Association between frontal plane knee control and lower extremity injuries: a prospective study on young team sport athletes

Räisänen, Anu; Pasanen, Kati; Krosshaug, Tron; Vasankari, Tommi; Kannus, Pekka; Heinonen, Ari; Kujala, Urho M.; Avela, Janne; Perttunen, Jarmo; Parkkari, Jari

doi:10.1136/bmjsem-2017-000311

Cited by 44 publications

(52 citation statements)

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“…In the current study, we found no association between the FPKPA during the SLS and future lower extremity injuries. In our previous study among older team sport athletes (mean age 15.7 ± 1.8 years), we detected a significant association between FPKPA and acute lower extremity injury and acute ankle injury: Displaying high FPKPA was associated with a higher odds of injury . The association between frontal plane knee control and the risk of injuries has not been previously studied in young, under 14‐year‐old athletes.…”

Section: Discussionmentioning

confidence: 76%

“…The visual assessment of frontal plane knee control correlates well with the FPKPA, when assessment if performed by experienced observer. 30 Previous studies on young athletes have shown that reduced frontal plane knee control is associated with higher risk of future injuries, 29,39,44,45 although all the studies are not in agreement. 46 As reduced knee control has been identified as an injury risk factor, using movement control tests to identify athletes who could reduce their injury risk by improving knee control seems sensible.…”

Section: The Single-leg Squat Testmentioning

confidence: 97%

“…In our previous study among older team sport athletes (mean age 15.7 ± 1.8 years), we detected a significant association between FPKPA and acute lower extremity injury and acute ankle injury: Displaying high FPKPA was associated with a higher odds of injury. 29 The association between frontal plane knee control and the risk of injuries has not been previously studied in young, under 14-year-old athletes. Padua et al 36 have utilized another field assessment test, the Landing Error Scoring System, to study the association between high-risk movement patterns and the risk of anterior cruciate ligament injury.…”

Section: Fpkpa and The Risk Of Lower Extremity Injurymentioning

confidence: 99%

“…27 A recent study on children and adolescents found no differences between boys and girls in the SLS performance scores based on visual assessment. 28 In our previous study, greater FPKPA during the SLS was associated with a higher risk of acute lower extremity injury and acute ankle injury in young (mean age 15.7 years) team sport athletes, 29 but there are no previous studies on this topic in subjects under the age of 14 years.…”

mentioning

confidence: 94%

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Investigation of knee control as a lower extremity injury risk factor: A prospective study in youth football

Räisänen

Arkkila

Vasankari

et al. 2018

Scandinavian Med Sci Sports

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This prospective study in youth football examined the relationship between frontal plane knee projection angle (FPKPA) during the single-leg squat and sustaining an acute lower extremity injury or acute non-contact lower extremity injury. Secondly, side-to-side asymmetry in FPKPA and sex as injury risk factors were explored. In addition, we investigated the influence of age, sex, and leg dominance on the FPKPA. A total of 558 youth football players (U11 to U14) participated in the single-leg squat test and prospective injury registration. FPKPA was not found as a risk factor for injuries at this age. There was no difference in the mean FPKPA between sexes. However, FPKPA was associated with age; oldest subjects displayed the smallest FPKPA. Among boys, the frontal plane knee control improved by age. Among girls, the relationship between age and FPKPA was not as clear, but the oldest girls displayed the smallest mean FPKPA in the study (12.2° ± 8.3°). The FPKPA was greater on the dominant kicking leg compared to the non-dominant support leg (P < .001 for boys, P = .001 for girls). However, side-to-side asymmetry in FPKPA was not associated with future injuries. In conclusion, frontal plane knee control in the single-leg squat was not associated with lower extremity injuries among young football players. As the single-leg squat to 90° knee flexion was too demanding for many subjects, easier single-leg squat test procedure or a different movement control test, such as a double-legged squat, could be more suitable for the young football players.

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Section: Discussionmentioning

confidence: 76%

Section: The Single-leg Squat Testmentioning

confidence: 97%

Section: Fpkpa and The Risk Of Lower Extremity Injurymentioning

confidence: 99%

mentioning

confidence: 94%

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Investigation of knee control as a lower extremity injury risk factor: A prospective study in youth football

Räisänen

Arkkila

Vasankari

et al. 2018

Scandinavian Med Sci Sports

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“…Knee valgus loading, high vertical ground reaction force as well as limited knee and hip flexion during a vertical drop jump task have been associated with ACL injury risk in young female athletes. A recent study suggested association between excessive knee valgus during a single‐leg squat and a risk of LE injuries as well as ankle injuries . Furthermore, a combination of knee valgus and lateral trunk motion during a single‐leg drop jump has been suggested being associated with increased risk of non‐contact knee injuries .…”

Section: Introductionmentioning

confidence: 99%

Altered hip control during a standing knee‐lift test is associated with increased risk of knee injuries

Leppänen

Rossi

Parkkari

et al. 2020

Scandinavian Med Sci Sports

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A few prospective studies have investigated hip and pelvic control as a risk factor for lower extremity (LE) injuries. The purpose of this study was to investigate whether deficits in hip and lumbopelvic control during standing knee‐lift test are associated with increased risk of acute knee and LE injuries in youth team sports. At baseline, 258 basketball and floorball players (aged 12‐21 years) participated in a standing knee‐lift test using 3‐dimensional motion analysis. Two trials per leg were recorded from each participant. Peak sagittal plane pelvic tilt and frontal plane pelvic drop/hike were measured. Both continuous and categorical variables were analyzed. New non‐contact LE injuries, and match and training exposure, were recorded for 12 months. Seventy acute LE injuries were registered. Of these, 17 were knee injuries (eight ACL ruptures) and 35 ankle injuries. Risk factor analyses showed that increased contralateral pelvic hike was significantly associated with knee injury risk when using categorical variable (HR for high vs low group 4.07; 95% CI 1.32‐12.6). Furthermore, significant association was found between high lateral pelvic hike angles and ACL injury risk in female players (HR for high vs low group 9.10; 95% CI 1.10‐75.2). Poor combined sensitivity and specificity of the test was observed. In conclusion, increased contralateral pelvic hike is associated with non‐contact knee injury risk among young team sport players and non‐contact ACL injuries among female players. More research to determine the role of pelvic control as a risk factor for knee injuries is needed.

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Consequences of Juvenile Idiopathic Arthritis on Single Leg Squat Performance in Youth

Kuntze

Nettel-Aguirre

Brooks

et al. 2021

Arthritis Care & Research

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Objective. Juvenile idiopathic arthritis (JIA) affects body structure and function outcomes that may increase the risk of acute joint injury. The purpose of this study was to examine single leg squat (SLS) biomechanics for youth with JIA and their healthy peers. The study design was a matched pair cohort study.Methods. Sixty-five youth (JIA n = 30; control n = 35) participated in this ethics-approved study. Participants performed 3 sets of 5 consecutive SLS tasks. Disease activity and functional status were assessed using the Juvenile Arthritis Disease Activity Score and Child Health Assessment Questionnaire. Indexed (most-affected leg [JIA]; dominant leg [control]) and contralateral extremity biomechanics were obtained using a 12-camera system. Outcomes included hip flexion/extension (FE), adduction/abduction (AA), and internal/external (IE) rotation range of motion (ROM). Data were analyzed using a multivariate random coefficient model in R (α⍺ = 0.05).Results. A total of 29 matched pairs were analyzed. Youth with JIA had low disease activity and performed the SLS with a more internally rotated hip (indexed leg P = 0.023, β = -1.9°). Female participants displayed greater hip FE (indexed leg P = 0.015, β = -4.3°; contralateral leg P = 0.005, β = -4.8°) and IE ROM (indexed leg P = 0.021, β = -2.1°) than male participants. Associations were observed for body mass index and hip IE ROM (contralateral leg P = 0.001, β = -0.4°), knee flexion angle, and hip FE ROM (indexed leg P = 0.001, β = 0.4°; contralateral leg P = 0.001, β = 0.5°) and AA (indexed leg P = 0.010, β = 0.1°; contralateral leg P = 0.002, β = 0.2°).Conclusion. This study identified functional alterations for an SLS in youth with JIA. These findings support the use of physical therapy as part of a multidisciplinary management approach, to restore normal hip posture and movement.

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Association between frontal plane knee control and lower extremity injuries: a prospective study on young team sport athletes

Cited by 44 publications

References 45 publications

Investigation of knee control as a lower extremity injury risk factor: A prospective study in youth football

Investigation of knee control as a lower extremity injury risk factor: A prospective study in youth football

Altered hip control during a standing knee‐lift test is associated with increased risk of knee injuries

Consequences of Juvenile Idiopathic Arthritis on Single Leg Squat Performance in Youth

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