scholarly journals Tracking Quantitative Characteristics of Cutting Maneuvers with Wearable Movement Sensors during Competitive Women’s Ultimate Frisbee Games

Sensors ◽  
2020 ◽  
Vol 20 (22) ◽  
pp. 6508
Author(s):  
Paul R. Slaughter ◽  
Peter G. Adamczyk
Keyword(s):  
Knee Flexion ◽  
Inertial Sensors ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Lower Body ◽  
Approach Speed ◽  
Anterior Cruciate ◽  
And Performance ◽  
Ultimate Frisbee ◽  
Wearable Inertial Sensors

(1) Ultimate frisbee involves frequent cutting motions, which have a high risk of anterior cruciate ligament (ACL) injury, especially for female players. This study investigated the in-game cutting maneuvers performed by female ultimate frisbee athletes to understand the movements that could put them at risk of ACL injury. (2) Lower-body kinematics and movement around the field were reconstructed from wearable lower-body inertial sensors worn by 12 female players during 16 league-sanctioned ultimate frisbee games. (3) 422 cuts were identified from speed and direction change criteria. The mean cut had approach speed of 3.4 m/s, approach acceleration of 3.1 m/s2, cut angle of 94 degrees, and ground-contact knee flexion of 34 degrees. Shallow cuts from 30 to 90 degrees were most common. Speed and acceleration did not change based on cut angle. Players on more competitive teams had higher speed and acceleration and reduced knee flexion during cutting. (4) This study demonstrates that a lower-body set of wearable inertial sensors can successfully track an athlete’s motion during real games, producing detailed biomechanical metrics of behavior and performance. These in-game measurements can be used to specify controlled cutting movements in future laboratory studies. These studies should prioritize higher-level players since they may exhibit higher-risk cutting behavior.

External Loading at the Knee Joint for Landing Movements in Alpine Skiing

1992 ◽  
Vol 8 (1) ◽  
pp. 62-80 ◽  
Author(s):  
Lynda Read ◽  
Walter Herzog
Keyword(s):  
Knee Joint ◽  
Knee Flexion ◽  
Inverse Dynamics ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
External Loading ◽  
Alpine Skiing ◽  
Joint Forces ◽  
Anterior Cruciate ◽  
Resultant Forces

The purpose of this study was to determine resultant knee joint forces and moments during a specific movement in Alpine ski racers. The movement analyzed consisted of a landing from a bump and the initiation of recovery (if necessary). Resultant loads were obtained using an inverse dynamics approach. Results of two specific skiers are contrasted, one skier landing in good form, the second skier landing in poor form. The skier landing in poor form exhibited larger knee flexion, and larger knee joint resultant forces and moments than the skier landing in good form. The movement of the skier landing in poor form has been associated with isolated anterior cruciate ligament (ACL) injury. However, the data obtained in this study do not indicate that either skier was in danger of ACL injury.

scholarly journals Hamstrings Stiffness and Landing Biomechanics Linked to Anterior Cruciate Ligament Loading

2013 ◽  
Vol 48 (6) ◽  
pp. 764-772 ◽  
Author(s):  
J. Troy Blackburn ◽  
Marc F. Norcross ◽  
Lindsey N. Cannon ◽  
Steven M. Zinder
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
Shear Force ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Knee Extension ◽  
High Stiffness ◽  
Landing Biomechanics ◽  
Anterior Tibial ◽  
Anterior Cruciate

Context: Greater hamstrings stiffness is associated with less anterior tibial translation during controlled perturbations. However, it is unclear how hamstrings stiffness influences anterior cruciate ligament (ACL) loading mechanisms during dynamic tasks. Objective: To evaluate the influence of hamstrings stiffness on landing biomechanics related to ACL injury. Design: Cross-sectional study. Setting: Research laboratory. Patients or Other Participants: A total of 36 healthy, physically active volunteers (18 men, 18 women; age = 23 ± 3 years, height = 1.8 ± 0.1 m, mass = 73.1 ± 16.6 kg). Intervention(s): Hamstrings stiffness was quantified via the damped oscillatory technique. Three-dimensional lower extremity kinematics and kinetics were captured during a double-legged jump-landing task via a 3-dimensional motion-capture system interfaced with a force plate. Landing biomechanics were compared between groups displaying high and low hamstrings stiffness via independent-samples t tests. Main Outcome Measure(s): Hamstrings stiffness was normalized to body mass (N/m·kg−1). Peak knee-flexion and -valgus angles, vertical and posterior ground reaction forces, anterior tibial shear force, internal knee-extension and -varus moments, and knee-flexion angles at the instants of each peak kinetic variable were identified during the landing task. Forces were normalized to body weight, whereas moments were normalized to the product of weight and height. Results: Internal knee-varus moment was 3.6 times smaller in the high-stiffness group (t22 = 2.221, P = .02). A trend in the data also indicated that peak anterior tibial shear force was 1.1 times smaller in the high-stiffness group (t22 = 1.537, P = .07). The high-stiffness group also demonstrated greater knee flexion at the instants of peak anterior tibial shear force and internal knee-extension and -varus moments (t22 range = 1.729–2.224, P < .05). Conclusions: Greater hamstrings stiffness was associated with landing biomechanics consistent with less ACL loading and injury risk. Musculotendinous stiffness is a modifiable characteristic; thus exercises that enhance hamstrings stiffness may be important additions to ACL injury-prevention programs.

scholarly journals Rapid Posterior Tibial Reduction After Noncontact Anterior Cruciate Ligament Rupture: Mechanism Description From a Video Analysis

2020 ◽  
Vol 12 (5) ◽  
pp. 462-469 ◽  
Author(s):  
Alberto Grassi ◽  
Filippo Tosarelli ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Video Analysis ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Initial Contact ◽  
Acl Injuries ◽  
Posterior Tibial ◽  
Anterior Cruciate

Background: The mechanisms of noncontact anterior cruciate ligament (ACL) injuries are an enormously debated topic in sports medicine; however, the late phases of injury have not yet been investigated. Hypothesis: A well-defined posterior tibial translation can be visualized with its timing and patterns of knee flexion after ACL injury. Study Design: Case series. Level of Evidence: Level 4. Methods: A total of 137 videos of ACL injuries in professional male football (soccer) players were screened for a sudden posterior tibial reduction (PTR) in the late phase of noncontact ACL injury mechanism. The suitable videos were analyzed using Kinovea software for sport video analysis. The time of initial contact of the foot with the ground, the foot lift, the start of tibial reduction, and the end of tibial reduction were assessed. Results: A total of 21 videos exhibited a clear posterior tibial reduction of 42 ± 11 ms, after an average of 229 ± 81 ms after initial contact. The tibial reduction occurred consistently within the first 50 to 60 ms after foot lift (55 ± 30 ms) and with the knee flexed between 45° and 90° (62%) or more than 90° (24%). Conclusion: A rapid posterior tibial reduction is consistently present in the late phases of noncontact ACL injuries in some male soccer players, with a consistent temporal relationship between foot lift from the ground and consistent degrees of knee flexion near or above 90°. Clinical Relevance: This study provides insight into the late phases of ACL injury. The described mechanism, although purely theoretical, could be responsible for commonly observed intra-articular lesions.

scholarly journals Poor Motor Coordination Elicits Altered Lower Limb Biomechanics in Young Football (Soccer) Players: Implications for Injury Prevention through Wearable Sensors

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4371
Author(s):  
Stefano Di Paolo ◽  
Stefano Zaffagnini ◽  
Nicola Pizza ◽  
Alberto Grassi ◽  
Laura Bragonzoni
Keyword(s):  
Injury Prevention ◽  
Lower Limb ◽  
Motor Coordination ◽  
Inertial Sensors ◽  
Cruciate Ligament ◽  
Vertical Jump ◽  
Wearable Sensors ◽  
Acl Injury ◽  
Anterior Cruciate ◽  
Acl Injury Prevention

Motor coordination and lower limb biomechanics are crucial aspects of anterior cruciate ligament (ACL) injury prevention strategies in football. These two aspects have never been assessed together in real scenarios in the young population. The present study aimed to investigate the influence of motor coordination on lower limb biomechanics in young footballers during an on-the-pitch training. Eighteen juvenile football players (10 y ± 2 m) were enrolled. Each player performed a training drill with sport-specific movements (vertical jump, agility ladders, change of direction) and the Harre circuit test (HCT) to evaluate players’ motor coordination. Wearable inertial sensors (MTw Awinda, Xsens) were used to assess lower limb joint angles and accelerations. Based on the results of the HCT, players were divided into poorly coordinated (PC) and well-coordinated (WC) on the basis of the literature benchmark. The PC group showed a stiffer hip biomechanics strategy (up to 40% lower flexion angle, ES = 2.0) and higher internal-external hip rotation and knee valgus (p < 0.05). Significant biomechanical limb asymmetries were found only in the PC group for the knee joint (31–39% difference between dominant and non-dominant limb, ES 1.6–2.3). Poor motor coordination elicited altered hip and knee biomechanics during sport-specific dynamic movements. The monitoring of motor coordination and on-field biomechanics might enhance the targeted trainings for ACL injury prevention.

scholarly journals Association of Prior Anterior Cruciate Ligament Tear With Decreased Career Longevity in Women’s National Basketball Association

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110092
Author(s):  
Joseph S. Tramer ◽  
Lafi S. Khalil ◽  
Toufic R. Jildeh ◽  
Mohammad Sattar ◽  
Alexander Ziedas ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
National Basketball Association ◽  
Healthy Controls ◽  
Acl Tear ◽  
History Of ◽  
Anterior Cruciate ◽  
And Performance

Background: The incidence of anterior cruciate ligament (ACL) injuries in women’s basketball exceeds that of men. There is a paucity of data regarding career performance in Women’s National Basketball Association (WNBA) athletes with a history of ACL reconstruction. Purpose: To determine whether WNBA athletes with a history of ACL injury prior to professional play have reduced career game utilization, defined as games played and started and minutes per game (MPG), as well as statistical performance, defined by player efficiency rating (PER). Study Design: Cohort study; Level of evidence, 3. Methods: Included were 42 WNBA players from 1997 to 2018 who had a history of ACL reconstruction before entering professional leagues. Body mass index (BMI), age, and position were collected for each player. Career data and performance statistics were likewise collected for each player’s entire WNBA career. A control group of WNBA players with no history of ACL injury were matched by position, BMI, and age at the time of WNBA debut. Statistics compared game utilization and performance to assess the impact of ACL reconstruction. Results: Athletes who sustained an ACL tear before entering the league played in fewer games per season in their first 3 professional seasons compared with healthy controls (24.2 ± 8.4 vs 28.2 ± 6.1; P = .02). Among athletes with a history of ACL reconstruction, 11 (26.2%) played only a single WNBA season, while no control athletes played in just 1 season. Additionally, athletes who had a previous ACL tear started significantly fewer games per season (9.0 ± 9.4 vs 14.0 ± 9.0; P < .01) and played fewer MPG (15.5 ± 7.2 vs 20.7 ± 5.5; P < .01) during their WNBA career. Athletes with a history of ACL tear had significantly shorter WNBA careers (4.8 ± 4.1 vs 8.1 ± 3.3 seasons; P < .001). Total professional play duration (WNBA + overseas) was significantly reduced in players with an ACL tear compared with controls ( P < .05). PER was not significantly different between cohorts at any time point. Conclusion: WNBA athletes with a history of an ACL tear before professional play had decreased career game utilization and workload throughout their career despite having similar PER compared with healthy controls.

scholarly journals Electromyographic Assessment of Anterior Cruciate Ligament Injury Risk in Male Tennis Players: Which Role for Visual Input? A Proof-of-Concept Study

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 997
Author(s):  
Alessandro de Sire ◽  
Nicola Marotta ◽  
Andrea Demeco ◽  
Lucrezia Moggio ◽  
Pasquale Paola ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Visual Input ◽  
Proof Of Concept ◽  
Tennis Players ◽  
Concept Study ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury incidence is often underestimated in tennis players, who are considered as subjects conventionally less prone to knee injuries. However, evaluation of the preactivation of knee stabilizer muscles by surface electromyography (sEMG) showed to be a predictive value in the assessment of the risk of ACL injury. Therefore, this proof-of-concept study aimed at evaluating the role of visual input on the thigh muscle preactivation through sEMG to reduce ACL injury risk in tennis players. We recruited male, adult, semiprofessional tennis players from July to August 2020. They were asked to drop with the dominant lower limb from a step, to evaluate—based on dynamic valgus stress—the preactivation time of the rectus femoris (RF), vastus medialis, biceps femoris, and medial hamstrings (MH), through sEMG. To highlight the influence of visual inputs, the athletes performed the test blindfolded and not blindfolded on both clay and grass surfaces. We included 20 semiprofessional male players, with a mean age 20.3 ± 4.8 years; results showed significant early muscle activation when the subject lacked visual input, but also when faced with a less-safe surface such as clay over grass. Considering the posteromedial–anterolateral relationship (MH/RF ratio), tennis players showed a significant higher MH/RF ratio if blindfolded (22.0 vs. 17.0% not blindfolded; p < 0.01) and percentage of falling on clay (17.0% vs. 14.0% in grass; p < 0.01). This proof-of-principle study suggests that in case of absence of visual input or falling on a surface considered unsafe (clay), neuro-activation would tend to protect the anterior stress of the knee. Thus, the sEMG might play a crucial role in planning adequate athletic preparation for semiprofessional male athletes in terms of reduction of ACL injury risk.

scholarly journals Single-Leg Landings Following a Volleyball Spike May Increase the Risk of Anterior Cruciate Ligament Injury More Than Landing on Both-Legs

2020 ◽  
Vol 11 (1) ◽  
pp. 130
Author(s):  
Datao Xu ◽  
Xinyan Jiang ◽  
Xuanzhen Cen ◽  
Julien S. Baker ◽  
Yaodong Gu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Flexion Angle ◽  
Ligament Injury ◽  
Time Range ◽  
Acl Injuries ◽  
Volleyball Players ◽  
Anterior Cruciate

Volleyball players often land on a single leg following a spike shot due to a shift in the center of gravity and loss of balance. Landing on a single leg following a spike may increase the probability of non-contact anterior cruciate ligament (ACL) injuries. The purpose of this study was to compare and analyze the kinematics and kinetics differences during the landing phase of volleyball players using a single leg (SL) and double-leg landing (DL) following a spike shot. The data for vertical ground reaction forces (VGRF) and sagittal plane were collected. SPM analysis revealed that SL depicted a smaller knee flexion angle (about 13.8°) and hip flexion angle (about 10.8°) during the whole landing phase, a greater knee and hip power during the 16.83–20.45% (p = 0.006) and 13.01–16.26% (p = 0.008) landing phase, a greater ankle plantarflexion angle and moment during the 0–41.07% (p < 0.001) and 2.76–79.45% (p < 0.001) landing phase, a greater VGRF during the 5.87–8.25% (p = 0.029), 19.75–24.14% (p = 0.003) landing phase when compared to DL. Most of these differences fall within the time range of ACL injury (30–50 milliseconds after landing). To reduce non-contact ACL injuries, a landing strategy of consciously increasing the hip and knee flexion, and plantarflexion of the ankle should be considered by volleyball players.

scholarly journals Anterior Cruciate Ligament Injury Prevention Exercises: Could a Neuromuscular Warm-Up Improve Muscle Pre-Activation before a Soccer Game? A Proof-of-Principle Study on Professional Football Players

2021 ◽  
Vol 11 (11) ◽  
pp. 4958
Author(s):  
Alessandro de Sire ◽  
Andrea Demeco ◽  
Nicola Marotta ◽  
Lucrezia Moggio ◽  
Arrigo Palumbo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Football Players ◽  
Professional Football ◽  
Activation Time ◽  
Exercise Protocol ◽  
Warm Up ◽  
Anterior Cruciate ◽  
Proof Of Principle

Neuromuscular warm-up has been shown to decrease the risk of anterior cruciate ligament (ACL) injury improving muscular firing patterns. All preventive training programs described in the literature have a duration of several weeks. To date, no studies have explored the immediate effect of a neuromuscular warm-up exercise on pre-activation time of the knee stabilizer muscles. Thus, this proof-of-principle study aimed at evaluating the acute effects of a neuromuscular warm-up exercises on the electromyographic activation of knee stabilizer muscles’ activation pattern. We included 11 professional football players, mean aged 23.2 ± 4.5 years, from a Southern Italy football team. All of them underwent a standard warm-up exercise protocol at the first day of the evaluation. At 1 week, they underwent a structured neuromuscular warm-up exercise protocol. We assessed as outcome measure the pre-activation time (ms) of rectus femoris (RF), vastus medialis (VM), biceps femoris (BF), and medial hamstrings (MH) upon landing. Outcomes were assessed before and after the standard warm-up and neuromuscular warm-up. Pre-activation time of RF, VM, BF and MH significantly improved only after neuromuscular warm-up (p < 0.05); moreover, there was a significant (p < 0.05) between-group difference in pre-activation time of all muscles after the neuromuscular warm-up compared with the standard warm-up. These findings suggested that physical exercise consisting of a structured injury prevention neuromuscular warm-up might have an immediate effect in improving the activation time of the knee stabilizer muscles, thus potentially reducing the risk of ACL injury.

Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears

2021 ◽  
pp. 194173812110295
Author(s):  
Patrick Ward ◽  
Peter Chang ◽  
Logan Radtke ◽  
Robert H. Brophy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Bone Bruises ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are common injuries; they are often associated with concomitant injuries to other structures in the knee, including bone bruises. While there is limited evidence that bone bruises are associated with slightly worse clinical outcomes, the implications of bone bruises for the articular cartilage and the risk of developing osteoarthritis (OA) in the knee are less clear. Recent studies suggest that the bone bruise pattern may be helpful in predicting the presence of meniscal ramp lesions. Evidence Acquisition: A literature review was performed in EMBASE using the keyword search phrase (acl OR (anterior AND cruciate AND ligament)) AND ((bone AND bruise) OR (bone AND contusion) OR (bone AND marrow AND edema) OR (bone AND marrow AND lesion) OR (subchondral AND edema)). Study Design: Clinical review. Level of Evidence: Level 4. Results: The literature search returned 93 articles of which 25 were ultimately included in this review. Most studies identified a high prevalence of bone bruises in the setting of acute ACL injury. Individual studies have found relationships between bone bruise volume and functional outcomes; however, these results were not supported by systematic review. Similarly, the literature has contradictory findings on the relationship between bone bruises and the progression of OA after ACL reconstruction. Investigations into concomitant injury found anterolateral ligament and meniscal ramp lesions to be associated with bone bruise presence on magnetic resonance imaging. Conclusion: Despite the ample literature identifying the prevalence of bone bruises in association with ACL injury, there is little evidence to correlate bone bruises to functional outcomes or progression of OA. Bone bruises may best be used as a marker for concomitant injury such as medial meniscal ramp lesions that are not always well visualized on magnetic resonance imaging. Further research is required to establish the longitudinal effects of bone bruises on ACL tear recovery. Strength of Recommendation Taxonomy: 2.

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