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OBJECTIVES: The purpose of this study was to compare functional movement screen (FMS) scores and drop vertical jump (DVJ) kinematics between those with and without anterior cruciate ligament reconstruction (ACLR), and to evaluate the association between FMS composite score and DVJ kinematics. DESIGN: Cross-sectional. PARTICIPANTS: Sixty individuals with and without a history of ACLR. MAIN OUTCOME MEASURES: Composite FMS score and the dorsiflexion, knee-flexion, hip-flexion, knee abduction, hip adduction, and trunk-flexion angles during a DVJ. RESULTS: The FMS scores did not differ between groups (P > .05). There were smaller peak and initial contact hip-flexion angles in the ACLR and contralateral limbs compared with controls, and smaller peak dorsiflexion angles in the ACLR compared with contralateral limbs (P < .05). Lower FMS score was associated with a smaller peak dorsiflexion angle, smaller peak knee-flexion angle, and larger peak knee abduction angle in the ACLR limb (ΔR2 = .14-.23); a smaller peak dorsiflexion angle and smaller peak knee-flexion angle in the contralateral limb (ΔR2 = .17-.19); and a smaller peak dorsiflexion angle, smaller peak knee-flexion angle, and larger peak knee abduction angle in the control limb (ΔR2 = .16-.22). CONCLUSION: The FMS scores did not differ between groups, but were associated with DVJ kinematics and should be a complementary rather than substitute assessment.
Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Lesões do Ligamento Cruzado Anterior/cirurgia , Fenômenos Biomecânicos , Estudos Transversais , Humanos , Articulação do Joelho , MovimentoRESUMO
The overhead squat, as part of the Functional Movement Screen (FMS), can analyze total- and lower-body mechanics. Shoulder taps, which incorporates a push-up position and challenges shoulder, trunk, and hip stability, may identify movement deficiencies indicated by multiple FMS actions which could be useful for law enforcement recruits. This study determined overhead squat and shoulder taps relationships, associations between these screens with body composition and fitness, and differences in body composition and fitness according to overhead squat/shoulder taps scores in recruits by sex. Retrospective analysis was conducted on 202 recruit datasets (158 males, 44 females), which included: overhead squat and shoulder taps scores; age, height, and body mass; skeletal muscle (SMM%) and body fat mass (BFM%) percentage; waist-to-hip ratio; grip strength; 60-s push-ups and sit-ups; 75-yard pursuit run; vertical jump; medicine ball throw; and multistage fitness test (MSFT). Spearman's correlations (p<0.05) determined relationships between the overhead squat and shoulder taps, and between the screens and other variables. Kruskall-Wallis H tests compared the variables when recruits were split into groups based on overhead squat/shoulder taps scores. A significant correlation was found between the screens for male (ρ=0.231) but not female (ρ=0.258) recruits. Overhead squat score had a moderate relationship with BFM% in females (ρ=-0.312). Shoulder taps had a small relationship with SMM% in males (ρ=0.163). There were no differences in body composition and fitness when recruits were split based on screen scores (p=0.086-0.994). While morphology may influence movement screen performance, the screens had minimal capacity for associating movement deficiencies to fitness.
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The purpose was to (1) compare the effect of a walking bout on femoral cartilage deformation between limbs with and without anterior cruciate ligament reconstruction (ACLR) and (2) examine the association between gait kinetics and the magnitude of cartilage deformation. A total of 30 individuals with primary unilateral ACLR completed this study [14 male, 16 female; age = 22.57 (3.78) years; body mass index (BMI) = 25.88 (5.68) kg/m2 ; time since ACLR = 61.00 (16.43) months]. Overground walking biomechanics were assessed on day 1, and a 30-min walking bout or 30-min resting bout (control) were completed on days 2 and 3 (counterbalanced order). Femoral cartilage thickness was measured using ultrasound before, immediately following, and 30-min following each intervention. Linear mixed effects models compared the effect of walking on cartilage thickness between the ACLR and contralateral limbs after adjusting for sex, BMI, speed, and the number of steps. Stepwise regression examined the association between the external knee flexion and adduction moments and cartilage deformation following walking. There was a significant limb × time interaction for medial cartilage thickness. Post hoc analyses indicated that cartilage thickness decreased immediately following walking in the contralateral but not ACLR limb. Main effects of limb were observed for medial, central, and lateral cartilage thickness indicating thicker cartilage in the ACLR compared with contralateral limb. A higher knee adduction moment was associated with greater cartilage deformation in the ACLR limb. Femoral cartilage in the ACLR limb exhibited a less dynamic response to walking than the uninvolved limb, which may be due to habitual underloading during gait.
Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Cartilagem Articular , Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Lesões do Ligamento Cruzado Anterior/cirurgia , Caminhada/fisiologia , Articulação do Joelho/fisiologia , Marcha/fisiologia , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/cirurgia , Fenômenos BiomecânicosRESUMO
BACKGROUND: Articular cartilage is important for knee function and can be imaged using ultrasound. The purpose was to compare femoral cartilage thickness and echo intensity (EI) measured at 90° and 140° of knee flexion and between limbs in a cohort with unilateral anterior cruciate ligament reconstruction (ACLR). We also examined associations between gait biomechanics and cartilage outcomes. METHODS: Twenty-seven individuals with primary unilateral ACLR participated (12 men, 15 women; age = 22.3 ± 3.8 years; time since ACLR = 71.2 ± 47.2 months). Ultrasound was used to obtain femoral cartilage measurements. Gait outcomes included peak KFA (knee flexion angle) and peak external knee flexion moment (KFM). Cartilage outcomes were compared using a 2 (position) × 2 (limb) repeated measures ANOVA (analysis of variance). Gait and cartilage associations were assessed using linear regression. FINDINGS: There were no position × limb interactions for any cartilage outcome (all P > 0.05). Medial (P = 0.038) and central cartilage (P < 0.001) were thicker, whereas central (P = 0.029) and lateral cartilage EI (P = 0.003) were lower when measured at 90° than those at 140° of knee flexion. Medial cartilage was thicker in the ACLR than that in the contralateral limb (P = 0.016). A larger KFM was associated with thicker medial cartilage (ΔR2 = 0.146, P = 0.021) and central cartilage (ΔR2 = 0.159, P = 0.039) measured at 140° of knee flexion in the ACLR limb but not at 90°. INTERPRETATION: Findings suggest that imaging position influences cartilage thickness and EI measurements in individuals with ACLR and should be considered in study designs and clinical evaluation. A greater KFM was associated with thicker cartilage within specific portions of the distal femur.