Monitoring lower limb biomechanical asymmetry and psychological measures in athletic populations—A scoping review

Abstract

BackgroundLower limb biomechanics, including asymmetry, are frequently monitored to determine sport performance level and injury risk. However, contributing factors extend beyond biomechanical and asymmetry measures to include psychological, sociological, and environmental factors. Unfortunately, inadequate research has been conducted using holistic biopsychosocial models to characterize sport performance and injury risk. Therefore, this scoping review summarized the research landscape of studies concurrently assessing measures of lower limb biomechanics, asymmetry, and introspective psychological state (e.g., pain, fatigue, perceived exertion, stress, etc.) in healthy, competitive athletes.MethodsA systematic search of MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science Core Collections was designed and conducted in accordance with PRISMA guidelines. Fifty‐one articles were included in this review.ResultsSignificant relationships between biomechanics (k = 22 studies) or asymmetry (k = 20 studies) and introspective state were found. Increased self‐reported pain was associated with decreased range of motion, strength, and increased lower limb asymmetry. Higher ratings of perceived exertion were related to increased lower limb asymmetry, self‐reported muscle soreness, and worse jump performance. Few studies (k = 4) monitored athletes longitudinally throughout one or more competitive season(s).ConclusionThis review highlights the need for concurrent analysis of introspective, psychological state, and biomechanical asymmetry measures along with longitudinal research to understand the contributing factors to sport performance and injury risk from biopsychosocial modeling. In doing so, this framework of biopsychosocial preventive and prognostic patient‐centered practices may provide an actionable means of optimizing health, well‐being, and sport performance in competitive athletes.

Longitudinal Monitoring of Biomechanical and Psychological State in Collegiate Female Basketball Athletes Using Principal Component Analysis

“…There is a paucity of longitudinal investigations conducted in the realm of sports medicine [ 53 ], especially studies that have concurrently monitored and integrated biomechanics and psychology in a real-world setting using force plates and wearable technology. Reporting of seasonal data is seldom completed, and our study highlights within- and between-season variability that might be expected across multiple seasons in real-world and vertical jump biomechanics and self-reported psychological state.…”

“…We aimed to determine whether there were any overarching associations between biomechanics and psychology throughout a competitive collegiate basketball season. Our recent scoping review [ 53 ] found that pain and rating of perceived exertion were related to lower limb biomechanics and asymmetry. Unfortunately, these relationships that have been previously observed are highly variable in strength and rarely examined longitudinally [ 53 ].…”

“…Our recent scoping review [ 53 ] found that pain and rating of perceived exertion were related to lower limb biomechanics and asymmetry. Unfortunately, these relationships that have been previously observed are highly variable in strength and rarely examined longitudinally [ 53 ]. While the findings of the current study support this association of biomechanics and pain, specifically with respect to jump movement strategy and on-court impact load (PC3 and PC4, respectively), the magnitude of these associations was weak ( r = |0.18-0.19|, p < 0.05) [ 77 ], and there were no other clear or overarching associations identified at the cohort level when controlling for between-subject variability.…”

“…For example, psychological stressors may be modifiable risk factors for injury and reinjury in and of themselves [ 44 – 51 ] or may add to the demands of a task in conjunction with the biomechanical stressors experienced [ 44 , 52 ]. Remarkably, very limited research has directly examined the link between biomechanical outcomes and psychological state as it relates to sports performance and risk of injury, with even fewer research studies doing so longitudinally throughout several competitive seasons [ 53 ].…”