scholarly journals Altered trunk and lower extremity movement coordination after neuromuscular training with and without external focus instruction: a randomized controlled trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Bahram Sheikhi ◽  
Amir Letafatkar ◽  
Abbey C. Thomas ◽  
Kevin R. Ford
Keyword(s):  
At Risk ◽  
Lower Extremity ◽  
Analysis Of Covariance ◽  
Ligament Injury ◽  
Neuromuscular Training ◽  
Trunk Flexion ◽  
Movement Coordination ◽  
External Focus ◽  
Flexion Extension ◽  
Segmental Coordination

Abstract Background This study sought to determine the effects of a 6-week neuromuscular training (NMT) and NMT plus external focus (NMT plus EF) programs on trunk and lower extremity inter-segmental movement coordination in active individuals at risk of injury. Methods Forty-six active male athletes (controls = 15, NMT = 16, NMT plus EF = 15) participated (age = 23.26 ± 2.31 years) in this controlled, laboratory study. Three-dimensional kinematics were collected during a drop vertical jump (DVJ). A continuous relative phase (CRP) analysis quantified inter-segmental coordination of the: (1) thigh (flexion/extension)—shank (flexion/extension), (2) thigh (abduction/adduction)—shank (flexion/extension), (3) thigh (abduction/adduction)—trunk (flexion/extension), and (4) trunk (flexion/extension)—pelvis (posterior tilt/anterior tilt). Analysis of covariance compared biomechanical data between groups. Results After 6 weeks, inter-segmental coordination patterns were significantly different between the NMT and NMT plus EF groups (p < 0.05). No significant differences were observed in CRP for trunk-pelvis coupling comparing between NMT and NMT plus EF groups (p = 0.134), while significant differences were observed CRP angle of the thigh-shank, thigh-trunk couplings (p < 0.05). Conclusions Trunk and lower extremity movement coordination were more in-phase during DVJ in the NMT plus EF compared to NMT in active individuals at risk of anterior cruciate ligament injury. Trial registration: The protocol was prospectively registered at UMIN_RCT website with ID number: UMIN000035050, Date of provisional registration 2018/11/27.

scholarly journals Effectiveness of Neuromuscular Training Based on the Neuromuscular Risk Profile

2017 ◽  
Vol 45 (9) ◽  
pp. 2142-2147 ◽  
Author(s):  
Timothy E. Hewett ◽  
Kevin R. Ford ◽  
Yingying Y. Xu ◽  
Jane Khoury ◽  
Gregory D. Myer
Keyword(s):  
High Risk ◽  
External Rotation ◽  
Risk Groups ◽  
Risk Profile ◽  
Analysis Of Covariance ◽  
Neuromuscular Training ◽  
Trunk Flexion ◽  
Hip Strength ◽  
Acl Injuries ◽  
Trunk Extension

Background: The effects of targeted neuromuscular training (TNMT) on movement biomechanics associated with the risk of anterior cruciate ligament (ACL) injuries are currently unknown. Purpose/Hypotheses: To determine the effectiveness of TNMT specifically designed to increase trunk control and hip strength. The hypotheses were that (1) TNMT would decrease biomechanical and neuromuscular factors related to an increased ACL injury risk and (2) TNMT would decrease these biomechanical and neuromuscular factors to a greater extent in athletes identified as being at a high risk for future ACL injuries. Study Design: Controlled laboratory study. Methods: Female athletes who participated in jumping, cutting, and pivoting sports underwent 3-dimensional biomechanical testing before the season and after completing TNMT. During testing, athletes performed 3 different types of tasks: (1) drop vertical jump, (2) single-leg drop, and (3) single-leg cross drop. Analysis of covariance was used to examine the treatment effects of TNMT designed to enhance core and hip strength on biomechanical and neuromuscular characteristics. Differences were also evaluated by risk profile. Differences were considered statistically significant at P < .05. Results: TNMT significantly increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. Athletes with a high risk before the intervention (risk profile III) had a more significant treatment effect of TNMT than low-risk groups (risk profiles I and II). Conclusion: TNMT significantly improved proximal biomechanics, including increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. TNMT that focuses exclusively on proximal leg and trunk risk factors is not, however, adequate to induce significant changes in frontal-plane knee loading. Biomechanical changes varied across the risk profile groups, with higher risk groups exhibiting greater improvements in their biomechanics.

scholarly journals Gender Differences in Lower Extremity Coupling Variability during an Unanticipated Cutting Maneuver

2005 ◽  
Vol 21 (2) ◽  
pp. 143-152 ◽  
Author(s):  
Christine D. Pollard ◽  
Bryan C. Heiderscheit ◽  
Richard E.A. van Emmerik ◽  
Joseph Hamill
Keyword(s):  
Gender Differences ◽  
Lower Extremity ◽  
Ligament Injury ◽  
Coordination Pattern ◽  
Vector Coding ◽  
Flexible System ◽  
Environmental Perturbations ◽  
Flexion Extension ◽  
M 12 ◽  
Coordination Patterns

The purpose of this study was to determine if gender differences exist in the variability of various lower extremity (LE) segment and joint couplings during an unanticipated cutting maneuver. 3-D kinematics were collected on 24 college soccer players (12 M, 12 F) while each performed the cutting maneuver. The following intralimb couplings were studied: thigh rotation (rot)/leg rot; thigh abduction-adduction/leg abd-add; hip abd-add/knee rot; hip rot/knee abd-add; knee flexion-extension/knee rot; knee flx-ext/hip rot. A vector-coding technique applied to angle-angle plots was used to quantify the coordination of each coupling. The average between-trial standard deviation of the coordination pattern during the initial 40% of stance was used to indicate the coordination variability. One-tailed t-tests were used to determine differences between genders in coordination variability for each coupling. Women had decreased variability in four couplings: 32% less thigh rot/leg rot variability; 40% less thigh abd-add/leg abd-add variability; 46% less knee flx-ext/knee rot variability; and 44% less knee flx-ext/hip rot variability. These gender differences in LE coordination variability may be associated with the increased incidence of ACL injury in women. If women exhibit less flexible coordination patterns during competition, they may be less able to adapt to the environmental perturbations experienced during sports. These perturbations applied to a less flexible system may result in ligament injury.

Maternal Thinness and Obesity and Customized Fetal Weight Charts

2021 ◽  
pp. 1-9
Author(s):  
Nieves L. González González ◽  
Enrique González Dávila ◽  
Agustina González Martín ◽  
Erika Padrón ◽  
José Ángel García Hernández
Keyword(s):  
At Risk ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Analysis Of Covariance ◽  
Large For Gestational Age ◽  
Perinatal Morbidity ◽  
Accurate Identification ◽  
Cephalopelvic Disproportion

<b><i>Objective:</i></b> The aim of the study was to determine if customized fetal growth charts developed excluding obese and underweight mothers (CC<sub>(18.5–25)</sub>) are better than customized curves (CC) at identifying pregnancies at risk of perinatal morbidity. <b><i>Material and Methods:</i></b> Data from 20,331 infants were used to construct CC and from 11,604 for CC<sub>(18.5–25)</sub>, after excluding the cases with abnormal maternal BMI. The 2 models were applied to 27,507 newborns and the perinatal outcomes were compared between large for gestational age (LGA) or small for gestational age (SGA) according to each model. Logistic regression was used to calculate the OR of outcomes by the group, with gestational age (GA) as covariable. The confidence intervals of pH were calculated by analysis of covariance. <b><i>Results:</i></b> The rate of cesarean and cephalopelvic disproportion (CPD) were higher in LGA<sub>only by CC</sub><sub><sub>(18.5−25)</sub></sub> than in LGA<sub>only by CC</sub>. In SGA<sub>only by CC</sub><sub><sub>(18.5−25)</sub></sub>, neonatal intensive care unit (NICU) and perinatal mortality rates were higher than in SGA<sub>only by CC</sub>. Adverse outcomes rate was higher in LGA<sub>only by CC</sub><sub><sub>(18.5−25)</sub></sub> than in LGA<sub>only by CC</sub> (21.6%; OR = 1.61, [1.34–193]) vs. (13.5%; OR = 0.84, [0.66–1.07]), and in SGA <sub>only by CC</sub><sub><sub>(18.5−25)</sub></sub> than in SGA<sub>only by CC</sub> (9.6%; OR = 1.62, [1.25–2.10] vs. 6.3%; OR = 1.18, [0.85–1.66]). <b><i>Conclusion:</i></b> The use of CC<sub>(18.5–25)</sub> allows a more accurate identification of LGA and SGA infants at risk of perinatal morbidity than conventional CC. This benefit increase and decrease, respectively, with GA.

Peak Torque Prediction Using Handgrip and Strength Predictors in Men and Women With Motor Complete Spinal Cord Injury

2021 ◽  
Vol 27 (3) ◽  
pp. 49-59
Author(s):  
Frederico Ribeiro Neto ◽  
Jefferson Rodrigues Dorneles ◽  
João Henrique Carneiro Leão Veloso ◽  
Carlos Wellington Gonçalves ◽  
Rodrigo Rodrigues Gomes Costa
Keyword(s):  
Handgrip Strength ◽  
Peak Torque ◽  
Shoulder Abduction ◽  
Trunk Flexion ◽  
Predictive Equations ◽  
Men And Women ◽  
Flexion Extension ◽  
Cord Injury ◽  
Complete Spinal Cord Injury ◽  
Hand Dynamometry

Objectives: To establish predictive equations for peak torque of muscle groups with totally and partially preserved innervation in individuals with motor complete spinal cord injury (SCI), based on hand dynamometry and strength predictor variables. Methods: The cross-sectional study conducted at a rehabilitation hospital consecutively recruited 108 men and women with SCI. All participants performed maximum peak torque tests for shoulder abduction/adduction (isokinetic), trunk flexion/extension (isometric), and handgrip strength testing (hand dynamometer) to establish predictive peak torque equations. The primary outcomes were peak torque variables. Handgrip strength, age, injury level, time since injury, age at injury, body mass, height, body mass index, and physical activity level were the secondary outcomes used as strength predictor variables. Results: Handgrip strength was a predictor variable for shoulder abduction/adduction peak torque. The best predictive models for shoulder abduction/adduction peak torque exhibited R2 = 0.57 and R2 = 0.60, respectively (p ≤ .05). Injury level showed the highest significant predictive capacity for trunk flexion/extension peak torque models (R2 = 0.38 and R2 = 0.29; p ≤ .05). Conclusion: Shoulder abduction/adduction peak torque predictive equations may be an alternative for use in an accessible strength tool (hand dynamometry) to evaluate training and rehabilitation programs. Trunk flexion/extension peak torque equations exhibited moderate correlations and high standard error of the estimates and should be used with caution.

Lower Extremity Joint Moments of Collegiate Soccer Players Differ between Genders during a Forward Jump

2008 ◽  
Vol 17 (2) ◽  
pp. 137-147 ◽  
Author(s):  
Joseph M. Hart ◽  
J. Craig Garrison ◽  
Riann Palmieri-Smith ◽  
D. Casey Kerrigan ◽  
Christopher D. Ingersoll
Keyword(s):  
Lower Extremity ◽  
Internal Rotation ◽  
Outcome Measures ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Initial Contact ◽  
Joint Angles ◽  
Joint Moments ◽  
Heel Contact ◽  
Hip Internal Rotation

Context:Lower extremity kinetics while performing a single-leg forward jump landing may help explain gender biased risk for noncontact anterior cruciate ligament injury.Objective:Gender comparison of lower extremity joint angles and moments.Design:Static groups comparison.Setting:Motion analysis laboratory.Patients or Other Participants:8 male and 8 female varsity, collegiate soccer athletes.Intervention:5 single-leg landings from a 100cm forward jump.Main Outcome Measures:Peak and initial contact external joint moments and joint angles of the ankle, knee, and hip.Results:At initial heel contact, males exhibited a adduction moment whereas females exhibited a abduction moment at the hip. Females also had significantly less peak hip extension moment and significantly less peak hip internal rotation moment than males had. Females exhibited greater knee adduction and hip internal rotation angles than men did.Conclusions:When decelerating from a forward jump, gender differences exist in forces acting at the hip.

Examining the Relationship Between a Neuromuscular Control Baseline Battery for Sport-Related Concussion and Anterior Cruciate Ligament Injury Risk

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S21.2-S22
Author(s):  
Ryan Moran
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Ligament Injury ◽  
Jump Landing ◽  
Eyes Closed ◽  
Eyes Open ◽  
Anterior Cruciate ◽  
The Relationship

ObjectiveTo examine the relationship between the m-CTSIB and Landing Error Scoring System in a sample of collegiate female athletes.BackgroundRecent literature has linked concussion and neuromuscular deficits in the lower extremity after injury. Neuromuscular control is frequently assessed using balance measures for concussion, but also dynamically to identify anterior cruciate ligament injury (ACL) risk via jump-landing movement screening.Design/MethodsThirty-nine healthy, collegiate female soccer (n = 22) and volleyball (n = 17) athletes completed the modified-Clinical Test of Sensory Interaction of Balance (m-CTSIB) and the Landing Error Scoring System (LESS). Measures consisted of total m-CTSIB sway index scores on individual conditions (firm surface eyes open [condition 1] and eyes closed [2], foam surface eyes open [3] and eyes closed [4]), m-CTSIB overall score, and total LESS errors. LESS scores were also categorized into a low (0–4 errors) and high (5 + errors) risk to determine if athletes with worse neuromuscular control on the LESS has worse balance on the m-CTSIB. A Spearman's rank-order correlation was conducted to determine the strength of the relationship between LESS and m-CTSIB performance. A series of Mann-Whitney U test were performed to determine differences between low and high LESS performance on m-CTSIB performance.ResultsThere was a weak, negative correlation between LESS and m-CTSIB performance (rs(37) = −0.153, p = 0.35). Further, there were no differences between the low and high risk LESS groups on sway index scores on conditions 1 (U = 158.5, p = 0.39), 2 (U = 156.0, p = 0.36), 3 (U = 165.5, p = 0.51), or 4 (U = 128.5, p = 0.08), as well as overall m-CTSIB scores (U = 150.5, p = 0.28).ConclusionsThere appears to be a lack of relationship between the LESS and m-CTSIB tests, revealing the independence of static and dynamic lower extremity neuromuscular function. Athletes who may be more at risk for ACL injury due to abnormal jump-landing biomechanics, do not differ from low-risk athletes on baseline balance assessment.

Abstract 91: Are At Risk Outpatient Cardiology Patients being Appropriately Evaluated for Lower Extremity PAD as Recommended by ACC/AHA Guidelines?

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Rajesh M Kabadi ◽  
Ankitkumar Patel ◽  
Rajani Sharma ◽  
Rita Schmidt ◽  
Elias Iliadis
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
High Risk ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Heart Association ◽  
Low Risk ◽  
Peripheral Artery ◽  
Artery Disease

Background: Lower extremity peripheral artery disease (PAD) is a common syndrome that afflicts many individuals and leads to significant morbidity. Once appropriate at risk patients are identified, ankle-brachial index (ABI) testing is a relatively quick and inexpensive test that is recommended for proper assessment of PAD, per the recommendations outlined in the American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines for the Management of Peripheral Artery Disease (PAD) (JACC, 2006). Outpatient cardiology practices often take care of individuals at risk for PAD and have the opportunity to test and appropriately treat this condition. Methods: A randomly selected group of 367 outpatients seen in a large academic cardiology practice from September 2011 underwent retrospective chart review. Risk factors for PAD that were assessed include history of smoking, hypertension, diabetes, hyperlipidemia, homocysteine levels, and CRP. Those that had three or more risk factors were classified as high risk and those with less than that were classified as low risk and frequency of ABI testing was evaluated. Fishers exact test was utilized for statistical analysis. Results: Fifty-one percent (N=187) of our population were classified as high risk for PAD, forty-three percent (N=158) were low risk, and six percent (N=22) were known to already have PAD. Amongst the high risk individuals, only six percent (N=12) had ABI testing performed while there were three percent (N=6) of low risk individuals that had this test (p=-0.34). Conclusions: There was no difference in ABI testing between high and low risk populations. Limitations of this study include lack of information regarding other diagnostic modalities that may have been used in place of ABI testing. Quality improvement may be achieved by increased use of such testing as this would allow for quicker identification of the disease, prompter treatment, and better outcomes, at a minimal cost.

scholarly journals Feedback cues improve the alignment and technique of children performing ACL injury prevention exercises

2020 ◽  
pp. jisakos-2020-000475
Author(s):  
Daphne I Ling ◽  
Caroline Boyle ◽  
Joseph Janosky ◽  
Brenda Chang ◽  
Naomi Roselaar ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Case Series ◽  
Ligament Injury ◽  
Neuromuscular Training ◽  
Level Of Evidence ◽  
Training Exercises ◽  
Neutral Alignment ◽  
Feedback Cues

ObjectivesThe appropriateness of neuromuscular training exercises across different age groups has not yet been investigated, particularly in younger children. The purpose of this study was to determine which neuromuscular training exercises can be performed with proper neutral alignment in various age groups.MethodsSeven exercises were selected for evaluation in children ranging from 8 to 17 years of age who were recruited from schools and youth sports organisations. Participants completed two trials of each exercise and were judged on maintaining neutral body alignment after receiving visual/verbal instruction on the first trial and feedback cues on the second trial. Three evaluators judged each exercise, which was deemed as correct when at least two evaluators agreed that neutral alignment was maintained. Comparisons were made across ages and between sex using the χ² test or Fisher’s exact test. The proportions of participants who performed the exercise correctly were also compared before and after feedback cues were provided.ResultsA total of 360 participants were evaluated (8–11 years: 165, 54% female; 12–15 years: 136, 40% female, 16–17 years: 59, 53% female). There were no significant differences in performance across ages and sex for nearly all exercises. The majority of children were not able to complete the exercises with proper alignment. The use of feedback cues significantly increased the proportion of participants who correctly completed the exercise (p<0.001).ConclusionsThese results demonstrate the importance of training coaches and physical education teachers to provide cues that reinforce proper technique during anterior cruciate ligament injury prevention exercises. Children should perform common neuromuscular training exercises with feedback on proper technique.Level of evidenceIV (case series).

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