanics of these three groups (ACLR-injured leg, ACLR-uninjured leg, control) before ACL injury (baseline) with biomechanics after ACL injury, surgery and return to physical activity (follow-up). RESULTS: ACL injury and ACLR altered lower extremity biomechanics, as both ACLR groups demonstrated increases in frontal plane movement (increased hip adduction and knee valgus). The ACLR-injured leg group also exhibited decreased sagittal plane loading (decreased anterior tibial shear force, knee extension moment and hip flexion moment). No high-risk biomechanical changes were observed in control group participants. CONCLUSIONS: ACL injury and ACLR caused movement pattern alterations of the injured and uninjured leg that have previously shown to increase the risk for future non-contact ACL injury.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Traumatismos en Atletas/fisiopatología , Traumatismos de la Pierna/fisiopatología , Fenómenos Biomecánicos , Estudios de Casos y Controles , Femenino , Articulación de la Cadera/fisiología , Humanos , Articulación de la Rodilla/fisiología , Pierna/fisiología , Movimiento/fisiología , Estudios Prospectivos , Adulto Joven
18.
J Appl Biomech ; 31(4): 244-9, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25838245

RESUMEN

A disparity exists between the rates of male and female lower extremity injuries. One factor that may contribute to this disparity is high-risk biomechanical patterns that are commonly displayed by females. It is unknown what biomechanical differences exist between males and females during an overhead squat. This study compared lower extremity biomechanics during an overhead squat and ranges of motion between males and females. An electromagnetic motion tracking system interfaced with a force platform was used to quantify peak lower extremity kinematics and kinetics during the descent phase of each squat. Range of motion measurements were assessed with a standard goniometer. Differences between male and female kinematics, kinetics, and ranges of motion were identified with t tests. Males displayed greater peak knee valgus angle, peak hip flexion angle, peak vertical ground reaction forces, and peak hip extension moments. Males also displayed less active ankle dorsiflexion with the knee extended and hip internal and external rotation than females. No other differences were observed. The biomechanical differences between males and females during the overhead squat may result from differences in lower extremity ranges of motion. Therefore, sex-specific injury prevention programs should be developed to improve biomechanics and ranges of motion.


Asunto(s)
Extremidad Inferior/fisiología , Movimiento/fisiología , Fenómenos Biomecánicos/fisiología , Femenino , Humanos , Masculino , Rango del Movimiento Articular/fisiología , Factores Sexuales , Adulto Joven
19.
J Appl Biomech ; 31(4): 205-10, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25734492

RESUMEN

The ankle, knee, and hip joints work together in the sagittal plane to absorb landing forces. Reduced sagittal plane motion at the ankle may alter landing strategies at the knee and hip, potentially increasing injury risk; however, no studies have examined the kinematic relationships between the joints during jump landings. Healthy adults (N = 30; 15 male, 15 female) performed jump landings onto a force plate while three-dimensional kinematic data were collected. Joint displacement values were calculated during the loading phase as the difference between peak and initial contact angles. No relationship existed between ankle dorsiflexion displacement during landing and three-dimensional knee and hip displacements. However, less ankle dorsiflexion displacement was associated with landing at initial ground contact with larger hip flexion, hip internal rotation, knee flexion, knee varus, and smaller plantar flexion angles. Findings of the current study suggest that restrictions in ankle motion during landing may contribute to contacting the ground in a more flexed position but continuing through little additional motion to absorb the landing. Transverse plane hip and frontal plane knee positioning may also occur, which are known to increase the risk of lower extremity injury.


Asunto(s)
Articulación del Tobillo/fisiología , Actividad Motora/fisiología , Fenómenos Biomecánicos/fisiología , Femenino , Articulación de la Cadera/fisiología , Humanos , Imagenología Tridimensional , Articulación de la Rodilla/fisiología , Masculino , Rango del Movimiento Articular/fisiología , Deportes/fisiología , Adulto Joven
20.
J Strength Cond Res ; 28(4): 1164-71, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23820560

RESUMEN

Abnormal movement patterns have been identified as important prospective risk factors for lower extremity injury, including anterior cruciate ligament injury. Specifically, poor neuromuscular control during the early landing phase has been associated with increased injury risk. Although it is commonly assumed that higher division collegiate athletes generally exhibit better movement patterns than lower division athletes, few studies compare the biomechanical differences on basic tasks such as jump landing between various levels of athletic groups. The objective of this study was to evaluate jump-landing and fitness differences among college-aged Intramural, Competitive Club, and National Collegiate Athletic Association (NCAA) Division I level athletes. Two hundred seventy-seven student-athletes (222 men, 55 women; age 19.3 ± 0.8 years) categorized as NCAA Division I, Competitive Club, or Intramural level athletes were evaluated during a jump-landing task using the Landing Error Scoring System (LESS), a validated qualitative movement assessment. Fitness was measured using the Army Physical Fitness Test (APFT). Results showed no significant differences in landing errors between the levels of athletic group (F(2,267) = 0.36, p = 0.70). There was a significant difference in landing errors between genders (F(1,268) = 3.99, p = 0.05). Significant differences in APFT scores were observed between level of athletic group (F(2,267) = 11.14, p < 0.001) and gender (F(1,268) = 9.27, p = 0.003). There was no significant correlation between the APFT and LESS scores (p = 0.26). In conclusion, higher level athletes had better physical fitness as measured by the APFT but did not as a group exhibit better landing technique. The implications of this research suggest that "high-risk" movement patterns are prevalent in all levels of athletes.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Traumatismos en Atletas/etiología , Traumatismos en Atletas/fisiopatología , Traumatismos de la Rodilla/etiología , Educación y Entrenamiento Físico/métodos , Aptitud Física/fisiología , Deportes/fisiología , Traumatismos en Atletas/prevención & control , Fenómenos Biomecánicos , Femenino , Humanos , Traumatismos de la Rodilla/prevención & control , Masculino , Personal Militar , Movimiento , Estudios Prospectivos , Estrés Mecánico , Estados Unidos , Adulto Joven
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