Unanticipated mid-flight external trunk perturbation increased frontal plane ACL loading variables during sidestep cuttings.

Unanticipated trunk perturbation is commonly observed when anterior cruciate ligament (ACL) injuries occur during direction-changing manoeuvres. This study aimed to quantify the effect of mid-flight medial-lateral external trunk perturbation directions/locations on ACL loading variables during sidestep cuttings. Thirty-two recreational athletes performed sidestep cuttings under combinations of three perturbation directions (no-perturbation, ipsilateral-perturbation, and contralateral-perturbation relative to the cutting leg) and two perturbation locations (upper-trunk versus lower-trunk). The pushing perturbation was created by customised devices releasing a slam ball to contact participants near maximum jump height prior to cutting. Perturbation generally resulted in greater peak vertical ground reaction force and slower cutting velocity. Upper-trunk contralateral perturbation showed the greatest lateral trunk bending away from the travel direction, greatest peak knee flexion and abduction angles, and greatest peak internal knee adduction moments compared to other conditions. Such increased ACL loading variables were likely due to the increased lateral trunk bending and whole-body horizontal velocity away from the cutting direction caused by the contralateral perturbation act at the upper trunk. The findings may help understand the mechanisms of indirect contact ACL injuries and develop effective cutting techniques for ACL injury prevention.

Falling decreased anterior cruciate ligament loading variables during single-leg landings after mid-flight external trunk perturbation.

Mid-flight external upper-trunk perturbation is associated with increased anterior cruciate ligament (ACL) injury risk during landing. This study aimed to assess the effect of natural, soft, and falling landing techniques on knee mechanics and vertical ground reaction forces (VGRF) during single-leg landings with/without mid-flight medial-lateral external upper-trunk pushing perturbation. Twenty-eight participants performed single-leg landings using the three landing techniques with/without mid-flight pushing perturbation. The perturbation was created by a customized apparatus releasing a slam ball and pushing the participants near the peak jump height at the upper trunk. Perturbation resulted in significantly greater lateral trunk bending angles, knee flexion angles at initial contact, peak knee abduction angles, and peak knee adduction moments compared to no perturbation. The falling condition significantly demonstrated the greatest lateral trunk bending angles, knee flexion angles, and peak knee external rotation moments and the smallest peak knee abduction angles, peak VGRF, and peak knee extension moments compared to natural/soft landings regardless of perturbation conditions. Mid-flight external perturbation resulted in variables associated with greater ACL loading during single-leg landings. Falling demonstrated variables associated with smaller ACL loading, particularly for perturbation conditions. Incorporating falling techniques into jump-landing training programs may guide players to safely fall on the ground when perturbation occurs. Falling provides an alternative strategy to potentially decrease indirect contact ACL injury risk when the sports environment allows.

The influence of decision making and divided attention on lower limb biomechanics associated with anterior cruciate ligament injury: a narrative review.

Cognitive loads have been shown to influence anterior cruciate ligament (ACL) injury risk. Two main sources of cognitive loads that athletes experience are decision making and dividing attention between multiple tasks. The aim of this paper was to review previous studies examining the effects of decision making and divided attention on lower limb biomechanics during landing and cutting. Previous research has shown decision making to significantly influence a number of biomechanical variables associated with increased risk of ACL injury, such as reduced knee flexion at initial contact, increased knee valgus angles, increased knee extension moment and increased knee valgus moment in decision-making tasks compared to pre-planned tasks. Furthermore, dividing attention between multiple tasks has been shown to result in reduced knee flexion at initial contact, increased vertical ground reaction force, and reduced stability during landing/cutting. The changes in lower limb biomechanics observed as a result of both decision making and dividing attention are likely due to a reduced ability to anticipate ground contact and implement protective movement patterns associated with reduced ACL loading. Collectively, these findings emphasise the need for tasks that incorporate decision making and divided attention when investigating ACL injury mechanisms and developing ACL injury risk screening assessments.

Trunk motion and anterior cruciate ligament injuries: a narrative review of injury videos and controlled jump-landing and cutting tasks.

The aims of this narrative review were to summarise trunk motion and external trunk perturbation observed in anterior cruciate ligament (ACL) injury videos and to review the association between trunk motion and ACL loading variables in controlled jump-landing and cutting tasks in non-injured populations. Video analyses have shown limited trunk flexion and increased trunk lateral bending towards the injured leg are associated with increased risk of ACL injuries, while trunk axial rotation away from the injured leg is more frequent than rotation towards the injured leg. Contact with the trunk before and at the time of the injury is common and might increase the risk of ACL injury. Controlled jump-landing and cutting studies have shown that limited trunk flexion and increased trunk lateral bending are associated with increased ACL loading. However, the findings of trunk axial rotation are not consistent with most video analyses. Mid-flight external trunk perturbation could increase ACL loading variables for one leg and is consistent with the videos of trunk-contact ACL injuries. These findings may help understand the role of trunk motion on primary ACL injury mechanisms and improve ACL injury screening tasks and ACL injury prevention strategies with the consideration of trunk motion.

Indirect contact matters: Mid-flight external trunk perturbation increased unilateral anterior cruciate ligament loading variables during jump-landings.

PURPOSE: To determine the effect of unanticipated mid-flight medial-lateral external perturbation of the upper or lower trunk on anterior cruciate ligament (ACL) loading variables during jump-landings. METHODS: Thirty-two participants performed double-leg vertical jump-landings while bilateral kinematics and kinetics were collected under 6 conditions (upper or lower trunk perturbation locations; no, left, or right perturbation directions). Two customized catapult apparatuses were created to apply pushing perturbation to participants near the maximal jump height. RESULTS: The ball contacted participants near the center of mass for the lower-trunk conditions and approximately 23 cm above the center of mass for the upper-trunk conditions. Under upper-trunk perturbation, the contralateral leg demonstrated significantly smaller knee flexion angles at initial contact and greater peak knee abduction angles, peak vertical ground reaction forces, peak knee extension moments, and peak knee adduction moments compared to other legs among all conditions. Under lower-trunk perturbation, the contralateral leg showed significantly smaller knee flexion angles at initial contact and increased peak vertical ground reaction forces and peak knee extension moments compared to legs in the no-perturbation conditions. CONCLUSION: Mid-flight external trunk pushing perturbation increased ACL loading variables for the leg contralateral to the perturbation. The upper-trunk perturbation resulted in greater changes in ACL loading variables compared to the lower-trunk perturbation, likely due to trunk and ipsilateral leg rotation and more laterally located center of mass relative to the contralateral leg. These findings may help us understand the mechanisms of indirect-contact ACL injuries and develop jump-landing training strategies under mid-flight trunk perturbation to better prevent ACL injury.

Lower Limb Asymmetry After Anterior Cruciate Ligament Reconstruction in Adolescent Athletes: A Systematic Review and Meta-Analysis.

OBJECTIVES: To identify reported (1) common biomechanical asymmetries in the literature after anterior cruciate ligament (ACL) reconstruction in adolescents during landing and (2) timescales for asymmetry to persist postsurgery. DATA SOURCES: We identified sources by searching the CINAHL, PubMed, Scopus, and SPORTDiscus electronic databases using the following search terms: asymmetry OR symmetry AND landing AND biomechanics OR kinematics OR kinetics. STUDY SELECTION: We screened the titles and abstracts of 85 articles using our inclusion criteria. A total of 13 articles were selected for further analysis. DATA EXTRACTION: Three reviewers independently assessed the methodologic quality of each study. We extracted the effect sizes directly from studies or calculated them for biomechanical variables assessing asymmetry between limbs of participants with ACL reconstruction. We conducted meta-analyses on variables that were assessed in multiple studies for both double- and single-limb landings. DATA SYNTHESIS: Asymmetry was more commonly identified in kinetic than kinematic variables. Anterior cruciate ligament reconstruction appeared to have a large effect on asymmetry between limbs for peak vertical ground reaction force, peak knee-extension moment, and loading rate during double-limb landings, as well as mean knee-extension moment and knee energy absorption during both double- and single-limb landings. CONCLUSIONS: Our findings suggested that return-to-sport criteria after ACL reconstruction should incorporate analysis of the asymmetry in loading experienced by each limb rather than movement patterns alone.

Full gait cycle analysis of lower limb and trunk kinematics and muscle activations during walking in participants with and without ankle instability.

BACKGROUND: Chronic ankle instability (CAI) has previously been linked to altered lower limb kinematics and muscle activation characteristics during walking, though little research has been performed analysing the full time-series across the stance and swing phases of gait. RESEARCH QUESTION: The aim of this study was to compare trunk and lower limb kinematics and muscle activity between those with chronic ankle instability and healthy controls. METHODS: Kinematics and muscle activity were measured in 18 (14 males, 4 females) healthy controls (age 22.4 ±â€¯3.6 years, height 177.8 ±â€¯7.6 cm, mass 70.4 ±â€¯11.9 kg, UK shoe size 8.4 ±â€¯1.6), and 18 (13 males, 5 females) participants with chronic ankle instability (age 22.0 ±â€¯2.7 years, height 176.8 ±â€¯7.9 cm, mass 74.1 ±â€¯9.6 kg, UK shoe size 8.1 ±â€¯1.9) during barefoot walking trials, using a combined Helen Hayes and Oxford foot model. Surface electromyography (sEMG) was recorded for the tibialis anterior and gluteus medius. Full curve statistical parametric mapping was performed using independent and paired-samples T-tests. RESULTS: No significant differences were observed in kinematic or sEMG variables between or within groups for the duration of the swing phase of gait. A significantly increased forefoot-tibia inversion was seen in the CAI affected limb when compared to the CAI unaffected limb at 4-16% stance (p = 0.039). No other significant differences were observed. SIGNIFICANCE: There appears to be no differences in muscle activation and movement between CAI and healthy control groups. However, participants with CAI exhibited increased inversion patterns during the stance phase of gait in their affected limb compared to their unaffected limb. This may predispose those with CAI to episodes of giving way and further ankle sprains.

Accelerometery and Heart Rate Responses of Professional Fast-Medium Bowlers in One-Day and Multi-Day Cricket.

The physical demands of fast-medium bowling are increasingly being recognised, yet comparative exploration of the differing demands between competitive formats (i.e. one-day [OD] versus multi-day [MD] matches) remain minimal. The aim of this study was to describe in-match physiological profiles of professional fast-medium bowlers from England across different versions of competitive matches using a multivariable wearable monitoring device. Seven professional cricket fast-medium bowlers wore the BioharnessTM monitoring device during matches, over three seasons (>80 hours in-match). Heart Rate (HR) and Acceleromety (ACC) was compared across match types (OD, MD) and different in-match activity states (Bowling, Between over bowling, Fielding). Peak acceleration during OD bowling was significantly higher in comparison to MD cricket ([OD vs. MD] 234.1 ± 57.9 vs 226.6 ± 32.9 ct·episode-1, p < 0.05, ES = 0.11-0.30). Data for ACC were also higher during OD than MD fielding activities (p < 0.01, ES = 0.11-.30). OD bowling stimulated higher mean HR responses (143 ± 14 vs 137 ± 16 beats·min-1, p < 0.05, ES = 0.21) when compared to MD matches. This increase in OD cricket was evident for both between over (129 ± 9 vs 120 ± 13 beats·min-1,p < 0.01, ES = 0.11-0.50) and during fielding (115 ± 12 vs 106 ± 12 beats·min-1, p < 0.01, ES = 0.36) activity. The increased HR and ACC evident in OD matches suggest greater acute physical loads than MD formats. Therefore, use of wearable technology and the findings provided give a valuable appreciation of the differences in match loads, and thus required physiological preparation and recovery in fast-medium bowlers.

The effect of dimple error on the horizontal launch angle and side spin of the golf ball during putting.

This study aimed to examine the effect of the impact point on the golf ball on the horizontal launch angle and side spin during putting with a mechanical putting arm and human participants. Putts of 3.2 m were completed with a mechanical putting arm (four putter-ball combinations, total of 160 trials) and human participants (two putter-ball combinations, total of 337 trials). The centre of the dimple pattern (centroid) was located and the following variables were measured: distance and angle of the impact point from the centroid and surface area of the impact zone. Multiple regression analysis was conducted to identify whether impact variables had significant associations with ball roll variables, horizontal launch angle and side spin. Significant associations were identified between impact variables and horizontal launch angle with the mechanical putting arm but this was not replicated with human participants. The variability caused by "dimple error" was minimal with the mechanical putting arm and not evident with human participants. Differences between the mechanical putting arm and human participants may be due to the way impulse is imparted on the ball. Therefore it is concluded that variability of impact point on the golf ball has a minimal effect on putting performance.

The effect of repetitive ankle perturbations on muscle reaction time and muscle activity.

The use of a tilt platform to simulate a lateral ankle sprain and record muscle reaction time is a well-established procedure. However, a potential caveat is that repetitive ankle perturbation may cause a natural attenuation of the reflex latency and amplitude. This is an important area to investigate as many researchers examine the effect of an intervention on muscle reaction time. Muscle reaction time, peak and average amplitude of the peroneus longus and tibialis anterior in response to a simulated lateral ankle sprain (combined inversion and plantar flexion movement) were calculated in twenty-two physically active participants. The 40 perturbations were divided into 4 even groups of 10 dominant limb perturbations. Within-participants repeated measures analysis of variance (ANOVA) tests were conducted to assess the effect of habituation over time for each variable. There was a significant reduction in the peroneus longus average amplitude between the aggregated first and last 10 consecutive ankle perturbations (F2.15,45.09=3.90, P=0.03, ɳp(2)=0.16). Authors should implement no more than a maximum of 30 consecutive ankle perturbations (inclusive of practice perturbations) in future protocols simulating a lateral ankle sprain in an effort to avoid significant attenuation of muscle activity.

Reliability of an experimental method to analyse the impact point on a golf ball during putting.

This study aimed to examine the reliability of an experimental method identifying the location of the impact point on a golf ball during putting. Forty trials were completed using a mechanical putting robot set to reproduce a putt of 3.2 m, with four different putter-ball combinations. After locating the centre of the dimple pattern (centroid) the following variables were tested; distance of the impact point from the centroid, angle of the impact point from the centroid and distance of the impact point from the centroid derived from the X, Y coordinates. Good to excellent reliability was demonstrated in all impact variables reflected in very strong relative (ICC = 0.98-1.00) and absolute reliability (SEM% = 0.9-4.3%). The highest SEM% observed was 7% for the angle of the impact point from the centroid. In conclusion, the experimental method was shown to be reliable at locating the centroid location of a golf ball, therefore allowing for the identification of the point of impact with the putter head and is suitable for use in subsequent studies.

The effects of bag style on muscle activity of the trapezius, erector spinae and latissimus dorsi during walking in female university students.

Back pain is common in adolescents which has been associated with carrying a bag. However, there is little research examining the effects of bag style in female adolescents. The aim of the study was to investigate the effects of different bag conditions on muscle activity of the trapezius, erector spinae and latissimus dorsi muscles in female university students during walking. Twelve female university students walked on a treadmill for 5 minutes at 1.1 m/s during five conditions; control, 1 strapped rucksack, 2 strapped rucksack, ipsilateral shoulder strap and contralateral shoulder strap, each containing 10% bodyweight. Electromyography for the trapezius, erector spinae and latissimus dorsi was recorded for the last 30 s of each condition. Two-way ANOVA and paired t-tests were used to identify differences between right and left muscles and between bag conditions. Results showed that muscle activity of the left trapezius was significantly higher than the right trapezius during the 1 strap rucksack condition. For the left trapezius, the 2 strapped rucksack and the control condition had significantly lower muscle activity compared to the 1 strapped rucksack and the ipsilateral shoulder strap. For the left erector spinae muscle, there was significantly greater muscle activity when wearing the contralateral shoulder strap compared to the control. For the right erector spinae, significantly lower muscle activity was observed when wearing the 2 strapped rucksack compared to the ipsilateral shoulder strap and contralateral shoulder strap. There were no significant differences in muscle activity of the latissimus dorsi muscles between any of the bag conditions. These findings suggest that a two strapped rucksack should be used when carrying loads to reduce spinal muscle activity which may, in turn, reduce reports of back pain in female adolescents.

A review of recent perspectives on biomechanical risk factors associated with anterior cruciate ligament injury.

There is considerable evidence to support a number of biomechanical risk factors associated with non-contact anterior cruciate ligament (ACL) injury. This paper aims to review these biomechanical risk factors and highlight future directions relating to them. Current perspectives investigating trunk position and relationships between strength, muscle activity and biomechanics during landing/cutting highlight the importance of increasing hamstring muscle force during dynamic movements through altering strength, muscle activity, muscle length and contraction velocity. In particular, increased trunk flexion during landing/cutting and greater hamstring strength are likely to increase hamstring muscle force during landing and cutting which have been associated with reduced ACL injury risk. Decision making has also been shown to influence landing biomechanics and should be considered when designing tasks to assess landing/cutting biomechanics. Coaches should therefore promote hamstring strength training and active trunk flexion during landing and cutting in an attempt to reduce ACL injury risk.

The athletic profile of fast bowling in cricket: a review.

Cricket is a global sport played in over 100 countries with elite performers attracting multimillion dollar contracts. Therefore, performers maintaining optimum physical fitness and remaining injury free is important. Fast bowlers have a vital position in a cricket team, and there is an increasing body of scientific literature that has reviewed this role over the past decade. Previous research on fast bowlers has tended to focus on biomechanical analysis and injury prevention in performers. However, this review aims to critically analyze the emerging contribution of physiological-based literature linked to fast bowling in cricket, highlight the current evidence related to simulated and competitive in-match performance, and relate this practically to the conditioning coach. Furthermore, the review considers limitations with past research and possible avenues for future investigation. It is clear with the advent of new applied mobile monitoring technology that there is scope for more ecologically valid and longitudinal exploration capturing in-match data, providing quantification of physiological workloads, and analysis of the physical demands across the differing formats of the game. Currently, strength and conditioning specialists do not have a critical academic resource with which to shape professional practice, and this review aims to provide a starting point for evidence in the specific area.

Bioharness(™) multivariable monitoring device: part. I: validity.

The Bioharness(™) monitoring system may provide physiological information on human performance but there is limited information on its validity. The objective of this study was to assess the validity of all 5 Bioharness(™) variables using a laboratory based treadmill protocol. 22 healthy males participated. Heart rate (HR), Breathing Frequency (BF) and Accelerometry (ACC) precision were assessed during a discontinuous incremental (0-12 km·h(-1)) treadmill protocol. Infra-red skin temperature (ST) was assessed during a 45 min(-1) sub-maximal cycle ergometer test, completed twice, with environmental temperature controlled at 20 ± 0.1 °C and 30 ± 0.1 °C. Posture (P) was assessed using a tilt table moved through 160°. Adopted precision of measurement devices were; HR: Polar T31 (Polar Electro), BF: Spirometer (Cortex Metalyser), ACC: Oxygen expenditure (Cortex Metalyser), ST: Skin thermistors (Grant Instruments), P:Goniometer (Leighton Flexometer). Strong relationships (r = .89 to .99, p < 0.01) were reported for HR, BF, ACC and P. Limits of agreement identified differences in HR (-3.05 ± 32.20 b·min(-1)), BF (-3.46 ± 43.70 br·min(-1)) and P (0.20 ± 2.62°). ST established a moderate relationships (-0.61 ± 1.98 °C; r = 0.76, p < 0.01). Higher velocities on the treadmill decreased the precision of measurement, especially HR and BF. Global results suggest that the BioharressTM is a valid multivariable monitoring device within the laboratory environment. Key pointsDifferent levels of precision exist for each variable in the Bioharness(™) (Version 1) multi-variable monitoring deviceAccelerometry and posture variables presented the most precise dataData from the heart rate and breathing frequency variable decrease in precision at velocities ≥ 10 km·h(-1)Clear understanding of the limitations of new applied monitoring technology is required before it is used by the exercise scientist.

Bioharness(™) Multivariable Monitoring Device: Part. II: Reliability.

The Bioharness(™) monitoring system may provide physiological information on human performance but the reliability of this data is fundamental for confidence in the equipment being used. The objective of this study was to assess the reliability of each of the 5 Bioharness(™) variables using a treadmill based protocol. 10 healthy males participated. A between and within subject design to assess the reliability of Heart rate (HR), Breathing Frequency (BF), Accelerometry (ACC) and Infra-red skin temperature (ST) was completed via a repeated, discontinuous, incremental treadmill protocol. Posture (P) was assessed by a tilt table, moved through 160°. Between subject data reported low Coefficient of Variation (CV) and strong correlations(r) for ACC and P (CV< 7.6; r = 0.99, p < 0.01). In contrast, HR and BF (CV~19.4; r~0.70, p < 0.01) and ST (CV 3.7; r = 0.61, p < 0.01), present more variable data. Intra and inter device data presented strong relationships (r > 0.89, p < 0.01) and low CV (<10.1) for HR, ACC, P and ST. BF produced weaker relationships (r < 0.72) and higher CV (<17.4). In comparison to the other variables BF variable consistently presents less reliability. Global results suggest that the Bioharness(™) is a reliable multivariable monitoring device during laboratory testing within the limits presented. Key pointsHeart rate and breathing frequency data increased in variance at higher velocities (i.e. ≥ 10 km.h(-1))In comparison to the between subject testing, the intra and inter reliability presented good reliability in data suggesting placement or position of device relative to performer could be important for data collectionUnderstanding a devices variability in measurement is important before it can be used within an exercise testing or monitoring setting.

Field based reliability and validity of the bioharness™ multivariable monitoring device.

The Bioharness™ device is designed for monitoring physiological variables in free-living situations but has only been proven to be reliable and valid in a laboratory environment. Therefore, this study aimed to determine the reliability and validity of the Bioharness™ using a field based protocol. Twenty healthy males participated. Heart rate (HR), breathing frequency (BF) and accelerometry (ACC) were assessed by simultaneous measurement of two Bioharness™ devices and a test-retest of a discontinuous incremental walk-jog-run protocol (4 - 11 km·h(-1)) completed in a sports hall. Adopted precision of measurement devices were; HR: Polar T31 (Polar Electro), BF: Spirometer (Cortex Metalyser), ACC: Oxygen expenditure (Cortex Metalyser). For all data, precision of measurement reported good relationships (r = 0.61 to 0.67, p < 0.01) and large Limits of Agreement for HR (>79.2 b·min(-1)) and BF (>54.7 br·min(-1)). ACC presented excellent precision (r = 0.94, p < 0.01). Results for HR (r= ~0.91, p < 0.01: CV <7.6) and ACC (r > 0.97, p < 0.01; CV <14.7) suggested these variables are reliable. BF presented more variable data (r = 0.46-0.61, p < 0.01; CV < 23.7). As velocity of movement increased (>8 km·h(-1)) data became more erroneous. A data cleaning protocol removed gross errors in the data analysis and subsequent reliability and validity statistics improved across all variables. In conclusion, the Bioharness™ HR and ACC variables have demonstrated reliability and validity in a field setting, though data collected at higher velocities should be treated with caution. Measuring human physiological responses in a field based environment allows for more ecologically valid data to be collected and devices such as the Bioharness™ could be used by exercise professionals to begin to further investigate this area.

The effects of opposition and gender on knee kinematics and ground reaction force during landing from volleyball block jumps.

The aim of this study was to examine the effect of opposition and gender on knee kinematics and ground reaction force during landing from a volleyball block jump. Six female and six male university volleyball players performed two landing tasks: (a) an unopposed and (b) an opposed volleyball block jump and landing. A 12-camera motion analysis system (120 Hz) was used to record knee kinematics, and a force platform (600 Hz) was used to record ground reaction force during landing. The results showed a significant effect for level of opposition in peak normalized ground reaction force (p = .04), knee flexion at ground contact (p = .003), maximum knee flexion (p = .001), and knee flexion range of motion (p = .003). There was a significant effect for gender in maximum knee flexion (p = .01), knee flexion range of motion (p = .001), maximum knee valgus angle (p = .001), and knee valgus range of motion (p = .001). The changes in landing biomechanics as a result of opposition suggest future research on landing mechanics should examine opposed exercises, because opposition may significantly alter neuromuscular responses.