Effects of foot rotation positions on knee valgus during single-leg drop landing: Implications for ACL injury risk reduction

Teng, P.S.P.; Kong, Pui Wah; Leong, Kah Fai

doi:10.1016/j.knee.2017.01.014

Cited by 34 publications

(19 citation statements)

References 30 publications

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“…It is important to note that the findings of the current study do conflict with previous research that suggest landing with an extreme toe-out position also increases risk of ACL injuries [14,15,33], even though the magnitudes of our findings during the toe-out, as well as the toe-in, conditions are not as high as those of the previous studies. One explanation of this is that it is most likely due to the changes in FPA based on the participants self-selected FPA and not a neutral or 0° position.…”

Section: Tablecontrasting

confidence: 99%

“…This could be due to the tibia becoming externally rotated relative to the femur, thus causing an internal knee adduction moment. Teng et al [33] observed this same response during single leg drop landing and suggested landing with extreme toe-out FPA should be avoided during single-leg landings. While peak knee adduction moment did increase with toe-out FPA in the current study, no other ACL-injury risk variables increased with toe-out FPA.…”

Section: Tablementioning

confidence: 68%

“…Previous research has shown that mechanics that increase risk of ACL injury include a combination of increased hip internal rotation, knee abduction, knee internal rotation, and internal knee adduction moment, leading to medial knee collapse [4,13,31,32]. It is important to note though, that little attention is placed on the ankle or the foot, even though the closed lower extremity kinetic chain starts with this segment and joint [1,33]. Ali and Rouhi [1] suggests that foot position during landing can affect the transfer of forces up the closed lower extremity kinetic chain, thus increasing chance of an ACL injury.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Foot Rotation on ACL Injury Risk Variables During Drop Landing

Peel

Thorsen

Schneider

et al. 2020

J. of SCI. IN SPORT AND EXERCISE

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Purpose Landing is considered a "high-risk" movement for anterior cruciate ligament (ACL) injuries. Foot progression angle (FPA) during landing has been shown to influence hip, knee, and ankle mechanics. The purpose of this study was to compare five FPA conditions during drop landings between males and females. Methods Twenty males and females were tested using five FPA conditions: self-selected, toe-in 15°, toe-in 30°, toe-out 15°, and toe-out 30°. Right hip, knee, and ankle joint kinematics and kinetics were collected using a 12-camera motion capture system and two force plates. Five successful trials were collected and compared between FPA conditions. Results The main effect for FPA condition was statistically different for initial contact hip flexion, hip abduction, hip internal rotation, knee flexion, knee abduction, knee external rotation, and ankle inversion angles compared to self-selected FPA at P < 0.05. Peak hip extension, hip abduction, knee adduction, knee internal rotation, ankle plantar flexion, and ankle inversion moments were also found to be statistically significant (P < 0.05). Overall, females experienced greater initial knee abduction angle (P = 0.028), hip abduction moment (P = 0.006), knee extension moment (P = 0.033), and knee internal rotation moment (P = 0.044), regardless of FPA condition. Males experienced greater initial contact hip abduction angle (P = 0.0017), regardless of FPA condition. Conclusion The results suggest that landing with large toe-in FPA will increase the magnitude of ACL injury risk variables, and females demonstrated a greater magnitude in these variables compared to males. Injury prevention programs may seek to target FPA as part of training activities to avoid large FPA toe-in landings.

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Section: Tablecontrasting

confidence: 99%

Section: Tablementioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

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Effects of Foot Rotation on ACL Injury Risk Variables During Drop Landing

Peel

Thorsen

Schneider

et al. 2020

J. of SCI. IN SPORT AND EXERCISE

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“…The reduction of dynamic valgus through treatment programs and adaptation of exercises has been discussed in the scientific environment. Although there are several types of squat, such as changes in the rotation of the foot during exercise, studies have shown divergent results in relation to the decrease in dynamic valgus through external rotation (toeout) and internal rotation (toe-in) during CCF exercises 45,46 . In our study, these variations were not analyzed, since, with the rotation of the foot, the knee moves beyond the frontal plane, making it impossible to reliably analyze the dynamic valgus by APPF and, therefore, the use of three-dimensional technique is necessary.…”

Section: Resultsmentioning

confidence: 99%

Comparative Analysis of the Effect of the Different Adaptations of the Squat Exercise on the Knee Frontal Plane Projection Angle

2020

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Closed kinetic chain exercises have been employed in rehabilitation and muscle strengthening programs, such as squatting. During the movement of the squat dynamic valgus, a change that affects all kinematics of the lower limb, tends to become exacerbated, necessitating adaptations in order to minimize the biomechanical disorder. Although studies have shown the effectiveness of squatting exercises, there is a lack of evidence to demonstrate, comparatively, the effectiveness of different adaptations in the decrease of dynamic valgus. The objective of the study was to evaluate to identify the efficacy of different adaptations in squatting exercise in the reduction of dynamic valgus. Therefore, study volunteers (n = 30) performed three types of squats: free squatting, squatting with elastic band and squatting with verbal command. The dynamic valgus wasmeasured by the knee frontal plane projection angle during the squatting movements, through captured images and analyzed by the software Tracker and ImageJ. Despite more cases in women, in both sexes, free squatting presented greater cases of medicalization of the knee than in comparison to the other two adaptations. Although both squat adaptations presented positive results, only squatting with verbal command showed a significant reduction of the dynamic valgus pointing out that this is the best adaptation treated. Keywords: Genu Valgum. Exercise Therapy. Motor Activity. Resumo Exercícios de cadeia cinética fechada vêm sendo empregados em programas de reabilitação e fortalecimento muscular, como é o caso do agachamento. Durante o movimento de agachamento o valgo dinâmico, alteração que afeta toda cinemática do membro inferior, tende a se tornar exacerbado, sendo necessárias adaptações com o intuito de minimizar o distúrbio biomecânico. Embora estudos tenham mostrado a eficácia dos exercícios de agachamento, faltam evidências que demonstrem, comparativamente, a efetividade de diferentes adaptações na minimização do valgo dinâmico. O objetivo do estudo foi identificar a eficácia de diferentes adaptações na execução do exercício de agachamento na redução do valgo dinâmico. Para tanto, os voluntários do estudo (n=30) três tipos de agachamentos: agachamento livre, agachamento com banda elástica e agachamento com comando verbal. O valgo dinâmico foi mensurado mediante o ângulo de projeção no plano frontal do joelho durante os movimentos de agachamento, através de imagens capturadas e posteriormente analisadas pelos softwares Tracker e ImageJ. Apesar de mais casos em mulheres, em ambos os sexos, o agachamento livre apresentou maiores casos de medicalização do joelho do que nas outras duas adaptações. Embora ambas adaptações de agachamento apresentaram resultados positivos, apenas o agachamento com comando verbal apresentou redução significativa do valgo dinâmico, apontando ser esta a melhor adaptação tratada. Palavras-chaves: Geno Valgo. Terapia por Exercício. Atividade Motora.

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“…In recent years, the incidence of ACL injury has been increasing [ 42 – 45 ]. Rehabilitation therapy is important to the restoration of knee function and early re-exercise [ 46 – 49 ], and proprioception plays an important role in recovery of knee joint stability [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Proprioceptive Changes in Bilateral Knee Joints Following Unilateral Anterior Cruciate Ligament Injury in Cynomolgus Monkeys

Zhang

Zeng

et al. 2018

Med Sci Monit

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BackgroundThe anterior cruciate ligament (ACL) is one of the most important structures maintaining stability of knee joints, and the proprioception of the ACL plays a key role in it. If the ACL is injured in the unilateral knee joint, it changes nerve electrophysiology, morphology, and quantity of the proprioceptors in the bilateral ACL. The aim of this study was to explore the proprioceptive changes in the bilateral knee joints following unilateral ACL injury, and to provide a theoretical foundation and ideas for clinical treatment.Material/MethodsNine normal cynomolgus monkeys were chosen and used to developed a model of unilateral ACL injury, and 3 monkeys without modeling were used as blank control. At the 4th, 8th, and 12th weeks, the changes in ACL nerves were inspected using electrophysiology [somatosensory evoked potentials (SEPs) and motor nerve conduction velocity (MCV)], and the changes of morphology and quantity of the proprioceptors in ACL were observed and measured under gold chloride staining.ResultsOn the injured and contralateral knee joints, the incubations were extended and the amplitudes were decreased over time. In addition, with the extension of time, the total number of proprioceptors in the ACL decreased, and the variable number of proprioceptors in the ACL increased.ConclusionsACL injury leads to attenuation of proprioception on the injured side, and also leads to the attenuation of proprioception on the contralateral side, and there is a tendency could get worse over time.

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Effects of foot rotation positions on knee valgus during single-leg drop landing: Implications for ACL injury risk reduction

Cited by 34 publications

References 30 publications

Effects of Foot Rotation on ACL Injury Risk Variables During Drop Landing

Effects of Foot Rotation on ACL Injury Risk Variables During Drop Landing

Comparative Analysis of the Effect of the Different Adaptations of the Squat Exercise on the Knee Frontal Plane Projection Angle

Proprioceptive Changes in Bilateral Knee Joints Following Unilateral Anterior Cruciate Ligament Injury in Cynomolgus Monkeys

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