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- Markström, Jonas, 1985-, et al.
(author)
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A minority of athletes pass symmetry criteria in a series of hop and strength tests irrespective of having an ACL reconstructed knee or being noninjured
- 2023
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In: Sports Health. - : Sage Publications. - 1941-7381 .- 1941-0921. ; 15:1, s. 45-51
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Journal article (peer-reviewed)abstract
- Background: Between-leg symmetry in 1-leg hop and knee strength performances is considered important after anterior cruciate ligament reconstruction (ACLR) to facilitate a safer return to sport. While few athletes with ACLR demonstrate symmetry in test batteries, reference data for noninjured athletes are lacking, thus questioning how ACLR-specific poor symmetry is.Hypothesis: Athletes with ACLR (hamstring autograft) show lower symmetry and have a lower proportion of symmetric individuals than noninjured athletes for knee flexion strength but not for hop for distance, vertical hop, and knee extension strength.Study design: Cross-sectional.Level of Evidence: Level 3.Methods: A total of 47 athletes with ACLR (median 13.0 months post-ACLR) who had returned to their sport, and 46 noninjured athletes participated. Symmetry was calculated between the worse and better legs for each test and combinations of them using the limb symmetry index (LSIWORSE-BETTER, ranging from 0% to 100%). The 2 groups were compared for these values and the proportions of individuals classified as symmetric (LSIWORSE-BETTER ≥90%) using independent t-tests and Fisher’s exact tests, respectively.Results: Athletes with ACLR were less symmetric than noninjured athletes for knee flexion strength with a lower LSIWORSE-BETTER (83% vs 91%, P < 0.01) and a lower proportion of symmetric individuals (39% vs 63%, P = 0.04). No differences between groups were revealed for the hop tests, knee extension strength, or combinations of tests (P > 0.05). Only 17% of the athletes with ACLR and 24% of the noninjured athletes demonstrated symmetric performances for all 4 tests.Conclusion: Athletes with ACLR (hamstring autograft) showed poorer symmetry in knee flexion strength than noninjured athletes, although both groups had few individuals who passed the test battery’s symmetry criteria.Clinical relevance: Symmetry is uncommon among athletes irrespective of ACLR and should be considered regarding expected rehabilitation outcomes and return-to-sport decisions post-ACLR.
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- Markström, Jonas, 1985-, et al.
(author)
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Side-hops challenge knee control in the frontal and transversal plane more than hops for distance or height among ACL-reconstructed individuals
- 2023
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In: Sports Biomechanics. - : Taylor & Francis Group. - 1476-3141 .- 1752-6116. ; 22:1, s. 142-159
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Journal article (peer-reviewed)abstract
- We compared knee landing mechanics with presumed relation to risk of anterior cruciate ligament (ACL) injury among three single-leg hop tests and between legs in individuals with unilateral ACL reconstruction. Thirty-four participants (>10 months' post-surgery, 23 females) performed the standardised rebound side hop (SRSH), maximal hop for distance (OLHD) and maximal vertical hop (OLVH). We calculated the following knee outcomes from motion capture and force plate data: finite helical axis inclination angles (approximates knee robustness), frontal and transversal plane angles at initial contact, peak angles of abduction and internal rotation during landing, and peak external moments of flexion, abduction and internal rotation during landing. Repeated-measures MANOVA analysis ('sex' as covariate) confirmed that SRSH induced greater angles and moments, particularly in the frontal plane, compared to OLHD and OLVH. There was between-leg asymmetry for peak knee flexion moment for males during OLHD and OLVH, and for females during SRSH. Our results advocate the SRSH over OLHD and OLVH for assessment of knee landing control to screen for movement patterns potentially related to ACL injury risk. However, clear differences in both knee kinematics and kinetics between OLHD and SRSH motivate the use of both tests to evaluate different aspects of landing control.
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- Naili, Josefine E., et al.
(author)
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A longitudinal case-control study of a female athlete preinjury and after ACL reconstruction : hop performance, knee muscle strength, and knee landing mechanics
- 2023
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In: Sports Health. - : Sage Publications. - 1941-7381 .- 1941-0921. ; 15:3, s. 357-360
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Journal article (peer-reviewed)abstract
- Athletes with an anterior cruciate ligament (ACL) injury followed by ACL reconstruction (ACLR) often perform various testing to guide return to sport, but preinjury data are rarely available for comparison. This longitudinal case-control study reports absolute value and between-leg symmetry data on maximal performances for single-leg hop height and distance, muscle strength, and side hop landing mechanics of an 18-year-old female soccer athlete collected 5 months before sustaining an ACL injury and again at 10, 13, and 29 months post-ACLR. Her data were compared across test sessions and to cross-sectional data of 15 asymptomatic female athletes.
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