Anterior Cruciate Ligament Injury Mechanisms and the Kinetic Chain Linkage: The Effect of Proximal Joint Stiffness on Distal Knee Control During Bilateral Landings

被引:15
作者
Cannon, Jordan [1 ,2 ]
Cambridge, Edward D. J. [2 ]
McGill, Stuart M. [2 ]
机构
[1] Univ Southern Calif, Musculoskeletal Biomech Res Lab, Div Biokinesiol & Phys Therapy, 1540 Alcazar St,G8, Los Angeles, CA 90089 USA
[2] Univ Waterloo, Dept Kinesiol, Spine Biomech Lab, Waterloo, ON, Canada
基金
加拿大自然科学与工程研究理事会;
关键词
biomechanics; dynamic valgus; hip; lumbar spine; musculoskeletal modeling; LOWER-EXTREMITY KINEMATICS; MUSCLE-ACTIVITY; NEUROMUSCULAR CONTROL; TRUNK POSITION; VIDEO ANALYSIS; LUMBAR SPINE; HIP-JOINT; HIGH-RISK; ACL; STABILITY;
D O I
10.2519/jospt.2019.8248
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
BACKGROUND: Neuromuscular deficits at the trunk and hip may contribute to dynamic knee valgus and anterior cruciate ligament injury mechanisms. However, comprehensive examination of neuromuscular patterns and their mechanical influence is lacking. OBJECTIVES: To investigate the influence of lumbar spine joint rotational stiffness (JRS) and the gluteal musculature contribution to hip JRS on dynamic knee valgus. METHODS: In this cross-sectional study, 18 university-aged women completed a drop vertical jump while we measured kinematics, kinetics, and 24 channels of electromyography (EMG) spanning the trunk and hip musculature. We classified each limb as high or low valgus, based on frontal plane knee displacement magnitude. We used anatomically detailed, EMG-driven biomechanical models to quantify lumbar spine JRS and muscle contributions to hip JRS. RESULTS: Low-valgus limbs generated greater gluteus medius frontal JRS (P = .002; effect size, 1.3) and gluteus maximus transverse JRS (P = .003; effect size, 1.2) compared to high-valgus limbs. Participants with bilateral high-valgus collapse had substantially reduced lumbar spine sagittal JRS compared to the group with low valgus on both limbs (P = .05; effect size, 5.1). Those with low valgus on both limbs also had a peak lumbar spine flexion angle of 24 degrees +/- 4 degrees, compared to the bilateral high-valgus group's angle of 38 degrees +/- 10 degrees (P = .09; effect size, 1.8). CONCLUSION: Participants who avoided` high medial knee displacement had greater proximal IRS. Increased IRS at the lumbar spine! and greater JRS contributions from the gluteal musculature are linked with preventing high medial knee displacement.
引用
收藏
页码:601 / +
页数:13
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