The purpose of the study was to compare the tibiofemoral contact forces of participants with chronic ankle instability versus controls during landings using a computer-simulated musculoskeletal model. A total of 21 female participants with chronic ankle instability and 21 pair-matched controls performed a drop landing task on a tilted force plate. A 7-camera motion capture system and 2 force plates were used to test participants’ lower-extremity biomechanics. A musculoskeletal model was used to calculate the tibiofemoral contact forces (femur on tibia). No significant between-group differences were observed for the peak tibiofemoral contact forces (P = .25–.48) during the landing phase based on paired t tests. The group differences ranged from 0.05 to 0.58 body weight (BW). Most participants demonstrated a posterior force (peak, ∼1.1 BW) for most duration of the landing phase and a medial force (peak, ∼0.9 BW) and large compressive force (peak, ∼10 BW) in the landing phase. The authors conclude that chronic ankle instability may not be related to the increased tibiofemoral contact forces or knee injury mechanisms during landings on the tilted surface.
Chronic Ankle Instability Does Not Influence Tibiofemoral Contact Forces During Drop Landings Using a Musculoskeletal Model
Yumeng Li, He Wang, and Kathy J. Simpson
Estimated Patellofemoral Compressive Forces and Contact Pressures during Dance Landings
Kathy J. Simpson, Eugene G. Jameson, and Susan Odum
Patellofemoral dysfunctions due to abnormal force loading are significant problems for dancers. Increased jump length was predicted to require increased quadriceps force during landing, which would increase patellofemoral forces and pressures. Six female dancers performed 10 traveling jumps each at 30, 60, and 90% maximum jump displacements (JDs). A sagittal view of the landing onto a force platform (500 Hz) was filmed (100 fps). Repeated-measures ANOVA (JD) and Scheffé post hoc analyses (p < .05) showed that greater peak patellofemoral pressures occurred at longer JDs and the corresponding times to these events decreased and knee flexion increased. Previous research and these findings indicate that different regions of the patella may endure higher loads at greater JDs even though the contact areas increase with greater patellofemoral forces. However, greater knee flexion and velocity could indicate more rapid distribution of load to various patellar regions, which would reduce the time any given patellofemoral region would be subjected to high loads.
Patellar Tendon Straps Decrease Pain and May Alter Lower Extremity Kinetics in Those With Patellar Tendinopathy During Jump Landing
Adam B. Rosen, Jupil Ko, Kathy J. Simpson, and Cathleen N. Brown
Patellar tendinopathy is often managed with a patellar tendon strap, however, their effectiveness is unsubstantiated. The purpose of this study was to determine if straps altered pain or lower extremity kinetics of individuals with patellar tendinopathy during landing. Thirty participants with patellar tendinopathy and 30 controls completed drop jumps with and without patellar tendon straps. Wearing the strap, tendinopathy participants demonstrated significantly decreased pain and reduced knee adductor moment; all participants displayed significantly decreased anterior ground reaction force while wearing a strap. Patellar tendon strapping may reduce pain due to alterations in direction and magnitude of loading.
Joint Coordination and Stiffness During Landing in Individuals With Chronic Ankle Instability
Yumeng Li, Jupil Ko, Marika A. Walker, Cathleen N. Brown, and Kathy J. Simpson
The purpose of the present study was to examine the effect of chronic ankle instability (CAI) on lower-extremity joint coordination and stiffness during landing. A total of 21 female participants with CAI and 21 pair-matched healthy controls participated in the study. Lower-extremity joint kinematics were collected using a 7-camera motion capture system, and ground reaction forces were collected using 2 force plates during drop landings. Coupling angles were computed based on the vector coding method to assess joint coordination. Coupling angles were compared between the CAI and control groups using circular Watson–Williams tests. Joint stiffness was compared between the groups using independent t tests. Participants with CAI exhibited strategies involving altered joint coordination including a knee flexion dominant pattern during 30% and 70% of their landing phase and a more in-phase motion pattern between the knee and hip joints during 30% and 40% and 90% and 100% of the landing phase. In addition, increased ankle inversion and knee flexion stiffness were observed in the CAI group. These altered joint coordination and stiffness could be considered as a protective strategy utilized to effectively absorb energy, stabilize the body and ankle, and prevent excessive ankle inversion. However, this strategy could result in greater mechanical demands on the knee joint.
Concussion History and Time Since Concussion Do not Influence Static and Dynamic Balance in Collegiate Athletes
Eric D. Merritt, Cathleen N. Brown, Robin M. Queen, Kathy J. Simpson, and Julianne D. Schmidt
Dynamic balance deficits exist following a concussion, sometimes years after injury. However, clinicians lack practical tools for assessing dynamic balance.
To determine if there are significant differences in static and dynamic balance performance between individuals with and without a history of concussion.
Clinical research laboratory.
Patients or Other Participants:
45 collegiate student-athletes with a history of concussion (23 males, 22 females; age = 20.0 ± 1.4 y; height = 175.8 ± 11.6 cm; mass = 76.4 ± 19.2 kg) and 45 matched controls with no history of concussion (23 males, 22 females; age = 20.0 ± 1.3 y; height = 178.8 ± 13.2 cm; mass = 75.7 ± 18.2 kg).
Participants completed a static (Balance Error Scoring System) and dynamic (Y Balance Test-Lower Quarter) balance assessment.
Main Outcome Measures:
A composite score was calculated from the mean normalized Y Balance Test-Lower Quarter reach distances. Firm, foam, and overall errors were counted during the Balance Error Scoring System by a single reliable rater. One-way ANOVAs were used to compare balance performance between groups. Pearson’s correlations were performed to determine the relationship between the time since the most recent concussion and balance performance. A Bonferonni adjusted a priori α < 0.025 was used for all analyses.
Static and dynamic balance performance did not significantly differ between groups. No significant correlation was found between the time since the most recent concussion and balance performance.
Collegiate athletes with a history of concussion do not present with static or dynamic balance deficits when measured using clinical assessments. More research is needed to determine whether the Y Balance Test-Lower Quarter is sensitive to acute balance deficits following concussion.
Upper Trunk–Pelvis Coordination During Running Using the Continuous Relative Fourier Phase Method
Yumeng Li, Rumit S. Kakar, Marika A. Walker, Li Guan, and Kathy J. Simpson
The upper trunk–pelvic coordination patterns used in running are not well understood. The purposes of this study are to (1) test the running speed effect on the upper trunk–pelvis axial rotation coordination and (2) present a step-by-step guide of the relative Fourier phase algorithm, as well as some further issues to consider. A total of 20 healthy young adults were tested under 3 treadmill running speeds using a 3-dimensional motion capture system. The upper trunk and pelvic segmental angles in axial rotation were calculated, and the coordination was quantified using the relative Fourier phase method. Results of multilevel modeling indicated that running speed did not significantly contribute to the changes in coordination in a linear pattern. A qualitative template analysis suggested that participants displayed different change patterns of coordination as running speed increased. Participants did not significantly change the upper trunk and pelvis coordination mode in a linear pattern at higher running speeds, possibly because they employed different motion strategies to achieve higher running speeds and thus displayed large interparticipant variations. For most of our runners, running at a speed deviated from the preferred speed could alter the upper trunk–pelvis coordination. Future studies are still needed to better understand the influence of altered coordination on running performance and injuries.
The Effects of a Lateral In-flight Perturbation on Lower Extremity Biomechanics During Drop Landings
Jae P. Yom, Kathy J. Simpson, Scott W. Arnett, and Cathleen N. Brown
One potential ACL injury situation is due to contact with another person or object during the flight phase, thereby causing the person to land improperly. Conversely, athletes often have flight-phase collisions but do land safely. Therefore, to better understand ACL injury causation and methods by which people typically land safely, the purpose of this study was to determine the effects of an in-flight perturbation on the lower extremity biomechanics displayed by females during typical drop landings. Seventeen collegiate female recreational athletes performed baseline landings, followed by either unexpected laterally-directed perturbation or sham (nonperturbation) drop landings. We compared baseline and perturbation trials using paired-samples t tests (P < .05) and 95% confidence intervals for lower-extremity joint kinematics and kinetics and GRF. The results demonstrated that perturbation landings compared with baseline landings exhibited more extended joint positions of the lower extremity at initial contact; and, during landing, greater magnitudes for knee abduction and hip adduction displacements; peak magnitudes of vertical and medial GRF; and maximum moments of ankle extensors, knee extensors, and adductor and hip adductors. We conclude that a lateral in-flight perturbation leads to abnormal GRF and angular motions and joint moments of the lower extremity.
Biomechanical Comparison between Elite Female and Male Baseball Pitchers
Yungchien Chu, Glenn S. Fleisig, Kathy J. Simpson, and James R. Andrews
The purpose of the current study was to identify the biomechanical features of elite female baseball pitching. Kinematics and kinetics of eleven elite female baseball pitchers were reported and compared with eleven elite male pitchers. Results suggested that females share many similarities with males in pitching kinematics, with a few significant differences. Specifically, at the instant of stride foot contact, a female pitcher had a shorter and more open stride and less separation between pelvis orientation and upper torso orientation. From foot contact to ball release, a female pitcher produced lower peak angular velocity for throwing elbow extension and stride knee extension. Ball velocity was lower for the female. Foot contact to ball release took more time for a female pitcher. Maximal proximal forces at the shoulder and elbow joints were less for a female pitcher.
Intratrunk Coordination During High-Effort Treadmill Running in Individuals With Spinal Fusion for Adolescent Idiopathic Scoliosis
Yumeng Li, Rumit S. Kakar, Marika A. Walker, Yang-Chieh Fu, Timothy S. Oswald, Cathleen N. Brown, and Kathy J. Simpson
The purpose of the study was to determine if the intratrunk coordination of axial rotation exhibited by individuals with spinal fusion for adolescent idiopathic scoliosis (SF-AIS) during running varies from healthy individuals and how the coordination differs among adjacent trunk-segment pairs. Axial rotations of trunk segments (upper, middle, lower trunk) and pelvis were collected for 11 SF-AIS participants and 11 matched controls during running. Cross-correlation determined the phase lag between the adjacent segment motions. The coupling angle was generated using the vector coding method and classified into 1 of the 4 major, modified coordination patterns: in-phase, anti-phase, superior, and inferior phase. Two-way, mixed-model ANCOVA was employed to test phase lag, cross-correlation r, and time spent in each major coordination pattern. A significantly lower phase lag for SF-AIS was observed compared with controls. Qualitatively, there was a tendency that SF-AIS participants spent less time in anti-phase for middle-lower trunk and lower trunk-pelvis coordinations compared to controls. Phase lag and anti-phase time was significantly increased from cephalic to caudal segment pairs, regardless of group. In conclusion, SF-AIS participants and controls displayed similar patterns of intra-trunk coordination; however, the spinal fusion hindered decoupling of intra-trunk motions particularly between the lower trunk-pelvic motion.
Does Wearing a Prophylactic Ankle Brace During Drop Landings Affect Lower Extremity Kinematics and Ground Reaction Forces?
Kathy J. Simpson, Jae P. Yom, Yang-Chieh Fu, Scott W. Arnett, Sean O’Rourke, and Cathleen N. Brown
The objective of the study was to determine if prophylactic ankle bracing worn by females during landings produces abnormal lower extremity mechanics. Angular kinematic and ground reaction force (GRF) data were obtained for 16 athletically experienced females who performed brace and no-brace drop landings. The brace condition displayed reduced in/external rotation and flexion displacements about the ankle and knee joints and increased vertical and mediolateral GRF peak magnitudes and rate of vertical GRF application (paired t test, P < .05). The ankle and knee joints landed in a less plantar flexed and more flexed position, respectively. No significant ab/adduction outcomes may have occurred due to interparticipant variability and/or a lack of brace restriction. Conclusion: During typical landings, this lace-up brace increases vertical GRF, decreases ankle and knee joint displacements of flexion and int/external rotation, but minimally affects ab/adduction displacements.