CAI patients displayed altered movement strategies, perhaps in an attempt to avoid perceived positions of risk. Although sagittal joint positions seemed to increase the external torque on the knee and hip extensors, frontal joint positions appeared to reduce the muscular demands on evertor and hip abductor muscles.
Changes in anterior knee laxity (AKL), genu recurvatum (GR) and general joint laxity (GJL) were quantified across days of the early follicular and early luteal phases of the menstrual cycle in 66 females, and the similarity in their pattern of cyclic variations examined. Laxity was measured on each of the first 6 days of menses (M1-M6) and the first 8 days following ovulation (L1-L8) over two cycles. The largest mean differences were observed between L5 and L8 for AKL (0.32 mm), and between L5 and M1 for GR (0.56 • ) and GJL (0.26) (p < 0.013). At the individual level, mean absolute cyclic changes in AKL (1.8 ± 0.7 mm, 1.6 ± 0.7 mm), GR (2.8 ± 1.0 • , 2.4 ± 1.0 • ), and GJL (1.1 ± 1.1, 0.7 ± 1.0) were more apparent, with minimum, maximum and delta values being quite consistent from month to month (ICC 2,3 = 0.51-0.98). Although the average daily pattern of change in laxity was quite similar between variables (Spearman correlation range 0.61 and 0.90), correlations between laxity measures at the individual level were much lower (range −0.07 to 0.43). Substantial, similar, and reproducible cyclic changes in AKL, GR, and GJL were observed across the menstrual cycle, with the magnitude and pattern of cyclic changes varying considerably among females. © Joint laxity continues to be a variable of interest as we seek to uncover the underlying risk factors for ACL injury in females.
Context The literature on gait kinematics and muscle activation in chronic ankle instability (CAI) is limited. A comprehensive evaluation of all relevant gait measures is needed to examine alterations in gait neuromechanics that may contribute to recurrent sprain. Objective To compare walking neuromechanics, including kinematics, muscle activity, and kinetics (ie, ground reaction force [GRF], moment, and power), between participants with and those without CAI by applying a novel statistical analysis to data from a large sample. Design Controlled laboratory study. Setting Biomechanics laboratory. Patients or Other Participants A total of 100 participants with CAI (49 men, 51 women; age = 22.2 ± 2.3 years, height = 174.0 ± 9.7 cm, mass = 70.8 ± 14.4 kg) and 100 individuals without CAI serving as controls (55 men, 45 women; age = 22.5 ± 3.3 years, height = 173.1 ± 13.3 cm, mass = 72.6 ± 18.7 kg). Intervention(s) Participants performed 5 trials of walking (shod) at a self-selected speed over 2 in-ground force plates. Main Outcome Measure(s) Three-dimensional GRFs, lower extremity joint angles, internal joint moments, joint powers, and activation amplitudes of 6 muscles were recorded during stance. Results Compared with the control group, the CAI group demonstrated (1) increased plantar flexion or decreased dorsiflexion, increased inversion or decreased eversion, decreased knee flexion, decreased knee abduction, and increased hip-flexion angles; (2) increased or decreased inversion, increased plantar flexion, decreased knee extension, decreased knee abduction, and increased hip-extension moments; (3) increased vertical, braking, and propulsive GRFs; (4) increased hip eccentric and concentric power; and (5) altered muscle activation in all 6 lower extremity muscles. Conclusions The CAI group demonstrated a hip-dominant strategy by limiting propulsive forces at the ankle while increasing force generation at the hip. The different walking neuromechanics exhibited by the CAI group could represent maladaptive strategies that developed after the initial sprain or an injurious gait pattern that may have predisposed the participants to their initial injuries. Increased joint loading and altered kinematics at the foot and ankle complex during initial stance could affect the long-term health of the ankle articular cartilage.
Changes in knee joint kinematics across the menstrual cycle were dependent on both the absolute and the relative magnitude of multiplanar knee laxity changes. The combination of relatively greater knee valgus coupled with relatively greater external rotation in those with large multiplanar knee laxity changes (C₄) suggests an increased susceptibility to high-risk knee joint positions on ground contact and early in the landing phase.
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