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Effects of transverse and frontal plane knee laxity on hip and knee neuromechanics during drop landings.

ABSTRACT: Varus-valgus (LAX(VV)) and internal-external (LAX(IER)) rotational knee laxity have received attention as potential contributing factors in anterior cruciate ligament injury. This study compared persons with above-and below-average LAX(VV) and LAX(IER) values on hip and knee neuromechanics during drop jump landings.People with greater LAX(VV) and LAX(IER) values will have greater challenges controlling frontal and transverse plane knee motions, as evidenced by greater joint excursions, joint moments, and muscle activation levels during the landing phase.Descriptive laboratory study.Recreationally active participants (52 women and 44 men) between 18 and 30 years old were measured for LAX(VV) and LAX(IER) and for their muscle activation and transverse and frontal plane hip and knee kinetics and kinematics during the initial landing phase of a drop jump. The mean value was obtained for each sex, and those with above-average values on LAX(VV) and LAX(IER) (LAX(HIGH) = 17 women, 16 men) were compared with those with below-average values (LAX(LOW) = 18 women, 17 men).Women with LAX(HIGH) verus LAX(LOW) were initially positioned in greater hip adduction and knee valgus and also produced more prolonged internal hip adduction and knee varus moments as they moved toward greater hip adduction and internal rotation as the landing progressed. These patterns in LAX(HIGH) women were accompanied by greater prelanding and postlanding muscle activation amplitudes. Men with LAX(HIGH) versus LAX(LOW) also demonstrated greater hip adduction motion and produced greater internal hip internal rotation and knee varus and internal rotation moments.Participants with greater LAX(VV) and LAX(IER) landed with greater hip and knee transverse and frontal plane hip and knee motions.People (especially, women) with increased frontal and transverse plane knee laxity demonstrate motions associated with noncontact anterior cruciate ligament injury mechanisms.

SUBMITTER: Shultz SJ

PROVIDER: S-EPMC2894638 | biostudies-literature | 2009 Sep

REPOSITORIES: biostudies-literature

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Effects of transverse and frontal plane knee laxity on hip and knee neuromechanics during drop landings.

Shultz Sandra J SJ Schmitz Randy J RJ

The American journal of sports medicine 20090529 9

<h4>Background</h4>Varus-valgus (LAX(VV)) and internal-external (LAX(IER)) rotational knee laxity have received attention as potential contributing factors in anterior cruciate ligament injury. This study compared persons with above-and below-average LAX(VV) and LAX(IER) values on hip and knee neuromechanics during drop jump landings.<h4>Hypothesis</h4>People with greater LAX(VV) and LAX(IER) values will have greater challenges controlling frontal and transverse plane knee motions, as evidenced ...[more]

PMID: 19483075

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Project description:PurposeThe purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ).MethodsFifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM),vastus lateralis(VL)}, {vastus medialis(VM),hamstring medialis(HM)}, {hamstring medialis(HM),hamstring lateralis(HL)} and the {vastus lateralis(VL),hamstring lateralis(HL)}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping.ResultsThe peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (p<0.05). Small peak knee flexion angles were significantly associated with higher HM amplitudes during the preparatory and initial contact phase (p<0.001). The amplitudes of the {VM,VL} and {VL,HL} were significantly positively associated with the peak hip flexion angle during the peak loading phase (p<0.05). Small peak hip flexion angles were significantly associated with higher VL amplitudes during the peak loading phase (p = 0.001). Higher external knee abduction and flexion moments were found in participants landing with less flexed knee and hip joints (p<0.001).ConclusionThis study demonstrated clear associations between neuromuscular activation patterns and landing kinematics in the sagittal plane during specific parts of the landing. These findings have indicated that an erect landing pattern, characterized by less hip and knee flexion, was significantly associated with an increased medial and posterior neuromuscular activation (dominant hamstrings medialis activity) during the preparatory and initial contact phase and an increased lateral neuromuscular activation (dominant vastus lateralis activity) during the peak loading phase.

Project description:The purpose was to evaluate the dynamic knee control during a drop jump test following injury of the anterior cruciate ligament injury (ACL) using finite helical axes. Persons injured 17-28 years ago, treated with either physiotherapy (ACLPT, n = 23) or reconstruction and physiotherapy (ACLR, n = 28) and asymptomatic controls (CTRL, n = 22) performed a drop jump test, while kinematics were registered by motion capture. We analysed the Preparation phase (from maximal knee extension during flight until 50 ms post-touchdown) followed by an Action phase (until maximal knee flexion post-touchdown). Range of knee motion (RoM), and the length of each phase (Duration) were computed. The finite knee helical axis was analysed for momentary intervals of ~15° of knee motion by its intersection (?AP position) and inclination (?AP Inclination) with the knee's Anterior-Posterior (AP) axis. Static knee laxity (KT100) and self-reported knee function (Lysholm score) were also assessed. The results showed that both phases were shorter for the ACL groups compared to controls (CTRL-ACLR: Duration 35±8 ms, p = 0.000, CTRL-ACLPT: 33±9 ms, p = 0.000) and involved less knee flexion (CTRL-ACLR: RoM 6.6±1.9°, p = 0.002, CTRL-ACLR: 7.5 ±2.0°, p = 0.001). Low RoM and Duration correlated significantly with worse knee function according to Lysholm and higher knee laxity according to KT-1000. Three finite helical axes were analysed. The ?AP position for the first axis was most anterior in ACLPT compared to ACLR (?AP position -1, ACLPT-ACLR: 13±3 mm, p = 0.004), with correlations to KT-1000 (rho 0.316, p = 0.008), while the ?AP inclination for the third axis was smaller in the ACLPT group compared to controls (?AP inclination -3 ACLPT-CTRL: -13±5°, p = 0.004) and showed a significant side difference in ACL injured groups during Action (Injured-Non-injured: 8±2.7°, p = 0.006). Small ?AP inclination -3 correlated with low Lysholm (rho 0.391, p = 0.002) and high KT-1000 (rho -0.450, p = 0.001). Conclusions Compensatory movement strategies seem to be used to protect the injured knee during landing. A decreased ?AP inclination in injured knees during Action suggests that the dynamic knee control may remain compromised even long after injury.

Dataset Information

Effects of transverse and frontal plane knee laxity on hip and knee neuromechanics during drop landings.

Publications

Effects of transverse and frontal plane knee laxity on hip and knee neuromechanics during drop landings.

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