Sidestep and crossover lower limb kinematics during a prolonged sport-like agility test

Danielle Potter; Kellie Reidinger; Rebecca Szymialowicz; Thomas Martin; Donald Dione; Richard Feinn; David Wallace; Juan C Garbalosa

Sidestep and crossover lower limb kinematics during a prolonged sport-like agility test

Int J Sports Phys Ther. 2014 Oct;9(5):617-27.

Authors

Danielle Potter, Kellie Reidinger¹, Rebecca Szymialowicz¹, Thomas Martin², Donald Dione³, Richard Feinn⁴, David Wallace⁵, Juan C Garbalosa⁶

Affiliations

¹ Student, Department of Physical Therapy Quinnipiac University, Hamden, CT, USA.
² Assistant Professor, Department of Biomedical Sciences, Quinnipiac University, Hamden, CT, USA.
³ Research Associate II, Yale University, School of Medicine, New Haven, CT, USA.
⁴ Assistant Professor, Frank H Netter, MD, School of Medicine, Quinnipiac University, Hamden, CT, USA.
⁵ Associate Professor, Department of Physical Therapy, Quinnipiac University, Hamden, CT, USA.
⁶ Director, Motion Analysis Laboratory, Clinical Associate Professor, Physical Therapy Department, Quinnipiac University, Hamden, CT, USA.

PMID: 25328824
PMCID: PMC4196326

Abstract

Background: Non-contact anterior cruciate ligament (ACL) injuries in athletes occur more often towards the end of athletic competitions. However, the exact mechanisms of how prolonged activity increases the risk for ACL injuries are not clear.

Purpose: To determine the effect of prolonged activity on the hip and knee kinematics observed during self-selected cutting maneuvers performed in a timed agility test.

Methods: Nineteen female Division I collegiate soccer players completed a self-selected cutting agility test until they were unable to meet a set performance time (one standard deviation of the average baseline trial). Using the 3D dimensional coordinate data the cut type was identified by the principle investigators. The 3D hip and knee angles at 32ms post heel strike were analyzed using a two-factor, linear mixed model to assess the effect of prolonged activity and cut type on the recorded mean hip and knee angles.

Results: Athletes performed either sidestep or crossover cuts. An effect of cut type and prolonged activity was seen at the hip and knee. During the prolonged activity trials, the knee was relatively more adducted and both the hip and knee were less flexed than during the baseline trials regardless of cut type. Regardless of activity status, during sidestep cuts, the hip was more internally rotated and abducted, and less flexed than during crossover cuts while the knee was more abducted and less flexed during the sidestep than crossover cuts.

Conclusions: During a sport-like agility test, prolonged activity appears to predispose the athlete to position their knee in a more extended and abducted posture and their hip in a more extended posture. This position has been suggested to place stress on the ACL and potentially increase the risk for injury. Clinicians may want to consider the effects of prolonged activity on biomechanical risk factors for sustaining ACL injuries in the design of intervention strategies to prevent ACL injuries.

Level of evidence: Level 4.

Keywords: ACL injury; cutting; knee; motion.