EMG-Informed Musculoskeletal Modeling to Estimate Realistic Knee Anterior Shear Force During Drop Vertical Jump in Female Athletes

Navacchia, Alessandro; Ueno, Ryohei; Ford, Kevin R.; DiCesare, Christopher A.; Myer, Gregory D.; Hewett, Timothy E.

doi:10.1007/s10439-019-02318-w

Cited by 27 publications

(34 citation statements)

References 56 publications

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“…In addition, there is a biomechanical association between the hamstrings and the trunk in dynamic movements; the force generated by the hamstring muscles is greater in trunk flexion than in trunk extension. 31 Navacchia et al 41 reported that an increase in hamstring contractions provided a protective effect on the ACL by reducing the peak anterior tibial shear force. In addition, when examining the magnitude of agonist-antagonist muscle coactivation during risky movements, women showed greater quadriceps muscle activations and relatively lower hamstring muscle activations, thereby showing a lower H:Q ratio of muscle activation compared with men in the precontact phase when they were performing side-step cutting or landing.…”

Section: Discussionmentioning

confidence: 99%

Core Strength Training Can Alter Neuromuscular and Biomechanical Risk Factors for Anterior Cruciate Ligament Injury

2020

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Background: Core stability is influential in the incidence of lower extremity injuries, including anterior cruciate ligament (ACL) injuries, but the effects of core strength training on the risk for ACL injury remain unclear. Hypothesis: Core muscle strength training increases the knee flexion angle, hamstring to quadriceps (H:Q) coactivation ratio, and vastus medialis to vastus lateralis (VM:VL) muscle activation ratio, as well as decreases the hip adduction, knee valgus, and tibial internal rotation angles. Study Design: Controlled laboratory study. Methods: A total of 48 male participants were recruited and randomly assigned to either the intervention group (n = 32) or the control group (n = 16). Three-dimensional trunk, hip, knee, and ankle kinematic data and muscle activations of selected trunk and lower extremity muscles were obtained while the participants performed side-step cutting. The core endurance scores were measured before and after training. Two-way analyses of variance were conducted for each dependent variable to determine the effects of 10 weeks of core strength training. Results: The trunk endurance scores in the intervention group significantly increased after training ( P < .05 for all comparisons). The intervention group showed decreased knee valgus ( P = .038) and hip adduction angles ( P = .032) but increased trunk flexion angle ( P = .018), rectus abdominis to erector spinae coactivation ratio ( P = .047), H:Q coactivation ratio ( P = .021), and VM:VL activation ratio ( P = .016). In addition, the knee valgus angle at initial contact was negatively correlated with the VM:VL activation ratio in the precontact phase ( R2 = 0.188; P < .001) but was positively correlated with the hip adduction angle ( R2 = 0.120; P < .005). No statistically significant differences were observed in the trunk endurance scores, kinematics, and muscle activations for the control group. Conclusion: Core strength training altered the motor control strategies and joint kinematics for the trunk and the lower extremity by increasing the trunk flexion angle, VM:VL activation ratio, and H:Q activation ratio and reducing the knee valgus and hip adduction angles. Clinical Relevance: Training core muscles can modify the biomechanics associated with ACL injuries in a side-step cutting task; thus, core strength training might be considered in ACL injury prevention programs to alter the lower extremity alignment in the frontal plane and muscle activations during sports-related tasks.

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Section: Discussionmentioning

confidence: 99%

Core Strength Training Can Alter Neuromuscular and Biomechanical Risk Factors for Anterior Cruciate Ligament Injury

2020

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“…Fleming et al 10 reported that the gastrocnemius acts as an antagonist to the ACL as it pulls the femur backward relative to the tibia with an in vivo quasi-static study. Similarly, Navacchia et al 36 reported a musculoskeletal modeling study showing that the gastrocnemius induces anterior tibial shear force more than the quadriceps during landing. However, the similar effect was not simulated because of the constraints used in the FE analysis of this study.…”

Section: Discussionmentioning

confidence: 90%

Hamstrings Contraction Regulates the Magnitude and Timing of the Peak ACL Loading During the Drop Vertical Jump in Female Athletes

Ueno

Navacchia

Schilaty

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Anterior cruciate ligament (ACL) injury reduction training has focused on lower body strengthening and landing stabilization. In vitro studies have shown that quadriceps forces increase ACL strain, and hamstring forces decrease ACL strain. However, the magnitude of the effect of the quadriceps and hamstrings forces on ACL loading and its timing during in vivo landings remains unclear. Purpose: To investigate the effect and timing of knee muscle forces on ACL loading during landing. Study Design: Descriptive laboratory study. Methods: A total of 13 young female athletes performed drop vertical jump trials, and their movements were recorded with 3-dimensional motion capture. Lower limb joint motion and muscle forces were estimated with OpenSim and applied to a musculoskeletal finite element (FE) model to estimate ACL loading during landings. The FE simulations were performed with 5 different conditions that included/excluded kinematics, ground-reaction force (GRF), and muscle forces. Results: Simulation of landing kinematics without GRF or muscle forces yielded an estimated median ACL strain and force of 5.1% and 282.6 N. Addition of GRF to kinematic simulations increased ACL strain and force to 6.8% and 418.4 N ( P < .05). Addition of quadriceps force to kinematics + GRF simulations nonsignificantly increased ACL strain and force to 7.2% and 478.5 N. Addition of hamstrings force to kinematics + GRF simulations decreased ACL strain and force to 2.6% and 171.4 N ( P < .001). Addition of all muscles to kinematics + GRF simulations decreased ACL strain and force to 3.3% and 195.1 N ( P < .001). With hamstrings force, ACL loading decreased from initial contact (time of peak: 1-18 milliseconds) while ACL loading without hamstrings force peaked at 47 to 98 milliseconds after initial contact ( P = .024-.001). The knee flexion angle increased from 20.9° to 73.1° within 100 milliseconds after initial contact. Conclusion: Hamstrings activation had greater effect relative to GRF and quadriceps activation on ACL loading, which significantly decreased and regulated the magnitude and timing of ACL loading during in vivo landings. Clinical Relevance: Clinical training should focus on strategies that influence increased hamstrings activation during landing to reduce ACL loads.

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“…The vastus intermedius and gastrocnemius medialis might contribute to an increase in ACL loading as antagonists of the ACL. 41 However, a causal analysis was not performed in this study, and the causal effect of these muscles on ACL loading remains unclear.…”

Section: Methodsmentioning

confidence: 95%

“…24 Three-dimensional motion capture systems and musculoskeletal modeling have been used to investigate in vivo biomechanics and neuromuscular activations and forces during landing tasks. 32,36,37,41,49,51 With the advance of musculoskeletal modeling and its optimization techniques, the estimation of muscle activations and forces better captures muscle physiology as compared with classic static optimization methods. 19,45 However, only a few musculoskeletal modeling studies have reported ligament loading and knee joint contact force with validated material properties and a 6 degrees of freedom (DOF) knee joint, which is necessary to obtain accurate ligament loading.…”

mentioning

confidence: 99%

Anterior Cruciate Ligament Loading Increases With Pivot-Shift Mechanism During Asymmetrical Drop Vertical Jump in Female Athletes

Ueno

Navacchia

Schilaty

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Frontal plane trunk lean with a side-to-side difference in lower extremity kinematics during landing increases unilateral knee abduction moment and consequently anterior cruciate ligament (ACL) injury risk. However, the biomechanical features of landing with higher ACL loading are still unknown. Validated musculoskeletal modeling offers the potential to quantify ACL strain and force during a landing task. Purpose: To investigate ACL loading during a landing and assess the association between ACL loading and biomechanical factors of individual landing strategies. Study Design: Descriptive laboratory study. Methods: Thirteen young female athletes performed drop vertical jump trials, and their movements were recorded with 3-dimensional motion capture. Electromyography-informed optimization was performed to estimate lower limb muscle forces with an OpenSim musculoskeletal model. A whole-body musculoskeletal finite element model was developed. The joint motion and muscle forces obtained from the OpenSim simulations were applied to the musculoskeletal finite element model to estimate ACL loading during participants’ simulated landings with physiologic knee mechanics. Kinematic, muscle force, and ground-reaction force waveforms associated with high ACL strain trials were reconstructed via principal component analysis and logistic regression analysis, which were used to predict trials with high ACL strain. Results: The median (interquartile range) values of peak ACL strain and force during the drop vertical jump were 3.3% (–1.9% to 5.1%) and 195.1 N (53.9 to 336.9 N), respectively. Four principal components significantly predicted high ACL strain trials, with 100% sensitivity, 78% specificity, and an area of 0.91 under the receiver operating characteristic curve ( P < .001). High ACL strain trials were associated with (1) knee motions that included larger knee abduction, internal tibial rotation, and anterior tibial translation and (2) motion that included greater vertical and lateral ground-reaction forces, lower gluteus medius force, larger lateral pelvic tilt, and increased hip adduction. Conclusion: ACL loads were higher with a pivot-shift mechanism during a simulated landing with asymmetry in the frontal plane. Specifically, knee abduction can create compression on the posterior slope of the lateral tibial plateau, which induces anterior tibial translation and internal tibial rotation. Clinical Relevance: Athletes are encouraged to perform interventional and preventive training to improve symmetry during landing.

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EMG-Informed Musculoskeletal Modeling to Estimate Realistic Knee Anterior Shear Force During Drop Vertical Jump in Female Athletes

Cited by 27 publications

References 56 publications

Core Strength Training Can Alter Neuromuscular and Biomechanical Risk Factors for Anterior Cruciate Ligament Injury

Core Strength Training Can Alter Neuromuscular and Biomechanical Risk Factors for Anterior Cruciate Ligament Injury

Hamstrings Contraction Regulates the Magnitude and Timing of the Peak ACL Loading During the Drop Vertical Jump in Female Athletes

Anterior Cruciate Ligament Loading Increases With Pivot-Shift Mechanism During Asymmetrical Drop Vertical Jump in Female Athletes

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