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      Visual-Spatial Memory Deficits Are Related to Increased Knee Valgus Angle During a Sport-Specific Sidestep Cut

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          Abstract

          Identifying athletes at an increased risk of injury is a promising approach to improve the effect of injury prevention interventions; however, it requires first identifying the potential athlete-specific risk factors. Cognitive ability was recently shown to correlate with noncontact anterior cruciate ligament injury rates and lower extremity mechanics, marking an underexplored area. A better understanding of how individuals' cognitive ability is associated with neuromuscular control during sport-specific tasks may improve injury prevention.

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          Most cited references46

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          Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study.

          Female athletes participating in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than do male athletes. Prescreened female athletes with subsequent anterior cruciate ligament injury will demonstrate decreased neuromuscular control and increased valgus joint loading, predicting anterior cruciate ligament injury risk. Cohort study; Level of evidence, 2. There were 205 female athletes in the high-risk sports of soccer, basketball, and volleyball prospectively measured for neuromuscular control using 3-dimensional kinematics (joint angles) and joint loads using kinetics (joint moments) during a jump-landing task. Analysis of variance as well as linear and logistic regression were used to isolate predictors of risk in athletes who subsequently ruptured the anterior cruciate ligament. Nine athletes had a confirmed anterior cruciate ligament rupture; these 9 had significantly different knee posture and loading compared to the 196 who did not have anterior cruciate ligament rupture. Knee abduction angle (P<.05) at landing was 8 degrees greater in anterior cruciate ligament-injured than in uninjured athletes. Anterior cruciate ligament-injured athletes had a 2.5 times greater knee abduction moment (P<.001) and 20% higher ground reaction force (P<.05), whereas stance time was 16% shorter; hence, increased motion, force, and moments occurred more quickly. Knee abduction moment predicted anterior cruciate ligament injury status with 73% specificity and 78% sensitivity; dynamic valgus measures showed a predictive r2 of 0.88. Knee motion and knee loading during a landing task are predictors of anterior cruciate ligament injury risk in female athletes. Female athletes with increased dynamic valgus and high abduction loads are at increased risk of anterior cruciate ligament injury. The methods developed may be used to monitor neuromuscular control of the knee joint and may help develop simpler measures of neuromuscular control that can be used to direct female athletes to more effective, targeted interventions.
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            Incidence and trends of anterior cruciate ligament reconstruction in the United States.

            Anterior cruciate ligament (ACL) injury is among the most commonly studied injuries in orthopaedics. The previously reported incidence of ACL injury in the United States has varied considerably and is often based on expert opinion or single insurance databases.
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              Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases.

              The mechanisms of anterior cruciate ligament injury in basketball are not well defined. To describe the mechanisms of anterior cruciate ligament injury in basketball based on videos of injury situations. Case series; Level of evidence, 4. Six international experts performed visual inspection analyses of 39 videos (17 male and 22 female players) of anterior cruciate ligament injury situations from high school, college, and professional basketball games. Two predefined time points were analyzed: initial ground contact and 50 milliseconds later. The analysts were asked to assess the playing situation, player behavior, and joint kinematics. There was contact at the assumed time of injury in 11 of the 39 cases (5 male and 6 female players). Four of these cases were direct blows to the knee, all in men. Eleven of the 22 female cases were collisions, or the player was pushed by an opponent before the time of injury. The estimated time of injury, based on the group median, ranged from 17 to 50 milliseconds after initial ground contact. The mean knee flexion angle was higher in female than in male players, both at initial contact (15 degrees vs 9 degrees , P = .034) and at 50 milliseconds later (27 degrees vs 19 degrees , P = .042). Valgus knee collapse occurred more frequently in female players than in male players (relative risk, 5.3; P = .002). Female players landed with significantly more knee and hip flexion and had a 5.3 times higher relative risk of sustaining a valgus collapse than did male players. Movement patterns were frequently perturbed by opponents. Preventive programs to enhance knee control should focus on avoiding valgus motion and include distractions resembling those seen in match situations.
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                Author and article information

                Journal
                The American Journal of Sports Medicine
                Am J Sports Med
                SAGE Publications
                0363-5465
                1552-3365
                April 09 2018
                May 2019
                April 15 2019
                May 2019
                : 47
                : 6
                : 1488-1495
                Affiliations
                [1 ]Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, Montana, USA
                [2 ]Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
                [3 ]Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, Ohio, USA
                [4 ]School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA
                [5 ]Department of Psychology, Montana State University, Bozeman, Montana, USA
                [6 ]School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
                [7 ]Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio, USA
                Article
                10.1177/0363546519834544
                30986095
                e15ae688-b908-46ee-acf4-0841d28eac27
                © 2019

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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