Improvements in landing biomechanics following anterior cruciate ligament reconstruction in adolescent athletes

Mueske, Nicole M.; Patel, Akash R.; Pace, J. Lee; Zaslow, Tracy; VandenBerg, Curtis; Katzel, Mia J.; Edison, Bianca; Wren, Tishya A. L.

doi:10.1080/14763141.2018.1510539

Cited by 16 publications

(23 citation statements)

References 32 publications

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“…Previous studies have shown that between limb asymmetries are often seen as the surgical limb offloading to the contralateral limb during the landing phase of the VDJ task, though specific asymmetric strategies differ by study [12,26,35,36]. Our study found decreased energy absorption on the surgical limb during landing which is consistent with previous research [12,23,37]. This is often thought to be a protective compensation while the surgical knee is still recovering.…”

Section: Discussionsupporting

confidence: 89%

“…An avoidance of active shock absorption may suggest that the patient continues to be apprehensive and protecting the reconstructed knee or does not have adequate strength to eccentrically control their landing. Consistent with previous research, we also found asymmetries for ankle and knee flexion moments during the landing phase for the surgical limb compared to the contralateral limb [23,26,40,41]. This reduced knee flexion moment further contributes to decreased shock absorption upon landing and can cause the knee to be more at risk to reinjury since the joint experiences more shear stress and resultant ACL tears when it is in a more extended position [19].…”

Section: Discussionsupporting

confidence: 89%

“…Research has shown that poor biomechanics are present in patients following ACLR in tasks such as the VDJ landing [11,19,22]. Mueske et al found that there is decreased energy absorption, decreased sagittal plane external flexion moments at the knee and ankle, and decreased peak dorsiflexion angle during the landing phase in adolescent athletes who had undergone ACLR compared to their uninvolved side [23]. Dynamic valgus, reduced active shock absorption, and decreased flexion of the lower extremity seen during the landing phase of the VDJ task have been associated with an increased risk for ACL injury [20,[24][25][26].…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical Symmetry during Drop Jump Landing and Takeoff in Adolescent Athletes Following Recent Anterior Cruciate Ligament Reconstruction

et al. 2021

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This study investigated asymmetry between lower extremities during the landing and takeoff phases of a vertical drop jump (VDJ) in adolescent athletes following anterior cruciate ligament reconstruction (ACLR) and examined if performance was affected by reducing jump height. Thirty-three athletes who underwent ACLR and were referred for 3D biomechanical assessment before returning to play (mean age 15.9, SD 1.3 years; 16/33 female; mean time since surgery 7.4, SD 1.2 months) completed the VDJ while kinematics and kinetics were collected using motion capture. Lower extremity symmetry was compared between phases using paired t-tests. Jump height was calculated to measure performance. Asymmetries in ankle inversion, ankle adduction, knee adduction, hip adduction, hip adduction moment, and hip rotation moment were observed in both phases. Asymmetry was also observed in both phases for sagittal moments and power integrals at the knee and ankle and total power integral, with the magnitude of asymmetry being smaller during takeoff for power absorption/generation. Jump height was related to power generation integrals during takeoff but not to the asymmetry of power generation. Since asymmetries are translated from landing through takeoff, rehabilitation should address both phases to decrease injury risk and maximize performance after return to play.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Biomechanical Symmetry during Drop Jump Landing and Takeoff in Adolescent Athletes Following Recent Anterior Cruciate Ligament Reconstruction

et al. 2021

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“…Of the studies assessed, 5 23,[37][38][39][40][41] were scored as high quality, 7 35,39,[42][43][44][45][46] were scored as moderate quality, and only 1 9 was scored as low quality (Supplemental Table, available online at http://dx.doi.org/10.4085/1062-6050-244-19.S1). The average score was 10.2 out of 14, suggesting moderate quality overall.…”

Section: Study Qualitymentioning

confidence: 99%

“…Participants were tested at approximately 4, 38 5, 38,40 6, 38,39,41-43 7, 23,44 8, 37,40 10, 35 and 12 38,39 months after ACLR. Ithurburn et al 45 reported the time from being cleared to return to sport rather than the time from ACLR (4 weeks after being cleared to return to sport and 2 years later).…”

Section: Time After Aclrmentioning

confidence: 99%

Lower Limb Asymmetry After Anterior Cruciate Ligament Reconstruction in Adolescent Athletes: A Systematic Review and Meta-Analysis

Hughes

Musco

Caine

et al. 2020

Journal of Athletic Training

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Objectives To identify reported (1) common biomechanical asymmetries in the literature after anterior cruciate ligament (ACL) reconstruction in adolescents during landing and (2) timescales for asymmetry to persist postsurgery. Data Sources We identified sources by searching the CINAHL, PubMed, Scopus, and SPORTDiscus electronic databases using the following search terms: asymmetry OR symmetry AND landing AND biomechanics OR kinematics OR kinetics. Study Selection We screened the titles and abstracts of 85 articles using our inclusion criteria. A total of 13 articles were selected for further analysis. Data Extraction Three reviewers independently assessed the methodologic quality of each study. We extracted the effect sizes directly from studies or calculated them for biomechanical variables assessing asymmetry between limbs of participants with ACL reconstruction. We conducted meta-analyses on variables that were assessed in multiple studies for both double- and single-limb landings. Data Synthesis Asymmetry was more commonly identified in kinetic than kinematic variables. Anterior cruciate ligament reconstruction appeared to have a large effect on asymmetry between limbs for peak vertical ground reaction force, peak knee-extension moment, and loading rate during double-limb landings, as well as mean knee-extension moment and knee energy absorption during both double- and single-limb landings. Conclusions Our findings suggested that return-to-sport criteria after ACL reconstruction should incorporate analysis of the asymmetry in loading experienced by each limb rather than movement patterns alone.

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Rehabilitation of Gymnasts

Tilley

James

2019

Gymnastics Medicine

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Improvements in landing biomechanics following anterior cruciate ligament reconstruction in adolescent athletes

Cited by 16 publications

References 32 publications

Biomechanical Symmetry during Drop Jump Landing and Takeoff in Adolescent Athletes Following Recent Anterior Cruciate Ligament Reconstruction

Biomechanical Symmetry during Drop Jump Landing and Takeoff in Adolescent Athletes Following Recent Anterior Cruciate Ligament Reconstruction

Lower Limb Asymmetry After Anterior Cruciate Ligament Reconstruction in Adolescent Athletes: A Systematic Review and Meta-Analysis

Rehabilitation of Gymnasts

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