Gender, Vertical Height and Horizontal Distance Effects on Single-Leg Landing Kinematics: Implications for Risk of non-contact ACL Injury

Abstract

There is a lack of studies investigating gender differences in whole-body kinematics during single-leg landings from increasing vertical heights and horizontal distances. This study determined the main effects and interactions of gender, vertical height, and horizontal distance on whole-body joint kinematics during single-leg landings, and established whether these findings could explain the gender disparity in non-contact anterior cruciate ligament (ACL) injury rate. Recreationally active males (n=6) and females (n=6) performed single-leg landings from a takeoff deck of vertical height of 20, 40, and 60 cm placed at a horizontal distance of 30, 50 and 70 cm from the edge of a force platform, while 3D kinematics and kinetics were simultaneously measured. It was determined that peak vertical ground reaction force (VGRF) and the ankle flexion angle exhibited significant gender differences (p=0.028, partial η 2 =0.40 and p=0.035, partial η 2 =0.37, respectively). Peak VGRF was significantly correlated to the ankle flexion angle (r= −0.59, p=0.04), hip flexion angle (r= −0.74, p=0.006), and trunk flexion angle (r= −0.59, p=0.045). Peak posterior ground reaction force (PGRF) was significantly correlated to the ankle flexion angle (r= −0.56, p=0.035), while peak knee abduction moment was significantly correlated to the knee flexion angle (r= −0.64, p=0.03). Rearfoot landings may explain the higher ACL injury rate among females. Higher plantar-flexed ankle, hip, and trunk flexion angles were associated with lower peak ground reaction forces, while higher knee flexion angle was associated with lower peak knee abduction moment, and these kinematics implicate reduced risk of non-contact ACL injury.

Differences and correlations in knee and hip mechanics during single-leg landing, single-leg squat, double-leg landing, and double-leg squat tasks

“…However, each landing and squat task can be performed with various forms (landing distance, height, consecutive jump, arm motion, etc.). Previous investigators have found that a small variation in landing tasks could cause significant changes in lower extremity biomechanics (Ali et al, 2013;Cruz et al, 2013). The findings of the current study should be limited to the selected tasks.…”

“…Previous investigators have utilized landings and squats to assess lower extremity biomechanics associated with ACL loading and injury risks (Ali et al, 2013;Bell et al, 2013;Hewett et al, 2005;Lyle et al, 2014;Nguyen et al, 2011;Padua, 2012;Padua et al, 2012;Stensrud et al, 2011). In the current study, the differences and correlations for five biomechanical variables were identified during a single-leg landing, a single-leg squat, a double-leg landing, and a double-leg squat.…”

“…While double-leg landings have been utilized to identify risk factors for ACL injuries (Hewett et al, 2005;Padua, 2012), single-leg landings have also been used for assessing lower extremity biomechanics associated with ACL loading and injury risks (Ali, Rouhi, & Robertson, 2013;Lyle, Valero-Cuevas, Gregor, & Powers, 2014). ACL injuries have been commonly observed during single-leg landings (Boden et al, 2000;Koga et al, 2010;Krosshaug et al, 2007).…”

Correlations Between Vertical Ground Reaction Force, Sagittal Joint Angles, and the Muscle Co-Contraction Index During Single-Leg Jump-Landing

“…The pVGRF changes based on the sagittal joint angle of the lower extremity during landing (7)(8)(9)(10). During singleleg landing, smaller knee and hip flexion angles (9,10) and smaller ankle dorsiflexion angles (11,12) generate larger pV-GRF magnitudes. It has been reported that the pVGRF is smaller during a landing when subjects consciously bend the knee and hip than during a natural landing (8,13).…”

Correlations between sagittal plane kinematics and landing impact force during single-leg lateral jump-landings

“…In males, during single-leg anterior jump-landing, ACL strain was shown to peak at maximum ground reaction force (GRF)4 ) . The peak VGRF (pVGRF) in males was reported to be larger than that in females5 ) . Therefore, pVGRF during single-leg anterior jump-landing is a risk factor of noncontact ACL injury in males.…”