Effect of changes in motor skill induced by educational video program to decrease lower- limb joint load during cutting maneuvers: based on musculoskeletal modeling

Abstract

Background: This study investigated the effects of changes in motor skills from an educational video program on the kinematic and kinetic variables of the lower extremity joints and knee ligament load. Methods: Twenty participants (age: 22.2±2.60 y; height: 1.70±6.2 m; weight: 25.4±7.01 kg) were instructed to run at 4.5±0.2 m/s from a 5 m distance posterior to the force plate, land their foot on the force plate, and perform the cutting maneuver on the left. The educational video program for cutting maneuvers consisted of preparatory posture, foot landing orientation, gaze and trunk directions, soft landing, and eversion angle. The measured variables were the angle, angular velocity of lower extremity joints, ground reaction force (GRF), moment, and anterior cruciate ligament (ACL) and medial collateral ligament (MCL) forces through musculoskeletal modeling. Results: After the video feedback, the hip joint angles increased in flexion, abduction, and external rotation (p > 0.05), and the angular velocity increased in extension (p = 0.006). The ankle joint angles increased in dorsiflexion (p = 0.021), and the angular velocity decreased in dorsiflexion (p = 0.002) but increased in abduction (p = 0.002). The GRF increased in the anterior-posterior and medial-lateral directions and decreased vertically (p > 0.05). The hip joint moments decreased in extension and external rotation (p > 0.05) but increased in adduction (p = 0.038). The knee joint moments were decreased in extension, adduction, and external rotation (p > 0.05). The abduction moment of the ankle joint decreased (p = 0.000). There were differences in the support zone corresponding to 64‒87% of the hip frontal moment (p = 0.001) and 32‒100% of the hip horizontal moment (p < 0.001) and differences corresponding to 32‒100% of the knee frontal moment and 21‒100% of the knee horizontal moment (p < 0.001). The GRF varied in the support zone at 44‒95% in the medial-lateral direction and at 17‒43% and 73‒100% in the vertical direction (p < 0.001). Conclusions: Injury prevention feedback reduced the load on the lower extremity joints during cutting maneuvers, which reduced the knee ligament load, mainly on the MCL.