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Int J Sports Med 2018; 39(13): 1009-1017
DOI: 10.1055/s-0044-102130
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

Does Chronic Ankle Instability Influence Knee Biomechanics of Females during Inverted Surface Landings?

Yumeng Li
1   Department of Health and Human Performance, Texas State University, San Marcos, United States
,
Jupil Ko
2   Department of Physical Therapy and Athletic Training, Northern Arizona University, Phoenix, United States
,
Marika Walker
3   Department of Kinesiology, University of Georgia , Athens, United States
,
Cathleen Brown
4   Department of Athletic Training and Kinesiology, Oregon State University, Corvallis, United States
,
Julianne Schmidt
3   Department of Kinesiology, University of Georgia , Athens, United States
,
Seock-Ho Kim
5   Department of Educational Psychology, University of Georgia, Athens, United States
,
Kathy Simpson
3   Department of Kinesiology, University of Georgia , Athens, United States
› Author Affiliations
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Publication History



accepted after revision 16 January 2018

Publication Date:
18 September 2018 (online)

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Abstract

The primary purpose of the study was to determine whether atypical knee biomechanics are exhibited during landing on an inverted surface. A seven-camera motion analysis system and two force plates were used to collect lower extremity biomechanics from two groups of female participants: 21 subjects with chronic ankle instability (CAI) and 21 with pair-matched controls. Subjects performed ten landings onto inverted and flat platforms on the CAI/matched and non-test limbs, respectively. Knee and ankle joint angles, joint angular displacements, joint moments and eccentric work were calculated during the landing phase and/or at the initial contact. Paired t-tests were used to compare between-group differences (p<0.05). We observed that CAI group displayed a significantly increased knee flexion angle, knee flexion displacement, peak knee extension moment and internal rotation moment, and eccentric work in the sagittal plane, possibly due to altered ankle biomechanics. Participants with CAI employed some compensatory strategy to improve their ankle and postural stability during landing onto the tilted surface. The increased knee extension and internal rotation moments of CAI participants could potentially result in a greater ACL loading. In future studies, it may be worthwhile to measure or estimate the ACL loading to confirm whether CAI could relate to the mechanism of ACL injury.

Key words

lower extremity - kinetics - kinematics ankle sprains - ACL injuries
 

  • References

  • 1 Berns GS, Hull ML, Patterson HA. Strain in the anteromedial bundle of the anterior cruciate ligament under combination loading. J Orthop Res 1992; 10: 167-176
    CrossrefPubMedGoogle Scholar
  • 2 Bisseling RW, Hof AL. Handling of impact forces in inverse dynamics. J Biomech 2006; 39: 2438-2444
    CrossrefPubMedGoogle Scholar
  • 3 Caulfield B, Crammond T, O’Sullivan A, Reynolds S, Ward T. Altered ankle-muscle activation during jump landing in participants with functional instability of the ankle joint. J Sport Rehabil 2004; 13: 189-200
    PubMedGoogle Scholar
  • 4 Caulfield BM, Garrett M. Functional instability of the ankle: Differences in patterns of ankle and knee movement prior to and post landing in a single leg jump. Int J Sports Med 2002; 23: 64-68
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Chen Q, Wortley M, Bhaskaran D, Milner CE, Zhang S. Is the inverted surface landing more suitable in evaluating ankle braces and ankle inversion perturbation?. Clin J Sport Med 2012; 22: 214-220
    CrossrefPubMedGoogle Scholar
  • 6 Delahunt E, Monaghan K, Caulfield B. Changes in lower limb kinematics, kinetics, and muscle activity in subjects with functional instability of the ankle joint during a single leg drop jump. J Orthop Res 2006; 24: 1991-2000
    CrossrefPubMedGoogle Scholar
  • 7 Delahunt E, Monaghan K, Caulfield B. Ankle function during hopping in subjects with functional instability of the ankle joint. Scand J Med Sci Sport 2007; 17: 641-648
    CrossrefPubMedGoogle Scholar
  • 8 DeMorat G, Weinhold P, Blackburn T, Chudik S, Garrett W. Aggressive quadriceps loading can induce noncontact anterior cruciate ligament injury. Am J Sports Med 2004; 32: 477-483
    CrossrefPubMedGoogle Scholar
  • 9 Dempster WT. Space requirements of the seated operator. In: WADC Technical Report. Dayton, OH: Wright Patterson Air Force Base; 1955: 55-159
    Google Scholar
  • 10 Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sport Phys Ther 2002; 32: 166-173
    PubMedGoogle Scholar
  • 11 Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Single-leg drop landing motor control strategies following acute ankle sprain injury. Scand J Med Sci Sports 2015; 25: 525-533
    CrossrefPubMedGoogle Scholar
  • 12 Fleming BC, Renstrom PA, Beynnon BD, Engstrom B, Peura GD, Badger GJ, Johnson RJ. The effect of weightbearing and external loading on anterior cruciate ligament strain. J Biomech 2001; 34: 163-170
    CrossrefPubMedGoogle Scholar
  • 13 Fong DT-P, Hong Y, Chan L-K, Yung PS-H, Chan K-M. A systematic review on ankle injury and ankle sprain in sports. Sports Med 2007; 37: 73-94
    CrossrefPubMedGoogle Scholar
  • 14 Garrick JG, Requa R. Epidemiology of foot and ankle injuries in sports. Clin Sports Med 1988; 7: 29-36
    CrossrefPubMedGoogle Scholar
  • 15 Gribble Pa, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F, Fong D, Hertel J, Hiller C, Kaminski T, McKeon P, Refshauge K, van der Wees P, Vicenzino B, Wikstrom E. Selection criteria for patients with chronic ankle instability in controlled research: A position statement of the international ankle consortium. J Orthop Sport Phys Ther 2013; 43: 585-591
    PubMedGoogle Scholar
  • 16 Gribble Pa, Robinson RH. Alterations in knee kinematics and dynamic stability associated with chronic ankle instability. J Athl Train 2009; 44: 350-355
    CrossrefPubMedGoogle Scholar
  • 17 Gribble Pa, Robinson RH. An examination of ankle, knee, and hip torque production in individuals with chronic ankle instability. J Strength Cond Res 2009; 23: 395-400
    CrossrefPubMedGoogle Scholar
  • 18 Gribble P, Robinson R. Differences in spatiotemporal landing variables during a dynamic stability task in subjects with CAI. Scand J Med Sci Sport 2010; 20: 1-10
    PubMedGoogle Scholar
  • 19 Gutierrez GM, Knight Ca, Swanik CB, Royer T, Manal K, Caulfield B, Kaminski TW. Examining neuromuscular control during landings on a supinating platform in persons with and without ankle instability. Am J Sports Med 2012; 40: 193-201
    CrossrefPubMedGoogle Scholar
  • 20 Hanavan EP. A mathematical model of the human body. Tech report, Wright-Patterson Air Force Base 1964; 1-149
    PubMedGoogle Scholar
  • 21 Harriss DJ, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 update. Int J Sports Med 2017; 38(14): 1126-1131
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Hoch MC, Staton GS, McKeon JMM, Mattacola CG, McKeon PO. Dorsiflexion and dynamic postural control deficits are present in those with chronic ankle instability. J Sci Med Sport 2012; 15: 574-579
    CrossrefPubMedGoogle Scholar
  • 23 Kobayashi T, Gamada K. Lateral ankle sprain and chronic ankle instability: A critical review. Foot Ankle Spec 2014; 7: 298-326
    CrossrefPubMedGoogle Scholar
  • 24 Kramer LC, Denegar CR, Buckley WE, Hertel J. Factors associated with anterior cruciate ligament injury: history in female athletes. J Sports Med Phys Fitness 2007; 47: 446-454
    PubMedGoogle Scholar
  • 25 Kristianslund E, Krosshaug T, Van den Bogert AJ. Effect of low pass filtering on joint moments from inverse dynamics: Implications for injury prevention. J Biomech 2012; 45: 666-671
    CrossrefPubMedGoogle Scholar
  • 26 Kulas AS, Schmitz RJ, Schultz SJ, Watson MA, Perrin DH. Energy absorption as a predictor of leg impedance in highly trained females. J Appl Biomech 2006; 22: 177-185
    PubMedGoogle Scholar
  • 27 Lee M, Youm C, Son M, Kim J, Kim Y. Effects of chronic ankle instability and induced mediolateral muscular fatigue of the ankle on competitive taekwondo athletes. J Phys Ther Sci 2017; 29: 1329-1335
    CrossrefPubMedGoogle Scholar
  • 28 Levin O, Vanwanseele B, Thijsen JRJ, Helsen WF, Staes FF, Duysens J. Proactive and reactive neuromuscular control in subjects with chronic ankle instability: Evidence from a pilot study on landing. Gait Posture 2015; 41: 106-111
    CrossrefPubMedGoogle Scholar
  • 29 Lin C-FC-W, Chen C-Y, Lin C-FC-W. Dynamic ankle control in athletes with ankle instability during sports maneuvers. Am J Sports Med 2011; 39: 2007-2015
    CrossrefPubMedGoogle Scholar
  • 30 Liu X. Biomechanical Difference between Chronic Ankle Instability Individuals and Healthy Individuals during Landing on Flat, Inverted and Combined Surfaces. Master's thesis, University of Tennessee, 2013
    PubMed
  • 31 Majewski M, Susanne H, Klaus S. Epidemiology of athletic knee injuries: A 10-year study. Knee 2006; 13: 184-188
    CrossrefPubMedGoogle Scholar
  • 32 Markolf KL, Burchfield DM, Shapiro MM, Shepard MF, Finerman GA, Slauterbeck JL. Combined knee loading states that generate high anterior cruciate ligament forces. J Orthop Res 1995; 13: 930-935
    CrossrefPubMedGoogle Scholar
  • 33 McLean SG, Felin RE, Suedekum N, Calabrese G, Passerallo A, Joy S. Impact of fatigue on gender-based high-risk landing strategies. Med Sci Sports Exerc 2007; 39: 502-514
    CrossrefPubMedGoogle Scholar
  • 34 Menadue C, Raymond J, Kilbreath SL, Refshauge KM, Adams R. Reliability of two goniometric methods of measuring active inversion and eversion range of motion at the ankle. Musculoskelet Disord 2006; 7: 60
    CrossrefPubMedGoogle Scholar
  • 35 Norcross MF, Lewek MD, Padua Da, Shultz SJ, Weinhold PS, Blackburn JT. Lower extremity energy absorption and biomechanics during landing, part II: Frontal-plane energy analyses and interplanar relationships. J Athl Train 2013; 48: 757-763
    CrossrefPubMedGoogle Scholar
  • 36 Nunley R, Wright D, Renner J, Yu B, Garrett WE. Gender comparison of patellar tendon tibial shaft angle with weight bearing. Res Sport Med 2003; 11: 173-185
    PubMedGoogle Scholar
  • 37 Nunley RRM, Wright D, Renner JJB, Yu B, Garrett WE, Garrett Jr. WE, Garrett WE. Gender comparison of patellar tendon tibial shaft angle with weight bearing. Res Sport Med 2003; 11: 173-185
    PubMedGoogle Scholar
  • 38 Palmieri-Smith RM, McLean SG, Ashton-Miller JA, Wojtys EM. Association of quadriceps and hamstrings cocontraction patterns with knee joint loading. J Athl Train 2009; 44: 256-263
    CrossrefPubMedGoogle Scholar
  • 39 Ramakrishnan K, Kadaba M, Wootten M. Lower extremity joint moments and ground reaction torque in adult gait. In: Biomechanics of Normal and Prosthetic Gait. JL Stein (ed). Vol. 7. New York, N.Y.: American Society of Mechanical Engineers; 1987
    Google Scholar
  • 40 Söderman K, Alfredson H, Pietilä T, Werner S. Risk factors for leg injuries in female soccer players: A prospective investigation during one out-door season. Knee Surg Sports Traumatol Arthrosc 2001; 9: 313-321
    CrossrefPubMedGoogle Scholar
  • 41 Terada M, Pfile KR, Pietrosimone BG, Gribble PA. Effects of chronic ankle instability on energy dissipation in the lower extremity. Med Sci Sports Exerc 2013; 45: 2120-2128
    CrossrefPubMedGoogle Scholar
  • 42 Terada M, Pietrosimone B, Gribble PA. Individuals with chronic ankle instability exhibit altered landing knee kinematics: Potential link with the mechanism of loading for the anterior cruciate ligament. Clin Biomech 2014; 29: 1125-1130
    CrossrefPubMedGoogle Scholar
  • 43 Willems T, Witvrouw E, Verstuyft J, Vaes P, De Clercq D. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train 2002; 37: 487-493
    PubMedGoogle Scholar
  • 44 Yamamoto H, Yagishita K, Ogiuchi T, Sakai H, Shinomiya K, Muneta T. Subtalar instability following lateral ligament injuries of the ankle. Injury 1998; 29: 265-268
    CrossrefPubMedGoogle Scholar
  • 45 Yeow CH, Lee PVS, Goh JCH. Sagittal knee joint kinematics and energetics in response to different landing heights and techniques. Knee 2010; 17: 127-131
    CrossrefPubMedGoogle Scholar
  • 46 Yeung MS, Chan KM, So CH, Yuan WY. An epidemiological survey on ankle sprain. Br J Sports Med 1994; 28: 112-116
    CrossrefPubMedGoogle Scholar
  • 47 Yu B, Garrett WE. Mechanisms of non-contact ACL injuries. Br J Sports Med 2007; 41 (Suppl. 01) i47-i51
    CrossrefPubMedGoogle Scholar