Augmented Feedback Supports Skill Transfer and Reduces High-Risk Injury Landing Mechanics

Abstract

Background There is a current need to produce a simple, yet effective method for screening and targeting possible deficiencies related to increased anterior cruciate ligament (ACL) injury risk. Hypothesis Frontal plane knee angle (FPKA) during a drop vertical jump will decrease upon implementing augmented feedback into a standardized sport training program. Study Design Controlled laboratory study. Methods Thirty-seven female participants (mean ± SD: age, 14.7 ±1.5 years; height, 160.9 ± 6.8 cm; weight, 54.5 ± 7.2 kg) were trained over 8 weeks. During each session, each participant received standardized training consisting of strength training, plyometrics, and conditioning. They were also videotaped running on a treadmill at a standardized speed and performing a repeated tuck jump for 10 seconds. Study participants were randomized into 2 groups and received augmented feedback on either their jumping (AF) or sprinting (CTRL) form. Average (mean of 3 trials) and most extreme (trial with greatest knee abduction) FPKA were calculated from 2-dimensional video captured during performance of the drop vertical jump. Results After testing, a main effect of time was noted, with the AF group reducing their FPKA average by 37.9% over the 3 trials while the CTRL group demonstrated a 26.7% reduction average across the 3 trials (P < .05). Conversely, in the most extreme drop vertical jump trial, a significant time-by-group interaction was noted (P < .05). The AF group reduced their most extreme FPKA by 6.9° (pretest, 18.4° ± 12.3°; posttest, 11.4° ± 10.1°) on their right leg and 6.5° (pretest, 16.3° ± 14.5°; posttest, 9.8° ± 10.7°) on their left leg, which represented a 37.7% and 40.1 % reduction in FPKA, respectively. In the CTRL group, no similar changes were noted in the right (pretest, 16.9° ± 14.3°; posttest, 14.0° ± 12.3°) or left leg (pretest, 9.8° ± 11.1°; posttest, 7.2° ± 9.2°) after training. Conclusion Providing athletes with augmented feedback on deficits identified by the tuck jump assessment has a positive effect on their biomechanics during a different drop vertical jump task that is related to increased ACL injury risk. The ability of the augmented feedback to support the transfer of skills and injury risk factor reductions across different tasks provides exciting new evidence related to how neuromuscular training may ultimately cross over into retained biomechanics that reduce ACL injuries during sport. Clinical Relevance The tuck jump assessment’s ease of use makes it a timely and economically favorable method to support ACL prevention strategies in young girls.

ACL Research Retreat VII: An Update on Anterior Cruciate Ligament Injury Risk Factor Identification, Screening, and Prevention

“…[275][276][277][278] However, expert modeling combined with self-modeling seems to be the most effective way to change landing biomechanics. 263,274,[279][280][281] Additionally, motor skills can be learned with an internal focus of attention (ie, on the movements themselves, as in ''flex your knees when landing'') or with an external focus of attention (ie, focus on the movement effect, as in ''touch the target as you land''). 282 Age-appropriate injury-prevention training programs can effectively modify biomechanics in children.…”

Reliability of knee biomechanics during a vertical drop jump in elite female athletes

“…Three-dimensional knee kinematics and kinetics, quantified using marker-based motion analysis systems, have been used to identify potential risk factors for ACL injuries [1,2]. Furthermore, knee kinematics and kinetics in vertical drop jumps are utilized for ACL injury risk assessment [2,3] and evaluation of training interventions [4,5].…”

Sport injuries treated at a physiotherapy center specialized in sports

“…Players of contact sports such as soccer and indoor soccer are more prone to injuries. At the same time, joint injuries also appear in modalities that do not involve physical contact such as volleyball; in this case, physical contact is not the main cause of injuries but jump is (24)(25)(26)(27). Jumping demands a lot of muscle power, at take off, and great joint stability to absorb the impact at the landing phase, where normal reaction force can reach values up to four times the body weight (26); such an impact may elicit several knee-related problems.…”

“…Jumping demands a lot of muscle power, at take off, and great joint stability to absorb the impact at the landing phase, where normal reaction force can reach values up to four times the body weight (26); such an impact may elicit several knee-related problems. For that reason, different prevention programs targeting volleyball have been discussed and recommended (25,27). In addition to the impact against the knee, there are other types of injuries related to rotation and angulation of the joint (e.g.…”