Observational Ratings of Frontal Plane Knee Position Are Related to the Frontal Plane Projection Angle but Not the Knee Abduction Angle During a Step-down Task (original) (raw)
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Spots Biomechanics, 2021
Multi-planar forces and moments are known to injure the anterior cruciate ligament (ACL). In ACL injury risk studies, however, the uniplanar frontal plane external knee abduction moment is frequently studied in isolation. This study aimed to determine if the frontal plane knee moment (KM-Y) could classify all individuals crossing a risk threshold compared to those classified by a multi-planar nonsagittal knee moment vector (KM-YZ). Recreationally active females completed three sports tasks-drop vertical jumps, single-leg drop vertical jumps and planned sidesteps. Peak knee abduction moments and peak non-sagittal resultant knee moments were obtained for each task, and a risk threshold of the sample mean plus 1.6 standard deviations was used for classification. A sensitivity analysis of the threshold from 1-2 standard deviations was also conducted. KM-Y did not identify all participants who crossed the risk threshold as the non-sagittal moment identified unique individuals. This result was consistent across tasks and threshold sensitivities. Analysing the peak uni-planar knee abduction moment alone is therefore likely overly reductionist, as this study demonstrates that a KM-YZ threshold identifies 'at risk' individuals that a KM-Y threshold does not. Multi-planar moment metrics such as KM-YZ may help facilitate the development of screening protocols across multiple tasks.
Journal of sport rehabilitation, 2012
Two-dimensional (2D) video analysis of frontal-plane dynamic knee valgus during common athletic screening tasks has been purported to identify individuals who may be at high risk of suffering knee injuries such as anterior cruciate ligament tear or patellofemoral pain syndrome. Although the validity of 2D video analysis has been studied, the associated reliability and measurement error have not. To assess the reliability and associated measurement error of a 2D video analysis of lower limb dynamic valgus. Reliability study. 20 recreationally active university students (10 women age 21.5 ± 2.3 y, height 170.1 ± 6.1 cm, weight 66.2 ± 10.2 kg, and 10 men age 22.6 ± 3.1 y, height 177.9 ± 6.0 cm, weight 75.8 ± 7.9 kg). Within-day and between-days reliability and measurement-error values of 2D frontal-plane projection angle (FPPA) during common screening tasks. Participants performed single-leg squat and drop jump and single-leg landings from a standard 28-cm step with standard 2D digital...
BMJ open sport & exercise medicine, 2018
Poor frontal plane knee control can manifest as increased dynamic knee valgus during athletic tasks. The purpose of this study was to investigate the association between frontal plane knee control and the risk of acute lower extremity injuries. In addition, we wanted to study if the single-leg squat (SLS) test can be used as a screening tool to identify athletes with an increased injury risk. A total of 306 basketball and floorball players participated in the baseline SLS test and a 12-month injury registration follow-up. Acute lower extremity time-loss injuries were registered. Frontal plane knee projection angles (FPKPA) during the SLS were calculated using a two-dimensional video analysis. Athletes displaying a high FPKPA were 2.7 times more likely to sustain a lower extremity injury (adjusted OR 2.67, 95% CI 1.23 to 5.83) and 2.4 times more likely to sustain an ankle injury (OR 2.37, 95% CI 1.13 to 4.98). There was no statistically significant association between FPKPA and knee ...
The Use of Functional Tests to Predict Sagittal Plane Knee Kinematics in NCAA-D1 Female Athletes
PubMed, 2015
Background: Landing with the knee in extension places increased loads on ligamentous restraints at the knee versus landing in flexion. Unfortunately, existing methods to predict landing kinematics require sophisticated equipment and expertise. The purpose of this study was to develop predictive models for sagittal plane tibiofemoral landing kinematics from the results of functional tests. Methods: Twenty-nine female, NCAA-D1 college athletes (mean ± standard deviation, age = 19.03 ± 1.09; mass=66.56 ± 13.47 kg; height = 171.16 ± 7.92 cm) participated in a descriptive, laboratory study. Participants performed five unilateral, dominant lower extremity (LE) landings from a 35cm platform onto a forceplate. LE three-dimensional kinematics were captured with electromagnetic sensors interfaced with motion analysis software. Then in a randomized order, participants performed three standardized functional tests: single limb triple hop (SLTH), countermovement vertical jump (CMVJ) and the Margaria-Kalamen (MK) test. Sagittal plane tibiofemoral joint angle at initial contact (IC) and excursion (EXC) in the first 0.1s after ground contact were entered into a statistical software package. Multiple linear regression analyses generated one model predicting IC and one predicting EXC from the independent variables. Alpha levels were set a priori at p ≤ .05. Results: A two variable (MK, SLTH) linear regression model that predicted EXC was significant (Adjusted R (2) = .213, p = .017), however the model that predicted IC was not (p = .890). Conclusion: Knee flexion excursion following a single leg landing task may be predicted with the MK and SLTH. The use of functional tests provides a practical means to predict landing kinematics to clinicians working with an active, athletic population. Level of evidence: 3, cohort study.
2021
Knee and hip muscles play a significant role in orientation of lower extremities during weight-bearing activities. The frontal plane projection angles during single leg landing movements and their relationship with lower extremity muscular strength were investigated in this study. This study followed a cross-sectional study design with 30 male participants of the age of 21.07±1.23 years, heights of 171.70±7.78 cm, weights of 70.74±10.55 kg, and BMIs of 23.89±2.88 kg/m 2. All the participants were university recreational athletes and free from any musculoskeletal injury. Frontal plane projection angles of the knee and hip joint were measured during single leg landing with the help of Vicon three-dimensional movement analysis systems. Muscle strength of knee extension, external rotation of the hip, and abduction of the hip were measured using an isokinetic dynamometer. A significant moderate negative relationship between hip abduction strength with the knee joint angle (r=−0.420, p=0.021) and hip adduction angle (r=−0.458, p=0.011) was found during landing. The hip external rotator strength was negatively correlated with the knee joint angle (r=−0.089, p=0.639) and hip joint angle (r=−0.191, p=0.311) during landing. The knee extensor strength was negative correlated with the knee joint angle (r=−0.057, p=0.765) and hip joint angle (r=−0.085, p=0.653) during landing. This study found a negative significant correlation between hip abductor strength and knee valgus during landing, which means that if the hip adduction angle increases, the knee valgus increases, possibly causing injuries in athletes. The findings of the current study emphasize the need to strengthen the lower extremities to increase hip strength to reduce knee instability during sports activities. This may allow coaches, trainers and clinicians to discover the causes of injury and develop strengthening programmes and neuromuscular control to reduce the risk of injuries.
Journal of Sport Rehabilitation
Context:Injuries to the anterior cruciate ligament (ACL) and patellofemoral joint (PFJ) are a significant problem in female athletes. A number of screening tasks have been used in the literature to identify those at greatest risk of injury. To date, no study has examined the relationship in 2-dimensional (2D) knee valgus between common screening tasks to determine whether individuals exhibit similar movement patterns across tasks.Objective:To establish whether frontal-plane projection angle (FPPA) during the single-leg squat (SLS), single-leg land (SLL), and drop jump (DJ) are related.Design:Cross-sectional study.Setting:University laboratory.Participants:52 national-league female football players and 36 national-league female basketball players.Main Outcome Measures:2D FPPA during the SLS, SLL, and DJ screening tasks.Results:Significant correlations were found between tasks. FPPA in the SLS was significantly correlated with SLL (r = .52) and DJ (r = .30), whereas FPPA in the SLL wa...
Gender differences in knee kinematics and its possible consequences
Croatian Medical Journal, 2005
Aim: To analyze anatomic and kinematic characteristics of male and female knees in the sagittal plane. Methods: Ten healthy male and 10 healthy female participants performed extension of their right lower leg in non-weight bearing and weight bearing conditions. The centers of knee joint motion were obtained by videographic motion analysis, and radii of condylar curves were calculated from digitalized X-ray scan. The Knee Roll software was made for this purpose. Results: The extension of the knee in non-weight loaded and weight loaded conditions is a combination of rolling and sliding joint surface motion with 6:5 ratio, in both genders. During the last 20 degrees of the extension of weight loaded male knee, rolling/sliding ratio changed to 8:1 (P<0.05). Average radii of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point, respectively. Gender differences in the radii of condylar curves, after the adjusting to body height were insignificant. Conclusion: A higher proportion of joint surface sliding with consecutive anterior tibial displacement in women indicates more strain during knee extension, potentially making the female anterior cruciate ligament tend and susceptible to injury. The gender differences in the knee kinematics are probably the consequence of different soft tissue structure or its activity, because no difference in the sagittal shape of femoral condyles was noted.
British Journal of Sports Medicine, 2011
Purpose: In vivo measurement of the forces and strains in human tissues is currently impracticable. Computer modeling and simulation allows estimates of these quantities to be obtained noninvasively. This paper reviews our recent work on muscle, ligament, and joint loading at the knee during gait. Methods: Muscle and ground-reaction forces obtained from a sophisticated computer simulation of walking were input into a detailed model of the lower limb to obtain ligament and joint-contact loading at the knee for one full cycle of gait. Results: Peak anterior cruciate ligament (ACL) force occurred in early stance and was mainly determined by the anterior pull of the patellar tendon on the tibia. The medial collateral ligament was the primary restraint to anterior tibial translation (ATT) in the ACL-deficient knee. ATT in the ACL-deficient knee can be reduced to the level calculated for the intact knee by increasing hamstrings muscle force. Reducing quadriceps force was insufficient to restore ATT to the level calculated for the intact knee. For both normal and ACL-deficient walking, the resultant force acting between the femur and tibia remained mainly on the medial side of the knee. The knee adductor moment was resisted by a combination of muscle and ligament forces. Conclusion: Knee-ligament loading during the stance phase of gait is explained by the pattern of anterior shear force applied to the leg. The distribution of force at the tibiofemoral joint is determined by the variation in the external adductor moment applied at the knee. The forces acting at the tibiofemoral and patellofemoral joints are similar during normal and ACL-deficient gait. Hamstrings facilitation is more effective than quadriceps avoidance in reducing ATT during ACL-deficient gait.