ACL Risk Factors Using Lower Limb Joint Angles in Single-Leg Drop Landing between Young Athletes with Normal and Flatfeet

Document Type : Original article

Authors

1 PhD Student of Kharazmi University of Tehran (Physical Education)

2 Assistant Professor of Kharazmi University of Tehran (Physical Education)

3 Assistant Professor, Department of Sport Science, School of Education and Psychology, Shiraz University, Shiraz, Iran

Abstract

Background and Aim: Knowledge of the changes of lower limb joint anglesduring landing provides good fundamental understanding to prevent knee injuries in people with flatfeet. Hence, the purpose of the present study was to compare lower limb angles as ACL risk factor during single leg drop landing in athletes with flatfeet and normal.
Materials and Methods: In the current investigation, 10 young male athletes with flatfeet and 10 young male athletes with normal foot participated. The foot arch was measured using navicular drop test. Navicular drop between 5 to 9 mm was classified as normal foot and navicular drop greater than 10 mm as flatfeet. The kinematic and kinetic data were recorded using motion analysis and force plate. Data processing was performed via Mathlab software and lower limb angles parameters in knee maximum flexion in three motion plates were statistically analyzed running MANOVA at significance level of α = 0/05.
Results: Significant differences were observed between the two groups in knee valgus (p=0/045) and hip adduction (p=0/037) angles in frontal plane. No Significant differences were observed between the two groups in other joint angles in other planes.
Conclusion: According to the results, changes in the normal structure of the foot arch and consequently body alignment might affectlower limb angles in daily activities and sport that can cause changes in the pattern of injuries. The results of the current study can help better organize a rehabilitation program and activities for those with flatfeet.

Keywords

Main Subjects


  1. Kaufman KR, Brodine SK, Shaffer RA, Johnson CW and Cullison TR. The effect of foot structure and range of motion on musculoskeletal overuse injuries. Am J Sports Med 1999; 27(5): 585-93.##
  2. Cote KP and Brunet II ME, Gansneder BM, and Shultz SJ.. Effects of pronated and supinated foot postures on static and dynamic postural stability. Journal of athletic training, 2005; 40-41. ##
  3. Perry J and Burnfield JM. Gait Analysis: Normal and Pathological Function. 2nd ed. New Jersey: Slack; 2010: p. 353. ##
  4. PoilMc T G and Cornwall MW. The relationship between static lower extremity measurements and rearfoot motion during walking. J Orthop Sports PhysTher. 1996; 24: 309-319. ##
  5. Chinn L and Hertel J. Rehabilitation of ankle and foot injuries in athletes. Clin Sports Med 2010; 29(1): 157-67. ##
  6. Mosavi SK, Shojaedin SS and Mimar R. The Comparison of Maximum Vertical Ground Reaction Force and electromyoghraphy leg muscles during single leg drop landing between men with genu varum deformity and normal knee From different Height. 2014; 6(2): 167- 87. ##
  7. Mothersole G. Ground reaction force profiles of specific jump-landing tasks in females: development of a systematic and progressive jump-landing model. 2013; Auckland University of Technology. ##
  8. Nagai T, et al. Knee proprioception and strength and landing kinematics during a single-leg stop-jump task. Journal of athletic training J Athl Train. 2013 Jan-Feb;48(1):31-8##
  9. Dufek JS and BT Bates. Biomechanical factors associated with injury during landing in jump sports. Sports Med. 1991 Nov;12(5):326-37. ##

10. Yi C-H, S-Y Park and S-H. Lee. Gender differences in knee angle on landing from a drop-jump: kinematic data in young adults. Journal of Physical Therapy Science. 2004; 16(1): p. 1-5. ##

11. Hewett T E 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) p: 492-501. ##

12. Hewett T E et al. The effect of neuromuscular training on the incidence of knee injury in female athletes a prospective study. The American journal of sports medicine, 1999; 27(6): p 699-706. ##

13. Griffin L Y et al. Understanding and preventing noncontact anterior cruciate ligament injuries a review of the Hunt Valley II meeting, January. The American journal of sports medicine, 2006; 34(9): p. 1512-1532. ##

14. Zhang L-Q et al. Six degrees-of-freedom kinematics of ACL deficient knees during locomotion—compensatory mechanism. Gait & posture. 2003; 17(1): p. 34-42. ##

15. Kanamori A et al. The forces in the anterior cruciate ligament and knee kinematics during a simulated pivot shift test: a human cadaveric studyusing robotic technology. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2000; 16(6): p 633-639. ##

16. Koga H et al. Mechanisms for noncontact anterior cruciate ligament injuries knee joint kinematics in 10 injury situations from female team handball and basketball. The American journal of sports medicine. 2010; 38(11): p. 2218-2225. ##

17. Kiapour A M et al. Uni-directional coupling between tibiofemoral frontal and axial plane rotation supports valgus collapse mechanism of ACL injury. Journal of biomechanics, 2015; 48(10): p. 1745-1751. ##

18. Chaudhari A M and T P Andriacchi. The mechanical consequences of dynamic frontal plane limb alignment for non-contact ACL injury. Journal of biomechanics. 2006; 39(2): p. 330-338. ##

19. Chaudhari A M et al. The effects of dynamic limb alignment on knee moments during single limb landing: Implications for the analysis of the non-contact injury to the anterior cruciate ligament. in 2003 Summer Bioengineering Conference 2003. ##

20. Cho J-H et al. Analysis of injury mechanism on ankle and knee during drop landings according to landing directions. Korean Journal of Sport Biomechanics. 2010; 20(1): 67-73. ##

21. Akbari H et al. Does Pronated Foot Predispose the Females to Risk of AnteriorCruciate Ligament injury. International Journal of Sport Studies. 2013; 3##

22. Lin C J, Lai K A, Kuan T S and Chou Y L. Correlating factors and clinical significance of flexible flatfoot in preschool children. Journal of pediatric orthopedics, 2001; (21): 378-382. ##

23. Blackburn JT, Norcross MF, Cannon LN and Zinder SM. Hamstring’s stiffness and landing biomechanics linked to anterior cruciate ligament loading. Journal of Athletic Training 2013; 48(6): 764- 72. ##

24. Nashner LM, Black FO and Wall CIII. Adaptation to altered support and visual conditions during stance: patients with vestibular deficits. The Journal of Neuroscience. 1982; (2): 536-544. ##

25. Yi-Fen Shih, Chao-Yin Chen, Wen-Yin Chen and Hsiu-Chen Lin. Lower extremity kinematics in children with and without flexible flatfoot: a comparative study. 2012; 13(31). ##

26. Winter DA. Biomechanics and motor control of human movement. John Wiley & Sons; 2009. ##

27. Brody D M. Techniques in the evaluation and treatment of the injured runner. Orthop Clin North Am. 1982; (13):541-558. ##

28. Williams D S and Mc Clay I S. Measurements used to characterize the foot and the medial longitudinal.Arch:reliability and validity. Phys Ther. 2000; (80): 864-871. ##

29. Kramer LC. The relationship of lower extremity malalignments in college students with a history of ACL injury. Thesis:Doctor of philosophy.The penn Sylvania state university, college of Health and Human Development. 2004; 35-36. ##

30. Mueller M J and KS Maluf. Tissue adaptation to physical stress: a proposed “Physical Stress Theory” to guide physical therapist practice, education, and research. Physical therapy. 2002; 82(4): 383-403.. ##

31. Hertel J, J H Dorfman and R A Braham. Lower extremity malalignments and anterior cruciate ligament injury history. J Sports Sci Med. 2004; 3(4): 220-225. ##

32. Williams D S, Mc C lay I S. Measurements used to characterize the foot and the medial longitudinal Arch: reliability and validity. Phys Ther.2000; 80:864-871. ##

33. Association G. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent 2014; 81(3): 14. ##

34. Post WR, Teitge R, Amis A. Patellofemoral malalignment: looking beyond the viewbox. Clin Sports Med 2002;21(3): 521-46. ##

35. De Leva P. Adjustments to Zatsiorsky-Seluyanov's segment inertia parameters. Journal of biomechanics. 1996; 29(9):1223-30. ##

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

37. Gokeler A et al. Abnormal landing strategies after ACL reconstruction. Scandinavian journal of medicine & science in sports 2010; 20(1): 12-19.. ##

38. Chen S, W H Hong and C Lu. Effects Of Different Landing Strategies To Decrease Knee Joint Loading. in 4th Kuala Lumpur International Conference on Biomedical Engineering. 2008; Springer. ##

39. Wang X, Wang PS, Zhou W. Risk factors of military training-related injuries in recruits of Chinese People's Armed Police Forces. Chin J Traumatol 2003; 6(1): 12-7. ##

40. Daneshmandi H, Alizadeh MH, Gharekhanloo R. Corrective exercise & Therapy. 1st ed. Tehran: Samt Publication; 2004. p. 87-118. [In Persian]. ##

  • Receive Date: 03 September 2018
  • Revise Date: 23 September 2018
  • Accept Date: 26 September 2018
  • First Publish Date: 21 March 2019