Search Results

Anterior cruciate ligament (ACL) injury is one of the most common knee injuries among adolescent athletes. Majority of the ACL injuries occur due to pivoting, sudden deceleration, and direction change without contact with any player. Preventive interventions can reduce risks of the ACL injury, thus developing a clinician friendly biomechanical assessment tool to identify athletes with such risk factors is crucial. In this study, the authors investigated the concurrent validity of a commercially available depth sensor, Microsoft Kinect, as a cost-effective alternative to the gold-standard 3-dimensional motion analysis systems in noncontact ACL screening for adolescent athletes during side-cut maneuvers. Study participants performed 45° side-cut maneuvers while collecting data from both systems concurrently. The sagittal and frontal plane kinematics were analyzed during the full stance phase and the first 20% of the stance (early deceleration). Absolute agreement (range: ICC = .767–.989) and consistency (range: ICC = .799–.992) were excellent for all measures except early deceleration frontal plane hip angle, which displayed good absolute agreement (ICC = .643) and consistency (ICC = .625). Findings showed that the Kinect has the potential to be an effective clinical assessment tool for sagittal and frontal plane trunk, hip, and knee kinematics during the side-cut maneuvers.

Context: Landing kinetic outcomes are associated with injury risk and may be persistently altered after anterior cruciate ligament injury or reconstruction. However, it is challenging to assess kinetics clinically. The relationship between sound characteristics and kinetics during a limited number of functional tasks has been supported as a potential clinical alternative. Objective: To assess the relationship between kinetics and sound characteristics during a single-leg landing task. Design: Observational Setting: Laboratory. Participants: There was total of 26 healthy participants (15 males/11 females, age = 24.8 [3.6] y, height = 176.0 [9.1] cm, mass = 74.9 [14.4] kg, Tegner Activity Scale = 6.1 [1.1]). Intervention: Participants completed single-leg landings onto a force plate while audio characteristics were recorded. Main Outcome Measures: Peak vertical ground reaction force, linear loading rate, instantaneous loading rate, peak sound magnitude, sound frequency were measured. Means and SDs were calculated for each participant’s individual limbs. Spearman rho correlations were used to assess the relationships between audio characteristics and kinetic outcomes. Results: Peak sound magnitude was positively correlated with normalized peak vertical ground reaction force (ρ = .486, P = .001); linear loading rate (ρ = .491, P = .001); and instantaneous loading rate (ρ = .298, P = .03). Sound frequency was negatively correlated with instantaneous loading rate (ρ = −.444, P = .001). Conclusions: Peak sound magnitude may be more helpful in providing feedback about an individual’s normalized vertical ground reaction force and linear loading rate, and sound frequency may be more helpful in providing feedback about instantaneous loading rate. Further refinement in sound measurement techniques may be required before these findings can be applied in a clinical population.

Context: Reductions in objectively measured moderate to vigorous physical activity (MVPA) have been reported among individuals with anterior cruciate ligament reconstruction (ACLR). Self-reported measures of physical activity are commonly used to assess participation in physical activity after ACLR despite the lack of evidence to support the validity of such measures within this population. Objective: The objective of this research was to determine the relationships between objectively measured MVPA, self-reported physical activity, and knee function among individuals with ACLR. Setting: University laboratory. Patients (or Other Participants): Thirty-one participants with a history of ACLR (sex: 23 females and 8 males; age = 19.8 [1.4] y) and 31 matched controls (sex: 23 females and 8 males; age = 20.6 [1.7] y) enrolled in this study. Intervention(s): None. Main Outcome Measures: Participants completed self-reported physical activity using the Tegner Activity Scale and the Marx Activity Rating Scale. Participant MVPA was objectively measured using an ActiGraph wGT3X-BT accelerometer for a 7-day period during which the monitor was worn for not less than 10 hours per day. Primary outcome measures were the amount of time spent in MVPA (minutes per week) and time spent in MVPA performed in bouts of ≥10 minutes (minutes per week). Relationships between the Tegner Activity Score, Marx Activity Rating Scale, and objectively measured MVPA variables were assessed using partial Spearman’s rank correlation coefficients after controlling for activity monitor wear time. Results: There were no significant relationships between objectively measured MVPA and self-reported physical activity (ρ ≤ 0.31, P ≥ .05) or self-reported knee-related function (ρ ≤ .41, P ≥ .05) among ACLR participants. Conclusions: Objectively measured physical activity is not significantly related to self-reported physical activity or self-reported knee function among individuals with a history of ACLR. Consideration of objective and self-reported physical activity within this population may provide key insights into disconnects between perception and the reality of physical activity engagement following ACLR.

Arthrogenic muscle inhibition (AMI) is a common impairment in individuals who sustain an anterior cruciate ligament (ACL) injury. The AMI causes decreased muscle activation, which impairs muscle strength, leading to aberrant movement biomechanics. The AMI is often resistant to traditional rehabilitation techniques, which leads to persistent neuromuscular deficits following ACL reconstruction. To better treat AMI following ACL injury and ACL reconstruction, it is important to understand the specific neural pathways involved in AMI pathogenesis, as well as the changes in muscle function that may impact movement biomechanics and long-term structural alterations to joint tissue. Overall, AMI is a critical factor that limits optimal rehabilitation outcomes following ACL injury and ACL reconstruction. This review discusses the current understanding of the: (1) neural pathways involved in the AMI pathogenesis following ACL injury; (2) consequence of AMI on muscle function, joint biomechanics, and patient function; and (3) development of posttraumatic osteoarthritis. Finally, the authors review the evidence for interventions specifically used to target AMI following ACL injury.

Mindfulness meditation (MM) has decreased kinesiophobia in patients with knee pathologies. Mobile application-delivered MM (Mobile MM) may reduce kinesiophobia in individuals after anterior cruciate ligament reconstructions (ACLR). The purpose of this study was to examine the feasibility (i.e., retention, adherence, and acceptability) and preliminary efficacy of a 4-week Mobile MM intervention in individuals with a history of ACLR. Nine participants ≥1 year post unilateral ACLR completed 12 sessions of Mobile MM over 4 weeks via the Headspace mobile application that were facilitated remotely through a Health Insurance Portability and Accountability ACT of 1996 (HIPAA) compliant teleconference system. Participant retention of 100% and intervention adherence of 100% were observed. Participants reported moderate to high acceptability for the Mobile MM. A large between-group effect size of 1.6 [0.13, 2.98] in the Tampa Scale of Kinesiophobia-11 change score was observed. Mobile MM is a feasible intervention to address kinesiophobia in individuals with a history of ACLR.