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Longitudinal effects of maturation on lower extremity joint stiffness in adolescent athletes.

ABSTRACT: BACKGROUND:Yearly changes in active joint stiffness may help explain when neuromuscular sex differences emerge in adolescent athletes that may relate to increased anterior cruciate ligament injury risk in females. HYPOTHESIS:Pubertal males would demonstrate increases in knee stiffness while pubertal females would not. Second, postpubertal female athletes would have significantly lower knee joint stiffness than postpubertal male athletes. STUDY DESIGN:Cohort Study; Level of Evidence 2 and Cross-Sectional Study; Level of Evidence 3. METHODS:Two hundred sixty-five females and 50 males participated in 2 testing sessions approximately 1 year apart. The subjects were classified as either pubertal (n = 182, age 12.4 +/- 0.9 years) or postpubertal (n = 133, age 14.5 +/- 1.4 years) based on the modified Pubertal Maturational Observational Scale at each visit. Active joint stiffness of the ankle, knee, and hip was estimated during a drop vertical jump. Stiffness was calculated as the slope of the moment-angle curve from a least squares linear regression during the stance phase. RESULTS:All athletes showed increased active knee stiffness during the span of a year (P < 0.05). However, this increase was not different when stiffness was normalized to body mass. Only males demonstrated greater magnitudes of ankle and hip active stiffness (P < .05). Peak ankle and hip moments, but not knee moments, in postpubertal males were significantly greater than postpubertal females (P < .05). Females had a higher knee to hip moment ratio than males (P < .05). CONCLUSION:Both males and females showed increased active knee stiffness during the span of a year; males demonstrated increased ankle and hip active stiffness as well. Differences in hip joint posture at initial contact (greater flexion in males) and external hip flexion moment (greater flexion magnitude in males) may indicate that males use a different hip recruitment strategy during drop vertical jumps than females.

SUBMITTER: Ford KR

PROVIDER: S-EPMC3968426 | biostudies-literature | 2010 Sep

REPOSITORIES: biostudies-literature

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Longitudinal effects of maturation on lower extremity joint stiffness in adolescent athletes.

Ford Kevin R KR Myer Gregory D GD Hewett Timothy E TE

The American journal of sports medicine 20100603 9

<h4>Background</h4>Yearly changes in active joint stiffness may help explain when neuromuscular sex differences emerge in adolescent athletes that may relate to increased anterior cruciate ligament injury risk in females.<h4>Hypothesis</h4>Pubertal males would demonstrate increases in knee stiffness while pubertal females would not. Second, postpubertal female athletes would have significantly lower knee joint stiffness than postpubertal male athletes.<h4>Study design</h4>Cohort Study; Level of ...[more]

PMID: 20522830

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Project description:When paired together, manual therapy and exercise have been effective for regaining range of motion (ROM) in multiple conditions across varied populations. Although exercise in an aquatic environment is common, research investigating manual therapy in this environment is limited. There is little evidence on AquaStretchTM an aquatic manual therapy technique, but anecdotal clinical evidence suggests its effectiveness.To investigate the effects of AquaStretch™ on ROM and function in recreational athletes with self-reported lower extremity injury and pain.Quasi-experimental design.Injured recreational athletes participated in a 30-minute intervention session of AquaStretch.™ Injuries ranged from ankle (sprains and overuse), knee (contusions, sprains, and overuse), and hip conditions (contusions, overuse, and pain). Before a single intervention (preintervention) and within 24 hours after the intervention (postintervention), participants completed the following patient-reported outcome instruments: the Lower Extremity Functional Scale (LEFS) and the Foot and Ankle Ability Measure (FAAM) Sports subscale. AROM measurements of the ankle, knee, and hip and the following muscle length tests were measured: Ober's test, measurement of the popliteal angle, and the modified Thomas test. Finally, the overhead deep squat test was performed as a test of function.Twenty-six recreational athletes with lower extremity injuries of the ankle, knee, and hip, aged 18-60 years (18 males, 8 females, mean age 27.4 years) completed the study. The overall group by time interaction for the mixed-model Generalized Estimating Equations analysis was statistically significant for the LEFS (all p<.002) and for the FAAM Sports subscale (p<.01). There were no statistically significant time (pre vs post) by group interactions for range of motion and other measures, including the Ober's test, the overhead deep squat test, popliteal angle, and the modified Thomas test for injured athletes.One session of AquaStretch™ in recreational athletes improved the patient-rated outcome measures of function specifically the LEFS and FAAM Sports subscale. These results suggest that AquaStretch™ may be an effective form of manual therapy to improve lower extremity function in injured athletes.2b, Individual Cohort Study.

Project description:BACKGROUND AND PURPOSE:There is limited evidence regarding risk factors for lower extremity overuse bone injury (LEOBI) in collegiate athletes. The purposes of the study were to: 1) determine incidence of LEOBI in selected sports and its impact on athletic participation and ADL, 2) assess risk relationships between LEOBI and selected risk factors, and 3) establish the viability of using calcaneal densitometry as a screening tool to identify risk for LEOBI. STUDY DESIGN:Prospective analytical cohort design. METHODS:Collegiate athletes in selected sports (swimming/diving, women's soccer, field hockey, cross-country/track) at one university were invited to participate. Consenting athletes completed an initial questionnaire including demographic information, history, and menstrual function. Measurements included height/weight, hip abductor strength, foot posture index, and calcaneal bone mineral density. Athletes were monitored for potential LEOBI for nine months and an algorithm was used to determine if physician referral was required. The primary outcome of interest was the occurrence of physician-diagnosed LEOBI. If LEOBI was diagnosed by the physician, the athlete completed a follow-up visit including a repeat bone mineral density scan. All athletes were invited for a repeat scan at the end of the year and completed a final questionnaire. Athlete demographics were summarized using descriptive statistics and differences in continuous risk factors were analyzed using t-tests and ANOVA. Finally, risk relationships for categorical variables were analyzed using chi-square and relative risk. RESULTS:84 athletes (64 female, 20 male) consented to participate. Over the study period, eight athletes (one male, seven females) were diagnosed with LEOBI (LEOBI group), five with stress fractures and three with medial tibial stress syndrome. The other 76 athletes who did not have a diagnosis of LEOBI were placed in the non-LEOBI group. Five of the eight were cross-country/track athletes; no swimming/diving athletes had bone injury. Sport (cross-country/track) had a significant relative risk value of 2.26 (95% CI = 1.18-4.32) for LEOBI. There was no association between LEOBI occurrence and sex, hip abductor strength, body mass index, foot type, and menstrual function. There was no difference in bone mineral density at initial or follow-up measures between LEOBI and non-LEOBI groups (p>.05) when analyzing all athletes. When analyzing ground-based athletes only at follow-up (n=44), athletes with LEOBI had lower bone mineral density of right (p = .05) and left (p =.07) calcaneus. The relative risk for developing LEOBI based on calcaneal bone mineral density below the mean of the study participants was 2.1 (95%CI = 1.09-3.35) on the left and 1.53 (95% CI=.80- 3.06) on the right. CONCLUSION:The incidence of LEOBI in this population of athletes was approximately 10%. Risk factors were sport (cross-country/track) and decreased left calcaneal bone mineral density. This study supports the use of calcaneal bone mineral density as a screening measurement for LEOBI risk and suggests the need for further investigation into additional LEOBI risk factors. LEVEL OF EVIDENCE:2.

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Longitudinal effects of maturation on lower extremity joint stiffness in adolescent athletes.

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Longitudinal effects of maturation on lower extremity joint stiffness in adolescent athletes.

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