WHAT SEPARATES AN INDIVIDUAL AT RISK OF ACL INJURY? A FIRST STEP TOWARDS AN ACL-RISK MOVEMENT PASSPORT

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Abstract

Background

Several prospective studies have suggested biomechanical risk factors for non-contact anterior cruciate ligament (ACL) injury. Ideally an individual at risk should be ranked at risk across a variety of dynamic tasks, with robust risk factors deserving an entry in the individual's “ACL risk movement passport”.

Objective

To determine if key prospective ACL risk factors rank individuals consistently across a variety of dynamic sporting tasks.

Design

Controlled laboratory study.

Setting

Biomechanics laboratory, Liverpool John Moores University.

Patients (or Participants)

Forty-one female athletes regularly participating in dynamic sports.

Interventions (or Assessment of Risk Factors)

5 trials of bilateral drop vertical jumps (DVJB), single-leg hops (SLHOP), single-leg drop vertical jumps (DVJ) and sidestep (SS) tasks were performed on both dominant (DOM) and non-dominant (NONDOM) legs. Lower extremity biomechanics of each task were captured using high speed 3-dimensional motion analysis and two force platforms.

Main Outcome Measurements

Knee abduction angle (KAA) and knee flexion angle (KFA) at initial contact, peak knee abduction moment (KAM), and peak vertical ground reaction force (VGRF) were extracted and population rankings were compared using Spearman's correlations.

Results

Moderate to good correlations were observed for KAA (ρ=0.481–0.827) whereas all other variables showed low to moderate correlations (ρ<0.39). DVJ and SLHOP showed moderate to high rank correlations across all risk factors. There were no systematic differences in correlation patterns between DOM and NONDOM trials.

Conclusions

From the existing risk factors, KAA showed most potential to providing a robust item on an individual's ACL risk movement passport. To help guide future identification of biomechanical risk factors of ACL injury, other robust ACL risk movement passport entries that show more consistent rankings across tasks deserve preference over entries that are highly task specific.

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