Effect of Corrective Exercises Program on Strength، ROM, and Performance in Basketball Players with Dynamic Knee Valgus

Document Type : Original article

Authors

1 Assistant Professor, Department of Physical Education and Sports Sciences, Faculty of Humanity Sciences, University of Kurdistan, Sanandaj, Iran

2 Professor, Department of Sport Injury and Corrective Exercise, Faculty of Physical Education and Sports Sciences, University of Guilan, Rasht, Iran

3 Professor, Department of Sport Injury and Corrective Exercise, Faculty of Physical Education and Sports Sciences, University of Tehran, Tehran, Iran

Abstract

Background and Aims: The most common mechanism of anterior cruciate ligament injury in basketball is non-contact and dynamic knee valgus is the key risk factor of these injuries. The purpose of the present study was to investigate the effect of corrective exercise program on strength, ROM, and performance in basketball players with dynamic knee valgus.
Materials and Methods: A total of 32 basketball players (age: 20.8± 1.7 years, weight :74.0± 5.2 kg, height: 183.9± 5.0 cm) with dynamic knee valgus participated in the current study and were randomly divided into two groups of exercise (n=16) and control (n=16). Assessment included ROM (dorsiflexion, abduction, and external rotation of the hip), strength (dorsiflexion, plantar flexion, abduction, and external rotation of the hip), and performance (balance and hop test) in dominant leg.
Results: Data analysis via ANCOVA showed that the exercise groups experienced significant reduction (P<0/01) in dynamic knee valgus (6/51 degree) during drop-jump task, significant improvement (P<0/01) in ROM (3/43 degree dorsiflexion with the knee flexion, 2/25 degree dorsiflexion with the knee extension, 2/38 degree abduction, and 1/75 degree external rotation of the hip), strength (2/32 kg dorsiflexion, 4/87 kg plantarflexion, 1/82 kg abduction and 1/58 kg external rotation of the hip), balance (3/33 cm), and hop tests (13/25 cm).
Conclusion:It can be concluded that participation in this corrective exercises program can lead to significant improvement in  strength and ROM distal and proximal knee joint and performance, and it seems that it can help for prevention of lower extremity injuries caused by dynamic knee valgus during functional activity.

Keywords

Main Subjects


  1. Chuter VH, Janse de Jonge X. Proximal and distal contributions to lower extremity injury: A review of the literature. Gait & Posture. 2012;(36): 7-15.##
  2. Ford KR, Myer GD, Hewett TE. Valgus knee motion during landing in high school female and male basketball players. Medicine & Science in Sports & Exercise. 2003; 35(10): 1745-50. ##
  3. Myer GD, Ford KR, Brent JL, Hewett TE. Differential neuromuscular training effects onACL injury risk factors in“high-risk” versus “low-risk” athletes. BMC Musculoskeletal Disorders. 2007; 8(1): 1-7. ##
  4.  Hewett TE, Myer GD, Ford KR, Heidt RS, Colosimo AJ, McLean SG, Van Den Bogert AJ, Paterno MV, Succop P. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes. The American Journal of Sports Medicine. 2005; 33(4): 492-501. ##
  5. Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. Journal of Athletic Training. 2007; 42(2): 311-19. ##
  6. Genuario JW, Faucett SC, Boublik M, Schlegel TF. A cost-effectiveness analysis comparing 3 anterior cruciate ligament graft types: bone-patellar tendon-bone autograft, hamstring autograft, and allograft. Am J Sports Med. 2011;40(2):307–14. ##
  7. Lubowitz JH, Appleby D. Cost-effectiveness analysis of the most common orthopaedic surgery procedures: knee arthroscopy and knee anterior cruciate ligament reconstruction. Arthroscopy. 2011; 27(10): 1317–22. ##
  8. Mihelic R, Jurdana H, Jotanovic Z, Madjarevic T, Tudor A. Long-term results of anterior cruciate ligament reconstruction: a comparison with non-operative treatment with a follow-up of 17–20 years. International Orthopaedics. 2011; 35(7): 1093-97. ##
  9. Alentorn-GeliE, Mendiguchía J, Samuelsson K, Musahl V, Karlsson J, Cugat R, Myer GD. Prevention of anterior cruciate ligament injuries in sports—Part I: Systematic review of risk factors in male athletes .Knee Surgery, Sports Traumatology, Arthroscopy. 2014; 22(1): 3-15. ##
  10. Hollman JH, Galardi CM, Lin I, Voth BC, Whitmarsh CL. Frontal and transverse plane hip kinematics and gluteus maximus recruitment correlate with frontal plane knee kinematics during single-leg squat tests in women. Clinical Biomechanics. 2014;29(4): 468-74. ##
  11. MagalhãEs E, Fukuda TY, Sacramento SN, Forgas A, Cohen M, Abdalla RJ. A comparison of hip strength between sedentary females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2010;40(10): 641-47. ##
  12. 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. Journal of Strength and Conditioning Research. 2006; 20(2): 345-53. ##
  13. Hewett TE, Ford KR, Hoogenboom BJ, Myer GD. Understandin and prevention ACL injuries: current biomechanical and epidemiological consideration. North American Journal of Sports Physical Therapy. 2010; 5(4): 234-51. ##
  14. Ireland ML. The female ACL: why is it more prone to injury? The Orthopedic Clinics of North America. 2002; 33(4): 637-51. ##
  15. Lawrence RK, Kernozek TW, Miller EJ, Torry MR, Reuteman P. Influences of hip external rotation strength on knee mechanics during single-leg drop landings in females. Clinical Biomechanics. 2008; 23(6): 806-13.
  16. Chaudhari AM, Andriacchi TP. The mechanical consequences of dynamic frontal plane limb alignment for non-contact ACL injury. Journal of Biomechanics. 2006;39(2): 330-38. ##
  17. Belanger L, Burt D, Callaghan J, Clifton S, Gleberzon BJ. Anterior cruciate ligament laxity related to the menstrual cycle: an updated systematic review of the literature. The Journal of the Canadian Chiropractic Association. 2013;57(1): 76-86. ##
  18. Daneshmandi H, Saki F, Daneshmandi L, Daneshmandi MS. Lower extremity alignment in female athletes with ACL reconstruction. Medicina dello Sport. 2012; 65(2): 211-21. ##
  19. Padua DA, Distefano LJ .Sagittal plane knee biomechanics and vertical ground reaction forces are modified following ACL injury prevention programs:a systematic review. Sports Health. 2009; 1 (2): 165-73. ##
  20. Boden BP, Torg JS, Knowles SB, Hewett TE.Video analysis of anterior cruciate ligament injury: abnormalities in hip and ankle kinematics. Am J Sports Med.  2009; 37(2):252–59. ##
  21. Sheehan FT, Sipprell WH, Boden BP .Dynamic sagittal plane trunk control during anterior cruciate ligament injury. Am J Sports Med. 2012; 40(5):1068–74. ##
  22. Bell  DR, Clark MA, Padua DA. Two- and 3-Dimensional Knee Valgus Are Reduced After an Exercise Intervention in Young Adults With Demonstrable Valgus During Squatting. Journal of Athletic Training. 2013;48(4):442–49. ##
  23. Mohammadi H, Daneshmandi H, Alizadeh M. The Effect of Dynamic Knee Valgus during Overhead Squat on Distal and Proximal Knee Joints Muscle Strength and Range of Motion in Basketball Player. J Sport Biomech. 2018; 3 (4): 17-27. ##
  24. Bell DR, Padua DA, Clark MA. Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement. Arch Phys Med Rehabil. 2008;89(7):1323–28. ##
  25. Hirth CJ, Padua DA. Clinical movement analysis to identify muscle imbalances and guide exercise. Athl Ther Today. 2007;12(4):10–14. ##
  26. Clark M, Lucett S. NASM Essentials of Corrective Exercise Training. National Academy of Sports Med; Lippincott Williams & Wilkins 2011. ##
  27. Willson JD, Davis IS. Lower extremity strength and mechanics during jumping in women with patellofemoral pain. J Sport Rehabil. 2009; 18(1): 76-90. ##
  28. 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. Journal of Strength and Conditioning Research. 2006; 20(2): 345-53. ##
  29. Bazett-Jones DM, Cobb SC, Joshi MN, Cashin SE, Earl JE. Normalizing hip muscle strength: establishing body-size-independent measurements. Archives of Physical Medicine and Rehabilitation. 2011; 92(1): 76-82. ##
  30. Delahunt E. Neuromuscular contributions to functional instability of the ankle joint. J of Body Works and Movement Therapies. 2007;11: 203-13. ##
  31. Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2006; 36(12):911–19. ##
  32. Ross MD, Langford B, Whelan PJ. Test-retest reliability of 4 single-leg horizontal hop tests.J Strength Cond Res. 2002; 16(4):617–22. ##
  33. Mohammadi H, Daneshmandi H, Alizadeh MH, Shamsimajlan A. Screening Tests for Neuromuscular Imbalance That Affecting the Non-Contact ACL Injury. Scientific Journal of Kurdistan University of Medical Sciences. 2015; 20(2): 85-105. ##
  34. Noyes FRBarber-Westin SDFleckenstein CWalsh CWest J. The drop-jump screening test: difference in lower limb control by gender and effect of neuromuscular training in female athletes. Am J Sports Med. 2005;33(2):197–207. ##
  35. Huston LJVibert BAshton-Miller JAWojtys EM. Gender differences in knee angle when landing from a drop-jump. Am J Knee Surg. 2001; 14(4):215–19. ##
  36. Nagano Y, Ida H, Akai M, Fukubayashi T. Biomechanical characteristics of the knee joint in female athletes during tasks associated with anterior cruciate ligament injury. The Knee. 2009; 16(2): 153-58. ##
  37. Herrington L. The effects of 4 weeks of jump training on landing knee valgus and crossover hop performance in female basketball players. J Strength Cond Res. 2010; 24(14):3427–32. ##
  38. Kato S, Urabe Y, Kawamura K. Alignment control exercise changes lower extremity movement during stop movements in female basketball players. Knee. 2008; 15(4):299 304. ##
  39. Noyes FR, Barber-Westin SDSmith STCampbell T. A training program to improve neuromuscular indices in female high school volleyball players. J Strength Cond Res. 2011; 25(8): 2151–60. ##
  40. Noyes FR, Barber-Westin SDSmith STCampbell TGarrison TT. A training program to improve neuromuscular and performance indices in female high school basketball players. J Strength Cond Res. 2012; 26(3):709–19. ##
  41. Noyes FR, Barber-Westin SDTutalo Smith STCampbell T. A training program to improve neuromuscular and performance indices in female high school soccer players. J Strength Cond Res. 2013;27(2):340-51. ##
  42. Lim BO, Lee YSKim JGAn KOYoo JKwon YH. Effects of sports injury prevention training on the biomechanical risk factors of anterior cruciate ligament injury in high school female basketball players. Am J Sports Med. 2009; 37(9):1728–34. ##
  43. McLeod TC, Armstrong T, Miller M,   Sauers JL. Balance improvements in female high school basketball players after a 6-week neuromuscular-training program. J Sport Rehabil. 2009; 18(4):465–81. ##
  44. Holm I, Fosdahl MAFriis ARisberg MAMyklebust GSteen H. Effect of neuromuscular training on proprioception, balance, muscle strength, and lower limb function in female team handball players. Clin J Sport Med. 2004; 14(2):88–94. ##
  45. Paterno MV, Myer GDFord KRHewett TE. Neuromuscular training improves single-limb stability in young female athletes. J Orthop Sports Phys Ther. 2004; 34(6) :305–16. ##
  46. Distefano LJ, Padua DABlackburn JTGarrett WEGuskiewicz KMMarshall SW.Integrated injury prevention program improves balance and vertical jump height in children. J Strength Cond Res. 2010; 24(2):332–42. ##
  47. Barber-Westin SD, Hermeto AA, Noyes FR . A 6-week neuromuscular training program for competitive junior tennis players. J Strength Cond Res.2010; 24(9):2372–82. ##
  48. Barendrecht M,  Lezeman HCDuysens JSmits-Engelsman BC. Neuromuscular training improves knee kinematics, in particular in valgus aligned adolescent team handball players of both sexes. J Strength Cond Res. 2011; 25(3): 575–84. ##
  49. Chappell JD, Limpisvasti O . Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks. Am J Sports Med. 2008; 36(6): 1081–86. ##
  50. Myer GD, Ford KRPalumbo JPHewett TE. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. J Strength Cond Res. 2005; 19(1):51–60. ##
  51.  Hertel J, Braham RA, Hale SA, Olmsted-Kramer LC. Simplifying the star excursion balance test: analyses of subjects with and without chronic ankle instability. J Orthop Sports Phys Ther. 2006; 36(3):131–37. ##
  52. Herrington L, Hatcher J, Hatcher AMcNicholas M. A comparison of Star Excursion Balance Test reach distances between ACL deficient patients and asymptomatic controls. Knee. 2009; 16(2):149–52. ##
  53.  Bell DR, Vesci BJ, DiStefano LJ, Guskiewicz KM, Hirth C, Padua DA. Muscle activity and flexibility in individual with medial knee displacement during overhead squat. Athletic Training and Sports Health Care. 2012; 4(3): 117-25. ##
  54. Herman DC, Weinhold PSGuskiewicz KMGarrett WEYu BPadua DA. The effects of strength training on the lower extremity biomechanics of female recreational athletes during a stop-jump task. Am J Sports Med. 2008; 36(4):733–40. ##
  55. Herman DC, Oñate JAWeinhold PSGuskiewicz KMGarrett WEYu BPadua DA. The effects of feedback with and without strength training on lower extremity biomechanics. Am J Sports Med. 2009;37(7):1301–08##.
  56. Lephart SM, Abt JPFerris CMSell TCNagai TMyers JBIrrgang JJ. Neuromuscular and biomechanical characteristic changes in high school athletes: a plyometric versus basic resistance program. Br J Sports Med. 2005; 39(12):932–38. ##
  57. Tsang KK, Dipasquale AA . Improving the q:h strength ratio in women using plyometric exercises. J Strength Cond Res. 2011; 25(10):2740–45. ##
  58.  Nagai TSell TCHouse AJAbt JPLephart SM. Knee Proprioception and Strength and Landing Kinematics During a Single-Leg Stop-Jump Task. Journal of Athletic Training. 2013; 48(1): 31-38. ##
  59.  Lloyd DG, Buchanan TS. Strategies of muscular support of varus and valgus isometric loads at the human knee. J Biomech. 2001; 34:1257-67. ##
  60. Willson JD, Ireland ML, Davis I . Core strength and lower extremity alignment during single leg squats. Med Sci Sports Exerc. 2006; 38(5):945–52. ##
  61.  Claiborne TL, Armstrong CW, Gandhi V, Pincivero DM. Relationship between hip and knee strength and knee valgus during a single leg squat. Journal of Applied Biomechanics. 2006; 22(1): 41-50. ##
Volume 8, Issue 3
October 2019
Pages 29-41
  • Receive Date: 13 July 2018
  • Revise Date: 10 January 2019
  • Accept Date: 22 January 2019
  • First Publish Date: 23 September 2019