آیا هشت هفته تمرین ثباتی می‌تواند میزان فلکشن زانو و نیروی برشی قدامی را تغییر دهد؟

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری، گروه آسیب‌شناسی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، ایران

2 دانشیار، گروه آسیب‌شناسی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، ایران

3 دانشیار، گروه ارتوپد فنی، دانشکده توانبخشی، دانشگاه علوم پزشکی اصفهان، ایران

چکیده

مقدمه و اهداف
آسیب لیگامان متقاطع قدامی اغلب در میان ورزشکارانی که حرکت فرود تک­پا را انجام می­دهند، رایج است. عوامل بیومکانیکی و نیروی برشی قدامی سازوکار اصلی بار وارده به لیگامان متقاطع قدامی هستند. وضعیت اندام تحتانی طی فعالیت می‌تواند باعث افزایش یا کاهش نیروی برشی قدامی ‌شود؛ بنابراین هدف از مطالعه حاضر ارزیابی اثر هشت هفته تمرینات ثباتی بر زاویه فلکشن زانو و نیروی برشی قدامی طی حرکت فرود به منظور پیشگیری از آسیب لیگامان متقاطع قدامی بود.
مواد و روش ­ها
30 ورزشکار بسکتبالیست به طور تصادفی به دو گروه تمرینی و شاهد تقسیم شدند. گروه تمرینی تمرینات ثبات مرکزی را طی هشت هفته انجام دادند، اما گروه شاهد این تمرینات را انجام ندادند. متغیرهای کینتیکی و کینماتیکی اندام تحتانی در پیش­آزمون و پس­آزمون طی فرود تک‌پا، توسط دستگاه تحلیل حرکت و دستگاه صفحه نیرو جمع­آوری شد. برای مقایسه متغیرها از تحلیل واریانس با اندازه‌گیری‌های مکرر در سطح معناداری 05/0>P استفاده شد.
نتایج
نتایج نشان داد که میزان فلکشن زانو در گروه تمرینی متعاقب 8 هفته تمرین به ‌طور معناداری افزایش یافت (05/0P<)؛ اما نیروی برشی قدامی در گروه تمرینی پس از هشت هفته کاهش معناداری پیدا نکرد (05/0P>).
نتیجه ­گیری
بر اساس یافته‌های مطالعه حاضر، تمرینات ثبات مرکزی با افزایش ثبات ناحیه مرکزی بدن، احتمالاً استراتژی فراخوانی عضلات این ناحیه را طی حرکت فرود بهبود داده است؛ بنابراین با توجه به نتایج مطالعه حاضر می‌توان نتیجه گرفت که تمرین ثباتی بخش مرکزی می‌تواند به کاهش عوامل خطر آسیب لیگامان متقاطع قدامی نظیر برخی عوامل بیومکانیکی طی حرکات دینامیکی منجر شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Can Eight Weeks of Stabilization Exercise Change the Amount of Knee Flexion and Anterior Shear Force?

نویسندگان [English]

  • Faraj Fatahi1 Fatahi 1
  • Gholam Ali Ghasemi 2
  • Mohammad Taghi Karimi Taghi Karimi 3
1 PhD Student in Corrective Exercise and Sport Injury, University of Esfahan, Iran
2 Associate Professor in Pathology and Corrective Exercise, School of Physical Education and Sports Sciences, University of Isfahan, Isfahan, Iran
3 Associate Professor, Isfahan University of Medical Sciences, Rehabilitation Faculty, Orthotics and Prosthetics Department, Isfahan, Iran
چکیده [English]

Background and Aim: Anterior Cruciate Ligament (ACL) injury occurs frequently among athletes during single-leg landing and identifying factors which cause the high incidence of ACL injury is of great importance. The biomechanical factors and anterior shear forces are the primary mechanisms of load sustained on the ACL. The lower extremity position during activity may increase or decrease the anterior shear force. Therefore, the objective of the present study was to evaluate the effect of eight-week stabilization training on knee flection and anterior shear force during a drop landing task to prevent ACL injury.
Materials and Methods: A total of 30 basketball athletes were randomly assigned into a training group (n = 15), and a control group (n = 15). Training group performed the Core stability training during eight weeks but control group did not perform these exercises. Lower extremity kinetics and kinematics variables were calculated in pretest and posttest during single leg drop landing using motion analysis and force plat. Data were analyzed using mixed ANOVA repeated measure with the significance level set at P< 0.05.
Results: The results revealed that the amount of knee flexion in the training group significantly increased after eight weeks of training (P< 0.05), but there were no significant reduction in anterior shear forces (P> 0.05).
Conclusion: Based on the findings of the current study, core stability training with increasing core stability has probably improved muscles recruitment strategy during drop landing. Therefore, according to the results of the present study, we can conclude that stabilization training can result in the reduction of risk factors of ACL injury including biomechanical and factors during dynamic movemen
 

کلیدواژه‌ها [English]

  • Stabilization Training
  • Kinetics
  • Kinematics
  • Single Leg Drop Landing
  • Injury prevention

مراجع

  1. Russell KA, Palmieri RM, Zinder SM, Ingersoll CD. Sex differences in valgus knee angle during a single-leg drop jump. Journal of athletic training. 2006;41(2):166-71. ##
  2. Trimble MH, Bishop MD, Buckley BD, Fields LC, Rozea GD. The relationship between clinical measurements of lower extremity posture and tibial translation. Clinical Biomechanics. 2002;17(4):286-90. ##
  3.  LaBella CR, Hennrikus W, Hewett TE, Brenner JS, Brookes MA, Demorest RA, et al. Anterior cruciate ligament injuries: diagnosis, treatment, and prevention. Pediatrics. 2014;133(5):e1437-e50. ##
  4.  Hewett TE. Neuromuscular and hormonal factors associated with knee injuries in female athletes. Sports medicine. 2000;29(5):313-27. ##
  5.  Hewett TE, Myer GD, Ford KR, Heidt RS, Colosimo AJ, McLean SG, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes A prospective study. The American journal of sports medicine. 2005;33(4):492-501. ##
  6. Malinzak RA, Colby SM, Kirkendall DT, Yu B, Garrett WE. A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clinical biomechanics. 2001;16(5):438-45. ##
  7. Boden BP, Torg JS, Knowles SB, Hewett TE. Video analysis of anterior cruciate ligament injury abnormalities in hip and ankle kinematics. The American journal of sports medicine. 2009;37(2):252-9. ##
  8. Yu B, Lin C-F, Garrett WE. Lower extremity biomechanics during the landing of a stop-jump task. Clinical Biomechanics. 2006;21(3):297-305. ##
  9. Dufek JS, Bates BT. Biomechanical factors associated with injury during landing in jump sports. Sports medicine. 1991;12(5):326-37. ##

10. Sell TC, Ferris CM, Abt JP, Tsai YS, Myers JB, Fu FH, et al. Predictors of proximal tibia anterior shear force during a vertical stop‐jump. Journal of Orthopaedic Research. 2007;25(12):1589-97. ##

11. Boden BP, Dean GS, Feagin Jr JA, Garrett Jr WE. Mechanisms of anterior cruciate ligament injury. Orthopedics. 2000;23(6):573-8. ##

12. Olsen O-E, Myklebust G, Engebretsen L, Bahr R. Injury mechanisms for anterior cruciate ligament injuries in team handball a systematic video analysis. The American journal of sports medicine. 2004;32(4):1002-12. ##

 

13. Walsh MC. The relationship between lower extremity muscle activity and knee flexion angle during a jump-landing task: ProQuest; 2008. ##

14. Ireland ML. Anterior cruciate ligament injury in female athletes: epidemiology. Journal of Athletic Training. 1999;34(2):150. ##

15. Krosshaug T, Nakamae A, Boden BP, Engebretsen L, Smith G, Slauterbeck JR, et al. Mechanisms of anterior cruciate ligament injury in basketball video analysis of 39 cases. The American journal of sports medicine. 2007;35(3):359-67. ####

16. 1DeMorat G, Weinhold P, Blackburn T, Chudik S, Garrett W. Aggressive quadriceps loading can induce noncontact anterior cruciate ligament injury. The American journal of sports medicine. 2004;32(2):477-83.

17. Beynnon BD, Fleming BC. Anterior cruciate ligament strain in-vivo: a review of previous work. Journal of biomechanics. 1998;31(6):519-25. ####

18. Markolf KL, Burchfield DM, Shapiro MM, Shepard MF, Finerman GA, Slauterbeck JL. Combined knee loading states that generate high anterior cruciate ligament forces. Journal of Orthopaedic Research. 1995;13(6):930-5. ####

19. Markolf KL, Burchfield DM, Shapiro MM, Shepard MF, Finerman GAM, Slauterbeck JL. Combined knee loading states that gvenerate high anterior cruciate ligament forces. Journal of orthopaedic research. 1995;13(6):930-5. ##

20. Hewett T, Zazulak B, Myer G, Ford K. A review of electromyographic activation levels, timing differences, and increased anterior cruciate ligament injury incidence in female athletes. British Journal of Sports Medicine. 2005;39(6):347-50. ##

21. Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. The effects of core proprioception on knee injury. The American Journal of Sports Medicine. 2007;35(3):368. ##

22. 22Hewett TE, Stroupe AL, Nance TA, Noyes FR. Plyometric training in female athletes. The American Journal of Sports Medicine. 1996;24(6):765. ##

23. Jackson KR. The effect of different exercise training interventions on lower extremity biomechanics and quality of movement in high school female athletes: University of Virginia; 2011. ##

24. Myer GD, Ford KR, Brent JL, Hewett TE. The effects of plyometric vs. dynamic stabilization and balance training on power, balance, and landing force in female athletes. The Journal of Strength & Conditioning Research. 2006;20(2):345-53. ##

25. Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. Deficits in neuromuscular control of the trunk predict knee injury risk. The American Journal of Sports Medicine. 2007;35(7):1123. ##

26. Araujo S, Cohen D, Hayes L. Six Weeks of Core Stability Training Improves Landing Kinetics Among Female Capoeira Athletes: A Pilot Study. Journal of human kinetics. 2015;45(1):27-37. ##

27. Sato K, Mokha M. Does core strength training influence running kinetics, lower-extremity stability, and 5000-M performance in runners? The Journal of Strength & Conditioning Research. 2009;23(1):133-40. ##

28. Nguyen A-D, Boling MC, Levine B, Shultz SJ. Relationships between lower extremity alignment and the quadriceps angle. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine. 2009;19(3):201.v##

29. Hart JM, Garrison JC, Kerrigan DC, Palmieri-Smith R, Ingersoll CD. Gender differences in gluteus medius muscle activity exist in soccer players performing a forward jump. Research in Sports Medicine. 2007;15(2):147-55. ##

30. Gribble PA, Mitterholzer J, Myers AN. Normalizing considerations for time to stabilization assessment. Journal of Science and Medicine in Sport. 2012;15(2):159-63. ##

31. Afonso MP. Modelling the gait of healthy and post-stroke individuals: Universidade do Porto; 2015. ##

32. Yu B. Effect of external marker sets on between-day reproducibility of knee kinem##atics and kinetics in stair climbing and level walking. Research in Sports Medicine. 2003;11(4):209-18. ##

33. Ali N, Robertson DGE, Rouhi G. Sagittal plane body kinematics and kinetics during single-leg landing from increasing vertical heights and horizontal distances: Implications for risk of non-contact ACL injury. The Knee. 2014;21(1):38-46. ##

34. Willardson JM. Developing the core: Human Kinetics; 2014. ##

35. Sell T, Akins J, Opp A, Lephart S. Relationship between tibial acceleration and proximal anterior tibia shear force across increasing jump distance. Journal of applied biomechanics. 2014;30(1):75-81. ##

36. McNair PJ, Prapavessis H, Callender K. Decreasing landing forces: effect of instruction. British Journal of Sports Medicine. 2000;34(4):293-6. ##

37. Sell TC, Ferris CM, Abt JP, Tsai YS, Myers JB, Fu FH, et al. The effect of direction and reaction on the neuromuscular and biomechanical characteristics of the knee during tasks that simulate the noncontact anterior cruciate ligament injury mechanism. The American journal of sports medicine. 2006;34(1):43-54. ##

38. Yu B, Lin CF, Garrett WE. Lower extremity biomechanics during the landing of a stop-jump task. Clinical Biomechanics. 2006;21(3):297-305. ##

39. Walsh M, Boling MC, McGrath M, Blackburn JT, Padua DA. Lower Extremity Muscle Activation and Knee Flexion During a Jump-Landing Task. Journal of athletic training. 2012;47(4):406-13. ##

 

40. Shelburne KB, Pandy MG, Anderson FC, Torry MR. Pattern of anterior cruciate ligament force in normal walking. Journal of biomechanics. 2004;37(6):797-805. ##

41. Olsen OE, Myklebust G, Engebretsen L, Bahr R. Injury mechanisms for anterior cruciate ligament injuries in team handball a systematic video analysis. The American journal of sports medicine. 2004;32(4):1002-12. ##

42. Shelburne KB, Torry MR, Pandy MG. Effect of muscle compensation on knee instability during ACL-deficient gait. Medicine and science in sports and exercise. 2005;37(4):642-8. ##

43. Shelburne KB, Torry MR, Pandy MG. Muscle, ligament, and joint-contact forces at the knee during walking. Medicine and science in sports and exercise. 2005;37(11):1948-56.

44. Li G, Rudy T, Sakane M, Kanamori A, Ma C, Woo SLY. The importance of quadriceps and hamstring muscle loading on knee kinematics and in-situ forces in the ACL. Journal of biomechanics. 1999;32(4):395-400.

45. MacWilliams B, Wilson D, DesJardins J, Romero J, Chao E. Hamstrings cocontraction reduces internal rotation, anterior translation, and anterior cruciate ligament load in weight‐bearing flexion. Journal of orthopaedic research. 1999;17(6):817-22. ##

46. Withrow TJ, Huston LJ, Wojtys EM, Ashton-Miller JA. Effect of varying hamstring tension on anterior cruciate ligament strain during in vitro impulsive knee flexion and compression loading. The Journal of Bone & Joint Surgery. 2008;90(4):815-23. ##

47. Li G, DeFrate LE, Rubash HE, Gill TJ. In vivo kinematics of the ACL during weight‐bearing knee flexion. Journal of orthopaedic research. 2005;23(2):340-4. ##

48. Withrow TJ, Huston LJ, Wojtys EM, Ashton-Miller JA. The relationship between quadriceps muscle force, knee flexion, and anterior cruciate ligament strain in an in vitro simulated jump landing. The American journal of sports medicine. 2006;34(2):269-74. ##

49. Blackburn JT, Padua DA. Influence of trunk flexion on hip and knee joint kinematics during a controlled drop landing. Clinical Biomechanics. 2008;23(3):313-9. ##

50. Kulas AS, Hortobágyi T, DeVita P. The interaction of trunk-load and trunk-position adaptations on kne##e anterior shear and hamstrings muscle forces during landing. Journal of athletic training. 2010;45(1):5-15.

51. Crossley KM, Zhang W-J, Schache AG, Bryant A, Cowan SM. Performance on the single-leg squat task indicates hip abductor muscle function. The American journal of sports medicine. 2011;39(4):866-73. ##

52. Hoffman JR, Tenenbaum G, Maresh CM, Kraemer WJ. Relationship Between Athletic Performance Tests and Playing Time in Elite College Basketball Players. The Journal of Strength & Conditioning Research. 1996;10(2):67-71. ##

53. Matthew Shirey D, Matthew Hurlbutt D, Nicole Johansen D, Gregory WK, Wilkinson SG, Hoover DL. the influence of core musculature engagement on hip and knee kinematics in women during a single leg squat.

54. Hodges PW, Moseley GL, Gabrielsson A, Gandevia SC. Experimental muscle pain changes feedforward postural responses of the trunk muscles. Experimental Brain Research. 2003;151(2):262-71. ##

55. Hodges PW, Richardson CA. Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. Journal of Spinal Disorders & Techniques. 1998;11(1):46-56. ##

56. Silfies SP, Mehta R, Smith SS, Karduna AR. Differences in Feedforward Trunk Muscle Activity in Subgroups of Patients With Mechanical Low Back Pain. Archives of Physical Medicine and Rehabilitation. 2009;90(7):1159-69. ##

57. Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Medicine and science in sports and exercise. 2004;36(6):926-34. ##

58. Kulas AS, Schmitz RJ, Shultz SJ, Henning JM, Perrin DH. Sex-specific abdominal activation strategies during landing. Journal of Athletic Training. 2006;41(4):381-6. ##

59. Iida Y, Kanehisa H, Inaba Y, Nakazawa K. Activity modulations of trunk and lower limb muscles during impact-absorbing landing. Journal of Electromyography and Kinesiology. 2011;21(4):602-9. ##

60. Hollman JH, Ginos BE, Kozuchowski J, Vaughn AS, Krause DA, Youdas JW. Relationships between knee valgus, hip-muscle strength, and hip-muscle recruitment during a single-limb step-down. Journal of sport rehabilitation. 2009;18(1):104. ##

61. Myer GD, Ford KR, PALUMBO OP, Hewett TE. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. The Journal of Strength & Conditioning Research. 2005;19(1):51-60. ##

62. Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. Deficits in neuromuscular control of the trunk predict knee injury risk a prospective biomechanical-epidemiologic study. The American journal of sports medicine. 2007;35(7):1123-30. ##

63. Thijs Y, Van Tiggelen D, Willems T, De Clercq D, Witvrouw E. Relationship between hip strength and frontal plane posture of the knee during a forward lunge. British journal of sports medicine. 2007;41(11):723-7. ##

64. Griffin LY, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE, et al. Noncontact Anterior Cruciate Ligament Injuries: Risk Factors and Prevention Strategies. Journal of the American Academy of Orthopaedic Surgeons. 2000;8(3):141-50. ##

 

65. Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010;40(2):42-51. ##

66. Alentorn-Geli E, Myer G, Silvers H, Samitier G, Romero D, Lázaro-Haro C, et al. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors. Knee Surgery, Sports Traumatology, Arthroscopy. 2009;17(7):705-29. ##

67. Stevens V, Vleeming A, Bouche K, Mahieu N, Vanderstraeten G, Danneels L. Electromyographic activity of trunk and hip muscles during stabilization exercises in four-point kneeling in healthy volunteers. European Spine Journal. 2007;16(5):711-8. ##

68. Tsao H, Hodges P. Immediate changes in feedforward postural adjustments following voluntary motor training. Experimental Brain Research. 2007;181(4):537-46. ##

دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 7، شماره 2
خرداد و تیر 1397
صفحه 11-22

فایل ها

سابقه مقاله

  • تاریخ دریافت: 27 بهمن 1395
  • تاریخ بازنگری: 02 خرداد 1396
  • تاریخ پذیرش: 05 خرداد 1396
  • تاریخ اولین انتشار: 01 تیر 1397

هم رسانی

ارجاع به این مقاله

آمار