Biomechanical and neuromuscular comparison of single- and multi-planar jump tests and a side-cutting maneuver: Implications for ACL injury risk assessment

Background: Non-contact anterior cruciate ligament (ACL) injuries arc a major problem among adolescent female soccer and handball players. Therefore, the aim of this study was to examine if known biomechanical and neuromuscular ACL injury risk factors obtained from single-planar jump-landings and multi-planar side-jumps can resemble the demands of side-cutting maneuvers, a known high-risk ACL injury movement for this population. Methods: Twenty-four female soccer and handball players (mean +/- SD: age: 17 +/- 1 year; height: 172 +/- 66 cm; mass: 67 +/- 9 kg) performed a series of functional tasks including two single-planar jump-landings, two multi-planar side-jumps and a sports-specific side-cutting maneuver on their dominant leg. Frontal and sagittal plane knee and hip joint kinematics and kinetics were calculated from three-dimensional motion analysis, whereas hamstring and quadriceps muscle pre-activity levels were measured with surface electromyography. Results: The sports-specific side-cut was distinguished by more knee flexion at initial contact, greater abduction angles and external knee abduction moments, higher biceps femoris and semitendinosus muscle pre-activity levels than both the single-planar jump-landings and multi-planar side jumps (p < .05). Whilst, poor-to-strong spearman rank correlation coefficients inconsistently were found for the biomechanical and neuromuscular ACL injury risk factors explored between the side-cut and the single-planar jump-landings (r(s) = 0.01-0.78) and multi-planar side-jumps (r(s) = 0.03-0.88) respectively. Conclusion: Single-planar jump-landings and multi-planar side-jumps should be used with caution to test for non-contact ACL injury risk factors in adolescent female soccer and handball players, because they do not mimic the biomechanical nor neuromuscular demands of the most frequent injury situation. (C) 2019 Elsevier B.V. All rights reserved.