Effect of landing stiffness on joint kinetics and energetics in the lower extremity.

Ground reaction forces (GRF), joint positions, joint moments, and muscle powers in the lower extremity were compared between soft and stiff landings from a vertical fall of 59 cm. Soft and stiff landings had less than and greater than 90 degrees of knee flexion after floor contact. Ten trials of sagittal plane film and GRF data, sampled at 100 and 1000 Hz, were obtained from each of eight female athletes and two landing conditions. Inverse dynamics were performed on these data to obtain the moments and powers during descent (free fall) and floor contact phases. Angular impulse and work values were calculated from these curves, and the conditions were compared with a correlated t-test. Soft and stiff landings averaged 117 and 77 degrees of knee flexion. Larger hip extensor (0.010 vs 0.019 N.m.s.kg-1; P less than 0.01) and knee flexor (-0.010 vs -0.013 N.m.s.kg-1; P less than 0.01) moments were observed during descent in the stiff landing, which produced a more erect body posture and a flexed knee position at impact. The shapes of the GRF, moment, and power curves were identical between landings. The stiff landing had larger GRFs, but only the ankle plantarflexors produced a larger moment (0.185 vs 0.232 N.m.s.kg-1; P less than 0.01) in this condition. The hip and knee muscles absorbed more energy in the soft landing (hip, -0.60 vs -0.39 W.kg-1; P less than 0.01; knee, -0.89 vs -0.61 W.kg-1; P less than 0.01), while the ankle muscles absorbed more in the stiff landing (-0.88 vs -1.00 W.kg-1; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Heel height affects lower extremity frontal plane joint moments during walking

Wearing high heels alters walking kinematics and kinetics and can create potentially adverse effects on the body. Our purpose was to determine how heel height affects frontal plane joint moments at the hip, knee, and ankle, with a specific focus on the knee moment due to its importance in joint loading and knee osteoarthritis. 15 women completed overground walking using three different heel heights (1, 5, and 9 cm) for fixed speed (1.3 ms(-1)) and preferred speed conditions while kinematic and force platform data were collected concurrently. For both fixed and preferred speeds, peak internal knee abduction moment increased systematically as heel height increased (fixed: 0.46, 0.48, 0.55 N m kg(-1); preferred: 0.47, 0.49, 0.53 N m kg(-1)). Heel height effects on net frontal plane moments of the hip and ankle were similar to those for the knee; peak joint moments increased as heel height increased. The higher peak internal knee abduction moment with increasing heel height suggests greater medial loading at the knee. Kinetic changes at the ankle with increasing heel height may also contribute to larger medial loads at the knee. Overall, wearing high heels, particularly those with higher heel heights, may put individuals at greater risk for joint degeneration and developing medial compartment knee osteoarthritis.     

Lower extremity kinematics and kinetics of Division III collegiate baseball and softball players while performing a modified pro-agility task

AIM: Females experience at least twice as many non-contact anterior cruciate ligament (ACL) injuries as males. The aim of this study was to investigate if males and females exhibited different characteristics while performing a modified pro-agility test. METHODS: Collegiate Division III male baseball (n=14) and female softball (n=13) players performed 4 trials of a modified pro-agility task, which consisted of running toward a force platform target for 5 steps, planting their right foot, and propelling themselves off of the target with their left foot. Kinematic and kinetic parameters were compared using a multivariate analysis of variance between gender with the level of significance set at P<0.05. RESULTS: Males and females exhibited similar knee valgus angles. Females had a greater maximum knee extension angle (10.14 degrees vs 17.43 degrees ), and greater knee range of motion (46.12 degrees vs 40.12 degrees ). Both groups reached maximum knee flexion at 52% of stance. Females had significantly more maximum hip flexion than males (28.86 degrees vs 22.75 degrees ). Females had significantly smaller minimum internal knee varus moments than their male counterparts (1.12 Nm/kg vs 1.55 Nm/kg). Vertical ground reaction forces as a percentage of bodyweight, and stance time, were not statistically different. The female group displayed an external knee rotation angle (2.49 degrees ) during the beginning of their stance, which was significantly different than the internal rotation angle (4.11 degrees ) in the male group. Early in stance knee rotation angle was highly correlated with the lack of internal knee varus moment (males R(2)=0.75, females R(2)=0.88). CONCLUSION: Females displayed knee moments and kinematics that may place them at greater risk for ACL injury during a stop-cut task. Females should be coached to perform stop cuts with more knee flexion and a more neutral knee rotation angle upon foot contact in an effort to reduce moments that may place the ACL at risk.     

Knee biomechanics during landings: comparison of pre- and postpubescent females

PURPOSE: The purpose of this investigation was to examine lower-extremity biomechanical differences between prepubescent and postpubescent female recreational athletes during three drop jump-landing sequences (static landing, vertical landing, and lateral landing) to determine whether maturation influenced injury risk. METHODS: Sixteen recreationally active postpubescent women (18-25 yr of age) and 16 recreationally active girls (8-11 yr of age) participated in this study. High-speed three-dimensional videography and force plate data were recorded for each subject's performance of the landing tasks and an inverse dynamics procedure was used to estimate knee joint resultant moments and forces. Kinematic and kinetic dependent variables were analyzed in three separate mixed-design 2 x 3 (maturation level x landing sequence) repeated measures multivariate analysis of variance. RESULTS: Statistical analyses indicated significant maturation level x landing sequence interactions for postpubescent participants who exhibited reduced knee flexion (4.5 degrees ) at initial contact, increased mediolateral knee joint forces [prepubescent: -0.63 +/- 0.21 N.(kg. radicalLH)(-1), postpubescent: 0.55 +/- 0.21 N.(kg. radicalLH)(-1)], and reduced knee extensor moments [prepubescent: -0.0124 +/- 0.001 N.m.(kg.BH. radicalLH)(-1), postpubescent: -0.0079 +/- 0.001 N.m.(kg.BH. radicalLH)(-1)] compared with their prepubescent counterparts. CONCLUSION: These findings suggest that developmental changes influence knee mechanics during landings in female athletes and highlight the need to examine multiple landing patterns when investigating landing strategies.     

Contributions of lower extremity joints to energy dissipation during landings

PURPOSE: The purpose of the study was to investigate changes in lower extremity joint energy absorption for different landing heights and landing techniques. METHODS: Nine healthy, active male subjects volunteered to perform step-off landings from three different heights (0.32 m, 2.5 m(-s); 0.62 m, 3.5 m(-s); and 1.03 m, 4.5 m(-s)) using three different landing techniques (soft, SFL; normal, NML; and stiff landing, STL). Each subject initially performed five NML trials at 0.62 m to serve as a baseline condition and subsequently executed five trials in each of the nine test conditions (3 heights x 3 techniques). RESULTS: The results demonstrated general increases in peak ground reaction forces, peak joint moments, and powers with increases in landing height and stiffness. The mean eccentric work was 0.52, 0.74, and 0.87 J x kg(-1) by the ankle muscles, and 0.94, 1.31, and 2.15 J x kg(-1) by the hip extensors, at 0.32, 0.62, and 1.03 m, respectively. The average eccentric work performed by the knee extensors was 1.21, 1.63, and 2.26 J x kg(-1) for the same three heights. CONCLUSIONS: The knee joint extensors were consistent contributors to energy dissipation. The ankle plantarflexors contributed more in the STL landings, whereas the hip extensors were greater contributors during the SFL landings. Also a shift from ankle to hip strategy was observed as landing height increased.     

Repeated sprints alter mechanical work done by hip and knee,but not ankle,sagittal moments

ObjectivesTo quantify the changes in work done by lower limb joint moments during maximal speed running following a sports-specific repeated running protocol.DesignObservational with repeated-measures.MethodsRecreational athletes (n = 18 (9 females), aged = 26.2 ± 6.2 years) performed 12 maximal 30-m sprints on a non-motorised treadmill. Three-dimensional kinematics and ground reaction forces were subsequently recorded during a 10-m maximal overground sprint before and immediately after the repeated running protocol, from which we calculated work done by sagittal plane hip, knee, and ankle moments. Relative work (J/kg) was reported as a percentage of positive and negative work done by the sum of joint moments.ResultsFollowing the repeated running protocol, maximal sprint speed decreased by 19% and was accompanied by reductions in total positive (−1.47 J/kg) and negative (−0.92 J/kg) work, in addition to work done by hip (−0.43 to −0.82 J/kg) and knee (−0.28 J/kg) moments during swing. Compared to before the repeated running protocol, less relative work was done by hip (−9%) and knee (−3%) extension moments during swing. Reductions in work done by hip and knee joint moments during swing were significantly correlated with reductions in maximum running speed (r = 0.61−0.89, p < 0.05).ConclusionsA sports-specific repeated running protocol resulted in reductions in mechanical work done by sagittal plane hip and knee joint moments during maximal overground sprinting. Interventions focused on maintaining positive work done by the hip flexors/extensors and negative work done by knee flexors/extensors during the swing phase of running may help prevent reductions in speed following repeated sprinting.     

The influences of sex and posture on joint energetics during drop landings

Previous observations suggest that females utilize a more erect initial landing posture than males with sex differences in landing posture possibly related to sex‐specific energy absorption (EA) strategies. However, sex‐specific EA strategies have only been observed when accompanied by sex differences in initial landing posture. This study (a) investigated the potential existence of sex‐specific EA strategies; and (b) determined the influences of sex and initial landing posture on the biomechanical determinants of EA. The landing biomechanics of 80 subjects were recorded during drop landings in Preferred, Flexed, and Erect conditions. No sex differences in joint EA were identified after controlling for initial landing posture. Males and females exhibited greater ankle EA during Erect vs Flexed landings with this increase driven by 12% greater ankle velocity, but no change in ankle extensor moment. No differences in hip and knee EA were observed between conditions. However, to achieve similar knee EA, subjects used 7% greater mean knee extensor moment but 9% less knee angular velocity during Flexed landings. The results suggest that sex‐specific EA strategies do not exist, and that the magnitude of knee joint EA can be maintained by modulating the relative contributions of joint moment and angular velocity to EA.     

Gender differences in frontal and sagittal plane biomechanics during drop landings

PURPOSE: To determine gender differences in lower-extremity joint kinematics and kinetics between age- and skill-matched recreational athletes. METHODS: Inverse dynamic solutions estimated the lower-extremity flexion-extension and varus-valgus kinematics and kinetics for 15 females and 15 males performing a 60-cm drop landing. A mixed model, repeated measures analysis of variance (gender (*) joint) was performed on select kinematic and kinetic variables. RESULTS: Peak hip and knee flexion and ankle dorsiflexion angles were greater in females in the sagittal plane (group effect, P < 0.02). Females exhibited greater frontal plane motion (group (*) joint, P = 0.02). Differences were attributed to greater peak knee valgus and peak ankle pronation angles (post hoc tests, P = 0.00). Females exhibited a greater range of motion (ROM) in the sagittal plane (group main effect, P = 0.02) and the frontal plane (group (*) joint, P = 0.01). Differences were attributed to the greater knee varus-valgus ROM, ankle dorsiflexion, and pronation ROM (post hoc tests). Ground reaction forces were different between groups (group (*) direction, P = 0.05). Females exhibited greater peak vertical and posterior (A/P) force than males (post hoc tests). Females exhibited different knee moment profiles (Group main effect, P = 0.01). These differences were attributed to a reduced varus moment in females (post hoc tests). CONCLUSION: The majority of the differences in kinematic and kinetic variables between male and female recreational athletes during landing were observed in the frontal plane not in the sagittal plane. Specifically, females generated a smaller internal knee varus moment at the time of peak valgus knee angulation.     

Association between ankle angle at initial contact and biomechanical ACL injury risk factors in male during self-selected single-leg landing

BackgroundIncreasing the ankle plantar-flexion angle at initial contact (IC) during landing reduces the impact features associated with landing, such as the vertical ground reaction force and loading rate, potentially affecting the risk of anterior cruciate ligament (ACL) injury. However, the relationships between the ankle plantar-flexion angle at IC and the previously identified biomechanical factors related to noncontact ACL injury have not been studied.Research questionThus, the purpose of this study was to determine whether significant relationships exist between the ankle plantar-flexion angle at IC and the biomechanical factors related to noncontact ACL injury.MethodsThe peak anterior tibial shear force, peak external knee valgus moment, peak knee valgus angle, and combined peak external knee valgus plus tibial internal rotation moments were measured in 26 individuals while performing self-selected, single-leg landing. Pearson correlation analyses were performed to assess the relationships between the ankle plantar-flexion angle at IC and the biomechanical factors mentioned above.ResultsThe greater ankle plantar-flexion angle at IC was related to smaller the peak knee valgus moment (r = −0.5, p = 0.009) and the combined peak knee valgus plus internal rotation moments (r = −0.58, p = 0.001).SignificanceThese results suggest that large ankle plantar-flexion angle at IC might be associated with lesser loading of the knee frontal plane and altering the self-selective ankle angle may result in biomechanical changes associated with ACL injury risk.     

Single‐leg drop landing motor control strategies following acute ankle sprain injury

No research currently exists investigating the effect of acute injury on single‐limb landing strategies. The aim of the current study was to analyze the coordination strategies of participants in the acute phase of lateral ankle sprain (LAS) injury. Thirty‐seven participants with acute, first‐time LAS and 19 uninjured participants completed a single‐leg drop landing task on both limbs. Three‐dimensional kinematic (angular displacement) and sagittal plane kinetic (moment‐of‐force) data were acquired for the joints of the lower extremity from 200 ms pre‐initial contact (IC) to 200 ms post‐IC. The peak magnitude of the vertical component of the ground reaction force (GRF) was also computed. Injured participants displayed a bilateral increase in hip flexion, with altered transverse plane kinematic profiles at the knee and ankle for both limbs (P < 0.05). This coincided with a reduction in the net‐supporting flexor moment of the lower extremity (P < 0.05) and magnitude of the peak vertical GRF for the injured limb (21.82 ± 2.44 N/kg vs 24.09 ± 2.77 N/kg; P = 0.013) in injured participants compared to control participants. These results demonstrate that compensatory movement strategies are utilized by participants with acute LAS to successfully reduce the impact forces of landing.     

Lower extremity joint kinetics and energetics during backward running

The purpose of this study was to measure lower extremity joint moments of force and joint muscle powers used to perform backward running. Ten trials of high speed (100 Hz) sagittal plane film records and ground reaction force data (1000 Hz) describing backward running were obtained from each of five male runners. Fifteen trials of forward running data were obtained from one of these subjects. Inverse dynamics were performed on these data to obtain the joint moments and powers, which were normalized to body mass to make between-subject comparisons. Backward running hip moment and power patterns were similar in magnitude and opposite in direction to forward running curves and produced more positive work in stance. Functional roles of knee and ankle muscles were interchanged between backward and forward running. Knee extensors were the primary source of propulsion in backward running owing to greater moment and power output (peak moment = 3.60 N.m.kg-1; peak power = 12.40 W.kg-1) compared with the ankle (peak moment = 1.92 N.m.kg-1; peak power = 7.05 W.kg-1). The ankle plantarflexors were the primary shock absorbers, producing the greatest negative power (peak = -6.77 W.kg-1) during early stance. Forward running had greater ankle moment and power output for propulsion and greater knee negative power for impact attenuation. The large knee moment in backward running supported previous findings indicating that backward running training leads to increased knee extensor torque capabilities.     

Altered movement strategies during jump landing/cutting in patients with chronic ankle instability

Centrally mediated changes in sensorimotor function have been reported in patients with chronic ankle instability (CAI). However, little is known regarding supraspinal/spinal adaptations during lower‐extremity dynamic movement during a multiplanar, single‐leg landing/cutting task. The purpose of this study was to investigate the effect of CAI on landing/cutting neuromechanics, including lower‐extremity kinematic, electromyography (EMG) activation, and ground reaction force (GRF) characteristics. One hundred CAI patients and 100 matched healthy controls performed five trials of a jump landing/cutting task. Sagittal‐ and frontal‐plane ankle, knee and hip kinematics, EMG activation in eight lower‐extremity muscles, and 3D GRF were collected during jump landing/cutting. Functional analyses of variance (FANOVA) were used to evaluate between‐group differences for dependent variables throughout the entire ground contact of the task. Relative to the control group, the CAI group revealed (a) reduced dorsiflexion, increased knee and hip flexion angles, (b) increased inversion and hip adduction angles, (c) increased EMG activation of medial gastrocnemius, peroneus longus, adductor longus, vastus lateralis, gluteus medius, and gluteus maximus, and (d) increased posterior and vertical GRF during initial landing, and reduced medial, posterior, and vertical GRF during mid‐landing and mid‐cutting. CAI patients demonstrated alterations in landing/cutting movement strategies as demonstrated by a higher susceptibility of foot placement for lateral ankle sprains, and more flexed positions of the knee and hip with higher EMG activation of knee and hip extensors to modulate GRF to compensate for the unstable ankle. This apparent compensation may be due to mechanical (limited dorsiflexion angle) and/or sensorimotor deficits in the ankle.     

Effects of medially wedged insoles on the biomechanics of the lower limbs of runners with excessive foot pronation and foot varus alignment

BackgroundExcessive foot pronation during running in individuals with foot varus alignment may be reduced by medially wedged insoles.Research questionThis study investigated the effects of a medially wedged insole at the forefoot and at the rearfoot on the lower limbs angles and internal moments of runners with excessive foot pronation and foot varus alignment.MethodsKinematic and kinetic data of 19 runners (11 females and 8 males) were collected while they ran wearing flat (control condition) and medially wedged insoles (insole condition). Both insoles had arch support. We used principal component analysis for data reduction and dependent t-test to compare differences between conditions.ResultsThe insole condition reduced ankle eversion (p = 0.003; effect size = 0.63); reduced knee range of motion in the transverse plane (p = 0.012; effect size = 0.55); increased knee range of motion in the frontal plane in early stance and had earlier knee adduction peak (p = 0.018; effect size = 0.52); reduced hip range of motion in the transverse plane (p = 0.031; effect size = 0.48); reduced hip adduction (p = 0.024; effect size = 0.50); reduced ankle inversion moment (p = 0.012; effect size = 0.55); and increased the difference between the knee internal rotation moment in early stance and midstance (p = 0.012; effect size = 0.55).SignificanceInsoles with 7˚ medial wedges at the forefoot and rearfoot are able to modify motion and moments patterns that are related to lower limb injuries in runners with increased foot pronation and foot varus alignment with some non-desired effects on the knee motion in the frontal plane.     

A longitudinal investigation of landing biomechanics following anterior cruciate ligament reconstruction

ObjectiveAbnormal movement patterns have been shown during landing in patients who have undergone anterior cruciate ligament (ACL) reconstruction surgery. The purpose of this study was to investigate landing biomechanics over time in this patient group to determine whether asymmetry between limbs reduced with time and after a return to physical activity.DesignProspective longitudinal study.SettingBiomechanics laboratory.ParticipantsFourteen patients who had undergone ACL reconstruction surgery.Main outcome measureSingle limb landing assessments were made at two time points; within the first year (mean of 10 months) and at 3 years (after patients had returned to sport) following ACL reconstruction. Three-dimensional motion analysis was used to record kinematic and kinetic variables, which were compared across time and limb using ANOVA models.ResultsMost biomechanical variables showed little change over time except for the external knee adduction moment at the operated knee, which increased (effect size d = 0.5), but remained less than the contralateral side. In the sagittal plane, asymmetrical landing patterns were seen at both assessments. Patients landed with reduced knee flexion angles (effect size range 0.76–0.9) and moments (effect size range 0.56–0.9) compared to the uninjured limb and made compensations for this by increasing the hip flexion moment (effect size range d = 0.6–0.75).ConclusionsAsymmetrical landing biomechanics persisted at three years after ACL reconstruction in athletes who returned to sporting activity. Long term implications of controlling the landing by increasing the hip moment are unknown and require further investigation.     

A three-dimensional biomechanical analysis of the squat during varying stance widths

PURPOSE: The purpose of this study was to quantify biomechanical parameters employing two-dimensional (2-D) and three-dimensional (3-D) analyses while performing the squat with varying stance widths. METHODS: Two 60-Hz cameras recorded 39 lifters during a national powerlifting championship. Stance width was normalized by shoulder width (SW), and three stance groups were defined: 1) narrow stance squat (NS), 107 +/- 10% SW; 2) medium stance squat (MS), 142 +/- 12% SW; and 3) wide stance squat (WS), 169 +/- 12% SW. RESULTS: Most biomechanical differences among the three stance groups and between 2-D and 3-D analyses occurred between the NS and WS. Compared with the NS at 45 degrees and 90 degrees knee flexion angle (KF), the hips flexed 6-11 degrees more and the thighs were 7-12 degrees more horizontal during the MS and WS. Compared with the NS at 90 degrees and maximum KF, the shanks were 5-9 degrees more vertical and the feet were turned out 6 degrees more during the WS. No significant differences occurred in trunk positions. Hip and thigh angles were 3-13 degrees less in 2-D compared with 3-D analyses. Ankle plantar flexor (10-51 N.m), knee extensor (359-573 N.m), and hip extensor (275-577 N.m) net muscle moments were generated for the NS, whereas ankle dorsiflexor (34-284 N.m), knee extensor (447-756 N.m), and hip extensor (382-628 N.m) net muscle moments were generated for the MS and WS. Significant differences in ankle and knee moment arms between 2-D and 3-D analyses were 7-9 cm during the NS, 12-14 cm during the MS, and 16-18 cm during the WS. CONCLUSIONS: Ankle plantar flexor net muscle moments were generated during the NS, ankle dorsiflexor net muscle moments were produced during the MS and WS, and knee and hip moments were greater during the WS compared with the NS. A 3-D biomechanical analysis of the squat is more accurate than a 2-D biomechanical analysis, especially during the WS.     

Adaptations in single-leg hop biomechanics following anterior cruciate ligament reconstruction

When a patient performs a clinically normal hop test based on distance, it cannot be assumed that the biomechanics are similar between limbs. The objective was to compare takeoff and landing biomechanics between legs in patients who have undergone anterior cruciate ligament reconstruction. Kinematics and ground reaction forces were recorded as 13 patients performed the single-leg hop on each leg. Distance hopped, joint range of motion, peak joint kinetics and the peak total extensor moment were compared between legs during both takeoff and landing. Average hop distance ratio (involved/noninvolved) was 93 ± 4%. Compared to the noninvolved side, knee motion during takeoff on the involved side was significantly reduced (P = 0.008). Peak moments and powers on the involved side were lower at the knee and higher at the ankle and hip compared with the noninvolved side (Side by Joint P = 0.011; P = 0.003, respectively). The peak total extensor moment was not different between legs (P = 0.305) despite a decrease in knee moment and increases in ankle and hip moments (Side by Joint P = 0.015). During landing, knee motion was reduced (P = 0.043), and peak power absorbed was decreased at the knee and hip and increased at the ankle on the involved side compared to the noninvolved side (P = 0.003). The compensations by other joints may indicate protective adaptations to avoid overloading the reconstructed knee.     

Effects of barbell back squat stance width on sagittal and frontal hip and knee kinetics

Different stance widths are commonly utilized when completing the barbell back squat during athletic general preparedness training. Width manipulation is thought to influence sagittal plane stimuli to the hip and knee extensors, the primary extensor musculature in the squat. However, how width manipulation affects frontal plane stimuli is less understood. Knowledge of hip and knee net joint moments (NJM) could improve exercise selection when aiming to improve sport‐specific performance and prevent injuries. Fourteen adult amateur rugby athletes were recruited for this study. After a familiarization period, participants performed wide‐ (WIDE, 1.5× greater trochanter width) and narrow‐stance (NARROW, 1× greater trochanter width) barbell back squats to femur parallel depth, using relative loads of 70% and 85% of one‐repetition maximum. Sagittal and frontal plane hip and knee kinetics and kinematics were compared between widths. A Bonferroni‐corrected alpha of 0.01 was employed as the threshold for statistical significance. Knee flexion angle was statistically greater in NARROW than WIDE (P < 0.0001, d = 2.56‐2.86); no statistical differences were observed for hip flexion angle between conditions (P = 0.049‐0.109, d = 0.33‐0.38). Hip‐to‐knee extension NJM ratios and knee adduction NJMs were statistically greater in WIDE than NARROW (P < 0.007, d = 0.51‐1.41). At femur parallel, stance width manipulation in the barbell back squat may provide substantial differences in biomechanical stimulus in both the sagittal plane and the frontal plane. In certain contexts, these differences may have clinically relevant longitudinal implications, from both a performance and a injury prevention standpoint, which are discussed.     

Landing technique affects knee loading and position during athletic tasks

Anterior cruciate ligament (ACL) injuries have been reported to occur with the ankle in a dorsiflexed position at initial contact. Few studies have attempted to quantify the biomechanical parameters related with such landing patterns during athletic tasks.ObjectivesThe purpose of this study was to evaluate the effects that two landing techniques have in lower extremity biomechanics while performing two tasks.DesignSingle-group repeated measures design.MethodsTwenty female soccer athletes from a Division I institution performed two landing techniques (forefoot and rearfoot) during two unanticipated tasks (sidestep cutting and pivot). Repeated measures analyses of variance were conducted to assess differences in the kinematic and kinetic parameters between landing techniques for each task.ResultsThe forefoot landing technique had significantly higher internal knee adductor moment than the rearfoot for both the pivot and sidestep cutting task (p < 0.001 and p = 0.003, respectively). For the sidestep cutting task, participants had increased knee valgus angle with the rearfoot, whereas for the pivot they had increased knee valgus with the forefoot landing technique (p < 0.05).ConclusionsThe results of this study highlighted that there are inherent differences in biomechanical outcomes between foot-landing techniques. The forefoot landing technique increasingly affects knee adduction moment loading, which can potentially place a higher strain on the ACL. Essentially, the demands of the landing technique on lower extremity biomechanics (e.g., hip and knee) are task dependent.     

An investigation into the role of gluteal muscle strength and EMG activity in controlling HIP and knee motion during landing tasks

ObjectivesTo examine the relationship between gluteal muscle activity and strength and knee and hip biomechanics during single leg loading tasks.DesignCorrelation study.SettingUniversity Biomechanics laboratory.Participants34 physically active, healthy participants, (17 males and 17 females).Main outcome measuresgluteal muscle EMG activity; hip abduction and extension muscle strength; knee and hip angles and moments.ResultsIn females knee abduction moments and angles were strongly correlated to hip abduction strength across all tasks, whereas in males the relationships were less clear across tasks with both hip abduction strength and gluteus medius EMG activity showing the strongest relationships in specific tasks.ConclusionHip and knee kinetic and kinematic variables related to the development of dynamic knee valgus would appear to be influenced by gluteal muscle strength and EMG activity. The level of influence varies across single leg squatting and landing tasks and varies between genders.     

Lower limb extensor moments in children with spastic diplegic cerebral palsy

In this retrospective study, we quantified the mean extensor moment at the ankle, knee and hip over the stance period in a group of independently ambulant children with spastic diplegia (n = 90; 167 limbs) and in a group of normally-developing (ND) children (n = 22; 22 limbs). The mean knee extensor moment and the mean support moment demonstrated greater variance in children with diplegia than in normally-developing children (P < 0.0001 and P < 0.001). This was explained by a strong relationship between the mean knee extensor moment and minimum knee flexion in stance (r2 = 0.615; P < 0.0001) in the affected group with a positive mean knee extensor moment for all those children who walked in greater than 20 degrees of knee flexion. We also found a linear relationship between the support moment and knee flexion (r2 = 0.805; P < 0.0001). Our data supported the biomechanical analysis of Hof [Gait Posture, 12 (2000) 196] who suggested that his modified support moment should be a linear function with eccentricity at the knee. Extensor moments at the ankle (r2 = 0.001376; P = 0.641) and hip (r2 = 0.0860; P = 0.000168) bore weak relationships with increasing knee flexion even though there was a strong positive relationship between minimum knee flexion and minimum hip flexion (r2 = 0.316; P < 0.0001). We conclude that children with spastic diplegic cerebral palsy (SDCP) who walk with a crouch gait rely on their knee extensors to prevent collapse of the lower limbs. Intervention directed at redistributing extensor moments between the joints of the lower limbs may slow the increase in knee flexion and prolong reasonable walking function in this group.