A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

Abstract

Purpose The deceleration (pressing) is a common situational pattern leading to anterior cruciate ligament (ACL) injury in football. Although mainly assessed for performance purposes, a stronger focus on movement quality might support the screening of at-risk athletes. The aim of the present study was to describe a 2D scoring system for the assessment of the deceleration task and to associate it with the knee joint loading (knee abduction moment) evaluated through the gold standard 3D motion capture. The hypothesis was that lower 2D scores would be associated with higher knee joint loading. Methods Thirty-four competitive football (soccer) players (age 22.8 ± 4.1, 16 females) performed a series of deceleration tasks. 3D motion analysis was recorded using ten stereophotogrammetric cameras, a force platform, and three high-speed cameras. The 2D qualitative assessment was performed via a scoring system based on the video analysis of frontal and lateral planes joint kinematics for five scoring criteria. The intra- and inter-rater reliabilities were calculated for each 2D scoring criteria. The peak knee abduction moment was extracted and grouped according to the results of the 2D evaluation. Results An ICC > 0.94 was found for all the 2D scoring criteria, both for intra-rater and inter-rater reliability. The players with low 2D frontal plane scores and low total scores (0–4) showed significantly higher peak knee abduction moment values (p < 0.001). A significant negative rank correlation was found between the total score and the peak knee abduction moment (ρ = − 0.25, p < 0.001). Conclusions The qualitative 2D scoring system described successfully discerned between athletes with high and low knee joint loading during a deceleration task. The application of this qualitative movement assessment based on a detailed and accurate scoring system is suitable to identify players and patients with high knee joint loading (high knee abduction moments) and target additional training in the scenario of the primary and secondary ACL injury risk reduction. Level of evidence Level IV.

Biomechanical and Neuromuscular Performance Requirements of Horizontal Deceleration: A Review with Implications for Random Intermittent Multi-Directional Sports

“…Furthermore, as the preparatory deceleration steps that have a greater impact on COD performance seem to occur in the sagittal plane, future research should investigate if deceleration capabilities measured during a COD task are associated with performance in that task only, or also with the deceleration capabilities in tasks without a COD. Such findings could lend further support for the use of horizontal acceleration-to-deceleration tasks without a COD for: (1) profiling a player's ability to decelerate rapidly prior to COD, (2) identifying athletes at a heightened risk of injury because of high-impact forces and knee joint loads [98,99] and (3) helping to determine when an athlete is ready to return to sport following injury [100][101][102][103].…”

The injury mechanism correlation between MRI and video-analysis in professional football players with an acute ACL knee injury reveals consistent bone bruise patterns

“…These new findings raise questions whether or not ACL injured athletes with “Typical” BB patterns should be treated differently after surgical stabilization. This sub-group of patients may need a high volume of neuromuscular training and increased attention on movement patterns, particularly related to the promotion to deceleration tasks or cutting mechanics [ 6 , 9 ], which should be implemented in the mid and late-stage rehabilitation process [ 4 ].…”

Anterior Cruciate Ligament Return to Play: Where Are We Now?

“…22 In a study that assessed the reliability of a 2D scoring system compared with 3D motion capture, Di Paolo et al used a deceleration task as the test of choice in their cohort, as sudden deceleration from a frontal sprint is a common scenario for ACL injury. 39 Another study did the same using a 90-degree change of direction at maximum speed. 45 Both motion patterns more closely recreate the conditions in which ACL injury occurs and it is possible that these types of assessments would better guide return to sport decision making and more closely identify athletes at risk of second ACL injury than the widely used criteria of muscle strength and hop tests.…”

“…While the authors suggest the utility of these assessments as a screening tool, they also recommend future validation studies, which may facilitate the inclusion of these assessments in return to sport criteria. 39 While not objective in nature, patient-reported functional and psychological outcomes play a part in return to sport. Fones et al 46 found that ACL return to sport after injury scores, which include both functional and psychological patientreported outcome measures (PROMs), as well as IKDC scores, were statistically higher in patients who returned to sport than in those who did not.…”