Fatigue Increases Dynamic Knee Valgus in Youth Athletes: Results From a Field-Based Drop-Jump Test

Fidai, Mohsin S.; Okoroha, Kelechi R.; Meldau, Jason E.; Meta, Fabien; Lizzio, Vincent A.; Borowsky, Peter; Redler, Lauren H.; Moutzouros, Vasilios; Makhni, Eric C.

doi:10.1016/j.arthro.2019.07.018

Cited by 10 publications

(8 citation statements)

References 43 publications

(47 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Third, post-operative rehabilitation leading up to the study was not controlled, and may have varied greatly based on the treating rehabilitation specialist; this is an important factor to consider as treatment varies significantly based on clinical specialty and experience level. 32,33 Based on the results of the current study, it is possible that increased focus on the CON throughout the course of rehabilitation could have altered results. Mirkov et al 33 and Hiemstra et al 34 highlight the effect of initial ACL injury on both the contractile and neural properties of the muscle, but as a whole, current studies fail to fully quantify and explain the magnitude of the detraining and initial injury on the CONTROL limb.…”

Section: Discussionmentioning

confidence: 95%

The Role of Fatigue in Return to Sport Testing Following Anterior Cruciate Ligament Reconstruction

Tallard

Hedt

Lambert

et al. 2021

International Journal of Sports Physical Therapy

View full text Add to dashboard Cite

Background Fatigue may play a role in anterior cruciate ligament (ACL) injury, but has not been incorporated into objective test batteries for return to sport decisions following ACL reconstruction (ACLR) surgery. The effect of fatigue on muscle function and performance following surgery and rehabilitation has been poorly studied. Purpose/Hypothesis The purpose of this study was to assess the effect of fatigue on performance of various hop tests used in clinical rehabilitation settings by examining LSI scores. The authors hypothesized that participants will have worse limb symmetry index scores following the fatigue protocol and that the operative limb (ACLR) will have a greater decline in function than the non-operative limb (CON). Study Design Cross-Sectional Study. Methods Participants (n=21 [Male = 15, Female = 6]; AGE = 24.6 ± 9.3) were at least six months post ACLR and in rehabilitation. Testing was performed over two separate sessions in either a non-fatigued (NFS) or fatigued state (FS). In the FS, individuals performed a series of exercises to exhaust muscular endurance, strength, and power systems, after which they performed as battery of seven hop tests (single hop for distance, triple hop for distance, crossover hop for distance, 6-meter timed hop, lateral rotation hop for distance, medial rotation hop for distance, and vertical jump for height). A 2(limb) x 2(time) ANOVA was used to compare limbs between each state. Results Differences between limbs (CON vs ACLR) were observed for all hop tests in the NFS whereby the ACLR limb was observed to have reduced performance (↓5.4-9.1%, p <0.05). When tested in the FS, significant differences in performance between limbs remained for only the crossover (↓4.9%), medial rotation (↓7.1%), lateral rotation (↓5.5%), and vertical hop (↓10.0%)( p <0.05). When comparing the NFS and FS states, only the CON limb was observed to have significant decreases in performance of the Triple Hop (↓7.4%), Crossover (↓8.7%), and Lateral Rotation (↓5.2%)( p <0.05). Conclusions Following ACL reconstruction, there appears to be a greater loss in jump performance in the CON limb in the FS. These findings suggest it may be crucial to consider and assess the endurance of both limbs rather than just the ACLR limb when determining readiness for return to play. Level of Evidence Level 3

show abstract

Section: Discussionmentioning

confidence: 95%

The Role of Fatigue in Return to Sport Testing Following Anterior Cruciate Ligament Reconstruction

Tallard

Hedt

Lambert

et al. 2021

International Journal of Sports Physical Therapy

View full text Add to dashboard Cite

show abstract

“…27 In the present study, 122 of the 293 (41.6%) ACL injuries initially identified, and 15 of the 45 (33.3%) included in the final analysis, occurred in speed position players. As this biomechanical, noncontact pivoting mechanism may be related to fatigue from overuse and neuromuscular deconditioning, 28,29 it is prudent to continue evaluating whether "load management" strategies are effective in reducing the risk of reinjury. 30,31 Given the prevalence z Adjusted mean differences compared between groups.…”

Section: Discussionmentioning

confidence: 99%

Game Utilization and Performance Following RTP From ACL Reconstruction Does not Influence a Subsequent Second ACL Injury in National Football League Players

Khalil

Lindsay-Rivera

Abbas

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

Self Cite

View full text Add to dashboard Cite

The purpose of this study is to evaluate differences in game utilization or performance following primary anterior cruciate ligament (ACL) reconstruction between National Football League (NFL) players with and without a second ACL injury. Methods: NFL players who underwent ACL reconstruction between 2013 and 2017 were identified. Players were classified as having one injury ("tear") or having later sustained a subsequent second (reinjury or contralateral) ACL injury ("retear"). Players were excluded if they tore their ACL prior to the NFL, did not return to play (RTP), did not play the season before injury, or had concomitant injuries. Demographic characteristics, game utilization statistics, and season approximate value (SAV) performance metrics were recorded. Statistical analysis compared data after RTP from primary ACL reconstruction (seasons þ1, þ2, and þ3) relative to the season before injury (season À1) between cohorts using mean differences and relative percentages. Results: Analysis included a total of 45 players, 32 in the "tear" group and 13 in the "retear" group. Demographics, level of play, and time to RTP after primary ACL reconstruction did not differ between the groups (P > .05). Tear and retear groups demonstrated similar utilization and performance metrics the season prior to injury (À1) and the 3 seasons following RTP (season of injury is "0"). Both groups had a similar decrease (relative percentage) in games played and started, snap counts, and SAV during the 3 seasons following RTP compared to baseline (P > .05). The draft pick position was correlated with the relative percentage of games started the first season after RTP (r ¼ .6, P ¼ .02). Conclusions: Game utilization and performance metrics following ACL reconstruction were not associated with a subsequent second ACL injury. Players with a higher draft pick position were more likely to return to the starting lineup following primary ACL reconstruction. Ultimately, player game utilization and performance following primary ACL reconstruction is not predictive of a subsequent second ACL injury. Level of Evidence: Level III, retrospective case-control study

show abstract

“…On the other hand, several studies have shown a 23.24% to 389.47% increase in DKV following different fatigue protocols [66][67][68][69][70][71][72]. These variable results seem to be due to the great heterogeneity of the fatigue protocols, as well as the DKV evaluation technique [73].…”

Section: Discussionmentioning

confidence: 99%

“…These variable results seem to be due to the great heterogeneity of the fatigue protocols, as well as the DKV evaluation technique [73]. In reference to this heterogeneity, it was suggested that the level of fatigue [70,74] and the specificity of the fatigue exercise [75] can influence the kinematics and DKV. That is why our SSFP was designed for being as specific, intense and similar to real competition situations as possible, increasing DKV in both the DL and NDL (356.59% and 49.34%, respectively).…”

Section: Discussionmentioning

confidence: 99%

Acute Effects of ACL Injury-Prevention Warm-Up and Soccer-Specific Fatigue Protocol on Dynamic Knee Valgus in Youth Male Soccer Players

Marco

Cortell-Tormo

García-Jaén

et al. 2020

IJERPH

View full text Add to dashboard Cite

Childhood anterior cruciate ligament (ACL) injuries—which can pose a major risk to a child’s sporting career—have been on the rise in the last few decades. Dynamic knee valgus (DKV) has been linked to an increased risk of ACL injury. Therefore, the aim of this study was to analyze the acute effects of an ACL injury prevention protocol (ACL-IPP) and a soccer-specific fatigue protocol (SSFP) on DKV in youth male soccer players. The research hypothesis was that DKV would be reduced by the ACL-IPP and increased by the SSFP. Eighteen youth male soccer players were divided according to baseline DKV. Those with moderate or large DKV performed a neuromuscular training protocol based on activation of the abductor and external rotator hip muscles. Those with little or no DKV performed a soccer-specific fatigue protocol. DKV was assessed using the single-leg squat pre- and post-protocols in both legs. The ACL-IPP significantly decreased DKV during single-leg squat (p < 0.01, effect size = 1.39), while the SSFP significantly increased baseline DKV in the dominant leg during single-leg squat (p = 0.012; effect size = 1.74). In conclusion, the ACL-IPP appears to acutely reduce the DKV in youth male soccer players, and the SSFP seems to acutely increase the DKV in those players who showed a light or no DKV in a non-fatigue situation. By using the SSFP, it may be possible to determine which players would benefit from injury prevention programs due to increased DKV during game scenarios, while hip abductor and external rotator neuromuscular training may be beneficial for players who have moderate and severe DKV during single-leg squat under non-fatigued scenarios.

show abstract

Fatigue Increases Dynamic Knee Valgus in Youth Athletes: Results From a Field-Based Drop-Jump Test

Cited by 10 publications

References 43 publications

The Role of Fatigue in Return to Sport Testing Following Anterior Cruciate Ligament Reconstruction

The Role of Fatigue in Return to Sport Testing Following Anterior Cruciate Ligament Reconstruction

Game Utilization and Performance Following RTP From ACL Reconstruction Does not Influence a Subsequent Second ACL Injury in National Football League Players

Acute Effects of ACL Injury-Prevention Warm-Up and Soccer-Specific Fatigue Protocol on Dynamic Knee Valgus in Youth Male Soccer Players

Contact Info

Product

Resources

About