Nelson Cortes

Two Different Fatigue Protocols and Lower Extremity Motion Patterns During a Stop-Jump Task

CONTEXT Altered neuromuscular control strategies during fatigue probably contribute to the increased incidence of noncontact anterior cruciate ligament injuries in female athletes. OBJECTIVE To determine biomechanical differences between 2 fatigue protocols (slow linear oxidative fatigue protocol [SLO-FP] and functional agility short-term fatigue protocol [FAST-FP]) when performing a running-stop-jump task. DESIGN Controlled laboratory study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A convenience sample of 15 female soccer players (age = 19.2 ± 0.8 years, height = 1.67 ± 0.05 m, mass = 61.7 ± 8.1 kg) without injury participated. INTERVENTION(S) Five successful trials of a running-stop-jump task were obtained prefatigue and postfatigue during the 2 protocols. For the SLO-FP, a peak oxygen consumption (Vo(2)peak) test was conducted before the fatigue protocol. Five minutes after the conclusion of the Vo(2)peak test, participants started the fatigue protocol by performing a 30-minute interval run. The FAST-FP consisted of 4 sets of a functional circuit. Repeated 2 (fatigue protocol) × 2 (time) analyses of variance were conducted to assess differences between the 2 protocols and time (prefatigue, postfatigue). MAIN OUTCOME MEASURE(S) Kinematic and kinetic measures of the hip and knee were obtained at different times while participants performed both protocols during prefatigue and postfatigue. RESULTS Internal adduction moment at initial contact (IC) was greater during FAST-FP (0.064 ± 0.09 Nm/kgm) than SLO-FP (0.024 ± 0.06 Nm/kgm) (F(1,14) = 5.610, P = .03). At IC, participants had less hip flexion postfatigue (44.7° ± 8.1°) than prefatigue (50.1° ± 9.5°) (F(1,14) = 16.229, P = .001). At peak vertical ground reaction force, participants had less hip flexion postfatigue (44.7° ± 8.4°) than prefatigue (50.4° ± 10.3°) (F(1,14) = 17.026, P = .001). At peak vertical ground reaction force, participants had less knee flexion postfatigue (-35.9° ± 6.5°) than prefatigue (-38.8° ± 5.03°) (F(1,14) = 11.537, P = .001). CONCLUSIONS Our results demonstrated a more erect landing posture due to a decrease in hip and knee flexion angles in the postfatigue condition. The changes were similar between protocols; however, the FAST-FP was a clinically applicable 5-minute protocol, whereas the SLO-FP lasted approximately 45 minutes.

A functional agility short-term fatigue protocol changes lower extremity mechanics

Abstract The purpose of this study was to evaluate the effects of a functional agility fatigue protocol on lower extremity biomechanics between two unanticipated tasks (stop-jump and sidestep). The subjects consisted of fifteen female collegiate soccer athletes (19±0.7 years, 1.67±0.1 m, 61.7±8 kg) free of lower extremity injury. Participants performed five trials of stop-jump and sidestep tasks. A functional short-term agility protocol was performed, and immediately following participants repeated the unanticipated running tasks. Lower extremity kinematic and kinetic values were obtained pre and post fatigue. Repeated measures analyses of variance were conducted for each dependent variable with an alpha level set at 0.05. Knee position post-fatigue had increased knee internal rotation (11.4±7.5° vs. 7.9±6.5° p=0.011) than pre-fatigue, and a decreased knee flexion angle (–36.6±6.2° vs. −40.0±6.3°, p=0.003), as well as hip position post-fatigue had decreased hip flexion angle (35.5±8.7° vs. 43.2±9.5°, p=0.002). A quick functional fatigue protocol altered lower extremity mechanics of Division I collegiate soccer athletes during landing tasks. Proper mechanics should be emphasized from the beginning of practice/game to aid in potentially minimizing the effects of fatigue in lower extremity mechanics.

Pivot task increases knee frontal plane loading compared with sidestep and drop-jump

Abstract The purpose of this study was to assess kinematic and kinetic differences between three tasks (drop-jump, sidestep cutting, and pivot tasks) commonly used to evaluate anterior cruciate ligament risk factors. Nineteen female collegiate soccer athletes from a Division I institution participated in this study. Participants performed a drop-jump task, and two unanticipated tasks, sidestep cutting and pivot. Repeated-measures analyses of variance were conducted to assess differences in the kinematic and kinetic parameters between tasks. The pivot task had lower knee flexion (−41.2 ± 8.8°) and a higher valgus angle (−7.6 ± 10.1°) than the sidestep (−53.9 ± 9.4° and −2.9 ± 10.0°, respectively) at maximum vertical ground reaction force. The pivot task (0.8 ± 0.3 multiples of body weight) had higher peak posterior ground reaction force than the drop-jump (0.3 ± 0.06 multiples of body weight) and sidestep cutting (0.3 ± 0.1 multiples of body weight), as well as higher internal varus moments (0.72 ± 0.3 N · m/kg · m) than the drop-jump (0.14 ± 0.07 N · m/kg · m) and sidestep (0.17 ± 0.5 N · m/kg · m) at peak stance. During the pivot task, the athletes presented a more erect posture and adopted strategies that may place higher loads on the knee joint and increase the strain on the anterior cruciate ligament.

Knee and hip sagittal and transverse plane changes after two fatigue protocols

UNLABELLED Fatigue has been shown to alter the biomechanics of lower extremity during landing tasks. To date, no study has examined the effects of two types of fatigue on kinetics and kinematics. OBJECTIVES This study was conducted to assess biomechanical differences between two fatigue protocols [Slow Linear Oxidative Fatigue Protocol (SLO-FP) and Functional Agility Short-Term Fatigue Protocol (FAST-FP)]. DESIGN Single-group repeated measures design. METHODS Fifteen female collegiate soccer players had to perform five successful trials of unanticipated sidestep cutting (SS) pre- and post-fatigue protocols. The SLO-FP consisted of an initial VO(2peak) test followed by 5-min rest, and a 30-min interval run. The FAST-FP consisted of 4 sets of a functional circuit. Biomechanical measures of the hip and knee were obtained at different instants while performing SS pre- and post-fatigue. Repeated 2 × 2 ANOVAs were conducted to examine task and fatigue differences. Alpha level set a priori at 0.05. RESULTS During the FAST-FP, participants had increased knee internal rotation at initial contact (IC) (12.5 ± 5.9°) when compared to the SLO-FP (7.9 ± 5.4°, p<0.001). For hip flexion at IC, pre-fatigue had increased angles (36.4 ± 8.4°) compared to post-fatigue (30.4 ± 9.3°, p=0.003), also greater knee flexion during pre-fatigue (25.6 ± 6.8°) than post-fatigue (22.4 ± 8.4°, p=0.022). CONCLUSION The results of this study showed that hip and knee mechanics were substantially altered during both fatigue conditions.

A Feedback Inclusive Neuromuscular Training Program Alters Frontal Plane Kinematics

Abstract Greska, EK, Cortes, N, Van Lunen, BL, and Oñate, JA. A feedback inclusive neuromuscular training program alters frontal plane kinematics. J Strength Cond Res 26(6): 1609–1619, 2012—Anterior cruciate ligament (ACL) neuromuscular training programs have demonstrated beneficial effects in reducing ACL injuries, yet further evaluation of their effects on biomechanical measures across a sports team season is required to elucidate the specific factors that are modifiable. The purpose of this study was to evaluate the effects of a 10-week off-season neuromuscular training program on lower extremity kinematics. Twelve Division I female soccer players (age: 19.2 ± 0.8 years, height: 1.67 ± 0.1 m, weight: 60.2 ± 6.5 kg) performed unanticipated dynamic trials of a running stop-jump task pretraining and posttraining. Data collection was performed using an 8-camera Vicon system (Los Angeles, CA, USA) and 2 Bertec (Columbus, OH, USA) force plates. The 10-week training program consisted of resistance training 2 times per week and field training, consisting of plyometric, agility, and speed drills, 2 times per week. Repeated measures analyses of variance (ANOVAs) were used to assess the differences between pretraining and posttraining kinetics and kinematics of the hip, knee, and ankle at initial contact (IC), peak knee flexion (PKF), and peak stance. Repeated measures ANOVAs were also used to assess isometric strength differences pretraining and posttraining. The alpha level was set at 0.05 a priori. The training program demonstrated significant increases in left hip extension, left and right hip flexion, and right hip adduction isometric strength. At IC, knee abduction angle moved from an abducted to an adducted position (−1.48 ± 3.65° to 1.46 ± 3.86°, p = 0.007), and hip abduction angle increased (−6.05 ± 4.63° to −10.34 ± 6.83°, p = 0.007). Hip abduction angle at PKF increased (−2.23 ± 3.40° to 6.01 ± 3.82°, p = 0.002). The maximum knee extension moment achieved at peak stance increased from pretraining to posttraining (2.02 ± 0.32 to 2.38 ± 0.75 N·m·kg−1, p = 0.027). The neuromuscular training program demonstrated a potential positive effect in altering mechanics that influence the risk of incurring an ACL injury.

Differential effects of fatigue on movement variability

When individuals perform purposeful actions to fatigue, there is typically a general decline in their movement performance. This study was designed to investigate the effects exercise-induced fatigue has on lower limb kinetics and kinematics during a side-step cutting task. In particular, it was of interest to determine what changes could be seen in mean amplitude and all metrics of signal variability with fatigue. The results of the study revealed that post-fatigue there was an overall decrease in absolute force production as reflected by a decline in mean amplitude and variability (SD) of the ground reaction forces (GRFV and GRFML). A decrease in mean and SD of the knee moments were also observed post-exercise. Interestingly, this trend was not mirrored by similar changes in time-dependent properties of these signals. Instead, there was an increase in the SampEn values (reflecting a more variable, irregular signal) for GRF force profiles, knee kinematics and moments following the exercise-induced fatigue. These results illustrate that fatigue can have differential effects on movement variability, resulting in a both an increase and decrease in movement variability, depending on the variable selected. Thus, the impact of fatigue is not simply restricted to a decline in force producing capacity of the system but more importantly it demonstrates that the ability of the person to perform a smooth and controlled action is limited due to fatigue.

Landing technique affects knee loading and position during athletic tasks

UNLABELLED 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. OBJECTIVES The purpose of this study was to evaluate the effects that two landing techniques have in lower extremity biomechanics while performing two tasks. DESIGN Single-group repeated measures design. METHODS Twenty 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. RESULTS The 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). CONCLUSIONS The 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.

Soccer-specific video simulation for improving movement assessment

The improvement of ecological validity of laboratory research studies has recently come to the forefront of technology with virtual reality scenarios. The purpose of this study was to assess differences between unanticipated and anticipated lower extremity biomechanics while performing a sidestep cutting task. A visualization software was developed for this purpose, which would recreate a soccer game situation for use in a laboratory setting. Thirteen participants volunteered for this study. Lower extremity biomechanical data were collected with a VICON motion analysis system and two force plates, under anticipated and unanticipated conditions while performing a sidestep cutting task. Paired t-tests were conducted to assess possible differences between conditions. Alpha level was set a priori at 0.05. We found an increased knee adduction angle (unanticipated: -7.2 ± 5.3°; anticipated: -4.0 ± 5.3°), and knee internal rotation (unanticipated: 8.1 ± 4.7°; anticipated: 5.2 ± 6.5°) when performing the unanticipated condition (p < 0.05). The methodological approaches for studies investigating the factors possibly associated with ACL injury may need to take into account the laboratory environment and how the task(s) are presented to the participants.

Effects of a combined resistance-plyometric training program on muscular strength, running economy, and Vo2peak in division I female soccer players.

Abstract Grieco, CR, Cortes, N, Greska, EK, Lucci, S, and Onate, JA. Effects of a combined resistance-plyometric training program on muscular strength, running economy, and V[Combining Dot Above]O2peak in division I female soccer players. J Strength Cond Res 26(9): 2570–2576, 2012—Resistance and plyometric training programs have demonstrated consistent improvements in running economy (RE) in trained and untrained adults in the absence of improvements in maximal oxygen consumption. The purpose of this study was to investigate the effect of a 10-week combined resistance-plyometric training program on the RE and V[Combining Dot Above]O2max in female soccer players. Fifteen Division 1A female soccer players (age 19.0 ± 0.7 years; height 1.67 ± 0.1 m; weight 61.7 ± 8.1 kg) performed a treadmill test for V[Combining Dot Above]O2max and RE at the end of a competitive season (PRE) and after a 10-week training program (POST). Isometric strength was measured in knee flexion and extension. Resistance training was conducted 2 d·wk−1 on nonconsecutive days; plyometric training was conducted separately on different nonconsecutive days. Eleven subjects were included in the PRE-POST analysis (age 19.0 ± 0.8 years; height 1.67 ± 0.5 m; weight 59.9 ± 6.7 kg). Descriptive statistics were compared using analysis of variance with repeated measures with a Bonferroni adjustment, and significance was set at p < 0.05. A significant increase occurred after training in the V[Combining Dot Above]O2peak (10.5%; p = 0.008), time to fatigue (6.9%; p = 0.017), and interpolated maximal speed (3.6%; p = 0.016), despite there being a decrease in the maximal respiratory exchange ratio (2.9%; p = 0.001). There was no significant change in the RE at 9 km·h−1; however, there was a significant decrease in the percentage of the V[Combining Dot Above]O2peak at 9 km·h−1 (−5.6%; p = 0.02). Maximal isometric strength of knee flexors and extensors did not change. The results suggest a plyometric-agility training program may increase the V[Combining Dot Above]O2peak in female soccer players; however, the effect on RE was equivocal.

Instruction and Jump-Landing Kinematics in College-Aged Female Athletes Over Time

CONTEXT Instruction can be used to alter the biomechanical movement patterns associated with anterior cruciate ligament (ACL) injuries. OBJECTIVE To determine the effects of instruction through combination (self and expert) feedback or self-feedback on lower extremity kinematics during the box-drop-jump task, running-stop-jump task, and sidestep-cutting maneuver over time in college-aged female athletes. DESIGN Randomized controlled clinical trial. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS Forty-three physically active women (age = 21.47 ± 1.55 years, height = 1.65 ± 0.08 m, mass = 63.78 ± 12.00 kg) with no history of ACL or lower extremity injuries or surgery in the 2 months before the study were assigned randomly to 3 groups: self-feedback (SE), combination feedback (CB), or control (CT). INTERVENTION(S) Participants performed a box-drop-jump task for the pretest and then received feedback about their landing mechanics. After the intervention, they performed an immediate posttest of the box-drop-jump task and a running-stop-jump transfer test. Participants returned 1 month later for a retention test of each task and a sidestep-cutting maneuver. Kinematic data were collected with an 8-camera system sampled at 500 Hz. MAIN OUTCOME MEASURE(S) The independent variables were feedback group (3), test time (3), and task (3). The dependent variables were knee- and hip-flexion, knee-valgus, and hip- abduction kinematics at initial contact and at peak knee flexion. RESULTS For the box-drop-jump task, knee- and hip-flexion angles at initial contact were greater at the posttest than at the retention test (P < .001). At peak knee flexion, hip flexion was greater at the posttest than at the pretest (P = .003) and was greater at the retention test than at the pretest (P = .04); knee valgus was greater at the retention test than at the pretest (P = .03) and posttest (P = .02). Peak knee flexion was greater for the CB than the SE group (P = .03) during the box-drop-jump task at posttest. For the running-stop-jump task at the posttest, the CB group had greater peak knee flexion than the SE and CT (P ≤ .05). CONCLUSIONS Our results suggest that feedback involving a combination of self-feedback and expert video feedback with oral instruction effectively improved lower extremity kinematics during jump-landing tasks.