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DOI: 10.1055/s-0035-1555930
The Utility of a High-intensity Exercise Protocol to Prospectively Assess ACL Injury Risk
Publication History
accepted after revision 25 June 2015
Publication Date:
28 October 2015 (online)
Abstract
This study investigated the utility of a 5-min high-intensity exercise protocol (SAFT5) to include in prospective cohort studies investigating ACL injury risk. 15 active females were tested on 2 occasions during which their non-dominant leg was analysed before SAFT5 (PRE), immediately after (POST0), 15 min after (POST15), and 30 min after (POST30). On the first occasion, testing included 5 maximum isokinetic contractions for eccentric and concentric hamstring and concentric quadriceps and on the second occasion, 3 trials of 2 landing tasks (i. e., single-leg hop and drop vertical jump) were conducted. Results showed a reduced eccentric hamstring peak torque at POST0, POST15 and POST30 (p<0.05) and a reduced functional HQ ratio (Hecc/Qcon) at POST15 and POST30 (p<0.05). Additionally, a more extended knee angle at POST30 (p<0.05) and increased knee internal rotation angle at POST0 and POST15 (p<0.05) were found in a single-leg hop. SAFT5 altered landing strategies associated with increased ACL injury risk and similar to observations from match simulations. Our findings therefore support the utility of a high-intensity exercise protocol such as SAFT5 to strengthen injury screening tests and to include in prospective cohort studies where time constraints apply.
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References
- 1 Bates NA, Ford KR, Myer GD, Hewett TE. Timing differences in the generation of ground reaction forces between the initial and secondary landing phases of the drop vertical jump. Clin Biomech (Bristol, Avon) 2013; 28: 796-799
- 2 Behrens M, Mau-Moeller A, Wassermann F, Bruhn S. Effect of fatigue on hamstring reflex responses and posterior-anterior tibial translation in men and women. PLoS One 2013; 8: e56988
- 3 Bishop DJ. Fatigue during intermittent-sprint exercise. Clin Exp Pharmacol Physiol 2012; 39: 836-841
- 4 Bogdanis GC. Effects of physical activity and inactivity on muscle fatigue. Front Physiol 2012; 3: 1-15
- 5 Borotikar BS, Newcomer R, Koppes R, McLean SG. Combined effects of fatigue and decision making on female lower limb landing postures: central and peripheral contributions to ACL injury risk. Clin Biomech 2008; 23: 81-92
- 6 Brophy R, Silvers HJ, Gonzales T, Mandelbaum BR. Gender influences: the role of leg dominance in ACL injury among soccer players. Br J Sports Med 2010; 44: 694-897
- 7 Cerulli G, Benoit DL, Lamontagne M, Caraffa A, Liti A. In vivo anterior cruciate ligament strain behaviour during a rapid deceleration movement: case report. Knee Surgery, Sport Traumatol Arthrosc 2003; 11: 307-311
- 8 Chappell JD, Herman DC, Knight BS, Kirkendall DT, Garrett WE, Yu B. Effect of fatigue on knee kinetics and kinematics in stop-jump tasks. Am J Sports Med 2005; 33: 1022-1029
- 9 Chavez A, Knudson D, Harter ROD. Activity-specific effects of fatigue protocols may influence landing kinematics: A pilot study. Int J Exerc Sci 2013; 6: 242-249
- 10 Cortes N, Greska E, Kollock R, Ambegaonkar J, Onate JA. Changes in lower extremity biomechanics due to a short-term fatigue protocol. J Athl Train 2013; 48: 306-313
- 11 Cortes N, Quammen D, Lucci S, Greska E, Onate J. A functional agility short-term fatigue protocol changes lower extremity mechanics. J Sports Sci 2012; 30: 797-805
- 12 Delextrat A, Gregory J, Cohen D. The use of the functional H:Q ratio to assess fatigue in soccer. Int J Sports Med 2010; 31: 192-197
- 13 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
- 14 Garrett WE, Califf JC, Bassett FH. Histochemical correlates of hamstring injuries. Am J Sports Med 1984; 12: 98-103
- 15 Gehring D, Melnyk M, Gollhofer A. Gender and fatigue have influence on knee joint control strategies during landing. Clin Biomech (Bristol, Avon) 2009; 24: 82-87
- 16 Greco CC, Da Silva WL, Camarda SRA, Denadai BS. Fatigue and rapid hamstring/quadriceps force capacity in professional soccer players. Clin Physiol Funct Imaging 2013; 33: 18-23
- 17 Greig M. The influence of soccer-specific fatigue on peak isokinetic torque production of the knee flexors and extensors. Am J Sports Med 2008; 36: 1403-1409
- 18 Harriss DJ, Atkinson G. Ethical standards in sports and exercise science research: 2014 update. Int J Sports Med 2013; 34: 1025-1028
- 19 Hashemi J, Breighner R, Chandrashekar N, Hardy DM, Chaudhari AM, Shultz SJ, Slauterbeck JR, Beynnon BD. Hip extension, knee flexion paradox: a new mechanism for non-contact ACL injury. J Biomech 2011; 44: 577-585
- 20 Hawkins RD, Hulse MA, Wilkinson C, Hodson A, Gibson M. The association football medical research programme: an audit of injuries in professional football. Br J Sports Med 2001; 35: 43-47
- 21 Hewett TE, Myer GD, Ford KR, Heidt RS, Colosimo AJ, McLean SG, van den Bogert AJ, Paterno MV, Succop P. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 2005; 33: 492-501
- 22 Hodgson M, Docherty D, Robbins D. Post-activation potentiation. Sports Med 2005; 35: 585-596
- 23 Hughes G, Watkins J. A risk-factor model for anterior cruciate ligament injury. Sports Med 2006; 36: 411-428
- 24 Krustrup P, Mohr M, Ellingsgaard H, Bangsbo J. Physical demands during an elite female soccer game: importance of training status. Med Sci Sport Exerc 2005; 37: 1242-1248
- 25 Laughlin WA, Weinhandl JT, Kernozek TW, Cobb SC, Keenan KG, O’Connor KM. The effects of single-leg landing technique on ACL loading. J Biomech 2011; 44: 1845-1851
- 26 Lovell R, Knapper B, Small K. Physiological responses to SAFT90: a new soccer-specific match simulation. Coach Sport Sci 2008; 3: 46-76
- 27 Lucci S, Cortes N, Van Lunen B, Ringleb S, Onate J. Knee and hip sagittal and transverse plane changes after two fatigue protocols. J Sci Med Sport 2011; 14: 453-459
- 28 Malfait B, Sankey S, Firhad Raja Azidin RM, Deschamps K, Vanrenterghem J, Robinson MA, Staes F, Verschueren S. How reliable are lower-limb kinematics and kinetics during a drop vertical jump?. Med Sci Sports Exerc 2014; 46: 678-685
- 29 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
- 30 Marshall PWM, Lovell R, Jeppesen GK, Andersen K, Siegler JC. Hamstring muscle fatigue and central motor output during a simulated soccer match. PLoS One 2014; 9: e102753
- 31 McLean SG, Fellin 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
- 32 Mohr M, Krustrup P, Bangsbo J. Fatigue in soccer: A brief review. J Sports Sci 2007; 23: 37-41
- 33 Oberländer KD, Brüggemann G-P, Höher J, Karamanidis K. Reduced knee joint moment in ACL deficient patients at a cost of dynamic stability during landing. J Biomech 2012; 45: 1387-1392
- 34 Oh YK, Lipps DB, Ashton-Miller JA, Wojtys EM. What strains the anterior cruciate ligament during a pivot landing?. Am J Sports Med 2012; 40: 574-583
- 35 Rahnama N, Reilly T, Lees A, Graham-Smith P. Muscle fatigue induced by exercise simulating the work rate of competitive soccer. J Sports Sci 2003; 21: 933-942
- 36 Raja Azidin RMF, Sankey S, Drust B, Robinson MA, Vanrenterghem J. Effects of treadmill versus overground soccer match simulations on biomechanical markers of anterior cruciate ligament injury risk in side cutting. J Sports Sci 2015; 1-10
- 37 Rampinini E, Bosio A, Ferraresi I, Petruolo A, Morelli A, Sassi A. Match-related fatigue in soccer players. Med Sci Sports Exerc 2011; 43: 2161-2170
- 38 Ruedl G, Webhofer M, Helle K, Strobl M, Schranz A, Fink C, Gatterer H, Burtscher M. Leg dominance is a risk factor for noncontact anterior cruciate ligament injuries in female recreational skiers. Am J Sports Med 2012; 40: 1269-1273
- 39 Samuelsson K, Desai N, McNair E, van Eck CF, Petzold M, Fu FH, Bhandari M, Karlsson J. Level of evidence in anterior cruciate ligament reconstruction research: a systematic review. Am J Sports Med 2013; 41: 924-934
- 40 Sanna G, O’Connor KM. Fatigue-related changes in stance leg mechanics during sidestep cutting maneuvers. Clin Biomech 2008; 23: 946-954
- 41 Shultz SJ, Schmitz RJ, Benjaminse A, Chaudhari AM, Collins M, Padua DA. ACL Research Retreat VI: an update on ACL injury risk and prevention. J Athl Train 2012; 47: 591-603
- 42 Shultz SJ, Schmitz RJ, Cone JR, Henson RA, Montgomery MM, Pye ML, Tritsch AJ. Changes in fatigue, multiplanar knee laxity, and landing biomechanics during intermittent exercise. J Athl Train 2015; 49 Epub ahead of print
- 43 Small K, McNaughton L, Greig M, Lovell R. The effects of multidirectional soccer-specific fatigue on markers of hamstring injury risk. J Sci Med Sport 2010; 13: 120-125
- 44 Small K, McNaughton LR, Greig M, Lohkamp M, Lovell R. Soccer fatigue, sprinting and hamstring injury risk. Int J Sports Med 2009; 30: 573-578
- 45 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
- 46 Tobin DP, Delahunt E. The acute effect of a plyometric stimulus on jump performance in professional rugby players. J Strength Cond Res 2014; 28: 367-372
- 47 Tsai L-C, Sigward SM, Pollard CD, Fletcher MJ, Powers CM. Effects of fatigue and recovery on knee mechanics during side-step cutting. Med Sci Sports Exerc 2009; 41: 1952-1957
- 48 Tschakert G, Kroepfl J, Hofmann P, Mueller A, Moser O, Groeschl W. How to regulate the acute physiological response to “aerobic” high-intensity interval exercise. J Sport Sci Med 2015; 14: 29-36
- 49 Vanrenterghem J, Gormley D, Robinson MA, Lees A. Solutions for representing the whole-body centre of mass in side cutting manoeuvres based on data that is typically available for lower limb kinematics. Gait Posture 2010; 31: 517-521
- 50 Vøllestad NK. Measurement of human muscle fatigue. J Neurosci Methods 1997; 74: 219-227
- 51 Wikstrom EA, Powers ME, Tillman MD. Dynamic stabilization time after isokinetic and functional fatigue. J Athl Train 2004; 39: 247-253
- 52 Yeung SS, Suen AMY, Yeung EW. A prospective cohort study of hamstring injuries in competitive sprinters: preseason muscle imbalance as a possible risk factor. Br J Sports Med 2009; 43: 589-594
- 53 Yu B, Queen RM, Abbey AN, Liu Y, Moorman CT, Garrett WE. Hamstring muscle kinematics and activation during overground sprinting. J Biomech 2008; 41: 3121-3126
- 54 Zebis MK, Bencke J, Andersen LL, Alkjaer T, Suetta C, Mortensen P, Kjaer M, Aagaard P. Acute fatigue impairs neuromuscular activity of anterior cruciate ligament-agonist muscles in female team handball players. Scand J Med Sci Sports 2011; 21: 833-840