Effect of Sex and Lateral Ankle Sprain History on Dorsiflexion Range Of Motion Asymmetry During the Weight Bearing Lunge Test.

Background: Reduced dorsiflexion range of motion (DFROM) which is commonly seen following lateral ankle sprain (LAS) has the potential to influence lower extremity biomechanics which have been linked to increased injury risk in the female athlete. Current research on the effect of sex and LAS history on DFROM is limited. Hypothesis/Purpose: This study had three aims 1) to determine the effect of sex, leg dominance and LAS history on DFROM, 2) to determine the effect of sex and LAS history on magnitude of DFROM symmetry and 3) to examine the association of sex on direction (whether dominant or non-dominant limb had the higher DFROM) of symmetry. Study Design: Cross-Sectional Study. Methods: DFROM was measured bilaterally in 105 recreational athletes all participating in multidirectional sports using the tape measurement method during the weight bearing lunge test (WBLT). A mean of three measurements was used for analysis. A 3-way mixed ANOVA was carried out to determine the interaction between sex, LAS history and leg dominance on DFROM and a 2-way ANOVA for the effect of sex and LAS history on asymmetry. A chi-square test was used to determine the association of sex and direction of asymmetry. Results: The results indicate no significant effect of sex, LAS history, and leg dominance on DFROM (p=0.65). Main effects were significant for sex and LAS on DFROM. The mean asymmetry for all participants was reported as 12.25±14.76cm. No significant effect of sex and LAS history on magnitude of asymmetry was reported. There was a significant association of sex and direction of asymmetry (χ2(1) = 11.26, p = 0.00). Sixty-five-point two percent of males were shown to have higher DFROM of their non-dominant limb compared to 75% of females who were higher in their dominant limb. Conclusion: Findings from this study suggest that DFROM is affected by sex and LAS history. While females have increased DFROM compared to males, those with LAS history are more likely to have a decreased DFROM on the involved side. The results also indicate that interlimb asymmetries in DFROM are present in athletes, therefore practitioners should exercise caution when using bilateral comparisons in injury and return to play assessments. Level of Evidence: 2b.

The effect of pointe shoe deterioration on foot and ankle kinematics and kinetics in professional ballet dancers.

Dancing en pointe significantly increases the risk of lower limb injuries by placing the foot and ankle joint in unfavorable positions. The pointe shoe, worn predominantly by female ballet dancers may aid movement and acts as a major stabilizer of the foot. The deterioration in pointe shoe structure with excessive wear may increase a dancer's risk of ankle and foot related injuries by placing excessive load on the joints when the foot is poorly aligned. The purpose of this study was to investigate differences in foot and ankle kinetics and kinematics between new and worn pointe shoes. Fifteen professional ballet dancers completed a series of bourreés (walking en pointe) in both new and worn pointe shoes (>20 h wear). Force and pressure analyses determined peak ground reaction force and centre of pressure velocity. A 2D kinematic analysis determined the magnitude of mid-foot flexion and ankle plantarflexion. The worn pointe shoe caused significantly greater mid-foot flexion (P <  0.01) and ankle plantarflexion (P  <  0.01) en pointe compared to the new pointe shoe. No significant changes in peak force (P = 0.855) or centre of pressure velocity (P = 0.297) were observed between conditions. The reduced structural integrity of the worn pointe shoe may be a causal factor for kinematic changes and subsequent pain and lower limb injuries in professional dancers.

Knee joint strength ratios and effects of hip position in rugby players.

Measures of knee joint function, although useful in predicting injury, can be misleading because hip position in traditional seated isokinetic tests is dissimilar to when injuries occur. This study aimed to determine the differences between seated and supine peak torques and strength ratios and examine the interaction of position with joint velocity. This was a cross-sectional, repeated measures study. Isokinetic knee extensor and flexor concentric and eccentric peak torque was measured seated and supine (10° hip flexion) at 1.04 and 3.14 rad·s(-1) in 11 Rugby players. Repeated measures analysis of variance and paired t-tests were used to analyze peak torques and strength ratios. Bonferroni post hoc, limits of agreement, and Pearson's correlation were applied. Seated peak torque was typically greater than that for supine for muscle actions and velocities. The values ranged from 109 ± 18 N·m (mean ± σ) for supine hamstring concentric peak torque at 1.04 rad·s(-1) to 330 ± 71 for seated quadriceps eccentric peak torque at 1.04 rad·s(-1). There was a significant position × muscle action interaction; eccentric peak torque was reduced more than concentric in the supine position. Knee joint strength ratios ranged from 0.47 ± 0.06 to 0.86 ± 0.23, with a significant difference in means between supine and seated positions for functional ratio at 3.14 rad·s(-1) observed; for seated it was 0.86 ± 0.23; and for supine, it was 0.68 ± 0.15 (p < 0.05). Limits of agreement for traditional and functional ratios ranged from 1.09 ×/÷ 1.37 to 1.13 ×/÷ 1.51. We conclude that hip angle affects isokinetic peak torques and knee joint strength ratios. Therefore, the hip angle should be nearer 10° when measuring knee joint function because this is more ecologically valid. Using similar protocols, sports practitioners can screen for injury and affect training to minimize injury.

Age- and sex-associated differences in isokinetic knee muscle endurance between young children and adults.

The purpose of this study was to examine the age- and sex-associated differences of repeated isokinetic knee extension and flexion. Fifty one participants, 30 young children (16 boys and 14 girls; aged 11 and 12 years) and 21 adults (9 males and 12 females; aged 18-35 years), agreed to participate in the study. Isokinetic concentric peak knee extension (PET) and flexion (PFT) torque were measured using a calibrated Biodex System 3. Participants performed 4 concentric extension-flexion cycles with maximum effort; after a 2 min rest, 50 continuous concentric cycles were performed at 1.56 rad.s-1. Total work of the extensors (WKEX) and flexors (WKFL) for the complete 50 repetitions was recorded. Average peak torque and average work for the first and last 3 repetitions were calculated to represent the percentage decline in torque and work. There were no significant differences between groups in the peak torque generated during the pretrial and endurance task, suggesting that participants gave a maximal effort at the start of the endurance task. There was a significant interaction effect in the total work done for both extensors and flexors, with adult males producing the greatest amount of work (6622 and 3444 J, respectively). When total work was divided by body mass, there were no significant sex effects, only main effects for group. The percentage decline for PET (40% vs. 60%), PFT (50% vs. 65%), WKET (43% vs. 61%), and WKFL (60% vs. 69%) demonstrated significant main effects for group, with greater fatigue in adults. We found no significant sex effect for fatigue. This study concludes that females do not resist fatigue from repeated isokinetic muscle actions to a greater extent than males, and that the greater fatigue in adults than in children is probably a product of greater initial torque production and work performed.

[Evaluation of knee peak torque in athletic and sedentary children]. / Atletik ve sedanter çocuklarda diz zirve torkunun degerlendirilmesi.

OBJECTIVES: We examined the influence of sex, level of activity, and pubertal status on knee extension (Ext) and flexion (Fl) peak torque (PT) in children using an allometric modeling approach. METHODS: A total of 140 students (67 males, 73 females) aged 12/13 years were enrolled from a Hong Kong junior high school, whose curricula were based on physical education (n=69) or arts (n=71). Isokinetic concentric Ext and Fl PT of the dominant leg was assessed at 1.04 rad/sec using a Cybex II+ dynamometer and body mass, stature, and pubertal stage were measured. A repeated-measures ANOVA test was performed on absolute PT data with muscle action (Ext and Fl) as a within-subject factor and between-subject factors including sex, group, and pubertal stage. To assess the effects on body size-adjusted PT, linear ANCOVA and log-linear ANCOVA techniques were used with body mass and stature taken as covariates. RESULTS: Peak torque was significantly greater in boys compared to girls, and in the physical education group compared to the arts group. When PT was adjusted for differences in body size, there was a greater difference in PT between girls in the two groups compared to boys, and there was a significant effect of pubertal stage. Allometric analysis showed that PT was influenced more by stature than body mass, and PT increased at a greater rate than body size (both p<0.01). CONCLUSION: There may be a need for a physical activity intervention in sedentary 12/13 year old girls. Peak torque appears to increase disproportionately to body size. This may result from a greater increase in leg muscle mass relative to body mass.

The cardiorespiratory, anthropometric, and performance characteristics of an international/national touring ballet company.

This study examined the cardiorespiratory and anthropometric indices of professional classical ballet dancers in relation to company seniority, gender, and supplemental training. Forty-nine participants from an international touring company carried out a peak Vo(2) test and vertical jump test. Anthropometric measurements and supplemental training activities were also recorded for each participant. Statistical analyses showed significant differences between gender and dancer seniority levels. Gender differences were seen for jump height (M = 52.7 +/- 7.12 cm; F = 37.6 +/- 5.32 cm) and peak Vo(2) (M = 49.32 +/- 3.72 ml.kg(-1).min(-1); F = 43.3 +/- 5.16 ml.kg(-1).min(-1)). Differences were also seen between dancer levels for peak Vo(2) (artist = 46.47 +/- 4.67 ml.kg(-1).min(-1); first artist = 42.72 +/- 5.81 ml.kg(-1).min(-1); soloist = 43.38 +/- 7.14 ml.kg(-1).min(-1); principal = 49.04 +/- 3.63 ml.kg(-1).min(-1)) and jump height (artist = 42.0 +/- 9.11 cm; first artist = 50.33 +/- 11.65 cm; soloist = 45.6 +/- 9.78 cm; principal = 44.67 +/- 9.53 cm). Pairwise post hoc comparisons showed that corps and principals had significantly greater relative peak Vo(2) than first artists and soloists (p < 0.05), while soloists and first artists had significantly greater jump heights compared to principals and corps (p < 0.05). Analysis of covariance modeling indicated that the self-reported mode of supplemental training had no association with relative peak Vo(2) or the percentage at which ventilatory threshold occurred. The present study has provided further insight into the cardiorespiratory profiles of classical ballet dancers, where soloists have significantly greater power capacities compared to principals and corps, who in turn had significantly greater aerobic power. These data can help guide strength and conditioning intervention strategies that need to take into account the nuances of the different seniority levels within a dance company.

Assessment and interpretation of isokinetic muscle strength during growth and maturation.

The majority of strength studies examining changes during growth and maturation have investigated isometric actions, which tell us little about the muscle under dynamic conditions. There are numerous methodological issues in the isokinetic testing of paediatric populations that require further investigation. However, several studies have indicated that children can be reliably assessed isokinetically using both concentric and eccentric actions. Most paediatric studies have examined the knee joint and more data are needed to elucidate the reliability of upper body isokinetic strength testing. The age- and sex-associated development of isokinetic strength is less well understood. Studies have indicated that isokinetic strength increases with age but the mechanisms associated with this increase require further investigation. Current data are also conflicting regarding the age at which sex differences become apparent in isokinetic strength. More work is needed to examine the influence of maturation on isokinetic strength development, but available data suggest that maturation is a non-significant contributory factor once stature and body mass are accounted for. Most studies have demonstrated a significant relationship between stature, body mass and isokinetic strength during growth and maturation. The importance that changes in body composition during growth have on isokinetic strength has been investigated using fat-free mass and muscle cross-sectional area. Data have shown that although fat-free mass and muscle cross-sectional area are important contributors to isokinetic strength, other unexplained factors also influence isokinetic strength development. Additional work needs to investigate possible qualitative changes in muscle during growth and maturation. More work is also needed to examine changes in eccentric strength with age and to investigate sex differences in upper body isokinetic strength. Future studies should preferably be longitudinal in nature and examine known covariates simultaneously using appropriate statistical techniques.