Effects of Motor Control Training on the Concept of Kinetic Control in Treating Patella Ligament Tendinopathy in a Female Football Player: A Case Study

Objectives: Patellar ligament tendinopathy, also known as jumper’s knee, is a group of pain symptoms of the anterior side of the knee joint. The Kinetic Control (KC) concept uses the movement control rating system, based on motor tests and exercises aimed at re-educating motor control. The present study explored the effects of motor control training on the KC concept in treating patella ligament tendinopathy in a female football player. Methods: The current case study was conducted on a 20-year-old female football player. She had been complaining of pain in the front of the right knee joint for two months. Her treatment involved KC training was conducted for 6 weeks (3 times a week for 30 minutes). To investigate the effectiveness of the presented therapy, the following tools were used: Visual Analogue Scale (VAS), The Victorian Institute of Sport Assessment–Patella (VISA-P scale), the Modified Laitinen Pain Questionnaire, Counter Movement Jump (CMJ) test on a dynamometric platform, and quadriceps muscle isometric test. The Asymmetry Index (AI) was applied to assess the asymmetry of quadriceps strength and lower limb loading. Results: The degree of pain (i.e. measured by the VAS) decreased from 7 points at pre-training to 1 point after 6 weeks of therapy. In the VISA-P measurement, pain decreased as a result of an increase in points from 53 to 82. Pain complaints (i.e. measured using the Laitinen questionnaire) decreased from 7 to 2 points. After treatment, the AI improved in all phases of the tests. Discussion: The achieved data indicated that the neuromuscular KC training was effective in treating patellar tendinopathy. However, it is necessary to conduct further studies with larger sample size.

Human Knee Inverse Dynamics Model of Vertical Jump Exercise

This work deals with the dynamics of the human knee during vertical jump exercise. The focus is on the joint forces necessary to produce the jump and to dissipate energy during landing. A two-dimensional (2D) sagittal plane, inverse dynamics human leg model is developed. This model uses data from a motion capture system and force plates in order to predict knee and hip joint forces during the vertical jump exercise. The model consists of three bony structures femur, tibia, and patella, ligament structures to include both cruciate and collateral ligaments, and knee joint muscles. The inverse dynamics model is solved using optimization in order to predict joint forces during this exercise. matlab software package is used for the optimization computations. Results are compared with data available in the literature. This work provides insight regarding contact forces and ligaments forces, muscle forces, and knee and hip contact forces in the vertical jump exercise.

Multiplane Loading of the Extensor Mechanism Alters the Patellar Ligament Force/Quadriceps Force Ratio

Since the direction of the quadriceps force and location of the patellofemoral contact point likely differ between axial and multiplane loadings, the force and moment balance solutions for a multiplane loading condition may not yield the same patella ligament force/quadriceps force ratio (FPL/FQ ratio) when compared with an axial loading condition. The purpose of this study was to compare the effects of an axial loading condition and an anatomical, multiplane loading condition on the FPL/FQ ratio at various knee flexion angles. Ten cadaver knees were used in this investigation. Each was mounted on a custom jig that was fixed to an Instron frame. Quadriceps muscle loads were applied with same resultant force magnitudes under two force directions, as follows: (1) axial loading (central quadriceps tendon loading parallel to the femoral axis), and (2) an anatomically based, multiplane loading condition (individual vasti loaded, taking into consideration physiologic muscle fiber orientation). Patellar ligament tension was measured using a buckle transducer. The patellar ligament force/quadriceps force ratio (FPL/FQ ratio) was calculated for both loading conditions at 0 deg, 20 deg, 40 deg, and 60 deg of knee flexion. Across the range of knee motion evaluated, the FPL/FQ ratio for the axial loading condition was significantly greater than the FPL/FQ ratio for the multiplane loading condition. Our results suggest that loading orientation affects the transfer of forces from the quadriceps tendon to the patellar ligament.